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Home My WebLink About25-0107C5-oo1102 BAYFIELD COUNTY SANITARY PERMIT APPLICATION Zoning District Lakes Class I. APPLICATION INFORMATION Soil Test County — �Q� (Please Print All Information) No: -��, Permit No: Property Owner's Name: lA1 County: Bayfleld p (�v\ Address of Property: R8 O TUC (fie !' Gl �A �S Sri$(ti Property Location: % %, S 3G T 5 N, R O y E (ore Property Owners Mailing Address: Township: 1, Gov. Lot #: x City, State I Z Code Phone Number Lot # Block #: CSM #: CSM Doc # Subdivision Name » s�ia ly - &- t y II. TYPE OF BUILDING: (Check One) Tax ID#: 3 O� State Owned ❑ Public (Explain the use/purpose1 1 or 2 Family Dwelling - No. of Bedrooms ill. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) ❑x New ❑ Replacement ❑ County Private Interceptor IJSI Reconnection ❑ Repair ❑ Revision "" ❑ Transfer of Owner (List Previous Owner below) B) A Sanitary Permit was previously Issued. Previous Permit Number.? t -"' Date Issued: ' I I' 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: Rate 6. System 7. Final Grade 1. Gallons I 2. Absorp. Area I 3. Absorp. Area I 4. Loading Ratek Per Day I Required (Sq.Ft.) Proposed (Sq. Ft.) (Gals. / Day! Sq.Fnch) Elev.(Feet) Elev. (Feet) 96-a' 00 I ov0 I jaw I I I VI. INFORMATION: Ca In Gallons Total Gallons # of Tanks Manufacturer'sSite Name nstructed Steel Fiber glass Plastic Exper. App. New I Existing Tanks I Tanks Septic Tank or �aGO 1aGG `4 ion. , Holdin Tank Lift Pump Tank f gl7G �gco t • X Siphon Chamber n t 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) ffappiying forSectfon C above I Owner's Signature(s): (No Stamps) John Welch Plumber's Na e: (Print) a plying (or Section A ore) above `� �� sck MP/MPRSW No: \ 2SO ch Plumber's Address: (Street, City State, Zip Code) Home Phone: Business Phone: -715 -�5a c s �. rsis Vlll. COUNTY DEPAR EN USE ONLY Disapproved Sanitary Pemlit/Transfer Fee: Date Issued: Issuing Agent's Signature / Date: }!7. Approved ❑ Owner Given Initial .f,(;�'`_- � - < �(. ( `.. , ,. Adverse Determination IX. CONDITIONS OF APPROVAL I REASONS FOR DISAPPROVAL: )(Lt) !_:� .4 i(.• �LZ �YIA �1,� IV"tC.l � l L� ciYt%v c t 55 3 C. , 3CJ (U) \:. I Pint Plan nn raVe'sa cola John & Dana Welch Septic System Plot Plan Scale: 1"=40' Lot Line 330 gallon pump tank L O T L I N E D R I V E W A Y 2° sch 40 pvc forcemain Cleanout Well To Turner Road Page 2of2 BAYFIELD COUNTY �I(�?\/\J� Zoning District �,I L MAR 0 4 '20t A TARP PERMIT APPLICATION Lakes Class I. INFORMATION C APPLICATION Soil Test 'County�g7,, da — I I (Please Print Al! Information) No ermiNo: Property 1Owners Name: 11 11 *jO d' t C \C\ Wa\Cv' County: Bayfleld Address of Property: R& TUC Property Location: '% 1/.S3, T S I N, R t7 �/ E (oreV a,80 (fie {` F tOa t 1 Property Owner's Mailing Address: Township: Rvas11 Gov. Lot #: I Po `x 1x13 City, State ' 1� ip.C y Phone Number Lot # Block #: CSM #: CSM Doc # Subdivision Name l end H a\1'& II. TYPE OF BUILDING: (Check One) ❑ State Owned Tax ID#: ❑ Public (Explain the use/purpose J� Q 1 or 2 Family Dwelling - No. of Bedrooms ill. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) ❑f New ❑ Replacement ❑ County Private Interceptor tXl Reconnection ❑ Repair ❑ Revision ❑ Transfer of Owner (List Previous Owner below) % B) ❑ A Sanitary Permit was previously issued. Previous Permit Number Date Issued: IV. TYPE OF NON -PLUMBING SYSTEM: (Check One) ' Replacements need previous permit number and date filled out above C) O 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 4. Loading Rate 5. Perc. Rate 6. System 7. Final Grade Per Day Required (Sq.Ft.) Proposed (Sq. Ft.) (Gals. ! Day! Sq.Ft.) (Min. Inch) Elev.(Feet) Elev. (Feet) o I i000 /O0o i 0.6 I I �6 a' VI. TANK NFORMATION: Capadty In al Gallons Total Gallons # of Tanks Manufeoturer's Name Prefab. Concrete Site Constructed Steel Fiber glass Plastic Exper' App' New I Existing Tanks j Tanks SiTanit \300 1a0O (on Y Holding Tank Lilt Pump Tank / Ioo 8G0 X Siphon Chamber ' rC: ' 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) itapp!jdng for Section C above Owners Signature("): (No Stamps) John Welch Plumper" Na (Print) If lying forSeWon A or e) above I Plum na �JoS)), MP/MPRSWNo: ch sc\1_8543 Plumber's Address: (Street, City State, Zip Code) Home Phone: Business Phone: 1 C s b�tr\ =s�la GIs- 15a VIII. COUNTY I DEPARTMENT USE ONLY Disapproved I Sanitary Permit/Transfer Fee: I Date Issued: I Issuing Agents Signature / Date: ❑ Approved ❑ Owner Given Initial Adverse Determination IX. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: Plot Plan on reverse side MAR 041025 0 Bayfield Co. Zoning Dept. John & Dana Welch Septic System Plot Plan Scale: 1" = 40' Lot Line At Grade 330 gallon pump tank Cabin L O T L 2" sch 40 forcemain N E 2" sch 40 pvc forcemain 3 Bedroom House 4" pvc sch 40 / Cleanout D R I o�\ V \ Well E W A To Turner Road Y Page 2 of 2 County �' IX � Industry Services Division Wiled 10. " is. 1400 E Washington AveSanitary Co.) Permit Number to be filled in Co.) ( by ,...r I '� P.O. Box 7182 Madison, WI 53707-7162 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 stateowned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary Turner Rd Bayfield purposes in accordance with the PrivaLaw. s. 15.04(0(m).Stats. I. Application Information — Please Print All Information Property Owner's Name Parcel 0 John WeiciJAgttmes ORIGINAL 37306 Property Owner's Mailing Address Property Location PO Box 1042 Govt Lot NW' R, SW'/., Section 36 rcle one) City, State I Zip Code Phone Number Marshfield, WI 54449 612-208-7494 T51N R4Eo& II. Type of Building (check all that apply) LotB ® I or 2 Family Dwelling — Number of Bedrooms Subdivision Name ❑ Public/Commercial — Describe Use Block # 0 City of ❑ State Owned — Describe Usc 0 Village of CSM Number an "' a ® Town of Russell Ill. Type of Permit (Check only one box on line A. Complete line B If applicable) A. I ® New System ❑ Replacement System I ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) ❑ Permit Renewal ❑ Permit Revision ❑ Change of I 0 Permit Transfer to New List Previous Permit Number and Date Issued B. Before Expiration Plumber Owner I IV. Type of POWTS System/Component/Device: (Check all that apply) ❑ Non -Pressurized In -Ground ❑ Pressurized In -Ground ® At -Grade ❑ Mound? 24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ Holding Tank 0 Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application I Dispersal Area Required (s0 I Dispersal Area Proposed (s0 Elevation 600 Rate(gpdsf) 1000 I1000 j,1em 962 .6 VI, Tank Info Capacity in 2k Gallons Total f! of Manufacturer V — a is NewTanks Existing Tanks Gallons Units a.o in ., y i+. tJ a Septic or Holding Tank x 1200 I Weiser Concrete Dosing Chamber x I 800 I Weiser concrete VD. Responsibility Statement— I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P tab is Signatu - MPIMPRS Number Business Phone Number Edward B. Redinger 221939 715-278-3456 Plumber's Address (Stmt, City, State, Zip Code) 1015 I Iw Ave East Ashland, WI 54806 VIII. County/Department Use Only WAppmved I ❑ Disapproved Permit h^ Date Issued Issuing Agent Signature ;,1- - 73 OwnerGiven Reason for Denial s 5s-tJ 7 IX. Conditions of Approval/Reasons for Disapproval s-4tk� t' ,-a7ruts p,tpjn-�cI pros' {Ylt • nin., .. sys(- I n...crJa-J Alras.«U.w'{- Attach to complete plans for the system and submit to the County only on paper not less than 812 x II Inches In sire SBD-6398 (R03/14) SUPERIOR PLUMBING MECHANICAL (715) 278-34S6 CST# 221939 Scale: 1" = 40' PIN; 37306 IIFB Acers '/,'J$ NW SW 536 TS1N R41 Town of Russell Bayfield Co. C5/'J i 9/23 dA cf Customer Name: John Welch/Nichevo Ferry Lines Adress: PO Box 1042 Marshfield, WI 54449 Site: Turner Rd Bayfield, WI FEB 022022 Bayfeld Co. Planning er.C Zoning Agencj Phone U; 612-208-7494 Email: NO WELL ON SITE RECEIVED /3S ( &,liI-6-n.de 457' /',Oo/4eo (,Je.-s.r'C-wk a" scL. yo 4zc rtaJ„ Sh%3/1S«.. r Town, City, Village, State or Federal Permits May Also Be Required LAND USE - SANITARY — Reconnection 22-11S SIGN - SPECIAL - CONDITIONAL - BOA - BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 25-0107 Tax ID# 37306 Issued To: WELCH, JOHN B & DANA M Location: NW '/4 of SW '/4 Section 36 Township 51 N. Range 4 W. Town of Russell in Doc # 2021 R-589065 Lot 4 CSM# 2172 Structure in a R-1 Zoning District For: Sanitation Permit Reconnect of Permit 22-11S (Disclaimer): Any future expansions or development would require additional permitting. Condition(s): To meet all setbacks. To be constructed per plan. Exterior sump shall meet requirements of SPS 382.30(10)(d). 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 CeCe Rudnicki work or land use has not begun. Authorized Issuing Official 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. 3 /5/25 This permit may be void or revoked if any performance conditions are not Date completed or if any prohibitory conditions are violated. S-'-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: Description Private Sewage System Reconnection Payment Amount: Submission Number. CS -00102 Transaction Number: CS -00102-2A526 Reference: 9023 Paid by: JOHN B WELCH, 88280 TURNER RD, BAYFIELD, WI 54814 Payment Type: Check Amount $50.00 $50.00 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit.