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24-34SR
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 fl Discrepancy fl Other Phone Number 715-739-6868 Plumber: Doug Manthey Fax Number Email Address Homeowner: Dan & Robyn Bruggeman norpines@cheqnet.net Immediate Phone Number So Zoning Sanitary Dept can call you right back (if needed) Permit #: 24-34S Plumber's Choice Zoning Dept No Inspection(s) during this time Date: 09/26/25 e �� Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice oning Dept Time: 09:00 Township: Barnes Address # & Road Name: qb or 1875 Buchman Rd ciI Directions To Site: Comments: ** Plumbers you must verify any change(s) by fax or email *` Notes from ulforms/sanitary/requestforinspection Zoning Dept (©4/12/04); ® June 2023 flAk pl ��SIO�PVS Industry Services Division General Information personal information you provide may be Pe c Private Onsite Wastewater Treatment Systems ( POWTS) Inspection Report (Attach to Permit) City DANIEL J & ROBYN K BRUGGEMAN C£ 1710 LOGAN AVE S BM Descrlp LiMINNEAPOLIS MN 55403 That InfnrmnNnn spfhgrkffn: TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road septic e it N/A Dosing N/A Aeration N/A Holding Town of: C�y •_ Sanitary Pe No: State Pie Transaction ID#: Parcel Tax No: Pump / Siphon Information Pump Mant7fi Pump Model ! lj Demand GPM Filter Manufacturer liter Model TDH Lift Friction Loss Head Total Forcemain Length Dia Dist, To Well Dispersal Cell Information DIMENSIONS Wi Le�p #of Cells SETBACK FROM Pip. Line Bit ing Wei0 Type of Cell 31/245 Manufacturer: Model Number: Pretreatment Unit Manufacturer: Model Number: licfrihrifinn Rvsfam Header I Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length Dia _ Length _ Dia _ Spac _ Spacing 0 Yes 0 No Elevation Data STATION BS HI FS ELEV Benchmark g Bldg. Sewer 0, 9(r Tank Inlet 3 , j Tank Outlet Dose Tank Inlet _ 0 6 Dose Tank Bottom Inst. Contour Header! Manifold j, j, Distribution Pipe Infiltrative Surface 7 Final Grade X Pressure Systems Only Rnil Cnvar Depth Over Depth Over Depth of Seeded! Sodded Mulched Cell Center Cell Edges Topsoil ❑ Yes ❑ No ❑ Yes 0 No COMMENTS: (Include code discrepancies, persons present, etc.) d jr4 / t'd r' � 1rf ,� �� / ohv to (< i# i Go /4 /�em 4 �i-� Ie r js;w/a'frn ?/p4yfrn/aY!9t uv49 Plan revision required? ❑ Yes $ No 24 Use other side for additional inform IJ. ;,& 9 A " y v/4 rstrsyt•/k Date FRrLR71n rR n4/T11 POWTS Inspector's Signature License Number 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: zoning((DbayfieldcountV.wi.aov 117 East Fifth Street Web Site: www.bayfieldcoUfltv.Wi.UoV/I47 Washburn, WI 54891 DANIEL J & ROBYN K BRUGGEMAN 1710 LOGAN AVE S MINNEAPOLIS MN 55403 As you know a V was contracted by you to install a private onsite wastewater tr tment system on yo it property described as: Notes: 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 �'e"under ) the above -mentioned plumber contacted our office to conduct a pre- over inspection as reDSPS 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: 64/ 141 r it /!z //k 5% e e A2-'/ ' UBormslsenitarypropertyowner-input April 2019 cc_ ��t. �eJtalon y{ D FS Department of Safety 10/1 field Idustry Professional Services, Sanitary Permit Number (to be filled in by Co.) SEP 3 0 2 24 Services Divisionau -s CR.Qviisi @�ffi -pplication 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 purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 1875 Buchman Rd I. Application Information —Please Print All Information Property Owner's Name Parcel if Dan & Robyn Bruggeman 2176 Property Owner's Mailing Address Property Location 1710 Logan Ave South Govt. Lot 1 City, State I Zip Code Phone Number Minneapolis, MN 55403 612-205-2367 ¼. ¼, Section 19 IL Type of Building (check all that apply) Lot /I T 44 N R 09 E or W 0 I or 2 Family Dwelling — Number ofBedrooms 5 _ Subdivision Name Block p ❑ Public/Commercial — Describe Use ❑ Cityof ❑State Owned —Describe Use CSM Number ❑ Village of 0 Town of Barnes's III. Type of POWTS Permit (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete lineC' applicable.) A. O New SystemReplacement System Existing System (explain) (explain) ❑ ® Other Modification to ❑ Additional Pretreatment Unit Additional Tank and Cell to accomodate 5 Bdrms B' O Holding Tank ® In -Ground O At-GradeDesign Type (explain) ❑ Mound ❑ Individual Site ❑ Other lain (conventional) C. ❑ Renewal Before ® Revision O Change o£ Plumber ❑ Transfer to New Owner list Previous Permit Number and Date Issued Expiration 04-24-34S 04/18/2024 IV. Die ersalrreatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (sf) I Dispersal Area Proposed (st) I System Elevation 750 0.7 1071.4 1118.0 93.4 Capacity in Total if of Manufacturer Tank Information Gallons Gallons Units e a New Tanks .._-----.j Existing Tanks 4 c S g v y rd t4 n a U ti Septic or Holding Tank 1250 &320 J1 2320 2 Wieser Concrete x Dosing Chamber 0 750 V. Responsibility Statement- I, the undersigned, assp\responsz ty for stauau of the POWTS shown on the attached plans. Plumber's Name (Print) I Plumb s gnatu MP/MPRS Number Business Phone Number Douglas Manthey MP 230722 715-739-6868 Plumber's Address (Street, City, State, Zip Code) PO Box 196 Drummond, WI 54832 VI. County/Department Use Only Approved I 0 Disapproved I Permit Fee I Date Issued Issuing Agent Signature ) 2 s� • %❑ Owner Given Reason for Denial /� /q#71/,g Conditions of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than S us x II inches in size SBD-6398 (R. 03/22) Nor Pines Plumbing Doug Manthey MP 230722 52085 N. Lake Owen Drive P.O. Box 196 Drummond, WI 54832 09/19/24 Revised Narrative for Bruggeman Septic Addition: Iii) flflfl liii SEP 302024 Bayfield Co. Zoning Dept. A Sanitary Permit was issued for this property on 04/18/24, Permit #07-24-345. Since the issuance of the Permit, the homeowner has begun construction which included a large amount of site work which has caused us to abandon the current Private Interceptor Main for the garage/bunkhouse due to ground elevation changes. I am asking for a revision of the Permit to include the addition of a 320 gallon septic tank to service the garage/bunkhouse and eliminate the existing 1250 Wieser Tank that was servicing that building. The other change would include the piping of the effluent from garage/bunkhouse to the north end of the dispersal cells (see revised Plot Plan). At this time, no work has been done on the Septic with the exception of the Private Interceptor Main for the garage/bunkhouse. Doug Manthey Nor Pines Plumbing 715-739-6868 Office 715-580-0140 Cell Y CHECK BOX AS APPLICABLE flSOIL EVALUATION Scale:1"=40' 40 60 so SITE MAP I PROJECT NAME (lgngdd) 10 Bruggeman Septic Addtion PROJECT ADDRESS: 1875 Buchman Rd BM Symbol: 7 BM Elevation: loS. S1 rr SKI oescdpgon: Top of Existing Well Casing Slope Gradient (%) 13 well Symbol lif applicable): Q or Tested Area: 3m = 1o3S9 93$-) Ers Tic e,. = 9's%bi Pre W5 z %ear = 93. 2 B(eriJ 1a4< ar = 92 Presious St" 9ar A Srvr Sc5 melts Tam - /b-295 e5 sy,Ae, . = ` Ce!I$ Iw/ / yia`T S :jc ,)t/ -e-11 . c I «If ,o,//t, ...<<L y SSL%D� t 3(1e); i11�3tZ - 5' eernE- _ '15b c.?D D.) G D'jrt CHEci SOXASAPPUCABLE. SEP 302024 ✓� SYSTEM PAGE2OF5 Ba�eld Co. Zoning D pt. PLOT PLAN DESIGNF OW: 1250 GPO Attach design flow calculations for commercial plans. Pipe MaterialASTM Standard (Tables 381 8304.30-5) s N sanitary sewer 4"PVD C f D17878 5 force Main: 2"PVC ( 01785 lndicatehozhby IMPORTANT: drawing en am, F Show ground elevation contours at suitable intervals. on the appropole ITS. N — h111 Cy�cueyape2 �rV r� �a \Oe Sc1.,'-(o a r SaR 3S Qo�5CS lieryoh Cif �o�� — Cow, a eL btw an : tCv� &rec,., ck &;\ j�bsor� g.. Y MP 220')2-2.. q%14�z`I n I o N �D O m N • C CD N un" Co w v p m m 4" CAST -A -SEAL FILTER OR BAFFLE (TANKS ARE MANUFACTURED TO _____4'-2" _____ M SIDE VIEW CAST -A -SEAL OUTL T cD a D! REQUIREMENTS W320 -MR TANK SPECIFICATIONS DIMENSIONS: WALL: 3" BOTTOM: 3" COVER: 4" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 58" LENGTH: 4'-2" WIDTH: 4'-2" BELOW INLET: 46 1/2" LIQUID LEVEL: 43" WEIGHT: BOTTOM 3,015 LBS. COVER 870 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 8.00 GAL/IN LOADING DESIGN: 8'-0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: 0- r i7 OF 1 In -Ground Dosed -Gravity Platgfff�FD u SEP 3 nQA Index & Cover Sheet UL Component Manual Design References: Bayfi C6.IA ' Dept. In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 5 Index & Cover Sheet Pg 2 of 5 Plot Plan Pg 3 of 5 Dispersal Area Cross -Section & Plan View Pg 4 of 5 Pump Tank Specifications Pg 5 of 5 Management Plan Attachments: Enclosures: Pump Curve POWTS Application for Review Manufacturer Tank Specs Soil Evaluation Report & Site Map Existing Sanitary Permit Project Name I Description n Septic Addition Owner Name(s): Dan & Robyn Bruggeman Phone: 612 _205 Owner Address: 1710 Logan Ave S. Minneapolis, MN Zip: 55403 Project Address: 1875 Buchman Rd Barnes, WI Govt. Lot: Township: Barnes Project Parcel ID #: 2176 2367 1/4 of 1/4, Section 19 J44 N -R9 E for w71 Designer Name: Douglas Ma Designer Address: PO Box 196 Drummond, WI Zip: 54832 E-mail: norpines@chegnet.net Conditl;ri&'`/ County: Bayfield Designer Information Phone: 715 -739 6868 _ License Number: MP230722 Remarks: Expansion of existin Signature: from 4 Bdrm to 5 Bdrm Date: 03/08/24 signature required on each submitted copy. CHECK BOX AS APPLICABLE. - CHECK BOX AS APPLICABLE. fl SOIL EVALUATION Scale: 4"0 40' BD Bo 0 SYSTEM 0 Wio (�.�unfDg SITE MAP PLOT PLAN PROJECT NAME: DESIGN FLOW: 1250 GPD (10 itgdd) 10' Bruggeman Septic Addtion Attach design flow calculations for commercial plans. PROJECT ADDRESS: 1875 Buchman Rd Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) N Sanitary sewer. 4' PVC / D1785 BM Symbol: $ BM Elevatlort IO3. S9 FT Force Maln: 2" PVC / D1785 BM Descdpnen: Top of Existing Well Casing Indicate north Iry IMPORTANT: Slope Gradient(%) 13 Well Symbol (it applicable): 0 drawing anarm« Show ground elevation contours at suitable intervals. of Tested Area: on the approprlte line. l3ri'I 1°3.aCi o4—_ S` 93t_J Pra Bb j �w>r: 93.2 p V) Ff-r iw t� i� La - 92 p rfE�ioc sS BrwA ur c. 6/ 65 celk 7a — /U .275 rrn a cells V Ex5 Sys v \\ V F s Lr�o j3JJryM.l celt ° F - SS C2o� * 4): 111S StZ ` A' S Per = `7$a FPD r ° Z 7' D.fi G -D a C N E iufll.`I2 ti — At1 co"Warvc.e F ' -o be ScL({o or 509- Z -S CAL O ' n tw• •@hl 1, tRviv-tT.k tv'¼ eTfOtnt.-t . &1.\ r p CoWsrj ') fcon a ` &'y MP 22D1)22. IN -GROUND DOSED -GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) iiiiSlli� 12" min. trench depth (iyplcat) min. aTYPICAL TRENCH (typical) CROSS SECTION VIEW (No Scale) G . (tYPlcaq � .. System Elevation = 93.4 ft (typical) Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) ------------------��--- L-------------j�-------7� g= 42 ft (typical) INSTALL PER TRENCH: 10 Quick4 Std -W @ 20 fe EISA/chamber = 200 ft2 + 1 Pairs of end caps @ 6 ft2 EISA/pair = 6 ft' = Proposed EISA per trench = 206 ft' Provide minimum 3 ft separation between trenches. observation Pipe (typical) Install per manufacturers / instructions. TYPICAL TRENCH PLAN VIEW (No Scale) IA= 3.0 ft (typical) > "—Quick4 Standard -W Chamber m (typical) (mfd by Infiltrator Systems. Inc.) O Install pursuant to manufacturers instructions. Required Infiltration Area = 200.3 ft2 x 1 trenches = Proposed Total EISA = 206 ft' TI MLO ln�r Distribution Method branched manifold 0 o C to c j%) t �iu- [ GRAVITY -DOSED D pelf 19F SEP 302024 SEPTIC / PUMP TANK SPECIFICATION (No Scale) Bayfield CotlkohiFt�g OL 10 Vent Pipe >10 it fromJ. Building Electrical must comply with 12" Min. or 2.0 ft above SPS 316 and NEC 300 Established Flood Elevationr—C..dut Weatherproof Extend manhole riser as necessary. (typical) ApprovedJunction Box Vent Approved Locking Manhole IMPORTANT: vent Cep with Warning Label Attached T ! (typical) Anchor tank(s) as necessary Idl i pursuant to SPS 383.43(8)(g) a Min. or 2.0 ft above .— Eclahlished Flood Elevation Finished Grade CAPACITIES @ 16.12 gal/in Depth (in) Volume (gal) A 26.5 427.2 B 2.0 32.2 [C] 7.5 120.9 D 12 193.5 IA` ic) Pump Tank Liquid Level = 48 in —L IID Force Main Diameter = in Weep Hole Block Force Main Length = ft 3" Approved Bedding Material Beneath Tank � Force Main Void Volume = 7.3 gal [C] Total Dose Volume (TDV) = 127 gal/dose ( c 0.2X design flow + force main void volume) Vertical Lift = _ 6 ft PUMP TANK: Volume = 750 gal Manufacturer. Pump Manufacturer. Goulds Pump Model: EPO411 (See attached pump verve.) Controls/Alarm Manufacturer. SJE Rhombus Controls/Alarm Model: SJE1025830 Float switches containing mercury are prohibited. Disconnect 18" Mln. (typical) . I "— Approved Joints with Approved Pipe 3 ft onto Solid Ground (typical) PUMP -OFF ELEVATION = 89 ft INSIDE BOTTOM ELEVATION = 88 ft SEPTIC TANK(S): Total Volume = 1250 gal Manufacturer(s): Wieser Concrete Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: Orenco Filter Model: 14B D ECE�d[ D SEP 302024 MAk 1 81024 Ba eld C Zoning Dept. 'Msconsin Department of Commerce SOIL EVALUATION REPORT Page_Of_ Division of Safety and Buildings in accordance with Comm 85, 'Ms. Mm. Code Co1nty 61j/ „Q /� Attach complete site plan on paper not less than 812 x 11 ' �r include, but not limned to: vertical and horizontal reference7d6is�teLnce "^" Parcel ID. a9 N y of 00/ / rc: r percent slope, scale or dimensions, north arrow, and loca8 ndnearest roe pya7tj1 4YPlease print all in/ormatlo 1,,,. Reviewed byby Date Personal Information you povids may be used for secmpary pu 5.01 (1) (m)) . U'L ` �' — !Q - a r.upv,q.wua. k(,AJuties nP•f 4 Dto I! HGovL L f 1/4 1/4S /9 T Vy N R 9" E(o Property Owners Mailing Address J Lot # Block # Stbd. Name or CSM# /soot) 93 tcl. SI_ o Z+...:::u Gcol. City State Zip Code Phone Muter O City ❑ Village -Tovm Nearest Road /X, fro I Wx 11"y1Jy l( _ ) c.r/-SC_3 Qack,uk�n1 ❑ New Constnxtion Use: ❑ Residential / Number of bedrooms Code derived design flow rate s -Q (,QQ GPD Replacement blic �^ 0 Putt dal-Desrnbe: Parent material 6- 1 (- C . Flood Plain elevation if apj*able ft• General comments LCS 1 d-� /07 rr .t v C'66te— andrecommendations: i '#�}'' Xi�, .^• - t I[t1 —❑ Boring I I I Bonng # IM cruised surface elev. Aw ft. Depth to limiting factor m. sr,a a,nlf Mahon Gate 1 Horizon o-2 Depth in. / Dominant Color Munsell /o rj Redox Description Qu. Sr. Cant. Color — Textue j S SWcttse Gr. Sr. Sh. s4s16< d`J4 Consistence v4' Boundary rvta — Roots /-I PD JIf ; C-ft#1 e7.A .% Efr#2 /.L t - I iX❑ Boring 1 Z 19 # rw _ _.._..,..w....e ee,. / O % e Dedh to limning factor �_ in. c„a�PuteI I Horizon k_]• Depth in. rut ------ Dominant Color Munxy _ _ Redox Description Qu. Sz. Cont. Color Tezlure Sfnrdtse Gr. Sr. Sh. Consistence Boundary Roots GPO/if 'Efi#1 'Ett#2 o c.) l /� r� s 7 rY — 1. l _ r1L'( MVLr LJ I , 2 /_ _. J1A, caLmd ri e RlN1 <3h r. Property Owner. j. KN oe�e- f ti BOnn9 # Bodng RHorizonPD0tTfJnantCOlO([Redox urn Description Qu. Sz. Cont. Color - Texture J r Strut are Gr. Sz. Sit/ O.j Consistence ht ( Boundary C V•7 Roots'EN# 7 Eff#2 flfou D iii SEP 302024 Bayf Rcc.;o iij Dept. Parcel ID 0 - Page L.. of 9'? n- Death to limiting factor /,U in. ii„It q,wRate o Bodng Boring # n ,, re., n Depth to limltvxl factor in.i e� a naM Boring * -_. - Ground surface elev. ft. Depth to limiting taCw in. ❑ Pit Sob lion Rate Depth in. Dominant Color Mansell Redox Description Qu. SL Con. Color Texture Slrrxdrre Cr. Sz. Sh. Consistence Boundary Roots GPO!!? Horizon 'E@#1 Efll2 - Effluent #1 = BOD, > 30 ≤220 mg1L and TSS >30 ≤ 150 mgt- - El huent#2 = BOD, _ 30 nand 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 depamnent at 608-266-3151 or TTY 608-264-8777. 501)4330 (p.0tno) SEP 302024 Bill Knuese 1875 Buchman Rd. Bench Mark A J s S to `1 Urg-N tZ 9 'ti . C fi Lo -hl Oy cloy z'f ( uy i5 y o5 ooj IOcOO `y4 Page 3 of '3 BAYFIELD COUNTY SANITARY PERMIT (#04)-24-34S STATE SANITARY PERMIT OWNER: DANIEL J & ROBYN K BRUGGEMAN GOVT LOT: 1 LOT: BLK: 1/4 1/4 SEC:19, T 44 N, R 9 W TOWNSHIP: Barnes SOIL TEST: 138-10 OTHER MODIFICATION SYSTEM TYPE: PLUMBER: Douglas Manthey TRACY POOLER Authorized Issuing Officer DATE: 4/18/2024 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 #:10-127S LICENSE: # MP 230722 Condition: System to meet all setbacks. Management plan to owner. Property maintain system per recorded agreement THIS PERMIT EXPIRES 4/18/2026OJ cnITh POSTIN N PLAIN VIEW W� 000 � N � O MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION O uGOULDS PUMPS SubmersibleSEP 302024 Effluent Pump neici Co. Zoninu Dept. I1 3 Q 7 1 EPEPOS Q APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 3/4" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/2" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140OF (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V. 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset • Power cord: 10 foot standard length, 16/3 SJTOW with three prong grounding plug. Optional 20 foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). 9 2002 Goulds Pumps Effective September, 2002 B3871 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ■ EP04 Impeller: Thermoplas- tic Semi -open design with pump out vanes for mechanical seal protection. METERS I FEI for o 'C 7 w x 6 5 2 5 O ¢ 4 3 2 1 ■ EP05 Impeller: Thermoplas- tic enclosed design for improved performance. • Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ■ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ■ Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. ■ Power Cable: Severe duty rated oil and water resistant. ■ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SP' Canadian StandardsAssociation Goulds Pumps is ISO 9001 Registered. V0 10 20 30 40 50 GPM 0 2 4 6 8 10 12 mVh CAPACITY Goulds Pumps ITT Industries 1= 13'-8" 'II illy II:. 4" CAST -A -SEAL 111tJ II I I I 1 I ` ``��/ ♦` J� III Ci'. 11 FILTER OR ii • I BAFFLE �, I 0 w w lcr r I LET 13"' tM :• TOP VIEW co TflYCD i P1)5 I:I a ---r+.--• --r-�--�r�•'.Y-'+"'��-_.=-..rim i+7 SIDE VIEW 4" CAST -A -SEAL 4" VENT h r-- OUTL T E d V Dd. 'n WLP1 200/800 -MR TANK SPECIFICATIONS DIMENSIONS: WALL: 3" BOTTOM: 3" COVER: 6" MANHOLE: 24" I.D. PRECAST CONCRETE RISER o HEIGHT: 53" LENGTH: 13'-8" WIDTH: 8'-0" BELOW INLET: 41" E LIQUID LEVEL: 36" •1 o WEIGHT: BOTTOM 14,800 LBS. COVER 8,170 LBS. V 3 $ INLET AND OUTLET: m c n 4" CAST -A -SEAL BOOT OR EQUAL GASKET Q INLET AND OUTLET BAFFLE AND FILTER: in o o J IZ -_l WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) *oft a LIQUID CAPACITY: 33.46 GAL/IN (SEPTIC) 22.24 GAL/IN (PUMP) LOADING DESIGN: 8'-0" UNSATURATED SOIL 000 04 TANK CAN BE USED AS: a SEPTIC / HOLDING / PUMP OR SIPHON c COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #9 (SMALL FIBER) w y CUSTOMIZED TANKS: - t° FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY P PAD REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: 1ZOF TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS PAGE 4 OF 5 GRAVITY -DOSED SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 40 Vent Pipe >10 ft from Building 12" Mln. or 2.0 ft above Established Flood Elevation ( �) Approved IMPORTANT: \ vent Cap Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) Finished Grade CAPACITIES @ 22.24 gaVin Depth (in) Volume (gal) A 18.5 411.44 B 2.0 44.48 [C] 5.5 122.32 D 10 222.40 a II ri A * Pump Tank Liquid Level = 36 in D Force Main Diameter = 2 in Block I 3" Approved Bedding Material Beneath Tank Electrical must comply with SPS 316 and NEC 300 Extend manhole riser as necessary. Weatherpnwf Junction Box Approved Locking Manhole with Warning Label Attached (typical) Conduit 4■ tAn. or 2.0 ft above Established Flood Elevation Airtight Seal Quick Disconne t Force Main Length = 45 ft Force Main Void Volume = 7.3 gal [Cl Total Dose Volume (TDV) = 127 ( ≤ 0.2X design flow + force main void volume) Vertical Lift = 6 ft PUMP TANK: Volume = 800 gal Manufacturer: Wieser Concrete gal/dose Pump Manufacturer. Goulds Pump Model: EPO411 (See attached pump curve.) Controls/Alarm Manufacturer. SJE Rhombus Controls/Alarm Model: SJE1025830 Float switches containing Float switches containing mercu�are prohibited prohibited. Pump Weep Hole _Alarm _On _Off A -Approved Joints with Approved Pipe 3 ft onto Solid Ground (typical) PUMP -OFF ELEVATION = 89 ft INSIDE BOTTOM ELEVATION = 88 ft SEPTIC TANK(S): Total Volume = 1200 gal Manufacturer(s): Wieser Concrete Install approved effluent filter at the septic tank outlet Immediately upstream of the pump tank inlet. Filter Manufacturer Orenco Filter Model: 14B W1250/750 -MR TANK SPECIFICATIONS 12-11 4" CAST -A -SEAL 4" CAST -A -SEAL E iV /i t111 a 1111 U o '1 a 1111 m -- / ♦ f l l c �� itll FILTER 1111 ���♦ LE till till ---n U 7` 4" VENT - OUTL T I ^ U 1 � a PUMP PAD DIMENSIONS: WALL: 2 1/2" BOTTOM: 3' COVER: 6" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 66" LENGTH: 12'-11" WIDTH: 7'-2" BELOW INLET: 53" LIQUID LEVEL: 48" WEIGHT: BOTTOM 8,740 LBS. COVER 6,120 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN. SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.66 GAL/IN (SEPTIC) 16.12 GAL/IN (PUMP) LOADING DESIGN: 8'-O" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC/SEPTIC, SEPTIC/SIPHON, OR SEPTIC/SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMIT FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: II (0 00 0 (Z N Z < U in F N D_ Li CI, OF ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 BAYFIELD COUNTY E C E I U E D CHECKLIST FOR SANITARY APPLICATONS SEP 302024 Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) ,Check List Bayfield Co. Zoning Dept. riginal Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.) 9 -Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) FJ Original Plot Plan (383.22(2)2. 3. & 4.a) /�oss Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer ❑ Pump Tank Diagram, Alarm and Pump Curve (when applicable) a'tontingency Plan / Management Plan (383.22-3(2)(b)1.f.) ❑ Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) ❑ Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) ❑ Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) ❑ ATU Servicing Agreement (Recorded at Reg. of Deeds) jd'�,ee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) Comolete Set$ of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached /to all copies) ❑ Soil and Site Evaluation Report (383.22-3(2)(b)1.e.) ❑ State Plan Review (when applicable) ❑ Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) e l Application Information must include: ❑ 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) z'Froject Address or Road Name where driveway Is/will come off of) 211 Type of Building 21II Type of Permit Type of POWTS System rc Dispersal / Treatment Area Information /I Tank Information II Responsibility Statement (Plumber's Information) Y *Date Stamp* Plot Plan: (To Scale or To Dimension) C3'Signature and Plumber Information ❑ Surface Elevation of Body of Water a'Oirection and Percent Land Slope -Tank and Filter Information and Location ❑ Wetlands / Navigable Bodies of Water 2 -Absorption Area (Proposed and Existing) 9 -Bench Mark (Location, Elevation and Description) ❑,.Well Locations Li -Component Manual Version D-taal Descriptions ❑..Piping Material Information (conveyance line, building sewer line, material type and diameter) �-(Owners Phone Number) li-Address Number and Road Lf' lcorth Arrow e'Contour Lines e'Structures and Driveways 'boring Locations q.Pfoperty Lines Turn Over ► Cross -Section and Over -Head Profile of the System: D �n TS Curface and System Elevation U osition of Observation and Vent Pipes ❑'P SEP 3 0 2024 ❑Mimensions and Depths Bayffeld Co. Zoning Dept. Sake, Model & Number of Chamber Units in each Cell Property Information p -How many systems will there be on this parcel of land? I Q-Ffas this property been split? (Property Statement shows Property History) Fees: ❑ Private Sewage System (Septic Tanks) $ 400.00 ❑ Private Sewage System (Holding Tanks) $ 400.00 ❑ Mounds or Systems requiring Pre -Treatment $ 500.00 IX Sanitary Revisions $ 25.00 ❑ Private Sewage System Reconnection $ 50.00 and Private Interceptor ❑ Return Inspection $ 50.00 ❑ Maintenance Agreements + $ 30.00 (checks made out to Reg of Deeds) u/forms/checklists/checklistforsanitaryapps(10/2009);(®7/2011);(®2/2012)([05/2/2012-dc) Proofed by: Department of Safety County & Professional Services, Bayfield (to be fited in by Co.) a Sanitary Permit Nuplher ([ a AR 1 � 2024 Industry Services Division Sanita 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 purposes in accordance with the Privacy Law, s. 15.04(Ixm), Stats. 1875 Buchman Rd Dan & Robyn Bruggeman 2176 Property Owner's Mailing Address 1710 Logan Ave South Property Location Govt. Lot 1 y., ¼, Section l9 T 44 N R 09 E o City, State Minneapolis, MN Zip Code 55403 Phone Number 612-205-2367 II. Type of Building (check all that apply) ®1 or 2 Family Dwelling— Number of Bedrooms 5 ❑ Public/Commercial — Describe Use Lot 4 Subdivision Name Block k O City of ❑ State Owned — Describe Use CSM Number O Village of ® 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 iii a licable. A. ❑ New System O Replacement System(explain) yp y ® Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit Additional Tank and Cell to accomodate 5 Bdmis B' O Holding Tank ® In -Ground ❑ At -Grade (explain) ❑ Mound O Individual Site Design O Other Typ ( a ex lain (conventional) C. O Renewal Before O Revision ❑ Change of Plumber O Transfer to New Owner List Previous Permit Number and Date Issued Expiration Design Flow (gpd) 750 Design Soil Application Rate(gpd/sf) 0.7 I Dispersal Area Required (st) 1071.4 I Dispersal Area Proposed (st) 1118.0 I System Elevation 93.4 Tank Information Capacity in Gallons Total Gallons ft of Units Manufacturer :l a U r? '$ ti m w C7 u Li. New Tanks I Existing Tanks Septic or Holding Tank 1250 1250 2500 2 Wieser Concrete X Dosing Chamber 750 V. Responsibility Statement- I, the undersigned, as m respa ili for i stalladoa of the POWTS shown on the attached plans. Plumber's Name (Print) Plu er's Doualas Manthev ign a ,. MP/MPRS Number MP 230722 Business Phone Number 715-739-6868 Plumber's Address (Street City, State, Zip Code) • // V PO Box 196 Drummond. WI 54832 roved ❑Disapproved .`...��.." ��.` � ."'�,. .,.°, .°,.� / �%�'7 % 'J l7 Owner Given Reason for Denial $ �/ ( /�/ �/ `' Conditions f Approval/Reasons for Disapp val Ana. k m rmmn1.t. "tart. rnr th. avat.m and .nhmit to the Cnnnty nniv nn saner not lees than A in x II inchesm ,¢e SBD-6398 (R. 03/22) MAR 1 8 ZUZ4 Nor Pines Plumbing Doug Manthey MP 230722 52085 N. Lake Owen Drive ]�'wT-T6t11 Drummond, WI 54832 Narrative for Bruggeman Septic Addition: The current system was installed in 2010 and was sized and installed to accommodate their 4 bedroom home. Since then they remodeled an existing garage w/bunkhouse, which was never connected to POWTS, and now are going to raze the existing home and construct a new 4 bedroom home. Due to new home location, elevations, and the need to increase POWTS to facilitate 5 bedrooms, we are proposing the following: 1. Use existing 1250 gallon tank w/filter for the waste from garage w/bunkhouse. 2. Install new 1250/750 Combo Tank w/filter to accept waste from new 4 bedroom home. 3. Add an additional cell containing 10 Quick4 Chambers to existing leach field to increase total size to accommodate 5 bedrooms. 4. Lift effluent from new home to outlet pipe of existing tank and gravity disperse to cells. 5. Sanitary Application contains previous Permit Information as well as Soil Test to support proposed plan. 6. Septic Maintenance Agreement previously recorded in 2010. Doug they Nor Pines Plumbing 715-739-6868 Office 715-580-0140 Cell PAGE 1OF5 In -Ground Dosed -Gravity Plan Index & Cover Sheet Component Manual Design References: MAR 1 8 2024 In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 5 Index & Cover Sheet Pg 2 of 5 Plot Plan Pg 3 of 5 Dispersal Area Cross -Section & Plan View Pg 4 of 5 Pump Tank Specifications Pg 5 of 5 Management Plan Attachments: Enclosures: Pump Curve POWTS Application for Review Manufacturer Tank Specs Soil Evaluation Report & Site Map Existing Sanitary Permit Project Name / Description Bruggeman Septic Addition Owner Name(s): Dan & Robyn Bruggeman Phone: 612 _205 Owner Address: 1710 Logan Ave S. Minneapolis, MN Zip: 55403 Project Address: 1875 Buchman Rd Barnes, WI Govt. Lot: 1 Township: Barnes Project Parcel ID #: 2176 2367 1/4 of 1/4, Section 19 , T 44 N -R 9 E for w71 County: Bayfield Designer Information Designer Name: Douglas Manthey Designer Address: PO Box 196 Drummond, WI E-mail: norpines@cheqnet.net License Number: MP230722 Remarks: Expansion of existi Signature: from 4 Bdrm to 5 Bdrm Phone: 715 739 - 6868 Zip: 54832 This space resery approval �vE PO •• ally D �ondiUon PP r�v-y Date: 03/08/24 signature required on each submitted copy. CHECK BOX AS APPLICABLE. IF\Il 4 �` CHECK BOX AS APPLICABLE. ❑ SOIL EVALUATION Scale: 1 40 60 BD 40' ❑✓ SYSTEM PAGE 2 OF 5 0 SITE MAP PLOT PLAN PROJECT NAME: 1 , DESIGN FLOW : 1250 GPD (loftgdd) 0 Bruggeman Septic Addtion Attach design flow calculations for commercial plans. PROJECT ADDRESS: 1875 Buchman Rd N Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) 5anitarySewer. 4" PVC / D1785 BM Symbol: BM Elevation: I03. S�'i FT ForceMain: 2" PVC / D1785 BM Description: Top of Existing Well Casing Indicate nosh IMPORTANT: Slope Gradient(%) by p 13 Well Symbol pf applicable): Q drawing an armw Show ground elevation contours at suitable intervals. of Tested Area: on the approprRe It.. rr��L awl= )c3,59 EIS IL G N = 9S.ol Ft . t� &o Bldg 93.2 1'i f.�11OUS �l^ R.- ` 'Tui r 0. P. baYc e L 4 vM s; AU;11 / cell - °G I «It W/lb &..2L9' 'h r 3t I11S �tZ ' • G -PD) S /U 111. I2�'Iz roo p ti r 1P — Au Cy�Loe��a�c ¢ ,,v5 okbe scl„(o or �L 5)Q 3S Bit -• Co on aa,leL,. i�oL.l stn G-ro„ 3c \ ' I�so�l' 'r Qo irs � ec ,on �. ` .LI! / on MP 2-30)�2 IN -GROUND DOSED -GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER 12' min. trench depth (typical) map. (typical) TYPICAL TRENCH CROSS SECTION VIEW (No Scale) S a' f 34. (typical) System Elevation = 93.4 ft (typical) Quick4 Standard -W w/End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) r-----------t--------��---- L— — — — — — — ------------- H - — — B=42 ft (typical) INSTALL PER TRENCH: 10 Quick4 Std -W @ 20 ft' EISA/chamber = 200 ftZ + 1 Pairs of end caps @6 ft2 EISA/pair = 6 ft2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) A=3.0ft (typical) '—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. (J) m W O n = Proposed EISA per trench = 206 ft2 Required Infiltration Area = 200.3 ft2 Distribution Method: 3 x 1 trenches = Proposed Total EISA = 206 ft` branched manifold C PAGE 4 OF 5 GRAVITY -DOSED SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 40 Vent Pipe >1011 from Building 12" Min. or 2.0 ft above Established Flood Elevators (typical) Approved IMPORTANT: ' Vent Cap Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) Finished Grade CAPACITIES @ 16.12 gal/in Depth (in) Volume (gal) A 26.5 427.2 B 2.0 32.2 [C] 7.5 120.9 D 12 193.5 * Pump Tank Liquid Level = 48 in Force Main Diameter = 2 in Force Main Length = 45 ft Force Main Void Volume = 7.3 gal Electrical must comply with SPS 316 and NEC 300 fi Weatherproof Junction Box Seal Extend manhole riser as necessary. Approved Locking Manhole with Warning Label Attached (typical) 4" Min. or 2.0 ft above Established Flood Elevation (typical) — Quick Disconnect j 18"I Min. (typal) LiZ4 I I Weep Approved Joints with II Hole Approved Pipe 3 ft onto A Solid Ground (typical) _Alarm B — On I (`PUMP -OFF Pump ELEVATION = 89 ft Block 3" Approved Bedding Material Beneath Tank [C] Total Dose Volume (TDV) = 127 gal/dose ( ≤ 0.2X design flow + force main void volume) Vertical Lift = 6 ft PUMP TANK: Volume = 750 gal Manufacturer: Wieser Concrete Pump Manufacturer: Goulds Pump Model: EPO411 (See allatlied pump kvrve J Controls/Alarm Manufacturer: SJE Rhombus Controls/Alarm Model: SJE1025830 Float switches containing mercury Float switches containing mercury INSIDE BOTTOM ELEVATION = 88 ft SEPTIC TANK(S): Total Volume = 1250 gal Manufacturer(s): Wieser Concrete Install approved effluent filter at the septic tank outlet immediately upstream of immediateIy upstream the pump inlet. Filter Manufacturer: Orenco Filter Model: 14B •MAR '1 8 ZU24 nsconsin Department of Commerce SOIL EVALUATION REPORT Page � of) Division of Safety and Buildings In accordance with Comm 85, Vs. Mm. Code Attach complete site plan on paper not less than 81/2 z 11 e include, but not limited to: vertical and horizontal reference Bna ParrpJ I.D. percent slope, scale or dimensions, north anow, and locati rid distance to nearest roe py a,' 2 V'{ a9 M Y 4(' of /ac:'r Please print all informatio OCT 1 3 i d ,L Reviewed byLi Date Personal Information you provide may be i9 for aecndpryyurpp Privacy Lew, s. 15.04 (1) (in)). r. . �(.Zih !a ~ (D �- II- P� Property owner 11 - BY_L14 I 1 �y Q t-ii r ` rlf'T 10 I .Govt. Lot 1/4 1/4 S /9 T Yy N R 9 E (or),1pv Property Owners Mailing Address i I U Lot # Blodi # Subd. Name or CSM# /?�Ofh9 rY 3 (-(I. SJ-. . J 'di! C. Lm:n Dog . City State Zip Code Phone Number ❑ City 0 Wage J Town Nearest Road 1Yia4 ( ) r) Beck wt —J ❑ New Construction Use: ❑ Residential I Number of bedrooms '1 Code derived design flow rate (eon GPD j9 -Replacement ❑ Public 9r co om, rctal - Describe: Parent material G I t. C r t ( /3r • 4 Flood Plain elevation if applicable Alit General comments L c S 1 j -a. /07 3 r.- -"C v C. LG cc. and recommendations: j�0 Boring /010 / O Boring # a pie Ground surfaceelev. ft. Depth to limiting factor in. 7 0��Rat Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cord. Color Texture Structure Gr. Sz. Sit. Consistence Boundary Roots GPD/W 'Eff#1 Eff#2 6-i' I /o /-Y I453M-( v'& 64-- 14 J. Li Bodn# ❑ 10 oa Ground surface elev. / ft. Depth to limiting factor_ in- c�a ern R Horizon Depth in. Dominant Color Mimsell Redox Description Qu. Sz. Cont Color Texture Structure Gr. Sz. Sri. Consistence Boundary Roots GPDI(P -E1f#1 E1fS2 o f //t34- I) ,J v utL.J I Z % ry _ f H1l_ z 6 -I/o rl f _ _ — - 2_ Effluent#1= SOD> 305220mg/L and TSS>a0≤15UOlflRKPWRJ•,vr- rot Name (Please Party- c D CcST-Nur'1-7 Sp Ova MAR 182024 o -ool-focoo KN ue1� Parcel ID# Page of PropertyOwner..- [3 ❑ Boring p7 I I B°""g # R1 _ r Intl c, I.r=n, elrv. / / ft. Depth to limiting factor �'y in. a es; -tin Rate I I Horizon Depth in. Dominant Color Munsef Redox Description Qu. Sz. Cont. Color Texture Structure Cr. Sz Sh. Consistence Boundary Roots GPDIfP 'Eff#1 'Eff#2 / 2 D_.6 -3C 7[ -IUD /Byrl/� 7> ry •, r C — — /J Y r f4sby c�•JG / 1L\V�� w] l f.0 cU ( •7 .7 /•� /. �. Boring # ❑ Boring n n Ground surface elev. R. Depth to limiting factor in. Fu] nu R� Horizon Depth in. Dominant Cole Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Cr. Sz. Sh. Consistence1 Boundary Roots GPD/tF 'Eff#1 'Eff#2 El Boring n Boring # fl Ground surface elev. ft Depth to limiting factor in. C..d eol- fMinn Rarn1 Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPDIfF 'Eft#1 E11#2 Effluent #1 = BOD, > 30 ≤220 mg&L and TSS >30 5150 mglt - Effluent#2 = BOD, 530 mp/L and TSS 530 mg/t 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. £M4330 (RO7/Ql) N 4100 11 �4 U - I Bill Knuese ocaie 1. 4u 1875 Buchman Rd. Bench Mark "- of II '" I r "f Oy ooy L 44 DIII y °r oaf Ioa70 LyE Page 3 of -3 commercewl.gov Safety and Buildings CkyAstfln h Ate/ O Z4 W. Washington Ave., P. x 16 County /l � N +� 201 /jsconsin Madison, 53707-7162 O ''li►! \ Sanitary Pemrt Number (m be� 7 n.l Department of Commerce State Trensstxion Number Sanitary Permit Application In accordance with s. Comm. g3.21(2), Wis. Aden. Code, submission of this form tote opriate governmental unit is required prior to obtaining a sanitary Permit Note: Application forms i6 state-owned POWTS are Personal information you provide may be used for secondary ProjectAddress(ifdiffer/mtthanmmL ad.ddreas) 187 -' f t/Lsth.4^P subndtted to the Department of Commerce. s in accordance with the Privacy Law. a. 15. t m), Stets. - I s.:s Application Information -Please Print All n , Name parcelg 0 y DO 1 Y4 O4 1 y Owner's nc Vf S� ��I t. "� . -, ZZ ppmpeM o i Oct / ono ,y Lomtion Property Owner's Mailing Address 9 3'(4 S `�e GavtLot� 1 q 00C) - City, Se Zip Code ne uum` r Y4 '/y Section ) p -. U- O i s fo wT g31oy 3 T4 &�Eori) II. Type of Building (check all that apply) Lot # Ij Subdivision Name & or 2 Family Dwelling -Number of Bedrooms Block 0 ❑ Cityof ❑ Public/Commercial - Describe Use CSM Number ❑ Village of ❑State Owned -Describe Use (�Towv of _iis rwrt�J III. Type of Permit: (Check only one box on tree A. Complete Gne B if applicable) I] New System i iteptacentmt System ❑ Treffiment/Holding Tank Replacement Only ❑ Other Modification to Existiu6 (exPl . A' ❑ Permit Renewal ❑ Permit Revision ❑ Change of PlumberPet Transfer to New Litt Previom Permit Number and Date Issued. B. BeforeExpiration IV Type of POWTS S m/Com onent/Dteviee: Check all that apply) Non-Pressurzed in -Ground ❑ Pressurized ln-Omund ❑ At -Grade ❑ Mouad? 24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) V. Dispersal/Treatment Area Information: Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sfDisperserArea Proposed (st) Systeoo t %'3 VL Tank Into Capacity in Gallons Total Gallons 0 of Units Manufacturer 3 ` jFl."io- a V N New Tamb EdstingTmla septic or Holding TSc /2 -o L't e3 Doaiag mamba -I I VII. Responsibility Statement- L the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. MP/MPRS Number Business Phone Number Plumber's Name (Print) I Plumber Sour. Stu le Crit)?'? 7/r 37G 2278 Plumber's Address (Street, City. State, Zip Code) P o. /fie K RI cjr sy09 I. Coen !Deartment Use Only issuin ❑ Approved Disapproved S f{(pV /O 2� IC/0 o io F ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapprov Properly abandon existing system I per Comm 83.33. Attach to compute plans for dm spleo SBD-6398 (R. 01/07) Valid thru 01/09 n cue In -Ground Soil Absorption SBD-10705-P (N.o1ro1) Version 2 i Component Manual Used 4 Number of Bedrooms _ 13 Percent Slope (%) 110 Depth to Soil Limiting Factor (in.) 0.7 In Situ soil application rate 400 Estimated Wastewater Flow (gpd) 600 Design Wastewater Flow (gpd) 1 Number of System Elevations 95 Proposed System Elevation #1 Proposed System Elevation #2 Proposed System Elevation #3 101 Original Grade #1 101 Finished Grade #1 97 Original Grade #2 97 Finished Grade #2 Original Grade #3 Finished Grade #3 Infiltrator Quick 4 Standard I Chamber Type Cell Area Wieser 1250LP Septic Tank Pol lok PL -525 Effluent Filter MAR 18 ?UL4 Surface Depth to System Soil Boring Grade Limiting Lowest Highest Elevation Number Elevation (ft.) Factor (in.) Elevation Elevation Acceptable 1 100 110 93.8 99.0 TRUE 2 101 110 94.8 100.0 TRUE 3 97 110 90.8 96.0 TRUE 4 3.0 -1.0 FALSE 5 3.0 -1.0 FALSE Page z of� A X Bill Knuese Scale 1: 40 1875 Buchman Rd. Bench Mark A — 4J+#'J' c `.j rd .'f y aV 4 L-a9^l`l 4-.S •vo,-lceoc Page 'J of IL `PRIVATE ONSITE WASTE TREATMENT SYSTEMS iscons/n (POWTs) Department of Commerce INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) ED GENERAL INFORMATION MAR 1 8 YUY4 Personal infnrmation von nrnvidr m u hr ,cM r— e. nn,.Ae......,.....e.. I n.:.._,.,, r ..... .. P�rtljt Holder's � •Vil6 eC T(j/ ryS 9 i CST BM Elev: Insp BM Elev: BM Description: Slnllw< ir_ul:�Ielan:u�tmurncl TYPE MANUFACTURER CAPACITY Septic r rrl Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO lft;Ari PIL WELL BLDG NTTo MR INTAKE ROAD Septic '✓ NA Dosing NA Aeration NA Holding PUMP! SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length jDia Dist. To Well DISPERSAL CELL INFORMATION i. mF I'11. DIMENSIONS Width Len1illNofd&s SETBACK P / L Bldg Well OHWM of Nay INFORMATION Waters CELL TO r 5c+ o r OD DISTRIBUTION SYSTEM Header I Manifold D Length Dia L SOIL COVER Depth Over Dep Cell Center 4 Cell Dia ELEVATION DATA STATION BS HI FS j ELEV Benchmark L4 . 1 I /ot) Bldg. Sewer c1 ?.20 5.71 St / Ht Inlet 70 C 2 St I Ht Outlet t7 7 C' Dt Inlet Dt Bottom Installation Contour Header/ Man. Dist. Pipe 1p r 74K/I Infiltrative Surface 1,65 �3,3ty Final Grade r County ?f1I4Sanitary Permit No: /O -/a7,≤ State Plan Transaction ID#: Parcel Tax No: Type of System LEACHING Manufacturer: -Z _ 1 CHAMBER Model Number: r , X Pressure Depth of Topsoil S ❑ Yens ❑Topsoil Yes No I COMMENTS: (Include code discrepancies, persons present et .) `i I U k : ) RRG., Th i� s�,ln�r Observation Pipes I�Yes O No U' Mulched 1111 y 5., cr to f`}i r� i aixmtc�ocd SS. rr�I l{ �IAtatlke t �a(y \k �kkr Plan revision required?❑ Yes 0' No 1 j j lb Use other side for additional information Date jP: (rjavo .3 5ys1•bf Iowe1' POWTS Inspector's Signature Cert No Bureau of Field Operations, PO Box 7302, Madison, WI 53701-7302 SBD-6710 (R.3/01) [dOULD5 PUMPS APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 3/4" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/2" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BONA -N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 SJTOW with three prong grounding plug. Optional 20 ,—. foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). Submersible MAR 8 u« Effluent Pump 3 "Q % ') EP04 V / 1 EP05 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ■ EP04 Impeller. Thermoplas- tic Semi -open design with pump out vanes for mechanical seal protection. METERS ,FEE 9 8 o 7 v 6 z 5 4 0 3 2 1 ■ EP05 Impeller. Thermoplas- tic enclosed design for improved performance. ■ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ■ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ■ Motor Cover. Thermoplastic cover with integral handle and float switch attachment points. ■ Power Cable: Severe duty rated oil and water resistant. ■ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING C1P' Canadian Standards Association Goulds Pumps is ISO 9001 Registered. 0 2 4 6 8 10 12 m3/h CAPAcm Goulds Pumps O2002 Goulds Pumps YV ITTindustries Effective September, 2002 83871 0 w Lu a� a 1 LET U N ENT 1 OUTL T na U Da N 'AD W1250/750 -MR TANK SPECIFICATIONS DIMENSIONS: WALL: 2 1/2" BOTTOM: 3" COVER: 6" MANHOLE: 24" I.D. PRECAST CONCRETE RISER o HEIGHT: 66" LENGTH: 12'-11" WIDTH: 7'-2" a BELOW INLET: 53" LIQUID LEVEL: 48" o WEIGHT: BOTTOM 8,740 LBS. COVER 6,120 LBS. a 3 INLET AND OUTLET: 'm 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 o c _I I (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.66 GAL/IN (SEPTIC) 16.12 GALAN (PUMP) x co LOADING DESIGN: 8'-0" UNSATURATED SOIL It $o TANK CAN BE USED AS: N SEPTIC/SEPTIC, SEPTIC/SIPHON, ND OR SEPTIC/SIPH0N d O COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: e R FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY N 0 REVIEW DATE cv a 3 Ui (I, LAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: 1 PRODUCTS NEEDED BY: ARE MANUFACTURED BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) MAR 1 8 2024 IrCheck List 2'Original Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.) lQ Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) Cd Original Plot Plan (383.22(2)2. 3. & 4.a) Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer lZ Pump Tank Diagram, Alarm and Pump Curve (when applicable) Contingency Plan / Management Plan (383.22-3(2)(b)1.f.) ❑ Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) ❑ Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) ❑ Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) ❑ ATU Servicing Agreement (Recorded at Reg. of Deeds) 9Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) ❑ 2 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary pplication and Maintenance Agreements are to be attached to all copies) Soil and Site Evaluation Report (383.22-3(2)(b)1.e.) ❑ State Plan Review (when applicable) ❑ Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) I Application Information must include: ❑ 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) Project Address or Road Name where driveway is/will come off of) ❑ (Owners Phone Number) 0II Type of Building II Type of Permit IV Type of POWTS System m/y Dispersal / Treatment Area Information VI Tank Information VI VII Responsibility Statement (Plumber's Information) ❑ *Date Stamp* Plot Plan: (To Scale or To Dimension) m Signature and Plumber Information vsurface Elevation of Body of Water j%irection and Percent Land Slope ❑ Tank and Filter Information and Location ❑ Wetlands / Navigable Bodies of Water V'Absorption Area (Proposed and Existing) Bench Mark (Location, Elevation and Description) CComponent Manual Version I/Address Number and Road ❑/�North Arrow Cd'Contour Lines structures and Driveways '❑ Boring Locations Property Lines //Well Locations E� Legal Descriptions ❑❑Wiping P.Raterial Inlonnatic'n (conxeyanc:. !ins, building sewer line, materiel type and diameter) Turn Over ► y . Cross=Section and Over -Head Profile of the System: P -Surface and System Elevation MAR 18 2024 Position of Observation and Vent Pipes dimensions and Depths [/,Make, Model & Number of Chamber Units in each Cell Property Information V'i-iow many systems will there be on this parcel of land? I G-ias this property been split? ) (Property Statement shows Property History) Fees: 1rivate Sewage System (Septic Tanks) $ 400.00 ❑ Private Sewage System (Holding Tanks) $ 400.00 ❑ Mounds or Systems requiring Pre -Treatment $ 500.00 ❑ Sanitary Revisions $ 25.00 ❑ Private Sewage System Reconnection $ 50.00 and Private Interceptor ❑ Return Inspection $ 50.00 ❑ Maintenance Agreements + $ 30.00 (checks made out to Reg of Deeds) u/forms/checklisis/cheddistforsanitaryapps (10/2009);(®7/2011);(®2/2012)(®5/2/2012 -dc) Proofed by: Department df Safety County & Professional Services, Bayfleld Sanitary Permit Number (to be filled i:Lby Co.) Industry Services Division 182024 Sanitary Permit Application Stale 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 purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. I. Aonlieatinn infn,aeinn _vt.oaa o.:. Alt c 1875 Buchman Rd m Dan & Robyn Bruggeman 2176 Property Owner's Mailing Address Property Location 1710 Logan Ave South Govt.Lot City, State I Zip Code Phone Number Minneapolis, MN 55403 612-205-2367 v.. v,, Section 19 B. Type of Building (check all that apply) Lot ft T 44 N R 09 Eo ® I or 2 Family Dwelling— Number ofBedrooms 5 Subdivision Name Block ft ❑ Public/Commercial — Describe Use 0 City of ❑ State Owned— Describe Use CSM Number ❑Village of O Town of Barnes 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 i a Gcable. A. ❑ New System O Replacement System N Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) Additional Tank and Cell to accomodate 5 Bdrms B' ❑ Holding Tank l In -Ground O At -Grade ❑ Mound ❑ Individual Site Design O Other Type (explain) (conventional) C. O Renewal Before ❑ Revision ❑ Change of Plumber O Transfer to New Owner List Previous Permit Number and Date Issued Expiration 750 0.7 1071.4 1118.0 93.4 Capacity in Total ft of Manufacturer Tank Information Gallons Gallons Units o $ v New Tanks I Existing Tanks c m 2 s W U rn m w C7 Pn Septic or Holding Tads 1250 1250 2500 2 Wieser Concrete X Dosing Chamber 750 V. Responsibility Statement- I, the undersigned, respo ili for i stalladon of the POWTS shown on the attached plans. Plumber's Name (Print) Plu er's a MP/MPRS Number Business Phone Number Douglas Manthey V ,. MP 230722 715-739-6868 PO Box 196 Drummond, WI 54832 Pproved ❑ Disapproved • `•'••//• . - "" "' •"""• %/�,r�f'7, �. Cl Owner Given Reason for Denial , `J(fr� / IfDr WY to complete plans for the system SBD•6398 (R. 03122) on paper not less than 8 1/2 x Apr.24. 2009 11:58AM BAYFIE)tl CO PLANNING & ZONING ��679 00 CHMA-Pr' R Private Sewage System 1 IMaintenance Agreement 542Ngg. cvr SIB ieL P rl /lists r2ag Zoao sS 7/sue, G✓2sr/ts lvy5 rarcei iuunbner nurncer trnw) Agraement Date (same as Notary Date) 9/to i/o ns owner, I twat oo nereoy canny me private sewage system Will be installed in accordance with the certified soil tester's report and approved plans and specifications on fib 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. 5'S'_1/4 of SE 114 Section Township 7T N. Range l W Town of__________________ Govt Lot I Lot_Bloct Subdivision Additional Legal Description: CSM# No. 6543 P. 1 PATRICIA A OLSON BAYFIELD COUNTY, W REGISTER OF DEEDS 2010R-53515 10/15/2010 10:45A}1 If EXEMPT is RECORDING FEE: 3.N PAGES: 2 Return To:'1r' C ek c1o4 I y Levi l fl - Type of Private (A) In -ground gravity ❑ (8) In -ground dosed ❑ (C) In -ground pressure distribution Sewage System: ❑ (D) Mound ❑ (E) At -grade Sewage System ❑ Oilier 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 (113) of the volume occupied by sludge and scum. Pump chamber (System types 8, C, 0, and 2): 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 Comm 83.55, 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, 0 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 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 law. The terms and conditions of the variance shall be binding upon and inure to the benefit of all current and future owners of such property. .,pia.... owner(s) Name(s)—Please Print �usR� m mr��Ks V1049 P195 Subscribed and swum to before me on this date Notarized Owner(s) — Slgnature(s) J,iIAun'Y3'1in�vri�e ���ublic . 1 et ,o l Srv5'f`r�s'. ly Commission Expires: "•- ' ,, Drafted by: r"noII ttI F &$4k- 2005 2005 U)Deb'sDatafFormsf Sanitary/SepilcMaintenanceAgrsemenl PAGES OF 5 In -ground Dosed -Gravity Management Plan IMPORTANT: Min(( Zu The owner of this in -ground dosed -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 = 750 gpd; BOD5 ≤ 220 mgL'; TSS ≤ 150 mgL-'; FOG ≤ 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 (i.e., 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 (113) 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: Local government unit: Bayfield County Zoning Phone: 715-373-6138 Local government unit address: PO Box 58 Washburn, WI HK Septic Phone: 715-798-3494 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. BAYFIELD COUNTY SANITARY PERMIT (#04)-24�34S STATE SANITARY PERMIT OWNER: DANIEL J & ROBYN K BRUGGEMAN G OV'T LOT: 1 LOT: BLK: 1/4 114 SEC: 19, T 44 N, R 9 W TOWNSHIP: Barnes SOIL TEST: 138-10 OTHER MODIFICATION SYSTEM TYPE: PLUMBER: Douglas Manthey TRACY POOLER Authorized Issuing Officer DATE: 4/18/2024 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 #: 10-1 27S LICENSE: # MP 230722 Condition: System to meet all setbacks. Management plan to owner. Property maintain system per recorded agreement. THIS PERMIT EXPIRES 4/18/2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION SS—ThLa3 P\tah teJtcorb Department of Safety 10/i my Professional Services, �� yfield Sanitary Permit Number (to be filled in by Co.) = u SEP 3 0 2 24 ndustry Services Division th5PflfWipp1ication 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 purposes in accordance with the Privacy Law, s. I5.04(lXm), Stats. 1875 Buchman Rd 1. Application Information —Please Print All Information Property Owner's Name Parcel # Dan & Robyn Bruggeman 2176 Property Owner's Mailing Address Property Location 1710 Logan Ave South Govt. Lot 1 City, State I Zip Code Phone Number Minneapolis, MN 55403 612-205-2367 Yy Ya, Section 19 T 44 N R PG E or W II. Type of Building (check all that apply) Lot # Subdivision N . 01 or 2 Family Dwelling— Number of Bedrooms 5 Block # ❑ Public/Commercial — Describe Use O City of ❑ State Owned —Describe Use ❑Village of CSM Number a 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 i !plicable.) A. ❑ New System ❑ Replacement System ® Other Modification to Existing System (explain) ❑ Additional Pn;trearnent Unit (explain) Additional Tank and Cell to accomodate 5 Bdrms B. ❑ Holding Tank ® In -Ground ❑ At -Grade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ® Revision [1Change of Plumber ❑ Transfer to New Owner List Previous Permit Number and Date Issued Expiration 04-24-34S 04/18/2024 IV. DispersaVrreatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (st) I Dispersal Area Proposed (si) I System Elevation 750 0.7 1071.4 1118.0 93.4 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units Co o ' U v b u New Tanks Existing Tanks y e o u u a U rn v, rn ti. t7 ii Septic or Holding Tank 1250 & 320 2320 2 Wieser Concrete X Dosing Chamber 750 V. Responsibility Statement— I, the undersigned, ass a ponsi ty for i stalla6 of the POINTS shown on the attached plans. Plumber's Name (Print) Plumb 's gnatu MP/MPRS Number Business Phone Number Douglas Manthey MP 230722 715-739-6868 Plumber's Address (Street, City, State, Zip Code) PO Box 196 Drummond, WI 54832 VI. County/Department Use Only Approved ❑ Disapproved Pew/rsmit Fee $/� Date Issued Issuing Agent Signature �(j O Owner Given Reason for Denial ) Conditions of Approval/Reasons for Disapproval clten uJ - r ev a a4r on r@d . / Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x it inchrs in size SBD-6398 (R. 03/22) PAGES OF5 In -ground Dosed -Gravity Management PIa I C[ I V I D IMPORTANT: 1111 SEP 302024 The owner of this in -ground dosed -gravity system shall be responsible for its perpetual operation ar�w�as� gg nag"ce pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. R&# H. 8ZP Dept. 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 = 750 gpd; BOD5 5 220 mgL-'; TSS S 150 mgL''; FOG ≤ 30 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 (Le., 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 (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: HK Septic Phone: 715-798-3494 Local government unit: Bayfleld County Zoning Phone: 715-373-6138 Local government unit address: PO Box 58 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. 10/8124, 9:39 AM CarmodyT"" BAYFIELD COUNTY SANITARY PERMIT (#04)-2434S (REVISION) STATE SANITARY PERMIT OWNER: DANIEL J & ROBYN K BRUGGEMAN G OV'T LOT: 1 LOT: BLK: 114 1/4 S EC:19, T 44 N, R 9 W TOWNSHIP: Barnes SOIL TEST: 138-10 OTHER MODIFICATION SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: Douglas Manthey TRACY POOLER DATE: 10/8/2024 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 #:10-127S LICENSE: # MP 230722 Condition: System to meet all setbacks. Management plan to owner. Properly maintain system per recorded agreement. Property abandon existing/old tank per SPS 383. THIS PERMIT EXPIRES 10/8/2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION https://www.carmodyinc.com/PermitApp/Permit Sign.aspx?Print=1&permitappid=7236 ' 1/2