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26-0272
Return to: 117 E 5th Street, PO Box 58 Washburn, WI 54891 permits@bavfieldcounty.wi.gov County Use Only: Bayfield County Planning and Zoning Department Submission #:1-0-0 3b LAND USE PERMIT APPLICATION Permit #: _-�-0 Date: Li 1 0 Property Owner Name: Authorized Agent Name (if applicable): - Telephone Number: Telephone Number: ? / I- am m - 1 4 1 7 rPrtIVFfl —.. Lay, at tc,, 7: 1c.'$, 5'q o / ctry, sate, Lip: Planning and Zoning Agency Contractor: 7 o Telephone Number: I E -Mail Address: $1i,.&- , /e CO. t,, clis, c )d os/ SECTION U! Prnnerty Infnrn"ntnn Project Address (if different from ailing a r s): ��^^ 7^ 0 %1 s— r,✓ PJ , V /-e.h i rt , fry , Legal Description (if additional space is needed attach a separate sheet): Section. Township. Range: 0 . 9 5 — 0 Town of: G y e Tax ID #: / S, p / ) Lot Size (Acres/Square Feet): Project Use is: Residential ❑ Commercial ❑ Municipal If Commercial. estimated cost of construction: $ Project Type is: O New Construction Addition/Alteration (existing structure) O Change Use (existing structure) O Relocate (existing structure) O RV Placement 21+ days 0 Sign O Establishing a Business 0 Temporary (12 or less months) O Shoreland Grading, Class A ❑ RV Placement 4+ months. Class A ❑ Other (describe): Structure Type is: ✓Residence ❑ Principal Structure (describe): ❑ Accessory Structure (describe): `❑ Shoreland Exempt Structure (describe): O Mobile Home (provide manufactured date): ❑ Shipping Container RrOther (describe): I�e /C Foundation Type: ❑ Basement 0 Walkout Basement ❑ Slab ❑ Crawlspace ❑ Ground ❑ Skids O Other (explain): 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: 2"a Floor Sq Ft: 3" Floor Sq Ft: Garage Sq Ft: Porch Sq Ft: Dec Ft: Other Sq Ft (describe): Other Sq Ft (describe): Total Sq Ft: Overall Height (finished grade to peak): # of Stories: Existing # of Bedrooms on property: Q Proposed # of Bedrooms in project: 0 SECTION E: RV and Sign Infotmatfon (check all that apply) Sign is: RV is: O New O Replacement ❑ New ❑ Replacement ❑ On -premise O Off -premise ❑ 1 -sided O 2 -sided Year: Vin #: ❑ On -building ❑ 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) Show location of: O Driveways O Frontage Roads (include name) O Existing Structures O Well (W) O Septic Tank (ST) ❑ Drain Field (DF) O Holding Tank (HT) O Privy (P) O Lake 0 River ❑Stream/Creek ❑Pond DFloodplain ❑Wetlands ❑Slopes over 20% N RECEIVED JUN 0 5 2026 Planning Co. g and Zoning Agency / � fo Setback or distance from furthest extent of structure County Use Only including eaves and overhangs to (include on site plan): Verified setbacks Road Centerline ft. p ft. Notes/Comments: Front Lot Line/Right-of-Way ft. ft. Side Lot Line 1 ft. >7 ft. J (North East South West, circle one) Side Lot Line 2 ft. r ft. (North East South West, circle one) Rear Lot Line ft. ft. Septic/Holding Tank ft. ft. Drainfield ft. ft. Privy ft. ft. Well ft. ft. Existing Structure/Building ft. ft. Wetland ft. ft. Elevation of Floodplain ft. ft. Ordinary High -Water Mark (OHWM) ✓ 10 o ft. ft. Other (describe) ft. 1 ft. Application Page 2 RECEIVED JUN 0 5 2026 Bayfield Co. Planning and Zoning Agency SECTION G: Additional Questions ❑ Yes O No Has the location of the proposed project* been staked? If no, what date will this be completed: Note: The site will not be inspected nor permit issued until after the staking date listed above. r9+ 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. O Yes K 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 O Holding Tank O Municipal/Public O Other (describe): ❑ Yes 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 O Other (describe): ❑ Yes P 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) O Cash (attached) O debidcredidecheck (department to call once payment is ready to be taken) How would you like to receive your permit card? ❑ Mail to: OR$Email to: P Property Owner Address O Agent Address ❑ Contractor Address O Other (provide name and email or address): 'Include eaves, overhangs, sanitary system, and well in staking measurements Section H: Acknowledgement and Signature All Land Use Permits expire Two (2) Years from the date of issuance if construction or use has nut 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.sovftooic/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. t Owner(s) or Authorized Agent Printed Name: 2 © 4 4 4f D Owner(s) or Authorized Agent Signature: o+ Date:` i NOTES: fr dl 1. If you are signing on behalf of the owner(s) a letteruthorization 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 Land Use Permit Application Review Checklist Submission #: Lc What zoning district is the roject located in? ❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 -1 ❑ F-2 ❑ W ❑ M -M ❑ Yes 1Jo Is lot substandard (does not meet current zoning dimensional requirements)? Deed of record: s ❑ 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)? es Ct O, / _ 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 o Are there wetlands on the property? ❑ Yes Io Is project associated with a nonconforming use or structure? ❑ Yes''flb Is project associated with a variance? Case #: ❑ Yes flo 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 Does the project require sanitary? ❑ Existing ❑ New ❑ Intercept O Reconnect O Non -Plumbing ❑ Public Sanitary Permit #: # of Bedrooms: _ Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes o ❑ Yes 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? es ❑ No Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use isjsidential ❑ Commercial O Municipal Project typ is? ❑ New Construction ition/Alteration O Change Use ❑ Relocate O RV Placement ❑ Sign ❑ Establishing a Busi ess ❑ Temporary ❑ Shoreland Grading ❑ Other, describe: Structure Type is: Residence O Principal Structur Accessory Structure ❑ Boathouse (one story only) ❑ Open-sided/Screened Structure (gazebo, etc.) O Stairway to navigable waters ❑ Mobile Home ❑ Shipping Container ❑ O her, describe Total Sq. Ft. of Project: 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 (exempt from fees) ❑ Return Inspection O Land Use Revisions O Special Use Permit - Class A O Floodplain ❑ Shoreland - Impervious Surface O Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 O Tower Collocation 2 ❑ Metallic Mine ❑ After -the -Fact (ATF) I $ Inspected by: Date of Inspection: 6 /� Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed: Approved by: �J/OC , �G Date of Approval: I h Condition(s): ('vAust meet and maintain setbacks from furthest extension of structure including eaves and overhangs. ❑ For personal storage only. 0 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. Jo 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 o sewer and pressurized water allowed in the structure. o plumbing or plumbing fixtures allowed. o 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, ated, rebuilt, or structurally altered nd use permits shall be obtained prior to the initiation of construction or a change in land use A quirements (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 13-M 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: RASPOTNIK, DOUGLAS A LU-02336 20055 US HWY 2 ASHLAND, WI 54806 Transaction Number: RASPOTNIK ,JULAINE R LU-02336-48100 20055 US HWY 2 ASHLAND, WI 54806 Description Amount Habitable Residential Principal Structure - $125.00 unenclosed area or non -habitable garage $0.20/square foot (minimum $125) Total: $125.00 Payment Amount: $125.00 Reference: 1061 Paid by: D Rasp LLC Payment Type: Check Transaction Date: 6/19/2026 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 — Yes / Impervious Surface - No Floodplain - No! Wetlands - No Mitigation - No / Affidavit #: LAND USE - X SANITARY - SPECIAL A - SPECIAL B/CONDITIONAL — BOA — No. 26-0272 Tax ID: 18012 Issued To: RASPOTNIK, DOUGLAS A & JULAINE R Location: S20 - T45N - R06W Town of Grand View BAYFIELD COUNTY Lal_:11r " WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Legal Description: PLAT OF TANK LAKE COVE LOT 3 IN DOC 2021 R-586882 Residential Structure in F-1 zoning district For: Addition/Alteration, Residence [Deck] [48 Total sq. ft.] (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 Scott Roush 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. June 19, 2026 This permit may be void or revoked if any performance conditions are not completed or if any prohibitory conditions are violated. Date Condition(s): Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs. 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. Requirements (e.g., permits/licensing/tax) of Local Town, Village, City, State or Federal agencies are required.