HomeMy WebLinkAbout26-0350RReturn to: County Use Only:
117 E 5's Street, Po Box 58 Bayfield County Planning and Zoning Department Submission #• LU -o?(d2,
Washburn, WI 54891 LAND USE PERMIT APPLICATION Permit#: -0 o
permits0bayfieldcounty.wi.gov Date: ( d'
SLL r WIN A: tieneral Imormation
Property Owner Name: t. Authorized Agent Name (if applicable):
Telephone Number: Telephone Number.
r/ -x.09.5849
E -Mail Address: E -Mail Address: 1i L
P eFForda6B grna;;.Lo/i 1 ifs
Mailing Address: Mailing Address: Bayfield Co.
Q Planning and Zoning Agency
City, State, Zip: c n n City, State, Zip:
Q(hl ( I0. 1 J4 /
Contractor. I Telephone Number: I E -Mail Address:
r LUJV L i%UtU J ill U11 IC! CLLL 11Ulll 111W11i L{1W Calf:
3L5 unft 4t htl/? "nrnU(9i)<.V/l 4tf 7
Legal Description (if additional space is needed attach a separate sheet):
lea W 330
Section, Township, Range: 5a` (e tc O H 'F (j(cVTown of. $ Tax
ID #: rte'; Lot Size (Acres/Square Feet): SECTION
C: Project Information (check all that apply) Project
Use is: @ Residential 0 Commercial 0 Municipal If Commercial, estimated cost of construction: $ Project
Type is: 0 New Construction 0 Addition/Alteration (existing structure) 0
Change Use (existing structure) 0 Relocate (existing structure) 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 0 Other (describe): Structure
Type is: 19 Residence 0 Principal Structure (describe): 0
Accessory Structure (describe): Shoreland Exempt Structure (describe): Mobile Home (provide manufactured date):
0
Shipping Container 0 Other (describe): Basement
l Walkout Basement 0 Slab 0 Crawlspace 0 Ground 0 Skids 0 Other (explain): Existing
Structure: Poo Pgri Length: SO' -0" Width:4C'-Q" Height: o 7'-(" H Proposed
Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade decks/
porches): BasementSq
Ft: 1° Floor Sq Ft: Loft Sq Ft 2n' Floor Sq Ft: 314 Floor Sq Ft: Garag
eSq Ft: Porch Sq Ft: Deck Sq Ft: Other Sq Ft (describe): Other Sq Ft (describe): Total
Sq Fe j a% C 3 5(p) Overall Height (finished grade to peak): T7 'p of
Stories: Existing # of Bedrooms on property: iN .'I Proposed # of Bedrooms in project: SECUON
E: RV andSi Iaformatlon (check all that Sign
is: RV is: New
0 Replacement 0 New 0 Replacement On -
premise Off -premise 1 -
sided 2 -sided Year: Vin #: On -
building 0 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 I & 2 of Land Use Permit Application
Information for information that is required to be provided on. site plan)
Show location of:
Driveways O Frontage Roads (include name) O Existing Structures O Well (W) O Septic Tank (Si') O Drain Field (OF)
Holding Tank ) O Privy O Lake O River Streant/Creek []Pond Flood lain Wetlands OSlopes over 20%
N
RECEIVED
JUL 032026
Bayfield 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 4(prr ft. R Notes/Comments:
r 1/ K ) Mt(`
w a ell ( x
lac
t(
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Front Lot Line/Right-of-Way U3 ft.
Sid t Line 1
o East South West, circle one) ti
fl.
Si a Lot Line
North East ou West, circle one) S ci
ft. nse
RearLotLinr flf13ft. Septic/
Holding Tank ft. ft. Drainfield
ft. Privy
ft. ft. Well
13 ft. ft. Existing
SttuctureBuilding ft. Wetland
ft. Elevation
of Floodplain ft. ft. Ordinary
High -Water Mark (OHWM) ft. Other (
describe) ft. ft. Application
Page 2
COMPANY
CUSTOMER Q-FFr,d;
SUBJECT
OTHER x38(05 (an
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DATE
DWG. NO.
DRAWN BY
L07 LJOI
SHEET NO. OP
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JUL 520261
Plann ng ?yfOl5 o. Zoning A...._
SECTION G: Additional Questions
Yes No Has the location of the proposed project* been staked? If no, what date will this be completed: T'
Note: The site will not be inspected nor permit issued until after the staking date listed above.
Yes O No Did a licensed surveyor mark lot line(s) if project i wAthin 10 feet of required setback? See page 2 of Land Use
Application Information for required setbacks. IV ff
Yes O No Did property owner or applicant mark lot line(s) if project is wixhin 30 feet of required setback? See page 2 of
Land Use A lication Information for reuired setbacks. 1*' Yes
No Is there an existing sanitary system on the property? If yes, what kind? f Drainfield
O Holding Tank Municipal/Public Other (describe): ouwcl t$
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? Draintield
Holding Tank Municipal/Public Other (describe): M(`J n C 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: Rezone
Class A Special Use O Class B Special Use O Conditional Use O Variance Fee
payment will be made via: RECEIVED Check (
attached) O Cash attached debittcredit/echeck (department to call once payment is ready to be taken) How
would you like toreceive your permit card? JUL 0520 J 2026Mailto: OR 0 Email to: O Property
Owner Address O Agent Address O Contractor Address O Other (provide name and j ( t4dress): Include eaves,
overhangs, sanitary system, and well in slaking nsasucmc^B Planning and en cy Section H:
Acknowledgement and Signature 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.ss i.eov_p piehvellands, 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 rea3gnalc time for the of inspection. purpose Owner(s)
or Authorized Agent Printed Name: " '' / a'-' iOwner(s)
orAuthorizedAgentSignature: \ , n2, i ! '-.l\U> Date: ,.,,. '^ a C") 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 projecL Application Page
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COMPANY DATE SHEET NO. 3 OF
CUSTOMER 3 Fpr ° DWG. NO. REV.
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JUL 052026
Bayfieid Co.
Planning and Zoning Agency
TOP OP Rooms
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COMPANY DATE SHEET NO. 4 OP
CUSTOMER DWG. NO. REV.
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7/10/26, 8:57 AM Novus-Wisconsin Access rev. 12.0206
Real Estate Bayfleld County Property Listing
Today's Date: 7/10/2026
Description Updated: 1/3/2023 m Ownership
Tax ID: 7564
PIN: 04-010-2-50-06-26-2 01-000-10000
Legacy PIN: 010104204000
Map ID:
Municipality: 010) TOWN OF BELL
STR: 526 T50N R06W
Description: N 1/2 NW 330 IN DOC 2021R-588535
Recorded Acres: 80.000
Calculated Acres: 78.804
Lottery Claims: 0
First Dollar: Yes
Zoning: F-1) Forestry -1
ESN: 107
S Tax Districts Updated: 3/15/2006
1 STATE
04 COUNTY
010 TOWN OF BELL
044522 SCHL-SOUTHSHORE
001700 TECHNICAL COLLEGE
Recorded Documents
MFL WITHDRAWAL ORDER
Date Recorded: 6/7/2021
0 SPECIAL WARRANTY DEED
Date Recorded: 5/5/2021
MFL TRANSFER ORDER
Date Recorded: 3/10/2016
WARRANTY DEED
Date Recorded: 10/26/2015
Updated: 10/28/2015
Property Status: Current
Created On: 3/15/2006 1:15:02 PM
Updated: 1/3/2023
DONALD J AND PATRICIA L JEFFORDS CORNUCOPIA WI
Billing Address: Mailing Address:
DONALD) AND PATRICIA L DONALD) AND PATRICIA L
JEFFORDS JEFFORDS
PO BOX 337 PO BOX 337
CORNUCOPIA WI 54827 CORNUCOPIA WI 54827
P'" Site Address * indicates Private Road
83865 COUNTY HWY C BAYFIELD 54814
Property Assessment Updated: 8/19/2024
2026 Assessment Detail
Code Acres Land Imp.
Gi-RESIDENTIAL 2.000 12,000 26,200
G6 -PRODUCTIVE FOREST 78.000 109,200 0
2 -Year Comparison 2025 2026 Change
Land: 121,200 121,200 0.0%
Improved: 26,200 26,200 0.0%
Total: 147,400 147,400 0.0%
2021R-589134 LLB'
N/A
2021 R-588535
2016R-562570 1157-262
2015R-560950 1151-12
History
https://novus.bayfiieldcounty.wi.gov/access/master.asp?paprpid=7564 1/1
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Emily Macgillivray
From: Emily Macgillivray
Sent: Monday, July 13, 2026 11:07 AM
To: 'pjeffor222@gmail.com'
Subject: Land Use Permit application for Cty Hwy C 83865 (Tax ID 7564)
Hi Donald and Patricia,
I'm reaching out to you aboutyour Land Use Permit application.
I made a site visit last Friday and everything Looks good in terms of setbacks.
Since the existing pole barn is already connected to your sanitary system, you will need to submit a
County Sanitary application for a "county private interceptor" to connect the new residence to the
system. The fee is $50.
Please note, this application will need to be signed by the plumber.
The County Sanitary Permit application will need to be approved and issued, before I can approve your
Land Use Permit application.
Let me know if you have any questions!
Kind regards,
Emily Macgillivray (she/her)
Assistant Zoning Administrator
Planning and Zoning Department
Bayfield County
117 E 5r' Street, PO Box 58
Washburn, WI 54891
Phone: 715-373-3511
emily.mac i1glivray(abayfieldcounty.wi.gov
Fraudulent Billing Alert: Be aware that individuals submitting applications to our department have
received scam emails. Bayfield County will NOT ask applicants to wire any funds. Please contact our
office at zQnjng@bayfie1dcouatywi:goy or 715 373-6138 with any questions or concerns.
7/17/26, 3:12 PM Re: Land Use Permit application for Cty Hwy C 83865 (Tax ID 7564) - Emily Macgillivray - Outlook
Outlook
Re: Land Use Permit application for Cty Hwy C 83865 (Tax ID 7564)
From Patti J <pjeffor222@gmail.com>
Date Fri 7/17/2026 10:57 AM
To Emily Macgillivray <emily.macgillivray@bayfieldcounty.wi.gov>
Hi Emily,
It will be an unfinished basement that will house the furnace, water heater and electrical panel.
On Fri, Jul 17, 2026, 9:57AM Emily Macgillivray<emily.macgillivravibayfieldcounty.wi. ov> wrote:
Hi Patti,
Thanks for submitting the County Sanitary application.
One more question, what is the room on the bottom level being used for? It's use/description is not labeled on the floor
plans.
Thanks!
Kind regards,
Emily Macgillivray (she/her)
Assistant Zoning Administrator
Planning and Zoning Department
Bayfield County
117E 5th Street, PO Box 58
Washburn, WI 54891
Phone: 715-373-3511
c av i l y. macgi l li vray_@bayfieldcounty.wi. goy
Fraudulent Billing Alert: Be aware that individuals submitting applications to our department have received
scam emails. Bayfield County will NOT ask applicants to wire any funds. Please contact our office at
zoning@bayfieldcounty.wi.gov or 715 373-6138 with any questions or concerns.
From: Patti J <pjeffor222@.gmail.com>
Sent: Thursday, July 16, 2026 1:33 PM
To: Emily Macgillivray<emily.macgillivrayjbayfieldcounty.wi.gov>
Subject: Re: Land Use Permit application for Cty Hwy C 83865 (Tax ID 7564)
Hi Emily,
Thank you so much for your help. I have attached the application (3 pages). Please let me know if there is anything else
you need.
Patti
On Tue, Jul 14, 2026 at 10:51 AM Emily Macgillivray <emily.macailliyravCn? ieldcountv.wi.aov> wrote:
about:blank?windowld=SecondaryReadingPane46 1/4
7/17/26, 3:12 PM Re: Land Use Permit application for Cty Hwy C 83865 (Tax ID 7564) - Emily Macgillivray - Outlook
Here's the county private interceptor option on the application:
Li 1 or 2 Family Dwelling - No. of Bedrooms
W. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) New Replacement County Private Interceptor
Reconnection Repair Revision •• Transfer of Owner (List Previous Owner below)
B) A Sanitary Permit was previously issued. Previous Permit Number. Date Issued: __.
IV. TYPE OF NON -PLUMBING SYSTEM: (Check One) • Replacements need previous permit number and date filled out above
C) Pit Privy Vault Privy (Vault size: gallons or _cubic yards)
I've attached the original sanitary permit for the system. I recommending asking your new plumber to fill out Section
V and do the site diagram. It can be on a separate sheet (just write "see attached" in the area for the drawing on the
application).
I will need a completed County Sanitary application signed by your new plumber to be able to move forward with the
Land Use Permit application.
Let me know if you have any additional questions.
Kind regards,
Emily Macgillivray (she/her)
Assistant Zoning Administrator
Planning and Zoning Department
Bayfield County
117 E 5th Street, PO Box 58
Washburn, WI 54891
Phone: 715-373-3511
emi Iy.macgil livray®hay fieldco unty.wi.goy
Fraudulent Billing Alert: Be aware that individuals submitting applications to our department have received scam
emails. Bayfield County will NOT ask applicants to wire any funds. Please contact our office at
zoning@bavfieldcounty.wi.gov or715 373-6138 with any questions or concerns.
about:blank?windowld=SecondaryReadingPane46 2/4
7/17/26, 3:12 PM Re: Land Use Permit application for Cty Hwy C 83865 (Tax ID 7564) - Emily Macgillivray - Outlook
From: Patti J <pjeffor222@.gmail.com>
Sent: Tuesday, July 14, 2026 10:31 AM
To: Emily Macgillivray<emily.macgillivray@bayfieldcounty.wi.gov>
Subject: Re: Land Use Permit application for Cty Hwy C 83865 (Tax ID 7564)
Hi Emily,
I looked at the application and we do not have the information requested for section V. The contractor who installed
the system may have it. We will be using a different plumber for the house.
When the permit was applied for, it was for a three bedroom home. I am attaching a copy of the permit and a picture
showing that the connection was started at the time.
The application does not have an option for a "county private interceptor". Would I have to draw everything in on
page two since the system is already in place and has been previously approved?
Please advise if what I send is sufficient or what else we need to do.
On Mon, Jul 13, 2026 at 11:06 AM Emily Macgillivray <emily macgillivrav dba ieldcountv.wi.gov> wrote:
Hi Donald and Patricia,
I'm reaching out to you about your Land Use Permit application.
I made a site visit last Friday and everything looks good in terms of setbacks.
Since the existing pole barn is already connected to your sanitary system, you will need to submit a County Sanitary
ap lick for a "county private interceptor" to connect the new residence to the system. The fee is $50.
Please note, this application will need to be signed by the plumber.
The County Sanitary Permit application will need to be approved and issued, before I can approve your Land Use
Permit application.
Let me know if you have any questions!
Kind regards,
about:blank?windowld=SecondaryReadingPane46 3/4
7/17/26, 3:12 PM Re: Land Use Permit application for Cty Hwy C 83865 (Tax ID 7564) - Emily Macgillivray - Outlook
Emily Macgillivray (she/her)
Assistant Zoning Administrator
Planning and Zoning Department
Bayfield County
117 E 5th Street, PO Box 58
Washburn, WI 54891
Phone: 715-373-3511
emily.mac_*i IIn ray_(d bay ieldcounty.wi.gov
Fraudulent Billing Alert: Be aware that individuals submitting applications to our department have received scam
emails. Bayfield County will NOT ask applicants to wire any funds. Please contact our office at
zn1ngbQyfieldcoujyaLgy or 715 373-6138 with any questions or concerns.
about:blank?windowld=SecondaryReadingPane46 4/4
Land Use Permit Application Review Checklist
Submission #: d
What zoning district is the project located in?
R-1 R- R-3 R-4 R-RB C 1 M A-1 A-2 F-2 W M -M
Yes jo Is lot substandard (does not meet current zoning dimensional requirements)?
Deed of record:
Yes Q4o 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)?
Yeso Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of
navigable waterway)
O Yes Is the project located in the Floodplain? Zone:
Yes No Are there wetlands on the property?
Yes l4o Is project associated with a nonconforming use or structure?
Is project associated with a variance? Case #: Yes
Yes l3Io Is project associated with a Special B or Conditional Use Permit? Permit #:
es No Is the project associated with a Special A Use Permit?
Yes No Does the project require nitary? -2/ U
0 Existing New Intercept Reconnect O Non -Plumbing O Public
SanitaryPermit #: of b- 0 sq7 # of Bedrooms: Yes
No Does the project require mitigation? Implementation
Deadline: Date of Compliance: Yes
IiNo 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 licant/property owner mark lot line(s), if project is within 30 feet of required setback? Project
use is? Residential Commercial Municipal Project
type is? iciw Construction Addition/Alteration Change Use O Relocate RV Placement Sign Establishing
a Busine s Temporary Shoreland Grading O Other, describe: Structure
Type is: esidence 0 Principal Structure Accessory Structure O Boathouse (one story only) Open-
sided/Screened Structure (gaz bo, etc.) O Stairway to navigable waters Mobile Home Shipping
Container O Other, describe Total
Sq. Ft. of Project: Number of Stories: Overall Height: 427 Fee
Type Calculation Fee Amount Habitable
Residential Principal and Accessory minimum $125) Structures -
Enclosed Areas —all enclosed areas within 0.50 x 'sq ft dwelling
except attached non -habitable garages Dwelling
Unenclosed Areas (decks, patios, etc.) or 0.20 x sq ft minimum $
125) Attached
Non -Habitable Garages Non -
Habitable Residential Principal and Accessory 0.20 x s ft qminimum $
75) Structures
Commercial
Principal Structures 250 + $0.005 x minimum $250) cost
of construction Commercial
Accessory Structures 150 + $0.005 x minimum $150) cost
of construction Municipal
Principal and Accessory Structures n/a 0 (exempt from fees) Return
Inspection O Land Use Revisions Special Use Permit - Class A O Floodplain Shoreland - Impervious Surface
O Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 Tower Collocation 2 Metallic Mine O
After -the -Fact (ATF)
Inspected by: Date of Inspe tion:
Wflhfqd
Re -Inspected by: J V Date of Re -Inspection:
Denied by: Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved D to of Ap r v I:
Cond' on(s): 3
Must meet and maintain set s from furthest extension of structure including eaves and
overhangs.
F f personal storage only.
For personal residence only.
l J.otor human habitation or sleeping purposes.
SST n State DNR Federal may require permittingqpg
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.
Si must meet the requirements of Article E of the Bayfield County Zoning Ordinance.
o 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 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner: Submission Number:
JEFFORDS, DONALD J AND PATRICIA L LU-02402
PO BOX 337
CORNUCOPIA, WI 54827 Transaction Number.
LU-02402-497D8
Description Amount
Habitable Residential Principal & Accessory 1,728.00
Structures - enclosed areas $0.50/ square foot
minimum $125)
Total: 1,728.00
Payment Amount: 1,729.25
Reference: 2741286505
Paid by: Patricia Jeffords
Payment Type: Other
Transaction Date: 7/17/2026
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 — No / Impervious Surface — No
Floodplain — No / Wetlands — No
Mitigation — No / Affidavit #:
LAND USE -X
SANITARY — Intercept 26-0349
SPECIAL A -
SPECIAL B/CONDITIONAL -
BOA -
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 26-0350 Tax ID: 7564
Issued To: JEFFORDS, DONALD J AND PATRICIA L
Location: S26 - T50N - R06W
Town of Bell
Legal Description: N 1/2 NW 330 IN DOC 2021R-588535
Residential Structure in F-1 zoning district
For: New Construction [1 - Story ], Residence on a Walkout Basement [3456 Total sq. ft. ] Height of 27'
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. July 21, 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.