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FIELD 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:
BUSKEY BAY RESORT LLC, STR-00258
27990 CHERRYVILLE RD
ASHLAND, WI 54806 Transaction Number:
STR-00258-37D28
Description Amount
3 unit $1,500.00
Total: $1,500.00
Payment Amount: $1,500.00
Reference: 001652
Paid by: Buskey Bay Resort LLC, Kevin or Valerie Zimmerman
Payment Type: Check
Transaction Date: 11/3/2025
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
Land Use Permit Application Review Checklist
Submission #: S Tt2- t)0d5 tj
Tax ID: 3 5 I.3LO
S -T -R: c- 4 7 -o FS
Town:
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 XNo
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 '4No
Are there wetlands on the property?
❑ Yes No
Is project associated with a nonconforming use or structure?
XYes ❑ No
Does the project require sanitary?
Sanitary Permit #: I l as U_b Public System:
# of bedrooms:
Yes ❑ No
Does the project require an affidavit? LLC ❑ Trust bus k� 1 u!1 - LB,
Affidavit #: UJ
Number of Units: 3
Number of Bedrooms: 1
Number of Bathrooms: 1 I,
Number of Stories: I ) I , )
❑ After -the -Fact (ATF)
ATF Fee Amount:
Inspected by: pc
Date of Inspection:
Inspection Notes:
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: \, r
Date of Approval:
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 persons. ffr i&Gh Ccn0\r\
❑ Additional conditions may be placed and need to be adhered to at the time of permit issuance.
Other Conditions:
117 E 6'h Street
PO Box 403 F3 YFIELD
Washburn, WI 54891
(715)373-6109
l>uxn t4 1_ra ftcldc lh t ;ep , 1
)
Short -Term Rental Application Packet
This application packet contains information for a Short -Term Rental permit through Bayfield County Planning and
Zoning Department. Completed application can be mailed/emailed to the address/email above.
Health
Zoning
Submission #
roej 2/ -
Fee Paid
Refund
Permit #
Date Issued
SECTION A: ESTABLISHMENT INFORMATION
Establishment Name
��� f�g¢
Establishment Tax ID # Town/City of
Establishment Street Addr ss
4 L/ o ./4
City
\
State
Zip
SECTION B: OWNER INFORMATION
Property Owner
1°��'v i N i>v;n�N. �t+�
Email Address
/J f'zr 5Lr .
Phone Number
? 2 ` 7
,y j ccv1'125
Owner Matunb Address City State zip
9 - i
Vi'fir �I / I1/
SECTION C: IF PERATING WITH PARTNER OR AUErfl
Legal Licensee (partnership, LLC, LLP, or Inc.)
i
j Email Address
Phone Number
Licensee Street Address
City
State
Zip
Agent Name (if applicable)
Email Address
Phone Number
Agent Street Address
City
State
Zip
SECTION D: RENTAL UNIT INFORMATION (see key
below)
Unit
Unit ID
Structure
Type
Heating
Source
Water
Source
Sanitary Source
# of Stories
# of
Bedrooms
# of
Bathrooms
1
�C�1jl RJtorrc&
r-'
I
2
��
1
3
�l
T I
fl 0
4
\30d
`(
( l
Structure Type:
House (H) Duplex (D) Cabir C Yur Y) A artmer A Condo CO Other (0), please describe
Heating Source:
Electric (E) Natural Gas G) Propane P)
Wood (W) Fuel (F) Other (0), please describe
Water Source:
Public/Municipal (M) Private We P
Sanitary Source:
Public/Municipal (M) Private Onsite Wastewater Syst41p�)
Site Plan
N
,:5ke� \t1 L L
l
NOTE: Please indicate "see attacnea" on Lu,h page U Mjuu hII1 ...r, 0_« Y„•« �� -r
2
Bayfield County Health Department — State Lodging License
Health Department (State Lodging License): All rental units require a Tourist Rooming House license through the State
of Wisconsin Department of Agriculture, Trade and Consumer Protection (WDATCP) or their authorized agent (Bayfield
County Health Department.
➢ Bayfield County Health Department issues permits on behalf of the State of WDATCP under ATCP 72, 73, 76,
78 and 79.
➢ ATCP 72 regulates lodging facilities including hotels, motels and tourist rooming houses.
➢ BayfieldCounty Ordinance Title 9 —Chapter 2 Food Protection Lodging, Pools, Campgrounds
Recreational/Educational Camps Tattoo and Body Piercing Establishments outlines the licensing program and the
authorized agent agreement between the Bayfield County Health Department and the State of Wisconsin.
➢ ATCP 72.03(20): "Tourist rooming house" means all lodging places and tourist cabins and cottages, other than
hotels and motels, in which sleeping accommodations are offered for pay to tourists or transients. It does not
include private boarding or rooming houses not accommodating tourists or transients, or bed and breakfast
establishments regulated under Ch. ATCP 73.
➢ Wis. Stat. § 97,67 (5) and § 97.605 (1)(c) "No license may be issued until all applicable fees have been paid."
➢ Wis. Stat. § 97.605 (1)(a) "No person may conduct, maintain, manage or operate a hotel, restaurant,
temporary restaurant, tourist rooming house, vending machine commissary or vending machine if the
person has not been issued an annual license by the department or by a local health department that is
granted agent status under s. 97.615 (2)."
➢ Within 30 days after receiving a complete application for a license, the department ?r is agent 1,shal1 e#t er
approve the application and issue a license or deny the application. If the applicton foi i1cehsis deli. -d,
the department or its agent shall give the applicant reasons, in writing,for the denja.r
➢ A license shall not be issued to an operator without prior inspection.
➢ Tourist rooming houses license expires on June 30`h. ATCP 72 requires an annual renewal application and fee.
Failure to maintain proper permitting will result in penalties. Licenses are non -transferable, except to immediate
family members as allowed in ATCP 72.
Your signature below will acknowledge you have received information as to where to obtain a copy of the code and
will comply with applicable Wisconsin Administrative Code(s). Personally identifiable information you provide may be
used for puroes other than that for which it was collected (Wis. Stat. § 15.04 (1)(m)).
Signature: Date: �r
Bayfield County Health Department — State Lodging License
TOURIST ROOMING HOUSE REQUIREMENT CHECKLIST
• Private wells shall be tested once per year for coliform bacteria and a copy of the results provided to the Health
Department.
• Private well and private septic systems must be properly constructed and code compliant.
• All bathroom facilities must include a toilet and sink, and at least one bathroom with bathtub or shower.
• Hot and cold running water shall be available at all sinks and washing facilities.
• All garbage and recycling shall be kept in separate, leak proof, nonabsorbent containers with tight fitting covers, and
shall be emptied often to prevent decomposition and overflow.
• Appliances and furnishings shall be clean, in good repair and installed to facilitate cleaning.
• Eating and cooking utensils shall be in good repair and cleaned by washing, rinsing, sanitizing (with 1 capful of
Bleach to I gal. of water), and air -drying.
• Mattress and pillow covers or protectors must be provided.
• Linens (sheets) shall be washed between guests.
• Blankets, quilts, and bedspreads shall be washable and maintained in a clean condition.
• Sheets shall be of sufficient size to cover the bed and have a fold —back of at least 12 inches.
• Housekeepers with communicable diseases shall refrain from working.
• All home construction shall comply with the Uniform Dwelling Code if constructed after June 1, 1980. A UDC
inspection may be requested depending on existing conditions.
• All cabins or homes constructed after June 1, 1980 must have two exits.
• Facilities with three or more units in one building must comply with the commercial building code.
• Fuel fired appliances must meet ventilation requirements based on the International Fuel Gas and International
Mechanical Codes.
• At least one smoke alarm per floor level shall be installed in cabins or homes constructed before April 1, 1992, After
1992, smoke alarms are required in each sleeping room.
• Every sleeping room must be 400 cubic feet per occupant over 12 years of age and 200 cubic feet per occupant under
12 years of age. All sleeping area ceilings shall be at least 7 feet high.
• There must be at least two directions of escape from every sleeping room.
• All exterior doors shall have key locking from the outside and non -key locking from the inside.
• Windows shall be screened. Openable windows are required in dwellings that lack air conditioning.
• Adequate guards & handrails are required on stairs and elevated platforms or decks exceeding 18".
• Adequate ventilation must be provided to all bathrooms.
• Pressure release valves on hot water heaters must be piped to within six inches of floor.
• There shall be no plumbing cross connections that may contaminate potable water supply.
• There shall be no electrical shock hazards (exposed wires within reach and missing plates).
• There shall be directions for use of fireplaces and wood stoves.
• All dwellings shall be maintained and equipped in a manner conducive to the health, comfort, and safety of all guests.
They shall be kept in good repair and sanitary condition.
• Effective measures shall be taken to minimize the presence of insects and rodents.
• A guest register shall be maintained and kept available at all times.
• No food items, alcohol, or other personal goods shall be accessible to guests beyond shelf stable prepackaged single
service food items.
• Carbon monoxide detectors shall be installed within 15 feet of all bedrooms, in sleeping rooms with fuel fired
appliances and in the basement if there is a fuel fired appliance present.
4