HomeMy WebLinkAbout25-0353Return to:
117 E;Sth Street, PO Box 58
Washburn, WI 54891
permits@bayiieIdcounty.wi.gov
County Use Only:
County Planning do n Departmepl Submission #: w —1
AND USE PE fYBIr1ATION Permit #:
IRI APR 0 0 [02 Date: —
Property Owner Name:
Head Space HQ, LLC
Authorized Agent Name (if applicable):
Sarah Gjertson
Telephone Number:
Telephone Number:
303.520.7805
same
E -Mail Address:
E -Mail Address:
Mailing Address: Mailing Address:
30875 Wedal Rd
City, State, Zip: City, State, Zip:
Washburn, WI 54891
Contractor: Telephone Number: E -Mail Address:
TBD
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):
W15A OF E35A OF NE SE IN
Section, Township, Range: Sec 13, TN 48, Rg 05 Town of: Barksdale
Tax ID #: 140 Lot Size (Acres/Square Feet): 15acres
Project Use is: ❑ Residential 2Commercial ❑ Municipal
Project Type is: El New Construction ❑ Addition/Alteration (existing structure)
El Change Use (existing structure) El Relocate (existing structure) ❑ RV Placement 21+ days
El Sign iS( Establishing a Business ❑ Temporary (12 or less months)
❑ Shoreland Grading, Class A El RV Placement 4+ months, Class A MOther (describe):
i r,rnirrt (Tntal on ft' - rnnu ;rd Placing 4 non -permanent structures for small lodging business
Structure Type is:
El Accessory Structure (describe):
El Shipping Container
El Residence
❑ Principal Structure (describe):
❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured
date):
E Other (describe): 4 "Pods" (not permanent structures) to be placed on gravel pads
Foundation Type:
❑ Basement ❑ Walkout Basement ❑ Slab ❑ Crawlspace ❑ Ground O Skids ❑ Other (explain):
Existing Structure: NJA Length: Width: Height:
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade -
Basement Sq Ft:
l' Floor Sq Ft:
Loft Sq Ft:
2° Floor Sq Ft:
3" Floor Sq Ft:
Garage Sq Ft:
Porch Sq Ft:
Deck Sq Ft:
Other Sq Ft (describe):
Other Sq Ft (describe):
68.3 sq it
Pods are 168 sq It (16' x 10' 6")
Total Sq Ft: 23e sq a
Poo
Overall Height (finished grade to peak): 9' 6"
# of Stories: r\fa
Existing # of Be rooms on property:
Proposed # of Bedrooms in project:
SECTION E: RV and Sign Information (check all that apply)
Sign is:
RV is:
❑ New
❑ Replacement
❑ New
❑ Replacement
❑ On -premise
❑ Off -premise
❑ I -sided
❑ 2 -sided
Year:
Vin #:
El On -building
❑ Multi -Tenant
Length:
Width:
Height:
Make:
Model:
6
y L
T
(N 8958'54"
W)
N 89'49'33" E-
�—
x 503.16' --
3.
�N 89';9'33"
E—
503.16
O
GARAGE
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TAX ID: 140
653,400 SQ.FT
15.00 ACRES
503.17'
16
We�1aI
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APR 032025
GE
'field Co. Zoning Dept.
I
tA�� TAV In. 1 n
SECTION F: Site Plan attach a site plan or drawsite plan inbox below (See pages 1 & 2 of Land Use Permit Application
Information for information that is required to be provided on site plan)
Show location of:
❑ Driveways ❑ Frontage Roads (include name) O Existing Structures ❑ Well (W) ❑ Septic Tank (ST) ❑ Drain Field (DF)
❑ Holding Tank (FIT) ❑ Privy (P) ❑ Lake ❑ River CEStream/Creek ❑Pond ❑Floodplain ❑ Wetlands ❑Slopes over 20%
N
_..�.
APR 0 3 2025 U
Ba)field Co. Zoning Dept,
Setback or distance from furthest extent of structure
including eaves and overhangs to (include on site plan):
County Use Only
Verified setbacks
Road Centerline
178
ft.
ft.
Notes/Comments:
Front Lot Line/Right-of-Way
178 ft.
ft.
Side Lot Line I
(North❑East❑South❑ Westi], check one)
400 ft.
ft.
Side Lot Line 2
North❑East0South❑West❑, check one)
98 ft.
ft.
Rear Lot Line
1110 ft.
it.
Septic/Holding Tank
n/a ft.
ft.
Drainfield
n/a ft.
ft.
Privy (lal (M
35 ft.
ft.
Well
n/a ft.
ft.
Existing Structure/Building k rn
72 ft.
ft.
Wetland
n/a ft.
ft.
Elevation of Floodplain
n/a ft.
ft.
Ordinary High -Water Mark (OH WM)
n/a ft.
ft.
Other (describe)
ft.
ft.
(N 89'58'54" W)
N 89'49'33" E
x 503.16' -- ----
N 89'49'33" '.
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$i 03.16'
GARAGE I GARAGE
TAX ID: 140
653,400 SQ. FT.
15.00 ACRES
I",z
503.17'
30.16' 304.78'
VJeoAI
VE
APR U 3 Z0Z5
Bayfield Co. Zoning Dept
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SECTION G: Additional Questions
Fl Yes ❑ No Has the location of the proposed project including eaves and overhangs and the sanitaryy syst�iii aid well been
staked? If no, what date will this be completed: G1I -1t41 ti VJL t -C -iU'r IWj m
El Yes
❑ No
Did a licensed surveyor mark lot line(s) if project is within FO feet of required et(rack? See page ? of and Use
Application Information for required setbacks.
El Yes
❑ No
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.
❑ Yes
El No
Is there an existing sanitary system on the property? If yes, what kind?
❑ Drainfreld ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe):
❑ Yes
El No
Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be installed or used
to manage wastewater?
❑ Drainfield ❑Holding Tank ❑Municipal/Public ❑ Other (describe):
El Yes
❑ 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:
El Rezone O Class A Special Use ❑ Class B Special Use ❑ Conditional Use O Variance
Fee payment will be made via:
O Check (attached) El Cash (attached) ❑ debit/credit/echeck (department to call once payment is ready to be taken)
How would you like to receive your permit card?
❑ Mail to: OR El Email to:
El Property Owner Address O Agent Address O Contractor Address O 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, dnr.wi.g< `'/t ic/wetlands, 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
(our) 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 Hayfield County in determining whether to
issue a permit. I (we) further accept liability which may be a result of Hayfield 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.
wyaf1 D8.V'I
Owner(s) or Authorized Agent Printed Nam se
II,,
Date: "1• tiZS
Owner(s) or Authorized Agent Signat
NOTES:
1. If you are signing on behalf of the owner(s) a lette 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.
E ElV[
H APR042025
4 2025
AFFIDAVIT OF AUTHORITY
(Trust)
Bayfield Co. Zoning Dept.
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 COUNTY
The undersigned affirms and states as follows:
2 ct r A
1. Address of Subject Property: 3 o ois
, We 4 cd .I \JJc1y1I ' u3 J
2. The Subject Property is owned by: *.di S.P6ICC fl -ii I L/1_- L
(Name 6f Trust)
3. The name(s) of the current Trustee(s): 3I
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. 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 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:
Print Name
Subscribed and sworn to before me this ,
day of Apt I :2022.
SEAL
Not Public7�ya County, Wisconsin Lj'•,
'panto . r ..... %F:....... .
N eNc yw.vvvlxx
Q-uz 'cs pe-" iVLq 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, WI
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5/21/25, 9:11 AM
Novus-Wisconsin Access rev. 12.0206
Real Estate Bayfield County Property Listing
Today's Date: 5/21/2025
Z Description
Updated: 4/22/2025
Tax ID:
140
PIN:
04-002-2-48-05-13-4 01-000-20000
Legacy PIN:
002101210000
Map ID:
Municipality:
(002) TOWN OF BARKSDALE
STR:
S13 T48N ROSW
Description:
W 15A OF E 35A OF NE SE IN DOC
2024R-603354 788
Recorded Acres:
15.000
Calculated Acres:
15.077
Lottery Claims:
0
First Dollar:
Yes
Zoning:
(AG -1) Agricultural -1
ESN:
103
Tax Districts
Updated: 3/15/2006
1
STATE
04
COUNTY
002
TOWN OF BARKSDALE
046027
SCHL-WASHBURN
001700
TECHNICAL COLLEGE
Recorded Documents Updated: 7/8/2013
0 WARRANTY DEED
Date Recorded: 5/24/2024
2024R-603354
® TERMINATION OF DECEDENT'S INTEREST
Date Recorded: 10/16/2023
2023R-600833
0 TRANSFER ON DEATH
Date Recorded: 5/14/2007 2007R-513844 970-179
® TERMINATION OF DECEDENT'S INTEREST
Date Recorded: 5/14/2007 2007R-513843 970-175
® CONVERSION
Date Recorded: 3/15/2006
445-89
® WARRANTY DEED
Date Recorded: 10/2/1987
371660 459-353
Property Status: Current
Created On: 3/15/2006 1:14:41 PM
IR Ownership Updated: 6/6/2024
HEAD SPACE HQ LLC WASHBURN WI
Billing Address: Mailing Address:
HEAD SPACE HQ LLC HEAD SPACE HQ LLC
30875 WEDAL RD 30875 WEDAL RD
WASHBURN WI 54891 WASHBURN WI 54891
T Site Address * indicates Private Road
30805 WEDAL RD
WASHBURN 54891
® Property Assessment
Updated:
6/24/2021
2025 Assessment Detail
Code
Acres Land
Imp.
G1 -RESIDENTIAL
2.000 16,500
49,500
G6 -PRODUCTIVE FOREST
13.000 20,800
0
2 -Year Comparison
2024 2025
Change
Land:
37,300 37,300
0.0%
Improved:
49,500 49,500
0.0%
Total:
86,800 86,800
0.0%
] Property History
N/A
https://novus.bayfieldcounty.wi.gov/access/master.asp?paprpid=140 1/1
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: Date of Approval: /,'2, fr�
Condition(s):
❑ Must meet and maintain setbacks from furthest extension of structure including eaves and
overhangs.
❑ For personal storage only.
❑ For personal residence only.
❑ N t for human habitation or sleeping purposes.
Town/State/DNR/Federal may require permitting
Uniform Dwelling Code (UDC) Permitfrom the locally contracted UDC Inspection Agency must be
obtained prior to the start of construction.
❑ A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be
obtained prior to the start of construction (if applicable).
se best management practices to limit and prevent erosion during construction.
❑ This permit cannot be transferred if property is sold.
.2"ABes�ayfield County Health Dept permit is required.
❑ Check with Town regarding room tax.
❑ Short -Term Rental is for a maximum occupancy of persons.
❑ SiSi must meet the requirements of Article E of the Bayfield County Zoning Ordinance.
XJ�T be constructed per plan.
.❑ Adhere to privy agreement.
❑ Temporary permit allowing existing structure for a period of less than 1 year.
❑ RV may not be used for permanent residence or storage.
❑ RV allowed for
❑ RV must be removed by
❑ No sewer and pressurized water allowed in the structure.
❑ No plumbing or plumbing fixtures allowed.
❑ No additional sleeping areas allowed without obtaining necessary sanitary permit(s).
❑ Land use permits shall be required for any new residence, any building or structure erected,
relocated, rebuilt, or structurally altered
❑ Land use permits shall be obtained prior to the initiation of construction or a change in land use
❑ Requirements (e.g., permits/licensing/tax) of Local Town, Village, City, State or Federal agencies are
required
❑ Sanitation requirements must be met (if applicable)
❑ Additional conditions may be placed and need to be adhered to at the time of permit issuance
Other Conditions:
///leef'i ft ncW f
Land Use Permit Application Review Checklist
Submission #:
What zoning district is the project located in?
❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ I EM1 ❑ A- F- ❑ F-2 ❑ W ❑ M -M
D Yes J2No
Is lot substandard (does not meet current zoning dimen requirements)?
Deed of record:
es IJ 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 o
Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of
navigable waterway)
❑ Yes No
Is the project located in the Floodplain?
Zone:
❑ Yes oh0
Are there wetlands on the property?
❑ Yes jaiIo
Is project associated with a nonconforming use or structure?
❑ Yes No
Is project associated with a variance?
Case #:
es ❑ No
Is project associated with a Special B onditional Use P
Permit #: 2S^
Ds io
Is the project associated with a Special A Use Permit?
Yes ❑ No
Does the project require sanitary?
❑ Existing 2l ew ❑ Intercept ❑ Reconnect ❑ Non -Plumbing ❑ Public
Sanitary Permit#: yJtJ rj02
❑ Yes thJo
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
❑ Yes No
Does the project require an affidavit?
Affidavit #:
❑ Yes ❑ N
Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback?
❑ Yes No
Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback?
Project use is? ❑ Residential ammercial ❑ Municipal
Project type is? New Construction ❑ Addition/Alteration ❑ Change Use 0 Relocate ❑ RV Placement 0 Sign
❑ Establishing a Business ❑ Temporary 0 Shoreland Grading ❑ Other, describe:
Structure Type is: O Residence ❑ Principal Structure ❑ Accessory Structure ❑ Boathouse (one story only)
❑ Open-sided/Screened Structure (gazebo, etc.) ❑ Stairway to navigable waters ❑ Mobile Home
❑ Shipping Container �Other,describe Ga
Total Sq. Ft. of Project. .R36' Number et St ies: Overall Height:
Calculated Fee Category:
❑ Residential Principal Structures - $0.75/square foot (minimum $125)
❑ Habitable Residential Accessory Structures - $0.50/square foot (minimum $75)
❑ Non -Habitable Residential Principal and Accessory Structures - $0.20/square foot (minimum $75)
❑ Commercial/Municipal Principal Structures - $0.75/square foot (minimum $125)
❑ Commercial/Municipal Acces ory Structures - $0.20/square foot (minimum $75)
Calculated Fee Amount:
Additional Fees: ❑ Return Inspection 0 Land Use Revisions ❑ Special Use Permit - Class A ❑ After -the -Fact (ATF)
❑ Floodplain 0 Shoreland - Impervious Surface ❑ Shoreland - Non -Conforming, etc. ❑ Tower Siting/Collocation 1
❑ Tower Collocation 2 ❑ Metallic Mine
ATF Fee Amount:
Inspected b .
Date of Inspection:
Re -Inspected by:
Date of Re -Inspection:
P YFIELD Bayfield County
Planning & Zoning Department
117 E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner:
HEAD SPACE HQ LLC
30875 WEDAL RD
WASHBURN, WI 54891
Description
Verified Fee Amount
Commercial/Municipal Principal Structures -
$0.75/square foot (minimum $125)
Submission Number:
LU-01567
Transaction Number:
LU-01567-2CF9A
Amount
$0.00
$177.00
Total: $177.00
Payment Amount: $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
_'Ji :i' i i.
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 25-0353 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 Tracy Pooler
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. June 04, 2025
This permit may be void or revoked if any performance conditions are not Date
completed or if any prohibitory conditions are violated.
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.