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Home My WebLink About24-181SRequest for Sanitary Inspection (24 Hrs. in Advance) Fax or email this form to Zoning Dept (24 Hrs.) prior to when you want an inspection Fax (715) 373-0114 or Email zoninciCcDbayfieldcounty.wi.gov Note fl Time Change fl Discrepancy fl Other Phone Number Plumber: S /\J\ \(�Co eW k� Fax Number Homeowner: L acrd Email Address Immediate Phone Number So Zoning Sanitary a4 — g ) Dept can call you right back (if needed) Permit #: 15 ao� 7S\ Plumber's Choice Zoning Dept Date: g3 3�S No Inspection(s) during this time Tuesday (9:30 am - 12:15 pm) (Tracy) Time: Plumber's Choice ZonDept Township: 11 W cJ�S V��u C F" Address # & Road Name: a1 6 SD Iv rn�rp - or Directions ✓ J) I To Site: l (1 Comments: �v ** Plumbers you must verify any thanLe(s,!fkY1ax or email ** Notes from Zoning Dept: July 2025 r""" a.r.. ...a _...._ ..--PECTION REPORT (ATTACH TO PERMI LARRY & DONNA KRAUS N6314 LOLA COURT TANK INFORMATION TYPE MANUFACTURER/MODEL# CAPACITY RFTRAr..KR Property Line Well I Water Service I Building All -Weather I Road OHWM Swimming Pool DEVIATIONS FROM APPROVED PLAN COMMENTS (Persons present, discrepancies, etc.) LOGH5 4 L GL 4 1h /rI 6eA5 / 1 r / Serv,cy/ COMPONENTS NOT INSPECTED Plan Revisl Required I] Yes No gat22 `obi Signature of Inspector: Ce . Number Sketch�6n other side 10 of 13 BAYFILLD COUNTY PLANNING & ZONING DEPARTMENT y .. Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zonina(Wbayfieldcounty.wi.aov 117 East Fifth Street Web Site: www.bayfieldcountv.wi.aoV/147 Washburn, WI 54891 Property Owner LARRY & DONNA KRAUS Information N6314 LOLA COURT WILD ROSE WI 54984 [ter As you know -t. /4c t//Pcib ' �S/y 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: ❑ C.Tank was pumped by: on at AM/PM ❑ :• Tank was crushed I removed and pipes disconnected by: On / at /, 7/ (AM / ?the above -mentioned plumber contacted our office to conduct a pre -cover inspection as required under DSPS 383. One of the following applies: J C System was inspected and appears to meet all applicable code requirements. fl System was inspected and appears to meet all applicable code requirements; however, a plan revision is necessary because the installation was substantially different than the original approval. System could not be inspected because plumber covered prior to scheduled time of inspection. ❑ System could not be inspected because plumber was not ready at scheduled time of inspection. County was unable to return to complete inspection. System could not be inspected because plumber was not ready at scheduled time of inspection. A re -inspection and $50 fee are required. System could not be inspected because County could not respond to plumber's time constraints. Comments: Wfarm slsanitarypropetlyownervinput April 2019 Department of Safety Count` = & Professional Services, Pl Sanitary Permit Number (to be filled in by to.) PS Industry Services Division �I I� (S jfi 4 Sanitary Permit Application Slate Transaction Number In accordance with SI'S 38311(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 stutc'owned POWTS are submitted It, Project Address (il'dilTcrent than mailinpe ddress) the Department orsufcty and Professional Services. Personal Information you provide may be used For secondar' '�16 SO ftI1e3\o i\•l\ RC% numoses in accordance with the Privacy Law. s. 15.041 hlmt. Stars. . . S`t \—act�l k Property Owner's Mailing Address tib3\'1 LtAc,, C --- City. State Zip Code \).\ t\a\OSQ L'i SL198L-I 11. Type of Building (check all that apply) XI or 2 Family Dwelling - Number of Bedrooms 0 Public,Vommercial - Describe Use 3a„a Govt Lot Phone Number ��o-6y7-o3�6 'SW ',,.F_:Seeion Lot a T 14O1 u o fl'C ❑State Owned —Describe Use . 0 City of ❑Villageof Nu r T�'fown of was 11n� ,t1 Ill. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line Cif a licable. A. rryy y: New System n Replacement SySo nt ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit ("plain) B' l Holdin''rank 6 .0 In -Ground .J At -Grade Q Mound r-, .. Individual Site lesi^rt r ._. Olher'hpe (explain) (conventional) C • ❑ Renewal Before D Revision Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued tixpiration Capacity in 'total a ofMwufueurer Tank information Gallons Gallons Units New Tanks heisting Tanks u `� -' r a o = J2 a .� �! u u tc V = Septic or braiding Tank ''l C,o .•IeGC t J C Dosing Chamber 8C% O __ V. Responsibility Statement- 1, the undersigned, assume res bility for installation of the POWTS shown on the attached plans. Plum r s Name (Print) Plumber's rc MP/MPRS Number I Business Phone Number •ic e� ` r ' htI e/ t 3e8 5-C' CIS-�c�- sa l Plumber's Address (Strut City. State, Zip Code) Lf�£L s JJLtI Utsyg9 VI Countyme artment Use Only Approved 0 Disapproved Permit Fee r )a CIssued Icsu' g A t Signature 0 Owner Given Reason for Denial s4oc)' j 1)21.1) 1 ) - -,._-- onditions fA�pprooval/RcasonsforDisapproval cnL \Sl and submit to the County oath -on paper not Its than a in x II Inches in size SBD-6398 (R. 03/22) 0 CONCRETE HOLDING TANK DESIGN ��o�� Single Tank Option N0V 272024 INDEX AND TITLE SHEET Bayfield Co. Zoning Dept. Project Larry & Donna Kraus - Holding Tank Owner Larry & Donna Kraus Address N6314 Lola Court Wild Rose, WI 54984 (920) 647-0386 Legal Description Par in SW SE, 521, T49N, R05W Township Town of Washburn County Bayfield Subdivision Name Lot No. Parcel ID Number Plan Transaction ID Number Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Soil test Page 5 Soil test plot plan Page 6 Holding tank agreement Page 7 holding serviicing contract Page 8 Holding tank specifications Page 9 Designer Michael Wroblewski Signature / l _/l il_4t / Phone No. 715-209-7521 License Number 1288503 Date 11/26/24 Desigied ptrst t to: Holding Tank Component Manual For POWTS (Version 2.0) SBD-108.55-P (N. 03107. R. 01/12) Versim 7.0(11112) Page 1 of 9 HOLDING TANK SPECIFICATIONS [3J Number of bedrooms Non-residential estimated flow (gpd) 2000.0 Minimum holding tank volume required (gal) ix. 2000.0 Proposed holding tank ca�a (gal) Wieser concrete xx`Tank Manufacturer W_P12001800-MR � pTank model number iISJ Electro systems _ _,p.�Alarm manufacturer LVftl01 larm model number juncton box. conduit bto s g outlet lsions and Data X for round tank Liquid depth below inlet invert (in) Maximum de th of soil cover (ft) Height (in) Outside Length (in) Dimensions Width (in) Only unV9 D NOV 212024 Bayfield Co. Zoning Dept. ik Anchor Calculations Weight of tank and cover Safety factor 971bs Ibs Weight of anchor required in Soil cover req. for anchor or yd3 Concrete counterweight HOLDING TANK CROSS SECTION manhole cover with locking device and finished vent cap warning label grade min. l 12 mi. in. Manhole and vent locations _ may be reversed. vent p pe ___ 18" mm. o tether weight service alarm on Electrical as per NEC 300 and SPS 316 3 in. beddrg under tark. 12.0 in. 29.0 in Note: All tankjoints, and joints between tank openings and piping are sealed watertight. All pipe and vent materials comply with SPS 384. Tanis is anchored as necessary to negate buoyancy. building sewer inlet Project: Larry & Donna Kraus - Holding Tank Transaction Number. Page 2 of 9 NOV 272014 Bayfield Co. Zoning Dept. Larry & Donna Kraus Holding Tank Plot Plan Legal Description: Par in SW SE. 521, T49N, R05W Scale: 1' =40 property line 4" pvc cleanout Trailer "No Well On Site >100' to property line 4" pv'c pipe - Insulated after 30from trailer rank tank .100 to property line North Maple Hill Road Page 3 of 9 ^.LZ APR 1O2U NOV 272024 Bayleli Cc, Ixiam' 5a::az,;:;„,1J.,t0 el�J Co.4ning Dept. :consin Department of Commerce SOIL EVALUATION REPORT pa9e_of_ Sion of safety and Buildings In accordance with Comm 85, W¢. Adm. Code County IIAYFIELD ittach complete she plan on paper not less than 8 1/2 x 11 inches in 5120. Plan must idude. but not smiled to. rental and horizontal reference point IBM). direction and JPaoei I D 38772 (37883) ercenl slope, scale or dimensions, north arrow and location and distance to nearest wad. Please print all information. I Reviewed by Date l-'oisonal inioinmemi you prove may oe uuolor occundary pun4RCa i Privacy Lax a 1594 tYlon.i EREOERICK & ANDREA DOI.LEN Govt Lot till 114 SI. 114 S .I T 4ri N R ?Ca E ta) W Pr, y Owners Mailing Address Lot ft I Block rr I SWd Name or CSMB 2910 FERN DR ClSlate Zip Code Phone Number dy QVllage •Town Nearest Road 'UN PRAIRP \41 5359(1 f 6031. 494-42SI U'ACLI RI IDAI I n \IAI'LI. 1111.1 Residential r Number of bedrooms Public or conmiercai - Describe 1_ Code dewed design flow rate III,!. Flood Plain elevation it applicable IWILDING 1'ANK OR MOUND SYSTEM ELEVATION AT 1113.1 ON 101.6 CON I OI iR DESIGN 11141 RAIL r. GPD-SQ fl TRE(:S TO BE Rf.IMO\'ED S Sl3'\A S LLP1 I\ PI.:M Ir. FIPFORE INS I'AI.LAT'IU\ I Bourg M Boring QPit Ground surface elev 11)1.(1 8. Depth to h mmng actor. I S at GPO 8. Horizon Oeplh m Dominant Color Munsell Redox Description Co. Si Cont. Color Texture Structure Gr. Si Sh Consistence Boundary Roots PDllr •E8%I 'E8#2 0-6 SYR1'I St IThIR + \t\IR (-W .\I .1, 111 6-14 5\'It?1 St. 1) SILK \1\TR t'W 3C 6 11) 18.22 5YR4 4 Cl <\e°n SI. 21513K MVFtt GW 3.A1 .6 Lb if 22-28 5YR4/(, QD51 a,vn Sl. _'FSRK M\'PR - 2F .6 LO Boring ewmg # U B10U, Ili Pit Ground surface Bleu 8 Depth to ImMg Wctor __ in CIA� H on Depth in Dominant Color Munsell Redox Desupion Co Sz Conl Color Texture Structure Cr Si Sb Consistence Boundary Roots GPD/R' •Eft#1 •Efi#2 0-h 5YRe I Si 3MGR \IVFR ('W 3\I .6 I.) fl 6-1X 5YR3!4 SL 3F513K \IVFR rW A' .6 LO 1 14-22 5VR4/6 Ili >1'a Y. 21-SHK \I\'I-R OW 3M .6 IA) 4 222-28 SYR4l6 c:u 3Yk no SL :PSBK \1VI-It - 21' .6 1.0 - tnxrent al=ecru. - uu_ zzu mglL and IJSx:1p_ 150 nigh. Elauent =80 _ 30 rngd, and TSS< 30 mgA. L'ST Name (Please Print) Signature / CST Number BRUCE W BLAKEMAN 708 14S Address Date Evaluation Conducted Telephone Number 64003 CHARLES JOHNSON ROAD ASIILAND, WI 54806 06.0%'1027 71 S-209.2569 N Property Owner DOLLfi_ Boring # El Bolnlg `19.4 Pit Ground surface Sew. Honkon Depth in. Dominant Coto Munsell Redox Description Ott Sz Cont Color Texture Structure Cr. Sz. Sh Consistence Boundary Roots GPD#f •Ef#1 •E##2 I t1-(. 5Y'R3.I St. 3MCR \IGII4 ('W 3M ii HI (6.211 SYR3-J St. 3MS13K MYFR CW 3C .6 Llt 3 20-36 5YRJffi CIF 5YR 6'K St. 2FSHK \I\'FR CW 3M .6 1.11 i 36-;9 51'Rw. ('21) 51KM. St. _21-SHK %I VFR AW 11 I. 1.11 49.fi(t 55`R5 fi 1'?D SIR I4 S(l. 2\ISI1K \II It - 'I. 4 .6 - -- ____ ____ _______ ______________ 1 _______ _____ ____ _____ Lii]Bong # LJ Boring Pit Ground surface elev ft Depth to Innong factor in Horizon Depth in Dominant Color Munsell Redox Des Description Ott. Sz Cant Color Texture Structure Cr. Sz. Sh. Consistence Boundary , Roots —._... __..._.. GPO/if .._._ •E##t •Eff#2 ll NOV 2/Z024 Parcel ID# Bay(iee i7t37'h Mp [2a 1. 1. `11 _ Depth to LmrUng 'actor m ZCEVED APR 10 2023 3y Page ui— Boring # H Bormg Ground surface Sew. _ It. Depth to finding factor -.__ in. Aod�on Ram pit SoY Horizon Depth in Dominant Color Munsetl Redox Description Cu Si Can Cabr Texture Structuio Cr Si $6 Consistence Boundary Roots GPOIft •E#al -E##? Effluent #1 = BOD,> 30 _ 220 mgll and TSS>30 ≤ 150 mg1L ' Effluent #2 = BOD, 30 mglL and TSS _ 30 MIL Ilho Department rd'Commerce is an equal opportunity service pmvidcr anti emplo)cr. II you need msistuncc to acct•+. xrx ices sir need material in on alternate IormaL parse contact the departn6em at (,UK -'_w6-3151 or ll'\ 6US-264-K777. 1INii iii Y,yy'ICy 6LLtcAI 5 5E 5,21 ry9N`F, 5!y APR 10 2023 �G 3 ci 3 7A',v of h/*s#[3,,R t/, jSiq Fl"v cl i nr � " ` ' ` D _ s V Is 1 S NOV 27 2024 �£_ /"_ sic' FzTs +1J/�{#of Bayfield Co. Zoning Dept >r t- AM-zt r' -BoV€ Gfze wb fl' /?' //€mtoc�. /dU. o &&L1; og. A&M ass 4Z Trs 72,wf,• cc.& ,zSo' flj N ?SST f�r2oP [ z.v� /uu6Qd 51 -It cu.t , ��11i( ircl.Gc� wb► Wu.b 93,7 is V/ Lol.i k yj je 5t)IPE 3'-8" h IIII 11 4" CAST -A -SEAL 1 jj 1 1 U 11 FILTER OR I ij I II BAFFLE 11 WLP1 200/800 -MR TANK SPECIFICATIONS DIMENSIONS: a WALL: 3' BOTTOM: 3" COVER: 6' MANHOLE: 24" I.D. PRECAST CONCRETE RISER 4" CAST -A -SEAL HEIGHT: 53" LENGTH: 13'-8" S WIDTH: 8'-0' BELOW INLET: 41" '01 LIQUID LEVEL: 36" WEIGHT: BOTTOM 14,800 LBS. COVER 8,170 LBS. A INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL /10 aI El o W a (OTHER STATES SEE CHART) LIQUID CAPACITY: 33.46 GAL/IN (SEPTIC) 22.24 GAL/IN (PUMP) g = LOADING DESIGN: 8'-0' UNSATURATED SOIL z :O TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON 4" VENT COVER: MIX DESIGN /8 (NO FIBER) W TANK: MIX DESIGN /9 (SMALL FIBER) --, CUSTOMIZED TANKS: I______ FOR CUSTOM TANKS CONTACT WIESER CONCRETE PTV9[ ytTounlT i7 ARE PAD J Q o Z I i REVIEWED BY F CD REVIEW DATE N a 0. DRAWINGS SUBMITTED • FOR APPROVAL APPROVED BY: SHEET NO. APPROVAL DATE: 1 7" OF PRODUCTS NEEDED BY: BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS rflJi Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) NOV 2 % ZOZ4 �. hayfield Co- Zo,nino Dept. n c Iu;� I: 1ls. /\ Original Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.) Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) Original Plot Plan (383.22(2)2. 3. & 4.a) Cross Section, Over -Head Profile of the System Schematic of Tank from Manufacturer ❑ 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) El ATU Servicing Agreement (Recorded at Reg. of Deeds) Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) l Qfl1Jte Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to al! coni;Cl 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 ADDlication: (Include the following Information) yI Application Information must include: j0 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) Project Address gr Road Name where driveway is/will come off of) II Type of Building III Type of Permit IV Type of POWTS System V Dispersal / Treatment Area Information VI Tank Information VII Responsibility Statement (Plumber's Information) *Date Stamp* Plot Plan: (To Scale or To Dimension) Signature and Plumber Information ElSurface Elevation of Body of Water ❑ Direction and Percent Land Slope ,Tank and Filter Information and Location ElWetlands / Navigable Bodies of Water ❑ Absorption Area (Proposed and Existing) ❑ Bench Mark (Location, Elevation and Description) f Component Manual Version r(Owners Phone Number) Address Number and Road North Arrow ❑ Contour Lines 4 Structures and Driveways Boring Locations Property Lines VWell Locations I\Legal Descriptions Pipi g r;Qai'enal Infor of on lconveyirice lc . LuUdtrig sewet mat'iial type and dpai Turn Over ► Cross -Section and Over -Head Profile of the System: p E C E Q V (5 D ❑ Surface and System Elevation 0 NOV 2 7 2024 ❑ Position of Observation and Vent Pipes Bayfield Co. Zoning Dept. ❑ Dimensions and Depths ❑ Make, Model & Number of Chamber Units in each Cell How many systems will there beon��this parcel of land? ' Has this property been split? ��6 (Property Statement shows Property History) Fees: ❑ Private Sewage System (Septic Tanks) $ 400.00 }�1 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/fortes/checdiswcheckllstforsanitaryapps (10/2009);(®7/2011);(®2/2012)(®s/2/2012 -dc) Proofed by: Department of Safety °" ant- l e1 c1 & Professional Servile 1 S Sanitary I ennil Number (to be filled inlay Co.) Ps Industry ServicesiDivision N0V 2 r 4 r�U- Iti S Sanitary Permit Application State Tmt"uetionNumber In accordance wiN SI'S 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 POWI:S are submitted to project Address (if different than mt the Department of Safety and Professional Scn•ices. Personal information you provide may be used for secondary ' % So N. fry WV,O�'•, purposes in accordance with the Privacy Low. s. 15.64(I)(m), Stars, L Application Information —Please Print All Information ) o s t.t (Jr. S'1 'd Property Owner's Name Parcel a property O, 1wnerr s Mailing Address N 6�`"1 i-6\G c -k-- Property Location G0VL Lot SL\J /..s5Fs:. Suclion T N H OS E or City, Stale II W ,\� dose W Zip Code Sf iG8 11 Phone Number 0 C t/ ( — 386 IL Type of Building (check all that apply) XI or 2 Family Dwelling - NumberofBedroonis Ate_ / \ O llublic/C'ommcrcial- Describe Use _.____ Lot a Subdivision Nana: Block a ❑ city or _ ❑ State Owned- Describe Use _--------------------- CSM Number ❑ Village of _________________________ _ 'Town of Ori . l '�IAQJI Ill. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if appIicaa//ble. A. Ir, New S stern ❑ Replacement Systemr . ' \ Y P Y 0 OWcr Modification to lixisting System (explain) ❑ Additional D n.trcatmem Unit (explain) B' J Holding Tank P In -Ground P At -Grade Mound !_! Individual Site Design(conventional) 7. Other Type (explain) C. ❑ Renewal Before ❑ Revision Change of Plumber ❑ Transfer to New Owner rst Previous Permit Number and Date Issued t:.xpiralion Capacity in Total a of Manufacturer lank Information Gallons Gallons Units a c 7 y New Tanks litistinp Tanks '2 c 3 L a- 1aoo w1 r s = t7 hptic or Bolding Tank .tlVC: tl l l t s-` /� v Dosing Chamber pC O V. Responsibility Statement- 1, the undersigned, assume rem4llIity for installation of the POWTS shown on the attached plans. Plumb is Name (Print) Plumber's rc P MP/MPIiS Number Phone Business PhoNumber \ 1 /�Ic�� e\ L MC7P\usF:� Plumber's Address (Street. City. State, Zip Code) ch, Mw L Iiskktn = s'/g9 VI County/De artmentUse Only AppmvcdI ,ac O Disapproved Q Owner Given licawn for Denial Permit Pee r a c Issued 5 540Q � � � i I lf'i � 2'4- lssu' g At Signature M4A1 I) t After to nansr not tear than a in x 11 inches in elan SBD-6398 (R. 03/22) Department of Safety County Bay t P i✓ft� r l lisps iJlil7�1+1 li_'NOV & Professervi IVIS4 V i Permit Number (to be filled in by Co.) S 27204 - I fl S Sanitary Permit Application PP Bayfiver Co nit State Transaction Number Dept. nen In accordance with SPS 383.21(2), Wis. Mm. Code, submission of this form to the appropriate governmen unit Project Address (if different than mailingdress) a„'J 6 5O 1$. Mc \o is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. t5.04(I)(m), Stats. qs = Sy 89 L Application Information —Please Print All Information Property Owner's Name 1—acc'- *- OOC*O \VCc\xl,S Parcel # 381_ Property Owner'smg Address Property Location is 6MA Lo \o. C+' Govt Let sw Y., Section - T N R 05 E or City, State 1t\ t\� dose W= I Zip Code Phone 519-1 'c Number —q7 -o186 ILType of Building (check all that apply) Lot # Subdivision Name XI or 2 Family Dwelling — Number ofBedrooms a. Block # 0 Public/Commercial — Describe Use ❑ Cityof ❑ State Owned — Describe Use 0 Village of 1 S CSM Number %Townof Iny.tdl III. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if applicable.) A. pp New System 0 Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) Holding Tank ❑ In -Ground ❑ At -Grade I ❑ Mound ❑ Individual Site Design I ❑ Other Type (explain) (conventional) C. ❑ Renewal Before 0 Revision ❑ Change of Plumber I ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) I Dispersal Area Required (st) Dispersal Area Proposed (so System Elevation 30p Capacity in Total Gallons # of Units Manufacturer Tank Information Gallons a S S R New Tanks ExistingTanks e y $ o.0 in rn iZu 0.. Septic or Holding Tank 1_00 ^noo tlG+x�� , Dosing Chamber 80 0 V. Responsibility Statement -I, the undersigned, assumercsposiility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) IPlumber's a MP/MPRS Number I Business Phone Number UMeick� lag8�o3 715-2o�— Sal ic''c,ek Plumber's Address (Street, City, State, Zip Code) 49 c 6- r sygq VL County/De artment ise Only 0 Approved 0 Disapproved Permit Fee $ Date Issued Issuing Agent Signature 0 Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval Attach to complete plans for the ystem and submit to the County only on paper not less than a I/2x I I incites in size SBD-6398 (R. 03/22) uuJ 272024 HOLDING TANK MANAGEMENT PLAN B22yfield Co. Zoning Dept This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and maintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-1 0855-P N. 03/07, R. 01/12), and the Bayfield County Sanitary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 60.0 to 400.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed in the current Service Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code. 5. All service events or inspections of this POWTS shall be reported to the county within 30 days 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Con- nection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with SPS 383.33 Wis. Adm. Code. 10. If there is a problem with, or question about this installation, the following persons may be contacted: a. Installer ......................... Ed^s Mechanical LLC Phone: 715-209-7521 b. Service Provider ............... Birch Street Sepiic Service Phone: 715-373-5683 c. Co. Zoning or Health Dept. Bayfield County Planning & Zoning Phone: 715-373-6138 11 Project: Larry & Donna Kraus - Holding Tank Transaction Number. Page 4 of 9 Document Number/Plan I.D. No. HOLDING TANK AGREEMENT L�rn�� pon�.t'a¼kS N631�{ Lo c\Ci- 54584 Parcel Identifier Number (PIN) I Agreement Date (same as Notary Date) on the following property or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. SPS 383, Wis. Adm. Code or Ch. 145, Wis Stats. SW 1/4 of �SEE ��114 Section ", Township L ,__N. Range OS W. Town of \ n� at.Sh F� V.C� Additional Legal Description: 5Ra N I Ach%a-X Gov't Lot — Lot, Bbdc_Subdivision CSM# Lot_CSM # Vol _Page _CSM Doc# DOCUMENT NUMBER 2024R-605384 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 11 /O5/2O24 AT 8:06 AM RECORDING FEE: $30.00 PAGES:2 Retr — BIG LAW'1' uPLMBING n r4N®d�nfB g4*64C Washburn, WI 54891 As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding tank installation and maintenance. If the owner fails to have the holding tank properly serviced in response to orders issued by Bayfield County or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, State., Bayfield County may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. 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. 3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Stats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NR113, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the county within 30 days from the date of change to the service contract. 4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis. Stats., and Ch. NR 114, WI's Adm. Code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained. 5. This agreement will remain in effect only until Bayfield County certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. SPS 383, WI's Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. Owner(s) Name(s) — Please Print Subscribed and swom to betore me on this date: � 9�Ry KA as " "`" t Klbe r 2�m , 2bzLl rerny -- oIQrrawrenal CiILOE LONGORIA Notary Public ate of Wisconsin Draftedby: /ThK& WiOUA\,J fit Date: /O/17 PenanS tnrarrrati n you provide may be used for seccoday p'aposes (Privacy Las, $15.04 Ukmll uirumNseNlryfioI igt ikagresnentdoc Attune 2018 unfi U liii NOV 2 I /uz4 File Number: 237856 ADDENDUM/EXHIBIT A A parcel of land located In the Southwest Quarter of the Southeast Quarter (SW1/4-SE1/4), Section Twenty-one (21), Township Forty-nIne (49) North, Range Five (5) West, Town of Washburn, Bayfeld County, Wisconsin, more particularly described as follows: Commencing at the South Quarter comer of said Section; thence N89°28'00"E along the South line of the SE1/4 of said Section a distance of 348.50 feet to the Point of Beginning; thence N00°49'49"E a distance of 620.00 feet; thence N89°28'00"E a distance of 576.22 feet; thence 500048112'W a distance of 620.00 feet to the South line of the SE1/4 of said Section; thence S89°28'00"W along said South line a distance of 576.51 feet to the Point of Beginning. For Informational Purposes Only, the above described lands are designated with the following: Tax ID Number(s): 04-050-2-49-05-21-4 03-000-21000 (Parent) 04-050-2-49-05-21-4 03-000-23000 (2023) Property Address(s): Vacant Land on North Maple Hill Road Washburn, WI 54891 Bayfield County Register of Deeds Document #2023R-600677 Page 2 of 2 HOLDING TANK SERVICING CONTRACT Contract Date I This contract is made between the Holding Tank Owner(s) Name(s) Llxcr d- 1�- ot\f\ok cc&S Pumper's Name (Print) pp�q \ae fl Pumper's Signature Pumpers' Registration # \�o We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT LOCATION I Legal Description: (Use Tax Statement) Tax IDN C� �Q�� C s�fti 3/a, SJ-- 3/4, L.t Ct Section ^�\ ,Township N, Range OS w Town of: Lot Size I Acreage Gov't Lot Loth CSM N Vol. Page CSM DocN Lot(s) No. Block(s) No. Subdivision: 1. The owner agrees to file a copy of this contract with Bayfield County as required in SPS 383.55, Wis. Adm. Code. 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local government unit which has signed the pumping agreement required by SPS 383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; CHL0E L0NG0RIA C. The location of the property on which the holding tank is installed; Notary Public d. The sanitary permit number issued for the holding tank; state of Wisconsin e. The dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the local government unit and the County named above within (10) business days from the date of change to this service contract. Owner(s) Name(s) (Print) hvi0. ture(s) Subscribed and Sworn to me: on this 'dayofL,i , by: _ otary Public My commission expires on: Revised: May 2016 (®May 2018) Drafted by / A IA Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (I)(m)] 12/2124, 1:35 PM CarmodyTF° BAYFIELD COUNTY SANITARY PERMIT (#04)-24-181 S STATE SANITARY PERMIT OWNER: LARRY & DONNA KRAUS G OV'T LOT: LOT: B LK: SW 1/4 SE 1/4 SEC: 21, T 49 N, R 5 W TOWNSHIP: Washburn SOIL TEST: 58-22 NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: Michael Wroblewski CECE RUDNICKI Authorized Issuing Officer DATE: 12/2/2024 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 #: LICENSE: # 1288503 Condition: Management plan to owners. Properly maintain system per recorded agreement. Tank to meet all setbacks and to be within 25' of an all weather road. THIS PERMIT EXPIRES 12/2/2026 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=7421 1/2