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Home My WebLink About26-0066getum to: County Use Only: 117 E 5th Street, PO Box 58 Bayfield County Planning and Zoning Department Submission #: LU' O41O$ Washburn, WI 54891 LAND USE PERMIT APPLICATION Permit it: N6 - oobb permits@bayfieldcounty.wi.gov Date: 3/ d'6 eo�- SECTION A: General Information Property Owner Name: Authorized Agent Name (if applicable): John and iJisa Eyerly Telephone Number: Telephone Number. nc CL WED 1 715-209-7001 715-209-1037 E -Mail Address: E -Mail Address: JAN 28 2026 jleyerly@gmailcom Mailing Address: Mailing Address: Bayfield Co. . PO Box 327 plannin g and Zoning A9 ency City, State, Zip: City, State, Zip: Cornucopia WI 54827 Contractor: Telephone Number: E -Mail Address: Hunter Holeman 715-209-2063 SECTION B: Property Information Project Address (if different from mailing address): 'Q'°' j S SsK44 Shofn OR. Legal Description (if additional space is needed attach a separate sheet): Lot 1 CSM #840 IN VS P329 (betted in Govt Lot 1) IN V. 967 P. 910 260 Section, Township, Range: Sec 20 TN50 RO6 Town of: Bell Tax ID #: 7442 Lot Size (Acres/Square Feet): 1 aaa SECTION C: Project Information (check all that apply) Project Use is: O Residential O Commercial ❑ Municipal If Commercial, estimated cost of construction: $ Project Type is: El New Construction O Addition/Alteration (existing structure) - ❑ Change Use (existing structure) ❑ Relocate (existing structure) O RV Placement 21+ days ❑ Sign ❑ Establishing a Business O Temporary (12 or less months) ❑ Shoreland Grading, Class A O RV Placement 4+ months, Class A []Other (describe): required (Total sq ft): required SECTION D: Structure Information (Does not apply to RVs and Signs, go to Section B) Structure Type is: O Residence O Principal Structure (describe): home with walk out basement ❑ Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): El Mobile Home (provide manufactured date): ❑ Shipping Container ❑ Other (describe): Foundation Type: O Basement JQ Walkout Basement O Slab 0 Crawlspace O Ground ❑ Skids ❑ Other (explain): Existing Structure:25x30=750(ne)+21x14-294th) O Length: Width: Height: Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade decks/porches): Basement Sq Ft: 1" Floor Sq Ft: Loft Sq Ft: tad Floor Sq Ft: 3'v Floor Sq Ft: 1044 1044 7x12=84 Garage Sq Ft: Porch Sq Ft: Deck Sq Ft: Other Sq Ft (describe): Other Sq Ft (describe): 24x34=864 10x25=274 24x12=288 Total Sq Ft: ua 104 %x1! I OverallHeight (finished grade to peak): 11 # of Stories: I I Existing # of Bedrooms on property: 6( Proposed # of Bedrooms in project: O SECTION E: RV and Sign Information (check all that apply) Sign is: RV is: ❑ New O Replacement ❑ New O Replacement O On -premise ❑ Off -premise O 1 -sided O 2 -sided Year: Vin #: O On -building O Multi -Tenant Length: Width: Height: Make: Model: Application Page 1 SECTION F: Site Plan - attach a site plan or draw site plan in box below (See pages 1 & 2 of Land Use Permit Application Information for information that is required to be provided on site plan) Sh7w location of: Driveways Ja Frontage Roads (include name) Q Existing Structures 2 Well (W) Septic Tank (ST) O Drain Field (DF) I Holding Tank O Privy (P) 'Lake O River ❑Stream/Creek ❑Pond ❑Floodplain ❑Wetlands ❑Slopes over 20% N SisKiult 5hxt T Drve '•w'l II � - f 5�¢c� �0� Q - ifv;c QI pdh $t,c 13 '\4 Setback or distancefrom furthest extent of structure County Use Only ineladin eaves and overhan to (includ o it I g gs e n sm a pan). Verified setbacks Road Centerline $ R Notes/Comments: Front Lot Line/Right-of-Way ft R Side Lot Line I R R �1 = — NN orth South West, circle one) )`So 106i - Side Lot ine 2 (North East South es circle one) 6- ft ft Rear Lot Line -6O R R Septic/Holding Tank ✓s o ft. R Drainfield R R Privy R R Well R R Existing Structure/Building R R Wetland R R Elevation of Floodplain R ft. Ordinary High -Water Mark (OHWM) R ( Other (describe) R R C��V- �tLt.e Vtr LAM i40tfu�AN L(8 2026 K r i e `OI Bayfiald Co. Planning and Zoning Agency Application Page 2 M SECTION G: Additional Questions ❑ Yes RNo Has the location of the proposed project including eaves and overhangs and the sanitary system and well been staked? If no, what date will this be completed: .. ❑ Yes No Did a licensed surveyor mark lot line(s) if project is within 10 feet of required setback? See page 2 of Land Use Application Information for required setbacks. ,l,Yes 0 No Did property owner or applicant mark lot line(s) if project is within 30 feet of required setback? See page 2 of Land Use Application Information for required setbacks. Yes O No Is there an existing sanitary system on the property? If yes, what kind? O Drainfield J1olding Tank O Municipal/Public ❑ Other (describe): I Yes Rio Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be installed or used / to manage wastewater? ❑ Drainfield Holding Tank ❑ Municipal/Public ❑ Other (describe): es + �No Will sleeping occur in the structure? If yes, contact local Uniform Dwelling Code (UDC) for approval and inspection requirements. is the project associated with any of the following: ❑ Rezone O Class A Special Use O Class B Special Use O Conditional Use O Variance Fee payment will be made via: ❑ Check (attached) 0 Cash (attached) Aebit/credit/echeck (department to call once payment is ready to be taken) How would you like to receive your permit card? Mail to: OR O Email to: N ?roperty Owner Address O Agent Address ❑ Contractor Address O Other (provide name and email or address): Section H: Acknowledgement and Signature All Land Use Permits expire Two (2) Years from the date of issuance if construction or use has not begun. Sanitary permit issuance, if required, needs to occur prior to Land Use Permit issuance. Failure to obtain a permit or starting construction without a permit will result in penalties. The local Town, Village, City, State or Federal agencies may also require permits. The new construction of one- & two-family dwellings requires review and approval by the local Uniform Dwelling Code (UDC) authority. Additions and 4 fd and two-family dwellings may require review and approval by the UDC authority. All municipalities are required to enforce the UDC. JAN 28 2026 If subject property is part of a Condominium Plat, applicant hereby certifies and represents that applicant has all gg� approvals and recorded documents required to complete the project for which this permit is sought includ&ipurernenl J6{h in Wisconsin statutes pertaining to condominium associations, the Declaration of the Condominium Association in which the property is located, and all other rules, regulations and requirements pertaining to that Condominium Association. You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources wetlands identification web page, dnr.wi.gov/topic/wetlands. or contact a Department of Natural Resources service center (715)685-2900. I (we) declare that this application, including any accompanying information, has been examined by me (us) and to the best of my (our) knowledge and belief it is true, correct, and complete. I (we) acknowledge that I (we) am (are) responsible for the detail and accuracy of all information that I (we) are providing and that will be relied upon by Bayfield County in determining whether to issue a permit. I (we) further accept liability which may be a result of Bayfield County relying on this information I (we) are providing in or with this application. I (we) consent to county officials charged with administering county ordinances to have access to the above -described property at any reasonable for the purpose of inspection. time \X Owner(s) or Authorized Agent Printed N \� 1 Owners) or Authorized Agent Signature.- _ C a1 e.5 0 Date:. NOTES: 1. If you are signing on behalf of the owner(s) a letter of authorization must accompany this application. 2. Specific conditions/instructions may be stated on the face of the issued Land Use Permits. Owners, agents, & contractors must all be aware of permit details & conditions and permit card must be posted on property prior to start of project. Application Page 3 N rent ebt DDAVANO No. 25-08.12,49 ® _, 0 NORTH ELEVATION nan IExtreme II • omae O9 W W W,P.xlremeMNfureYPlan'. °EWON ED; Submltt WRI -� h000 b �vnlft ,APPROVED: WA — Ir Memlr uisb EAST ELEVATION RECEIVED JAN 282026 Bayfield Co. Planning and Zoe^≤ nnzncY 2 I— cci Z 4 1/4e = T-0' DATE 08-08-2025 Elevations DMWING No. 25-08-124c JAN 2 8 Zko' Bayfield Co. planning and Zoning Agency Crawl Space Foundation Plan LI, Floor Plan Extreme Menciirec Mat 7t5 -U1-3019 n3ao9 W W W. Catrtme Mea f are5 Plan C O E 0 2 1/4"=1'-O' onrE: 08-08-2025 Foundation Floor Plan door Loading Specifcations for Wood I -Joists and Components Floor LL = 40psf FLoor DL= 10psf Deflection Criteria = L/480 E New Addition _ I [Existing Home :MCEIVED JAN 282026 Bayfield Co. ing and Zoning Acer 2 8 Roof Loading Speclfcatlons for Manufactured Roof Truss Total Load = 57psf -LL = 40 psf -DL = 17 psf - top cord = 7psf - bottom cord =10 psf Cross Section Scale: T liDRAWING M. WRE C O y D N Y C w3 p O '= ` 1 CD()F - to o —o N w 1/2" = 1_0' WE 08-08-2025 Cro88 Sections Bayfield County Impervious Surface Calculations JAN 26 'L0'Lo These calculations are REQUIRED per WI Admin Code NR 115.05(1)(e) and Section 131 °a 1� -1- 40(h) of the Bayfield County Code of Ordinances. The undersigned hereby makes application or construction, reconstruction, expansion, replacement or relocation of any impervious surface within 300 feet of the ordinary high water mark and agrees that all activities shall be in accordance with the requirements of the Bayfield County Code of Ordinances and all other applicable ordinances and the laws of the State of Wisconsin. Pursuant to Chapter 1, Title 13, Section 13-1-106(d) of the Bayfield County Zoning Ordinance(s), Planning and Zoning Department employees assigned to inspect properties shall have access to said properties to make inspections. Property Owner(s): Oh>1 $ LUso- cyM\Y Mailing Address: Po SOX 3e7 Lotnvrof�r WS S J7 Property Address C oAl�' S�sk1vV,t' )o1�s P 2 C yr nuc. p t a u/$. g'l�dl Legal Description: Section, Township, Range 1/4, 1/4, o Sec Township N, Range W Authorized Agent/Cohtractor Gov't Lot Lot # CSM# �NO Vol & Page vS i.329 Lot(s) # Block(s) # Subdivision Town of: I �P/LI Parcel ID # (PIN #) Opolol�000 S'. Tax ID # Date: Impervious Surface: An area that releases as runoff all or a majority of the precipitation that falls on it. "Impervious surface" excludes frozen soil but includes rooftops, sidewalks, driveways, parking lots and streets unless specifically designed, constructed and maintained to be pervious. Calculation of Impervious Surface: Percentage of impervious surface shall be calculated by dividing the surface area of existing and proposed impervious surfaces on the portion of a lot or parcel that is within 300 feet of the ordinary high water mark by the total surface area of the lot or parcel, multiplied by 100. Impervious Surface Standard: Allow up to 15% impervious surface but not more than 30% impervious surface on the portion of a lot or parcel that is within 300 feet of the ordinary high water mark. A permit can be issued for development that exceeds 15% impervious surface but not more than 30% impervious surfaces with a mitigation plan that meets the requirements of the Bayfield County Ordinance(s). Existing Impervious Surfaces: For existing impervious surfaces that were lawfully placed when constructed but that do not comply with the standards in Section(s) 13-1-32(g) and Section 13-1-40(h), the property owner may do any of the following: a. Maintenance and repair of all impervious surfaces: b. Replacement of existing impervious surfaces with similar surfaces within the existing building footprint; c. Relocation or modification of existing impervious surfaces with similar or different impervious surfaces, provided that the relocation or modification does not result in an increase in the percentage that existed on the effective date of the county shoreland ordinance, and meets the applicable setback requirements in Section 13-1-32. Impervious Surface Item Dimension Area (Square Footage) 5y 2>0 ( t Existing House l( f M b � Existing Accessory N X 3 $� Building/Garage Existing Sidewalk(s), Patio(s) & lx 75 -to lal"Q/ 33 3 Deck(s) x)0 t tfr X(o Existing Covered Porch(es), Driveway & Other Structures . 10 x as c2S 0 Proposed Addition/House .I q x g ) J Z Proposed Accessory Building/Garage J oaX 2(p 3 1z_ Proposed Sidewalk(s) & Patio(s) L >1' 5C q g Proposed Covered Porch(es) & Deck(s) Proposed Driveway YZttCCJVED Proposed Other Structures JAN 28 2UZ6 6ayfi`d Co. Pla Total: o a. Total square footage of lot: `' O )r(} b. Total impervious surface area: 2 ¶S 3 c. Percentage of impervious surface area: 100 x (b)/a = La '7 %O If the proposed impervious surface area is greater than 15% mitigation is required. Total square footage of additional impervious surface allowed: @ 15% @ 30% Issuance Information (County Use Only) Date of Inspection: Inspection Record: Zoning District ( ) Lakes Classification ( J Condition(s): Stormwater Management Plan Required: Elves ❑ No Signature of Inspector: Date of Approval: u/forms/impervioussurface Created: May 2012 (®Apr 2016; Sept 2020) Proofed by: RECEIVED ! \ As' JA l� 2026 NA Applicant Checklist Yes ❑ No Will new electrical installation occur with project/structure? If yes, contact State for inspection requirements. ❑ Yes jx. No Will new plumbing installation occur with project/structure? If yes, contact State for inspection requirements. ❑ Yes $.No Is the project/structure to be used for commercial purposes? If yes, contact the State of Wisconsin Commercial Buildings & Structures to determine if they require review and approval. ❑ Yes No Is the project located in the Floodplain? If yes, additional materials and fee will be required. Reference the FEMA Map (httos://mse.fema.gov/oortal/bome) and Title 13, Chapter 2 of Bayfield County Zoning Ordinance (littps://www.bayfieldcounty.wi.gov/7 11/Tide-I 3---Zonin -Code . Yes ❑ No Is the project located in the Shorelands, within 300 feet of a river/stream OR landward side of floodplain OR 1000 feet of a lake/pond/flowage (whichever is greater)? If yes, shoreland regulations will apply. 1`'Yes ❑ No Is your property a waterfront lot and will any part of your project be located within 300 feet of the water OR is your entire lot located within 300 feet of the water? If yes to either, complete and include Impervious Surface Form (https://www.bayfieldcounty.wi.gov/DocumentCenter/View/3 I 59/lmervious-Surface-PDF . ❑ Yes SNo Are there wetlands on the property. If yes, wetland regulations will apply. A 25 -foot setback is required to any mapped wetlands. Reference Department of Natural Resource Surface Data Viewer Map (https://dnrmaps.wi.gov/H5/?Viewer=SWDV). ❑ Yes No If applicable, did you contact the road authority to see if a driveway permit or regulations apply to placement of driveway? ❑ yes flNo Was the property purchased recently? If yes, include a recorded deed. A copy of recorded deed can be acquired from the Bayfield County Register of Deed's office. . Yes ❑ No is a site plan included with all information requested on Page 1 of the Land Use Permit Application Information? If no, a site plan with all applicable information on Page 1 is required for all submissions. �( .. "'SYes ❑ No Is a floor plan(s) included with all information requested on Page 4 of the Land Use Permit Application Information? Floor plans are required for residences, commercial buildings, or additions/alterations to these structures. N Yes ❑ No If structure is in Shorelands, have building elevations with all information requested on Page 5 of the Land Use Permit Application Information been included? ❑ Yes KNo Is this application to correct a violation or has the project already commenced? If yes, at minimum an after -the - fact fee will apply. If not permittable, the structure will need to be removed. ].Yes ❑ No If addition, does the existing structure meet required setbacks, see Page 2 of the Land Use Permit Application Information? If no, be aware that it is the property owner's responsibility to show the structure was legally placed and there may be limitations to expansion of the structure, see Bayfield County Section 13-1-44) (https://www.bayfieldcounty.wi.gov/7I I,Titl -13--Zoning-Code). ❑ Yes O No Is the use of the project/structure allowed per Bayfield County Section 13-1-62 (https://www.bayfieldcounty.wi.gov/7 1I/Title-13—Zoning-Code). If no, be aware it is the property owner's responsibility to show the use was legally established and there may be limitation to expansion of the use, see Hayfield County Section 13-1-40 (bttps:/'www.bayfleldcountv.wi.gov/7lllritle-13--Zoning-Code). Yes ❑ No Have all fees been included with the completed application? See Fee Schedule on website (httos://www.baytieldcounty.wi.pov/I389/Fee-Schedule). If no, all applicable fees need to be paid before permit can be issued. ❑ Yes No Is property owned by multiple owners or is someone aside from the property owner applying? If yes, a Letter of Authorization Form needs to be included. Form available on website (https://www.bayfieldcountv.wi.gov/ 1340/A lications-Forms . ❑ Yes Z No Is property owned by a Trust or Business entity (LLC, Corp., etc.)? If yes to either, an Affidavit of Authority needs to be included Forms available on website (hups://www.bayfieldcounty.wi.gov/l 340/Applications- Forms). _______ Yes _______ O No Is Land Use Application completed and signed? Land Use Permit Application Information Page 6 Land Use Permit Application Review Checklist Submission #: p O W t zoning district is the project located in? 12'R -1 ❑ 2❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M ❑ Yes No Is lot substandard (does not meet current zoning dimensional requirements)? Deed of record: es ❑ No Is the project located in the Shorelands (Shorelands are lands within 300 feet of a river/stream OR landward side of floodplain OR 1000 feet of a lake/pond/flowage, whichever is greater)? Yes ❑ No Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of navigable waterway) ❑ Yes N Is the project located in the Floodplain? Zone: ❑ Yes 96Jo Are there wetlands on the property? ❑ Yes E4"N,0 Is project associated with a nonconforming use or structure? ❑ Yes ltcJo Is project associated with a variance? Case #: ❑ Yes 4p Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes 44p Is the project associated with a Special A Use Permit? ❑ Yes No Does the project require sanitary? 0 Existing ❑ New ❑ Intercept ❑ Reconnect ❑ Non -Plumbing O Public Sanitary Permit #: # of Bedrooms: ❑ Yes 4o Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ es No Does the project require an affidavit? Affidavit #: Yes ❑ No Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback? ❑ Yes ❑ No Did pplicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use is? Residential O Commercial O Municipal Project type is? ❑ New Construction Addition/Alteration O Change Use O Relocate ❑ RV Placement ❑ Sign ❑ Establishing a Bus' ss O Temporary O Shoreland Grading O Other, describe: Structure Type is: Residence ❑ Principal Structure O Accessory Structure O Boathouse (one story only) ❑ Open-sided/Screened Structure (gazebo, etc.) ❑ Stairway to navigable waters ❑ Mobile Home ❑ Shipping Container ❑ Other, describe Total Sq. Ft. of Project: tOM. Number of Stories: ) Overall Height: I ( Fee Type Calculation Fee Amount ❑ Dwelling Enclosed Areas — all enclosed areas within N $0.75 x sq ft (minimum $125) dwelling except attached non -habitable garages $ ❑ Dwelling Unenclosed Areas (decks, patios, etc.) or $0.20 x sq ft (minimum $125) Attached Non -Habitable Garages $ ❑ Habitable Residential Accessory Structures $0.50 x sq ft (minimum $75) ❑ Non -Habitable Residential Principal and Accessory $0.20 x s ft q (minimum $75) Structures $ ❑ Commercial/Municipal Principal Structures $250+$0.005 x (minimum $250) cost of construction $ ❑ Commercial/Municipal Accessory Structures $150 + $0.005 x (minimum $150) cost of construction $ ❑ Return Inspection ❑ Land Use Revisions O Special Use Permit - Class A ❑ Floodplain horeland - Impervious Surface ❑ Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 ❑ Tower Collocation 2 ❑ Metallic Mine ❑ After -the -Fact (ATF) $ Inspected by:,ht ( Date of Ins�je ion: V9 Re -Inspected y: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed: Approved by: Date of Approval: fnii( IlcfJil(tJvtci Cond' n(s): U J Gust meet and maintain setbacks from furthest extension of structure including eaves and overhangs. O For personal storage only. �or personal residence only. ❑Not for human habitation or sleeping purposes. I�Town/State/DNR/Federal may require permitting ❑ A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be ed prior to the start of construction. Z;Zniform Q'Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be obtained prior to the start of construction (if applicable). 2Use best management practices to limit and prevent erosion during construction. ❑ This permit cannot be transferred if property is sold. 0 A Bayfield County Health Dept permit is required. ❑ Check with Town regarding room tax. ❑ Short -Term Rental is for a maximum occupancy of persons. ❑ Jgn must meet the requirements of Article E of the Bayfield County Zoning Ordinance. B'To be constructed per plan. ❑ Adhere to privy agreement. ❑ Temporary permit allowing existing structure for a period of less than 1 year. 0 RV may not be used for permanent residence or storage. ❑ RV allowed for 0 RV must be removed by ❑ No sewer and pressurized water allowed in the structure. ❑ No plumbing or plumbing fixtures allowed. ❑ No additional sleeping areas allowed without obtaining necessary sanitary permit(s). ❑ Land use permits shall be required for any new residence, any building or structure erected, relocated, rebuilt, or structurally altered ❑ Land use permits shall be obtained prior to the initiation of construction or a change in land use ❑ Requirements (e.g., permits/licensing/tax) of Local Town, Village, City, State or Federal agencies are required ❑ Sanitation requirements must be met (if applicable) 0 Additional conditions may be placed and need to be adhered to at the time of permit issuance Other Conditions: 134-YFIELD Bayfield County Planning & Zoning Department 117 E 51 Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number: EYERLY, JOHN E & LIISA A LU-02105 PO BOX 327 CORNUCOPIA, WI 54827 Transaction Number: LU-02105-3F0B3 Description Amount Shoreland - Impervious Surface $25.00 Habitable Residential Principal Structures - enclosed areas $0.75/square foot (minimum $125) $125.00 Total: $150.00 Payment Amount: $153.57 Reference: 2813331105 Paid by: John Eyerly Payment Type: Credit Card Transaction Date: 2/26/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. Town, City, Village, State or Federal Permits May Also Be Required Substandard — No I Nonconforming — No Shoreland — Yes / Impervious Surface - Yes Floodplain - No / Wetlands - No Mitigation - No / Affidavit #: LAND USE -X X SANITARY - SPECIAL A - SPECIAL B/CONDITIONAL - BOA - BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 26-0066 Tax ID: 7442 Issued To: EYERLY, JOHN E & LIISA A Location: S20 - T50N - R06W Town of Bell Legal Description: LOT 1 CSM #840 IN V.5 P.329 (LOCATED IN GOVT LOT 1) IN V.967 P.910 260 Residential Structure in R-1 zoning district For: Addition/Alteration [1 - Story ], Residence on a Walkout Basement [104 Total sq. ft. ] Height of 11' (Disclaimer): You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Any future expansions or development would require additional permitting. Condition(s): See back of card NOTE: This permit expires two years from date of issuance if the authorized construction Emily Macgillivray work or land use has not begun. Authorized Issuing Official Changes in plans or specifications shall not be made without obtaining approval. This permit may be void or revoked if any of the application information is found to have been misrepresented, erroneous, or incomplete. February 26, 2026 This permit may be void or revoked if any performance conditions are not Date completed or if any prohibitory conditions are violated. Condition(s): Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs. For personal residence only. Town/State/DNR/Federal may require permitting. A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be obtained prior to the start of construction (if applicable). Use best management practices to limit and prevent erosion during construction. To be constructed per plan.