APPLICATION FOR PERMIT BAYFIELD COUNTY, WISCONSIN. Date Stamp (Received) MAY 2 i L^ i:

Transcription

1 I SUBMIT: COMPLETE APPLICATION. TAX STATEMENT AN Fr.E TO: B"f'ld "o:-3ty Plnning nd Zoning eprt. PO Box 58 Wshburn,WI (715) 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. APPLICATION FOR PERMIT BAYFIEL COUNTY, WISCONSIN te Stmp (Received) MAY 2 i L i: Permits: te: Amount Pid: Refund: ;X< )CQ-j -Mt 35-3 TYPE OF PERMIT REQUESTE- Owner's Nme: '(<L\/\J!? M...lk ' Address of Property: r, < <) "i r/>./-ji /:-j. itrctor:. /-" ' ; /1 '(/\ o/'.y-! L/((C//],-lr- Authorized Agent: (Person Signing Appliction on belfof Owner(s)) P?./ <7-0/n< PROJECT LOCATION n Shorelnd LAN USE 0 SANITARY PRIVY 0 CONITIONAL USE SPECIAL USE B.O.A. OTHER Legl escription: (Use Tx Sttement) _1/4, 1/4 ills Lot(s) Section, Township N, Rnge Non-Shoreind 1 Miling Address: 90 G/v'4 City/tte/Zip: j-s Contrctor Phone: I Plumber: jy/-5 Agent Phone: 'T/o Tx I # CSM %7 Vol & Pge CTe? Town ot: 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 City/Stte/Zip: Mr / r'j'f S53"J ujr y73 "'?/" T 'CT7? Agent Miling Address (include Qty/Stte/Zip): OM.AO/W -T ty OLTH Lot(s) No. Block(s) No. Subdivision: Telephone: 6 3., Cell Phone: b - Plumber Phone: Written Authoriztion Attched Yes jfno ReciK-ded ocument: (i.e. Prorty Ownership) WK 77/< Lot Size istnce Structure is from Shoreline : Acrege 1.7 W \ A 7 ~7_ feet istnce Structure is from Shoreline ; ~3" feet Is Property in FloodplinZone?,Yes :INo Are Wetlnds Present? I Yes NCJo Vlue t Time of Completion * include donted time & mteril ', 0 T Project jmew Construction Addition/Altertion I J Conversion L; Relocte (existing bidg) i Run Business on Property n ft of Stories /f 1-Story 1-Story + Loft i 2-Story Foundtion ' i Bsement Foundtion Use i Yer Round!~~ # of bedrooms in structure 1 2 L; 3 L;! - None Wht Type of Sewer/Snitry System Is on the property? li Municipl/City 1 (New) Snitry Specify Type: Snitry (Exists) Specify Type: IQ QU I/' Privy (Pit) or ' I Vulted (min 200 gllon) i Portble (w/service contrct) i Compost Toilet None Type of Wter on property I City )ywe\\ 1 Existing Structure: (if permit being pplied for is relevnt to it) Proposed Construction: Length: Length: Width: Width: Height: Height: Proposed Use Residentil Use Commercil Use Municipl Use ~s Proposed Structure Principl Structure (first 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 Bunkhouse w/ (!J snitry, or I! sleeping qurters, or i I cooking & food prep fcilities) Mobile Home (mnufctured dte) Addition/Altertion (specify) Accessory Building (specify) /U' r-j'ojn i'j/"/ 0 Accessory Building Addition/Altertion (specify) _\]/6iCm. Qtf/iyj -7-- '- imensions 1 x.) ( t7d'x (>J ) _( -2L.l Squre Footge s~w _._LQL Specil Use: (explin) Conditionl Use; (explin) Other: (explin) 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 exmined 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. 1 (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): ( /-Ul< '1 /&-<9-.p- _v-z --(< te s5/ (If there re MiJltiple Owners listed on the eed AH Owners must sign fir letter(s) of uthoriztion loriztion rftust ( itompny this ppliction) Authorized Agent: Address to send permit (If you j re signing on behlf of the oyuner(s) letter of i uthoriztion must ccompny this ppliction)?0 G'i M ih 5b..J'7. APPLICANT - PLEASE COMPLFTE FrLOT PLAN ON REVERSE SIE te Attch Copy of Tx Sttement If you recently purchsed the property send your Recorded eed

2 'box 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 Existing 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% / / Wo.:y<J>CO <ftl < <? /- ( ' s-.<- --. ~T1 ff 1 J{ Plese complete (1) - (7) bove (prior to continuing) (8) Setbcks: (mesured to me closest point) ri 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 TT"0FeeT ; ~E/ '") / Vfo 0.. f) 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 offloodplin -. /U- 777FeeT LI Yes LI No Setbck to Septic Tnk or Holding Tnk Setbck to rin Field / /3 Setbck to Well U FeeT 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 surveyed corner to the other previously surveyed comer or mrked by licensed surveyor t the owner's expense. 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 comer, 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 sun/eyor t the owner's expense. (9) Stke or Mrk Proposed Loction(s) of New Construction, SepticTnk (ST), rin field (F), HoldineTnk (HT), Privy (P), nd Well (W). NOTICE: All Lnd Use Permits Expire 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): Permit#:,5 Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming Yes (eed of Record) Yes (Fused/Contlguous Lot(s)) Yes Snitry Number: # of bedrooms: Snitry te: Reson for enil: Permit te: :-/s/ 0'No ri'imo /dno Mitigtion Required Mitigtion Attched Yes Yes imo wo Affidvit Required Affidvit Attched Yes Yes -No STNo Grnted by Vrince (B.O.A.) Yes No Cse #: Ws Prcel Leglly Creted Ws Proposed Building Site elineted TYes No fes No Previously Grnted by Vrince (B.O.A.) Yes Mo Cse #: Were Property Lines Represented by Owner Inspection Record: fgy ff'f A C/ 7 <fle (F-'ilH/ffU Ws Property Surveyed &Yes P/<ilf Yes ~ Zoning istrict ( /1 ~/ ) Lkes Clssifiction ( ) ) te of Inspection: Inspected by: te of Re-lnspection: Condition(s): Town, Committee or Bord Conditions Attched? n Yes Q No-(If No they need to be ttched.) Condition: No ccessory building shll be used for humn hbittion / sleeping purposes without necessry county nd UC permits. No pressurized wter shll enter the building /J unless pproved connection to POWTS. Must S,eof,nspec rnddp.etintesosn Hold For Snitry: Condition: Construction site best mngement "shll be implemented to prevenny erosion" or "sedimenttion onto neighbonng properties or wetlnds. Hold For TBA: Hold For Affidvit: Hold For Fees: No No 6/l57??r Augus+ 2017

3 Ifty, Villge, Stte or Federl My Also Be Required fouse-x SJMITARY - IGN- rspecial- CONITIONAL - BOA - BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: Vincent & Noelle Petersen Loction: 1/4 Of - 1/4 Section 35 Township 45 N. Rnge 9 w. Town of Brnes Lot 3 Block Subdivision CSM# 67 For: Residentil Accessory Structure: [ 1-Story; Grge (42' x 60') = 2,520 sq. ft.; Porch (8' x 20') =160sq.ft] Totl Overll = 2,680 sq. ft. (isclimer):: Any future expnsions or development would require dditionl permitting Condition(s): No ccessory building shll be used for humn hbittion / sleeping purposes without necessry County nd UC permits. No pressurized wter shll enter the building unless pproved connection to POWTS. Must meet nd mintin setbcks. Construction site best mngement prctices shll be implemented to prevent ny erosion or sedimenttion onto neighboring properties or wetlnds. NOTE: This permit expires 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. June 18, 2018 te

4 SUBMIT: COMPLETE APPLICATION. TAX STATEMENT AN FEE TO: Byfield Ciunty Plnning nd Zoning eprt. PO Box 58 Wshburn,WI (715) 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 AIL PERMITS HAVE BEEN ISSUE TO APPLICANT. APPLICATION FOR PERMIT BAYFIEL COUNTY, WISCONSIN T ~o r le t<i.i5trrit>li(riii:ei"(itl) ;!-i MAY 1 6 2U16 Permits: te: Amount Pid: Refund: FILL OUT IN INK (NO PENCIL) 19-Q9C- 1 :B TYPE OF PERMIT REQUESTE-- LAN USE SANITARY PRIVY CONITIONAL USE 0 SPECIAL USE B.O.A. 0 OTHER Owner's Nme: Kv -S Ve.C\ f\ Address of Property: 3060 Lcutgb Miling Address: iress: I uiv/stie/ip: City/Stte/Zip: ii 3Ys ActQxHo.s \JL s>/733 City/Stte/Zip: &\rnes lx 5<y673 T lone: 7/5837W Cell Phone: 7/5y58553C Contrctor: Contrctor Phone: T: r\-. Plumber Phone: "(AleT Co /zsfeuchon 7/6<//0<35/A 'BeroeGh flu. U>n >< n 7/ Authorized Agent? (Person Signing Appliction on behlf of Owner(; Agent Phone: Agent lufiiling Address (include City/Stte/Zi Written Authoriztion PROJECT LOCATION Legl escription: (Use Tx Sttement) _1/4, 1/4 Section, Township N, Rnge. w Tx I #,756 Lot(s) CSM Vol & Pge Lot(s) No. Block(s) No. Subdivision: ToWCLOf: u.fne-s Attched Yes No Recorded ocument: (i.e. Property Ownership) 17l\ 7039S Lot Size Acrege '/ /.,-/ / Shorelnd 1-1 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 : Jeet istnce Structure is from Shoreline : <!'JL feet Is Property in FloodplinZone? I _:i Yes No Are Wetlnds Present? L Yes STNo Non-Shorelnd Vlue t Time of Completic-n * include donted time & mteril, Project '{'(New Construction U Addition/Altertion! ' Conversion \ i Relocte (existing bldg) # of Stories!:i 1-Story 3g; 1-Story + Loft X 2-Story 11 Foundtion )fi,' Bsement! Foundtion ttcrf bedrooms in structure 1 i_l 2 >S.3 u Wht Type of Sewer/Snitry System Is on the property? [I Municipl/City ~ (New) Snitry Specify Type: LJ Snitry (Exists) Specify Type: Privy (Pit) or i_] Vulted (min 200 gllon) Type of Wter on property LJ City )(Well Ll Run Business on Property u Use X. Yer Round u None : i Portble (w/service contrct) i 1 Compost Toilet! None Existing Structure: (if permit being pplied for is relevnt to it) Proposed Construction: Length: Length: (o 2. Width: Width: Height: Height: 8 Proposed Use -Wt -fc4 ssun JUN 19 2W Cfimmeircipl.Use Municipl Use L j ~K Proposed Structure Principl Structure (first 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 Bunkhouse w/(i i snitry, or IJ sleeping qurters, or L! cooking & food prep fcilities) Mobile Home (mnufctured dte) Addition/Altertion (specify) Accessory Building (specify) Accessory Building Addition/Altertion (specify) imensions ( x ) (3' x ) (, X J (,8 x.0 ) Squre Footge -&- y9o&/ 50- Specil Use: (explin) Conditionl Use: (explin) Other: (explin) 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 exmined 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 relyjj»i on tjiis informtion I (y»\) 3<r (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 Ifmjf for tie purpole of in: Owner(s): t/*- (If there re Multiple Owners lisfed on the eed Alj/)wners must sign or letter(s) of uthoriztion must ccompny this ppliction) te 5///e> Authorized Agent: Address to send permit (If you re signing on behlf of the owner(s) letter of uthoriztion must ccompny this ppliction),,t /sm 3/AA iio /r H733 Copyo%hSttement If you recently purchsed the property send your Recorded eed APPLICANT - PLEASE COMPLETE PLOT PLAN ON REVERSE SIE te

5 rshow Loction of: Show/Indicte: 'or Sketch your Property (regrdless of wht you re pplying for) 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) Fill Out in Ink - NO PENCIL All Existing 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% _r_ 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 <0 30 A) { Q3& 0 C7 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 9 : Aff\ _ A.'l\ _ A?A _ r I Yes XNO Setbck to Septic Tnk or Holding Tnk Setbck to rin Field Setbck to Privy (Portble, Composting) 3LS> 3E> A?A Setbck to Well S " 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 ccvner to the other previously sun/eyed comer or mrked by licensed surveyor t the owner's expense. 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 sun/eyor t the owner's expense. (9) Stke or Mrk Proposed Loction(s) of New Construction, Septic Tnk (ST), rin field (F), Holding Tnk (HT), Privy (P), nd Well (W). NOTICE: All Lnd Use Permits Expire 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. Issunce Informtion (County Use Only) Permit enied (te): Permit#: /Of Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming The locl Town, Villge, City, Stte or Federl gencies my lso require permits. Yes (eed of Record). Snitry Number: /<?'t>f # of bedrooms: Snitry te 12- Reson for enil: Permit te: Yes (Fused/Contiguous Lot(s)) Yes ic-fl-k ETNo No J& No Mitigtion Required Mitigtion Attched Yes Yes B'No j No Affidvit Required Affidvit Attched Yes Yes No No Grnted by Vrince (B.O.A.) Yes /B No Cse #: Previously Grnted by Vrince (B.O.A.) Yes J3-NO Cse ft Ws Prcel Leglly Creted Ws Proposed Building Site elineted 0-Ves No P Yes No Inspection Record: 57&/!i p[ t{ f towiof W?/ te of Inspection: %3 _ Inspected by: ft7/ Were Property Lines Represented by Owner Ws Property Surveyed B-es jy/es Zoning istrict ( fi- /) Lkes Clssifiction ( f ) te of Re-lnspection: No No Condition(s): Town, Committ'ee smmitt'ee 01or Bord Conditions Attched? Yes d No - (If No they need to be ttched.] Signture of lnsp9<torts /??% Condition: Construction site best mngement prctices shll be implemented to prevent ny erosion or sedimenttion onto neighboring properties or wetlnds. Necessry UC permit shll be obtined. Hold For Snitry: Hold For TBA: Hold For Affidvit: U Hold For Fees: te ofapprov. / 7 ~irt Augus ( My 2018)

6 My Also Be Required FNUSE-X SANITARY-18-39S SIGN - SPECIAL - CONITIONAL - BOA - BAYFIELI PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: Rick Vergin Loction: V4 Of - V4 Section 9 Township 44 N. Rnge 9 w. Town of Brnes Pr in 7 Lot Block Subdivision CSM# For: Residentil Use: [ 2- Story; Residence (32' x 44') = sq. ft.; eck (18' x 30') = 540 sq. ft. ] Totl Overll = 1,948 sq. ft. (isclimer): Any future expnsions or development would require dditionl permitting. Condition(s): Construction site best mngement prctices shll be implemented to prevent ny erosion or sedimenttion onto neighboring properties or wetlnds. Necessry UC permit shll be obtined. NOTE: This permit expires 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. June 19, 2018 te

7 SUBMIT: COMPLETE APPLICATION, TAX STATEMENT AN FEE TO; Byfield County Plnning nd Zoning eprt. PO Box 58 Wshburn,WI (715) MiC'3 APPLICATION FOR PERMIT BAYFIEL COUNTY, WISCONSIN INSTRUCTIONS: No permits will be issued until ll fees re pid. Checks re mde pyble to: Byfield County Zoning eprtment.~ BSytield GO. O NOT START CONSTRUCTION UNTIL ALl PERMITS HAVE BEEN ISSUE TO APPLICANT. TYPE OF PERMIT REQUESTE - Owner's Nme: &\-crj r\-\\ Address of Property: 3W L< 'J JUN Permits: te: Amount Pid: Refund: FILL OUT IN INK (NO PENCIL) /?-<r- f'( -K LAN USE SANITARY PRIVY CONITIONAL USE SPECIAL USE B.O.A. OTHER Miling Address: H<u Cvxv City/Stte/Zip: ''~jc:l<'\-uo A- City/Stte/Zip: [\\ f T, L!I 'Tb w Telephone: Cell Phone: ~]i-'ss((-iw 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 _1/4, 1/4 legl escription: (Use Tx Sttement) IL Section, Township N,Rnge Lot(s) CSM w Ai Vol & Pge MlT Town of: "igl'c V~S 'CSM oc ff Lot(s) No. Block(s) No. Subdivision: Attched Yes No Recorded ocument: (Showing Ownership),l< 6Q>HU Lot Size Acrege 3- -SlShorelnd 1 Kt 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 : i' feet istnce Structure is from Shoreline : feet Is Property in Floodplin Zone? 1:1 Yes T>CNO Are Wetlnds Present? n Yes >lo 0 Non-Shorelnd Vlue t Time of Completion $ * include donted time & mteril.-k>-< _L Project T) New Construction ' Addition/Altertion 1! Conversion 1_1 Relocte (existing bldg) ft of Stories J 1-Story I 1-Story + Loft 2-Story I Foundtion U Bsement Foundtion u # of bedrooms in structure i 2 3 Wht Type of Sewer/Snitry System Is on the property? Municipl/City l(new) Snitry Specify Type:,SepV-(" Snitry (Exists) Specify Type: ii Privy (Pit) or I I Vulted (min 200 gllon) Type of Wter on property City 1)<Well --1! Run Business on Property U Use 3 Yer Round T None 0 Portble (w/service contrct) LI Compost Toilet U None Existing Structure: (if permit being pplied for is relevnt to it) Proposed Construction: Length: Length: Width: Width: Height: Height: Proposed Use Residentil Use Commercil Use Municipl Use / ~s Proposed Structure Principl Structure (first 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 Bunkhouse w/ (U snitry, or U sleeping qurters, or U cooking & food prep fcilities) Mobile Home (mnufctured dte) Addition/AItertion (specify) Accessory Building (specify) Accessory Building Addition/Altertion (specify) imensions ( xr, ) t x ) (3 X ) t x ) Squre Footge \<<<s. 2)-7 Specil Use: (explin) Conditionl Use: (explin) Other: (explin) FAILURE TO OBTAIN A PERMIT or STARTING CONSTRUCTION WITHOUTA PERMIT WILL RESULT IN PENALTIES I (we) declre tht this ppliction (including ny ccompnying informtion) hs been exmined 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 1 (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): \S-----'Y (If there re Multiple Owners listed on the eed All Owners must sign or letter(s) of uthoriztion must ccompny this ppliction) te l Authorized Agent: te (If you re signing on behlf of the owner(s) letter of uthoriztion must ccompny this ppliction) Attch Address to send permit Copy of Tx Sttement If you recently purchsed the property send your Recorded eed APPLICANT - PLEASE COMPLETE PLOT PLAN ON REVERSE SIE

8 w (2) (3) (4) (5) (6) (7) 'slow: rw or Sketch your Property (regrdless of wht you re pplying for) Show Loction of: Show/Indicte: Show Loction of ("' Show: Show: Show ny (*): Show ny (*): Proposed Construction "Es2_fYL (XV-V'<\>!< North (N) on Plot Pln '**" " Fill Out in Ink - NO PENCIL (*) rivewy nd (*) Frontge Rod (Nme Frontge Rod), _ i_... \v AliExistmg"St7uctureso'nyo upy7perty' 0 L-C- c ' C-WV<, (*) Well (W); (*) SepticTnk (ST); (*) rin Field (F)F(*) Holding Tnk (HT) nd/or (*) Privy (P) (*) Lke; (*) River; (*) Strem/Creek; or (*) Pond (*) Wetlnds; or (*) Slopes over 20% ( PS. Q, < -_. -c ) \\ cwc 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 -1 ZS- '-) Q 3 :yof:eet *e- -H5- 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 5 *, Yes 'Wlo Setbck to Septic Tnk or Holding Tnk Setbck to rin Field Setbck to Privy (Portble, Composting) ) \'QJ3 Setbck to Well V 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 th<? other previously sun/eyed corner or mrked by licensed surveyor t the owner's expense. 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 expense. (9) Stke or Mrk Proposed Loction(s) of New Construction, SepticTnk (ST), rin field (F), HoldineTnk (HT), Pri\ nd Well (W). NOTICE: All Lnd Use Permits Expire 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. Issunce Informtion (County Use Only) Permit enied (te): Permittt: : R-002 Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming The locl Town, Villge, City, Stte or Federl gencies my lso require permits. Yes (eed of Record). Snitry Number: W's Reson for enil: Permit te: Yes (Fused/Contiguous Lot(s)) Yes '\'[ B No tfno J No Mitigtion Required Mitigtion Attched # of bedrooms: Snitry te; 6// Yes Yes ETNo B No Affidvit Required Affidvit Attched Yes Yes 0 No 0No Grnted by Vrince (B.O.A.) Yes JZ No Cse #: Previously Grnted by Vrince (B.O.A.) Yes WNo Cse #: Ws Prcel Leglly Creted Ws Proposed Building Site elineted Inspection Record: te of Inspection: Yes No,B-Yes No //7i'/7 Of/ Condition(s): Town, Committee or Bord Cond Signture of Inspector 6//y i ]nspectedbv: w/ CWe Condition: A UC permit from the loclly contrcted UC inspection gency must be obtined prior to the strt of construction. Must meet nd mintin setbcks. Were Property Lines Represented by Owner Ws Property Surveyed Hold For Snitry: Hold For TBA: Hold For Affidvit: Hold For Fees: B Yes u Yes Zoning istrict Lkes Clssifiction te of Re-lnspection: No No /) _L_ Condition: Construction site best mngement prctices shll be implemented to prevent ny erosion or sedimenttion onto neighboring properties or wetlnds.» Augus ( My 2018)

9 ity, Villge, Stte or Federl fits My Also Be Required JUSE-X UNITARY S IGN- ESPECIAL - CONITIONAL - BOA - BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: Brend rll Loction: V4 of - 1/4 Section 8 Township 44 N. Rnge 9 w. Town of Brnes Lot 2 Block Subdivision CSM# 337 For: Residentil Use: 2- Story; Residence (30' > L 30') = 900 sq. ft.; Porch (10' x Totl Overll =1,200 (isclimer):: Any future expnsions or development would require dditionl permitting. 30') =300 sq. ft. ] Condition(s): A UC permit from the loclly contrcted UC inspection gency must be obtined prior to the strt of construction. Must meet nd mintin setbcks. Construction site best mngement prctices shll be implemented to prevent ny erosion or sedimenttion onto neighboring properties or wetlnds. NOTE: This permit expires 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 June 21, 2018 te

10 Byfield County Plnning nd Zoning eprt. PO Box 58 Wshburn, Wl (715) 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. APPLICATION FOR PERMIT BAYFIEL COUNTY, WISCONSIN.*. estrpp (Received) ;'1 MAY 16?08.Permit ft: Amount Pid: Refund: l-rsn l'\ Kte-7/ n\ V/Pf. OF PERMIT REQUESTE--?S LAN USE SANITARY Q PRIVY CONITIONAL USE SPECIAL USE B.O.A. OTHER Owner's Nme: \qa - ' <tbe<<ly\q Adrfress of Property: s: LV? > 55 Fnntrrtnr- Miling Address: City/Stte/Zip: '<-<J/.. itw~t~t U.' City/Stte/Zip:! {j. kjl 5(73 i:ontrctor Phone! Plumber: VA sac ( %-W? MnA Vvj--Vk L?7-te 5ce Wo >*1 Authorized Agent: (Person Signing Appliction on behlf of Owner(s)) Agent Phone: Leel escription: (Use Tx Sttement) Section <- L/, Township 7"~f N,Rnge Tx IS 1 Lot(s) CSM \ic\o w Agent Miling Address (include City/Stte/Zip): Vol & Pge \0 Lot(s) No. Block(s) No. Subdivision: Town of: BriA Telephone: Cell Phone: (> ( \-> r( 7oo Plumber Phone: Written Authoriztion Attched A Yes No Recorded ocument: (i.e. Property Ownership) csovt/ <o3b\ Lot Size Acrege ~-s 5?Shorelnd il Is Property/Lnd within 300 feet of River, Strem (ind. intermittent) Creek or Lndwrd side of Floodplin? If yes continue y. 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 : T\5-T " feet Is Property in Floodplin Zone? I : Yes FNo Are Wetlnds Present? X Yes L; No Non-Shorelnd Vlue t Time of Completion * include donted time & mteril s?-?<5 COO Project }i New Construction Addition/Altertion Conversion I ' Relocte (existing bldg) Run Business on Property ft of Stories i 1-Story y- 1-Story+Loft 2-Story Foundtion fy Bsement Li Foundtion w}\ Use 'yi. Yer Round # of bedrooms in structure None Wht Type of Sewer/Snitry System Is on the property? - Municipl/City y. (New) Snitry Specify Type: ( 'flu Snitry (Exists) Specify Type: Privy (Pit) or L Vulted (min 200 gllon) ' I Portble (w/service contrct) Compost Toilet Type of Wter on property ' City Well!l None Existing Structure: (if permit being pplied for is relevnt to it) Proposed Construction: Length: Length:.<g Width: Width: "\ 3. Height: Height: 3? Proposed Use Residentil Use Commercil Use Municipl Use Rec'd for Issur _ Q_ e Proposed Structure Principl Structure (first structure on property) Residence (i.e. cbin, hunting shck, etc.) with Loft with Porch <?CUCv'r</ with (2nd) Porch Me/A with eck with (2"d)Beek\ "t?o.y, with Attched Grge Bunkhouse w/(i i snitry, or U sleeping qurters, or I i cooking food prep fcilities)-* Mobile Home (mnufctured dte) _\_)s'w-v Addition/Altertion (specify) Accessory Building (specify) Accessory Building Addition/Altertion (specify) imensions ( < x 33.} ( /B x-t (' r x ic ) ( C. x A~ (/_6JS>x ) U \ Ify 3T X3"k' ( x il l (/(.(76x ( X ) Squre Footge?oti '/3 0 ~SL 7f. s ~WT TT ±+6r i3t1 JUN ' 5?"' Secretril SU-...Q. Specil Use: (explin) Conditionl Use: (explin) Other: (explin) FAILURE TO OBTAIN A PERMIT or STARTING CONSTRUCTION WITHOUT A PERMIT WILL RESULT IN PENALTIES 1 (we) declre tht this ppliction (including ny ccompnying informtion) hs been exmined 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 1 (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): (If there re Multiple Owners listed onhe ee-u Owoers mystign oilett-(s) of uthoriztion must ccompny this ppliction) Authorized Agent: %;( /< Address to send permit [If you re signifig'orftiehlfofthe own5r(s) c letter of uthoriztion must ccompny this ppliction) it W ' kr %?,r \.X APPLICANT - PLEASE COMPLETE PLOT PLCT1 OFT REVERSE SIE te te ~7->/P Attch.. Copy of Tx Sttement If you recently purchsed the property send your Recorded eed

11 In the box below: rw or Sketch your Property (regrdless of wht you re pplying for) ( (2) (3) (4) (5),(6) (7) Show Loction of: Show/Indicte: Show Loction of ( Show: Show: Show Show ny(»): ny(*): Proposed Construction North (N) on Plot Pln (*) rivewy nd (*) Frontge Rod (Nme Frontge Rod) All Existing 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% 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 -te <- Setbck from the Lke (ordinry high-wter mrk) eet Setbck from the Estblished Right-of-Wy f- Setbck from the River, Strem, Creek wr Setbck from the Bnk or Bluff Setbck from the North Lot Line 1-. Setbck from the South Lot Line ~<s>i Setbck from Wetlnd Setbck from the West Lot Line IMi TFeeT 20% Slope Are on the property Af Yes No Setbck from the Est Lot Line Elevtion of Floodplin Setbck to Septic Tnk or Holding Tnk Setbck to Well wt Setbck to rin Field Setbck to Privy (Portble, Composting) Prior to the plcement or construction of structure within ten (10) feet of the minimum re! uired setbck, the boundry line from which the setbck must be mesured must be visible from one previously surveyed comer to the other previously surveyed corner or mrked by licensed surveyor t the owner's expense. 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 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 mrkedyicense dyreyothecwnerxpnse (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 Expire 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. Issunce Informtion (County Use Only) Permit enied (te): Permit ft: iqll Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming Yes Yes Yes The locl Town, Villge, City, Stte or Federl gencies my lso require permits. (eed of Record) 1-ffQ Snitry Number # of bedrooms: Snitry te: Reson for enil: Permit te: (Fused/Contiguous Lot(s)) C-SSI- /BNo - No tfno Mitigtion Required Mitigtion Attched Yes Yes -No B No Affidvit Required Affidvit Attched Yes ftno Yes 0 No Grnted by Vrince (B.O.A.) Yes-No Cse #: Previously Grnted by Vrince (B.O.A.) Yes g/no Cse #: Ws Prcel Leglly Creted Ws Proposed Building Site elineted Qes No \Q Yes Q No Were Property Lines Represented by Owner Ws Property Surveyed \yies -Bfes No No Inspection Record: Zoning istrict ( A'~i te of Inspection: 7"/ Inspected by:.. Lkes Clssifiction ( f ) te of Re-lnspection: Condition(s): Town, Committee or Bord Conditions Attched? Yes No - (If N& they need to be ttched.) _ZL Signture of Inspector: 4--/yfff Condition: Construction site best mngement prctices shll be implemented to prevent ny erosion or sedimenttion onto neighboring properties or wetlnds. Necessry UC permit shll be obtined. te of Approvl;./ Hold For Snitry: Hold For TBA: Hold For Affidvit: Hold For Fees: August 2017

12 Byfield County Web AppBuilder tssssssnsss T-T;- -.- isymnk'ses V * t. SI'S M -.< stms) e3g2s633es 6S6352 SS2) : ;-<< ISS. ;<ltil»oq424ao? lihoo ' ' ":i[, T,. -,.-. f- BuRBiiwir' [(0(» p5AQZ120QOj w.'','',-i ""u»""' T V 'v!*. y-..- ;L.. si;'*.,. "41S. *..-' '. -.c. ' <? T\ -- t ">;-.:*. - t '092c4:c5002toooc] <t- Privte Forest Crop Entered After Open.-' Approximte Prcel Boundry i: ''S'-L 1:1, mi Privte Forest Crop Entered Before Open LJ Section Lines km. Lnd Entered After Open Rivers Government Lot Entered Before Open Lkes LJ Municipl Boundry Byfield County, Byfield County Lnd Records. Lnd - MFL Open After 2004 nd MFL Closed After 2004 Tie Lines ~ Red Cliff Reservtion Boundry ''MFL Pe" Before 2005 nd MFL Closed Before 2005 Mender Lines All Rods Federl Web AppBullder foraregis Byfield County Lnd Records Byfjeld County

13 Town, City, Villge, Stte or Federl Permits My Also Be Required LAN USE - X SANITARY-18-50S SIGN - SPECIAL - CONITIONAL - BOA - BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: enn Steering / Mike Furtk, Agent Loction: 1/4 of 1/4 Section 20 Township 44 N. Rnge 9 w. Town of Brnes Lot 1 Block Subdivision CSM# 2010 For: Residentil Use: [ 1.5- Story; Residence (58' x 32') = 2,204 sq. ft; Porch #1 (8' x 10') = 80 sq. ft.; Porch #2 (6' x 18.5') = 111 sq. ft; eck #1 (15.25' x 6') = 91.5 sq. ft; Bonus Room (10.75' x 32') = 344 sq. ft.; Attched Grge (36' x 32') = 1,152 sq. ft. ] Totl Overll = 4,579 sq. ft. (isclimer): Any future expnsions or development would require dditionl permitting. Condition(s): Construction site best mngement prctices shll be implemented to prevent ny erosion or sedimenttion onto neighboring properties or wetlnds. Necessry UC permit shll be obtined. IOTE: This permit expires 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. rhlis permit my be void or revoked if ny performnce conditions re not ieted or if ny prohibitory conditions re violted. Trcy Pooler Authorized Issuing Officil June 22, 2018 te