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Home My WebLink About24-99Sa' INBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY ** TIME RECEIVED REMOTE CSID DURATION PAGES STATUS December 30, 2024 at 9:21:54 AM CST 7157983470 39 1 Received DEC/30/2024/M0N 09:01 AM Andry Rasmussen & So FAX No. 7157983470 P. 001/001 Request for Sanitary Inspection (24 Hrs. in Advance) Fax this form to Zoning Dept (24 Hrs.) prior to when you want an Inspection —(715) 373-0114 If you do not have a fax and must email the inspection; you must email all staff members. Note fl Time Change flDiscrepancy fl Other Phone Number Plumber: flncfry /,t51''tll sae i o .f*77S 5-- 4 .—3r35-S Fax Number r/ /lJ - 7gj7 gy Homeowner: Email Address l rr� ndr' rqs Fart r rLP ¢ (YIl s a &t ras, Immediate Phone Number So Zoning Sanitary Dept can call you right back (if needed) Permit #; y Q9 Plumber's Choice Zoni Dept Date: i!a o No Inspection(s) during this time j /� 0 Tuesday (9:30 am - 12:15 pm) (Tracy) Time: Plumber's Choice 12: pm Zo ept ■� Mot;. Township: Address It & Road Name: or I19(q �l5Vid LI ILL o Directions LTo Site: Comments: ** Plumbers you must verify any change(s) by fax or email ** Notes from u/forms/sanitary/2questforinspeclbn Zoning Dept (0012104); ® Juna 2023 o��arer� Private Onsite Wastewater Treatment •Spy Systems ( POWTS) Inspection Report (Attach to Permit) Industry Services Division General Information Personal information you provide may be used for secondary purposes [ Privacy Law, s. 15.04 (1)(m) ] Permit Holder's Name: U City U Village U Town of: Ka ax'1 nQ A KQC\man Tr s*' CST BM Elev: I Insp BM Eiev: I BM Description: Tank Information setback to: TYPE MANUFACTURER CAPACITY Prop. Line .ALeIL Building Air Intake Road p1{ it ic Pracc� s-}- cod. y-- t p -I- N/A Dosing N/A Aeration N/A Holding (A\ tO.r (.r v i eo County Sanitary 2-q- ermit No: 9cs State Plan Transaction ID#: Parcel Tax No: Pump I Siphon Information Pump Manufacturer Pump Model Demand GPM Filter Manufacturer Oretrl Filter Model 1--T0 S 2: . TDH Lift Friction Loss Head Total Forcemain Length Dia Dist. To Well Dispersal Cell Information DIMENSIONS Width Length # of Cells SETBACK FROM Prop. Line So--- Building 404- Well W HWM c rvl t Ss Type of Cell (�v►� u Manufacturer: Model Number. Pretreatment Unit Manufacturer: Model Number: )istribution System Elevation Data STATION BS HI FS ELEV Benchmark too' t.s' o I . ' Bldg. Sewer '1. 27' q z , 3' Tank Inlet 8 . 2 J Tank Outlet ' 9' Q Dose Tank Inlet Dose Tank Bottom Inst. Contour Header! Manifold c I ' 91 _ ► Distribution Pipe Infiltrative Surface o. C! I ,L Final Grade S f X Pressure Rvsfpms ()nil Header / Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length Dia Length Dia Spac Spacing LO Yes 0 No iotI cover Depth Over Depth Over Depth of Seeded / Sodded Mulched Cell Center Cell Edges Topsoil 0 Yes 0 No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) �Q -f--m Arc�rc� �c�S+�S (�o W e � � • L.OG,I�- S a'i' �-0.� Y1 nk ' D1d t ns Qc-}. ctic-tYm • pid ,n d� v am Plan revision required? 0 Yes No Use other side for additional information. Date 1 POWTS Inspector's Signature I O1S—p( I License Number =rn CRn_R71 n IR n4M1 l Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zonin-qCcDbayfieldcounty.wi gov 117 East Fifth Street Web Site: www bayfieldcounty.wi.govl147 Washburn, WI 54891 Katherine A Hedman Trust 5112 Oliver Ave S Minneapolis, MN 55417 As you know Arc�� Rc sYnu &..W1 4 $fns 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: 1 I- Tank was pumped by: o Tank was crushed / removed and pipes disconnected by: on at AM/PM On i 123 20 25 at 12:00 (AM I �M the 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. fl 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: Ulform slsanitarypropertyowner-input April 2019 axe^9npro Industry Services Division County tl �. r�� p q J I !_ �- JUL is 9 L L� 4822 Madison Yards Way Ba�eld I' Madison, WI 53705 Sanitary Permit umber (to be filled in by Co.) xbM Del)(. P.O. Box 7302 Madison, WI 53707 s s g � J :,c. Zoning �, 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 Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary 12945 Son bird Ln. Cable WI Song purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. r 1. Application Information — Please Print All Information Property Owner's Name Parcel # Katherine A Hedman Rev Trust 9378 Property Owner's Mailing Address Property Location 5112 Oliver Ave S. Govt. Lot 2 City, State I Zip Code Phone Number Minneapolis, MN 55417 218-260-6189 ¼. ¼, Section 13 II. Type of Building (check all that apply) Lot # T43 N R 08 or ZI or 2 Family Dwelling — Number of Bedrooms 2 Subdivision Name ❑Public/Commercial — Describe Use Block # ❑City of __ State Owned —Describe Use CSM Number Village of down of Cable III. Type of POWTS Permit: (Check either "New" or"Replacement" and other applicable on line A. Check one box on line B. Complete line C if a licable. A. �✓ New System ❑Replacement System lij0ther Modification to Existing System (explain) Additional Pretreatment Unit (explain) ❑Holding Tank ZIn-Ground ❑At -Grade Mound Individual Site Design JJOlherTYe (explain) (conventional) C. ❑ Renewal Before Revision Change of Plumber Transfer to New Owner List Previous Permit Number and Date Issued Expiration NA IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (sf) I Dispersal Area Proposed (sf) I System Elevation 300 0.7 429 1452 192.0 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units s o New Tanks I ExistingTanks o v 2 a a U in y SEC Septic or Holding Tank 760 760 1 Superior Precast ✓ Dosing Chamber LIII fl V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Jason Kuettel 675751 715-798-3355 Plumber's Address (Street, City. State, Zip Code) PO Box 66 Cable, WI 54821 VI. County/Department Use Only ved ❑ Disapproved Permi a Da e 1 s ed Issuing A ign ure ❑ Owner Given Reason for Denial 7 L/ Conditions Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 8 I/E x 11 inches in size SBD-6398 (R. 02/22) Wisconsin Department of Sateyans Professional Services Soil Evaluation Report Oiviaion of Industry Services )n accordance whh SPS 385,Wis.Adm Coda Attach complete site plan on paper not less than 8% X 11 Inches in size. -� JUL G;1?f1Z1 Pace: "':- 1 of6' Plan must include but not limited to: Vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, location and distance to nearest road. Please Print All Information Personal information you provide may be used for secondary purposes. (privacy Law,s.15.04(1)(m)). County: Bavfield Parcel I.D. 9378 Review By' ��3 J Date: 3 ,2 Property Owner: Katherine A Hedman Rev Trust Property Location S13,T43N,R08W Property Owners Mailing Address: 5112 Oliver Ave. S Lot: Block: 0 ISubdivision Name or CSM # City Mineapolls IState MN I Zip Code 55419 IPhono Number. 0 Town Cable INearest Road: Songbird Lane Number of Bedrooms: 2 Code env design flow rate: 7 New JQ Residential 300 J- Replacement ]— Public or Commercial - Describe: Parent Material: Flood Plain If Applicable: 81.7 General Comments & Recommendations: System Elevation: 92 Load Rate: 0.7 Elevation Range. 88.8 To 92-33 face Elev: Depth to Limiting Factor: Boring #1 I- eorp Pt Ground surSoil 95.8 FL 120 In. Application Rate: Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPO/ft' 'Eff#1 Eff#2 1 0-6 7.5YR2.5/1 WA SL 2MSBK MFR CS 3CO 0.6 1.0 2 6-24 7.5YR4/6 N/A LS OSG ML CS 3CO 0.7 1.6 3 24-120 7.5YR4/4 NIA MS OSG ML N/A N/A 0.7 1.6 4 5 6 7 Ground surface Elev: Depth to Limiting Factor. Boring # 2 Bores atSoil 93.9 Ft. 120 In. Application Rate: Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/it' •Eff#1 Eff#2 1 0-10 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 10-20 7.5YR4/6 N/A LS OSG ML CS 3CO 0.7 1.6 3 20-120 7.5YR4/4 WA MS OSG ML N/A N/A 0.7 1.6 4 5 6 7 'Effluent #1 = BOD 5>305 220 mg/I and TSS>30 9m *Effluent #2= BOD 5 < 30 mg/I and TSS ≤ 30 mg/I CST Name (Please Print) Mark S. Thompson SI n CST Number: 877598 Address: 12006 N US Hwy 63 hayward, WI 54643 Da a -o ucted: Tuesday, July 2. 2024 Telephone Number 7151699-4081 SBD-8330 (R04fI S) Property Owner: Katherine A Hedman Rev Trust Parcel I.D. 9378 Page: 2 of 6 Boring # 3 F Borr Fit Ground surface Elev: Depth to Limiting Factor: 95.25 Ft. 120 In. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft' 'Eff#1 Eff#2 1 0-8 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 8-30 7.5YR4/6 N/A LS 0SG ML CS 3Co 0.7 1.6 3 30-120 7.5YR4/4 N/A MS 0SG ML N/A N/A 0.7 1.6 4 5 6 7 Boring #4 r-" Bor it Pitt Ground surface Elev: Depth to Limiting Factor: 0 Ft. 0 Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/fN *Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 5 Ground surface Elev: Depth to Limiting Factor: Bari✓ �t 0 Ft. 0 In. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft' 'Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 6 Ground surface Elev: Depth to Limiting Factor: r Bores Pit 0 Ft. Din. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft' Eff#1 Eff#2 1 2 3 4 5 6 7 'Effluent #1 = BOO 5>30 < 2 20 mg/l and TSS>30 < 150mg/1 `Effluent #2 = BOO 5< 30 mg//and TSS ≤ 30 mg/I The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777 Sa60330(R.07100) ------- 95.8 ------ — — 95 95 95_25 95 --- System —__ __ -- levation 94 0_7 94 94 - ----93.8 $ ---- 93.9 93 0_7 93 0_7 3 ------ --- 92.75 0_7 92 -- 92 - 0.7 92 92_23 $ - 0.7 91 ------ 91 --------- 91 ------ 90 90 ---------- 90 89 ----- 89 -------- 89 - 88.8 - 88 -- 88 ------ 88.25 88 - 87 87 87 Z -- 86.9 86 - 86 86 --- - 85.8 85 L.F.. 85 - 85.25 85 ------- 3 84 84 84 - --_ - - --• 83.9 83 83 83 82 82 ----- 82 81 81 81 80 --- 80 80 ------------- 79 79 --- 79 ------------ -- 78 78 ------- 78 ------------- 77 77 -------- 77 -- 76 ------ 76 ------ 76 --- 75 ----- 75 ----- 76 74 74 ---- 74 -- I i� it JUL Owner Information: Name: Katherine A Hedman Rev Trust Location: S13.T43N.R0BW Township: Cable County: Bavfleld Lot #: 0 1 BM=100: Nail w/ribbon on the base of twin oaks near 61 B1 = 95.8 B2 = 93.9 B3 = 95.25 Lake= 81.7 No Well Garage 12945 N w c CST: a c S. Thom 1"=60Only in Tested Area 30 60 715/699-4081 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) Pg 1 of 4 Pg 2 of 4 Pg 3 of 4 Pg 4 of 4 Attachments: Index & Cover Sheet Plot Plan Dispersal Area Cross -Section & Plan View Management Plan Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Hedman 2 Bed Owner Name(s): Katherine A Hedman Rev Trust Owner Address: 5112 Oliver Ave. S Minneapolis, MN Project Address: Govt. Lot: 2 12945 Songbird Ln. Cable, WI 54821 Township: Cable Project Parcel ID #: 9378 Phone: 218 -260 -55419 Zip: 55920 1/4 of 1/4, Section 13 T43 N -R 08 E County: Bayfield Designer Information Designer Name: Jason Kuettel Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 Remarks: or W Phone: 715 -798 -3355 Zip: °t'- Condltloh PQ9O 4f® !u1232 See C,QFIIl i Signature: Date: 7,/q Jty Original si at re required on each submitted copy. Owner Information Name: Katherine A Hedman Rev Trust Location: S13,T43N,R08W Township: Cable County: Bayfield Lot #: 0 Songbird Lane 1=60' Only in Tested Area 30 60 BM=100: Nail w/ribbon on the base of twin oaks near Bi 61= B2 = B3 = Lake= No Well 2024 ,,, ki Co. Zoning Dept. 95.8 93.9 95.25 81.7 Garage ■ 12945 IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) min. 12' SOIL COVER 12' min. trench j _________________ depth (typical) 3h• '' (typical) ...� .. .. System Elevation = 92.0 (typical) Septic Tank(s) Manufacturer. Suoerior Precast Septic Tank(s) Volume(s): 760 gal gal gal gal Effluent Filter Manufacturer: Orenco Effluent Filter Model #: FT -0822 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) lii Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) F_---��-------Y� --- B= 46 ft (typical) INSTALL PER TRENCH: 11 Quick4 Std -W @ 20 if EISA/chamber = 220 ft' + 1 Pairs of end caps @6 ft2 EISA/pair = 6 ft' = Proposed EISA per trench = 226 ft2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / InstructIons. TYPICAL TRENCH PLAN VIEW (No Scale) IA=3.0ft (typical) "-Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturers instructions. Required Infiltration Area = 429 ft2 Distribution Method: x 2 trenches = Proposed Total EISA = 452 ft2 branched manifold D U m W O m a SEPTIC TANK SS SECTION AND SPECI.ICA.TjotjS " SCR.40PVC INSP. ornr 6 " HPI. ABOVE ,� (when tnle+ trma.,Vo�e 4c lourfed APPROVED MANHOLE / FIN6R4D? W/ Lcc4C4{. • W""�fR�%ivy L,466L y III. dV u" MIN. 18" IN. INLET OUTLET APPR D O FILTER APPROVED MFG. Oh€t�cn PIPE 3' ONTO SOLID model n cro9zt SOIL 3" APPROVED BEDDING UNDtP, TF.'r!}C SPECIFICATIONS SEPTIC TANK MANUFACTURER: 5 /xLc2p/eLc3r TANK SIZES! SE TIC iC,U GAL. Lt'> NOTES: I7� JUL 092024 U hayfield Co. Zoning Dept. r �S- 063X3 B (' I, I,J L L U L4 I BaYfl2d CO. Zoning Dept] - Industry Services Division 4822 Madison Yards Way Madison, 53705 P.O.O. Box Box 37 Madison, WI 53707 County Bayf eld —.— Sanita� rryit Number (to be filled in by Co.) i1 99s 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 purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. Project Address (if different than mailing address) 12945 Songbird Ln. Cable W 9 , 1. Application Information — Please Print All Information Property Owner's Name Parcel # Katherine A Hedman Rev Trust 9378 Property Owner's Mailing Address Property Location 5112 Oliver Ave S. Govt. Lot 2 City- State Zip Code Phone Number Minneapolis, MN 55417 218-260-6189 Section 13 T43 N R 08 E or II.Type of Building (check all that apply) ZI or 2 Family Dwelling— Number of Bedrooms 2 Lot # Subdivision Name ❑PubliclCommercial — Describe Use ❑State Owned —Describe Use Block # ❑City of Village of CSM Number Town of Cable Ill. Type of POWYS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if a licable.) A. New System ❑Replacement System IllOther Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B. Holding Tank In -Ground UAAt-Grade Mound Individual Site Design Other Type (explain) (conventional) C. ❑ Renewal Before Expiration ❑Revision]Change of Plumber aransfer to New Owner List Previous Permit Number and Date Issued NA IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required (sf) Dispersal Area Proposed (sf) I System Elevation 300 0.7 429 452 92.0 Tank Information Capacity in Gallons Total Gallons # of Units Manufacturer , v ' u° o $ .. rn 2 — vt C i7 u a New Tanks I Existing Tanks Septic or Holding Tank 760 760 1 Superior Precast ✓ Dosing Chamber O O A'. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) I Plumber's SienawreI MP/MPRS Number I Business Phone Number Jason Kuettel -- 675751 715-798-3355 Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 VI. County/Department Use Only XA d ❑ Disapproved ❑ Owner Given Reason for Denial Permit F iatt- IIsss d -L Issuing A t ign ore � L Conditions o Approval/RReeeasonsfor Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 8 lax 11 inches in size SBD-6398 (R. 02/22) PAGE4OF4 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, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. 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), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 300 gpd; GODS S 220 mgL-'; TSS 5 150 mgL-'; FOG 530 mgL-' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.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 (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (Le., 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, Wisc. Admin. Code. o Effluent filter(s) 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 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Andnj/ Rasmussen & Sons Phone: 715-798-3355 Local government unit: BaYfield Co. Zoning Phone: 715-373-6138 Local government unit address: 117 E 5th St. Washburn, WI ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. 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, Wisc. 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, Wisc. Admin. Code. °) 5S oo3g3 Private Sewage System Maintenance Agreement (CRTtir2\rJE A ricer...(' `S' -a Trt S i 9q5 Sc),46 ,12V L/.1- c4tr-&w- S4t3Lt .-...-.. 97>B 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 WI Adm. Code, as from time to time amended. (COMPLETE Legal is required) __ 1/4 of 1/4 Section Township _N. Range_ W. Additional Legal Description: .3&± M?'9Cct'Ct Town of C.AQLC (Acreage) 7, 0 Govt Lot Z Lot_ Block Subdivision Lot CSM S_ Vol._ Page CSM Doc-, DOCUMENT NUMBER 2024R-603903 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 07/09/2024 AT 1:48 PM RECORDING FEE: $30.00 PAGES: 2 Recording Area Return To: Planning and Zoning partment JJL{ 20N Sayfialri C_ -:1! ;1r9 Dept. Z In -ground grari y 0 In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Seotic Tank (system types A througn El: The septic tank shall be pumped by a certified saptage servicing operator within three (3) years of the da:e or installation and a: least cr.e every throe (3) years thereafter unless, upon inspection by a licensed master plumber or other parson 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. Pumo Chamber (system types 8, C. D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided aboveee. 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 effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) year 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 -grade! and In -ground 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 Bay -field 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. Bayheld 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 tar 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. e&� I Co Tt^,.4& f '�,M LLA21t_ and sworn to before me on JWy 3, 2t5ay J 31,ao25 CHERYL K. I4UNTER W e P bEc-51T'of Minnesota My Commission Expires January 31,•202$ H JUL 10 zuz E)=IT "Alr Parcel 1: A parcel of land located in Government Lot Two (2), Section Thirteen (13), Township Forty- three (43) North, Range Eight (8) West, Town of Cable, Bayfield County, Wisconsin, bounded and described as follows: Commencing at the NE comer of said Sec. 13; thence South 1°54'21" East along the East line of the Sec., 298.12 feet to a point on the meanderline, 80 feet, more or less, South of the water's edge of Cable Lake and the point of beginning; thence continuing South 1°54'21" East, 522.23 feet to the centerline of a 2 rod roadway; thence North 88°44'11" West along said centerline, 94.81 feet; thence South 66°48'39" West along said centerline, 83.85 feet; thence North 66°13'41" West along said centerline, 239.56 feet; thence North 23°54'23" West along said centerline, 100.51 feet; thence North 89°40'21" West, along said centerline, 203.32 feet; thence North 45°47'21" West along said centerline, 100.91 feet and the end of said 2 rod wide roadway easement; thence North 1054121 West, 336.19 feet to a point on the meanderline, 22 feet, more or less, from the water's edge of Cable Lake; thence South 85°03' East along said meanderline, 252.87 feet; thence South 87° 1714" East along said meanderline, 449.87 feet to a point 80 feet, more or less, from the water's edge of Cable Lake and the. point of beginning. Including all lands lying between the above described meanderline and the ordinary high water mark of Cable Lake. Parcel 2: Together with an easement for ingress, egress and utilities as more particularly described in a Warranty Deed from Eugene S. Wald and Susan M. Wald, husband and wife, to Donna M. Ferguson dated February 27, 1995 and recorded in the Bayfield County Registry on March 3, 1995 in Volume 635 of Records on Page 151 as Document No. 418084. Said easement was restated in Quit Claim Deeds from Donna M. Ferguson to Eugene S. Wald and Susan M. Wald, husband and wife, as survivorship marital property, dated January 8, 1997 and recorded in said Registry on January 31, 1997 in Volume 692 of Records on Page 185 as Document No- 431959 and from Eugene S. Wald and Susan M. Wald, husband and wife, to Donna M. Ferguson dated January 28, 1997 and recroded in said Registry on January 31, 1997 in Volume 692 of Records on Page 188 as Document No. 431960. Together with Grant of Easements by and between Eugene S. Wald and Susan M. Wald, husband and wife, and Donna M. Ferguson, dated January 8, 1997 & January 28, 1997 and recorded in said Registry on January 31, 1997 in Volume 692 of Records on Page 190 as Document No. 431961. Parcel 3: Together with a perpetual non-exclusive easement for roadway and utility purposes, as more particularly described in Grant of Easement from Anna M. Barry to Eugene S. Wald and Susan M. Wald, husband and wife, as survivorship marital property, and Donna M. Ferguson, dated January 15, 1997 and recorded in the Bayfield County Registry on January 17, 1997 in Volume 691 of Records on Page 309 as Document No. 431770. BAYFIELD COUNTY SANITARY PERMIT (#04)-2499S STATE SANITARY PERMIT OWNER: KATHERINE A HEDMAN (REV TRUST) G OV'T LOT: 2 LOT: BLK: K: 1/4 1/4 SEC: 13, T 43 N, R 8 W TOWNSHIP: Cable SOIL TEST: 91-24 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: JASON KUETTEL TRACY POOLER DATE: 7/3112024 Authorized Issuing Officer CHAPTER 145.135(2) WISCONSIN STATUTES a. The purpose of the sanitary permit Is to allow installation of the private sewage system described in the permit. b. The approval of the sanitary permit is based on regulations In force on the date of approval. c. The sanitary permit is valid and may be renewed for specified period. d. Changed regulations will not impair the validity of a sanitary permit. e. Renewal of the sanitary permit will be based on regulations In force at the time renewal is sought, and that changed regulations may Impede renewal. f. The sanitary permit Is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 C. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #: 19-0414 (COUNTY) /154- 19(1-B LICENSE: # MP 675751 Condition: System to meet all setbacks. Management plan to owner. Properly maintain system per recorded agreement. THIS PERMIT EXPIRES 7/31/2026 POST IN PLAIN VIEW