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Raturnio: County Use Only: 117 E 5"' Street, PO Box 58 Hayfield County Planning and Zoning Department Submission #: LU-O 1 't Washdurn, WI 54891 LAND USE PERMIT APPLICATION Permit#: permits(Wbavfieldcounty.wi.eov Date: 3 / g/ a-O�6 Authorized Agent Name (if applicable): Telephone Number: Telephone Number: 715-413-0007 E -Mail Address: E -Mail Address: RECEIVED Jhpremierconerete@gmail.com � Mailing hwy Nss: Mailing Address: 4505 ctFEB 242026 City, State, Zip: City, State, Zip: o. Barnes WI 54873Planning anti Baynelnnd np Contractor: I Telephone Number: E -Mail Address: Project Address Legal Description (if additional space is needed attach a separate sheet): Wt 4 ot Bayllele cushy survey map 2357 southeast waiter of thevnonheasl quarter sectIon 34 townshlp45 nodK range 9 west, town of beme3. BaytlW curly Section, Township, Range: 34,45,9 Town of: Barnes Tax ID #: 39391 Lot Size (Acres/Square Feet): 5.710 SECTION C: Project Information (check all that apply) Project Use is: ❑ Residential O Commercial ❑ Municipal If Commercial, estimated cost of construction: $1a9fl00.00 Project Type is: E New Construction ❑ Addition/Alteration (existing structure) ❑ Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21+ days ❑ Sign ❑ Establishing a Business El Temporary (12 or less months) ❑ Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A ❑ Other (describe): SECTION D: Structure Information (Does not apply to RVs and Signs, go to Section E) Structure Type is: ❑ Residence ❑ Principal Structure (describe): E Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured date): ❑ Shipping Container ❑ Other (describe): Foundation Type: Cl Basement O Walkout Basement ❑ Slab ❑ Crawlspace O Ground ❑ Skids E Other (explain): pole shed Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade decks/porches): Basement Sq Ft: I" Floor Sq Ft: Loft Sq Ft: 2nd Floor Sq Ft: 3'd Floor Sq Ft: Garage Sq Ft: Porch Sq Ft: Deck Sq Ft: Other Sq Ft (describe): Other Sq Ft (describe): Total Sq Ft1�� aj iZ Overall Height (finished grade to peak): a f e # of Stories: 0 Existing # of Bedrooms on property: 0 Proposed # of Bedrooms in project: 0 SECTION E: RV and Sign Information (check all that apply) Sign is: RV is: ❑ New ❑ Replacement ❑ New ❑ Replacement ❑ On -premise ❑ Off -premise ❑ 1 -sided ❑ 2 -sided Year: Vin #: ❑ On -building O Multi -Tenant Length: Width: Height: Make: Model: Application Page 1 C':ECEIVEO FEB 247076 SECTION F: Site Plan — attach a site plan or draw site plan in box below (See pages 1 & 2 41'addse Permit Application Information for information that is required to be provided on site plan) Planning and Zitging AgenaY Show location of: ❑ Driveways 0 Frontage Roads (include name) O Existing Structures ❑ Well (W) ❑ Septic Tank (ST) O Drain Field (DF) ❑ Holding Tank (FiT) ❑ Privy (P) O Lake ❑ River ❑ Stream/Creek ❑Pond ❑Flood lair. ❑ Wetlands ❑Sloes over 20% N Rocs% Setback or distance from furthest extent of structure County Use Only including eaves and overhangs to (include on site plan): Verified setbacks Road Centerline 75 ft. ft. Notes/Comments Front Lot Line/Right-of-Way 50 ft. ft. Side Lot Line 1 50 ft. ft. (North3I South West, circle one) Side Lot Line 2 3 ft. ft. (North East South es circle one) Rear Lot Line 350 ft. ft. Septic/Holding Tank na ft. ft. Drainfield na ft. ft. Privy na ft. ft. Well na ft. ft. Existing Structure/Building na ft. ft. Wetland na ft. ft. Elevation of Floodplain na ft. ft. Ordinary High -Water Mark (OHWM) na ft. ft. Other (describe) ft. ft. Application Page 2 Jab: J L H Convete Wall Layout Date. M012025 Y IDtR. 131 PM FEB 242026 Yes ❑ No 1-las the location of the proposed project including eaves and overhangs and been staked? If no what date will this be com leted: _ ' 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 Inf n for reauired sethacks. ❑ Yes 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 No Is there an existing sanitary system on the property? If yes, what kind? O Drainfield O Holding Tank O Municipal/Public ❑ Other (describe): ❑ Yes $I No Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be installed or used to manage wastewater? O Drainfield ❑ Holding Tank ❑ Munici al/Public ❑ Other (describe): ❑ Yes 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 O Class B Special Use ❑ Conditional Use ❑ Variance Fee payment will be made via: ❑ Check (attached) O Cash (attached) 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 O Email to: .Property Owner Address ❑ Agent Address O Contractor Address ❑ Other (provide name and email or address): owIedzenient and Si nature 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 Plat, 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. Ivor more information, visit the Department of Natural Resources wetlands identification web page, dnr wi.gov/iooichvetlands, 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 time for the purpose of inspection. Lan CC e- \st Cr Owner(s) or Authorized Agent Printed Name: 1-1O11 Owner(s) or Authorized Agent Signature: -2 Date: ' I7- dQ2(O 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 RECEIVED AFFIDAVIT OF AUTHORITY HAR 032026 (Corporation, LLC, etc.) Bayfield co. PURPOSE. This Affidavit of Authority is used to certify the individual submitting an appp7 c�a�o^3$°ing Agency authorized when the property is owned by a corporate/business entity. STATE OF WISCONSIN ) ss. HAYFIELD COUNTY The undersigned affirms and states as follows 1 Address of Subject Property: Lo 1 tdo. 2357 Vol I) 397-591' a°0k/- &p4/a0 5W au r%.c vr}ko•s1 Qae w >(ciiuy, 34J j1.14 11, nzr 2 The Subject Property is owned by: 5 H 1n'mlo✓ (OAAt (Name of Company) 3. The name(s) of the current President or Managing Member itcyl tit i'fdlli5k 4. I certify that the company named in paragraph 2 is valid and in effect on the date signed below I am the duly appointed agent of the Company named above in paragraph 2, and I have the authority under the terms of said authorization to submit an application to the Bayfield County Zoning Department concerning the Property described in paragraph 1. I further certify that the information and statements made within this affidavit are true, accurate, and complete to the best of my knowledge. 5. I em authorized by the above -named Company to apply for and bind the Company to the terms and conditions of any decision or permit issued by the Hayfield County Zoning Department. 6 By signing this affidavit, I attest that I am unaware of any known or unknown person(s) who would contest this application I agree to Indemnify Bayfield County or such person or legal entity suffering a damage resulting from any illegalities of the application Dated Ol-aq_at)�-(, L4n(c Hollrslt Print Name this_ day of C- My Bayfield County, WI c..., - fxlti I cgs. �, � Is �p li R� - Yam - r '•BA 6C x"c r E' -0 nRI:D/:Tax,ID#39392 TOWN OF BARNES !.... " W„{4� - Sr• r.- .rr7 ^.•.� ._gyp V � Y T lH . PRPI13 TaxSD'#•39341 ,. J&H PREMIER CONCRETE LLC _ _ ..AA ?L LTt :: „fin ws `'j$+ is 3/2/26, 8:23 AM Novus-Wisconsin Access rev. 12.0206 R al Estate Bayfield County Property Listing Property Status: Current Date: 3/2/2026 Created On: 9/6/2024 10:21:58 AM Itoday's • 1 ' Description Updated: 4/2/2025 10 Ownership Updated: 4/2/2025 Tax ID: 39391 J&H PREMIER CONCRETE LLC BARNES WI PIN: 04-004-2-45-09-34-1 04-000-16000 Legacy PIN: Billing Address: Mailing Address: Map ID: J&H PREMIER CONCRETE LLC J&H PREMIER CONCRETE LLC Municipality: (004) TOWN OF BARNES 4605 CO HWY N 4605 CO HWY N STR: S34 T45N R09W BARNES WI 54873 BARNES WI 54873 Description: LOT 4 OF CSM 2357 IN V13 P347 IN DOC 2024R-604126 1347 IM 2025R-606954 P Site Address * indicates Private Road Recorded Acres: 5.710 N/A Calculated Acres: 5,714 Lottery Claims: 0 ® Property Assessment Updated: 5/19/2025 First Dollar: No Zoning: (I) Industrial 2026 Assessment Detail ESN: 104 Code Acres Land Imp. X4 -EXEMPT OTHER 5.710 0 0 Tax Districts Updated: 9/6/2024 2 -Year Comparison 2025 2026 Change 1 STATE Land: 0 0 0.0% 04 COUNTY Improved: 0 0 0.0% 004 TOWN OF BARNES Total: 0 0 0.0% 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE Recorded Documents Updated: 9/6/2024 ® QUIT CLAIM DEED Date Recorded: 3/26/2025 2025R-606954 ® CERTIFIED SURVEY MAP Date Recorded: 7/26/2024 2024R-604126 13-347 ® CERTIFIED SURVEY MAP Date Recorded: 7/25/2007 20078-515239 9-189 CW Property History Parent Properties Tax ID 04-004-2-45-09-34-1 04-000-11000 34941 HISTORY © Expand All History White=Current Parcels Pink=Retired Parcels H 39391 This Parcel T Parents ♦ Children https://novus.bayfieldcounty.wi.gov/access/master.asp?paprpid=39391 1/1 Land Use Permit Application Review Checklist Submission #: What zoning district is the project located in? ❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C 12 / ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M El Yes .0'flo Is lot substandard (does not meet current zoning dimensional requirements)? Deed of record: ❑ Yes giio 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 (210 Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of navigable waterway) ❑ Yes o Is the project located in the Floodplain? Zone: ❑ Yes .allo Are there wetlands on the property? ❑ Yes o Is project associated with a nonconforming use or structure? ❑ Yes E10 Is project associated with a variance? Case #: ❑ Yes ZlNo Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes giio Is the project associated with a Special A Use Permit? ❑ Yes )2*o Does the project require sanitary? O Existing O New O Intercept O Reconnectn-Plumbing O Public Sanitary Permit #: # of Bedrooms: ❑ Yes_.fl'No Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes ,alo Does the project require an affidavit? Affidavit #: ❑ Yes 2110 Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback? ❑ Yes 12 -IC Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use is? O Residential J'Cmmercial ❑ Municipal Project type is?.ew Construction ❑ Addition/Alteration ❑ Change Use O Relocate O RV Placement ❑ Sign ❑ Establishing a Business O Temporary O Shoreland Grading O Other, describe: Structure Type is: ❑ Residenceincipal Structure O Accessory Structure ❑ 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: Number of Stories: Overall Height: 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) ❑ Non -Habitable Residential Principal and Accessory $0.20 x s ft q (minimum $75) Structures $ Commercial/Municipal Principal Structures $250 + $0.005 x /.2T7 ok'iCA (minimum $250) cost of construction $ Cfr32 ❑ Commercial/Municipal Accessory Structures $150+$0.005 x (minimum $150) cost of construction $ ❑ Return Inspection O Land Use Revisions ❑ Special Use Permit - Class A O Floodplain O Shoreland - Impervious Surface O Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 O Tower Collocation 2 O Metallic Mine ❑ After -the -Fact (ATF) $ M Inspected by: Date of Inspection: (' Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed: Approved by: Date of Approval: Condition(s): ❑ Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs. ❑ For personal storage only. ❑ For personal residence only. cot for human habitation or sleeping purposes. wn/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. 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. ❑ 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. ❑ Sign must meet the requirements of Article E of the Bayfield County Zoning Ordinance. To be constructed per plan. ❑ Adhere to privy agreement. 0 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 be removed by ENoust 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) ❑ Additional conditions may be placed and need to be adhered to at the time of permit issuance Other Conditions: FIELD 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: Submission Number: J&H PREMIER CONCRETE LLC LU-02121 4605 CO HWY N BARNES, WI 54873 Transaction Number. LU-02121-3EEF3 Description Amount Commercial/Municipal Principal Structures - $250.00, $890.00 plus $5.00/$1,000 cost of construction Total: $890.00 Payment Amount: $890.00 Reference: 2381 Paid by: J & H Premier Concrete Payment Type: Check Transaction Date: 3/9/2026 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 / Nonconforming — No Shoreland - No / Impervious Surface — No Floodplain — No / Wetlands — No Mitigation — No I Affidavit #: LAND USE -X SANITARY - SPECIAL A - SPECIAL B/CONDITIONAL - BOA - BAYFIELD COUNTY ral :1 ''III I WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 26-0082 Tax ID: 39391 Issued To: J&H PREMIER CONCRETE LLC Location: S34 - T45N - R09W Town of Barnes Legal Description: LOT 4 OF CSM 2357 IN V13 P347 IN DOC 2024R-604126 1347 IM 2025R-606954 Commercial Structure in I zoning district For: New Construction, Principal Structure [3952 Total sq. ft. ] Height of 26' (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 Tracy Pooler 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. March 09, 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): Not 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 (if applicable). To be constructed per plan. No sewer and pressurized water allowed in the structure.