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20-139S REVISION
Request for Sanitary Inspection (Fax this form to Zoning Dept when you want an inspection - 373-0114) Note: From Zoning Dept Time Change Discrepancy Other Plumber:^)^^(L\d,\n(^ Phone Number ~\\5 L>Z?q g}-l^ Fax Number Home Owner:S^<blt Qoo^ Sanitary Permit #:20- IW Date: Plumber's Choice ^/i^/zo Zoning Dept No inspection durina these times 9:30 am-12:30 pm Tues. (Tracy) 9:30 am-12:30 pm Thurs. (Tracy) Time:Plumber's Choice Zoning Dept Z'-o^piy-r^ Immediate Phone Number so Zoning Dept can call you right back (if needed) Township:\[W^\0^)Y^ Address # & Road Name: or Directions To Site: 45lbo Su^ar fa^ Dr. Comments: Reminder: You must confirm any change(s) that have been made prior to or this inspection will not be scheduled and a memo will be sent voiding the inspection. Thank You! **Plumber must verify any change(s) by fax or no inspection will be scheduled u/forms/sanitary/requestforinspectionZoning Dept (©4/12/04)©June 2018 &SL-—.-Wisconsin Department of Commerce Safety and Buildings Division GENERAL INFORMATION Per.'jflgal infnrmation you provide P^Fml Holder's Name: PRIVATE ONSITE WASTE TREATMENT SYSTEMS(POWTS)INSPECTION REPORT (ATTACH TO PERMIT) used for secondary purposes [ Privacy Law, s. 15.04 (l)(m) ] State Plan Transaction ID#: County •e.(<l TANK INFORMATION ELEVATION DATA Pi/PE Septic Dosing Aeration Holding MANUFACTURER CAPACITY TANK SETBACK INFORMATION TANK TO Septic Dosing Aeration Holding P/L WELL BLDG VENT TO AIR INTAKE ROAD NA NA NA PUMP / SIPHON INFORMATION Manuracturer Model Number TDH Lift Forcemain Friction Length Loss System Dia Dist. Head To Well TDH Demand GPM Ft STATION Benchmark Bldg. Sewer St/Htlnlet St/Ht Outlet Dt Inlet Dt Bottom Installation Contour Header/Man. Dist. Pipe Infiltrative Surface Final Grade BS HI FS ELEV DISPERSAL CELL INFORMATION DIMENSIONS SETBACK INFORMATION CELL TO Width P/L Length Bldg No of Cells Well OHWMofNav Waters Type of System LEACHING CHAMBER Manufacturer: Model Number: DISTRIBUTION SYSTEM Header/Manifold Length _ Dia. Distribution Pipe(s) Length _ Dia Spac. X Pressure Systems Only X Hole Size X Hole Spacing Observation Pipes D Yes D No SOIL COVER Depth Over Cell Center Depth Over Cell Edges Depth of Topsoil Seeded / Sodded D Yes D No Mulched D Yes D No COMMENTS: (Include code discrepancies, persons present, etc.)^ank..^ ^" /c?^-^ "? /n ^vicm^unuuue^weuis^aiiu^ ^ ^^O^U. .^ f(^"/^?^/-t^ ^) /^ viu f^^ ^ •J ^ ))^/S //^ 4 7^y,^ - ^'l^i/G^ " ;^''",V^J^ "€rr L-, ^>/^^i^.^ 0^^/'• "^''3 8 "/c/^7'c'-^w ^x/ L^ c^^p^ &\,.^^i ^^// .,^^ Wsr\lW^WTl&^_Plan revision required^ Yes D No Use other side for additional information Date POWTS Inspector's Signafure 1T_J_7 ;3 Cert No Bureau of Field Operations, PO Box 7302, Madison, Wl 53701-7302 SBD-6710(R.3/01) - .'.. ••'• • / yU- • ": ' Tracy Pooler From: Tracy Pooler Sent: Monday, January 25, 2021 11:54 AM To: butterfieldinc@hotmail.com Subject: \ StevefCooley I am looking for the plan revision and associated numbers for the Steven Cooley septic system Located at 45160 Sugar Bay Dr.^eh^ /^^r^vh/y ^0'y^/7.^//vA^ (AJ^ ^ ^ r^'s'(or? -C/K(- q/a6/a4 j3 ! lMl ^1 ] ^1 1 <n i l HI J: ! =L ^ . I Ki l *• ; i^ - 1 - 3 _ ; ; ; ? il l l f t l S. S = = - r = mi l ! 5 ! " ^ Z f 1^ ^ ^ ^ ; I i ? ^ . § y & 3 | ;2 S £ l i ' ? : 5 . |5 £ • . 3 ; ; • • ; = . • — 3 . 3 ' . . , & 3 !1 ? 1 1 3 < < lE V ' i ? : ? ! m ;§ . > § . 3 ]. a S 3 . 3 - ; 5 V. ll ^ l l r > l - •S i ' s ' c r^ * '€ * ^ ^ a ^1 '5 - _^ ' rr > ^ > ' ir : - %y N :v ^ ^ S s 5 5. ^ I ' 7 im-* 3 = 't " L fi ~ ~ 3 -^ 5 ' 6 C " ^ c/ ; SL 3 £ . @t i y^ — ^ ' ' ff u i " ci o , — ^ . , , Ct 3 • " - 5 - S !» .u<^15% 0) •> ? ! 0 R ws £ ^! Department of Safety & Professional (Sier^c^, , .^ Industry Service^DwislBn:' 11 l!i -S:<?OS|S —il MAR1820J County <3<^f:e1d San^tja^ Permit Number (to be filled in by Co.)ill -State'Transaction NumberSanitary Permit Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appmpKhto,i^y,et»rsi@nt^'}f^ 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 puiposes in accordance with the Privacy Law, s. 15.04(I)(m), Stats. I. Application Information - Please Print All Information Project Address (if different than mailing address) _5A.«^<- Property Owner's Name 6-^<\»<y\ T <*- 'Jblene A Co0><y Parcel# TAX lO: 3'708S' 0'/-03V-a-'»3-0(.-<^-3 05-«>3-3*«OGO Property Owner's Mailing Address v?rk00 •s"3<-<- p^7 o<- Property Location Govt. Lot 3 City, State Co^«, l^X Zip Code SHS^\ II. Type of Building (check all that apply) ^> 1 or 2 Family Dwelling - Number of Bedrooms D Public/Commercial - Describe Use D State Owned - Describe Use. Phone Number '71S'S'IH-S')&0 -'/4,-'A. Section Lot #T_t3__N R 0<« &<r/^l Subdivision Name Block # D City of. CSM Number csn^ ^6-s M.\\ p. >T3 a Village of XTown of AJ 0. mO. k'G.q <!> rt III. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if applicable.) A.^New System D Replacement System D Other Modification to Existing System (explain)D Additional Pretreatment Unit (explain) B.D Holding Tank 8. In-Ground (conventional) D At-Grade D Mound D Individual Site Design D Other Type (explain) c.D Renewal Before Expiration Revision D Change of Plumber D Transfer to New Owner -ist Previous Permit Number and Date Issued ^O-tS^S 62/^/90 rV. Dispersal/Treatment Area and Tank Information: ^ fcC> Qu'.c-K*/ PluA C.h«w»berA <**/3 Sxf-s A^ i«nd<s Design Flow (gpd) 6,00 Design Soil Application Rate(gpd/sf) 0.5- Dispersal Area Required (sf) 1^00 Dispersal Area Proposed (sf) )S\& ^ System Elevation &(^^S Tank Information Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units Manufacturer £, 0 I?S PM So s '&..n ^•£ U Septic or Holding Tank l^S-O l^SQ (jjlescr Ccmc.re.^e. Dosing Chamber V. Responsibility Statement- I, the undersigned, assume re^%nsibility.^brmg(alj^6on aTthe POWTS shown on the attached plans. Plumber's Name (Print) Tro^Ts B^-hT^-T to Plumber^[nature yzz^ Plumber's Address (Street, City, State, Zip Code)£/7 IV3V6. fciJ A^ft^r R.wd77 H&YLvar<*, i-JJ ^*/0C/3 MP/MPRS Number &S-.S8/7<? Business Phone Number •7/S-&3V- 8/7^ VI. County/Department Use Only D Approved D Disapproved D Owner Given Reason for Denial Permit Fee Date Issued Issuing Agent Signature Conditions ofApproval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x II inches in size SBD-6398 (R. 03/22) $R-M!?.isconsin I sowl^-z^ Wisconsin Department of Safely & Professional Services Division of Industry Services; "e . pi12^'^^•'^ Attach complete site plan on paper not less than 81/2x11 indies In size. Plan mi|^t.'incfu[ler but not limited to vertical and horizontal reference poinl (BM), direclion and pGrcenJislopo, scale or tlimonsions. north arrow, and location and distance to nearesl roacl. ji Please print all information. SOIL EVALUATION REPORT In accordance with SPS 385, WlSi Adm. iGode tw^S.l^ifl?Page._oL Property Location ^-3£>1<&& A_C<&ok.y__ _.. _._-.J_GoviL013 - - J" Couqlyw ]a Parcel 1.1 m.oiReviewed •I |Bj_Ji^.&d.<L.._,___ ,__JIF ~' ~"-- T^-^-STC^S MAH i y|^Sj^.o-U'^^/,3-jOfc-.o^3_o.£=.o&^.3.^.ooJ "^•d'HL^ '/< S OS T lt/2> N R C>(j, DateIM^.cr r E(or) W J3ereoiwUnfonnatiun you provide^nay t)c used for senondary purposes (Privacy l-.a"^^;0'KfWL'y;J'_':| Property Owner JS-'Lc^ic^ Property Owner's Mailing Address ^Qc.^ _ _...„.. .._4,J.j6A. ii- -<:^^^&3,^JL\_^JL33-- - - „ ,,_.^_^..City, State, Zip | Phone Number j D City D Villago 'B Town j Nearest Road -C^le.,.-LslX__£ltao)L^__.|(^'5)S-/t./r.S'y&.O.J_ _. __^G.»O>.\<A^T< -.„... _JjSi^AcJ2i6,Y-^r_J Site Address or CSM ;md Lol S: a NewConstrucliun Use: OS Residenlial/Numberorbedrooms D Replacement D Public or commercial - Describe: Parent material '10-^ hiiHdoAV^ General comments and recommendations: Code derived design flow rate GOOGPD Flood Plan elevation if applicable^_ft, \ , Boring,?Q Boring }it Ground surface elev. ^(a.OQft.Depth to limiiing factor^ \{ftm. t ctev. S>.m ft. Horizon -1- ..^- _3- J{ — Depth In. 0-(. _ J^l^ l&-4t H^L<,&. Soil Applicalion Rate GPD/R? •Effffl Reclox Description Qu. A.;. Cont. Color 1— SO .J !£& j.&jc-io.&Ll ^ j Borina#QBoringlapii Ground surface elov.^l11^>of(.Dspth to iimiting factor *-\'*'t* in. / etev. ?3.23(l. Horizon ^1 3 ^L Depth In. ^'^_ ^-e.- _yii51_-. -5i-.t39.- Dominant Color i Munsell |_|6?J/3- jsS'i&f/'i-. _7-5W^/'<- Tb-y/^/f _l4<i.cU,%nA-?. CST Namo (Pleaso Print) Tr&.-^Ia 6o*-t<cAtf ^ „_- AddresstifWUtJ S^\< R^Tf f-hfWHf£,WWf) r^^^r/£-r-=-:^-_-- Soil Application Rate GPD/Ft:- •Efffil ._.A..T_J ..-A^7-_.| -_<=>.-»- •Ef?2 JLS-C— _L.C,._- -J^C- J_< <<tf&a'7*} Telephone Number •7t3-i.ZV-Sl'7G • Efflucnl ^1 = BOD > 30 5 220 nig/L and TSS > 30 < 150 my/L • Efflucnl ti2 = BOD. < 30 mq/L and TSS 5 30mg/Lp^ ASO.^ Lf<Hll2SRS.H - SBD.8330(R03/22) R-OOZI^ Wisconsin Department of Safety & Professional Services Division of Industry Services SOIL EVALUATION REPORT Page__of_ ^3tsgsS^ ln accordance with SPS 385, \N^ Ac Attach complete site plan on paper not less than 81/2x11 inches in size. Plan mLJ^/incftiyef but not limited to vertical and horizontal reference point (BM), direction and percent^ ope, scale or dimensions, north arrow, and location and distance to nearest road. !1 HAR 1 8 Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s.-lS^b'^H^fei^. Z Parcel I Bc^cl^ 2826o^-2>-«/3-0^.0^3 oT-U&3-3'(fto^ Reviewed by Date Property Owner .S^Me^ "V 4- ^^<ne A CfeCi^- Property Location Govt. Lot 3 1/4 K % S 0^ T ^3 N R &(j, E(or)W Property Owner's Mailing Address ^S-\LO S^fl.rS^ T>. Site Address or CSM and Lot #: Li^ 4 c.&Mtt\<\03 M.l\^.i^r?> City, State, Zip r-<j^, LJ-L s^g^\ Phone Number ( T/'S) S-W-S'7&0 D City D Village '0 Town T'^G.WkCjK&.yM-t V5-J(.0Nearest Road j&r P>d.Y Pr New Construction Use: D9 Residential/Numberofbedrooms D Replacement D Public or commercial - Describe: Parent material Aa.<v^ /siit-i-aA&Vk General comments and recommendations: Code derived desiflnflow rate C 00 GPD Flood Plan elevation if applicable_ft. Boring #D Boring KPit Ground surface elev. ^(a.bOft.Depth to limiting factorS: \ln0 in. / elev. S^l ft. Horizon _L A- _3_ _y_ Depth In. 0-t. <•-!& ia-m H8-ILIS Dominant Color Munsell lisva3/^ 7.S^RI<A( 7.SW'/S •y.stR5"/^ t-\of>-i2.en& Redox Description Qu. Az. Cont. Color * V CLf-e. S)troA\£ Texture _LS_ _s_ _A_ S<^ LLlJ Structure Gr.Sz. Sh. <y _St- _^_ _^_ P.E. 1ft&t»3& Consistence mui _caJ_ _nA_ m) •ic^S Boundary A JS^- Roots ^u A_-1L _IL Soil Application Rate GPD/Ft2 *Eff#1 C>.-7 0.-7 0.-7 0.'? *Eff#2 l.(o I.C l.G 1.^ Boring #QBoring EPit Ground surface eIev.^OOft. Depth to limiting factor^-l'^l< in. / elev. 7^.83ft. Horizon J. A-3 _<L Depth In. O-lo G'f< \<{- S\ S1.J34 Dominant Color Munsell )(>W3f3 -tKt^/t 7.SW ^/f 1.SWyfH ^ln*-: t.o^.4 Redox Description Qu. Az. Cont. Color • ^ e.re _9 *T-t-t-l C ^~7^ Texture 4s- A- _5_ tA ^1 Structure , Gr.Sz. Sh. _^_ <33 J@L (D A tn C)l3S ; ^_~ff —: Consistence /Ad^T _•**]_ rt.1 ml :>•-> <, Boundary _t0 Roots ->^(. \(^ _LL Soil Application Rate GPD/Ft2 *EfW1 0.7 o.'~l D.~t e.l *Eff#2 ». (, t. C. \.c. 1. ^ CST Name (Please Print) Trc^iis Qo<-l«*^<' /</ Signati CST Number <..y5>a'7<? Address l^LUf Sf-e^C St6<^ ^7 1-hyuMf^ burf/B^ Date Evaluation Conducted Telephone Number lis-f.zf-sn^ Effluent#1 = BOD > 30 < 220 mg/L and TSS > 30 < 150 mg/L Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L SBD-8330 (R03/22) Boring # D Boring[pit Ground surface elev.^3.Deplj StirMofl^jn.l '^ MAR 182025 IJj Page ^ of ilev.^O^t. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr.Sz. Sh.consisterB§yf|eMTon|n^lg%.GPD/Ft2 *Eff#1 *Eff#2 0-G voigA/a _Ls,jsa_ja&ji-r 4^^6/L Cl-~l l.L (*-5o 7.5W^4—JL -ft J&&-»I. (. SO'SCt -r.swiM ^«<v\-^_l£-Q.-l >.Q> 10-S-O 7.ml1/M _£^_<wA HAL 1^o.s 1.0 SO-114 T.SYAS/,,C6 a. 1 1. Co Wo<>novk S;s S'^r^'.Ct^A htl AOVtJt- (A >ft C I U Js ;0r»4 Boring #D Boring D Pit Ground surface elev._ft.Depth to limiting factor_.in. / elev._ft. Horizon Depth In. Dominant Color Munsell ViuA +fc .AC. r^/'Avvwv^*^ Redox Description Qu. Az. Cent. Color u&iOn.S 0. O.T L<A Texture <t.C> Structure Gr.Sz. Sh. \ ICI-^ !»c Consistence d/ft.^ r<».+e Boundary A^_ Roots Soil Application Rate GPD/Ft2 *Eff#1 *EfW2 Boring #D Boring D Pit Ground surface elev.ft.Depth to limiting factor_Jn. / elev._ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cent. Color Texture Structure Gr.Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 S 150 mg/L * Effluent #2 = BOD, < 30 mg/L and TSS <. 30 mg/L SCALE = 1:40 -fc.-1 0 10 25 40 50 60 45160 Sugar Bay DrP/0 Govt Lot 3 Sec.02, T43N, R06W Town of Namakagon Bayfield County aax ID:37085 Property Owners: Steven J & Jolene A Cooley BM = Top of Concrete Foundation ELEVATIONS BM= 100.00 ft B1 = 96.00ft B2 = 94.00ft B3 = 92.50ft Page 3 of 4 SOIL PROFILE SHEET OWNER: S+c<t«n T <- J~o)e^e A ^o&^ey SOIL TESTER: Tr-^.-A )Sa 4-fer/^/<^ SYSTEM ELEVATION: __ LOAD RATE: 0, S/\, Q SYSTEM RANGE: 2>(j> _• 0 Q^to,_ fO ^S',0 9(.^.00 C)S w CYt-LOO 55.%T jDFnmn | 1- MAR 1 8 2025 ![Jj -Ksynelcj Co. Zoning Dec;, <^ so cio,s0 &C..OO 5?.o0 Page Lf of ^ Real Estate Bayfield County Property Listing Today's DAte: 1/22/2025 Property Status: Current Created On: 5/20/2015 9:19:44 AM 1^1 Description Updated: 1/23/2023 Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar; ESN: 37085 04-034-2-43-06-02-3 05-003-34000 (034) TOWN OF NAMAKAGON S02 T43N R06W LOT 4 CSM #1903 IN V.ll P.173(LOCATED IN GOVT LOTS 3 & 4) IN DOC2019R-577610 3.350 3.350 1 Yes 123 Updated: 5/20/2015 STATE COUNT/ TOWN OF NAMAKAGON SCHL-DRUMMOND TECHNICAL COLLEGE Ownership STEVEN 3 & JOLENE A COOLEY Updated: 1/23/2023 CABLE WI Billing Address: Mailing Addr^: |^ j^ ^ STEVENJ&30LENE A COOLEY STEVEN J & jilSAer^ A 45160 SUGAR BAY DR COOLEY || ij ,^r..,nr,^r 11 ;JCABLE WI 54821 45160 SUGAR 8AV DA'tA^ ', 0 WL"' ^ CABLE WI 54821 ^aytieJd Co, ZQnins DeDt!»•___ ^ . "'"" -"—•••••c'---- Site Address * indicates Private Road 45160 SUGAR BAY DR Property Assessment 2025 Assessment Detail Code Acres Gl-RESIDENTIAL 3.350 2-Year Comparison 2024 Land: 75,000 Improved: 315,200 Total: 390,200 CABLE 54821 Updated: 3/25/2022 Land 75,000 2025 75,000 315,200 390,200 Imp. 315,200 Change 0.0% 0.0% 0.0% ;*' Recorded Documents B WARRANTY DEED Date Recorded: 5/30/2019 E3 CERTIFIED SURVEY MAP Date Recorded: 1/28/2015 Updated: 5/20/2015 2019R-577610 2015R-557557 11-173 Property History Parent Properties 04-034-2-43-06-02-3 05-003-30000 04-034-2-43-06-02-3 05-004-20000 04-034-2-43-06-02-3 05-004-10000 HISTORY B Expand All History White=Current Parcels Pink=Retired Parcels B Tax ID: 24329 Pin: 04-034-2-43-06-02-3 05-004-10000 Lea. Pin: 034104102000 Q Tax ID: 24328 Pin: 04-034-2-43-06-02-3 05-004-20000 Lea. Pin: 034104101000 S3 Tax ID: 24317 Pin: 04-034-2-43-06-02-3 05-003-30000 Lea. Pin: 034104006000 37085 This Parcel 'T' Parents -^ Children Tax ID 24317 24329 BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS i!l i s EI if i? ;niSubmit the Following (Use Permanent Ink): jpl ' J |||| !j!s MAR i a ^ 1^ Ef Check List •3.^,^., _,l)ayte!d Co. Zo/^a .^.7 •D Incte^-)2age-mi£^ecL (OpLiuiidl) ' —-.^.,,y,,,_ Soil Evaluation Report (Submitted in Deed Holders Name - not prospective buyers) riqinal Plot Plan 'Cross Section Soil Profile Sheet (optional) D Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Reeort: (Include the following Information) 'arcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used. Property Owner's Information (not prospective buyer's name) Location (Accurate Legal Description with Sec/Twp/Range) Q/^ead Name (where driveway is/will be coming off of) cfjFtOSapIain ElevaEi^n, Flow Rate, Comments and Recommendations Complete Soil Boring / Pit Information Date Soil Evaluation was conducted Name, Signature, Number, Address and Phone Number O^Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) LlyBench Mark (Description, Elevation and.Location) H Contour Lines (Example = 98.0796.0794.0') Property Location (Sec/Twp/Range/, Accurate Legal Description) 10/Borings (Locations and Elevations) ff percent and Direction of Land Slope 3 Well Location (Including Neighboring Wells, if applicable) Location of Wetland Areas, Floodplain and Navigable Waters 3, Driveways, and Structures (Location and Descriptions) -ocation of Property Lines D-BrtSting-SysteflrtOEafTon Address Number and Road Name Current Surface Elevation of Wetlands and Navigable Waters ", Owner and Property Information North Arrow Fee: H Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checklistforcsts PAGE 1 OF 4 In-Ground Gravity Plan Index & Cover Sheet Component Manual Design References: In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg1 of 4 Pg2of4 Pg3of4 Pg4of4 MAR '- b ^U?t'Index & Cover Sheet Plot Plan Dispersal Area Cross-Section & Plan View Management Plan Attachments:Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Cooley - Sugar Bay Dr Owner Name(s): Steven J & Jolene A Cooley Owner Address: 45160 Sugar Bay Dr.; Cable, Wl Phone: 715 -514 _5780 Zip:. 54821 Project Address: 45160 Sugar Bay Pr Govt.Lot: 3&4 1/4 of Township: Namakagon 1/4, Section °2 , T 43 N-R 06 County: Bayfield or W Project Parcel ID #: 04-034-2-43-06-02-3 05-003-34000 Designer Information Designer Name: Travis Butterfield _ Phone: 715 .634 _8176 Designer Address: 14346W State Road 77; Hayward, Wl zip: 54843 E-mail: office@butterfielddrilling.com This space reserved for approval stamp. License Number: Remarks: Revision to previous perpqi't Signature:Date: Original signature required on each submitted copy. PLOT PLAN SCALE =1:40 0?'-4-^ 0 10 •+ 25 ^40 50 60 ST = 1250gal prefab concrete septic tank made by Wieserr Concrete w/ BEST GF-IOEffluent Filter AA = Absorption Area consisting of three cells, spaced >3ft apart, containing a total of 60 Quick 4 Plus Chambers 5~ QLQ^m02<a> w 0QL 45160 Sugar Bay Dr P/0 Govt Lot 3 Sec.02, T43N, R06W Town of Namakagon Bayfield County Jax ID:37085 ^ 4" PVC Sch 40ASTM F891 Property Owners: Steven J & Jolene A Cooley BM = Top of Concrete Foundation ELEVATIONS BM= 100.00 ft B1 = 96.00ft B2 = 94.00ft B3 = 92.50ft Page 2 of 4 IN-GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down-sizing credit) I SOIL COVER Septic Tank(s) Manufacturer: Wieser Concrete Inc 1250 gal Septic Tank(s) Volume(s): gal — gal gal Effluent Filter Manufacturer:BEST FILTER Effluent Filter Model #: GF-1 0 12" min. trench depth(typical) 34"^x'z .4 •». (typical) TYPICAL TRENCHCROSS SECTION VIEW (No Scale) Quick4 Standard-W w/ End Cap (typical) System Elevation =86-75 ft (typical) (Show location of inlet / outlet pipe connection on plan view.) Provide minimum 3 ft separation between trenches. Observation Pipe(typical) Install per manufacturer's instructions. ~~//~ ~y/~ —<—m——in^—niH __^____--^--- TYPICAL TRENCH PLAN VIEW (No Scale) (typical) INSTALL PER TRENCH: 20 + Quick4 Std-W @ 20 ft EISA/chamber = 40° Pairs of end caps @ 6 ft2 EISA/pair = 6 ft2 ft2 A = 3.0ft (typical) -Quick4 Standard-W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. 3> , ;^:. 0:- c-~i n>0m co 0 = Proposed EISA per trench = 406 ft2 Required Infiltration Area = 1200 ft2 Distribution Method: trenches = Proposed Total EISA = 1218 ^ branched manifold PAGE 4 OF 4 In-ground Gravity Management Plan IMPORTANT: The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wise. Admin, Code. Pursuant to SPS 383.52 (2), Wise. 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), Wise. Admin. Code. Maximum Dispersal Area Operatinfl Limits: Design Flow = ^00 gpd; BODs ^ 220 mgL-1; TSS ^ 150 mgL-1; FOG^30mgL-1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system ;V|A; ;,,''!'"' o nuisance factors (/.e. odors, user complaints, etc.} o mechanical malfunction (/'.e., pumps, valves, switches, floats, etc.) o material fatigue (/'.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 (/.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (;'.e., pump re-cyding, float switch settings, etc.) o electrical components - if applicable (/'.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, Wise. 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 Wise. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Butterfield, Inc. _ p^ne: 715-634-8176 Local government unit: Bayfield County Planning & Zoning phone: 715-373-61 38 Local government unit address: 117 E 5th Street P.O. BOX 58 Washbum, Wl zip: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wise. 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, Wise. 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, Wise. Admin. Code. xn- y T=\ 1 c'.^s'c^':' ^5-»C.O .Sog^r B^ Or S^-Csrtvs 3- ^. Tol&Atf /^ 6sok EL£\if\^ )o^ ^3 Q(^ = 0.6' HI = ImVAi- = 1^5' Oo4le+= U. 75' SyAVc^ rS-7^ t4cc^cr ; \^1S I 00.00 C( IOd.5-0^ &^. 00 (^ Z^-7Sft 2l»-}S^ a-?. 75-^ BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS i Submit the Following (Use Permanent Ink) (Title 15, Section 15-l-10(e)) ivj^j:, ^ ^ ^j,.-, H" Check List B/6riginal 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)) )riginal Plot Plan (383.22(2)2. 3. & 4.a) :ross Section, Over-Head Profile of the System and Schematic of Tank from Manufacturer D Pump Tank Diagram, Alarm and Pump Curve (when apptieabte) [^Contingency Plan / Management Plan (383.22-3(2)(b)l.f.) D Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) D 4-totdmgTank Agreement (383.21(2)(c)(5) (ReeentelTSTReg. of Doods) D yolding Tank Sorvicc Controct (Original SigflataTH-of Pumper ffng~Property-Qume^-t383-?t^tc^5) D-ATU Servicing Agreement (Rocorded at Reg. of DQQdo) D Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) B^-Gemgiete-Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) [YSoil and Site Evaluation Report (383.22-3(2)(b)l.e.) D Stale Plan Review (when applicable) D Copy ofWarranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) Application Information must include: 3/23 diait Parcel ID# - fdo not use 12 digits anymore-obsolete) S'Project Address or Road Name where driveway is/will come off of) B^Owners Phone Number) II Type of Building Ill Type of Permit Type of POWTS System V Dispersal / Treatment Area Information Tank Information Efvil Responsibility Statement (Plumber's Information) * Date Stamp* Plot Plan: (To Scale or To Dimension) D Signature and Plumber Information 0' Address Number and Road a Surface Elevation of Body of Water 3 North Arrow ^Direction and Percent Land Slope sf Contour Lines @f Tank and Filter Information and Location E-T Structures and Driveways [^Wetlands / Navigable Bodies of Water @T Boring Locations Area (Proposed and Existing) Q/ Property Lines @f Bench Mark (Location, Elevation and Description) D/Well Locations Manual Version H Legal Descriptions St Piping Material Information (conveyance line, building sewer line, material type and diameter) Turn Over > Cross-Section and Over-Head Profile of the System: Ef Surface and System Elevation 'osition of Observation and Vent Pipes Dimensions and Depths Make, Model & Number of Chamber Units in each Cell Property Information How many systems will there be on this parcel of land? \ B^Has this property been split? Ves (Property Statement shows Property History) Fees: a Private Sewage System (Septic Tanks) $ 400.00 D Private Sewage System (Holding Tanks) $ 400.00 D Mounds or Systems requiring Pre-Treatment $ 500.00 ianitary Revisions_ $ 25.00 D Private Sewage System Reconnection $ 50.00 and Private Interceptor D Return Inspection $ 50.00 D Maintenance Agreements ^ $ 30.00 (checks made out to Reg of Deeds) u/forms/checklists/checklistforsanitaryapps(10/2009);(®7/2011);(®2/2012)(®5/2/2012-dc) Proofed by: 4/21/25, 10:50 AM Carmody™ BAYFIELD COUNTS SANITARY PERMIT r#04)-20-139S (REVISION) STATE SANITARY PERMIT OWNER: JOHN & PAULA WEBER TRUST DTD 12/19/2005 GOVTLOT: LOT: 4 BLK: CSM: 1903 1/4 1/4 SEC:2,T43N,R6W TOWNSHIP: Namakagon SOIL TEST: 13-25 NEW SYSTEM SYSTEM T^PE: Non-Pressurized In-Ground PLUMBER: TRAVIS BUTTERFIELD 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 #: 20-139S LICENSE: # 652879 CECE RUDNICKI Authorized Issuing Officer DATE: 4/17/2025 Condition: REVISED PLAN AND DEEPER SOIL VERIFICATION. THIS PERMIT EXPIRES 4/17/2027 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:::7452 1/2 , j?l Industry Services Division 1400 E Washington Ave P.O. Box 7162 Madison, WI 53707-7162 County ^ald Permit Nun»yr (to be filled in tSanitary Permit Numyr (to be filled in by Co.) <SO-1^ 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 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. _F^ R (P [?J ?1 "f/ fS f?^ Project Addjess (if different than mailing address) I. Application Information - Please Print All Information a ressw/w ^ffi Property Owner's Name —r— ^->. i » !r^.CA«^<SLO ^ do \er»e. Coo\e^ II 11 AUG 21 2020 Parcel# ' ^-^fl $-7C»9& Q<\ -O-^H •- SM3- &io-^ •2^ Property Location QO^ ^^^ Govt. Lot Property Owner's Mailing Address\^% C\*-J^ A\eS^ L{\ City, State 0-\\ODO(X. *^x Zip Code^T^& II. Type of Building (check all that apply) ?^1 or 2 Family Dwelling - Number of Bedrooms D Public/Commercial - Describe Use D State Owned - Describe Use Phone Number^^^i^-sr?^'/<,!/4, Section Lot # (circle one) T "-f J N; R/J(.0_EorW J_ Subdivision Name Block # CSM Number D City of _ D Village of iTown of li>^o>jc\Q^oqen III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A tem D Replacement System D Treatment/Holding Tank Replacement Only D Other Modification to Existing System (explain) B.D Permit Renewal Before Expiration D Permit Revision D Change of Plumber D Permit Transfer to New Owner List Previous Permit Number and Date Issued IV. Type ofPOWTS System/Component/Device: (Check all that apply) lon-Pressurized In-Ground D Pressurized In-Ground D At-Grade D Mound > 24 in. of suitable soil D Mound < 24 in. of suitable soil D Holding Tank D Other Dispersal Component (explain)_ D Pretreatment Device (explain)_ V. DispersaI/Treatment Area Information: Design Flow (gpd)^00 Design Soil Application Rate(gpdsf) .<T Dispersal Area Required (sf) CX.QO Dispersal Area Proposed (sf)l^t8 System Elevationno VI. Tank Info Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units Manufacturer js e^ §e o0; U iti 5 o ff3'£ 0 Septic or Holding Tank /^s~o ^SD l^l'€5^~>c Dosing Chamber VII. Responsibility Statement- I, the undersigned, assumejesponsibility for ijistallation of the POWTS shown on the attached plans. Plumber's Name (Print) ^w»^ ^^/</J Plumbej,»^8Tgnature MP/MPRS Number ^5-^<r?^ Business Phone Number w-^y-2?/o^ Plumber's Address (Street, City, State, Zip Code) ''IW(s ^ J^/te- ^ ^9 C^Urc^ . UJ~^ ^'/5't/3 -I-VIII. County/Department Use Only Approved D Disapproved D Owner Given Reason for Denial Permit Fee%^Date Issued ^-(97-^b ^. /^?7/? ^^^ IX. Conditions ofApproval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 81/2x11 inches in size SBD-6398 (R. 08/14) Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85. Wis. Mm. Code Page.of Attach complete site plan on paper not less than 81/2x11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1} (m)). County BAYFIELD Parcel 1.0. 04-034-2-43-06-02-3 05-003-34000 Date Property Owner STEVE.N H & JOLENE A, COOLEy Property Location Govt. Lot 3 1/4 1/4 S 2 T 43 N R 06 iTorf^' Property Owner's Mailing Address 168 CLUB VIEW LN Lot # 4 Blocf<#Subd. Name or CSM# CSM #1903 ;ity |~1 Village |^|Town -NAMA.KAGON City ALTOONA. State Wl Zip Code Phone Number 514-578054720 ) (715 ) Nearest Road SUGAR BAY DR j*j New Construction Use! • Replacement Parent material General comments and recommendations: Residential / Number of bedrooms Public or commercial - Describe: Code derived design flow rate Flood Plain elevation if applicable SYSTEM ELEVATION 99.0' SIZED AT 0,5 600 GPD ft. 1 Boring # Hon'zon 1 2 3 Depth in. 0-12 12-48 48-96 Boring U pit Ground surface elev. 1.01.50' Dominant Colorl Munsell 7.5YR 5/4 7.5YR 5/4 Redox Description Qu. Sz. Cent. Color DJSTURBED/FILL :, Depth to limiting factor >9 Texture LS s FS Structure Gr. Sz. Sh. OSG OM Consistency ML F in. Boundary AS Roots 3VF-F 0 0 Soil Application Rate GPD/ff *Eff»1 0 0.7 0.5 *Ef»2 0 1.6 1.0 2 Boring # Horizon 1 2 3 Depth in. 0-10 10-60 60-108 Boring Ll Pit Gro Dominant Cola Munsell 7.5YR 5/4 7.5YR 5/4 103.35- -id surface etev. Redox Description Qu. Sz. Cont. Color DFSTURBED/FILL Texture LS s FS >epth to limitiri! Structure Gr. Sz. Sh. OSG OM >]08"actor _ in. Consistence ML Boundan AS Roots 3VF-F 0 0 Soil Application Rate GPD/ff *EfW1 0 0.7 0.5 *Efi#2 0 1.6 1.0 * Effluent #1 = BOP, > 30 ^ 220 mg/L and TSS >30 ^ 150 mg/L * Effluent #2 = BOP, 5 30 mg/L and TSS 5 30 mg/L CST Name (Please Print) KEVIN MCKINNEY Signature CST Number 224234 Address : 130 LEONARD SCHOOL RD CABLE WI 54821 Date Evaluation Conducted 4/30/2Q20 Telephone Number 7)5-798-3494 Pg1 of 4 Pg2of4 Pg3of4 Pg 4 of 4 In-Ground Gravity Plan Index & Cover Sheet Component Manual Design References: Version 2.0, SBD-10705-P (N.01/01, R. 10/12) PAGE 1 OF 4 tn'i^ K ft3 '•' ;l INI AUG21Z02C Index & Cover Sheet :iy ^; Plot Plan Dispersal Area Cross-Section & Plan View Management Plan Attachments:Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Cooley - Sugar Bay Dr Owner Name(s): Steven & Jolene Cooley Owner Address: 168 Club View Ln, Altoona, WI Phone: 715 .514 -5780 Zip:. 54720 Project Address: 45160 Sugar Bay Pr, Cable, WI 54821 Govt. Lot: 3 1/4 of Township: Namakagon 1/4, Section2 , T43 N-R06 E County: Bayfield or W 3 Project Parcel ID #: 04-034-2-43-06-02-305-003-34000 T^ 37^^^ Designer Information Designer Name: Travis Butterfield _ Phone: 715 _634 _8176 Designer Address: 14346 W State Rd 77, Hayward, Wl zip: 54843 E-mail: office@butterfielddrilling.com This space reserved'for approval starry. License Number: 652879 Remarks: Signature:b'ateF8/20/2020 jinal signature required on each submitted copy. Property line ) TOP OF GRADE 108.20' STEVE .& JOLENE COOLEY 16.8 CLUB VffiVLN ALTOONA, WI 54720 715-5 J 4-5780 PIN 04034243060230500334060 LOT NCSM ^19.03 S02T43NR06W TOWN OF NAMAKAGON BM TOP OF TWO INCH WOODEN STAKE RECOMMENDED SYSTEM ELEVATION 99.0' SIZED AT (L$ f 2.5^> i^iif^r Ce>^^-e 'fan/ ^ Gi^^ t ^'uk/s ^t- frl-kr 'Tr^rh ^ m^ ^w?r ^ ^"PY IN-GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down-sizing credit) -U-i-^ SOIL COVER 12" min. trench depth(typical) I— min. 12" (typical) Septic Tank(s) Manufacturer: Wieser Concrete Inc 1250 Septic Tank(s) Volume(s): gal _ gal gal Best Filter Effluent Filter Manufacturer: Effluent Filter Model #: GF1 0-8 -'.. -^ 34"--—^—-1 ., •• •• '(typical) TYPICAL TRENCHCROSS SECTION VIEW (No Scale) Quick4 Standard-W w/ End Cap (typical) System Elevation =99-00 ft (typical) (Show location of inlet / outlet pipe connection on plan view.) Provide minimum 3 ft separation between trenches. iit Observation Pipe(typical) Install per manufacturer's Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) (typical) INSTALL PER TRENCH: 20 + 1 Quick4 Std-W @ 20 ff EISA/chamber = 40° Pairs of end caps @ 6 ft2 EISA/pair = ^. ft2 ft2 A = 3.0ft (typical) -Quick4 Standard-W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. -a>Qm 00 0Tl -^ = Proposed EISA per trench = x ft2 Required Infiltration Area = 120° ft2 trenches = Proposed Total EISA = 1218 ft2 Distribution Method: branched manifold ^t^ ^Q? PAGE 4 OF 4 In-ground Gravity Management Plan IMPORTANT: The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. 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), Wise. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 60° gpd; BODs ^ 220 mgL-1; TSS ^150 mgL-1; FOG ^ 30 mgL-1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (/.e. odors, user complaints, eto.) o mechanical malfunction (/.e., pumps, valves, switches, floats, etc.} o material fatigue (/.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 (/'.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (/'.e., pump re-cycling, float switch settings, etc.) o electrical components - if applicable (;.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 affluent 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 sen/icing 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, Wise. 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 Wise. Admin. Code. Report any component failure or malfunction to: Name of individual or company: TrSVJS Butterfield _ p^ne: 715-634-8176 Local government unit Sawyer County Zoning & Conservation phone: 71 5-634-8288 Local government unit address: 10610 Main St, Suite 49, Hayward, Wl ZIP: 54843 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wise. 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, Wise. Admin. Code. Contincjency 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, Wise. Admin. Code. * 2 0 2 0 R ---5-838"5"3 Private Sewage System Maintenance Agreement Owners) Name <^-i.^^rL T n^\A J^(A^<- A. Coot^k/ Owners) MaBlnfl Address L^ 8 ^-1.^ \/^A^ L<ro'u.--. Ai-^oo^^. (Mi 54-T 2-0 Site Address •t-{'5\ <o0 /)uqo-^' 6'oLy D^^<z-, ^lc^U^, W/ 5'^62 Tax(D# ^os^r As owner. I (we) do hwaby cwtify Iha private sewaga system wiH be installed in accordance with the certified soil tester's report and approved plans and speclficaUonson flla with BayfieU County Planning and Zoning Dapartmant. T\w syatem win be operated In «uch a mannaraa to mmtUw designed (rians. I (we) agrw to maintain said private ayatem al Ihe batow toted location In acconlanca with nrfas estabtehed In <he Wl Adm. Code. as (rom time to lime amended. (COMPLETE Legal to roqutrad) .1/4 of_1/4 Section 2- Townshto 4.3 N. Range (n W. Additional Legal Description: Town of KlAiYi<xh<a.^oO (Acrenga) _ GovlLot. Lot _ Block SubdMskm. Lot ±L C8M # 1£T<33 Vol. 11 Page H3 CSM Doc H _^i^R_££2^' 2020R-583853 DENISE TARASEWICZBAYFIELD COUNTY, WIREGISTER OF DEEDS08/24/2020 11:45AMTF EXEMPT #: RECORDING FEE: 30.00 PAGES: 1 Recording Area Return To: Planning and Zoning Department 7 In-ground gravity D Mound D In-ground dosed D In-ground pressure distributton Sewage System: a At-grade Sewage System 0 Other. Seotic Tank (sytam types A through E): Tha septlc tank shall be pumped by a cartifled teptage servicing operator within three (3) years of the date of InatafiaUon and at toaat onca every three (3) years theraafter unlesa. upon Inspecdon by a llcemed master plumber or other penon authorized to makeBuch Inspection, the tank Is found to hava lasa than ono-thfrd (1/3) of the voluma oocuptod by aludgc and scum. Pump Chombftf (syatem types B. C. D, and E]: The pump chamber shall also ba rinsed and pumped out when the saptte tank to serviced as provided above. The swltchaa and pump controls aball also be Inspected and maintained to ensum operablBty of said components. Seotte Tank Effluent Fitter (system types A through E): The seplte tank effluant flttor shall be Inspected end malntalnad as nece-ary and In accortance with manufacturer's spedflcaUons. Filter maintenance reports shall be submWed to the County as required by SPS 383.55. Wte. Admln. Coda. Prfvale SBwaae Svatam DisBenal^Cga.ftytem types A Uuwgh E): The private sewage system dtetributfon cefl shall ba vteuany Iropactod by a certined aeptage awvldog operator, POWTS inspector, or llcansed master phmiber wflhin threa (3) yearn of Uw date of InslstoUon and at toast once avery three(3) years Ihereaflar to datermlna whether waatewaler or effluenl from the system to ponding on the eround surface. Mounds. AKirade. and In-around Praaaure Svatem Latarate (system types C. D and E): The laterate shall be Rushed out and swabbed i( needed whenthe wattewater dfetribudon cell component Is Inspected as provided above. OWIM{S} aym (hat failure to comply with this agiwnwnt will result hi action being taken to pay aH chargea and costs Ifiwrmd by BayHaM County for InsfMctton. pwnpfrig,. liauSng, or ottmwlss swvidng and roa/nte/n/ng ff» prtato satwige aystafli (an* In such a maruw as to prvwnt or atwteany human fisatth hazard caused by Ow syslwn. BoySaV County shsB noWy U» owner of any costs which shaB be paid by lh» owtwr\from tha date ofnoHca. lnth»ev»nlltMownwdo9smtpwl^cMtawtthlnlMty(30)days,thaownwspacMca»yogiMslhotalll may bo placed onthe lax mtt as a spaclal oswssmenl for the abolamanl of a human heetth hewrd, and ttw lax shatl'tm collected ff, ^30^ £M ss^\NOTARY V ^)*)/ «' Owrw(s) Named) - Please Print Notartzed Ownwfa) \oi '{-^\.i— /+. C. oo Ls_\^ Subscribed and \7 -1' NotaiyTPui iefbre moon this date: ^/\i,^A\';w\t^--' ^XTONota^PubHc -r^/f. /^ /(.ff^c/ef^_.^My Con)mla^lon Expires;2^/Z^ZL f>^/'^//Go^ ^A'lr ~Ylr —— -^ Drafted by:Date: ^>^ Proofed by: ullamwlKuMuyttttfSamlnlw<o»»givw»WtRmtMdJun«2»18 BAYFIELD COUNTY SANITARY PERMIT (#04)-20-139S STATE SANITARY PERMIT OWNER: STEVEN & JOLENE COOLEY GOVtSLOT: LOT: BLK: CSM: SUBDIVISION: Csm #1903 1/4 1/4 SEC:2,T43N,R6W TOWNSHIP: Namakagon SOIL TEST: 36-20 & 71-20 NEW SYSTEM 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 #: SYSTEM TYPE: Non-Pressurized In-Ground PLUMBER: TRAVIS BUTTERFIELD LICENSE: # 652879 TRACY POOLER DATE: 8/27/2020 Authorized Issuing Officer Condition: THIS PERMIT EXPIRES 8/27/2022POST IN PLAIN VIEW MUST BE VISIBLE FROM ROAD FRONTING THE LOT DURING CONSTRUCTION