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HomeMy WebLinkAbout24-139SRequest for Sanitary Inspection ( Fax this form to Zoning Dept when you want an inspection — 373-0114) Note: Time Chan e From Zoning Dept ❑ 9 Discrepancy ❑ Other Phone Number Plumber: iVl..c 7(S_G63 ro88 Fax Number Home Owner: DIAL IIIAQ�� 1 Sanitary Permit #: �t Plumber's Choice Zoning Dept No inspection during these times Date: 1H I2(=i 19 9.30 am —12:30 pm Tues. (Tracy) OK IJES- 930 am —12:30 pm Thurs. (Tracy) Tme. Plumber's Choice Zoning Dept Immediate Phone Number so Zoning OK Dept can call you right back (if needed) Township: Arlrlracc i! R Road Name: '-1 b4"o IJ lX-E L S4S Zj or Directions To Site: Comments: Reminder: You must confirm any change(s) that have been made prior to or this inspection will not be scheduled and a memo will be sent voiding the inspection. Thank You! Plumber must verify any change(s) by fax or no inspection will be scheduled " atoms anitary/requestfonrsspepion Zaruna Dept (t4/I21041 June 3 Industry Services Division General Information Permit Holder's Name: Tank Information TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Septic • e morn` (jO' } R0t P N/A Dosing ,r N/A Aeration N/A Holding Private Onsite Wastewater Treatment Systems ( POWTS) Inspection Report (Attach to Permit) DIANA J MARTY 14943 GREEN CIRCLE DR CHESTERFIELD MO 63017 BIVIDescdptran: Tap o -c ... se\\ setback to: County Sanitary ermlt No: �4 -1339 State Plan Transaction ID#: Parcel Tax No: Pump I Siphon Information Pump Manufacturer ump Model Demand GPM Filter Manufacturer a� ilter Model 250 TDH Lift Friction Loss Head Total Forcemain Length Dia Dist. To Well Dispersal Cell Information DIMENSIONS Width Length # of Cells Well 0 WM CI4 o14 SETBACK FROM Prop. Line Sc Building .\C'# Type of Cell QU, tic y Manufacturer: Model Number. Pretreatment Unit Manufacturer: Model Number: )istribution System Header I Manifold Distribution Pipe(s) I X Hole Size X Hole Observation Pipes Length _ Dia Length _ Die Spac'1 Spacing 0 Yes 0 No Elevation Data STATION BS HI FS ELEV Benchmark i- an'too 11 Bldg. Sewer Tank Inlet 5.29 q2e q4.54 Tank Outlet 5 b Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/ Manifold (0 , (01 Distribution Pipe --1 Infiltrative Surface j c ' Final Grade X Pressure Systems Only Soil Cover Depth Over Depth Over Depth of Seeded I Sodded Mulched Cell Center Cell Edges Topsoil 0 Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, et 1c'nk \Y\*t\\kttcyl r\-i b *-c \c ►nt ti i l A k' Ao( S4Q \ a)aner . Plan re co,✓ec Plan revision required?. Yes 'No Use other side for additional informatio' . �) fctkrt preen}. \ASkAked -1-aItILsl2-4. r spe cttct.R;urnbev -it;S pi ttvre s (A. Plum r dates nit knnst v.,., POWTS Inspector's Signature License Number c4 sue,, pt duos c +ink in ,�l uctvre Date CRnl.71n rR n1191 .< Pt _rnb v�eare r Property Owner Information As you know BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zoning(abayfieldcountv.wi.00v Web Site: www.bavfieldcounty.wi.gov/147 DIANA J MARTY 14943 GREEN CIRCLE DR CHESTERFIELD MO 63017 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, applicabie code requirements: y{-�wnoo n Tank was pumped by: (J on \0(2-12.M at AM/PM Tank was crushed remove nd pipes disconnected by: Ra5ML)5Say-\ txcc vcho>\ On i i 12-D( 21-i at ( DC (AM /IPMythe above -mentioned plumber contacted our office to conduct a pre -cover inspection as required un er 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: Pc- rk cn` ( cCt Gn Czm\) �C C, - T"fl`<- Vcc' CCye e _ f Qcc'(1G, U/formslsanilarypropertyowner-input April 2019 SHEEPFARM CONSTRUCTION msdunlavy@yahoo.com SHEEPFARM PLUMBING & HVAC CONTRACTOR MP# 1006993 $ 4pfbtk\ ELECTRICAL CONTRACTOR & RESIDENTIAL MASTER ELECTRICIAN ELECT# 1008049 Sheepfarm Construction LLC. • 77794 Hill Rd., • Glidden, WI 54527 • Phone 715.663.0088 SLAtc I14 zc' NSW ?LGT Pt_►au Accoa D o IIv STALL&TI OM o 7 wt.) StPilC S. STEM BM=WuiToP= Ico IOOn�af*�v�� On;EIAA ��K2Ei� S- e-nc TA►.�K wi l f4 pcwl�� F,t;t tL- ssiMn1_1a 3cP ' (--A 5 I1'3 L112c:35-3Reu.5 cc Ib c41Am8Cv5 Ati'� Rcw bF (p C44A1M&P5 p,_p?ot.) 13c(Ctt -5 U 4 a N'"' r ox � G✓�y fiEt: rilr L3 pacreZ MAY 2 6 2025,1 Bayfield Co. Planning and Zoning Agency 41) 2 propo5c4 3 "Jy.Wpvc w/ tlOAM OjJER t►a'fl(-L Q,7 ( • Lc r i4 M + Job Name MART? Fire€4bNa) Town ofCaA 1lCtoo Countyof Description 114, 114, Sec. 33 ,T _ _ N,R tz,00 Parcel ID# _j b—T(D . Signature � ui MP81006993 Date �2cL±f Sheet a of ON /2 Ed rtttttr.c�. _ (Department of Safety FEJI u n"t`'��,�.�j D& Professional Services, '�"^`"'"-- ary Permit Number (to be filled in by Co.) .. S I '. PS LP 0 3 2014 Industry Services Division 0 I I ark Application Stale Transaction Number ht accordance with SPS 383 21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing addressl is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWfS are submitted to the Department of Safety and Professional Services. Personal information you provide may he used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Slats. I. Application Information —Please Print All Information Property Owner's Name Parcel k t)lAk3P 3. M arc Property yOwner's Mailing Address II __ �f Property Location rye �f 4c 2i G. b `• q00 W �Q.Crs �' t -/°t 2D • Govt. Lot (Floc City, State Zip Code Phone Number CLA&.c W IS IS' I`d2 2fo2. e13-3lo'1`i l:. Section!_ /'/, T N R IO W Type of Building (check all that apply) Lot 9 X1. 1 or 2 Family Dwelling— Number of Bedrooms— .5bt L�R`�u — Block p CtI LY ❑ Public/Commercial — Describe Use O City of O Village of C State Owned — Describe Use CSlvt Number fill own of &A14 %&LA) 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 if a..nlicable.) A. New System y Replacement System(explain: p y ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit ex Lvni B. ❑ Holding Tank fn -Ground ❑ At -Grade ❑ Mound gn ther Type (explain) ❑ Individual Si OUesi (conventional) - C.1 ❑ Renewal Before ❑ Revision ❑ Change of Plumber 0 Transfer to New Owner .ist Previous Permit Nurfber and Daf Issued !.. Expiration IV. Dis ersal/freatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) I Dispersal Area Required (st) Dispersal Area Proposed (sf) System Elevation N50 i12c N(o I 99.8t 44 _ Capacity in I Total 0 of Manufacturer Tank htformation Gallons Gallons Units a U `3 , I Y U New Tanks Existing Tanks yc 2 y . I Cr 7L Septicor Holding Tank 1 — Iajo 8 O� x i K i Dosing Cha,nber `Q se AbS It sFlt,Rx'kTtr0.S V. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MFRS Number Business Phone Number 1(�i 6.. u- U It✓t� Qi93 1tS.1�,3,fX3$g Plumber's Address (Street, City, State, Zip de) `rn L( 1-1tt-.4 GL bDct '4's CIS M VI. County/Department Use Only I Approved ❑ Disapproved Permit Fee Iss d Issuing Age ig re /���,� ❑ Chvner Given Reason for Denial Conditions o Approval/Reasons for Disapproval c Attach to complete plans for the system and submit to the County only on paper not less than 8 5/2 x It Inches In size SBD-6398 (R. 03/22) �8iEE0 U I5 n SR=Q � Illfl�l �z�ty SLP G :; c :. '' Wisconsinof Department a Safety and Professional Services Division of Industry Services 1 B6yfield Co. Zoning DEUPage_of 4 tips :' SOIL EVALUATION REPORT In accordance with SPS 385. Wis. Adm. Code County Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include. 8ayfield 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. i16962 Parcel I.D. Please print all Information. IReviewed Personal information you provide may be for by Date used secondary purposes (Privacy Law. s. 15.04(1)(m)). f ) `( \.7 I Property Owner Property Location Diana J Marty 0a Govt. Lot4 % '. 533 T44 N R6 E(or) W Pmperly Owner's Mailing Address 14943 Green Circle Dr. Site Address or CSM and Lot 46400 W Jackson Lake Rd City Chesterfield I State MO 163017 Zip Code Phone Number 262893367' ❑ Clty ❑ Village Grand View l7 Town I 1W Nearest Road Jackson Lake I New Construction Use: ❑E Residential/Numberofbedrooms3 Code derived designflow rate450 GPO Replacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable it. Parent material Outwash General comments and recommendations: In -ground gravity with lift- install system 2-3in ground .5 loading If Installed in 1-3 area) .4 loading installed in 4-6 area, system installed shallow as possible while matching up to existing building drain. Boring # UBoring 102.8 94.8 �J QPit Ground surface elev._ft. Depth to limiting factor �� in. / elev.ft. Horizon 1 Depth In. 0-5 Munsell 5yr 3/2 Dominant Color7JTe�,,,ureIP5 Structuredary Cr. w Roots 3co soil Application Rate GPO/Ft' 'Eff#1 .6 •Eff#2 1.0 2 5-36 5yr4/6 W 3m .4 .6 3 36-96 5yr 6/3 - .7 1.6 Boring # Oaoring 107.3 9699.3 UJPit Ground surface elev.ft. Depth to limiting factor In. / elev.ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •ER#1 EH#2 1 0-9 5yr 3/2 - sl 2mabk ml cw 3co .6 1.0 2 9-60 5yr 4/6 - Is 0sg ml gw 3co .5 1.0 3 60-96 5y46/3 ms 059 ml - 2m .7 1.6 CST Name (Please Print) Signature I CST Number Edward B. Redinger - 221939 Address Date Evaluation Conducted I Telephone Number 1015 11th Ave. E. Ashland, W 54806 9/30/22 715-292-6670 Effluent #1 = SOD > 30 s 220 rn98- and TSS > 30 s 150 mg& Effluent #2 = ROD, s 30 mg/L and TSS 530 m A- SBD-8330 (R04/21) Pd - e-a-ap is 1 o r) C! (1171H iuHi�i I Page of 4 Boring 103.5 Illl FIJI I 3 I Boring# � Pit Ground surface elev. ft. -Depth to limiting factor 95.. in.! elev. ❑ ft. L-� hayfield ...... -,.,. Horizon Depth In. Dominant Color Munsell Redox Description Cu. Az. Cant. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft' 'Eft#1 'Eft#2 1 0-6 5yr 4/2 sl 2mabk dl cw 3co .6 1.0 2 6-50 5yr 516 - ft Osg ml gw 3m .6 .6 3 50-96 5yr 6/3 - ms Osg ml - - .7 1:6 ❑4 Boring # ❑ Boring 94, g 87.2 Q Pit Ground surface elev. ft. Depth to limiting factor 9� in. / elev._ft. Soil Application Rate Horizon 1 Depth In. 0-4 Dominant Color Munsell 5yr 4/1 Redox Description Cu. Az. Cont. Color - Texture sl Structure Cr. Sz. Sh. 2mabk Consistence dl Boundary Cw Roots 3m GPDIFI' Eft#1 .6 •Etf#2 1.0 2 4-52 5yr4/3 - Is lfabk dl gw 2m .4 3 52-56 5yr 5/1 sl 2mabk dl 9w 3f .6 .6 1.0 4 56-92 5yr 5/6 - s 0sg dl - 2f .7 1.6 I S I Boring # ❑ Boring 95.7 Q Pit Ground surface elev._ft. Depth to limiting factor 96 In. / elev. 87.7 ft. Horizon Depth In. Dominant Color Munsell Redox Description Cu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots 6011 Appllca ton Hale GPO/Ft' 'Eff#1 ,Eff#2 1 0-4 5yr4/1 - SI 2mabk dl cw 3m .6 1.0 2 4-72 5yr4/3 - Is 1fabk dl gw 2m .4 .6 3 72-96 5yr 5/6 - ms Osg dl - - .7 1.6 Effluent #1 = BOD > 30 5 220 rng/L and TSS > 30 5150 mg/L ' Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L PP -7oc(b IH�I!I Page 3 of 4 Boring 6 I Boring # ❑� Pit Ground su96.4 rface elev.ft. Depth to limiting factor in. / elev.88'4n. Horizon 1 , Depth In. 0-4 Dominant Color Munsell 5yr4/1 Redox Description Qu. Az. Cont. Color Texture sl Structure Cr. Sz. Sh. 2mabk Consistence dl •1 Boundary Cw Roots 3m Soil Application Rate GPDIFt2 E6#1 .6 Eff#2 1.0 2 3 4-70 70-96 5yr 413 5yr 5/6 Is ms lfabk Osg dl dl gw 2m .4 .7 .6 1.6 ❑ Boring # o Boring o Pit Ground surface elev.It. Depth to limiting factor in. / elev.ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. I Consistence Boundary Roots Soil Application Rate GPD/Ft2 'Eft#1 •Eft#2 I� Bortng # ❑ Boring ❑ Pit Ground surface elev._ft. Depth to limiting factor in.I elev._t. Soil Application Rate I Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/Fl2 'Eft#1 •Eft#2 Effluent #1 = BOD > 30 s 220 ng/L and TSS > 30 5150 mg/L ' Effluent #2 = BOD. s 30 mg/L and TSS s 30 mg/L Customer Name: Diana Marty Adress: 14943 Green Circle Dr. P pra Chesterfield, MO 63017 SUPERIOR SITE: 46400 W. Jackson Lake Rd. WI PLUMBING MECHANICAL (715) 2 / 8 - 3456 Phone#: 262-893-3674 Email: CST# 221939 - "``7777 Scale: 1" -- 4t' PIN: 16962 GO 1 Acre Lot 4 S33 T44N R6W Town of Grand View Bayfield Co. 7ro ,A- 'ter. 7 �` rep Q 1 r iii SEPL. I Bevfietc*0 Zoning Dep N I Sheepfarm Construction LLC. D E C E 0 d[ D 77794 Hill Road Glidden, WI 54527 SSP C Bayfield Co. Zoning Dept. INDEX SHEET FOR CONVENTIONAL SEPTIC SYSTEM PROJECT NAME: Marty Conventional System OWNER: Diana Marty OWNER ADDRESS: 14943 Green Circle Dr Chesterfield, MO 63017 PROJECT ADDRESS: 46400 W Jackson Lake Rd Cable, WI 54821 LEGAL DESCRIPTION: Lot 4 S33 T44 R6W Town of Grand View in Bayfield County PARCEL ID#: 16962 CONTENTS 1. INDEX SHEET 2. PLOT PLAN 3. CHAMBER CROSS SECTION 4. TANK CROSS SECTION 5. FILTER MAINTENANCE +0.floo l 6. SOIL EVALUATION 7. SOIL EVALUATION a 'I ` ,llipt 00 8. SOIL EVALUATION 9. SOIL EVALUATION 10. SYSTEM MANAGEMENT AND MAINTENANCE 'System is designed and to be installed and maintained according to In -Ground Soil Absorption Componenet Manual for POWTS Version 2.0 SBD10705-P (N.01/01) ®All work is GUARANTEED to be done in workmanship quality by Sheepfarm Construction, by both Mike and Crew PLUMBER'S Michael S. Dunlavy 1 M.P. #1006993 TE: August 8, 2024 p_I t o.FIo Ui SHEEPFARM CONSTRUCTION msdunlavy@yahoo.com SHEEPFARM PLUMBING & HVAC CONTRACTOR MP# 1006993 $MtprkTh\ ELECTRICAL CONTRACTOR & RESIDENTIAL MASTER ELECTRICIAN ELECT# 1008049 Sheepfarm Construction LLC. • 77794 Hill Rd., • Glidden, WI 54527 • Phone, 7,15.663i.Uj8 C: 32UZ4 �IJoKTH SGRta ( 1a } I © u� Bayfield Co- Zoning L Dept. I QQ.Q .sp t.c. one ©nT€ 11) A 6O Nc4-eTG cCF`7* r.. w u- -r" +oLywk c %%.:T4E4 SinrF►utrkzo2 Qua- L 1N a,EquAt-(L s CF a9EAcM Rot: L'Nc 2 F.! VEWA`t o 9y 1 NCW ' Job Name M4rry Fire#tfbgCIO TownofKRANDVII6W Countyof£4VflELD Description 1/4 1/4, Sec. , T ______NM � Parcel ID# 16<16 2- Signatu� p —R_ MP#1006993 Date 14u6 sT Z92Y/ Sheet a of 2 Au cii SHEEPFARM CONSTRUCTION msdunlavy@yahoo.com SHEEPFARM PLUMBING & HVAC ELECTRICAL CONTRACTOR CONTRACTOR & RESIDENTIAL MASTER ELECTRICIAN MP# 1006993 ELECT# 1008049 Sheepfarm Construction LLC. • 77794 Hill Rd., • Glidden, WI 54527 • Phone 715.663.0088 CROSS Cecua4 op �ecz [ lA 'ibw E N D S��r✓� a— a w 'I I jr Imo. L_ Ltc c aPccoR -1 C tia 5 3'-I'' t �� x X43" l c a( to kj C HC\n&tl eECw\wc as u ` T'-1 ag 1pjEsvj 12c≥ L( Bc.iL\A Mt = i cr G Tot IDF U36LL _ Job Name AAf6RTN_Fire# W{o�{C�b Townof Ga4rua \JEW Countyof3Ay .t-1 Description 1/44,, 1/4, sec. 33 ,T "14 N, R b .i�Q Parcel ID# t 16 6 ,- Signatur�, ]X.J [� r MP#1006993 Date g Z.o Z9 Sheet 3 of JO SEP 'U 3 IU&i Bayfield 1o. Zoning 112.0° 70.0" • / 55.64" X 103.64" X 40.25" _ 1004.8 GALLONS 231 (ACTUAL) �/ \ JIjT \ 1004.8 25.0 GALLONS/INCH ! s, _ 40,25 (ACTUAL) 1.) ALL TANKS ARE EFFLUENT FILTER COMPATABLE. 2.) OUTLET BAFFLES ONLY SUPPLIED PER REQUEST. 3.) 4' AND 6" MULTIPLE OPENINGS ARE AVAILABLE. 4.) NOTIFY WHEN DEPTH OF BURY IS GREATER THAN 72". 5.) 24` AND 30 MANHOLE OPENINGS ARE AVAILABLE. 6.) NOTIFY WHEN INSTALLING tN EXTREME WET CONDITIONS. FILE # 20080254 G.P.D. = 500 GALLONS WEIGHT = 10,000 LBS. ONEIDA CONCRETE PRODUCTS RHINELANDER, WI (800) 236-3124 SEPTIC TANK - 1000 GALLON P9 L{ of 10 POL Ox Inc Innovations in PsnmsLDainage Zabel & Wastewater Products A Division of Polylnk Inn. II \VJ cr PL -68 Effluent Filter PL -68 Filter and Tee PL -68 is much more than just an effluent filter. The housing can also be used as an inlet baffle (tee) or an outlet baffle. The housing is designed to accept Polylok's snap in gas deflector to deflect gas bubbles away from the tee and to keep the solids in the tank. Features: • Offers 68 linear feet of 1/16" filter slots, which significantly extends time between cleaning. • Accepts 3/4" PVC handle. • Locks in any 360° position when used with PL -68 Tee. • PL -68 Housing can be used as an inlet or outlet tee. • Gasket prevents bypass. PL -68 Installation: Ideal for residential waste flows up to 800 gallons per day (GPD). Easily installs in any new or existing 4" outlet tee. 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the outlet pipe, or use a Polylok Extend & Lok if not enough pipe exists. 4. Insert the PL -68 filter into tee. 5. Replace and secure the septic tank cover. PL -68 Maintenance: The PL -68 Effluent Filter will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. 1. Do not use plumbing when filter is removed. 2. Pull PL -68 out of the tee. 3. Hose off filter over the septic tank. Make sure all solids I fall back into septic tank. 4. Insert filter back into tee/housing. Related Products: PL -68 Filter Concrete Baffle Extend & LokTM Extend & LokT°s Easily installs into existing tanks. 1/16" Filtration Slots GZ Accepts 3/4" PVC Extension Handle 800 GPD Y4 Fits Any Tee On The Market Gasket Prevents c4>Sfr 68 Linear Ft. of Bypass 1/16" Filtration Slots Easy Installation Accepts 3" & 4" Filter Locks in Any (SCHD 40 & 360°Position SDR 35 Pipe) 16" & 18" Available Optional Gas Deflector 0 Spacer Bushing 4" SCHD 40 to SDR 35 ®Certified NSF/ANSI Standard ndd ard 46 0 Spacer Bushing 4" SCHD 40 to 110mm Pipe Filter Concrete Baffle 2" Extender Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com p� SocIC) State Bar of Wisconsin Form 5-2003 PERSONAL REPRESENTATIVE'S DEED Document Number Document Name THIS DEED, made between Douglas Rowe as Personal Representative of the estate of Keith C. Rowe ("Decedent"), ("Grantor," whether one or more), and Diana J. Marty ("Grantee," whether one or more). Grantor conveys to Grantee, without warranty, the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Bayfield County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): (See Attached Exhibit A for Legal Description) III lil 111 111 l 111 l ll thU III Ill UI IU ll l DIHhI *2016R-564835 2* 2016R-564835 PATRICIA A OLSON BAYFIELD COUNTY, WI REGISTER OF DEEDS 08/16/2016 10:43AM IF EXEUPT C: 11 REC0RDIIl6 FEE: 30.00 PAGES: 2 Name and ReturnAddress Q Unn Spears, CerLsarts "S on & Cotetnao,.G. ,� PO Box 547 Washburn, WI54891 ': Z024 04-021-2-44-06-33-4 05-004.60000 Parcel Identification Number (PIN) This is not homestead property. t9 (is not) Personal Representative by this Deed does convey to Grantee all of the estate and interest in the Property which Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the Personal Representative has since acquired. Dated `f c.c /" / , 2016 PERSONAL REPRESENTATIVE: AUTHENTICATION Signature(s) .,, -O Lr Rout authenticat 0 * .� L.t Car-ko n MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Atty. John IL Carlson, SBN 1050163 Notary Public, State of Wisconsin PO Box 547, Washburn, Wisconsin 54891 My commission (is permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS is A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. PERSONAL REPRESENTATIVE'S DEED ®2003 STATE BAR OF WISCONSIN FORM NO. 5-2003 'Type name below signatures. INFOVRO" Legai Furth - laea19SS7021 . trtlop,mmma mn V116.5 Pala (SEAL) Douglas Rowe / 1KNdEDGMENT STATE OF Wisconsin ) ss. Bayfield COUNTY) Personally came before me on the above -named Douglas Rowe, as Personal Representative of the Estate of Keith C. Rowe to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. 2016 Dept. SEP 0 3 Lu,_ , <J EXHIBIT A - LEGAL DESCRIPTION Bayfield Co. Zoning Dept. Personal Representative's Deed / Rowe Estate to Diana J. Marty A parcel of land located in Government Lot Four (4), Section Thirty-three (33), Township Forty- four (44) North, Range Six (6) West, Town of Grand View, Bayfield County, Wisconsin, more particularly described as follows: Commencing at the east quarter comer of Section 33, running thence N.88°33'17" W, 2222.06 feet; thence S.27°25' 17"E, 252.85 feet to a point which is marked by an iron stake driven into the ground and herein referred to as Point A; thence S.01°38'58"W., 141.60 feet to a point which is marked by an iron stake driven into the ground and herein referred to as Point B; thence S.00°28'32"E, 270.90 feet to a point which is marked by an iron stake driven into the ground and herein referred to as Point C; thence S.00°28'32"E, 18.30 feet to a point which is marked by an iron stake driven into the ground and herein referred to as Point D; thence S.25°38'58"W, 101.10 feet to a point marked by an iron stake driven into the ground and herein referred to as Point E, being the point of beginning; thence continuing along the same course 151.80 feet to a point marked by an iron stake driven into the ground and herein referred to as Point F; thence S.63°44'05"E, 253.79 feet to a point marked by an iron stake driven into the ground and herein referred to as Point G; thence along the same course to the intersection of said line extended with the shore line of Jackson Lake; thence northerly along the shore line of Jackson Lake to the point of intersection of the said shore line with a line having its westerly end as the point designated as Point E and running thence S.72°20'56"E., to such point of intersection passing through an iron stake driven into the ground on said line at a point 285.73 feet distant from said Point E; thence from said point of intersection to Point E, the place of beginning. [Ref V163 P534] VII6 5 P.2 13 Department of Safety crli ' tbasNt_anlb D & Professional Services, L 8 - D — Permit Number he filled in by Co.) PS - SEP 0 3 Z0 4 Industry Services Division [III (to a I ary aI i Application State Cransaction Number In, accordance with SPS 38321(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 POWIS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may he used for secondary purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. I. Application Information — Please Print All Information I Property Owner's Name Parcel II t)lANa 5, nnan I�96a Property Owners Mailing Address "I 64QO �/.). QC.�S R Property Location WI��BS �Zi2 •,I 1A -D Ciovt. Lot L_ City, State Zip Code Phone Number C A (3_c Ulf Is S y�2 2 b2- - 613.3(0-141 .i, `/,, Sectimi 93__ T ___ N R H. Type of Building (check all that apply) Lot A or 2 Family Dwelling— NumberofBedrooms ���t ll L C�� C --- Block 4 ❑Public/Commercial — Describe Use ❑ City of G State Owned — Describe Use ❑ Village of CSM Number Cuwnof 6,CANJ) V&Lj 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 applicable.) A. -_ New System Replacement SystemExisting (explain) ❑ Other Modification to System❑ (explain Additional Pretreatment Unit i B' ❑ Holding Tank 'in -Ground ❑ At -Grade ❑ Mound ❑ Individual Site Design ❑ Other Tye (explain) g p (conventional) C. 0 Renewal Before ❑ Revision ❑ Change of Plumber Owner ❑ Transfer to New O List Previous Permit Number and Date Issued Expiration IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (sp Dispersal Area Proposed (sf) I System Elevation yso .4 If 2S Ilbo I 9 .8' Capacity in Total II of Manufacturer r Tank •nformation Gallons Gallons Units b •�', New Tanks Existing I anks = [' s m Septic or Holding Tank Dnsing C'hvnber i iryeo W + O VIGY Paeos x��— . 58 ! AbS I Nf i %aIA JLS V. Responsibility Statement- I, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plays. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Mt a. u ti UAv 1 Ot7 113 ncS63, fb88---- Plumher's Address (Street, City, State, Zip de) `I1�i9y 1-llw ob (c DDEIv 54's c'lcZ� VI. County/Department Use Only Permit FFeyeee/� )ate Issued Issuing Age ig rc Approved O Disapproved $ O Owner Given Reason for Denial (/✓ l t k4 Condition of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than a u1 x 11 inches In size SBD-6398 (R. 03/22) SYSTEM Nt MA?IAGEM 'y /nn Management of this system is critical. As a condition of approval of these plans thisJ system ' Z U Y4 D management must be reviewed with the homeowner, and the homeowner must be provided. iQeazoning Dept. complete set of plans including this management section. GEN AL ?roper functioning of an on -site disposal system, "septic system", is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil absorption cell to recycle the water in a manner to protect ground water quality and public health. 1 • if the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal residential use begins to ensure adherence to contaminant load design criteria. 2. Install water -saving appliances whenever and wherever possible., 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. &. Avoid surge flows of water; try to spread laundry throughout the week. I. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the flitter must be. back -washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to'examine the state of the in - situ soil absorption cell, Quarterly innspeciions are recommended, and licensed plumber should be notified if effluent is consistently ponded in the absorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 5. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump, lithe alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Wastewater monitoring of volume and quality is not a normal requirement for residential systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54(2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. SS -O)() Private Sewage System Maintenance Agreement ig4Na MAtt iy4u3CaizEF#JCiaccE1k l desreacELD nOn b Nf,�FDD W. racl'-sc taiLE QO CABLE LJ1 9iX2 i Tax ID#'�Q� 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 33 Township 14N. Range _____W. Additional Legal Description: J EE O rVAC.a*€Eb TDO C_ Town of6j �44a V �[ lEtA) (Acreage) Gov't Lot I Lot Block Subdivision Lot _ CSM # Vol. _ Page _ CSM Doc # DOCUMENT NUMBER 2024R-604574 DANIEL J. HEFFNER REGISTER OF DEEDS (7 BAYFIELD COUNTY. WI RECORDED 09/03/2024 AT 11:07 AM RECORDING FEE: $30.00 PAGES: 3 Area Return To: U P n l n an P 1-1 Planning and Zoni Deg, ent $afield Co. Zoning Dept. INIn -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. Pump Chamber (system types 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. Seotic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturers 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) 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 -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. Owner(s) 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. Bayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days fmm 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 bylaw. 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. Owner(s) Name(s) — Please Print Subs and sworn to before me on this date: } } ,OIGLna Gtr? y s OPerrr y •• Notarized Owner(s)— Signature(s) v NoPry Public �cf� %^�tv ve:•' O�, ; AR My Commisgion Expires: [/6 1* Drafted by: kttMct Ousk Date: AIoocr 6 ( ≥ 2'1 6 .%/t4 (e C'OU.i4 c.' L M1'��t;VISCOw _ ulfomWsanitary/septcmaintenceagreement Revised July 2020 State Bar of Wisconsin Form 5-2003 PERSONAL REPRESENTATIVE'S DEED Document Number Document Name THIS DEED, made between Douglas Rowe as Personal Representative of the estate of Keith C Rowe ("Decedent"), ("Grantor," whether one or more), and Diana J. Marty ("Grantee," whether one or more). Grantor conveys to Grantee, without warranty, the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Bayfield County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): (See Attached Exhibit A for Legal Description) IIfl III IIIII IIIIIIIII III III MII III II 2016R-564835 2* 2016R-564835 PATRICIA A OLSON BAYFIELD COUNTY, WI REGISTER OF DEEDS 08/16/2016 10:43AM IF EXEMPT 0: 11 RECORDING FEE: 30.00 PAGES: 2 Name and Return Address Spears, Carlson & Coleman, S.C. PO Box 547 Washburn, WI 54891 04-021-2-44-06.33-4 05.004.60000 Parcel Identification Number (PIN) This is not ho property: d D ((I (is not) Ift SLy LUZ4 Bayfield Co. Zoning Dept. Personal Representative by this Deed does convey to Grantee all of the estate and interest in the Property which Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the Personal Representative has since acquired. Dated `J 24 /`r / , 2016 PERSONAL REPRESENTATIVE: AUTHENTICATION Signatures) Dunlar Aemr_ authenticat o n (o TlT1E: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Atty. John R. Carlson, SBN 1050163 Notary Public, State of Wisconsin PO Box 547, Washburn, Wisconsin 54891 My commission (is permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. PERSONAL REPRESENTATIVE'S DEED ®2003 STATE BAR OF WISCONSIN FORM NO. 5-200.3 *Type name below signatures. INFO.PRO' Lead Farm. ($55.20I• V116.5 P•2 12 ) as. Bayfield COUNTY) Personally came before me on , 2016 the above -named Douglas Rowe, as Personal Representative of the Estate of Keith C. Rowe to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. EXHIBIT A - LEGAL DESCRIPTION Personal Representative 's Deed / Rowe Estate to Diana J. Marie A parcel of land located in Government Lot Four (4), Section Thirty-three (33), Township Forty- four (44) North, Range Six (6) West, Town of Grand View, Bayfield County, Wisconsin, more particularly described as follows: Commencing at the east quarter corner of Section 33, running thence N.88°33'17" W, 2222.06 feet; thence S.27°25' 17"E, 252.85 feet to a point which is marked by an iron stake driven into the ground and herein referred to as Point A; thence S.01 °38'58"W., 141.60 feet to a point which is marked by an iron stake driven into the ground and herein referred to as Point B; thence S.00°28'32"E, 270.90 feet to a point which is marked by an iron stake driven into the ground and herein referred to as Point C; thence S.00°28'32"E, 18.30 feet to a point which is marked by an iron stake driven into the ground and herein referred to as Point D; thence S.25°38'58"W, 101.10 feet to a point marked by an iron stake driven into the ground and herein referred to as Point E, being the point of beginning; thence continuing along the same course 151.80 feet to a point marked by an iron stake driven into the ground and herein referred to as Point F; thence S.63°44'05"E, 253.79 feet to a point marked by an iron stake driven into the ground and herein referred to as Point G; thence along the same course to the intersection of said line extended with the shore line of Jackson Lake; thence northerly along the shore line of Jackson Lake to the point of intersection of the said shore line with a line having its westerly end as the point designated as Point E and running thence S.72°20'56"E., to such point of intersection passing through an iron stake driven into the ground on said line at a point 285.73 feet distant from said Point E; thence from said point of intersection to Point E. the place of beginning. [Ref V163 P534] V1165 P213 9/9/24, 9:29 AM CarmodyTm BAYFIELD COUNTY SANITARY PERMIT (*04)-24.-139S STATE SANITARY PERMIT OWNER: DIANA MARTY GOVT LOT: 4 LOT: BLK: 1/4 1/4 SEC: 33, T 44 N, R 6 W TOWNSHIP: Grand View SOIL TEST: 100-24 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: MICHAEL DUNLAVY TRACY POOLER DATE: 9/9/2024 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: # 1006993 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 9/9/2026 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=7367 112