HomeMy WebLinkAbout25-0194117 E 6a' Street
PO Box 403
Washburn, WI 54891
(715) 373-6109
permits(a,bayfieldcoun .wi.gov
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F- YFIELD
JAN 3 C 2I1c5
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Short -Term Rental AppTC�'a?It)n Packet
This application packet contains information fora Short -Term Rental permit through Bayfield County Planning and
Zoning Department. Completed application can be mailed/emailed to the address/email above.
SECTION A: ESTABLISHMENT INFORMATION
Establishment Name
Ss\O.v wei )oo -S
Establishment Tax ID #
Town/City of
Establishment Street ddress
all 3 Gl� CU�n Nw
Ci
' %; �
State
Wl
Zip I
S4 `�!
SECTION B: OWNER INFORMATION
Property Owner r'
Vl-CJ
Email Address
Phone Number
Owner Mailing Address
Th X 00T
City
State
WI
Zip
SMS/ .
SECTION C: IF OPERATING WITH PARTNER OR AGENT
Legal Licensee (partnership, LLC, I.LP, or Inc.)
Email Address
Phone Number
Licensee Street Address
City
State
Zip
Agent Name (if applicable)
S 'r i2OAA4OJS
Email Address Phone Number
14ciVIn Lvt�1.UU� S Coot& (9-15 y 13
Agent Street Address
P ' tsc )Jai?i uozk1
City T
State
UA
Zip
Sz( r
SECTION D: RENTAL UNIT INFORMATION (see key
below)
Unit
Unit ID
Structure
Type
Heating
Source
Water
Source
Sanitary Source
# of Stories
# of
Bedrooms
# of
Bathrooms
2___
14
_E
P
P
/
2
2
Structure Type:
House (H) Duplex (D) Cabin (C) Yurt Y) Apartment A Condo CO Other (O), please describe
Heating Source:
Electric (E) Natural Gas (NG) Propane P Wood (W) Fuel (F) Other O please describe
Water Source:
Public/Municipal (M) Private Well P
Sanitary Source:
Public/Municipal M) 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: I' [ 83 Old (t)uv\4j UA-)q K
2. The Subject Property is owned by: 4 fn' LkX5
(Name of Compan))
3. The name(s) of the current President or Managing Member: UC,-_,1CLTYUd.LkjLY�
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: L4lI ) /ZOIS
Print Name
Subscribed and sworn to before this 1_
day of 20 2O..5
Notary Public, Coun
0.14:::) L' -
My commission:
CARMEN KAY DINER
Notarial Seal- Iowa
Commission Number 943516
M ; ommissfon Expires Nov 1, 2025
PROCESSING INFORMATION
INITIAL PROCESSING. Once the department receives your affidavit, the department will review It for
completeness. If the information is not complete, the department may reject your affidavit and the
application.
REQUEST FOR MORE INFORMATION. The department may request that you provide more information
or evidence to support your affidavit.
DECISION. The department will review all documents submitted as part of the application for registration
and title, this form included, and may approve, deny or request more information.
Land Use Permit Application Review Checklist
Submission #: �'-- mtHcz
Tax ID: 36 7 1O 1
S -T -R: I I - S t- o9
What zoning district is the project located in?
❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 DA -2'F4 ❑ F-2 ❑ W ❑ M -M
❑ Yes No
Does lot meet the zoning dimensional requiremer is or is it substandard?
Deed of record:
❑ Yes'lo
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 k No
Are there wetlands on the property?
❑ Yes ' o
Is project associated with a nonconforming use or structure?
Yes ❑ No
Does the project require sanitary?
Sanitary Permit #: 21 -,as Public System:
# of bedrooms: 3
Yes ❑ No
Does the project require an affidavit?
Affidavit #:
Number of Units:
Number of Bedrooms: I, j
Number of Bathrooms: I, 1, I
Number of Stories: It I ,
O After -the -Fact (ATF)
ATF Fee Amount:
Inspected by:
Date of Inspection:
Inspection Notes:
— p1EVLhvs rw'V\ t 21-c220
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by:
Date of pprova:
Approval:
_0 L9
Condition(s):
"own/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. pa (t( n
-Term Rental is for a maximum occupancy of persons.
,Short
O 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
LAND USE —X (previous 21-0220)
SANITARY - 21-72S
SPECIAL A -
SPECIAL B/CONDITIONAL —
BOA —
No. 25-0194 Tax ID: 38761
Issued To: B & W BAYFIELD LLC
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Location: S11 - T51 N - R04W
Town of
Legal Description: LOT 1 CSM #2228 IN V.13 P.34 AS DOC 2022R-593489 (LOCATED IN NW SW)
Residential Structure in F-1 zoning district
For: [3 -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 6 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 25, 2025
This permit may be void or revoked if any performance conditions are not Date
completed or if any prohibitory conditions are violated.