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117E 5"' Street, PO Rox 58 Bayfield County Planning and Zoning Department *thmission.si L U -0 al 17,
Washburn, WI 54891 LAND USE PERMIT APPLICATION rb - 0073 . <.
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Property Owner Name Authorized Agent Name (if applicable):
)amel and Allison Koch
Mailing Adder: MailingAddress: ayfeldCo.
25155 Sunset Ln :inning tr.d Zor:ing Agency
City,
82City, State, Zip:
Cable, WI 54821
Contractor. Tclephone Number. I E -Mail Address:
Project Address
LOT 2 CSM #1063 LOCATED IN GOVT LOT 1 IN V.6 P.414
Section, Township, Range: S18 T43N ROSW Town of: Namakagon
Tax ID #: 38199 Lot Size (Acres/Square Feat): aois
SEfl1QN(Prcjra 1a —
Project Use Is. O Residential 0 Commercial 0 Municipal If Commercial, estimated cost of construction: $
Project Type is: a New Construction 0 Addition/A iteration (existing structure)
❑ Change Use (existing structu e) ❑ Relocate (existing structure) ❑ RV Placement 21+ days
0 Sign 0 Establishing a Business ❑ Temporary (12 or less months)
❑ Shoreland Grading, Class A ❑ RV Placement 4+ monhs, Class A ❑ Other (describe):
Structure Type is: 0 Residence 0 Principal Structure (describe):
❑ Accessory Structure (describe): 0 Shorcland Exempt Structure (describe): 0 Mobile Home (provide manufncbaed
Garage date):
0 Shipping Container O Other (describe):
❑ Basement O Walkout Basement O Slab O Crawlspace 0 Ground 0 Skids ❑ Other (explain):
Existing Structure: Length: Width: Height
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade
decks/p):
Basement Sq Ft I" Floor Sq Ft Loft Sq Ft 2°d Floor Sq Ft 3'd Floor Sq Ft.
Garage Sq Ft Porch Sq Ft Deck Sq Ft Other Sq Ft (describe): Other So Ft (descnbel:
romr Oq it 241)0 poamd2)
Overall Height (finished grade to peak): 19'
# of Stories: 1
Existing # of Bedrooms on pmpetty:3
j Proposed # of Bedrooms in act
PNj 0
SECTION -1St RV aadslawiairyealan
(chockalltlutanotr)
Sign is:
RV is:
❑ New
0 Replacement
0 New 0 Replacement
❑ On -premise
O Off premise
❑ 1 -sided
❑ 2 -sided
Year: Vin #:
❑ On -building
0 Multi -Tenant
Length:
Width: Height:
Make: Model:
Application Page 1
4 9 Application Page 2
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RECEIVED
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/ PlannIng and Zoring Agency
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Planning and= _, Agency
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FEB 19 2026
a' BayfielCo.
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Bayfield Co.
Planning and Zoning Agency
u4RV LL
t:
FEB 19 ZU?6
El Yes
O No
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
El 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.
❑ Yes
El 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.
El Yes
O No
Is there an existing sanitary system on the property? If yes, what kind?
O Dramfield El Holding Tank ❑ Munici l/Public ❑ Other (describe):
❑ Yes
O No
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):
❑ Yes
El 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 ❑ Class A Special Use ❑ Class B Special Use ❑ Conditional Use ❑ Variance
Fee payment will be made via:
❑ Check (attached) ❑ Cash (attathe El debit/credit/echeck (department to call once payment is ready to be taken)
How would you like to receive your permit card?
❑ Mail to: OR 0 Email to:
O Property Owner Address ❑ Agent Address ❑ Contractor Address ❑ Other (provide name and email or address):
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 alterations to one -
and two-family dwellings may require review and approval by the UDC authority. All municipalities are required to enforce the
UDC.
If subject property is part of a Condominium PIm, applicant hereby certifies and represents that applicant has all necessary
approvals and recorded documents required to complete the project for which this permit is sought including requirements set forth
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.sov/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) thither accept liability which may be a result ofBayfield County relying on this information I (we) are
providing in or with this application. I (we) consent toernty officials ebaged with administering county ordinances to have
access to the above -described property at any reasonable/time purposdof inspection.
Ii
Owners) or Authorized Agent Printed Name:
Owner(s) or Authorized Agent Signature: Date: a� n.(0
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 potcd on property prior to start of
Application Page 3
Land Use Permit Application Review Checklist
Submission #
- Q'
hat zoning district is the project located in?
-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M
❑ Yes 1No
Is lot substandard (does not meet current zoning dimensional requirements)?
Deed of record:
Yes ❑ 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 loo
Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of
navigable waterway)
❑ Yes
Is the project located in the Floodplain? Zone:
❑ Yes o
Are there wetlands on the property?
❑ Yes o
Is project associated with a nonconforming use or structure?
❑ Yes Jo
Is project associated with a variance? Case #:
❑ Yes o
Is project associated with a Special B or Conditional Use Permit? Permit #:
❑ Yes o
Is the project associated with a Special A Use Permit?
❑ Yes?Jo
Does the project require sanitary?
0 Existing ❑ New 0 Intercept ❑ Reconnect ❑ Non -Plumbing ❑ Public
SanitaryPermit #: # of Bedrooms:
Does the project require mitigation?
❑ Yes 'B*o
Implementation Deadline: Date of Compliance:
❑ Yes 4o
Does the project require an affidavit? Affidavit #:
es ❑ No
Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback?
❑ Yes o
Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback?
Project use is?P1Residential ❑ Commercial ❑ Municipal
Project type is?A` New Construction ❑ Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign
❑ Establishing a Business ❑ Temporary ❑ Shoreland Grading O Other, describe:
Structure Type is: ❑ Residence O Principal Structure Accessory Structure O Boathouse (one story only)
❑ Open-sided/Screened Structure (gazebo, etc.) O Stairway to navigable waters ❑ Mobile Home
❑ Shipping Container ❑ Other, describe
Total Sq. Ft. of Project: 00 Number of Stories: Overall Height: Q.
Fee Type
Calculation
Fee Amount
❑ Dwelling Enclosed Areas — all enclosed areas within
$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)
IVon-Habitable Residential Principal and Accessory
$0.20 x sq ft
(minimum $75)
Structures
$ 0
❑ 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 O Land Use Revisions O Special Use Permit - Class A O Floodplain O Shoreland - Impervious
Surface ❑ Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 O Tower Collocation 2 O Metallic
Mine
❑ After -the -Fact (ATF)
$
Inspected by:
uS
Date of Inspection:
Re -Inspected b .
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter it
Approved by:
Date of Approval:
s�
26
Condition(s):
ust meet and maintain setbacks from furthest extension of structure including eaves and
overhangs.
�₹or personal storage only.
❑ For personal residence only.
of for human habitation or sleeping purposes.
❑ 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.
❑ A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be
obtained prior to the start of construction (if applicable).
se best management practices to limit and prevent erosion during construction.
❑ This permit cannot be transferred if property is sold.
❑ A Bayfield County Health Dept permit is required.
❑ Check with Town regarding room tax.
❑ Short -Term Rental is for a maximum occupancy of persons.
❑ Sign must meet the requirements of Article E of the Bayfield County Zoning Ordinance.
o be constructed per plan.
❑ Adhere to privy agreement.
❑ Temporary permit allowing existing structure for a period of less than 1 year.
❑ RV may not be used for permanent residence or storage.
❑ RV allowed for
❑ RV must be removed by
Apo sewer and pressurized water allowed in the structure.
( No plumbing or plumbing fixtures allowed.
additional sleeping areas allowed without obtaining necessary sanitary permit(s).
d use permits shall be required for any new residence, any building or structure erected,
ted, rebuilt, or structurally altered
P
d 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)
❑ Additional conditions may be placed and need to be adhered to at the time of permit issuance
Other Conditions:
HAYFIELD Bayfield County
Planning & Zoning Department
117 E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner:
KOCH, ALLISON LEE & DANIEL ROBERT
25155 SUNSET LN
CABLE, WI 54821
Description
Non -Habitable Residential Principal and Accessory
Structures - $0.20/square foot (minimum $75)
Amount:
Reference: 2880888725
Paid by: Allison Koch
Payment Type: Credit Card
Transaction Date: 2/23/2026
Submission Number:
LU-02117
Transaction Number.
LU-02117-3E97B
Amount
$480.00
$491.42
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 / Nonconforming — No
Shoreland — Yes / Impervious Surface - No
Floodplain - No! Wetlands - No
Mitigation - No I Affidavit #:
LAND USE -X
X
SANITARY -
SPECIAL A -
SPECIAL B/CONDITIONAL —
BOA —
No. 26-0073 Tax ID: 38199
Issued To: KOCH, ALLISON LEE & DANIEL ROBERT
Location: S18 - T43N - R05W
Town of Namakagon
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: LOT 2 CSM #1063 LOCATED IN GOVT LOT 1 IN V.6 P.414
Residential Structure in R-1 zoning district
For: New Construction [1 - Story ], Accessory Structure on a Slab [2400 Total sq. ft. ] Height of 19'
(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
work or land use has not begun.
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.
This permit may be void or revoked if any performance conditions are not
completed or if any prohibitory conditions are violated.
Scott Roush
Authorized Issuing Official
March 03, 2026
Date
Condition(s): Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs.
For personal storage only.
Not for human habitation or sleeping purposes.
Use best management practices to limit and prevent erosion during construction.
To be constructed per plan.
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.