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HomeMy WebLinkAbout26-0287117 E 6a' Street PO Box 403 Washburn, WI 54891 (715)373-6109 perm its:rabavtieldcounty.wi.gov P YFIELD Short -Term Rental Application Packet This application packet contains information for both a Tourist Rooming House license through Bayfield County Healt Department and a Short -Term Rental permit through Bayfield County Planning and Zoning DE4VEtJleted application and applicable fees can be mailed/emailed to the address/email above. Establishment Tax ID can be found (o through NOVUS(https://novus.bayfieldcounty.wi.gov/access/master.asn) JUN 1 12026 City of Washburn, City of Bayfield, Town of Pilsen: License through Bayfield County Health Qy t pnt is required. Please review and fill out pages 1-4. Planning and Zoning Agency All Other Towns: A license through the Health Department and permit through the Planning and Zoning Department are required. Please review and fill out pages 1-5. -SECTION:A: ESTABLISHMENT INFORMATION Establishment Name Port Wing Association Establishment Tax ID # 0 Town/City of Port Wing Establishment Street Address 81405 Orients Lake Rd. City Port Wing we WI Zi 5465 SECTION I3: OWNERINEORMATIQN Property Owner J. Madison Properties LLC Email Address driftwoodproperties@hotmail.com Phone Number (612) 414-2226 Owner Mailing Address 18583 Pathfinder Dr. City Eden Prairie State MN Zip 55347 SECTION C: IF OPERATING WITH.PARTNER'OR AGENT Legal Licensee (partnership. LLC. LL', or Inc.) 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 ke below Unit Unit ID Structure Type Heating Source Water Source Sanitary Source # of Stories # of Bedrooms # of Bathrooms I H E/P P P 2 2 2 2 3 4 Structure Type: House (H) Duplex D Cabin (C) Yurt Y Apartment (A) Condo CO Other (O), please describe Heating Source: Electric E Natural Gas G Propane P Wood Fuel (F) Other (O), please describe Water Source: Public/Municipal M Private Well P Sanitary Source: Public/Municipal (M) Private Onsite Wastewater System (P) 0 Site Plan Show location of: ❑ Driveways ❑ Frontage Roads (include name) ❑ Existing Structures ❑ Well (W) ❑ Septic Tank (ST) O Drain Field (DF) ❑ Holding Tank (HT) O Lake O River O Stream/Creek O Pond O Floodplain O Wetlands O Slopers over 20% N �>4 II RECEIVED JUN 112026 Bayfield co. Planning and Zoning Agency Setbacks from furthest extent including eaves and County Use Only overhangs of structure to: Verified setbacks Road Centerline ft. R Notes/Comments: Front Lot Line/Right-of-Way ft. ft. Side Lot Line I ft. ft. (North East South West, circle one) Side Lot Line 2 ft. ft. (North East South West, circle one) Rear Lot Line ft. ft. Septic/Holding Tank 15 ft. ft. Drainfield ft. ft. Privy ft. ft. Well 1) 14 ft. ft. Existing Structure/Building ft. ft. Wetland (Lake) 175 ft. ft. Elevation of Floodplain ft. ft. Ordinary High -Water Mark (OHWM) ft. ft. NOTE: Please indicate "see attached" on this page if submitting site plan as a separate document. 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. > Bayfield County 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 toaotttages, other than hotels and motels, in which sleeping accommodations are offered for pay to ts. It does not include private boarding or rooming houses not accommodating tourists or transients, or bed and breakfast establishments regulated under Ch. ATCP 73. JUN 117026 > Wis. Stat. § 97.67 (5) and § 97.605 (1)(c) "No license may be issued untiLll pafiKda@tl&fees have been paid." n'i ss and Zoning Agency > 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 or its agent shall either approve the application and issue a license or deny the application. If the application for a license is denied, the department or its agent shall give the applicant reasons, in writing,for the denial. > 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. APPLICATION FEES —Required for all tourist rooming house within Bayfield County Check or money :order payable to Bayfield County Health Department When will your rental be in operation: O Summer O Winter ® Year -Round Ill $586.30— License Fee ($286.30 (County fee: $272, State fee: $14.30)) + Pre -Inspection Fee ($300) Pre -Inspection Fee includes bacteriological sample analysis for private drinking water supply. C# Rush Fee ($50) — A one-time $50 rush fee will be charged for inspections requested within 7 business days. However, depending on scheduling, staff may not be able to accommodate all rush requests. 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 purposes other an that for which it was collected (Wis. Stat. § 15.04 1 m . Signature: Date: Bayfield County Planning and Zoning Short -Term Rental Permit PLANNING AND ZONING QUESTIONS 1. Is the property in the shoreland, within 300 feet of a river/stream OR landward side of floodplain OR 1000 feet of a lake/pond/flowage, whichever is greater? ❑ Yes 0 No 13 Unsure 2. Is there a wetland located on the property? ❑ Yes ll No 0 Unsure 3. Is there a floodplain located on or near the property? ❑ Yes ❑ No IN Unsure 4. Is this project associated with any of the following: ❑ Rezone ❑ Conditional Use ❑ Special Use ❑ Variance 5. Did you contact the town to see if any ermits/r uirements apply to your project? ® Yes 0 No Zoning Department Use Permits: Short -Term Rental permits through Bayfield County Planning and Zoning Department are non -transferable, except as per the exemptions identified in ATCP 72.04(3). Short -Tenn Rental permits are regulated by Bayfield County Ordinance Section 13-1-35. APPLICATION_ FEES Check or money order payable to Bayfield County Planning and Zoning I unit: $500 2 unit: $1,000 3 unit: $1,500 4 unit: $2,000 To ensure your application is complete and can be processed by the Department, check you have the following items: RECEIVED IE Applicant Information (Page I) IN Site Plan (Page 2) JUN 112026 Cd Floor Plan(s) — Provide sheet for each floor within each unit. Bayfield Co. ® Fees paid Planning and Zoning Agency 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. r, Owner(s) or Authorized Agent Printed Na Owner(s) or Authorized Agent Signature: NOTE: If you are signing on behalf of t 5 Conceptual Main Level Floor Plan Based on the listing and user -provided layout corrections. Not to scale. LIVING ROOM KITCHEN / DINING BEDROOM I HALL I -Uff-F'L'I' BEDROOM 2 HALL 2 neIRROOM RECEIVED JUN 112026 Bayfield Co. Planning and Zoning Agency Second Level Floor Plan RECEIVED Conceptual layout (not to scale) JUN 112026 Bayfield Co. Planning and Zoning Agency AFFIDAVIT OF AUTHORITY (Corporation, LLC, etc.) PURPOSE. This Affidavit of Authority is used to certify the individual applying for a permit is authorized when the property is owned by a corporate/business entity. RECEIVEDSTATE OF MINNESOTA ) ) ss. ,;UN 112626 HENNEPIN COUNTY ) Bayfield Co. The undersigned affirms and states as follows: planning and zoning Agency 1. Address of Subject Property: 81405 Orients Lake Road, Port Wing, WI_ 2. The Subject Property is owned by: J. Madison Properties LLC (Name of Company) 3. The name(s) of the current President or Managing Member: _Driftwood Properties LLC 4. I certify that the company named in paragraph 2 is valid and in effect on the date signed below. I am the duly appointed agent of the Company named above in paragraph 2, and I have the authority under the terms of said authorization to apply for permits from 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 Company to apply for and bind the Company to the terms and conditions of any permit that may be issue 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 for permit. Dated: _Benjamin A. Wagner (rod Properties LLC Predisent)_ Print Name Subscribed and sworn to before me this ` l day of 2Ic. Not ry blic, Atv+ytcP`"t County, Minnesota My commission: acv. t 1O d GmyHettiPR Stark Notary PublicMinnesotaamn+r+.e�t«anvi�t.anm Land Use Permit Application Review Checklist Submission #: STEQ- 0035 D Tax ID: Q 1Town:-4?6r4 S -T -R: t 5-4 1- b°1 Jr4lap, What zoning district is the project located in? ❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 R-RB DC D 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 OW DM-M Yes O No Does lot meet the zoning dimensional requirements or is it substandard? Deed of record: Yes O No Is the project located in the Shorelands (Shore lands are lands within 300feet of a river/stream OR landward side of floodplain OR 1000 feet of a lake/pond/flowage, whichever is greater)? ❑ Yes XNo Is the project located in the Floodplain? Zone: Yes ❑ No Are there wetlands on the property? ❑ Yes No Is project associated with a nonconforming use or structure? `Yes ❑ No Does the project require sanitary? Sanitary Permit #: ()7._G as Public System: # of bedrooms: 3 cD °'1 halci�+� Yes ❑ No Does the project require an affidavit?'LLC ❑ Trust Affidavit #: Number of Units: I Number of Bedrooms: Z Number of Bathrooms: Z. Number of Stories: Z ❑ 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: �O -Z3 -Z� 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. I (� )—dShort-Term Rental is fora maximum occupancy of 4 y persons. Additional conditions may be placed and need to be adhered to at the time of permit issuance. Other Conditions: P YFIELD Bayfield County Planning & Zoning Department 117 E 5w Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: J MADISON PROPERTIES LLC, 18583 PATHFINDER DR EDEN PRAIRIE . MN 55347 Description 1 unit Submission Number: STR-00350 Transaction Number: STR-00350-471387 Amount $500.00 Total: $500.00 Payment Amount: $500.00 Reference: 151 Paid by: J Madison Properties LLC Payment Type: Check Transaction Date: 6/23/2026 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 Shoreland ,Wetlands Substandard LAND USE - X SANITARY - 07-92S SPECIAL A — SPECIAL B/CONDITIONAL— BOA — No. 26-0287 Tax ID: 25706 Issued To: J MADISON PROPERTIES LLC, Location: S05 - T49N - R09W Town of Orienta BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Legal Description: LOT 1 OF CSM #1214 FILED IN V.7 OF CSM P.303, LOCATED IN GOVT LOT 2 IN V.922 P.16 IM 2025R- 609166 Residential Structure in R-RB zoning district For: [1 -Unit] Short -Term -Rental (Disclaimer): Any future expansions or development would require additional permitting. Condition(s): Town may require permitting. Short -Term Rental is for a maximum occupancy of 10 persons. NOTE: This permit expires two years from date of issuance if the authorized construction Desi Niewinski 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 23, 2026 This permit may be void or revoked if any performance conditions are not Date completed or if any prohibitory conditions are violated.