HomeMy WebLinkAbout26-0335Return to: County Use Only:
117 E 5'° Street, PO Box 58 Bayfleld County Planning and Zoning Department Submission #;: LU "O??tQ
Washburn, WI 54891 LAND USE PERMIT APPLICATION Permit #: ab- 033
permits Pbavfieldcountv.wi.gov Date: "71 fi rryad
SECTION A: General Information
Property Owner Name:
Robert Blaszkowski
Authorized Agent Name (if applicable):
Telephone Number:
Telephone Number:
651-373-5116
E -Mail Address:
E -Mail Address:
BobBlasz@proton.me
Mailing Address:
Mailing Address:
15344 64th PIN
City, State, Zip:
City, State, Zip:
RECEIVED
Maple Grove, Mn 55311
Contractor:
Telephone Number:
E-Mpil Add,(ess:
UN 620rS
SECTION B: Property Information
Project Address (if different flrom mailing address): „I,_:_..,.,,.,
9535 South Buskey Bay Drive
Legal Description (if additional space is needed attach a separate sheet):
Replace Front Deck
Section, Township, Range: 28 47 8
Town of: Iron River
Tax ID #: 20601
Lot Size (Acres/Square Feet):
$TIQ1 C: Project;lnformation chee =aM that apply)
Project Use is: El Residential ❑ Commercial ❑ Municipal
Project Type is: ❑ New Construction ddition/Alteration (existing structure)
O Change Use (existing structure) ❑ Relocate (existing structure) O RV Placement 21+ days
❑ Sign ❑ Establishing a Business ❑ Temporary (12 or less months)
❑ Shoreland Grading, Class A O RV Placement 4+ months, Class A El Other (describe):
required (Total sft): required
SECTION D. Structure Information Does nq.�ply to RVs and Sigfls, go to Section B)
Structure Type is: esidence ❑ Principal Structure (describe):
❑ Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): O Mobile Home (provide manufactured
date):
❑ Shipping Container O Other (describe):
Foundation Type:
❑ Basement 21 Walkout Basement O Slab ❑ Crawlspace ❑ Ground ❑ Skids El Other (explain):
Existing Structure: Length: I Width: i4HI Height:
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade
decks/porches):
Basement Sq Ft: 1" Floor Sq Ft: Loft Sq Ft: 2MFloor Sq Ft: 3`° Floor Sq Ft:
1 -
Garage Sq Ft Porch Sq Ft: Depkpq Ft:, Otherjq Ft (describe): Other S9 Ft (describe):
Total Sq Ft: IUve.nil heignt (nntsnea gim,e to peak):
# of Stories:
Existing # of Bedrooms on property: IMoposed#of8edmoms in project
SECTION E: RV and Sin Information (check all that a l
Sign is:
RV is:
❑ New ❑ Replacement
❑ New O Replacement
❑ On -premise O Off -premise
❑ 1 -sided O 2 -sided
Year: Vin #:
❑ On -building ❑ Multi -Tenant
Length: Width: Height:
Make: Model:
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:
O Driveways ❑ Frontage Roads (include name) ❑ Existing Structures ❑
Well (W) ❑ Septic Tank (ST) ❑ Drain Field (DF)
❑ Holding Tank (HT) ❑ Privy (P) ❑
Lake ❑ River ❑Stream/Creek ❑Pond []Floodplain [I Wetlands ❑Slopes over 20%
N
JUN 26 2026
BaYfi ,Ri Co.
Planning end
Setback or distance from furthest extent of structure
County Use Only
including eaves and overhangs to (include on site plan):
Verified setbacks
Road Centerline
JL)j4
(o6.t ft.
Notes/Comments: rr (� (
l ('2 4t a 1 1 r�' 1
( f ( } Si(�l{ a d� Vtn
CPu J
a t out? )L,( o &a ( >
Front Lot Line/Right-ot-Way
in i - ft.
d0 ft.
Side Lot e I
(Nodhouth West, circle one)
g ft.
D -�
ti.
Side Lc inc 2
e
(North East South circle one)
ft.
J d
ft.
Rear Lot Line
ft.
ft.
%/.O t v'C t f\
Septic/Holding Tank
C ft.
ft.
Drainfield
ft.
Privy
ft.
at
Well
ft.Existing
Structure/Building
ft.
(;urrt^;-t><fJG°Y�St°^
{ ek[ShP reAA4zXpavtSlu
Wetland
ft.
ft.
Elevation of Floodplain
ft.
ft.
I
Ordinary High -Water Mark (OHWM)
g ft.
ft
t s
Other (describe)
ft.
ft.
SECTION G: Additional Questions
Yes
❑ No
Has the location of the proposed project including eaves and overhangs and the sanitary system and well been
staked? If no, what date will this be completed:
Yes
❑ No
Did a licensed surveyor mark lot line(s) if project is within 10 feet of required setback? See page 2 of Land Use
Application Information for required setbacks.
❑ 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
❑ No
Is there an existing sanitary system on the property? If yes, what kind?
2I Drainfield El Holding Tank ❑ Municipal/Public 0 Other (describe):
❑ Yes
[> 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 0 Holding Tank ❑ Municipal/Public ❑ Other (describe):
JN Yes
❑ No
Will sleeping occur in the structure? If yes, contact local Uniform Dwe1ltn>r E®de.GL1I)C1for approval and
�+C �7 VV �t Ltii
inspection requirements.
Is the project associated with any of the following:
N 2 6 2026
O Rezone ❑ Class A Special Use O Class B Special Use O Conditional Use O Variai4II''
Fee payment will be made via: tia id Co.
Iffi Check (attached) ❑ Cash (attached) ❑ debit/credit/echeck (department to call onc&(jl8jmenvBrsmady4, taken)
How would you like to receive your permit card?
❑ Mail to: OR PO Email to:
O Property Owner Address ❑ Agent Address El Contractor Address ❑ Other (provide Name and Email or Address):
H:.Acknowled ement:and$' _. tore
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.gov/topic/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 coun ordinances to have
access to the above -described property at any reasons q�for th p o inspecti
/
Q(JP 1✓
Owner(s) or Authorized Agent Printed Name:
Z�
Owner(s) or Authorized Agent Signature: Date:
NOTES:
I. if you are signing on behalf of the owner(s) a letter of 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 prior to start of project.
5
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Bayfield County
Impervious Surface Calculations
These calculations are REQUIRED per WI Admin Code NR 115.05(1)(e) and Section 13-1-32(c) and 13-1-40(h) of the
Bayfield County Code of Ordinances. The undersigned hereby makes application for construction, reconstruction,
expansion, replacement or relocation of any impervious surface within 300 feet of the ordinary high-water mark and
agrees that all activities shall be in accordance with the requirements of the Bayfield County Code of Ordinances and all
other applicable ordinances and the laws of the State of Wisconsin. The calculations are also REQUIRED in the case of a
land division where the lot to be created or reconfigured will be reduced in lot area.
Pursuant to Chapter 1, Title 13, Section 13-1-106(d) of the Bayfield County Zoning Ordinance(s),. Planning and Zoning
Department employees assigned to inspect properties shall have access to said properties to make inspections;
Property Owner(s):
Bob & Peggy Blaszkowski
JUN 25 ?O?5
Mailing Address:
Property Address:
15344 64th PI N Maple Grove Mn 55311
9535 South Buskey Bay Drive Iron River Wi 54847
Legal Description:
Section, Township, Range
1/4, 1/4,
Sec 28 Township 47 N, Range 8 w
Authorized Agent/Contractor
Gov't Lot
Lot #
CSM#
Vol & Page
Bob Blaszkowski
Lot(s) #
Block(s) #
Subdivision
Town of:
Pike Lake Park
Iron River
Parcel ID # (PIN #)
04120(o,01
Tax ID #
Date:
z�
Impervious Surface: An area that releases as runoff all or a majority of the precipitation that falls on it. "Impervious
surface" excludes frozen soil but includes rooftops, sidewalks, driveways, parking lots and streets unless specifically
designed, constructed and maintained to be pervious. Impervious surface standards shall apply to the construction,
reconstruction, expansion, replacement or relocation of any impervious surface that is or will be located within 300 feet of
the ordinary high water mark of any navigable waterway on any riparian lot or parcel and any nonriparian lot or parcel that
is located entirely within 300 feet of the ordinary high-water mark of any navigable waterway.
Calculation of Impervious Surface: Percentage of impervious surface shall be calculated by dividing the surface area
of the existing and proposed impervious surfaces on the lot or parcel by the total surface area of that lot or parcel and
multiplying by 100. If an outlot lies between the ordinary high-water mark and the developable lot or parcel described in
subd. 1. and both are in common ownership, the lot or parcel and the outlot shall be considered one lot or parcel for the
purposes of calculating the percentage of impervious surfaces.
Impervious Surface Standard: Allow up to 15% impervious surface but not more than 30% impervious surface on the
portion of a lot or parcel that is within 300 feet of the ordinary high-water mark. A permit can be issued for development or
land division approved that exceeds 15% impervious surface but not more than 30% impervious surfaces with a mitigation
plan that meets the requirements of the Bayfield County Ordinance(s).
Existing Impervious Surfaces: For existing impervious surfaces that were lawfully placed when constructed but that do
not comply with the standards in Section(s) 13-1-32(c) and Section 13-1-40(h), the property owner may do any of the
following:
a. Maintenance and repair all impervious surfaces:
b. Replace existing impervious surfaces with similar surfaces within the existing building footprint;
c. Relocate or modify existing impervious surfaces with similar or different impervious surfaces, provided that the
relocation or modification does not result in an increase in the percentage that existed on the effective date of the
county shoreland ordinance and meets the applicable setback requirements in Section 13-1-22.
Impervious Surface Item Dimension Area (Square Footage)
Existing House 1 .! e�'1
f8' 3' x Zo' 3 = 3'7D
5 — z3
5jB31utp3 —
lull' tz'
Existing Accessory
Building/Garage
6xr49 '}$ 3$ILc9b
114
Existing Sidewalk(s), Patio(s) &
Deck(s)
tl
$ (p X I
i
Existing Covered Porch(es),
Driveway & Other Structures
3(OK —3cv (ak —6�r
3S1 Q
Proposed Addition/House
Proposed Accessory
Building/Garage
Proposed Sidewalk(s) & Patio(s)
IN
Proposed Covered Porches) &
I_______________________________
Deck(s)
Proposed Driveway
_______________________________
Proposed �Ok $'
q co 5 —
5"33
/ -_19,S
s13 9 — to
18%
Total:
( t�
a. Total square footage of lot:
136,0>f,b
FI
b. Total impervious surface area: `('A L Seca -1
c. Percentage of impervious surface area: 100 x (b)/a = 13 , 5 z /�
If the proposed impervious surface area is greater than 15% mitigation is required.
Total square footage of additional impervious surface allowed: @ 15% @ 30%
Issuance Information (County Use Only)
Date of Inspection:/,� ro��
Inspection Record:
Condition(s):
Stormwater
Management Plan Required:
Yes :No
Signature of Inspector:
Date of Appr val:
iG urn
X1/I3/ o'
u/forms/impemioussurface
Created: May 2012 (@Apr 2016. Sept 2020)
Proofed by.
1TEMEHT AND FEe TO:
Bayfield County
Planning and Zoning Depart.
PO Box 58
Washburn, WI 54891
(715) 373-6138
APPLICATION FOR PERMIT
BAYFIELD COUNTY, WISCONSIN
$ra. I4 j}
0999---
JUN 08 LULU
INSTRUCTIONS: No permits will be issued until all fees are paid. Eayfeld Ca,
Checks are made payable to: Bayfield County Zoning Department.
DO NOT START CONSTRUCTION UNTIL ALL PERMITS HAVE BEEN ISSUED TO APPLICANT.
Permit R:
Date:
7-1_&IJ
Amount Paid:
W!ate iL"' / _�
(,Q
Refund:
Original Application MUST be submitted FILL OUT IN INK (NO PENCIL)
OR
TYPE OF PERMIT REQUESTED—* I ctAND USE ❑ SANITARY C PRIVY = CONDITIONAL USE iIi SPECIAL USE . B.O.A. U OTHER
Owner's Name:
Mailing A ress:
)1O3 s&
rei
it /State Zimn� 5$�
Telephone:
t t til
Address of Properly:
City/State/Zip:
9 5 0
t V rl
'{
Cell Phone:
Contractor:
Contractor Phone:
Plumber:
Plumber Phone:
Authorized Agent: (Person Signing Application an behalf of Ownegs))
Agent Phone:
Agent Mailing Address (IriNYsOi.LGi - $
Written
Authorization
JUN 267876
Attached
Yes No
PROJECT
I
Tax IDa
Recorded Document: (Showing Ownership)
LOCATION
LegalDescrfption: (Use Tax Statement)
OrQ Plannin, Bath
-Li4 r2 7Ls/C,rt%
I
Gov't Lot I
I Lol(s) I
CSM
I Vol & Page
CSM Doc a
I I
lol(s) a
I Block a
Subdivision:
1/4, 1/4
Section �Z ,Township � N, Range S< W
I Town f: - `
Lot Size
Acreage c'
`
XShoreland
Is Property/Land within 300 feet of River, Stream (Ind. Intermittent)
Creek or Landward side of Floodplain? If yes —continue —s.
Distance Structure is from Shoreline :
I feet
Is your Property
in Floodplaln
zone'?
Yes
Are Wetlands
Ipresent?
Yes
�No
s Property/Land within 1000 feet of Lake, Pond or Flowage
If yes --continue --►
Distance Structure is from Shoreline :
feeto
Non-Shoreland
Value at Time
Total 0 of
What Type of
Type of
of Completion
'include
Project
Project
bedrooms
Sewer/Sanitary System(s)
Water
donated time
Project
U of Stories
Foundation
on
is on the property or
on
& material
property
Will be on the property?
property
ew Construction
-s<- 1 -Story
Basement
1
Municipal/City
City
Addition/Alteration
-St ry+
1 -Story
Foundation
-,� 2
(New) Sanitary Specify Type:
ell
S m
SOL.
Conversion
2 -Story
Slab
3
.X Sanitafy(Exists) Specify Type:
Relocate (existing bldg)
X ? o5a- S
Privy (Pit) or Vaulted (min 200 gallon)
Run a Business on
Use
None
Portable (w/service contract)
Property
Year Round
Compost Toilet
None
Existing Structure: (if addition alteration or business is being applied for) I Length: Width: Height:
Proposed Construction: (overall dimensions) I Length: 23- Width: ra Height:
Proposed Use
✓
Proposed Structure
DimensionsSquare
Footage
TI
Principal Structure (first structure on property)
( X
-_
Residence (i.e. cabin, hunting shack, etc.)
( X
Residential Use
with Loft
( X
with a Porch
( X
with (2nd) Porch
( X
with a Deck
( X
with (2nd) Deck
( X )
Commercial Use
with Attached Garage
( X
'_
Bunkhouse w/ ( sanitary, or sleeping quarters, or cooking & food prep facilities)
( X
—_
Mobile Home (manufactured date)
( X
Municipal Use
x
Addition/Alteration (explain) r
( ta' X )
II
Accessory Building (explain)
( X
APPLICANT - PLEASE COMPLETE PLOT PLAN ON REVERSE SIDE
in the box below: Draw or Sketch your Property (regardless of what you are applying for) Fill Out in Ink — NO PENCIL
(1) Show Location of: Proposed Construction
(2) Show / Indicate: North (N) on Plot Plan
(3) Show Location of (a): (a) Driveway and (') Frontage Road (Name Frontage Road)
(4) Show: All Existing Structures on your Property
(5) Show: (e) Well (W); (') Septic Tank (Si]; (') Drain Field (DF); (') Holding Tank (HT) and/or (t) Privy (P)
(6) Show any (e): (') Lake; (') River; (') Stream/Creek; or (') Pond
(7) Show any (a): (') Wetlands; or (') Slopes over 20%
L-1
I(tl 16<ty 411
-k
4.
i 8 fE-a4 -
fi µem )
JUN z 6 2026 I It,
Please complete (1) — (7) above (prior to continuing)
Changes in plans must be approved by the Planning & Zoning Dept.
(8) Setbacks: (measured to the closest point)
Description
Setback
Measurements
Description
Setback
Measurements
Setback from the Centerline of Platted Road
Feet
Setback from the Lake (ordinary high-water mark)
Feet
Setback from the Established Right -of -Way
Feet
Setback from the River, Stream, Creek
Feet
Setback from the Bank or Bluff
Feet
Setback from the North Lot Line
Feet
Setback from the South Lot Line
( Feet
Setback from Wetland
Feet
Setback from the West Lot Line
Feet
20% Slope Area on the property
Yes No
Setback from the East Lot Line
9. 3 Feet
Elevation of Floodplain
Feet
Setback to Septic Tank or Holding Tank
4 Feet
Setback to Well
Feet
Setback to Drain Field
a.Feet
Setback to Privy (Portable, Composting)
Feet
Prior to the placercem or ro nsirvctmn of a ttruaure wnh.n ten µo) feet of the rmnmum «eu:red setback, the boundary Lire from which the setback must be measured must be visible from one previoutfy :urxyed corner to We
other previously surveyed comeror marked by a heensed suryeyorvt the owner's topense.
Prior ..the placement or construction of a structure more then ten not feet but test than thirty l a0) feet from the minimum re tuned set back On; boundary one from w hch the setback must be measured must be vrs:ble from
re prevwusly surveyed corner ta the other preciously surveyed come, arvetAvbie by the Department by use of a corecteneompass Irons, bgwn corner wchm 500 feet of the pmpoted :de of the structure, or must be
marked by a licensed surveyor at the owne/s erpenst.
(9) Stake or Mark Proposed Location(s) of New Construction Septic Tank (Si], Drain field (DFI. Holding Tank (HT), Privy P and Well (W ).
NOTICE: All Livid Use Permits L spire One (1) Year front the Date of Issuance if Construction or Use has not begun.
For the Construction Of New One & Two Family Dwelling: ALA Municipalities Are Required To Enforce The Uniform Dwelling Code.
The local Town, Village, City, State or Federal agencies may also require permits.
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 he 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 or contact a department of natural resources service center (715) 685-2900.
Issuance Information (County Use Only)
Sanitary Number:
U of bedrooms:
Sanitary Date:
Permit Denied (Date):
Reason for Denial:
Permit &c
Permit Date: _
Is Parcel a Sub -Standard Lot..
Yes (Deed of Record) No
Mitigation Required
Yes
Affidavit Required
�
Yes No
Is Parcel in Common Ownership
Is Structure Non
Yes (Fused/Contiguous Lot(s)) No
No
Mitigation Attached
yes jMo
Affidavit Attached
/Yes No
-Conforming
,_/i'es J
Granted by Variance (B.O.A.)
Previously Granted by Variance (B.O.A.) 4_
5-21-2020
To whom it may concern,
Marty and Shelley Herman are wishing to make structural changes to the deck on their property
at Buskey Bay Estates in Iron River Wisconsin. The property owners of Buskey Bay Estates
approve of their proposed changes they wish to make,
Best Regards,
Barb Beeksma,
Residing Secretary of Buskey Bay Estates LLC i-CEJVP
,Ilinf I- ,
111111110I110011110101011111I1111111011110111111111110111101111 III 2I OII lilt
* 2 0 1 6 R 5 6 6 4 0 2 7
State Bar of Wisconsin Form 9-2009
DESIGNATION OF TOD BENEFICIARY
Under Wis. Stat. § 705.15
Document Name
Document Number
THIS DESIGNATION is made by Marty Herman and Shelley Hakala-
Hemran husband and wife (collectively, "Owner") of the following described
real estate in Hayfield County. State of Wisconsin (the "Property") (attach
Exhibit A If more space Is needed):
see attached
Owner transfers the Property without probate upon death of the sole owner,
or upon the last to die of multiple owners, to the following TOD beneficiary,
without warranties:
Select A or B:
® A.
Insert name of beneficiary, whether one or more. This revokes
all previous TOD beneficiary designations.
o B. The sole purpose of this instrument is to revoke all previous TOD
beneficiary designations.
This designation is effective only upon the recording of this instrument.
2016R-564027
PATRICIA A OLSON
BAYFIELD COUNTY, WI
REGISTER OF DEEDS
06/20/2016 09:30AM
TI EXEMPT 1: 104
RECORDING FEE: 3D.OO
PAGES: 2
Recording Area
Marty Herman and Shelley Hakala-Herman
2917 Palisade Drive
Duluth, MN 55811
Name and Return Address
024-1154-07 000
Parcel Identification Number (PIN)
This Is not homestead property
(is) (is not)
JUN 2620irq
o.
This transaction is Fee Exempt under Wis. Stat. § 77.25(1om), and exempt from the filing of a transfer retLrn under
Wis. Staf. § 77.21(1). The transfer contemplated by this instrument maybe subject to encumbrances, liens and other
matters created by or affecting Owner, Including claims In Owner's estate.
Dated June 15 2016
AUTHENTICATION
authenticated this _ day of
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not.
authorized by § 706.06. Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY
Andrew & Bransky, P. A.
By: Aaron R. Bransky
302 West Superior Street, Suite 300
Duluth, MN 55802
(Signatures miay be authenticated or acknowledged. Both
are not necessary.)
ACKNOWLEDGMENT
STATE OF MINNESOTA - )
)ss.
COUNTY OF ST. LOUIS ) .
Personally came before me this ? day of
June, 2018 the above -named Marty Herman and Shelley
Hakala-Herman. husband and wife,
to me known to be the person who executed the foregoing
instrum tee and ack wledg the same.
Aaron R Bransky
Notary Public, State of Minnesota
My Commission Is permanent (If rJpt1 state expira�date:
SS .)
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
DESIGNATION OF TOD BENEFICIARY STATE BAR OF WISCONSIN FORM NO.9-2000
• Type name below signatures.
V1162 P155
11111 i00IiiIIiiiiiuiiiii�iii�iiHiiiiiiiiiiiiiiitiiiii�iiit
I�I State Bar of Wisconsin Form 9-2009
DESIGNATION OF TOD BENEFICIARY
Under Wis. Stat. § 705.15
Document Name
Document Number
THIS DESIGNATION Is made by Marty Herman and Shelley Hakala-
Herman, husband and wife (collectively, Owner") of the following described
real estate in Bavfield County, State of Wisconsin (the Property) (attach
Exhibit A If more space is needed):
see attached
Owner transfers the Property without probate upon death of the sole owner.
or upon the last to die of multiple owners, to the following TOD beneficiary,
without warranties:
Select A or B:
0 A.
Insert name of beneficiary, whether one or more,
all previous TOD beneficiary designations.
2016R-564027
PATRICIA A OLSON
BAYFIELD COUNTY. WI
REGISTER OF DEEDS
06/20/2016 09:30AN
TF EXDIPT I: 101
0Eca0Flls FEE: 30.00
PAGES: 2
Recording Area
Marty Herman and Shelley Hakala-Herman
2917 Palisade Drive
Duluth, MN 55811
Name and Return Address
024-1154-07 000
Parcel Identification Number (PIN)
This is not homestead property
(is) (is not)
0 B. The sole purpose of this Instrument Is to revoke all previous TOD
beneficiary designations.
This designation Is effective only upon the recording of this Instrument.
This transaction Is Fee Exempt under Wis. Stat. § 77.25(10m), and exempt from the filtr)p,pf.Q j 'ansfer rettirn under
Wis. Stat § 77.21(1). The transfer contemplated by this instrument maybe subject to en16 IIhb hS lens and other
matters created by or affecting Owner, Including claims in Owner's estate.
Dated June 15. 2016
AUTHENTICATION
Signature(s)
authenticated this — day of
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by 706.08, Wis. State.)
THIS INSTRUMENT WAS DRAFTED BY
Andrew & Bransky, P. A.
By: Aaron R. Bransky
302 West Superior Street, Suite 300
Duluth, MN 55802
(Signatures mhy be authenticated or acknowledged. Both
are not necessary.)
ACKNOWLEDGMENT
STATE OF MINNESOTA
)ss.
COUNTY OF ST. LOUIS ) .
Personally came before me this 1 day of
June. 2018. the above -named Marty Herman and Shelley
Hakala-Herman. husband and wife.
tome known to be the person who executed the foregoing
Instrum tqq and ack edg the same.
Aaron R. Bransky
Notary Public, State of Minnesota
My Commission Is permane t (If t state exp(reti ate:
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
DESIGNATION OF TOD BENEFICIARY STATE BAR OF WISCONSIN FORM NO.9-2009
'Type name below signatures.
V 1162 P155
That part of the Lot Fifteen (15), Block Two (2), Pike Lake Park, being a subdivision of Lot Eight (8),
Section. Twenty-eight (28), Township Forty-seven (47) North, Range Eight (8) West, Town of Iron
River, Bayfield County.Wisconsin, described as follows:
Commencing at the Northeasterly corner of said Lot 15, thence Southeasterly along the easterly
boundary line of said Lot:a distance of 270 feet to the point of beginning; thence Southeasterly along
the Easterly boundary line of said Lot a distance of 63 feet to a point; thence Southwesterly on a line
parallel with -the Northerly boundary line of said Lot; •54 feet to a point; thence Northwesterly a
distance of 63 feeton a line parallel to the Easterly boundary of said Lot to a point; thence
Northeasterly on"a line.parallel.to;the Northerly boundary line of said Lot, 54 feet to the point of
beginning. (Also known as Cabin No: 5)
Together with an undivided 1/6 interest as a tenant in common with others of Lots 17 and those
portions of Lots 15 and 16, which are not separately parceled out for the four other cabins as Cabin
Lots, referred to as the "Common Properties".
V 1162 P156 ' JUN 21,
III11111111II 11 II I IIIII IIIIIII 110 II11 ilifi Ith I I I 11IiiII
*2020R-583000 2*
Document Number AFFIDAVIT
This agreement is made between the 2020R-583000
Government Unit and Real Property Owner(s) DENISE TARASEWICZ
Government Unit Date: BAYFIELD COUNTY, WI
Bayfield County Planning and Zoning June 30, 2020 REGISTER OF DEEDS
Tax ID # Property Owner(s) 07/06/2020 02:30PM
Buskey Bay Estates LLC TF EXEMPT #:
20601 RECORDING FEE: 30.00
Martin Herman, A ent
We, the Real Property Owner(s) acknowledge that this document applies to the following PAGES: 2
property (attach separate sheet if necessary)
See Attached Deed ........_._.__.--.-.___._------........._...._....._._...
Return to
Bayfield County Zoning
Based upon the Property Owners' decision and the Bayfield County Zoning Ordinance, the
Planning and Zoning Department is authorizing a deck (12' x 32.4') to a residence which is
deemed non -conforming located at 9535 S Buskey Bay Dr, also know as cabin 5.
o The structure's footprint was 1 540 sq. ft. at the time of the structure became non-
conforming.
o A lifetime total of 770 sq. ft. of expansion is allowed.
o A 80 sq. ft. expansion is requested at this time.
o A total of 690 sq. ft. remains for any future expansion(s).
[Any future structural alterations shall require a land use permit]
Article C, of Title 13, Chapter 1, Section 13-140 (d) (2) of Bayfield County Zoning Code -
Improvement or Expansion of Non-Shoreland Nonconforming Structures. Non-shoreland
nonconforming structures may be improved internally, externally, or expanded provided that:
(d) Non-Shoreland Nonconforming Structures. JUN 2 b jU/A
6z;:.
(2) Improvement or Expansion of Non-Shoreland Nonconforming Structures. Non-
shoreland nonconforming structures may be improved internally, externally, or
expanded provided that:
a. A structure that is nonconforming as to structural or dimensional
standards may not be expanded or enlarged so as to increase its
dimensional nonconformity.
b. Where practicable, additions to non-shoreland nonconforming structures
shall conform to all applicable provisions of this Chapter.
c. The lifetime total of all expansions shall not exceed fifty percent
(50%) of the structure's footprint that existed at the time the
structure became nonconforming; an owner shall provide
documentation of the footprint of a structure at the time it became
nonconforming, and any expansion shall be documented by recorded
affidavit.
C. By signing this affidavit the owner(s) hereby agree that said permit inures to the benefit of, and
said terms and conditions are binding upon, the owner(s) and all successors and assigns of
the owner(s) interest in the property. This affidavit is made for the purpose of making the
foregoing a matter of public record in the office of the Bayfield County Register of Deeds. Any
violations) of the above provisions will result In enforcement actions.
This affidavit is made for the purpose of making the foregoing a matter of public record in the office of the Bayfield County Register of Deeds. Any
violation(s) of the attached provisions will result in enforcement actions.Each undersigned owner(s) of the above -described property agrees that a
condition of being issued a land use permit for the construction of such a land use thereon, the owner shall cause all the attached requirements to be
met.
That part of the Lot Fifteen (15), Block Two (2), Pike Lake Park, being a subdivision of Lot Eight (8),
sectionTw'enty-eight (28), Township Forty-seven (47) North, Range Eight (8) West, Town of Iron
River, Bayfield County. Wisconsin, described as follows:
Commencing at the Northeasterly corner of said Lot 15, thence Southeasterly along the easterly
boundary line of said Lot:a distance of 270 feet to the point of beginning; thence Southeasterly along
the Easterly boundary line of said Lot a distance of 63 feet to a point; thence Southwesterly on a line
parallel with•the Northerly boundary line of said Lot; 54 feet to a point; thence Northwesterly a
distance of 63 feet on a fine parallel to the Easterly boundary of said Lot to a point; thence
Northeasterly'on line:parallel tothe Northerly boundary line of said Lot, 54 feet to the point of
beginning. (Also known as Cabin No: 5)
Together with an undivided 1/6 interest as a tenant in common with others of Lots 17 and those
portions of Lots 15 and 16, which are not separately parceled out for the four other cabins as Cabin
Lots, referred to as the "Common Properties".
V 1//i'j746 P 6. LL wEG
Page 1 of I
Real Estate Bayfield County Property Listing
Today's Date: 5/26/2020
Description
Updated: 8/16/2017
Tax ID: 20601
PIN: 04-024-2-47-08-28-1 00-250-21000
Legacy PIN: 024115407000
Map ID:
Municipality:
(024) TOWN OF IRON RIVER
SIR:
528 T47N R08W
Description:
PIKE LAKE PARK LOTS 15-17 BLOCK 2
IN V.935 P.19 1215
Recorded Acres:
1.630
Calculated Acres:
1.639
Lottery Claims:
0
First Dollar:
Yes
Zoning:
(R-1) Residential -1
I Tax Districts Updated: 3/15/2006
1 STATE
04
COUNTY
024
TOWN OF IRON RIVER
163297
SCHL-MAPLE
001700
TECHNICAL COLLEGE
�T Recorded Documents Updated: 3/15/2006
® TRANSFER ON DEATH
Date Recorded: 6/20/2016 2016R-564027 1162-155
I CONVERSION
Date Recorded: 50401 800.1010;935-19
Property Status: Current
Created On: 3/15/2006 1:15:36 PM
a Ownership Updated: 7/7/2008
BUSKEY BAY ESTATES LLC SEFFNER FL
Billing Address:
Mailing Address:
BUSKEY BAY ESTATES LLC
BUSKEY BAY ESTATES LLC
ATTN: DANIEL L BURGESS
ATTN: DANIEL L BURGESS
2104 FAIRWAY VIEW CT
2104 FAIRWAY VIEW CT
WENTZVILLE MO 63385
WENTZVILLE MO 63385
F Site Address • Indicates Private Road
9505 S BUSKEY BAY DR
IRON RIVER 54847
9515 S BUSKEY BAY DR
IRON RIVER 54847
9525 S BUSKEY BAY DR
IRON RIVER 54847
9535 S BUSKEY BAY DR
IRON RIVER 54847
9545 $ BUSKEY BAY DR
IRON RIVER 54847
® Property Assessment
Updated: 8/2/2012
2020 Assessment Detail
Code
Acres Land Imp,
G1 -RESIDENTIAL
1.630 208,900 5,000
2 -Year Comparison
2019
2020
Change
Land:
208,900
208,900
0.0%
Improved:
5,000
5,000
0.0%
Total:
213,900
213,900
0.0%
If Property History
https://novus.bayfieldcounty.org/access/REAL%20ESTATE/listing.asp?tid=632890&pid=20601 &tyr=2019 5/26/2020
Town, City, Village, State or Federal
Permits May Also Be Required
LAND USE -X
X
SANITARY -
SIGN -
SPECIAL -
CONDITIONAL -
BOA —
No. 20-0160 Issued To: Bus
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTUCTION
Estates LLC I Martin Herman
Location: -
1/4 of - 1/4
Section 28
Township 47
N. Range 8 W.
Town of Iron River
Gov't Lot
Lot 15-17
Block
2 Subdivision
Park Lake Park
CSM#
For: Residential Addition I Alteration: [I -Story; Deck (12' x 32.4') = 387.96 sq. ft.]
(Disclaimer): Any future expansions or development would require additional permitting.
Condition(s): A UDC permit from the locally contracted UDC inspection agency must be obtained prior to
the start of construction If required. Deck must be at least 5 feet from septic tank. Deck cannot
extend closer to East property than current deck.
You are responsible for complyp,g 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 tKe1 violates the law or other penalties or costs. For more information, visit the department of natural resources wetlands identification web cape or contact a department of natural resources service center 171516BS.2900.
Carr
NOTE: This permit expis one year from date of issuance if the authorized construction work or
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.
Todd Norwood
Authorized Issuing Official
July 13, 2020
Date
RECEIVED
Letler of Aulhorizalion JUL 0 2 2026
Bnrfteld County Planning &. Zoning Department
BaYfield Co.
Planning and Zoning Agency
PURPOSE. This Letter of Authorization is used to authorize a single property owner to act on
hehalfof multiple property owners or a designated agent to act on behalf of the property owner/s.
Ifmultiple property owners, each property owner must submit this signed letter.
�us SAY-'-S/AT goy 5Mszsw5l
1 1' �j�FX�Y ef5i t ( roperty owner) a th riz
(authorized agent) to submit a a U$e /'M.f r n(Example: land use, special
use, conditional use, rezone/map amendment, appeal, v ance, text amendment, etc.) for the
following described project (Example: con vcti n of residence or other structure, short-term
rental or other use change, etc.) apph gn my,behalf for
the following described property: X535 5 D j LC e/[/ /t(
pi,/XLA PAS �� 935 �' 9
Legal description of subject property: GO7S /6—I �� y
of suble tpropeM / /
IS7
Sign atur
Dated
AFFIDAVIT OF AUTHORITY
(Corporation, LLC, etc.)
PURPOSE. This Affidavit of Authority is used to certify the indlvidtRECit;VEOplicetion is
authorized when the property is owned by a corporatefbusiness entity.
STATE OF WISCONSIN I JUL
)as.
BAYFIELD COUNTY
022026
Bayfield Co.
planning and Zoning Agency
The undersigned affirms and states as follows:
1. Address of Subject Property:
2. The Subject Property is owned
(Name o Compan )
3. The name(s) of the current President or Managin
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 t hate the
authority under the terms of said authorization to submit an application to the Bayheld County
Zoning Department concerning the Property described in paragraph 1. 1 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 decision or permit 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:,)
P int Nam
Subscribed and sworn to before me this
day of t,.,,- , 20&.
Notary Pub Ic, �� )�'�� County, Wisconsin
My commission: r -ate 9
MICHAEL K. SCHNEEBERC,ER
NOTARY PUBLIC
STATE OF WISCONSIN
MAP OF SURVEY
LOTS 15, 16 8► 17, BLK. 2, PIKE LAKE PARK SUBD.,
IN GOVT. LOT 8, SEC. 28, T. 47 N.R. 8 W.
BAYFLELD COUNTY, WIS. ;(
LEGEND
O IRON PIPE SET THIS SURVEY
I po� • IRON PIPE FOUND IN PTH
Qom• O TACK IN WOOD STAKE -THIS SURVEY
BEARINGS —FROM PLAT
A I' SCALE: ONE INCH c 30 FEET
j `90p0 i DRAWN BY: FRANK STRYCHARSKE
1973 • �' , �►. s8E � DO
e �Wr 3�i9q g" \ \ i 2
Pi
N .s \ u+ SURVEY BY
\rsto p' \ Ng THOMAS W. NELSON
WIS. REG. NO. S-263
ar \ \ ASHLAND
1?E�DNG45PA) \
SEA 44� SVlt-
THrs a �w AunHDaa;E� vRIarr aNur
-►. Mct- �£55\1` ai ` fir{ ' o$•ti `�v W SEAL es UM IN 90
\� �� v 6 o' \ 's� PRINT ISSUED_____________
N \\
\±'1
..ro
11
717/26, 8:55 AM
Novus-Wisconsin Access rev. 12.0206
Real Estate Bayfleld County Property Listing
Today's Date: 7/7/2026
fJ Description
Updated: 11/2/2021
Tax ID:
20601
PIN:
04-024-2.47.08-28-1 00-250-21000
Legacy PIN:
024115407000
Map ID:
Municipality:
(024) TOWN OF IRON RIVER
STR:
528 T47N R08W
Description:
PIKE LAKE PARK LOTS 15-17 BLOCK 2
IN V.935 P.19 1215
Recorded Acres:
1.630
Calculated Acres:
1.639
Lottery Claims:
0
First Dollar:
Yes
Zoning:
(R-1) Residential -1
ESN:
118
Tax Districts Updated: 3/15/2006
1 STATE
04 COUNTY
024 TOWN OF IRON RIVER
163297 SCHL-MAPLE
001700 TECHNICAL COLLEGE
-� Recorded Documents
Updated: 3/15/2006
O CORRECTION INSTRUMENT
Date Recorded: 10/18/2024
2024R-605140
O ASSIGNMENT OF LEASE INTEREST
Date Recorded: 9/25/2024
2024R-604849
O ASSIGNMENT OF LEASE INTEREST
Date Recorded: 11/8/2021
2021 R-591912
O TRANSFER ON DEATH
Date Recorded: 6/20/2016
2016R-564027 1162-155
O CONVERSION
Date Recorded:
504015 800-1010;935-19
O WARRANTY DEED
Date Recorded: 10/19/2000
460415
O SATISFACTION
Date Recorded: 8/12/1974
296310 V. 271 P. 187-196
Property Status: Current
Created On: 3/15/2006 1:15:36 PM
a Ownership Updated: 11/2/2021
BUSKEY BAY ESTATES LLC SUPERIOR WI
Billing Address:
Mailing Address:
BUSKEY BAY ESTATES LLC
BUSKEY BAY ESTATES LLC
ATTN: SCOTT MYERS
ATTN: SCOTT MYERS
6720 JOHN AVE
6720 JOHN AVE
SUPERIOR WI 54880
SUPERIOR WI 54880
r Site Address * indicates Private Road
9505 S BUSKEY BAY DR
IRON RIVER 54847
9515 S BUSKEY BAY DR
IRON RIVER 54847
9525 S BUSKEY BAY DR
IRON RIVER 54847
9535 5 BUSKEY BAY DR
IRON RIVER 54847
9545 S BUSKEY BAY DR
IRON RIVER 54847
11 Property Assessment
Updated: 9/10/2025
2026 Assessment Detail
Code
Acres Land Imp.
GI -RESIDENTIAL
1.630 262,600 849,200
2 -Year Comparison
2025 2026 Change
Land:
262,600 262,600 0.0%
Improved:
849,200 849,200 0.0%
Total:
1,111,800 1,111,800 0.0%
tom' Property History
N/A
https://novus.bayfieldcounty.wi.gov/access/master.asp?paprpid=20601 1/1
Bayfield County, WI
71712026, 8:52:50 AM 1:258
0 0 0.01 0.01 ml
vL;�"'Wetlands Approximate Parcel Boundary , , ter, , I I
Rivers
Building Footprint 2015
Lakes
• Building
0.01 0.01 0.02 km
Bayfetl County Land Rewrds Deparhnenl
Bayteb County Zanirg Appluadon
Mis'//mapahayleldmunty wrgaaZomn0 WADI
Bayfield County, WI
7/7/2026.8:52:11 AM 1:516
:i' Wetlands Approximate Parcel Boundary
Rivers Road Type
- - -' Lakes Town
Building Footprint 2015
a Building
0 0.01 0.01 0.02 mi
0 0.01 0.02 0.04 km
Bayfieu County lam Records Oeparhnent
SayMW Canty ZoNrg App tIcn
nts:t;mapaayWmunr). qov/ZonLgWAW
Document Number AFFIDAVIT
This agreement Is made between the 2020R-583000
Government Unit and Real Propetty Owners DENISE TARASEWICZ
Government Unit Date: BAYFIELD COUNTY, WI
Bayfleld County Planning and zoning June 30.2020 REGISTER OF DEEDS
Tax ID # Property Owner(s) 07/06/2020 0230PH
Buskey Bay Estates LLC IF E%EHPT e:
206011Martin Herman Agent RECORDING FEE: 30.00
We, the Real Property Owner(s) acknowledge that this document applies to the following PAGES: 2
property (attach separate sheet if necessary)
See Attached Deed ..._...-_...._._..-...-._........._._...-
Return to
Bellied County Zoning
? Based upon the Property Owners' decision and the Bayfteld County Zoning Ordinance, the
Planning and Zoning Department is authorizing a deck (12' x 32.4') to a residence which is
deemed non -conforming located at 9535 S Buskey Bay Dr, also know as cabin 5.
o The structure's footprint was 1 540 sq. ft. at the time of the structure became non -
jconforming.
o A lifetime total of 770 sq. ft. of expansion is allowed. Q
o A sq. ft expansion is requested at this time.
o A total of 690 sq. ft. remains for any future expansion(s).
[Any future structural alterations shall require a land use permit]
c'. Article C, of Title 13, Chapter 1, Section 13-140 (d) (2) of Bayfeld County Zoning Code -
Improvement or Expansion of Non-Shoreland Nonconforming Structures. Non-shoreland
nonconforming structures may be improved internally, externally, or expanded provided that
(d) Non-Shoreland Nonconforming Structures.
(2) Improvement or Expansion of Non-Shoreland Nonconforming Structures. Non-
shoreland nonconforming structures may be improved internally, externally, or
expanded provided that:
a. A structure that is nonconforming as to structural or dimensional
standards may not be expanded or enlarged so as to increase its
dimensional nonconformity.
b. Where practicable, additions to non-shoreland nonconforming structures
shall conform to all applicable provisions of this Chapter.
C. The lifetime total of all expansions shall not exceed fifty percent
(50%) of the structure's footprint that existed at the time the
structure became nonconforming; an owner shall provide
documentation of the footprint of a structure at the time it became
nonconforming, and any expansion shall be documented by recorded
affidavit.
O By signing this affidavit the owner(s) hereby agree that said permit inures to the benefit of, and
said terms and conditions are binding upon, the owner(s) and all successors and assigns of
the owner(s) Interest in the property. This affidavit is made for the purpose of making the
foregoing a matter of public record in the office of the Bayfield County Register of Deeds. Any
violation(s) of the above provisions will result in enforcement actions.
This affidavit is made for the purpose of making the foregoing a matter of public record In the office of the Bayfield County Register of Deeds. Any
violation(s) of the attached provisions will result in enforcement actians.Each undersigned owner(s) of the above -described property agrees that a
condition of being issued a land use permit for the construction of such a land use thereon, the owner shall cause all the attached requirements to be
met.
Printed Name(s) of Owner(s): State *00n.7uly
Acknowledgment
&
- q.� 1 Personalty came before me on
[11�iL�J the alongside -named Npr IN . trunnln
sign r)f(eA .i. / u, -to me known to be the person(s) who executed the foregoing
Onmts_day o/ 6 NotaryPublic
�2 G � ___
2 .n'•. US MycgprdLssion expires on:
r'� 4') -c -J by :
p-
That part of the Lot Fifteen (15), Block Two (2), Pike Lake Park, being a subdivision of Lot Eight (8),
Section Twenty-eight (28), Township Forty-seven (47) North, Range Eight (8) West, Town of Iron
River, Bayfield County. Wisconsin, described as follows:
Commencing at the Northeasterly corner of said Lot 15, thence Southeasterly along the easterly
boundary line of said Lot:a distance of 270 feet to the point of beginning; thence Southeasterly along
the Easterly boundary line of said Lot a distance of 63 feet to a point; thence Southwesterly on a line
parallel with the Northerly boundary line of said Lot; 54 feet to a point; thence Northwesterly a
distance of 63 feet -on a line parallel to the Easterly boundary of said Lot to a point; thence
Northeasterlyon=a line.parallel1o;the Northerly boundary line of said Lot, 54 feet to the point of
beginning. (Also known as Cabin No. 5) 1
Together with an undivided 1/6 interest as a tenant in common with others of Lots 17 and those
portions of Lots 15 and 16, which are not separately parceled out for the four other cabins as Cabin
Lots, referred to as the "Common Properties".
V 1 6 y6
Emily Macgillivray
From: Emily Macgillivray
Sent: Monday, July 13, 2026 8:40 AM
To: 'BobBlasz'
Subject: RE: RE: Deck
Hi Bob,
I've gone ahead and approved your application.
I made an error calculating the fee when you were in the office, and we will need an additional $43.80. If
you want, you can send us another check in the mail (or if you are in the area this week, you can drop one
off at our office in Washburn or during my office hours on Wednesday from 10 am to 12 pm in Iron River).
If you'd prefer to pay by credit or debit card or e -check overthe phone, you can call our clerk Dylan at
715-373-3515 to make the payment.
Once we receive the additional payment, Dylan will move forward with issuing the permit.
Let me know if you have any questions!
Kind regards,
Emily Macgillivray (she/her)
Assistant Zoning Administrator
Planning and Zoning Department
Bayfield County
117E 5a' Street, PO Box 58
Washburn, WI 54891
Phone: 715-373-3511
emily.macgillivrayc bayfieldcounty.wi.Qgov
Fraudulent Bitting Alert: Be aware that individuals submitting applications to our department have
received scam emails. Bayfield County will NOT ask applicants to wire any funds. Please contact our
office at wnu1gbavf eldcounty.wl.gov or 715 373-6138 with any questions or concerns.
From: BobBlasz <BobBlasz@proton.me>
Sent: Thursday, July 9, 2026 10:42 AM
To: Emily Macgillivray<emily.macgillivray@bayfieldcounty.wi.gov>
Subject: RE: RE: Deck
Thank You :)
Sent with Proton Mail secure email.
Land Use Permit Application Review Checklist
'Submission #: O
What �,�ha'R-zoning district is the project located in?
ld1 ❑ -2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M
❑ Yes No
Is lot substandard (does not meet current zoning dimensional requirements)?
Deed of record:
lfl'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)?
Iles ❑ No
Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of
navigable waterway)
❑ Y s Lyf o
Is the project located in the Floodplain? Zone:
lS'yes ❑ No
Are there wetlands on the property?
Yes ❑
Is project associated with a nonconforming use or structure? O q'
❑ Yes o
Is project associated with a variance? Case #:
❑ Yes
Is project associated with a Special B or Conditional Use Permit? Permit #:
❑ Yes o
Is the project associated with a Special A Use Permit?
❑ Yes dNo
Does the project require sanitary?
O Existing ❑ New ❑ Intercept O Reconnect O Non -Plumbing ❑ Public
Sanitary Permit #: # of Bedrooms:
❑ Yes 4jo
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
Yes ❑ No
Does the project require an affidavit? Affidavit #: O0O
ED'Yes ❑ No
Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback?
M Yes ❑ No
Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback?
Project use is? VResidential ❑ Commercial ❑ Municipal
Project type is? ❑ New Construction Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign
❑ Establishing a Busine s ❑ Temporary ❑ Shoreland Grading O Other, describe:
Structure Type is: IL4esidence O Principal Structure O Accessory Structure O Boathouse (one story only)
❑ Open-sided/Screened Structure (gazebo, etc.) O Stairway to navigable waters ❑ Mobile Home
❑ Shipping Container ❑ Other, describe
Total Sq. Ft. of Project: 400 Number of Stories: — Overall Height:
Fee Type
Calculation
FelAmount
❑ Habitable Residential Principal and Accessory
Structures - Enclosed Areas — all enclosed areas within
dwelling except attached non -habitable garages
$0.50 x sq ft
(minimum $125)
$
Dwelling Unenclosed Areas (decks, patios, etc.) or
Attached Non -Habitable Garages
$0.20 x 4pa sq ft
(minimum $125)
$
❑ Non -Habitable Residential Principal and Accessory
Structures
$0.20 x sq ft
(minimum $75)
$
❑ Commercial Principal Structures
$250 + $0.005 x
cost of construction
(minimum $250)
$
❑ Commercial Accessory Structures
$150 + $0.005 x
cost of construction
(minimum $150)
$
❑ Municipal Principal and Accessory Structures
n/a
$0 (exempt from fees)
❑ Return Inspection ❑ Land Use Revisions ❑ Special Use Permit - Class A O Floodplain Shoreland - Impervious
Surface O Shoreland - Non -Conforming, etc. ❑ Tower Siting/Collocation 1 ❑ Tower Collocation 2 O Metallic Mine
❑ After -the -Fact (ATF)
$
Inspected by:
Date of Inspection:
rn (✓ic&.
o
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by:
Date of Appr vat:
0
Condi
4('1ust meet and m . tain setbacks from furthest extension of structure including eaves and
overhangs.
❑ For personal storage only.
❑ For personal residence only.
❑_ Not for human habitation or sleeping purposes.
Q own/State/DNR/Federal may require permitting
❑ A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be
obttaaned prior to the start of construction.
lQ'A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be
obta* ed prior to the start of construction (if applicable).
19 -Use best management practices to limit and prevent erosion during construction.
❑ 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.
❑ S' n must meet the requirements of Article E of the Bayfield County Zoning Ordinance.
To 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)
0 Additional conditions may be placed and need to be adhered to at the time of permit issuance
Other Conditions:
K: Applications and Farms/Applications/land Use/Updated 2/25/2026 mdk
B-1YFIELD 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: Submission Number:
BUSKEY BAY ESTATES LLC, LU-02382
6720 JOHN AVE
SUPERIOR, WI 54880 Transaction Number:
LU-02382-49C0A
Description Amount
Shoreland - Impervious Surface $25.00
Habitable Residential Principal Structure - $125.00
unenclosed area or non -habitable garage
$0.20/square foot (minimum $125)
Total: $150.00
Payment Amount: $150.00
Reference: 11127 & 11129
Paid by: Robert S Blaszkowski
Payment Type: Check
Transaction Date: 7/15/2026
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
Substandard - No / Nonconforming - Yes
Shoreland — Yes I Impervious Surface - Yes
Floodplain - No I Wetlands - Yes
Mitigation - No / Affidavit #: 2020R-583000
LAND USE — X
SANITARY —
SPECIAL A —
SPECIAL B/CONDITIONAL—
BOA —
No. 26-0335 Tax ID: 20601
Issued To: BUSKEY BAY ESTATES LLC
Location: S28 - T47N - R08W
Town of Iron River
BAYFIELD COUNTY
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: PIKE LAKE PARK LOTS 15-17 BLOCK 2 IN V.935 P.19 1215
Residential Structure in R-1 zoning district
For: Addition/Alteration [Deck], Residence on a Walkout Basement [406 Total sq. ft.]
(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.
Emily Macgillivray
Authorized Issuing Official
July 15, 2026
Date
Condition(s): Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs.
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 (if applicable).
Use best management practices to limit and prevent erosion during construction.
To be constructed per plan.