HomeMy WebLinkAbout25-0171117 E Street B=YFIELD
PO Box 403
Washburn, WI 54891 n
(715)373-6109 E 9 1 0 v D
permits 2bayfieldcounty.wi.gov
JAN 312075
Health
Zoning
Submission #
Fee Paid
Refund
Permit #
Date Issued
kr-TcTfl[Y AWtal Application Packet
This application packet contains information for a Short -Tenn Rental permit through Bay field County Planning and
Zoning Department. Completed application can be mailed/emailed to the address/email above.
SECTION A: ESTABLISHMENT INFORMATION
Establishment Name
GUI//SP��n/y Pima ow LAkei -SL)Pe&24oe LLG
Establishment Tax ID #
Z`19 `j
Town/City of
RNS9V-Li-
Establishment Street Address
3eDV5 A46CAN7— Keigo
City_ _
BayFt4FF�
State
wr
Zip
548YZI
SECTION B: OWNER INFORMATION
Property Owner, J C
KERN i ICAWex-/ � 6MW-St
Email Address II �
ta"spern prnesen/gtcU
Ma,t.
Phone Number
`� aM
�a SI — 7�S— �e
Owner Mailing Address
1176V A-e?Jb" PA-t- ✓ C -1""-
City
State
A4A(
Zip
Ss-Y[y9
SECTION C: IF OPERATING WITH PARTNER OR AGENT
Legal Licensee (partnership, 1.1,C. LLP, or Inc.)
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
below
Unit
Unit ID
Structure
Type
Heating
Source
Water
Source
Sanitary Source
# of Stories
# of
Bedrooms
# of
Bathrooms
'
P
P
P
2--
2
3
4
Structure Type:
House Duplex D Cabin C Yurt Apartment A Condo CO Other (0), please describe
Heating Source:
Electric E Natural Gas G Propane P Wood Fuel Other (0), please describe
Water Source:
Public/Municipal M Private Well P
Sanitary Source:
Public/Municipal Private Onsite Wastewater System P
AFFIDAVIT OF AUTHORITY
(Corporation, LLC, etc.)
PURPOSE. This Affidavit of Authority is used to certify the individual applying for a permit is authorized
when the property is owned by a corporate/business entity.
STATE OF WISCONSIN )
) ss.
BAYFIELD COUNTY )
The undersigned affirms and states as follows:
1. Address of Subject Property: 35 OQjtj QA%' t�T Rni yF t cl I� IA Z CAo
2. The Subject Property is owned by: J%NFi4SF5pl ELNES N LAVZ I�9,1OR7 LLG
(Name of Company)
3. The name(s) of the current President or Managing Memberj�EI T14 S(jew�
4. 1 certify that the company named in paragraph 2 is valid and In effect on the date signed below. I
am the duly appointed agent of the Company named above in paragraph 2, and I have the
authority under the terms of said authorization to apply for permits from the Bayfield County
Zoning Department concerning the Property described in paragraph 1. 1 further certify that the
Information and statements made within this affidavit are true, accurate, and complete to the best
of my knowledge.
5. 1 am authorized by the above -named Company to apply for and bind the Company to the terms
and conditions of any permit that may be issue by the Bayfield County Zoning Department.
6. By signing this affidavit, I attest that I am unaware of any known or unknown person(s) who would
contest this application. I agree to indemnify Bayfield County or such person or legal entity
suffering a damage resulting from any illegalities of the application for permit.
Dated: 07 Fs 2025
aITR SO-i✓�RU--5EN
Print Name
Subscribed and sworn to before me this �d h
day of (r t 20 `LrD SRI U KSLLI SOWMYA
r^!'a+ MALLIPUDI
r + : Notary Public • Minnesota
My Commission Expires
w � rJan 37, 2029
Notary Public, Xo C unty, Ufiy cftsin jLi v Gu-j
My commission: I
Land Use Permit Application Review Checklist
Submission#: 5TR- 00055
I Tax ID: 2998`! S-T-R: 29- 5/ —03
What zoning district is the project located in?
❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 )dR-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M-M
❑ Yes ;. 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 �Ao
Is the project located in the Floodplain?
Zone:
❑ Yes WNo
Are there wetlands on the property?
❑ Yes IgNo
Is project associated with a nonconforming use or structure?
,`Yes ❑ No
Does the project require sanitary?
Sanitary Permit #: 144 9 -2 `l-7 Public System:
# of bedrooms: 5 , �[ kkdyoy
Yes ❑ No
Does the project require an affidavit?
Affidavit #:
Number of Units: I
Number of Bedrooms:
Number of Bathrooms:
Number of Stories: 7-
0 After -the -Fact (ATF)
ATF Fee Amount:
Inspected by:
�.s; �;-eW;�sk;
Date of Inspection:
y-a�-as
Inspection Notes:
-�rev�o,J5 17�rM, IS-Oct83
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: Dom; ` , ^ ) ,
am}
Date of Approval• � r d 1— O s
l,
\ w\ Y\ M
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.
P5hort-Term Rental is for a maximum occupancy of .65( persons.
❑ Additional conditions may be placed and need to be adhered to at the time of permit issuance
Other Conditions:
Town, City, Village, State or Federal
Permits May Also Be Required
Shoreland
LAND USE — X (previous 15-0083)
SANITARY—149797
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
BAYFIELD COUNTY
\ 1A 1
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 25-0171 Tax ID: 29984
Issued To: SOENCKSEN, KEITH & KAREN
Location: S29 - T51 N - R03W
Town of
Legal Description: CLIFF POINTE SUBDIVISION (LOCATED IN GOVT LOT 1) LOT 6 & 7 IN 2017R-566786
Residential Structure in R-RB 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 8 persons.
NOTE: This permit expires two years from date of issuance if the authorized construction Desi Niewinski
work or land use has not begun.
Authorized Issuing Official
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. April 21, 2025
This permit may be void or revoked if any performance conditions are not
completed or if any prohibitory conditions are violated.
Date