Pierce County CONDITIONAL USE PERMIT Application

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PIERCE COUNTY WISCONSIN DEPARTMENT OF LAND MANAGEMENT & RECORDS PLANNING, ZONING, SURVEYING & GIS Pierce County Courthouse 414 W. Main Street P.O. BOX 647 Ellsworth, WI 54011 715-273-6746 OR 715-273-6747 Fax: 715-273-6864 www.co.pierce.wi.us Pierce County CONDITIONAL USE PERMIT Application APPLICABILITY: A conditional use permit is required within a zoning district for a use that is listed as a Conditional Use on the Pierce County Zoning Code s Table of Uses. Pierce County Zoning Code 240.88 defines a conditional use permit as, A permit, issued by the Land Management Committee, stating that a use permitted as a conditional use may be established, expanded or enlarged subject to any conditions placed on the authorization and the provision of this chapter. APPLICATION: Applicants are encouraged to meet with Department staff for a pre-application conference. The application for a conditional use permit must be complete and received by the Department in order to be processed. A general checklist is as follows: Contact, Site, and Zoning Information (Page 1); Written statement specifically describing the proposed use (Page 2); Affidavit, Authorization to Examine Premises and Certification of Information Form (Page 3); Plot plan (Page 4); Town Recommendation Form Town Plan Commission Approval may be needed prior to Town Board Approval. Site development plan, grading plan, erosion control plan (if applicable); and, Fee: $300. Cash or check made payable to Pierce County Zoning REVIEW PROCESS: A conditional use permit authorizes a land use in Pierce County and is subject to conditions and limitations which may be placed upon it to protect public health, safety, and welfare. Conditions are established by the Land Management Committee (or Board Adjustment if located within the St. Croix Riverway District) following a public hearing to give the applicant, local officials, and neighbors the opportunity to discuss the proposal. An application may be denied if the Land Management Committee decides that the use is not appropriate at the proposed location. The Land Management Committee may, in approving an application for a conditional use permit, impose such restrictions and conditions that its determines are required to prevent or minimize adverse effects from the proposed use or development on other properties in the neighborhood and on the general health, safety and welfare of the county. Such conditions may include, but not limited to financial sureties, activities which may take place, hours of operation, access provisions, required landscaping, limits or size of structures or operations, and requirements for renewals. The Land Management Committee may limit the use of land to one specific use permitted in the zoning district for which the conditional use permit is sought. Failure to comply with a condition is grounds for revoking the permit. The property owner may apply for amended conditions on future dates should the proposed use need to expand or change. Amendments require another public hearing. APPEAL RIGHTS: Any applicant who is aggrieved by conditional use permit decisions issued by the Land Management Committee may, within 30 days of the filing of each such decision in the office of the Zoning Administrator, file a certiorari review action with the Pierce County Circuit Court. For specific information regarding Conditional Use Permits, read Pierce County Zoning Code 240-76. This chapter can be purchased at our office or reviewed on our website listed above. Working today for a better tomorrow

Pierce County Conditional Use Permit Application Pg 1 CONTACT INFORMATION: Property Owner Contact/Agent (if not owner) Mailing Address Mailing Address Daytime Phone ( ) Daytime Phone ( ) SITE INFORMATION: Property Location: Lot, Block, Subdivision/CSM being part of the ¼ of the ¼ or Gov. Lot #, Section, Town N, Range W, Town of, Pierce County, WI. Site address: Parcel # - - Alternate Parcel # ZONING INFORMATION: Zoning District (Check one): Exclusive Agriculture Primary Agriculture Ag-Residential General Rural General Rural Flexible General Rural Flexible-8 Rural Residential-8 Rural Residential-12 Rural Residential-20 Commercial Light Industrial Industrial Overlay District (Check one): Floodplain Shoreland / Wetland Kinnickinnic River Blufflands St. Croix Riverway Planned Residential District Not Applicable Type of Conditional Use Permit (Check One): Agritourism ( 240-35B) Recycling Facility ( 240-37.1.C) Large Solar Energy System ( 240-41D) Direct Market Agriculture ( 240-35B.2) Salvage Yards ( 240-37C) Large Wind Energy System ( 240-41D) Nursery ( 240-35B.4) Sawmills/Planing Mills ( 240-37D) Sludge Disposal Orchard ( 240-35B.5) Warehouse & Storage ( 240-37.1.B) Solid Waste Facility Winery ( 240-35B.6) Cemeteries Utility Facilities >1000 sq ft Bed & Breakfast ( 240-36A) Private Institutional ( 240-38A) Temp Concrete/Asphalt Plant ( 240-42F) Boardinghouse ( 240-36B) Campgrounds ( 240-39A) Planned Res. Development ( 240-51) Farm & Home Business ( 240-36D) Nature-Based Operations ( 240-39C) Signs ( 240-60N) General Retail & Services ( 240-36E) Private Outdoor Recreation ( 240-39E) Kinnickinnic River Bluff Tree Removal Home Business ( 240-36F) Residential Parks ( 240-39F) ( 240-45) Home Occupation ( 240-36G) Resorts ( 240-39G) Shoreland Vegetation Removal ( 240-46) Kennels ( 240-36I) Accessory Residence ( 240-40A) Nonconforming Structure Expansion Retreat Centers ( 240-36M) Duplexes ( 240-67A.2) Heavy Industrial Uses ( 240-37E) Manufactured Home Parks ( 240-40B) Adult-oriented entertainment business Hydraulic Dredge Material Storage Multiple-family Dwellings ( 240-37G) Light Industrial Uses ( 240-37.1.A) Airports ( 240-41A) St. Croix Riverway Uses or Structures Mining, Accessory Uses ( 240-37B) Airstrips ( 240-41A) ( 239-8C) Describe: Nonmetallic Mining (( 240-37A) Filling & Grading ( 240-41E) Recycling Collection Point ( 240-37.1D) Other: For specific information regarding Conditional Use Permits, read Pierce County Zoning Code section listed above. This chapter can be purchased at our office or reviewed on our website: www.co.pierce.wi.us then select Pierce County Code.

Pierce County Conditional Use Permit Application Pg 2 PROPOSED USE: In the space below or in an attached narrative, describe the proposed use. Include information regarding present use of property, activities to be included, buildings and structures to be used, adjacent land uses, equipment to be operated, hours of operation, outside storage, number of employees, facilities to accommodate the public, and other information required by the Zoning Administrator. I hereby certify that the above application and all attachments are true, correct, and complete to the best of my knowledge and belief. Signed: Date: Attachments include: Plot Plan; Site development plan, grading plan, erosion control plan (if applicable); Town Recommendation/Approval Statement; Affidavit, Authorization to Examine Premises, and Certification of Information Forms; and, Fee: $300, cash or check payable to Pierce County Zoning. Date Filed: Fee: Code Reference: Overlay District: LEAVE BLANK - FOR RECEIVING AGENCY USE ONLY Signed: (Zoning Administrator)

Pierce County Conditional Use Permit Application Pg 3 AFFIDAVIT: TO WHOM IT MAY CONCERN: This affidavit is to verify, to the best of my knowledge, that the conditional use permit requested in the attached application does not violate any Deed Restriction. Owner(s) Notarized Signature(s): Owner Signature Owner Name - Printed Co-Owner Signature (if applicable) Please print Co-Owner Name (if applicable) Acknowledgement: This instrument was acknowledged before me on this date by NOTARY PUBLIC Signature Notary Public Name - Printed County of, State of Wisconsin. My commission expires:. Affix seal AUTHORIZATION TO INSPECT PREMISES: I hereby authorize the Pierce County Department of Land Management & Records to inspect premises at: (Address) Date: (Signature of Owner) CERTIFICATION: I hereby certify that I have been informed and understand that if I, my agent, or my attorney does not appear at the public hearing, and/or if I do not provide the information requested by the Zoning Administrator, the Board/Committee may dismiss the appeal or application or may dispose of the matter on the record before it. Date: (Signature of Applicant/Appellant)

Pierce County Conditional Use Permit Application Pg 4 How to create a Plot Plan/Map This Conditional Use Permit application requires a plot plan. A plot plan is a drawing that shows the entire construction site and all structures, existing and proposed. To assist creating a plot plan, follow these directions: 1. Find your property by going to Pierce County Home Page http://www.co.pierce.wi.us/. 2. From the horizontal list on top of the webpage, click on Tax & Land Information. 3. In the middle of this webpage, click on Property Data Search. 4. Type in the computer number, parcel address, or parcel owner, and then press Go. a. If you are taken to the Real Estate Tax Summary. Scroll down to the bottom of the page and click on Go to Map. b. If you are taken to a list of properties, find the correct address and click on the Map Icon. 5. The computer will automatically go to the selected property. A basic report caption shows up on the right side of the screen. To continue making the map, close out that caption by clicking on the upper right corner. 6. On the top of the screen there is a tab labeled Legend. Click on the tab and a list of information will show up to the left of the screen that you can add to your map. Hide the tab by clicking on the upper right corner. 7. Enlarge the parcel by clicking the Zoom In tool at the top of the screen. After clicking this tool, use your mouse to left click and drag a boxed area over the selected parcel. Your computer will zoom into the area. If you zoomed in too far, click on the Zoom Out Magnifying Glass tool, repeat the same process, and your computer will zoom out of that area. 8. Now print the map. At the top of the page, click on the tab labeled Print Map. A print map caption will show up on the right of the screen. Give your map a title and author (i.e. John & Jane Doe, N111 410 th Street). Click on Print Map. The computer should automatically show you a.pdf document. a. If using Google Chrome click on the menu in the upper right hand corner of the screen, then click Print. b. If using Internet Explorer click on the menu in the upper right hand corner of the screen, then click Print. If you click print but nothing happens, you may have to disable a pop up blocker. 9. The figure to the right is an example of information to draw on to the plot plan. On your printed map, please indicate the following: Location & size of proposed construction Lot dimensions and lot size Locate & label road and any easements All existing structures. Slopes greater than 20% Driveway slope (must be 12% or less) Waterways and Floodplains (staff in the office will help with this) Distances from construction to roads, well, septic tank, drain field, lot lines, and waterways. This can be measured from your computer screen. Go to the top and middle of your screen and select the measuring tool. * Note: If you need assistance with task #9 or any part of creating your plot plan/map, please call our office or bring your map to the Land Management Department and ask staff for assistance. 10. Please attach an approved State, County, or Town Driveway Permit if this requires new access to the parcel. 11. Sign your name as owner or agent to the bottom of the map. 12. Bring this map to the Land Management Department. Add additional pages to the application, if necessary. Please number the pages.

PIERCE COUNTY WISCONSIN Pierce County Courthouse DEPARTMENT OF LAND MANAGEMENT & RECORDS 414 W. Main Street, P.O. BOX 647 Zoning: 715/273-6747 Ellsworth, Wisconsin 54011 Planning: 715/273-6746 Fax: 715/273-6864 www.co.pierce.wi.us Town Recommendation Form Request: Conditional Use Permit Map Amendment - (Rezone) Plat Approval Concept, Preliminary, Final (Circle One) Other- Applicant/Agent: Name Site Address (if applicable) Property Description: ¼ of the ¼, or Gov. Lot # Section, T N, R W, Lot, Block, Subdivision Town of Parcel # - - Alternate Parcel # Zoning District Acreage A town recommendation is required as part of the application for a rezone (map amendment) or a conditional use permit. This recommendation is necessary whether a town has adopted a comprehensive plan or has not. Pierce County will seek to further each Town s planning goals when considering the establishment of conditionally permitted uses and when considering approval of a request for a rezone/map amendment. Pierce County will consider adherence to applicable goals, objectives, and policies, of an adopted or amended town comprehensive plan to be consistent with the public interest for decisions relating to that Town. In cases where an adopted plan gives guidance regarding the establishment of a proposed conditional use, the specific portion of the plan relating to the request should be referenced. If a town plan is silent regarding the establishment of a proposed use, or a town has not adopted a comprehensive plan, the recommendation will be advisory in nature. Pierce County will approve re-zonings (map amendments) within a given town only when the proposed amendment is consistent with that town s comprehensive plan. The specific portion of the plan which supports the rezone request should be referenced. It should be noted that if a town s comprehensive plan is silent on a proposed rezone, approval cannot be granted unless consistency is achieved through plan amendment. In cases where a town has not adopted a comprehensive plan, a rezoning request will be considered based upon its consistency with the Pierce County Comprehensive Plan. In such cases, a town s recommendation regarding the proposed rezone will be used to assist the Land Management Committee in evaluating applicable goal statements. Questions regarding the need for a Town Recommendation and its generation or use should be directed to Land Management Department Staff at (715) 273-6746. Town Recommendation: Approval Denial Justification/PlanReference: Concerns/Suggested Conditions: Please attach additional information as necessary. Town Chair Signature: Meeting Date: