Loading...
HomeMy WebLinkAbout26-0466Re?urn to: 117 E 5`" Street, PO Box 58 County Use Only: Bayfield County Planning and Zoning Department Submission #: LV o).So`b LAND USE PERMIT APPLICATION Permit #: )- Date: Authorized Agent Name (if E -Mail Address: gerci City a Zip: ' - �� City, State, Zip: Etd EKED Contractor>1 Telephone Number: E -Mail Address: Morton Buildi((gs 218-398-1322 brooke.lee@mortonbuildings.com — Project Leeal"Description (if additional Apace is needed anarh senarate sheetl- SP Section, Township, Range: 510 T43N R06W Town of: Namakagon Tax ID #: t.j51 f S Lot Size (Acres/Square Feet): 3.2 SECTION C: Project Information (check all that apply) Project Use is: El Residential ❑ Commercial O Municipal Project Type is: El New Construction 0 Addition/Alteration (existing structure) ❑ Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21± days ❑ Sign ❑ Establishing a Business 0 Temporary (12 or less months) ❑ Shoreland Grading, Class A 0 RV Placement 4+ months, Class A ❑ Other (describe): Structure Type is: 0 Residence ❑ Principal Structure (describe): El Accessory Structure (describe): 0 Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured garage date): 0 Shipping Container 0 Other (describe): Foundation Ttipe: ❑ Basement ❑ Walkout Basement O Slab ❑ Crawlspace 0 Ground ❑ Skids ❑ Other (explain): Proposed Structure (Provide Sq Ft based on outside dimensions. including unfinished areas, attached garages/above grade decks/porches): Basement Sq Ft: I" Floor Sq Ft: Loft Sq Ft: 2Floor Sq Ft: 3r° Floor Sq Ft: Garage Sq Ft: Porch Sq Ft: Deck Sq Ft: Other Sq Ft (describe): Other Sq Ft (describe): 2668 Total Sq Ft: 2688 Overall Height (finished grade to peak): 22' # of Stories: 1 Existing # of Bedrooms on property:O Proposed # of Bedrooms in project: 0 SECTION E: RV and Sign Information (check all that apply) Sign is: R V is: ❑ New ❑ Replacement 0 New ❑ Replacement ❑ On -premise ❑ Off -premise ❑ 1 -sided 0 2 -sided Year: Vin#: ❑ On -building ❑ Multi -Tenant Length: Width: Height: Make: Model: 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 cation of:� riveways �' Frontage Roads (include name) ❑ Existing Structures ❑ Well (W) ❑ Septic Tank (ST) �ITin Field (DF) O Holding Tank (HT) O Privy (P) ❑ Lake ❑ River ❑Stream/Creek ❑Pond ❑Floodplain O Wetlands ❑Slopes over 20% 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. Notes/Comments: AUG 24 2026 Front Lot Line/Right-of-Way /Q t. ft. Side Lot Lie I /O ft. (Nortast❑South❑West❑ check one Sayfield Co. Planning and Zoning Agency Side Lot Line 2 ft. ft. North❑East❑Soul 'est❑, check one),�0 Rear Lot Line /0 ft. Septic/Holding Tank ft- ft. Drainfield •ft. 3 ft. Privy _.----- ft. ft. Well --� ft. ft. Existing Structure/Building �__— ft. ft. Wetland .`ft. 7 Z) ft. Elevation of Floodplain _ft. Ordinary High -Water Mark (OHWM) ft. ft. Other (describe) ft. ft. SECTION G: Additional Questions es O 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: ❑ Yes ❑ No Did a licensed surveyor mark lot line(s) if project is within 1 quired setback? See page 2 of Land Use Application Information for required setbacks. ❑ Yes O No Did property owner or applicant mark lot tine(s) if project is w th3 of required setback? See page 2 of Land Use Application Information for required setbacks. es O No Is the an existing sanitary system on the property? If yes, what kind? /j�e. Z Drainfleld ❑ Holdin Tank ❑Municipal/Public ❑ Other (describe): ❑ Yes No Will pressurized water be installed in the structure? If yes, what kind of sanitary system wAJ f?s4I?j used to manage wastewater? O Drainfield ❑ Holding Tank ❑ Municipal/Public 0 Other describe): sayrzid Co. ❑ Yes No Will sleeping occur in the structure? If yes, contact local Uniform Dwelling Code (U5V6'alan2 ncy 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) O Cash (attached) debit/credit/echeck (department to call once payment is ready to be taken) How would you li a to receive your permit card? (tJp4j44 /.a /vI Cf� tail to: O Email to: ❑ Property Owner Address O Agent AddressContractor Addresser (provide Name and Email or Address): 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 pan 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.uo% topic %wdands, orcontact 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 rea le time for the purpose of inspection. Owner(s) or Authorized Agent Printed Name24r kj' Owner(s) or Authorized Agent Signature: Date: NOTES: I. If you are signing on behalf of the owner(s) a letter of authorization must accompany this application. 2. Specific conditions/instructions maybe 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 proiect. by' Gr FECE 'EO AUG 242925 PianningCaYelnd d Cc. ping Agency o State Bar of Wisconsin Fotm 7-2003 TRUSTEE'S DEED Document Number N Document Name THIS DEED, made between Patrick M. Gaughan as Trustee of The Patrick M, Gaughan Living Trust dated May 1.2014. and " whether one or more), and Erik C. Dahlbere and Jill D. Dahlberg. husband and wife, as survivorsmarital property ("Grantee," whether one or more). Grantor conveys to Grantee, without warranty, the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in BAYFIELD County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): See the annexed Exhibit A. DOCUMENT NUMBER 2O26R-613317 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED 08/13/2026 AT 8:OO AM RECORDING FEE: $30.00 TRANSFER FEE: $8100.00 PAGES: 2 ELECTRONICALLY RECORDED Recording Area Erik C. Dahlberg and Jill D. Dahlberg 1901 West Pioneer Road Mequon WI 53097 21562-26 0 stif=:`s-w "L� b 04-034-2-43-06-10-105-003-10000 04-034.2-43-06.10-2 05-002-01000 04-034-2-43.06-10-1 05-003-08000 AUG 242026 Parcel Identification Number(PIN) The Patrick M. Gaughan Living Trust dated Dated 3y 06740 May 1, 2014, and restated on January 14, 2022 AUTHENTICATION Signature(s) authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) (SEAL) ACKNOWLEDGMENT 1k.e U. *UB% G STATE OF WISCONSIN 'TBAy 7•-t'Q- I G COUNTY Personally came before me on rw 30, WZto the above -named Patrick M. Gaughan. rustee to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Attorney Max T. Lindsey SBN 1112865 ANICH, WICKMAN& LINDSEY, S.C., ASHLAND, WI Publ', tat of Wisconsin My Contmi, ^ion (is ermanent) (expires: /O /Z9 )z.OZ9 (Signatures maybe authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. TRUSTEE'S DEED O 2003 STATE BAR OF WISCONSIN FORM NO. 7-2003 Type name below signatures Bayfield County Register of Deeds Document #2026R-613317 Page 1 of 2 EXHIBIT "A" Lot Two (2), Certified Survey Map No. 001007 as recorded in the Office of the Register of Deeds for Bayfield County, on August 19, 1998 in Volume 6 of Certified Survey Maps on Page 300 as Document No. 443325, being a part of Government Lot Two (2) and Government Lot Three (3), Section Ten (10), Township Forty-three (43) North, Range Six (6) West, located in the Town ofNamakagon, Bayfield County, Wisconsin. TOGETHER with an easement for ingress and egress over the existing driveway as shown on Certified Survey Map No. 001007, and as set forth in that Declaration of Easement dated 124-02 and recorded in the office of the Register of Deeds for Bayfield County, Wisconsin on 12-9-02. AND Lot One (1), Certified Survey Map No. 000295 as recorded in the Office of the Register of Deeds for Bayfield County, on October 9, 1979 in Volume 3 of Certified Survey Maps on Page 98 as Document No. 330684, being a part of Government Lot Two (2), Section Ten (10), Township Forty-three (43) North, Range Six (6) West and being a part of Government Lot Five (5), Section Three (3), Township Forty-three (43) North, Range Six (6) West located in the Town of Namakagon, Bayfield County, Wisconsin. AND Lot Four (4), Certified Survey Map No. 1084 as recorded in the Office of the Register of Deeds for Bayfield County, on April 13, 2000 in Volume 7 of Certified Survey Maps on Page 29 as Document No. 456426, being a part of Government Lot Three (3), Section Ten (10), Township Forty-three (43) North, Range Six (6) West located in the Town of Namakagon, Bayfield County, Wisconsin. RECEIVED AUG 242026 Bayfield Co. Planning and Zoning Agency Bayfield County Register of Deeds Document #20268-613317 Page 2 of 2 Real Estate Bayfield County Property Listing Today's Date: 8/25/2026 Description Updated: 3/18/20.22 Tax ID: 24545 PIN: 04-034-2-43-06-10-2 05-002-01000 Legacy PIN: 034106004000 Map ID: Municipality: (034) TOWN OF NAMAKAGON STR: S10 T43N R06W Description: LOT 1 CSM #295 V.3 P.98 (LOCATED IN GOVT LOT 2) & PART OF GOVT LOT 5 SEC 3 IN 2022R-593649 (PATRICK M GAUGHAN LIVING TRUS TRUST DTD 05/01/2014) 369P IM 2003R-484183 Recorded Acres: 6.810 Calculated Acres: 6.818 Lottery Claims: 0 First Dollar: No Zoning: (R-1) Residential -1 ESN: 123 I Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 034 TOWN OF NAMAKAGON 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE 'a� Recorded Documents Updated: 3/15/2006 ® QUITCLAIM DEED Date Recorded: 3/2/2022 2022R-593649 ® QUIT CLAIM DEED Date Recorded: 2/14/2022 2022R-593425 ® CONVERSION Date Recorded: 484183 334-393;865-370 Property Status: Current Created On: 3/15/2006 1:15:47 PM • Ownership Updated: 3/18/2022 PATRICK M GAUGHAN LIVING TRUST FOREST LAKE MN Billing Address: Mailing Address: PATRICK M GAUGHAN LIVING PATRICK M GAUGHAN LIVING TRUST TRUST 7660 200TH ST 7660 200TH ST FOREST LAKE MN 55025 FOREST LAKE MN 55025 11 Site Address * indicates Private Road N/A O Property Assessment Updated: 4/25/2013 2026 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 6.810 28,800 0 2 -Year Comparison 2025 2026 Change Land: 28,800 28,800 0.0% Improved: 0 0 0.0% Total: 28,800 28,800 0.0% Property History N/A RECEIVED AUG 4 Z026 gayfield Co. Plannk'9 and Zoning AgenCY di &, Bayflold County Impervious Surface Calculations Those calculations are REQUIRED par WI Admin Code NR 115,05(1)(0) and Section 13.1-32(g) and 13-1- 40(h) 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 Bayfiold County Code of Ordinances and all other applicable ordinances and the laws of the State of Wisconsin. 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. =Owno,1;1:, /4' Mailing Ad re Property Address Nat f ; &,/ 55o ?'T Legal Description: 114, 114, Section, Township, Range 3 Township N, Ran e W 9 Soc _ Authorized Agont/Contractor Govt Lot Lot It CSM# Vol & Page 5 / ays q8 Lot(s) # Block(s) it Subdivision Town of: sJatn.ak on - Parcel ID # (PIN #) Tax ID # Dale: 04-03y I3 Db-10-Z os-6D7---ocbo Iak5%/S 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. Calculation of impervious Surface: Percentage of impervious surface shall be calculated by dividing the surface area of existing and proposed impervious surfaces on the portion of a lot or parcel that is within 300 feet of the ordinary high water mark by the total surface area of the lot or parcel, multiplied by 100. 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 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 p hen constructed but that do not comply with the standards in Section(s) 13-1-32(g) and Section 13 fs -1 owner may do any of the following: AUG 312026 a. Maintenance and repair of all impervious surfaces: Bayfield Co. b. Replacement of existing impervious surfaces with similar surfaces within th 1 i�r6affflafrf1�4SAJtprint: c. Relocation or modification of 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 '13.1-32. Inylolvlolin Itn(nnn heal I "i•:IIrIII I iuunn o n:Iiatl AI I.I'•:r:11ry 1 h llldll lU/l :411 Arta I i' Inl{) :: IlinwIIk(t:), I 'allu(n) rQ h'I h(r.) I MI' III!) I't'it l I'i'' 1111V(rw.ly ::. IIIwI ;.It�n 111111!1 l'llF i iota' I )1lllt lll.tt. i-i I'ugr, „I ir•wolhl•.1: I'. ti,t(s) I`i.gr,r It „''rodI!un:h(nv) Iii rl , .r,ll I)rivnwuy I'ropusod OIhoi S1t u:luttr; Total: I)imonnlon '/2 A 1 / tar %'t /6D' Aron (Square Footago) RECEIVED AUG 312026 Planning Co. ng and Zoning ggwy 2689 ---- r2 e Total squmo footage of lot: _1_ I V 1, (/ (—'9 L " U total impervious surface at ea. ] l'ercrmtngo of impervious surtaco area: 100 x (b)/a = ' :7_71 If the proposed impervious surface area is greater than 15% mitigation is required. I ulal rliunro fnolarlo of additional Impervious surface allowed: @ 15% © 30% Ic•. u.itn ' I,,! , '.' ii (r unly Ilex only) tlnr. .d III t Ninllaalplgn) i toy ,'{I1/ (rIiApl .'(ips: g I /0/U) Pleated by Land Use Permit Application Review Checklist r.J ,Submission#: r W3at zoning district is the project located in? W -R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB CCCI ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M ❑ YesNo 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 No Is the project located in the Floodplain? Zone: Yes ❑ No Are there wetlands on the property? ❑ Yes o Is project associated with a nonconforming use or structure? ❑ Yes o Is project associated with a variance? Case #: ❑ Yes No Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes No Is the project associated with a Special A Use Permit? Does the project require sanitary? ❑ Yet*Jo O Existing O New O Intercept ❑ Reconnect O Non -Plumbing ❑ Public Sanitary Permit #: # of Bedrooms: ❑ Yes Va Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes No Does the project require an affidavit? Affidavit It: ❑ Yes Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback? ❑ Yes Eo Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project dse is Residential ❑ Commercial ❑ Municipal Project type is? New Construction ❑ Addition/Alteration ❑ Change Use O Relocate O RV Placement ❑ Sign ❑ Establishing a Business O Temporary O Shoreland Grading ❑ Other, describe: Structure Type is: O Residence O Principal Structure ccessory Structure O Boathouse (one story only) ❑ Open-sided/Screened Structure (gazebo, etc.) O S airway to navigable waters O Mobile Home ❑ Shipping Container O Other, describe Total Sq. Ft. of Project: Number of Stories: I Overall Height: 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 $ O Non -Habitable Residential Principal and Accessory $0.20 x s ft q (minimum $75) Structures $ ❑ Commercial Principal Structures $250 + $0.005 x (minimum $250) cost of construction $ El 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 O Special Use Permit - Class A O Floodplain O Shoreland - Impervious Surface O Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 O Tower Collocation 2 O Metallic Mine ❑ After -the -Fact (ATF) $ N ,�D2vV:oLS Fee. Inspected by: Date of Inspection: o GS Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed: Approved by: c /f- i t Date of Approval: g ?l ne Condition(s): vlust meet and maintain setbacks from furthest extension of structure including eaves and overhangs. ,+For personal storage only. ❑ For personal residence only. ,E] 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. ❑ 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 o sewer and pressurized water allowed in the structure. plumbing or plumbing fixtures allowed. o 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, eellocated, 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 ]3 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: DAHLBERG, ERIK C & JILL D LU-02508 1901 W Pioneer Rd Mequon, WI 53097 Transaction Number: LU-02508-4CEFA Description Amount Shoreland - Impervious Surface $25.00 Non -Habitable Residential Principal and Accessory $537.60 Structures - $0.20/square foot (minimum $75) Total: $562.60 Payment Amount: $563.85 Reference: 1317223055 Paid by: Erik Dahlberg Payment Type: Other Transaction Date: 8/31/2026 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 — Yes / Impervious Surface — Yes Floodplain — No I Wetlands — Yes Mitigation — No / Affidavit #: LAND USE - X SANITARY - SPECIAL A - SPECIAL B/CONDITIONAL - BOA - BAYFIELD COUNTY I_� 1 : 1'i I I I WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 26-0466 Tax ID: 24545 Issued To: DAHLBERG, ERIK C & JILL D Location: S10 - T43N - R06W Town of Namakagon Legal Description: LOT 1 CSM #295 V.3 P.98 (LOCATED IN GOVT LOT 2) & PART OF GOVT LOT 5 SEC 3 IN 2022R-593649 (PATRICK M GAUGHAN LIVING TRUS TRUST DTD 05/01/2014) 369P IM 2003R-484183 Residential Structure in R-1 zoning district For: New Construction [1 - Story ], Accessory Structure on a Slab [2688 Total sq. ft. ] Height of 22' (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 Scott Roush 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 31, 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 storage only. Not for human habitation or sleeping purposes. Use best management practices to limit and prevent erosion during construction. To be constructed per plan. 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.