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Home My WebLink About24-67S Johnson^•j"tTM£l> ff',.1%^2^'^7^|TK^^/ ~. >«. I.-',,. ; SEP 2020z|3 .ayfieii Industry Services Division 4822 Madison Yards Way Madison, WI 53705 P.O. Box 7302 Madison, WI 5302 County .^ . F. I tBmigim. 1>»^<e.ld ^ Sanitary Permit Number (to be filledw-^S^mtary:Feimit Application In accordance with SPS 383,21(2), Wis. Aclm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned 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(1 )(m), Stals. 1. Application Information -Please Print All Information Sanitary Permit Number (to be filled in by Slale Trahsaclion Number Project Address (if different than mailing address) V\a<y\<2jr 1^4 Parcel # -^ 3: f> ^<&^ M-d(4-Z-^6'o'7.2.'y.S ea.-doo.'ffwo Property Owner's Name fv\ -f La.urei 3ohn5w T^tiS^ o't <^0f2-Lu >wner'^NProperty Owner'^Mailing Address 5335 €^fa.\^ V^i^^r Property Location Govt. Lot. City, State C>>^\askci lot Zi|5 Code ^0^0 II. Type of Building (check all that apply) §t I or 2 Family Dwelling - Number ofBedrooms D PnbHc/Commercial - Describe Use D State Owned - Describe Use Phone Number ^•m-wrf .01 # -M^SVl-A Section l^L LK» N R 0~L_*^W Subdivision Name Block ff CSM Number ltfZ< a City of. D Village of IXTown of ^Q.l'l'^L 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.^ New System D Replacement System D Other Modification to Existing System (explain)D Additional Pretreatment Unit (explain) B.D Holding Tank St In-Oround (conventional) D Al-Gradc 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 OwnerlIList Previous Permit Number and Date Issued IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd)^0 Design Soil Application Rate(gpd/sf) .^ Dispersal Area Required (sf)^S3 Dispersal Area Proposed (sf)<?ao System Elevation 106f Tank Information Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units Manufacturer 0£ 0 ^1il sE 0 •s§ p-i Septic or Holding Tank Z2^1 ^i&<.er Dosing Chamber V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) ;had Rochwite Plumber's Address (Street, City, State, Zip Code) 8385 S County Road S, Lake Nebagamon, WI 54849 Plumber's SignatureA^c) <T^MP/MPRS Number 220595 Business Phone Number 715-292-2415 VI. County/Department Use Only Permit Fee^ VISJ^ Date Issued ^s/pproved a Disapproved D Owner Given Reason for Denial ?W2.44 iuing Agt'QfSiggj^ure ^%S^ /^J7/7 Conditions ofApproval/Reasons for Disapproval <xje- ^-o^<\ SBD-6398 (R. 02/22) Attach to comptetc pl»ns for the system nnd submit to the County only on paper not less thnn 8 i/3. x 11 inches in size Ceu) f/^-/>^^^Dji^uu^, ^^^/^ ^COVED Wisconsin Department of Safety and Professional Services Division of Industry Services ^3 202G23 Page 1 of 3 Bayfield CoSOIL EVALUATION REP(??"3 -: z^a AS.0 Agsncy 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)). CountyBayfield Parcel I.D. 04-016-2-46-07-29-3 02-000-50000 Reviewed b'y-^Date Property Owner Timothy M. & Laura A. Johnson Trust of 2012 Property Location Govt. Lot V,V4 S 29 T 46 N R 7 E (or) W Property Owner's Mailing Address 3333 Emerald Valley Pr Lot # 2 Block #Subd. Name or CSM# CSM# 1425 inV.8P.316 City Onalaska State Wl Zip Code 54650 Phone Number D City D Village S Town Delta Nearest Road 14125 Warner Rd |3 New Construction Use: S Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement D Public or commercial - Describe: Parent material Sandy outwash _ Flood Plan elevation if applicable N/A ft. General comments and recommendations: System elevation 98.9' -102.0' Boring #D Boring Pit Ground surface elev. 103.0 ft.Depth to limiting factor 90 in. Horizon 1 2 3 4 Depth In. 0-2 2-6 6-23 23-90 Dominant Color Munsell 7.5YR 3/2 10YR5/3 7.5YR 4/4 7.5YR 3/4 Redox Description Qu. Az. Cont. Color Texture Is Is s(15%GR) cos Structure Gr.Sz. Sb. Osg Osg Osg Osg Consistence ml ml ml ml Boundary cw cw cw Roots 2vf 1m/1f 1m/2f 1vf Soil Application Rate GPD/R2 *Eff#1 0.7 0.7 0.7 0.7 *Eff»2 1.6 1.6 1.6 1.6 Boring #D BoringS Pit Ground surface elev. 103.4 ft.Depth to limiting factor 90 in. Horizon 1 2 3 4 5 Depth In. 0-3 3-5 5-21 21-32 32-90 Dominant Color Munsell 7.5YR 3/2 10YR 5/3 7.5YR4/4 7.5YR 4/4 7.5YR 4/4 Redox Description Qu. Az. Cent. Color Texture Is Is s (15% GR, 1% ST)_ s Structure Gr.Sz. Sh. Osg Osg Osg Osg Osg Consistence ml ml ml ml ml Boundary cb cw cw cw Roots 2vf 1f/1vf 1m/3f 1f 1f Soil Application Rate GPD/Ft2 *EfW1 0.7 0.7 0.7 0.7 0.7 *Efl#2 1.6 1.6 1.6 1.6 1.6 * Effluent #1 = BOD, > 30 s 220 mg/L and TSS > 30 S 150 mg/L ' Effluent #2 = BOD, > 30 s> 220 mg/L and TSS > 30 ss 150 ma/L CST Name (Please Print) Keith Witey Address 11623 E. Larson Dr. Lake Nebagamon, Wl 54849 Signahjipe^- ^-s^^g?' '^——-"" Date Evaluation Conducted 7/30/2022 CST Number 654921 Telephone Number 218-451-2611 SBD-8330(R04/15) ^LCBVED Boring #D Boring ^ Pit Ground surface elev. 103.3 S':P Z 0 Z02ift.pth to limiting factor 90 in. Horizon 1 2 3 4 Depth In. 0-3 3-5 5-32 32-90 Dominant Color Munsell 7.5YR 3/2 10YR5/3 7.5YR 4/4 7.5YR 4/4 Redox Description Qu. Az. Cont. Color Texture Is Is S(20%GR) s Bayfie'd -Isnnim 3, ,.j 7,-. Structure Gr. Sz. Sh. Osg Osg Osg Osg -"0. !"0''l'QSi-icv Consistence ml ml ml ml Boundary cw cw cw Roots 2vf 1f/2vf 1m/3f 1vf Soil Application Rate GPD/Ff *EfW1 0.7 0.7 0.7 0.7 *Ef»2 1.6 1.6 1.6 1.6 Boring #D BoringD pit Ground surface elev.Depth to limiting factor.in. Horizon Depth In. Dominant Color Munselt Redox Description Qu. Az. Cont. Color Texture Structure Gr.Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *EfW1 *Eff»2 Boring #D BoringD pit Ground surface elev.Depth to limiting factor. Hon'zon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr.Sz. Sh. Consistence Boundary Roots _Soil Application Rate GPD/Ft2 *Eff#1 *Ef»2 * Effluent #1 = BOD, > 30 s 220 mg/L and TSS > 30 s 150 mg/L * Effluent #2 = BOD, > 30 s; 220 mg/L and TSS > 30 s 150 mg/L ^.. Q '^.Jc0u <-n •t ..J •;--> --.J .3 "•J .MlJu'1 <Si8 2.'; <N~S ^' rMn(T3 Johnson Trust of 2012 Soil Report Plot Plan \ \\ ^< Prooerh/ line~. "^ >^.. >,'^\ 195.50' \ 3.4%\ Timothy M. & Laura A. Johnson Trust of 2012 ####WarnerRd Lot 2 CSM # 1425 in V.8 P.316 Sec29T46NR07W 'own of Delta 34-016-2-46-07-29-3 02-000-50000 L.520 Acres \\\\ Q '102'\Bellevue Lake \ 104', Proposed 40' x 40' building site 4 bedrooms 299.22' \\ aui| A}j3dQJd Scale 1:40 <- NOTES: It Bench Mark = Top of iron property stake Elev = 100.0' - No well - Property line not to scale, see dimension - Survey stake - Bellevue Lake elev. = 55' CST#654921 Page 3 of 3 :^.".fsi:?5V^n 'Ft.L-'.^i-i V ii^i SEP 202023 Bayneld Co. D!anning 21.:; Zc'Tng Agency In-Ground Gravity Plan Index & Cover Sheet PAGE 1 OF 4 Component Manual Design References: 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 JohnsonTrustof2012 Owner Name(s): Timothy & Laura Johnson Owner Address: 3333 Emerald Valley Dr Phone: Zip:. 54848 Project Address: #### Warner Rd Govt. Lot: _ NW i /4 of SE -) ,4^ Section_29_, T46N-R 7 E |_|or W I/ Township: Delta _ County: Bayfield Project Parcel ID #: 04-016-2-46-07-29-3 02-000-5000 Designer Information Designer Name: Keith Wiley _ phone: 218 .451 .2611 Designer Address: 11623 E Larson Pr Lake Nebagamon, Wl zjp: ^4849 E-mail: s.shoreseptic@gmail.com Lj^^Number: D 2388 PSS .f^'r\^RiA'!'t'». •c"']\"MrrVi,\Hnr iipprovjl ^tJ^np 'P.O.W.T.S ConnieAPS°cvuED '\j^y ^S'YdmtCire:<^2 Original signature required on each submitted copy. Date: ^ -^^-..2-^ Johnson Trust of 2012 Septic System Plot Plan /K m> I'«u0tji€ ^-> (--JC3CYj ..'-3 '-^J CL. i^U--i Y'^.c\\\\\\v^•»,^ Prooertv line ^'•-.. "•... 195.50' 3.4% Timothy M. & Laura A. Johnson Trust of 2012 ####WarnerRd Lot 2 CSM # 1425 in V.8 P.316 Sec29T46NR07W [own of Delta M-016-2-46-07-29-3 02-000-50000 1.520 Acres 2 rows of EzFlow 9 units each (90') ^-0 '102' 104' Proposed 40' x 40' building site 4 bedrooms *'.<A ••s.-. \'^ ^'8. \^.\t '^.^ 3ui| Ayadojd 299.22' Wieser 1250 gallon tank w/ polylok 525 filter NOTES: Scale 1:40 Bench Mark = Top of iron property stake Elev = 100.0' - No well - Property line not to scale, see dimension(s) ® - Survey stake - Beltevue Lake elev. s 55' - All vent, observation and conveyance pipes 4" ASTM D1785 Page 2 of 4 IN-GROUND GRAVIP^ DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down-sizing credit) SOIL COVER Wieser Septic Tank(s) Manufacturer. 1250 gal Pplvlok Septic Tank(s) Volume(s): gal — gal Effluent Filter Manufacturer: , gal Effluent Filter Model #:525 12" min. trench depth(typical) System Elevation = 100 (typical) _ft. P^PICAL TRENCHCROSS SECTION VIEW (No Scale) Provide minimum 3 ft separation between trenches. OBSERVATION PIPE DETAIL (No Scale) TOPICAL TRENCH PLAN VIEW (No Scale) (Show location of inlet / outlet pipe connection on plan view.) l^=:—f—==4--^-. 4-0 Perforated Lateral (typical) -//- Observation pipe shall be installed at junction between two units. Observation Pipe(typical) 10 (typical) J. Screw-Type orSlip Cap (loose) 4"0 PVC Pipe Top of pipe to terminate at orabove finished grade (4)1/4"-1/.2"X6"Stots@ 9t> apart Anchoring Device .ft Finished Grade(mulched & seeded) Topsoil Cover(min. 1 foot) InfiKration"?Surface *-s =--^ (typical) INSTALL PER TRENCH: .10-ft bundles @ 50 ft2 EISA/unit = 450 5-ft bundles @ 25 ff EISA/unit = ft2 ft2 -A =3.0-ft (typical) EZ1203H Bundle(typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. -u>0m co0-n^ C-') -a r\^ cr> 1-^c-i I,-.--} ,<-^> = Proposed EISA per trench = 450 ft2 Required Infiltration Area = trenches = Proposed Total EISA = 90° .ft2 . ft" Distribution Method: branched manifold r.0 i> . J.<r;-'0 4" CAST-A-SEAL TOP VIEW 4" CAST-A-SEAL SIDE VIEW WLP1250-MR TANK SPECIFICATIONS DIMENSIONS:WALL: 2 1/2" BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 52 1/2" LENGTH: 10'-0 1/4" WIDTH: 7'-0" BELOW INLET: 41" LIQUID LEVEL: 36"WEIGHT: BOTTOM 4,945 LBS.COVER 3,865 LBS. INLET AND OUTLET: 4" CAST-A-SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL #10(OTHER STATES SEE CHART) LIQUID CAPACITI': 34.81 GAL/IN HOLDING TANK:OUTLET HOLE PLUGGEDACTUAL CAPACITC: 1,323 GALLONS LOADING DESIGN: S'-O" UNSATURATED SOIL TANK CAN BE USED AS:SEPT1C / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #S (NO FIBER)TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETE TANKS ARE MANUFACWRED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: [El=>101a-1 EI0 >;03 s I0 $m 2^ "CL F a,Bw SHEET NO. 1 OF 1 - '—WB^E yK&^ SEP 2 0 2023 -a.,.nj3ayfie;dco: _, PAGE 4 OF 4 I n-g round Gravity Managementmn IMPORTANT: 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. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, 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 = __GOO___ gpd; BOD5^220mgL-1; TSS 5 150 mgL-1; FOG$30mgL-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, etc.) 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, eto.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (/.e., pump re-cycling, float switch settings, ete.) o electrical components - if applicable (/.e., wiring, connections, switches, controls, timers, alarms, etc.] o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) 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 filteris) 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: Superior SeptJC Systems _ phone: 715-292-2415 Local government unit: Bayfield County Zoning _ phone: 715-373-6138 Local government unit address: 117 E 5th St Washbum, Wl _ ZIP: 54891 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 In 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-complying 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. FILE INFORMATION POWTS OWNER'S MANUAL & MANAGEMENT PLAN SYSTEM SPECIFICATIONS Page..of. Owner-i-jmothy M. & Laura A. Johnson Trust of 2012 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 (BODa) Total Suspended Solids (TSS) Pretreated Efftuent Quality Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) Fecal Coliform (geometric mean) Maximum Effluent Particle Size Other: 4 DNA EZINA 400 gal/day 600 gal/day 0.7 gal/day/ft2 Monthly average* <30 mg/L ^220 mg/L D NA <150mg/L Monthly average <30 mg/L <30 mg/L 0 NA <104cfu/100ml 14 in dia. D NA 0NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Tank Manufacturer Wieser El Septic D Dose D Holding Tank Manufacturer D Septic D Dose; D Holding Effluent Filter Mantifacturer Effluent Filter Model 525 Pump Manufacturer Pump Model Pretreatment Unit D Sand/Gravel Filter D Mechanical Aeration D Disinfection Manufacturer Dispersal Cell(s) 0 In-Ground (gravity) D At-Grade D Drip-Line Other: Other: ^% vol. ^250 ,fr¥ € .in)voi.i.^ APR Polylok^,/^,, D Peat Filter D Wetland D Other: DNA 11 rlT; 17"' d^ 122WJ QNA ^oninc; D. 0NA EINA DMA D In-Ground (pressurized) D Mound D Other: ENA 0NA i 'p!\ 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: 3 g V(S (Maximum 3 years) DMA 0 When combined sludge and scum equals one-third (%) of tank volume D When the high water alarm is activated At least once every: 3 § ineTr{s) (Maximum 3 years) D NA At least once every: _3 § ^(s? _D NA At least once every: _g ^%s) _0 NA At least once every: g ^%(s) 0 NA At least once every: g ^"^ 0 NA E1NA 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 affluent on the ground surface. The ponding of affluent 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 (%) 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 affluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <A2 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 _ 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 affluent. 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 ;n1 ^ ; , When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure|itiat fiesysitenrtl is!pro()enly| and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: jpj! . _ _ || /i • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. nl " '<-'u'"7 l~. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Opefi'Stbr. , ,^, ; .; : • 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. 13 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 DIFRCULT OR IMPOSSIBLE ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Superior Septic Systems Phone 715-292-2415 Name Superior Septic Systems Phone 715-292-2415 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Mr. Biffy Phone 715-395-4000 Name Bayfield County Zoning Phone 715-373-6138 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. BA;yFIELD Bavfield county Planning & Zoning Department 117 E 5& Street P.O.Box 58 Washburn,WI 54891 Phone: 715-373-6138 Fax: 715-373-4010 Property Owner: JOHNSON TRUST, TIMOTHY M & LAURA A 3333 EMERALD VALLEY DR ONALASKA, WI 54650 Description Private Sewage System (Septic Tanks) Total: Payment Amount: Submission Number: SS-00347 Transaction Number: SS-00347-F132 Amount $400.00 $400.00 $400.00 Reference: Tax ID 13088/Check #1657 Paid by: Superior Septic Systems - Chad Rochwite Payment Type: Check Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. 12/15/23, 8:28 AM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 12/15/2023 IAP Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN: ^Tax Districts 1 04 016 041491 001700 Updated: 2/18/2021 13088 04-016-2-46-07-29-3 02-000-50000 016106004002 (016) TOWN OF DELTA S29 T46N R07W LOT 2 CSM #1425 IN V.8 P.316 (LOCATED IN NW SW & SW NW SEC 29 & NE SE SEC 30) IN V.1154 P.170 1.520 1.800 0 No (R-l) Residential-1 110 Updated: 3/15/2006 STATE COUNT/ TOWN OF DELTA SCHL-DRUMMOND TECHNICAL COLLEGE aa Ownership Property Status: Current Created On: 3/15/2006 1:15:16 PM Updated: 2/18/2021 TIMOTHY M & LAURA A JOHNSON TRUSTOF 2012 ONALASKA WI Billing Address: TIMOTHY M & LAURA A JOHNSON TRUST OF 20123333 EMERALD VALLEY DR ONALASKA WI 54650 Mailing Address: TIMOTHY M & LAURA A JOHNSON TRUST OF 2012 3333 EMERALD VALLEY DR ONALASKA WI54650 Site Address * indicates Private Road N/A Property Assessment Updated: 8/29/2011 2023 Assessment Detail Code Acres Land Imp. Gl-RESIDENTIAL 1.520 25,600 0 2-Year Comparison 2022 2023 Change Land: 25,600 25,600 0.0% Improved: 0 0 0.0% Total: 25,600 25,600 0.0% -* Recorded Documents Updated: 12/21/2010 2015R-561774 1154-170 B WARRANTY DEED Date Recorded: 12/22/2015 B QUIT CLAIM DEED Date Recorded: 10/14/2015 2015R-560794 1150-450 B TERMINATION OF DECEDENT'S INTEREST Date Recorded: 9/27/2010 2010R-534806 1047-775 0 QUIT CLAIM DEED Date Recorded: 4/25/2006 2006R-506310 942-815 81 CONVERSION Date Recorded: 3/15/2006 503306 a CERTIFIED SURVEY MAP Date Recorded: 11/17/2005 2005R-503306 8-316 Property History N/A Private Sewage System Maintenance Agreement Owner(s) Name 'T^Ht^ ^•^(^3-Jo^^J T^f- ^ ^/<^ Owner(s) Mailing Address 332^ &wo^ 64^s ^)^: n^M^ ^ Address - 3rSite Address?{^ ^^^J^ Tax ID #3o^ 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 be operated 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)Sat. ^<^o( , -$?^_ T4l/^ ' %07 ^1/4 of__1/4 Section _Township _N. Range W. Additional Legal Description: Town of U-t ^A-(Acreage)Gov't Lot Lot. Lot _ . Block.Subdivision CSM#Vol.Page.CSMDoc#. DOCUMENT NUMBER2024R-603347 DANIEL J. HEF-F-NER REGISTER OF- DEEDS BAYFIELD COUNTY, Wl RECORDED 05/24/2024 AT 10:45 AM RECORDING FEE: $30.00 PAGES: 2 Recording Area Return To: Planning and Zoning Department '1 AY ;.' '-•'/-.}'/- In-ground gravity D Mound D In-ground dosed D In-ground pressure distribution Sewage System: D 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-third (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 serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank affluent 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 the 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. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise 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 shall be binding upon and inure to the benefit of all current and future owners of such property. Owner(s) Name(s) - Please Print )irr\OJT\^^ .^O^IA^oA-? Notarized Owner(s) - Signatpre(s) Subscribed and sworn to before me on this date: ^lwl^Lf Notary Public!A^^My Commission Expires:auqu^ ^i^ow Drafted by Ck«dl •^JL^Date. t/. M. 2.^ Proofed by: u/farms/sanitary/septicmaintenceagreementRevised July 2020 4/12/24, 1:24 PM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 4/12/2024 Property Status: Current Created On: 3/15/2006 1:15:16 PM '"SS Description Tax ID: PIN: Legacy PIN: Map ID; Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN; Updated: 2/8/2024 Ownership Updated: 2/8/2024 ^Tax Districts 1 04 016 041491 001700 13088 04-016-2-46-07-29-3 02-000-50000 016106004002 (016) TOWN OF DELTA S29 T46N R07W LOT 2 CSM #1425 IN V.8 P.316(LOCATED IN NW SW & SW NW SEC 29& NE SE SEC 30) IN V.1154 P.170 1.520 1.800 0 No (R-l) Residential-1 110 Updated: 3/15/2006 STATE COUNTS TOWN OF DELTA SCHL-DRUMMOND TECHNICAL COLLEGE Recorded Documents Updated: 12/21/2010 B WARRANTS-DEED Date Recorded: 12/22/2015 2015R-561774 1154-170 Q QUIT CLAIM DEED Date Recorded: 10/14/2015 2015R-560794 1150-450 83 TERMINATION OF DECEDENT'S INTEREST Date Recorded: 9/27/2010 2010R-534806 1047-775 Q QUIT CLAIM DEED Date Recorded: 4/25/2006 2006R-506310 942-815 a CONVERSION Date Recorded: 3/15/2006 503306 Q CERTIFIED SURVEY MAP Date Recorded: 11/17/2005 2005R-503306 8-316 TIMOTHY M & LAURA A 30HNSON TRUST ONALASKA WI Billing Address: TIMOTHY M & LAURA A 30HNSON TRUST 3333 EMERALD VALLEY DRONALASKA WI 54650 Mailing Address: TIMOTHY M & LAURA AJOHNSON TRUST 3333 EMERALD VALLEY DRONAU\SKA WI 54650 ip Site Address indicates Private Road N/A Property Assessment Updated: 8/29/2011 2024 Assessment Detail Code Acres Gl-RESIDENTIAL 1.520 2-Year Comparison 2023 Land: 25,600 Improved: 0 Total: 25,600 Property History Land Imp. 25,600 0 2024 25,600 0 25,600 Change 0.0% 0.0% 0.0% N/A n y'; https://novus.bayfieldcounty.wi.gov/access/master.asp 1/1 BAYFIELD COUNTY SANITARY PERMIT # 24-67S STATE SANITARY PERMIT ◻TRANSFER/RENEWAL PREVIOUS NO. OWNER: TIMOTHY & LAURA JOHNSON TRUST OF 2012 PROPERTY LOCATION: TOWN OF DELTA SEC 29, T46N, R7W LOT 2 CSM #1425 PLUMBER: CHAD ROCHWITE LIC. #: 220595 TRACY POOLER 6/26/2024 AUTHORIZED ISSUING OFFICER DATE Condition: System to meet all setbacks. Management plan to owner. Properly maintain per recorded agreement. THIS PERMIT EXPIRES 6/26/2026 UNLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R. 06/23) 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 a 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.