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HomeMy WebLinkAbout25-37SINBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY "" TIME RECEIVED REMOTE CSID DURATION PAGES STATUS Auguut 20, 2025 at 2:04:17 PM CDT 7157983470 36 1 Received AUG/20/2025/i1JED 12:38 PM Andry Rasmussen & So FAX No.7157983470 P.001/001 / u Request for Sanitary Inspection (24 Hrs. in Advance) Fax this form to Zoning Dept (24 Hrs.) prior to when you want an inspection — (715) 373-0114 If you do not have a fax and must email the inspection; you must email all staff members. Note Time Change fl Discrepancy fl Other Phone Number Plumber: /( Qr� F#+ fry ffos rwssNn r, Fax Number r� /%✓5-_ Wa7 3Y 7o Homeowner: nir Email Address 7n4 andr'y,vydor�f 64rdr TiuJ rn;Ss •ras1 c° Immediate Phone Number So Zoning Sanitary Permit #: +j 37 Dept can call you right back (if needed) Plumber's Choice Dept No Inspection(s) during this time Date: 1 q aS Y` Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice ept Time: 1f°�o r Township: nn Address # & Road Name: or �" q % ?RSo -rylcti llti-vr' 3g� Directions To Site: Comments: Plumbers you must verify any change(s) by fax or email -' Notes from u/forms/sanitarylrequestforinspection Zoning Dept (®4/12/04): ® June 2023 a�inxr.� eat Industry Services Division General Information Private Onsite Wastewater Treatment Systems ( POWTS). Inspection Report (Attach to Permit) City WAGNER FAMILY LIV TRUST 5510 MAHONEY AVE BM Descdp. MINNETONKA MN 55345 -cathacRtn- Village L I Town of. County SanitaryPermit No: State Plan'Transaction ID#: Parcel Tax No: TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Se tic c,vsr jkwa 4 I U N/A Dosing N/A Aeration N/A Holding Pump / Siphon Information Pump Manufacturer Pump Model Demand GPM Filter Manufacturer Filter Model TDH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well Dispersal Cell Information DIMENSIONS Watt( Le g th # of Cellsg e SETBACK FROM Prop.. Line Bujding 0 Well OHWM — Type of Cell in i t u w1k' �1 Manufacturer: Model Nu'Mber Pretreatment Unit Manufacturer: Model Number. Elevation Data -ff I E y STATION HI • ELEV Benchmark 00 Bldg. Sewer 7 Tank Inlet — C Tank Outlet s Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/ Manifold 4.3 Ii Y Distribution Pipe Infiltrative Surface r Final Grade stribution System X Pressure Systems Only Header / Manifold Length Dia Distribution Pipe(s) Length Dia _ Spec_ X Hole Size X Hole Spacing Observation Pipes 0 Yes ❑ No Soil Cover Depth Over flan fla +ar Depth Over Call Fdnrs Depth of Topsoil Seeded / Sodded ❑ Yes 0 No Mulched 0 Yes 0 No tie lt COMMENTS: (Include code discrepancies, persons present, etc.) (t� t. 1 to , .Rt o� f ur rc,4 . �tr��all t d let - . 0 e�Vl a en_c ma r Ufn1C/J -kAVth da,il, �o A'ta.f "OY" f Iro(,�S �- CI�LL�I'S CAs4m oa Ittn g(aM bdroAzI s5 la�►raJ good un site (Sand �- Ivamy saw Atud w1 r - Ijw bcnchmgrlc 6c— glrcr.tJ d�/yvt Jt 6uckc wc+Atd lx SWAW2bc),g' 6tiOWtT cslygr u Ian revisibti required Yes EI No I u a other side for additional information. d� as a� I / q( 'tl_____ ��lit/ (r Date POWTS Inspectors Signature License Number Rm� S RR71n /R Mr911 aublued on ktttftuw JAM Property Owner Information As you know BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zoning(d bayfieldcountv.wi.gov 117 East Fifth Street Web Site: www.baVfieldcounty.wi.gov/147 Washburn, WI 54891 WAGNER FAMILY LIV TRUST 5510 MAHONEY AVE MINNETONKA MN 55345 onsite wastewater treatment system on your property described as: Notes: was contracted by you to install a private Abandonment of Old System to meet all applicable code requirements: 1 e Tank was pumped by: r Tank was crushed / removed and pipes disconnected by: on at AM/PM On at (AM / PM) the above -mentioned plumber contacted our office to ccoond}ct a pre -cover inspection as required under DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. System was inspected and appears to meet all applicable code requirements; however, a plan revision is necessary because the installation was substantially different than the original approval. System could not be inspected because plumber covered prior to scheduled time of inspection. ❑ System could not be inspected because plumber was not ready at scheduled time of inspection. County was unable to return to complete inspection. System could not be inspected because plumber was not ready at scheduled time of inspection. A re -inspection and $50 fee are required. LIISystem could not be inspected because County could not respond to plumber's time constraints. Comments: C(�11h tVIS�Q`i( ( ee[I ins+a(I ecf ofl inal(�� Bev\AM n\( 4udch duAg dunes, 6A<-ruc fcvn (iJC.) heL4t/fti b.1 0Aml cr. . 0tucf41wts btgidc,i 'g11M cs1sl (—C I U/forms/sanilarypropertyowner-input April2019 Industry Services Division 4822 Madison Yards Way fi?,2 Madison, 37 County Bayfield itary Permit Number (to be filled rn by Co.) `'� -� Madison, 53707 pe� 3 7 ,9 Sanitary Permit Application to Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appDa� e(gp r7� (p� is required to obtaining a sanitary Note: Application forms for state-owned P WTS to t. Project Address different than prior permit. are submitte (if mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 88850 Mariner Mile. Ba field WI , I. Application Information — Please Print All Information Property Owner's Name Parcel # Wagner Family Liv Trust 38235 Property Owner's Mailing Address Property Location 5510 Mahoney Ave Govt. Lot City, State Zip Code Phone Number Minnetonka, MN 55345 970-333-0424 %, %, Section 35 T 51 N R 04 E or II. Type of Building (check all that apply) Lot # Subdivision Name a1 or 2 Family Dwelling —Number of Bedrooms 4 2 Opublic/Commercial — Describe Use Block # Cityof ❑State Owned — Describe Use Village of CSM Number #21 27 OTown of Russell IIL Type of POWTS Permit: (Check either "New" or "Replacement" and other applicableon line -A. Check one box:.on lihe B :.Cbinplete1ine C if ` licable. A. INew System OReplacement System ❑Other Modification to Existing System (explain) Additional Pretreatment Unit (explain) PIndividual B.❑Holding Tank ❑✓ In -Ground ❑At -Grade ❑Mound Site Design Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision Change of Plumber ❑Transfer to New Owner List Previous Permit Number and Date Issued Expiration NA N. Dis ersal/TreatmentArea=and: TankInformationc Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 600 0.7 857 892 92.0 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units U H New Tanks Existing Tanks 9. a 0.0 . Z C7 A. Septic or Holding Tank 1250 1250 1 Superior Precast LJ✓ Dosing Chamber ❑ ❑ V. Responsibility Statement- I, the undersigned:assume'responsibility- for -Installation •.of the-POWTS shown on the attached,plags. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Jason Kuettel 675751 715-798-3355 Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 VI. County/Department':Use Only Approved 0 Disapproved Permit Fee Date Issued Issu' g Agent Signatu �� ❑ Owner Given Reason for Denial `_/00 . O0 (Q 1 ,•1,' Conditions of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 81/2 x 11 inches in size SBD-6398 (R. 02/22) • I n I• SOIL EVALUATION Scale: =4,J. PAGE 2 SITE MAP �� �� ❑ SYSTEi1 OF 1 PROJECT NAME: PLOT PLAN wrr6Nzc'�- A70 t:'-E;ra, to, D.:S;c,fF_,,,• c4 (:;r, GPD A¢tach design Pow calculations for commercial plans. FPaiECTA00Ri=SS Tz J - 41.21 v ;c rL �, LC. Pipe Material / ASTM Standard (Tables 354 3Q-3 & 334.30-5 ) S�Md Symccl:. $- 8�yt Eta- 'on. 100 1 +- FT N V Sanitary 5e,•r.r SCI Description: N tt11� 10 1 o `• Wr11 rb -' Fcrce Al an: Slope Gradient (°4) yyetl Symbol(if a� bcable tnd:cala north by IMPORTANT Tom: of Tested Area: 7 S / R ): 0 drawirg an 3rrc:� on the approprite ttne. Show ground elevation contours at suitable inter/als. ______ L1 & —i/ I / --.-H i 5 .Biel I rr�3� J i I ! : t j ±IEH—f1 iith±±1 I i; -- , : ___;_1_'_± . j __-' /1; _ _ H\ L LL\ \1 /_ H. . .7! :. . p: I::: :..i " -.TTJ .:T1i/ :.: .±.: -•- ::T ____ RECRIve l CST / K7 67S7 3 N0V 012029 Bayfieki Co. ZoRa� A9� SE?T7C '? AJI;{ C'oSS SE 1_011 -AND S -CI a .� C .Ti GNS 1.1;` SCIt`+©PVC ItTSP. PT?E kn( e+ •rnc-x.110 64s �� bur{;za 30t1L G .=.,�E. ('v� �,} HAY 21 OZ5 Sayfield Co. Zoning Dept. APPROVED i Trt" SHAD /,il/djc- 8&1.. 1 Ij'IL AP PR( PIPE ONTO SD IL 3" APPR(W D EEDDING UI1D�P. T rftc SPECIFICATI-OHS S EPThC. Ta&[K ?iA.IUFACTU'R.r:-SyQeZlut?.. nCcoerj _' T.AtIK S TES: SE?TIC J'ZS'c GAL. OUTLET r PAGE 1 OF 4 In -Ground Gravitv Plan Index & Cover Sheet MAY 2.1 2025 Component Manual Design References: Bay In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-20field Co. Zoning Dept. Pg 1 of 4 Index & Cover Sheet Pg2of4 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name I Description Wagner Family Trust Owner Name(s): Wagner Family Liv Trust Owner Address: 5510 Mahoney Ave. Minnetonka, MN Project Address: 88850 Mariner Mile. Bayfield, WI 54814 Govt. Lot: 1/4 of Township: Russell Project Parcel ID #: 38235 Designer Name: Jason Kuettel Phone: 970 -333 - 0424 Zip: 55345 1/4, Section 35 , T51 N -R 04 County: Bayfield Designer Information Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 Remarks: E❑or w Phone: 715 -798 -3355 Zip: 54821 This space reserved for approval stamp. Signature:r4 Date: 5 75 Original signature required on each submitted copy. RECEIVED NOV 012023 Soil proL9Ia Sheaf S7tn^i 'leva.ion� � o LoSy;F R3 Zt to 4b.Co 1.: •.•.j ... t qf •� 3 9� .. a. as T ' T ° / i1114 8 I .. IL '•SOIL EVALUATION ' =��� j �o S YS T f SITE MAP � i� ri, PLOIP!11)1 0ESFL:w'4' 2 •1'L ur-r] ' ;;:t awn d�si;n r:o',•i caf..-�t►�.,i�I��C� l��a�(�flft��i ��Q�� rP,QJEcrAoQ=3S 73 +'�- -,z; v L' $ LL �� Pip IbhI-a-dal i ASIM S ?ndard (i Tablas 3 24 3C 3324.30-5) « �njj 11 1 .- � iar; J�/T.:.i: �( '-Y3CC!!. ��:' �� l S3!!tta � �?:v?^ °l SC� l.(l7 G, �._ rT 8&1 G-3svipticn. N �''« & ti d" Wr1I'=t t'rt!Gr Fcr•_� ,+.(si1: 13 Sioce Gradia.m ('.b} �il • 5 % „ indicala north by IMPORTANT; �f! Symccl (if scplic3:.ls): O dra:virq an sr -:v Show ground elevation contours appnprit_ %n.- at suitableint..ni313. p — SU LI [LaA-L ► G 9p v I 1 LS3 Th11 ) 7I i ! I3j� t' f i ---rte: { ' i t b 4 L___ I 'i LHL,i i I t j I , i i / \._i i 'iL � 1 � H! Hi7'T/. II = i i 1i � ' "'\.s ! i `-te`_ _..��....,_�y•� j l J i"\ l---�-1 I ! l l E j _ i 1 --� __ ____ t_ •1 i___ 'I f /vii _�' �:�C 'Vnf�'.J'%i� t_.. � ,�t.�• f� - •`- - y .._ . .... _ .. ----; _ - • - -- - ... .. . _ • _ I IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER 12" min. trench depth (typical) min. 12" (typical) .a .. . (typical) ;'4_'\\a..e• System Elevation = 92.0 (typical) Septic Tank(s) Manufacturer. Superior Precast Septic Tank(s) Volume(s): 1 250 gal gal gal gal Effluent Filter Manufacturer. Orenco Effluent Filter Model #: FT -0822 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) ft Quick4 Standard -W w/End Cap (Show location of inlet / outlet pipe connection on plan view.) r- ----------- --------'jam---- L------------r--------�---- B = 90 ft (typical) INSTALL PER TRENCH: 22 Quick4 Std -W @ 20 ff EISA/chamber = 440 ft2 + 1 Pairs of end caps @6 ft' EISA/pair = 6 ft2 = Proposed EISA per trench = 446 ft' Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / instructions. TYPICAL TRENCH PLAN VIEW (No Scale) TA = 3.0 ft (typical) `Quick4 Standard -W Chamber (typical) (mid by Infiltrator Systems, Inc.) Instal pursuant to manufacturers instructions. Required Infiltration Area = 857 ft2 > m 0 P vuL W o - O ?j co 0 N 0- nr m r I� Distribution Method: x 2 trenches = Proposed Total EISA = 892 ft2 branched manifold In -ground Gravity Management Plan MAY ? 'i 2025 IMPORTANT: 3ayfield Co. Zoning Dept. The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 600 gpd; BOD5 ≤ 220 mgL''; TSS ≤ 150 mgL''; FOG ≤ 30 mgL'1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Andry Rasmussen & Sons Local government unit: Bayfield Co. Zoning Local government unit address: 117 E 5th St. Washburn, WI Phone: 715-798-3355 Phone: 715-373-6138 ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. Ft, Industry Services Division 4822 Madison Yards Way County Bayfield ' f Madison, 3 Permit Number (to be filled in by Co.) - S5oP.OB0Vadison, 53707 Oitary , 7 2025 Sanitary Permit Application U flAY 21 o Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the pt. Project Address (if different than mailing address) isrequired prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submittea to the Department of Safety and Professional Services. Personal information you provide may be used for secondary 88850 Mariner Mile. Ba leld WI purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. Y' 1. Application Information — Please Print All Information Property Owner's Name Parcel # Wagner Family Liv Trust 38235 Property Owner's Mailing Address Property Location 5510 Mahoney Ave Govt. Lot City, State I Zip Code Phone Number Minnetonka, MN 55345 970-333-0424 '• 1%, Section 35 T51 N R 04 E or 1i I1. Type of Building (check all that apply) Lot # ❑✓ I or 2 Family Dwelling — Number of Bedrooms 4 2 Subdivision Name Liublic/Commercial — Describe Use Block # City of Village of State Owned — Describe Use CSM Number #2127 Town of Russell Ill. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if applicable.) A. JNew System I�I� I JReplacement System L ❑Other Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B. ❑Holding Tank �Ih-Ground Dkt-Grade Mound Individual Site Design Other Type (explain) (conventional) C. []Renewal Before ❑Revision JChange of Plumber Transfer to New Owner List Previous Permit Number and Date Issued Expiration NA IVV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) I Dispersal Area Required (st) I Dispersal Area Proposed (s0 I System Elevation 600 0.7 857 892 92.0 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units 2 A to u New Tanks Existing Tanks iU vv J ti u O a Septic or Holding Tank 1250 1250 1 Superior Precast ✓ O Dosing Chamber 0 C O V. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) I Plumber's SignatureI MP/MPRS Number I Business Phone Number Jason Kuettel 675751 715-798-3355 Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 VI. County/Department Use Only Approved ❑ Disapproved I Permit Fee $ Date Issued Iss V g Agent Signatur Z I O Owner Given Reason for Denial 'too. 00 (Q 1,3 /.G Conditions of Approval/Reasons for Disapproval Anacn m mmryMe pians for Inc system and submit to the County only on paper not less than 8 to x II inches in size SBD-6398 (R. 02/22) €oIVCD NOV 01 2023 ' Wisconsin Departmentof Safety B.Professional Servi+es � Bay5eid Co Page "r of / 7' '\ Division of Industry Services Planning and Zoning Agency SOIL EVALUATION REPORT 4yan„s4 In accordance with SPS 385, Wis. Adm. Code County aA iFr Eel Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must Include, but not limited to vertical and horizontal reference point (BM), direction and percent slope. Parcel I.D. -Z scale or dimensions, north arrow, and location and distance to nearest road. 313 Z- 3 5 Please print all Information. Reviewed by 1l�(� Datpr1� Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). Property Owner Property Location ❑ IB' Ere/2 c- J ✓Llf} vJfGNC.Z Govt. Lot % ''4 S3$ T S/ N R Or{ E(or) W Property Owner's Mailing Address Site Address or CSM and Lot #: S/o ,MAt4tfrE1 44E 7-Ob - CDT Z c$M 'ZIZ7 City, State, Zip j Phone Number ❑ City ❑ Village Town Nearest Road Mtfflrorit4 SS3 (770 ) S- dt(2t/ ,Zv1se— ^„p,<tN2rLMt�E New Construction Use: 19 Residential/Numberofbedrooms 3 Code derived deslgnfiow rate 'ISO GPD Replacement ❑ Public or commercial -Describe: '— Flood Plan elevation if applicable ft Parent material pvrwadH- General comments and recommendations: to O TI Boring # Boring ®Pit Ground surface elev.CI≤, ? ft. Depth to limiting factor)" In. / elev.d•>_4Tft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. ConL Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots ., rwr•,w GPD/Ftr 'Eff#1 •Efi#2 oz 7.stt f — �s o (. iV 6k3 Ifl4 6"? to 2 Z S S Y/t-'/-t — Sw1k,4, ace r.t 6t- jncS o.') j. L 3 9 -3 33 9 7'S' -e / •s of " e — — SN 5 ""aSG. / ofG n. 0 — )i 0.7 o.-, /.G i . G Boring # nI oring Pit Ground surface elev.96 77 ft. Depth to limiting factor≥ _ In. I elev$_6 ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/Ftt 'Eff#1 Elf#2 0`3 ).S'CA."JI — LI ss6 Mr 343 (Iv! a,) t 2y,,7 •S ' — nw (b%I4 o.') t 9 3F 7.s Ya-'79 — S 9 or( n.l ) e. 1,6 N y —/'b ?.c —/G — .S " SG fK — CST Name (Please Print) / Signature CST Number _p Address Date Evaluation Conducted Telephone Number Pa 9°s6 C ce vlJt z S- 75 -375 Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 5150 mg/L • Effluent #2 = BOD, S 30 mg/L and TSS 5 30 mg/L SBD-8330 (R03/22) Pa 35D J1 -H3 a1/L, Page Z of ❑ Boring SQ goring # Jj Pit., •, .,. Ground surface elev.� • tZ ft. Depth to limiting factor))) in. / elev$ 7, I Jft. Snil Annllcatinn Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. ef(, Consistence M i Boundary Roots 14- GPD/Ft2 •Eff#1 C - 'Eff#2 (. 1 _ ro 7,S -i.r Z77Jt,4 - S aj -- 1. Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots •rr^ GPD/Ft2 •Eff#1 *Eff#2 LIII Boring # ❑ Boring ❑ Pit Ground surface eiev. ft. Depth to limiting factor In. / elev. ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Tr'• GPD/Ft2 •Eff#1 *Eff#2 • Effluent #1 = BOD > 305220 mglL and TSS > 305150 mg/L ' Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 mg/L SOIL EVALUATION S SYSTEM PAGE 2OF SITE MAP PLOT PLAN PROJECT NAM=: Wa6,�en P �7ea CZ3G„P 774 yso c c --- Attach design Pow calculations for iai plans. PROJECT ADDRESS ir3MPr21N'=rx- MIIC- Pipe Alatedal / AST;MI Standard (Tables 3a sl.30-3 & 331.30.5) am 4rmccl &Ad Eavation. /d d . r FT N Samtar/ Sewer 1 BMDescnpden. t Aar to 10e 14VAITt r, Rree Main: I Slope Gradient (?I) WallSmbol (ifIndlcala none by 1IMPORTANT: of SlopeTestedArea7• S /.. / ( ) 0 drawing an arry on me appmprea a. Show ground elevation contours at suitable intervals. SRMrs ti q cw Ji1� cu— ! J ig I � I l ;w r' -2oT l I I % i ; i— —! 5 n1te/i ts4 4 � l ei i l l l I 4!E_ i f�3�z?S i i I I �_ I; i I l l ZYINI e< I \ /_I - -- I e I i 1 I I r l - i IU L\7 Im:≥IL1 s �� 4t, 0.7 I - a� � p RECENEd CST / w 6 Sl 9� �,/z3 N0V 0120291 yfiekl vlannmg ' BaCo. ar j Zonru..a...... SEPTIC TAN' CROSS S--.T.-OH AND S?ECI:iOTioIiS y" GC41•4OPVC INSP. PIPE 6e KIN. ABOVE G .DE.(opt) MAY 21 2025 `whe-(1 lnle+ fn�e�h01 Q. IS Bayfield Co. Zoning Dept. APPROVED MANHOLE F TNISHED GRADE W/ Lcc . W'�Fl 10' L4g6L w 4" NIH. 18" JJ I FILET OUTLET APPR LED RA-F-P�E— O FILTER APPROVED MFG. O4€v1cO PIPE 3' ONTO SOLID model I cy0$2z_ SOIL Ii 3" APPROVED BEDDING UHDEP, TANK SPECIFICATIONS SEPTIC TANK HA}UtACTLTRER: S�Q��ZIatL'�l:ecs3rj— T ;NK S LES: SE'TIC )'ZSc GAL. NOTES PAGE 1 OF 4 In -Ground Gravity Plan ! C Vl I D Index & Cover Sheet ll MAY 21 2025 Component Manual Design References: Ba field Co. Zoning Dept. In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-202y/ Pg 1 of 4 Pg2of4 Pg3of4 Pg4of4 Index & Cover Sheet Plot Plan Dispersal Area Cross -Section & Plan View Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description er Family Trust Owner Name(s): Wagner Family Liv Trust Owner Address: 5510 Mahoney Ave. Minnetonka, MN Project Address: 88850 Mariner Mile. Bayfield, WI 54814 Govt. Lot: 1/4 of Township: Russell Project Parcel ID #: 38235 Designer Name: Jason Kuettel Phone: 970 -333 -0424 Zip: 55345 1/4, Section 35 , T51 N -R 04 E ❑ or W ❑✓ County: Bayfield Designer Information Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 Remarks: Phone: 715 -798 -3355 Zip: 54821 Signature: Date: 5/7'I/ZS Original signature required on each submitted copy. RECEIVED NOV 012023 SOIl rFOCilt 3(,v�t aayeea2 PWnnWl arq zt2i ,fl Srstzm=levgyon 9z• o Lad 2_: o• Syst:m Rn�g=.99•Zi to Qo• 60 IT 96 If4 zGc r c�`S.7 GC 7W 9� . f 75Tt,w C. . ...... .... 9.t.Q o 9° o.a5So_¢o S4 f _ ass 3 ' 8>.co iL,., & " j —� SOIL cVALUATIOI`! '=a'? I SYST I���' SITE MAP PLOT P N D in it oJ_�T rl.-.',I_: ri ii a 1111 MkY 2 1 2025 wt}6Nert g /7ea :; I;: ^Y3, n cw:i .- . _ ;n eow .3 . a @1d'C&rmnept: Peoaeoucoaeas 717 ' 4.h-'el.=n„'eI t N Pipddat?ral i ASTdd Sc3noard (Tablas 3- 3C-3 d 3? =30O) O MSyrxl - c1A-iav3[cn. /=1c.- i t� 3arta:jSewer �SGU 40 (wtf 8M Caaccal:rn NAa'— .. to" WrUrt rb`-'e I Fcr-a ,Aam: N41 Sloce Gradient ('.5) Well y mc.I f a-plica Ind;ca:e noon t, IMPORTANT: ort=_;ta;vaa 7�_-% / G �I-I: O a. aw,r7arar.:" Show ground elevation contours atsuitable intervals. pn ro 3por:r.'ta'i•'a. 4-- LIA WAGM ec- ` / J --'-- Y?s TB—n"4rcw�'cMti1-,� S'jSt,e1Rlat Ji) it I I t? 1 /____Y[aff✓ fee &S �� —I /______I, 7-Kcv ` ' io'�iarr,re H -/ I — V l I I —� .� %— -- — — -- -- ------ -- to _I L. \� - --- - *NO vzpze'tCY 'N - ON P,4otr a I me b•757S1 5/2 (It5 IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER 12" min. trench depth (typical) min. 12" (typical) (tyPlcal) ;'' System Elevation = 92.0 (typical) Septic Tank(s) Manufacturer. Superior Precast Septic Tank(s) Volume(s): 1 250 gal gal gal gal Effluent Filter Manufacturer. Orenco Effluent Filter Model #: FT -0822 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) ft Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) L— — — — — — — ------------- I" B= 90 ft (typical) INSTALL PER TRENCH: 22 Quick4 Std -W @ 20 ff EISA/chamber = 440 ft2 + 1 Pairs of end caps @6 ft2 EISA/pair = 6 ft2 = Proposed EISA per trench = 446 ft2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturer's / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) IA = 3.0 ft (typical) `-Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. Required Infiltration Area = 857 D W ui C) a m A P N uuu W 7 NO a O ` m to v m rte. J ft2 Distribution Method: x 2 trenches = Proposed Total EISA = 892 ft2 branched manifold In -ground Gravity Management Plan dMAY 2 1 2025 gi IMPORTANT: Bayfield Co. Zoning Dept The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 600 gpd; BOD5 5220 mgL-'; TSS 5150 mgL"'; FOG ≤ 30 mgL-' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (Le., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats, when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Andry Rasmussen & Sons Local government unit: Bayfield CO. Zon Local government unit address: 117 E 5th St Washburn, WI Phone: 715-798-3355 Phone: 715-373-6138 ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. SS- ojg 10 Private Sewage System Maintenance Agreement C Wy0N C4 IA.J"lli �-,zus�eS t As owner, I (we) do hereby tartly me private sewage system will be installea In accordance with the certified sob testers 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 WI Adm. Code, as from time to time amended, �(COMPLE E Leeggall is required) 1/4 of 1/4 Sectioon4t. Township y! N. Range W. Additional Legal Description: /) ecrO O-� O /`Id 1/i(l $CC OVVI _e Town of_______________ S.SL l (Acreage) /Gov't Lot Lot _ Block Subdivision Lot o2 CSM # aa7vnl.'a Page o?76 CSM Doe u.?ada S81P3s In -ground gravity ❑ Mound O in -ground dosed At -grade Sewage System DOCUMENT NUMBER 2025R-607561 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED 05/21/2026 AT 12:47 FM RECORDING FEE: $30.00 PAGES: 1 Return To: pJ a lt8 N a n g e rt t liD MAY 222025 ❑ in -ground pressure distribution Sewage System: ❑ 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 typos 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 lank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specifications. Fitter 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 pending on the ground surface. Mounds,. At -grade, anti Ingg4rfd Pressure System l..aterals (system types C, D and E): The laterals shall be flushed out and swabbed if needed when the wastewater distribution cart component is inspected as provided above. Owner(s) agree that failure to con ,fy with this agreement will result in action being taken to pay all charges and costs incurred by Bay ietd County for inspection, pumping, hauling, or otherwise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system. Saylield 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 he placed on the tax roll as a special assessment for the abatement of a human health hazaN, 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. mmgel fl Molls) — crease rnax fizz ws tit �7B,.,5Tt:c tadzed Owner(s) Drafted by: Ti" CLHriS Date: .5/it /tS (scribed and sworn to before me on m.wr„ro Proofed by MARK A BAL TER( NOTARY PUBLIC- r;ap,lary 'cmanlviseJuly2 20 V �F Revised July 2020 My Commission Expires Jan. 31, 2028 BAYFIELD COUNTY SANITARY PERMIT (#04)-25-37S STATE SANITARY PERMIT OWNER: WAGNER FAMILY LIV TRUST GOVT LOT: LOT: 2 BLK: CSM: 2127 1/4 1/4 SEC: 35, T 51 N, R 04 W TOWNSHIP: Russell SOIL TEST: 172-23 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: JASON KUETTEL TRACY POOLER DATE: 6/3/2025 Authorized Issuing Officer 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: # MP 675751 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 6/3/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION