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26-0356
Return to: County Use Only: 117 E 5`" Street, PO Box 58 Baytield County Planning and Zoning Department Submission #: LUONI? Washburn, WI 54891 LAND USE PERMIT APPLICATION Permit if: a 6 b3 permits@bayfieldcounty.wi.gov Date: Z ld'd'(!�'o)A SECTION A: General Information - Property Owner Name: Authorized Agent Name (if applicable): Jacob and Dana Benson Telephone Number: Telephone Number: 715-331-9105 RECEIVED E -Mail Address: E -Mail Address: jake.benson©bayfieldcounty.wi.gov JUL 0u2026 Mailing Address: Mailing Address: ,/ 27015 S. Maple Hill Rd Bav'field Co City, State, Zip: City, State, Zip: Planning and Zoning Agency Washburn WI, 54891 Contractor: Telephone Number: E -Mail Address: SECTION B: Property Information Project Address (if different from mailing address): Legal Description (if additional space is needed attach a separate sheet): 1 SQ A IN NW COR OF NW NW IN DOC 2018R-575245 509 Section, Township, Range: S33 T49N R05W Town of: WASHBURN Tax ID #: 31150 I % Y1J 5V Lot Size (Acres/Square Feet): 1 SECTION C: Project Information (check all that apply) Project Use is: O Residential El Commercial ❑ Municipal if Commercial, estimated cost of construction: $ Project Type is: ❑ New Construction Addition/Alteration (existing structure) ❑ Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21+ days ❑ Sign ❑ Establishing a Business ❑ Temporary (12 or less months) ❑ Shoreland Grading, Class A El RV Placement 4+ months, Class A ❑ Other (describe): required (Total sc ft): required SECTION D: Structurelnformation (Does not applyJo RVs and Sigus,. go to SectiouS_ Structure Type is: O Residence El Principal Structure (describe): El Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured date): ❑ Shipping Container El Other (describe): Foundation Type: O Basement ❑ Walkout Basement ❑ Slab O Crawlspace ❑ Ground ❑ Skids El Other (explain): Existing Structure: Length: Width: 28 Height: 30 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"n Floor Sq Ft: 3r° Floor Sq Ft: Garage Sq Ft: Porch So Ft: Deck Sq Ft: Other Sq Ft (describe): Other Sq Ft (describe): 1O Total Sq Ft: l O Overall Height (finished grade to peak): lo # of Stories: It Existing # of Bedrooms on property' 4 Proposed It of Bedrooms in project: d 6 SECTION E: RV and Sign Information (check all that apply) Sign is: R V is: ❑ New El Replacement ❑ New ❑ Replacement ❑ On -premise El Off -premise ❑ I -sided ❑ 2 -sided Year: Vin#: ❑ On -building El Multi -Tenant Length: Width: Height: Make: Model: Application Page I 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: Driveways ❑ Frontage Roads (include name) ❑ Existing Structures ❑ Well (\V) ❑ Septic Tank (ST) O Drain Field (DF) ❑ holding Tank (HT) ❑ Privy (P) ❑ Lake ❑ River O Stream/Creek ❑Pond ❑Floodplain ❑Wetlands ❑Slopes over 20% N ® RECEIVED JUL 082026 Bayfield Co. Planning and Zoning Agency ��F -hwv- 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. ft. Notes/Comments: Front Lot Line/Right-of-Way ft. ft. Sid.' I of Line 1 ft. ft. )East South Vest circle one) 3� Side Lot Line 2 3S I ft. ft. (North South West, circle one) Rear Lot Line s s ft. ft. Septic/Holding Tank ( ft. I' ft. Drainfield ft. ft. Priory — ft. ft. Well S ft. ft. Existing Structure/Building 4A ft. ft. Wetland -- ft. ft. Elevation of Floodplain _ ft. ft. Ordinary High -Water Mark (OHWM) _ ft. ft. Other (describe) — ft. ft. Application Page 2 CTA N G: Additipttal ps Ogjks ,.,, . 9 Yes ❑ 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 N 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 N 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. l�"YeS ❑ No Is there an existing sanitary system on the property? If yes, what kind? 9 Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe): ❑ Yes gNO 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) inspection requirements. Is the project associated with any of the following: JUL 0 2026 ❑ Rezone O Class A Special Use ❑ Class B Special Use ❑ Conditional Use ❑ Variance Fee payment will be made via: tS'hCo. ❑ Check (attached) ❑ Cash (attached) ❑ debit/credit/echeek (department to call once payment is ready ttonb etakn en �n9 Agenq How would you like to receive your permit card? tIJ do' N t -t . . - ore.' ❑ Mail to: OR NEmail to: f-- ,,-Su' aloe— ❑ Property Owner Address ❑ Agent Address ❑ Contractor Address ❑ Other (provide name and email or address): 1ne ale eaves, ucerhangs, an tan- scstent and well in staking measurements ,ection H: Acknowledgement and Signature - - _._. - ..tt' '- '.i All Land Use Permits expire Two (2_) Years from the date of issuance if construction or use has not begun. Sanitary pennit 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.nov/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:"T7, ko tie 5c.•� �M Owner(s) or Authorized Agent Signature: S4 1�u_t�J Date: -716 Iaort NOTES: I. 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 N Toy' SCE-' _ P2o?OSFL 7DIc$ RECEIVED ' L43' JO J JUL 087076 Bayfield Co. Planning and Zoning Agency -ro? ePADG 3opn /'•7 0 ❑ ❑ /T' p ❑ ❑ ❑ 1 z=3, /f3' v � GeY SIDS -Mi RECEIVED JUC 082026 Bayfield Co. Planning and Zoning Agency TMP 3O,p4 - - 110' 0" ____Li A --- I 2 -3 —Z' 1 -k (%sg so& 5607)t 573 1'c to ' FLOORPLAN SKETCH Borrower: Jacon & Dana Benson File No.: 5276265 Property Address: 27015 South Maple Hill Road Case No.: City: Washburn Slate: WI Zip: 54891 Lender: WESTconsin Credit Union RECEIVED JUL 082026 Baylield Co. Planning and Zoning Agency 12431 ndosed Porch � 28'4 Bedroom Kitchen Bath Bath Lnu ry Bedroom Bedroom s _ Dining = lx2 S. rn Family CM f% I =G Bedroom Entry =w+WL'a� UoSE 28'4Y," 28'4Y.." / H1 :reN loft FirstFloor ¶2070' Fiat Floor x tA0+1207 in SecondFIoor 120345ar❑ 42'5'x 2843: x 1.00- 12015, $e:ona floor.l.W - ltvoa, hosed porn, 992rt'a Orx 2641 x 0.50. 3.5501 ❑ 42'3"x 284'. x 100• I1090m 111 Bayfield County, WI .a L ..&i-Lf t. F , - � v �fv of PRPIU/Tax rU�3110a 6 -''Yt'. `t - PHILLIP C FREEMAN - ^ 7t - ;� Lr�! 7 .. •r - dF�" x�. y...i:._ .,—w. �:tyr ! `..�p�FL HI'._L FCC A. siyka ' • _ ___ i-M'P' -:'.Ie1 r - - fat - PRPID/Tax4D # + ,t. PRPIb/Tax4ID #�3.11B ,3'r, - DAVID R 1-5 r & SUSAN &' ,-'gJACOB M <', UANIWBEN'SON ¶ „r, r -?9s._ �•,+w. ,* " ;• ' _ PRPITaxJID # 31I49 .' a�� ti JACOBMM & U NA BENSON ." ,...F tea.#` r . w•fy +�•: -" T Y r�� •r •YP - A.. y J^: 4i ` s ,.n.aKL•.0 H� r 7/13/26, 8:51 AM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Property Status: Current Today's Date: 7/13/2026 Created On: 3/15/2006 1:16:06 PM "1 Description Updated: 11/6/2018 Tax ID: 31150 PIN: 04-050-2-49-05-33-2 02-000-40000 Legacy PIN: 050105603000 Map ID: Municipality: (050) TOWN OF WASHBURN STR: 533 T49N R05W Description: 1 SQ A IN NW COR OF NW NW IN DOC 2018R-575245 509 Recorded Acres: 1.000 Calculated Acres: 1.000 Lottery Claims: 1 First Dollar: Yes Zoning: (AG -1) Agricultural -1 ESN: 130 ` Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 050 TOWN OF WASHBURN 046027 SCHL-WASHBURN 001700 TECHNICAL COLLEGE ,yam Recorded Documents Updated: 3/15/2006 0 WARRANTY DEED Date Recorded: 11/2/2018 2018R-575245 0 CONVERSION Date Recorded: 472699 564-405;565- 132;823-369 Ownership Updated: 11/6/2018 JACOB M & DANA BENSON WASHBURN WI Billing Address: Mailing Address: JACOB M & DANA BENSON JACOB M & DANA BENSON 27015 S MAPLE HILL RD 27015 S MAPLE HILL RD WASHBURN WI 54891 WASHBURN WI 54891 P Site Address * indicates Private Road 27015 S MAPLE HILL RD WASHBURN 54891 ® Property Assessment Updated: 7/30/2024 2026 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 1.000 5,400 115,100 2 -Year Comparison 2025 2026 Change Land: 5,400 5,400 0.0% Improved: 115,100 115,100 0.0% Total: 120,500 120,500 0.0% Property History N/A 3/3 https://novus.bayreldcounty.wi.gov/access/master.asp?paprpid=31150 1/1 Land Use Permit Application Review Checklist 'Submission #: z yI2 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 41 Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of navigable waterway) ❑ Yes 7Sio Is the project located in the Floodplain? Zone: ❑ Yes 4icio Are there wetlands on the property? ❑ Yeso Is project associated with a nonconforming use or structure? ❑ Yes o Is project associated with a variance? Case #: ❑ Yes fd'10 Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes ac0 Is the project associated with a Special A Use Permit? Yes Z No Does the project require sanitary? ❑ Existing ❑ New ❑ Intercept ❑ Reconnect ❑ Non -Plumbing O Public Sanitary Permit #: Itof Bedrooms: 5 ❑ Yes No Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes ZNo Does the project require an affidavit? Affidavit It: ❑ Yes JXNo Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback? ❑ Yes 2rNo Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use is?J2esidential ❑ Commercial ❑ Municipal Project type is? ❑ New Construction Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign ❑ Establishing a Business ❑ Temporary ❑ Shoreland Grading ❑ Other, describe: Structure Type is:2Iesidence O Principal Structure ❑ Accessory Structure ❑ 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: C Number of Stories: Overall Height: Fee Type Calculation Fee Amount ❑ Habitable Residential Principal and Accessory Structures - Enclosed Areas — all enclosed areas within dw Iling 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 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 ❑ Land Use Revisions ❑ Special Use Permit - Class A ❑ Floodplain ❑ Shoreland - Impervious Surface O Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 O Tower Collocation 2 O Metallic Mine ❑ After -the -Fact (ATF) $ iA Inspected by: Date of Inspection: Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Maile k Approved by: Date of Approval: 4� Condition(s): ❑ Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs. ❑ For personal storage only. ❑For personal residence only. Njt 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). ❑ 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. ❑ Sin 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: K: Applications and Forms/Applications/land Use/Updated 2/25/2026 mdk p a. LYFIELD 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. BENSON, JACOB M & DANA LU-02412 27015 S MAPLE HILL RD WASHBURN, WI 54891 Transaction Number: LU-02412-4A509 Description Amount Habitable Residential Principal Structure - $162.00 unenclosed area or non -habitable garage $0.20/square foot (minimum $125) Total: $162.00 Payment Amount: $165.86 Reference: 5480937945 Paid by: Jacob Benson Payment Type: Debit Transaction Date: 7/21/2026 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 / Affidavit #: LAND USE -X SANITARY - SPECIAL A - SPECIAL B/CONDITIONAL - BOA - BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 26-0356 Tax ID: 31150&31118 Issued To: BENSON, JACOB M & DANA Location: S33 - T49N - R05W & S32 - T49N - R05W Town of Washburn Legal Description: 1 SQ A IN NW COR OF NW NW IN DOC 2018R-575245 509 & E1/2 E1/2 NE NE IN DOC 2018R-575245 Residential Structure in A-1 zoning district For: Addition/Alteration [1 - Story ], Residence [Porch] on a Crawlspace [810 Total sq. ft. ] Height of 10' (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 Tracy Pooler 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. July 22, 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): 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. To be constructed per plan.