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Home My WebLink About25-0289CJ— vv I t BAYFIELD COUNTY Zoningoistrict F_.1 SANITARY PERMIT APPLICATION 5 takes Class 1. APPLICATION INFORMATION Soil Test I County fl (Please Print All Information) No: A Permit No: Lu _ Pro erty Owner's Name: 1 �LL County: Bayfield Address of Prope : Property Location: '3oco6 A1ctiuJ _ aC '/< 9E,v.sJ3 T1f4 N. R C 5 E (o Property Owners Mailing Address: Townshi Gov. Lot #: City , State1 _1 Zip Code ti iii Phone Number Lot # Block #: CSM #: CSM Doc # Subdivision Name Ol h V V t'J 30 .'j 20 i o I I IS 11. TYPE OF BUILDING: (Check One) ❑ State Owned vnmM t�,v✓t Tax ID#: Public (Explain the use/purpose t44'Apt-towVo` ) 1 '-kD MAY C 62025 1 or 2 Famil Dwelling - No. of Bedrooms 111. 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 '* ❑ 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) ❑ Pit Privy j. Vault Privy{2)(Vault size: 2Dotgallons or I cubic yards) ❑ Portable Privy ❑ Camping Transfer Unit Container ❑ Composting Toilets ❑ Incinerating Toilet V. ABSORPTION SYSTEM INFORMATION: N R 1. Gallons 2. Absorp. Area 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.) (Gals. / Day / Sq.Ft.) (Min. Inch) Elev.(Feet) Elev. (Feet) 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 %(T% ,, ,& �_ _so4 / 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 Section C above Owner's ig re(s. oStamps) flcctdcc Fi ' u'{ -r, crt ' Plumber's Name: (Print) ii applying for Section A or above Plumber gnature: (No to s) MP/MPRSW No: Plumber's Address: (Street, City State, Zip Code) Home Phone: Business Phone: VIII. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved I Sanitary Permit/Transfer Fee: Date Issued: I Issuing Agent's Sign ture I Date: Approved ❑ Owner Given Initial 5/j/ Adverse Determination �Z� 2 IX. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: ;A....�... - Plot Plan on reverse �1 \ t Yr- /a 1 _'f 1 -rte �,5n 1 side 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/fors/sanitary/bayfieldcountysanitaryapplication Revise: June 2018 Proofed by: hr vJ F;rc v4- A&4M be (W 8958'54" W) MAY G ' 2025 Li yfieldd Co. Zoning Dept. 6Nivtw A AeCc56 rJ v.l E 5 April 28.2025 State of Wisconsin Governor Tony Evers Department of Agriculture, Trade and Consumer Protection Secretary Randy Romanski II MAY 0 6 2025 Bayfield Co. Zoning Dept. Wedal Woods 30805 Wedal Road Washburn. WI 54891 Dear Ms. Gjertson: Environmental Health Technical Specialist Ted Tuchalski of the Wisconsin Department of Agriculture, Trade and Consumer Protection. Division of Food and Recreational Safely has reviewed the application for a variance pertaining to Wisconsin Administrative Code, Chapter ATCP 79 Campgrounds. The variance request affects the Wedal Woods campground located at 30805 Wedal Road in Washburn, Wisconsin. The variance request relates to the number of required toilets for dependent campsites within a campground. The variance request indicates that the campground consists of 4 dependent campsites with operator provided camping cabins that each have a capacity for 2 persons. The variance request is to provide 2 toilets. Wis. Admin. Code § ATCP 79.16 (3)(d)l. reads: (d) Uinimum number of toilets: dependent ccrmpsiles. 1. Except as provided under subd. 2.. an operator with dependent campsites shall provide the number of toilets specified in Table ATCP 79.16. If a campground has more than 100 dependent campsites, one additional toilet for each sex shall be provided for every additional 75 campsites or fraction thereof except that urinals may be substituted for up to 50% of the calculated number of toilets required for males. Table ATCP 79.16 requires 2 toilets for women and 2 toilets for men for 4 dependent campsites. Upon evaluation of the variance request, the Division of Food and Recreational Safety conditionally authorizes the variance for providing 2 toilets to serve 4 dependent campsites. The conditions are as follows: 1. No justified complaints are received regarding the toilets or their capacity. 2. The maximum campground occupancy shall be reduced to 8 persons. 3. The variance becomes null and void if the campground expands or modifies any campground attributes. Ricconcin -Americas Dairylund 2811 Agriculture Drive • PQ Box 8911 • Madison. WI 53708.8911 • Wisconsin.gov An equal opportunity employer Page I of 3 April 28.2025 1111 MAY 0 E 2025 Bayfield Co. Zoning Dept. A Sanitarian will evaluate the establishment periodically to ensure compliance with these requirements. A copy of this variance and the supporting documentation shall be made available to your inspector upon request. This authorization is in effect for five years and will expire on April 28, 2030 and is not transferable to any other campground, location, entity or licensee. Before the authorization (variance) expires, you must resubmit a variance and all supporting documentation which will be re-evaluated by our department. This authorization is subject to compliance with current and future Wisconsin laws and regulations. The specifics of this authorization will be verified during each future inspection and failure to meet the requirements as accepted may be cause [hr this authorization to be summarily suspended. If you have any questions on this authorization please contact Ted Tuchalski at 608-566-4217 or e-mail him at 'fhaddeus.Tuchalski(a� Wisconsin.gov. Sincerely, /t1GlLIML,t& ��2 d rlrJad.'2 Danielle Vollendorf: RS (�J Environmental Health Services Supervisor Division of Food and Recreational Safety Wisconsin Department of Agriculture. Trade and Consumer Protection Cell Phone (608)338-3282 Daniel]eM. Vollendorf(g)wi sconsin.gov Cc: Michelle Simone, Lead EH Sanitarian, Bayfield County Health Department, michelle.simone(a hayfieldcounty.wi.gov, Sarah Gjertson, licensee, sarah.gjertsongmail.eom Licensee ID: pending HEAD SPACE HQ. LLC Facility ID: pending Wedal Woods 30805 Wedal Road Washburn, WI 54891 Page 2 of 3 MAY 062025 Head Space HQ, LLC Tax ID #140 Bayfield Co. Zoning Dept. Sanitary Permit Application Addendum Please note this application is for two VAULT privvys on a parcel that has no well, septic, or drain field. As vault privvys, there will be no soil or water impacts of human waste. The vaults will be each be 200 gallons, and pumped by No. 2 Septic as needed. 1. Name the frontage road and use as a guideline, fill in the lot dimensions and indicate North (N). Please see the attached survey map for parcel dimensions (15 acres) with direction North indicated. 2. Show the approximate location and size of the building. There is no "building". Please see the attached survey map for the intended location of the two vault privvys. 3. Show the location of the well, septic tank and drain field. Please note there is no well, septic, or drain field on this parcel. 4. Show the location of any lake, river, stream or pond if applicable. Bono Creek is indicated on the survey map. The Northernmost point of the creek is over seven hundred feet from the intended location of the vault privvys. 5. Show the approximate location of other existing structures. There are two existing structures, both labeled "garage" on the attached survey map. 6. Show the approximate location of any wetlands or slopes over 20 percent. Per the Bayfield County GIS map system, there are no marked wetlands on the property. A topo showing the elevations/slopes (from the same GIS map system) has been attached. Both privvys will be located on flat ground hundreds of feet from slopes over 20 percent. 7. Show dimensions in feet on the following: a. Building to all lot lines Privy #1: N: 183' W: 190' S: 1116' E: 313' Privy#2: N: 160' W:362' S:1139' E: 140' b. Building to centerline of road Privy #1: 193' Privy#2: 170' c. Building to lake, river, stream or pond (to Northernmost tip of Bono Creek) Privy #1: 757' Privy#2: 780' d. Septic / holding tank to closest lot line N/A e. Septic/holding tank to building N/A f. Septic / holding tank to well N/A g. Septic / holding tank to Lake, river, stream or pond N/A h. Privy to closest lot Line Privy #1: closest lot Line is to the North, at 183' Privy #2: closest lot line is to the East, at 140' i. Privy to building Privy #1: closest building is smaller "garage" at 145' Privy #2: closest building is larger "garage" at 78' j. Privy to lake, river, stream or pond (to Northernmost tip of Bono Creek) Privy #1: 757' Privy#2: 780' k. Drain field to closest lot line N/A L. Drain field to building N/A m. Drain field to well N/A n. Drain field to lake, river, stream or pond N/A o. Well to building N/A CHU MAY 062025 Bayfield Co. Zoning Dept. From Bayfield County GIS Maps —showing terrain of the parcel, and approximate location of the two vault privvys shown in red. II II MAY O E ZOh LW _ 4 t 1< I I r HE --fl 5 FCCE If LLC 4 P 4" ' r FIBERGLASS PRIVY VAULT (Approximately 36" Square - 36" Deep) (Approximately 200 Gallons Approximately 120 pounds) *Rodent Resistant *No Rotting Gelcoated, Reinforced Fiberglass Floor (40" Square) and Toilet Stool with 4" Vent Permanently Bonded to Vault. Uses Standard Seat (not included) 1111 MAY 062025 ***** Can be hauled in pickup or trailer. Kittleson's Incorporated is a family owned business that has been providing custom fiberglass fabrication for over 45 years. We have experience with a wide range of fiberglass products including custom parts designed to your specifications as well as several of our own design. Contact OCAflOi 2401 27th Street Rice Lake, WI 54868 . COm AC! kittinc@hotmail.com (715) 234-4657 Co. Zoning Dept. PRIVY AGREEMENT (ATTACHED TO THE SANITARY PERMIT APPLICATION) DOCUMENT NUMBER Property Owner(s): 2025R-607 127 c4 6pcce 4-i L�� DANIEL J. HEFFNER MailI Address: IeAm PfjI7(6Y'cdress fl, y� REGISTER OF NTDEI S 5 V 3V erty es cV` 61J A BAYFIELD COUNTY, WI Legal Description: Section, Township, Range RECORDED 2 04/ t 0/2025 AT 2:45 PM 1/4, S 13 T 400 N, R O�•'7 W RECORDING FEE: $30.00 hct.nt 5 AtMs of 3t°tu 5 PAGES: t Gov't Lot Lot # CSM# Vol & Page CSM Doc. # Lot(s) # Block(s) # Subdivision Return To: ZONING Tax ID # Date: n E5 C r 0 #) Id t Lin n isS USIII 1. NO PLUMBING will be installed in the habitable building Bayfield Cho. Zuni a Dept. 2. NO PLUMBING includes: water closets, sinks, bathtubs or showers, laundry facilities, or any other I e or receptacle receiving domestic waste, will be installed in the premises served by the privy unless a code compliant soil absorption system or holding tank exists, or a valid sanitary permit to install such a system has been issued. 3. A privy vault / pit shall maintain minimum setbacks as specified in Table 1. Table 1 Well Building Lake /Stream Additional County Setbacks OPEN PIT 50 Ft. 15 Ft. Min. 75 Ft. SEALED VAULT 25 Ft. 15 Ft. Min. 75 Ft. 4. Privies for public buildings shall comply with SPS 353.63. 5. Privies used for one- and two-family purposes shall be constructed in such a manner so as to exclude flies, rats and other vermin. Doors should be self -closing and vault ventilators should terminate at least one foot above the roof. 6. Privies as per SPS 391.12 (1) states as follows: (a.) The storage chamber of a vault privy shall conform with the requirements of s. SPS 384.25 relating to holding tanks and shall have a minimum storage capacity of 200 gallons or one cubic yard. (b.) The storage chamber of a pit privy shall be sited and located in soil recognized to provide treatment and dispersal in accordance with s. SPS 383.44 (4)(b). 7. The privy shall be kept clean and sanitary. The contents of the pit or vault shall be disposed in accordance with NR 113, Wis. Adm. Code. 8. This agreement shall be binding on the owner, their heirs and assignees. This document shall be recorded by the Register of Deeds in a manner, which allows its existence to be determined by reference to the property where the privy is installed. Printed Owner(s) Name(s) This instrument was signed in the State of CA-) Countyof Cw�;2Ir) before me �ttilliir r __ r r q�17�G1CG}}prliL^. xou G Vr IGVh r/rn' T On this f D Pif day ``�__ ` ri Notary Public My commission expires on: f = SEAL ____r ••y (An' Je D V\ %,, CO Drafted By: (must be filled out by person submitting form) ttfdlMOOOC 2 u/Porms/sanitary/privyform - ®October 2019 coz ¶1 13-k FIELD Bayfield County Planning & Zoning Department 117 E 5w Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-4010 Property Owner: Submission Number: CS -00113 Transaction Number: CS-00113-2A73B Description Amount County Sanitary Permit: 2-5 $300.00 Total: $300.00 Payment Amount: $300.00 Reference: 3005 Paid by: HEAD SPACE HQ LLC, WASHBURN WI 54891 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 - Privy SIGN - SPECIAL - CONDITIONAL - BOA - BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 25-0289 Tax ID# 140 Issued To: HEAD SPACE HQ LLC Location: NE '/4 of SE 1/4 Section 13 Township 48 N. Range 5 W. Town of Barksdale in Doc # 2024R-603354 Residential / Commercial Structure in an Ag-1 Zoning District For: Sanitation Permit 2 Vaulted Privies (2 200 gallon Kittleson Tanks) (Disclaimer): Any future expansions or development would require additional permitting. Condition(s): To meet all setbacks. To be constructed per plan. Adhere to privy agreement. 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 5/21/25 Date