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117 E 5`" Street, PO Box 58 Bayfield County Planning and Zoning Department
Washburn, WI 54891 LAND USE PERMIT APPLICATION
perniits@bayfieldcounty.wi.gov
County Use Only:
Submission #: L.u-oa'b I
Permit: a6 -oaf
Date:
SECTI4 .A;.Genera• .formati. _
Property Owner Name:
Authorized Agent Name (if applicable):
o r C
Telephon N rub r:
Telephone Number: RF n
E -Mail A dress
E -Mail Address: MAY 212026
Mailing Address:
Mailing Address: Bayfield co.
Q Q
planning anj Zcning Ageno/
City, State, Zi : ,
City, State, Zip:
or
Contractor:
Telephon Nu 2f:
E -Mail rl�dres : n
SECTION B: PropertyInformation '•
Project Address (if different from mailing address): ,� /
Legal Description if additionalspace is needed attach a sekarate sheet):
Es
Section, Township, Range: Jet -.Jo Twp. So 1V T wn of: QE;h
Tax ID #: g rT Lot Size (Acres/Square Feet): 2o Acre
SECTION C:.Fr t Information check,altthatapp1y..
Pro'ect Use is: esidential ❑ CommercJ ❑ Municipal
Project Type is: EPl1ew Construction ❑ Addition/A ration (existing ucture)
❑ Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21+ days
❑ Sign ❑ Establishing a Business ❑ Temporary (12 or less months)
❑ Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A ❑ Other (describe):
required (Total sft): required
SECTION D: Structure Information (Does not apply to RVs and Signs, go to Section E)
Structure Type is: ❑ Residence ❑ Principal Structure (describe):
El Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): El Mobile Home (provide manufactured
datef ):
� I
❑ Shipping Container ®"Other (describe): nQ/e sl, o _ Barn
l" t���III �a
Foundation Type:
El Basement ❑ Walkout Basement El Slab ❑ Crawlspace Ground ❑ 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/porches):
Basement Sq Ft:
1Flopr q Ft:
Loft Sq Ft:
2"a Floor Sq Ft:
3r° Floor Sq Ft:
D
Garage Sq Ft:
Porch Sq Ft:
Deck Sq Ft:
Other Sq Ft (describe):
Other Sq Ft (describe):
Total Sq Ft: Q
Overall Height (finished grade to peak): 9 a Ft
# of Stories: Existing # of Bedrooms on property:
Proposed # of Bedrooms in project:
SECTION E: R n r n brmatiou (check all that apply)
R I ' is:
Sign is:
❑ New El Replacement
❑ New El Replacement
El On -premise ❑ Off -premise
❑ 1 -sided El 2 -sided
Year: Vin It:
El On -building El Multi -Tenant
Length: Width: Height:
Make: Model:
7
Ct
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)
Show location of:
E Driveways O Frontage Roads (include name) ❑ Existi g Structures ❑ Well (W) ❑ Septic
Tank (ST) O Drain Field (DF)
❑ Holding Tank (HT) 0 Privy (P) ❑ Lake O
River ❑ earn/Creek ❑Pond ❑Floodplain OWetlands ❑Slopes over 20%
^
W
RjCE VED
MAY 2120'%6
Tee:
S CTIO
Additional u
No Has the location of the proposed project including eaves and overhangs and the sanitaP)a99$i@dMdd' '� e�rry1
Yes
staked? If no, what date will this be completed:
Yes
O 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
❑ 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 ❑ Munici al/Public ❑ Other (describe):
xes
Hydra7`
rll pressurized water be installed in the structure? If yes, what ind of sanitary system will be insI Iled or used
to manage wastewater? frost Prow /-�y rant for 4n,,,�4 jr
FCr
nMra/
❑ Drainfield El Holding Tank ❑ Municipal/Public El Other (describe):
❑ Yes
j214o
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
Feeayment will be made via:
C5'Check (attached) El Cash (attached) El debit/credit/echeck (department to call once payment is ready to be taken)
yoy#would you like to receive your permit card?
Mail to: Email to:
��OR❑
l '≤operty Owner Address ❑ Agent Address El Contractor Address ❑ Other (provide Name and Email or Address):
S tjo. :-elcknowled emettt.a d,Si -ature __..._. -.- -
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/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 time for the purpose of inspection.
Owner(s) or Authorized Agent Printed Name: %i2 6 S Q, Qn4ez /cC
Owner(s) or Authorized Agent Signature: (tnyeci- D,4.&n44172.Ct4 Date: .5 13-a6
NOTES: V
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.
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Land Use Permit Application Review Checklist
_ n1
Submission #:
What zoning district is the project located in?
❑ R-1 ❑ R-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:
❑ 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 FNo
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 ❑ No
Are there wetlands on the property?
Yes $'No
Is project associated with a nonconforming use or structure?
❑ Yes 'No
Is project associated with a variance? Case #:
❑ Yes R No
Is project associated with a Special B or Conditional Use Permit? Permit #:
❑ Yes 0 No
Is the project associated with a Special A Use Permit?
❑ Yes F No
Does the project require sanitary?
❑ Existing ❑ New O Intercept ❑ Reconnect O Non -Plumbing ❑ Public
SanitaryPermit #: # of Bedrooms:
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
Does the project require an affidavit? Affidavit #:
❑ Yes GGNo
❑ Yes No
❑ Yes No
Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback?
❑ Yes No
Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback?
Project use is? Residential ❑ Commercial O Municipal
Project type is? C'New Construction ❑ Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign
❑ Establishing a Business ❑ Temporary O Shoreland Grading ❑ Other, describe:
Structure Type is: ❑ Residence ❑ Principal Structure Accessory Structure O Boathouse (one story only)
❑ Open-sided/Screened Structure (gazebo, etc.) O Stairway to navigable waters ❑ Mobile Home
❑ Shipping Container O Other, describe
Total Sq. Ft. of Project: o Number of Stories: Overall Height:
Fee Type
Calculation
Fee Amount
❑ Habitable Residential Principal and Accessory
Structures - Enclosed Areas— all enclosed areas within
dwelling except attached non -habitable garages
$0.50 x sq ft
(minimum $125)
$
❑ Dwelling Unenclosed Areas (decks, patios, etc.) or
Attached Non -Habitable Garages
$0.20 x sq ft
(minimum $125)
$
❑ Non -Habitable Residential Principal and Accessory
Structures
$0 20 x s ft
q
(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 (exemptfrom fees)
❑ Return Inspection ❑ Land Use Revisions O Special Use Permit - Class A ❑ Floodplain O Shoreland - Impervious
Surface ❑ Shoreland - Non -Conforming, etc. ❑ Tower Siting/Collocation 1 O Tower Collocation 2 ❑ Metallic Mine
❑ After -the -Fact (ATF)
$
Inspected by:
Lc'
Date oflnspe�gtio
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):
"4?ist meet and maintain setbacks from furthest extension of structure including eaves and
((overhangs.
'1For personal storage only.
❑ For personal residence only.
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.
❑ A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be
obtained prior to the start of construction (if applicable).
bi` Ise 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.
❑ 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
❑ No sewer and pressurized water allowed in the structure.
❑ No plumbing or plumbing fixtures allowed.
tlo additional sleeping areas allowed without obtaining necessary sanitary permit(s).
rand use permits shall be required for any new residence, any building or structure erected,
�relocated, rebuilt, or structurally altered
G
, cand 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)
' dditional conditions may a placed and need to be adhered tot the ime of permit iss qce
Other Conditions: test Rvv X �
wa 6¼.a ®I'14], I�$cA
_
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K: Applications and Forms/Applications/land Use/Updated 2/25/2026 mdk
B=YFIELD 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:
GINGERICH,AMOS D & MARYANN E LU-02281
7702 STATE HWY 13
PORT WING, WI 54865 Transaction Number:
LU-02281-46564
Description Amount
Non -Habitable Residential Principal and Accessory $432.00
Structures - $0.20/square foot (minimum $75)
Total: $432.00
Payment Amount: $432.00
Reference: 1039
Paid by: Amos D Gingerich
Payment Type: Check
Transaction Date: 6/1/2026
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 - Yes
Mitigation - No / Affidavit #:
LAND USE -X
X
SANITARY -
SPECIAL A -
SPECIAL B/CONDITIONAL —
BOA —
No. 26-0223 Tax ID: 28506
Issued To: GINGERICH, AMOS D & MARYANN E
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Location: S30 - T50N - R08W
Town of Port Wing
Legal Description: E1/2 SW SE IN V.775 P.952 553 IN DOC 2025R-607823
Residential Structure in A-1 zoning district
For: New Construction [1 - Story], Accessory Structure on the Ground [2160 Total sq. ft. ] Height of 22'
(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
June 01, 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.
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.
Additional conditions may be placed and need to be adhered to at the time of permit issuance.
Water should only be used for providing drinking water to animals.