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HomeMy WebLinkAbout25-51S^ 55-00^4 Department of Safety & Professional Services, Industry Services Di|^si((ai f[ County itag/ Pi B&.s/C.eld^uhilit Nuhiber (to be filled in by Co.) ^-6jS rans^ion NumberSanitary Permit Application MAY 2 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 &S^ff?Adtid.Qo 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. I. Application Information - Please Print All Information aWj8;iA<flfess (if different than mailing address) S</35' Ta^<-6 ^cl Property Owner's Name PCL^CK T T^^ Parcel # Tny fO; 1^3 (W-flOV.^V-(M-03-3 OS-.OOV.&t.QOh Property Owner's Mailing Address JL^>^v^ ftc^\o ^\\\\ ft6 City, State H^^6.rAi\AJT Zip Code 5lt3t/3 n. Type of Building (check all that apply) 1 or 2 Family Dwelling - Number of Bedrooms D Public/Commercial - Describe Use D State Owned - Describe Use Phone Number -?/^^-J(/t/3 Lot # Property Location Govt. Lot A/LtJ '/4, £?£ '/4. Section to: T HI N R 0 9 ^ iffw)\Subdivision Name Block # CSM Number C&f* ** 14 <J6l.\ v0*|.^l-'^ D City of. D Village of •fe'Town of lAzrntf' DI. 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.D New System tem D Other Modification to Existing System (explain)D Additional Pretreatment Unit (explain) B.D Holding Tank ^In-Ground (conventional) D At-Grade D Mound D Individual Site Design D Other Type (explain) c.Renewal Before Expiration D Revision D Change of Plumber D Transfer to New Owner ,ist Previous Permit Number and Date Issued IV. Dispersal/Treatment Area and Tank Information: ^"^ Oo;CKM PloA CV>A.<nb<ra u// ^Ae.f-J cf Cr\S-3, Design Flow (gpd) 3oo Design Soil Application Rate(gpd/sf) &.-7 Dispersal Area Required (sf)w^Dispersal Area Proposed (sf) <y5-^ » System Elevation ^3.C>0 Tank Information Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units Manufacturer JS S,<! Si §S 0 llsK B s ^-° s'& 0 cdh Septic or Holding Tank 75Z)-ISO ^uper^csf f>KCeL&4- Dosing Chamber V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Tn^.'S B)oU<r^iff /d Plumber's Signature MP/MPRS Number 65'S&7<> Business Phone Number 7AS-63W-8)~7^ Plumber's Address (Street, City, State, Zip Code) / /yjt^,^6^+< Po^ 7-? A/&yt^<rd, L^X 6'^g</3 VI. County/Department Use Only Approved D Disapproved D Owner Given Reason for Denial Permit Fee $ HOP- Date Issued>^J<(/)»p5' /\^f^/^Z5^/J 6/1^ Conditions ofApproval/Reasons for Disapproval 5^i a^fcfacA^f &^ - 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. 03/22) s^-oo-wy Wisconsin Department of Safety & Professional Services '\'(T Division of Industry Services ''- ff11 !riih'i ;ft•y ^s MAS w SOIL EVALUATION REPORT Page I of SOtt HST In accordance with SPS 385, Wis. Adm. Code Attach complete site plan on paper not less than 81/2x11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). "sue \ACounty B<xyF\&lA Parcel I.D. Tn»io;)&t/3 OWOOM -3-W-O^ -0^-3 05-OQ1/ -&£.ftun Property Owner Pc^ricK T Q^-fs Property Location D' Govt. Lot"'N\Ai 1/4 &e1/4SOS T W NRO^ E (or) W Property Owner's Mailing Address SG^(^U Radio /-It 1} 8eL Site Address or CSM and Lot #: L^ ] C^ N 14 ^jo\. I ^^.^CoS 5^3^- City, State, Zip H^uj&r^,^! SHSV^ Phone Number (7/S')^(.-3W^_ D City Village M Town le.e'-nf.S Nearest Road T^i^es Rd. Q New Construction 8 Replacement Parent material. General comments ^ Use: 12 &.r>&^ Residential / Number of bedrooms Public or commercial - &>•)<• t^jei.-S and recommendations: R. Describe: Man. _SL - P^esAup 'iZC.^\<\ Code derived designflow rate 300 GPD Flood Plan elevation if applicable_ft. &f&>jr>d Sy&^no Boring #Q Boring yA Ground surface elev.^.'XS'ft.Depth to limiting factor "SIOQ in. / elev._ft. Horizon I A- A- _^_ Depth In. 6-8 S-3M ^H-H^ 1/S--10& Dominant Color Munsell I 0 fA 3/3 1 ft VS ^ 7.SSI«M/4 •i.si» •s'/y Redox Description Qu. Az. Cant. Color Texture _k- 1$. _s_ _5_ Structure Gr.Sz. Sh. _fi!S_ 0 _^_ f6 Consistence ft»u C<~ ^»v ft- -e^L j^L Boundary 15- ^-~s Roots ^.f^^M -L£_ Soil Application Rate GPD/Ft2 *Ef?1 0.7 0.-7 0.-7 0.') *EfW2 I.L. (.6, s-C. 1.^, Boring #QBoring ylt Ground surface elev. 97.00ft.Depth to limiting factor^ 100 in. / elev._ft. Horizon ! •) ^L H Depth In. 0--! 7^1 2»-44 yv-1 OG Dominant Color Munsell iQY83/2> 10VH<l|t( T.SlR^Al 7.91^/H Redox Description Qu, Az. Cont. Color Texture J^_ !s s _5_ Structure Gr.Sz. Sh. tS as 69 0 Consistence in.wfr <n«^>l rsl ml Boundary _s_ ts- LS- Roots jsAiL _[&.- _LL JA- Soil Application Rate GPD/Ft2 *Ef?1 O.T 0^7 to.-7 0.-7 *Efffti2 l.fc, /._€. _LA- A-C_ CST Name (Please Print) 'ftcno.lc) A ^we.^&lA Tf Signature'/^^^ Date Evaluation Conducted os-/ '<?8/$jr CST Number s^c^sg Address J W^ ^ U 77 //Ay^r^kU- 5V39J Telephone Number 7, S'^'SH -& 17 (^ Effluent #1 = BOD > 30 < 220 mg/L and TSS > 30 < 150 mg/L * Effluent #2 = BOD,.< 30 mg/L and TSS < 30 mg/L ?4 150 feM^ rr^l SBD-8330 (R03/22) Page..0^ Boring # Q Boring I Pit Ground surface elev..(?7.50ft.Inl|Lfcepth t^in^tinj f&or^t^in. / elev._ft, Ill MAY2:^0/h i Horizon t Si A. ^L Depth In. 0--? >n H.3S 35-J-ol. Dominant Color Munsell \ &w-»/3 10<(R.liJM •y.Ste^ •?.SVR-S'A/ Redox Description Qu. Az. Cont. Color Texture -Ls- -LS_ J>_ ^- Structure Gr. Sz. Sh. u Ce J3-L _se_ Oct.yj'^i'ffCohsjste'rtce''' A>>t IT (»»,•<(<- _c»L ml BolfiH&aH-" li- 4s- jRoots MiL Afrs _LLir GPD/Ft2 *Eff#1 Q-f 0--7 (»•'» O.T *Ef?2 i.l» ».(<• 1. <0 I.G Soil Application Rate Boring #D BoringD Pit Ground surface elev.Jt.Depth to limiting factor.Jn. / elev., Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Ef?1 *EfW2 Boring #D Boring D Pit Ground surface elev.Depth to limiting factor.Jn. / elev.__ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Eff#1 *EfW2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS > 30 < 150 mg/L * Effluent #2 = BOD, S 30 mg/L and TSS < 30 mg/L SCALE = 1:40 1—I—»—I—i-0 10 25 40 50 5435 James Rd Lot1,CSM#14v.1 p.265 Sec. 02, T44N, R09W Town of Barnes Bayfield County TAX ID: 1243 BM = Nail w/ Ribbon in 14" Red Pine ^•^v^\^^UPPEREAU CLAIRELAKE ^\\' Proposed 2Bdrm Dwelling Proposed Well To James Rd \\^0 CTS^ ELEVATIONS BM= 100.00 ft B1 = 97.75ft B2 = 97.00ft B3 = 97.50ft Lake = 88.50 ft ^^\\&-- 9^JA*.*Mw^^'^1^0^ *7/T-5<^3t<43> \yi R^<^ASp^^J(~mwit^s^^80^ H&.^tM-a.t-jx 5*-(^3 7/S-t»3'4-&l1^ p^< 1°^ 0 ll ll w I i SOIL PROFILE SHEET OWNER: ?<^<-;£^ T G>O-C<Y _ SOIL TESTER:_ SYSTEM ELEVATION: LOAD RATE: 0."7 /I.C SYSTEM RANGE: 95. OC^ to 9S. C?0 li MAY ?3"im U ttaytiejci co. Zonina OeD( QD.-75 R e c-cyw «\ < nd^a^- Sy^kx^*- £!€^A.^''tsv\ R&n^& \.75 w^^~^E LAK£ t-e.^e.c ^-7.0C^ ^s,oo 2^-7 B^oWi- 9-7.SO ^.00 ^.00 '^C^of-e.i- Page H of ^ 1,0001-CompartmentTank iPRiSpApCD)\\n iLi lr\PRECASTCONCRETE Weielirfmlbs) Tank; 5,-SU lid; Total.:' Vofam* st C'Qncrete Total :s 2,4 Ydi Gailtins Per Inch.; 24.4 1025 GaUans Enlarged Qets& ConditsonsilyAPPROVED DEPT. OF SAFETY AND PROFESSIONALSERVICESDIVISION OF INDUSTRY SERVICES 5"NiwrJEnclSBS£ Manhole Openiags Produced by Superior Precast Concrete, LLC PO BOX 1390 Haywa rd, WI 54843 lyadg-IeneBaffle PRECASTCONCRETEDesign conrorms to Ay I M C1227, Specification for Precast Concrete Septic Tanks and Wl SPS 384.25, POWTS Holding Components or Treatment Components The information provided on any Superior Precast Concrete (SPC) drawing or document shall be verified by the purchasers licensed professional engineerfor suitability of use. Configuration may change from drawing, consultwith SPC.Casket •[Pound in Place) This is proprietary information, and remains the property of Superior Precast Concrete, LLC. " Real Estate Bayfield County Property Listing Today's Date: 5/14/2025 U^ Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN: Tax Districts Updated: 10/30/2024 1243 04-004-2-44-09-02-3 05-004-06000 004104503000 (004) TOWN OF BARNES S02 T44N R09W LOT 1 CSM #14 V.l P.265 (LOCATED IN GOVT LOT 4 & NW SE) IN V.901 P.425 358C IM 2004R-494345 IN DOC 2024R-605227 2.083 2.083 0 Yes (R-3) Residential-3 104 Updated: 3/15/2006 1 04 004 041491 001700 ;* Recorded Documents STATE COUNTY TOWN OF BARNES SCHL-DRUMMOND TECHNICAL COLLEGE Updated: 3/15/2006 B WARRANTY DEED Date Recorded: 10/24/2024 2024R-605227 a TERMINATION OF DECEDENT'S INTEREST Date Recorded: 10/24/2024 2024R-605226 S3 CONVERSION Date Recorded: 494345 226-342;901-425 MAVi'lMi tfVneici Ownership \1 Property Status: Current Created On: 3/15/2006 1:14:44 PM Updated: 10/30/2024 PATRICK TDUFFY Billing Address: PATRICK T DUFFY 16269W RADIO HILL RD HAYWARD WI 54843 HAYWARD WI Mailing Address: PATRICK T DUFFY 16269W RADIO HILL RDHAYWARD WI 54843 Site Address * indicates Private Road 5435 JAMES RD Property Assessment BARN ES 54873 Updated: 10/4/2016 2025 Assessment Detail Code Acres Land Imp. Gl-RESIDENTIAL 2.090 222,700 67,100 2-Year Comparison 2024 2025 Change Land: 222,700 222,700 0.0% Improved: 67,100 67,100 0.0% Total: 289,800 289,800 0.0% Property History N/A In-Ground Gravity Plan | " I Index & Cover Sheet PAGE 1 OF 4J? I ^ I ^i! t3 Ill MAY 2 3 2025 KiUs Component Manual Design References: ^w^,\ r.,' •7^,^, r,--,^ In-Ground Soil Absorption for POWTS Version 2.1 (May 202^5^tf ^"i"!y "3}" Pg1 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 Duffy - James Rd Owner Name(s): Patrick T Puffy Phone: 715 -296 -3443 Owner Address: 16269W Radio Hill Rd ; Hayward, Wl Zip:. 54843 Project Address: 5435 James Rd Govt. Lot:NW 1/4 of SE 1/4, Section °2 _, T 44 N-R09 or W • Township: Barnes County: Bayfield Project Parcel ID #: 04-004-2-44-09-02-3 05-004-06000 (TAX ID: 1243) Designer Information Designer Name: Travis Butterfield _ phone: 715 -634 -8176 Designer Address: 14346W State Road 77; Hayward, Wl E-mail: office@butterfielddrilling.com Zip:. 54843 This space reserved for approval stamp. License Number: 652879 Remarks: Signature:Date: os / I^/^ST ^/ Original signature required on each submitted copy. PLOT PLAN SCALE = 1:40 & t—»-0 10 -+--+- 25 40 50 -4 80:^ 3J -0~-~!"~^ 00 CYI ^ Q.,w L—sco 0 0 ''.^1w roil£i 5435 James Rd Lot1,CSM#14v.1 p.265 Sec. 02, T44N, R09W Town of Barnes Bayfield CountyTAX ID: 1243 BM = Nail w/ Ribbon in 14" Red Pine ST = 750 gal. prefab concrete septic tank made by Superior Precastwith Lifetime LT-1/8 Filter AA = Absorption Area consisting of two cells, spaced >3ft apart containing a total of 22 Quick 4 Plus Chambers Existing system is to be properly abandoned Existing Garage Proposed Well Proposed 2 Bdrm Dwelling ^ 4" PVC Sch 40 ASTM F891 ELEVATIONS BM= 100.00ft B1 = 97.75ft B2 = 97.00ft B3 = 97.50ft Lake = 88.50 ftUPPER EAU CLAIRE LAKE Page 2 of 4 IN-GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down-sizing credit) u SOIL COVER Septic Tank(s) Manufacturer: Superior Precast 750 gal Septic Tank(s) Volume(s): gal _ gal gal Effluent Filter Manufacturer:Lifetime Filter LLC Effluent Filter Model #: LT-1/8 12" min. trench depth(typical) 34 -^-.- -.^ -^ (typical) TYPICAL TRENCHCROSS SECTION VIEW (No Scale) Quick4 Standard-W w/ End Cap (typical) System Elevation = 93-°° ft (typical) (Show location of inlet / outlet pipe connection on plan view.) Provide minimum 3 ft separation between trenches. m——^- — — — ~ ~//~ ——————— -y/- — Observation Pipe(typical) Install per manufacturer's instructions. TYPICAL TRENCH PLAN VIEW (No Scale) (typical) INSTALL PER TRENCH: 11 + 1 Quick4 Std-W @ 20 ff EISA/chamber = 220 Pairs of end caps @ 6 ft2 EISA/pair =6 ft2 ft2 A = 3.0ft (typical) -Quick4 Standard-W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. ro,co^<B 0., -D>s^-s^ 0 ^-. mLn'ra§ su }.ru\' '•-o === ~n 1\ ^ ^—.<&"R = Proposed EISA per trench = x2_ ft2 Required Infiltration Area = trenches = Proposed Total EISA = 452 ft2 ft2 Distribution Method: branched manifold PAGE40F4 In-ground Gravity Management Plljh !?ff JE! IE H IMPORTANT: ljii MAY23ZQZ5 M The owner of this in-ground gravity system shall be responsible for its perpetual operation anJ:iTiaJritenanfi©;'pjy]r^]j^|t 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 = 30° gpd; BODs <. 220 mgL-1; TSS ^ 150 mgL-1; FOG ^ 30 mgL-1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (/.e. odors, user complaints, etc.} o mechanical malfunction (/.e., pumps, valves, switches, floats, etc.) 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, ete.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (;.e., pump re-cycling, float switch settings, eto.) o electrical components - if applicable (/'.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, 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: Butterfield InC _ ^^ 715-634-8176 Local government unit: Bayfield County Planning & Zoning _ p^ 715-373-6138 Local government unit address: 117 E 5th Street P.O. BOX 58 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 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$ -OOS^q Private Sewage System Mal fB^^^^Ince Agreement Owner(s) Name Pc^fSC^ T Do^Ai-Owner(s) Mailing Address )(»S»(^ l^J ^cud'.o ^ ^ (^ lAc^w&rd. Isix S4A43 Site Address SV35' TAr^CA ft<N Tax ID #1^43 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 Legal is required) MUJ 1/4 of Section O'a Township _N. Range Additional Legal Description: W v .tai P.M^S ACtC- tnaotat4(t-*<1yA*<5' IM Ooc aoAfn-bosay? Town of \5&r n. e & _ (Acreage) S.Ob'3 Gov't Lot Lot Block_Subdivision Lot t CSM#Vol. _J_Page ^(*S CSMDoc# 3Ll»to?>3% DOCUMENT NUMBER2025R-6077 1 1 DANIEL J.HEFF-NER REGISTER OF DE:EDS BAYF-IELD COUNTY. Wl RECORDED06/03/2025 AT 1 1 :03 AM RECORDING FEE: $30.00 PAGES: 1 Recording Area Return To: Planning a^ Zd^iii JUN U /l .[i^^ "'""ysc .. ^\ -^'!n;r.u i,)ui''li' 53 In-ground gravity Mound In-ground dosed D At-grade Sewage System 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 types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds, At-arade, and In-around Pressure System Latera!s (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 j^SS?ii?tf.osts within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessQ^S-SoiftlffffffWl^sent of a human health hazard, and the tax shall be collected as provided by law. The terms and conditions of the agreement sl Tding up(re to the benefit of all current and future owners of such property. Owner(s) Name(s) - Please Print ^ f ^\.\^ P^r-.^T&.CC^ ^\^w""yS/\r^'^ Notarized Owner(s) - Signature(s) 'Il*lte2/? OF ^v^c? i\\Wi?Sisy' ft.-Q5L^ Subscribed and sworn to before me on this date: ^1^/^[5 Notary Public'^M^Jc My Commission Expif^g:-^f^cL. Drafted by: Vlowa,)clAciDKe.fc(sTr Date: OS/ /S ,55 Proofed by: u/forms/sanitary/septicmaintenceagreement Revised July 2020 B^-VFIELD E3 Property Owner: DUFFY/ PATRICK T 16269W RADIO HILL RD HAYWARD, WI 54843 Description Certified Soil Tests - Review & Filing Total: Payment Amount: Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Fee Submission Number: SR-00248 Transaction Number: SR-00248-2D89D Amount $50.00 $50.00 $50.00 Reference: 4459 Paid by: Butterfield/ 14346W State Rd 77, Hayward WI 54843 Payment Type: Check Transaction Date: 6/12/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit RAyFIELD S3 Property Owner: DUFFY, PATRICK T 16269W RADIO HILL RD HAYWARD/ WI 54843 Description Private Sewage System (Septic Tanks) Total: Payment Amount: Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Submission Number: SS-00544 Transaction Number: SS-00544-2D8D7 Amount $400.00 $400.00 $400.00 Reference: 4459 Paid by: Butterfield/ 14346W State Rd 77, Hayward WI 54843 Payment Type: Check Transaction Date: 6/12/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTS SANITARY PERMIT f#04)-25-51S STATE SANITARY PERMIT OWNER: PATRICK T DUFFY GOVTLOT: LOT: 1 BLK: CSM:14V.1 P.265 NW 1/4 SE 1/4 SEC: 2, T 44 N, R 9 W TOWNSHIP: Barnes SOIL TEST: 50-25 REPLACEMENT SYSTEM SYSTEM TYPE: Non-Pressurized In-Ground PLUMBER: TRAVIS BUTTERFIELD TRACY POOLER Authorized Issuing Officer DATE: 6/12/2025 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: # 652879 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 6/12/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION