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117 E 5th Street, Po Box 58 Bayfield County Planning and Zoning Department
County Use Only:
Submission #: LU-031{-j
Washburn,W154891 LAND USE PERMIT APPLICATION
j Permit #: o b
not nntspbavtieldcountv.wi.gov
Date'
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Property Owne ame:
Authorized Agent Name (if applicable):_
_ 1
Telep otYc Number:
Telephone Number:
c—vnci
E -Mail Address:
rvWt1.
E -Mail Address:
Mailing Addre :
Mailing Address: Baytield Co.
_
D (LG Lr.
Plannini and Zoning A en
CityState.tare,, zip: c41 W v2
City, State, zip:
Contractor:
Telephone Number: E -Mail Address:
V( rs/"
O9
ffliONB:ProperWInfdISdOfl _IT IT T- {»r`'
Proje t Address (if different from mailin add Cs �G� Y y
I
a �6(
Legal Description (if additional s ace is needed attach a separate sheet):
SYt.# 17
Section, Township, Range: t 7 -r<% (J of: � Town 4t •L —�
�
Tax ID #: F Z Lot Size (Acres/Square Feet): vs 5 C Lrc.I
G17ON C: Pro t Information check aB that, 1 -. - - ' '
Project Use is: kesidential 0 Commercial 0 Municipal If Commercial, estimated cost of construction: $
Project Type is: 0 New Construction U ition/Alteration (existing structure)
❑ Change Use (existing structure) 0 Relocate (existing structure) 13RV Placement 21+ days
0 Establishing Business tporary (12 or less months)
❑ Sign a
O Shoreland Grading, Class A 0 RV Placement 4+ months, Class A ❑ Other (describe):
required Total sq ft): required
ISECTION D: Structure Information' not apDly to RVs and Sins, o to Section
Structure Type is: 0 Residence ❑ Principal Structure (describe):
❑ Accessory Structure (describe): 0 Shoreland Exempt Structure (describe): 0 Mobile Home (provide manufactured
date):
❑ Shipping Container 0 Other (describe):
Foundation Type:
❑ Basement ❑ Walkout Basement 0 Slab 0 Crawlspace 0 Ground 0 Skids 0 Other (explain):
Existing Structure: Length: Width: Height:
Proposed Structure (Provide Sq F1 based on outside dimensions, including unfinished areas, attached garages/above grade
decks/porches):
Basement Sq Ft:
I "Floor Sq Ft:
Loft Sq Ft:
2"t Floor Sq Ft:
3n° Floor Sq Ft:
Garage Sq Ft:
Porch Sq Ft:
Deck Sq 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: Proposed # of Bedrooms in project
,SECTION E:,RV and!Sig 5lnfortitatlon check all that apply)'
Sign is:
❑ New 0 Replacement
RV is:
@4ew 0 Replacement
O On -premise ❑ Off -premise
❑ I -sided ❑ 2 -sided
Year: �ZZ Vin #:1P °e z.3c 3
❑ On -building 0 Multi -Tenant
" '2i31, I
Length: Width: Height:
Make:
Q.l.I Model: —
Application Page I
SECTION F: Site Plan — attach a site plan or draw site plan in box below (See pages I & 2 of Land Use Permit Application
Tnfntmntinn fnr infnrmntinn that is remuired to be provided on site plan)
Show location of:
C2tDriveways E Frontage Roads (include name) O Existing Structures O Well (W) ❑ Septic Tank (ST) O Drain Field (DF)
O Holdin Tank HT ❑ Pri ) ❑ Lake ❑ River ❑Stream/Creek ❑Pond ❑Flood lain OWetlands OSlopes over 20%
N
-4$;--
UN 14 2026
Bayfield Co.
Planning and Zoning Agency
S 2(w ro Z6rx 8 Y2 I
1 to fi✓ I
i� tZV 1
SOYA
3gyrd
k or distance from furthest extent of structure
County
Use Only
ing eaves and overhangs to (include on site plan):
Verified setbacks
enterline
Len
4`w ft.
ft.
Notes/Comments:
t" -c G&S
W� �(Illn
Lot LinelRight-of--Way
eft.
ft.y
otLinel
13S� ft.
/O� ft
East Sothes ucircle one
�Artd
Mporw r 4 I vsouth
ot Line 2
420ft•
�0� ft�
Westcircle oneLot
Oil
Ott1ufield
Line
ft.
i00
ft•,.rP4jA0fQ
R
c/HoldingTank
ft.
ft
/� v
ft.
ft.
Well
ft.
ft.
Existing Structure/Building
ft.
ft.
Wetland
ft.
ft.
Elevation of Floodplain
ft •
ft.
Ordinary High- Water Mark (OHWM)
ft.
i ft.
'
Other(describe)
ft.
ft.,
Application Page 2
SE ON
G: AdditionalQuestions
Ycs
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.
❑ Yes
o
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
@iqo
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.
es ❑ No Is there an existing sanitary system on the property? If yes, what kind? \'0Y
❑ Drainfield O Holding Tank O Municipal/Public I&der (describe): rivy
❑ Yes o Will pressurized water be installed in the structure? If yes, what kind of sanitary ystem will be installed or used
to manage wastewater?
❑ Drainfield ❑ Holding Tank ❑ Municipal/Public O Other (describe):
Yes ❑ No Will sleeping occur in the structure? If yes, contact local Uniform Dwelling Code (UDC) for approval and
inspection requirements. RECiVFn II
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 JUN
Fee payment will be made via:
❑ Check (attached) ❑ Cash (attached) [ 'debi /credit/echeck (department to call once is
payment rea
How would you like.io receive your permit card?
❑ Mail to: OR mail to:
roperty Owner Address ❑ Agent Address O Contractor Address O Other (provide name and email or address):
'Include caves, overhangs, sanitary system, and well in staking measurements
Section H: Acknowled ement and Signature
All Land Use Permits expire Two (2) Years from the date of issuance if construction or use has not begun. Sanitarypermit
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
UDC.
the
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
property is located, and all other rules,
the
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.
Resources wetlands identification
For more information, visit the Department of Natural
web page, dnr.tvi �ov'to idw tlands, or contact a De
center (715)685-2900. J-'= partment of Natural Resources service
I ) that this I (we) knowledge dend belief applis anon, including any accompanying information
true, has been examined
accuracy of all informatio by me (us) and to the best of my
I (we) providing and that
issue a permit. I (we) further c are ct, and complete. I (we) acknowledge that I (we) am (are)
responsible nr e detail and
with
will be relied by Bayfield County determining
providing in or with this pplic Y in whether to
accept liability which may be a result ofelied upon ld County
to atron. I
access the relying on
eisribed (we) consent to county officials charged y g this (we)
property at an reasonable a information i are
any time dmrmslering
for the p
sfins county ordinances to have
Owner(s) or Authorized A arPose of inspection.
gent Printed Name:
OwnerNOTES:
or Authorized Agent Signature:
I • if you are signng
on behalf of th
2 Specific conditions/i s) a letter of autho Date: (v - I y-2,6
must all be aware o instructions may be stated on the face of th 'mustaccompany this application.
emrit details & conditions and ermit Use Permits,
card must beand
Osten on ' agents, & contractors
ro a rice to start of ro•ect.
Application Page 3
SI
THIS RE(
VEHICLE.
FOR TEi
RECREATI01
OR SE.
MANUFACTU .
COMPLIANCE WI f
RECREATI0'
NFPJ
"�_ MIrIV
INDUSTRY
A, SSOC!ATION
LI
Land Use Permit Application Review Checklist
Submission #:
What zoning district is the proje ocated in?
❑ R-1 ❑ R- ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M
❑ Yes 4cfo
/
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 No
Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of
navigable waterway)
❑ Yes LVNo
Is the project located in the Floodplain? Zone:
❑ Yes o
Are there wetlands on the property?
❑ Yes I"No
Is project associated with a nonconforming use or structure?
❑ Yes MLNo
Is project associated with a variance? Case #:
❑ Yes l(Vo
Is project associated with a Special B or Conditional Use Permit? Permit #:
❑ Y�s fl4Jo
Is the project associated with a Special A Use Permit?
es ❑ No
Does the project require sanitary? CS — 4:4 Co °j
0 Existing ❑ New 0 Intercept 0 Reconnect 15Non-Plumbing 0 Public
Sanitary Permit #: a-6- 03oS # of Bedrooms:
❑ Yes o
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
❑ Yes m4o
Does the project require an affidavit? Affidavit #:
❑ Yes E4io
Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback?
❑ Yes No
Di pplicant/property owner mark lot line(s), if project is within 30 feet of required setback?
Project use is? Residential 0 Commercial ❑ Municipal
Project type is? ❑ New Construction ❑ Addition/Alteration 0 Change Use ❑ Relocate Placement 0 Sign
❑ Establishing a Business 0 Temporary 0 Shoreland Grading ❑ Other, describe:
Structure Type is: 0 Residence 0 Principal Structure 0 Accessory Structure ❑ Boathouse (one story only)
❑ Open-sided/Screened Strr cture (gazebo, etc.) ❑ Stairway to navigable waters ❑ Mobile Home
0 Shipping Container k7'Other, describe (i
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)
$
0 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 0 Land Use Revisions 0 Special Use Permit - Class A 0 Floodplain 0 Shoreland - Impervious
Surface 0 Shoreland - Non -Conforming, etc. ❑ Tower Siting/Collocation 1 0 Tower Collocation 2 0 Metallic Mine
❑ After -the -Fact (ATF)
$
Inspected by:
Date of
Re -Inspected by:
Denied by:
Reason for Denial:
Date Denial Letter Mailed:
Approved by:
Condi ' n(s): J V
l4iust meet and maintain setbacks
Date of Re -Inspection:
Date of Denial:
Date of
extension of structure including eaves and
overhangs.
❑ For personal storage only.
❑ For personal residence only.
❑ N for human habitation or sleeping purposes.
Ir3'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).
❑ 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.
❑ 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.
❑ 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:
CLassc Qe(rnrI /11uS4- iJe olqfccnecp wi hlvl
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:
TRUHLSEN, DWAYNE K
LU-02347
1305 PRAIRIE LN
ST CROIX FALLS, WI 54024
Transaction Number:
GASPER,SARAH L
LU-02347-482E0
1305 PRAIRIE LN
ST CROIX FALLS, WI 54024
Description Amount
Recreational Vehicle (RV) Placement $75.00
Amount: $75.00
Reference: 2520
Paid by: Sarah Gasper
Payment Type: Check
Transaction Date: 6/29/ 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 / Affidavit #:
LAND USE - X
SANITARY — Non -Plumbing Portable Privy (26-0305)
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
No. 26-0306 Tax ID: 39672
Issued To: TRUHLSEN, DWAYNE K & GASPER, SARAH L
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Location: S27 - T50N - R04W
Town of Bayfield
Legal Description: LOT 4 CSM 2417 V14 P46 IN DOC 2025R-608823 IM 2025R-608921
For: Recreational Vehicle (RV) in R-RB zoning district
Make: Escape RV Model #: E -One VIN #: 1P9EB2303NR733613 Year: 2022
(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. June 29, 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.
Town/State/DNR/Federal may require permitting.
Class A RV permit must be obtained within 4 months or RV must be removed.