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HomeMy WebLinkAbout25-0196117 E 6'" Street PO Box 403 Washburn, WI 54891 (715)373-6109 D permits bayfieldcoun 13! VFIELD Health Zoning Submission # fP\ 1r Fee Paid ,� 1 Refund JAN 30 2025 I Permit # Date Issued �i�rRental Application Packet This application packet contains information for a Short -Tenn Rental permit through 13aytield County Planning and Zoning Department. Completed application can be mailed/emailed to the address/email above. SECTION A: ESTABLISHMENT INFORMATION Establishment Name , CUrr� Q5e c o e- Establishment Tax ID # 3(0 11• Town/City of � . Establishment Street Address ' sc U ✓t Ci • n i1 w20 ate w Zip s i SECTION B; OWNER FORM ON Property Owner L. itn6 Se1F Email Address Phone Number Owner Mailing Address Pbmx)ooS Cit • I� ria State ta Zit'-p��, 4&VI c SECTION C. IF OPERATING WITH PARTNER OR AGENT Legal Licensee (partnership, LLC, I.L.P, or Inc.) Email Address Phone Number Licensee Street Address City State Zip Agent Name (if applicable) U)f r\Asako-r Rj'u'k Email Address I At4wunQ W+�Stdcv Phone Number £awl LiISVi3-� Agent Street Address I City ?b psox I6tCJI hcAJe, 4d State Wt Zip ikzu 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 1 r+ _ P m a y z 3 4 Structure Type: House H Duplex D Cabin C) Yurt Y Apartment A) Condo CO Other (O), please describe Heating Source: Electric (E) Natural Gas(NO) Propane P Wood W Fuel Other O please describe Water Source: Public/Municipal M Private Well P Sanitary Source: Public/Municipal (M) Private Onsite Wastewater System (P) 'F prb�C✓`t^ OtNY"er IBS 3',-, kJbh'1f.N ic..O Rb Ise✓ 4 LLC 23 S__1t7E6a'Street B YFIELD W (7 5) 3733-6109 91 p 45 v t perm its(abayfieldcount7 - v -iI MAR 0 6 202'. IMPT--Term IY N a� o. A°ppiication Packet This application packet contains information for a Short -Term Rental permit through Bayfteld County Planning and Zoning Department. Completed application' can be mailed/emailed to the address/email above. SECTION A: ESTABLISHMENT INFORMATION Establishment Name , Ccarr; aye f -k ost Establishment Tax ID # go- Town/City of Establishment Street Address 4 — U Ci State a Zip zpj SECTIONS: OWNER E4FO1tMA1ION Property Owner L P 6ineL. st f rw,1reut4T Email Address Phone Number Owner Mailing Address vo Ci �- State wt Zip Sls,c SECTION. C. IF OPERATING WITH PARTNER OR AGENT Legal Licensee.(pannership, LLC,:I:LP, or Inc) Email Address PhoneNumber Licensee Street Address City State Zip Agent Name (if applicable) Wi Email Address l tov<d Phone Number t6vM L17? Agent Street Address "'b Flox S ri12atht�. € A City &4ArbO State WI Zip s4e14 SECTION D: RENTAL UNIT INFORMATION (see Ice below Unit Unit ID Structure Type Heating Source Water Source Sanitary Source # of Stories # of Bedrooms # of Bathrooms H+ we P m 2 3 4 Structure Type: House (H) Duplex D Cabin (C) Yurt (Y) A artmenl (A) Condo CO Other (0), please describe Heating Source; Electric E Natural Gas(NO) Propane (P) Wood Fuel Other (O), please describe Water Source: Sanitary Source: Public/Municipal Private Well P Public/Municipal.(M) Private Onsite Wastewater System (P) �wyzr�ta t9t '4r tS 3 n V)bMenic D 11 U I Pro rer' -J (IL - 44/ 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: 3 y ?'6T- z (lit Vw Me. a a t 1 B.. , 'Jr .c ei 2. The Subject Propertyis owned by: son O o,rteni c o PropeflJ.r ( w t c• ^si ) LLC (Name of Company) 3. The name(s) of the current President or Managing Member: 57) w✓k- e..'n,% % c 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: Y /J S /'/G v'- 7C c ≤7cr_ Print Name Subscribed sworn to before me this day of ,2Q.. E£ Notary Public. N. County, Wisconsin �OM� My commission: L\ pt1— CC FkcP- CALIFORNIA JURAT GOVERNMENT CODE § 8202 A notary public or other officer completing this certificate verifies only the Identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California'•'' Countyof 41A MAC ■ REVMAA. a1p5TAJ0 !!! Notnry Gu611c C Can1tyM� $an matte County Cnmmk'fa Y 2)56975 +ry Com. Enirn YaY 10.7025 Place Notary Seal and/or Stamp Above Subscribed and sworn to (or affirmed) before me on this IS day of P R�{R (- ,20 'iS by Date Month Year (1) MMR-K R£INS�� (and proved be the SignatL OPTIONAL Name(s) of Signer(s) Completing this Information can deter alteration of the document or fraudulent reattachment of this form to an unintended document Description of Attached Document Title or Type of Document Q' If F 19 M 1T OF p` mr it 4 Document Date: ��`�2O2 S Number of Pages: Signer(s) Other Than Named Above: ©2019 National Notary Association Land Use Permit Application Review Checklist Submission #: S jIQ_ pp ?j ( Tax ID: 3(°]o j 't ( S -T -R: 27-5Q —0 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 %(Vo 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 o Is project associated with a nonconforming use or structure? ❑ Yes >(N0 Does the project require sanitary? Sanitary Permit #: Public System: Q es S>j- # of bedrooms: AYes ❑ No Does the project require an affidavit? Affidavit #: Number of Units: I Number of Bedrooms: Number of Bathrooms: I Number of Stories: I ❑ After -the -Fact (ATF) ATF Fee Amount: Inspected by: �► Date of Inspection: a-ag-as Inspection Notes: rfv.txrs V W r\' oftr q n L.C Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed: Approved by: 1 eM N.`2wn\ Date of Approval: yr 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: Town, City, Village, State or Federal Permits May Also Be Required LAND USE — X (previous 20-0182) SANITARY — Pikes Bay SPECIAL A - SPECIAL B/CONDITIONAL - BOA - BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 25-0196 Tax ID: 36291 Issued To: LR REINSTA SELF EMP RETIREMENT TRUST Location: S22 - T50N - R04W Town of Legal Description: LOT 2 CSM #1764 IN V.10 P.239 (LOCATED IN OUTLOT 3; LOTS 16 & 17 & OUTLOT 1 PORT SUPERIOR SHORES & GOVT LOT 1) IN DOC 2020R-583738 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 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.