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Home My WebLink About26-0218117 E 61i Street PO Box 403 Washburn, WI 54891 (715) 373-6109 permits(dtbav fie Idcoun tv. wi. uov C O U N T Y Health Zoning Submission # lt•oo3 Fee Paid ,00 Refund Permit # - Date Issued 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 Zonin ,epar3tt glt��mpleted application and applicable fees can be mailed/emailed to the address/email above. Establishment Tax IlYcan be fo t through NOVUS(Ilttns://novus.bayfieldcounty.wi.gov/access/ntaster.asp) MAR 3 1 2U 6 r"TERED ala1la6 City of Washburn, City of Bayfield, Town of Pilsen: License through Bayfield County Hea}�tment is re Please review and fill out pages 1-4. Planning and Zoning Agency All Other Towns: A license through the Health Department and permit through the Planning and Zoning Department are required. Please review and fill out pages 1-5. SECTION A: ESTABLISHMENT INFORMATION Establishment Nam I Establishment Tax ID # 6601 Town/City of — aayVit.W Establishment Street Address Fa4 1 City State AYE Zip SY&91 SECTION B: OWNER INFORMA ION Property Owner Email Address LPgn4.c Phone Number 7N CRS 3 Owner Mailing Address C tn6 State Zip rvZL ≤145 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 ke below) Unit Unit ID Structure Type Heating Source Water Source Sanitary Source # of Stories # of Bedrooms # of Bathrooms 1 t3 1.5 2 3 4 Structure Type: House H Du lex D Cabin (C)Yurt Y A artment (A)Condo(CO) Other (O), lease 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/Munici al M Private Onsite Wastewater S stem P Site Plan Show location of: ❑ Driveways 0 Frontage Roads (include name) 0 Existing Structures ❑ Well (W) 0 Septic Tank (ST) ❑ Drain Field (DF) ❑ Holding Tank (HT) 0 Lake 0 River 0 Stream/Creek 0 Pond ❑ Floodplain 0 Wetlands 0 Slopers over 20%q N .%� MAR 312026 hayfield Co- Planning Zed v✓ 4oast 5T � z � Setbacks front furthest extent including eaves and County Use Only overhangs of structure to: Verified setbacks Road Centerline 1 1 ft. ft. Notes/Comments: Front Lot Line/Right-of-Way ft. ft. Side Lot Line 1 a ft. ft. (North East Soutl We. , circle one) 20t r Side Lot Lin ft. ft. (North Ens South West, circle one) _�• Rear Lot Line $ ft. ft Septic/Holding Tank ft. ft. Drainfield ft. ft. Privy ft. ft. Well J$, ft. ft. Existing Structure/Building ft. ft. Wetland ft. ft. Elevation of Floodplain ft. ft. Ordinary High -Water Mark (OHWM) ft. ft. NOTE: Please indicate "see attached" on this page if submitting site plan as a separate document. Bayfield County 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? 0 Yes 21'10 ❑ Unsure 2. Is there a wetland located on the property? ❑ Yes Z No ❑ Unsure 3. Is there a floodplain located on or near the property? ❑ YesZ No O Unsure 4. Is this project associated with any of the following: ❑ Rezone 0 Conditional Use ❑ Special Use ❑ Variance 5. Did you contact the town to see if any ennits/re uirements apply to your project?Yes No Ycs Zoning Department Use Permits: Short -Term Rental permits through Bayfield County Planning and Zoning Department are non -transferable, except as per the exemptions identified in ATCP 72.04(3). Short -Tenn Rental permits are regulated by Baytield County Ordinance Section 13-1-35. APPLICATION FEES Check or money order payable to Baytield County Planning and Zoning I unit: $500 2 unit : $1,000 3 unit: $1,500 4 unit: $2,000 To ensure your application is complete and can be processed by the Department, check you have the following items: Applicant Information (Page 1) Site Plan (Page 2) MAR 312026 ❑ Floor Plan(s) — Provide sheet for each floor within each unit. Bayfield co. ❑ Fees paid Planning and _Zarin,; AcEncy 1 (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 1 (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 1 (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 Na Owner(s) or Authorized Agent Signature: NOTE: If you are signing on behalf of the owner(s) a letter of authorization must accompany this application. REcE;vED MAR 31 2026 Dinning Living Room Kitchen / Full bath M Bedroom Water Analysis Submitted By: MFK00071 Kaiser, Sam 103 Eau Pleine Dr Mosinee, WI 54455 Submitted For: Sam Kaiser 33485 Maki Rd Washburn, WI 54891 MAR 312026 Barfield Co. Planning and Zoning Agency AgSour e. LABORATORIES Laboratory Sample # DF40083 0667-29 Date Received: Date Reported: Information Sheet# 07/28/2025 08/25/2025 DW072825-01 Date/Time Collected 07/2712025 05:00 PM Sample Location Pressure WDNR Lab Certification Number 737109450 WDATCP Lab Certification Number 55-424 Total Calcium EPA 200.8 :rflflEniiiiiii1Iml 84074 ugfL '[*.n, at NA . c a ... o a , 381126 1 - • s NA 8/222025 HM Total Coliform 5M9223 B 24HR Absent -Safe 3 <1 CFU/10omL Cl CFU/10on,L NA 1 NA 7/28/2025 SS/HM/AE Total Copper EPA200.8 15 ug/L 1300 0.33611.121 1 NA 8/22/2025 HM E. ..It 5M9223 B 24HR Absent CFUI100mL <1 CFU/100mL NA I NA 7/2812025 SSIHM/AE Total Iron EPA200.8 <30 ug/L 300 30/100 1 NA 8/22/2025 HM Total Hardness (calculation) EPA200.8 321540 ug/L NA 131/437 NA NA 8122/2025 HM Total Potassium EPA200.8 1426 ugh. NA 39/129 1 NA 8/22/2025 HM Total Magnesium EPA200.5 27102 ug/L NA 8.857130 1 NA 8/222025 HM Total Manganese EPA200.8 <0.209 ugh. 50 0.20910.698 1 NA 8222025 HM Total Sodium EPA200.8 9100 ug/L NA 341113 1 NA 8/22/2025 HM Nitrate as N EPA300.0 [2.200] mg/L 10 mg/L 0.841/2.802 1 NA 7/26/2025 AF Lab pH SM4500J18 7.6 S.U. 6.5-8.5 mg/L NA I NA 7/282025 HM/EQ Sulfate EPA 300.0 15 mg/L 250 mg/L 1.55215.174 1 NA 7/282025 AP Total Zinc EPA 200.8 7.136 ug/L 5000 0.421/1.403 1 NA 8/222025 HM Sample Comments: The data provided for Calcium, Copper, Iron, Magnesium, Manganese, Potassium, Sodium, and Zinc are for informational purposes only. They are not to be used for regulatory compliance. [Bracketed results] specify values greater than or equal to the LOD but less than or equal to the LOQ and are within a range of less -certain quantitation. Results greater than the LOQ are considered to be in the range of certain quantitation. LOD/LOQ units are the same as Result units. LOD = Limit of Detection All LODs and LOQs are RL = Reporting Limit MCL = EPA Maximum Contamination Limit LOQ = Limit of Quantitation adjusted to reflect dilution NA = Not Applicable (see link below for more information) chttps://www.epa.govlyour-drin king.water/table.reguiated-drinklnq.water-cOfltam inants> DISCLAIMER: The results issued on this report only reflect Me analysis of the sample(s) submitted at our lab and may not be construed as an endorsement ofMe sampling method employed. This report shall not be reproduced except In full, without written approval of Me laboratory. The accuracy of Mass results are limited by Me Integrity of Me sample and the accuracy of Me test method. Reports are kept on file for five years. Page I of 2 3700 Downwind Drive • Marshfield, WI 54449 • P: 715.898.1402 • marshfield@agsource.com Water Analysis Submitted for: Laboratory Sample # Sam Kaiser h1Aft 312026 DF40083 -. 0667-29 AgSource_ Date Received: Date Reported: 6ay0eid Co. Information Sheet # LABORATORIES 28Jul-2025 08125/2025 Planning and Zr-ning Agency DW072825-01 Date/Time Collected 07127/2025 05:00 PM Sample Location Pressure WDNR Lab Certification Number 737109450 WDATCP Lab Certification Number 55-424 Test Comments: 3: A sample reported as Absent -Safe (<1 CFU/100mL) Indicates that coliform bacteria was not detected in the sample. This does not guarantee that other contaminants do not exist. "Safe— refers `only to the sample's bacteriological result. Report Authorized by: S J� `' — Date: 08/25/2025 [Bracketed results] specify values greater than or equal to the LOD but less than or equal to the LOQ and are within a range of less -certain quantitation. Results greater than the LOQ are considered to be in the range of certain quantitation. LOD/LOQ units are the same as Result units. LOD = Limit of Detection All LODs and LOQs are RL = Reporting Limit MCL = EPA Maximum Contamination Limit LOQ = Limit of Quantitation adjusted to reflect dilution NA = Not Applicable (see link below for more information) <https://www epe gov/vour-drinking-water/table-regulateddrinking-water-contaminants> DISCLAIMER: The results issued on this report only reflect the analysis of the sample(s) submitted at our lab and may not be construed as an endorsement of the sampling method employed. This report shall not be reproduced except in full, without written approval of the laboratory. The accuracy of these results are limited by the Integrity of the sample and the accuracy of Me test method. Reports are kept on file for five years. Page 2 of 2 3700 Downwind Drive • Marshfield, WI 54449 • P: 715.898.1402 • marshfieldoagsource.com Land Use Permit Application Review Checklist Submission #: SIR- oo 3 Tax ID: 66o ( 'S -T -R: ,%%-1-f- Town: q 1e/W 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 'gNo 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 #: (2( as Public System: # of bedrooms: 3 Yes O No Does the project require an affidavit? KLLC ❑ Trust L PK &ry trf i- SrS C(.C_ Affidavit #: Number of Units: Number of Bedrooms: ?j Number of Bathrooms: Number of Stories: O After -the -Fact (ATF) ATF Fee Amount: Inspected by: iW -\ fl es� Date of Inspection: ( .) �_ �C(O Inspection Notes: Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason. for Denial: Date Denial Letter Mailed: Approved by: C 1�V1, Date of Approval: cJ—Z1-Zio 2 -oa18 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: R VFIELD 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: LPK ENTERPRISES LLC 138160 ST HWY 153 MOSINEE, WI 54455 Description 1 unit Submission Number: STR-00333 Transaction Number. Amount $500.00 Total: $500.00 Payment Amount: $500.00 Reference: 1057 Paid by: LPK Enterprises LLC, Lowell G Kaiser Payment Type: Check Transaction Date: 5/29/2026 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 LAND USE -X SANITARY -16622 SPECIAL A - SPECIAL B/CONDITIONAL — BOA — No. 26-0218 Tax ID: 6601 Issued To: LPK ENTERPRISES LLC BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Location: S28 - T49N - R04W Town of Bayview Legal Description: LOT 1 OF CSM 915 IN V6 P111 IN DOC 2025R-606482 234 Residential Structure in A-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. May 29, 2026 This permit may be void or revoked if any performance conditions are not Date completed or if any prohibitory conditions are violated.