APPLICATION FOR PERMIT. BAYFIELD COUNTY, WISCONSIN ~^, lj ; Pa* Stamp (Received) 11 J JUN04ZU1

Transcription

1 SUBMIT: COMPLETE APPLICATION, TAX STATEMENT AN F, E TO; Byfield County Plnning nd Zoning eprt. PO Box 58 Wshbum,WI (715) INSTRUCTIONS: No permits will be issued until ll fees re pid.' Checks re mde pyble to: Byfield County Zoning eprtment. APPLICATION FOR PERMIT BAYFIEL COUNTY, WISCONSIN ~, lj ; P* Stmp (Received)! -. ;: ; ' 11 J JUN04ZU1 O NOT START CONSTRUCTION UNTIL ALL PERMITS HAVE BEEN ISSUE TO APPLICANT. fwm ','1, Permit If: )te: Amount Pid: Refund: FILL OUT IN INK (NO PENCIL) -of? 1 4 (p'lq-l ga-w TPE OF PERMIT REQUESTE- Owner's Nme: cs> f PuwU ToskiA Address of Property:.n trctor: sl Contrctor: LAN USE SANITARY PRIVY CONITIONAL USE SPECIAL USE 0 B.O.A. OTHER Miling Address: CityStteZip: [ S.5:W QQ f) W6 CityStteZip: Telephone: -2 Cell Phone: -W-4- Contrctor Phone: Plumber: Plumber Phone: Authorized Agent: (Person Signing Appliction on behlf of Owner(s)) Agent Phone: Agent Miling Address (include CityStteZip): Written Authoriztion Attched Yes Jlo PROJECT LOCATION -14, 14 Legl escription: (Use Tx Sttement) Gov't Lot 0 Section, Township N. Rnge Lot(s) 0 Tx IS CSM li2t> Vol & Pge 0 & Lot(s) No. lz Town of: 3<?Lm <f Block(s) No. Recorded ocujjient: (i.e. Property Ownership) «<t -oesq 50-2j Subdivision: f4, CkvffJ Lot Size h Acrege..Shorelnd Non-Shorelnd is PropertyLnd within 300 feet of River, Strem find. intermittent) Creek or Lndwrd side of Floodplin? If yes continue - Is PropertyLnd within 1000 feet of Lke, Pond or Flowge If yes continue 'ynpe Structuc is froshgxpline : >5e ) -±> feet ;i Q Ts'tnce Stniciure is from Shoreline :.feet Is Property in Floodplin Zone? LI Yes ;XNC Are Wetlnds Present? Yes "No Vlue t Time of Completion * include donted time & mteril $ l >oo Project New Construction AdditionAltertion S<f Conversion rj Relocte (existing bldg)? i Run Business on Property # of Stories 1-Story 1-Story+Loft 2-Story X {-CAW Foundtion Bsement U Foundtion Jl Use,'j Yer Round # of bedrooms in structure LI 1 n 2 3 u U None Wht Type of SewerSnitry System Is on the property? I! MuniciplCity (New) Snitry Specify Type: J< Snitry (Exists) Specify Type: f>6wt> ' Privy (Pit) or Ll Vulted (min 200 gllon) F\ Portble (wservice contrct) Compost Toilet Type of Wter on property G City XSVell J i None Existing Structure: (if permit being pplied for is relevnt to it) Proposed Construction: f-lq t- 7 ' Width: <S Width: * - Proposed Use Residentil Use AlfQLuJ' -ommercil JUN 06 2;J1 MMmLst Rec'd for Issunc JUN 1Z 2018 V- X v 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(! 1 snitry, or!! sleeping qurters, or ;J cooking & food prep fcilities) Mobile Home (mnufctured dte) AdditionAltertion (specify) Accessory Building (specify) Accessory Building AdditionAltertion (specify) Specil Use: (explin) Conditionl Use: (explin) Other: (explin) p.l» LtA'lMt 0 shcs -ff) Mfl FAILURE TO OBTAIN A PERMIT or STARTING CONSTRUCTION WITHOUT A PERMIT WILL RESULT IN PENALTIES imensions J x _) T Squre Footge 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 fy with this ppliction. I (we) consent to county officils chrged with dministering county ordinnces to hve ccess to the bove described property t ny resppffte me for the purpose qj Ownerfs (If there rs listeqfin fhe eed All Owners must sign or letter(s) of uthoriztion must ccompny this ppliction) te Oll ft& Authoitied Agent: te (If you re signing on behlf of the owner(s) letter of uthoriztion must ccompny this ppliction) Address to send permit jyrfs.sh 6en IMI sse,... If you recently purchsed the property send your Recorded eed APPLICANT - PLEASE COMPLETE PLOT PLAN ON REVERSE SIE

2 )w: rw or Sketch your Property (regrdless of wht you re pplying for) Show Loction of: (2) ShowIndicte: (3) Show Loction off*): (4) Show: (5) Show: (6) Show ny (*): (7) Show ny (*): Proposed Construction North (N) on Plot Pln Fv KV (*) rivewy nd (*) Frontge Rod (Nme Frontge Rod) All Existing Structures on your Property Fill Out in Ink - NO PENCIL (*) Well (W); (*) Septic Tnk (ST); (*) rin Field (F); (*) Holding Tnk (HT) ndor (*) Privy (P) (*) Lke: (*1 River: (*) StremCreek; or (*) Pond (ITWetlndl,; or (*) Slopes over 20% \. ' "_ SOU'IU- _ _.- _ Wr\e\ (l f2iv- rfoc Plese complete (1) - (7) bove (prior to continuing) J N e- -fu1, y\ 4» Chnges in plns must be pproved by the Plnning & Zoning ept. (8) Setbcks: (mesured to the closest point) -f' -72?? z? -7,, 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 S-, 'f-jyo W(Wr C,C:r> Ci T FeelT 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 J FeeT rt-a? \ H Yes lano Setbck to SepticTnk or Holding Tnk Setbck to rin Field Setbck to P"'iVPoTti_Comppsting) 4 S> VA Setbck to Well JK> 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 suneyor 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 suneyed 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 mrked by licensed surveyor t the owner's expense. (9) Stke or Mrk Proposed Loction(s) of New Construction, SepticTnk (ST), rin field (F), HoldinpTnk (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): Snitry Number: # of bedrooms: Snitry te: Reson for enil: Permit #: N-7 Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming Permit te: Yes (eed of Record). Yes (FusedContiguous Lot(s)) Yes Cn'13-i tfno rfno No Mitigtion Required Mitigtion Attched Yes B- No Yes Q-No Affidvit Required Affidvit Attched Yes -Q'No Yes BNo Grnted by Vrince (B.O.A.) Yes CLMO Cse S: Previously Grnted by Vrince (B.O.A.) Yes 0-No Cse ft: Ws Prcel Leglly Creted Ws Proposed Building Site elineted 0 Yes No JYes 0 No Inspection Record:<i 7< <J({ fcm'-fh} } Were Property Lines Represented by Owner Ws Property Surveyed yf6s Yes Zoning istrict ( f- ( ) Lkes Clssifiction ( - ) te of Inspection: Inspected by: te of Re-lnspection: Condition(s): Town, Cdmmittee or Bord Conditions Attched? Yes No - [W No they need to be ttched.) Signture of Inspector:! lil 'A?<,rn,riti e'yi, y &c{ u ctct P n'y J : of-- Hold For Snitry: Hold For TBA: Hold For Affidvit: Hold For Fees: te of Approvl: No No Augus ( AAy 2018)

3 rcity, Villge, Stte or Federl ;its My Also Be Required FNUSE-X SANITARY - SIGN - SPECIAL - CONITIONAL - BOA - BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: Scott & Pmel Toshner Loction: 14 Of 14 Section 19 Township 44 N. Rnge 9 W. Town of Brnes Gov't Lot Lot 30 Block Subdivision Clerwter CSM# For: Residentil Other: [ Stirs to the Lke (58' x 3') = 174 sq. ft. ] (isclimer): Any future expnsions or development would require dditionl permitting. Condition(s): Build s proposed, minimize erosion, ny ctivity in the wter contct NR for permitting. 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 12, 2018 te

4 SUBMIT: COMPLETE APPLICATION. TAX STATEMENT AN FEE TO: Byfield County Plnning nd Zoning eprt. PO Box 58 Wshburn,WI (715) w ftm> rs c-f APPLICATION FOR PERMIT BAYTOLrCOUNTY,WISCONSINENTERE' tejsmp (Received) \ JUN Uo.u'ic Permit #: te: Amount Pid: >-<3-f 7-7-i\ 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. Refund: TYPE OF PERMIT REQUESTE - LAN USE SANITARY PRIVY CONITIONAL USE SPECIAL USE B.O.A. OTHER Owner's Nme: Ki] li Address of Property: S3 (sicoe-. b. Contrctor: s Miling Address: CityStteZip: 5'3?<?< oe ~(5ftW [. 73 CityStteZip: ~A <, u)i 5~($75 Contrctor Phone: 2-06 '-81 Plumber: Telephone: Cell Phone: (}1 > Plumber Phone: Authorized Agent: (Person Signing Appliction on behlf of Owner(s)) Agent Phone: Agent Miling Address (include CityStteZip): Written Authoriztion Legl escription: (Use Tx Sttement) Gov't Lot Section 3)0, Township il> N, Rnee 0' Tx I# (4-5 digits) <?6-r Lot(s) CSM Vol. &-Pge 13K Lot(s) No. Town of: Bi< Block(s) No. Attched Yes No Recorded eed (i.e. S ssigned by Register of eeds) ocument? - R W> Subdivision: Lot Size 74 Acrege -7z Shorelnd Is PropertyLnd within 300 feet of River, Strem (md. intermittent) Creek or Lndwrd side of Floodplin? If yes continue - Is PropertyLnd within 1000 feet of Lke, Pond or Flowge If yes continue istnce Structure is from Shoreline : O' _feet istnce Structure is from Shoreline : feet Is Property in Floodplin Zone? Yes 'No Are Wetlnds Present? Yes No 3 Non-Shorelnd Vlue t Time of Completion * include donted time & mteril $ b.o Project y[ New Construction AdditionAltertion Conversion Relocte (existing bidg) Run Business on Property ft of Stories ndor bsement 1-Story 1-Story + Loft y: 2-Story Bsement No Bsement Foundtion SOC Use Sesonl Yer Round ft of bedrooms i 2 3. None Wht Type of SewerSnitry System Is on the property? MuniciplCity (New) Snitry Specify Type: K~ Snitry (Exists) Specify Type: <SPht Privy (Pit) or i Vulted (min 200 gllon) Portble (wservice contrct) Compost Toilet None Wter City Well Existing Structure: (if permit being pplied for is relevnt to it) Proposed Construction: ~M_ ~ Width: Width: I zt ~T~ -2 ji' 20" Proposed Use Residentil Use LJ Commercil Use Municipl Use I z 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( snitry, or sleeping qurters, or cooking & food prep fcilities) Mobile Home (mnufctured dte) AdditionAltertion (specify) Accessory Building (specify) A tiai -f Accessory Building AdditionAltertion (specify) imensions ( X) ( X?Z ) ( ' X ) Squre Footge 7% 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 Bytield County in determining whether to issue permit. I (we) further ccept libility which my be result of Byfield C(y*trt7' lying 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 propertytyny re<onble tijf? for the purpose of inspection. Owner(s): < _ te 4~'''> _t_ Co <. <?C-< (If there rmutftptetownersiisted on the eed AH Owners must sign or letter(s) of uthoriztion must ccompny this ppliction) 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 Tx Sttement If you recently purchsed the property send your Recorded eed

5 ?M; rw or Sketch your Property (regrdless of wht you re pplying for) ( w w (4) (5) (6) (7) Show Loction of: ShowIndicte: Show Loction of(*): Show: Show: Show ny (*): 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) ndor( (*) Lke; (*) River; (*) StremCreek; or (*) Pond (*) Wetlnds; or (*) Slopes over 20% > Privy (P)...J-.' 1 I n 0 ' N < " 0 "r \ I -<. <. \ 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 ,00 &> 0 NA 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 property Elevtion of Floodplin t y 5'fYes No Setbck to Septic Tnk or Holding Tnk Setbck to rin Field Setbck to Privy (Portble, Composting) f) 5' 0 Setbck to Well 5 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 suneyed corner 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 expense. (9) Stke or Mrk Proposed Loction(s) of New Construction, Septic Tnk (ST), rin field (F), Holding Tnk (HT), Privy (P), nd Well.fW). 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): Snitry Number: # of bedrooms: Snitry te: Reson for enil: Permit ft: l-or& Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming Yes Yes Yes (eed of Record) Permit te: (FusedContiguous Lot(s)) -13>-l9 0 No 6 No 0 No Mitigtion Required Mitigtion Attched Yes LJ Yes "No No Affidvit Required Affidvit Attched Yes Yes 0-No B-No Grnted by Vrince (B.O.A.) Yes _ No Cse #: Previously Grnted by Vrince (B.O.A.) Yes B-No Cse #: Ws Prcel Leglly Creted Ws Proposed Building Site elineted etves No 0Yes No Were Property Lines Represented by Owner Ws Property Surveyed E-fYes TYes No No Inspection Record: Zoning istrict ( o te of Inspection: Inspected by: <z- Lkes Clssifiction ( te of Re-lnspection: Condition(s): Town, Commitfee or Bord Conditions Attched? ~ Yes H No-(If No they need to be ttched.) Signture of Inspector1 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 unless pproved connection to POWTS. Must meet nd mintin setbcks. Hold For Snitry: Hold For TBA: Hold For Affidvit: Hold For Fees: LJ te ofapprov yf 2016

6 Villge, Stte or Federl "ivfy Also Be Required 7o USE - X SANITARY - SIGN - SPECIAL - CONITIONAL - BOA - BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: Keith & Coleen Lois Loction: 14 Of % Section 30 Township 45 N. Rnge 9 W. Town of Brnes N163.6'of Gov't Lot 1 Lot Block Subdivision CSM# For: Residentil Accessory Structure: [ 1- Story; Grge (24' x 32') = 768 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. 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 13, 2018 te

7 SUBMIT: COMPLETE APPLICATION, TAX STATEMENT AN FEE TO: Byfield County 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. APPLICATION FOR PERMIT BAYFIEL COUNTY, WISCONSIN ;\~"\ Q ESSt6p O NOT START CONSTRUCTION UNTIL ALL PERMITS HAVE BEEN ISSUE TO APPLICANT. JUN ByfieM Co'; Zoning ept Permit#: te: Amount Pid: Refund: FILL OUT IN INK (NO PENCIL) %1-0-0)-?? 7>- f-'f TYPE OF PERMIT REQUESTE- MOwner's Nme: O.P1 <h-0- Address of Property: LAN USE SANITARY PRIVY H CONITIONAL USE 0 SPECIAL USE B.O.A. OTHER ATreK A'AC. Sotq ST'TswT d Contrctor: \c<ry\ Oft.pe Miling Address: OQQ (RcM CityStteZip: CityStteZip: h. <5TeiyA) ~QrQ Ll S'; Contrctor Phone: 1'771-S 71 wl bt\j ( Telephone: Cell Phone: 7S> Authorized Agent: (Person t: Signing ppliction on on behlf of Owner(s)) Agent Phone: Agent Miling Address (include CityStteZip): Written Authoriztion PROJECT LOCATION _14, 14 Legl escription: (Use Tx Sttement) Tx I # 226 Section s Town of:, Township N,Rnge g X? horelnd Non-Shorelnd Plumber: Plumber Phone: Attched Yes No Recorded ocument: (Showing Ownership) C,R S5C(53 Gov't Lot Lot(s) CSM Vol & Pge CSM oc «Lot(s) No. Block(s) No. Subdivision: 0 T SoA5er<?;wdo Lot Size Acrege c;.r es 3.S',&ls PropertyLnd within 300 feet of River, Strem (incl. intermittent) Creek or Lndwrd side of Floodplin? If yes continue 1000 feet of Lke, Pond or Flowge If yes continue istnce Structure is from Shoreline : '0 feet istnce Structure is from Shoreline : ( Q feet Is Property in Floodplin Zone? I! Yes XNO Are Wetlnds Present? I J Yes XNO Z6- Vlue t Time of Completion * include donted time & mteril Project New Construction # of Stories > 1-Story CAdditionAltertion 1-Story + Loft $.- Conversion 2-Story ;-J Relocte (existing bidg)! I Run Business on i_t Property Existing Structure: (if permit being pplied for is relevnt to it) Proposed Construction: n Foundtion J Bsement Foundtion SLc Use Li Yer Round XS&..Ai # of bedrooms in structure 1 X2 I I 3 -F ~To J None U MuniciplCity Wht Type of SewerSnitry System Is on the property? II (New) Snitry Specify Type: ]X Snitry (Exists) Specify Type: Pield J Privy (Pit) or I I Vulted (min 200 gllon) i I Portble (wservice contrct)! I Compost Toilet None Width: Width: ~3 Type of Wter on property U City <Well ~w~ 7r 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 Gre Bunkhouse w(i I snitry, or 1.1 Sleeping qurters, or Fl cooking & food prep fcilities) Mobile Home (mnufctured dte) AdditionAltertion (specify) SQ R E. A) ~H PORCk Accessory Building (specify) Accessory Building AdditionAltertion (specify) imensions J x _) ( 10 o?') Squre Footge H(? Specil Use: (explin) Conditionl Use: (explin) Other: (explin) property t ny resonble time for the purpose of inspect! Owner(s): (If thererejlultipte Owners listed on the\eiaii Ownersmust sigh rfr lter(s) of uthoriztion must cconpny this ppliction) v" te"- 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 iw or Sketch your Property (regrdless of wht you re pplying for) r5how Loction of: Show Indicte: '(31 Show Loction of (* (4) Show: (5) Show: (6) Show ny (*): (7) Show ny (*): )<-S>0 f w ' q.a T NL'L 0o6V 22 \ 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) ndor (*) Privy (P) (*) Lke; (*) River; (*) StremCreek; or (*) Pond (*) Wetlnds; or (*) Slopes over 20% N Xls7G SFRUT I 2.H T2? Pr o p o s «< Sc r e CA Trcl o' '- ' 'vr ~- - Lje 0 50' <-2 f g60 *Jor7 <LoT LiNQ -L 6)'<2&r ot LiMj o.l AL<7&.irr Lc.K o 1v -<Sy<v<>'iT k-'swti >Rl -«.la)r4 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 S'Q 10 _ >) Q 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 tj I Q So n Yes 11 No Setbck to Septic Tnk or Holding Tnk Setbck to rin Field Setbck to Privy (Portble, Composting) Setbck to Well i. 0 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 suneyed 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 surveyor t the owner's expense. (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. The locl Town, Villge, City, Stte or Federl gencies my lso require permits. Issunce Informtion (County Use Only) Permit enied (te): Snitry Number: # of bedrooms: Snitry te: Reson for enil: Permit ft: :J6P<3 Permit te: Lo-19- Is Prcel Sub-Stndrd Lot Is Prcel in Common Ownership Is Structure Non-Conforming 0 Yes Yes Yes (eed of Record) (FusedContiguous Lot(s)) No No No Mitigtion Required Mitigtion Attched Yes Yes No No Affidvit Required Affidvit Attched Yes Yes No No Grnted by Vrince (B.O.A.) Yes No Cse ff: Previously Grnted by Vrince (B.O.A.) Yes No Cse #: Ws Prcel Leglly Creted Yes No Were Property Lines Represented by Owner Ws Proposed Building Site elineted Inspection Record: lyjfv'. wr6) Yes No ><;->< ffse y 7'A c-'tr- Jecc'<ff**'t,<_. te of Inspection: Cy~JS f QC I Inspected by: Condition(s): Town, Committee or Bord Conditions Attched? Yes No - (If No they need to be ttched.) Ws Property Surveyed Yes Yes Zoning istrict ( Lkes Clssifiction ( te of Re-lnspection: No No 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. Hold For Snitry: Hold For Affidvit: U Hold hor hees: te of Approvl: 7',,, August 2017 ( My 2018)

9 Villge, Stte or Federl rjvfy Also Be Required 0 USE - X UNITARY - SIGN - SPECIAL - CONITIONAL - BOA - BAYFIEL COUNTY PERMIT WEATHERIZE AN POST THIS PERMIT ON THE PREMISES URING CONSTUCTION No Issued To: Mrtin & Jonne Ktzmrek Loction: V4 Of V4 Section 8 Township 44 N. Rnge 9 W. Town of Brnes Gov't Lot Lot Block Subdivision Sunset Condo Unit 4 CSM# For: Residentil Addition Altertion: [ 1- Story; Screen Porch (10' x 24') = 240 sq. ft. ] (isclimer): Any future expnsions or development would require dditionl permitting. 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. 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 12, 2018 te