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HomeMy WebLinkAbout25-41S€^f^SSK >S-CX)ITS5- ''-'I ?i^_ ^ IS MAY 2 9 202^%SSj) !llJlnl,^,Zi%^/ B^Q:^^^\ l!! l?ac^ Industry Services Divisii 4822 Madison Yards Way'-' Madison, WI 53705 P.O. Box 7302 Madison, WI 53707 CountyBayfield Sanitary Permit Number (to be filled in by Co.) ^S-^IS 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 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. Project Address (if different than mailing address) 89775 W Sunset Dr, Cornucopia, Wl54827 I. Application Information - Please Print All Information Property Owner's Name Tasty Plunderer LLC Parcel #3y^^ 04-010-2-51-06-21-1 05-001-04100 Property Owner's Mailing Address3173SunnysideSt Property Location 1Govt.Lot. City, State Stoughton, Wl Zip Code53589 EL Type of Building (check all that apply) r|l or 2 Family Dwelling - Number ofBedrooms _3_ iblic/Commercial - Describe Use IState Owned - Describe Use Phone Number612-965-2076 _'/4, Lot # 'A. Section T 51_N R 06_E or 27 Subdivision Name Block # Qdty of. CSM Number [Village of ^iTown of Bell HI. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if| applicable.)A • [New System :placement System [Other Modification to Existing System (explain) ]|[Additional Pretreatment Unit (explain) B.I • [Holding Tank IIn-Ground (conventional) I|At-Grade I Mound Individual Site Design I Other Type (explain) c.Renewal Before Expiration I Revision ;hange of Plumber "ransfer to New Owner!,ist Previous Permit Number and Date Issued IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) | Design Soil Application Rate(gpd/sf) | Dispersal Area Required (sf)Dispersal Area Proposed (sf) | System Elevation Tank Information Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units Manufacturer II(S U 31^1 <5rS COiZ U Septic or Holding Tank 1250/750 2000 Weiser 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 Plumber's Signature>1).^^.^^_MP/MPRS Number1092768 Business Phone Number 715-682-6050 Plumber's Address (Street, City, State, Zip Code)44941 State Hwy 13, Ashland, Wl 54806 VJL County/Department Use Only^^^Approved D Disapproved D Owner Given Reason for Denial Permit Fee $ ^00 Date Issued ^ ) | Jsj(U]l (p/^/as /y L ig Agent Signatui ^^lA W^m Conditions ofApprovaVReasons for Disapproval ^L.a^(\cU^i A^/ Attach to complete plans for the system and submit to the County only on paper not less than 81/2x11 inches in size SBD-6398 (R. 02/22) io)^^^i^ ^a)ic6 Bayfield County Soil Test # IV MAY20Li)Zb ^ ..._,..___._^^'c'y"^^u^^^_r^T.._.^Waiver of a Thorough Soil & Site Evaluation Bayfisid Co Zcniny Dept (subject to 15-1 -1 0(d)). SOil TiST^ 3C~- ^5 I ^ (/fy\\M^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_"%^ ^lrfW5 ^/61 Contractor Property Address ^ ,^77^ ^ ^t/n,^ ^^ Authorized Agent_ ^£>^V\^.C^^>ln ^J:Agent's Telephone. Telephone / LW) ^2 H^L -/?=2 ^3 Written Authorization Attached: Y or N/ Accurate Legal Description is requested: ,1/4 of_1/4 Section^/ Township<?/ N. Range (^> W. Town of_ Lot_Block _Subdivision_ CSM#^?/J Volume_Page_of Deeds Parcel I.D# ^^5 -$ b "7 _Acreage. Govt. Lot _Page_of Deeds Parcel I.D# 3^ 369 Additional Legal Description:. Indicate reasoning for your determination: ^-,/<ti/ .'6/-f-e- l^O/ ^{1^1'^^ ^>^€i^ / ' .'^^ \^ ^W 5~ -f-0 ^(i^K^I ^4-hu^^-/-^Zzw/^^ ]^J7^ Signature of County Officjalt? /L7^ Date /<^ / \A^i /X-^-, ^/t/A/»»/^^ Signature of Certified Soil Tester -f-/'7- ^^~ Date //o// Certification # (Submit a Plot Plan & Fee) u/forms/soiltestwaiver(KLK) February 2005 Pg Pg: Pg Pg 1 2 3 4 of 4 of 4 of 4 of 4 Attachments: PAGE 1 OF 4 Holding Tank Plan •\i K ft'1 ii:' n w F r.Index & Cover Sheet EJ " p Ks w I yi) jn] .... . If!!Cii MAY Z7?^ ^Component Manual Design References: Holding Tank Version 2.1 (May 2022-2027) B^y%i;; r-\ ^on;nQ ijsp,- Index & Cover Sheet Plot Plan Holding Tank Specifications Management Plan Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map (if applicable) Holding Tank Pumping Contract (if applicable) Holding Tank Agreement (if applicable) Project Name / Description Tasty PIunderer LLC / Holding Tank 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 Pr, Cornucopia, Wl 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 Designer Information Designer Name: Dean Blakeman _ Phone: 715 .682 -6050 Designer Address: 44941 State Hwy 13, Ashland, Wl zip: 54806 E-mail: dean@blakemanplumbing.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:. ^ - ^^—— _ Date: ^/Z-1 / ioZS- Original signature required on each submitted copy. •/27/. CHECK BOX AS APPLICABLE. SOIL EVALUATION SITE MAP PROJECT NAME: Tasty Plunderer LLC Scale: 1"= 20' 20 30 CHECK BOX AS APPLIC^E. JJ3 [^ _ |^ J[ ^' J^_ JHi 40 /////////77)i////// (5 ft grid) 7ZZ 52 2Z^ PROJECT ADDRESS; 89775 W Sunset Dr, Cornucopia, Wl 54827 BM Symbol: -^ BM Description: BM Elevation:100 FT Top of well casing C^B^^S.g^Mic[^1 SYSTriJ^I"PLOT P&^ 2 7 2'» DESIGN FLOW: B--:!y"(il;iii4v>P; . j ^, ^T^, j,i Attach design flow calculations for commerci'al pldns. Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) Sanitary Sewer:. Force Main: 4" ./.SDR35 Slope Gradient (%)of Tested Area:Well Symbol (If applicable): Q Indicate north by drawing an am3W on the approprite line. IMPORTANT: Show ground elevation contours at suitable intervals. I it II! W ! i lit"..... ",l..,.,., l!liHi! MAY 27 ZOZ' '^ !uayf!eld Gc. .lor.'n? u9i:'1. HOLDING TANK SPECIFICATIONS (No Scale) Electrical must comply withSPS 316 and NEC 300 \1/ ^ Weatherproof•Junction and A[ann Box Approved Locking Manhafewilh Warning Label Attached(typical) •Conduit 4"0 Vent Pips >-10 ft from Bu?igA,pp"™d 12" Min'orlo'ft above Established Flood Elevation(typical) 18"Mln. v(typical) •Airtight Seal § Inlel Approved Joints withApproved Pipe 3 ft ontoSolid Ground(typical) ^\1/ Finished Grade •', •:. ;- ^«.:-, ~w 4" Mjn.or2.0ft above Established Flood Elevation(typical) :\1/ ^ ;— Max. 12" or 90% of total volume if more than one tank Compartment 1 Vol =1,372.68 gg| ^ Compartment 2 Vol = 773.76 gg| TOTAL HOLDING TANK VOLUME = 2,101.5 ga| 4.' •'.< : ]—WatartlghlPlug 3" Approved Bedding Material Beneath Tank TANK MANUFACTURER: WeiSCF Anchor tank as necessary pursuant to SPS 383.43(8)(g) Ballast Weight = [(cu.ft.tank.vol x 62.4 Ibs/cu.ft) - Ibs.tank.wt] x 1.5 Ballast Weight = [( 280.93 cu.ft. x 62.4 Ibs/cu.ft) - 14,860 ms] x 1.5 = 4,005.10 ibs PAGE 3 OF 4 Holding Tank Management Plan IMPORTANT: p ;;-:;y'ffp-;i;^ -\ - /- ,'.-• .', ; .. - The owner of this holding tank(s) shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. 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), Wise. Admin. Code. Estimated Daily Wastewater Flow = _'-"-'^ _ gpd Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (/".e. odors, user complaints, ete.) o mechanical malfunction (/.e., pumps, valves, switches, floats, etc.} o material fatigue (/.e., leaks, breaks, corrosion, etc.) o neglect or improper use (/".e., exceeding design capacities, prohibited activities, efo.) o electrical components (/".e., wiring, connections, switches, controls, timers, alarms, efc.) 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 sen/icing operator licensed under s. 281.48 Wise. 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, Wise. 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. p^ 715-682-6050 Local government unit: Bayfield County Zoning _ phone: 715-373-6138 Local government unit address: 1 17 E 5th St, Washbum, Wl ^, 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wise. 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, Wise. 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, Wise. Admin. Code. !ri1 IF 'i! !E J! lv? I? !^ 1-^ ' " II i; Ill MAY Z' .l;l^. iuf K^^i^:..''w^^., CAST-A-SEAL TOP VIEW 4" VENT W1250/750-MRTANK SPECIFICATIONS DIMENSIONS:WALL: 2 1/2"BOTTOM: 3"COVER: 6"MANHOLE: 24" I.D. PRECAST CONCRETE RISERHEIGHT: 66" O.D.LENGTH: 155" O.D. WIDTH: 86" O.D.BELOW INLET: 53° O.D.UQUID LEVEL 48"WEIGHT: 14,860 LBS. SEPT1C INLET AND OUTLET:4" CAST-A-SEAL BOOT OR EQUALGASKET, CAST-A-SEAL BOOT OR EQUALINLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL jp0(OTHER STATES SEE CHART) UQUID CAPACITl': 27.66 GAL/IN (SEPTIC)16.12 GAL/IN (PUMP) LOADING DESIGN: 8' 0" UNSATURATED SOIL TANK CAN BE USED AS:SEPTC/SEPTIC, SEPT1C/PUMP OR SEP7IC/SIPHON COVER; MIX DESIGN f& (NO FIBER)TANK: MIX DESIGN jflO (STRUCTURAL RBER) CUSTOMIZED TANKS;FOR CUSTOM TANKS CONTACT WIESER CONCRETE PUMP PAD SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS DRAWINGS SUBMITTEDFOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: co10£ ^j-I "I3^1(000|o|= 00 I £ < s<I ^ SHEET N07 1 1 Document Number/Plan I.D. No. Owner Name (s)Tasty Plunderer LLC, Ben Peyer / t^yo-^^awj-e(| Parcel Identifier Number (PIN) 04-010-2-51 -06-27J05-00 1 -04100 HOLDING TANKAGREEMENT Owner(s) Mailing Address 3173 Sunnyside ST Stoughton Wl 53589 Agreement Date (same as Notary Date) <5-N-16 We acknowledge that application is being made for the installation of (a) holding tank(s) 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. _1/4of. Town of Betj_ _1/4 Tax Additional Legal Description: Gov't Lot \ Lot_ Lot_l_ CSM # _Block Vol Section '-' Township ID #38369 LOT 1 CSM #2145 IN V.12 P.317 _Subdivision_ _Page _CSM Doc# N. Range 06 w. (LOCATED IN GOVTLOT 1) _CSM#_ 2020R-585r17 DOCUMENT NUMBER2025R-607495 OAIMIEL-J. HEFF-NER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED 05,16/2025 AT 1 0:50 AM RECORDING FEE: $30.00 PACK SE£ir£ MAY 1928H Bayfiiafr) pn Zoning Dept. 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. Actm, 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, Stats., Bayfield County may enter upon the property and sen/ice 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 alt 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 114Wis. 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. Stats., and Ch. NR 114, Wl'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, Wl'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. Owner(s) Name(s) - Please Print Jamie Klema, Agent ^<sC "£><•<-> ?6-^<- Subscribed and sworn to before me on this date: <fc4- \\pj^,Wb _^im^^"^^> _'••^x'^ Notqry Public My Corrisa|ission, Expires:oil^ton -s1^ w -^Tw^- Draftad hv<Jamie Klema, Dahl Construction Personaf information you provide may be used for secondary purposes [Privacy Law, s. 15.0-4 (!)(m)] Date ^-l4-2^Stfi %^ ~--^^^u/forms/sanftary/holdingtankagree? HOLDING TANK SERVICING CONTRACT Contract Date ^- 1^-25 This contract is made between the fpi !r- '! ^1 f?Di ii i^ iL- i! ^ &!^ill! MAY '; 62025 Bsytjeld C:.- ZDiiing Dept Holding Tank Owner(s) Name(s)IC rv^: 1^ \ \> o^^ 5^ o^, ^e o ?^y<£^ Pumper's Name (Print) Dc^l^^ B^tcta^ei' Pumper's Signature .,X'A-^- Pumpers' Registration # /^a3 We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECTLOCATION Legal Description: (Use Tax Statement) Tax ID»S8S^ Section ' L I , Township *=>| _ N. Range Gfc> W Gov'ttot Lot»CSM»Vol. Page CSM Doc 0 Lot(s) No.Block(s) No. .1/4, _ 1/4, Town of: %ew lot Size T7,'500Sf: Acreage \.~1<S 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 bv ^|jg_pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of sfl^iqig the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service th^Aplfljafl tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in seffTciPl the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local government unit which has sT 383.55, Wis. Adm. Code, and the County, a report for the servicing of ths pumper further agrees to include the following in the semiannual report: the pumping agreement required by SPS >g tank(s) on a semiannual basis. The a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; 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..^'^^/s^w^^"^.•-4. This agreement will remain in effect until the owner or pumper terminates this contract. In the ^^it'ofa.change.Jrf-tRBS contract, the owner agrees to file a copy of any changes to this service contract or a copy cfa new^il^@yc6tit(s%t with the local government unit and the County named above within (10) business days from tfe date-fi^Piaff^e to ths service contract..^\^ ^/i': '^10\ Owner(s) Name(s) (Print) 3am1^ ^^a A^^-b u Owner's Signature(s)Subscribed and Sworn to'^/yS> UO'V1^^''////"Ufc ( ) ' Notary Public n: Oll^t^lMy commission expires on Revised: May 2016 (®May 2018) Personal information you provide may be used for secondary purposes [Privacy Law. s. 15.04 (l)(m)] Drafted by ® System Explorer &zyfie°id County Public Access5/23/2025 © Real Estate Personal Link To Treasurer Page To Pay 2nd half or Past Year taxesonly by Credit Card, Echeck, or DebitCard to the Bayfield County Treasureruse this link. Pay Bayfield County Treasurer ByCredit Card For Credit Card or Echeck payments tothe foilowing municipalities use themunicipality link below. December and January Jurisdiction ,»a0014e Public Access Real Estate r~1 TaxID; 7748 Alt./LegacyID: PIN: _ _ _ :_ .. Owner Name: f;,^, Last/Org.: #: Road:Site Address: Search Results - Records Found: 1 PIN: 04-010-2-51-06-27-1 05-001-04100TaxID: 38369 1.780 Ac.S27-T51N-R06WGQVT LOT 1 Owners: TAST/PLUNDERER LLC3173SUNNYSIDESTSTOUGHTON WI 53589 Site: 89775 W SUNSET DR Current Property Tax ID: 38369TAST/ PLUNDERER LLC 3173 SUNNYSIDE ST STOUGHTON WI 53589 ^ ^ fr| ^a{^J^o^JUJ '^ 'W !;E/2iif20^4:3telopr|| il1^ " . 1111MAY 2 ' 20sl^ Property | Tax Records Statement Real Estate Bayfield County Property Listing Today's Date: 5/23/2025 Description Updated: 11/12/2020 a Ownership ion^TC!ccit Property Status: Current Created On: 11/12/2020 1:39:17 PM Updated: 11/12/2020 Tax ID: PIN: Legacy PIN: Map ID:Municipality: STR: Description: Recorded Acres: Calculated Acres:Lottery Claims: First Dollar: ESN: y Tax Districts 38369 04-010-2-51-06-27-1 05-001-0-1100 (010) TOWN OF BELLS27 T51N R06W LOT 1 CSM f 2145 IN V.12 P.317(LOCATED IN GOVT LOT 1) 1.780 1.7800No107 Updated: 11/12/2020 TASTIf PLUNDERER LLC Billing Address: TASTY PLUNDERER LLC3173 SUNNYSIDE STSTOUGHTON WI 53589 STOUGHTON WI Mailing Address: TASTf PLUNDERER LLC3173 SUNNYSIDE STSTOUGHTON WI 53589 y Site Address * indicates Private Road 89775 W SUNSET DR Property Assessment CORNUCOPIA 54827 Updated: 9/22/2022 1 04010 044522001700 rded Documents STATE coumYTOWN OF BELL SCHL-SOLTTHSHORE TECHNICAL COLLEGE Updated: 1/7/2020 B CERTIFIED SURVEY MAP Date Recorded: 10/29/2020 B QUIT CLAIM DEED Date Recorded: 12/26/2019 2025 Assessment DetailCode Gl-RESIDENTIAL 2-Year Comparison Land: Improved: Total; Property History Acres 1.780 Land 44,500 Imp.0 2024 2025 Change 44,500 44,500 0.0%0 0 0.0% 44,500 41,500 0.0% 2019R-580393 Parent Properties 04-010-2-51-06-27-1 05-001-04000 04-010-2-51-06-27-1 05-001-05000 04-010-2-51-06-27-1 05-001-06000 04-010-2-51-06-27-1 05-OQt-07000 Tax ID7748 7750 7751 HISTORY B Comt White=Current Parcels Pink=Retired Parcels B Tax ID: 7751 Pin: 04-010-2-51-06-27-1 05-001-07000 Leg. Pin: 010105909006Acres: 2.39 Owner: TASTT PLUNDERER LLCLast Values: 2020 Land: 11-fSOO Improvements: 0Created: 3/15/2006 Retired; 2020BTax ID; 7750 Pin: (M-010-2-51-06-27-I 05-001-06000 Lea. Pin: 010105909005Acres; 2.08 Owner: TAST(r PLUIMDERER LLCLast Values: 2020 Land: 6140QJmDrovements: 0Created: 3/15/2006 Retired: 2020B Tax ID: 7749 Pin: CM-010-2-51-DG-27-1 05-001-05000 Lea. Pin: 010105909004Acres: 1.54 Owner: TASTY PLUNDERER LLCLast Values: 2020 Land: 33400 Improvements: 0Created: 3/15/2006 Reh-red: 2020BTax ID: 7748 Pin: 04-010-2-51-06-27-1 05-001-04000 Lea. Pin: 010105909003Acres: 1.65 Owner; TASTif PLUNDERER LLCLast Values: 2020 Land: 33700 Improvements: 0Created; 3/15/2006 Retired; 2020 38369 This Parcel •••Parents +• Children Progress: !oj '^ g 11!? B BAYFIELD COUNPf |ijl |?|;CHECKLIST FOR SANITARY APPLICATONS ^i: MAY y / ^fj/5 ^ Submit the FollowinQ (Use Permanent Ink) CTitle 15, Section 15-l-10(e)) Bsv%!f;, ,^ ., :-., ^ 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(0) ^ Original Plot Plan (383.22(2)2. 3. & 4.a) D 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)l.f.) D Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) D Holding Tank Agreement (383.2 l(2)(c)(5) (Recorded at Reg. of Deeds) ^fn^ p^^i ^) D Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) (^tff^ O^^eV^ D ATU Servicing Agreement (Recorded at Reg. of Deeds) D Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) ^^, ^f 6an^-} ^ 2 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) , Soil and Site Evaluation Report (383.22-3(2)(b)l.e.) D State Plan Review (when applicable) D Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) I Application Information must include: [^ 23 digit Parcel ID# - (do not use 12 digits anymore—obsolete) 15> Project Address or Road Name where driveway is/will come off of) ^ (Owners Phone Number) ^ II Type of Building 81 III Type of Permit IV Type of POWTS System D V Dispersal / Treatment Area Information ^ VI Tank Information VII Responsibility Statement (Plumber's Information) D *Date Stamp* Plot Plan: (To Scale or To Dimension) Signature and Plumber Information ^ Address Number and Road 1^ Surface Elevation of Body of Water ^1 North Arrow Direction and Percent Land Slope ^9 Contour Lines ^ Tank and Filter Information and Location ^ Structures and Driveways ^ Wetlands / Navigable Bodies of Water ^S) Boring Locations lAbsorption Area (Proposed and'Existing) • j8 Property Lines Bench Mark (Location, Elevation and Description) ^ Well Locations ^ Component Manual Version -^ Legal Descriptions aiping Material Information (conveyance line, building sewer line, material type and diameter) Turn Over > Crbss-Section and Over-Head Profile of the System: IU} @ ^ ; i fc4 /^If J '^'" ;;I" 11 D Surface and System Elevation i-;?! M/i' .. '/uyi; iijl d Position of Observation and Vent Pipes fe1^;-'; D Dimensions and Depths D Make, Model & Number of Chamber Units in each Cell Property Information 1^ How many systems will there be on this parcel of land? ^ Has this property been split? »^5 (Property Statement shows Property History) Fees: D Private Sewage System (Septic Tanks) $ 400.00 D Private Sewage System (Holding Tanks) $ 400.00 n Mounds or Systems requiring Pre-Treatment $ 500.00 H 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: BAYFIELD COUNTS SANITARY PERMIT (#04)-25^JS STATE SANITARY PERMIT OWNER: TASTf PLUNDERER LLC GOVTLOT:1 LOT: BLK: 1/4 1/4 SEC: 27, T 51 N,R6W TOWNSHIP: Bell SOIL TEST: 36-25 NEW SYSTEM SYSTEM J\PE: 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 6/4/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION