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HomeMy WebLinkAbout25-0224lllsox403 t D E G E a d FIELD
Washburn, WI 5489
(715) 373-6109 LIII JAN 172025
perm itsbayfieldcounw.wi. gov
Bayfiold Co. Zoning oect
Health
Zoning
Submission #
'Fee.
Fee Paid
ho
Refund
Permit#
Date Issued
Short -Term Rental Application Packet
This application packet contains information for a Shat -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 /
a_,QO.t hL.n. CAL, n
#
Establishment Tax ID i Town/City of
I7'9 ('coy) i �i arYlC5
Establishment Street Address
5o3tf5 PcAsu1a Rd
City State
arms Wt
Zip
5Yt7'?3
SECTION B: OWNER INFORMATION
Property Owner '1'io( j
LOOM tojvr Ca4%v" L.LC, troki-&ss
Email Address
Yeess'@a/(cin—'CS.Cc"-",
Phone Number
S"-965"6
Owner Mailing Address
NF5oS INLc- Pad
City
fus'r'Tr'y
State
wz
Zip
5Sf zo
SECTION C: IF OPERATING WITH PARTNER OR AGENT
Legal Licensee (partnership, LLC, IL!', 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 key
below)
Unit 1 Unit ID
Structure
Type
Heating
Source
Water
Source
Sanitary Source
# of Stories
# of # of
Bedrooms Bathrooms
H
P
P
P
z
4 z
2
3
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 l Propane P Wood W) Fuel (F) Other (0), please describe
Water Source:
Public/Municipal (M) Private Well (P)
Sanitary Source:
Public/Municipal (MI 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: 'Lt5 P .w S L P J. 6 c�.nc�S, iJ . 5 973
2. The Subject Property is owned by: 1, oon Lv no/: ? 0 h . LL. C
(Name of Company)
3. The name(s) of the current President or Managing Member: leJ cad 1}Hw 22tSS
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. 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: t —VI
red 1Ze5
s
Print Name
Subscribed and sworn to before me this �.•""""""+ra,
day of J CW►UG , 2021.
.
• cA
• OA/'
Notary ublic, �-lL► County, Wisconsin
My commission: Z G 1.Q2 .S)%1/B%-'O
retvt-.cOOINU INI-UKMATION
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#: 5Vte- Oco 13
Tax ID: j 79H
S -T -R: /0.-9q-05
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 No
Does lot meet the zoning dimensional requirements or is it substandard?
Deed of record:
`f Yes O 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 XNo
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#: ft -3105 Public System:
# of bedrooms: 4 , $
Yes ❑ No
Does the project require an affidavit?
Affidavit #:
Number of Units: I
Number of Bedrooms: y
Number of Bathrooms: ' .
Number of Stories: 2
❑ After -the -Fact (ATF)
ATF Fee Amount:
Inspected by:
1<J N�ew��sk:
Date of Inspection: 5— j- c
Inspection Notes:
-tvtRe-Inspected
by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by:
1� niifwl'r(s�c'
Date of Approval:
5-1-a5 as �aay
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 5 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 19-0277)
SANITARY - 19-36S
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
No. 25-0224 Tax ID: 1799
Issued To: LOON LANDING CABIN LLC
Location: S10 - T44N - R09W
Town of
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: PAR G & H IN GOVT LOT 2 IN V.1148 P.466 549D
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 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.
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.
Authorized Issuing Official
May 01, 2025
Date