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Home My WebLink About24-69S FullingtonSS-091% ^ys-^,.^ w^%Vs J?^:v&::'""" ~ ^x^' r ^'~~^fS^^y^ 5// 7/ •- - \A A <-MAY Department of Safety & Professional Services, Industry Services Division h~^^ Sanitary Permit Number (to be filled in by Co.) 24-(o°>S •'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. NotB: Application forms for statc-owncd POWTS are submitted to the Department of Safety and Protessiona! 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 Number Project Address (if different than mailing address) 1. Application Information - Please Print All Information ;rty Owner's Name f ^» ,J^^^/^r^M pvU.ift^/J Parcel if W7fo^oe^i. n^ 9 i^z oo^wsi^o Property Owner's Mailing Address ^z-z^ T>ft%. 6^J€ ^ Property Location Govt. Lot City, StateSo 1^ ^r^s yj^ l^y^-7^ Zip Code II. Type of Building (check all that apply) or 2 Family Dwelling - Number ofBedrooms D Public/C'ummerdal - Describe Use D State Owned - Describe Use Phone Number -7/^<^^^<JA- Lot ft _'/4, Section T ~T*TN R C</^ E Subdivision Name Block#Aa.^iflg' &A)J>£> i^tir ^t? CS.M Number D City of. D Village of rfT^nof ^/W^^S 1M. Type of PQWTS Permit: (Check either "New" or "Reptacemeat" and otKer applicable on Uite A. Check one box on line fl. Complete fine C if applicable.) A.D New System ^^ss.replacement System Other Modification to Kxisting System (explain)D Additional Prclreatment Unit (explain) B.a Holding Tank [h-Ground (conventional) D At-Grade D Mound D Individual Site Design D Other'I ype (explain) c.D Renewal 'Before Expiration D Revision D Change of Plumber D Transfer to New OwnerlList Previous Permit Number and Date Issued W. Dispersat/Trcatment Area aud Tank Information: Design fjlow (gpd)L"&^%T Design Soil Application Rate(gpd/sf) | Dispers.il Area Required (sf))11^t<f ^.g^7 Dispersal Area Proposed (sf) /^e? System Elevation^^ Tank Information Capacity in Gallons Total Gallons New Tanks Existing Tanfcs # of Units Manufacturer IIfi 0 11I evi V,^ •3 r§sS: 0 Scpliuw llullHU^TOik 7^^/VW ^,^4, ,^^7- Dosing Chamber V. Responsibility Statement- I, the undersigned, ass" Plumbers S| iastnUation of the POWTS shown on the attached plans. Plumber'sJ'iamc (Print) ^i>l> ^ ^fM-Z^ MP/MPRS Number Business Phone Number \HP^W2- \7l^-^'"W^- Plumber's Address (Street, City, State, Zij^^9 ^^/'7/^€ /^T^e^f^/^ ^ ^9r7^7/ VI. County/Department Use Only ;nnit Fee 1<>XTC| Date Issued . ] lulling Ageiit-Signat^ ~ I \c,Yl±^C?^3^/'/^>^Approved D Disapproved D Owner Given Reason for Denial Permit Fees Conditions ofApproval/Reasons for Disapproval <^UL. cdtoucVs,^ CA»r<A Attach to complete plans for the system and submit to the County anly on paper not less than S 1/2 x 11 inches in size SBD-6398 (R. 03/22) .^""s''/:, SR-0,0056,w^., ^ „I „ I -. ! Ut)i'GiN^^;?SMAY 207H24 a \^^ SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code W. n ~^iS!": ue ^'\'f'' '•••.. On 1-; '•• rc ; ; ^.'-..-..'. ^''%^^ 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)). v Page.jLof_3_ County KeU Iparcell.D. '-7^ ^7^7^ 0y-£»y/-3*W-09-/6'o' 00^7^SOOOQ Date.,^73 l^^?/ Property Owner I(°ff^ -t WpjJ.r^e^ Ft>iH/^f\ Property Location Govt. Lot V4 % S (t? T ^ N R (9^a ^ E (or) W Property Owner's Mailing Address 3^? D&^r- ^ro^<- <U Site Address or CSM and Lot #:IWr Arcu-*- ^(0^^^^ ^'^ City, State, Zip ^On^PO^S/Lja ffitTS Phone Number (?/$~)_$^"'^^1 D City _ D Village iBoTA^S Town Nearest Road Q New Construction Use:JS^Residential/Numberof bedrooms 3 ieplacement D Public or commercial - Describe: Parent material Code derived designflow rate 73C? GPD Flood Plan elevation if applicable_tt. General comments and recommendations:foll^A/^cJ? ^(^ Boring #D Boringipn Ground surface elev,47STft.Depth to limiting factor.(@®_in./ elev. Horizon T~K ~3_ n Depth In. 0-3 3-^s^-w?^0 Dominant Color Munsell /ow^ TS^.5/^[C^L^/04^A/ Redox Description Qu. Az. Cont. Color Texture _SL_ 5_3: _s_ Structure Gr.Sz. Sh. 3L^Y. O^c-0^- Consistence ft^G- Avt- _^L_ ^<- Boundary ^5 cs cS Roots ^E~w Soil Application Rate GPD/Ff *Eff#1 J.7^~ 21: _-L^ *Eff#2 / 0 ( ^ J^_ -i^- Boring #QBoring 3Jt Ground surface elev.tei Depth to limiting factor 1^0 in. / elev._ Horizon JL _A_T _LL _5_ Depth In. Q^Llpf -7-^ zH^H ^H3o Dominant Color Munsell \Q^^JW^3 "l^SL^hl? ^lo^N Redox Description Qu. Az. Cont. Color Texture -SL- _$_ _5_ _?_^ Structure Gr. Sz. Sh. ^i^^L j2^_ oia> Ose Consistence (<y\{«-^£~^L~^L: /r»L Boundary -c^-c5ZFC5 Roots 3T3: Soil Application Rate GPD/Ff *EfW1-^- _^t^L _^z_ _^_ •Eff#2 'W-J5: ^f_/ ^~s_ CST Na/w (Please Print)jJ^5 Signature /^>CST Number(W^7</ Address.3SCD ^A.; ^L^^^S Date Evaluation_ Conducteder'^^^- Effluent #1 = BOD > 30 £ 220 mg/L and TSS > 30 s 150 mg/L Telephone Number-W- 734 -/iW Effluent #2 = BOD, < 30 mg/L and TSS <, 30 mg/L SBD-8330 (R03/22) ^\<^ ^1\^02M^ Boring # [,- \ j; 'I 'it Ground surface ele^^W^ ft.MAY Y- U [^(^0 liimfing factor /(?0 in. Page..of. IS-pi / elev._ft. Horizon I -5^~3- 3Z Depth In. G^gs:<^343-1^ Dominant Color Munsell \^Hi.^7^3^ [^_(0^1 Lilti Redox Description Qu. Az. Cont. Color Texture st _5_s s Structure Gr. Sz. Sh. ^v^L -s^- 3S Consistence fW^- /y^ _^L_ /wL- Boundary <«scs c5 Roots^H: Soil Application Rate GPD/Ft2 *Eff#1IE _^L,7Z7: *Eff#2 MO- _l^_T^~ ~[^_ Boring #D BoringDPii Ground surface eiev.Depth to limiting factor.in. / elsv._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/Ft2 *Eff#1 *Eff#2 Boring #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/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS > 30 < 150 mg/L * Effluent #2 = BOD, s 30 mg/L and TSS < 30 mg/L J^» O^k^ ^ AJofcrN-I 0 y> 40 r'^o- ^s&e,vk^|(L -£l0o.01 ^M^o^.AiM, •-SoilPib &• -^!,S5 6^'qg.^ ^3'^./S 0<k^l -Ta-p?+/Houj^<ae<s FlJlfY^'krv Prdpj^^y Sl\».-n^,}l0<:}c0 - (W6ro^6^Lo»nm.^ U^^ (^ru^ ^ 0^004-0?-^^- (^9 0&-<fi7S.^owo Tstvy^ f) ^arnes B^-fieU CQUL^ Ou-^ -3^' t> Uj^fi^^^-^ 3 'nr'l 3> .-...^~< ^'^ !V> "i^:i C-; f^' d ,. -.'r~< ' "h? ll^WS^ Qrsc^T^' l^ ^! ^p asr^7W^w In-Ground Gravity Plan Index & Cover Sheet Component Manual Design References:In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) i'/!AV ! ' Sc/^S^ ^ /^Ih^/w? h^l^Ltfj^ ^ /^^l^cr^eur' Owner's Name: ^T^^ ^ t^lf^T^^I f:\/Uj^-h^ 3z^r \>€fr 6rc0€ fU Project Name:_J^^ Owner's Address: -5^U9i>3 ^P^-IA^^ IAJ-T ^'M 8 75^ Legal Description:. Municipality: County:. -$7^ <7V^r ^t>^U) -S^f, /illagc. City of. ie^ "gn^Jes. Subdivision Name:)_ Lot Number: l>l^e<L -^rD\}€ &>^*Mio/n^ (J^*T M'^ Block Number: Parcel I.D. Number: ^-C64- ^<44^>?' Ifc^-- M^- ^^ <80tQ _S^^ ^ &^^ ^fe-TPage 1_ Page 2. Page 3. Page 4_ Page 5_ Page 6_ Page 7_ T/o-r TL^ <W>T\L. -r?M « 3V^h^ ft^L-b ^ic.^ B-z-Flt^ ^flpto) Q^^S ^Tu^ Page 8_ Page 9. ^ FjC77i^i£: <£Wue<Kj r- <F{ l-t^^ ^LOA-€^ ^/^o^yrz^ f^b^^^^r^ PL^J^u L_Tfe7- m.p i Page 10_ Page 11. Page 12. ^\{ r^Pz- ^:i r^'F^> Page 13_ Page 14_ Page 15_J/ Name of Designer:_ y() Signature^T /a 06 y / <;^ "tf £License Number Date:_ .mber: *^P (3^4^ sr/141-z^- In OJW^yfcA l-;So?(P^ 6, -4ZS5- feo-^SS- fo3-WS 0-N^l -It l&ff +/n0^r-ae<s RjlH»^^ S^.TW^O^ - ^r&^C^Q^ ^e4-w-c?^'-o?-ffe-? 0s^<9?s.?coso •AOft- -TOu/^ ^ &ewes B^-fe^ Cs^^ w^ -if %?^& ^ff^/^-^s^^ ')\/£^ ^^^sr^ ^£ iMP's^. P^^t^j- Ot^K W -fo Upp^&^CWKUt4 '^^r^.i.- ^"5'^f d^LL-5 4'^ ^^•_s- w 0<w mw^' ;'^--^- -°%y.J^';f'W ^ A^e^T j>rop^ ^ \h u^-^ "7?^-?.'^U^^s ^H 65rHS7sn^ ^j, p, ^'^•^-" /" ''. " ,£/a^"F"^f/"" '>/ ^.-•€—•^ WARNING DEATH MAY OCCUR IF TANK IS ENTEREDWITHOUT PROPER EQUIPMENT TOP VIEW OF MANHOLE COVER 4 /AfCH PRESSSEAL GASKETINSTALLED WHEN POURED os •3.00 ^-\/~\ 4 INCH PRESS SEAL GASKET FILTER 3.50 SECTION VIEW OF TANK AND COVER BAFFLE • 54.00- • 58.00. • 64.00- 124.50I I118.50 14.50 23.00- FILTER 12.00 23,00- TOP VIEW OF TANK (TAPERED) 56.0 _0 OUTLET END VIEW OF TANK Model Number. 1000 Approved for: SEPTIC, SIPHON, HOLDING, OR PUMP Weight 8300 Ibs. Inlet Dim. 42" Outlet Dim. 40" Liq. Depth 36.50" Gal. /In. 28.32 Max. Cap. 1034 gal. SKAW PRE-CAST 26255 105th Street, New Auburn Wisconsin 54757 www. skawprecast. corn Phone:(715)967-2277 Toll Free: 1-800-924-862C Fax:(715)967-2707 IN-GROUND DOSED-GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down-sizing credit) SOIL COVER TYPICAL TRENCH PLAN VIEW (No Scale) 1—i—t 12° rnin, trench depth(typical) System Elevation = (typical) TYPICAL TRENCHCROSS SECTION VIEW (No Scale) Provide minimum 3ft separation between trenches. OBSERVATION PIPE DETAIL (No Scale) (Show location of inlet / outlet pipe connection on plan view.) Scraw-Type orSlip Cap (loose) 4"0 PVC Pipe Top of pipe to terminateat or above finished grade (4)1/4"-1/.2"X6"Slots@ 9'0 apart Anchoring Device c r^j 4"0 Perforated Lateral (typical) -^ Obsarvation pips shall bs installed at Junction between two units. Observation Pipe(typical) 1- INSTALL PER TRENCH: -^- B= ^h (typical) sc K. (typical) ^13| 1 10-ft bundles @ 50 ft2 EISA/unit =, ^^ .^"•^ft2 5-ft bundles @ 25 fl2 EISA/unit = d ft2 ^A=3.0 ft (typical) EZ1203H Bundle (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. ~t-? ^.^. Finlshsd Grademulched & seedad) Topsoil Covsr(min. 1 foot) = Proposed EISA per trench = >>t>-€s ft2 Required Infiltration Area = 3$b x 5 trenches = Proposed Total EISA = /^^ ft2 - - W^!—-i Distribution Method: TTfe S u:^.y^-t ^y .^c-y^•^r'' EZflow1203H-GEO ESTABLISH VEGETATIVE COVER NATIVE BACKFILL 6" MIN. COVER OR PER CODE 01UJ|u| FILTER FABRIC 12" EZflow BUNDLE (TYP.)36" MIN.TRENCHWIDTH 4" PERFORATED PIPE N1UJISil 01D|Ql0|0:10-1 ul0:1§1UJlCt:l II01UJlsL NOTE: PRODUCT CONFIGURATION AND INSTALLATION DEPTH MUST COMPLY WITH APPLICABLE REGULATORY REQUIREMENTS. ^E-=jL::^3 L:. INFILTRATOR INFILTRATOR SYSTEMS INC. 4 Business Park Rd. Old Saybrook, CT 06475(800) 221-4436 EZflow 1203H - GEO Drannby: EMB Checked by: DFH 08/07/2013 '•In M; Years of Proven Dependabilty ii'ifcihirsnBi gQ(S|S33EQ3 os 'efftuent9:ilter! Nearly Twice the Filtering Capacity Estimated to go 3 Times Longer Between Cleanings Cleaning Made Easy Does Not Retain Solids Between Plates Lowest Price UN I Q UEIRL'ATEIDESIGN - Eliminates the collection of solids inside the cartridge. - Nearly twice the filtering capacity of any other filter. [|'^o]nr»»)lajiBNiaycasfi By eliminating solids between plates drastically reduces the need to clean. Cleaning made simple and efficient. HL-TERl RATINGS LT-1/8: 3500 GPD/ftesidential Strength Filtration 1/8" - LT- 1/16: 3350XSTO/Residential Strength Filtrationl/16" - LT - 1/32: 300Q GPD/Recommended for GommercNI use with Residential Strength - Filtratnwi t/32" - LT- 1/64: 2500 GPD/Re«^mitnended1brGommerGial usage with Residential Strength - Filtration \W fc/^ - 2700 Inches of Linear Filtration (Nearly Twice the Competition) ^ I ,f<OWTS. RU^IWFOKniATION Owner -^WiUS£&Permit » ~ ~~~ —f J3ES1GN PARAMETERS Number of Bedrooms Number of Public Facility Units Estimated ;flow (average) Design flow (oeak). (Efitimated x 1.5) Soil Application Rate Standard Influent/Effluent Otuality Fats, Oil & Grease (FOG) Biochemical Oxygen Demand (BODgl Total Suspended Solids (TSS) Pretreated Effluent Quality BiQchemical Oxygen Demand (BODe) Total Suspended Sofids (TSS) Fecal Coljform (geometric mean) Maximum Effluent Particle Size Other: "Values typical for domestic wastewater and ; MAINTgNANCE SCHEDULE [OWNERS MANUAL & MANAGEMENT PLAN Paga SYSTEM SPECIFICATIONS^^ DMA —aim 3^>gal/day4fegal/day *>*"7 aal/day/ft2 |Monthly average* >30 mg/L ; >20 mg/L D NA ngOmg/L : lonthly average !$30 mg/L ; JS30 mg/L D NA :104cfu/1o{)ml in dia.DMA D NA setnic tank efflitent. Septic Tank Capacity ' j6£>{^_aaL OWA Septic Tank Manufacturer $'/[^t*J ^f€C^t7~ a NA Effluent Filter Manufacturer 'L.lf'lETm^E... D NA Effluent Filter Model f^~-a NA Pump Tank Capacity ^L SCKP^ Pump Tank Manufacturer Pump Manufacturer B-fffA Pump Model S°fW Pretreatment Unit D Sand/Gravel Filter a Mechanical Aeration a Disinfection €WA. d Peat Filter D Wetland a Other: Dispersal Cell(s) )-Ground (gravity) a At-Grade D Drip-Line DMA a In-Ground (pressurized) a Mound a Other: Other:D NA Other:a NA Other:a NA Service Event Service Frequency Inspect condition of tank(s>At least once every: ^2/1$ Ii»n^rttus) ;(IVIaximum 3 years)DMA Pump out contents of tank(s)When combined sludge and scum equals one-third (%} of tank volume 0 NA Inspect dispersal cell(s)At least once every:D month(s)B^ear(g)(IVIaximum 3 years) D NA Clean affluent filter At least once every:IteS?3' €>^- %?CM^/•a NA Inspect pump. pump controls & alarm At least once every:D month(s) _OYear(s>NA Flush laterals and pressure test i At least once every;a month(s)D vear(<NA At least once every:a month(s)a iNA NAMAINTENANCE INSTRUCTIONS I ]—-• —-—- MSp^Lherta^LandDdispersbLcells sha".be made by an individual carrying one of the following licanses or certifications: inapectionTn'i'iTsr ,'^asTlr ^!umbeLRestr!cted sewel'; POWTS .'"spector; POWTS Maintainer; Septa8e"Servicina Operator. Tank _a visual inspection of the tank(s) to identify any missing or broken hardware^identify any lcracks or leaks, The'diSDer^l*'^re^r.,c°rr'bi"ed..slud8e and scum ar"f to check for any back up or ponding of affluent on the ground surface. af'effS^, "t^'^-S ^!sua"^nspected t°.check the sfflue"t levels i"theobs6rvation'pipes]andto^heck for any ponding immedwtenQtiflca^icwu^t^^i re^|j^i2^LTt^luent °" the 9rou"d surface maY indicate a failing condition and requires the con^,Se,J:(SS"^la^;mJlat!cm^sludpe and scum.in any tank equals one-thirl( ^ or more of the tank volume, the entire Wisconiin"Admin^t^tisvealC^e.removed b^ a septage sel'vljcir1g Operator and disposed of in accordance with chapter NR 113. units and a^v^^d^9nb^T!!m^ of effluent filters, mechanical or pressurized components, pretreatmentat intervals of S12J months, shall be performed by a cenmedPOWTS'MaimEUrw " A service report shall be providedj to the lofral ragulatory authority within 10 days of completion of any service event. ,{„ Page.of START UP AND OPERATION For new construction, prior to use of the ROWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment 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 inffltraiive surface. During extended power outages pump tanks may fill abpve normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dosejand may overioad 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 POVtTTS 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-gradejsoil 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 butts7 condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (su'TIP 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 property and safely abandoned in compliance with chapter SPS 383.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • Tne contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shpll be excavatecf and removed or their covers removed and the void space filted with soil,gravel or another inert solid material. CONTINGENCY PLAN : ^th,? Powrs 'teils and cannot be repaired the following measures have been, or must be taken, to provide the opportunity to obtain asanitary permit for a code compliant replacement system" -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 itructure, 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. Replarement systems must comply with the rules intime of their permit Issuance. ' ' ' • ' ' a A.>s-u!tab.te-replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be and barring advances in POWTS technology, a holding tank may be installed as a last resort.' The.sne has not been eva*"!ated to identily a suitable replacement area. Upon failure of the POWTS a soil and site evaluation performed to locate !a suitable; replacement area. If no replacement area is available a holding tank may be installed as alast resort to replace the faile|d POWTS. ^ Mowd.a^d.^grade.soil abjsorPtion systems may be reconstmcted in place following removal of the biomat at the infiltrative of such systems must comply with the rules in effect at that time. ! :JRE^E!rTlwKS^WD^OLDmGJANKS MAY CONTAIN POISONOUS GASSES AND LACK SUFFICiEWT§•»; O^G.ElTOSUP^ORT_LIFfc NEVER ENTER A TREATMENT fANKORHOLDING^TANKU'NDERANY'^?.--DI'^t^??.ANCE' IDEATH MAY RESULT- ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK IS VERY _ADDITIONAL INFORMATION. POWT3 MAINTAINER Name:-/7^ ^//u-z.^^^^^/^ Phone: .SEPTAGE SERVICING OPERATOR (PUMPER) Name: TI^ •z3<r- -z^^ J-OCAL REGULATORY AUTHORITf Name: Phone: T5^//y^£> ^. 2»^/^<? ^f^3^3-^/^y _^_^l^^^v^t0^'»" "Wnents of Ch.of this documen^oe'sn^a^eeTrpa^^^^^ 383.22(2)(b)(1)(d)&(0 and 383.54(1), (2) & (3), VWsconsin Admin.strative Code. Use ^J^ . ' (Rev. 3/13) 6/27/24, 1:13PM Real Estate Bayfield County Property Listing Today's Date: 6/27/2024 Novus-Wisconsin Access rev. 12.0206 Property Status; Current Created On: 11/6/2015 9:21:40 AM fi?Il^? Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: ESN: Tax Districts 004 041491 001700 Updated: 12/12/2022 37274 04-004-2-44-09-16-2 00-675-80000 (004) TOWN OF BARNES S16 T44N R09W DEER GROVE CONDOMINIUM UNIT 8 IN DOC 2019R-576445 TOG WITH UNDIVIDED INT IN COMMON 0.000 0.000 0 Yes 104 Updated: 11/6/2015 TOWN OF BARN ES SCHL-DRUMMOND TECHNICAL COLLEGE '<.••* Recorded Documents Updated: 11/6/2015 Q CONDOMINIUM DEED Date Recorded: 2/21/2019 Q CONDO PLAT Date Recorded: 5/6/2015 2019R-576445 2015R-558630 2-137 B DECLARATION OF CONDOMINIUM Date Recorded: 5/6/2015 HISTORY B Expand All 2015R-558629 1141-981 Ownership JEFFREY M & MAUREEN K FULLINGTON Billing Address: JEFFREY M & MAUREEN K FULLINGTON 3225 DEER GROVE RD SOLON SPRINGS WI 54873 Site Address * indicates 3225 DEER GROVE RD * Property Assessment 2024 Assessment Detail Code G2-COMMERCIAL 2-Year Comparison Land: Improved: Total: Property History Parent Properties Updated SOLON Mailing Address: JEFFREY M : 12/12/2022 SPRINGS WI M & MAUREEN K FULLINGTON 3225 DEER GROVE RD SOLON SPRINGS WI Private Road Acres 0.000 90,900 148,300 239,200 04-004-2-44-09-16-2 05-004-10000 White=Current Parcels Pink=Retired Parcels 63 Tax ID: 1995 Pin: 04-004-2-44-09-16-2 05-004-10000 Leg. Pin:004111103000 54873 BARN ES 54873 Updated: 4/1/2020 Land 90,900 90,900 148,300 239,200 Imp. 148,300 0.0% 0.0% 0.0% Tax ID 1995 37274 This Parcel 't' Parents ^ Children https://novus.bayfieldcounty.wi.gov/access/master.asp7paprpids37274 1/1 'VM ! I Owner(s) Mailing Address^51D^^OS ^ ^^^©^1^4^ ^'/.,. .'-//^-,.€•l/^ Private Sewage System Maintenance Agreement Owner(s) Name ^W%^ ^" /U^U&S^S FLtU4^G^&^ Site Address^9^ =P»^(ZO? ^o £&(^JE5.-^^^4.?7^ Tax ID # As owner. I (we) do hereby certily the prtvale sewage system will be installed in accordance 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. 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. (GOMPLETE Legal i» required) J-ownship 44" N. Range <T W.-?gc&e(^^ff:^_1/4of__1/4 SectionfSQSft.Additional Legal Description: fcJlfiJ (T* TownofKAAKSRS (Acreage)Gov'tLot. t-ot.Block.Subdivision Lot..CSM#.Vol..Page.CSMDoc#. DOCUMENT NUMBER2024R-6035S2 DANIEL. J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. Wl RECORDED 06,12/2024 AT 1 1 :00 AM RECORDING FEE: $30.00 PAGES: 1 Recording Area Return To: Planning and Zoning Department •In-ground gravity Mound In-ground dosed D At-grade Sewage System D In-ground pressure distribution 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 8, C, D, and E): The pump chamber shall also be rifised 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 aperability 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 Sewaoe System Dispersal Cel| (system types A through E): The private sewage system distribution ceH 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 Laterais (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 will resulS in action tjeing taken to pay alt charges and cosls incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the private sewags system tank in such a manner as to prevent or abate any human health hazard caused by Iha system Bayfield County shall notify the owner of any costs which shall t>e 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, Ihe owner specifically agrees ihat 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 be collected as provided by law. The lenns and conditions of the agreement shall be btndmg upon and Inure to the benefit of all current and future owners of such property. Owner(s) Name(s) - Please Print .J'&^ir-e^ ^\ \ \ yvj^^ "IWr^i- f^UFn0^^ Subscribed and sworn to before me on this date: ^»'\' c,A MP \l 4~/3o/^^(/ /,>";' /' \\OTA/^^ ^ Notarized Owner(s) - Signature(s) -^Z^^L - Notary My Commission Expires: l^\ ^BLIC\ 7x\ Drafted by:T<3 D n <^/VZD^te: S~/30/^l(3A/+-T "^ ^ %*. .*'[,"7^ / Z^7 '^-'wisS r ""lllHlltl11 Proofed By: ufforms/sanitary/septicmaintenceagreement Revised July 2020 BAYFIELD COUNTY SANITARY PERMIT # 24-69S STATE SANITARY PERMIT TRANSFER/RENEWAL PREVIOUS NO. OWNER: Jeffrey & Maureen Fullington PROPERTY LOCATION: Town of Barnes Deer Grove Condominium Unit #8 SEC 16, T44N, R9W PLUMBER: Todd L Sinz LIC. #:139462 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. Tracv Pooler AUTHORIZED ISSUING OFFICER 6/27/2024 DATE Condition: System to meet all setbacks. Management plan to owner. Properly maintain per recorded agreement. Properly abandon existing/old system per SPS 383. THIS PERMIT EXPIRES 6/27/2026 UNLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R. 06/23)