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Home My WebLink About24-126S'"' INBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY " TIME RECEIVED REMOTE CSID DURATION PAGES STATUS October 10, 2024 at 1:26:57 FM CDT 7157983470 42 1 Received 0CT/10/2024/THU 12:08 PM Andry Rasmussen & So FAX No, 7157983470 P.001/001 Request for Sanitary Inspection (24 4lrs. 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 Time Change fl Discrepancy fl1Other Phone Number Plumber: �pI f1t�i'l� &ESUWSSPn o- Sim, Number r y pFax / /s - '79 7�[fir L Email Address —fl nHomeowner: t )S noff"rycs. ibis O r S. p 1 Immediate Phone Number So Zoning Sanitary Permit #: Dept can call you right back (if needed) Plumber's Choice Zoning Dept No inspection(s) during this time Date: OK Tuesday (9:30 am - 12:16 pm) (Tracy) Time: Plumber's 0bd1ce Zoning Dept @I OK Township: Address # & 2 7 Road Name: or �'[xxnn 2O WAl/ dnah /lU Directions To Site: Comments: Plumbers you must verify any change(s) by fax or email ** Notes from ulformslsanitary/request a nspection Zoning Dept (04112104); @June 2023 �Qipe.xrey� �Fioa F'� r� Pg,w lmtAe' Industry Services Division General Information Permit Holders Name: Tank Information TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Septic 6r"n, (� N/A Dosing N/A Aeration N/A Holding Private Onsite Wastewater Treatment Systems ( POWTS) Inspection Report lAftorh to Pnrmitl ROBERT JAMES ZELLER 5327 NASHUA DR CALEDONIA IL 61011 own setback to: County Sanitary ermit No: it7 � IBS State Plan Transaction ID#: Parcel Tax No: Pump! Siphon Information Pump Manufacturer ump Model Demand GPM Filter Manufacturer Filter Model TDH Lift Friction Loss Head Total Forcemain Length Dia Dist. To Well Dispersal Cell Information DIMENSIONS Width Lengi #ofCells L SETBACK FROM Prorine Bu We 0H (- Type of Cell r /, ii w Manufacturer: Model Number. Pretreatment Unit Manufacturer: Model Number: )istribution System Header! Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length _ Dia Length _ Dia Spac Spacing 0 Yes ❑ No Elevation Data STATION BS HI FS ELEV Benchmark r Bldg. Sewer fl Cl , 6fr Tank Inlet o?, 6 Tank Outlet g6a'j Dose Tank Inlet Dose Tank Bottom Inst. Contour 3 Header I Manifold Distribution Pipe Infiltrative Surface Final Grade X Pressure Systems Only Soil Cover Depth Over Depth Over Depth of Seeded / Sodded Mulched Cell Center Cell Edges Topsoil 0 Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) &K v. s a rr, J POW'/ it i S�vr rr H Plan revision required? ❑ Yes I / Use other side for additional information. Date POWTS Inspectors Signature License Number SRn1J1n rR n'L911 Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zonina(a�bayfieldcountv.wi.00v Web Site: www.bayfieldcounty.wi.aov/147 ROBERT JAMES ZELLER 5327 NASHUA DR CALEDONIA IL 61011 As you know onsite wastewater treatment system on your property described as: Notes: Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 was contracted by you to install a private Abandonment of Old System to meet all applicable code requirements: 1 . Tank was pumped by: C. Tank was crushed / removed and pipes disconnected by: on at AM/PM On at (AM / PM) 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. ❑ 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: Ulforms/sanitarypropertyowner-input April 2019 2"t lUi �f L5 II D I" �s Industry Services Division 822 Madison Yards Way Madison,WI 53705 �Q County Bayfield Sanitary Permit Number (to be filled in by Co.) UG 122074 +°,a4rh P.O. Box 7302) Madison, WI 53707 _ J`, Bayfield Co. Z0S Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) 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 3920 Waltman Rd. Barnes WI purposes in accordance with the Privacy Law, s. 15.04(l)(m), Scats. + I. Application Information— Please Print All Information Property Owner's Name Parcel # Robert Zeller 1444 Property Owner's Mailing Address Property Location 5327 Nashua Dr. Govt. Loth City, State I Zip Code Phone Number Caledonia, IL 61011 815-978-8041 A• A• Section 04 T 44 N R 09 E or W II. Type of Building (check all that apply) Lot # Subdivision Name I or 2 Family Dwelling— Number of Bedrooms 2 U V ❑PublidCommercial — Describe Use Block # City V of State Owned — Describe Use Village of CS Number Town of Barnes 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 IZiRePlacement System Other Modification to Existing System (explain) Additional Pretreatment Unit (explain) B' ❑Holding Tank ZIn-Ground 1 1kt-Grade Mound J Individual Site Design Other Type (explain) (conventional) C. U Renewal Before Revision Change of Plumber Transfer to New Owner List Previous Permit Number and Date Issued Expiration NA IV. DispersaVPreatment 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 0.71429 452 95.0 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units , U v New Tanks Existing Tanks v e o v v to W W n. U c H o, Septic orflolding Tank 760 760 1 Superior Precast ✓ Dosing Chamber O C V. Responsibility Statement- I, the undersigned, assume responsibility for Installation or 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 eQ pproved O Disapproved Permit Fee ate Issue % Issuing nt Si azure Owner Given Reason for Denial g �3z Conditions of A roval/Reasons for Disapproval l J� Attach to complete plans for the system and submit to the County only on paper not less than 8 12 x 11 inches in size SBD-6398 (R. 02/22) Waco N Department of Safety and Profesion{I$frvicas oivisio�indusyyb}rvice9 22024 9-0112 Soil Evaluation Report in attodance with SPS 385, M.M. Cade Attach complftg(tpj0 r7pgpagiEj8$s than 8% X 11 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, 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: Bayfield Parcel I.D. 1444 Revie B Date: ty / _ .� Property Owner: Robert James Zeller Property Location S4,T44N,R09W Property Owners Mailing Address: 5327 Nashua Dr Lot: Block: Subdivision Name or CSM # City Caledonia State Zip Code IL 6101 1 Phone Number: 0 own Barnes Nearest Road: Waltman Road Number of Bedrooms: 2 Code derived design flow rate: r New r Residential 300 r Replacement r Public or Commercial - Describe: Parent Material: Flood Plain if Applicable: 85.62 General Comments & Recommendations: System Elevation: 95 Load Rate: 0.7 Elevation Range: 91.51 To Borin #1 r Bor pit Ground surface Elev: Depth to Limiting Factor: g 98.61 Ft. 120 In. Soil Application Rate: Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/fta 'Eff#1 Eff#2 1 0-10 7.5YR2.5/3 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 10-24 7.5YR4/6 N/A LS OSG ML CS 2M 0.7 1.6 3 24-120 7.5YR4/4 N/A MS OSG ML N/A N/A 0.7 1.6 4 5 6 7 Ground surface Elev: Depth to Limiting Factor: Boring # 2 r Bores Prt 97.96 Ft. 120 In. Soil Application Rate: Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/fta 'Eff#1 Eff#2 1 0-6 7.5YR2.5/3 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 6-20 7.5YR4/6 N/A LS OSG ML CS 2M 11.7 1.6 3 20-120 7.5YR4/4 N/A MS OSG ML N/A N/A 0.7 1.6 4 5 6 7 'Effluent #1 = BOD 5>30 < 220 mg/I and 0 < 1 0m 'E nt #2 = BOD 5< 30 mg/land TSS < 30 mg4 CST Name (Please Print) Mark S. Thompson . a CST Number: 877598 Address: 12006 N US Hwy 63 Hayward, WI 54843 Date uesday, August 6, 2024 Telephone Number 715/699-4081 SBD-8330 (R04/15) Page: Z 1 of 6 �' .L�Prt}�ea gwrUlr: E S D Robert James Zeller AUG 1 2 2024 Bay Parcel I.D. 1444 Page: 2 of 6 or r Pit Ground surface Elev: Depth to Limiting Factor: Bpi 97.49 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 GPDRt2 *Eff#1 Eff#2 1 0-8 7.5YR2.5/3 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 8-18 7.5YR4/6 N/A LS 0SG ML CS 2M 0.7 1.6 3 18-120 7.5YR4/4 N/A MS 0SG ML N/A N/A 0.7 1.6 4 5 6 7 Boring #4 Ground surface Elev: Depth to Limiting Factor: r Bore Ft t 0 Ft. 0ln. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 5 Boring#5 Ground surface Elev: Depth to Limiting Factor: C' Borr Pit 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/ft2 7Eff#1 Eff#2 1 2 3 4 5 6 7 Boring #6 Ground surface Elev: Depth to Limiting Factor: r Borr Pt 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/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 *Effluent #1 = BOD 5>30 < 2 20 mg/I and TSS>30 ≤ 150mg/I *Effluent #2 = 8OO5< 30 mg/I 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 SBP8330(R.W/00) fl 1111 AUG 122024 100 ------- 100 -- - 100 - System --- -- — Elevation 99 ------- 99 ------ 99 ----- -- 98.51 ------ -- 98 ---- 98 ------- 98 ----- - — ---------- 97.96 ---- 97 -- 0.7 97 97 -- 97.49 96_51 $ ----------• -------- 96 ------- 0_7 96 -----------• 96.29 96 ------• 0.7 --------- 95 95 -------- 94 --- - --------------- 94 - --- ------ ------------- 94 ------------ 93 93 93 --- 92 ---- 92 ----------- 92 — - - - 91.51 - ------------- 91 ---- 91 91 ------- - — — - 90.96 --------- 90 --- 90 ------- 90 ---- 90.49 89 ------- ----- -------------- 89 -------- ---------- Z ----------- 89 -------- 88.51 ----- -- 88 -------• L.F.. 88 ----- 88 - --- 87.96 ------ 87 ------------ 87 ------- L.F. 87 -------- 87.49 86 86 -------- 86 ----- 85 ---- 85 --------- 85 - ----- 84 ----- 84 ------ 84 83 - 83 ------------ 83 --------- 82 --------- 82 ---------- 82 ---- 81 81 ----------- 81 -- 80 - 80 ---------- 80 ------ 79 ------- ----- 79 --- ------------ 79 -- AUG 12 [024 Ba Lg ac . Zoning Dept. n :ion: BM=100: Bottom of log siding on the NE comer of house Dbert James Zeller 54.T44N.R09W BI = 98.51 Barnes B2 = 97.96 Bayfield 83 = 97.49 0 Lake= 85_62 Robinson Lake Existing System J� B1 am / 4 Ground @ Tank = 99.38 50' yto Wallman Road Well Only in Tested Area 40 60 B3 Bz ark S. T m so 75 7151699-4081 PAGE 1 OF 4 AUG 122024 LI In -Ground Gravity Plan BayfieidCo.ZoningDept. Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Zeller 2 Bed Owner Name(s): Robert Zeller Phone: 815 _978 - 8041 Owner Address: 5327 Nashua Dr. Caledonia, IL Zip: 61011 Project Address: 3920 Wallman Rd. Barnes, WI Govt. Lot: 1/4 of 1/4, Section 04 T44 N -R 09 E ❑ or W ❑✓ Township: Barnes County: Bayfield Project Parcel ID #: 1444 Designer Information Designer Name: Jason Kuettel Phone: 715 -798 -3355 Designer Address: PO Box 66 Cable, WI Zip: 54821 E-mail: ti dryras.com License Number: 675751 Remarks: ?,Jn1loo e?S 1tlnoo aia WAVE Q3AOdddd f) S'J. �� Od_ Signature: _ Date: __,._1 Original si t re required on each submitted copy. Owner Information Name: Robert James Zeller Location: S4 T44N.R09W Township: Barnes County: Bavtield Lot #: 0 flflV D Robinson Lake flj AUG 122024 Bayfleld Co. Zo ept. Existing System i. BM=100: Bottom of log siding on the NE corner of house B3 Ground @ Tank = 99.38 9 , P'" 1 ,I,to Waltman Road N WE S 1"=30Only in Tested Area •f-Aej-;ar Pranci r ?60 W/ or.e^co ,c cTe Well 90' 22 y1' C \ifl-b 2tr B2 B1 = 98.51 B2 = 97.96 B3 = 97.49 Lake= 85.62 40 60 e4� An? y-,S7Sl e �7I� IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers G E N E D 3 -ft Trench (down -sizing credit) AUG 122024 D to 4 J!_t' g v Bayfield Co. 71pn1r9 Dept. SOIL COVER 2 - mm. trench depth (tyWcel) min. 12" (typical) (typical) System Elevation = 95 (typical) Septic Tank(s) Manufacturer. Superior 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) ft Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) I------------77---------7j----- 1 L------------��-------�f---- f Br 46 ft (typical) INSTALL PER TRENCH: 11 Quick4 Std -W @ 20 ft' EISA/chamber = 220 ft2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturer's / instructions. TYPICAL TRENCH PLAN VIEW (No Scale) IA = 3.0 ft (typical) "—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. + 1 Pairs of end caps @6 ft' EISA/pair = 6 ft' = Proposed EISA per trench = 226 ft' Required Infiltration Area = 429 ft2 Distribution Method: x 2 trenches = Proposed Total EISA = 452 ft2 branched manifold D O m CA) O m TANK ��I111777I C Oss 57: Okf ��Il lllll�/l AUdGC 12 1U 1 z Bgoe�l c,:( 4o°en�D prise. �r o= 6 (When % (Q.+ ((w c'ele PS FINISHED TN=SHED GLADE 18" tIN.! I j4LET << APPROVED PIPE 3' ONTO SOLID SOIL A P P R D BA-FftE — O FILTER MEG. f{-enCO model TO$2L 3" APPROVED BEDDING UNDER TANK SPECIFICATIONS SEPTIC TANK Y,A.WNFACTURER: S'vpi ot- ?j2erA-rr- T-,NK SILE` SE'TIC 760 GAL. JP i,"d Time APPROVED MANHOLE WI Lcr 4C . '+" HIII. OUTLET r �STing 9 D n �l9 if Industry Services Division 822 Madison Yards Way Madison, WI 53705 County Bayfield Sanitary Permit Number (to be filled in by Co.) UG 122024 P.O. Box 7302 Madison, WI 53707 at4- lacers Bayfield Co. Zt9iJiy 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 3920 Waltman Rd. WI Barnes, purposes in accordance with the Privacy Law, s. 15.04(1 )(m), Scats. I. Application Information— Please Print All Information Property Owner's Name Parcel # Robert Zeller 1444 Property Owner's Mailing Address Property Location 5327 Nashua Dr. Govt. Lot/t City, State Zip Code Phone Number Caledonia, IL 61011 815-978-8041 ¼ ,, Section 04 T 44 N R 09 E or W II. Type of Building (check all that apply) Lot # ❑ I or 2 Family Dwelling - Number ofBedrooms2 o v Subdivision Name ❑Public/Commercial - Describe Use Block # of_______________________ SCity State Owned -Describe Use JVillage of CSi Number Town of Barnes III. Type of POINTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i a licable.) A. ❑New System Replacement System ❑Other Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B' ❑Holding Tank ]In -Ground I lAt-Grade ❑Mound J Individual Site Design Other Type (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/st) I Dispersal Area Required (sf) I Dispersal Area Proposed (sf) I System Elevation 300 0.7 429 452 95.0 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units n 2 o c U p U New Tanks Existing Tanks W g y y a! j 0,0 CI rn ii.0 ii Septic or Holding Tank 760 760 1 Superior Precast ✓ II Dosing Chamber LIII O C V. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) I Plumber's Signature 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 pproved 0 Disapproved Permit Fee $ Date Issued Issuing nt Si ature ❑ Owner Given Reason for Denial % S /1 .? z onditions o pproval/Reasons for Disapproval pc Attach to complete plans ror the system and submit Co the County only on paper not less than 81/1 x 11 inches in size SBD-6398 (R. 02/22) PAGE4OF4 1111 AUG 1 22IY4 In -ground Gravity Management Plan IMF O WARTcZoning Dept. 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; BOD5 5 220 mgL 1; TSS 5150 mgL"1; FOG 5 30 mgL-1 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 (Le., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, 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: Andry Rasmussen & Sons Local government unit: Bayfield Co. Zoning Phone: 715-373-6138 Phone: 715-798-3355 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. Private Sewage System Maintenance Agreement DOCUMENT NUMBER 2o'SCE tecc-e(L j 2024R-604335 53L7 NASHv.R tom?. ( ALpy tfl, tL 6f o„ Site Address 39zo (aALLA*A/,r IR3 ,ylanc.S, 1-, Tax ID R %yNq 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 rile_ w•th 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 fisted 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 O`i Township 44 N. Range OS w. Additional Legal Description: S cE ATT9oacb Town of f1QNC-S (Acreage) I. 5 Govt Lot Lot _ Block Subdivision Lot _ CSM # _ Vol. _ Page _ CSliM Doc # DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 08/12/2024 AT 2:20 PM RECORDING FEE: $30.00 PAGES: 2 Return To: Planning and I in fi4aint ntV LS AUG 13LUZ4 In -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other _ Area Septic Tank (system types A through E): The septic tank shall be pumped by a cenit:ed septage servicing operator within three (3) years of the date of installation and a: least once every three (3) years thereafter unless, upon inspection by a Gcehsed master plumber or other person authorized to make such inspection. the tank is found to have less than one-third (113) of the volume occupied by sludge and scum. Piano 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 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 333.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds. At -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. Owners) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayrietd County for inspection, pumping, hauling, or otherwise servicing and maintaining the private sewage system lank in such a manner as to prevent or abate any human health hazard caused by the system. Bayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by la&. 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 crnnegs) name(s1- rtease runt Subscribed and swam to before me on this date: )os3e&t aeLt 2 /j /11ti5U 1� oi), lrie=eby %7A,. 0-A424L X13! Zy ,1c, l�� NOTARVPUBLIC.STARO LUWS -- - -.-..-MyCannYlfOeE,t11tK1111/1017 State Bar of Wisconsin Form 3-2003 QUIT CLAIM DEED Document Number ii Document Name THIS DEED, made between Robert James Zeller and Joanne K Zeller, husband and wife, as joint tenants, ('Grantor,' whether one or more), and Robert James Zeller, ("Grantee," whether one or more). Grantor quit claims to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Bayfeid County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): That part of Government Lot Ten (1�Sedion Four (4), Township Forty-four (44) North; Range Nine (9) West, more particularly described as followsCo=hr.c:ng at the northeast comer of said Lot at a stake on the shore of Robinson Lake; thence running south along the east line of said Lot a distance of approximately 620 feet more or less to a stake on the north side of roadway: thence running northerly and northwesterly along the edge of said roadway a distance of approximately 256 feet to a stake, said stake being 120 feet west of the east line of said Lot thence running north, parallel with the east line of said Lot a distance of 377 feet to a stake on the shore of Robinson Lake; thence running easterly along the shore of said lake to the point of beginning. Together with fight of ingress and egress on the mad leading Into said property, Town of Barnes, Bayfield County, Wisconsin. Commonly known as 3920 Waltman Road Dated__________ (SEAL) w RobertJan Iler (SE's-) Jo4 nne K Zeller AUTHENTICATION Signature(s) _- _. authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Rodney W. Kimes. Bolarien. Koepke & Kimes, S.C. 542 E. Grand Avenue, Beloit, Wisconsin 53511 (Signatures may be authenticated r NOTE: THIS IS A STANDARD FORM. ANY MODDIG QUIT CLAIM DEED O2003 STATE B, 'Type name below signatures. PATRICIA A OLSON BAYFIELD COUNTY, WI REGISTER OF DEEDS 2013R-551210 09/03/2013 09:15AM IF EXENPT t: RECORDING FEE: 30.00 TRANSFER FEE: 474.00 PAGES: 1 Recording Area Name and Return Address Robert James Zeller 6465 Harvest Lane Machesney Park, 1161114 0041062.6 Parcel Identification Number (PIN) This is not j mete r e.'.9 jd D (is) otnot lei �r II E VU AUG 1 32U4 Ba�eld Co. Zoning Dept. (SEAL) �`\ ACKNOWLEDGMENT STATE OF VA1�S(�06>s;{� ) ss. �'1D C`OUNTY) Personally came b�eif7oreme on D ) ca g ) WI 3 the above -named Mary .. 2,ltkt a .Joanne_ A . tale r to me known to be the person(s) who executed the foregoing instrpglent and acknowledged the same. FORM Ku. .. . •v . FORM NO.3-2003 n /Nd0&0" Legal Fans • (BOa)65S2a21 • infopohmnmm V1113 P875 8127/24, 2:46 PM Carmody""' BAYFIELD COUNTY SANITARY PERMIT (#04)-24126S STATE SANITARY PERMIT OWNER: ROBERT JAMES ZELLER G OV'T LOT: LOT: 10 BLK 1/4 1/4 SEC: 4, T 44 N, R 9 W TOWNSHIP: Barnes SOIL TEST: 121-24 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: Jason Kuettel TRACY POOLER DATE: 8/27/2024 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 #: LICENSE: # MP 675751 Condition: System to meet all setbacks. Management plan to owner. Properly maintain system per recorded agreement. Properly abandon existing/old system per SPS 383 THIS PERMIT EXPIRES 8/27/2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION https://www.carmodyinc.com/PermitApp/Permit_Sign.aspx?Print=l &permitappid=7350 1/2