HomeMy WebLinkAbout25-02376St117 E 03et J3 YFIELD
PO Box 403
Washburn, Wl 54891 rd fly 12 II
715 373 6109 L5 (J 15
nermits(2ibavfieldcountv.wifr .
rtb 3n2to025
Bayfiel9°ort°"1'�r�m�Rental pplication
Health
Zoning
Submission #
1R
Fee Paid
Refund
Permit #
Date Issued
Packet
This application packet contains information for a 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
_Q�(G
Establishment Tax ID #
I`{o9'/
Town/City of
rotmfnor4
Establishment Street Address nn p
7 5 a'/hh, t tafr IZl
City
pnwmm and
State. Ztp
W r 5_ 83
SECTION B: OWNER INFORMATION
Property Owner
I.LG
Email Address
I Phone Number
12- i4- 1990/
Owner Mailing Address
i5l S 1 a.mmi I lake- j2oad
City 1
pr`wrnn+Orrd
State 1
W Jc9s2
Zip
SECTION C: IF OPERATING WITH PARTNER OR AGENT
Legal Licensee (partnership. I.LC. I.I.P. or Inc.)
Ia G t-
Email Address
r-Rbizc l7 $1wreAesc.ca
Phone Number
(/12 -37q-19°/
Licensee Street Address
91S(S lla,mmrJ (42 /2oac(
City
prumrttiand
State
i
Zip
Agent Name (if applicable)
\l2r(dn nj oytke r-\
Email Address
r(kWktU5Tw"1'tlass.tow\
Phone Number
(H2.-374- 1`tgl
Agent Street Address
I-7ZS':enwo'� PArl-wa-)/
C \
_nn�a�a/;s
State
fl
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
1
C
F
P
Z
'(
2-
3
4
Structure Type:
House H Duplex (D) Cabin (C) Yurt Apartment (A) Condo CO Other (O), please describe
Heating Source:
Electric (E) Natural Gas G Propane P Wood Fuel (F) Other O please describe
Water Source:
Public/Municipal (M) Private Well (P)
Sanitary Source:
Public/Municipal al Private Onsite Wastewater System (P)
AFFIDAVIT OF AUTHORITY
(Corporation, LLC, etc.)
oflERIE0
APR 2 5 Z0Z5
Bayfield Co. Zoning Dept.
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: �T f i ' �rysi"r �. ) �15C
54/
2. The Subject Property is owned by: V)3 1< LLC
(Name of Company)
3. The name(s)ofthe current President orManaging Member: 1T,2LIii g412.Mf&1-1��
C(RtA(39
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 indemnity Bayfield County or such person or legal entity
suffering a damage resulting from any illegalities of the application for permit.
Dated: Zj i1 I -2-025
\� 1)
UzaZLIrD 19C\ \AO�i11Y )S p
Print Name PAUL L BOND
+ - Notary Public
Subscribed an sworn to before is Minnesota
day of r) , 2025 'z.�s6 My Commission Expires Jan. 31, 2030
� VY�
Notary Public, County, w4sg€jnsF-4n,Q6&v
My commission.
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 #: STIQ- °O(d
Tax ID: j./94/
S -T -R: '3O-'I'f-O7
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 'IINo
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 No
Is project associated with a nonconforming use or structure?
Yes O No
Does the project require sanitary?
Sanitary Permit #: 1 b' -1 5(o Public System:
# of bedrooms: 3
es ❑ No
Does the project require an affidavit?
Affidavit It:
Number of Units: I
Number of Bedrooms:
Number of Bathrooms: 2
Number of Stories: 2
❑ After -the -Fact (ATF)
ATF Fee Amount:
Inspected by: Date of Inspection: s -up 'as
Inspection Notes: LL
—VY-f-ViOOS ferM4
ly-ooa-7
-- Cufer'Abees Rr O i C�bur ov` ny M Fsor kcd w \cc�
Re -Inspected by: I Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: �S Date of Approval: s_ r -as
S_6 a 7
Condition(s):
Town/State/DNR/Federal may require permitting
tl 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 lD 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 14-0027)
SANITARY -10456
SPECIAL A -
SPECIAL B/CONDITIONAL —
BOA —
No. 25-0237 Tax ID: 14094
Issued To: VBK LLC
Location: S30 - T44N - R07W
Town of
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: PAR IN GOVT LOT I IN V.1128 P.184 (LOT 1 OF CSM V.3 P.153) 296A
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 6 persons.
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
May 06, 2025
Date