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Short -Term Riai('a AppTicaflon Packet
1 his application packet contains inlitmtation lbr a Short -Tenn Rental permit through Ba%field County Planning and
ion flu Department. Completed application can be mailed/emailed to the addresscntail ahoce.
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_SECTION B. OWNER INFORMATION
Properla C) icr % it V( \ Email Address
UG4Phone Number
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lgat.. Clalrtc 'IZ <7c SECTION C: IF OPERATING WITH PARTNER OR AGENT
Legal I.ieer I C II P. ..r III,.) Email Address I Phone Number
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Caltt Name I (applicable) Ttittutil Address I'hont Number
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SECTION D: RENTA NIT INFORMATION see key bel)
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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 i
i ss
BAYFIELD COUNTY
The undersigned affirms and states as follows
1 Address of Subject Property tht'-/(r(-.ti."x',� i�c llru'>' `j 5'/Q
2 The Subject Property is owned by Ir ft LI C� " r t r I }-r t jn iy IV' L i7
(Name of Company(
3 The name(s) of the current President or Managing Member. r uv t
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 t0 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 applicatio r permit
Dated ≤'/<.
W;ii.'o 2. ca L t,
Print Name
Subscri ed and sworn to before me this
day of — 20'�
Notary Public. s— County
My
commission
JEAN A. AYERS
Notary Public
State of Wisconsin
DC'r).�
Land Use Permit Application Review Checklist
Submission #:S TiQ —6 Uo-)(o Tax ID: 33°18' 3
S -T -R: a —L-(L1- G-) Town: Z) vn ry
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:
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 SNo Is project associated with a nonconforming use or structure?
Yes ❑ No Does the project require sanitar ?
Sanitary Permit #: 2,591 3 Public System:
# of bedrooms: ?i
] Yes 0 No I Does the project require an affidavit? XLLC ❑ Trust \), rC U , �^m V LL -C'
I Affidavit It:
Number of Units: I
Number of Bedrooms: 3
Number of Bathrooms: 2 -
Number of Stories:
0 After -the -Fact (ATF)
ATF Fee Amount:
Inspected by: L)cS ` n 1 \ Date of Inspection:
1 Iv w;�.S�� y3 -a
Inspection Notes:
-rC v17�s tDtrn C -- l-0503
Cuvc q bcdvbonnS 4 beds �- '
Re -Inspected by: I Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: ` >�. Date of Approval: 5 _ 03
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. p
g3hort-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
LAND USE —X (previous 18-0503)
SANITARY - 259733
SPECIAL A -
SPECIAL B/CONDITIONAL —
BOA —
No. 25-0310 Tax ID: 33983
Issued To: VAUDREUIL FAMILY IV LLC
Location: S22 - T44N - R07W
Town of
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: LOT 2 CSM #1447 IN V.8 P.362 (LOCATED IN GOVT LOT 2) 188G
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 28, 2025
Date