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HomeMy WebLinkAbout26-0178Return to: 117 E 5th Street, PO Box 58 Washburn, WI 54891 permits@bayfieldcounty.wi.gov Bayfield County Planning and Zoning Department LAND USE PERMIT APPLICATION County Use Only: Submission #: Permit #: 2'6' 0l7 Date: SECTION A: General Information Property Owner Name: )o Authorized Agent Name (if applicable): rro J c Tel phone Numb r: Ccl Tele hone Number: IS- - -� att 11S-3 - i9ff E -Mail Address: KnK; E -Mail Address: o ah o. o Mailing Ad e sj [a (�t ,0 / Key Mailing Address: / S T c C T City, State, Zip: p VuV'i' VUl Jo'/ City, State, Zip: .Lr Contractor: Telephone Number: E -Mail Address: „SECTION B;,,i'ro er:Lnfvrma_ Project Address (if different from mailing address): Legal Descript on (ifaddiionpI space is ne ded attach i e arate sheet): ���/Set? Section, To nship, Range: 147 K 01 Town of: [..f ti Tax ED #: 3 ? 1-fje Oe'c a& - c �a Lot Size (Acres/Square Feet): y, 9 f g SECTION C: Project Information (check all that apply)! Project Use is: j Residential El Commercial El Municipal Project Type is: New Construction El 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) El Shoreland Grading, Class A El RV Placement 4+ months, Class A El Other (describe): required (Total sq ft): required SECTION D: Structure Information (Does not apply to RVs and Signs, go to Section E) Structure Type is: ❑ Residence ❑ Principal Structure (describe): ❑ Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): El Mobile Home (provide manufactured date): ❑ Shipping Container (Other (describe): Yb I,4 ` tea r N� Foundation Type: �[ ❑ Basement ❑ Walkout Basement Slab ❑ Crawlspace I'Ground El Skids El Other (explain): Existing Structure: 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't Floor Sq Ft: I 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 Ft: 2 Overall Height (finished grade to peak): # of Stories: ( Existing # of Bedrooms on property: a Proposed # of Bedrooms in project: O SECTION E: RV and Sign Information (check all that apply) Sign is: RV is: ❑ New El Replacement ❑ New El On -premise El Off -premise ❑ 1 -sided ❑ 2 -sided Year: Viu,#: O 7 2026 ❑ On -building El Multi -Tenant Length: Width: Height: M°i Make: Plannnnga"elldnl Co.Aeency 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 thatis required to be provided on site plan) Show location of: ❑ Driveways El Frontage Roads (include name) ❑ Existing Structures ❑ Well (W) ❑ Septic Tank (ST) ❑ Drain Field (DF) ❑ Holding Tank (HT) El Privy (P) ❑ Lake El River ❑Stream/Creek ❑Pond ❑Floodplain El Wetlands ❑Slopes over 20% N \ 9'4t' (�r V• RECEIVE 0. p Lk R: MAY 07202 Bayfield Co. Planning and Zoning A Setback or distance from furthest extent of structure County Use Only including eaves and overhangs to (include on site plan): Verified setbacks Road Centerline 66ft. ft. Notes/Cotltments: C /.d4 C Sf(oe J C�� cf Front Lot Line/Right-of-Way I. d ft. Side Lot Line I (NorthastDSouthDWestD, check one) 230 ft ^ _ Qlp ft ��.��� jK l 1 tP � - �(�,I1JC(�i a ,1 \'1 c' -c u o9 Side Lot Line 2 North❑East)'$South❑West❑, check one) ft. �S ft. ��'F' Rear Lot Line fj ft. ft. Septic/Holding Tank ft. ft. Drainfield ft. ft. Privy ft. ft. Well ft. ft. j ((/L�1 Lt 'Q1J3 on �tllC Existing Structure/Building ft. ft. Wetland ft. ft. U.JQ ASt .x p d C1 Elevation of Floodplain ft. ft. sr (1 (.A«,(d , / / Ordinary High -Water Mark (OHWM) ft. ft. Other (describe) ft. ft. ency ?d t f(\ &S (3e�bbckco SECTION G: Additional uestiori ❑ Yes 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: f%Z ❑ Yes 5i No Did a licensed surveyor mark lot line(s) if project is within 10 feet of req rred setback? See page 2 of Land Use Application Information for required setbacks. '[c'es ❑ 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? ❑ Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe): ❑ Yes C 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 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 ❑ Class B Special Use ❑ Conditional Use ❑ Variance Feepayment will be made via: heck (attached) ❑ Cash (attached) ebit/creditlecheek (department to call once payment is ready to be taken) How would you like to receive your pern._. card? Mail to: OR,mail to: roperty Owner Address ❑ Agent Address O Contractor Address O Other (provide Name and Email or Address): Section H: Acknowledgement 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. For more information, visit the Department of Natural Resources wetlands identification web page, dnr.wi.gov/tonic/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 time for the purpos of p ion. OF n Owner(s) or Authorized Agent Printed Name: [ rr�-t & II6 Owner(s) or Authorized Agent Signature: K C� o 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. O tractors must all be aware of permit details & conditions and permit card must be posted on property r�b`Stdt ect. MAY 077026 Bayfield Co. Planning and Zoning Agency 5/12/26,4:18 PM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 5/12/2026 9 Description Updated: 3/17/2022 Tax ID: 38746 PIN: 04-022-2-47-09-24-2 02-000-52000 Legacy PIN: Map ID: Municipality: (022) TOWN OF HUGHES STR: S24 T47N R09W Description: N 1/2 SW 1/4 NW 1/4 NW 1/4 IN DOC 2022R-593123 Recorded Acres: 0.000 Calculated Acres: 4.980 Lottery Claims: 0 First Dollar: No ESN: 116 I Tax Districts Updated: 3/17/2022 1 STATE 04 COUNTY 022 TOWN OF HUGHES 163297 SCHL-MAPLE 001700 TECHNICAL COLLEGE s" Recorded Documents Updated: 6/10/2019 © QUIT CLAIM DEED Date Recorded: 1/24/2022 2022R-593123 © WARRANTY DEED Date Recorded: 4/22/2019 2019R-577160 Property Status: Current Created On: 3/17/2022 8:19:53 AM 4W Ownership Updated: 3/17/2022 FRANK POLKOSKI IRON RIVER WI Billing Address: Mailing Address: FRANK) POLKOSKI FRANK 3 POLKOSKI 66790 E DEEP LAKE RD 66790 E DEEP LAKE RD IRON RIVER WI 54847 IRON RIVER WI 54847 P Site Address * Indicates Private Road N/A 8 Property Assessment Updated: 5/30/2023 2026 Assessment Detail Code Acres Land Imp. G6 -PRODUCTIVE FOREST 5.000 8,000 0 2 -Year Comparison 2025 2026 Change Land: 8,000 8,000 0.0% Improved: 0 0 0.0% Total: 8,000 8,000 0.0% ff Property History Parent Properties Tax ID 04-022-2-47-09-24-2 02-000-50000 38000 HISTORY ®wand All History White=Current Parcels Pink=Retired Parcels l+1 38746 This Parcel T Parents i Children hltps:Hnovus.bayfieldcounty.wi.gov/accesstmaster.asp?paprpid=38746 1/1 Bayfield County, WI 5/1212026,4:18:20 PM 1.918 0.01 0.02 0.04 mi Approximate Parcel Boundary Road Type — Town Building Footprint 2015 a Building 0.02 0.04 0.07 km BayrieW County Land Reconis Oepamnent Bayfield County Zaein g Applkadon bepel/maps.bayeeWcamty i.gov/Zenb'WABI Land Use Permit Application Review Checklist Submission #: What zoning district is the project located in? ❑ R-1 ❑ ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 I►i'F-1 ❑ F-2 ❑ W ❑ M -M ❑ Yes u4� Is lot substandard (does not meet current zoning dimensional requirements)? Deed of record: ❑ Yes 1Z1A0 / 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 Et4i Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of navigable waterway) ❑ Yes No Is the project located in the Floodplain? Zone: ❑ Yes E34io Are there wetlands on the property? ❑ Yes No Is project associated with a nonconforming use or structure? ❑ Yes o Is project associated with a variance? Case #: ❑ Yes E'Np Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes ffl.4tp Is the project associated with a Special A Use Permit? ❑ Yes EflA0 Does the project require sanitary? O Existing O New ❑ Intercept ❑ Reconnect O Non -Plumbing O Public Sanitary Permit #: # of Bedrooms: ❑ Yes o Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes Does the project require an affidavit? Affidavit #: ❑ Y s No Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback? es ❑ No Di1 applicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use is? Res' ential O Commercial O Municipal Project type is? L4Iew Construction ❑ Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign ❑ Establishing a Business ❑ Temporary ❑ Shoreland Gr#ing O Other, describe: Structure Type is: O Residence ❑ Principal Structure Accessory Structure ❑ 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: Number of Stories: I Overall Height: Fee Type Calculation Fee Amount O Habitable Residential Principal and Accessory Structures - Enclosed Areas — all enclosed areas within dwelling except attached non -habitable garages $0.50 x sq ft 5020 z } 6 ,y,r r U.. (minimum $125) $ ❑ Dwelling Unenclosed Areas (decks, patios, etc.) or Attached Non -Habitable Garages (minimum $125) $ $63,9',) ❑ Non -Habitable Residential Principal and Accessory Structures $0.20 x sq ft (minimum $75) $ ❑ Commercial Principal Structures $250 + $0.005 x cost of construction (minimum $250) $ ❑ Commercial Accessory Structures $150 + $0.005 x cost of construction (minimum $150) $ ❑ Municipal Principal and Accessory Structures n/a $0 (exempt from fees) ❑ 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) $ Inspected by: Date of Inspection: l(t 4iuw-t'j (/Lfeie, Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed: Approved by: AM Date of Approval: m t G l Condytion(s): ❑/Must meet and maintain setbacks from furthest extension of structure including eaves and ove a ngs. For personal storage only. ❑ FF personal residence only. "t for human habitation or gpurslee in oses. P pwn/State/DNR/Federal Vmay 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). ❑ Use 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. El Sign must meet the requirements of Article E of the Bayfield County Zoning Ordinance. 0 To 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 N'wer and pressurized water allowed in the structure. ❑ No plumbing or plumbing fixtures allowed. 0 No additional sleeping areas allowed without obtaining necessary sanitary permit(s). 0 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: K: Applications and Forms/Applications/Land Use/Updated 2/25/2026 mdk IMYFIELD Bayfield County Planning & Zoning Department 117 E 5w Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number: POLKOSKI, FRANK LU-02248 66790 E DEEP LAKE RD IRON RIVER, WI 54847 Transaction Number: LU-02248-456B3 Description Amount Non -Habitable Residential Principal and Accessory $563.20 Structures - $0.20/square foot (minimum $75) Total: $563.20 Payment Amount: $563.20 Reference: 1709 Paid by: Frank J Polkoski Payment Type: Check Transaction Date: 5/14/2026 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 I Wetlands - No Mitigation - No I 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. 26-0178 Tax ID: 38746 & 18633 Issued To: POLKOSKI, FRANK Location: S24 - T47N - R09W S24 - T47N - R09W Town of Hughes Legal Description: N 1/2 SW 114 NW 1/4 NW 114 IN DOC 2022R-593123 & S 112 SW 1/4 OF NW NW Residential Structure. in F-1 zoning district For: New Construction [1 - Story ], Accessory Structure on the Ground [2816 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 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. May 14, 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 storage only. Not for human habitation or sleeping purposes. Town/State/DNR/Federal may require permitting. No sewer and pressurized water allowed in the structure.