A-T - APPLICATION FOR PERMIT ~~^^ ^ BAYFIELD COUNTY, WISCONSIN,'i.,^ jop. ^4'^lT ^ ^ JLJL 11 ::^ l! SayfieSd Co. Zoning Depfc

Transcription

1 SUBMIT: COMPLETE APPLICATION, TAX STATEMENT AN FEE TO: Byfield County Plnning nd Zoning eprt. PO Bo 58 Wshburn,WI 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. A-T - APPLICATION FOR PERMIT ~~ BAYFIEL COUNTY, WISCONSIN,'i., jop. 4'lT JLJL 11 :: l! SyfieSd Co. Zoning epfc '' j+r'j1- Permit#: te: Amount Pid; Refund: FILL OUT IN INK NO PENCIL /s?- we 7-/<9-/ Q7S 7--IS TYPE OF PERMIT REQUESTE- Owner's Nme: AUc A 11 Address of Property:?t<056 v/y /3 LAN USE 0 SANITARY PRIVY H CONITIONAL USE SPECIAL USE B.O.A. OTHER Miling Address:,12 itv*li /. City/Stte/Zip: City/Stte/Zip: M. M i-a ns 7o7 3.fc Telephone: ssq-sn Cell Phone: Contrctor: Contrctor Phone: Plumber: Plumber Phone: Authorized Agent: Person Signing Appliction on behlf of Owners Agent Phone; Agent Miling Address include City/Stte/Zip: Written Authoriztion PROJECT LOCATION Legl escription: Use T Sttement T I # -3 "5-7 Gov't Lot Lots CSM Vol & Pge CSM oc # Lots No. Blocks No. Subdivision: Attched Yes No Recorded ocument: Showing Ownership Jon e- SlbSoS Section, Township N,Rnge Town of: w.\{ Lot Size Acrege? Shorelnd j 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? ' J Yes No Are Wetlnds Present?! Yes tbno >Non-Shorelnd Vlue t Time of Completion * include donted time & mteril $ < Project! New Construction Addition/Altertion Li Conversion!! Relocte eisting bldg # of Stories 1-Story [ \ 1-Story + Loft 2-Story Foundtion Bsement I : Foundtion? A/A-t # of bedrooms in structure Li 1 2 1! 3 Wht Type of Sewer/Snitry System Is on the property? Municipl/City! New Snitry Specify Type:?? Snitry Eists Specify Type: -C Privy Pit or i Vulted min 200 gllon Type of Wter on property Li City SWell.-}! Run Business on Property fhi ftln». tsi Use ' Yer Round y, None 'i Portble w/service contrct! Compost Toilet None Eisting 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 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 ' snitry, or ' I sleeping qurters, or I Mobile Home mnufctured dte Addition/Altertion specify Accessory Building specify Ou< Accessory Building Addition/Altertion specify ] cooking & food prep fcilities 1!_ t imensions _ 3 / J Squre Footge 3 Specil Use: eplin Conditionl Use: eplin Other: eplin 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 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 jil ncccurcyofll informtion 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 o\\ this informtion I we tn 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 resonbl time fol- the purpose of inspectioil. Owners:.V u If there re MultiplQwnSrs listed on the eed Attbwners mustsignorletters of uthoriztion must ccompny this pplicti:ion te 7 Zo>8 Authorized Agent: If you re signing on behlf of the owners letter of uthoriztion must ccompny this ppliction te Address to send permit?a T. }.brtf i3 o, 5'4&tJT CopyoSttement / If you recently purchsed the property send your Recorded eed APPLICANT - PLEASE COMPLETE PLOT PLAN ON REVERSE SIE

2 ->s k he bo below: rw or Sketch your Property reprdless of wht you re pplying for Show Loction of: Show/Indicte: Show Loction of*: Show: Show: Show ny *: 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 * Lke; * River; * Strem/Creek; or * Pond * Wetlnds; or * Slopes over 20% Fill Out in Ink - NO PENCIL Privy P - 0, os -?"nj 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 -Ifb fcs'6 po t /o*»0 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 Yes Li No QS Setbck to Septic Tnk or Holding Tnk Setbck to rin Field Setbck to Privy Portble, Composting «0 _ typ _ Setbck to Well /W _ 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 corner 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 corner, 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 surveyor t the owner's epense. 9 Stke or Mrk Proposed Loctions of New Construction, Septic Tnk ST, rin field F, Holding Tnk HT, Privy Pl, nd WelLW. 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. Issunce Informtion County Use Only Permit enied te: Permit #: / 06 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 Fused/Contiguous Lots Snitry Number: Reson for enil: 3{f Permit te: :7-/<9'/ X No No No Mitigtion Required Mitigtion Attched # of bedrooms: Snitry te: 0 Yes Yes No VNO Affidvit Required Affidvit Attched w"»/ ZOVT> Yes S No Yes gno Grnted by Vrince B.O.A. Yes S; No Cse ff: Previously Grnted by Vrince B.O.A. Yes [No Cse #: Ws Prcel Leglly Creted Ws Proposed Building Site elineted 18 Yes No r\es No iftf Were Property Lines Represented by Owner Ws Property Surveyed Yes Yes» No tfno Inspection Record: Jf -,<.<r. A5 / hn' O/- U*e/i'W'<-«-r' fo ftc-lvy, '- ojt fiji Zoning istrict ft I Lkes Clssifiction 6te of Inspection: [ -2., inspected by: te of Re-lnspection: Conditions: Town, Committee or Bord Conditions Attched? Yes No - If No they need to be ttched. -/Utrc S> A* t // /yt' imvi kt'r- p $/<0~ ffos, jjo rt&itnr. f* t sycf yv- T- <c-dv-</ WU-<ir- / h'. /J /v«jt /A< I'/,< cv -\c>. Signture of Inspector: j te of Approvl: :-ru*s' Hold For Snitry: Hold For TBA: Hold For Affidvit: Hold For Fees: /IT? c b<. A>-J P C M, 5 lcc UAo j os4 pt;/* ifi-i-k nc-jr p«'<-- fcyt'si-it- <J Augus My 2018

3 i, City, Villge, Stte or Federl nts My Also Be Required lfter-the-fct wived LAN USE - X SANITARY SIGN - SPECIAL - CONITIONAL - BOA - BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: Alden & Ktherine Alien Loction: SW A of NW V4 Section 27 Less 2 A Pr in SW Cor Township 51 N. Rnge 4 W. Town of Russell Gov't Lot Lot Block Subdivision CSM# For: Residentil Accessory Structure: [ 1- Story; Crport 23' 15' = 345 sq. ft. ] isclimer: Any future epnsions or development would require dditionl permitting. Conditions: Structure shll not be used for humn hbittion / sleeping purposes. No pressurized wter in structure without n pproved connection to POWTS. Must meet nd mintin setbcks. 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. Todd Norwood Authorized Issuing Officil July 12, 2018 te

4 SUBMIT: COMPLETE APPLICATION. TAX STATEMENT AM FEE TO: Byfield County Plnning nd Zoning eprt. PO Bo 58 Wshburn,WI 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 I] r'i I il! Bte Stmp.lReceluedl 1:; i, i; 1AY30: I/ zu' ]0 -\ I!.' l!!i J Permitff: te: Amount Pid: Refund: FILL OUT IN INK NO PENCIL!9-/ 7- y?s -1-t TYPE OF PERMIT REQUESTE- Owner's Nme: LOJ rtu-fl Address of Property: T. </ 15 Contrctor: $6.f LAN USE SANITARY PRIVY 0 CONITIONAL USE SPECIAL USE H B.O.A. H OTHER Miling Address: ItCL Wu<»u4 Qs City/Stte/Zip: sf.t -e Contrctor Phone: Plumber: City/Stte/Zip: I Q Telephone: «< SwS >4\ Cell Phone: zz<.?.w4- Plumber Phone: Authorized Agent: Person Signing Appliction on behlf of Owners Agent Phone: Agent Miling Address include City/Stte/Zip: Written Authoriztion PROJECT LOCATION IS 1/4, _ t-w_ 1/4 Legl escription: Use T Sttement Z 16 Gov't Lot Lots CSM Vol & Pge Lots No. Blocks No. Subdivision: Attched Yes No Recorded ocument: i.e. Property Ownership AL&<W < Knfe Section, Township N,Rnge Town of: 1<LL- Lot Size Acrege 36. Shorelnd ri Is Property/Lnd within 300 feet of River, Strem incl. intermittent Creek or Lndwrd side of Floodplin? If yes continue. F; 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? H Yes No Are Wetlnds Present? Yes yno Non-Shorelnd Vlue t Time of Completion * include donted time & mteril» Project New Construction Addition/Altertion II Conversion U Relocte eisting bidg # of Stories %. 1-Story LI 1-Story + Loft II 2-Storv Foundtion % Bsement % Foundtion LI ffof bedrooms in structure U 1 %2 3 LJ Wht Type of Sewer/Snitry System Is on the property? 1-1 Municipl/City U New Snitry Specify Type: Snitry Eists Specify Type: ST t>f Privy Pit or n Vulted min 200 gllon Type of Wter on property U City Well n! I Run Business on Property u Use Yer Round S<<nrfi None Portble w/service contrct U Compost Toilet il None Eisting Structure: if permit being pplied for is relevnt to it Proposed Construction: Length: 4l.» Length: 45. ' Width: tfi Width: - ft ' Height: Jr Height: 4 Proposed Use *K Residentil Use Commercil Use Municipl Use y 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/lj snitry, or sleeping qurters, or cooking & food prep fcilities Mobile Home mnufctured dte Addition/Altertion specify CKJ LA<-& Accessory Building specify Accessory Building Addition/AItertion specify _. J_ imensions e z&. J_ J_ Squre Footge ZT-4 Specil Use: eplin Conditionl Use: eplin Other: eplin 1 we declre tht this ppliction inciuding 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 th% detil nd ccurcy of ll infotmtion 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 Couif\ relying on this informtion le qm 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 resorblg tiie fr the purpose of insiol." Owners: v_ If there re Multiple Owners listed on the ed All Owners must sign or letters of uthoriztion must ccompny this ppliction te Z.4.Zol8 Authorized Agent: te tlf you re signing on behlf of the owners letter of uthoriztion must ccompny this ppliction Attch loermit. 3<>SO \ is «typ tj S.itJ.. _ 1 Copy of 1 T Copy of Sttement T If you recently purchsed the property send your Recorded eed 3 APPLICANT - PLEASE COMPLETE PLOT PLAN ON REVERSE SIE

5 / /be\ow: Aw 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 *:?1 t s -' 11,?-: / sl v./ -$-60' Proposed Construction North N on Plot Pln * rivewy nd * Frontge Rod Nme Frontge Rod All Eisting Structures on your Property * Well W; * Septic Tnk ST; * rin Field F; * Holding Tnk HT nd/or * Lke; * River; * Strem/Creek; or * Pond * Wetlnds; or * Slopes over 20% " N >._ ; d{o u I T< v p i I r<> Ctk Fill Out in Ink - NO PENCIL \ Privy P? 31 5> c "? ft f\," I lr Plese complete 1-7 bove prior to continuing 8 Setbcks; mesured to the closest point L */1 0 Chnges in plns must be pproved by the Plnning & Zoning ept. escription Mesurement escription Mesurement Setbck from the Centerline of Pltted Rod Setbck from the Estblished Right-of-Wy Setbck from the North Lot Line Setbck from the South Lot Line Setbck from the West Lot Line Setbck from the Est Lot Line Setbck to Septic Tnk or Holding Tnk Setbck to rin Field Setbck to Privy Portble, Composting -$'ft0 " f?0-74o FeeT 6 - A-T Ko 80 _ 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 eftttorl 6 /4tt Setbck to Well Yes V No &ct TZ/? 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 sun/e'/ed corner or mrked by licensed sltveyor 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 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 surveyor t the owner's epense. 9 Stke or Mrk Proposed Loctions 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. Snitry Number: Issunce Informtion County Use Only Permit enied te: Reson for enil: w& # of bedrooms: Snitry te: : <! M> / HTV Permit #: n-ci Permit te: : 7-/5-/2' Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming Yes eed of Record. Yes Fused/Contlguous Lots Yes 9S.NO I? No No Mitigtion Required Mitigtion Attched Yes Yes >?No TNo Affidvit Required Affidvit Attched Yes!S'No Yes <&;No Grnted by Vrince B.O.A. Yes & No Cse ft Previously Grnted by Vrince B.O.A. Yes INo Cse #: Ws Prcel Leglly Creted Ws Proposed Building Site elineted S Yes No Yes No -<tkt-s Were Property Lines Represented by Owner Ws Property Surveyed inspnord: U/iSSkU fs 0 f/-f., rtyl.' VH.<>crr».*l f-c1 ipc.'?l/'..fl-+. -ru <Jfr*y /A-Ay.'1 Sul *»C. ehvkttir J-it--rc'- te of inspection: /,? ' "spected by: Conditions: Town, Committee or Bord Conditions Attched? Yes No-If No they need to be ttched. Yes Yes Zoning istrict firb} Lkes Clssifiction te of Re-lnspection: ToyniJ M'.i sk- pus.v oa i>44.::- l.. Mtc. </pc /.f, <t., y-ams,{]<a \ic oji, " i - t» - - No»No "gnture of lnspector- Uw Hold For Snitry: Hold For TBA: Hold For Affidvit: Hold For Fees: teopappfovl Xi W ff\' /T C..' $/.C<. prljlt da-l <S4-1A' o.-'- \ s\\ Augus My 2018

6 Ky, Villge, Stte or Federl rn/ly Also Be Required I USE - X UNITARY rs!gn - SPECIAL - CONITIONAL - BOA - BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: Alden & Ktherine Alien Loction: SW A of NW 1/4 Section 27 Less 2 A Pr in SW Cr Township 51 N. Rnge 4 W. Town of Russell Gov't Lot Lot Block Subdivision CSM# For: Residentil Addition / Altertion: [ 1- Story; Enlrge Bedrooms 8' 28' = 224 sq. ft. ] isclimer: Any future epnsions or development would require dditionl permitting. Conditions: Proposed dditions must meet nd mintin setbcks. Necessry UC requirements nd permits must be obtined. 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. Todd Norwood Authorized Issuing Officil July 12, 2018 te