HomeMy WebLinkAbout26-0310RECEIVED
117E0sweet yFIELD
POBox403 JUN 29 202
Washburn, WI 54891
(715) 373-6109 tiayfie d Co.
permits([,bavl icldcounty.wf �n�np and Zoning Agency
Health
Zoning
Submission #
06SS
Fee Paid
oo.00
Refund
Permit#
p4-o3go
Date Issued
________
o
Short -Term Rental Application Packet
This application packet contains information for both a Tourist Rooming House license through Bayfield County Health
Department and a Short -Term Rental permit through Bayfield County Planning and Zoning Department. Completed
application and applicable fees can be mailed/emailed to the address/email above. Property Tax ID can Lth_un through
NOVUS(https://novus.bayfieldcounty.wi.gov/access/mastcr.asp).�
City of Washburn, City of Bayfield, Town of Pilsen: License through Bayfield County Health Departin required.
Please review and fill out pages 1-4.
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
T c e ot1 Lo`-' Lake
Property Fax 11) #
I ggZl
fo City of
Iror-, f a''ve-r
Establishment Street Address
City
Iran River
State
LJ I
Zip
SECTION B: OWNER INFORMATION
Property (hvtter rt
v -Pau.Q�t lLtnnut
Email Address
a21eSCI, low
Phone Number Zq2 O5O-1 CT
7l� •242•383a e�)
Owner Mailing Address
1 I 2-I- fl9aA-re kv
City
,4akQ.cn d
State
IA l
Zip
5LfrSP&
SECTION C: IF OPERATING WITH PARTNER
OR AGENT
Legal Licensee (partnership, LLC, LI.P, 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 11)
Structure
Type
Heating
Source
Water
Source
Sanitary Source
# of Stories
# of
Bedrooms
# of
Bathrooms
F
P
1.5
i.5
3
4
Structure Type:
House(H)Duplex Cabin C Yurt A artment (A)Condo CO Other (O), pleasedescribe
Heating Source:
Electric Natural Gas G Propane (P) Wood Fuel Other (O), please describe
Water Source:
Public/Municipal Private Well
Sanitary Source:
Public/Municipal Private Onsite Wastewater System
Site Plan
County CIS mapping tool can assist with development of a site plan. Note that parcel lines in this tool can be up
to 200 feet off of the true surveyed location: https://maps.bayfieldcounty.wi.gov/ZoningWAB/
Show location of:
El Driveways ❑ Frontage Roads (include name) ❑ Existing Structures ❑ Well (W) El Septic Tank (Si) ❑ Drain Field (DF)
❑ Holding Tank (HT) ❑ Lake ❑ River ❑ Stream/Creek ❑ Pond ❑ Flood lain ❑ Wetlands ❑ Slopers over 20%
N Lon Lc�Fe
Fiala la
�II Weld `
East I LL )Z
O
R�,C�IVEC�
JUN 29 2U7B
BaYfieb Go. q enCY
Planning and Zon'n9 A
Setbacks from furthest extent including eaves and
County Use Only
overhangs of structure to:
Verified setbacks
Road Centerline
> 1000 ft.
ft.
Notes/Comments:
Front Lot Line/Right-of-Way
> 1000 ft.
ft.
Side Lot Line 1 from F-ap5�
75 ft.
ft.
4&jlijEast South West, circle one
Side Lot Line - ftrni. kn -
0 ft.
ft.
(North as Sou es circle one
Rear Lot Line
( ft.
ft.
Septic/Holding Tank
26 ft.
ft.
Drain field
5Z) ft.
It.
Well
1, ft.
ft.
Existing Structure/Building J
2 ft.
ft.
Wetland
75 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.
I
rpry1
?'Dl�7
\{
C
✓' L�-2/L. �PJ
In the box below: Draw orM_k& lih flour
Property(regardlessowhat you are apptng for)
(1)
Show Location of:
Proposed Construction
_
f A
(2)
Show/Indicate:
North (N) on Plot Plan
(31
Show Location of ('):
(') Driveway and ('I Frontage Road (Name Frontage Road)
(4)
Show:
All Existing Structures on your Property
(5)
Show:
('I Well (W);(') SepticTank Drain Field (DF);('1 Holding Tank (HT) and/or)') Privy
(P)
(6)
Show any('):
(•) take; (') River; (') Stream/Creek; or(') Pond
(7)
Showany
(') Wetlands; or(') Slopes over 20%
//
iif/v1% / 4k (
gEC
EWED s
JUN
29 2026 b
e
—a
ytD(a in ._
nd Zoning Agency
punning
Please complete (1) -(2) above ( pros to mmminnpl
Changes In plans must be approved by the Planning & Zoning Dept.
(8) Setbacks: (measured to the closest point)
Description
Measurement
Description
Measurement
Setback Irons the Centerline of Platted Road
> / U&O Fee[
Setback from the take (ordinary h)gh-water mark)
_ feet
Setback from the Established Right -of -Way
00 Feet
Setback from the River, Stream, Creek
Feet
Setback from the Bank or Bluff
Feet
Setback from the North Lot Line h
feet
Setback from the South Lot Line hsc
Ito O Feet
Setback from Wetland
75 Feet
Setback from the West Lot Line rs t1
T S Feet
20%Slope Area on the property
Yes No
the E ^' ^ m Asw
Feet
Elevation of Floodplain
Feet
Setback to Septic -Tank or Holdin Tank tasi hoe
c Feet
Setback to Well
lO ---Feet
Setback to Drain Field &-
D
(roe'S he.L
Setback to Privy (Portable, Com ostin )
__!et
Feet
__ ___
olM1rvru , nm. iMun .n uoun1.11La +m..rmI. ne rwunu,pI-rrumwbm le. elW, mrn of m. awaa—r nuer< evmvM w.rnvW wrvrym[amnrolM
net
wnn mewm,w..,....esm=., u,menw Its Keel 5 car. ,nrm«, ,sea .,ue.
let11cr Mrt kY Ibn IMM1r Ifa11-111-11M mwe,se,enuneJxtbL. Ixe Wwsary tlne 4om *tishrht w,N[! s,sat le meawatlmu+l Le r,yA4lmm
r,de wtMm un+ Pd<u.a..mombnw 0.Nnnmtl ov caw avatn.acc,p.m umva Lesa,,,ry, wane toe t.a ulrrw v,. W,1 vie ur me,u u.m,emmmlhe
(9) Stake or Mark Proposed Location(s) of New Construction, Septic Tank EST) Drain field (OF). Holding Tank lHT) Pew (friifL and Well(W).
NOTICE: All Land Use Permits [spire One (1) Year Irom the Date of Issuance it Construction or Use has not begun.
for The Construction Of New One & Two Family Dwelling: ALL Muniopalitles Are Required To Enforce The Uniform Dwelling Code.
The local Town. Village, City. State or Federal agencies may also require permits.
Issuance Information (County Use Only)
Sanitary Number: 3 Uof bedrooms: •J 7
Sanitary Da
Permit Dented (Date):
Reason for Denial:
i `✓�/
PermitU: �q F
Permit Date: 2
,
IS Parcel a Sub -Standard Lot
I Yes (Deed of Record) I- No
Mitigation Required
Yes 'No
Affidavit Required
r>Ires
Is Parcel in Common Ownership
:. Yes (Fused/Contiguous tonsil N°
Mitigation Attached
J Yes No
Affidavit Attached
)Ig Yes No
is Structure Non -Conforming
::: Yes No
Granted by Variance (BOA.)
Previously Granted by Variance (B.O.A.)
Yes ' . a:
r Ye£ (Cm
Was Parcel Legally Created
es _ No
Were Property Lines Represented by owner
s: Yes :: No
Was Proposed Building Site Delineated
- Yes No1¼/ftWas
Property Surveyed
:: Yes :No
Inspection Record:
Zoning District (It I
Ukes Classification I t-
Dateoflnspection: 10—'l! —(1 Inspected by:
Date of Re -Inspection:
Condition(s):Town, Committeeorr Boardd Conditions Attached? 'Yes No --(If Na they need t attazhedd
Sign lure of lnspe
Dateof Approval:
told for Sanitary: Hdd For TBA: Hold For Anidavol Held For Fees:
Li
..xv,v t 2017
Floor Plan
One floor plan for each level of building which will be available to renters. Please attach additional sheet if
needed.
Provide exterior dimensions sufficient to calculate floor area (square feet) for each level. Label each internal room and indicate if it
will be used for sleeping space.
U
RECEIVED
2 JUN 292025
-.. .._/ Piannin BaYfiela r.,
9 ana Z,,. •t„y „gency
lo' r
2
NOTE: Please indicate "see attached" on this page if submitting floor plan as a separate document.
S
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 ❑ No 0 Unsure
2.
Is there a wetland located on the property? 0 Yes 0 No 0 Unsure
3.
Is there a floodplain located on or near the property? 0 Yes 0 No 0 Unsure
4.
Is this project associated with any of the following: ❑ Rezone 0 Conditional Use 0 Special Use
❑ Variance
5.
Did you contact the town to see if any ermits/re uirements apply to yourproject? 0 Yes ❑ 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 -Term Rental permits are regulated
by Bayfield County Ordinance Section 13-1-35.
APPLICATION FEES — Required for Short Term Rentals where Bayfield County Zoning Regulations apply
Check or money order payable to Bayfield County Planning and Zoning
1 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:
Cd Applicant Information (Page 1)
13 Site Plan (Page 2)
S Floor Plan (Page 5)
f2'Fees paid — Health Department and Zoning Department
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: —
Owner(s) or Authorized Agent Signature: ` t wtnx ti Date: (e - ZZ
NOTE: If you are signing on behalf of the owner(s) a letter of authorization must accompany this application.
RECEIVED
JUN 292026
BaYfield Co.
Planning and Zoning Agency
Bayfield County Land Records and GIS 1.3 [Land Records I ! ��
iw1w I Name, Address, Parcel# et I Q
USNG C.
o
ion River ��Dfi�Q�£TDQSD
F
THOMAS C & PAULA A CUNNINGHAM
Tax ID# 18921
Ali
o^m^.
CA[sTEwsoFncE
w s.s.: Ooe. "130985
sr,county, WIS. —
RECOMM AT/o;40A-M.
ON EC 2 1996 U A 4
BAYFIELD CTY. CERT . SURVEY _/ MAP # DDO q40
LOCATED IN GOVT LOT 6. SECTION 2. T.47N..
R.8 W.. TWN. OF IRON RIVER. BAYFIELD CTY..
WISCONSIN
,o�``��SCONS� '•
O .. WILLWA ','•'s NG ° SHEARM _ IqV
40
/\ A S74 Qj t SUVER� �(I`
LSC
3 161 O 5\e
z a
�� N gS�SO e mzmui
J _
O lJ av i-N
o LOT2 1 N
m „_, O O F-
CC ?Ulfv
IN
v^w -
Z N <'Ny
30'4 O I,I
mZ<Z
LOTS 50
\NN LOT 1 C3 R���►v
Kati JUN
w C•4\ 2 y zp7h'
s a L5 .J
S p Q Pfannirzg rld
25 2y\�QA Qb �\
• 0 QOr
N RRIV4E ROAD EASEMENT
TO EA T LONG LAKE ROAD
LEGEND 30 A'66 N
• SET 1" x 24• IRON REBAR 1112 9 30•
weighing 2.670 Ibs/ft B3- 4,
SCALE: 1" = 80' -4
0 40 80' 160' SOUTH 1/4 CORNER
2-47-8
SHEET 1 OF 3
Cm
.a.
HR
SANITARY PERMIT
In accord with ILHR 83.05. Wis. Adm. Code
Attach complete plans (to the county copy only) for the system, on paper
than 81 2 x 11 inches in Size. — -
• See reverse side for instructions for completing this
The information you provide may be used by other government agency
Irnvacy Laws. 1o.U' t4 tm)1. -' - f
State Plan I.D. Number
I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property Owner Name
TOM- CiINNSJJCs-MA4%-
Property Location
#1/4 SIAJ1a,S T yr/ ,N,R g -f yr W
Prope t OQwner's MailingAddress A- I
1�� b y 11 ✓�v�
Lot Number
3
Block Number
City, Sta Zip Code
-`� la�Ld WZ- sy8O
Phone Number
('7/s) Eta-SI4'
Subdivision Name or CSM Number
II. TYPE OF BUILDING: (check one) ❑ State Owned
Public 1 or 2 Family Dwellin - No. of bedrooms _�
tty
O wan uer
Nearest Road
1.LV&-' AkE
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 0 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church /School 8 0 Mobile Home Park 12 ❑ Service Station / Car Wash
5 ❑ Hotel / Motel 9 0 Office/ Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. i New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System SystemTank Only___ Existing System________ ExistintgSystem
- ---
--------
,./j
B) A Sanitary Permit was previously issued. Permit Number 1I Date Issued
V. TYP OF SYSTEM: (Check only one)
Non -Pressurized Distribution Pressurized Distribution Experimental Other
11 J) Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In -Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System -In -Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
ft.) ft.) (Min./inch) /. Elevations
Required (sq. ft.) Proposed (sq. (Gals/day/sq. p O
5O < 7lFeet/O.tJieet
VII. TANK
INFORMATION
Capacity
in gallons
GallonsTanks
Manufacturer's Name
cone ere
Site
Con-
steel
glass
Plastic
APpr
New
Existinc
structed
Tanks
TanksLC�
Septic Tank or Holding Tank
Ooa
SSIUore it
L
❑
❑
❑
❑
0
Lift Pump Tank ISiphon Chamber
❑
❑
❑
0
❑
❑
Vlll. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumbers Name: (Print)
iba.v a `R-$lake�ltctrf
Plumbe 's Signature: (No Stamps)
I�au�
MP/MPRSW No.:
r5'/
Business Phone Number:
1/c— Coka- looms
Plumber'sAddress(Street. City, State, Zip Cod
k. l td w= syffot�
IX. COUNTY / DEPARTMENT USE ONLY
❑Disapproved Sanitary Permit F a pntluae Groundwater
Date Issued
Issuing Agent Signature (No Stamps)
❑Aproved
P
sur<nerge Fee)
❑Owner Givenlnitial
_ _
Adverse Determination Il/LI
X. CONDITIONS OF APPROVAL / RE SONS FOR DISAPPROVAL:
tlp.63981q 059x1
DISTPIpUTION: OrieiMito count,. One cony To: $ehlviaViLliMf UiV1�011.nWMr. Plumber
'r Loca4/dn; Count-j;Uai4 e1in
oPer{-� pwner: P�°PeTi-( � Iga.. T�II N
Thr�s �knpin�.aw� GoQ+. Lo+S� IM SW H -
iw Lo3 _.
aleck' .Town oP: ronft ua . L
# �4' be�lfoar�s: 3
fls�l«�Q w 5 {£506 Nnnenres+ Pa:ii. ERs I«l(c. Rc�
� I �
L. ! -L .- - i
111111 IIIIIIIIII I IIIIh lIH IIII II iilIII IIII
*2017R-51099 1*
FLOWS AND LOADS
AFFIDAVIT
Leaal Description: / rye
_114, _1/4, Gov't Lot I Section Q Township N, Range QA W
Lot 3 Block Subdivision or CSM ______)
Addt'I
05 oav-P&CCD
PIN # pg' -04-2 `tl —08 "02 3 Township lran ?` r4
Property Owner I DC1YI4 4 Iat.tt&- i.AAJLI IL4Wt
Mailing Address 1 121 " tC1 .1 . c
City. State, Zip a,y�r� r k> )
2011R-570993
DENISE TARASEWICZ
BAYFIELD COUNTY, WI
REGISTER OF DEEDS
11/28/2017 08:OOAM
IF EXEMPT I:
RECORDING FEE: 30.00
PAGES: 1
RECEIVED
JUN 2 9 202fi
Planning Bayfiekl Co.
and Zoning 4 cor irg Area
Return To:
Planning and Zoning Dept
It has been determined that the existing private sewage system (or components ereof) located on the
above described parcel of land is sized for # ._- bedrooms and gallons per
day. Therefore the POWTS is not adequately sized to accommodate an increase in the number of
bedrooms for the dwelling served or to be served. To resolve this situation without replacing the private
sewage system at this time, the owner(s) of the above described property agree to the following
stipulations:
1. Occupancy exceeding this number may constitute a violation of State and County private sewage
system regulations. The Governmental Unit may issue orders to correct and/or may commence
legal action if at any time it is determined that occupancy exceeds the maximum listed number
contrary to this agreement.
2. It is understood when the existing POWTS fails it shall be replaced with a properly sized and
code compliant private sewage system. This information is on file in the office of the County
Planning & Zoning Department.
3. This Agreement is binding upon the Owner and his/her heirs, successors, and assignees. The
Owner shall have this Agreement filed and recorded with the County Register of Deeds in a
manner which will permit the existence of the Agreement to be determined by reference to the
Property containing the sewage system.
4. This Agreement will remain in effect until the Governmental Unit, responsible for the issuance of
sanitary permits for POWTS, certifies that this restriction is no longer required.
it gallons per day or (P persons (maximum occupancy for structure)
_ gallons per day or persons (child occupancy for day care in structure)
Owner(s) Name(s) — Please Print
Subscribed and sworn to before me on this date:
altrQ h
y &X"1 /2
Notarized Owners) — Signature( )
Notary Public
I �
My Commission Expires:
Dr ftedby: f'C# ( lax>$t/Z7
u/forms/sanitaryMowsandloadsfjuly20l4 Proofed by:
SUBMIT:(OMYIDF9 APPLICATION, TAR
5TATENI MANDPEE To: I APPLICATION FOR PERMIT
8ayfeld County BA E C 5
Planning and Zoning Depart.
PO BOA 56 0��0
Washburn, WI 54991 OCT
(715)373.6138 LiI
STNUCnONt: No peteRs will be issued until all lees are paid.
Checksare made payable to: Bayheld Ceunryioning Oepennront.
00 NOT START CONSTRUCTION UNTIL ALL PERMITS HAVE BEEN ISSUED TO APPLICANT.
10 2011
Permitth
Date:
7_
Amount Paid:
It'1 I'. -'
11
Refund
IAN 2g 207-.5
H ROAJng�, Oll^9A8encY
TYPE OF PERMIT REQUESTED-* I ❑ LAND USE ❑ SANITARY U PRIVY ❑ CONDITIONAL USE P SPECIAL USE 0 0.O -A 0 O
Owners Name: _ Mailing Address: City/State/14:
I{tofYttC, r v
Telephone.
7K (,S� 5145
woem rmyeeq-.� v CAY/state/Zip:
8121 JI�OrI?4'VY✓ to! Fi
Can Phone:
7�5. 2ciL -j5:X,
- od
Contractor,
Contractor Phone:
Plumber.
Plumber Phone:
�- —
Autbodved Agent 1penonseninv Aosaaaemaa,, tutan of oseerlsll
Agent Phone;
Agent Mailing Address prelude Clty/Stale/Zip):
_ICj4H yap . l
Written AuthadlatlOn
Attached
I) L( /F a L�-�
I I yes i No
PBDBCr
"1F (
tegaippscripUnn tuneTaetlalerllennCl
ax Og 1
24
Recorded Document:
(te Prope,ly Ownership)
Govt Lot
Ici
lolls)
\.J
CM
Vol &Page
ITown
Lot(s) No.
Block(s) No,
SubdleiIon:
Settbn G? , Townsmp N,Range �' W
of:
Icon P ytr
Lot Size
t.( (F Z ..
Acreage
1-(c LW
300 feet of River. Stream fistareen ml
Landward side
Shoreline:
feet
Shoreland " yr 1s Property/land
/' within 1000 feet of take, Pond'- Fbwage Distanco Structure prom Shoreline:
It yes --continue � %) feet
IS Property in Are Wetlands
Floodplain Tone? Present?
Yes Yes
AND )XNo
Value at Time
of Completion
include
Eon scud :.me S
material
Project
A of Stories
Foundation
A
of
bedrooms
What Type of
Sewer/Sanitary System
Is on the property?
Water
New Construction
1-Sto
Basement
1
Municipal/City
City
S
Addition/Alteration
1 -Story + Loft
:4,Foundation
2
(New)Sanitary Specify Type:
pk Well
(' rYLC.:FC
Conversion
2 -Story
_3--
K Sanitary (Exists) specify Type
F14A
Relocate o -•;.nee nldel
X
X
Privy (Pit) u Vaulted (nun eW yalmm
Run a Business on
Property
Use
No
Portable lw/service contract)
A Year Round
Compost Toilet
None
I_ Existing Structure: (if permit befog applied for b relevant to it Length: Width: Height: ef✓/'Y
Proposed ConslruNon: Length: Width: Height
Proposed Use
J
Proposed Structure
Dimension,
Square
F e
Principal Structure (first structure on property)
( %
Residence (i.e. cabin, hunting shack, etc.)
I x )
withLoft
I x )
(N Residential Use
with a Porch
( x )
with (2w) Porch
( x )
with a Deck
I If
for lssuar
with (2ne) Deck
I xmmercialUssewith
Attached Garage
( xBunkhouse
[Rec'a
w/I sanitary, 9r sleeping quarter% as cooking & lood prep facilities)
( xMobile
Home (mnufactured date)
I xeCret2❑al
5';
Addition/Alteration (specify)
( %
Municipal Use
Accessory Building (spcciNl
I x
Accessory Building Addition/Alteration (specify)
I %
Special Use: (explain)
I K
Conditional Use: (explain)
( x
Other: (explain)
( x
IA111111110 OBTAIN A PERMIT a STARTING CONSTRUCTION WITHOUT A PetMII WILL RESULT IN PE N>rTlrs
heel eisa, lurmnaw4nen lac camwmMmrdreeeNnl N.Mmumrwdbea set +rd teI. by Nlew eel LlwYnpasslelasn�m ad aed[anoYw. I w eeh eeo dta Nelleel on
Inrt•a note let 11n0.1nI.Me«uoasyMW+Wemutm11ee1aw total Prw.1 as 1Nlawebe abed open bye fldd4WYn MYmrrue Wv I lest hint., uren WMM allies mry ya
.awl aaayneld teen,elraewlru.w>ryrlpitlest wnpnlwu'Idlne etwrh eBe issue m.Ile•1<om.nr lo.vumrdxawallurMweb Mmnewme<zmr adwwalo low access eais. .mud.ewbaa
owner(s): _
hr there are
P! letter(s) of authorization must accompany this applkahon)
Date It-' , _ / a
Authorized Agent: Data
(d you are signing on behalf of the owneels) a letter of authorization must accompany this epplest'mn)
Attach
Address to send permit Copy el Tea sta4nlent
It Mu lerenite punnated the pmMny send yell, Recorded Deed
APPLICANT - PLEASE COMPLETE PLOT PLAN ON REVERSE SIDE
TOWN BOARD RECOMMENDATION - - (CLASS A)
Date Zoning Received: (Stamp
Bayfield County Planning and Zoning Department rtc V Cl V C '' I�
P.O. Box 58 -Washburn, WI 54891 9 202 oil NOV 1 6 201;
Phone —(715)373-6138 Website: SUN
Fax — (715) 373-0114 www.bayfieldcounty.org/14
e-mail: zoning@bayfieldcounty.org Bayfieb Co 6a' i`ler7 Co. Zoning Dr^t.
_____________________________________________________F D0b9aod ZooAwAgzrr
Property Owner(s) are responsible to give this form to the Town Clerk. Attach a copy of your land use application ffront/backl. ;
This is a Class A special use request. Note: The Town's Planning Commission meets prior to the Town. Once the Town meets
they will forward their recommendation to the Planning and Zoning Department. Ask Town if you should be present at their meetings.
------------------------------------------------------------------
I i I
Property 0wner„a `- t�l _ _ G c Contractor _ _________
I Property Address LO1O5 GC1<k Authorized Agent
I Con R. 'cc wt 5 1} -7 33Age((nt' Telephone
Telephone 71 `J (OS2 Si 4&4")-% 1E 2&) 2 33 vritten1uthorizatiorr Attached: Yes ( ) No
I I
I Accurate Legal Description involved in this request (specify only the property involved with this application)
1/4 of 1/4, Section 02.- Township 141 N., Range oW. Town of ron fipt YC4� j
Govt. Lot Lot _ Block _ Subdivision CSM# 190
Volume Page I 33 of Deeds Tax I.D# f ti1- ( Acreage I , Z
I I
I Additional Legal Description:
I I
Applicant: (State what you are asking for) Zoning District: Lakes Classification
'. ir~ iA c t d [._L' -Fc n� r
L-----------
r------------------------------------- --------------------------------------,--------y---------------
We, the Town Board, TOWN OF I nf1 1� do hereb recommend to
❑ Table U Approval ❑ Disapproval
Have you reviewed this for Compatibility with the Comprehensive and/or Land Use Plan: 0 Vas ❑ Nn
Township: (In detail clearly state Town Board's reason for recommendation of tabling, approval or disapproval)
1-k mm Our -&-t In nkt n
•• THE FOLLOWING MUST BE INCLUDED WITH THIS FORM:
1. The Tabled, Approval or Disapproval box checked
2. The Town's reasoning for the tabling, approval or disapproval
3. The form returned to Zoning Department not a copy or fax
Receiving Town Board approval, does not allow the start
of construction or business, you must first obtain your
permit card(s) from the Planning and Zoning Department.
uiformsnownboardrewmmendation-ClassA
Land Use Permit Application Review Checklist
•Submission#: ST(Z-oo3 a
Tax ID: I'6gd-I
S -T -R: - L{7....
Town: j'o n r. j ved
What zoning district is the project located in?
R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M
❑ Yes No
Does lot meet the wino dam__ =i row irementc or is it substandard?
Deed of record:
Yes O 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 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 #: Zb' Z -7(j Public System:
# of bedrooms:)
❑ Yes %No Does the project require an affidavit? O LLC O Trust
Affidavit #:
Number of Units: I _
Number of Bedrooms:
Number of Bathrooms: Z
Number of Stories: 2
❑ After -the -Fact (ATF)
ATF Fee Amount:
Inspected by: ;D '
lyv l
Date of Inspection: _ 2°1 _ 2(
Inspection Notes:
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: \\__'' �(
��l \�Y�I ��\� N�
Date of Approval: I -� !"
� �2-�ZtO �-I— 'J(U
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.
❑ Additional conditions may be placed and need to be adhered to at the time of permit issuance.
Other Conditions:
IYFIELD 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:
CUNNINGHAM, THOMAS C & PAULA A
112119TH AVE W
ASHLAND, WI 54806
Description
1 unit
Submission Number:
STR-00352
Transaction Number:
STR-00352-49366
Amount
$500.00
Total: $500.00
Payment Amount: $500.00
Reference: 2337
Paid by: Thomas & Paula Cunningham
Payment Type: Check
Transaction Date: 7/6/2026
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
LAND USE —X
SANITARY — 282763
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
No. 26-0310 Tax ID: 18921
Issued To: CUNNINGHAM, THOMAS C & PAULA A
Location: S02 - T47N - R08W
Town of IRON RIVER
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: LOT 3 OF CSM #940 V.6 P.163 (LOCATED IN GOVT LOT 6)
Residential Structure in R-1 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 6 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. July 02, 2026
This permit may be void or revoked if any performance conditions are not Date
completed or if any prohibitory conditions are violated.