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SS-c^o^f/ ^f!KI»ffy^ ^-•» ^%IS V .5^^=^' •:''.t_S75^v'' Industry Services Division 4822 Madison Yards Way Madison, WI 53705 P.O. Box 7302 Madison, WI 5302 Sanitary Permit Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this fonn to die appropriate govemmemal 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. Pasona] infonnatioa you provide may be used for seconday pinposes in accordance wifli die Privacy Law, s. 15.04(I)(m), Stats. I. Application Information - Please Print All Information County sffftuy ^w;to be filled in by Co.)fp^frg^;^s^LT"w<m^51ur~^^f^sod^j ^ Parcel If -^y •5<?Wtl~ WO^O-^ /7?T% -^ y^/ A?^ ]^OGt Property Owner's Name A'^^t" . :'il--.JI'\^ Property Owner's Mailing Address ,3^, /^ /h^.ti? City, State S/a^f!u^ F^ Zip Code -^^r U. Type of Building (check all that apply) W\ or 2 Family Dwelling - Number of Bedrooms D PubIic/Commereial - Describe Use a Stole Owned - Describe Use Phone Number 7/^-J?^- ^7/ Property Location Govt.Lot. ^ v,.5£}A, Section Lot #^T ^? N R S~ EorP® Subdivision Name Block # CSM Number ^M. a City of. a Village of _ Fownof £••>, m. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other appUcaMe on line A. Check one box on line B. Complete line C if applicable.), A.D Replacement System D Other Modification to Existing System (explain) B^^_ a Additional Pretreatment Unit (explain) B.D Holding Tank a In-Ground (conventional) D At-Grade Mound D Individual Site Design D Other Type (explain) c.D Renewal Before Expiration D Revision D Change of Plumber D Transfer to New Ownerl[List Previous Permit Number and Date Issued IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) 6? oo Design Soil Application Rate(gpd/sf)^0 Dispersal Area Required (sf) ^0 S/^Dispersal Area Proposed (st) ^u ^ System Elevation ^snutj. ^7^6 Tank Information Capacity in Gallons New Tanks Existing Tanks Total Gallons '# of Units Manufectunr Septic or Holding Tank M 5&/7y»Sooo C^^-i-c^ Dosing Chamber V. Responsibility Statement-1, the undersigned, assume for installation of the POWTS thown on the attached plan*. Plumber's Name (Print) ^'.*; t^t£?A~><J-^1 MP/MPRS Number U^3t>3 Business Phone Number r^-m-os^i Plumber's Addr^s (Street, City, State, Zip Code) 3^ 5^^w? ^. /^^^ ^- s'y^i VI. County/Department Use Only Approved D Disapproved a Owner Given Reason for Denial Permit Fee $^DO Date Issued^"ww-1'z5 ^//^?J7/ ?^^1 Conditions ofApproval/Reasoas for Disapproval S^ a^c^ro^ d^rd^. Attach to complete plans for tte system and submit to the County only on paper not less thin 81/2 x 11 inches in size SBD-6398 (R. 02/22) 801 ft» nfocottsm OQ>3(tment;ofCofttmwceDMsJonoTSafetyand.BuDctinsfS Attarti icontpteto ffte tHwm \K:W^ psrcem atop®, scate.ordifffeFisfons, i ^)'w .SQtt EVALUATION SEPOftT .ftRO<9(^fl^^.Gtirt(ft.»»,v!?t,:Attot. eagde ^-ool^b .IPfiae,,,I,,or..;3 p<»»oiwMB(omtB(^yw,pmW<n^^(»w.BSp»»iWA^ County B^fESBl^ ft)B8U;G.^y 3 y/y Date/W/^ i j^j PropejT^'Oww MICHAELBAO-EN 7 KJElr-?FSQK)£ZE 6oA£u(, .-? ;t,tt,;$B..<y4^. :30^ T 47 W ..R- 5 Property OwiWs.MsJfingW88« .t.3$3'VA?IBllR|gN w'"""~ -^^"' BJjwicJR.wer^gs j ^ ^ ^ •']«^(,'Ji^»l^amei«^W. -~^ '• ^ -?/^ PhoaeN'umbera,m'wss age .Ijyrown FirTTTTM Nssfssiftpad JFRANZEE/ NewCswfrucUon .•Us«;w^^^^^s^—.-l i^i&^i'w'wm'Wtfe^S-OestSMs __ .PwBiitmstetial :LACOS3tB%>»B , .,:...:.: : Gensral'eommei'its sndmeooffirwBdatiofts: €88"GPO fto(Xt'Rtglp,^(B?si.ifapp((a^ HQLSSSQ TA^<3R.M(%?&¥STEME?yA;RQN AT99t220N97;? 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J L A . - ^ ! . % . . . F I . L . . . j : l » f r .^ , ^ - . ^ . ^ - . ^ ^ _ . ^ . ^ . , ^ > . . . . ^ . . . . ^ ^ ^^ ^ " S i ^ l ^ . S l [ ' , : • T ' ^ ^ \ ' S ; V • ; • ' m" .^ Real Estate Bayfield County Property Listing Today's Date: 5/7/2025 ^ Description Tax ID: PIN! Legacy PIN: Map ID: Municipality: S7R: Description: Recorded Acres; Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN: f Tax Districts 1 04 020 020170 001700 Recorded Documents Updated: 11/15/2023 39144 04-020-2-47-05-30-4 01-000-12000 (020) TOWN OF EILEEN S30T47NR05W LOT 2 OF CSM 2316 IN DOC 2023R-601175 10.000 9.950 0 No (AG-l)Agricultural-l 113 B CERTIFIED SURVEY MAP Date Recorded; 11/7/2023 B TRANSFER BY AFFIDAVIT Date Recorded: 12/27/2017 0 WARRANTY DEED Date Recorded: 11/13/2023 B CONVERSION Date Recorded: Updated: 11/9/2023 STATE COUNTVTOWN OF HLEEN ASHLAND SCHOOL TECHNICAL COU.EGE Updated: 3/15/2006 2023R-601132 13-249 2017R-571343 2023R-601175. 497-407 Ownership KEVIN & MANDYSCHOLZE Billing Address: KEVIN & MANDY SCHOL2E1353 VAN BUREN STBLACK RIVER FALIS WI 54615 Property Status: Current Created On: 11/9/2023 1:56:33 PM Updated; 11/15/2023 BLACK RIVER FALLSWI Mailing Address: KEVIN & MANDY SCHOLZE1353 VAN BUREN STBLACK RIVER FALLS WI 54615 f Site Address * indicates Private Road 25780 FRANZEL RD Property Assessment 2025 Assessment Detail Code Acres Sm-AGRICULTURAL FOREST 2.000 G4-AGRICUL7URAL 8.000 2-Year Comparison 2024 Land: 3,400 Improved: 0 Total: 3,400 'Property History Parent Properties 04-020-2-47-05-30-4 01-000-lOpQO , ,TIT il; MASON 54856 Updated: 3/6/2025 Land 1,600 1.600 Imp. 0 0 2025 Change 3,200 -5.9% 0 0.0% 3,200 -5.9% Tax ID MAY 1/ &V'H?IC! -' Wi.-iF' OSC't HISTORY mExpandATHJsto^ White=Current Parcels Pink=ReUred Parcels B Tax ID: 16011 Pin: 04-020-2-47-05^30-4 01-000-10000 Leg, Pin: 020106405000 39144 This Parcel T Parents -^Children Wisconsin Department of Commerce Division of Safety and Buildings ^'^. SOIL EVAtOATlW-REPORT in accordance with Comm 85, Wis. Adm. Code i^? 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 I.D.^\\^ Reviewed by w\Date 1 9-/Z-^ Property Owner MICHAEL BAILEN / KEVW SCHOLZE Property Location Govt. Lot NE 1/4 SE 1/4 S 30 T 47 N R 5 I'(orH^ Property Owner's Mailing Address 1353 VAN BUREN Lot #Block #Subd, Name or CSM#^3/6 City State Black River Falls , WI Zip Code ] 54615 ]( Phone Number 715 ) 972-0001 ;ity Q Village BJTown FTTPFM Nearest Road FRANZEL New Construction Usej Q Replacement Parent material General comments and recommendations: Residential / Number of bedrooms Public or commercial - Describe: LACUSTRINE Code derived design flow rate 600 GPD Flood Plain elevation if applicable HOLDFNG TANK OR MOUND SYSTEM ELEVATION AT 99.22 ON 97.3 CONTOUR DESIGN LOAD RATE = .4 GPD/SQ. FT. GRASS TO BE MOWED BEFORE INSTALLATION 1 Boring # Horizon 1 2 3 4 Depth in. 0-8 8-13 13-15 15-22 Boring 1 Pit Gro Dominant Colo Munsell 5YR3/3 5YR3/4 2.5YR3/4 2.5YR4/4 id surface elev. 97.3 Redox Description Qu. Sz. Cont. Color F1F2.5YR5/6 :. Depth to limiting Texture CL CL c c Structure Gr. Sz. Sh. 3MGR 3MABK 2CABK 2CABK actor Consistence MVFR MFR MFR MFR in. Boundary cw cw AW Roots 3F 3F 3F 2F Soil Application Rate GPD/ff *Eff#1 .4 .4 .2 .2 *EffS2 .6 .6 .3 .3 2 Boring # Horizon 1 2 3 4 Depth in. 0-8 8-13 13-15 15-22 Boring LJ Pit Gro Dominant Colo Munsell 5YR3/3 5YR3/4 2.5YR3/4 2.5YR4/4 97.3 id surface elev. Redox Description Qu. Sz. Cont. Color F1F2.5YR5/6 Texture CL CL c c 'epth to limitin; Structure Gr.Sz. Sh. 3MGR 3MABK 2CABK 2CABK 1. Factor Consistence MVFR MFR MFR MFR in. Boundary cw cw AW Roots 3F 3F 3F 2F Soil Application Rate GPD/ff *Ef»1 .4 .4 .2 .2 *Efi#2 .6 .6 .3 .3 > Effluent #1 = BOD > 30 ^ 220 mg/L and TSS >30 5 150 mg/L * Efftuent #2 = BOD. 5 30 mg/L and TSS 5 30 mg/L CST Name (Please Print) BRUCE W BLAKEMAN Signature -CL/ CST Number 708148 Address 64903 CHARLES JOHNSON ROAD ASHLAND, WI54806 Date Evaluation Conducted 08/29/2023 Telephone Number 715-209-2569 $ 50 cl-15-53 c^A. Property Owner.BAILEN / SCHOLZE ParcellD#_16011 Page -of_ 3 E Horizon 1 2 3 4 iring # Depth in. 0-8 8-14 14-15 15-22 Boring '1 Pit Gro Dominant Coloi Munsell 5YR3/3 5YR3/4 . 2.5YR3/4 2.5YT4/4 id surface elev. Redox Description Qu. Sz. Cont. Color F1F2.5YR5/6 Texture CL CL CL c epth to limitinc Structure Gr.Sz. Sh. 3MGR 3MABK 2CABK 2CABK Factor Corisistence MVFR MFR MFR MFR in. Boundary cw cw cw Roots 3F 3F 3F 2F Soil Application Rate GPD/ff *Eff#1 .4 .4 .4 .2 *Eff#2 .6 .6 .6 .3 Horizon E n iring # Depth in. Boring 3 pit Grc Dominant Colo Munsell nd surface elev. Redox Description Qu. Sz. Cont. Color t. Texture 3epth to limitin Structure Gr. Sz. Sh. factor Consistence Boundary Roots Soil Application Rate GPD/fF *Eff#1 *Ef?2 Horizon Boring # n Depth in. Boring I Pit Gr( Dominant Colo Munselt nd surface elev.. Redox Description Qu. Sz. Cont. Color •t Texture )epth to limitin' Structure Gr. Sz. Sh. factor in. Consistence Boundary Roots Soil Application Rate GPD/ff *Efl#1 *Efi#2 * Effluent #1 = BOD. > 30.5 220 mg/L and TSS >30 ^ 150 mg/L * Effluent #2 = BOD ^ 30 mg/L and TSS $ 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330Test (R.07/00) U/ ^ T ~ / ° e o ^ c w e 1^^IIr^r ^C7 ^ ^C/ 5^1^^^^0^ ^§' t-p •Y A 5 0 (7 - ?°<^^^1 §5r^ z0 ^.^rr z&•^'^7&(^\f t v\ ?frft H^^»0y T0ftt/ t '; , '0,0 ^,^^I ?>Mr~ <h, ?0^^.^co c.^^ ^>c>^?~pf t \^41 -^^^ ^^^<^^ ^£'^£h ?r-^r- >^?^ ^fT . t/1 ^i/ t <J J0 ^1<1^^^^ ^>^r-ro^^^Q, r"N 0^ . ^?uo °F v IA ) ^ ^ Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way Madison, WI 53705 AV '? -' ',ln'/€ > (. '• '•''. Phone:608-266-2112 '\ Web: http: /dsps.wi.go\ • Email: dspsfrf-wisconsin.gov 'i Tony Evers, Governor Dan Hereth, Secretary May 21,2025 CUST ID NO.: 664303 ANTHONY PATRICK BROWN 315SANBORNAVE ASHLAND, WI 54806 CONDITIONAL APPROVAL Identification Numbers Plan Review No.: PWTS-052500934-C Application No.: DIS-052519531 Site ID No.: SIT-145008 Please refer to all identification numbers in each correspondence with the Department. PLAN APPROVAL EXPIRES: 05/21/2027 MUNICIPALITY: TOWN OF EILEEN BAYFIELD COUNTY SITE: SCHOLZE MOUND 25780 FRANZEL ROAD ASHLAND, WI 54806 NE 1/4 SE 1/4 SEC.30 TOWN 47N RANGE 05W FOR: Design Wastewater Flow Value: 600 Bedrooms: 4 Limiting Factor(s): 13 inches Maintenance Required: Effluent Filter ConditionallyAPPROVED DEPT. OF SAFETY AND PROFESSIONALSERVICESDIVISION OF INDUSTRY SERVICES /^ SEE CORRESPONDENCE EZflow Mound Component Manual - (9/7/23) SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • The pressure network is to be constructed in accordance with publications "Pressure Distribution Component Manual for POWTS (Version 2.1); (May 2022-2027)". • This system is to be constructed and located in accordance with the approved plans and with the EZflow Mound Component Manual, (9/7/23) • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Prior to the construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a '/4-inch wire, the site is too wet to prepare. If it cmmbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state-approved effluent filter is required. Maintenance information must be given to the owner of (lie tank explaining that periodic cleaning of the filter is required. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (1l)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacturer's requirements. • Verify property line(s) prior to installation. |i|| ^y 9 ^ ';..>^ • Pump Floats to be set and verified per the approved plan. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount ofsdil availabfei CM proper treatment. If no other site is available, trees in the basal area of the POWTS Dispersal Area must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. • With new construction, it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Any tall grasses, leaves and shmbs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • The proposed system area shall be fenced off or protected from construction activity on the site. • Provide surface water diversion around the treatment tanks and mound dispersal component. • All SPS Table 383.43-1 and WDNR setbacks must be maintained. OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code S SPS 383.540'). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for confomiance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbmg in the state unless licensed to do so by the Department per s. 145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, .^•-f^'r-ffj-^K^^ Timothy Zoromski Division of Industry Services Phone: Email: timothy.zoromski@wisconsin.gov Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 Refund Expected: $0.00 ) llliit! ^ i'i!MAY 2 1 ?0^ {y-' 'J'-:5L\ EZfloww MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential ApplicationINDEX AND TFTLE PAGE Project Name: Owner's Name: Owner's Address: Sc^i^JL ^bt^IS Michael Baiten/Kevin Scholze 1353 Van Buren Black River Falls, Wl Legal Description: Township: County: Subdivision Name: Lot Number: NE1/4 SE S30 T47N R5W Eileen Bayfield Block Number: Parcel I.D. Number 16011 ' Pa^yi / ^wA; T»-< /b r^: yn^Plan Transaction No.: ^-0^6-^-^-^'- 36 V W 'A» - /^ccn CondiiionallyAPPROVED DEPT. OF SAFETY AND PROFESSIONALSERVICESDIVISION OF INDUSTRY SERVICES Page 1 Page 2 Page3 Page 4 PageS Page 6 Page? PageS Index and title Data entry EZflow mound drawings Lateral and dose tank Distribution media System maintenance specifications Management and contingency plan Pump curve and specifications SEE CORRESPONDENCE Designer: Anthony Brown Date: 05/OS Signature: ^ License Number: Phone Number: /"L.^ - ^L.-- 7/T ^^Lj2j2^L Designed Pursuant to the EZffow Mound Component Manual Ver. August 20,2007, 9/7/2023 SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribufaon Component Manual Ver.fcO SBD-10706-P (N. 01/01, R. 10/12) 2 1 May 2022-27 EZffow Mound Version 3.0 (R. 3/1/12)Page 1 of 8 ^B;! (I Of C) Mound and Pressure Distribution Component Design MM' 2 Design Worksheet Site Information Residential or Commercial Design 406.06 1.50 600.00 ^.00 97.30 13.00 0.40 Estimated Wastewater Flow (gpd) Peaking Factor (e.g. 1.5 = 150%) Design Flow (gpd) Site Slope (%) Installation Contour Line Elevation (ft) Depth to Limiting Factor (in) In-sihj Soil Application Rate (gpd/ft2) 140.00 Contour Length Available (ft) Distribution Cell Information Cell Width (ft) 3,1,5.6^8_9_orJO^nly | 100.00| = Dispersal Cell Length (ft)6.00 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) Influent Wastewater Quality (1 or 2) (c or e) Pressure Disributlon Information Center or End Manifold Lateral Spacing (ft) Number of Laterals Orifice Diameter (in) (e.g. 0.25)M56 3.50 2JOQ 150.66 90.00 O.W 4.55^72 2.94 ^16.20 Are the laterals the highest point in the distribution [~ ~~ Y network? Enter Y or N If N above, enter the elevation (ft) of the highest point. [~ Estimated Orifice Spacing (ft) = [__JO;7l]ft'i/orifice Forcemain Diameter (in) Forcemain Length (ft) Inside Pump Tank Elevation (ft) Foreemain Filter Loss (ft) System Head (ft) x 1.3 Vertical Lift (ft) Friction Loss (ft) Total Dynamic Head (ft) Does the forcemain drain back?L ..Y..Enter Y or N 24.47,^0742 114.89^016 Foreemain Drainback (gal) 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) Lateral in. dia. -0.75~ Too" ~\25~ T50'~2W ~3SO Mameter Selection options x x x x x choice x Manifold Diameter Selection in. dia.^25 Tso~^0~3^0- options x x choice x Treatment Tank Information 1250.00| Septic Tank Capacity (gal) I Weiser Concrete j Manufacturer Dose Tank Information 750.00] Dose Tank Capacity (gal) 16.12] Dose Tank Volume (gal/in) I Weiser Concrete | Manufacturer Gallons/lnch Calculator (optional) Total Tank Capacity (gal) Total Working Liquid Depth (in) gal/in (enter result in cell B49) Effluent Filter Information Pplytok j Filter Manufacturer PL525 [ Filter Model Number Prpject:Page 2 of 8 Mound Plan View 0 ESIIII I [I NAY 212025 ^ Bayfietd Co. Zoning Dept w ^:^:A^HJ^^:^^^:^:::.ii^:::^^ W/:^3Sii»'99SiW9'l'9S9^fi?WWf!f:Wt:SS»fit ?SK3^;?S^3^?^^W»E?^^?K?R»'^^ y± -T J-+ ft B D 6.00 100.00 ^3.00 600.00^7oo Mound Component Dimensions E F G ~ZL32 ^IZOO 0.50 (ft2) Dispersal Cell Area (gpd/ft) Linear Loading Rate H I J Too^82 8.69 1981.71 ^TO.OO K Lw ^12.29 124.58 -28^50i (ft2) Basal Area Available (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZffow Dispersal Area Finished Grade 101.22 (ft)IiH 99.22 (ft) Dispersal Cell Elevation 99.72 (ft) Lateral Invert Elevation .0 97.30 (ft) Contour Elevation 6.0 % Site Slope Shading KeyCQi^ffl TopsoilTopsoil Cap ~2\\',';^,'.\ SubsoilCap T] r~—l ASTM C33 Sand 11I Tilled Layer EZflow Media ^s.& L;-5:^1Ill«s'il 1 T 2.0ft 0.5ft Typical Dispersal Cell See Page 5 Approved Geotextile Fabric Cover ^^\T See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project:Page 3 of 8 Center Connection Lateral Layout Diagram ID] E I3 i I ^ i II11 ^1AY 9 1 ^'U^ '^yt!6!ci Gc, 2or«r,o OeD-' Fore* m*in oo.noeotfon w"» tw or woss to manifold at an» point. Ltwato are identical Jt •= Turn-upwfballvhmorol—noutplug |^x-»M Orifices point up, except every 5th one points down for drainage. «'2->| L*twate&(ofc»m*in<rfpycSch4C per SPSTabte 384.30-5 ~7F s^ Number of Laterals Lateral Diameter Lateral Length (P) Lateral End (Z) Lateral Spacing (S) Lateral Flow Rate System Flow Rate AT5C "49^8 Nfi ~^o6 T54 ^016 in ft Ft ft 3pm ?pm Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity ^7156 ^.65 14 10.71 ^.OOj 1.50 ~3.08 'in Ift ft2/orifice ft in ft/sec Dose Tank Information Electrical as per NEC 300 and SPS 316.300 WAC Tank component is property vented Weiser Concrete Capacity Volume 750.00 ~\6A2 Dimensior~A~ ~B~ ~c ~D~ Total Inches ~25M ~2M ~M3 12.0046^3 Gallons 409.43 ~323A TJ4.89 193.44 750.00 Alarm Manufacturer ISJE Rhombus Alarm Model Number Pump Manufacturer Gould Pump Model Number JEP05 1 1 Locking cover with warninglabel and locking device andsealed watertight 4 in. min. Alternate outletlocation Forcemaln diameter 2 in. Weep hole or anti- siphon device Pump off elevation (ft) ^f adding And BackfiJTAs Per Manufacturer I 91.001 Dose tank elevation (ft) I 90.001 Pump Must Deliver |30.16|gpm at | 16.20|ftTDH Note- Switches containing mercury may not be used in this system Project:Page 4 of 8 Rs ^ if K^ f'i :L" :! ? EL ';ljill! MAY •) EZflow® Distribution Cell Media Layout 6.00 |Cell Width (ft) | 1.50 |Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements Component Legend SR1-7A Bundle - 5 ft or 10 ft lengths >sVR^.SR1-12A or EZ 1201A in 5 ft or 10 ft lengthsHit SR3-12H or E2 1201P or ^3S@^S^^^ SR3-12H in 5 ft or 10 ft lengths 4" Perforated Distribution Pipe With Pressure Lateral Inside Turnup Enclosure ----- Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical r 6.00—1CeU Width - A (ft) [JOO.OOjCell Length - B (ft) Center Connection Lateral L ayout Diagram Project: Page 5 of 8 ^ l^^ jfil ISli^i ^ II MAYrni^ ^ BawieJd Co- ZcT.in^ LisoMound System Maintenance and Operation Specifications Service Provider's Name POWTS Regulator's Name Design Flow-Peak | Estimated Flow - Average] Septic Tank Capacity) Soil Absorption Component Size) Type of Wastewater[ Septic and Pump Tank | Effluent Fiterl Pump and Controls | Alarm) Pressure System I Mound I Other] Bayfield C°unt^Plannmg and Zoning System Flow and Load Parameters "600" ~400^ ^\2SO 600 Domestic | Phone I Phone] s gpd Maximum Influent Particle Size gpd Maximum BOD5 gal Maximum TSS I2 Maximum FOG Maximum Fecal Coliform 715-373-6138 ~UQ ~220 ~f50 30 >10E4 Service Frequency Inspect and/or service once every 3 years Inspect and clean as necessary at least once every 3 years Test once every 3 years Should test periodically Laterals should be flushed and pressure tested every 3 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards n ng/L Tig/L ng/L rfu/WOmL 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the EZfiow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZffow products approved for use with the EZfiow Mound Component Manual Ver. August 20,2007. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum-up Detail Finished Grade 6-8" Diameter Lawn Sprinkler Valve Box Lateral Ends at Last Orifice Where Variable Length Cleanout Begins EZflow Synthetic Media •Distribution Lateral Threaded Cleanout Plug or Ball Valve Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Feet Lateral Cleanout Project:Page 6 of 8 HiIt ^ ^ e IH! M 1^if '±1 yi fc ^ ^ " MAY 2 1 ?OZ5Mound System Management Plan PursuanttoSPS 383.54.Wis.Adm. Code B-yff'vC v ZQ 1 HO D&p General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [EZflow Mound Component Manual 8/20/07, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) andSSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water lightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Seplic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septictank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at leasl once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter Is equipped with an alarm,the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm.The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If (he contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner as to when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if suchproducts are used they shall be approved for septfc tank use by the Wisconsin Department of Commaree. Pump Tank The dosing (pump) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify properoperation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it should be noted if it is functional during pump operation, and If not, it should be cleaned. **"*Wo one should ever enter a septfc or dose tank since dangerous gases may be present that could cause death. *"* Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aerab'on of the infiltrative surface within themound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Infiuent quality into the mound system may not exceed 220 mg/L BODg, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODg, 30 mg/L TSS, 10 mg/L FOG, and 10< cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation.The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test whenthe system was installed to determine if oriflce clogging has occurred and iforifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition.See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Page 7 of 8 ^ IH 4 - . , . . | . , ] N N r ^ t . . , ^ | - i ^ \ " i l. . ^ L J •• V . : . . J ., , r , , | - ~ l - . 4 - l .; - " ^ — y — ' f . : " ; f r - - i ^- - - t - — T - ". , ^ . — , • . - . - < — ^, ^ ^ J ^ ^ .• — l 4 : u . , - ^ - t . k - ^ . u i j ^ . ^ . ; ^ . ^ ^ ^ > - ^ :> i . 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J . . - . j . . .. - ^ — . - A . — ^ ' . l ^ : - . ,^ _ , ^ - . _ - ^ - , - , ^ _ ^ . . ^ , ^ , - . - ^ - . - ^ . , - , ^ ^ . » ^ 14 - 1 - - I - ' - H ' 1 : - i l - ' ; .. . . , 1 , ^ -- r : - . S . - . - ^ - l . - t ^ l - t - t - ;. . . , 4 ^ j . . A i - £ ^ H , - ~ - ' ; r " " " I " " " ; ' " ^ ^ r " i G r ; r ~ T ^ T ~ 'i r ^ r ' r r ' TECHNICAL BROCHURE B3871 R1 R I®!1]MAY 2 1 2025 Bayfeld Co. Zoning Dept EP04 & EP05 Series Model 3871 SUBMERSIBLE EFFLUENT PUMPS GOULDSTECHNOLOG a xylem brand Goulds Water Technology Wastewater FEATURES EP04 Impeller: Thermoplastic semi-open design with pump out vanes for mechanical seal protec- tion. EP05 Impeller: Thermoplastic enclosed design for improved performance. Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resis- tance. Motor Housing: Cast iron for efficient heat transfer, strength, and durability. APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump •Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: %" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 11/2" N FT. • Mechanical seal; carbon-rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104° F (40° C) continuous 140° F (60° C) intermittent. • Class B Insulation • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. Power Cable: Severe duty rated oil and water resis- tant. Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTINGS Tested to UL 778 and CSA 22.2108 Standards By Canadian Standard* Association>us File#LR38549@: Bsyfieid Co Zoning D&pt- Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 SJTW with three prong grounding plug. Optional 20 foot length, 16/3 SJTWwith three prong grounding plug (standard on EP05). • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. PERFORMANCE RATINGS Total Head(ft. of water) 5 10 15 20 25 30 Gallons PerMinute EP04 53 46 36 21 0 EP05 62 55 46 33 11 PAGE 2 Wastewater METERS |FEFT 10| 30 y QI Goulds Water Technology Uj - 16 ~~W 6 a- ¥-i£r MAY 2 12025 Bayfielcj Co, Zoning Dept 30 40 50 GPM 4 6 CAPACIT/ 10 12 m3/h MODEL INFORMATION Older Nc EP0411 EP0411A EP0411F EP0411AC EP0412 EP0412F EP0511F EP0511AC EP0512F HI .4 .5 /oh 115 230 115 ?30 \mf 12 6 13 6.5 Minimui Grcuit Breakei 20 10 20 10 *hasi 1 Float Switd Style Plug/No Switch Piggyback /Wide-AngIe Plug/No Switch Piggyback/Wide-Angle -Piug7- No Switch Plug/No Switch Tlug/No Switch ?ig9yback / (Vide-Angle ^lugTNo Switch Con) Lengt 10' 10' 20' 20- 10' 20- 20' 20' 20' Ditdiaige Connectioi w 1%" 1%" w r/s" VA" 1%- w 1i4" Wnimui On Level Manual 12" Manual 12" Manual Manual Manual 12" Manual Off Level Manual 6" Manual 6" Manual Manual Manual 6" Manual Minimun Baaln Diamete 15- 15" 15" 15" 15" 15" 15" 15" 15- MaximuiSolid* Size %• ShippmiWaightIbs/kg 20/9.1 21/9.5 20/9.1 21/9.5 20/9.1 20/9.1 22/10 '3/10.4 22/10 PAGE 3 DIMENSIONS (All dimensions are in inches. Do not use for construction purposes.) /-$lr-- 7%^.ii-.-.-.n.^^ *-^^v1.. w/\/^! j ,'/' / / T 4% L .—9%Vl [D! I G U I MAY 2 12026 Bayfield Co. Zoning Dept .&s.^^^^•—---^--—^ r—1-t- ' ~T- 1%NPT J 3%yj COMPONENTS Item No. 1 2 3 4 5 6 7 8 9 10 Description Impeller Base Pump casing Mechanical seal Ball bearings 0-rings Power cord Oil filled motor Motor housing/stator assembly Motor cover lem Let's Solve Water Xylem, Inc. 2881 East Bayard Street Ext, Suite A Seneca Falls, NY 13148 Phone:(866)325-4210 Fax; (888) 322-5877 www.gouldswatertechnology.com Goulds is a registered trademark of Goulds Pumps, Inc. and is used under license. CZOIZXylemlnc. B3871 R1 April2013 TOP VIEW 4" VENT -PUMP PAD SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS W1250/750-MR TANK SPECIFICATIONS DIMENSIONS:WALL: 2 1/2"BOTTOM: 3" COVER: 6" MANHOLE: 24" I.D. PRECAST CONCRETC RISERHEIGHT: 66" LENGTH: 12'-H" WDTH: 7'-2" BELOW INLET: 53"LIQUID LEVEL: 48" WEIGHT: BOnOM 8,740 LBS.COVER 6,120 LBS. INLET AND OUTLET:4* CAST-A-SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL ftO(OTHER STATES SEE CHART) UQUID CAPACITi': 27.66 GAL/IN (SEP71C) 16.12 GAL/IN (PUMP) LOADING DESIGN: 8'-0" UNSATURATCD SOIL TANK CAN BE USED AS:SEPTIC/SEPTIC. SEPTIC/SIPHON,OR SEPT1C/SIPHON COVER: MIX DESIGN j^B (NO OBER)TANK: MIX DESIGN ^10 (STRUCTURAL FIBER) CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: ^- tD1$5M gmi^"i-Q°' I0^0x 00 ec. 0R ^I 0i SHEETNO."1 OF 1 ^ !R 1^ I J II AY Z 1 ^26 !Ly; lnmnitiim m ftcuft DniM»eSWastwittfProduch Zabel'ADniiaonofPnlyloklnc. ^yTieic' Cc, ^on'nci uep7. PL-525 Effluent Filter 1/16" Filtration Slots [lOftOQGPD Alarm Switch(Optional) Accepts 1" PVC Extension Handle Rated for 10,000 GPD 525 Linear Ft.of 1/16" FiItraUon Slots Accepts 4"& 6" SCHD 40 pipe PL-525 Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" fUtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball instaUed with every filter. When the fUter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. Feahues: • Rated for 10,000 GPD (gallons per day). • 525 Unear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts FVC extension handle. PL-525 Installation: Idea] for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If die filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 fflter into its housing. 5. Rqdace and secure the septic tank cover. PL-525 Maintenance: The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the fUter be cleaned every time the tank is pumped, or at least every three years. If the installed fUter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. 5. Hose off filter over the sepdc tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making CarttfiedtoNSF/ANSI Standard 46 Gas Deflector Automatic Shut-OffBalI L^,.___^ sure tihe filter is properly aligned and completely inserted. 7. Replace and secure septic tank cover. Outdoor SmartFilteKS Alarm Potylok, Zabd & Best filters accept the SmartFilter® switch and alarm. Ixtend&Lok™ EasUy installs into existing tanks. Polylokjnc. 3 Pairfield Blvd. WaUingford, CT 06492 ToU Free: 877.765.9565 Fax: 203.284.8514 vww.polylok.com rr' ;'.; '!•' ;..: li w! i^ in> JJ.! '^ ':- '': :' 1'1 : i|r BAYFIELD COUNTY ; „,/; ,v. iCHECKLIST FOR SANITARY APPLICATONS nAf :' Submit the Following (Use Permanent Ink) 0'itle 15, Section 15-l-10(e)) L ' ^ ^ [3Check List L/Original Sanitary Application (Submitted in Deed Holders Name - not prospective buyers) (383.21(1)1.) [a/Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) [^Original Plot Plan (383.22(2)2. 3. & 4.a) E/Cross Section, Over-Head Profile of the System and Schematic of Tank from Manufacturer 'ump Tank Diagram, Alarm and Pump Curve (when applicable) El Contingency Plan / Management Plan (383.22-3(2)(b)l.f.) Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) / 0ATU Servicing Agreement (Recorded at Reg. of Deeds) E Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) 0 2 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) SSoil and Site Evaluation Report (383.22-3(2)(b)l.e.) Ef §tate Plan Review (when applicable)/Ef Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) Y_ -..._- ... _x^B I Application Information must include: 0 23 diait Parcel ID# - (do not use 12 digits anymore-obsolete) f' 13' Project Address or Road Name where driveway is/will come off of) 0 (Owners Phone Number) f3 II Type of Building Q HI Type of Permit 13 IV Type of POWTS System Ef V Dispersal / Treatment Area Information E) VI Tank Information G3 yil Responsibility Statement (Plumber's Information) *Date Stamp* Plot Plan: (To Scale or To Dimension) \3 ^ignature and Plumber Information D Address Number and Road /'' [^Surface Elevation of Body of Water \^ North Arrow / /B Direction and Percent Land Slope 0 Contour Lines 0 Tank and Filter Information and Location 0 Structures and Driveways ^ Wetlands / Navigable Bodies of Water B/Bpring Locations [^Absorption Area (Proposed and Existing) B Property Lines 0pench Mark (Location, Elevation and Description) E'T Well Locations / Ef Component Manual Version G3/ Legal Descriptions Piping Material Information (conveyance line, building sewer line, material type and diameter) Turn Over ^- Crcss-Section and Over-Head Profile of the System: / — ... -iC ;''" '.- i; !!"Surface and System Elevation ;;^ ^ !: !i "' B Position of Observation and Vent Pipes 'j ; „„ „,, / i.:' '!/•;' '/ , :1/Q Dimensions and Depths / /:. - l3Make, Model & Number of Chamber Units in each Cell ; ^ ,^: i ,,; i; Property Information C'fHow many systems will there be on this parcel of land? _J_ E3 Has this property been split? f-'c' (Property Statement shows Property History) Fees: D Private Sewage System (Septic Tanks) $ 400.00 a P/rivate Sewage System (Holding Tanks) $ 400.00 lounds or Systems requiring Pre-Treatment $ 500.00 D Sanitary 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: Private Sewage System Maintenance Agreement Owner(s) Name Ae^'iA B. Sc^'isa ^—Mxwi-^—9-- r3«.kcl^*- Owner(s) Mailing Address GOZ\'^ ObfCjlK^ U Kfc^.Wi- 5~^^^' Site Address 2.5'780 F^<| Rd. ^u^,Wi,. ^^'r Tax ID #3C1(^ As owner, I (we) do hereby certify the private sewage system will be installed inaccordance 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 said private 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) _/V£_1/4 of -Sfc" 1/4 Section 5 C» Township ^7 N. Range ^> W. Additional Legal Description: Town of Lot_Block ')ee^(Acreage)io Gov'tLot. Subdivision Lot <L CSM # ^'(f- Vol. 13 Page 2f? CSM Doc « 202? K ~6'C)jfJ2 DOCUMENT NUMBER2025R-607566 DANIEL. J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. Wl RECOROED 05/2 1 ,2025 AT 2: 1 7 PM RECORDING FEE; $30.00 PAGES'- 1 Recording Area Return To:r^ll^UI i !nPldntiing and Zoning Departr :-.:( n 2025 ^uiiiiiLi L'yiit. C] In-ground gravity Kf Mound D In-ground dosed D In-ground pressure distribution Sewage System: D At-grade Sewage System D Other Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation 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-third (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 septic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic 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, Wis. 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 swabbed if needed whenthe wastewater distribution cell component is inspected as provided above. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate anyhuman health hazard caused by the system. Bayfield County shall notify the owner of any costs 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 provided by law. The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future owners of such property. Owner(s) Name(s) - Please Print Ke^\ B- Sc^cl'ee-. SubscfredI iWti»Ji(???t%tWteeiWROn ^ date:; Notary Public State of Wisconsin ^ Notarized Owner(s) - Signature(s) ••'^ ^ Notary Public My Commission ExpTres:^V^ ^50 Drafted by:T^>~^)^iA?^r^t^-'IN3ate:' S^| U?( ^ ^"0"Proofed by: u/forms/sanitary/septicmaintenceagreementRevised July 2020 BAYFIELD COUNTS SANITARY PERMIT f#04)-25-34S STATE SANITARY PERMIT OWNER: KEVIN SCHOLZE GOVT LOT: LOT: 2 BLK: CSM: 2316 1/4 1/4 SEC: 30, T 47 N, R 5W TOWNSHIP: Eileen SOIL TEST: 134-23 NEW SYSTEM SYSTEM JVPE: Mound > 24 in. of suitable soil PLUMBER: TONY BROWN 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 #: LICENSE: # 664303 TRACY POOLER Authorized Issuing Officer DATE: 5/30/2025 Condition: THIS PERMIT EXPIRES 5/30/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION