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HomeMy WebLinkAbout25-29SSS-0052&^s"^^!'' ^t)'B.»f s~,-5n •'^2^'•^SswSy Department of Safety & Professional Services, Industry Services .Division County 3^yir'^^ Sanitary Permit Number (to be filled in by Co.) 3S- ^5 Sanitary Permit Application 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 puiposes in accordance with the Privacy Law, s. 15.04(I)(m), Stats, fr^ E ffs !p State Transaction Number I. Application Information - Please Print All Information Project Address (if different than mailing address) ^-Z.70 Lr^^^-^^kRl Property Owner's Name Clv^is^-i^ 'K^.-h$<^^oi^ Parcel ffNAY 1 3 20^5 (Ctt.,< Tb ~ 3^~t '-S' IllZ 3/7"' ^"3--~^ ^s-/- $ TL Ba^e'd co. Zoning Dept. City, State ^U^kf-'^/i ^^ ; (check a Zip Code^^^ 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 '7/\s" g-77-^^^7 Property Location Govt. Lot V",. z p&x ' ^ 'A, Section 3zs~ Lot #T_tl_N R_l _Xo<®Subdivision Name Block # CSM Number d City of. a Village of I? Town of_t-!_u^_k^£_ 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.D New System p<t Replacement System D Other Modification to Existing System (explain)D Additional Pretreatment Unit (explain) B.D Holding Tank 8'In-Ground (conventional) a At-Grade D Mound D Individual Site Design D Other Type (explain) c.d Renewal Before Expiration D Revision D Change of Plumber D Transfer to New OwnerlIList Previous Permit Number and Date Issued IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) ^&£5 Design Soil Application Ratc(gpd/sf) . 7 Dispersal Area Required (sQL(7-c\Dispersal Area Proposed (sf)Lf^i System Elevation / ^.0 Tank Information Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units -T Manufacturer ^ s112& 11a 3sE 0 Septic ur Halding Tank -7^0 -75-0 U) frC-S-O. if C-e-.^C,.^ BeomgChnn*w- V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) All^ Tff^^sk-i ^^NtP/MPRS Number 2.2.^0^ 0 Business Phone Number -^&~2.<?Z.-^rt Plumber's Address (Street, City, State, Zip Code) <-"' Ha Bc.^ jr^z- ^^^ ^^^ •^}^-_ VI. County/Department Use Only Approved D Disapproved a Owner Given Reason for Denial Permit Fee ^000&Date Issued ^/z$^>>L i>(ig Aggat-Sign,//^7/^ ^2JL Conditions of Approval/R^n^fo^Disapproval 5^^^^^ ^U-4 . / - MS, ^ 9 '/I 5e-\ Attach to complete plans for the system and submit to the County only an paper not less than 81/2x11 inches In size SBD-6398 (R. 03/22) IVIay, S. 2111, 1U:41i BAYhlhLU CO PLANNING & ZONING In-Ground Gravity Plan Index & Cover Sheet Component Manual Design References: Version 2.0. SBD-10705-P(N.01/01, R. 10/12) Pglof^ Pg 2 of 7 Pg 3 of 7 Pg 4 of -t No, 9975 P. 3 PAGE 1 OF 7 D) ! NAY 1 3^!,- !'^ Bayfield Co. Zoning Dept.Index & Cover Sheet Plot Plan Sefh^'T^14^ Cya.^ Section & Plan View Management Plan Attachments: P.i f ^ 7^^ ^.+ ^.•^ ^ ^ ^ Enclosures: POWTS Appjjcation for Review ^SA^^ F&^^'1 Soil Evaluation Report & Site Map 7)4^< ^.4-e-^ ^ c-e- ^ ^ i^-e-fi >^e/z-f- Project Name / Description Owner Name(s): C^^'s-ir^^ Rutsc^u/ phone: 7,5-- gci7_- ^7-7 Owner Address: 23// ^3 ^^.s'f^ ^s^-p^ll ^~T Zip: ^ ^ l/^ »iect Address: <oZ7<^ ial^ ^\^^--c-«-^^^ 'jLl^=>^ 7^/^-^^ L^J TProject Address: (oZ7<^ L^j^e ^\^^^^.<i J^ Govt Lot: J-f_ _1/4 of_1/4, Section ^-s~. T l/ 7 N-R ^ E~^~Z^ Is '' ^ -^ Township: H^^^^ Project Parcel ID #: "T^ tt>^ 3 5~/ / 5 . County: 3A^;~e_ or W Designer Information Designer Name: A//^ J^o / kp ^ ^' _ Phone: 7/<T-3%- ^//^ Designer Address: F-o- 3 ^ S~2--2^ ^0.. IR < ^-^r ^J -^ Zip: ^/<?</"7 Sla /- ^ ,^» i / ^\ /^ ^-i ^. . ^ .... . . t J n.O l^t ^*l l^*^/^/^ 0 /^ <<*^ ^^\ T^htiCAt^q U^l JL-ej^ o i/T1"^. •• <^ <o /^\, License Number: -z^o° 90 RemarKs: This space reserved, for approval Stamp. Signature:Date:s~-^-zsr Original sitjnatura required on each submitted copy. s^-00 ^^ ^ L4" 02A" rff ^ CA5T-A-S FILTER ORBAFFLE [Lnj] [LTU] -d: &JU1 4" CAST-A-SEAL TOP VIEW b=AT-l=^ OPTIONAL FLAT COVERIS AVAILABLE FOR EXCHANGEFOR DOME COVER. WLP750-MR TANK SPECIFICATIONS DIMENSIONS:WALL: 2 1/2"BOTTOM: 3"COVER: 4"MANHOLE: 24" I.D. PRECAST CONCRETE RISERHEIGHT: DOME COVER 61" O.D.FLAT COVER 53 1/4" O.D. OUTSIDE DIAMETER: 84" O.D.BELOW INLET: 42" O.D. LIQUID LEVEL: 37" WEIGHT: 6,150 LBS. INLET AND OUTLET:4" CAST-A-SEAL BOOT OR EQUAL CASKET, CAST-A-SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL #10(OTHER STATES SEE CHART) LIQUID CAPACITY: 20.28 GAL/IN HOLDING TANK:ACTUAL CAPACITY: 790 GALLONS"OUTLET HOLE PLUGGED LOADING DESIGN: 8' 0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC/ HOLDING/ PUMP OR SIPHON COVER: MIX DESIGN jj!8 (NO FIBER)TANK: MIX DESIGN jj!10 (STRUCTURAL FIBER) CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETE PUMP PAD SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: slQ| ^a; g CD8 IDs. ^- z 00Ld5 I$ ins CM 1-~)£ I001 00m3 <=) ui= a.LUen CM Q; SHEET NO. L°F<1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page..of FILE INFORMATION SYSTEM SPECIFICATIONS Owner ^ ^ ^4-; Permit # DESIGN PARAMETERS ^^_K<-t.5 <L 0A!^ W TfATT3 Number of Bedrooms Number of Public Facility Units Estimated (average) flow Design (peak) flow = (Estimated x 1.5) In Situ Soil Application Rate Standard Influent/Effluent Quality Fats, Oil & Grease (FOG) Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) Pretreated Effluent Quality Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) Fecal Coliform (geometric mean) Maximum Effluent Particle Size Other: SiVfeidB^ NA '2- c: ° gal/day S 0 0 _ga|/day • 7 gal/day/ft2 Monthly average* <30 mg/L ^220 mg/L @ NA <150mg/L Monthly average ^30 mg/L <30 mg/L S NA <104cfu/100ml % in dia. JS NA PNA yttlnl *Valuss typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE inkjJ^anufacturer VL) a e'S'S ' QWc D Dose D Holding /'5an|^lanufacturer Septic D Dose d Holding '—rQUi..Tuent Filter Manufacturer Effluent Filter Model p/L S Pump Manufacturer Pump Model Pretreatment Unit a Sand/Gravel Filter D Mechanical Aeration D Disinfection Manufacturer Dispersal Cell(s) @I In-Ground (gravity) a At-Grade D Drip-Line Other: Other: -r C&AC., vol. -7 ,S vol. tot \/ loC,^ <° D Peat Filter D Wetland D Other: DNA 0 gal SNA gal DNA BNA SNA DMA D In-Ground (pressurized) D Mound D Other: SNA S NA Service Event Inspect condition of tank(s) Pump out contents of tank(s) Inspect dispersal cell(s) Clean effluent filter Inspect pump, pump controls & alarm Flush laterals and pressure test Other: Other: Service Frequency At least once every: ^ g ^al% (Maximum 3 years) D NA S When combined sludge and scum equals one-third (14) of tank volume B When the high water alarm is activated At least once every: ^j gj Ss (Maximum 3 years) D NA At least once every: ^ g S(s)s D NA At least once every: _^ g r;^;(hs()s) _D NA At least once every: BS£{S)B NA At least once every: g S"e?(s s a NA 8NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shali be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The dispersal cetl(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of affluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third (%) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (12/02) Page &- ofSTART UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals that may impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the inflltratlve surface. During extended power outages pump tanks may fill above normal highwater levels. When power Is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal level$ within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: D A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result In the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. D A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. D Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING»SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF APERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER . Name Phone "71 SEPTAGE ) lleilh ? SERVICING Name "T^&xvitia Phone -7 IS- 3- ^ik^^CP^^I^ ^^i^(ft OPERATOR(PUMPER) % P^liC^skt ^Jr& 7Z.- ^i-OG>(o .S Id "pt^nht ,'• •nK.atf&irS>!ia.s; Name ^H Phone -^ I i. K«T, S tS9 r 2.92- ^&s; -y s fc:(JWrt ^c,S'fc."?l«-i«-J> LOCAL REGULATORY AUTHORITY Name t5 &y-f-«€ i A. CLc.' u tt fy "2.8S <'""n Phone -7/ S~ 3-?^-&^. This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies In compliance with chapter Comm 83.2Z(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. Private Sewage System Maintenance Agreement Owner(s) Name ^l\nd~i^_'^jUAOV<J Owner(s) Mailing Address ;^\\4S^ +^r^+ ^~+ Site AddressM^"^< U, Vu X ^y/' ^/'? Tax ID #35^ As owner, I (we) do hereby certify the private sewage system will be installed in accordance with the certified soil tester's report and approved plans and specifications on file with Bayfield County Planning and Zoning Department. The system will be operated in such a manner as to meet the designed plans. I (we) agree to maintain saidprivate system at the below listed location in accordance with rules established in the Wl Adm. Code, as from time to time amended. (COMPLETE Legal is required) -1/4 of..1/4 Section ^.^ Township ^/7 N. Range _^__W. Additional Legal Description: ol €c. r<;-eVC> It^ 3W."lCf.\}e.l^f ^ _ (Acreage)^ .Block CSM#. Gov't Lot ^- Subdivision ol.^Page^'77^o ~ /T57?Vol CSMDocff. DOCUMENT NUMBER202SR-6073S7 OANIEL. J. HEF-FNER REGISTER OF DEEOS BAYF1ELD COUNTY, Wl RECORDED05/06/2025 AT 8:22 AM RECORDING FEE: $30.00 PAGES: 3 Recording Area Return To: j on< F.o.' ••^^ /WWo.&^g^ fsl6M^'L^'""t«^3-»/ [ ?'/^-'o)C''S~"^"s-}'-'] In-ground gravity D Mound D In-ground dosed D At-grade Sewage System D In-ground pressure distribution Sewage System: D Other. -^- Septlc Tank (system types A through E): The septio tank shall be pumped by a certified septage servicing operator within three (3) years of the date of instaiiation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank Is found to have less than one-thlrd (1/3) of the volume occupied by sludge and scum. Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septlc tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operablllty of said components. X- Septic Tank Effluent Filter (system types A through E): The septlc tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wls. Admin, Code. ^ private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS Inspector, or licensed master plumber within three (3) years of the date of Installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds. At-arade. and In-around Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbedif needed when the wastewater distribution cell component Is inspected as provided above. Owner(s) agree that failure to comply with this agreement wtl! result in ecfion being taken to pay a", chargss sfla' cosis '.wwrfnS by Bayi'wid Cuuniy mr inspection, pumpSng, hauling, or otherwise SQfvlclng and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system, Bayfteld County shall notify the owner of any cosls 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 provlfl^V^'ldWl////^^6-M' Llc^///^The terms and conditions of the agreement shall be binding upon and Inure to the benefit of all current and future owners of such profis'ifj^'. . • • . .'^^ ^-.•.nT^.-.v^ Owner(s) Name(s) - Please Print f A^^-n^ ^YS^^^ Subscribed and sworn to before me on this date; ^auS^WS Notarized Owner(s) - Signature(s) sst^n'Explres;' -c^< i/M. ZD2S^UwQ^A-. fi A^uJ Drafted bvfTon / % / ^e>^ ^ /' Date: 5~cr-(^(?Aj6 Proofed by:.:fj? u/forms/sanHaiy/septicmalntenceagreementRevised July 2020 rIr't-11U)lr*l fILru] .-n 0> BEARINGS ARE GRID BASEDwees - e» VFietD couNrv mm THE e. »y.LINE MEASURED TO BEARNSB'W40'£ i-nC\JC3C^i co +1Jly)l •900I LEGAL PESCRIPTION: A PARCEL OF LAW LQCA TED IN GOVT LOT 4, SECTION 26. T47N, fKW, TOWN OFHUGHES. BAYFIELD COWTY, WfSCOfrfSIN, MORE PARTICULARLY DESCHIBED ASFOUOWS; MHCEt >: COMMEWCINO <IT THE WESTYi CORMEH OF SAID SECTION: THEHCE NWtlWEAt-ONG THE E-WVf UN£ A DtSTANCE OF 1,326.27 FEET: m£NCeNOtrZri2'WADISTANCE OF 1.163.60 FEGT; rHEWE NOOt2ff'3S'£A OISTANCE OF G97.Z2 FEET TO AMEANDER CORNER, SWD CORNEB SEim NWW31-S A OISTMCE OF a FEET MOREOn tESS f ROM WE ORDINARY HIGH WATER MAW OF IRON LME: THEHCEsas-awe ALONO A ME/IWOER UWE A DISTANCE OF ns.ss FEET ro A MEWOSRCOnwER 3AIO CORHHI SEWS SOOWIBWO OISWACE OF <8 FEEr MORE OR LESSFROM THE ORDINARY HIGH WATER MARK OF IRON LAW THENCE SWOS'IS'W AD13TANCE OF S96.68FE£r; THENCE M91WWWA DfSTANCE OF 24B.7SFEET TO WSromroFBEoiwMNS. THE ABOVE OESCffiSEO PWCEl OF UNO COHTAMS fM423 SQUWS reerUOBE OfltESS, WHICH IS 3.62 ACRCS MORE OH IESS IHCl.UOmS THAT UNO IWWS aEIWEEWTHE MEANDER LINE AND THE OWWARY HIGH WATER MARK OF IRON LAKE, auRveycm's CEBTIFICATE: 1, PATRICKA. MCKUW, WIICONSIHHWFHSIOW^ UWS SURVEYOR S^Wl, BOHERCBYcenrvY rmr mia IMP WAS waew rm OWECTOW opcHHsmimrscHow, OWWH OFTHEAfOVE OESCHHeOMa MAPPSD PAHCEIS, WO THE MHMMWON SHOWN ON THIS M,P »COriRECTANa/UXUfUTeTOWESISrOFMYMOWieOaEANDBV.iePAmmeTSWt!MINIMUM SMNCMRO REQUWEMSNTS FOR SURVEYS UNOSRAt-7 OF WISCONSIN ADMMISTmTIVCCODE. OT JMWW.~/r^, '.< ;,!<• •• •/-. Z^'2-f \ _^-"PINE RIPSf UWD SURVEYIHa. LLC.PATRICKSwp.L.g.s-ma LEGEND 0 -SET 1 1/4" 0.0. « 1B" IRON PIPE • -FD. MONUMENT AS NOTED ( ) -PREVIOUSLY RECORDED AS8r|.ttL 80' SCALE _80'_160'240' FEET PLAT OF SURVEY A PARCEL OF LAND LOCATED IN BOVEWMENT LOT <SECTION 25, TOWNSHIP 47 WOWHRAW8E S WESr.TOWN Of HUSHES. BA ?IEtD couwry, VWSCONSIN.)RON^KE LINE TABLELINE iBEARINOlDISTANi1.1 ISOO'OZ'IB'Wl STANC47.14' Km%v.<c,BECAME APPARENT WHENE8TABUSINO THE BOUNDARIES OF THIS PARCEL INCONJUNCTION WITH ESTABLISH INO THE LOCATIONS FORTHE PERTINENT OOVEHNMENT LOTS SURROUNUNOSAID PARCEL. THE MONUMENTED LOCATION FOR THEWEST LINE OF OOVEflMENT LOT 4 DOCS NOT FtT THEMMHMATICAL LOCATION FOR BA1D LINE. FURTHER,THESE APPEARS TO BE ERRORS WWM CaM#11W INESTABLISHING THE WEST LINE OF GOVERNMENT LOT A. IDK? NOT ACCEPT THE %" CAPPED REBAR MONUMENTINOTHE NORTHWEST CORNER OF CSM IfHBO AB THAT 8AMECOftNER WAS MONUMENT60 flV WILLIAM SHEARMAN,PL9 K1378 M A PIAT OF SURVEY OA7EDM/1M1 WtilEALSO ESTABLIBHING THE WEST LINE OF OOVTLOT 4. IWO HOWEVER ACCEPT THE %" CAPPED REDAR FURTHEREAST AS SHOWN ON TWO PLAT AS FT HAS BEENACCEPTED BY NUMEROUe 8URVEVOR8 I ACCEPTEDTHE FOUND MONUMENTATION AS SHOWN WITHIN THISPIAT AS DID WIUtAM SHEARMAN, Pl.8 tft37B A WILLIAMANOERSON. PL8 (f2M7. THE LOCATION OF THEBEMONUMENTS HAVE aEEMINGLY BEEN ACQUIESCED TOBY ADJOINING LANDOWNERS %^ ff±.<1 / sii A5 s?o's^^ ANY LAND BELOW7HE OROIHARY HtGH WATER MARK OFA LAKE OR NAVIGABLE STREAM IS SUBJECT TO WEPUBLIC TRUST IN NAVIGABLE WATERS THAT 18ESTABLISHED UNDER AfiTICLE IX. SECTION 1 OF THESTATE CONSTITUTtON. wesry, CORNERsec, ss, ww. fwn FD. aAY.CTY.MON. , ,„„, „.,, i-——^y°2a'orE._._.^.__24&58'. L.P, TANK \EPTIC ^€^LIDVENT ® • 16.23' UTILITY 0POLEs$^ .'5^3" l/%"lr~-^ ' 1k'^!s ***•-", S90.S?. PARCEL 1 153,423 Sq.FI.±3.52 Acres* :^ :r*-K;s§ /FOS" CAPPED REBAR<NW CORNER CSM<t18a)NBO'4We-4,Bi'FROM FO. AND HELD 1 »• IRON PIPE FprmoHpipeNORTH. 1.W^ftOW SOUTH IIHE__J FD.1" IRON PIPE VW TGEr- NORTH - & WFROM SOUTH LINE FO.DROtiPIPENoo'o2'ire-33a'-FROM SET MONUMENT ~- N89'50'58"W ""••oJ.FO.K-cAppEoneBAR 3,930.79' 248.75'-"' EASry, CORNERSEC. 26, nm TOW fD. MftB. NHt. ff-N89°50'68"W FE)%"CAPPeOREBAfl-^—*518.73' N88-58WE<SBB-S8'4S-E) ^""SfSS^SSJ BWCORNEROFCEMtllM 6,257.06'?257.371 I.:.s^s ^js,§Sii III^i S^ii;3^?S§|jl£||§ Si 0^ifil f^lI] II!§Pa? t;llsl 11 §yj 'S - f n Qo 3' " i 3 rr i w m s- - 1 0 f c ?$ § l> ^ 0 §§ ^ rn : c - 0 :3 ° ; % t r l r~ w < ^ 5- < - » ° la l §s ^ g3 1 I? 0 P 6 " i S ^ i r - 0 r r i o §0 ? 3- » - n r * i^ ^' F n ^ 3: ^Il l 1§ 1 3§ § :o s ^ / 5: O S , £ - i < - i Pl ?s S -n 0 j i o 0 1 o S : 0 0 9^ ^ § S ^ 5 5 5 ^ ^5 2 i ^ i n i 2 ^ i §^ $ S t / i 6 S C > S c> 3 ^ 2 ? % § a ' § ^ ^ m ^ m 3 f r i i :Q g ^ s o??s f iy Tn 0 ) rh m-ts is§ ms :0Sa . 3dnir n I* - C5 r" " S^ § S § ^ I l n l ni ? ~ : y % ^ ^ ? m s ni S S S § ? % ^ § 5 ? g-^ [ n g . i ^ O ^ ^< ^ 5 s Q ^ o ^ ( ^ ^ . ^^ g s ^ % ^ . ^ ^ n\ v " ' ^ ^ 3 ~ K ^ '^ S ^ r u 5 § § i 8 !H I I ! i l l s° fy ;^ 0 ?l 3 ^ S 5 S K 3b . ( > • » il l ^ l s j ! l^ l l i i l l l :f a " £ l m 0-- * ^? S J ^ j S A. - r > ^ ? i Q g8 5 ^ s ^g a : S £ ' » : s i ' 2 s ^§ § £ S ( ^ P . il ^ P I I I 3^ 1 I. 2 ! 8 ^ C H m ^Is ra A: TO(^ -d X ^ ?| s §i ! ir , m '' < ' ' _ T - ' Gi^^@s b o t— 00 s s* . r- i0IIi' 0 !^to c=> . ? i ^" ' -• " d ^s C/ > f f l °0C) < .; - ; - q y t - 1 .3 - 0 -s 1^^K v. . r * •s . ^ §§ :s9^^II§§§?Us ^§1^ 0 Ot ~ t 03cu1,<&a.sy35' <0 3§^- ^co 1-~ . ^ c= > r- ; ' u- ' ^= > . [n F B (s r S i G= L T G [n F B C o A J .<a-n T s ° n c<> I BAYFIELD COUNTYCHECKLIST FOR SANITARY APPLICATOf !S;glJI^ Submit the FollowinQ (Use Permanent Ink) Q-itle 15, Section 15-l-10(e)) 0 |j MAY 1 3 2025 ^\Ul}f k./^-^UUI I JL«^ -J. ^\J\^^j U U I I/-A I i Cs Lf-^L\} 1—*/ EZf Check List »,«..,.,.,.. ^ , ^UayfeidCo^oningpepiSi 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)) Ef Original Plot Plan (383.22(2)2. 3. & 4,a) ^ Cross Section, Over-Head Profile of the System and Schematic of Tank from Manufacturer d Pump Tank Diagram, Alarm and Pump Curve (when applicable) Ef Contingency Plan / Management Plan (383.22-3(2)(b)l.f.) ST Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) D Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) D Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) D ATU Servicing Agreement (Recorded at Reg. of Deeds) Ef Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) ff . ComB!§teSet. of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to alt copies) GT Soil and Site Evaluation Report (383.22-3(2)(b)l.e.) D State Plan Review (when applicable) D Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) Ef I Application Information must include: D 23 dlqit Parcel ID# " (do not use 12 digits anymore-obsolete) 13 Project Address or Road Name where driveway is/will come off of) 13 (Owners Phone Number) II Type of Building Ef III Type of Permit Ef IV Type of POWTS System SS V Dispersal / Treatment Area Information Tank Information Ef VII Responsibility Statement (Plumber's Information) D *Date Stamp* Plot Plan: (To Scale or To Dimension) Ef Signature and Plumber Information Bf Address Number and Road 0 Surface Elevation of Body of Water Ef North Arrow 0 Direction and Percent Land Slope 0 Contour Lines Ef Tank and Filter Information and Location Ef Structures and Driveways 53' Wetlands / Navigable Bodies of Water E Boring Locations Ef Absorption Area (Proposed and Existing) El Property Lines ET Bench Mark (Location, Elevation and Description) El Well Locations Ef Component Manual Version Gf Legal Descriptions 0 |3igi»^^ate^|In?Ega^ and. diameter)1 Turn Over >• nl ! ;LCross-Section and Over-Head Profile of the System: ED Surface and System Elevation E3 Position of Observation and Vent Pipes E3 Dimensions and Depths [3 Make, Model & Number of Chamber Units in each Cell Property Information D How many systems will there be on this parcel of land? _J_ D Has this property been split? P s (Property Statement shows Property History) Fees; E3 Private Sewage System (Septic Tanks) $ 400.00 a Private Sewage System (Holding Tanks) $ 400.00 D Mounds or Systems requiring Pre-Treatment $ 500.00 D Sanitary Revisions $ 25.00 D Private Sewage System Reconnectlon $ 50.00 and Private Interceptor D Return Inspection $ 50.00 CE) Maintenance Agreements ^ $ 30.00 (checks made out to Reg of Deeds) ^^- , f-j! Dayfeld Co. Zoning D@piL u/forms/checkllsts/checklistforsanitaryapps(lO/2009);(®7/20H);(®2/2012)(®5/2/2012-dc)Proofed by: v> , ^ n w y ^ ^ ^ ~ ^ - / , < 6 '—-^ r (t ^by ^ '< ? y •<fo \^ . - .s 'S -<< -~ ^ &^I ^ i^^ x %^ , ^ ^ - r^^"n~ - ^ ! ^ ^ E^1 c. ^^V< • • < s - r-y~0 -+ • I ^-a c~ - r - r—CJ < t ~ ^ -< ^ s > s? S ^ ? ^ p < ^ ?^ - 4 - 1^ ? ' ^? - 7 ^ .0 ^^ Of e 5 & » " y & 4 ^ n e pi ' ^ c , o ^ f - e . i ' y ° v- \ EM ? Sf ° ^ ? »s a p T s < a - S ; e . f f p i ' . 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