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HomeMy WebLinkAbout26-0542Return to: 117 E 5th Street, PO Box 58 Washburn, WI 54891 p erm its (ut bayfi a Id cou nty.wi.gov Bayfeld County Planning and Zoning Department LAND USE PERMIT APPLICATION County Use Only: Submission #: I.U- oaSNa Permit#: ab-0 Date: l O 7 >o a6 SECTION A: General Information Pro arty Owner Name: Authorized Agent Name (if applcab e . b pue Bufuuetd °duo e Tel hone Number: Telephone Number- 93010 s a3 E-Mailpddrfss: G �� a b0ht.co5 E -Mail Address: �3 7!�- ✓.wed Mailing Address: v/s A Mailing Address: Ci , State, Zi : t S 7o City, State, Zip: Contractor: Telephone Number: E Mail Address: SECTION B: Property Information Project Address (if different frompiailing address) t') k t4 € Le I Description (if additional space is needed attach a separate sheet); /f?6 (le4J of3 'n lr. iI / 79.1 1117 ��-�•(dq7 c V-eL OV Section, Township, Range: - Town of: six �: /tt. zt.ne1/- Tax ID #: Z 3 ' Lot Size (Acres/Square Feet): SECTION C: Project Information (check all that apply) Project Use is: residential ❑ Commercial ❑ Municipal If'Commercial, estimated cost of construction: $ Project Type is: fNew Construction 0 Addition/Alteration (existing structure) ❑ Change Use (existing structure) 0 Relocate (existing structure) 0 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 0 Other (describe): required (Total sq ft): required SECTION D: Structure ormation Does:not apply to RVs and Signs, go to Section E Structure Type is: ❑ Residence 0 Principal Structure (describe): 3 &ASE. ❑ Accessory Structure (describe): 0 Shoreland Exempt Structure (describe): 0 Mobile Home (provide manufactured date): ❑ Shipping Container 0 Other (describe): Foundation Type: ❑ Basement ❑ Walkout Basement )1 Slab 0 Crawlspace 0 Ground 0 Skids 0 Other (explain): Existing Structure: Length: Width: Height Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade decks/porches): Basement Sq Ft Pt Floor Sq Ft: Loft Sq Ft: 2°a Floor Sq Ft: 3'' Floor Sq Ft: Garage Sq Ft: Porch Sq Ft: Deck Sq Ft: Other Sq Ft (describe): Other Sq Ft (describe). , Total Sq Ft: 9 Overall Height (finished grade to peak): 3 # of Stories: Existing # of Bedrooms on property: Proposed # of Bedrooms in project: SECTION E: RV and Sign Information (check all that apply) Sign is: R V is: ❑ New 0 Replacement ❑ New 0 Replacement ❑ On -premise ❑ Off -premise ❑ 1 -sided 0 2 -sided Year: Vin #: ❑ On -building 0 Multi -Tenant Length: Width: Height Make: Model: r - MATTHEW R GIRNAU TRUSTEE TOWN OF NAMAKAGON TREASURER STATE OF WISCONSIN - BAYFIELD COUNTY TOWN OF NAMAKAGON ARLENE (COOKIE) SKULTETY REAL ESTATE PROPERTY TAX BILL FOR 2025 PO BOX 659 PAYMENTS should reference: Tax ID: 23942 DOCUMENT RECORDING, or anything else should reference: CABLE WI 54821 �yp W RECEIM PIN: 04-034-243-05-07-205-003-30000 Phone: (715) 798-2501 Alternate/Legacy ID: 034-1003-03 000 E -Mail: ariene.skultety@townofnamakagon.gov SEP 10 2426 OwnerRIship:M STE MARY GIRNAU TRUSTEE J & U TRUST * 2 total owners BayT t �o. a 2..... .. Important: Be sure this description covers your property. Note "•that bills be full this description is for tax only and may not a legal description. See reverse side for important information. Property Description / Location of Property RICHARD J & MARY C GIRNAU IRREV TRUST Site Address: 44755 BASS LAKE RD 2909 DAVIS DR EAU CLAIRE WI 54701 Description: Sec 07 Tn 43 Rg 05 LOT 2 CSM #132 V.2 P.176 (LOCATED IN GOVT LOT 3) IN V.1161 P.389 19D (RICHARD J & MARY C GIRNAU IRREV TRUST DTD 06/02/2016) Please include self-addressed, stamped envelope for return receipt. Acreage: 1.820 Please inform your treasurer of any billing address chances. Document: 2016R-553838 1161-389 Assessed Value I Average Net Assessed Value Real EstateTax:_ _ _ _, 1,442.17 Land Improved Total Assessment Ratio Rate First Dollar Credit: -27.81 (Does NOT reflect lottery Lottery Credit: -0.00 $65,500 $45,500 $111,000 0.59645 or first dollar credit) Net Real Estate Tax: 1,414.36 0.012992535 Total Due: 1,414.36 Estimated Fair Market Value An "X" means unpaid School taxes reduced by Land Improved Total prior year taxes. school levy tax credit. For payment in full ❑ $93.93 Pay to TOWN OF NAMAKAGON TREASURER by $109,800 $76,300 $186,100 January 31, 2026 Estimated State Aids % Tax Allocated Tax District Net Tax Change Warning Taxing Jurisdiction 2024 2025 2024 2025 If not paid by due dates, installment COUNTY 155,380 140,811 537.06 626.01 16.6 TOWN OF NAMAKAGON 225,075 239,553 232.65 292.09 25.5 option is lost and total tax is delinquent SCHL-DRUMMOND 170,700 158,647 511.45 481.24 -5.9 and subject to interest and if applicable, TECHNICAL COLLEGE 239,079 231,762 39.50 42.83 8.4 penalty. (See reverse) Totals 790,234 770,773 1,320.66 1,442.17 9.2 First Dollar Credit 31.95 27.81 -13.0 Lottay & Gaming Credit 0.00 0.00 0.0 NetPropertyTax 1,288.71 1,414.36 9.8 FOR INFORMATIONAL PURPOSES ONLY - Voter -Approved Temporary Tax Increases Total Total Addnl Taxes Year Taxing Jurisdiction Addnl Taxes Applied to Property Increase Ends SCHL-DRUMMOND 221,423 91.97 2027 SCHL-DRUMMOND 381,426 158.43 2045 1, Little Bass Lake „. ac a � K � t � .92. 14,.. `. J 1v y k ___ *j!' 1:; ___ st[ ____ e •- 3 150' d: 1 inch = 54'feet s 0 25 50 100 US F 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) El Existing Structures ❑ Well (W) ❑ Septic Tank (ST) El Drain Field (DF) El Holding Tank (HT) ❑ Privy (P) ❑ Lake O River ❑Stream/Creek ❑Pond ❑Floodplain ❑Wetlands Mopes over 20% N RECEIVED SEP 10 2026 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 ft. fl 3 t Notes/Comments: Front Lot Line/Right-of-Way ft. ft Side Lot Line 1 (North East Sou es ircle one) �� ft. �� ft. Side Lot Line 2 o uth West,circle one) a R R 2. Rear Lot Line R R Septic/Holding Tank R ,3 ft Drainfield ft ft Privy ft ep ft Well 73 ft Existing Structure/Building ft. 3 ft Wetland ft R Elevation of Floodplain R ft Ordinary High -Water Mark (OHWM) ft. 71-5 0 - Other (describe) ft R Application Page 2 RECEDED SEP 10 2026 nnvfield Co. SECTIONG::Additional uStions pianning and Zoning AgeY *Yes ❑ No Has the location of the proposed project` been staked? If no, what date will this be completed: —0 Note: The site will not be inspected nor permit issued until after the staking date listed above. fl,Yes ❑ 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 ❑ 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. IN Yes ❑ No Is there an existing sanitary system on the property? If yes, what kind? Drainfield O Holding Tank ❑ Municipal/Public O Other (describe): ❑ Yes iMNo Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be installed or used to manage wastewater? ❑ Holding Tank ❑ Munici aliPublic O Other (describe): ❑ Yes KNo Will sleeping occur in the structure? If yes, contact local Uniform Dwelling Code (UDC) for approval and action requirements. 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 Fee payment will be made via: Check (attached) ❑ Cash (attached) ❑ debit/credit/echeck (department to call once payment is ready to be taken) How would you like to receive your permit card? Vl Mail to: OR ❑ Email to: !sQ Property Owner Address O Agent Address ❑ Contractor Address O Other @rovide name and email or address): "Include eaves, overhangs, sanitary system, and well in staking measurements • Section .Il: Acknowled ement 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, dur.wi.aov/tooiciwetlands. 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: 7Cf(r Owner(s) or Authorized Agent Signature 4$7 Date: ?` rt 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. RECEIVED OCT 032026 Bayfield Co. Planning and Zoning Agency AFFIDAVIT OF AUTHORITY (Trust) Tam l� a3g4,P- PURPOSE. This Affidavit of Authority is used to codify the individual submitting an application is authorized when the property is owned by a Trust. STATE OF WISCONSIN ) ss. BAYFIELD COUNTY The undersigned affirms and states as follows; 1. Address of Subject Property: / 4' iss {'lac c LIkC Mo. CAP4F" 1,JiS 4 ©-' 2. The Subject Property is owned by: /SI -/{ &'L> X. AM! l 6&R GAR iAU. (Name of Trust) 3. The name(s) of the current Trustee(s): MAtt"FiF_ tV ( IQNAL4 4. I certify that the Trust named in paragraph 2 is valid and in effect on the date signed below. I am the duly appointed agent of the Trust named above in paragraph 2, and I have the authority under the terms of said authorization to submit an application to the Bayfield County Zoning Department concerning the Property described in paragraph 1. I further certify that the information and statements made within this affidavit are true. accurate, and complete to the best of my knowledge. 5. I am authorized by the above -named Trust to apply for and bind the Trust to the terms and conditions of any decision or permit that may be issued by the Bayfield County Zoning Department. 6. By signing this affidavit, I attest that I am unaware of any known or unknown person(s) who would contest this application. I agree to indemnify Bayfield County or such person or legal entity suffering a damage resulting from any illegalities of the application. Dated: /J —/ 2. G, Print Name Subscribed and sworn to before me this day of ().kDbGr . 20 9 ,e,.... OILLET "'a Notary Iftiblic. County, Wisconsin I .: p J 2 % Pug 1 •. ATE OF, %pat Ib.0i3g92 Letter of Authorization Bayficld County Planning & Zoning Department PURPOSE. This Letter of Authorization is used to authorize a single property owner to act on behalf of multiple property owners or a designated agent to act on behalf of the property owner/s. if multiple property owners, each property owner must submit this signed letter. 1, / � t r^n) , (A(property owner), authorize /Ct Jnrct A t r.✓Q� a..� (authorized ag(t t) to submit a Ini±i LLw (Example: land use, special use, conditional use, rezone/map amendment, appeal, variance, text amendment, etc.) for the following described project (Exam le: construction of residence or other structure, short-term rental or otter use change, etc.) a. r- r [4 a application on my behalf for the following described property: •J Legal description of subject property: S! -C7 T 4 R5 p5 tch) CSM isa V.,a P /7(O Address ofsubjeetproperty: /j4f%SS.B,•scr Lcq!<6'Ra 4:Efle&S'/ ( Signature � • iRECEIVED io Dated OCT 032026 Bayfield Co. Planning and Zoning Agency Bayfield County 7)( / c3 7q- L Impervious Surface Calculations ( l These calculations are REQUIRED per WI Admin Code NR 115.05(1)(e) 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 Bayfield 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. Property Owner(s): NA CA Mailing Address: Property Address LJrs, 953 c5 -s z4cs-h?3. CABLE LJi.5* 9D Vt9qve(q;aE Legal Description: Section, Township, Range 114. 1/4, r� Sec 07 Township N. Range SSW Authorized AgenuConoactur Gov't Lot Lot # CSM# Vol & Page 3 a /3j.__,a-/7(0 Lot(s)# abck(s)# SubdMsion Town of: N Parcel ID # (PIN #) Tax ID # Date: o4 -03q- 41. -a5-o .a.czsc'033ADO x379 0 -- 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 placed enCCsvEe'�j but that do not comply with the standards in Section(s) 13-1-32(g) and Section 13-1-40(h), the property owner may do any of the following:OCT 0 2026 a. Maintenance and repair of all impervious surfaces: Bayfied Co. Planning and Zoning Agency b. Replacement of existing impervious surfaces with similar surfaces within the existing building footprint; 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 nnnlirohle _.....__,. 74 /P. a37+ . Impervious Surface Item Dimension Area (Square Footage) Existing House Existing Accessory Building/Garage X 7)(5 ��xT-- Existing Sidewalk(s), Patlo(s) & Deck s 1 C2 Existing Covered Porch(es), Driveway & Other Structures 1p Proposed Addition/House Proposed Accessory Building/ing/Garage 3' J ✓C Proposed Sidewalk(s) & Patio(s) Proposed Covered Porch(es) &)VED Deck(s) —"- RECC Proposed Driveway _ OCT 032026 Proposed Other Structures Bayfield Co. Planning and Zoning Agency Total: a. Total square footage of lot: 79, oZ 7 7 a 54. FT. b. Total impervious surface area: c≥ 3 / ! c. Percentage of impervious surface area: 100 x (b)/a = . 9 oZ If the proposed impervious surface area is greater than 15% mitigation is required. Total square footage of additional impervious surface allowed: @ 15% @ 30% ( Issuance Information (County Use Only) Date of Inspection: Inspection Record: Zoning District I takes Uanslfication ( ) Condition(s): Stonnwater Land Use Permit Application Review Checklist .omission #: i — 4 What zoning district is the project located in? 1 ❑R-2 ❑R-3 ❑R-4 DR-RB ❑C ❑1 ❑M ❑A-1 ❑A-2 ❑F-1 ❑F-2 ❑W DM -M ❑ Yes No Is lot substandard (does not meet current zoning dimensional requirements)? Deed of record: files ❑ 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)? es ❑ 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 o Are there wetlands on the property? ❑ Yes 5No Is project associated with a nonconforming use or structure? ❑ Yes No 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? O Existing ❑ New ❑ Intercept ❑ Reconnect O Non -Plumbing O Public Sanitary Permit #: # of Bedrooms: ❑ Yes o ❑ Yes No Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes No 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? Residential ❑ 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: O Residence O Principal Structure] Accessory Structure O 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: Number of Stories: Overall Height: t 3 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) $ ❑ Dwelling Unenclosed Areas (decks, patios, etc.) or Attached Non -Habitable Garages $0.20 x sq ft (minimum $125) $ O 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 (exemptfrom fees) ❑ Return Inspection ❑ Land Use Revisions ❑ 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 ❑ Metallic Mine ❑ After -the -Fact (ATF) $ Inspected by: uS G Date of Inspection: Co Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed: Approved by: Date of Approval: Condition(s): L.Must meet and maintain setbacks from furthest extension of structure including eaves and (Xverrhangs. or personal storage only. ❑ For personal residence only. 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). AUse best management practices to limit and prevent erosion during construction. O 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. o plumbing or plumbing fixtures allowed. o additional sleeping areas allowed without obtaining necessary sanitary permit(s). nd use permits shall be required for any new residence, any building or structure erected, elocated, 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 134YFIELD Bayfield County Planning & Zoning Department 117E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number: GIRNAU IRREV TRUST, RICHARD J & LU-02542 MARY C 2909 DAVIS DR Transaction Number EAU CLAIRE, WI 54701 LU-02542-5676E GIRNAU TRUSTEE,MATTHEW R 235511-1/4 AVE CAMERON, WI 54822 Description Amount Non -Habitable Residential Principal and Accessory $190.40 Structures - $0.20/square foot (minimum $75) Total: $190.40 Payment Amount: $190.40 Reference: 6071 Paid by: Richard J. Girnau / Mary C. Girnau Payment Type: Check Transaction Date: 10/7/ 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 / 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. 26-0542 Tax ID: 23942 Issued To: GIRNAU IRREV TRUST, RICHARD J & MARY C & GIRNAU TRUSTEE, MATTHEW R Location: S07 - T43N - R05W Town of Namakagon Legal Description: LOT 2 CSM #132 V.2 P.176 (LOCATED IN GOVT LOT 3) IN V.1161 P.389 19D (RICHARD J & MARY C GIRNAU IRREV TRUST DTD 06/02/2016) Residential Structure in R-1 zoning district For: New Construction [1 - Story ], Accessory Structure on a Slab [952 Total sq. ft. ] Height of 13' (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. October 07, 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.