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HomeMy WebLinkAbout24-73S Crandall-Balbin^f<yf.v{:.^. !^.. :^.>:-^ '^1)HC/JJ-I^J. <i"X ,'v"n'f-u-s^)~'J{^h^-\53 Department of Safety & Professional Services, Industry Services Division County.,'"PrU^^M Sanitary Permit bTfiIled in by Co.) W-1ZS. Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for stateowned POWTS are submitted to the Dqiartment of Safety and Professional Services. Personal information you provide may be used for secondary puiposes ia accordance with the Privacy Law, s. 15.04(l)(m), Stats. I. Application Information - Please Print All Information Project Address (if different than mailing address) •oWv^ Property Owner's Name ^ir/r, 6^b i^ ^ fr^^ Cnz^^-d Parcel # ~^^D /qi5L/ Property Owner sTMailing Address 4^nn S^nv-inA State [ Zi] Property Location Govt. Lot. City, State nrunvTT^wQ. u^r- Up Code 5^<? II. Type of Building (check all that apply) D 1 or 2 Family Dwelling - Number of Bedrooms D Public/Commercial - Describe Use D State Owned - Describe Use 1 Phone Number ^S--^-SO-0(^$ Lot # Jsl|UJ_'/4,_S^_l/«, Section T W N R (3-7 Eor/ Subdivision Name Block # CSM Number a City of _ D Vmage of [Town of 'Dry-r^iwnvJ? m. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other applicable on Une 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 'In-Ground (conventional) D At-Grade D Mound D Individual Site Design D Other Type (explain) c.D Renewal Before Expiration D Revision D Change of Plumber D Transfer to New OwnerlList Previous Permit Number and Date Issued IV. DispersaVTreatment Area and Tank Information: Design Flow (gpd) 1^0. Design Soil Application Rate(gpd/sf)^2 Dispersal Area Required (sf)^lQ Dispersal Area Proposed (sf)'^^^System elevation^ ^ Tank Information Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units Manufacturer •^r^^£^cnT_ a^ 2,03 UIIi£ 0 61 m ~s 1-< w<L>£ SE U cd Ox Septic or Holding Tank ~^w 5SO ^Dosing Chamber V. Responsibility Statement- I, the undersigned, assume responsibility for instaUation of the POWTS shown on the attached plans. Plumber's Name (Print)Plumber's Sign;MP/MPRS Number-7^301 Business Phone Number ?/€T-SSW^Z3 Plumbed Address (Street, City, State, Zip Code) \^/ ^357/-N7^~'T7?¥tu^-fAfl. Vo/^^.A^u^aud, u^^SV^ '.. County/Department Use Only ~£^\Approved D Disapproved D Owner Given Reason for Denial Permit Fee KSJKw Date Issued ~]HW Signature i^//^7/7 Conditions ofApproval/Reasons for Disapproval ^9Yr^r^ fu^^/^^ ^^^ Sa£- G^c^cWA oAA^V\or^\ Attach to complete plans for the system and submit to the County only on paper not less than 81/2x11 inches in size SBD-6398 (R. 03/22) SR-0007fc S:G~^<^ Wisconsin Department of Safety & Professional Services ^7-V \!'- SOIL EVALUATION REPORT; T^z.t>. i^js-4i\BP«\7A ^ ^^^ \^ill^ In accordance with SPS 385, Wis.Adm.Code Attach complete site plan on paper n6t 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)). Page ' of A County w^/GtiJ -fA^lrf/fff Parcel I.D. <s4- <3/Q z.-4^-61~3r4- <s 2.» doe -.<;<s tfoc? <3/&f6^f"5,-^i6C-6K"«^/^/?i%3 Property Owner •SA^A B^i-0^ ^ <f^tiYX>. ^'/SAA/OAi'1- Property Location Govt. Lot fVW % 5& y*s g/T ^^4 N R C-l E (or) w Property Owner's Mailing Address^i-f€^ BL<J£ /f<S^W ^P,Site Address or CSM and Lot #: City, State, Zip DRiJHt^^^.\hii Sjg^Z Phone Number ( 7f^)S^Q -&4S3 D City D VillagejD^Vf^H^fi Town Nearest Road BUIG f^JQ&Af /Q>. New Construction Use: Si Residential/ Numberof bedrooms ^E D Replacement D Public or commerdal - Describe: Parent material. General comments and recommendations: Code derived designflow rata ,15^ GPD Flood Plan elevation if applicable_ft. Boring #D Boring Ground surface elev.'. 77'3:1 ft. Depth to limiting factor 7B in. / elev, Horizon / J- J- _1- J2_ Depth In. o-y e!-^4 24. 47 W-S& ^- 7B, Dominant Color Munsell yy^ ^i5/i ffVl? ^3sm YC S-YA y/4 .S1K ^4 Redox Description Qu. Az. Cont. Color -M.h/A J^_NANA Texture ^7~ J.s_ C5^/ s C5.cd Structure Gr. Sz. Sh. t f- -5tM. tc.sUiOw€>^ Consistence w pr- /w-Pr ~mT Ml Boundary d.w <StA/ 4Wfw" ^ RootswIm Soil Application Rate GPD/R2 *Ef»1 !5 - 7 _L.7 --7 *Effiff2 ^ /.z ~/7^~ /.z /,6 ^, I Boring #BBOrin£l - . . , W.l< ^^. .„__,„__._.._. -^QPit Ground surface elev. / ^"-'ft. Depth to limiting factor tisy in. / elev.J^i Horizon / ^A1_ Depth In. d-/^ /o" it. i^SiSp7^ Dominant Color Munsell ^_s^ z1^ 5W ^3. A-y/? ^€6JR ^/4 Redox Description Qu. Az. Cont. Color _M.M^A/i~w Texture ~AL f6 e.s,<^' §,^ Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Ef»1 _i_IT~r- .7 *Eff#2 .f /'^TT /.z CST Name (Please Print),^£Wi^"K^HU^eH Address ^Z^Z^ ^^^6///Z6. c^eiis, w/ 64^'iL Signs Date Evaluation Conducted^/<3Z /2^ CST Number'~2.^/y/^ Telephone Number7/s'<$"^ -^'^-s'4 * Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 s; 150 mg/L * Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L P^A '71 If 2M~ 0<?tA ^0 SBD-8330 (R03/22) 3.Boring ff D BoringLPit Ground surface etev M\. Page ^- of Depth to limiting factor ^^ in. / elev.^^ft. v tiorfzon.^> T^ _3_ -± Depth In. £>-& S-2.1 n-si Si-M Dominant Color Munsetl 5'1R ^'% 5W ^sn ^^R '^4 Redox Description Qu. Az. Cant. Color ^ A/A /t/ArtM Texture "jT _^_ S.^f C-S^b Stmcture Or. Sz. Sh. 1 fcU 2 d s^ 3L Consistence mf-r my^~mT ~mT Boundary j^L^^^ Roots ~ML lft\ Soil Application Rate GPD/Ft2 *Ef»1^^L _1_-7 <Efl»2 _f_ /.^ la t-if. Boring #D Boring D 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 *EfS1 *Ef»2 Boring #d Boring Pit Ground surface elev.._ft.Depth to limiting factor.Jn. / elev.__ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cent. Color Texture Structure Or. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Ef»1 *EfB»2 * Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 s 150 mg/L ' Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L Jtr »St -^ t &^<A'p ^1^^ v^ ^j ~~Q ^0 '^0 Vb r^ -^ ^ ^ <-i<s ^x o\ ^e ;fi— '^i^e^ I vf<rft^ "^ ^_./'- &.' ^ ^ Sofi Profile Sheet S^-I^L Owner: ^RV CJK^WU. Soil Tester •.__J^W/^^H^^ ^ _ ^ f System Elevation-. %.^ Load Rate: ' ? _ System Range-. ^_ to ^-^^ ff/- mr BZ n/5'M w^f ?f. TB- ^ <slZ^S • ^5.21 s/ ^.AS' 3 /* •^. PAGE 1 OF 4 In-Ground Gravity Plan Index & Cover Sheet 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 OwnerName(s): '3urt3a?m <^6m) QWM{ Phone :'7/SU-<>^0- 0^6^ Owner Address: 4t?L^n R^L Pf\nOi^A. pnjL/^t^dLQ.tZip: S^(?^^ Project Address: €?F\/M:=/ Govt. Lot:(^UJ 1/4 of_6^Ll/4, Section ^?/ , T WN-R (97 E I Township: "p fLUY-ryVT/uA County: P/^c^^'I Project ParceIID #: -Tt^^P ;^Kl/ or W n Designer Information Designer Name: ^.^^h f^t^AA _Phone:/7^-S$^- ,^73 Designer Address: /0^7/Aj;T^iiA^v^^^2 Vcu^W. . Zip: €>Li^:5 E-mail: License Number: ^798^0 / Remarks: wan^^^^!Lsp.ace-t:&s?t (^UUi'OO 88S_ Toval|stamp. Signature: -Jf^^ ZLNnoocnaidAva^G'aAoyddV AnBUompuoo s-r^'o'd V-' /^Qri^inal signature r^qfiired on each submitted copy. Date: i'-/0 "^7/_ T-iI D?I <^^ <3a O?^ .^\ ~-Q <1 «sQ .^-<0b ^tk *^ ^ ^ ^d <>n <A ^ »s. '1't -^ 11 ' 8N-GROUND GS:9.AVSTY DISPERSAL AREA Uniform Elevation Trenches with Qu8ck4 Standard-W Chambers 3"ft Trench (down-sizSng credit) SOIL COVER Sapdo TanK(s) Manufacturer!^/25^L.26^1- £S^. 081 Septlo Tanl<(s) Volume(a); gal — gal flat Efflusnt FlltecManufaoturer; _<22^-^^^.^..&2__-^L<.^c2_^2'CL^; Efflusnt Filter Modal #; ^.^L^»^».<S«SL. 12" inln, Irsnchdoptli(typ'toal)TYPICAL TRENCHCROSS SECTION VIEW (No Scale) Clulol<4 Standard"Ww/End Cap(typical) System Elevation ^l^.J^.(typical) (Show location of Inlet / outlet pipe conneotlon on plan vlsw.) Provide minimum 3 ft separation between tt'Bnohss, ObBsrvallonPlpa(lypteal) Install par manufaotufQr's Instructions, TYPICAL TRENCHPLAN VIEW (No Scale) (typical) JNSTALL PER.TRINCH;^, Quick4 Std"W @ 20 fp EISA/chamber» ^^,, Pairs of end caps @ 8?ft2 EISA/pair = ft" fta A " 3,0 ft(lyploal) -Qulck4 81'andard-W Chambsr(typical) (mfd by Inflltrator SystsmB, Ino.) Install pursuant (o rnanufaolurBi-'B inBtructlans, ImOd0Tl 4&. = Proposed E ISA per trench a X L ft"Required Inflltratlon Area ^ 2sU:L^ ff Distribution Method; trenches a Proposed Total EISA a 2s.sisJ^L ft2 PAGE 4 OF In-ground Gravity Management Plan 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 = /^-d9 _____ gpd; BODs S 220 mgL-1; TSS ^ 150 mgL-1; FOG <. 30 mgL-1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (/.e. odors, user complaints, etc.) o mechanical malfunction (/.e., pumps, valves, switches, floats, 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, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (/.e., pump re-cycling, float switch settings, efc.) o electrical components - if applicable (/.e., wiring, connections, switches, controls, timers, alarms, ete.) o distribution laterat 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 Seotic and dose tankfs) 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 filterfs) 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: '^1)^7^ GAirTl^r\ _ Phone: 11 £S~'^SS^-/^ '75> Local government unit: 9)OJt_^ <^i CffuM^ T^VA^ Phone: ^1^-3 73 -' (^/3^ Local government unit address: P6 0C:Y 5^ U3lf?k^)q<f^ LO^C: ZtP: ^4S<?^/ 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. Continflency 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. 3 IN'is "wV S -k. tanks I M-540 The Infdtrator IM-540 is a lightweight strong and durable septic/pump tank. This watertight tank design is offered with fnfiltrator's line of custom-fit risers and heavy-duty lids. Infiltrator injection molded tanks provide a revolutionary improvement in plastic tank design, offering long-term exceptional strength and watertightness. & • Strong injection molded polypropylene construction • Lightweight plastic construction and inboard lifting lugs allow for easy delivery and handling • Integral heavy-duty green lids that interconnect with TW™ risers and pipe riser solutions • Structuralfy reinforced access ports eliminate distortion during installation and pump-outs • Reinforced structural ribbing offers additional strength • Can be installed with 6" to 48" of cover • Can be pumped dry during pump-outs • Suitable for use as a pump tank or rainwater (non-potable) tank • No special installation, backfill or water filling procedures are required • No special water filling requirements are necessary • The tank may be backfilled with suitable native soil. See installation instructions for guidance. TAt'IKCUTAWAY Reinforced 24" structural access port {nSERCUTAWAY Reinforced watertight mid-seam gasketed connection Protecting the Environment with Innovative Wasfewater Treatment SoiutioriS INFILTRATOr IM-540 General Specifications and Illustrations The IM-540 is an injection molded two piece mid-seam plastic tank. The IM-540 injection molded plastic design allows for a mid-seam joint that has precise dimensions for accepting an engineered EPDM gasket. Infiltrafor's gasket design utilizes technology from the water industry to deliver proven means of maintaining a watertight seal. The two-piece design is permanently fastened using a series of non-corrosive plastic alignment doweis and locking seam clips. The IM-540 is assembled and sold through a network of certified Infiltrator distributors. .64.9 [1,648] EXTERIOR LENGT14-]INLETCONNECTION TOP VIEW(TYP.) 61.7 TERI^IRWIDTH LIFTING STRAP(TYR) Must be backfilled and installed in accordance with Infiltrator Water Technologies, jnfiltrator IM-Series Septic Tank General Installation Instructions and for shallow ground water conditions reference the Infiltrator IM- Series Tank Buoyancy Control Guidance. Please visit www.infiltratorwater.com/images/pdf/ ManualsGuides/TANKd.pdf for the latest information. INLET CONNECTION (TW.) Total Capacity Length Width Height Maximum Burial Depth I Minimum Burial Depth I Maximum Pipe Diameter I Weight 552 gal (2090 L) 64.9" (1648 mm) j 61.7" (1567 mm) | 54.6" (1387 mm) 48" (1219 mm) 6" (152 mm) 4" (100 mm) 169!bs(77kg) j END VIEW , 241610] diam. ACCESS OPENING WITH LOCKING UD SECTION A-A' TANK BOTTOM HALF INFILTRATOr 4 Business Park Road P.O. Box 768 Old Saybrook, CT 06475 860-577-7000 • Fax 860-577-7001 1-800-221-4436 www.infjltratorwater.com MID-HEIGHT SEAMSECTION DETAIL U.S. Patents: 4,759,661: 5,017,041 ; 5.156,488: 5,336,017:5.401 ,116: 5.401,459; 5.511.903; 5,716.163: 5,588.778; 5.839,844 Canadian Patents: 1,329,959; 2,004,564 Other- patents pending. Intiltrator, Equalize^ Quick4, and SideWinder are registered trademarks of Infittrator Water Technologies, infiltrator is a registered trademark in France. Inffltrator Water Technologi^ is a registered trademark in Mexico. Contour, MicroLeaching, PolyTuff, ChamberSpacer, MultlPort, PosiLock, QuickCut, QuickPlay, SnapLock and StraightLock are trademarks of Infiltrator Water Technologies. PolyLok is a trademark of PolyLok, Inc. TUF-TITE is a registered trademark of TUF-TITE, INC. UKra-Rib is a trademark of IPEX Inc. © 2013 InfHtrator Water Technologies, LLC. All rights reserved. Printed in U.SA IMH me Contact Infiltrator Water Technologies' Technical Services Department for assistance at 1-800-221-4436 Ig^I (-1 ^5ii ',:Ct '^ a ^ S S y | ^ ® i i S M i S a i ! •' ^ i & S S S S P If t- !§ ' ffi ~ 3. '& .w ^ % 11 I I li§ ? s : n I' 5 ? | I ar . - S T " ' g ' ^ l gl fe ea j ys au' l Mg ] g g , l w 1 1 STi Si ' i "V I <@0-a -- a eS i QV -i ! ^ . t »» A "I r o te " " " § W II 1 1 I I I I s j , 'E f ^ g g : '• ^ g f t g ) § • .? "S t C3 >a9 I d<nM 3 §1 sH £ 2 s .p a J-. 3 s»^"IHiKi wjk ft i i ^B @2s S , § " ® L i S . K - i » I ' " a 3 S S I' ^ t S ! ^ . '( 43 W B W " « t •§ ' ( g I 0' vrenco •BJIJIJJ 'ss;^0^01;Q'CQ:0?0;G| ?aM A. Overall hsigtit, sn (mm) B. Housing hagftt, in (mm) C. Cartridge heght, in (mm) D. Outlet p'qse diameisr, irt (mm} E. Outlet height to iiwerf, in (mm) F. Defector plate diameter, in (mm) Mesh size, in (nun) Filter suriacs area, f? (m^* How area, ^(m^ PSGS0621-18 22.7 (577) 21.0(533) 'i7.75 (451) 4.5(114) 13.5(343) 6.63 (168) 1/8 (3.2) 6.3 (0.59} 1.9(0.18} PSGPSOS2W8 22.7(577] 21.0 (533) 17.75(451) 4.5 (114) 13.5(343} 6.63 (168) 1/16(1.6) 6.3 (0.59) 1.9 (Q.18) * FSSB-arBa sds&iaSas UB fcia? smscs sea ef all siSsssBlBseSAes Bjttun Its Stsrcsrtmigs. " %t'aies B tfsM^a? ftg &jy ^%a% (ff^a e? fig B^B ^cM^ &'^ Se refes^ Sfflte^'^? fe ;%a-(art^ NIB-H-FIS-2 fiev.3©06/ZlPage2of2 Qreneo Systems8 e 800-348-SS43 ° -i-1 541-4S9-4M9 ° www.orenco.com 6/10/24, 9:35 AM Real Estate Bayfield County Property Listing Today's Date: 6/10/2024 Novus-Wisconsin Access rev. 12.0206 Property Status: Current Created On: 3/15/2006 1:15:19 PM ^ Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN: Tax Districts 1 04 018 041491 001700 14154 Updated: 1/25/2010 04-018-2-44-07-31-4 02-000-20000 018104501000 (018) TOWN OF DRUMMOND S31 T44N R07W THAT PART OF NW SE IN V.523 P.68 320 10.370 10.815 1 Yes (R-2) Residential-2 112 < Recorded Documents S CONVERSION Date Recorded: Updated: 3/15/2006 STATE COUNTi' TOWN OF DRUMMOND SCHL-DRUMMOND TECHNICAL COLLEGE Updated: 3/15/2006 523-68 Ownership SARA BALBIN GARY D CRANDALL Billing Address: SARA BALBIN & GARY DCRANDALL46400 BLUE MOON RDDRUMMOND WI 54832 Site Address * indicates 46400 BLUE MOON RD Property Assessment 2024 Assessment Detail Code Gl-RESIDENTIAL G6-PRODUCTIVE FOREST 2-Year Comparison Land: Improved: Total: [SS Property History Updated: 7/14/2009 DRUMMOND WI DRUMMOND WI Mailing Address: SARA BALBIN & GARY DCRANDALL 46400 BLUE MOON RDDRUMMOND WI 54832 Private Road Acres 2.000 8.370 2023 199,200 220,200 419,400 DRUMMOND 54832 Updated: 8/9/2021 Land Imp. 185,000 220,200 14,200 0 2024 Change 199,200 0.0% 220,200 0.0% 419,400 0.0% N/A https://novus.bayfieldcounty.wi.gov/access/master.asp 1/1 Document Number PRIVATE SEWAGE SYSTEM MAINTENANCE AGREEMENT Document Title DOCUMENT NUMBER2024R-60346S DANIEL J. HEFFNEE:R Rt:GISrE:K OF DEEDS E3AVFIE!-.D COUNTY. W/l RECORDED 06/'04./2024AT 1 1:04 AM !- ? t:; COKU I N G !- E E/$30.0 0 "AGES: 3 Recording Area Name and Return Address Planning and Zoning DeEartment i (/' -• .. <JUN '; :• /i|/- Parcel Identification Number (PIN) THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE. This information must be completed by submitter: document title, name & return address, and PIN (if required). Other information such as the granting clause, legal description, etc., may be placed on this first page of the document or may be placed on additional pages of the document. WRDARev. 12/22/2010 Private Sewage System Maintenance Agreement Owners) Name> ^ Dq, L. ^>( /l/ -G_)^^ <, ^.^ Owner(s) Mailing Address /, Site Address 9^9^ /?/^e/^cf^7 //<^.- Tax ID # ^T?? \A m^^ ^J 5^^'^ /y/j?v 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 Wt Adm. Code, as from time to time amended (COMPLETE Legal is required) .1/4 of 1/4 Section Township w<Range 0-7.w. ^L.^ Additional Legal Descnption: T^ P^tZ^ 0-f A/JU S^- XA/ V< 5^-3 'Pl^mmCnJ ' (Acreage) /^. 3~?GovtLr ^8 ^ Recording Area Town of Lot Block Subdivision Lot CSM#Vol..Page.CSMDocs^ Planning and Zon|p^ Djap^rtmljintl JUN U 52U24 In-ground gravity D Mound D In-ground dosed Q in-ground pressure distribution Sewage System: D At-grade Sewage System Q 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 inspecfion, 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 effiuent fitter 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 ceil 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. Ownerfs) 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. BayReid 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 tfiat all the cy^ f/}c} charges may jbe placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected a^^swcQ^fsy-f^. / The terms and conditions of the agreement shall tie binding upon and inure to the benefit of all current and future owners of st/6? ^iSfs'erty. '' • .^A ^ ^ ••' M^^. '•^^-Nor^Owner(s) Namej[s) -1iamefe) - Please Print T7 ,T^'^T1 )^,H>i^ ^^\/ C^^^i^L^ Subscribed and 2>|SQ9(| to before me on this date," tf- •' ^ ^'-~'\'-. ^>--. uc Notanzed Owne^fe) - Signature's) ^?^1 Public •on(mission |bxpires:-<&|^\^0^ //° ^'I'SCO Ill 11»^ Drafted by: ^^/^ <^^f^s/^ate. Proofed by: u/foffns/sanitary/septicmaintenceagreementRevised July 2020 DOCUMENT NO. 38S797 Volume 523 Page 68 STATE BAE OF WISCONSIN. FORM 1—M8ZWARRANTY DEED This Deed, made between ....5.ICTJGlEN..HU,.U.AM..J.AMEa...-an.... adult..s.iri^le..man................................................................................. .., Grantor, «nd GARY V. RIUUTOALL, »n arinl* mnn an^ SARA PAT.POT, an..adu.Lt..»ojiiasL.AS-jx).ua.t..tenan.t&. Grantee, WitneSSBth, That the said Grantor, foi a valuable consideration...... of..pnfi..A)11 ar.-and .jo.tJier...valuah1 &.Aoaside.ca.tioas.. conveys to Grantee the following described real estate in .—Bay£ield... County, State ot Wisconsin: THIS SPACE RESERVEO FOR RECORD1N® DATA S.SREGISTER'S OFFICE Bayfidd County, Wis. RECORDED AT ?.'-^0f M.ON DEC 211990 • n Vol. W ol A!' PW //•& ^te/f^e^ REGISTER OF OEEIK BAVRHflCOUNWABSTRACT ^a mu COMPANY 7?\ Tax Parcel No:77| All that part of the Northwest Quarter of the Southeast Quarter (NWi.SE}), Section Thirty-one (31), Township Forty-four (44) North, Range Seven (7) West, lying Northerly of Picture Lake. Also all that part of the said NW}, SE( lying Southerly of Picture Lake and Westerly of a reference line described as follows: Commencing at a point on the North line of said NWi, SEi being an angle point in the Lake, which is 762.41 feet East of the Center of Section 31, measured along the said North line of the NW{, SEi, and being the point of beginning of said reference line; thence running S.1°30'24"W, a distance of 1322.88 feet to a point on the South line of said NW}, SEi, and the end of the described reference line. TR^SFER FEEi'/^M 'i£NfAl'WEATHER(ZAWN YES Dj This .....J.S..OJ3.t.......... homestead property.(is) (is not) Together with all and singular the hereditamenta and appurtenancea thereunto belonging; And.......gKan£QE.warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except all easements, exceptions, and reservations of record. and will warrant and defend the same. of .........^^^^^??=^.............., 19.^'..Dated this ...;.......o<.fe'..-^'*"L................. day of .(SEAL) ^ AUTHENTICATION Sigmaturefs) ......... .(SEAL) • ...Si6phen..WUliam..Jaaes. ACKNOWLEDOMBNI STATE OF WISCONSIN .(SEAL) ..^A.l^y/s.<^.......County. authenticated this ........day of........................... 19...... _ Personally came, „ the above named TITLE: MEKBEB STATE BAR OF WISCONSIN (Hnot,authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY .Gyff.x..L.au'...Q.f.fifi.e. :x to me known to Be tK^pSiSU.ll^r—/S?o executed theforegoing instrumenti^S&bg^aft^Jfld^^e same.'*.r^^^ .H.axwa.rd,..WI.....54.8.43.,........,.,......,.,..,, y,^ F-,^ ,s5:<^^f.<S^:.,...,...County, Wi,. (Signatures may te authenticated or acknowledged. Both My Commission is pennfinent. (If not, state expTOtim are not necessary.) r. ' _ __ ,,„>„. '/—Volume 523 Page 68 date: -.-..^--^-<'-'=<.----------19-( .;Ui!. /.<sV r.a) /?/- *Naaca yt penonB sitninc In any eupacity nhould be typed or printed bdow their siffnuturea, WAnRANTY DSED BAYFIELD COUNTY SANITARY # STATE SANITARY PERMIT D TRANSFER/RENEWAL PREVIOUS NO. OWNER: Sara Balbin & Gary Crandall PROPERTY LOCATION: Town ofDrummond NW V4 SE V4 SEC 31, T44N, R7W PLUMBER: Ryan Strand LIC. #: 798301 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. (0 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. Tracy Pooler AUTHORIZED ISSUING OFFICER 7/1/2024 DATE Condition: System to meet all setbacks. Management plan to owner. Properly maintain per recorded agreement. Structure not approved for sleeping THIS PERMIT EXPIRES 7/1/2026 UNLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURDsfG CONSTRUCTION SRn-Ofi499 ('R Ort/7'n