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HomeMy WebLinkAbout24-81SRequest for San€tary Inspection (Fax this iomi to Zoning Dept when you want an inspection — 373-0114) _I I tote: Fnym Zoning Dept Time Chas ge [] Discrepancy L Other Phone Number I1 Plumber: i J f1NiCS CL&H6sL/S i 7/S =79� —287 Fax Mumbgr Home win Ln.t//G flyg. L 5anifary Permit#: t/ — -i S 1 j Plumber's Choice 1 Zoning Dept No inspection during these times Elate: ; I 11:30 am — 2:30 pm V+Jed. (den) 7/7 5'1,2 '/ . ! OK 9:90 arrt 12:30 pm Tues. (Josh) j n J lf 30 am12:30 pm Thurs. (Joshi I l lilt@: PEL£tt16er's GE9aisr: F Zoning Dart "Modiste Phone fii:£nlber &0 zMUi:s 2 r'0.o Pin OK 'dept can ca t ytru taack ie` REEded Township: �j k1.�"✓'C. R.1�`S y i Address & _--_ goad Marcie: ,Z o'l 9U 42 GOrCo z ' Efty<.E Y'Rir,G or Directions l@ -Site; t cemrnents: y CoaJ1,AcT ML'/- Eo4T 7/s 7s 92 z pig: You must corfrmi any crange(s) That have been made pdorto or E5es nspcCtiaa [n+rr! ao# be scheduled and a memo wlllbe sent voiamg the inspeciien. Than[ Yoe Plumber must vedf(1 any cbe-'Bge(s) by fax or no 91tsledfon will be sthegl' e Zogr.'t1EDs*.tz'Q,toYwmspa. ion:r9 D aU 1<J41 eJo;suige3 egS:60'bZ £Z Inf L,d bZ£ZS6LSLLI paAMD-8 T SP tZ£ZS6LSTLT 10D W ZT:TS:6 1e 6ZOZ '£Z ALn( Sn1VIS S3DVd NonYNn0 GISD 310W3d 03AI303d 3WI1 nn AllnddSS300nS 03AI3D3d )tld : NOIIVDIdIiON ONnOSNI .r pF.fARTdlFyd, y ,�o $P d S � Industry Services Division General Information Permit Holder's Name: Tnnk TYPE MANUFACTURER CAPACITY Prop. Line Well Buildin Air Intake Road Septic i L' -G D N/A Dosing N/A Aeration N/A Holding Private Onsite Wastewater Treatment Systems ( POWTS) Inspection Report (Attach to Permit) maybeused for secondary purposes f Privacy Law, LANIE DEMEYER 1865 ISLAND LAKE RD SOLON SPRINGS WI 54873 setback to: of: Sanitary Pe No: State Plan Transaction ID#: Parcel Tax No: 9/17 Pump / Siphon Information Pump Manufacturer PumP Model Demand GPM Filter Manufacturer Filter Model TDH Lift Friction Loss Head Total Forcemain Length Dia Dist. To Well Disoersal Cell Information DIMENSIONS Width Length # of Cells SETBACK FROM Pr4jaJne B ' i� W/, II OHWM Type of Cell nuf er: Model Number: Pretreatment Unit Manufacturer: Model Number: Distribution System Elevation Data STATION BS HI FS ELEV Benchmark (oo . (fl91 Bldg. Sewer Tank Inlet q� 5 Tank Outlet 1(0 .8 Dose Tank Inlet Dose Tank Bottom Inst. Contour Header I Manifold R 5 ,gq Distribution Pipe Infiltrative surface Cf/ g Final Grade X Pressure Systems Only Header I Manifold Distributio pe(s) / X Hole Size X Hole Observation Pipes Length _ Dia — Length P Dia /= Spac 5_ Spacing 0 Yes ❑ No Still Cover Depth Over Depth Over Depth of Seeded I Sodded Mulched Cell Center Cell Edges Topsoil 0 Yes 0 No 0 Yes 0 No COMMENTS: (Include code discrepancies, persons present, etc.) Il lid or 7D �/IS� "i 46C& dG.%i aS Plan revision for a ditto ❑Yes No Use other side for additional Inform lion. ____________________J Date POWTS Inspector's Signature License Number CRn-a71n rR nwi) Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zoning bavfieldcounty.wi.gov Web Site: www.bayfieldcounty.wi.gov/147 LANIE DEMEYER 1865 ISLAND LAKE RD SOLON SPRINGS WI 54873 Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 As you know 3ame-c cn'c was contracted by you to install a private onsite wastewater treatment system on your property described as: Notes Abandonment of Old System to meet all applicable code requirements: •'r Tank was pumped by: C. Tank was crushed / removed and pipes disconnected by: on at AM/PM On 1 at _ (AM /(he above -mentioned plumber contacted our office to conduct a pre -cover inspection as required under DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. /❑ System was inspected and appears to meet all applicable code requirements; however, a plan revision is necessary because the installation was substantially different than the original approval. ❑ System could not be inspected because plumber covered prior to scheduled time of inspection. ❑ System could not be inspected because plumber was not ready at scheduled time of inspection. County was unable to return to complete inspection. System could not be inspected because plumber was not ready at scheduled time of inspection. A re -inspection and $50 fee are required. System could not be inspected because County could not respond to plumber's time constraints. Comments: Ultoin, stsanilarypropetlyowner-input April 2019 e s Department of Safety & Professional Services, Industry Services Division County Bayfield Sanitary Permit Number (to be filled in by Co.) .— I S 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 state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats, 2290 N Golden Eagle Try L Application Information — PleasePrint All Information Property Owner's Name Parcel ft 4Q67 Lanie DeMeyer 04-004-2-45-09-17-2 0 9000 Property Owner's Mailing Address Property Location 1865 Island Lake Rd Govt. Lot V. A, Section 17 T45 N R 09 E od'Wl City, State Barnes, WI Zip Code 54873 Phone Number cY g: 3 II. Type of Building (check all that apply) 91 or2FamilyDwelling—NumberofBedrooms 2 Lot R 22 Subdivision Name 1jlrrh�oa Vi�ec,, Whiterabbits a4 tot'ol�v�tc in Block* ❑Public/Commercial— DescribeUse ❑ State Owned —Describe Use ❑ Cityof t,J }/ O Villageof 024 ® Town of Barnes` � •"'1d cn , . CSM Number M. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C ' ,applicable.) A. ❑ New System I Replacement SystemExisting ❑ Other Modification to System (explain) Additional Pretreatment Unit (explain) P ) B. ❑ Holding Tank VIn-Ground ❑ At -Grade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) onventional) C. ❑ Renewal Before Revision ❑ Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration IV.Dis ersal/PreatmentArea and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (sf) Dispersal Area Proposed (sf) I System Elevation 300 0.7 428.6 446.6 96.5 Tank Information Capacity in Gallons Total Gallons k of Units Manufacturer p o v p w`U V u 8 3 'm', u m -o lE V P. New Tanks Existing Tanks Septic orHolding Tank 750 — 750 1 Wieser Dosing Chamber V. Responsibility Statement— I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum • 's Name (Print) Plumber' Signature PRS Number Business Phone Number �: p� ': ? PlumoeiG�llate, ip s�Addr7 t8trent, Ctty,Code VI. County/Department Uai Only Approved ❑ Disapproved ❑ Given Reason for Denial Owner Permit Fee Date Issued l 2 2 I uing A Si re Conditions of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 812 x 11 inches in size SBD-6398 (R. 03/22) • liii Wisconsin Department of Safety& ProfessionalServices MAR 1 42024 Page Division of Industry services SOIL EVALUATION REPO eld Co. Zoning Dept. •_ In accordance with SPS 385, Wis. Adm. Code County 8aY field Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. 04-004-2-4 -09-17-2 00-3 Please print all Information. e 1 of 3/ , Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). i Property Owner Property Location ❑ ❑ Lanie DeMeyer Govt. Lot Y. Y. S 17 T 45 N R 09 E (or)® Property Owner's Mailing Address Site Address or CSM and Lot #: 1865 Island Lake Rd Whiterabbits Add to Potawatomi Lot 22 City, State, Zip Phone Number ❑ City ❑ Village V Town Nearest Road Barnes, WI 54873 ( ) I Barnes N Golden Eagle Trl ❑ New Construction Use: Residential/Numberofbedrooms 2 Code derived designflow rate 300 GPD ® Replacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable N/A ft. Parent material Sandy outwash (Rubicon Series) General comments and recommendations: H Boring# ❑Boring ®Pit Ground surface elev. 98_1 ft. Depth to limiting factor 96 in. / elev. 90_1 ft. Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPO/Ft' •Eff#1 •Eff#2 1 0-5 10YR2/2 — Is 0sg ml cb lvf 0.7 1.6 2 5-9 7.5YR 3/3 — s osg ml cw 1co/IM1f 0.7 1.6 3 9-44 7.5YR 4/4 — s osg ml cs 1co/1f 0.7 1.6 4 44-96 10YR 5/4 — $ 0sg ml — — 0.7 1.6 2❑ Boring # Boring Pit ®Pit Ground surface elev. 98.9 ft. Depth to limiting factor 96 in. / elev. 90.9 ft. Soil Aoolicatlon Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •E4#1 'Eff#2 1 0-5 10YR 2/2 — Is Osg ml cs 1vf 0.7 1.6 2 5-26 7.5YR 3/4 — s 0sg ml cw 1m/2f 0.7 1.6 3 26-32 7.5YR4/4 — Cos Osg ml cw 1vf 0.7 1.6 4 32-41 7.5YR 3/4 — S osg ml Cs — 0.7 1.6 5 41-96 10YR 5/4 s 0sg ml — — 0.7 1.6 CST Name (Please Print) Signature CST Number 654921 Keith Wiley Address Date EIuation Conducted Telephone Number 11623 E Larson Dr. Lake Nebagamon, WI 54849 9/25/2023 & 2/13/2024 I218.451-2611 * Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 s 150 mg/L * Effluent #2 = BOD, s 30 mg/L and TSS 5 30 mg/L SBD-6330 (R03122) Pr) &O #S /vc Page2 of 3• ❑ ❑ Poring " V LS Il Boring # ® Pit Ground surface elev. 98.6 MAR Dgp (Y�`ng or 96 in. I elev. 90.8 ft. I `� Rnvfiplri ('n 7nnina DBot. I Soil Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' *Eff#1 'Eff#2 1 0-5 10YR 2/2 — Is Osg ml cw if/1vf 0.7 1.6 2 5-14 7.5YR 3/3 — s Osg ml gw 2f/1'd 0.7 1.6 3 14-50 7.5YR 3/4 — s 0sg ml as lm/lf 0.7 1.6 4 50-56 10YR 5/4 — Is Osg ml as — 0.5 1.0 5 56-96 10YR 6/4 — s 0sg ml — — 0.7 1.6 Boring # Boring ❑ Pit Ground surface elev. 98.9 ft. Depth to limiting factor 96 in. / elev. 90.9 ft. SoilAnnllcation Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 'Eff#1 -Eff#2 1 0-4 IOYR 2/2 — Is Osg ml Cw if/lvf 0.7 1.6 2 4-14 7.5YR 3/3 — Osg ml gw 1co/1f 0.7 1.6 3 14-39 10YR 5/4 — s Osg ml gw 3m/1f 0.7 1.6 4 39-96 10YR 6/4 — s Osg ml — — 0.7 1.6 ❑ Poring Boring # ❑ ❑ Pit Ground surface elev. ft. Depth to limiting factor in. I elev.R. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' *Eff#1 'Eff#2 Effluent #1 = BCD > 30 5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = BCD, s 30 mg/L and TSS 5 30 mg/L DeMeyer (2 bedroom) Soil Report Plot Plan North �J Prn 0 Scale 1:30 4 x Bench Mark = Top of iron pipe Elev = 100.0' 0 L9 2 bedroom cabin rl 200.0Property line Shed ti 0 Lanie DeMeyer 2290 N Golden Eagle Trl WHITERABBITSAD0 TO POTAWATOMILOT22 517 T45N R09W Town of Barnes 04-004-2-45-09-17-2 00-317-09000 0.464 Acres NOTES: - Property lines not to scale - No well -Site level CST # 654921 i��.�' Page 3 of 3 BAYFIELD COUNTY Lanie DeMeyer CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): �� � C IK u l,( I[ l=l [a'Check List Ill�uuulfuUllUUU1111 MAR L11 42024 ❑ Index Page / Title Sheet (Optional) Bayfield Co. Zoning Dept. 9' Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) ' Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) 9 Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used @'Property Owner's Information (not prospective buyer's name) G7 Property Location (Accurate Legal Description with Sec/Twp/Range) 9 Road Name (where driveway is/will be coming off of) Er Floodplain Elevation, Flow Rate, Comments and Recommendations E? Complete Soil Boring / Pit Information U' Date Soil Evaluation was conducted G7 CST Name, Signature, Number, Address and Phone Number 9' *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) @'Bench Mark (Description, Elevation and Location) @'Contour Lines (Example = 98.0' /96.0' /94.0') Cy Property Location (Sec/Twp/Range/, Accurate Legal Description) 9 Borings (Locations and Elevations) [Percent and Direction of Land Slope U' Well Location (Including Neighboring Wells, if applicable) ELocation of Wetland Areas, Floodplain and Navigable Waters U' Buildings, Driveways, and Structures (Location and Descriptions) Q'Location of Property Lines EX Existing System Location 6P Address Number and Road Name U' Current Surface Elevation of Wetlands and Navigable Waters [CST, Owner and Property Information U North Arrow Fee: [Certified Soil Tests - Review & Filing Fee $ 50.00 u/forms/sanitary/checklist/checklistforests N Golden Eagle Trl Property Address 5-09-17-2 00-317-09000 Tax Parcel Number Bayfield County add to Potawatomi lot 22 Legal Description 17 Section Range Page Index 1 Property Information 2 Data Entry 3 Plot Plan 4 Drainfield Cross -Section 5 Tank Information 6 Maintenance Plan 7 Contingency Plan Keith Wiley Designer's Name ;, . - mil/ Designer's Signature D2388PSS Designer's License Number 218-451-2611 Designer's Phone Number 2/15/24 Date MAY 072U24 Bayfield Co. Zoning KEITH `r'111.EV -ter nS a2S FiiESKO W,INNES0TA Desi9�e� Apnuoil!puoo Page 1 of 7 ft _______________________ NAY0720. 720. By'O'd Co. Zoning DeAi In -Ground of sorption for POWTSComponent Version 2.1 (May 2022-2027) Manual Used 2 Number of Bedrooms 0 Percent Slope (%) 96 Depth to Soil Limiting Factor (in.) 0.7 In Situ soil application rate 200 Estimated Wastewater Flow (gpd) 300 Design Wastewater Flow (gpd) 1 Number of System Elevations 96.5 Proposed System Elevation #1 Proposed System Elevation #2 Proposed System Elevation #3 98.1 Original Grade #1 98.1 Finished Grade #1 98.8 Original Grade #2 98.8 Finished Grade #2 Original Grade #3 Finished Grade #3 Wieser 750 Septic Tank Polylok PL -525 Effluent Filter Infiltrator Quick4 Plus Standard I Chamber Type 12 Height of Chamber (in.) 20 sq.ft. per chamber(ESIA) 3.3 sq.ft. per end cap (EISA) 4 laying length of chamber(ft.) 1.5 length of endcap(ft.) 34 Chamber width(in.) 2 Rows of Chambers 3 Distance Between Cells (ft.) 11 Number of chambers in first row 11 Number of chambers in second row Number of chambers in third row 22 Proposed Number of Chambers Used 428.6 Minimum Distribution Cell Area Required (sq.ft.) 446.6 Distribution Cell Area Proposed (sq.ft.) Page 2 of 7 North S Wieser precast W750 -MR w/polylok 525 filter Two rows of 11 Infiltrator Quick 4 Plus Standard chambers I Scale 1:30 K Bench Mark = Top of iron pipe Elev = 100.0' DeMeyer (2 bedroom) Septic System Plot Plan Q. ti o 200.0' O N m Shed 2 bedroom lot $yo°_ cabin R fl S G) e 7 17;7 Lanie DeMeyer 2290 N Golden Eagle Trl WHITERABBITSADDTO P0TAWATOMILOT 22 S17 T45N R09W Town of Barnes 04-004-2-45-09-17-2 00-317-09000 0.464 Acres Property lines not to scale No well Site level All vent, observation & conveyance pipes 4" ASTM D1785 Page 3of 7 Cross Section of a Two Cell In Ground Component Using Leaching Chambers Observation/Vent Pipes / �. 98.10 Innisheci Grade ----------- == -- - Finished Grade._ 98.80 Slope 0% Ce eperation / 98.10 Original Grade ; , % pfig ;- final Grade 98.80 97.50 Top of Chamber \ Rio of Chamber 97.50 96.50 System Elevation System Elevatianl 96.50 .1�reatrryentnd Dtspereaf [one- --- 1�- -. ,. a Limiting Factor Q (j Observation/Vent pipes to be constucted and capped with approved materials for the particu r eay el 47 feet 47 feet Observation / Vent Pipes to be located at the ends of the distribution cells. O/2 Zoning Dept. Page 4 of 7 4" CAST -A -SE" TOP VIEW r � n SIDE VIEW ti O N s. U Q 4" CAST-AZ§EAL, m OUTLET na JMP PAD WLP750-MR TANK SPECIFICATIONS DIMENSIONS: WALL: 2 1/2" BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 54" OUTSIDE DIAMETER: 7-0" BELOW INLET: 42" LIQUID LEVEL• 37" WEIGHT: BOTTOM 3,740 LBS. COVER 2,410 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 CAPACITY: 20.28 GAL/IN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 790 GALLONS 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 4110 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: a II 3 a � m N N TANKS ARE MANUFACTURED TO MEET OR EXCEED POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 6 of 7 FILE INFORMATION Owner Lanie DeMeyer Permit # DESIGN PARAMETERS Number of Bedrooms 2 O NA Number of Public Facility Units ® NA Estimated (average) flow 200 gal/day Design (peak) flow = (Estimated x 1.5) 300 gal/day In Situ Soil Application Rate 0.7 aVda /ft' Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) ≤30 mg/L Biochemical Oxygen Demand (BODs) ≤220 mg/L O NA Total Suspended Solids (TSS) ≤150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODs) ≤30 mg/L Total Suspended Solids (TSS) ≤30 mg/L !a NA Fecal Coliform (geometric mean) ≤10° cfu/1 00ml Maximum Effluent Particle Size k in dia. O NA Other: ® NA `Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 ❑ (ss) year � earls (Maximum 3 years) O NA Pump out contents of tank(s) ® When combined sludge and scum equals one-third (th) of tank volume O NA O When the high water alarm is activated Inspect dispersal cell(s) At least once every: 3 ❑ month(s) year(s) (Maximum 3 years) ® ❑ NA Clean effluent filter At least once every: 3 ❑ months(s) ® year(s O NA Inspect pump, pump controls & alarm At least once every: O month(s) O year(s) ® NA Flush laterals and pressure test At least once every: ❑ month( ❑ year(s) ) ® NA Other: At least once every: ❑ month(s) ❑ year(s) ® NA Other: ® NA SYSTEM Tank Manufacturer Wieser O NA ❑ Septic O Dose O Holding vol. 75O gal Tank Manufacturer M'NA ❑ Septic O Dose O Holding vol. gal Effluent Filter Manufacturer Polylok O NA Effluent Filter Model 525 Pump Manufacturer [l'NA Pump Model Pretreatment Unit EX NA ❑ Sand/Gravel Filter O Peat Filter ❑ Mechanical Aeration ❑ Wetland ❑ Disinfection O et- Manufacturer jDj I P� , Dispersal Cell(s) ON ®In -Ground (gravity) MM ❑In-GrDlM(f}4s r'zad) ��99 ❑ At -Grade ❑ Moun ❑ Drip -Line ❑ Otherd Co. Zoning Other: ® NA Other: NA 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 (14) 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 of 7 START 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 ur�th�t t1 4scr4- q perly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: jjfl(' I( till MAY • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. U % �024 • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Ser?1f#401 toning Dept. • 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: ❑ 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. ❑ 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. Fjf 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. ❑ 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 NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name',#.v,c t Fe' T Name K C. Phone 7/S 7S1 Phone 7,r79-_3 fl t/ SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name z",77c Name Bayfield County Zoning Phone 7 /1 — 7 i c- 3 979 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 chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. BAYFIELD COUNTY Lanie DeMeyer CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): @'Check List ❑ Index Page / Title Sheet (Optional) U' Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) 'Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) Cad' Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used Q"Property Owner's Information (ngt prospective buyer's name) ID' Property Location (Accurate Legal Description with Sec/Twp/Range) ID' Road Name (where driveway is/will be coming off of) nn (� M'Floodplain Elevation, Flow Rate, Comments and Recommendations iR 1 " E U i I r)) ID'Complete Soil Boring! Pit Information 11 0 1111u 11 MAY 0 / ) j j LL'i U' Date Soil Evaluation was conducted Bayfield Co. Zoning Defn GYCST Name, Signature, Number, Address and Phone Number U' *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) 'Bench Mark (Description, Elevation and Location) l2Contour Lines (Example = 98.0' /96.0' /94.0') UProperty Location (Sec/Twp/Range/, Accurate Legal Description) U' Borings (Locations and Elevations) 'Percent and Direction of Land Slope U' Well Location (Including Neighboring Wells, if applicable) ID'Location of Wetland Areas, Floodplain and Navigable Waters ID' Buildings, Driveways, and Structures (Location and Descriptions) fs'Location of Property Lines (2' Existing System Location 7Address Number and Road Name U' Current Surface Elevation of Wetlands and Navigable Waters lD' CST, Owner and Property Information ED' North Arrow Fee: ID' Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checklistforests Ruth Hulstrom From: Ruth Hulstrom Sent: Monday, July 1, 2024 2:51 PM To: cmfoat@cheqnet.net Cc: Tracy Pooler Subject: RE: DeMeyer Sanitary Application - Tax ID 4167 Michael, Following up again since I have not heard back. See message below from Last week. Thanks, Ruth Hulstrom, AICP I Director Planning and Zoning Department 117 E 5th Street, PO Box 58 Washburn, WI 54891 Phone: 715-373-3514 Fax: 715-373-0114 Email: ruth.hulstromla7bayfleldcounty.wi.gov I3-tYFIELD From: Ruth Hulstrom Sent: Thursday, June 27, 2024 10:06 AM To: cmfoat@cheqnet.net Cc: Tracy Pooler<tracy.pooler@bayfieldcounty.wi.gov> Subject: DeMeyer Sanitary Application - Tax ID 4167 Michael, As a follow up of our phone conversation today, please see the attached sanitary permit application for the Lanie Demeyer property identified as Tax ID 4167. You indicated on the phone that there is not existing POWTS on the subject property, only a privy. Can you verify that the department can update pg. 1 attached sanitary application noting that this is a new system and not a replacement system given that there is no existing POWTS on the property? III. Type of PORTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check i applicable.) �. ❑ New System SRcplacement System ❑ Other Modification to Existing System (explain) ❑ Additiona B ❑ I-IoldingTank 'In -Ground onventional) ❑ At -Grade ❑ Mound ❑ Individual C. ❑ Renewal Before Revision Expiration ❑ Change of Plumber ❑ Transfer to New Owner tst Previous I N. DispersaUTreatment Area and Tank Information: nesien Flow (aod) I Design Soil Application Rate(gpd/sfl I Dispersal Area Required (sf) I Dispersal Area Proposed (sf Thanks, Ruth Hulstrom, AICP I Director Planning and Zoning Department 117 E 5th Street, PO Box 58 Washburn, WI 54891 Phone: 715-373-3514 Fax: 715-373-0114 Email: mth.hulstrotn@bayfieldcounty.wi.gov B4YFIELD /c 7! #°r,� a ti &t6/b%t'J"L 13o /bras' „gam �l� �✓7N s ¢ fly Sfls U,� T% r' n �S T/t/✓'rr c a-,� !S' e+� v tvr L C. pa r /' 7/'s ''� 6Je-Dl2ad•n S�/�nG SysrE�+ /e.,GL `lJ .�U . Au/ Qv/L. sr:. y 577 d �.v s l CfJ L L la///E /` 11/1/23, 9:21 AM Real Estate Bayfleld County Property Listing Today's Date: 11/1/2023 Novus-Wisconsin Access rev. 12.0206 Property Status: Current Created On: 3/15/2006 1:14:53 PM Description Updated: 10/24/2023 Tax ID: 4167 PIN: 04-004-2-45-09-17-2 00-317-09000 Legacy PIN: 004133709000 Map ID: Municipality: (004) TOWN OF BARNES SIR: S17 T45N R09W Description: WHITERABBITS ADD TO POTAWATOMI LOT 22 DESC IN 2021R-592431 1915 Recorded Acres: 0.464 Calculated Acres: 0.464 Lottery Claims: 0 First Dollar: Yes Zoning: (R-1) Residential -1 ESN: 104 I Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 004 TOWN OF BARNES 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE IQ Ownership LANIE DEMEYER Billing Address: LANIE DEMEYER 1865 ISLAND LAKE RD SOLON SPRINGS WI 54873 Updated: 10/24/2023 SOLON SPRINGS WI Mailing Address: LANIE DEMEYER 1865 ISLAND LAKE RD SOLON SPRINGS WI 54873 Site Address ' indicates Private Road 2290 N GOLDEN EAGLE TRL BARNES 54873 ® Property Assessment Updated: 10/4/2016 2023 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 0.460 3,200 6,100 2 -Year Comparison 2022 2023 Change Land: 3,200 3,200 0.0% Improved: 6,100 6,100 0.0% Total: 9,300 9,300 0.0% property History aJ Recorded Documents Updated: 9/15/2016 B WARRANTY DEED N/A Date Recorded: 9/28/2023 2023R-600639 Grantee: LANIE DEMEYER Sale Price: 0 0 Acres ® WARRANTY DEED Date Recorded: 12/6/2021 2021R-592431 Grantee: DELICIA M & STEVEN A HANSEN Sale Price: 0 0 Acres ® TERMINATION OF DECEDENTS INTEREST Date Recorded: 6/16/2017 2017R-568777 ® TERMINATION OF DECEDENTS INTEREST Date Recorded: 6/16/2017 2017R-568776 © CONVERSION Date Recorded: 3/15/2006 726-293 © WARRANTY DEED Date Recorded: 12/29/1997 438292 721-205 https://novus.bayfieldcounty.wi.gov/access/master.asp 1/1