HomeMy WebLinkAbout25-02501 1 7 16't' street
I'( I box 4( 13
U a:hhum- WI 54391
(715)37? -6109
YFIELD
E6 lflD
FEB 0 5 2025
Health
Zoning
Submission #
Fee Paid
Refund
Permit #
—
Date Issued
Short Tet t"I�Q(Ilq�0"ion Packet
This application packet contains inhumation liar a Short -Tenn Rental pennit through F3a\ field Counts Planning and
/_onin_ Department. Completed application can he mailed cmailed to the addres'email above.
I.,tablishment Name Establishment Tns II) I rn 4'it of
fr,J r �" LUCK �1
l..stablishntent 5tree ddres n n C it\ State � Zip
--i ri Ar n 5y%>
SECTION B: OWNER INFORMATION
Proper () ncr yt +tkc.t( J Email Address
Phone Number
1 14sue L?vt- Irv-tiC(
(Amer \failing Address C -j -T State -
State zip
15 Y'3 4 S . &i/ t RoTi- 1l4U�l f l
3r -C t tvr c: it OPERATING WITH PARTNER OR AGENT
I rgal Licensee Ip; ncnhip. I I C. ) II'. or In, Email .Address Phone Number
..� — licensee Street Address Cia State Lip
\ enl Name Iifapplicable) [Entail Address j Phone Number
Q t _ f<. Ate' ion S {'v nol� v �y,1,,� 715 79e
ent Street \dJt ss g � Lip
{Mo,(:,n C'it� State
35O- uctnau,g h PcI (9,o. 6ev WO (- It bl e �•JS 5` d
SECTION D: RENTAL1INIT INFORMATION (see ke • below)
I nit Unit ID Structure IIeatitte I Water Sanitan Source of Stories of ut
I fle _ _ Source Source Bedrooms Raultroom,
II li
_�— ._L.... —. ._1—.. _— ±1 � .-- - T __
]tlu'lure Is pe:
Ilou,c(III DuLestih cabin(() Yun(YI Apartmeni(A) Condo((UI Other (O).please JcxrIbe
Heating Source:
_�
I lcctri-(t I Aalund Gls(NG) Pt panc(P) Wood (WI Fuel (II oilier (oi 'a,e describe
nal Source: Sanitary Source:
I Public Municipal t1) ['u'.ate \\'ell ll') _ Public Municipal (M) Pit' ate OL site \\ astew'ater Ssste171 (PI
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:5C.OI()i0 f cu &wes, t J 1
5'-i fl3
2. The Subject Property is owned by: FO u_eb. Ise.. IJ41
(Name of Company)
3. The name(s) of the current President or Managing Member. 1
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 o e application for permit.
Dated: 6 - 20 Z "
lC��i ���J�►
Print Name
Subscribed and sworn to before me this
day of19G! , 2011.
4I,-4
Notary Publi( County, Wisconsin
My commission:
MIYAKASPAR
NOTARY f a*STATE OF 0I$
Land Use Permit Application Review Checklist
Submission #: 5-Ti2 —6u 0? 7
Tax ID: $
S -T -R: I (p —U
What zoning district is the project located in?
❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 R-RB ❑ C ❑ I ❑ 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:
XYes ❑ 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 0 No
Does the project require sanitary?
Zi 8 7LOO (I h W 7)
Sanitary Permit #: Public System:
# of bedrooms: 2_
Yes ❑ No
Does the project require an affidavit?
Affidavit #:
Number of Units: I
Number of Bedrooms: 2.
Number of Bathrooms: 2
Number of Stories: Z
❑ After -the -Fact (ATF)
ATF Fee Amount:
Inspected by:
Date of Inspection:
Inspection Notes:
a3 001
•-prcv,bi' �evn.r� 0
—CoY'rcv4 beds P.r 12 , 3 bedwoS
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: ` � `
Date of Approval J
8 _ X'
c-0 of Sa
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 1 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 ,Floodplain,Wetlands
LAND USE — X (previous 23-0060)
SANITARY - 98760
SPECIAL A -
SPECIAL B/CONDITIONAL —
BOA —
No. 25-0250 Tax ID: 3899
Issued To: FOURBWISC LLC
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Location: S16 - T44N - R09W
Town of
Legal Description: POINT'O PINES PLATTED LOT 9 IN DEED 2022R-597647 2775
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. Short -Term Rental is for a maximum occupancy of 4 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. May 08, 2025
This permit may be void or revoked if any performance conditions are not Date
completed or if any prohibitory conditions are violated.