2108 Attachment 14 Reports.docx

DOCX document 2 MB Posted

Attached to
New Permit System
Solicitation number
2108
Issued by
Kenosha County, Wisconsin

About this file

This attachment to a Request for Proposals for a Permitting Solution demonstrates the reporting, forms, and documentation requirements that Kenosha County, Wisconsin expects the new permit system to replicate and generate. The document provides examples of critical outputs including management reports (such as zoning permits issued reports), denial letters, permit applications, permit placards, foundation survey notices, receipts, and payment/revenue reports. The examples span permit types including zoning permits for residential and agricultural structures, with specific details on applicant information, property locations, permit statuses, contractor details, and associated fees. The sample reports cover permit issuance periods, individual permit records with dimensions and square footage, and revenue tracking by transaction type and fund allocation. All documentation examples originate from Kenosha County's Division of Planning and Development and reflect the operational format and data structure currently in use.

The file establishes the functional requirements and output specifications that the new permit system solution must accommodate, including the ability to generate standardized forms, letters, and reports that maintain consistency with current county operations. The examples demonstrate that the system must capture and process diverse permit-related transactions, support multiple zoning districts and construction types, track payment methods and revenue codes, and produce both applicant-facing documents and internal management reports. These specifications indicate that system conversion must accurately transfer existing permit, project, code violation, and sanitary maintenance information while enabling replication of the critical management, operational, and financial reporting functions currently performed by Kenosha County's planning and development operations.

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Other files

File Type Posted
2108 Attachment 1 Checklist.pdf PDF
2108 Attachment 11 Web.docx DOCX document
2108 Attachment 10 SaaS.docx DOCX document
2108 Attachment 2 Signature.docx DOCX document
2108 Attachment 8 Requirements.docx DOCX document
2108 Attachment 7 Effort.xlsx XLSX spreadsheet
2108 Attachment 13 Partner_Info.docx DOCX document
2108 Addendum 1.docx DOCX document
2108 Attachment 12 ClientServer.docx DOCX document
2108 Attachment 4 Tech.docx DOCX document
2108 Attachment 5 Prof Svcs.docx DOCX document
2108 RFP Documents.pdf PDF
2108 Attachment 3 Prop State.docx DOCX document
Revised Attachment 4 Tech.docx DOCX document
2108 Attachment 9 Cost.xlsx XLSX spreadsheet
2108 Attachment 6 Reference.docx DOCX document
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Request for Proposals for Permitting Solution (#2108) Kenosha County, Wisconsin

Attachment 14 – Examples: Reports, Forms, Letters

Contents

Management Report Example – Zoning Permits Issued2
Letter example – Zoning Permit Denial3
Form example – Zoning Permit Application4
Form example – Zoning Permit Placard5
Letter example – Foundation Survey First Notice6
Form example – Receipt7
Report example – Payment and Revenue8

Management Report Example – Zoning Permits Issued

Letter example – Zoning Permit Denial

Form example – Zoning Permit Application

Form example – Zoning Permit Placard

Letter example – Foundation Survey First Notice

Form example – Receipt

Report example – Payment and Revenue

KC_ATT_6_Reference Page 2 of 2 image1.emf

Kenosha County3/26/2021

10:26:47AM ZONING PERMITS ISSUED

For the Period 1/1/2019 thru 1/1/2020

Permit No. Date Issued Type and Sub-Type Status Site Address and Parcel No. Owner Mailing Address Contractor Mailing Address

10/10/2019 ISSUED

95-4-119-024-0200

ZONING, AGRICULTURALZONE19-00407 32817 GENEVA RD

SF RESIDENCE W/ ATT GARAGE (3051)

RANDY J EBERTOWSKI & ANDREA R

DELAUNE

32805 GENEVA RD

BURLINGTON, WI 53105

R&M ELSBURY CARPENTRY INC.

5046 BRIAR RIDGE COURT

4/25/2019 ISSUED

70-4-120-271-0300

ZONING, RESIDENTIALZONE-221 10901 256TH AVE

(140)

CAREFREE ESTATES LIMITED PRSHP

43 REVERE DR

SOUTH BARRINGTON, IL 60010

6/12/2019 ISSUED

30-4-220-112-0230

ZONING, RESIDENTIALZONE19-00220 705 248TH AVE

DECK (252)

JONATHAN D HARTMAN

705 248TH AVE

KANSASVILLE, WI 53139

(262) 220-6234

JONATHAN D HARTMAN

705 248TH AVE

10/9/2019 ISSUED

30-4-220-283-0401

ZONING, RESIDENTIALZONE19-00408 27925 41ST ST

POOL (594)

DECK (1060)

JASON P & AMANDA M METEYARD

27925 41ST ST

SALEM, WI 53168

(262) 266-4528

GM BUILDERS

35421 N 1ST AVE

INGLESIDE, IL 60041

5/13/2019 ISSUED

30-4-220-271-0307

ZONING, AGRICULTURALZONE19-00158 3702 252ND AVE

RESIDENTIAL ADDTIION (576)

JAMES R TERRY

25410 31ST ST

(262) 249-2192

RON FOX CONSTRUCTION

21623 31ST ST

BRISTOL, WI 53104

9/9/2019 ISSUED

30-4-220-121-0520

ZONING, RESIDENTIALZONE19-00368 21700 9TH ST

FENCE ()

FRANK J DUNN

21700 9TH ST

(847) 736-6060

FRANK J DUNN

21700 9TH ST

8/12/2019 ISSUED

30-4-220-131-0321

ZONING, AGRICULTURALZONE19-00321 1271 224TH AVE

REPLACE (6) PANEL ANTENNA ()

DISH ()

ADAM HUMBURG (SBA COMMUNICATIONS)

1271 224TH AVE

KANSASVILLE, WI 53138

(563) 352-8124

E-VERGENT.COM, LLC

8330 CORPORATE DR

RACINE, WI 53406

5/29/2019 ISSUED

30-4-220-311-0120

ZONING, RESIDENTIALZONE19-00202 5150 301ST AVE

SF RESIDENCE W/ ATT GARGE (2932)

DECK (240)

TAUN P PARKERS

29900 52ND ST

(262) 220-6673

HARPE DEVELOPMENT

PHIL ANDERSON

8501 75TH ST. #H

KENOSHA, WI 53142

Kenosha County3/26/2021

10:26:47AM ZONING PERMITS ISSUED

For the Period 1/1/2019 thru 1/1/2020

Permit No. Date Issued Type and Sub-Type Status Site Address and Parcel No. Owner Mailing Address Contractor Mailing Address

5/10/2019 ISSUED

30-4-220-304-0750

ZONING, RESIDENTIALZONE19-00171 29875 41ST ST

DECK (544)

IAN P LAMPE

29875 41ST ST

(262) 220-6399

IAN P LAMPE

29875 41ST ST

8/28/2019 ISSUED

30-4-220-364-0300

ZONING, AGRICULTURALZONE19-00350 22122 60TH ST

SF RES W/ ATT GARAGE (5431)

DECK (177)

ROBERT J CONRAD

22411 45TH ST

(262) 274-4032

LIBERTY BUILDERS, LLC

4244 97TH ST

Pleasant Prairie, WI 53158

4/3/2019 ISSUED

30-4-220-253-0301

ZONING, AGRICULTURALZONE19-00085 22510 45TH ST

POLE BARN (5940)

DEAN & JANICE NAU TRUST

22510 45TH ST

(262) 220-6530

HERDA CONSTRUCTION LLC

8955 184TH AVE

BRISTOL, WI 53182

4/15/2019 ISSUED

30-4-220-272-0242

ZONING, RESIDENTIALZONE19-00106 3327 264TH AVE

SF RESIDENCE W/ ATT GARAGE (3672)

DECK (528)

ERIN HARMON

29715 41ST ST

(440) 039-1387

THEO KOEHNKE

29510 KARCHER RD

12/20/2019 ISSUED

30-4-220-131-0321

ZONING, AGRICULTURALZONE19-00474 1271 224TH AVE

REPLACE (3) PANEL ANTENNA ()

ADAM HUMBURG

1271 224TH AVE

KANSASVILLE, WI 53138

SAC WIRELESS ON BEHALF OF AT&T

540 W MADISON, 9TH FLOOR

CHICAGO, IL 60661

5/23/2019 ISSUED

30-4-220-281-0211

ZONING, AGRICULTURALZONE19-00195 27001 31ST ST

DETACHED GARAGE (2400)

JEROME J DEBELL

27001 31ST ST

(262) 253-7486

JEROME J DEBELL

27001 31ST ST

5/31/2019 ISSUED

30-4-220-063-0315

ZONING, AGRICULTURALZONE19-00207 555 312TH AVE

POLE BARN (4432)

CODY J MYERS

555 312th AVE

(262) 290-2137

PEKUL BUILDINGS

W3219 STATE RD 11

ELKHORN, WI 53121

6/28/2019 ISSUED

30-4-220-312-0320

ZONING, RESIDENTIALZONE19-00246 5024 308TH AVE

3 - SEASON ROOM ADDITION (720)

TODD R PEYRON

5024 308TH AVE

(262) 262-0999

TODD R PEYRON

5024 308TH AVE

image2.emf

COUNTY OF KENOSHA

Division of Planning & Development

[TODAY]

[OWNER]

[OWNER ADD 1]

[OWNER CITY], [ZIP]

Premises – [SITE NUMBER] [STREET NAME]

Parcel # – [SITE APN]

[SITE CITY]

To Whom It May Concern, This is to advise you that the enclosed zoning permit application submitted to this office on [APPLIED] for the construction of single-family residence w/ accessory living unit on the above referenced parcel has been denied for the following reasons.

- Section 12.18.6-. General Land Use Regulations, Accessory Living Unit, Application:

All drawings and plans for the construction, installation, enlargement or alteration of any such Accessory

Living Unit shall first be presented to the Division of Planning & Development for examination.

All such plans and drawings shall be drawn to scale and shall indicate thereon all distances and dimensions so as to accurately and explicitly show all floor plans, lot lines and all information pertaining to the

Accessory Living Unit.

- Section 12.18.6-4. General Land Use Regulations, Accessory Living Unit, Requirements: The following rules apply to an Accessory Living Unit.

(a) Only one Accessory Living Unit is permitted per single-family dwelling.

(b) The Accessory Living Unit shall not exceed 600 square feet in area.

(c) No more than two people may reside in the Accessory Living Unit.

(d) The entire structure must appear or continue to appear as a single-family dwelling. A separate garage or driveway is not permitted.

(e) No separate address is permitted.

(f) No separate utility connections and/or meters are permitted.

(g) A physical access between the main living unit and the accessory living unit must be present within the single-family dwelling unit. The required connection may not be through an attic, basement, garage, porch or other non-living area. A door may be used to separate the accessory living unit from the rest of the single-family dwelling unit.

(h) In addition to the internal physical connection required above, only one separate outdoor side or rear access, being a patio door, may be provided; however, the structure shall continue to appear as a typical single-family dwelling.

(i) An external stairway which serves the Accessory Living Unit is prohibited.

(j) The Accessory Living Unit may contain a separate bathroom, laundry, living, efficiency kitchen, sleeping (one bedroom) and recreation areas, including exterior porches, patios, and/or decks.

(k) The Accessory Living Unit shall be occupied by a resident related through blood, marriage or adoption to the resident occupant of the single-family dwelling.

(l) An Accessory Living Unit should be considered and regulated as part of, or as a permitted addition to, a single-family dwelling. It shall not require conditional use approval or special site plan review.

(m) When an application is submitted for a zoning permit to accommodate what is explicitly listed as, or could possibly be, an Accessory Living Unit, the building plan shall be marked as "Not a separate dwelling unit nor apartment."

(n) A standardized affidavit affecting real estate shall be attached to the zoning permit and recorded in the

Register of Deeds.

According to the submitted application, the construction plan set is not to-scale. A to-scale construction plan set must be submitted.

According to the submitted application, the proposed accessory living unit will exceed 600 sq. ft. in area. Said accessory living unit area must be reduced to 600 sq. ft. or less.

Andy M. Buehler, Director Division of Planning & Development

19600 75th Street, Suite 185-3 Bristol, WI 53104-9772

(262) 857-1895

According to the submitted construction plan set, garage space is proposed on opposite sides of the principal structure. Attached garage space must be contiguous.

According to the submitted application, the building plan is not marked as “Not a separate dwelling unit or apartment”.

If revised application materials are submitted and the permit is able to be issued, a standard Affidavit Recording of Shoreland

Mitigation document will be recorded against the property title pursuant to section 12.18.6-4(n). Said document will be drafted by Planning & Development and be required to be signed/notarized by the property owner before being recorded with the

Kenosha County Register of Deeds office. The standard 30.00-dollar recording fee payable in the form of cash or check to

“Register of Deeds” will apply.

Copies of the aforementioned Ordinance excerpts have been enclosed for reference.

The complete Kenosha County General Zoning & Shoreland/Floodplain Zoning Ordinance can be found online at http://www.kenoshacounty.org/DocumentCenter/Home/View/570.

If you have any questions, please feel free to contact me at (262) 857-1901, during regular business hours.

Sincerely, Ben Fiebelkorn

Senior Land Use Planner

Cc: Andy Buehler, Director, Division of Planning Operations

Town of Salem Clerk

Town of Salem Building Inspector

Enclosures http://www.kenoshacounty.org/DocumentCenter/Home/View/570 image3.emf

Department of Planning and Development

19600-75th Street, Suite 185-3

Bristol, WI 53104 Telephone: (262)857-1895

Facsimile: (262)857-1920

ZONING PERMIT

APPLICATION

Owner MARIA A HILL Date 01/26/2021

Mailing Address 2936 22ND ST Phone #

THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO DO THE WORK HEREIN DESCRIBED, AND AS SHOWN ON THE REQUIRED SITE PLAN FORM OR ATTACHED REGISTERED SURVEY

HEREOF, AND HEREBY AGREES THAT ALL WORK WILL BE DONE IN ACCORDANCE WITH ALL THE LAWS OF THE STATE OF WISCONSIN AND ALL THE ORDINANCES OF THE COUNTY OF

KENOSHA, APPLICABLE TO THE FOLLOWING DESCRIBED PREMISES:

Parcel No. 45-4-221-091-0312 Zoning District(s) R-2

Property Address 17255 8TH PL

Subdivision Name CSM # Lot 0 Block Unit

STRUCTURE

DESCRIPTION

TYPE OF

CONSTRUCTION

SIZE

(L' @ H')

SIZE

(L' @ W')

AREA

(sq feet)

HEIGHT

(feet)

# OF

STORIES

SF RESIDENCE W/ ATT GARAGE Wood Frame 66 X 75.4 5,809 19

For Office Use Only

Permit No.

Foundation Survey Due Date

Waiver of Liability Due Date

Board of Adjustments Approval Date

Conditional Use Permit Approval Date

Sanitation Approval

Receipt # Check #

Amount

Contractor

Address

Phone #

Applicant

Address

Phone #

THIS ZONING PERMIT IS ISSUED SUBJECT TO:

1. ANY FEDERAL, STATE OR LOCAL RESTRICTIONS AND/OR DEED RESTRICTIONS.

2. EACH APPLICANT FOR A ZONING PERMIT IS CHARGED WITH KNOWLEDGE OF THE COUNTY ZONING ORDINANCE. COPIES OF THE TEXT OF THIS OR PORTIONS THEREOF AND

COPIES OF THE OFFICIAL ZONING MAPS ARE AVAILABLE FOR SALE, COPYING OR INSPECTION UPON REQUEST. ANY STATEMENT MADE, SITE PLAN SUBMITTED, ASSURANCE GIVEN

OR PERMIT ERRONEOUSLY ISSUED CONTRARY TO THIS ORDINANCE IS NULL AND VOID.

3. THIS PERMIT SHALL EXPIRE EIGHTEEN (18) MONTHS FROM DATE OF ISSUANCE.

4. REMARKS:

NOTICE: YOU ARE RESPONSIBLE FOR COMPLYING WITH STATE AND FEDERAL LAWS CONCERNING CONSTRUCTION NEAR OR ON WETLANDS, LAKES, AND STREAMS. WETLANDS THAT

ARE NOT ASSOCIATED WITH OPEN WATER CAN BE DIFFICULT TO IDENTIFY. FAILURE TO COMPLY MAY RESULT IN REMOVAL OR MODIFICATION OF CONSTRUCTION THAT VIOLATES THE

LAW OR OTHER PENALTIES OR COSTS. FOR MORE INFORMATION, VISIT THE DEPARTMENT OF NATURAL RESOURCES WETLANDS IDENTIFICATION WEB PAGE http://dnr.wi.gov/wetlands/locating.html OR CONTACT A DEPARTMENT OF NATURAL RESOURCES SERVICE CENTER (262) 884-2300.

Date Permit Issued

Director of Planning Operations

THE UNDERSIGNED HEREBY ATTESTS THAT THE ABOVE INFORMATION

IS TRUE, ACCURATE AND HAS RECEIVED THE ABOVE NOTICE.

KORNDOERFER HOMES

7900 DURAND AVE., BUILDING 10

(262) 898-0273

JEANIN LANGENFELD

7900 DURAND AVE., BUILDING 10

(262) 898-0273 $300.00

KENOSHA, WI 53140

STURTEVANT WI 53177

STURTEVANT WI 53177

01/26/2021

(262) 620-7085

SUBJECT TO SUBMITTING A FOUNDATION SURVEY TO THIS OFFICE PRIOR TO OCCUPANCY. ACCESS TO BE VIA ROAD RESERVATION (FUTURE 8TH PLACE). RESIDENCE

MUST BE LOCATED AT LEAST 65 FEET FROM THE RIGHT-OF-WAY OF CTH "D" (172ND AVE) AND AT LEAST 30 FEET FROM THE RIGHT-OF-WAY OF FUTURE 8TH PLACE

(NORTH PROPERTY LINE). SUBJECT TO BEING CONGNIZANT OF ANTICIPATED 8TH PLACE ROAD IMPROVEMENTS AND PROXIMITY TO PROPOSED SEPTIC MOUND

SYSTEM.

METES AND BOUNDS

07/15/2021

SANT21-00003

WEB596

ZONE21-00003

BY SUBMITTING PAYMENT, I CONFIRM THAT I AM BOUND BY THE

TERMS AND CONDITIONS OF THE PERMIT APPLICATION

image4.emf

Division of Planning and Development 19600-75th Street, Suite 185-3

ZONING PERMIT

Permit Number: Date Issued:

Expiration Date:

Parcel #:

Site Address:

Subdivision:

Project(s):

Name:

CSM #: Lot(s): Block: Unit:

FOR INFORMATION REGARDING THIS PERMIT CALL (262) 857-1895

It is unlawful to commence work before this permit is placed in a conspicuous place on the premises.

ZONE21-00003 01/26/2021

07/27/2022

45-4-221-091-0312 MARIA A HILL

17255 8TH PL TOWN OF PARIS, WI

METES AND BOUNDS 0

Zoning District(s):

Renewal

Mailing Address: 2936 22ND ST KENOSHA, WI 53140

SF RESIDENCE W/ ATT GARAGE - 66 X 75.4 -

R-2 image5.emf

As of this date, this department has not received a foundation survey for the structure that was permitted for your property through the issuance of Kenosha County zoning permit # ZONE20-00085

As required by the Kenosha County General Zoning and Shoreland/Floodplain Zoning Ordinance, specifically

Section 12.05-4, a foundation survey must be submitted for any principal structure. In addition, the ordinance states that no further construction may commence unless the Director of Planning and Development shall find that the foundation location is consistent with the permit as issued and shall so certify. The foundation survey serves to verify that the type of structure, dimension and setbacks as indicated when the zoning permit was issued are accurate and what actually has been built meets the county ordinance requirements.

Your permit will not be considered complete and no further zoning permits will be issued until this department receives the foundation survey.

Please contact this department at (262) 857-1895 during regular weekday business hours within five (5) business days upon receipt of this letter to discuss options available to complete this business.

If your permit was pulled by a contractor or other agent acting on your behalf, please contact them to verify if the work has been done and if an original size copy of the survey has been sent to this office. If you have an original size copy of your foundation survey (not a proposed stake-out survey) and wish to drop it off or mail it, please use the following address:

Kenosha County Department of Planning and Development

19600 75th Street, Suite 185-3

Bristol WI 53104

What is a foundation survey requirement? Please visit our FAQ page at the following address:

http://www.kenoshacounty.org/FAQ.aspx?TID=33

Re: Foundation Survey Requirements for Permit # ZONE20-00085

October 02, 2020

Premises - 1138 87TH AVE VILLAGE OF SOMERS, WI

Parcel # - 82-4-222-093-0470

FIRST NOTICE

JEFFREY ZONDAG

5802 EVARIT DR

MOUNT PLEASANT, WI 53406

image6.emf

FEE DESCRIPTION AMOUNT

PERMIT #: RECEIPT #:

DATE PAID: PAY METHOD:

CHECK #:

ZONE21-00003

1/26/2021

WEB596

CREDIT

SITE ADDRESS:

APPLICANT:

OWNER:

CONTRACTOR:

PAID BY:

17255 8TH PL

JEANIN LANGENFELD

MARIA A HILL

KORNDOERFER HOMES

KORNDOERFER HOMES, JEANINE LAN

R E C E I P T

RESIDENTIAL

RESIDENTIAL SINGLE FAMILY 300.00

300.00RESIDENTIAL Total

Grand Total 300.00

Total Amount Paid 300.00

Receipt By: BJF image7.emf

RECEIPT TOTALRECEIPT # PAID BY CASH AMT CHECK AMT

Kenosha County, WI Planning & Development

DATE: 3/17/2021

TIME: 8:03:42AM

PAYMENT EDIT REPORT

For the Period 3/16/2021 thru 3/16/2021

TYPE CHECK # CREDIT AMT

ETRAKIT PUBLIC REG USE

PE-WEB623 Tracy Siemon 0.00 0.00 150.00FEE 150.00 PE-WEB624 Barry Cheney 0.00 0.00 80.00FEE 80.00

CASHIER TOTAL 0.00 0.00 230.00230.00

GRAND TOTAL 0.00 0.00 230.00

2NUMBER OF RECEIPTS:

NUMBER OF CHECKS: 0

230.00

NUMBER OF CREDIT CARDS: 2

BFiebelk

Text Box

APPROVED/DIGITALLY SIGNED BY BEN FIEBELKORN ON 03-17-2021

Page 1Kenosha County, WI Planning & Development

DATE: 3/17/2021

TIME: 8:04:09AM

REVENUE ACCOUNTING

For the Period 3/16/2021 thru 3/16/2021

100Fund:

0Agency

0Organization:

1002Activity:

0200Business Unit:

DATE PAID BANK ACCT RECEIPT # REV CODE TRANASACTION DESCRIPTION DEBIT AMOUNT CREDIT AMOUNT

3/16/2021 PE-WEB623 ACCESSORY BUILDING OVER 150 SQ FT100.000.0000.100200 0.00150.00

3/16/2021 PE-WEB624 DECK ONLY100.000.0000.100200 0.0080.00

Business Unit 0200 Totals: 0.00230.00

Activity 1002 Totals: 0.00230.00 Organization 0 Totals: 0.00230.00

Agency 0 Totals: 0.00230.00

8200Agency 8200Organization:

4442Activity:

4250Business Unit:

DATE PAID BANK ACCT RECEIPT # REV CODE TRANASACTION DESCRIPTION DEBIT AMOUNT CREDIT AMOUNT

3/16/2021 PE-WEB623 ACCESSORY BUILDING OVER 150 SQ FT100.820.8200.444250 150.000.00

3/16/2021 PE-WEB624 DECK ONLY100.820.8200.444250 80.000.00

Business Unit 4250 Totals: 230.000.00

Activity 4442 Totals: 230.000.00 Organization 8200 Totals: 230.000.00

Agency 8200 Totals: 230.000.00

Fund 100 Totals: 230.00230.00

GRAND TOTALS 230.00230.00

image8.jpeg

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