APPLICATION FOR PERMIT BAYFIELD COUNTY, WISCONSIN. ^~ Da^e Stamp (Received) !'! '-; ^ ' t -^ **. ^?

Transcription

1 SUBMIT: COMPLETE APPLICATION. TAX ST&TEMENT AN FEE TO: Byfield County Plnning nd Zoning eprt. PO Bo 58 Wshburn,WI (715) INSTRUCTIONS: No permits will be issued until ll fees re pid. APPLICATION FOR PERMIT BAYFIEL COUNTY, WISCONSIN ~ e Stmp (Received) Checks re mde pyble to: Byfield County Zoning eprtment. Y ;. -, O NOT START CONSTRUCTION UNTIL ALL PERMITS HAVE BEEN ISSUE TO APPLICANT: 0!'! '-; ' t - **.? Permit (t: te: Amount Pid: Refund: -TP 19-n= U'?s IQ-I-I~)\ \-- TYPE OF PERMIT REQUESTE- Owner's Nme: "podhuxu &t Address of Property: (Locu\ (LLnJ n LAN USE SANITARY PRIVY CONITIONAL USE SPECIAL USE B.O.A. OTHER City/Stte/Zip: yzj tofjsj- I P-Cd Miling Address: City/tte/Zip: r-h-s UJL S-V7J Telephone: Cell Phone: ~!> : ~Uo5 ) Contrctor: Contrctor Phone: Plumber: Plumber Phone: Authorized Agent: (Person Signing Appliction on behlf qj Owner(s)) 0-(\ P(n4k "'n, PROJECT LOCATION 6_ Legl escriotion: (Use T Sttement) Agent Phone: Agent Miling Address (include City/Stte/g:/ y~. 'i-w PO < 30 wymlc PIN: (23 digits) 04"- -T-, 0\y\ C.CW 3~OGO<J y Town of: Gov't Lot Lot(s) CSM Vp\ & Pge < >-z-n Section, Township N, Rnge '-' / W &UV/YJS Lot(s) No. Block(s) No. Subdivision: Written Authoriztion Attched \J/es C No Recorded ocument: (i.e. Property Ownership) Volume " Pge(s) Lot Size Acrege (".y 3 Shorelnd SNon-Shorelnd Is Property/Lnd within 300 feet of River, Strem (incl. intermittent) Creek or Lndwrd side of Floodplin? If yes continue > n Is Property/Lnd within 1000 feet of Lke, Pond or Ftowge If yes continue istnce Structure is from Shoreline :.feet istnce Structure is from Shoreline : feet Is Property in Floodplin Zone? Yes ' BNo Are Wetlnds Present? >Yes No - Vlue t Time otcompletion $ * include donted time & mteril Project New Construction Addition/Altertion Conversion n Relocte (eisting bidg) Run Business on Property 1% # of Stories nd/or bsement i<>1-story 1-Story+Loft 2-Story Bsement// No Bsement Foundtion Use Sesonl > Yer Round # of bedrooms T 2 3 None n Municipl/City Wht Type of Sewer/Snitry System Is on the property? (New) Snitry Specify Type: C. Snitry (Eists) Specify Type: L- Privy (Pit) or : Vulted (min 200 gllon) Portble (w/service contrct) Compost Toilet None Wter City [Kwell Eisting Structure: (if permit being pplied for is relevnt to it) Proposed Construction: Length: Length: -<3- Width: */ Width: Height: co Height: Proposed Use [ J Residentil Use LJ Commercil Use Proposed Structure Principl Structure (first structure on property) Residence (i.e. cbin, hunting shck, etc.) with Loft with Porch with (2") Porch with eck with (2" ) eck with Attched Grge imensions ( ) _ A ) ( ) _ ) ( ) ( ) Squre Footge Municipl Use Bunkhouse w/( snitry, or sleeping qurters, or cooking & food prep fcilities) Mobile Home (mnufctured dte) Addition/Altertion (specify) Accessory Building (specify) Accessory Building Addition/Altertion (specify) ( s Specil Use: (eplin) ~) lrv><- -K.<Vrw, (&P<, I-«-- Conditionl Use: (eplin) Other: (eplin) U 1 ( ( ~ft~ FAILURE TO OBTAIN A PERMIT or STARTING CONSTRUCTION WITHOUT A PERMIT WILL RESULT IN PENALTIES I (we) declre tht this ppliction (including ny ccompnying informtion) hs been emined by me (us) nd to the best of my (our) knowledge nd belief it is true, correct nd complete, I (we) cknowledge tht I (we) m (re) responsible for the detil nd ccurcy of ll informtion I (we) m (re) providing nd tht it will be relied upon by Byfield County in determining whether to issue permit. I (we) further ccept libility which my be result of Byfield County relying on this informtion I (we) m (re) providing in or with this ppliction. I (we) consent to county officils chrged with dministering county ordinnces to hve ccess to the bove described property t ny resonble time for the purpose of inspection. Owner(s): _ te (If there re Multiple Owners listeonlthe eed All Owtn$(S must sign ojletter(s) of uthoriztion must ccompny this ppliction) Authorized Agent:_/U<- {/ [/LT _ te. Address to send permit (If you re signing oy\h\f of tyieowner(s) letter 'r QfuinonzTion guthoriztion must ccomnv ccompny inis this licik ppliction) L-W p<\y/v L/:?L APPLICANT - PLEASE COMPLETE PLOT PLAN ON REVERSE SIE 9--/7 s«/ Attch Copy of T Sttement If you recently purchsed the property send your Recorded eed

2 ?e bo below: rw or Sketch your Property (regrdless of wht you re pplying for) (1) Show Loction of: (2) Show/Indicte: (3) Show Loction of (*) (4) Show: (5) Show: (6) Show ny (*): (7) Show ny (*): Proposed Construction North (N) on Plot Pln (*) rivewy nd (*) Frontge Rod (Nme Frontge Rod) All Eisting Structures on your Property ( '') Well (W); (*) Septic Tnk (ST); (*) rin Field (F); (*) Holding Tnk (HT) nd/or (*) Privy (P) (*) Lke; (*) River; (*) Strem/Creek; or (*) Pond (*) Wetlnds; or (*) Slopes over 20% $ c'e- c\i \\chmc Plese complete (1) - (7) bove (prior to continuing) (8) Setbcks: (mesured to the closest point) Chnges in plns must be pproved by the Plnning & Zoning ept. escription Mesurement escription Mesurement z ~ff~ f9 LL Setbck from the Centerline of Pltted Rdd I io-t Setbck from the Lke (ordinry high-wter mrk) Setbck from the Estblished Right-of-Wy Setbck from the River, Strem, Creek Setbck from the Bnk or Bluff Setbck from the North Lot Line Setbck from the South Lot LineCo \i> Setbck from Wetlnd \' >*,Uui,\,-dCceA) >.r Setbck from the West Lot Line ys)0 f 20% Slope Are on property BlYesBE No Setbck from the Est Lot Line /o4 Elevtion of Floodplin TK Setbck to Septic Tnk or Holding Tnk Setbck to Well Setbck to rin Field Setbck to Privy (Portble, Composting) Prior to the plcement or construction of structure within ten (10) feet of the minimum required setbck, the boundry line from which the setbck must be mesured must be visible from one previously sun/eyed comer to the other previously sun/eyed comer or mrked by licensed surveyor t the owner's epense, Prior to the plcement or construction of structure more thn ten (10) feet but less thn thirty (30) feet from the minimum required setbck, the boundry line from which the setbck must be mesured must be visible from one previously surveyed corner to the other previously surveyed corner, or verifible by the eprtment by use of corrected compss from known comer within 500 feet of the proposed site of the structure, or must be mrked by licensed surveyor t the owner's epense. ~r (9) Stke or Mrk Proposed Loction(s) of New Construction, Septic Tnk (ST), rin field (F), Holding Tnk (HT), Privy (P), nd WeHJW). NOTICE: All Lnd Use Permits Epire One (1) Yer from the te of Issunce if Construction or Use hs not begun. For The Construction Of New One & Two Fmily welling: ALL Municiplities Are Required To Enforce The Uniform welling Code. The locl Town, Villge, City, Stte or Federl gencies my lso require permits. Issunce Informtion (County Use Only) Permit enied (te): Snitry Number: :o?<77(3. Reson for enil: # of bedrooms: Snitry te: <f-5 > -?8 Permit ft: icq Permit te: Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming Yes (eed of Record) Yes (Fused/Contiguous Lot(s)) Yes No No No Mitigtion Required Mitigtion Attched LJ Yes L. No J Yes l_ No Affidvit Required Affidvit Attched Yes Yes No No Grnted by Vrince (B.O.A.) Yes No Cse #: Previously Grnted by Vrince (B.O.A.) Yes No Cse ft Ws Prcel Leglly Creted Yes No Were Property Lines Represented by Owner Ws Proposed Building Site elineted Yes No Ws Property Surveyed Inspection Record 1: iff pkftpi -K? $r couf r\i.' 9f r. to <tfft. Yes Yes Zoning istrict ( Lkes Clssifiction ( No No te of Inspection: Inspected by: te of Re-lnspection: Condition(s):Town, Committed or Bord Conditions Attched? H Yes - No-(If No they need to be ttched.) Condition: My not be used for humn hbittion unless ll pplicble zoning/snitry & UC codes re fully met. Hold For Snitry: Hold For Affidvit: Hold For Fees: t L,fc,f,W"Pu i 'f-/tw 6 'AV'i'/ti/ te of Approvl // NoTf?lT)ooto Puu-'o ri

3 Byfield County Web AppBuilder imosutwkw) essomnwrwm t ::'»k'93o2010c"jl':'oc":i] [0;tOC'-ISO3c.Iu;uQC':400':.0] wmtiseismsfflsm.flpiuiekfiseruu fr i egcgo sfsseswwvfvi LOj.XL4;A5.0.9_3o20AOW10uOpJ R;IQli:42-l;,00'.; Jnury 2,2018 1:1,304 Buildings? Recorded Mp Comer Tie Sheets All Rods Section Comer Monument on File CFR Section Corner Monument Referenced on Survey County Survey Mps Federl ~:r~ Un Recorded Mp Privte Stts Tie Lines Town Rivers Municipl Boundry ougls Co Prcels Section Lines Ashlnd Co Prcels Approimte Prcel Boundry Mender Lines '-rc< 5,3o6 \ I > mi 0.1km Web AppBuldTforArcGIS Byfield County

4 fts Fity, Villge, Stte or Federl My Also Be Required!;NUSE-X SANITARY (9/30/1998) SIGN - SPECIAL - Clss A CONITIONAL - BOA - BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: Todd & Mrion Koleski / Crig Mnthey, Agent N of Co Hwy N Less Pr in Loction: SW 1/4 of NE VA Section 36 Township 45 N. Rnge 9 W. Town of Brnes Gov't Lot Lot Block Subdivision CSM# For: Residentil Other: [ 1 - Unit; 1- Story; Short-term Rentl ] (isclimer): Any future epnsions or development would require dditionl permitting. Condition(s): My not be used for humn hbittion unless ll pplicble zoning, snitry, nd UC codes re fully met. Get license from Byfield Public Helth nd limit occupncy to 6 individuls. NOTE: This permit epires one yer from dte of issunce if the uthorized construction work or lnd use hs not begun. Trcy Pooler Authorized Issuing Officil Chnges in plns or specifictions shll not be mde without obtining pprovl. This permit my be void or revoked if ny of the ppliction informtion is found to hve been misrepresented, erroneous, or incomplete. This permit my be void or revoked if ny performnce conditions re not completed or if ny prohibitory conditions re violted. Mrch 13, 2018 te

5 SUBMIT: COMPLETE APPLICATION, TAX STATEMENT AN FEE TO; Byrield County Plnning nd Zoning eprt. PO Bo 58 Wshburn, Wl (715) APPLICATION FOR PERMIT BAYFIEL COUNTY, WISCONSIN \\~\ tj? Stirinp (Recived, FEB 2 1 WW fo.it- \!. 'ind Permits: te: Amount Pid: R-OCSQ 5--1% 3--1% INSTRUCTIONS: No permits will be issued until ll fees re pid. ',;.,"'!.::! Checks re mde pyble to: Byfield County Zoning eprtment. O NOT START CONSTRUCTION UNTIL ALL PERMITS HAVE BEEN ISSUE TO APPLICANT. TPE OF PERMIT REQUESTE-- C,LAN USE SANITARY PRIVY CONITIONAL USE 0 SPECIAL USE B.O.A. 0 OTHER Owner's Nme: -/ /'-/.,// /yi, iv 0, Address of Property: G 3o G,, //v /i/ Miling Address:,03. /rst- City/Stte/Zip: \cr/«city/stte/zip: Poo.., / 9?-y m3 Telephone: Cell Phone:,?<.-9~ '1 Contrctor: Contrctor Phone: Plumber: Plumber Phone: Authorized Agent: (Person Signing Appliction on behlf of Owner(s)) Agent Phone: Agent Miling Address (include City/Stte/Zip): Written Authoriztion PROJECT LOCATION S«1/4. T I # Legl escription: (Use T Sttement) 3'7o <] i c-c. /o 13 Section, Township N,Rnge Gov't Lot Lot(s) CSM Vol & Pge c] w 3 f t3', Lot(s) No. Block(s) No. Subdivision: Attched Yes No Recorded ocument: (i.e. Property Ownership) (7 ft. ftfcy Town of: Lot Size Acrege / fi.o n Shorelnd ; I Is Property/Lnd within 300 feet of River, Strem (incl. intermittent) Creek or Lndwrd side of Floodplin? If yes continue.! Is Property/Lnd within 1000 feet of Lke, Pond or Flowge If yes continue istnce Structure is from Shoreline :.feet istnce Structure is from Shoreline :.feet Is Property In Floodplin Zone? Yes -?<No Are Wetlnds Present? Yes LNO <l-non-shorelnd Vlue t Time of Completion * include donted time & mteril Project New Construction Addition/Altertion Conversion Relocte (eisting bidg) ff of Stories tl-story i 1-Story+Loft 2-Story Foundtion =K Bsement Foundtion i; # of bedrooms in structure i 3 i I Wht Type of Sewer/Snitry System Is on the property? 1 I Municipl/City (New) Snitry Specify Type: v Snitry (Eists) Specify Type: r-il i Privy (Pit) or : I Vulted (min 200 gllon) Type of Wter on property City /Well I Run Business on Property Use Yer Round i;-4~w-/,+ None : Portble (w/service contrct) Compost Toilet None Eisting Structure: (if permit being pplied for is relevnt to it) Proposed Construction: Length: "5J- Length:.3. // Width: 3i( Width: / ' Height: Height: y Proposed Use Proposed Structure imensions Squre Footge Residentil Use Commercil Use Principl Strpf't'iir1 [f[r<ilt structure on property) Residence (i.e. cbin, hunting shck, etc.) with Loft with Porch with (2nd) Porch with eck with (2nd) eck with Attched Grge,..3 Ao<-zr G. X - U X 0 /'fc'd- ~JSL 0,0 Municipl Use ~K Bunkhouse w/(i i snitry, or I sleeping qurters, or! ; cooking & food prep fcilities) Mobile Home (mnufctured dte) Addition/Altertion (specify) ',ll,'n Usf fff f)j/ /7cVft[ Accessory Building (specify) Accessory Building Addition/Altertion (specify) /ff y w Specil Use: (eplin) Conditionl Use: (eplin) Other: (eplin) FAILURE TO OBTAIN A PERMIT Of STARTING CONSTRUCTION WITHOUT A PERMIT WILL RESULT IN PENALTIES I (we) declre tht this ppliction (including ny ccompnying informtion) hs been emined by me (us) nd to the best of my (our) knowledge nd belief it is true, correct nd complete. I (we) cknowledge tht I (we)m (re) responsible for the detil nd ccurcy of ll informtion I (we) m (re) providing nd tht it will be relied upon by Byfield County in determining whether to issue permit. I (we) further ccept libility which mybe result of Byfield County relying on this informtion I (we) m (re) providing in or with this ppliction, j (we) congent to county officils chrged with dministering county ordinnces to hve ccess to the bove described property t ny resonble time for the purpose of inspection. Owner(s): _ > /z Lh (If there re Multiple Owners listed on the eed AU Owners must sign or letter(s) of uthoriztion must ccompny this ppliction) te Z-i'ZolS Authorized Agent: Address to send permit (If you re signing on behlf of the owner(s) letter of uthoriztion must ccompny this ppliction) APPLICANT - PLEASE COMPLETE PLOT PLAN ON REVERSE SIE te Attch Copy of T Sttement If you recently purchsed the property send your Recorded eed lor GWGTLM i<bt: PW'v'ciiTocruL <= W\rn? P P-

6 iw or Sketch your Property (regrdless of wht you re pplying for) Show Loction of: Show/Indicte: (3) Show Loction of (*) (4) Show: (5) Show: (6) Show ny (*): (7) Show ny (*): Proposed Construction North (N) on Plot Pln (*) rivewy nd (*) Frontge Rod (Nme Frontge Rod) All Eisting Structures on your Property (*) Well (W); (*) Septic Tnk (ST); (*) rin Field (F); (*) Holding Tnk (HT) nd/or (*) Privy (P) (*) Lke; (*) River; (*) Strem/Creek; or ( ' ) Pond (*) Wetlnds; or (*) Slopes over 20% /y f(0 yl '.<5 <- ' o -5 ' > f.'. N ' f 0-f1 K'1' >f " ~f i </ y Afc AJ Plese complete (1) - (7) bove (prior to continuing) (8) Setbcks: (mesured to the closest point) Chnges in plns must be pproved by the Plnning & Zoning ept. escription Mesurement escription Mesurement Setbck from the Centerline of Pltted Rod Setbck from the Estblished Right-of-Wy Setbck from the North Lot Line Setbck from the South Lot Line Setbck from the West Lot Line Setbck from the Est Lot Line /A FeeT <f 1 FeeF 9? X / fc> Setbck from the Lke (ordinry high-wter mrk) Setbck from the River, Strem, Creek Setbck from the Bnk or Bluff Setbck from Wetlnd 20% Slope Are on the property Elevtion of Floodplin / n Yes t No Setbck t&epticjnkr Holding Tnk SetbclCto rin Field Setbck to Privy (Portble, Composting) FPRt Setbck to Well j?_ Prior to the plcement or construction of structure within ten (10) feet of the minimum required setbck, the boundry line from which the setbck must be mesured must be visible from one previously surveyed comer to the other previously surveyed comer or mrked by licensed surveyor t the owner's epense. Prior to the plcement or construction of structure more thn ten (10) feet but less thn thirty (30) feet from the minimum required setbck, the boundry line from which the setbck must be mesured must be visible from one previously surveyed comer to the other previously surveyed comer, or verifible by the eprtment by use of corrected compss from known corner within 500 feet of the proposed site of the structure, or must be mrked by licensed sun/eyor t the owner's epense. (9) Stke or Mrk Proposed Loction(s) of New Construction, SepticTnk (ST), rin field (F), Holding Tnk (HT), Privy (P), nd Well (W). NOTICE; All Lnd Use Permits Epire One (1) Yer from the te of Issunce if Construction or Use hs not begun. For The Construction Of New One & Two Fmily welling: ALL Municiplities Are Required To Enforce The Uniform welling Code. The locl Town, Villge, City, Stte or Federl gencies my lso require permits. Issunce Informtion (County Use Only) Permit enied (te): Snitry Number: 'Tf # of bedrooms: Snitry te: : i/n Reson for enil: Permit #: lgc&q Permit te: :-N- Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming Yes (eed of Record). Yes (Fused/Contiguous Lot(s)) Yes -8 No 'BNo b No Mitigtion Required Mitigtion Attched Yes S. No Yes No Affidvit Required Affidvit Attched Yes Yes & No 1 No Grnted by Vrince (B.O.A.) Yes TMMo Cse ft Previously Grnted by Vrince (B.O.A.) Yes QJMo Cse ft: Ws Prcel Leglly Creted Ws Proposed Building Site elineted Inspection Record: ' Y/f SLYes No G-Yes No Were Property Lines Represented by Owner te of Inspection: Inspected by: <9- Ws Property Surveyed Yes B-No Yes No Zoning istrict ( f } Lkes Clssifiction ( ) te of Re-lnspection: Condition(s): Town, Committee or Bord Conditions Attched? Yes No - (If No they need to be ttched. Condition: My not be used for humn hbittion unless ll pplicble zoning/snitry /] & UC codes re fully met. Signture of Inspector Wi ot //-w/-4 7 OCu/euiJ te of Approvl y//s\ Hold For Snitry: Hold For TBA: Hold For Affidvit: Hold For Fees: Augus+ 2017

7 Villge, Stte or Federl Also Be Required?E-X fy (10/6/1998) ICIAL - JITIONAL - A- BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION Issued To: Todd & Mrion Koleski I OF CO HWY N LESS Loction: SW 74 of NE VA Section 36 Township 45 N. Rnge 9 W. Town of Brnes FGov't Lot Lot Block Subdivision CSM# For: Residentil Addition: [ 1- Story; eck (eisting) (6' 8')(6' 10') = 108 sq. ft. Addition under eck (10' 24') = 240 sq. ft. ] (isclimer): Any future epnsions or development would require dditionl permitting. Condition(s): My not be used for humn hbittion unless ll pplicble zoning, snitry, nd UC codes re fully met. Vction rentl limited to 6 occupnts. NOTE: This permit epires one yer from dte of issunce if the uthorized construction work or lnd use hs not begun. Chnges in plns or specifictions shll not be mde without obtining pprovl. This permit my be void or revoked if ny of the ppliction informtion is found to hve been misrepresented, erroneous, or incomplete. This permit my be void or revoked if ny performnce conditions re not completed or if ny prohibitory conditions re violted. Trcy Pooler Authorized Issuing Officil Mrch 14, 2018 te