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HomeMy WebLinkAbout24-176SINBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY "` TIME RECEIVED REMOTE CSID DURATION PAGES STATUS January 7. 2025 at 8;21:20 AM CST 7157983470 36 1 Received JAN/07/2025/TUE 08:01 AM Andry Rasmussen & So FAX No, 7157983470 P.001/001 Request for Sanitary Inspection (24 Hrs. in Advance) Fax this form to Zoning Dept (24 Hrs.) prior to when you want an inspection — (715) 373-0114 If you do not have a fax and must email the inspection; you must email all staff members. Note Time Change fl Discrepancy fl Other Phone Number Plumber: /� Al_l `y flu. pnusSPn r 5 , Fax Number ry Homeowner: Email Address 1 n( Aindr1(r`!ISdirt mmede0fYirP Immediate Phone Number r So Zoning Sanitary Permit #: f _ '� 1 _ `( (f/ Dept can call you right back (if needed) Plumber's Choice Zonin Dept No Inspection(s) during this time Date: � I lcxJ ® Tuesday (9:30 am - 12:15 pm) (Tracy) Time: Plum1ber's Choice Zon pt 1Dco am �4W Cu► Ii Township: Address # & Road Name: or I/ {� r 7-1 )5 S /3a l oi, Directions To Site: Comments: *" Plumbers you must verify any change{s f i,l email "• Notes from Zoning Dept: ulfmms/sanitary/requestforinspection Zoning Dept (©4/12104); e June 2023 GD Industry Services Division General Information Permit Holder's Name: Tank TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Septic £ % N/A Dosing N/A Aeration N/A Holding Private Onsite Wastewater Treatment Systems ( POWTS) Inspection Report /Aftanh fn Permit) RICHARD J & MARY C GIRNAU IRREV TRUST 04 (7 m)] 2909 DAVIS DR liege fl Town of: EAU CLAIRE WI 54701 map BBM Elev: BM Description: setback to: County Q c Sanitary eJ rmit No: a4- Ins State Plan Transaction ID#. Parcel Tax No: 2)53/2 Pump I Siphon Information Pump Manufacturer Pump Model Demand GPM Filter Manufacturer Filter Model TDH Lift Friction Loss Total Forcemain Length Dia EDWell Dispersal Cell Information DIMENSIONS Width 3 Length # of Cell SETBACK FROM Prop. ' e Building Wel OH)tUjtr Type of Cell PZ0 Manufacturer. Model Number. Pretreatment Unit Manufacturer: Model Number: )istribution System Header I Manifold Distributionffipe(s) �L 3 X Hole Size X Hole Observation Pipes Length Dia Length Dia Spac Spacing ❑ Yes ❑ No Soil Cover Elevation Data STATION BS HI FS ELEV Benchmark Bldg. Sewer Tank Inlet 6• B� Tank Outlet 6. ci $ Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/ Manifold Distribution Pipe 91.94' Infiltrative Surface g, Final Grade ty X Pressure Systems Only Depth Over Depth Over Depth of Seeded / Sodded Mulched Cell Center Cell Edges Topsoil 0 Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Cor /j( / ny &Ia e•l UI rca4 7b c jl / Plan revision required? ❑ Yes Use other side for additional informa444on. `D /9z;7/3 Date POWTS Inspector's Signature RRn.R71 n rR nw91) License Number Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zonina(a)bayfieldcountv.wi.00v Web Site: www.bayfieldcounty.wi.gov/147 — RICHARD J & MARY C GIRNAU IRREV TRUST — 2909 DAVIS DR EAU CLAIRE WI 54701 Hayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 As you know Mil5M Uc4 5 L/t) `i-9 .) , S was contracted by you to install a private onsite wastewater treatment system on your property described as: Notes: Abandonment of Old System to meet all applicable code requirements: • Tank was pumped by: Tank was crushed / removed and pipes disconnected by: on at AM/PM On at rc 1PM) the above -mentioned plumber contacted our office to conduc a pre -cover inspection as required under DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. ❑ System was inspected and appears to meet all applicable code requirements; however, a plan revision is necessary because the installation was substantially different than the original approval. ❑ System could not be inspected because plumber covered prior to scheduled time of inspection. ❑ System could not be inspected because plumber was not ready at scheduled time of inspection. County was unable to return to complete inspection. System could not be inspected because plumber was not ready at scheduled time of inspection. A re -inspection and $50 fee are required. System could not be inspected because County could not respond to plumber's time constraints. Comments: Ufiormslsanilarypropertyowner-input Apri12019 :• u. .-. - I ndustry Sen ices Division C'olmly 1822 Madison Yard. \\'a) Bayreld NOVI, . �f. O� C U[5 \Lldisun. WI 537115 Sannan perms Number Ito de tilled m by Co P) SI P.O. Box 731)2 Madison. WI 53707 u — Cl Sanitary Permit Application State rmadimt NumM•r In accordance Milt tips. M3,2 Ii2). Wis Atha ('ode. submission oI [I11N Innit to the appropriate govlrnlllental unit I'roic t Address l il'di0irennhan mailing address) is required print to nhur,i'llg a sanit:uf pe'mllt Note Application limits lily state-maed M)WFS are submrtled to the Department of S;im% and Professional Services Personal mthmtat[onyou provide nm) he used for secondan 44755 Bass Lake Rd. Cable, WI purreses is aca'nl.lncc with the Pkiva) I.;nt. s 150111 ltml. Setts I. Application I n rormation —Please Print All Information Property Ott ner's Name Parcel A Richard J & Mary C Girnau Irrev Trust 23942 Propeny Owner's Mailing Address I'ropeny Location 2909 Davis Dr. lint, I'll City. State I Zip Code Phone Number Eau Claire, WI 154701 715-835-9723 )'1, Section 07 1.43 N R 05 li o W\1' II. Type of Building (check all that apply) [.or Is z1 or2 Family Dwelling - Nwnb:rol'llcdrtanns 2 2 -- Subdivision Name e.I ❑I'uM1be'Commercial - Ikscrihe lase e ?" 11"11' Cot of ❑Stme Dulled- Describe Use -- VilIageof CSM Number #132 V2 P176 IDIounof Namakagon III.'I'ype ori'ow'l,5 Permit: (Check either "New" or"Replacement" and other applicable on line A. Check one bas online 13. Complete line C i a livable.) A. 7Ncw Svstem ❑I(epl:Icen11er11 G: stein ❑1)11w; Modification to latsii,g System n (explain) Additional Pretreatment I[nit texplainl ' 0l loldmg'Link � In -timid ❑\l.Gwde Mound Indniduai Site Design Other'Typc lexplann Icom cntiotudl C. ❑ Reneutl IleIbre ❑Revision CTnange ui Plumber I1I'ranster to New Ounce Iasi PL't ous Penns Number and Date Issued Expiration NA IV. Dix ersal/rrcalment Area and 'tank Information: Design Flat' (epd) Design Soil Application R:net gpd $I) I Dispersal Area Rcquned lsf) I Dispersal Area lkoposcd is I System Elevation 300 0.7 428 1450 95.0 ('apaeit) in 'total a ill' Manufacturer 'Tank Infwnfalon ( alkw s Gallons Ilails - (.l New Tanks licisting'rank, ; G c 8 2 + ") a;J n r _ a Septic or Uoldmp FUlik 750 I 750 1 Superior Precast ✓ losing t'hunier O Q V. Responsibility Statement- 1. the undersigned, assume respunsiliilily for installation or the POWTS shown on the attached plans. Plumber's Name 11'rint) P'lunder's Sigtmuac hlVAlliIt5 Numi'r Itusiness Phone Number Jason Kuettel 675751 1715-798-3355 P'lumber's Address (Street. City. State. Zip ('tide ) PO Box 66 Cable, WI 54821 PI. ('ounty/Depnrtntent Use Only \ppruveJ ❑ Disapproved� Per ut I rr 9 Date issuedIssui vat 5lgnutmc % ❑ Owner Give Re:mon for Ieniai i (/ems /] ('unditio n. 1f AppmyalDteaslnls for Disapproval Anath hi rnmpll,le 11,0% for the w stem anit.uhruh to the (bunry .'nit on paper not tax than a Vr a 111nrhr, Ni sill, SISD-6398 (Pt. 02/22) D C K fi{�6E0F4 In -Ground Gravity Plan U Index & Cover Sheet N0V 12 zo/4 Component Manual Design References: Bayfield Co. Zoning Dept. In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 4 Pg 2 of 4 Pg 3 of 4 Pg 4 of 4 Attachments: Index & Cover Sheet Plot Plan Dispersal Area Cross -Section & Plan View Management Plan Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Girnau 2 Bed Owner Name(s): Richard & Mary Girnau Owner Address: 2909 Davis Dr. Eau Claire, WI Project Address: 44755 Bass Lake Rd. Cable, WI Govt. Lot: 1/4 of 1/4, Section 07 —,T43 N -R 05 E ❑ or W ❑✓ Township: Namakagon County: Bayfield Project Parcel ID #: 23942 Phone: 715 -835 -9723 Zip: 54821 Designer Information Designer Name: Jason Kuettel Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 Remarks: Phone: 715 -798 -3355 Zip: 54821 I IIU Space rescrticvl or aprovdl ,tamp. Signature: Date: I'�lz/z`� Original si a re required on each submitted copy. so4 TEST W r Wmfn DepvManl4 .ty and Pmlurbrol swiva o thfan er In th,,W Samoa Soil Evaluation Report In aaoN.no with SPS ]a4, wtAda, code t!?ch rmmfllem site nlan on naoer not less than 8'% X 11 Inches in size. Page: ' Plan must include but not limited to: Vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, location and distance to nearest road. Please Print All Information County: Ba le�ld Parcel I.D. 23942 R d t� : ,!' Date: j / j ; 2 `7 Personal Information you provide may be used for secondary purposes. (privacy Law,s.15.04(1)(m)). Property Owner. Richard & MaCGirnau Property cation S07,T49N,ROSW Property Owners Mailing Address: 2909 Davis Drive Lot: Block: 2 Subdivision Name or CSM # City IState Eau Clare II I Zip Code IPhone 4701 I0 Number. Town Namakagon Nearest Road: Bass Lake Road Code derived desl9n flow rate: FNew Residential j7 Number of Bedrooms: 2 300 (— Replacement (— Public or Commercial - Describe: Parent Material: Flood Plain if Applicable: 84.15 General Comments & Recommendations: - System Elevation: 2Z Load Rate: 0.7 Boring #'l r Bor(7 Pit Grourldsttlface Elev: Depth to Limiting Factor: g 100.93 Ft. 120 In. Soil Application Rate: Horizon Depth in. Domm.Color Munsell Redox Description Qu, St Cont. Color Texture Structure Gr.Sz,Sh. Consistence Boundary Roots GPD/ft' Eff#1 Etf#2 1 0-10 7.5YR2.511 N/A SL 2MSBK MFR CS 3CO 0_6 1.0 2 10-30 7.5YR4/6 N/A SL 2MSBK MFR CS 3M 0_6 1.0 3 30-120 7.5YR414 N/A MS OSG ML N/A 1F 0_7 1.6 4 5 6 7 1— Bor)v Rt Ground surface Elev: Depth to Limiting Factor: Boring #2 99.59 Ft. 120 In. Soil Application Rate: Horizon Depth in. Comm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. ConsistencePNIA Roots GPD/iP Eff#1 Eff#2 1 0-12 7.5YR2.5/1 WA SL 2MSBK MFR 3C0 0_6 1.0 2 12-28 7.5YR416 N/A SL 2MSBK MFR 3M 0.6 1.0 3 28-120 7.5YR4/4 N/A MS OSG ML 1F 0.7 1.6 4 5 6 `Efliuent #1 = BOO 5>305 220 mg/1 d TSS≥30 c 1 0mg/I / Ef#uerii.#2 = BOD 5< 30 myl and TSS ≤ 30 mg/I CST Name (Please Print) Sig tyres hziL- ) CST Number. 877598 v Mark S. Thompson tv - Address; 12006 N US Hwy 63 Date Ey�luatlon orlfiucte Telephone Number Hayward, WI 54843 TuesB y, November 5, 2024 715/6994081 I SBD-8330 (R04/15) sR -Do I gs Wisconsin Oepafnenl of Safely and Professional Services Division of Industry Services Soil Evaluation Report 2024 In attmtlansa with SPS 395, Ws.Adoo Code _ .11ofi6 •.'.'iu U ii.i.'i:. Attach complete site pian uu pope, uY, ,COO a Irv„ - Plan must include but not limited to: Vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, location and distance to nearest road. Please Print All Information County: Bayfleld Parcel I.D. 23942 Reviewed By: Date: Personal information you provide may be used for secondary purposes. (privacy Law,s.15.04(1)(m)). Property Owner: Richard J & Mary C Girnau Property Location S07,T43N,R05W Property Owners Mailing Address: 2909 Davis Drive Lot: Block: 2 Subdivision Name or CSM # City IState Eau Clare I I Zip Code IPhone WI I 4701 Number: I 0 Town Namakagon Nearest Road: Bass Lake Road Code derived design flow rate: Number of Bedrooms: 2 300 jv` New Residential j— Replacement J— Public or Commercial - Describe: Parent Material: Flood Plain if Applicable: 84.15 General Comments & Recommendations: System Elevation: 97 Load Rate: 07 Elevation Ran e: 93.93 To 97,26 Boring #1 r Borg' Fit Ground surfaceEle: Depth to Limiting Factor: v 120 In. Soil Application Rate: Horizon Depth in. Domm.Color Munsell Redcx Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPO/f2 *Eff#1 Eff#2 1 0-10 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 10-30 7.5YR4/6 N/A SL 2MSBK MFR CS 3M 0.6 1.0 3 30-120 7.5YR4/4 N/A MS 0SG ML N/A 1F 0.7 1.6 4 5 6 7 Ground surface Elev: Depth to Limiting Factor: Boring # 2 r Borry Pit 99.59 Ft. 120 In. Soil Application Rate: Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/fta `Eff#1 Eff#2 1 0-12 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 12-28 7.5YR4/6 N/A SL 2MSBK MFR CS 3M 0.6 1.0 3 28-120 7.5YR4/4 N/A MS 0SG ML N/A 1F 0.7 1.6 4 5 6 7 *Effluent #1 = BOD 5>30 < 2 20 mgA 4nd TSS>30 < 1 0mg/1 / Effluen #2 = BOD 5< 30 mg/I and TSS < 30 mg/I CST Name (Please Print) Sig t r CST Number: 877598 Mark S. Thompson Address: 12006 N US Hwy 63 Date Eyvalu tioQ on(iucte' : Telephone Number Hayward, WI 54843 / TuesZl7ay, November 5, 2024 715/699-4081 • SBD-8330 IR04/15) p 9nfA Pnperty Owner: Richard J & Mary C Girnau Parcel I.D. 2342 age. D IuJ L5 round surface Elev: Depth to Limiting Factor: Soil App. Rate Berl Pa 99.97 Ft. 120 In. m.Color Redox Description Structure Consistence BoundaryRoots GPO/ft' p Texture •Eff#1 Eff#2 unsell Qu. Sz. Cont. Color Gr.Sz.Sh. YR2.5/1 W7.5YR4/6 5YR4/6 N/A N/A SL SL 2MSBK 2MSBK MFR MFR CS CS 3CO 3M 0_6 0.6 1_0 1_0 .5YR4/4 N/A MS OSG ML N/A IF 0.7 1.6 5 6 7 Boring #4 Horizon Depth in. Ground surface Elev: Depth to Limiting Factor: r" Bor' Pit t 0 Ft. 0 In. Domm.Color Redox Description Texture Structure Consistence Boundary Roots Munsell Qu. Sz. Cont. Color Gr.Sz.Sh. Soil App. Rate ft2 GP"Eff#1D/Eff#2 1 2 3 4 5 6 7 Boring # 5 r Bores at Ground surface Elev: Depth to Limiting Factor: 0 Ft. 0 In. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPO/ft' •Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 6 Horizon Depth ≥" Born Prt Ground surface Elev: Depth to Limiting Factor: 0 Ft. 0 In. Domm.Color Redox Description Texture Structure Consistence Boundary Roots Munsell Qu. Sz. Cont. Color Gr.Sz.Sh. Soil App. Rate GPO/ 2 .E ff#1Eff#2 2 3 4 5 6 7 "Effluent #1 = BOD 5>305 2 20 mg/I and TSS>30 < 150mg/I *Ef fluent #2 = BOD 5< 30 mg/I and TSS ≤ 30 mg/I The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777 flu 2 2024 IIUII /oning Dept. ssoszza(R.onao) NOV 12'10'14 Soil Profile Sheet Page: 3 of 6 leld Co. Zoning Dept. Owner: Richard J & Mary C Girnau Soil Tester: is. Thompson ' 97.26 System Elevation: 97 Load Rate: System Elevation: y 93.93 To B2 101 B1 101 B3 101 --- ---- 100.93 --- - -- - 100 -------- -- 100 ------- 100 -------- 99_59 99.97 ------------- 99 -------------- 0.6 ------------ 98 --------- 98_43 $ 98 -- 98 -- ---- ---------- 0_7 97 ----------- 0_6 ------------ 97.3 $ 97 -----97------ 0-6 97_26 t --- ---------- 0.7 - ---------- 0-7 96 -------------- 96 - 96 ----------- -- 95 ----------- ---------- 95 ----- - 95 ------------ 94 ----------- - -------------- 94 - ---- - 93.93 ------------- --------------- 93 -------------- 93 --- 93 -------- ------------- ---� 92_97 ------ 92.59 T3' 92 --------------- 91 ---------- --------------- 91 9 --------------- - - ------------ 90.93 - - -------------- 90 ---------- L.F. 90 ----------- 90 ----------- — 89.97 --------- 89_59 89 __ — -- 89 ------------ L_F. 89 --- --- 88 — ---- - 88 — -------_ -- ----- System -------------- 87 — — 87 ---- ---- 86 -------------- 86 ------------- ------------ 86 ---------- 85 ----------- ---- --- 85 ------------ --------------- 85 --------------- 84 ------------ --------------- 84 --------------- ------------- 84 - - 83 ------- ------ 83 -------------- 83 - - 82 ------------- ------ -- 82 -------------- -- 82 - 81 ----------- --- 81 -------------- --------------- 81 ----------- -------------- 80 ----------- -------------- 80 --------------- 79 ---------- ------ 79 --------------- --------------- 79 --------------- NOV 122024 Owner Information : Richard J & Mary C Gimau ion: S07,T43N.R05W ship: F Namakaaon ty: Bayfield 2 Driveway a1' Little Bass La4ke_ BM 'p Only in Tested Area Well Road BM=100: ip 00, 99, Nall with ribbon on the t5ailgio tieo. %oIur g Oepi. near Power pad B3 61 B2 B1 = 100.93 B2 B3 = 99_97 Lake= 84_15 #: Driveway tion: BM=100: Nail with ribbon on the base o tree NOV 1 22024 ird J & Mary C Girnau near power ped Bayfieeg . Zoning Dept. S07,T43N,R05W Bi = _ Namakaoon I B2 = 99.59 Bavfield I B3 = 99_97 2I Lake= 84_15 Only in Tested Area Well 750 .a ILTeet- 1 L PLO IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3 -ft Trench (down -sizing credit) IIL!1�� 'j'L7111_ ��I,IIL�III • • �7 ii�.1��G�iil Septic Tank(s) Manufacturer. Superior Precast Septic Tank(s) Volume(s): 750 gal gal gal gal Effluent Filter Manufacturer. Orenco Effluent Filter Model t FT -0822 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) Provide minimum 3 ft separation between trenches. TYPICAL TRENCH (Show location of inlet / outlet pipe connection on plan view.) PLAN VIEW (No Scale) 4110 Observation pipe shall be Installed at junclion between two units. Perforated Lateral Observation Pipe (typical) (typical) B= 45 ft (typical) INSTALL PER TRENCH: 4 10 -ft bundles @ 50 ff EISA/unit = 200 ft' + 1 5 -ft bundles @ 25ff EISA/unit = 25 ft' = Proposed EISA per trench = 225 ft' OBSERVATION PIPE DETAIL (No Scale) Screw -Type or Sop Cap (loose) 40 PVC Pipe Top of pipe to terminate at or above finished grade (4) 1/4"-l/D %6" Slots @ apart 10 ft Anchoring Device A=3.0 ft (typical) i Bundle (typical) Finished Grade (mulched 8 seeded) Topsail cover (min.lfoot) Infiltration Surface (mid by Infiltrator Systems, Inc.) w Install pursuant to manufacturer's instructions. Required Infiltration Area = 428 ft' x 2 trenches = Proposed Total EISA = 450 ft2 C Co O 4 m" z a o C) Distribution Meth]: o r') branched manifold - a SEPTIC TANliC CROSS S_Ci_OY .=.}iu SPEC= iC,.TIONS 4" GCFl,4o PVC INSP. pror 6 H:tl, ABOVE GRL Dr (apt) (when snle-F cr'o-nVo�e 4s burled ) J FINISHED GRADE 18" 1HIN.I I pI LET APPR D BA-tL*E- !HLJ O FILTER --� APPROVED riFG. OV___O PIPE 3' ONTO SOLIDI I model R T082Z- sort 3" n,PPROVSD BEDDING UND&P, TANK SPECIFICATIONS SEPTIC TANK IIANUFACTURE SoPeaion1 �7(ZL-�p TANK SOLES. S_'TIC ?SO GAL. NOTES BayfieldCc Zoning PPROVED HOLE W/ L«,g4. W/fR IW- U}BEL 4" NTH. OUTLET r C ii'' iii+ [ Ii NI IS Int � , T 8 - Industry Division Services Ewan& .. - Ys II �, -1821 Madison Vends \\'nt Ba eld Sanitanl'crntilNumlx•r(to heliltedinbvCo • N0V 1 F= U'I4 Madison. \VI 5371)5 P.O. Bus 73112 Madison. tVI 53707 .-t —_ 1 8a' field CO Z.0 3inIJ Dull C Sanitary Permit Application State Itarnacnnn Number 111 accordance ,a 1, SRS 3$3,21(2). Wis r\din ('rile. submission W'Ihi.s limn to the apporymale gnvernmemul unit l'rorcet Address (if dillerent than mailing address) is required prim to oblanmte a sanilany permit Note Application t'rm, for store-mtned POW I S are suhm tied to the Depanmrni oiSalet, and PmRssioreJ Services 14rsonal mlbrnauon you provide m•, be coed li'rsccondan 44755 Bass Lake Rd. Cable WI purposes in accordance ,alb the Priv '%I.aw. s 150.1( Ikm). Sims. ' 1. Application Information — Please Print Ali Information I'ropenv Owner's N:mte Parcel n Richard J & Mary C Girnau Irrev Trust 23942 Property Owner's Mailing Address Property Locution 2909 Davis Dr. Gail I„1 C'in. State I Zip Code Phone Number Eau Claire, WI 54701 715-835-9723 `eclinn 07 l'43 N R 05 li or \t' II. Type orBullNing (check all that apply) lot a al or 2 Family Dwelling - Number ofltedronis 7 2 _. Subdivision Name -- Block U ❑'ubhel('omnurcial - Describe lice [jcit of Estate Owned - Ikscrihe Use --_. CS\I Nunthcr Vdlageof -- #1 32 V2 P1 76 Rl howl of Namakagon 111. Type of PO\VTS Permit: (Check either "New" or"Replacement" and other applicable on line A. Check one box online B. Complete line C it n licable.) A. I.New System ❑kcplaecurcnl System �t hire, \hd,6calion to Iixsung Sestein (explain) ❑Addmonat Pretreatment I Init (explain) ' Qlloldmg'I'ank Oln-(itoulld 1 3\t-Rmde DMmind India dual Site Design Other' 1'ype lexptunrl (consenitlmntl I C'. ❑ Itcaeaal iikIre ❑Revision irange of Plumber D1'ran ter to New (honer last Previous Permit Number tad Date Issued Fzpimilon NA IV. Dis crsal/I'renttneal Area and •funk Information: Design Now (gpdI Design Soil Application katelgpd/s0 I Dispersal Area Required (A) I Dispersal Arc., Proposed 1s0 System hlcsau'm 300 0.7 1428 1450 95.0 ('apaeit in lulot a of Mantllhetuler 'rank hlh arnatillll (iallmlx (iallnns ❑alts "— ' t 'ft Y — Sewrnnta I:iai„g'runl. c = - p srlak or tudmg rani 750 I 750 1 Superior Precast 11Z3 O_iung(v:anl., Q V. Responsibility Statement- 1, the undersigned. assume re5pamihilln• for installation or the POpiS sitown an tile attached pines. Plumber's Name (Print) I'lumlur's Signaune MI'/MPItS NumMr Business Phone Number Jason Kuettel I 675751 715-798-3355 I'lumber's Address(SlreeL City. State. Zip('mlcl / PO Box 66 Cable, WI 54821 VI. County/Deportment Use Only app o,ed 0 Disapproved Pen tat lice 0� C Date b sued Issui cal Signature ❑ t,,,ner tinm, Reason fir I)un,al I ( mlditxms f AppnwaVRcastnts Ibr�Divtppmenl Let .ttrach is mmptrte plan+ for the a)nrm and summit 1a an, t"ouno rim, nn paprr not i", man a sae , i r mrna m .ra S13D-6398 (it. 02/22) PAGE4OF4 In -ground Gravity Management Pla �` IMPORTANT: 1111 NUV 121024 U The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance)p�RlU PPt_ requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 300 gpd; BODS ≤ 220 mgL-'; TSS 150 mgL"'; FOGS 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 (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 (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Andry Rasmussen & Sons Local government unit: Bayfleld Co. Zoning Phone: 715-373-6138 Local government unit address: 117 E 5th St. Washburn, WI Phone: 715-798-3355 ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. Private Sewage System Maintenance Agreement KIC1+Alib I- MAZY GtrznM-u I Iztze i 'r -ti ZQ09 1.t4V , S t2. CAV CLA I,ZC, vJ Site Address N4 )SS rga-sc t,4 -Lt? F2, CA-3ce. tai ""'"" 2.39yz 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 Bayfeld County Planning and Zoning Department. The system will be operated in such a manner as to meet the designed plans. I (we) agree to maintain said private system at the below fisted location in accordance with rules established in the WI Adm. Code, as from time to time amended. (COMPLETE Legal is required) / ✓ 1114 of 1N I'/1/4 Section / Township '3N. Range 5 w Additional Legal Description: Town of /rAM,kkA2O/1J (Acreage) I. ?& Govt Lot a Lot_ Block Subdivision Lot 'L CSM # 172 Vol. � Page 117(0 CSM Doc # 70537 ( DOCUMENT NUMBER 2024R-605467 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED 11/ 12/2024 AT 2:15 PM RECORDING FEE: $30.00 PAGES: 1 Return To: Area Planning and q ink44r4nn E D I�J�Ujl N0V 1 3 2024 ® In -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: O Mound O 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. 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 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 -ground Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbed If needed when the wastewater distribution cell component Is inspected as provided above. Owner(s) agree that failure to comply with this agreement will result In action being taken to pay all charges and costs Incurred by Hayfield 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. Bay/fold 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 ¢y law. The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future owners of such pr�i(GR S• w SG ��• Owner(s) Name(s) — Please Print r f c 4P, 217 G+RN� U Tu T s) Gilf/t/LL(l Subscribed and sworn to before me on this date: TA J �%dUtNhbef Q 2oZAU Notri Sjd0 ner(s)-Sig at re(s) Notary Public My Cbmmissio Expires: 7 3 5 Drafted by: Ti-'.. CJJ9-2-IC Date: 2e Proofed by: Wfonnslsanitary/septicmaintenceagreement Revised JUN 2020 11120/24, 11:01 AM CarmodyTm BAYFIELD COUNTY SANITARY PERMIT (#04)-24176S STATE SANITARY PERMIT OWNER: RICHARD J & MARY C GIRNAU RNAU IRREV TRUST G OV'T LOT: LOT: 2 B LK: 1/4 1/4 SEC: 7, T 43 N, R 5 W TOWNSHIP: Namakagon SOIL TEST: 173-24 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: Jason Kuettel CECE RUDNICKI DATE: 11 /20/2024 Authorized Issuing Officer CHAPTER 145.135(2) WISCONSIN STATUTES a. The purpose of the sanitary permit Is to allow Installation of the private sewage system described in the permit. b. The approval of the sanitary permit is based on regulations in force on the date of approval. c. The sanitary permit Is valid and may be renewed for specified period. d. Changed regulations will not impair the validity of a sanitary permit. e. Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. f. The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 C. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #: LICENSE: # MP 675751 Condition: System to meet all setbacks. Management plan to owners. Properly maintain system per recorded agreement. THIS PERMIT EXPIRES 11 /20/2026 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=7415 1/2