HomeMy WebLinkAbout25-0212�C nI I I I BAYFIELD COUNTY n E C II U zoning District —2
l/ V SANITARY PERMIT APPLIC/IJIV7iJIONPR 282025 jJ/kes Class
I. APPLICATION INFORMATION
Soil Test
County
(Please Print All Information)
No: Bavi
, 02
Permit No:
L
Property Owner's Name:
County: Bayfield
McKinney Revocable Trust
Address of Property:
Property Location:
45975 S. Lake Owen Drive
NE ' NE '/+. S 04 T 43 N, R 07 E (or) W
Property Owner's Mailing Address:
Township:
Gov. Lot #:
PO Box 358
Cable
City, State I
Zip Code
Phone Number
Lot#
I Block #: I
CSM #: I
CSM Doc# I
Subdivision Name
Cable, WI
54821
715-798-3645
11, TYPE OF BUILDING: (Check One)
❑ State Owned
Tax ID#:
❑ Public (Explain the use/purpose
8360
® 1 or 2 Family Dwelling - No. of Bedrooms 2
Ill. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) ❑ New ❑ Replacement ❑ County Private Interceptor
® Reconnection ❑ Repair ❑ Revision k ❑ Transfer of Owner (List Previous Owner below)
B) ❑X A Sanitary Permit was previously issued. Previous Permit Number _ ______ Dat Issued: 1998
IV. TYPE OF NON -PLUMBING SYSTEM: (Check One) * Replacements need previous permit number and date filled out above
C) ❑ Pit Privy ❑ Vault Privy (Vault size: gallons or _cubic yards)
❑ Portable Privy ❑ Camping Transfer Unit Container ❑ Composting Toilets ❑ Incinerating Toilet
V. ABSORPTION
SYSTEM INFORMATION:
1. Gallons
I 2. Absorp. Area
I 3. Absorp. Area
I 4. Loading Rate
I 5. Perc. Rate
I 6. System I
7. Final Grade
Per Day
Required (Sq.Ft.)
Proposed (Sq. Ft.)
I (Gals. / Day / Sq.Ft.)
I (Min. Inch)
I Elev.(Feet)
Elev. (Feet)
450
864
83.46
VI. TANK
Capacity
Fiber
INFORMATION:
In Gallons
Total
Gallons
# of
Tanks
Manufacturer's
Name
Prefab.
Concrete
Site
Constructed
Steel
-
glass
Plastic
Exper.
App.
New
Existing
Tanks
Tanks
Septic Tank or
Holding Tank
1000
1000
Rasmussen
X
Lift Pump Tank /
Siphon Chamber
VII. RESPONSIBILITY -STATEMENT:
I the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Owner's Name(s): (Print) if applying for SectionCabove
Owner's Signature(s): (No Stamps)
Plumber's Name: (Print) If applying for Section A or B) above I
P)4 S' not No Stamps)
MP/MPRSW No:
Doug Manthey
MP 230722
Plumber's Address: (Street, City State, Zip Code)
I Home Phone:
Business Phone:
PO Box 196 Drummond, WI 54832
I
715-739-686.8
VIII. COUNTY! DEPARTMENT USE ONLY
❑ Disapproved
I Sanitary Permit/Transfer Fee: I
Date Issued:
Iss ing Agent's ignatur / Date:/�
Approved
❑ Owner Given Initial
6f
���� 1%
Adverse Determination
IX. CONDITIONS OF APPROVAL I REASONS FOR DISAPPROVAL:
Plot Plan on reverse side
Lot Line Imo( IS C E [ V E
APR 2 8 ?&n
f ayfield Co. Zonin Dept.
IA
ra
�S
I
Name of Frontage Road ( J. i.Af Ke Ot,ie. Ut:Qc
1. Name the frontage road and use as a guideline, fill in the lot dimensions and indicate North (N)
2. Show the approximate location and size of the building.
IMPORTANT
DETAILED PLOT PLAN
3. Show the location of the well, septic tank and drain field.
IS NECESSARY, FOLLOW
STEPS 1-7 (a -o) COMPLETELY
4. Show the location of any lake, river, stream or pond if applicable.
5. Show the approximate location of other existing structures.
6. Show the approximate location of any wetlands or slopes over 20 percent.
7. Show dimensions in feet on the following:
a. Building to all lot lines i.
Privy to building
b Building to centerline of road j.
Privy to lake, river, stream or pond
c. Building to lake, river, stream or pond k.
Drain field to closest lot line
d. Septic / holding tank to closest lot line I.
Drain field to building
e. Septic/holding tank to building m.
Drain field to well
f. Septic / holding tank to well n.
Drain field to lake, river, stream or pond
g. Septic / holding tank to lake, river, stream or pond o.
Well to building
h. Privy to closest lot line
Submit To: Bayfield County Zoning Department, PO Box 58, Washburn, WI 54891
u/formslsanitarylbayfieldcountysanitaryapplication
Revise: June 2018 Proofed by: —
Tracy Pooler
From: Tracy Pooler
Sent: Tuesday, April 29, 2025 11:12 AM
To: Douglas Manthey (norpines@cheqnet.net)
Subject: McKinney - 45975 Lake Owen Drive
Doug,
I do not see the $50 septic reconnect fee associated with this permit request.
Tracy Pooler - AZA
Planning and Zoning Department
117 E 5th Street, PO Box 58
Washburn, WI 54891
Phone: 715-373-3512
Fax: 715-373-0114
Email: tracy. op oler@ba ieldcoun .wi.gov
]3 YFIELD Bayfield County
Planning & Zoning Department
117 E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-4010
Property Owner: Submission Number:
CS -00112
Transaction Number:
CS -00112-29E51
Description Amount
Private Sewage System Reconnection $50.00
Total: $50.00
Payment Amount: $50.00
Reference: 5246
Paid by: A -Z ENTERPRISES, INC., DBA NOR -PINES PLUMBING, PO BOX 196,
DRUMMOND, WI 54832
Payment Type: Check
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
Town, City, Village, State or Federal
Permits May Also Be Required
LAND USE -
SANITARY - Reconnect [298268]
SIGN -
SPECIAL -
CONDITIONAL -
BOA -
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 25-0212 Tax ID# 8360 Issued To: MCKINNEY REVOCABLE TRUST
Location: NE '/4 of NE'/4 Section 4 Township 43 N. Range 7 W. Town of Cable
in Doc # 2021 R-589267
Residential Structure in an R-2 Zoning District
For: Sanitary Reconnect to 1 1000 gallon Rasmussen Tank
(Disclaimer): Any future expansions or development would require additional permitting.
Condition(s): To meet all setbacks. To be constructed per plan.
You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or
modification of construction that violates the law or other penalties or costs. For more information, visit the department of natural resources wetlands identification web page or contact a department of natural resources service center (715) 685-2900.
NOTE: This permit expires two years from date of issuance if the authorized construction
work or land use has not begun.
Changes in plans or specifications shall not be made without obtaining approval.
This permit may be void or revoked if any of the application information is found
to have been misrepresented, erroneous, or incomplete.
This permit may be void or revoked if any performance conditions are not
completed or if any prohibitory conditions are violated.
Tracy Pooler, AZA
Authorized Issuing Official
Date