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 | ||
| 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 | ||
| 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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Text version
Request for Proposals for Permitting Solution (#2108) Kenosha County, Wisconsin
Attachment 14 – Examples: Reports, Forms, Letters
Contents
| Management Report Example – Zoning Permits Issued | 2 |
| Letter example – Zoning Permit Denial | 3 |
| Form example – Zoning Permit Application | 4 |
| Form example – Zoning Permit Placard | 5 |
| Letter example – Foundation Survey First Notice | 6 |
| Form example – Receipt | 7 |
| Report example – Payment and Revenue | 8 |
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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