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25-0354
Return to: 117 e 5th Street, Po Box 58 Ba field County Planning and Zoning Department Washburn, W154891 LAND USE PERK T pP�I `�9 4 ? II II Q »� County Use Only: Submissio #: Permit ' Date: to - - SECTION A: General Informatiofll ` - ` "I. - Property Owner Name: Authorized Agent Name (if applicable): Head Space HQ, LLC Sarah'Gleason--" Telephone Number: Telephone Number: 303.520.7805 same E -Mail Address: E -Mail Address: sarah.gjertson@gmail.com same 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 dillerent 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): W 15A OF E35A OF NE SE IN Section, Township, Range: Sec 13, TN 48, Hg 05 Town of: Barksdale Tax ID #: 140 Lot Size (Acres/Square Feet): 15acres SECTION C: Project Information (check all that apply) project Use is: ❑ Residential i&Commercial ❑ Municipal Project Type is: ❑ New Construction ❑ Addition/Alteration (existing structure) ❑ Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21+ days ❑ Sign aEstablishing a Business ❑ Temporary (12 or less months) ❑ Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A .Other (describe): re uired Totals ft: required Placing 4 non permanent structures for small lodging lousiness 'on (Does not apply to RVs and Signs, go to Section E) Structure Type is: ❑ Residence ❑ Principal Structure (describe): ❑ Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured date): ❑ Shipping Container El Other (describe): 4 "Pods" (not permanent structures) to be placed on gravel pads Foundation Type: ❑ Basement ❑ Walkout Basement ❑ Slab ❑ Crawlspace ❑ Ground H Skids ❑ Other (explain): Existing Structure: NIA Length: Width: Height: Proposed Structure (Provide Sy Ft rased on outside dimensions, including unfinished areas, attached garages/above grade decks/ arches : Basement Sq Ft: I" Floor Sq Ft: Loft Sq Ft: 2"d Floor Sq Ft: 3`d Floor Sq Ft: Garage Sq Ft: Porch Sq Ft: Deck Sq FI: Other Sq Ft (describe): Other Sq Ft (describe): 68.3 sq It Pods are 168 sq ft (16 x 106') Total Sq Ft: 236sgit 4j Overall Height (finished grade to peak): 91611 11 of Stories: h/q Existing # of Bedrooms on property: Proposed # of Bedrooms in project: SECTION E: RV and Sign Information check all that al' Sign is: R V is: ❑ New ❑ Replacement ❑ New ❑ Replacement ❑ On -premise ❑ Off -premise ❑ I -sided ❑ 2 -sided Year: Vin #: ❑ On -building ❑ Multi -Tenant Length: Width: Height: Make: Model: 0 rcFovE0 APR 0 3 2025 Images from the manufacturer website: https://www.glamoina_nodsofamerica.coap/mo ft ) ��. Zoning Dept Example of what the Pods might took like on my property, although ideally farther apart. Example of interior (N 8958'54" W) 2_____N89933E E 11L VJ oAAnt tiAt drivcway\CCt45 pops = PIanrrcA a.tl^ou5•ey x 503.16' 33.00' N 89 49'33 E 503.16' n 0 U GARAGE GARAGE D APR 0 3 2025 z o0 w \ Bayfield Co. Zoning Dept. z z 4.3 N � N N TAX ID: 140 653,400 SQ.FI 15.00 ACRES ./ O vJ E O L6 O 503.17' Zt 30.16' 304.78' - 168.23' TAY In. 1 r c ri'.r q !llt 2 f1 SECTION F: Site Plan - attach a site plan or draw site plan in box below (See pages I & 2 of Land Use Permit -Application Information for information that is required to be provided on site plan) Show location of: ❑ Driveways 4 Frontage Roads (include name) Existing Structures ❑ Well (W) ❑ Septic Tank (ST) G Drain Field (DF) ❑ Holding Tank (HT) ❑ Privy (P) ❑ Lake ❑ River KStream/Creek ❑Pond ❑Floodplain ❑Wetlands ❑Slopes over 20% N 5Ce a nvVcdl 51k fi0v" Setback or distance from furthest extent of structure including eaves and overhangs to (include on site plan): County Use Only Verified setbacks Road Centerline 200 ft. ft. Notes/Comments: Front Lot Line/Right-of-Way 200 ft. ft. Side Lot Line I (North ❑East ❑South❑ WestE, check one) 145 ft. ft. Side Lot Line 2 North❑EastOSouth❑WestD, check one) 355 ft. ft. Rear Lot Line 1095 ft. ft. Septic/Holding Tank n/a ft. ft. Drainfield n/a ft. ft. Privy ltANntd{ (oc tf1011) 45 ft. ft. Well n/a ft. ft. Existing Structure/Building(aia 178 ft. ft. Wetland n/a ft. ft. Elevation of Floodplain n/a ft. ft. Ordinary High -Water Mark (OHWM) n/a ft. ft. Other (describe) ft. ft. N 89' 9'33" C' `• w O O z o M�Q o z z Ui oho •0 N N a� cp b ti heVJ a &an55 41'jv\ 308wS Wedal RJR d,rlvtWn clues = Plf.v,vnet)l outhmn5t 0, rn to (N 8958'54" W) N 89'49'33" E Weda �oql� �E"'5fJ3.16' l�l U D APR 0 3 2025 Hayfield Co. Zoning Dept. CO (202�) TAX ID: 140 653,400 SQ.FT. 15.00 ACRES 30.16' 304.: 1 ri TAY ifl- 1 503.17' N Zoo -&:ti •Fcwn be rM '(ci ccet -Frown west r\ li; n IR 1p Ifll SECTION G: Additional Questions 1, ; t H Yes ❑ No Has the location of the proposed project including eaves and overhangs and the sanita system and well been staked? lino. what date will this he completed: GD C Y'Fj m O Yes ❑ No Did a licensed surveyor mark lot line(s) if project is within FO feet of required setback? See page 2 of land Use Application Information for required setbacks. 0 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 O No Is there an existing sanitary system on the property? If yes, what kind? ❑ Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe): ❑ Yes H 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): 0 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 El Class A Special Use ❑ Class B Special Use El Conditional Use O Variance Fee payment will be made via: O Check (attached) ❑ Cash (attached) ❑ debit/creditfecheck (department to call once payment is ready to be taken) How would you like to receive your permit card? ❑ Mail to: OR O Email to: O Property Owner Address ❑ Agent Address O Contractor Address ❑ Other (provide Name and Email or Address): sarahgjertson@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.,,ov to tic 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 Bayfield County in determining whether to issue a permit. I (we) further accept liability which may be a result of Bayfield 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. Owner(s) or Authorized Agent Printed Name: swohcjea: t I� Owner(s) or Authorized Agent Signat Date: 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 priorto start of prolect. {D)� L C C II I [ 1111 APR U 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: 1. Address of Subject Property: 3 O$ O 5 W e d tt l 4 t 'Joti bW-}1 '.J3 1 [5L'zt\J 2. The Subject Property is owned by: *Ad SDUce i4 A' I L_ -L- L (Name 6fTrust) 3. The name(s) of the current Trustee(s): 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: R 4' Kati Print Name Subscribed and ds�worn to before me this _ day ofq��° ` .2O2. "t\ C/S Not Public, a , County, Wisconsin 'y.G`•. •"u1iII' N �� YVIANV�vJI/fN �fi�a ��� 4Sm My commission: PROCESSING INFORMATION INITIAL PROCESSING. Once the department receives your affidavit, the department will review ft 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 , � C y ht $VM7 � 2. eS-4.4. ' r-;; ':t'c . PRPID/Tax ID # 141 R k tF� MIc11 w 6 LAZORIK i. `mo t- PRPIO%T # 140 � Vii;• t. t NEAP SPACENQ LLCM J 1•: Y � 1. S � � 1 '�:.� -...� 1'y.'� � t� 4ti .may �' �� rr - .r� + --'Y � � • µ jT5e rn . r 4' '���.'... , f .. A, �..,i _ 4.+� _ a' 6 �• Bayfield County, WI Y 1 N Ik < o � PRPID/Tax ID #414, k J to RICHARD 6 LINDA GUSKL a a f. a n � rc PRPID/Tax ID'# 141 MICHAEL G LAZ0RIK 7 /D VVEDAL RC i PRPID/Tax ID # 115 ARLENE TOSCH LE PRPIL .1.: =D # 14:7 PRPID/Tax ID EA.L S ACE Nay L LC 2 HEAD SPACE .F W ddfr;rtct#re Ad `4/23/25, 8:57 AM Novus-Wisconsin Access rev. 12.0206 t® Real Estate Bayfield County Property Listing Today's Date: 4/23/2025 Property Status: Current Created On: 3/15/2006 1:14:41 PM S 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 786 Recorded Acres: 15.000 Calculated Acres: 15.077 Lottery Claims: 0 First Dollar: Yes Zoning: (AG -1) Agricultural -1 ESN: 103 '3 Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 002 TOWN OF BARKSDALE 046027 SCHL-WASHBURN 001700 TECHNICAL COLLEGE 0 Ownership HEAD SPACE HQ LLC Billing Address: HEAD SPACE HQ LLC 30875 WEDAL RD WASHBURN WI 54891 Updated: 6/6/2024 WASHBURN WI Mailing Address: HEAD SPACE HQ LLC 30875 WEDAL RD WASHBURN WI 54891 P Site Address * indicates Private Road 30805 WEDAL RD ® Property Assessment WASHBURN 54891 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% Recorded Documents Updated: 7/8/2013 Property History ® WARRANTY DEED Date Recorded: 5/24/2024 N/A 2024R-603354 © TERMINATION OF DECEDENT'S INTEREST Date Recorded: 10/16/2023 2023R-600833 © 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 https://novus.bayfieldcountywi.gov/access/master.asp?paprpid=140 1/1 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 ❑ 1 ❑ M 1 ❑ A- F- ❑ F-2 ❑ W ❑ M -M ❑ Yes )2No Is lot substandard (does not meet current zoning dimen requirements)? Deed of record: es ❑ 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 Euio Is the project located in the Floodplain? Zone: ❑ Yes No Are there wetlands on the property? ❑ Yes Z11No 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 r onditional Use Pe Permit It: '2.S- -O'6Q ❑ Yes �ijo Is the project associated with a Special A Use Permit? ❑ Yes ❑ No Does the project require sanitary? 0 Existing 2lJew 0 Intercept 0 Reconnect 0 Noj9pibing 0 Public SanitaryPermit #: G1 2.5 ❑ Yes thjo Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes Vo Does the project require an affidavit? Affidavit #: ❑ Yes 13ip 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? 0 Residential Commercial 0 Municipal Project type is? New Construction ❑ Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign 0 Establishing a Business ❑ Temporary ❑ Shoreland Grading 0 Other, describe: Structure Type is: ❑ Residence ❑ Principal Structure 0 Accessory Structure 0 Boathouse (one story only) 0 Open-sided/Screened Structure (gazebo, etc.) 0 Stairway to navigable waters ❑ Mobile Home ❑ Shipping Container Other, describe Ga Total Sq. Ft. of Project. 4f36 Number if St ries: 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: 0 Return Inspection 0 Land Use Revisions 0 Special Use Permit - Class A ❑ After -the -Fact (ATF) ❑ Floodplain 0 Shoreland - Impervious Surface ❑ Shoreland - Non -Conforming, etc. 0 Tower Siting/Collocation 1 ❑ Tower Collocation 2 ❑ Metallic Mine ATF Fee Amount: Inspected b . Date of Inspection: / Re -Inspected by: Date of Re -Inspection: I - Denied by: Date of Denial: Reason for Denial: Approved by: Date of Approval: //,z 5 Condition(s): ❑ Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs. ❑ For personal storage only. 0 For personal residence only. ❑ N t for human habitation or sleeping purposes. Town/State/DNR/Federal may require permitting Uniform Dwelling Code (UDC) Permit from 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 Bayfield County Health Dept permit is required. ❑ Check with Town regarding room tax. ❑ Short -Term Rental is for a maximum occupancy of persons. ❑ Sin must meet the requirements of Article E of the Bayfield County Zoning Ordinance. Z 9 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: K / ,/� NiZerl ( �r% R 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: Submission Number: HEAD SPACE HQ LLC LU-01568 30875 WEDAL RD WASHBURN, WI 54891 Transaction Number: LU-01568-2CF9D Description Amount Verified Fee Amount $0.00 Commercial/Municipal Principal Structures - $177.00 $0.75/square foot (minimum $125) 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 — No. 25-0354 Tax ID: 140 Issued To: HEAD SPACE HQ LLC BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION 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.