HomeMy WebLinkAbout25-0351Return to:
117 E 5th Street, PO Box 58
Washburn,Wl 54891
permit5@bayfieldcounty.wi.gov
yfield County Planning and Zoning Department
LAND USE PERMIT APPLICATION
APR :; c L^r^
County Use Only:
Submission #:U^O(S65
Permit #: 2-5'- 0^5)
Date: ^-L(-^C^5~
SECTION A: General Information
Property Owner Name:
Head Space HQ, LLC
Authorized Agent Name (if applicable):
Sarah Gjertson
Telephone Number:
303.520.7805
Telephone Number:
same
E-Mail Address:
sarah.gjertson@gmail.com
E-Mail Address:
same
Mailing Address:
30875 Wedal Rd
Mailing Address:
City, State, Zip:
Washburn, Wl 54891
City, State, Zip:
Contractor;
TBD
Telephone Number:E-Mail Address:
SECTION B: Property Information
Project Address (if different from mailing address):
New address application submitted, will be 30805 Wedal Rd (adjoins 30875 Wedal Rd)
Legal Description (if additional space is needed attach a separate sheet):
W15AOFE35AOFNESEIN
Section, Township, Range: Sec 13, TN 48, Rg 05 Town of: Barksdale
Tax ID #: 140 Lot Size (Acres/Square Feet): is acres
SECTION C: Project Information (check all that apply)
Project Use is: D Residential KCommercial D Municipal
Project Type is:
E] Change Use (existing structure)
D Sign
D Shoreland Grading, Class A
required (Total sq ft):
D New Construction
D Relocate (existing structure)
S Establishing a Business
D RV Placement 4+ months, Class A
required
D Addition/Alteration (existing structure)
D RV Placement 21 + days
D Temporary (12 or less months)
^.Other (describe):
Placing 4 non-permanent structures for small lodging business
SECTION D: Structure Information CDoes not apply to RVs and Signs, go to Section E)
Structure Type is:
D Accessory Structure (describe):
D Shipping Container
LI Residence D Principal Structure (describe):
D Shoreland Exempt Structure (describe): D Mobile Home (provide manufactured
date):
E Other (describe):4 "Pods" (not permanent structures) to be placed on gravel pads
Foundation Type:
D Basement D Walkout Basement D Slab D Crawlspace D Ground B Skids D Other (explain):
Existing Structure:.- N/A Length:Width:Height:
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/ 'above grade
decks/porches):
Basement Sq Ft:1st Floor Sq Ft:Loft Sq Ft:2nd Floor Sq Ft:3rd Floor Sq Ft:
Garage Sq Ft:Porch Sq Ft:Deck Sq Ft:
68.3 sq ft
Other Sq Ft (describe):
Pods are 168 sq ft (16'x 10'6")
Other Sq Ft (describe):
Total Sq Ft: 235 sq ft Rffp ^^Overall Height (finished grade to peak): 9' 6"
# of Stories: r\fo^ Existing # of Bedrooms on property:Proposed # of Bedrooms in project:
SECTION E: RV and Sign Information (check all that apply)
Sign is:
D New
D On-premise
a 1-sided
D On-building
.ength:
D Replacement
D Off-premise
D 2-sided
D Multi-Tenant
Width:Height:
RVis:
D New
Year:
Make:
D Replacement
Vin#:
Model:
SECTION G: Additional Questions
B Yes D No Has the location of the proposed project including eaves and overhangs and the sanitary system and well been
staked? If no, what date will this be completed: p^L^-tinU^—lAiillV^- ^W^f\'c{€. -Pz?<' lV$pe^+)"(5T\
B Yes a No Did a licensed surveyor mark lot line(s) if project is within
Application Information for required setbacks.
feet of required setback? See page 2 of Land Use
Did property owner or applicant mark lot line(s) if project is within 30 feet of required setback? See page 2 of
Land Use Application Information for required setbacks.
B Yes D No
D Yes B No Is there an existing sanitary system on the property? If yes, what kind?
D Drainfield D Holding Tank D Mlunicipal/Public D Other (describe):
D Yes B No Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be installed or used
to manage wastewater?
D Drainfield D Holding Tank D MunicipaI/Public D Other (describe):
B Yes D No Will sleeping occur in the structure? If yes, contact local Uniform Dwelling Code (UDC) for approval and
inspection requirements.
Is the project associated with any of the following:
B Rezone D Class A Special Use D Class B Special Use D Conditional Use D Variance
Fee payment will be made via:
B Check (attached) Q Cash (attached) D debiVcredit/echeck (department to call once payment is ready to be taken)
How would you like to receive your permit card?
D Mail to: OR B Email to:
B Property Owner Address D Agent Address D Contractor Address D Other (provide Name and Email or Address):
sarah.gjertson@gmail.com
Section H: Acknowledgement and Signature
All Land Use Permits expire Two (2) Years from the date of issuance if construction or use has not begun. Sanitary Permit
issuance, if required, needs to occur prior to Land Use Permit issuance. Failure to obtain a permit or starting construction without a
permit will result in penalties.
The local Town, Village, City, State or Federal agencies may also require permits. The new construction of one- & two-family
dwellings requires review and approval by the local Uniform Dwelling Code (UDC) authority. Additions and alterations to one-
and two-family dwellings may require review and approval by the UDC authority. All municipalities are required to enforce the
UDC.
If subject property is part of a Condominium Plat, applicant hereby certifies and represents that applicant has all necessary
approvals and recorded documents required to complete the project for which this permit is sought including requirements set forth
in Wisconsin statutes pertaining to condominium associations, the Declaration of the Condominium Association in which the
property is located, and all other rules, regulations and requirements pertaining to that Condominium Association.
You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams.
Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or
modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural
Resources wetlands identification web page, dnT^vi,a>\;;lQDiG{wella^^^^ or contact a Department of Natural Resources service
center (715)685-2900.
I (we) declare that this application, including any accompanying information, has been examined by me (us) and to the best of my
four) knowledge and belief it is true, correct, and complete. I (we) acknowledge that I (we) am (are) responsible for the detail and
accuracy of all information that I (we) are providing and that will be relied upon by Bayfield County in determining whether to
issue a permit. I (we) further accept liability which may be a result ofBayfield County relying on this information I (we) are
providing in or with this application. I (we) consent to county officials charged with administering county ordinances to have
access to the above-described property at any reasonable time for the purpose of inspection.
5^^>>A^
Date: 4-1^7-^
Owner(s) or Authorized Agent Printed Name^ sarahGisnsm
Owner(s) or Authorized Agent Signati
NOTES:
1. If you are signing on behalf of the owner(s) a lettep-ef authorization must accompany this application.
2. Specific conditions/instructions may be stated on the face of the issued Land Use Permits. Owners, agents, & contractors
must all be aware of permit details & conditions and permit card must be posted on property prior to start of project.
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Show location of:
B Driveways D Frontage Roads (include name) B Existing Structures D Well (W) D SepticTank(ST) D Drain Field (DF)
D Holding Tank (HT) D Privy (P) D Lake D RiverB Stream/Creek D Pond D Floodplam D Wetlands 0 Slopes over 20%
N
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Setback or distance from furthest extent of structure
including caves and overhangs to (include on site plan):
County Use Only
Verified setbacks
Road Centerl ine
Front Lot Line/Right-of-Way
Side Lot Line 1
(NorthDEastDSouthDWestEl, check one)
Side Lot Line 2
(NorthDEastESouthDWestD, check one)
Rear Lot Line
Septic/Holding Tank
Drainfield
privy^^ L^-h^)
Well
Existing Structure/Buildin^j^ (WTM.^)
Wetland
Elevation ofFloodplain
Ordinary High-Water Mark (OHWM)
190 ft.
190 ft.
345
ft.
ft.
ft.
177 ft.
1100 ft.ft.
n/a ft.
n/a ft.ft.
40 ft.ft.
n/a ft.ft.
122 ft.
n/a ft.
n/a ft.
n/a ft.
ft.
ft.
ft.
ft.
Notes/Comments:
Other (describe)ft.ft.
(N 89'58'54" W)
A/ 89'49f33" E-
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TAX ID: 140
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AFFIDAVIT OF AUTHORITT
(Trust) baydelci Co. 'aininp l.)ep'
PURPOSE. This Affidavit of Authority is used to certify the individual submitting an application is
authorized when the property is owned by a Trust.
STATE OF WISCONSIN )
) ss.
BAYFIELD COUNTi' )
The undersigned affirms and states as follows:
1. Address of Subject Property: 5 O^DH\^^^ I P^ , U)^^l^^Y\ ^ I ^4-g^j
v: -^-M ^yiA^ ^(Pii^i^ _.2. The Subject Property is owned by:^
3. The name(s) of the current Trustee(s): ^C\A~M/^ 6^ \ <// 't^^'^
(Name 6f Trust)
^a^4
4. I certify that the Trust named in paragraph 2 is valid and in effect on the date signed below. I am
the duly appointed agent of the Trust named above in paragraph 2, and I have the authority under
the terms of said authorization to submit an application to the Bayfield County Zoning Department
concerning the Property described in paragraph 1.1 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 Trust to apply for and bind the Trust to the terms and
conditions of any decision or permit that may be issued 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.
Dated: L^-^
L^5j^ri^\\ ^^l^v^
Print Name ^IIHK^
Subscribed and sworn to before me this V^, .sssl\^--c<:<&/y/
davof /^p^Y ' .20^5-. "~ ^Oov"'" '""^-^
WC/L/AW _ |rol SEAL |^j
'Not'aC'y Public; Sen-Lff-i'e. )d ~ County, Wisconsin ~'-^: /^^'• —•"' - • T "•- ——— '• '^^•: .•''.~!*-f
>: /-^0^ ^'•A---..".-:.;^:^"^^^
+ Ne^i-p^ v^wvUY ^^i^/v^ ly^ I$KA^-fi^ Ct^^
P^P^ ^71^ ^ P^^A/IVT^J
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.
Bayfield County, Wl
5/21/25, 9:11 AM Novus-Wisconsin Access rev. 12.0206
Real Estate Bayfield County Property Listing
Today's Date: 5/21/2025
Property Status: Current
Created On: 3/15/2006 1:14:41 PM
ISP Description
Tax ID:
PIN:
Legacy PIN:
Map ID:
Municipality:
STR:
Description:
Recorded Acres:
Calculated Acres:
Lottery Claims;
First Dollar:
Zoning:
ESN:
^ Tax Districts
1
002
046027
001700
Updated: 4/22/2025
140
04-002-2-48-05-13-4 01-000-20000
002101210000
(002) TOWN OF BARKSDALE
S13 T48N R05W
W 15A OF E 35A OF NE SE IN DOC
2024R-603354 78B
15.000
15.077
0
Yes
(AG-1) Agricultural-1
103
Updated: 3/15/2006
STATE
TOWN OF BARKSDALE
SCHL-WASHBURN
TECHNICAL COLLEGE
•* Recorded Documents Updated: 7/8/2013
^ Ownership
HEAD SPACE HQ LLC
Billing Address:
HEAD SPACE HQ LLC
30875 WEDAL RD
WASHBURN WI 54891
Site Address * indicates
30805 WEDAL RD
[f
S—i Property Assessment
2025 Assessment Detail
Code
Gl-RESIDENTIAL
G6-PRODUCTIVE FOREST
2-Year Comparison
Land:
Improved:
Total:
SS Property History
Updated:6/6/2024
WASHBURN WI
Mailing Address:
HEAD SPACE HQ LLC
30875 WEDAL RD
WASHBURN
Private Road
Acres
2.000
13.000
2024
37,300
49,500
86,800
J WI 54891
WASHBURN 54891
Updated: 6/24/2021
Land
16,500
20,800
2025
37,300
49,500
86,800
S/24/2021
Imp.
49,500
0
Change
0.0%
0.0%
0.0%
2024R-603354
2023R-600833
Date Recorded: 5/24/2024
Q TERMINATION OF DECEDENT'S INTEREST
Date Recorded: 10/16/2023
B3 TRANSFER ON DEATH
Date Recorded: 5/14/2007 2007R-513844 970-179
Q TERMINATION OF DECEDENT'S INTEREST
Date Recorded: 5/14/2007 2007R-513843 970-175
E3 CONVERSION
Date Recorded: 3/15/2006 445-89
B WARRANTS DEED
Date Recorded: 10/2/1987 371660 459-353
N/A
https://novus.bayfieldcounty.wi.gov/access/master.asp?paprpid=140 1/1
Land Use Permit Application Review Checklist
ji7^ySubmission #:
What zoning district is the project located in?
D R-l D R-2 D R-3 D R-4 D R-RB D C d I DM D A-l D A-2 0<i D F-2 D W D M-M
D Yes [^to Is lot substandard (does not meet current zoning dimensional requirements)?
Deed of record:
^0Yes D No Is the project located in the Shorelands (Shorelands are lands within 300 feet of a river/stream OR
landward sideoffloodplain OR 1000 feet of a lake/pond/flowage, whichever is greater)?
D Yes ?No Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of
navigable waterway)
D Yes ^ No Is the project located in the Floodplain?
Zone:
D Yes 52^\o Are there wetlands on the property?
D Yes 0'No Is project associated with a nonconforming use or structure?
D Yes ZfNc Is project associated with a variance?
Case #:/Yes D No Is project associated wit^a Special B or Conditional Use Permit?
Permit #: 2.5-0^
D Yes 01Mo Is the project associated with a Special A Use Permit?
a Yes P<o Does the project require sanitary?
D Existing ,0 New D Intercept DReconnect
Sanitary Permit#: Vftu.fifjt Prl^l/
D Non-Plumbing D Public
D Yes 01MO Does the project require mitigation?
Implementation Deadline:Date of Compliance:
D Yes IZlMo
D Yes F: No
Does the project require an affidavit?
Affidavit #:Affidavit #:
Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback?
Did applicant/property owner mark lot line(s), if project is within 30 feet of required :D Yes ZfNo
Project use is? D Residential zE-TCommercial D Municipal
Project type is?^3^Iew Construction D Addition/Alteration D Change Use D Relocate D RV Placement D Sign
D Establishing a Business D Temporary D Shoreland Grading D Other, describe:
Structure Type is: D Residence D Principal Structure D Accessory Structure D Boathouse (one story only)
D Open-sided/Screened Structure (gazebo, etc.) D Stairway to navigable waters D Mobile Home
D Shipping Container ^ Other, describe /^t^f//,ft./ <^^///
Total Sq. Ft. of Project: ^}^Number-'&fSt^ifies:^Overall Height:/^
Calculated Fee Category:
D Residential Principal Structures - $0.75/square foot (minimum $125)
D Habitable Residential Accessory Structures - $0.50/square foot (minimum $75)
Dj^on-Habitable Residential Principal and Accessory Structures-$0.20/square foot (minimum $75)
/Q Commercial/Municipal Principal Structures - $0.75/square foot (minimum $125)
D Commercial/Municipal Acc^bry Structures - $0.20/square foot (minimum $75)
Calculated Fee Amount: jf/ /^7
Additional Fees: D Return Inspection D Land Use Revisions D Special Use Permit - Class A D After-the-Fact (ATF)
D Floodplain D Shoreland - Impervious Surface D Shoreland - Non-Conforming, etc. D Tower Siting/Collocation 1
D Tower Collocation 2 D Metallic Mine
ATF Fee Amount: _^7 ^ ^Al/^Inspected by:Date of Inspection
Re-lnspected by:Date of Re-lnspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailecj:
Approved bj
/^^-l
Date of Approval:
Condition(s):
D Must meet and maintain setbacks from furthest extension of structure including eaves and
overhangs.
D For personal storage only.
D For personal residence only.
D Not for human habitation or sleeping purposes.
^0'Town/State/DNR/Federal may require permitting
\^k Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be
obtained prior to the start of construction.
D A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be
obtained prior to the start of construction (if applicable).
J2/Use best management practices to limit and prevent erosion during construction.
D Thys permit cannot be transferred if property is sold.
J2TA Bayfield County Health Dept permit is required.
D Check with Town regarding room tax.
D Short-Term Rental is for a maximum occupancy of_ persons.
D Sjgn must meet the requirements of Article E of the Bayfield County Zoning Ordinance.
constructed per plan.
^D Adhere to privy agreement.
D Temporary permit allowing existing structure for a period of less than 1 year.
D RV may not be used for permanent residence or storage.
a RV allowed for _,
D RV must be removed by
D No sewer and pressurized water allowed in the structure.
D No plumbing or plumbing fixtures allowed.
D No additional sleeping areas allowed without obtaining necessary sanitary permit(s).
D Land use permits shall be required for any new residence, any building or structure erected,
relocated, rebuilt, or structurally altered
D Land use permits shall be obtained prior to the initiation of construction or a change in land use
D Requirements (e.g., permits/licensing/tax) of Local Town, Village, City, State or Federal agencies are
required
D Sanitation requirements must be met (if applicable)
D Additional conditions may be placed and need to be adhered to at the time of permit issuance
Other Conditjons:/^ 7^ ^/^^^/y'^y
pAypiELD
H
Property Owner:
HEAD SPACE HQ LLC
30875 WEDAL RD
WASHBURN, WI 54891
Description
Verified Fee Amount
Bayfield County
Planning & Zoning Department
117 E 5th Street
P.O.Box 58
Washburn/WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Submission Number:
LU-01565
Transaction Number:
LU-01565-2CF98
Amount
$0.00
Habitable Residential Accessory Structures -
$0.50/square foot (minimum $75)
$177.00
Total:
Payment Amount:
$177.00
$177.00
Reference: 3002 & 3008
Paid by: HEAD SPACE HQ LLC, WASHBURN, WI 54891
Payment Type: Check
Transaction Date: undefined
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit
Town, City, Village, State or Federal
Permits May Also Be Required
Substandard - No / Nonconforming - No
Shoreland - Yes / Impervious Surface - No
Floodplain - No / Wetlands - No
Mitigation - No / Affidavit #:
LAND USE-X
SANITARY - New 25-0289
SPECIAL A -
SPECIAL B/CONDITIONAL - 25-0350
BOA -
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 25-0351 Tax ID: 140
Issued To: HEAD SPACE HQ LLC
Location: S13-T48N - R05W
Town of Barksdale
Legal Description: W 15A OF E 35A OF NE SE IN V.411 P.300 78B IN DOC 2024R-6043354
Commercial Structure in F-1 zoning district
For: New Construction [1 - Story], Camping Cabin on Skids [236 Total sq. ft] Height of 10'
(Disclaimer): You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Any
future expansions or development would require additional permitting.
Condition(s): See back of card
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.
TRACY POOLER
Authorized Issuing Official
June 04, 2025
Date
Condition(s): Town/State/DNR/Federal may require permitting.
A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be obtained
prior to the start of construction.
Use best management practices to limit and prevent erosion during construction.
A Bayfield County Health Dept permit is required.
To be constructed per plan.
Adhere to privy agreement.
Adhere to CUP conditions.