HomeMy WebLinkAbout26-0423Return to: County Use Only/:,
117 E 5th Street, PO Box 58 Bayfield County Planning and Zoning Department Submission #: w..0e SS
Washburn, WI 54891 LAND USE PERMIT APPLICATION Permit #: -8
permits bayfieldcounty.wi.zov Date: % &
;SECTION A: General Information
Property Owner Name:
L
Authorized Agent Name (if applicable):
BERGREN, CHRISTOPHER L & LEVOIR, REBECCA
Telephone Number:
Telephone Number: RLCCIVED
651-278-6652
E -Mail Address:
E -Mail Address: MAY 1 3 2026
ch risberg ren@gmall.com
Mailing Address:
Mailing Address: Bayfield Co.
1421 CARRIAGE RD
Planning and Zoning Agency
City, State, Zip:
City, State, Zip:
WOODBURY MN 55125
Contractor: Telephone Number: E -Mail Address: J3 j.
self
Htion
Project Address (if different from mailing address):
36499 COUNTY HWY J BAYFIELD 54814
Legal Description (if additional space is needed attach a separate sheet):
PAR IN SE NW & SW NEW OF CO HWY J IN 2022R-595061
Section, Township, Range: S01 T50N R04W Town of: BAYFIELD
Tax II, ;.-: 4313 Lot Size (Acres/Square Feet): 16.830
C: eruiect Information (check all that al
Project Use is: ❑ Residential ❑ Commercial ❑ Municipal If Commercial, estimated cost of construction: $
Project Type is: El New Construction ❑ Addition/Alteration (existing structure)
❑ Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21+ days
❑ Sign 0 Establishing a Business ❑ Temporary (12 or less months)
❑ Shereland Grading, Class A ❑ RV Placement 4+ months, Class A ❑ Other (describe):
re aired Total sq ft): required
on (Does not apply to RVs and Sins, g o Ste
S. rure Type is., ❑ Residence ❑ Principal Structure (describe):
❑ ssory Structure (describe): ❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured
date):
C Shg Container ❑ Other (describe):
Foundation Type:
H Basement ❑ Walkout Basement ❑ Slab ❑ Crawlspace ❑ Ground ❑ Skids ❑ Other (explain):
Existing Structure: Length: Width: Height:
Pror350(/ Stn,cture (Provide Sq Fl based on outside dimensions, including unfinished areas, attachedgarages/above grade
decks/porches):
Basement Sq Ft:
I" Floor Sq Ft:
Loft Sq Ft:
2n1 Floor Sq Ft:
311 Floor Sq Ft:
1860
1860
Garage Sq Ft:
Porch Sq Ft:
Deck Sq Ft:
Other Sq Ft (describe):
Other Sq Ft (describe):
840
Total Sq Pi: ho
I Overall Height (finished grade to peak): 29
# of Stories: I Existing = of Bedrooms on property: Proposed ;1 of Bedrooms in project: 3
sE: RN and Sign Information (.check all that apply)
Sign is:
2I is:
❑ New ❑ Replacement
C New ❑ Replacement
❑ On -premise ❑ Off -premise
❑ I -sided ❑ 2 -sided
Year: Vin #:
C On- building ❑ Multi -Tenant
Length: Width: Height:
Make: Model:
Application Page I
SEJ '.. F: Site Plan — attach a site plan or draw site plan in box below (See pages t& 2 of Land Use Permit Application
Jnformatiun for inlarmation 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%
4
RECEIVED
MAY 13 2026
Bayfieid Co.
Planning and Zoning Agency
Setback or distance from furthest extent of structure
including eaves and overhangs to (include on site plan):
County Use Only
Verified setbacks
Road Centerline
600 ft.
ft.
Notes/Comments:
$f x �b 7
v`l ryt
S(/], S -I 6 4
a
4 cf f (/() '-e a
Front Lot Line/Right-of-Way
570 ft.
ft.
Side Lot Line l
(North East South West, circle one)
242 ft.
ft.
Side Lot Line 2
(North East South West, circle one)
1 80 ft.
L
l v tr
Rear Lot Line
600 ft.
ft.
Septic/Holding Tank
60 ft.
ft.
Drainfield
go ft.
Privy
— ft.
ft.
Well
25 ft.
— ft.
Existing Structure/Building
180 ft.
ft.
Wetland
----- ft.
ft.
Elevation of Floodplain
ft.
ft.
Ordinary High -Water Mark (OHWM)
— ft.
ft.
Other (describe)
— ft.
ft.
Application Page 2
G: Additional Questions
a Yes
U No
Has the location of the proposed project including eaves and overhangs and the sanitary system and well been
staked? If no, what date will this be completed:
O Yes
O No
Did a licensed surveyor mark lot line(s) if project is within I0 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 setba CC!
Land Use A lication Information for re uired setbacks.
❑ Yes -L No
Is there an existing sanitary system on the property? If yes, what kind? MAY 13 2026
❑ Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe):
G Yes a No
Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be 's&or used
to manage wastewater? Planning and Zoning Agency
❑ Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe):
O Yes ❑ 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:
O Rezone ❑ Class A Special Use O Class B Special Use O Conditional Use O Variance
Fee payment will be made via:
O Check (attached) ❑ Cash (attached) O debit/credit/echeck (department to call once payment is ready to be taken)
How would you like to receive your permit card?
O Mail to: ORE Email to:
E Property Owner Address ❑ Agent Address O Contractor Address ❑ Other (provide name and email or address):
Ali 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
dive ;nns 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
approva:s 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/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: P J C✓ L nel12h
Owner(s) or Authorized Agent Signature: Date:
NOTES:
1. If you are signing on behalf of the owner(s) a letter o 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
RECEIVED
MAY 15 2026
Sayli&d Co.
Planning and Zoning Agency
1265.74
o p5T
s 4e� h
0
RT •
O Q \\\\
I
L bYV \1
M OVP
u ' 1463.64 Ce
.
�a.t 'fin` ,' ♦H. #yt
OWNER: BEROREN,CHWBTOPHERL
'� j '4-:' f`�n 6tEVOW. REBECCAL
OWNER ADDRESS 1421 CARRIAGE RO
WOOCBURY'1455115
SOEA➢0RESS 35469 COUNTY RWYJ
BAYNEL➢ 54614
T. ID:
4313
PIN:
0 .OO 25DD401-204-W80000
MUNICIPALITY:
TOWN OF 6AYFIELD
SIB:
501 15514104W
Oeeniplion:
PAR IN SE 1N1& SW NE W OF CO
HWY J IN 20228.595091
RECQ 49Eirsee:
16330
ZONnp:
HO1)AOOcu0Ma1-1
ATTENTION
e1 `" " Important:
---- w..».e�.nxy. w.P..w.n mm.M..wil. im.e:angaY
:.... ..:«
11r,r—i IL
I I l I I I � I I I I S II Ilib ex. INOTES: ei Imo..,. �"',,,Q^^I 1 1 mx
__ °". ^ u""'m SLAB L ' _ J L J L _ _ J I c'
C7 I 1 ark I I a:`
A I l e I I L�'"L`_•I
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I I I,.,�
e.wrpIO,eoso.s-0x5-O a..e':" s.»II
-.I— °k#.'m f. f{$S
w - t I `
' -- RECEIV I �A dd yy
�....vu. — I �g 'I I l55'
!! MAY '13 202G ' t II
II i � $
IL
I II
Bayfteld Co.Planning and Zoning Agency --- ----------J L--
Eg
pI� I "^`"` I I upx I I I_c Iii
,,,,� I L______J __ _J L_ J
�...
m a ..
ET
... ,Y`�� N BASEMENT/SLAB FOUNDATION PLAN
SILL DETAIL SILL DETAIL .ASBB1!NT DETAIL w U
51•x~ ET 0• frnO "'^` . SILL DETAIL s PATIO PATO DETAIL . BRO ILKEIW SLAB DETAIL .II fgLLMN DETAIL
e'.co."`..t .. ce.' w.....s»...t.--
4-4.44 LO4n-4o
4444....4.....:.4.:v«—:4444 w..w we.4..v.e..-..
NOTES:
In
101011S S4OS1W 043. P4tI. 40440? *d *74W 440a00.004
10 e #o 0140 140 ML ¶4-4040
MO 'dO• "4 -OW 10704014404 140-4.744.404.7.14-4.74.04. OaS 'On C
flea
Important:
D*44,.1a [44 .*0,w. 740;..m,mIJ4:.
01:44:1,4 yu:1,4 *07X674„
toot 0
Ezdryb. '050 • S'b'
RECEIVED
MAY 13 2026
Bayfield Co.
planning and Zoning Agenc.Y
MAIN LEVEL FLOOR PLAN
ATTENTION
_-m-� a •" �°",,.:: ��m..M.. �,.,..�,.r..�.�
�[6v ev �sryum ews�w� �rar� +Ivr re.Kw P s Pow
rmirmi eo.Pae R w na. ecao.
Important:
RECaWED
MAY 13 2026
Bayfield Co.
Punning and Zoning Agency
FRONT ELEVATION
REAR ELEVATION
LI;
a)
U
C
a)
a
N
a)
C
rn
m
m
ATTENTION
Important:
J:J:uNiym':,.AIIF.
i:f',4uLL5i'4
A.:Pvnve ra,rynJi:nlmmJ.rte:nntii::n
kr... m-wJ-ca.s4
d,m m., mun
§
RECEIVED
MAY 13 2026
LEFT ELEVATION
Wield Co.
planning and Zoning Agency
11
RIGHT ELEVATION
a)
U
C
a)
N
a)
C
U)
N
m
5/14/26, 10:03 AM
Novus-Wisconsin Access rev. 12.0206
Real Estate Bayfield County Property Listing
Today's Date: 5/14/2026
Description Updated: 6/27/2022
Tax ID:
4313
PIN:
04-006-2-50-04-01-2 04-000-30000
Legacy PIN:
006100406990
Map ID:
Municipality:
(006) TOWN OF BAYFIELD
SIR:
Sal T50N R04W
Description:
PAR IN SE NW & SW NEW OF CO HWY 3
Recorded Acres:
Calculated Acres
Lottery Claims:
First Dollar:
Zoning:
ESN:
IN 2022R-595061
16.830
17.162
0
No
(AG -1) Agricultural -1
105
'S Tax Districts Updated: 11/19/2009
1 STATE
04 COUNTY
006 TOWN OF BAYFIELD
040315 SCHL-BAYFIELD
001700 TECHNICAL COLLEGE
047060 PIKES BAY SANITARY
s Recorded Documents Updated: 3/15/2006
91 WARRANTY DEED
Date Recorded: 6/15/2022 2022R-595061
O CONVERSION
Date Recorded: 687-199
Property Status: Current
Created On: 3/15/2006 1:14:53 PM
81 Ownership Updated: 6/27/2022
CHRISTOPHER L BERGREN WOODBURY MN
REBECCA LLEVOIR WOODBURY MN
Billing Address:
Mailing Address:
BERGREN, CHRISTOPHER
L & BERGREN, CHRISTOPHER L &
LEVOIR, REBECCA L
LEVOIR, REBECCA L
1421 CARRIAGE RD
1421 CARRIAGE RD
WOODBURY MN 55125
WOODBURY MN 55125
11 Site Address * indicates Private Road
36499 COUNTY HWY 3 BAYFIELD 54814
® Property Assessment
Updated: 7/9/2019
2026 Assessment Detail
Code
Acres
Land
Imp.
Gl-RESIDENTIAL
2.000
75,000
0
G6 -PRODUCTIVE FOREST
14.830
19,300
0
2 -Year Comparison
2025
2026
Change
Land:
94,300
94,300
0.0%
Improved:
0
0
0.0%
Total:
94,300
94,300
0.0%
it Property History
N/A
https://novus.bayfieldcounty.wi.gov/access/master.asp?paprpid=4313 ill
Bayfield County, WI
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Approximate Parcel Boundary Town
Road Type
County Building Footprint 2015
Building
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BaygaW County Land Records Depadment
Bayntld County Za dng Apprratbn
ndps:r/mops.eaylemcounty wl.g0r/ZonInpwAB/
RECEIVED
LriIu; ill \nlDulfnlin
MAY 18 2026
Itn\Iit•liI ('uuulI'Iuuuhig\w Y,nnillg IlrpIIIunrnl
Bayfield Co.
planninn and Zoning Agency
1'I'I(I'()SI., I Iiu 1 cllrI ul Aulhi,Iliuuun in u,'I Ill nulhulin• n vn4lr pruprlly uwnta' Ii) ail uu
hChaII ul nuIIlylll' lnuprI IV l Vnrl�1 tit a dt•.4iµnlnrd uhcnl III uro on ht'IIIIII uI flit prnprlly nwntrR.
If IlllilllpltIllnl,i 11V a\\ llt'l', i at Il prtlpt'i I1' uwlltl iiiii.51 luhtnll Iiii. fIi ',iit tI it 11ei.
(bcLc.L 1 CUJ t ' (pnupclly owned, nullnn lir CJlrt;kiIItt.,r 1 JIvf. (c'..Y\
(ull l I,ul Ilia : II�CI II) It% Nlhl l l ll .1 c;, IL%t. (.. " ( (Ikanlplc. I.Ind uHc, 4pc.Ci;ll
Ii,t c unduual;ll ii e. Irr,.loc iiiap wurnllnlcnl, nppenl, VIIllillit't', lid ;1111ll!IIIICIII, dc.) Iul` (he
IIIIIII\\III) tIc�rllhctI pILIIokI (I \;IIIIItII. ulltitltIetioll ttl Iv.,Ith'It, I',n dllt'I tillllk,I(IIC, Shot'I-len I
Irnt:Il 'II ulhcr oar rhnnl,c, iii /1/N,: k,Jf C (rIlpphculiun ('Ii lily Irehull' 1111
tic (olIo\\iii g tic+nihcd plupcuy
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;Atldrru l,l ubjrcl properly: 3 LlCl9._. i l� _. _.-1��� j4"�� S RftI
Signnainre
o used
Land Use Permit Application Review Checklist
Submission #: O
What zoning district is the project located in?
❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M wa-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M
❑ Yes 90
Is lot substandard (does not meet current zoning dimensional requirements)?
Deed of record:
❑ Yes o
Is the project located in the Shorelands (Shorelands are lands within 300 feet of a river/stream OR
andward side of floodplain OR 1000 feet of a lake/pond/flowage, whichever is greater)?
❑ Yes Q4o
Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of
navigable waterway)
❑ Yes O'No
Is the project located in the Floodplain? Zone:
❑ Yes LMo
Are there wetlands on the property?
❑ Yes Q-f'.lg.
Is project associated with a nonconforming use or structure?
❑ Yes 94o
Is project associated with a variance? Case #:
❑ Yes IW1Jg.
Is project associated with a Special B or Conditional Use Permit? Permit #:
❑ Yes D4Io
Is the project associated with a Special A Use Permit?
Yes ❑ No
Does the pro�je require sanitary?
0 Existing B New 0 Intercept ❑ Reconnect 0 Non -Plumbing ❑ Public
SanitaryPermit #: # of Bedrooms:
❑ Yes Ilo
/
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
❑ 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 ❑ No
Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback?
Project use is? 91rResjdential 0 Commercial ❑ Municipal
Project type is?Mew Construction ❑ Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign
❑ Establishing a Busin,ess ❑ Temporary 0 Shoreland Grading 0 Other, describe:
Structure Type is: VResidence 0 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 ❑ Other, describe
Total Sq. Ft. of Project: Number of Stories:
Overall Height:
Fee Type
Calcu ation
Fee Amount
❑ Habitable Residential Principal and Accessory
Structures - Enclosed Areas — all enclosed areas within
dwelling except attached non -habitable garages
$0.50 x 3i ao sq ft
(minimum $125)
$ 46o
❑ Dwelling Unenclosed Areas (decks, patios, etc.) or
Attached Non -Habitable Garages
m (
$0.20 x i'— sq ft
(minimum $125)
$
❑ Non -Habitable Residential Principal and Accessory
Structures
$0.20 x sq ft
(minim $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 0 Special Use Permit - Class A 0 Floodplain ❑ Shoreland - Impervious
Surface 0 Shoreland - Non -Conforming, etc. 0 Tower Siting/Collocation 1 0 Tower Collocation 2 ❑ Metallic Mine
❑ After -the -Fact (ATF)
$
Inspected by:
Date oil ectiew
C ✓L .
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
i
Date Denial Letter Mailed:
Approved by:
Date of Appr al:
):
lMuICondition
st meet and in setbacks from urt est extension of structure including eaves and
overhangs.
❑ For ersonal storage only.
or personal residence only.
❑ No or human habitation or sleeping purposes.
�o /State/DNR/Federal may require permitting
Ls(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.
❑ Si must meet the requirements of Article E of the Bayfield County Zoning Ordinance.
L9'io 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 YFIELD 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:
Submission Number:
BERGREN, CHRISTOPHER L
LU-02255
1421 CARRIAGE RD
WOODBURY, MN 55125
Transaction Number.
LEVOIR, REBECCA L
LU-02255-4591C
1421 CARRIAGE RD
WOODBURY, MN 55125
Description Amount
Habitable Residential Principal & Accessory $1,860.00
Structures - enclosed areas $0.50/square foot
(minimum $125)
Habitable Residential Principal Structure - $168.00
unenclosed area or non -habitable garage
$0.20/ square foot (minimum $125)
Total: $2,028.00
Payment Amount: $2,029.25
Reference: 7485540595
Paid by: Christopher Bergren
Payment Type: Other
Transaction Date: 8/13/2026
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 I Affidavit #:
LAND USE -X
SANITARY — New 26-108S
SPECIAL A -
SPECIAL B/CONDITIONAL -
BOA -
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 26-0423 Tax ID: 4313
Issued To: BERGREN, CHRISTOPHER L & LEVOIR, REBECCA L
Location: S01 - T50N - R04W
Town of Bayfield
Legal Description: PAR IN SE NW & SW NE W OF CO HWY J IN 2022R-595061
Residential Structure in A-1 zoning district
For: New Construction [1 - Story ], Residence on a Basement [4560 Total sq. ft. ] Height of 29'
(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. August 14, 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.
For personal residence only.
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.