HomeMy WebLinkAbout26-0083I17 E 60 Street
PO Box 403
Washburn, WI 54891
(71RC- V D
MAR 022026
Bayfieid Co.
Planning anj Zoning Agency
P--YFIELD
Health
Zoning
Submission #
-00
Fee Paid
Refund
Permit #
- 0033
Date Issued
0 a
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. Establishment Tax ID can be found
through NOVUS ( )
City of Washburn, City of Bayfield, Town of Pilsen: License through Bayfield County Health Department is 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: ESTABLISHMENTINFORMATI0N
Establishment Name
L'I)Kc Fioui;-
Establishment Tax ID #
100 79
Town/City of
Establishment Street Address
I3560 Cot I
City
orbit'
State
wl
Zip
S'1s7,
'SECTION B: OWNER INFORMATION
Pro
Prerty Owner
kanom inln
Email Address
Z2lsakri c(!79,VA41-
Phone Number
Ga4 65) •2.53 •L$7C
Owner Mailing Address
�I3 2ttncr h vc-
Cit
Levllle
State
MN
Zip
55113
SECTION C: IF OPERATING WITH PARTNER OR AGENT
Legal Licensee (partnership, LLC. LLP, 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 k
:below
Unit
Unit ID
Structure
Type
Heating
Source
Water
Source
Sanitary Source
# of Stories
# of
Bedrooms
# of
Bathrooms
1
Pt
P
US
2
3
4
Structure Type:
House (H) Duplex D Cabin (C) Yurt Y Apartment (A) Condo CO Other (0), please describe
Heating Source:
Electric E Natural Gas G Propane P Wood (W) Fuel (F) Other O please describe
Water Source:
Public/Municipal Private Well (P)
Sanitary Source:
Public/Municipal M Private Onsite Wastewater System (P)
EHi RE
-fltiVED
MAR 022026
Site Plan Bayfield Co.
Planning and Zening Agency
Show location of:
❑ Driveways ❑ Frontage Roads (include name) 0 Existing Structures ❑ Well (W) 0 Septic Tank (ST)
O Drain Field (DI')
❑ Holding Tank (HT) 0 Lake ❑ River-❑ . Streem/Creek 0 Pond 0 SFlood lain 0 Wetlands 0 Slopers over 20%.
Spruce
S-fi
13 &cV
H
ailkc
GLx o r
N
/-) pus
JZuarayt
av
c
Vk
HWy 11
Setbacks from furthest extent including eaves and
County Use Only
overhangs of structure to:
Verified setbacks
Road Centerline
75 ft.
ft.
Notes/Comments:
Front Lot Line/Right-of-Way
6 0 ft.
ft.
Side Lot Line I
ft,
ft.
(North East Sou Wes circle one)
Side Lot "ne 2
(No t oath West, circle one
ft.
M
ft.
Rear tine
(j ft,
ft
Septic/Holding Tank
ft,
ft.
Drainfield
ft,
g..
Privy
ft.
ft.
Well
ft.
_. ft.
Existing Structure/Building
ft.
ft.
Wetland
ft.
ft
Elevation of Floodplain
ft.
ft.
Ordinary High -Water Mark (OHWM)
ft.
ft.
rn-rr_ m____ e_ -n_
.,, .. ,C„n wtucatc ace attacneu on mts page it submitting site plan as a separate document.
RECEIVED
MAR 0 2 2026
Bayfield County Health Department — State Lodging License
hayfield Co.
Planning and Zoning Agency
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.
➢ regulates lodging facilities including hotels, motels and tourist rooming houses.
outlines the licensing program and the
authorized agent agreement between the Bayfield County Health Department and the State of Wisconsin.
> ATCP 72.03(20): "Tourist rooming house" means all lodging places and tourist cabins and cottages, other than
hotels and motels, in which sleeping accommodations are offered for pay to tourists or transients. It does not
include private boarding or rooming houses not accommodating tourists or transients, or bed and breakfast
establishments regulated under Ch.
➢ Wis. Stat. § 97.67 (5) and § 97.605 (lxc) "No license may be issued until all applicable fees have been paid."
> Wis. Stat. § 97.605 (1)(a) "No person may conduct, maintain, manage or operate a hotel, restaurant,
temporary restaurant, tourist rooming house, vending machine commissary or vending machine if the
person has not been issued an annual license by the department or by a local health department that is
granted agent status under s. 97.615 (2)."
> Within 30 days after receiving a complete application for a license, the department 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 30r°. 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 Beyliield County
Check or money order payable to Bayfield County Health Department
When will your rental be in operation:
❑ Summer 0 Winter Year -Round
$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.
❑ 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 than that for which it was collected (Wis. Stat. § 15.04 1 m . Signature: qi4r, 1��� Date: 3I 31 1 i`(i
RECEIVED
MAR 022026
Bayfield County Planning and Zoning Short -Term Rental Permit
Bayfi@ICo.
ening Agency
• PLANNING AND ZONING QUESTIONS
1.
Is the property in the shoreland, within 300 feet of a river/p6eam OR landward side of floodplain OR 1000 feet
of a lake/pond/flowage, whichever is greater? ❑ Yes No O Unsure
2.
Is there a wetland located on the property? O Yes No O Untite
3.
Is there a floodplain located on or near the property? O Yes ltNo
O Unsure
4.
Is this project associated with any of the following: O Rezone
❑ Variance
O Conditional Use ❑ Special Use
5.
Did you contact the town to see if any its/ uirements apply
to your project? Yes O 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
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 y application is complete and can be processed by the Department, check you have the following items:
NJ /Cpplicant Information (Page 1)
@'frite Plan (Page 2)
S Floor Plan(s) — Provide sheet for each floor within each unit.
(VFees paid
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 ��u (f(,
Owner(s) or Authorized Agent Printed Name: I - M tt t ' `a H 44p I 4
Owner(s) or Authorized Agent Signature:
Date:
NOTE: If you are signing on behalf of the owner(s) a letter of authorization most accompany this application.
Kittnen
11'3" x 8'2'
Stairs
•(Down) Stairs (Up)
Living Room
17'1" x 117"
•
Dining Room
106" x 11'9"
1.4
RECEIVED
MAR 032026
Bayfield Co.
Plannir. j z�,, �:
•
Bathroor•
6'11" x 10'4"
4'1" x 2'2"
Bedroom
12'0" x 10'l"
4'0" x 2'2"
RECEIVED
MAR 032026
Bayfield Co.
Planning and Zoning AgenCY
Land Use Permit Application Review Checklist
Submission #: s-( -00
Tax ID: O O
S -T -R: - y3-
Town:
What zoning district is the project located in?
R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ I ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M
,Yes ❑ No
Does lot meet the zoning dimensional requirements or is it substandard?
Deed of record:
❑ Yes )KNo
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 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 If: Public System: Card.¢,
# of bedrooms:
❑ Yes [No
Does the project require an affidavit? ❑ LLC ❑ Trust
Affidavit If:
Number of Units:
Number of Bedrooms: Z
Number of Bathrooms:
Number of Stories: 2
❑ After -the -Fact (ATF)
ATF Fee Amount:
Inspected by: D� I,
\�I f;�c j�
Vv J �--(
Date of Inspection: 2 _r�,r1 / _
I o4lY
Inspection Notes:
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: A \ .
t s ��W ��S�`
Date of Approval: � _ 1 1 I �f 00%
le
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:
}3XYFIELD 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:
KANNAPIRAN, MADHU
813 Brenner Ave
Roseville, MN 55113
Description
1 unit
Submission Number:
STR-00327
Transaction Number:
STR-003273F7FF
Amount
$500.00
Total: $500.00
Payment Amount: $511.90
Reference: 5801165665
Paid by: Madhu Kannapiran
Payment Type: Credit Card
Transaction Date: 3/6/2026
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
Substandard
LAND USE -X
SANITARY — Cable
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
No. 26-0083 Tax ID: 10074
Issued To: KANNAPIRAN, MADHU
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Location: S18 - T43N - R07W
Town of Cable
Legal Description: ASSESSOR'S PLAT NO. 2 LOT 17 BLOCK 9 IN V.1128 P.673 IN DOC 2021 R-589749 15V
Residential Structure in R-1 zoning district
For: [1 -Unit] Short -Term -Rental, Maximum Occupants Allowed is
(Disclaimer): Any future expansions or development would require additional permitting.
Condition(s): Town may require permitting.
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. March 11, 2026
This permit may be void or revoked if any performance conditions are not Date
completed or if any prohibitory conditions are violated.