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HomeMy WebLinkAbout26-0285Return to: County Use Only: 1'/ 117 E 5`" Street, PO Box 58 Bayfield County Planning and Zoning Department Submission #�- 0 X05 Washburn, WI 54891 LAND USE PERMIT APPLICATION Permit : lrO?'Spermits@bayfieldcountv.wi.gov Date: Property Owner Name: Authorized Agent Name (if applicable): Sample, Scott J. Sample, Ryland R. Telephone Number: Telephone Number: (612) 749 7753 (763) 780 6079 _ E -Mail Address: E -Mail Address: hlGEIVED Scott@scottsample.com r.sample0128@gmail.com Mailing Address: Mailing Address: JUN 182026 8274 Yuma Way N 7981 Hinkley Rd #116 City, State, Zip: City, State, Zip: Bayfteld Co. Maple Grove, MN, 55311 Baxter, MN, 56425 Planning and zoning Agency Contractor: I elcphone Number: E -Mail Address: N/A N/A N/A SECTION B: Property Information Project Address (if different from mailing address): 87685 Bark Point Rd, Herbster, WI 54844 Legal Description (if additional space is needed attach a separate sheet): PAR IN GOVT LOT 2 IN V.865 P.587 SUBJ TO EASE IN DOC 2020R-583141 Section, Township, Range: 04, 50, 07 Town of: Clover I ax ID i : 11361 Lot Size (Acres/Square Feet):7.5, 326,700sft SECTION C: Project Information (check all that apply) Project Lice is: Xt! Residential ❑ Commercial ❑ Municipal If Commercial, estimated cost of construction: $ Project Type is: ❑ New Construction ® Addition/Alteration (existing structure) ❑ Change Use (existing structure) ❑ Relocate (existing structure) 0 RV Placement 21+ days ❑ Sign 0 Establishing a Business 0 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 Sigrts, go to Section E) Structure Type is: ❑ Residence ❑ Principal Structure (describe): 0 Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): 0 Mobile Home (provide manufactured date): ❑ Shipping Container ItN Other (describe): Patio & Sidewalk Foundation Type: ❑ Basement ❑ Walkout Basement ® Slab 0 Crawlspace 0 Ground. ❑ Skids ❑ Other (explain): Existing Structure: See attached; 7,644.56 sft Length: Width: Height: Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade decks/porches): Basement Sq Ft: 151 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 Sq Ft (describe): Patio; 370sft Total Sq Ft: -8;g14 4gy{t 3 p Overall Height (finished grade to peak): # of Stories: Existing # of Bedrooms on property: Proposed # of Bedrooms in project: SECTION E: RV and Sign Information check a h tl of apply Sign is: RV is: ❑ New ❑ Replacement ❑ New 0 Replacement ❑ On -premise ❑ Off -premise ❑ 1 -sided ❑ 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 I & 2 of Land Use Permit Application Information for information that is required to be provided on site plan) Show location of: ❑ Driveways ❑ Frontage Roads (include name) ❑ Existing Structures ❑ Well (W) ❑ Septic Tank (ST) ❑ Drain Field (DF) ❑ Holding Tank (HT) ❑ Privy (P) ❑ Lake ❑ River ❑Stream/Creek ❑Pond ❑Floodplain ❑Wetlands ❑Slopes over 20% N Bayfield County, WI *_ __ x5.95' l�� N!•i'.`4 tiN! &fie;' ..A�* )'Am:*! ,i.aon. IH.B R.1 O smmun pa,, minoam I:AB e..o.oO'o o, w+•l woo ;t . tVED 001 -. !V Cai ,bo CM,.tiwl Boom .��.o". ❑.N .�w,_ ❑E.�.�. _ ..,�P.,..,. JUN 18 2026 Bayfield Co. Planning and Zoning Agency Setback or distance from furthest extent of structure County Use Only including eaves and overhangs to (include on site plan): Verified setbacks Road Centerline 122 ft, ft. Notes/Comments: _ ul . ��7� r t(zf .Q u Co, ��( run'? Front Lot Line/Right-of-Way ft, ft. Side Lot Line I North East South West, circle one) ft, ft. Side Lot Line 2 ft, ft. (North East South West, circle one) .F !{ ()WM 6 A `^ RearLot Line ft, ft. ft. ft. Septic/Holding Tank n� kx `f �I Jrr?'�' 11 9 yt.CQ 6A� G S*M ( r e t / S 1J0-&' Z(/i l t ( ) KY' Drainfield ft. R. Privy ft. ft. Well ft. ft. Existing Structure/Building ft. ft. Wetland ft. ft. Elevation of Floodplain ft. ft. Ordinary High -Water Mark (OI-IWM) 140 ft. ft. Other (describe) ft. ft. Application Page 2 RECEIVED JUN 18 2026 SECTION G: Additional Questions.." ® Yes ❑ No Has the location of the proposed project* been staked? I [no, what date will this be completed: Note: The site will not be inspected nor permit issued until after the staking date listed above. ❑ Yes X 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? O Drainfield X Holding Tank O Municipal/Public O Other (describe): ❑ Yes X 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 O Holding Tank O Municipal/Public ❑ Other (describe): El Yes l3D 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 ❑ Conditional Use ❑ Variance Fee payment will be made via: ❑ Check (attached) ❑ 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 f Email to: ® Property Owner Address O Agent Address ❑ Contractor Address ❑ Other (provide name and email or address): 'Include caves, overhangs, sanitary system, and well in staking measurements . All 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.eov/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 purpose of inspection. Owner(s) or Authorized Agent Printed Name: Ryland Sample Owner(s) or Authorized Agent Signature: _ Date: 6/18/2026 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 CEVED Bayfield County JUN 18 2026 Impervious Surface Calculations Bayfield Co. These calculations are REQUIRED per WI Admin Code NR 115.05(1)(e) and Section fl4L9 of the Bayfield County Code of Ordinances. The undersigned hereby makes application for construction, reconstruction, expansion, replacement or relocation of any impervious surface within 300 feet of the ordinary high-water mark and agrees that all activities shall be in accordance with the requirements of the Bayfield County Code of Ordinances and all other applicable ordinances and the laws of the State of Wisconsin. The calculations are also REQUIRED in the case of a land division where the lot to be created or reconfigured will be reduced in lot area. Pursuant to Chapter 1, Title 13, Section 13-1-106(d) of the Bayfield County Zoning Ordinance(s), Planning and Zoning Department employees assigned to inspect properties shall have access to said properties to make inspections. Property Owner(s): Sample, Scott J. Mailing Address: Property Address: 4387 Willshire Blvd #140, Mound, MN 55364 87685, Bark Point Rd, Herbster, WI 54844 Leoal Description: Section, Township, Range PAR IN GOVT LOT 2 IN V.865 P.587 SUBJ TO EASE IN DOC 2020R-583141 Sec 04 Township Clover N, Range 07 W Authorized Agent/Contractor Gov't Lot Lot # CSM# Vol & Page Ryland Sample 2 Lot(s) # Block(s) # Subdivision Town of: Parcel ID # (PIN #) Tax ID # Date: 04- 014-2-50-07-04-1 05-002-10000 11361 6/18/2026 Impervious Surface: An area that releases as runoff all or a majority of the precipitation that falls on it. "Impervious surface" excludes frozen soil but includes rooftops, sidewalks, driveways, parking lots and streets unless specifically designed, constructed and maintained to be pervious. Impervious surface standards shall apply to the construction, reconstruction, expansion, replacement or relocation of any impervious surface that is or will be located within 300 feet of the ordinary high water mark of any navigable waterway on any riparian lot or parcel and any nonriparian lot or parcel that is located entirely within 300 feet of the ordinary high-water mark of any navigable waterway. Calculation of Impervious Surface: Percentage of impervious surface shall be calculated by dividing the surface area of the existing and proposed impervious surfaces on the lot or parcel by the total surface area of that lot or parcel and multiplying by 100. If an outlot lies between the ordinary high-water mark and the developable lot or parcel described in subd. 1. and both are in common ownership, the lot or parcel and the outlot shall be considered one lot or parcel for the purposes of calculating the percentage of impervious surfaces. Impervious Surface Standard: Allow up to 15% impervious surface but not more than 30% impervious surface on the portion of a lot or parcel that is within 300 feet of the ordinary high-water mark. A permit can be issued for development or land division approved that exceeds 15% impervious surface but not more than 30% impervious surfaces with a mitigation plan that meets the requirements of the Bayfield County Ordinance(s). Existing Impervious Surfaces: For existing impervious surfaces that were lawfully placed when constructed but that do not comply with the standards in Section(s) 13-1-32(c) and Section 13-1-40(h), the property owner may do any of the following: a. Maintenance and repair all impervious surfaces: b. Replace existing impervious surfaces with similar surfaces within the existing building footprint; c. Relocate or modify existing impervious surfaces with similar or different impervious surfaces, provided that the relocation or modification does not result in an increase in the percentage that existed on the effective date of the county shoreland ordinance and meets the applicable setback requirements in Section 13-1-22. Impervious Surface Item Dimension Area (Square Footage) Existing House Areas calculated with CAD; See attached. 2,127sft Existing Accessory Building/Garage 1,151sft Existing Sidewalk(s), Patio(s) 836.91 aft Existing Covered Porch(s), & Deck(s) Existing Driveway 3,528.67sft Other Structures ; CEIVE© Proposed Addition/House JUN 18 7026 Proposed Accessory Building/Garage avrield Co. Plannln;i ao-7 oning Agency Proposed Sidewalk(s) & Patio(s) —370sft Proposed Covered Porch(s) & Deck(s) Proposed Driveway Proposed Other Structures Total: a. Total square footage of lot: 7.5 acres, 326,700.00sft b. Total impervious surface area: 8,014.42sft c. Percentage of impervious surface area: 100 x (b)/a = If the proposed impervious surface area is greater than 15% mitigation is required. Total square footage of additional impervious surface allowed: @ 15% N/A @ 30% NIA (County Use Only) Date of Inspection: / �1 Inspection Record: Zoning District ( ) Condition(s): Stormwater Management Plan Required: ❑ Yes l Signature. of Inspector: Date of Approval: u/forms/impervioussurface Created: May 2012 (®Sept 2016, Sept 2020, Feb 2026) Proofed by: WI Docusign Envelope ID: 44807B1A-83C7-8BA9-814D-9483AE4F91 B5 Letter of Authorization Bayfield County Planning & Zoning Department PURPOSE. This Letter of Authorization is used to authorize a single property owner to act on behalf of multiple property owners or a designated agent to act on behalf of the property owner/s. If multiple property owners, each property owner must submit this signed letter. I, Scott Sample (property owner), authorize Ryland Sample (authorized agent) to submit a land use permit (Example: land use, special use, conditional use, rezone/map amendment, appeal, variance, text amendment, etc.) for the following described project (Example: construction of residence or other structure, short-term rental or other use change, etc.) extension of existing patio application on my behalf for the following described property: Legal description of subject property: Tax ID; 11361, Zone; 1, Section; 04, Township ID; 50 (Clover), Range; 07 Address of subject property: 87685 Bark Point Road, Herbster, WI 54844 C $asy& •Signature 6/18/2026 Dated JUN "I 8 2026 Baylield Co. Planning and Zoning Agency Bayfield County, WI 6/16/2026, 2:40:42 PM Section Lines Meander Lines Survey Maps Approximate Parcel Boundary — - Government Lot UnRecorded Map 10' Contour Lines O Municipal Boundary - - Driveways Rivers All Roads — Town x7'+ a r'w3 +^M a„ u'r,' *.`} Hilt di' l ^ice.4'-- Mti4 .1 imp¢ r l yii JUN 18 2026 BayfieId Co. Planning and Zoning Agency 1:1,566 0 0.02 0.04 0.07 mi 0 0.03 0.06 0.12 km Beyaaa BaytMd Camry Land Rewda Department M1XpsJlmapa EayreU nM.wl gpv/Bayath WAs/ Bayfield County, WI 6/16/2026, 2:41:16 PM 0 Section Lines LIIIApproximate Parcel Boundary 10Contour Lines 91 Walking Path & Overlook Rivers All Roads E] Existing Patio ❑ Proposed Patio Meander Lines Town H Existing Brick Sidewalk Municipal Boundary — — Driveways Existing Retention crushed Rock Driveways Existing Structures 1:500 0 0.01 0.01 0.02 ml 0 0.01 0.01 0.03 km JUN 182026 sayreid Bayfield Co. Planning and Zoning Agency eayneld county Land Records Department Imps /!maps bayrelacoumywi gwl8aylicldwAt/ bluff S Iz ,mile w RECEIVED JUN 18 2026 Bayfield Co. Planning and Zoning Agency Land Use Permit Application Review Checklist Submission #: O What zoning district is the project cated 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 IW10 Is lot substandard (does not meet current zoning dimensional requirements)? Deed of record: es ❑ 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)? tZY4es ❑ No Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of navigable waterway) ❑ Yes S'Np Is the project located in the Floodplain? Zone: ❑ Yes B4o Are there wetlands on the property? ❑ Yes E'No Is project associated with a nonconforming use or structure? 0 Yes 4Jp Is project associated with a variance? Case #: ❑ Yes D4p Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes I4l9 Is the project associated with a Special A Use Permit? ❑ Yes o Does the project require sanitary? ❑ Existing ❑ New O Intercept ❑ Reconnect ❑ Non -Plumbing ❑ Public Sanitary Permit #: # of Bedrooms: ❑ Yes I34o / Does the project require mitigation? Implementation Deadline: Date of Compliance: 0 Yes ❑ o 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? ❑ Yes 0 No Did pplicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use is? e ' ential ❑ Commercial ❑ Municipal Project type is? oiAew Construction ❑ Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign ❑ Establishing a Business ❑ Temporary ❑ Shoreland Grading 0 Other, describe: Structure Type is: 0 Residence ❑ Principal Structure 0 Accessory Structure 0 Boathouse (one story only) ❑ Open-sided/Screened Structure (gazebo, etc.) 0 Stairway to navigable waters ❑ Mobile Home ❑ Shipping Container �Ybther, describe 4(v ar-e 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 Att hed Non -Habitable Garages $0.20 x sq ft (minimum $125) $ l4Jon-HabitabIe Residential Principal and Accessory Structures $0.20 x ,� 7y sq ft (minimu5) m$ 7 ❑ 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 0 Land Use Revisions 0 Special Use Permit - Class A 0 Floodplain oreland - Impervious Surface 0 Shoreland - Non -Conforming, etc. 0 Tower Siting/Collocation 1 0 Tower Collocation 2 0 Metallic Mine ❑ After -the -Fact (ATF) j $ Inspected by: Date of Inspectioo6/ C Re -Inspected by: J Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed: Approved by: Date of A proval: V Co .W(usn(s): ust meet and maintain setbacksfroIn furthest extension of structure including eaves and overhangs. ❑ For personal storage only. ❑ For personal residence only. ❑ Not for human habitation or sleeping purposes. p'fwn/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 obtai d 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. Sii must meet the requirements of Article E of the Bayfield County Zoning Ordinance. �❑ D'fo 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 ❑ NgseVQ& and pressurized water allowed in the structure. ciIo 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: K: Applications and Forms/Applications/Land Use/Updated 2/25/2026 mdk P` 'FIELD 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: SAMPLE, SCOTT J 8274 Yuma Way N Maple Grove, MN 55311 Description Shoreland - Impervious Surface Non -Habitable Residential Principal and Accessory Structures - $0.20/square foot (minimum $75) Submission Number: LU-02365 Transaction Number. LU-02365-48215 Amount $25.00 $75.00 Total: $100.00 Payment Amount: $102.38 Reference: 3672649155 Paid by: Ryland Sample Payment Type: Debit Transaction Date: 6/23/2026 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 I Nonconforming - No Shoreland - Yes I Impervious Surface - Yes Floodplain - No! Wetlands - No Mitigation - No / Affidavit #: LAND USE - X SANITARY - SPECIAL A - SPECIAL B/CONDITIONAL — BOA — No. 26-0285 Tax ID: 11361 Issued To: SAMPLE, SCOTT J Location: S04 - T50N - R07W Town of Clover BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Legal Description: PAR IN GOVT LOT 2 IN V.865 P.587 SUBJ TO EASE IN DOC 2020R-583141 Residential Structure in R-RB zoning district For: New Construction, Patio Area [370 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 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. Emily Macgillivray Authorized Issuing Official June 23, 2026 Date Condition(s): Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs. Town/State/DNR/Federal may require permitting. Use best management practices to limit and prevent erosion during construction. To be constructed per plan. No plumbing or plumbing fixtures allowed.