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HomeMy WebLinkAbout24-49S Wiitala^Sss"^.Department of Safety & Professional Services, Industry Services .Division County B<-^~^'<- 1<^ Sanitary Permit Number (to be filled in by Co,) /y/y o. ~ 'j3^W5_ 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 sanitaiy permit. Note; Application forms for state-owned POWTS are submitted tothe Department of Safety and Professional Services. Personal information you provide may be used for secondary puiposes in accordance with the Privacy Law, s. l5.04(I)(m), Stats. State Transaction Number I. Application Information - Please Print All Information Project Address (if different than mailing address) ^S'c-^c- '^^i-i, l^k-C ^.. Property Owner's Name ^, C.^^ ^ ^ ^J I I '^ ( << Parcel#ttr^KT& "3sr'YC7 (i? •^^oc-.o '"Rj-t-U i^^ City, State ^ ..-..-. IJ^ Y- <£ ^l ^~~ ' t/ -d ^ V1^/' Zip Code^/^ /7 II. Type of Building (check all that apply) 1 or 2 Family Dwelling - Number of Bedrooms. D Public/Commercial - Describe Use D State Owned - Describe Use Phone Number 7/^-7, ^-1 ^ I Property Location Govt.Lot. ^','/",. r^^L\ /occ-iU 3$ *n . _ )^ V,. Section Lot #T ^7 N R ^ ^o^ Subdivision Name Block # CSM Number a City of. a Village of 5B Town of '..^^^'•i JS^-^-- III. 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.) A.(3 New System D Replacement System D Other Modification to Existing System (explain)D Additional Pretreatment Unit (explain) B.D Holding Tank B In-Oround (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 Ownerl|List Previous Permit Number and Date Issued IV. DispcrsaI/Treatiijent Area and Tank Information: Design Flow (gpd)1^Design Soil Applicatiptl^RatcCgpd/sO .-7^ Dispersal Area Rgguirccl^Sf)7 I ^ ^Dispersal Area Proposed (i ^. System Elevation c\ 5 3 ' Tank Information 3\fi\W> Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units Manufacturer is.•s -sE U Scptiu orftoying Tank -7JT 7^2?1-Uh'•&$•<£.« C.e.^C..^ DosinrehmnbCT V. Responsibility Statement-1, the undersigned, assume responsibility for installation of the POWTS shown un the attached plans. Plumber's Name (Print) ' ^ 7?<9 ^ ^-<»s^' Plumber's Sign. /^y/ -— 7^-^ MP/MPRS Number ^2.£>0ct 0 Business Phone Number -^S"~2.t?2.-i//rt Plumber's Address (Street, City, State, Zip Code) ' " •,TM B^ S-2.-^ ' ^^^ ^.^^ ^1. ^S</7 VI. County/Department Use Only _/1 Approved 5Ati-^L D Disapproved D Owner Given Reason for Denial Permit Feen i7}rr.Issuing Agent Signature /6~y7<y/o? Conditions ofApproval/Reasons for Disapproval i:)^pm ^ muv cin ^M^- ^)/VVxw^vm ^w w WM Attach to complete plant for the system and submit to the County only on paper not less thnn 81/2x11 Inches In size SBD-6398 (R. 03/22) Wisconsin Departmentof Safety ai Division of Industry Services OBlBIJiALrS5rt?lces MAY Q'o'L^Page__of_ SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code Attach complete site plan on paper not less than 81/2x11 inches in size. Plan must include,but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location 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)). County ^Y-P^ (1 Parcel 1.0.'^)cT^5s-Yf^ Reviewed by ms Date I s.M.a4- • >erty Owner i . , .. ]{\C l^^ v A ^AJ' i +« f^( Property Location r^K<--^Y I <-"^R <--c ^ '^ D Govt-Lot .SiA'V- £,\V%S 33. T ^Hf N R $ E (or)@ Property Owner's Mailing Ati.dressIf '€'000 Rj-h^i U^~&-Site Address or CSM and Lot #:'if^C^'D ~ ^ ^ l^. k^-^ -rc-^ ^.' t/-&(^ Statei^r Zip Code^vry'7 Phone Number (1!b)7st\ D City D Village B Town |^ »/-c. «^i fc-i Nearest RoadM-L, U k^ ESNewConstfuction \Jse:M Residential/Numberofbedrooms J- I Public or commercial - Describe: Parent material ^•^^n'Sa.l "Tt i Code derived desianflowrate /-> <-s GPD Flood Plan elevation if applicable_ft. General comments and recommendations: Boring #[.3 Boring ait Ground surface elev.,^-T.S ft.Depth to limiting factor.•y 7f.,in. / elev,_ft. Horizon ~L 2- ,3. Depth In. <?-^Ir5llif! Dominant ColorMunsell ID Y^-^// 7.rr(z- t/l^ £'Y^ £-/(ft Redox Description Qu. Az. Cont Color /J c- ^ /J o A-'C fJ OA/Y Texture JET^ ~s- Structure Gr. Sz. Sh. M-4 kk 0 0 Consistence ^t.tl/'^-r- /VIL- IV{L Boundary £-5 ^^ Roois 5<?o 2-1*\T^T Soil Application Rate GPD/Ff *Efl»1~r . Y . 7 *Ef»2 -"7ZE~TM 2.Boring #QBoring 'It Ground surface elev,.11^.Depth to limiting factor*7/^<9in. / elev._ft. Horizon I _^_3 Depth In. ^--? "7 -ZS ZC-^Kc Dominant ColorMunsell -7. S"J (2-3/i s'rii -f/d £"Y^-/^ Redox Description Qu. Az. Cent Color /•sl o A-'^ /\/p/^'€ f~S <•- rV^ Texture ~M~TT~x Structure Gr.Sz. Sh. l^L^. 0 D Consistence A4 u^-K" n/iL m L- Boundary €tS- €:S Roots 3^ ~2- 1't^. ~JS_ Soil Application Rate GPD/R2 *Efl»1 ^7 . T . 7 *Efi»2~TK l.(^TV ~ZL 0^— '^^L-CST t^ame (Please.PrirKr-T^y^0 ^~oS ^Signature CST Number 2.2^s©q'0 Address 'g0. B&k S'2-2. ^yc.^ R<y«.r'a,1^ St/ft^7 Date Evaluab'on Conducted. '-i-z-^r-^1:f * EffluentSI = BOD > 30 S 220 mg/L and TSS > 30 s 150 mg/L Telephone Number .» , ,^>'W^z^-^^ * Effluent #2 = BOD, £ 30 mg/L and TSS S 30 mg/L SBD-8330 (R04/21) Boring # d BoringI Pit Ground surface etev.-.11^. Page C. of Depth to limiting factor -7'/CV in. / elev._ft. Horizon I ^_ .3 • Depth In. o-T b-n fi -i^ Dominant Color Munsell 7S'Y^5/i- -/. r^ ^6 ^? JT/6 Redox Description Qu. Az. Cont. Color /^J C* *'v;.f ^J c> /'t-/f ^ e..7^< Texture S [L_ L-S, 5 Structure Or. Sz. Sh. f-F^^ c 0 Conslstence m u-f-v Hi L H I L- Boundary c<S c.5 Roots ~^0 ^ <-n7^? Soil ApplfcaGon Rate epo/Ft2 *Ef»1~~T *7 .~7 •EWQ .7TT" j_k- Boring it D BoringD Pit Ground surface elev._ft.Depth to limiting factor.in. / elev._ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/R2 *Efl»1 *E? Boring #[_] BoringD Pit Ground surface elev..Depth to limiting factor.). / elev.ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Applicab'on Rate GPD/Ff *EfiB1 •BS»2 *Effluent#1 =BOD>30<220mg/LandTSS>30s150mg/L *Eff]uent#2=BOD,s30mg/LandTSS<;30mg/L ~®^ fs- ^Jw ^ V: ^.""f •Ai s '>k -^t>? ^ «kr* X1 ? ^-s Olsse.yya.4 ?<?"»« er>!p&.- O.&f-a.;/ " &"4" •?.' i li'-^lC.'ariWcsfis I g-S-SiAij?( SsSa '0J_J. Wl^p' ofc&Hs-sn en^ee^gH •^& -^9/y y^q,<>_ «?-^O/SiL" '<-..^» ^"-- ''•9^'^•'^"^'/<-T*x'^^^1^'-.'••» p^ope's'eATS'-elJ ^.w^.e.'s'i^e^&e ^r-. p.\^^. -r)^•^h- yi (I^ i-^ ^ ^5~ ~^- —!L S ?•H s~ +- 3S^ ^(S- V) -h 4- <^«n ns ~^ r- -+ •<-^ < ^^' s^ z-^ ^ p* 0 <» plIft u ?- •pl r^J~ '»•w I' ^i31«Arf !«x. •s- •*- r\ J ^ s< M ^-h -1;. K^.6-I ??W, 2^- ?-(n t.1 f. f 5'~?ii\5? -?~i^ ^ s-o 5 w n-m~K~w M?^p;^J^-5\a T^ Bs?-^~k-^t'r^v?^ t.^ .*^^ 0.\ 33>.-< en C3f'0-&.^< 0I .s -^ M4T?20r^-fe) o?T<A?3f (^•^ 1':?s I•%<?' iiPi°il§ 1:°^^ •oi H^ ^? S-^t* ^ sl^M^S;^-^^l;s> as' ^j^r^^ *2 ^-{~S"~at § -;-^?, <A)CT^'•sr?J ?? ST s ^ss ^S '.IFWSEi^€•^ii-^i.?j4JS13?^T^^?^T°<;I^(ST °s c.^f5.-?'-?^-s !T^1 ^ Iflay. b, 201, 10;41AM BAYFIELD CO PLANNING & ZONI16 In-Ground Gravity Index & Cover Component Manual Design Refe fences: Version 2.0, SBD-10705-P (N.01/01, R. 10/12) pgi of 7 Pg2ofT P@ 3 of -7 Pg 4 of .7 No, 9975 P. 3 PAGE 1 OF 7 MAY 06?02'i Index & Cover Sheet Plot Plan Sef^'s-"T'^ni^ 'OT^-IS Section & Plan View Management Plan Attachments: PI i'of 7 f'c, ^ ^ 1 '^7^7 Enclosures: POWTS Application for Review €. S^^'-^a ^ f<^m.r ft? Soil Evaluation Report & Site Map y\\ A.* wk •€."<.&. ^ <-^- A 9 t'"e^'"--i£^' Project Name / Description t: 'B- ^<=-^ i LJ f i ^-< (^ Phone: '7^ ~- '7^__-_1^_2'_L Owner Address: ^5"ooo ^ -^ Lr^c fiA^ -^^^ ?^^ ^fzip; ^Y g- '/7 Owner Name(s) ; S-c- <^-^-^ <% S c'0 C/ (-Project Address: Govt. Lot: 7^-^m .5 ^ 1/4 of ^' 1/4, Section 3.^ . T ^/7 N-R S> el Township: -^ i/ a ^ /?^i ^' & r- _ County: '^"< Y •^'~€ Project Parcel ID #: '^T^ ^ T '€> t:i 35"l/c7^ or W ^ Designer Snforma&ion : 7lS~"372.-L/t ^(CDesiflner Name: A / /^ ^ ^o / ke s- ^ ' _ Phone: Designer Addr®®®: P-o. 3 °K ^~^- rT^o^ tR' ^•&r ^J I- ZID: S~~¥Sl/'7 E-^nw[\ ^<sn^/^^•€^^1^^ •uJ\^'e^Qi<^^^^ This space renewed for approval stamp. License Number: -z^e>^€i0 RemarKs: 7^ Signature:^^c^Date:. ..y^-2.5^2 ^ Original signature required on each submitted copy. j£l£]L ^^w!a4-4el®_"T^.^'^TwS'y^" S^[d)^y^f^wfiW<i.•^^4/4^fc ^ Sv^ia ^i f / ^; .^-^ -^ ^ f^ ^<.'r><»'3 ^ (?./-< »-^& i^o^-r^ 40 'vrtoj^,-'•' •-— ./ •*"" i'tt&l 8" 'J I ;i3J'&1':9, "' *"' •"^ '^'1§5lJ "l^?4f~^. ?? ^r-^+^r"+"7s?/ ^^^v• -II*l£fi^T=&-li ^ ^^J":5-^^"?'5<@t '&ra f?^ I l-f^'^ ^^^</^m'ff ^i .!^'V>';^'.iS) JS S'-.t-d <.'i ^l'®^'-'-'it'd'W»I?a—'»S-ae'.«f us i^&^aSqo -""' ''e/vy ^a®.^ •"s"|"l"y1 ^af^y •{•'"^A'"" -S.9 | '.? ,o-?^l ^i;^J;f^;w'^t""^ '^^f l7..,j-r1^ 0<2><?.J? <?? t.9 | '^. 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'^-3 -O-J'^w^ jf^fmf^^/^'^^s ^.^^j^ ^n^Q'/ '.' • • pr.AM/^o^' ^{o^ -.»" ••<d- C--.J co 4" CAST-A-SEAL TOP VIEW OPTIONAL FLAT COVERIS AVAILABLE FOR EXCHANGE FOR DOME COVER. WLP750-MR TANK SPECIFICATIONS DIMENSIONS:WALL: 2 1/2" BOTTOM: 3"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.UQUID 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 #10(OTHER STATES SEE CHART) LIQUID CAPACITY: 20.28 GAL/IN HOLDING TANK:ACTUAL CAPACITT: 790 GALLONS"OUTLET HOLE PLUGGED LOADING DESIGN: 8' 0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC/ HOLDING/ PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER)TANK: MIX DESIGN #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 DRAWINGS SUBMITTEDFOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: 0:1=)1010.1 8Sn-1 <131 1^1<1al coin± ^-|z 00Li0S ms CMrQ|0 >- 0t Qlx 6b| CM Igll 0pQ,B(7) <1 Qlwlw\ Lda: SHEET NO. 1 /OF 1 Bayfield County, Wl [P?lKy°<l?l<6ii.l?9722 KATHLEENZ''CHASEtTRUS.TEE lf^EI6Hj^!.'NINA;R;f;OX^O^rRU^EES 5/14/2024, 8:00:48 AM ::y.;: Wetlands Approximate Parcel Boundary Building Footprint 2015 '* Building 1:2,629 0.03 0.07 0.13ml 0.05 0.1 Bayflsld County Land Records Department 0.2km Bayfield County Zoning Appiicatton https://maps.bayf!etdcounty,wi.gov/ZoningWAB/ 5/14/24, 8:00 AM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 5/14/2024 Property Status: Current Created On: 4/9/2009 10:36:10 AM iSL Description Tax ID: PIN; Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN: Tax Districts 1 04 024 163297 001700 Updated: 2/28/2017 35496 04-024-2-47-08-33-3 03-000-12000 (024) TOWN OF IRON RIVER S33 T47N R08W PAR IN SW SW DESC IN V.1000 P.879 30.228 30.228 0 Yes (R-l) Residential-1 Updated: 4/9/2009 STATE COUNTf TOWN OF IRON RIVER SCHL-MAPLE TECHNICAL COLLEGE -v Recorded Documents Updated: 4/9/2009 Ownership RICHARD A & ANDREA D WIITALA Billing Address: RICHARD A & ANDREA D WIITALA65000 RUTH LAKE RD IRON RIVER WI 54847 Site Address * indicates 65000 RUTH LAKE RD Property Assessment 2024 Assessment Detail Code Gl-RESIDENTIAL G6-PRODUCTIVE FOREST 2-Year Comparison Land: Improved: Total: 2/28/2017 IRON RIVER WI Mailing Address: RICHARD WIITALA A & ANDREA D 65000 RUTH LAKE RD IRON RIVER WI 54847 ; Private Road Acres 1.000 29.228 2023 49,800 72,700 122,500 IRON RIVER 54847 Updated: Land 6,000 43,800 2024 49,800 72,700 122,500 7/28/2022 Imp. 72,700 0 Change 0.0% 0.0% 0.0% B3 QUIT CLAIM DEED Date Recorded: 8/8/2008 2008R-522275 1000-879 Property History Parent Properties 04-024-2-47-08-33-3 03-000-10000 Tax ID 20012 HISTORY B3 Expand All History White=Current Parcels Pink=Retired Parcels E3 Tax ID: 20012 Pin: 04-024-2-47-08-33-3 03-000-10000 Leo. Pin: 024109401000 35496 This Parcel ^ Parents ^ Children Co/\ \}^.^-tton^{ BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS ; u u '- Submit the Following (Use Permanent Ink) CTitle 15, Section 15-l-10(e)) , „;, Sl Check List Ef Original Sanitary Application (Submitted in Deed Holders Name - not prospective buyers) (383.21(1)1.) Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) 13'Original Plot Plan (383.22(2)2. 3. & 4.a) [^ Cross Section, Over-Head Profile of the System and Schematic of Tank from Manufacturer D Pump Tank Diagram, Alarm and Pump Curve (when applicable) Ef Contingency Plan / Management Plan (383.22-3(2)(b)l.f.) Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) D Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) D Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) D ATU Servicing Agreement (Recorded at Reg. of Deeds) Ef Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) ^. Complete Set of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies') 53'Soil and Site Evaluation Report (383.22-3(2)(b)l.e.) D State Plan Review (when applicable) D Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) 0' I Application Information must include: D 23 digit Parcel ID# - (do not use 12 digits anymore-obsolete) El Project Address or Road Name where driveway is/will come off of) 13 (Owners Phone Number) II Type of Building H' III Type of Permit Sf IV Type of POWTS System Bf V Dispersal / Treatment Area Information Tank Information Ef VII Responsibility Statement (Plumber's Information) D *Date Stamp* Plot Plan; (To Scale or To Dimension) Ef Signature and Plumber Information ^ Surface Elevation of Body of Water Ef Direction and Percent Land Slope Ef Tank and Filter Information and Location Q! Wetlands / Navigable Bodies of Water Ef Absorption Area (Proposed and Existing) ET Bench Mark (Location, Elevation and Description) M Component Manual Version 0 BBSSi!BBS^Biit^^^iJ^Hfiiil"I^IB|iBi^^^i^.t.A,*^f*.-l^.(^.~^.^.^^^r;f^u^^::*^;-^..-'.^ S Address Number and Road Ef North Arrow [gf Contour Lines 0' Structures and Driveways B Boring Locations 0 Property Lines ^ Well Locations Legal Descriptions Turn Over > Cross-SectiQn and Over-Hea(LProflle_of the System : Surface and System Elevation (^Position of Observation and Vent Pipes ^Dimensions and Depths ^ Make, Model & Number of Chamber Units in each Cell Property Information a How many systems will there be on this parcel of land? <5k a Has this property been split? ^o (Property Statement shows Property History) Fees: ^ Private Sewage System (Septic Tanks) $ 400.00 D Private Sewage System (Holding Tanks) $ 400.00 d Mounds or Systems requiring Pre-Treatment $ 500.00 D Sanitary Revisions $ 25.00 D Private Sewage System Reconnection $ 50.00 and Private Interceptor D Return Inspection $ 50.00 Ef Maintenance Agreements ^ $ 30.00 (checks made out to Reg of Deeds) u/forms/checklists/checkllstfbrsanitaryapps (lO/2009);(®7/2011);(®2/2012)(®5/2/201Z-dc) Proofed by: BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS MAY 0 y^j^ Submit the Following (Use Permanent Ink): 0 Check List E] Index Page / Title Sheet (Optional) El Original Soil Evaluation Report (Submitted in Deed Holders Name - not prospective buyers) El Original Plot Plan D Cross Section Soil Profile Sheet (optional) D Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) G3 Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used I7] Property Owner's Information (not prospective buyer's name) (3 Property Location (Accurate Legal Description with Sec/Twp/Range) El Road Name (where driveway is/will be coming off of) IZl Floodplain Elevation, Flow Rate, Comments and Recommendations 0 Complete Soil Boring / Pit Information El Date Soil Evaluation was conducted [2 CST Name, Signature, Number, Address and Phone Number D *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) 0 Bench Mark (Description, Elevation and Location) £] Contour Lines (Example = 98.0796.0',94.0') 12 Pioperty Location (Sec/Twp/Range/, Accurate Legal Description) E] Borings (Locations and Elevations) E3 Percent and Direction of Land Slope 0 Well Location (Including Neighboring Wells, if applicable) ri Location of Wetland Areas, Floodplain and Navigable Waters [2 Buildings, Driveways, and Structures (Location and Descriptions) £? Location of Property Lines Ef Existing System Location [Z[ Address Number and Road Name 12 Current Surface Elevation of Wetlands and Navigable Waters 21 CST, Owner and Property Information North Arrow Fee: E3 Certified Soit Tests - Review & Filing Fee . $ 50.00 . . u/forms/sanitary/checklist/checklistforcsts MAY 06^024 Private Sewage System Maintenance Agreement Owner(s) Name/^f/?// d ^At f. lail(o^OOO€'fllff^W^ fiO Site Address raxTDS ^;-y^y? ^, ^ff^it3S'^ As owner, I (we) do hereby certify the private sewage system will be installed in accordance with the certified 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 said private 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) WLw c'f _<?_ 'k^l/4 Section 9 3 Township L/ 7 N- Ran9e —^—W. ^"""•cn-i;', "y' n3s;r:;"sn: ~P^S<- / n V/. < c:"~'0 'f S:I'7C1 Town of £jl/D^Q^L>^ (Acreage) 3_<2^ Gov-t Lot QL^O Lot.Block_Subdivision Lot..CSM#.Vol...Page.CSMDoc#. OOCUMENT NUMBER2024R-6030-77 DANIEL J. HEFF-NER REGISTER OF DEEDS BAYFIELD COUNTS. Wl RECORDED 04/29/2024 AT 8:45 AM RECORDING FEE: $30.00 PAGES; 2 Recording Area Return To: j©n/ /^o/^oS-/0 Bo.' 'Bo^ ^':j^.< •^"^^^y'7 r?o.'-B^ ^-y-K ^ In-ground gravity D Mound D In-ground dosed D In-ground pressure distribution Sewage System: At-grade Sewage System D Other. Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter 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-thlrd (1/3) of the 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 sen/iced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operabillty of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with 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 distribution 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 installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on ite ground surface. Mounds, At-arade. and In-around Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbed if needed when the wastewater distribution cell component Is inspected as provided above. Ownerfs) agree that failure to comply with this agreement v/ill result in mtk" he!"g tskw is pay sK c-'.s;ye<; wia uosis incurred by Sayfield County for sns^ssuon, piiit;p!,iy, iiaunng, or oiherwise 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 the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. The terms and conditions of the agreement sha',1 be binding upon and inure to the benefit of all current and future owners of such Owner(s) Name(s) - Please Print fli^HiO /\ \A//,{TAL^ Subscribed and sworn to before me on this date, d\\ ^5 .^0^^:.».-^os:^ A.1'.^ . ?ns'}Notarized Owner(s)^- Sigriatuce(s) Jl^n1y Commission Expires: .^nATOLm LT,A^7 .>,»?y°-2^c^^'BMItt**^^ : ^-7-Z~:-Z^ Proofed by;:TE u/forms/sanitary/septicmalntenceagreementRevised July 2020 DOCUMENT NO.STATE BAR OF WISCONSIN FORM 3-1982 QUIT CLAIM DEED Richard B. Wiitala and Jennifer L. Wiitala, husband and wife, as joint tenants quit claims to Richard A. Wiitala and Andrea D. Wiitala, husband and wife, as joint tenants tfae following described real estate in BAYFIELD County, State of Wisconsin: A parcel of land located in the Southwest Quarter of the Southwest Quarter (SWV4 SWy4) of Section Thirty-three (33), Township Forty-seven (47) North, Range Eight (8) West, Town of Iron River, Bayfield County, Wisconsin, described as follows: Commencing at the Southwest corner of the said SW1/4 SW%; thence North along the West line of said SWV4 SWV4, a distance of 990 feet to a point; thence angle to the right 90° a distance of 1311 .06 feet to a point; thence angle to the right 90° a distance of 990 feet to a point; thence West along the South line of said SWV4 SWY4 a distance of 1311.06 feet to the place of beginning. This is not homestead property. Dated this.. ^ Y^day of July, 2008. (SEAL) Richar<fB. Wiitala h /",/' .PATRICIA A OLSONBAy"ELD_ COUNTY; WI"REGiSTER~OF"DEfeDS' seieiQR—sasa-zs 08/88/2808 89:15AM TFEXEWTIs 8 RECORDING FEE: 11.W PflGES; 1 RETURN TO Richard A. Wiitala7^'/^y^ ^5cc.^' f /yy^ ^w^> o^^-^y- Tax Parcel No: 024-1094.01000 (SEAL) AUTHENTICATION Signature(s) k>;^,g^ S>. Ui'i-tsJo- <^d authenticated this ^.t/Jh day of_g^^___> 200^.^ ACKNOWLEDGMENT STATE OF MINNESOTA <:OUNTy OF /hoo^f }ss. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY WEHNER LAW OFFICE Attorney Richard Wehner (Signatures may be authenticated or acknowledged. Both are not necessary.) *Namcs of persons signing in any capacity should be typed or printed below their signatures. •^ 'JB-.Personally came before me thiss^/day of July, 2008, the above named Richard B. Wiitala and Jennifer L. Wiitala, husband and wife to me known to be the persoa(s) who executed the foregoing instrument and acknowledge t]ie same. * /^^S3? ^, Notary t>ublic A^I^A County, MN. My Commission's expiration date: /-3/ ~'^-£>/n TERESA ANN KANADA Notary Publio-Mlnnesota My Comm. Expires Jan. 31,2010 >»»ur»*«« VlOOO P879; QUFT CLAIM DEED POWTS OWNER'S MANUAL & FILE INFORMATION MANAGEMENT Py^ p /^^age. SYSTEM SPECIFICATIONS .of. Owner ^ c ii^i v 'L ^ i i ~t~^ I ^Permit # DESIGN PARAMETERS Number of Bedrooms Number of Public Facility Units Estimated (average) flow Design (peak) flow = (Estimated x 1.5) In Situ Soil Application Rate Standard Influent/Effluent Quality Fats, Oil & Grease (FOG) Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) Pretreated Effluent Quality Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) Fecal Coliform (geometric mean) Maximum Effluent Particle Size Other: J DNA ^(NA /00 gal/day / 5"0 gal/day_ - 7 gal/day^t2 Monthly average* <30 mg/L s;220 mg/L @ NA <150mg/L Monthly average ^30 mg/L ^30 mg/L B NA <104cfu/100ml % in dia. g] NA PNA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Tank Manufacturer UJ D Septic D Dose D Tank Manufacturer D Septic D Dose D J»' e-sey Holding Holding Effluent Filter Manufacturer p& S Effluent Filter Model Pump Manufacturer Pump Model Pretreatment Unit D Sand/Gravel Filter C&AC". vol. '-? vol. '0£, PL D D Mechanical Aeration D D Disinfection Manufacturer Dispersal Cell(s) gl In-Ground (gravity) D At-Grade D Drip-Line Other: Other: D D D D Peat Filter Wetland Other: ONA ^Z-- gal BNA gat DNA BNA SNA DNA In-Ground (pressurized) Mound Other: ^ NA ^INA Service Event Inspect condition of tank(s) Pump out contents of tank(s) Inspect dispersal cell (s) Clean effluent filter Inspect pump, pump controls & alarm Flush laterals and pressure test Other: Other: Service Frequency At least once every: -j ^ ^r(s) (Maximum 3 years) D NA S When combined sludge and scum equals one-third {%) of tank volume B When the high water alarm is activated At least once every: ^ § ^nrt(^(s) (Maximum 3 years) DMA At least once every:3 mPnthJS) D NAS year(s) At least once every: ^j g ^S(s()s) D NA At least once every: H ^°anr%(s) B NA At least once every; H ^oa?tA(s) _laNA glNA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications; Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third (16) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of ^12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (12/02) Page 2- ofSTART UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals that may impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: D A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. D A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. j8 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. D Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the Infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOTENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF APERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER \ -Name ^ |^H j?& | |^&S^; C^^^lc. ?b^K Phone "?l 5' ^ 2—4 I S~(ft SEPTAGE SERVICING OPERATOR (PUMPER) Name -T^ic-nA&S ?£>/fcloSj<< (U'r&n^.tfer&2.pf| Phone *7/5~ 3'7-Z—t^-Oofc ^, Name Phone ~MU -7,^ l^t f~ S9 2^Z- Cos y< k\(7^ik^^ 7s-k LOCAL REGULATORY AUTHORITY Name Phone 8&y- "71 3> T^il 3-7^' €Lc'UfL'f~(^ "Z.'o^i •(ffl3f!5f^ fe."?lu.*J»| i t § <c This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapterComm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. BAYFIELD COUNTS SANITARY PERMIT (#04)-24^9S STATE SANITARY PERMIT OWNER: RICHARD A &ANDREA D WIITALA GOV'TLOT: LOT: BLK: SW 1/4 SW 1/4 SEC: 33, T 47 N, R 8 W TOWNSHIP: Iron River SOIL TEST: 50-24 NEW SYSTEM SYSTEM TYPE: Non-Pressurized In-Ground PLUMBER: Allan (Tony) Polkoski MCKENZIE SLACK DATE: 5/16/2024 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 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #: LICENSE: # MPRS 220090 Condition: System to meet all setbacks. Management plan to owner. Properly maintain system per recorded agreement. THIS PERMIT EXPIRES 5/16/2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION