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HomeMy WebLinkAbout24-48S Drinkwine,^"^,w^ '~:<^- ^.^y APR 2'ZO^ j 111 Department of Safety yj & Professional Services, !~ Industry Services Division^'Krlsr""~^ fy County Sanitary Permit Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for stateowned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. State Transaction NumbeT I. Application Information - Please Print All Information Project Address (if different than mailing address) £y-^10 (£.. RbbD-^ani^l^w.Property Owner's Name Parcel# F. Tn^i L Pn'n K u )i n^ AddressAddress ^7^ ^rh'i^^ T^y^o -5^ $2^-7 Property Location Govt.Lot City, State ^^, t^XC Zip Code 6^ ^7^ II. Type of Building (check all that apply) ri-i or 2 Family Dwelling - Number of Bedrooms D Public/Commercial - Describe Use D State Owned - Describe Use Phone Number 7/^-sr^r-^^ Lot # f£^'/4,5U^ '/4. Secdon T L/S-N R WEO^ Subdivision Name Block # CSM Number D City of _ DViUageof ?fTownofj3zm^2_ m. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if applicable.) ^-New System D Replacement System D Other Modification to Existing System (explain)D Additional Pretreatment Unit (explain) B.D Holding Tank ^B-Jn-Ground (conventional) D At-Grade D Mound D Individual Site Design D Other Type (explain) c.D Renewal Before Expiration D Revision D Change of Plumber D Transfer to New OwnerList Previous Permit Number and Date Issued IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) 5 oo Design Soil Application Rate(gpd/sf) _z_ Dispersal Area Required (sf) 2L</^ Dispersal Area Proposed (sf) oy^. System Elevation _ac Tank Information Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units Manufacturer I 0 IIssw -S S 3f SE 0 Septic or Holding Tank ^75~^^£€^ /-e^c^ ^/^A_Dosing Chamber V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name CPrint) ^rarvi Plumber's Signature^-MP/MPRS Number ^7?^3QI Business Phone Number 7/5~-ss^y^7^ Plumbefr's Address (Street, City, State, Zip Code) ^7/'/V 'Tm^n'iyviL^n^. \\u/i0a^^- ^ ^^s> V^. County/Department Use Only^Approved D Disapproved D Owner Given Reason for Denial Pemut Fe< $. Issuing ^fcnt S^nature %^-/^z ^/ki/ Conditions of^pprovaVReasons for Disapproval £^fi2- Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 03/22) Wiseonsi§D^pa!tpi^nt.pfS?rfetyrand Professional ServicesDiv^in^nlystigSiferifrtea; ij;| IBI - ... !!!1 SOIL EVALUATION REPORTHIS APR 2 5?UZ4. '^'- "' '-u'"' Iniccordance with SPS 385, Wis. Adm. Code Attach complete site plarhoripap^not iess.tii^n'ft.'l/Z x 11 inches in size. Plan must include, but not limited to: verticat arid Ktii'izdntaire^^i'ee point (BM), direction and percent slope, scale or dimensions, north arrow, and tocafion and distance to nearest road. - Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1 )(m)). plbfr- ^©j?y Page ' of County BAYFIELD Parcel I.D.TctY: XD. 3S'^-&-7 Reviewed by Date :>roperty Owner l^X^o^'. L. Dri^Lj^^A Property Location Govt.Lot $£-%$'Ld % S 34 T 4S' N R O? E (or) 3roperty -3^2.? ^c^je^s. ^.J -=F^- Site Address or. CSM and Lot #: \0 a.^ ^m^\ ^2.1^ ^ ^o^!^a^ LtG P.rl City B^\rv\.-e$- State LOl Zip Code ^grz? Phone Number | D City D Village E^Town (•5-zj? 2.0^4 B&v-i^Ls onl Nearest Road ^O^i-'iASo^ go. g^jl GPD jf. Code derived designflow rate_ Flood Plan elevation if applicable. [^ New Construction Use: ^ Residential / Number of bedrooms 2. D Replacement , D Public or commercial - Describe: Parent material O^CtjC-\a-\ f~)0 ^ UJQJ?\^ General comments and recommendations: ^, ^ ^ \ j I rs, ^ / ^,.rt/7C~(<~? ^£>\\9. $Lj$j-e^^(. ^(g,1 L^^^-e eT4--c?^-2-s Boring #nBoring(^Pit Ground surface elev.lt'Depth to limib'ng factor /£>6in. / elev.<?i0.2%. Horizon } 7- 3 JA_ Depth In. ~o~^ 5-^€> 20-M_ fci-Jo5 Dominant Color Munsell -T.Syy. 3/z- « Y^Vy 5/3 Redox Description Qu. Az. Cent. Color Texture ^ ^_^-3~ Structure Gr. Sz. Sh. 6-s?'^7 'f • It Consistencs ~KL It l\ tf Boundary •c<3T tl Roots [^CIM7aT Soil ApplicationRate GPD/Ft2 *EfiS1 _!7_ -YZL-TY *Efl»2 1.^sl.L f.fc "2J- Boring #DBoringBPn Ground surface elevff3.Depth to limiting factor l0'2.\n. f elev.3D^3s. Horizon z -z. ^ -LL Depth In. 0-(pi~(T tQ-SD £6 -to Dominant Color Munsell -?.^wr ^,2- K ^5 •I V/t£ tf 5/3 Redox Description Qu. Az. ConL Color Texture -^- _5_<; s Structure Gr.Sz. Sh. ^—£^_ '/ It t Consistence fhf It «r ')- Boundary JC^ If (/ Roots /V3-S: {y ^ ~^^_ Soil ApplicationRate GPD/Ft2 *EflS1 .'-? _LL _^L ~r *Ef?2 _1^_ J^L- /.^ (.fc I CST Name MERTON MAKI Address 10869N SMITH COURT HAYWARD, Wl 54843 Signature'n-e^^^^c. Date Evaluation Conducted q ^l^-Z-c^ CST Number 224901 Telephone Number (715) 634-8719 * Effiuent #1 = BOD > 30 <. 220 mg/L and TSS > 30 < 150 mg/L Effluent#2 = BOD, & 30 mg/L and TSS < 30 mg/L SBD-8330(R04/21) Horizon T 1L _!_ Li_ Depth In. _^-G6 -^ 22-^g ^^.c Dominant Color Munsell -7.^ 3/2 ./ ^ " 7tf" ^ Redox Description Qu. Az. Cent Color r Texture ^_ _^_JL _j_ Structure Gr.Sz. Sh. <9-^ <\ !{ // Consistence l(. •f k t! !r' :t'-i^Bouhdaiy '• ii ADDf^~-^- _>L Roots L- Of-lQw7il^ luF Soil ApplicationRgte ; III GPD/R2 *lw ZL^n .1 .7 *Ef?2\L~ i.(.JSL \.^ Boring #D Boring D Pit Ground surface elev._ft.Depth to limiting factor.jn. / elev._ Horizon ~2^ ~a Depth in. FY~ n-z-^. f&C i ST\ Dominant Color Munsell ^ '- 2JO ^- ^?M - ^ ~i6o Redox Description Qu. Az. Cont Color 300^ -. pw=^ zi.^ V [ 2- /-Q4 ^ -t- ^-Lt- Texture ~KS ^e^_ +- •e.vy .V— Structure Gr. Sz. Sh.7t7-^ -2-Z- 1c ^= 5;' Consistence 4^L^ ) 4^c- Boundary ?U(1 Roots a: Soil ApplicationRate GPD/Ft2 *EfiS1 *Ef?2 Boring #D BoringD Pit Ground surface elev-_Depth to limiting factor.Jn. / elev.._ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr.Sz. Sh. Consistence Boundary Roots Soil ApplicationRate GPD/Ft2 *Ef?1 *Eff»2 * Eff:luent#1 = BOD > 30 s 220 mg/L and TSS > 30 £ 150 mg/L Effluent #2 = BOD, £ 30 mg/L and TSS s 30mg/L _J (A .1 p-1 s?s-0-v' I N0 .cN I [f\ (0 ^^ 0 (n • ^' aT•-1 _^05 SL7rro r> p- £ ^ -etf5 -4V\l ^A srT?^£ .^^ -c -^ rf:^ 2. ^ 0-0 c, UJ•J^^^ JT- TO^vj pp- ^T< hv • \Al^»N €*.-J > .50- t? \A y 9-r" r ^1r*y^£^A) 03fl-C^>d' p-nb 0;p 5n1&I-^ ;\. 0-£r\ 1: 0 rt-1 f> r- 132.6 -.£> <^s ^ ft..Co ; ft '^ M -0CT- Wt ex? ^ ....-p:^sb I II Ii i ^ j0 ^- SsJ j \< ' oO ^•\ (i -^Q \A —a i i•I,..,.,.)....I { ! I 00»t-6<00 ^ jt0B .,-Q ^s}.-..K: —sbG|: -n0 -J V,! ^^' .(,.......(.-.ll......(.-....j......^,...^« I Io i t i•tilt «o ii i i (i -0w -.{^^ I-»„-., I i t ' ! .-.J 4., <%^ w,f JO ....s-5 s S iiii U -J--^^"" ^ -s^ ? d. --5' w^ » I»I D • I • •l • '! "'sr, •^J5 I• « I I i It.—,(.....>(_.,.(.....,10 I j Ii ji i i,jr-!' I JD J5 yO..s w ??.. ^ -£> ^ -^^ w^ .,.0;& w p. 1) ..Q (Uw 0 -^CQ -.0^ \53 Hi'§ •I; 1^</-1 i? - [TY- |s!- \^'^ (/1^e!3h. yy 1"K9 Ii % IU -s i-^. ^ra^Fts". ^ ^w^ In-Ground Gravity Plan Index & Cover Sheet PAGE 1 OF 4D) » Uil | APR 252024 B Component Manual Design References: 3avfe!ri r;?, 7r;.i!nu Deo;.In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) — - Pg1 of 4 Pg2of4 Pg3of4 Pg4of4 Index & Cover Sheet Plot Plan Dispersal Area Cross-Section & Plan View Management Plan Attachments:Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Owner Name(s): ^WT& -J^ 7<3(AJ L, '^nXj<a} <'7V€. Phone: 7lS~ - 5^?- ^OLf ff- Owner Address: ?37,/3^ 6d\^^> M, €2>LH^^-bl-3^ Zip: 5^7'::? Project Address: H'^,/0 B-, (^bp\<W\ /-^J^- (^ ^ Govt. Lot:6?E- 1/4 of -5\j^ 1/4, Section ^'^ , T (/S"N-R C^ EJ or W ^ Township: f^LrQ^S Project Parcel ID #: -f7^6 X^D - ,?C5 ^ ^ 7 County:^^j2^ Designer Information Designer Name: ^^f). ^fi^/^S _ Phone: <%T-SST-/^75' Designer Address: ik^j ^A€V\X^^H'^ (SA^ Zip: 5 ^^3 E-mail: License Number: ^<9^^0 I Remarks: Signature: Original signature required on each submitted copy. K'SDict'^'Serveci For approval stamp ?-^ticnai1Lr-.CSaiticiN/£° ^y''..-s i\:'~-^ ". ,^-r''fJ'^QO^^ ,y^ Date: ^-$23-Sy 1-52.0 * ^ ^s?^ ^-4- ^ £„ 0? +% -0 ?>4^/=-» r ^ L ^yf. ^ -yS'g: 4 Tjft J1'=?9v5- ^i-T '<• •^~ ^-^<' <r^;f' i-(^ \\' ^0, _J UJ > 0 -J 3 iS.^ ^ chl^D ^ ^ Ns5 ^ y * ^- r y N l~ ? ^- 0 — M\ r' f, ^ v)' r ^ ~c _ '•:' ? p ^ f^ r i- T£ ^A) J316 IN-GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with QuicM- Standard-W Chambers 3-ft Trench (down-sizing credit) Im _LJL,alr^ SOIL COVER ;—mln, 12"(lyplca!) 12" inln, Irenchdaplli(typiaal) SQptlc Tanl<{8) ManufEicturer! -/2zZ^.Sj£JA- Z^jQi Septlc Tanl<(s) Volume(a); gal w^^^. gal Efflusnt Filter Manufaoturer; gal Efflusnt Filter Model #; £:ijL^JsL2s^ TYPICAL TRENCHCROSS SECTION VIEW (No Scale) Qu|ol(4 Standard-Ww/find Gap(typical) System Elevation ^3£^, ft(typical) (Show location of Inlet / outlet pipe connection on plan view.) Provides minimum 3 ft separation faetwesn trenohas, INSTALL PER TRENCH: ObBsryalton.Plpo(typical) tnetall par manutacluror'Bliislt'uotloiis, TYPICAL TRENCHPLAN VIEW(No Scale) ^.. B s JSLSL^. ft (typical) Z2.. Qulck4 Std-W @ 20 fl? EtSA/chamber« «2.^£« ft2 A " 3,0 ft(lyploal) -Qulcl<4 Qtandard-W Chamber(typloal) (mfd by tnflllrator SystamB, Ino,) Install pursuant.to manufapturef'e inBtrucltans. "a s%' + .—L^. Pairs of end caps @ W EISA/pair s »^^^ ft2 ^ ^td^ §^r-o S^^ -^ (-0-?s- ^ Proposed E18A per trench a )( ft" Required tnflltration Area « ^2s£» ^ Distribution MetRocJ; trenches v proposed Total E1SA " JC2.2L ft2 &^M^»«^^m <^^/({ tn-ground Gravity Management Plan ^ ig ^ ^ n „? ^ ^. IMPORTANT: PAGE 4 OF 4 i,I m APR 252024 B The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. Admin. Cod6ytii^i6yStei-i'liSh|Hp3nL be considered a human health hazard if not maintained in accordance with this approved management plan. Furthemnore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wise. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = ^r7fi _ gpd; BODg S 220 mgL-1; TSS ^ 150 mgL-1; FOG ^ 30 mgL-1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (/.e. odors, user complaints, etc.) o mechanical malfunction (/.e., pumps, valves, switches, floats, ete.) o material fatigue (/.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (/.e., exceeding design capacities, prohibited activities, etc.} o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (/.e., pump re-cyding, float switch settings, etc.) o electrical components - if applicable (/.©., wiring, connections, switches, controls, timers, alarms, ete.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification) o surface discharge of efRuent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and ctose tankfsl shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats, when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wise. Admin. Code. - o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wise. Admin. Code. Report any component failure or malfunction to: Name of individual or company: .K\ ^f^ ^>?%A^/ _ Phone: /IS '~S^??^/^'7<9 Local government unit: ^)(U^^0. ^TUA+^'J^'^ _ Phone: ^5^7^-^,^ Local government unit address: f^ KC/^ 5<S (A^U)^//?L,- UJC ZIP: ^>^i^/ Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wise. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wise. Admin. Code. Contingency Plan tn the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be abandoned and replaced by a code-comptying dispersal component in a pre-determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wise. Admin. Code. '>..!c~^ •>\.! 4" CAST-A-SEAL TOP VIEW OPTIONAL FLAT COVERIS AVAILABLE FOR EXCHANGEFOR DOME COVER. WLP750-MRTANK SPECIFICATIONS DIMENSIONS:WALL: 2 1/2"BOTTOM: 5"COVER: 4"MANHOLE: 24" I.D. PRECAST CONCRETE RISERHEIGHT; DOME COVER 61" O.D.FLAT COVER 53 1/4" O.D. OUTSIDE DIAMETER: 84" O.D.BELOW INLET: 42" O.D.LIQUID LEVEL: 37" WEIGHT: 6,150 LBS. INLET AND OUTLET:4" CAST-A-SEAL BOOT OR EQUALGASKET, CAST-A-SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL #)Q(OTHER STATES SEE CHART) LIQUID CAPACITY: 20.28 GAL/IN HOLDING TANK:ACTUAL CAPACITY: 790 GALLONSOUTLET HOLE PLUGGED LOADING DESIGN: 8' 0" UNSATURATED SOIL MN TANKS:WILL HAVE ONE VENT OVER OUTLET AND WILL HAVE TWO VENTS IN COVER OVER INLET TANK CAN BE USED AS: SEPT1C/ HOLDING/ PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER)TANK: MIX DESIGN jj(10 (STRUCTURAL FIBER) CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETE PUMP PAD SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS U38 mla ^- z COGS S u->s CMI--) 0 j>- Pls Qlx 00 JOB INFORMATION; CUSTOMER: ]OB NAME: DATE NEEDED: APPROVED BY: APPROVAL DATE: I s\lit 0F-ELLJc7) alylw\ UJ|Q;| SHEET NO. 1 .OF 1 OrencoT E R PSC-Series Biotube® Effluent Filte " W! S11-f ^ n r on 0,1rv-^ j LUL"! —r:^7- Opb'onai float switch bracket Hasdie Bio&teSter CSHTKfee ijefjecterpiate & .•^s, ; "^•v^U.^airy£sf ^-i-F.^'W!^~msT .:_a";?S ^.-•'^-^^9. Housmg Orenco PSC-Ssries Bsoai&e BHusfit Rtes are desig-ied % remove solids from efisuent ieaving wasewater tenis. Oreneo's paienf-pending PSC-Ser!^ BioiUBe Bffuait RiteR s'e used to improve the quaiiiy or effluent from wstewater tanks. iiTiprQved effluent quainy extends drainfietd iire m onsite dispsreal systeBTs and improves the perfcnnance ar domsirearo li^tment in effiuenf sewsrs. The Siotube niter cara-n^e fife lighfly in ffis housing vsNle being easy to remove for maiRtenance. TTie passivety seif-eIeapJng design sdsnds maintsnance cycle intervals. RSsrmssh fe avaifabie ffl 1,8m or 1/16in (3.2mm or 1.6mm) mssh opening sees. Tiie handfe cm be extended with PVC p^e (not inciudsd) for bete access to fe canrajge. A 3/4H! {19mm) diameter tee handis is induded. Models PSGS0621-18 and PSCW0621-18 are NSF 48 certified. PSCSOS21-18, PSCW0621-18, PSCPSG621-18. PSCPW0621-18 PS£•18-LJ Ffcat auiteb iBaci-st apgea:Bisfss .loBoEisiafchtesfeEiisiaiieaA = ifcats'BfclibraetetinsBStsd B = forus&ratSl Qrsnai M-saa'EslsnteSB = float saitdi brediei teSsSed sail ibr uss wBi Ofaao M-sETiSS tete Caiwdge 'ssQts. s (iiim^.18 =18(457) fitef teasing RE^iii, in ^im):2i- =21 io3^ Bin yoBffiiJ) fiter digmsta- CaBstse:S = s-,d£!2safeaeri3rTM3s3334ouB3t-S = F-35ete!iuie4aa@6ttes ! FSSa-aedtcpgoa. in t'snu; S!5n!c=}/8(3.aP = 1/iea.s) FSC-s335sa3tBbs3'sSiffl.'!tager .- -:> Orenco PSC-Senss Biotube Effluent Hlter Housing Biosybg fiter cartridge Handis componenfe Deriector plaie PVC.ABS Polypropyfene, DCPD PVC.sfainJess steel ABS Sreneo SystsfflS® ° 8SS-348-S843 0 ri 541-45S-444S " Kiww.orsnco.coiR 8T8-FT-FTS.2 Rev. 3 ©05/21 Page 1c? .2 Orenco D) i^E Hi iiiiI Ill APR 252024 W Savfelcl Co. ZoniriQ Oeu^ Specifications Modei A. Overall height, in (mm) B. Housing height, in (mm) C. Cartridge height, in (mm) 0. OuUet pipe diameter, ?n {mm) E. Outlet height to invert, in (mmj F. Deffector plate diameter, in (mm) Mesh size, in (ram) Filter surface area, ft2 (m2)* Row area, TP (my* PSGS0621-18 22.7 (577) 21.0(533) 17.75(451) 4.5(114) 13.5(343) 6.63 (168) 1/8 (3.2) 6.3 (0.59) 1.9(0.18) PSCPS0621-18 22.7 (577} 21.0(533) 17.75(451) 4.5(114) 13.5(343) 6.63 (168) 1/16(1.6) 6.3 (0.59) 1.9(0.18) ? Rtterarsa is dsSneiias the laBlsmfass area cfsS 'nS'.fduslSolubes vnlian the fiitsrcarfmlgB. " Flawacea is dsffnfdas tiie total opsn sea (ar area 0?;?® mesh opanings) ofalf Sis WsiidaaS Biatubes swftai Ihs SSercaiHnige. nro-Fr-Frs-2 Rev.3©06/Z1Page 2 of 2 Orenco Systems® • 800-348-9843 ° -i-1 S41-459-4449 • www.oreneo.com 4/13/24, 7:48 AM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 4/13/2024 ??;[:1 ;: CrrreRt j /^pp 9 C^^On:/3Ll/18/2008 12:22:55 PM ^ Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Aaes: Lottery Claims: Rrst Dollar: Zoning: ESN: 35267 Updated: 12/15/2023 ss3i Ownerehip i - ' (:;-„ /•^;;i;;a •i^ ANDRE 3 &30DI L DRJNKWINE Updated: 12/15/2023 BARNES WI 04-004-2-45-09-34-3 04-000-42000 (004) TOWN OF BARNES S34T45NR09W PAR IN SE SW IN DOC 2021R-586657 10.000 9.400 0 Yes (F-l) Forestry-1 104 Billing Address: ANDREJ&30DILDRINKWINE3723 SCHIESS RDBARNES WI 54873 Site Address " Mailing Address: ANDRE3&30DILDRINKWINE3723 SCHIESS RDBARNES WI 54873 [ indicates Private Road 4210 E ROBINSON LAKE RD ;^- property Assessment BARNES 54873 Updated: 4/1/2023 2024 Assessment Deteii •@ ^ , ^, , Code •9 Tax Districts ^^^^ ^ Gl-RESIDENTEAL 1 STATE GG-PRODUCnVE FOREST 04 COUNT/ 004 TOWN OF BARNES 2-Year Comparison 041491 SCHL-DRUMMOND Land; TECHNICAL COLLEGE amproved;' Total: Updated: 11/18/2008 0017QO Recorded Documents Acres 1.000 9.000 2023 17,200 12,400 29,600 Land 5,000 12,200 2024 17,200 12,400 29,600 Q PERSONAL REPRESENTATIVES DEED Date Recorded: 1/25/2021 2021R-586657 63 WARRANTY DEED Date Recorded: 10/16/2008 2008R-523345 1004-516 Property History Parent Properties 04-004-2-45-09-34-3 04-000-400QO Imp. 12,400 0 Change 0.0% 0.0% 0.0% Tax ID 35247 HISTORY 63 Expand Aiirister/White=Current Parcels Pink=Reta'red Parcels ©Tax 2&; 314S Pin; G4-OQ—2-45-03-34-3 04-COO-10QQC Lsss. Pte OC41219Q3QOQ S3 Tax ID; 34916 PSE-i: 04-004-2-45-09-34-3 CH-OQQ-20000 Q Tax SS; 35247 Pin: 04-Q04-2-45-09-34-3 04-QOO-40000 35267 nisParceS H'Parents ^ChHdren ^b^TM. -7,^-^ ^ -^o^? i\r^ Prmjicw^-a https://novus.bayfieldcounty.wi.gov/access/master.asp 1/1 Private Sewage System Maintenance Agreement Owner(s) Name Andre&Jodi Drinkwine Owner(s) Mailing Address 3723 Schiess Rd., Barnes Wi. 54873 Site Address 421 OE. Robinson Lk. Rd. Tax ID # 35^7 As owner, I (we) do hereby certify the private sewage system wilt be installed inaccordance with (he cerfified soil tester's report and approved plans and specifications on file with Bayfield County Planning and Zoning Department The system will beoperated in such a manner as to meet the designed plans. I (we) agree to maintain saidprivate system at the below listed location in accordance with rules established in the Wl Adm. Code, as from time to time amended. (COMPLETE Legal Is required) W of_1/4 Section 34 Township 45 N. Range 09 W. Addibonal Legal DescnptionPAR IN SE SW IN DOC 2021R-586657 Town of BameS _ (Acreage) 10 Gov'tLot. Lot _ Block_ Subdivision . Lot _ CSM # ____ Vol. _ Page _ CSM Doc # _ -in-- - u yfi.,,,, ^'7DOGliMENT NUMBER2024R-602620 •;;":') -.'"pi, DANIEL J. HEF-F-NER RKGISTEK OF DEEDS BAYF-IELD COUNTY. Wl RECORDED 03, I 8/2024 AT 8:45 AM RECORDING F'EE: $30.00 PAGES:2 Recording Area Return To: Planning and Zoning Department In-ground gravity D Mound D In-ground dosed D In-ground pressure distribution Sewage System: D At-grade Sewage System D Other. Seotic Tank (system types A through E): The septic tank shall bs pumped by a certified septaga servicing operator within three (3) years of the date of Installation and at least once every three (3) years thsreafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-lhini (1/3) of Ihe volume occupied by sludge and scum. Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided above. The switches and pump controls shall also be inspecled and maintained to ensure openability of said components. Seofa'c Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessar/ and in accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Cods. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspectad by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or efflusnt from the system is ponding on (he ground surface. Mounds. At-arade. and In-around Pressure System Laterats (system types C, D and E): The laterals shall be flushed out and swabbed if needed when(he wastewater distribution cell component is inspected as provided above. Owners) agree that failure to comply wHfi IMs agraemenl will result In action being taken to pay all charges and casts incurred by Bayfield County for inspection, pumping, hauling, or othenvise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system. Bayfield County shall notify the owner of any costs which shall be paid by (he owner within thirty (30) daysfrom the dale of notice. In the event the owner does not pay the costs within thirty (30) days. ihe owner specifically agrses that all the costs and charges may be placed on the tax mil as a special assessment for the abatement of a human health hazard, and the tax shall tie collected as pmwded by law. The terms and conditions of the agreement shall be liinding upon and Inure to the benelil of all current and future owners of such property. Own^r(s) Name(s) - Please Print tt--4r ^^.-i- 1 • pr'^^ —-'- / JOOl^L_. ^ i^AVLvU^^ Notar ie7(s)'!- Slgnature(s) ^mlT.^^^t- 3rai Subscribed and sworn to before me on this date: f^d/i -7,3-o>^ NOta?yTlii|bl.fo-\^^V\£^ML^ My'Commtesion Expifes:"'^z^rrot hozi Drafted by:.^Mfc!?y\/ •?' ^'..••—••••.^'v '<-,^ W.u.^ ^yf '/^^•\ \Proofed by: u/fonms/sanltary/septicmalntenceagreementRevised July 2020 y,PUB^ /// -^^.•••-....-••1'r^yX^OF-^^'^.'1^1,,,,^>"' Document Number State Bar of Wisconsin Form 5-2003PERSONAL REPRESENTATIVE'S I Documcnl Name THIS DEED, made between WENDY REP VANCE as Personal Representative of the estate of DENNIS CLARK REP ("Decedent"), ("Grantor," whether one or more), and ANDRE DRINKWINE and JODI DRINKWINE, husband and wife, as Survivorship Marital Property ("Grantee," whether one or more). Grantor conveys to Grantee, without warranty, the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Bayfietd _ County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): A parcel of land located In the SE1/4 of ths SW1/4, Section 34, Township 45, Range 9 West, Town of Barnes, Bayfleld County, Wisconsin, bounded and described as follows: Commencing at the South 1/4 corner of said Section 34; thence North 89°41'30" Wast, along the South line of the section, 986.36 feet to th9 point of beginning; thenco continuing North 89'4-t'30"West along said Uno, 318.36 feet to the S 1/16 SW corner; thsnee North 0-t" 43'51" West along the West line of the forth, 1 347.S6 feet to the C 1/16 SW corner; thence South 89'36'47" East along the North line of the forty, 318.12 feet; Uisnce South 01*44'30" East, 1347.53 feet to (he point of beginning. .2021R-586657 DANIEL J. HEFFNERBAYFIELD COUNTY, HIREGISTER OF DEEDS01/25/2021 11:20AM•TF EXEMPT ?:RECORDING FEE: 30.00 TRANSFER FEE: 90.00PAGES: 1 Recording Area Name and Return Address Michael A. Kelsey, Attorney at Law PO Box 718 Hayward.Wl 54843 04-004.2.45-09-34.3 04.000-42000 Parcel Identification Number (PIN) This Is not homestead property. (^ (is not) Personal Representative by this Deed does convey to Grantee all of the estate and interest in the Property which Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the Personal Representative has since acquired. Dated l^j -^ PERSONAL REPRESENTATIVE: * lU^Ufl-^ V^/^- ^UTH^S Signature(s) _(SEAL) /A^W^f- Szft \A^A^-_ * Wendv Rep VanSe _(SEAL) ' Wendv Rep Van! ACKNOWLEDGMENT authenticated on ^ j'^.Cj J'^0 STATE OF ^U 5 -^Tf^yhfr^ ),. ,„,..„,„„,,,.^^?^%%.^5k?^h couw¥^^:^y^^-• 'f^': ^'.•'7'-^.'''.''.'': ''-^'i "i'l'S'JV.-fS'^W ."-.'--.sPersonally came b5f6re me on _ / -.slsl- ^•f^^SDS i^': o'ss •. the above-named WendvRepVance^^'1'?')^.^ ^:^= ":.^:,y%:^ ^/-.?.- to me known to be the person(s) who'" instrument and acknowledged the same. TITLE; MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) • THIS INSTRUMENT DRAFTED BY: Michael A. Ketsev. Attorney at Law State Bar No. 01013300 (Signntuna may be authtnticnted or ncknowtedgcd. Bath are not necessary^NOTE: THIS IS A STANDARD FORM. ANY MODIFIGATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. PERSONAL REPRESENTATIVE'S DEED 02003 STATE BAR OF WISCONSIN . FORM NO. 5.2003 •Type name below signatures. INFO-PRO® www.hfoprofonns.com Notary Public/State of , My commission (is permanent) (expi 3^-3 Private Sewage System Maintenance Agreement Owner(s) Name Andre&Jodi Drinkwine Owner(s) Mailing Address 3723 Schiess Rd., Barnes Wi. 54873 Site Address 4210E.RobinsonLk.Rd. Tax ID # 35^7 As owner, I (we) do hereby certify the private sewage system will be installed in accordanca with the certified soil tester's report and approved plans and specificationson file with Bayfield County Planning and Zoning Department The system will be operated in such a manner as to meet the designed plans, t (we) agree to maintain said private system at the below listed location in accordance with rules established in the WIAdm. Code, as (rom t&ne to time amended. (COMPLETE Legal Is required) .1/4 of_1/4 Section 34 Township 45 N. Range 09 W. Additional Legal DescnpbonPAR IN SE SW IN DOC 2021R-586657 Town of BameS _ (Acreage) 1Q_ Gov-tLot. Lot _ Block. Subdivision . Lot^ CSM#_Vol._Page_ CSMDoc#. Tl •••• ;'!,";" "' U s'n •'.>„ ".'•'] 'DOCiU'MENT NUMBER2024R-602620 ';::''" i-i'sui DANIEL J. HEF-F-NER REGISTER OF DEEDS BAYF-IELD COUNTY. Wl RECORDED 03, I 8/2024 AT S:45 AM RECORDING f-'KE: $30.00 PAGES: 2 Recording Area Return To; Planning and Zoning Department In-ground gravity D Mound D In-ground dosed D In-ground pressure distribution Sewage System: a At-grade Sewage System D Other SeolicTank (system types A through E}: The seplie tank shall bs pumped by a certified septage servicing operator within three (3) years of the data ofInstallation and at least ones every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the lank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. Pump Chamber favslem types B, C, D, and E): Ths pump chamber shall also be rinsed and pumped out when the septic tank is serviced as providedabove. The switches and pump controls shall also be inapecled and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank eRIuent filter shall be inspected and maintained as necessary and in accordancewith manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribuBon cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of instaBalion and at least once every three(3) years thsreafter to dstermine whether wastewater or affluent fi-om the system is ponding on the ground surface. Mounds. At-arade. and In-oround Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbed if needed when (he wastewater distribution cell component is inspected as provided above. Owners) agree that failure to comply with Ihia agivement will result In action being taken to pay all charges and costs incumd by Beyfield County for inspeclion, pumping, hauling, or ofheewise servicing and mainlainhg the private sewage system tank in such a manner as to prevent or abate anyhuman health hazard caused by the system. Bayfield County shall notify the owner of any costs which shall be paid by (he owner within thirty (30) days from the dale of notice. In Ihe event the owner does not pay the costs wilhin thirty (30) days, ihe owner specifically agrees that all the costs and chargesmay be placed on the lax mil as a special assessment for the abatement of a human health hazard, and the tax shall Isa collected as provided by law. The terms and condiSons of the agreement shall be binding upon and inure to the benefit of all current and future owners of such property. Own?r(s) Name(s) - Please Print ti^ ft^'r--i- ^' pi-'^k^^ ^ JnoUit— ^\v\^\)^\t^ Otm^.toU^L/^- Subscribed and sworn to before me on this data: f^cJli ^,X)>^ NOtafyT^blic ,<^--'^JYTAj2^^z-- My Commission Expires: ......--.^,! / ^ Drafted by:^tw^\-^\>^;..-""-..;.r \^^Tffi^^ ^^yf^oTA^ ^UBL\° / ^OF^f^""fnriuin****'" Proofed by: u/fomiateanitary/septicmalntenceagresmentRevised July 2020 \^\PUBLVG /(TJ°^:G..^ Document Number State Bar of Wisconsin Form 5-2003PERSONAL REPRESENTATIVE'SDflt^ Document Name •, THIS DEED, made between WENDY REP VANCE as Personal Representative of the estate of DENNIS CLARK REP ("Decedent"), ("Grantor," whether one or more), and ANDRE DRINKWINE and JODI DRINKWINE, husband and wife, as Survivorship Marital Property ("Grantee," whether one or more). Grantor conveys to Grantee, without warranty, the following described real estate, together with the rents, profits, fixtures and other appunenant interests, in Bayfield _ County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): A parcel of land located In the 5E1/4 of the SW1/4, Section 34, Townshtp 45, Range 9 West, Town of Barnes, Bayfleld County, Wisconsin, bounded and dsscribed as follows: Commencing at the South 1/4 cbrnar of said Section 34; thence North 89*41 '30" Wast, along the South line of the section, 98S.36 feet to the point of bagfnnlng; thenco continuing North 89'41'30"West along said fine, 318.36 feat to tho S 1/16 SW corner: thencs North 01° 43'51" West along the Wost line of the forth, 1 347.36 feet to the C 1/16 SW corner; thence South 89°36'47" East along the North line of the forty, 318.12 feet; thence South 01*44'30" Bast, 1347.53 feet to the point of boginnlng. * 2 0-'2li1:;R -"5T'6"6"5"7"""T"* 2021R-586657 DANIEL J. HEFFNERBAYFIELD COUNPf, WIREGISTER OF DEEDS01/25/2021 11:20AM•TF EXEMPT #: RECORDING FEE: 30.00TRANSFER FEE: 90.00PAGES: 1 Recording Area Name and Return Address Michael A. Keteey, Attorney at Law PO Box 718 Hayward.Wl 54843 04.004-2^5-09-34.3 04.000-42000 Parcel Identification Number (PIN) This ts not homestead property. Qa) (is not) Personal Representative by this Deed does convey to Grantee all of the estate and interest in the Property which Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property wb\cb the Personal Representative has since acquired. Dated pj^/^ PERSONAL REPRESENTATIVE: ^ 1/4W/_(SEAL) U^W^ V^ \A^fA^- * Wendv Reo VanSe (SEAL) <TIC ACKNOWLEDGMENT Signature(s' authenticated on ^ j^Q f'^0 STATE QpN^) Un^hrYiL \^^^_ 4T-|^la(Wl^h COUW^SS-S"S--S^•^^.•'&-'/:.'"-"-'"-.v£.' Personally came Is^fore me on _l^M'^ff^^)^ i^:^9\:. the above-named Wendv Rep Vance ^^^':'^ ?• '^ ^-: ^| "'.^^%:^ -Y/"// to me known to be the person(s) instrument and acknowledged the same. ?y/^-^ <^C'Uli TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) ' THIS INSTRUMENT DRAFTED BY: Michael A. Kelsev. Attorney at Law State Bar No. 01013300_ (Signnluna mny be aulhendcated or ncknowlcdgcd. Both arenol neccssaryONOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. PERSONAL REPRESENTATIVE'S DEED 02003 STATE BAR OF WISCONSIN . FORM NO. 5.2003 •Type name below signatures. INFO-PRoa vnw.woprohxms.com NotaryPubIic/State of J^ My commission (is permanent) (expires: BAYFIELD COUNTY SANITARY PERMIT (#04)-24^8S STATE SANITARY PERMIT OWNER: ANDRE &JODI DRINKWINE GOVTLOT: LOT: BLK: SE 1/4 SW 1/4 SEC: 34, T 45 N, R 9 W TOWNSHIP: Barnes SOIL TEST: 47-24 NEW SYSTEM SYSTEM m3E: Non-Pressurized In-Ground PLUMBER: Strand, Ryan TRACY POOLER DATE: 5/13/2024 Authorized Issuing Officer CHAPTER 145.135(2) WISCONSIN STATUTES a. The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. b. The approval of the sanitary permit is based on regulations in force on the date of approval. c. The sanitary permit is valid and may be renewed for specified period. d. Changed regulations will not impair the validity of a sanitary permit. e. Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. f. The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 a 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #: LICENSE: # MP 798301 Condition: System to meet all setbacks. Management plan to owner. Property maintain system per recorded agreement. THIS PERMIT EXPIRES 5/13/2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION