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Land Use Permit Application Review Checklist
Submission #:
Tax ID:
STR
Town:
What zoning district is the project located in?
El R-1 El R-2 ❑R-3 ❑R-4'_R-RB El ❑I El ❑A-1 ❑A-2 ❑F-1 El F-2 ❑W El M -M
'Ci Yes El No
Does lot meet the zoning dimensional requirements or is it substandard?
Deed of record:
,Yes El 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:
LYes ❑ No
Are there wetlands on the property?
El Yes `l. No
Is project associated with a nonconforming use or structure?
1Yes El No
Does the project require sanitary?
Sanitary Permit #: Public System:
# of bedrooms:
❑ Yes No
Does the project require an affidavit? El LLC ❑ Trust
Affidavit #:
Numberof Units: I
Number of Bedrooms: `r
Number of Bathrooms:
Numberof Stories: f
❑ After -the -Fact (ATF)
ATF Fee Amount:
Inspected by:
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: ;
Date of Approval:
Condition(s):
1 Town/State/DNR/Federal may require permitting.
❑ This permit cannot be transferred if property is sold.
❑ A Bayfield County Health Dept permit is required.
El Check with Town regarding room tax.
f Short -Term Rental is for a maximum occupancy of _ _ persons.
El Additional conditions may be placed and need to be adhered to at the time of permit issuance.
Other Conditions:
117 F 6"Street
PO flux '103
Washburn, WI 54891
(715) 373-6109
perriiut�a'i?�y fieldc?oGimy.wi. uy
P YFIELD
Health Zctnirt
Submission #
Fee Paid
Refund
Perin it #
Date Issued
Short -Term Rental Application Packet
'ibis application packet contains information for a Short -icon Rental pennit through I3aylield County Planning and
Zoning Department, Completed application can be mailed/entailed to the address/email above,
SECTION A: ESTABLISHMENT INFORMATION
Lstablishntent Name —W —
1:stablishment Tax ID t� I'o��n/C'ity of
Establishment Street Address iv
State Zip
j Co
SECTION B: OWNER INFORMATION — —
Property Owner 1 Email Address Phone Number
(A, 5
Owner Mailing —�'Address City
1 acs f" Id State Zip
P
SECTION C: IF OPERATING WITH PARTNER OR AGENT
Legal Licensee (h,utncrship, I,IC, LLP. or toe.) Timail Address
I one Number
wrxj i h C t(ir� wi& ( YLif t/ _ )I,r� "l I r ( y -? � >> i
Licensee Street Address _— — — .LL_—
_ City — — — State rip
Z ( f
U ('e( Jr
Agent Name ( I 1 if a p plicable -J
) Entail Address --� —�
Phone Number — —
Agent Street Address jiiv
,State_ Zip JSECTION D; RENTAL UNIT INFORMATION see lie below —
Unit Unit 11 Fstrucrure heating
Witter Sanitary Source 4 of Stories 13cd1 ooms Bathrooms
of
— l y'pe Source
—Sourer — — rooms
4
Structure type:
douse (I1) Uu�cx (I)) Cabin (C) Yurk(Y) Ap irlment (A) Condo(CO) Other (O lease describe
Heating Source: — — --_ ---
I;lectiis (6) Natural (ias (N(;) Propane (l') Wood (W) 1 uel (H') Othcr(O)please describe
Water Source: -- — _—
Sanitary Soured: — — — — — __—
Public Mw1ieipal (M) Private Well (P) P lblic/Mttnicipal(M) Private Onsite Wastewater System (P)