HomeMy WebLinkAbout25-0184117 E 6'h Street F� �
PO Box 403 R-3 a111 d
Washburn. WI 54891
(7)5) 373-6109 MAR 28202
nc m1L_t�_hnyficldninms_wtiApv
Bayfield Co. Zoning
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Short -Term Rental Application Packet
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 Hayfield 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
required. Please review and fill out na_'es 1-5.
SECTION A: ESTABLISHMENT INFORMATION
Establishment Name
he S
T x ID # Town/City of
8-3
- , s - -f-
5 e-
Establishm nt Strcct Address
EEstabEfishmcm
State Z;_
ys-zs (t,SK 8
5 gy
SECTION B: OWNER INFCIRMAT1ON
Property Owner. t<ri5+7.i q g. -!San Email Address Phone Number
TteS Res { Lc Kmect,.-lSon1441etgm'+l.eo ygp -i573
Owner Mailing Address City State I Zip
X57_5 S w% ' j
SECTION C.• IF OPERAflNG9InJ PARTNER OR AGENT
Legal Licensee (partnership. LLC. I.L.P. or Inc) Email Address
Phone Number
Licensee Street Address
City
State
Zip
Arent Name (if applicable) J
mail Address i qco k gor+h
Phone Number
or4h .. ; e
t;
»-77 a
Agent Street Addre s t Zip
35010 van Qo4yc(�0 y
C
gbEe l.
SECTION D: RENTAL UNIT INFORMATION (see ke below
Unit
Unit ID
Structure
Heating
Water
Sanitary Source
# of Stories
# of
# of
Type
Source
Source
Bedrooms
Bathrooms
(-
/
2
3
4
Structure Type:
House H) Duplex D Cabi C Yurt Y) Apartment A Condo CO Other (O), please describe
Heating Source:
Electric (II) Natural Ga (NO Propane (P) Wood W) Fuel (F) Other(O , please describe
Water Source:
Sanitary Source:
Public/Municipal (Ni) Privac We P
1'ublic!Munici al (M) Private Onsite Wastewater System
MAR 282025
Show location of:
LJUJIIlUJ�.
❑ Driveways O Frontage Roads (include name) ❑ Existing Structures ❑ Well (W) O Septic Tank (ST) O Drain Field (DF)
O Holding Tank (FIT) ❑ _Lake ❑ River O Stream/Creek ❑ Pond ❑ Flood lain O Wetlands O Slopers over 20%
N
Setbacks from furthest extent includinjiTT
ly
overhangs of structure to:
ks
Road Centerline
tes/Coniments:
Front Lot Line/Right-of-Way
Side Lot ine I
(North -ast outh West, circle one)
Side Lot Line 2
North East South e . circle one)
Rear Lot Line
ft,
ft.
Septic/Holding Tank
ao ft.
ft.
Draintield
O ft.
ft.
Privy
rU/k ft.
ft.
Well
ft.
ft.
Existing Structure/Building
ft,
ft
Wetland
Fl.
ft.
Elevation of Floodplain
ft.
ft.
Ordinary High -Water Mark (OHWM)
+� ft,
ft.
ntrvrc. or......_
�• • •���� •.•u ta•c ncc anacuru on ems page it submitting site plan as a separate document.
k\t1JQ1 :4
3'
R 3
ufofl0
MAR 282025
Bayfield Co. Zoning Dept.
v
Zr
Giu
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Bayfield C ounty Planning and Zonin Short -Term Rental 282025
+ayumu uU. tunuly Liep
PLANNING AND ZONING QUESTIONS
I. Is the property in the shorclaud. within 300 feet osa river/stream OR landward side of floodplain OR 1000 feet
of a lake/pond/flowagc, whichever is renter? pJ Yes No 0 Unsure
2. Is there a wetland located on the property? 0 Yes No 0 Unsure
3. Is there a (]oodplain located on or near the property? ❑ Yes 0 No 'nsure
4. Is this project associated with any of the following: 0 Rezone 0 Conditional Use 0 Special Use
0 Variance
5. Did YOU contact the town to see if any etmits/re uirements apply to your project? Yes 0 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:
9 Applicant Information (Page 1)
0 Site Plan (Page 2)
9 -Floor Plan(s) - Provide sheet for each floor within each unit.
rteFee aid
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. I
Owner(s) or Authorized Agent Printed Name:( 1a,, 1.I4SlY)-,r
Owner(s) or Authorized Agent r l t
g Signature: Date:
NOTE: If you are signing on behalf of the owner(s) a letter of authorization must accompany this application.
1 his application packet contains information for both a Tourist Rooming House license through Bayfield County Health
Department and a Short -Tenn 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 Hayfield 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
required. Please review and fill out naees 1-5.
SECTION A: ESTABLISHMENT INFORMATION
E` a lishment Name
f -
Establishment Tax ID x 'T'jo^w�n/City of
e ih
e", Rwet
Establishment
75 Street Address
a.
�1J
City State
23(leja
Zip
.J A
_i_. ors
LOX
VT I
SECTION B: OWNER INFO TI
Property Owner I ;SF+t9 U4eJon Email Address
I Phone Number
'9W -get-
'.5 7S
Owner ailing Address City
State
Zip
5) S. &sM&e )t. rcn Qtve2
y4'/7
SECTION C: IF OPERATING IViTli PARTNER OR AGENT
Legal Licensee ipannership. LLC'. LLP. or Inc.i Email Address
Phone Number
Licensee Street Address
City
State
Zip
A cut Name (if applicablf ) Email Address hone Number
ncIAgent
Street Addres, City
State
Zip
SECTION D: RENTAL UNIT INFORMATION (see key
below)
Unit
Unit ID
Structure
Heating
Water
Sanitary Source
4 of Stories
tr of
# of
Type
Source
Source
ou
Bedrooms
Bathrooms
2
3
4
Structure Type:
House (H) Duplex D) C in CJ YuriCV) Apartment A Condo CO
Other(O), please describe
Heating Source:
Electric (B Natural Gas (NG) Propane (P) Wood (W) Fuel F) Other (0). please describe
Water Source: Sanitary Source:
Public/Municipal 1M) Private Well P) Public/Municipal (M) Private Onsite
Wastewater System P)
till MAR 282025
0
Show location of:
0 Driveways ❑ Frontage Roads (include name) 0 Existing Structures 0 Well (W) 0 Septic Tank (ST) 0 Drain Field (DF)
❑ Holding Tank (HT) 0 Lake 0 River 0 Stream/Creek ❑ Pond 0 Flood lain 0 Wetlands 0 Slopers over 20%
N
Setbacks from furthest extent including eaves and
overhangs of structure to:
County Use Only
Verified setbacks
Road Centerline
I7 ft.
ft.
Notes/Comments:
Front Lot Linc'Right-of Way
Side Lot tc I
(Nort ouch West, circle one)
ft.
ft.
Side Lot Line 2
North East South Ves circle one)
ft.
V
ft.
Rear Lot Line
fl.
It.
Septic/Holding Tank
ft.
fl
Drainfield
ft
ft.
Privy
tj A ft.
ft.
Well
ft.
ft.
Existing Structure/Building
ft.
ft.
Wetland
ft.
ft.
Elevation of Floodplain
fl
ft
Ordinary High -Water Mark (OHWMM)
NOTE: ato.....:...,:....._ .._..- - -
ft.
ft.
-
3ev a,.acueu un This page a submitting site plan as a separate document.
-- , f �eMAGR 2 8 2025
�eld Co. Zoning Dept.
flT1;
ic
OcT
103
il�
BEDROOM j PRIMARY BEDROOM
8'10" x 7'11" 9'9" x 7'11"
LIVING ROOM I I' KITCHEN
9'3" x 9,8„ 7,9,E x 9,8„
BATH FOYER
H DINING AREA
6'8"x5'7"
C° 3
o
N 1v
ni
.0 'I'raj
and Zoning Short -Term Rental
HESE�V59
MAR 282025
PLANNING AND ZONING QUESTIONS
1, Is the property in the shoreland, within 300 feet of river/stream OR landward side of floodplain OR 1000 feet
of a lake/pond/flowage. whichever is greater? '.]Yes ❑ No 0 Unsure
2. Is there a wetland located on the property? 0 Yes No ❑ Unsure
3. Is there a floodplain located on or near the property? ❑ Yes ❑ No Unsure
4. Is this project associated with any of die following: ❑ Rezone - Conditional Usc ❑ Special Use
❑ Variance
5. Did yot contact the town to see if any ernits/re uirements apply to your project? Yes 0 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 : S500 2 unit :51,000 3 unit: 51300 4 unit: S2A00
To ensure your application is complete and can be processed by the Department. check you have the following items:
G✓Applicant Information (Page 1)
Q Site Plan (Page 2)
Floor Plan(s) - Provide sheet for each floor within each unit.
C�-fcecpa>�,
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 1 (we) arc 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.
Owner(s) or Authorized Agent Printed Name:
Owner(s) or Authorized Agent Signature:
NOTE: If you are signing on behalf of the owner(s) a letter of
Date:
authorization must accompany this application.
C RUC��
ilfi MAR 2 8 Z0Z5 BUJ
Bayfield Co. Zoning Dept.
117 E 6°' Street
Po Box 403
Washburn, WI 54891
(715)373-6109
P mots"I lla fieldenunty.Lt rx
RA-YFIELD
Health
Zoning
Submission #
Fee Paid
Refund
Permit #
Date Issued
Short -Term Rental Application Packet
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 Hayfield 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
required. Please review and fill out pages 1-5.
SECTION A: ESTABLISHMENT INFORMATION
Establishment Name
Establishment Tax ID #
Town/City of
h
Esrablishmetit StrecLAddress City State Zi
&s. i342 .Zeon R�✓ei2 t�J.L �y7g7
SECTION B: OWNER INFO ON
Property Owner Rriwr Cav)Email Address Phone Number
LLI .S -i 7
Owner Mailing Address p City State Zip
957c5 , 51� y� Z�w. RJue1Q belt
SECTION C: IF OPERATING WIWITH PARTNER OR AGENT
Legal Licensee (Partnership. LLC. LLP. or Inc.) Email Address
Phone Number
Licensee Street Address
City
State
Zip
Agent Name (if applicable)
d
Email Address
Phone Number
/579ifl
Agent Street Addr ss
1 p. D
City
@ A )'e
State Zip
ZJ1.
SECTION
D: RENT IT INFORMATION (seekey
below)
Unit
Unit ID
Structure
I leaning
Water
Sanitary Source
I 4 of Stories
t: of
:: of
Type
Source
Source
Bedrooms
Bathrooms
Ut�
2
3
4
Structure Type:
House H) Duplex D) Cabin C) Yuri Y Apartment A) Condo CO Other (O). please describe
Heating Source:
Electric (E) Natural Gas(NU) Propane (PI Wood t W) Fuel (F) Other (Oh please describe
Water Source:
Sanitary Source:
Public/Municipal (M) Private Well P)
Public/Municipal M) Private Onsite Wastewater System P)
Site Plan
.Show location of:
-- I LvLJ
I�a��� ddAA
O Driveways O Frontage Roads (include name) O Existing Structures O Well (W) 0 Septic Tank (Sl9Mf 16,9pr 17r ht OAe
O 1 bolding Tank (FIT) O Lake ❑ River
O Stream/Creek O Pond O Floodplain O Wetlands ❑ Slo ers over 20%
N
Setbacks front furthest extent including eaves an7k'&
ly
overhangs of structure to:
ks
Road Centerline
tes/Comments:
Front Lot Line/Right-of-Way
Side Lot Line I
(North ' South West, circle one)
Side Lm Line 2
ft.
Nert6 East South. circle one)
Rear Lm Line
7 ft
ft
SeptiOHolding Tank
ft.
ft
Drainfield
(93 Fl
ft
Privy
ft.
ft.
Well
ft.
ft.
Existing Structure/Ftuilding
Fl.
ft,
Weiland
ft.
ft.
Elevation of Floodplain
ti
ft.
Ordinary High -Water Mark ;OHWM)
wih rn_
7 f.
--
ft.
.i. r.: rwase muicarc -see attached on this page It submitting site plan as a separate document.
.t
-7 i
r-------. ____..r,y,,.,� ___
,
Jj
MAR 282025
Bayfleld Co. Zoning Dept.
�
�V
=
O
�
fV
CV
O
-o
and Zoning Short -Term Rental]
1AR 2 ' 'I(;'
PLANNING AND ZONING QUESTIONSII I
1.
Is the property in the shoreland, within 300 feet of a river/stream OR landward side of floo Y iP RL2 m0 j
ufa lake/pond/flowage, whichever is greater? ❑ Yes ❑ No O Unsure
2.
Is there a wetland located on the property? O Yes GatNo O Unsure
3.
Is there a flood lain located on or near the property? O Yes O No NKJJnsure
4.
Is this project associated with any of the following: ❑ Rezone 0 Conditional Use O Special Use
❑ Variance
5.
Did you contact the town to see if any etntits/re uirements apply to your project? 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 I)
'Site Plan (Page 2)
li loor 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 (arc)
responsible for the detail and accuracy of all information that I (we) are providing and that will be relied upon by Hayfield
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.
Owner(s) or Authorized Agent Printed Na
Owner(s) or Authorized Agent Signature:
NOTE: If you are signing on behalf of tl
en'
117 1-: 6'r' Street
PO Box 4113
Washburn. WI 54891
(715) 373-6109
Iwrmils..a-hu_vt7cldcwpty,%} i,euv
R ` Y]PIELD
nn MAR 2 8 2025
Short -Term ental Application Packet
)_'70minanant_
This application packet coma ins information Ibr a Short-] edit Rental permit through 13avlield County Planning and
Tuning Department, Completed application can be inn ilcd'emniled to the address'ernitiI above.
SECTION A: ESTABLISHMENT TNFfDMATrnM
Establishment Name
he 1
Establishment Tax ID #
Spt,•}
Town/City of
Establishment Street Address
City
von i
t>82
515 5.K
State
Zip
SECTION B: OWNER INFORMATION
R n
y
Propert Ooner r�{;nq
IanaiIAddress
��,�» Lt �rf�o_� J 9 4�a.�!• e�,
Phone Number
y $D - � y
8 - IS
0 U
Illnul.41AR.
�``[�
Show location oF.
❑ Driveways ❑ Frontage Roads (include name) ❑ Existing
t�Irl r�,,
Structures ❑ Well (W) C Septic Tank
❑ Holding Tank (HT) 0 Lake 0 River 0 Stream/Creek 0 Pond 0 Flood lain 0 Wetlands 0 Slopers over 20%
N
Setbacks from furthest extent including eaves and
County Use Only
overhangs of structure to:
Verified setbacks
Road Centerline
ft.
ft.
Notes'Comments:
Front Lot Line Richt-of-Ua`
ft.
fl.
Sid Lot ne I
ft
ft
�s oath West. circle one)
Side Lo .ine 2
__
ft.
fl.
(North East Soutl 'e t circle one)
Rear Lot Line
ft.
ft.
Septic'Holdine Tank
a, ft.
ft.
Drainfield
ft.
ft.
Privy
ft.
ft.
Well
v ti.
ft.
_
ExistingStruclurt3uilding
) ft.
ft.
Wetland
ti.
ft.
Elevation of Floodplain
Ij
ft.
Ordinary High -Water Mark(OHWM)
ft.
ft.
Nf1TF• PI..o... :...i:........ _.__....
_
» - ••• •- w ,« annrcueu un tuts page it suumitting site plan as a separate document.
MAR 2 8 2025
Bayfleld Co. Zoning Dept
I
�
'_ --�.J � i 4, � .� �'�. mot...
BEDROOM
16'8" x 7'1"
DINING AREA
10'1" x 6'6"
KITCHEN
67" x 9'4"
LIVING ROOM
BATH 10'1" x 9'3"
6'3" x 6'0" -
Bayfield County Planning and Zoning Short-'Yerut Rental Permit
1. Is ncc property in the• shoreland. within 300 feet of a ri+er stream OR landward side of tloodplain OR
of s I skOwnd`tlot\age, t\hichever is seater? ❑ Yes ❑ No ❑ Unsure
?_Is there a ++eland located on the property? ❑ Yes V No 0 Unsure
3. Is there a flood lam located on or near the�proipert-y? O Yes O No Unsure
4. Is this project associated with any of the follo++ing: ❑ Rezone 0 C'onditional Use ❑ Special Use
❑ Variance
5. Did you contact the town to see it any pennits'requirements apple to our project? W't'es ❑ No
Zoning Department Use Permits: Short -Terns Rental permits through Bayfield County Planning[id iSt iI4 D&pa4liLn�
are non -transferable, except as per the exemptions identified in ATC'P 72.0-1(3). Short=ferns Rent )emti are (e t 1•tjed D
by Hayfield County Ordinance Section 13-1-35. liuu MAN 2 0 LUL9
APPLICATION FEES ($500 per unit)
Check or money order payable to Bayfield County Planning and Zoning
I unit : $500 '_ unit, : $1.000 3 units : 51.500 4
units : $2.000
To ensure +nor application is complete and can be processed b\ the Department. check you have the follow ing items:
iApplieant Information (Page I)
( Site Plan (Page 2)
i;,� door Plan(s) - Provide sheet fipr each floor++ithin each unit.
I (++e) declare that this application. including any accontpanving information, has been examined by me (us) and to the
best of my (our) knots ledge and belief it is trite. correct, and complete. I (we) acknowledge that I (++e) am (are)
responsible fix the detail and accurac'\ ofall information that I (we) are providing and that will be relied upon by 13afield
County in determining +whether to issue a permit. I t e) further accept liability +t hick may be a result of•Bayfield County
reh ing on this intormation I (+te) are providing in or with this application. I (++c) consent to county officials charged with
administering counts ordinances to have access to the above -described properat any reasonable time for the purpose of
inspection.
Owner(s) or Authorized Agent Printed Na
Oa ner(s) or Atuhorized Agent Signature:
NOTE: If)ou are signing on behalf of the owner(s) a letter orauihorization must aecompany this application.
NORTHS COUNTRY
VACATION RENTALS
To Whom it may concern,
MAR 282025
1 hereby authorize North Country Vacation Rentals to act as my agent to procure p&(fteldrCtAa P9 Dept.
nformation pertaining to my property m• 5575 S. Buskey Bay Dr. Iron River. WI 54847
Units Wolfs Den, Bear Bungalow. Moose Ridge and The Loon's Nest
;n the Town o! Iron River
Sign,aore
Kristine Carlson
My contact information is.
Address 9575 S. Buskey Bay Dr. Iron River, WI 54847
480-848-1575
Phone:
Email _kmcarlson1991@gmail.com
MAR 28''L J
Bayfield Co. Zoning Dept.
NORT
OUNTRY
.nirnc Fnnt;♦ - .. .
1111 MAR 2 8 2020
Bayfield Co. Zoning Dept
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: _ 5 '5 S is B ciSk-1 1 k ( r on R ; 0Q ,
2. The Subject Property is owned by: t /tt S{ Re -�- L 5 9�y 7
(Name of ompany)
3. The name(s) of the current President or Managing Member: <c5 c.L n Q Ccic'Sorb
4. I 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. I further certify that the
information and statements made within this affidavit are true, accurate, and complete to the best
of my knowledge.
5. I 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:
Print Name
Subscribed and sworn to before me this
day of , 2p
Notary Public, County, Wisconsin
My commission:
..u� ,i4 g,, ..Y+w...nz +:Fwca,. :.z.wa...<. .>:wvz.. .Ufla •' ..xaw:i. :zarr.� aJwe®' -
AFFIDAVIT OF AUTHORITY
(Corporation, LLC. etc.)
HE9L �VE0
MAR2520z5 8 2025
Bayfield Co. Zoning Dept
PURPOSE. I ht. Arhrulvu n; Authunty is used to centiv the individual eppl7my for a perms 6 ena hrnTk
whet the properl:. s O.ien by a cut pnraterbus,ness entity.
STATE OF WISCONSIN I
)ss.
BAYFIELD COUNTY
The undersigned affirms and states as iolto
1. Address of Sub;ect Property I_ - 5L- r%5 r f
-
2 The Subject Property is owned ny. _ ( } K__y �� j� ' y
(Name of ompanyj
3 The names) of the current President or Managing Member n g
4. I certify that the company named in paragraph 2 is valid and in effect on the date signed below. I
am the duty aDpornted agent of the Company named above in Daragraph 2. ant I have tr,e
allthonly under the terms of said authorization to apply for permits from the Bayfield County
Zoning Deoarrrent concerning the Property described in paragraph i. I further certify that the
informauon.and statements made within this affidavit are true, accurate, and complete to the best
of my knowledge
I am autnonzed by the above -named Company to apply for and hind the Company to the terms
and conditons of any permit that may he issue by the Bayfield County Zoning Department
6 By signing tilts aficavit. 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 ) )2o2 5
Pont Name
Subscribed and sworn to before me this 29
day of _1 ,v(M ...-- 2O5 LiBVa'r
Vie...... lei C.,
VV
Notary P.im,_ 15 _ Rtl is I �pTAf? y'
ray cumro,: ;,tin Ci__� County. Wisconsn_
'gTFOF W1SG�'
1/ 1111111''
Land Use Permit Application Review Checklist
Submission #: STtQ- 0 0 j%(p
Tax ID: 7O53
S -T -R: 2-97t%
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 XNo
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 o
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 #: 1 3 7 a 10 ( 1 k9 ) Public System:
# of bedrooms: 7
Yes ❑ No
Does the project require an affidavit?
Affidavit #:
Number of Units:
Number of Bedrooms: Z, 2 , I , I
Number of Bathrooms: I I I
Number of Stories: ( / 1 I I
❑ After -the -Fact (ATF)
ATF Fee Amount:
Inspected by:T\ N ;f' �C
J
Date of Inspection:
Inspection Notes: 1W
^r\U prc4< r2C11 { "l fees Wct vtcl c rM +ice h+tibv-U 015
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: � �3 tN'
Date of Approval: L 9 3-2S
v(
!V
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. LL
I) 4
%Short -Term Rental is for a maximum occupancy of persons. 0 rc 4- ok- crrt
❑ 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
SANITARY - 137210
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
No. 25-0184 Tax IDs: 37053, 37052, 37051, 37050
Issued To: THE SPOT RESORT LLC
Location: S28 - T47N - R08W
Town of Iron River
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: BUSKEY BAY CONDOMINIUM UNIT 4 TOG WITH UNDIV INT IN COMMON ELEMENTS DESC IN 2021 R-
592469 BUSKEY BAY CONDOMINIUM UNIT 3 TOG WITH UNDIV INT IN COMMON ELEMENTS DESC IN 2021R-592469
BUSKEY BAY CONDOMINIUM UNIT 2 TOG WITH UNDIV INT IN COMMON ELEMENTS DESC IN 2021R-592469 BUSKEY
BAY CONDOMINIUM UNIT 1 TOG WITH UNDIV INT IN COMMON ELEMENTS DESC IN 2021R-592469
Residential Structure in R-1 zoning district
For: [4 -Unit] Short -Term -Rental
(I rir r.l�hurr). Any toIme expansions or development would require additional permitting
Condition(s): Town may require permitting. Short -Term Rental is for a maximum occupancy of 14 persons between 4 units.
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
April 23, 2025
Date