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HomeMy WebLinkAbout26-0573£eturr.,to: 117 E.Sth Street, PO Box 58 Bayfield County Planning and Zoning Department Washburn, WI 54891 LAND USE PERMIT APPLICATION permits (W bayfieldcounty.wi.aov County Use Only: Submission #: LU-0359d• Permit#: __________ Date: to - CTI,ONA:.General Information . I, Property Or Name: Authorized Agent Name (if applicable): fr r Telephone Number: Telephone Number: 7/ -Z7 E -Ma' Address: ^ E -Mail Address: OCT 08 2026 �L r Da ( Mailing Address: Mailing Address: Planning and Zoning Agency City, State, Zip: City, State, Zip: Contractor: Telephone Number: E -Mail Address: 'SECTION B:. ro er" Information Project Addr ss (if different from mailing address): Legal Description (if additional spa a 's need99 ttach a separate sheet): sGf/a h Section, Township, Range: cc' Town of: t<Q Tax ID k: -� (U C Lot Size (Acres/Square F et): -TION C: Project Information (check all that apply) Project Use is: ' Residential ❑ Commercial ❑ Municipal liConunercial, estimated cost of construction: $ Project Type is: ❑ New Construction,Addition/Alteration (existing structure) ❑ Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21+ days ❑ Sign ❑ Establishing a Business ❑ Temporary (12 or less months) ❑ Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A ❑ Other (describe): required (Total sft): required ECTIQN, p Structure Informatiotl D: es.pot-a l y t. RVs,apd $g*is, go to Section) Structure Type is: El Residence ❑ Principal Structure (describe): Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): El Mobile Home (provide manufactured date): - I O Shipping Container Other (describe): /e-4 4a ax' S�lt ` .V (G1r Foundation Type: ❑ Basement O Walkout Basement Slab ❑ Crawlspace O Ground O Skids O 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: I l77 O Loft Sq Ft: Deck Sq Ft: 2"^ Floor Sq Ft: Other Sq Ft (describe): 3`" Floor Sq Ft: Other Sq Ft (describe): Garage Sq Ft: Porch Sq Ft: Total Sq Ft: Overall Height (finished grade to peak): # of Stories: Existing # of Bedroom n property: Proposed # of Bedrooms in project: C> SECTION E: RV and Sign Information (check all that apply)! Sign is: RV is: ❑ New O Replacement ❑ New O Replacement ❑ On -premise O Off -premise ❑ 1 -sided O 2 -sided Year: Vin #: ❑ On -building O Multi -Tenant Length: Width: Height: Make: Model: S Application Page 1 RECEIVED OCT 0 8 2026 SECTION F: Site Plan — attach a site plan or draw site plan in box below (See pages I & 2 of Land t.��i7ation Information for information that is required to be provided on siteplan)cY 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% _ / l�hopp�,wl/ I � 7j fii�' M s � I r� Ve Setback or distance from furthest extent of structure County Use Only including eaves and overhangs to (include on site plan): Verified setbacks Road Centerline 2 l ft. 7 ft. Notes/Comments: Front Lot Line/Right-of-Way t 5 ft. ft. Sid t Line 1 [ 'C ...ft. 7✓ orth ast South West,circle one t e Lot L' (North E Sou es circle one) t 0 ft. ft. Rear Lot Line 33 ft. Septic/Holding Tank ft. j c ft. Drainfield yt b t) C. ft. ft. Privy .. ft. ft. Well to 4f ft. /D ft. Existing Structure/Building ft. ft. Wetland ft. ft. Elevation of Floodplain ft. ft. Ordinary High -Water Mark (OHWM) ft. ft. Other (describe) ft. ft. Application Page 2 4WONAiAdiiltional u tip s, es ❑ No Has the location of the proposed project* been staked? If no, what date will this be completed: Note: The site will not be inspected nor permit issued until after the staking date listed above. Yes ❑ 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 se c . 2 of Land Use Application Information for required setbacks. AYes El No Is there an existing sanitary system on the property? If yes, what kind? I U 8 7026 El Drainfield Holding Tank ❑ Municipal/Public El Other (describe): ❑ Yes o Will pressurized water be installed in the structure? If yes, what kind of sanitary sy V f 1Xd oused to manage wastewater? ❑ Drainfreld ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe): El Yes o 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 O Class A Special Use ❑ Class B Special Use ❑ Conditional Use ❑ Variance Fee payment will be made via: El 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? ❑ Mail to: OR Email to: ;'roperty Owner Address El Agent Address O Contractor Address ❑ Other (provide name and email or address): 'Include eaves. ovLrhangs, sanitary system. and well in staking measurenunts Section H: Acknowledgement and Signature - All Land Use Permits expire Two (2) fears 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.wi.gov/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 1(we) am (are) responsible for the detail and accuracy of all information that I (we) are providing and that will be relied upon by Hayfield County in determining whether to issue a permit. I (we) further accept liability whiAmaya result of yfield Co el ' nntis information f (we) are providing in or with this application. I (we) consy offrci a inistering county ordinances to have access to the above -described property at any reame ose ection. I6 26 2 Owner(s) or Authorized Agent Printed Name: . So Owner(s) or Authorized Agent Signature: Date: NOTES: 1. If you are signing on behalf of the owner(s) a lette/of authorization must accompany this application. 2. Specific conditions/instructions may be stated on the faceof 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 Real Estate Bayfield County Property Listing Today's Date: 10/8/2026 • L>s Description Updated: 11/20/2017 Tax ID: 36660 PIN: 04-026-2-46-05-07-3 02-000-13000 Legacy PIN: Map ID: Municipality: (026) TOWN OF KELLY STR: 507 T46N R05W Description: LOT 1 CSM #2017 IN V.12 P.27 Recorded Acres: Calculated Acres Lottery Claims: First Dollar: ESN: (LOCATED IN NW SW) 7.240 7.240 0 Yes 119 `'I Tax Districts Updated: 8/22/2013 1 STATE 04 COUNTY 026 TOWN OF KELLY 020170 ASHLAND SCHOOL 001700 TECHNICAL COLLEGE -.Recorded Documents Updated: 8/22/2013 © WARRANTY DEED Date Recorded: 8/28/2015 2015R-560148 1148-68 © CERTIFIED SURVEY MAP Date Recorded: 10/25/2017 2017R-570564 12-27 o LAND CONTRACT Date Recorded: 3/15/2013 2013R-548630 1102-971 © QUIT CLAIM DEED Date Recorded: 3/15/2013 2013R-548629 1102-970 0 CERTIFIED SURVEY MAP Date Recorded: 2/13/2013 2013R-548194 11-12 Property Status: Current Created On: 8/22/2013 11:50:58 AM -" Ownership Updated: 8/11/2015 BRADLY S THEIS MASON WI Billing Address: Mailing Address: BRADLY S THEIS BRADLY S THEIS 62210 US HWY 63 62210 US HWY 63 MASON WI 54856 MASON WI 54856 'r Site Address * indicates Private Road 62210 US HWY 63 MASON 54856 ® Property Assessment Updated: 4/10/2019 2026 Assessment Detail Code Acres Land Imp. GI -RESIDENTIAL 1.000 4,200 18,100 G4 -AGRICULTURAL 0.570 100 0 G6 -PRODUCTIVE FOREST 5.670 9,100 0 2 -Year Comparison 2025 2026 Change Land: 13,400 13,400 0.0% Improved: 18,100 18,100 0.0% Total: 31,500 31,500 0.0% a Property History Parent Properties Tax ID 04-026-2-46-05-07-3 02-000-12000 36288 HISTORY 0 Expand All History White=Current Parcels Pink=Retired Parcels Il 36660 This Parcel T Parents i Children RECEIVED OCT 082025 B Planning anZoning Agency Land Use Permit Application Review Checklist 'Submission #: What zoning district is the project located in? ❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M ❑ Yes o Is lot substandard (does not meet curve t zoning dimensional requirements)? Deed of record: ❑ Yes loo l 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 LO Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of navigable waterway) ❑ Yes o Is the project located in the Floodplain? Zone: ❑ Ye Are there wetlands on the property? ❑ YesNo Is project associated with a nonconforming use or structure? ❑ Yes Is project associated with a variance? Case #: ❑ Yes o Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes No Is the project associated with a Special A Use Permit? ❑ Yes rJo Does the project require sanitary? O Existing O New ❑ Intercept O Reconnect O Non -Plumbing O Public Sanitary Permit #: # of Bedrooms: ❑ Yes io Does the project require mitigation? Implementation Deadline: Date of Compliance: Does the project require an affidavit? Affidavit it: Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback? ❑ Yes No ❑ Yes No frIes ❑ No Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use is? esidential 0 Commercial 0 Municipal Project type is? ❑ New Construction,. ddition/Alteration 0 Change Use O Relocate 0 RV Placement 0 Sign ❑ Establishing a Business 0 Temporary ❑ Shoreland Grading 0 Other, describe: Structure Type is: O Residence O Principal Structureccessory Structure 0 Boathouse (one story only) O Open-sided/Screened Structure (gazebo, etc.) O 5 airway to navigable waters ❑ Mobile Home ❑ Shipping Container 0 Other, describe Total Sq. Ft. of Project: a0O Number of Stories: Overall Height: 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) $ ❑ 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 0 Special Use Permit - Class A 0 Floodplain 0 Shoreland - Impervious Surface O Shoreland - Non -Conforming, etc. 0 Tower Siting/Collocation 1 0 Tower Collocation 2 ❑ Metallic Mine ❑ After -the -Fact (ATF) $ Inspected by: \_4_.._. fl � _ Date of Inspection: 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): ust meet and maintain setbacks from furthest extension of structure including eaves and overhangs. or personal storage only. ❑ For personal residence only. d'ot for human habitation or sleeping purposes. i❑ 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). 3yse 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. )lab 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 'Lho sewer and pressurized water allowed in the structure. Flo plumbing or plumbing fixtures allowed. ICJ 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 and 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 I 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: - THEIS, BRADLY S LU-02592 62210 US HWY 63 MASON, WI 54856 Transaction Numbers LU-02592-57A3F Description Amount Non -Habitable Residential Principal and Accessory $200.00 Structures - $0.20/ square foot (minimum $75) Total: $200.00 Payment Amount: $204.76 Reference: 9969726795 Paid by: Bradly Theis Payment Type: Credit Card Transaction Date: 10/19/2026 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 - SPECIAL A - SPECIAL B/CONDITIONAL — BOA — No. 26-0573 Tax ID: 36660 Issued To: THEIS, BRADLY S Location: S07 - T46N - R05W Town of Kelly BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Legal Description: LOT 1 CSM #2017 IN V.12 P.27 (LOCATED IN NW SW) Residential Structure in A-1 zoning district For: Addition/Alteration [1 - Story ], Accessory Structure on a Slab [1000 Total sq. ft. ] Height of 11' (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 work or land use has not begun. 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. This permit may be void or revoked if any performance conditions are not completed or if any prohibitory conditions are violated. Scott Roush Authorized Issuing Official October 19, 2026 Date 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.