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HomeMy WebLinkAbout25-41SRequest 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 fl Time Change fl Discrepancy fl Other Phone Number 715-682-6050 Plumber: Blakeman Plumbing & Heating, Inc. Fax Number Email Address Homeowner: Tasty Plunderer LLC steven.waby@blakemanplumbing.com Immediate Phone Number So Zoning Sanitary Dept can call you right back (if needed) Permit #: 25-41 715-292-1361 Plumber's Choice Zonin Dept No Inspection(s) during this time Date: 07/07/2025 � Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zo Dept Time: 11:00am Township: Bell Address # & Road Name: 89775 W Sunset Dr, Cornucopia, WI 54827 or Directions To Site: Comments: Inspect Holding Tank Installation ** Plumbers you must verify any change(s) by fax or email ** Notes from u/fors/sanitary/requestforinspection Zoning Dept (®4/12104); ® June 2023 POWTS HOLDING TANK INSPECTION REPORT (ATTACH TO PERMIT) TASTY PLUNDERER LLC 3173 SUNNYSIDE ST STOUGHTON WI 53589 TANK INFORMATION TYPE MANUFACTURER/MODEL# CAPACITY 91� I�NfilIVA1 illW4r, IpSf),-isO SETBACKS Property Line Well Water Service Building All -Weather Road OHWM Swimming Pool 40 O 1OO4- DEVIATIONS FROM APPROVED PLAN COMMENTS (Persons present, discrepancies, etc.) 1 �QYIi�aV,huhl V wdtny-�.0�"5 �porJ1 I(avk hale QuJc, fuvC1 G11 (UJ&ccr") &4'j 104 j — pl Imo. 'ii (a U4 pUaq (,.A nsc✓s;addpc( by, k'pm k'UCi C '4 "S . added by fap ri'. 1.10"* ' t �J4 f fff 4CAMC. llatc flL UlnaIn f{(IMN�I Q15f(hS v*q Alarm Ci UWlS oh' Ulna ca Pe nca nskll ed COMPONENTS NOT INSPECTED Plan Revisio equired ❑ Yes No D a Signature of Inspec r: Cert. Number SKCetch on other side 10 of 13 �J 4: Property Owner Information As you know onsite wastewater treatment system on your property described as: BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zoning(dbayfieldcounty.wi.gov Web Site: www.bayfieldcounty.wi.gov1147 TASTY PLUNDERER LLC 3173 SUNNYSIDE ST STOUGHTON WI 53589 Notes Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 was contracted by you to install a private Abandonment of Old System to meet all applicable code requirements: •o Tank was pumped by: Tank was crushed! removed and pipes disconnected by: on at AM/PM On at (AM I PM) the above -mentioned plumber contacted our office to cond t 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. System could not be inspected becauseCountycould not respond to plumber's time constraints. Comments: �1�� ? V 1 41 t1l1K tIIS�U1f6� f pl(AI, Ulforms/sanitaryprapeayowner-input Apri12019 i¶1Vl5S -0055 ` a�pARmmi - -' MAY I'- 9 202 Industry Services Divisio j 4822 Madison Yards Way County Bayfield Sanitary Permit Number (to be filled in by Co.) pS Madison, WI 53705 P.O. Box 7302 t° f Co. Zoning�ept Madison, WI 53707 �r t2S - 41/ JBayfielci Sanitary Permit Application State Transaction Number In accordance with SPS 383.2I (2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) 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 purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. 89775 W Sunset DrCornucopia, WI 54827 , I: Application Information — Please Print All Information Property Owner's Name Parcel # 3�136GL Tasty Plunderer LLC C 04-010-2-51-06-21-1 05-001-04100 Property Owner's Mailing Address Property Location 3173 Sunnyside St Govt. Lot 1 %� %, Section 27 City, State Stoughton, WI Zip Code 53589 Phone Number 612-965-2076 T51 N R 06 E or R. Type of Building (check all that apply) Lot/I Subdivision Name Jl or 2 Family Dwelling —Number ofBedrooms 3 _ Block/I ❑Public/Commercial — Describe Use OCity of ❑State Owned — Describe Use JVillage of CSM Number aTown of Bell III. -Type of POWTS P&initi (Check either "New" or "Replacement" andother applicable on line A. Check ohe box on line B C6mplete`lme'C' a - l*cable. A. ✓ INew System OReplacement System jlOiher Modification to Existing System (explain) Additional Pretreatment Unit (explain) B. Holding Tank IIIn-Ground lkt-Grade Mound Individual Site Design Other Type (explain) (conventional) C. [JRenewal Before Revision Change of Plumber ❑Transfer to New Owner List Previous Permit Number and Date Issued Expiration IV. DispersalfrreatmentArea.and Tank: Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation Capacity in Total # of Manufacturer , o Tank Information Gallons Gallons Units ? '►° 8 y y New Tanks Existing Tanks U va H cn w C7 P-4 Septic or Holding Tank 1250/750 2000 1 Weiser ✓ Dosing Chamber c V. Responsibility Statement ; I,'the undersigned, assume responsibility for lnstallahon of the POWTS shoyy on the attached plans p lh' 8 �,. Plumber's Name (Print) Plumber's Signature Ti>— MP/MPRS Number 1092768 Business Phone Number Dean Blakeman 715-682-6050 Plumber's Address (Street, City, State, Zip Code) 44941 State Hwy 13, Ashland, WI 54806 .^County/D'epartineat.Use Only Approved O Disapproved Permit Fee Date IssuedL n Agent Signatur jj ❑ Owner Given Reason for Denial 14 c)o (Q/'1/a Conditions of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x I I inches in size SBD-6398 (R. 02/22) PAGE 1 OF 4 Holding Tank Plan Index & Cover Sheet Component Manual Design References: Holding Tank Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Holding Tank Specifications Pg 4 of 4 Management Plan ill] MAY272025 7 2025 J Bayfield Co. Zoning Dept. Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map (if ap Holding Tank Pumping Contract (if appli Holding Tank Agreement (if applicable) Project Name / Description Tasty Plunderer LLC / Holding Tank plicable) cable) Owner Name(s): Jeremy & Ben Peyer Phone: 608 -877 -6894 Owner Address: 4745 Beard Ave. S Minneapolis, MN Zip: 55410 Project Address: 89775 W Sunset Dr, Cornucopia, WI 54827 Govt. Lot: 1 1/4 of 114, Section 27 , T 51 N -R 06 E Oor W ✓V Township: Bell County: Bayfield Project Parcel ID #: 04-010-2-51-06-27-1 05-001-04100 Designer Information Designer Name: Dean Blakeman Phone: 715 -682 -6050 Designer Address: 44941 State Hwy 13, Ashland, WI Zip: 54806 E-mail: dean @bl akeman pl u m bi ng . com This space reserved for approval stamp. License Number: 1092768 Remarks: Dahl Construction is submitting HT pumping contract, HT agreement, and sanitary permit fee. Signature.• I -- Date: c/27/2015' Original signature required on each submitted copy. CHECK BOX AS APPLICABLE. CHECK BOX AS APPLIC E. E P ^L A YC& F-1SOIL EVALUATION Scale: 1" RI = 20' SITE MAP0 Za 30 4o PLOT P NMAY 27 202: PROJECT NAME: (5 ft grid) 52 DESIGN FLOW: R�Vfiwlr�Q� 2onj.,�l�gg Tasty Plunderer LLC VA Attach design flow calculations for commercial puns. PROJECT ADDRESS: 89775 W Sunset Dr, Cornucopia, WI 54827 Pipe Material I ASTM Standard (Tables 384.30-3 & 384.30-5) Sanitary sewer. 4r1 / SDR 35 BM Symbol:- BM Elevation: 100 FT Force Main:________________I________________ BM Description: Top of well casing Indicate north by IMPORTANT: Slope Gradient (%) Well Symbol (if applicable): 0 drawing an amaw Show ground elevation contours at suitable intervals. of Tested Area: on the approprite One. _ ts2 P I 1 i 2�'-� I of I I m l r I J�PAR(�X85' ( I )(8J! • I �. ! (. I `T•O ( 4 I Q 2 t "lI o t I• I d 0 ' a — a J Dic -1-�o I m � Own -rrN8 [yj 2 I, a� zc •m m I. fi I � � liii MAY 2 7 2 025 Bayfield Co. Zoning Dept. PAGE 3 OF 4 HOLDING TANK SPECIFICATIONS (No Scale) 'CO Vent Pipe Weatherproof X10 ft from Jundian and Alarm Bmc Approved Building 12' Min. or 20 ft above lApproved Electrical must comply with Loddng Manhole Vent vAth arning Label Attached Established Flood Elevation 4' Min. or 20 ft above Flood Elevation SPS 316 and NEC 300 (typical)Established (typical) (typical) -Conduit Airtight Seal ` t Finished Grade f 18' Min. (typical) y. ;4 f; q, ,• • . inlet Inlet Invert --Watertight PlugApproved Joints Approved Pipe 3 ft onto , Max. 12 or 3096 of total volume If more than one tank Solid Ground I (typical) Alarm -On b, i• Compartment I Vol =11372.68gsl Compartment 2 Vol 0 773.76 gal • TOTAL HOLDINGTANK VOLUME= 2,101.5 gal 1 3' Approved Bedding Material Beneath Tank TANK MANUFACTURER: Weiser Anchor tank as necessary pursuant to SPS 383.43(8)(g) Ballast Weight = [(cu.ft.tank.vol x 62.4 Ibs/cu.ft) - lbs.tank.wt] x 1.5 Ballast Weight = [( 280.93 cu.ft. x 62.4 lbs/cu.ft) - 14,860 lbs] x 1.5 = 4,005.10 lbs Holding Tank Management Plan 1111 MAY 272025 IMPORTANT: tBay#ieid Co. Zonirro Dept The owner of this holding tank(s) 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 holding tank(s) 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. Estimated Daily Wastewater Flow = 300 gpd 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 neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o surface discharge of effluent or sewage back-up into structure served SERVICING FREQUENCY o The tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wisc. Stats. when the wastewater in the tank(s) reaches a level of one foot below the inlet invert of the tank(s). Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. Tank pumping reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wis. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Blakeman Plumbing & Heating, Inc. Phone: 715-682-60550 Local government unit: Bayfield County Zoning Phone: 715-373-6138 Local government unit address: 117 E 5th St, Washburn, WI 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 component of this holding tank(s) cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agecy for review and approval. System Abandonment If use of this tank(s) is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. s D ( m' 1111 MAY 2? ZU1b, 6a eid Co. Zoning Dept. TANK SPECIFICATIONS DIMENSIONS: WALL 2 1/2" BOTTOM: 3" COVER: 6" MANHOLE 24 I.D. PRECAST CONCRETE RISER HEIGHT: 66" O.D. LENGTH: 155" O.D. WIDTH: 86" O.D. BELOW INLET: 53" O.D. LIQUID LEVEL • 48" 4" CAST -A -SEAL WEIGHT: 14.860 LBS. SEPTIC INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET, CAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.66 GAL/IN (SEPTIC) 16.12 GAL/IN (PUMP) LOADING DESIGN: 8' 0" UNSATURATED SOIL w 4" VENT co INLET - -_ OUTLET — �• N I II PUMP PAD SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS TANK CAN BE USED AS: SEPTIC/SEPTIC, SEPTIC/PUMP OR SEPTIC/SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT MESER CONCRETE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: SHEET NO. �F1 55 -Doss ��ovr""'"ew, 2 9 202 Industry Services Divisi �— 4822 Madison Yards WayN_..........' County MAY Madison, WI 53705 Sanitary Permit Number (to be filled in by Co.) Bayfield Co. Zoning P.O. Box 7302 ept Madison, WI 53707 a$ - 4/S Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) 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 purposes in accordance with the Privacy Law, s. 15.04(l)(m). Studs 89775 W Sunset Dr, Cornucopia, WI 54827 I. Application Information — Please Print All Information Property Owner's Name Parcel #'?y%c6 Tasty Plunderer LLC 04-010-2-51-06-21-1 05-001-04100 Property Owner's Mailing Address Property Location 3173 Sunnyside St Govt. Lot 1 City, State I Zip Code Phone Number Stoughton, WI 53589 612-965-2076 ___'A,_¼. Section 27 T51 N R06 E or II. type of Building (check all that apply) Lot # Subdivision Name I or 2 Family Dwelling — NumberofBedrooms .1 IIIIPublic/Commercial — Describe Use Block # City of ❑State Owned — Describe Use Village of Pz, CSM Number Town of Bell Ill. Type of POWTS Permit: (Check either "New" or"Replacement" and other applicable online A. Check one box on line B. Complete line C i a licable. A. ✓ New System ❑ Y Re lacemcnt ❑ P System they Modification to Existing System (explain) Y� ( p ) Additional Pretreatment Unit ex lum ❑ (' P ) Holding Tank thIn-Ground ❑4t -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 IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required (so Dispersal Area Proposed (at) System Elevation Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units a U o v V u Ta New nks Existing Tanks v e y m Septic or Molding Tank 1250/750 2000 1 Weiser fl Dosing Chamber V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Dean Blakeman I Plumber's Signature T— MP/MPRS Number Business Phone Number 1092768 715-682-6050 Plumber's Address (Street, City, State, Zip Code) 44941 State Hwy 13, Ashland, WI 54806 V County/Department Use Only Approved ❑ Disapproved Permit Fee I Date Issued L 'ne Agent Signa[u ❑ Owner Given Reason for Denial 4ov (p a 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 It inches in also SBD-6398 (R. 02/22) prr 2 D - .r ` I1 . I Soil Test # 2.0 2 z Bayfield County MAY Waiver of a Thorough Soil & Site Evaluation SO4 TEST _ Ba field Co. Zoning Dept. _ _ # 3+ - a5 y (subject to 15 1 10(d)) I RV1 0MY7 a certified soil tester determine that in my professional judgment the following site (see below) is unsuitable for any treatment component other than holding tanks. Due to soil & site conditions, a thorough soil and site evaluation is not needed to make such a determination. Property Owner /45i P/OM Owls C.— Contractor Property Address '977c4 97 7 c ,es,,5d ,0r Authorized Agent .Copt P_2.' Agent's Telephone Telephone/ (4!Ll) -,9,2 Written Authorization Attached: Y or N Accurate Legal Description is requested: 114 of 114 Sectional 2 Township /N. Range t W. Town of / Govt. Lot I Lot Block Subdivision CSM#�/ Volume Page of Deeds Parcel I.D# 3 e 9 Acreage Additional Legal Description: Indicate reasoning for your determination: "A Lk,r; zoi' I, i5 ,' 5" ,o $&cs*/ Si ature of Certified Soil Tester -j°J-- 22 Date Y7 -1J Signature of County Official 62 Date Ii17 // Certification # (Submit a Plot Plan & Fee) u/forms/soiltestwaiver(KLK) February 2005 ;, PM!1 Iii 15. III a MIii iililllii iii iii miiiimi IIiuuI::ui:Ipii ii 1IIIiii!;:I!Pa:I: Ii i •laUU!I i I IiIiIIU!JIIIiiiIIF I' I IR IIi1 jiil,iII1IIrii1u,ip, .1111k Wae MM I 15Will. illN I iL:ii PAGE 1 OF 4 Pg 1 of 4 Pg 2 of 4 Pg 3 of 4 Pg 4 of 4 Attachments: Holding Tank Plan Index & Cover Sheet Component Manual Design References: Holding Tank Version 2.1 (May 2022-2027) Index & Cover Sheet Plot Plan Holding Tank Specifications Management Plan HECEvW D MAY 272025 Bayfield Co. Zoning Dept. POWTS Application for Review Soil Evaluation Report & Site Ms Holding Tank Pumping Contract Holdina Tank Aareement (if a Project Name / Description Plunderer LLC / Holdina Tank Owner Name(s): Jeremy & Ben Peyer Phone: 608 -877 Owner Address: 4745 Beard Ave. S Minneapolis, MN zip: 55410 Project Address: 89775 W Sunset Dr, Cornucopia, WI 54827 Govt. Lot: 1 1/4 of 1 /4, Section 27 , T 51 N -R 06 E ❑ or W ❑✓ Township: Bell County: Bayfield Project Parcel ID #: 04-010-2-51-06-27-1 05-001-04100 [1 Designer Information Designer Name: Dean Blakeman Phone: Designer Address: 44941 State Hwy 13, Ashland, WI d blk 1 ' It,.' e-mail; can , a ulull g.com This space reserved for approval stamp. License Number: 1092768 715 -682 -6050 zip: 54806 Remarks: Dahl Construction is submitting HT pumping contract, HT agreement, and sanitary permit fee. Signature:• '� — Date: c/27/2O2c 2O2S Original signature required on each submitted copy. CHECK BOX AS APPLICABLE. CHECK BOX AS APPLIC . IP ❑ SOIL EVALUATION 0 scale: 1 o 2D 30 40 0 SYST SS Ni5l11inJ CX NL/V4F SITE MAP PLOT P NMAY 272025 PROJECT NAME: (e re grid) 5' DESIGN FLOW: B In sfor miner, 29eq Tasty Plunderer LLC Attach design flow calculations for commerdral pl8ns. PROJECT ADDRESS: 89775 W Sunset Dr, Cornucopia, WI 54827 Pipe Material I ASTM Standard (Tables 384.30-3 & 384.30-5) Sanitary Sewer 4 / SDR 35 BM Symbol: BM Elevation: 1 00 FT Force Mahn: / BM Description: Top of well casing Indicate north by IMPORTANT: Slope Gradient (%) Well Symbol (If applicable): 0 drawing an enwu Show ground elevation contours at suitable intervals. of Tested Area: on the epproprhe tne. 2S -0 5S /; -- 2, I ooI ( on o 6 z I X S1' I r I L i 2 O 400 OI = fl core' 111111 O z ti I •y m JC m ZCz GZ �� mnm '` I. azo I ',, z m z m S K oho r == l O d l m m a I � l n m 1111 MAY 272015 Bayfield Co. Zoning Dept PAGE 3 OF 4 HOLDING TANK SPECIFICATIONS (No Scale) Eledd®I must mmply with SP5316 end NEC 200 1eMin. (trpl®) Approved Jolnla with. Approved Pipe 3 ft only 6olld Ground (wdl) —Jundlen and Alarm Box Approved Wdiip Manhele with Warning Label Atladmd (tyd®0 a. Max. 1? or90%of loW volume If more than one tank Compadmanl I Vol =1,37168 d 4'0 Vent Pipe NO ft from Building Min. or 2.0 If above had Flood FJevallon 4•µm. or 2.0 ft above MW1I Sdabli ied Fbod 9eveti Compadmant2Vd= 773.76 gal TOTAL HOLDING TANK VOLUME 2,101.5 gal 3' Appmred Beddbg Malarial Beneath Tank TANK MANUFACTURER: Weiser Anchor tank as necessary pursuant to SPS 383.43(8)(8) Ballast Weight = [(cu.ft.tank.vol x 62.4 Ibs/cu.ft) - lbs.tank.Wt] x 1.5 Ballast Weight a 1( 280.93 cuff. x 62.4 lbs/cu.ft) - 14,660 Ibs] x 1.5 = 4,005.10 lbs !fl'F4 Holding Tank Management Plan Jf MAY 2720z5 2025 IMPORTANT: Bayfield Co. Zoning Dept. The owner of this holding tank(s) 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 holding tank(s) 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. Estimated Daily Wastewater Flow = 300 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 neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o surface discharge of effluent or sewage back-up into structure served SERVICING FREQUENCY o The tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wisc. Scats. when the wastewater in the tank(s) reaches a level of one foot below the inlet invert of the tank(s). Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. Tank pumping reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wis. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Blakeman Plumbing & Heating, InC. Phone: Local government unit: Bayfield County Zoning Phone: Local government unit address: 117 E 5th St, Washburn, WI 715-682-6050 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 component of this holding tank(s) cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agecy for review and approval. System Abandonment If use of this tank(s) is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. TOP VIEW DII MAY 2 7 ZOZb Bayfleld Co. Zoning Dept. W1250/750 —MR TANK SPECIFICATIONS DIMENSIONS: WALL: 21/2" BOTTOM: 3' COVER: 6" MANHOLE 24' I.D. PRECAST CONCRETE RISER HEIGHT: 66" O.D. LENGTH: 155" O.D. WIDTH: 86" O.D. BELOW INLET: 53' O.D. LIQUID LEVEL: 48" 4" CAST -A -SEAL WEIGHT: 14,860 LBS. SEPTIC INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET, CAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.66 GAL/IN (SEPTIC) 16.12 GAL/IN (PUMP) LOADING DESIGN: 8' 0" UNSATURATED SOIL a w 4" VENT OUTLET INLET — — 1J I.I j PUMP PAD TANKS ARE MANUFACTURED REQUIREMENTS TANK CAN BE USED AS: SEPTIC/SEPTIC, SEPTIC/PUMP OR SEPTIC/SIPHON COVER: MIX DESIGN 18 NO FIBER) TANK: MIX DESIGN /10 STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE FOR APPROVAL APPROVED BY: PROVAL BATE: ODBCTS NEEDED BY: 5 U F 02 V 1 Document Number/Plan I.D. No. HOLDING TANK AGREEMENT Tasty Plunderer LLC, Ben Peyer , t'1,bent, 3173 Sunnyside ST Stoughton WI 53589 Parcel Identifier Number (PIN) Agreement Date (same as Notary Date) 04-010-2-51-06-27105-001-04100 5- Iy -'.$ We acknowledge that application is being made for the installation of (a) holding tank( on the following property or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. SPS 383. Wis. Adm. Code or Ch. 145, Wis Stats. 1/4 of Town of Bell Additional Legal Description: LOT 1 CSM #2145 IN V.12 P.317 (LOCATED IN GOVT LOT 1) 1/4 Section 27 Township 51 N. Range 06 W• Tax ID #38369 Gov't Lot 1_ Lot, Block_Subdivision CSM#_ Lot 1 CSM # Vol _Page _CSM Doc# 2020R-585117 DOCUMENT NUMBER 2O25R-6O7495 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 05/16/2025 AT 10:50 AM RECORDING FEE: $30.00 PA&S: C 6 IVE 111 MAY 192O 2O Return To: Planning and Zoning Department As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding tank installation and maintenance. If the owner fails to have the holding tank properly serviced in response to orders issued by Bayfield County or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Slats., Bayfield County may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. 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. 3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Stats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NR113, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the county within 30 days from the date of change to the service contract. 4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis. Slats., and Ch. NR 114, WI's Adm. Code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained. 5. This agreement will remain in effect only until Bayfield County certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. SPS 383. WI's Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. Dn Per HOLDING TANK SERVICING CONTRACT 1111 MAY "1 62025 Contract Date S- IL/-�5 This contract is made between the Holding Tank Owner(s) Name(s) Cr-L1 tot Sc o4 4, 3er. ?e'lev� Bayfield Co. Zoning Dept Pumper's Name (Print) Pumper's Signature Pumpers' Registration # We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT Legal Description: Ta*lek 314, 314. LOCATION (Use Tax Statement) 3 O�V� -�l Li Town of: Lot Size Acreage Section ,Township 1 N, Range C rd W i.� 175oo Gorr( Lot Lot# CSM It Vol. Page CSM Dock Lotls) No. Block(s)No. Subdivision: 1. The owner agrees to file a copy of this contract with Bayfield County as required in SPS 383.55, Wis. Adm. Code. 2. The owner agrees to have the holding tank(s) serviced by . umper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of J g the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service th tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in s cl the holding tank(s) as mutually agreed upon by the owner and pumper. S 3. The pumper agrees to submit to the local government unit which has slthe pumping agreement required by SPS 383.55, Wis. Adm. Code, and the County, a report for the servicing of th g tank(s) on a semiannual basis. The pumper further agrees to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the contract, the owner agrees to file a copy of any changes to this service contract or a copy with the local government unit and the County named above within (10) business days from t service contract. OWner(s) Nam(s) (Print) Owner's Signature(s) Subscribed and Sworn to(*7S 7S Box's >' � on this day of - � t�,.a'2 by: 3 .tjt- otary Public Pu My commission expires on: v 7 1161 Z1 Revised: May 2016 (®May 2018) Personal information you provide may be used for secondary purposes [Privacy Law. s.15.04 (I)Im)) Drafted by System Explorer 5/23/2025 Real Esaze • Pe venal Proverty tS Unk To Treasurer p00s To Pay 2nd half or Past Yeartaxes only by CreditCard, Emedt, or Debit Card mNe eayleld County Treasurer use se this link. {Y Par Barfield County Treasum By Crefft Cad For Credit Cad or Edreck payment to the following mundpallnes use the munkipality link below. December and January Jurisdiction gg,. V'T Ol Games ta0014e Town or HHay d ---- �91y�Msid ---- fv Otr W Wazhbum Public Access Real Estate Beard, (P ofl Tax10: n48 ALt,/LegaWID: D 1� l2 0 4:3 P PINOwner - Taxm• 3B3fi Name: pye Ia4/gg.: TASTY �'"°ALL` 3173SUNNYSLDEST MAY 27 7025 Site Address; S: Road: STOUGHTON WI 53589 Search Results- Records Found: I I Property I Tax Records I Tax Bill I Statement I DocumerBaj,fifto. AonI1 "Dent DD2-51-us27-1 o5-001-04100 Real Estate Bayfield County Property Listing 4Tax DISWcta Updated: 11/12/2020 18369 1.700 At Today's Date: 5/23/2025 0.0600 TASTY PWNDn1ER LLCDescription Updated: 11/12/2020 31735UNNYSiDE ST Tax ID: 38369 STOUGHION WI 53509 PIN: 04-010.2-51-06-27-105-001-04100 89775W SUNSET 0R Legacy PIN: Map 10: Munidpalitic (010)TOWN OF BELL Slit 527 ISIN R06W Description: LOT ICSM#2145 tN V12 P317 (LOCATED IN GOVT LOT 1) Recorded Aaes: 1.780 (akuleted Agee: 1.780 Lottery Calms: 0 not Ddiar. No ESN: 107 1 STATE 04 COUNTY 010 TOWN OF BELL 044522 SOILrAl1THS-ORE 001700 TIOINICAL COLLEGE O Recorded Documents Updated: 1/7/2020 B CERTIFIED SURVEY MAP Date Recorded: 10/29/2020 202UR SSSSl 17 12-317 El QUITCLAIM DEED Daze Rec ded: 12/26/2019 2019R-500393 Property Status: Current Created On: 11/12/2020 1:39:17 PM a Ownership Updated:11)12/2020 TASTY PLUNDERER LLC STCUGHFON WI 0ll(ling dp dress: Malline Addrtls, TASTY PLUNDERER LLC TASTY PLUNDERER LLC 3173 SUNNYSIDE ST 3173 SUNNYSIDE ST STOUGHTON WI 53589 STWGHION WI 53589 T Site Address ' Indicates Private Road 89775W SUNSET DR CORNUCOPIA 54827 ® Property Assessment Updated: 9/22%2022 2025 Assessment Detail Code Ayes Land Imp. GL -RESIDENTIAL 1.]80 44,500 0 2 -Year Comparison 2024 2025 Change Land: 44,50] 44,500 0.0% Improved: 0 0 0.0% Total: 44,500 44,500 0.0% Is Property History Parent Properties Tax ID 04.010-2-50-00-27-1 05-00t-04 Jno 04-010-2-50-00-27-1 05-001-050007744 04-0162-51-0627-105-00106000 04-010-2-51-06-27-105N1-0]000 nSI HISTORY C$9_mpress All 0(or VAdte=parent Parcels pnk=Retired Parcels ® Progress: I Print I II �c�� BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS MAY 272025 Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) Bayfield Co. Zoning Dept Check List 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)) Original Plot Plan (383.22(2)2. 3. & 4.a) ❑ Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer Pump Tank Diagram, Alarm and Pump Curve (when applicable) Contingency Plan / Management Plan (383.22-3(2)(b)1.f.) ❑ Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) ❑ Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) ('fr .. pr,,,wr 5 ❑ Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) (EEDM Owna/') ❑ ATU Servicing Agreement (Recorded at Reg. of Deeds) ❑ Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) Kfm. �a4( (m5E, R 2 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached l to all copies) 'IA Soil and Site Evaluation Report (383.22-3(2)(b)1.e.) ❑ State Plan Review (when applicable) ❑ Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) $ I Application Information must include: 14 23 digit Parcel ID# -- (do not use 12 digits anymore —obsolete) $ Project Address or Road Name where driveway is/will come off of) N II Type of Building III Type of Permit IV Type of POWTS System 0 V Dispersal / Treatment Area Information 10 VI Tank Information I VII Responsibility Statement (Plumber's Information) ❑ *Date Stamp* Plot Plan: (To Scale or To Dimension) .A Signature and Plumber Information Surface Elevation of Body of Water Direction and Percent Land Slope Tank and Filter Information and Location 10 Wetlands / Navigable Bodies of Water th\Absorptlon Area (Proposed and=Existing) (Owners Phone Number) Address Number and Road North Arrow Contour Lines 11 Structures and Driveways ABoring Locations P4 Property Lines Bench Mark (Location, Elevation and Description) Well Locations $ Component Manual Version ' Legal Descriptions `iping Material Information (conveyance line, building sewer line, material type and diameter) Turn Over ► Cross -Section and Over -Head Profile of the System: I i [ U V ❑ Surface and System Elevation p6J MAY / Z0P5 El Position of observation and Vent Pipes ga field Co. Zoning Dept ❑ Dimensions and Depths ❑ Make, Model & Number of Chamber Units in each Cell Property Information 1p How many systems will there be on this parcel of land? _I__ Has this property been split? S (Property Statement shows Property History) Fees: ❑ Private Sewage System (Septic Tanks) $ 400.00 ❑ Private Sewage System (Holding Tanks) $ 400.00 ❑ Mounds or Systems requiring Pre -Treatment $ 500.00 ❑ Sanitary Revisions $ 25.00 ❑ Private Sewage System Reconnection $ 50.00 and Private Interceptor ❑ Return Inspection $ 50.00 ❑ Maintenance Agreements + $ 30.00 (checks made out to Reg of Deeds) u/forms/checklists/checklistforsan taryapps (10/2009);(07/2011);(®2/2012)(®5/2/2012 -dc) Proofed by: BAYFIELD COUNTY SANITARY PERMIT (#04)-25-41 S STATE SANITARY PERMIT OWNER: TASTY PLUNDERER LLC G OV'T LOT: 1 LOT: B LK: 1/4 1/4 SEC: 27, T 51 N, R 6 W TOWNSHIP: Bell SOIL TEST: 36-25 NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: DEAN BLAKEMAN TRACY POOLER Authorized Issuing Officer DATE: 6/4/2025 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: # 1092768 Condition: Properly Maintain System Per Recorded Agreement. Must be within 25 ft of an all- weather road. THIS PERMIT EXPIRES 6/4/Z022 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION