HomeMy WebLinkAbout25-0110117 E 6" Street
5
PO Box 403
Washburn, WI 54891
(715)373-6109
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P,:.YFIELD
FEB 1 4 2025 o
Health
Zonin
Submission #
Fee Paid
$`°
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Refund
Permit#
Date Issued
Sa leld Co. Z ni D t. tea( 713
Short -Term Renta4 �pp7Ication Packet -_ly.
This application packet contains information for both a Tourist Rooming House license through Bayfield County Health
Department and a Short -Term Rental permit through Bayfield County Planning and Zoning Department. Completed
application and applicable fees can be mailed/emailed to the address/email above.
City of Washburn, City of Bayfield, Town of Pilsen: License through Bayfield County Health Department is required.
Please review and fill out pages 1-4.
All Other Towns: A license through the Health Department and permit through the Planning and Zoning Department are
reA Please review and fill nut na¢es 1-5.
..._r------------ .-.__..
SECTION A: ESTABLISHMENT INFORMATION
Establislunent Name
Establislunent Tax ID #
�-1 �
Town/City of
ac.
Estab ishment Street Address
City
SpW
ZIP
SECTION B: OWNER INFORMATION
Property Owner
Email Address
Phone Number
7�
caner Mailing Address
V�gge
Ci
19�
State
/
ZIP
SECTION C: IF OPERATING WI PARTNER OR AGEN"f
Legal Licensee (parmership. LLC, LLP, or brc.)
Email Address
Phone Number
Licensee Street Address
City
State
ZIP
Agent Name (if applicable)
Email Address
Phone Number
Agent Street Address
City
State
ZIP
SECTION D: RENTAL UNIT INFORMATION see ke
Unit Unit ID Structure Heating Water
Type Sou Source
below
Sanitary Source # of Stories # of # of
Bedrooms Bathrooms
1
2
3
4
pe:
u lex D Cabin C Yurt Apartment(A) Condo CO Other (0), lease describe
o rce:
Slectric NaturalOther O), lease describe
urce:
Public/lAunici al M rivate Well P
Sanitary Source:
Public/Municipal M rivate Onsite Wastewater Sys ern P
Site Plan
Show location of:
k Drivcways K Frontage Roads (include name) V Existing Structures 0 Well (W) �( Septic Tank (ST) Z Drain Field (DF)
❑ Holding Tapk (HT) IQ Lake ❑ River ❑ Stream/Creek ❑ Pond ❑ Floodplain ❑ Wctlands%. Slopes over 20%,W
10-ff 2�lr�ej-\
FEB 1 4 Y025
�vmPi
Setbacks from furthest extent incitthing eaves and County Use Only
overhangs of structure to: Verified setbacks
Road Centerline ft. ft. Notes/Comments:
Front Lot Line/Right-of-Way ft. ft.
Side Lot Line 1 ft.
Side Lot Line 2
NorthE1EaS SoutbE1West[I circle one
ft.
L)
ft.
Rear Lot Line
ft.
It.
Septic/Holding Tank
ft.
ft.
Drainfield
ft.
ft.
Privy
Well
ft•
ft'
Existing structure/Building
Elevation of Floodplain
Ordinary High -Water Mark (OHWM)
40TE: Please indicate "see attached" on
Bayfield Co. Zoning Dept.
ft. Ct.
ft. ft.
if submitting site plan as a separate document.
2
Bayfield County Health Department — State Lodging Lice e FEB 1 4 2025
Bayfield Co. Zoning Dept
Health Department (State Lodging License): All rental units require a Tourist Rooming House license through the State
of Wisconsin Department of Agriculture, Trade and Consumer Protection (WDATCP) or their authorized agent (Bayfield
County Health Department.
➢ Bayfield County Health Department issues permits on behalf of the State of WDATCP under ATCP 72, 73, 76,
78 and 79.
➢ ATCP 72 regulates lodging facilities including hotels, motels and tourist rooming houses.
➢ Bayfield County Ordinance Title 9 Chapter 2 Food Protection Lodaine Pools Caminrounds,
Recreational/Educational Camps Tattoo and Body Piercing Establishments outlines the licensing program and the
authorized agent agreement between the Bayfield County Health Department and the State of Wisconsin.
➢ ATCP 72.03(20): "Tourist rooming house" means all lodging places and tourist cabins and cottages, other than
hotels and motels, in which sleeping accommodations are offered for pay to tourists or transients. It does not
include private boarding or rooming houses not accommodating tourists or transients, or bed and breakfast
establishments regulated under Ch. ATCP 73.
➢ Wis. Stat. § 97.67 (5) and § 97.605 (1)(c) "No license may be issued until all applicable fees have been paid."
➢ Wis. Stat. § 97.605 (1)(a) "No person may conduct, maintain, manage or operate a hotel, restaurant,
temporary restaurant, tourist rooming house, vending machine commissary or vending machine if the
person has not been issued an annual license by the department or by a local health department that is
granted agent status under s. 97.615 (2)."
➢ Within 30 days after receiving a complete application for a license, the department or its agent shall either
approve the application and issue a license or deny the application. If the application for a license is denied,
the department or its agent shall give the applicant reasons, in writing,for the denial.
➢ A license shall not be issued to an operator without prior inspection.
➢ Tourist rooming houses license expires on June 30ih. ATCP 72 requires an annual renewal application and fee.
Failure to maintain proper permitting will result in penalties. Licenses are non -transferable, except to immediate
family members as allowed in ATCP 72.
APPLICATION FEES —Required for all tourist rooming house within Bayteld County
Check or money order payable to Bayfield County Health Department
When will your rental be in operation:
❑ Summer ❑ Winter Year -Round
JK $575 — License Fee ($275) + Pre -Inspection Fee ($300)
Pre -Inspection Fee includes bacteriological sample analysis for private drinking water supply.
❑ Rush Fee ($50) — A one-time $50 rush fee will be charged for inspections requested within 7 business days.
However, depending on scheduling, staff may not be able to accommodate all rush requests.
Your signature below will acknowledge you have received information as to where to obtain a copy of the code and
will comply with applicable Wisconsin Administrative Code(s). Personally identifiable information you provide may be
used for purposes other than that for wipch it was c911ected (Wis Stat § 15.04 (1)(m)).
Signature: /, /
FloD f
�ECEMO
FEb 142025
r-foe7"
oeirokw\1
and Zoning Short -Term Rental Pepoa C E � V E II II
PLANNING AND ZONING QUESTIONS
1.
Is the property in the shoreland, within 300 feet of a river/stream OR landward side of tloodplain OR 1000 feet
of a lake/pond/flowage, whichever is greater? W Yes ❑ No ❑ Unsure
2.
Is there a wetland located on the property? ❑ Yes XNo ❑ Unsure
3.
Is there a flood lain located on or near the property? ❑ Yes ig No ❑ Unsure
4.
Is this project associated with any of the following: ❑ Rezone ❑ Conditional Use ❑ Special Use
❑ Variance
5.
Did you contact the town to see if any permits/requirements apply to yourproject? RYes ❑ No
Zoning Department Use Permits: Short -Term Rental permits through Bayfield County Planning and Zoning Department
are non -transferable, except as per the exemptions identified in ATCP 72.04(3). Short -Tenn Rental permits are regulated
by Bayfield County Ordinance Section 13-1-35.
APPLICATION FEES
Check or money order payable to Bayfield County Planning and Zoning
1 unit: $500 2 unit: $1,000 3 u�:$1,500 4 unit $$2,000
To ensure your application is complete and can be processed by the Department, check you have the following items:
'Applicant Information (Page 1)
❑ Site Plan (Page 2)
❑ Floor Plan(s) —provide sheet for each floor within each unit.
❑ Fees paid
I (we) declare that this application, including any accompanying information, has been examined by me (us) and to the
best of my (our) knowledge and belief it is true, correct, and complete. I (we) acknowledge that I (we) am (are)
responsible for the detail and accuracy of all information that I (we) are providing and that will be relied upon by Bayfield
County in determining whether to issue a permit. I (we) further accept liability which may be a result of Bayfield County
relying on this information I (we) are providing in or with this application. I (we) consent to county officials charged with
administering county ordinances to have access to the above -described property at any reasonable time for the purpose of
inspection. A ,
Owner(s) or Authorized Agent Printed Name: /
Owner(s) or Authorized Agent Signature: Date:
NOTE: If you are signing on behalf of the owner(s) a letter of authorization must accompany this application.
Bayfield County Planning an(l Zoninu Short -Terns Rental
n 7nF
l'ermif '
r �� �4 2o6
PLANNING AND ZONING QUESTIONS
Hayfield Co. Zoning
1.
Is the property in the shoreland, within 300 feet of a river/stream OR landward side
of a lake/pond/flowage, whichever is greater? NI Yes ❑ No ❑ Unsure
of floodplain OR 1000 feet
2.
Is there a wetland located on the property? ❑ Yes No ❑ Unsure
3.
Is there a flood lain located on or near the property? ❑ Yes o ❑ Unsure
4.
Is this project associated with any of the following: ❑ Rezone ❑ Conditional Use
❑ Variance
❑ Special Use
5.
Did you contact the town to see if any permits/requirements apply to your ro'ect?
Yes ❑ No
Zoning Department Use Permits: Short -Term Rental permits through Bayfield County Planning and Zoning Department
are non -transferable, except as per the exemptions identified in ATCP 72.04(3). Short -Term Rental permits are regulated
by Bayfield County Ordinance Section 13-1-35.
APPLICATION FEES
Check or money order payable to Bayfield County Planning and Zoning
I unit: $500 2 unit : $1,000 3 unit: $1,500 4 unit : $2,000
To ensure your application is complete and can be processed by the Department, check you have the following items:
,,Applicant Information (Page 1)
Fite Plan (Page 2)
loor Plan(s) — Provide sheet for each floor within each unit.
EirFees paid
I (we) declare that this application, including any accompanying information, has been examined by me (us) and to the
best of my (our) knowledge and belief it is true, correct, and complete. I (we) acknowledge that I (we) am (are)
responsible for the detail and accuracy of all information that I (we) are providing and that will be relied upon by Bayfield
County in determining whether to issue a permit. I (we) further accept liability which may be a result of Bayfield County
relying on this information I (we) are providing in or with this application. I (we) consent to county officials charged with
administering county ordinances to have access to the above -described property at any reasonable time for the purpose of
inspection. , n , i 11 1. 1 11
Owner(s) or Authorized Agent Printed Name:
Owner(s) or Authorized Agent Signature: � [ �Date:
NOTE: If you are signing on behalf of the owner(s) a letter of authorization must accompany this application.
Land Use Permit Application Review Checklist
Submission #: STD_ —00
Tax ID:
S-T-R: t 9-'1 `( -09
What zoning district is the project located in?
R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M-M
❑ Yes )2�No
Does lot meet the zoning dimensional requirements or is it substandard?
Deed of record:
Yes ❑ No
Is the project located in the Shorelands (Shorelands are lands within 300 feet of a river/stream OR
landward side of floodplain OR 1000 feet of a lake/pond/flowage, whichever is greater)?
Yes ❑ No
Is the project located in the Floodplain?
Zone:
❑ Yes No
Are there wetlands on the property?
❑ Yes No
Is project associated with a nonconforming use or structure?
Yes []No
Does the project require sanitary?
Sanitary Permit #: $ 15 54 Public System:
# of bedrooms: a
❑ Yes J%No
Does the project require an affidavit?
Affidavit #:
Number of Units: I
Number of Bedrooms: I
Number of Bathrooms:
Number of Stories:
❑ After -the -Fact (ATF)
ATF Fee Amount:
Inspected by: n '�
Date of Inspection:
\� w;
Inspection Notes:
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: I ` J v W
Date of Approva 2 l: -� 1
J
Condition(s):
,Town/State/DNR/Federal may require permitting
❑ This permit cannot be transferred if property is sold.
❑ A Bayfield County Health Dept permit is required.
❑ Check with Town regarding room tax.
)�
Short -Term Rental is for a maximum occupancy of persons.
❑ Additional conditions may be placed and need to be adhered to at the time of permit issuance
Other Conditions:
1 ! YFIELD Bayfield County
Planning & Zoning Department
117 E 511, Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner: Submission Number:
WARRICK, WILLIAM C & CHRISTINE A STR-00106
48555 CLEARWATER RD
GORDON, WI 54838 Transaction Number:
STR-00106-25D28
Description Amount
1 unit $500.00
Total: $500.00
Payment Amount: $500.00
Reference:1713
Paid by: WM. Craig Warrick
Payment Type: Check
Transaction Date: undefined
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
Town, City, Village, State or Federal
Permits May Also Be Required
Shoreland ,Floodplain
LAND USE — X
SANITARY — 87534
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
No. 25-0110 Tax ID: 4186
Issued To: WARRICK, WILLIAM C & CHRISTINE A
Location: S19 - T44N - R09W
Town of Barnes
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: CLEARWATER - PART OF GOVT LOT 3 LOT 10 7191
Residential Structure in R-1 zoning district
For: [1-Unit] Short -Term -Rental
(Disclaimer): Any future expansions or development would require additional permitting.
Condition(s): Town may require permitting. Short -Term Rental is for a maximum occupancy of 4 persons.
NOTE: This permit expires two years from date of issuance if the authorized construction
work or land use has not begun.
Changes in plans or specifications shall not be made without obtaining approval.
This permit may be void or revoked if any of the application information is found
to have been misrepresented, erroneous, or incomplete.
This permit may be void or revoked if any performance conditions are not
completed or if any prohibitory conditions are violated.
Desi Niewinski
Authorized Issuing Official
March 27, 2025
Date