HomeMy WebLinkAbout25-42S^-oo^i
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Industry Services Division
4822 Madison ^Yards Wa^
Madison, W^) 70^ [|11 [bP.O.Boxj^02L!:1 y) lh
Madison, \Mt 3370,7
^ Satpt^ry Permit Number (to be filled in by Co.)
^-,/ K ','fi?
County
Bayfield
35-41S
Permit Application
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appfepq3(8^6v6iT)rn£Hjaljm,ilti
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.
State Transaction Number
Project Address (if different than mailing address)
10685 Angus Lake Rd. Iron River, Wl 5484-
I. Application Information - Please Print All Information
Property Owner's Name
Jeff & Angela Colby
Parcel #
19218
Property Owner's Mailing Address
717WilsonAve
Property Location
Govt.Lot.
City, State
Cleveland, Wl
Zip Code53015
II. Type of Building (check all that apply)
1 or 2 Family Dwelling - Number ofBedrooms 3
'ublic/Commereial - Describe Use
IState Owned - Describe Use
Phone Number
920-629-2451 NW ,/. NE',4._'/4, Section 10
Lot #-47 _N R °8 E or W
Subdivision Name
Block #
CSM Number
|||cityof_
Qvillage of
r7lTownoflronRiver
III. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i
applicable.)
A.lew System Replacement System Ither Modification to Existing System (explain) || [Additional Pretreatment Unit (explain)
B.[—]Holding Tank IIn-Ground
(conventional)
I[At-Grade DMound Individual Site Design [Other Type (explain)
c.Renewal Before
Expiration
Revision 'hange of Plumber ,ist Previous Permit Number and Date IssuedFransfer to New Owner]'INA
IV. Dispersal/Treatment Area and Tank Information:
Design Flow (gpd)450 Design Soil Application Rate(gpd/sf)
0.7
Dispersal Area Required (sf)642 Dispersal Area Proposed (sf)678 System Elevation
95.5
Tank Information
Capacity in
Gallons
New Tanks Existing Tanks
Total
Gallons
# of
Units
Manufacturer
s
p: 0
0 ^S SM V,sE U
Septic or Holding Tank 1000 1000 Superior Precast r~r
Dosing Chamber m aV. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
Jason Kuettel
Plumber's Signature
.. z^.'^Z^rM~
MP/MPRS Number675751 Business Phone Number
715-798-3355
Plumber's Address (Street, City, State, Zip Code)
PO Box 66 Cable, Wl 54821
~TT
VI. County/Department Use Only
Approved D Disapproved
D Owner Given Reason for Denial
Permit Fee$zw-Date Issuedr^*&\^?s~ 6,
Issuing Ag^ft Sigajlture^^V)t5 •^/t.f
Conditions ofApproval/Reasons for Disapproval
<Sc^ aMo^cf^JI QJ)J^(\
Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size
SBD-6398 (R. 02/22)
fe^i^%r'5R.-002.53
,-^.'^Soil Evaluation Report
in accordance with SPS 385.Wis.Adm Code
'^^- ^~^/ Wisconsin Department of Safety and Professional Servises
i j !G i^
m
II ^ JE
y /'u/^
iJSli
Attach complete site plan on paper not less than SVz X 11
Plan must include but not limited to: Vertical and horizontal
point (BM), direction and percent slope, scale or dimensions,
location and distance to nearest road.
Please Print All Information
Personal information you provide may be used for secondary
(privacy Law,s.15.04(1)(m)).
iches in siz
tal referenc
north arrov
purposes.
Property Owner:
Jeff & Angela Colbv
Property Owners Mailing Address:
717WilsonAve
City
Cleveland
fs/ New
Seneral
System
I- Replacement
Parent Material:
acement
Vlaterial:
;ommem
levation:
StateWl Zip Code53015 3hone Number:0
Number of Bedrooms:Residential .—..—• - —-..—...-.
F~ Public or Commercial - Describe:
i Recommendations:
95.5 Load Rate:
3
Flood Plai
07
Pag 1^-S,,.
bounty:
Bavfield
'arcel I. D.
19218
?eviei /^t 77,^ G^/^
'roperty Location
NW1/4NE1/4,S10,T47N,R08W
Site Address or CSM and Lot #
10685 Angus Lake Road
Town
Iron River
Nearest Road:
Angus Lake Road
Flood
Applicable:
Ei§Vi
Code derivedderived design flow rate
Plain if aDDlicable
88.86
ion Ranae: 91,74
r Bor. F7 Rt Ground surfac! Elw; . -Depth t°.l-imitin9 Fact.or:,.98.63 Ft. 120 in. Elev. 88.63 ft
Horizon
1
2
3
4
5
6
7
Depth in
0-4
4-24
24-120
Domm.Colc
Munsell
7.5YR2.5/;
7.5YR4/6
7.5YR5/1
Redox Descriptioi
2u. Sz. Cent. Cole
N/A
N/A
N/A
Fextun
SL
LS
MS
Structure
Gr.Sz.Sh.
2MSBK
OSG
OSG
;onsisteno
MFR
ML
ML
Boundan
cs
cs
N/A
Roots
sco
3M
1F
Bor.fu? Pit Ground surface Elev: Depth to Limiting Factor:
98.74 Ft. 120 in. Elev. 88.74 ft
Horizon
1
2
3
4
5
6
7
Depth in
0-4
4-26
26-120
3omm.Colo
Munsell
7.5YR2.5/3
7.5YR4/6
7.5YR5/1
Redox Descriptior
Su. Sz. Cont. Cola
N/A
N/A
N/A
exture
SL
LS
MS
Effluent#1 = BOD 5>30< 220 mg/l and TSS?30 < 150mg/l
;ST Name (Please Print)
MarkS. Thompson |
Address: 12006 N US Hwy 63
Hayward, Wl 548431 m^ate £>!!8rfuatfpn pdndu<
^ Tuesday, M.
Structure
Gr.Sz.Sh.
21VISBK
OSG
OSG
onsistena
MFR
ML
ML
Boundary
cs
cs
N/A
Roots
3CO
3M
1F
450
To 9573
Soil Application Rate:
GPD/ft2
*Eff#1
0.6
0.7
0^
Eff#2
1.0
1.6
M
Soil Application Rate:
GPD/ft2
*Eff#1
M
QJ.
07
Eff#2
1.0
1.6
L6
"Effttispt #2 = BOD 5 < 30 mg/1 and TSS <. 30 mg/1
20,2025
;ST Number: g^gg
'elephone Number
715/699-4081
SBD-8330 (R04/21)
^\^<- l^(o^^ - ^5^-^^
Property Owner:Jeff & Angela Colbv Parcel I. D.19218 Page:IN M i«
li( MAT 28
'^
2025 Ill'
Boring #;
Horizon I
1
2
3
4
5
6
7
3epth i
0-6
6-22
22-121
Boring # A
-lorizonl
1
2
3
4
5
6
7
)epth h
Boring # 5
^rizon]
1
2
3
4
5
6
7
lepth ii
Boring # 6
^rizonl
1
2
3
4
5
6
7
epth ir
p Ground surface Elev: Depth to Limiting Factor:
97.56 Ft. 97.56 in. Elev. 87.56 ft
Domm.Colorl
Munsell
7.5YR2.5/3
7.5YR4/6
7.5YR5/1
Redox Descriptio
Qu. Sz. Cont. Coli
N/A
N/A
N/A
Fextu
SL
LS
MS
Ground surface Elev:~ Bar f>/ Rtt
0 Ft.
3omm.Color|
Munsell
Redox Descriptioi
2u. Sz. Cont. Cole 'extui
Ground surface Elev:Boris? Pit 0 Ft.
)omm.Color|
Munsell
Redox Descriptior
2u. Sz. Cent. Cole extur
Ground surface Elev:Borp Rt "•""""—° .-.=".
0 Ft.
iomm. Color
Munsell
^edox Description
!u. Sz. Cont. Colo extun
Structure
Gr.Sz.Sh.
2MSBK
OSG
OSG
Sonsistenc
MFR
ML
ML
Bounda
cs
cs
N/A
Roots
300
3M
1F
Depth to Limiting Factor:
0 In.
Structure
Gr.Sz.Sh.;onsistenc Boundai Roots
Depth to Limiting Factor:
0 In.
Structure
Gr.Sz.Sh.;onsisteno ioundar Roots
Depth to Limiting Factor:
0 In.
Structure
Gr.Sz.Sh.;onsistena ioundar Roots
Soif^Rj^Ratf
GPD/ft2
*Eff#1
0.6
0^
OJ
Eff#:
1.0
1^
M
>oil App. Rate
GPD/ft2
*Eff#1 EfW2
;oil App. Rate
GPD/ft2
>Ef»1 Ef»2
oil App. Rate
GPD/ft2
Eff#1 :ff#2
"Effluent #1=BOD5>30<, 220 mg/l and TSS>30 <. 150mg/l *Effluent #2 = BOD 5 < 30 mg/1 and TSS < 30 mg/1
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access
services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777
SBD-8330(R.07/00)
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Owner Information:
I Name:
I Location:
|Township:
I County:
I Lot#:
Jeff & Angela Colbv
NW1/4NE1/4.S10,T47N.R08W
Iron River
Bavfield
10685 Angus Lake Road
BM=100: Top of 2nd step of sidewalk halfway down
B1 =
B2=
B3=
Lake=
98.63
98.74
97.56
88.86
^ . .^M^^^/^WelF
Existing
House—^.|
BM^
97' 99'
B1
Shed
10685
>,I<u
Q
B3
B2
Proposed
New
House
Old well to be
abandoned
^/^ \^(^\^^;%%^c^^f > ""y^
1 "=40'Only in Tested Area
'<sr<
^#87~i
715/699-4081
,rv-.
oc
',7^1
iS'2)
[rin3
•:c'0CDa
tnJr]
In-Ground Gravity Plan
Index & Cover Sheet
Component Manual Design References:
In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027?^
PAGE 1 OF 4
Q ^ I i II 1^
\,-,; j ?^ MAY mo^ li;
Pg1 of 4
Pg2of4
Pg3of4
Pg 4 of 4
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
Colby 3 Bed
Owner Name(s): Jeff & Angela Colby
Owner Address: 717WilsonAve Cleveland, Wl
phone: 920 -629 -2451
Zip:53015
Project Address: 10685 Angus Lake Rd. Iron River, Wl 54847
Govt. Lot: _ NW 1/4 of NE -1/4^ Section^0, T^7 N-R08 E Q or W [/]
Township: Iron River County: Bayfield
Project Parcel ID #: 19218
Designer Information
Designer Name: Jason Kuettel _ Phone: 715 .798 -3355
Designer Address: po Box 66 Cable, Wl Zip:. 54821
E-mail: tim@andryras.com 'ii~ ^p,u~i !\'s^n'i-J i>>i' .M'^LOVS
License Number: 675751
Remarks:
Signature:Date
Original signature'required on each submitted copy.
: 5-A?/v
Owner Information:BM=100: Top of 2nd step of sidewalk half wav down
I Name:
I Location:
|Township:
I County:
I Lot #:
Jeff & Angela Colbv
NW1/4NE1/4.S10,T47N.R08W
Iron River
Bavfield
10685 Angus Lake Road
B1 =
B2=
B3=
Lake=
98.63
98.74
97.56
88.86
^STC/tn C<_ - q6'.S'0
^^'i
Existing
Hous<
Well
BM~^
Shed
10685
>,<DI
99'
^
^
,f e/tfcCVC-c
H^ct\ 4<? <'••"-
(J)<t4<-- B2
G^(<-h H
c \-^j-^^
Proposed
New
House
0/d well to be
abandoned
N J'.x-TV^- ^(_
1 "=40'Only in Tested Area ^ ^s^~\
5/T-V^S
EOsutrX'00
S-s:0'
SOG_<D°09.°^
^
r\3
•ec
r~<c:F~<:Cjr
Finl
:?un3
5°=;
i^:S:S
IN-GROUND GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard-W Chambers
3-ft Trench (down-sizing credit)
^^^
SOIL COVER
— min. 12"(typical)
Septic Tank(s) Manufacturer:
SuDerior Precast
1000 gal
Orenco
Septic Tank(s) Volume(s):
gal — gal
Effluent Filter Manufacturer:
gal
Effluent Filter Model #:FT-0822
12"
min. trench
depth(typical)TYPICAL TRENCHCROSS SECTION VIEW
(No Scale)
Quick4 Standard-W
w/ End Cap
(typical)
System Elevation = 95.5 ^
(typical)
(Show location of inlet / outlet pipe connection on plan view.)
Provide minimum 3 ft
separation between trenches.
._________/-:
Observation Pipe(typical)
Install per manufacturer's
instructions.
TYPICAL TRENCH
PLAN VIEW
(No Scale)
|}3JI^{B|s|8|s|l{llj |^ll]!l|liB(||s|aiEJ||^I^B|||
INSTALL PER TRENCH:
-^-------7^---J"
It 1A=Mft(typical) _
(typical)
•.^•l(B
0
n>nFffl 0m
.U_ Quick4 Std-W @ 20 ff EISA/chamber = 220
+ J_ Pairs of end caps @ 6 ft2 EISA/pair = 6.
ft2
ft2
-Quick4 Standard-W Chamber(typical) ^
(mfd by Inflltrator Systems, Inc.) :^..
Install pursuant to manufacturer's instructions. ^.s
i-v0 '^v. CO
o. .== o
= Proposed EISA per trench = 226 ft2 Required Infiltration Area = 642 ft2
x 678 trenches = Prooosed Total EISA = 678 ^
Distribution Method:
branched manifold
PAGE 4 OF 4
In-ground Gravity Management Plan
IMPORTANT:
The owner of this in-ground gravity system 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 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), Wise. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow = 45° gpd; BODs ^ 220 mgL-1; TSS $ 150 mgL-1; FO,G^^O;J?ngL-1
'"3 ,'p1, • " .1 i'," IL.. ^ •.^ 1^i
Inspection Checklist INSPECT EVERY 3 YEARS |Uj
iP^I'/ho type of use ^ ^^ , ,; .^
o age of system pi llpl • '
o nuisance factors (/.e. odors, user complaints, ete.) _,,.-r,^',
o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) I:L:;v-eic '.. , ;i : '^-'^^
o material fatigue (/.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 (/.e., exceeding design capacities, prohibited activities, etc.)
o extent of ponding in distribution cell prior to dosing
o dosing irregularities - if applicable (;'.e., pump re-cycling, float switch settings, ete.)
o electrical components - if applicable (/.e., wiring, connections, switches, controls, timers, alarms, ete.)
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, Wise. 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 Wise. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: Andry Rasmussen & Sons _ phone: 715-798-3355
Local government unit: Bayfleld CQ. Zoning _ phone: 715-373-6138
Local government unit address: 117 E 5th St. Washbum, Wl _ ZIP: 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 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, Wise. Admin. Code.
S^PTIC TAJ-;:<CROSS S^CTIO.'-i' AND SPZCTF CATIOi1;^
4" Scri.trOP^ INSP. p^?E 6. ",MI?f. A30VZ GRADrYop^ !DJ 11 11 IE ^
Cuhem ^nlfc+ r^fl-<,x^o\& l£- ou.ri'e.d. >) - ----^->../ j^ - - - . - ^
^ MAY 2 8/0,'- ^ APPROVED'-'-' /u/:l ^ H^/HOLE"
FIMISHID GRADS ^^^ ^-3^r;-, ^^ ^^ W/Lccki^
-WR>}W^ ^Q^_
-4" HIM.
OUTLET
APPR^XED &A-FfiEi:E—
Of FILTER.
NFG. OKilCo
model S .pTO 8 2-"2-
APPRO'/EO
PIPE 3'
ONTO SOLID50 [L
3" APPROVES BH)DIh?e U?£P, T^h'K
SPECIFICATIONS
SEPTZC
TAM;< MANUFACTURED; ^_/^l^.±--L'^.^^'^
TAW SIZES; SS?TIC ,/tiO-O GAL.
NOTES:
SS-03651 N??^^Sfi2^
Private Sewage System Maintenance Agreement
Owner(s) Name
"StP-^ c.^LS'T: <r- A^G£/~.'a ccc-i3r
Owner(s) Mailing Address
7l~l \^\LSo/^ ^1-- CL^J<=LA.f^> , l^.530 \S
Site Address
/0&6S" /q/^/ooj L^^^ ^^.fl^Off & ]> v-c-G ^ ^.^r
Tax ID #/ <7 z-)6
As owner, I (we) do hereby certify the private sewage system will be installed in
accordance with the certified soil tester's report and approved plans and specifications
on file with Bayfield County Planning and Zoning Department. The system will be
operated in such a manner as to meet the designed plans. I (we) agree to maintain said
private system at the below listed location in accordance with rules established in the Wl
Adm. Code, as from time to time amended. (COMPLETE Lega] is required)
ij-L_1/4 of Alc 1/4 Section / 0 Township _^_N. Range 06 W.
Additional Legal Description: S ft: A Tri^Cli-s:'-
Town of //Zo^ ft^'c/L- (Acreaaet ^.o? Gov't Lot
Lot
Lot.
Block Subdivision
CSM#Vol.. Page.CSMDoc#^
OOCUMENT NUMBER2025R-607 640
DANIEL J- HEF-F-IMER
REGISTER OF DEEDS
BAYFIELD COUNTY, WI
RECORDED
05/2S/2025 AT 2:59 PM
RECORDING FEE: $30.00
PAGES: 2
Recording Area
Return To:
Planning arff^Zo
Bayfield Co. Zoning DepL
D In-ground pressure distribution Sewage System:
D Other.
In-ground gravity
D Mound
D In-ground dosed
D At-grade Sewage System
Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage sen/icing operator within three (3) years of the date of
installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make
such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum.
Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided
above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components.
Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance
with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wls. Admin. Code.
Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified
septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three
(3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface.
Mounds, At-arade, and In-around Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbed if needed when
the wastewater distribution cell component is inspected as provided above.
Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfield County for
inspection, pumping, hauling, or otherwise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any
human health hazard caused by the system. Bayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days
from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges
may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law.
The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future owners of such py^c^f^ dQggy^.^Subscribed and sworn to before me on this date: ^J^/Owner(s) Name(s) - Please Print
Tc-/= F <—o '- (Z '*<
,'^bir^ <Loi-3 >'^v\ ^3, 3d^^s^.^6\;p".^
Notarized Owner(s) - Signature(s)
^^ <^Y My Commission Empires:A rOVf- "\
Drafted by: _:77"-"- (- L '»i2k:~Date: ^-12- - t^
Proofed by:
n/fornns/sanitary/septicmaintenceagreement
Revised July 2020
EXHIBIT A
That part of the Northwest Quarter of the Northeast Quarter (NW1ANE1/4) of Section 10, Township 47
North, Range 8 West, lopted in the Town of Iron River, Bayfield County, Wisconsin, described as
follows: Commencing at the North 1/4 corner between Section 10 and Section 3, Township 47 North,
Range 8 West; thence East along the section line a distance of 1,300.8 feet to an iron pipe; thence
angle to the right 90° a distance of 1,216.2 feet to an iron pipe; thence angle to the right 90° a
distance of 807.3 feet to an Iron pipe; thence angle to the left 5°12' a distance of 111.0 feet to an iron
pipe located on the lakeshore of Angus Lake, which is known as the place of beginning; thence
retracing on the same line a distance of 111.0 feet to an iron pipe; thence angle to the right 5°12' a
distance of 807.3 feet to an Iron pipe; thence angle to the right 90° a distance of 100 feet to an iron
pipe; thence angle to the right 90° a distance of 904,8 feet to an Iron pipe located on the east side of
Angus Lake; thence northerly along the lakeshore a distance of 100 feet to the place of beginning. All
angles given are deflection angles.
BAYFIELD COUNTS SANITARY PERMIT t#04)-25-42S
STATE SANITARY PERMIT
OWNER: JEFF E & ANGELA K COLBY
GOVTLOT: LOT: BLK:
NW 1/4 NE 1/4 SEC: 10, T 47 N, R 8 W
TOWNSHIP: Iron River
SOIL TEST: 42-25
NEW SYSTEM
SYSTEM TYPE: Non-Pressurized In-Ground
PLUMBER: JASON KUETTEL
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: # MP 675751
Condition: Properly Maintain System Per Recorded Agreement
THIS PERMIT EXPIRES 6/4/2027
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION