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HomeMy WebLinkAbout25-61SINBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY TIME RECEIVED REh10TE CSID DURATION PAGES STATUS July 23, 2025 at 8:07:28 NI CDT 7153724159 39 1 Received Jul 23 2025 23:27 HP Faxpolkosia Plumbing 7153724159 page 1 Request for Sanitary Inspection (24 Firs. 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 fj Time Change fl Discrepancy fl0ther Plumber: C;, // i° IN y / o i k e S el Phone Number 71 s 2'1 2— �-( / s� Fax Number Cl'! om% Homeowner: J o(� re k Email Address oh�be�.��ertor Sanitary / I S iP Immediate Phone Number So Zoning Dept can call you right back (If needed) Permit#: -i( S— Plumber's Choice Zoning Dept Date: 7 -z ---ac' Time: Plumber's Choice Dept Township: j s Address #& Road Name:! r wt S 4 1 r2 �� S Z t o J c v or • 1n for a�? 2 : (.e.s c —(orh �Qffi m Directions Ltc,1c Grass f2�" bD joc7f £ t - kf'fc r " y To Site: e u& 9 rZ S G r e w RI Comments: Plumbers you must verify any changes) by fax or email'k:1 Notes from La# u/forms/sa nitoryiroqu ostfolnspection Zoning Dept (©4/12704); 5 June 2023 POWTS HOLDING TANK INSPECTION REPORT (ATTACH TO PFRtAlT\ JOHN E & BARBARA A GREK 68525 CROSS RD ASHLAND WI 54806 TANK INFORMATION TYPE MANUFACTURER/MODEL# CAPACITY ' r (� SETBACKS Property Line Well Water Service Building All -Weather Road OHWM Swimming Pool ww. w'Oat DEVIATIONS FROM APPROVED PLAN COMMENTS (Persons present, discrepancies, etc.) head`At ,. 16hy k cvcJ 'd' fill c* } purP0S 6q fl,"0 O rNrlj kckar-s '. on- a�r . 'to,Af creu) e' ufl 4ct4 r1 u}- c"ic�• a��fM'• LiE alarnn• ink COMPONENTS NOT INSPECTED PQ Yes sfo oequired Djqit Signature of I ectl l�� v�` Cert. Numb 5Ketcn-on otner sloe 10 of 13 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(a)bayfieldcounty wi goy Web Site: www bayfieldcountv.wi.govl147 JOHN E & BARBARA A GREK 68525 CROSS RD ASHLAND WI 54806 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: :• Tank was pumped by: 'YVI Pi) t f C)SJ1/I on C) ldglpc c at AM/PM • Tank was crushed I removed and pipes disconnected by: a ` 1 ( J On at (AM 1 PM) the above -mentioned plumber contacted our office to conduc 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 couldnot be inspected because County could not respond to plumber's time constraints. Comments: I_ O\1LIJ�4(421 fl➢ r Ulformslsanitarypropertyowner-input April 2019 SS -X0577 .. nnrue4� ('? Department of Safety & Professional Services, Industry Services.Division Sanitary Permit Application 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(1)(m), Stats. I. Application Information — Please Print All Informatlon Propjty wncr's Name County s ex -F� U Sanitary Permit Number (to be filled in by Co.) State Transaction Number Project Address (if different than mailing address) Parcel # I( -- v b v i & v J o h n &v Property Owner's Mailing Address sz≤` ,,osS fi2� Property Location Govt. Lot a�t�l flC1414J �+ k +ui e City, State it j frc Zip Code Phone Number c l ..k) ...1 I ! $ 7 7�P 2 573 E V4, '/,, Section _/0 IL Type of Building (check all that apply) Lot # T ? N R • .o iK I or 2 Family Dwelling —Number ofBedrooms Subdivision Name O Public/Commercial-Describe Use Block # O State Owned— Describe Use O City of CSM Number O Village of Q9 Town of Ps ( IlL'Type of POWTS Permit: (Check either "New" or "Replacement" andother applicable on line A. Check one box on line B. Complete line C if a liable. A. ❑ New System y ® Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) Holding Tank ❑ In -Ground ❑ At•Grade 0 Mound ❑ Individual Site Design 0 Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration iv. ulspersaui'reatsnent Area and Design Flow (gpd) Design Soil Appi 300 - Tank Information Capacity Gallons fames Holding Tank - Ski o DosingChaar6� A Y. Responsibility Statement i, the u, Plumber's Name (Print) Ail mi€; Plumber's Address (Street, City, State, Zip S"2 -Z Total # of Manufacturer Gallons Units ting Tanks ______ -sc i J-- c. __ !d, assume responsibility for installation of the POWTS shown on the attached plans. lumber's ���� r's Sig ature i /MPRS Number Business Phon P :ode) , I Approved I O Disapproved rcrmit tree Date Issued , L O Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval Asa t'4' '715-Z-iicp fb) E 1 1 II \VJ JUN 17?O? _1 VIIV1 Attach to complete plans for the system and submit to the County only on paper not less than 8 112x 11 inches in size SBD-6398 (R. 03/22) 'crefer '� Owner. L1 scr, p+1 o L L't 6-� la/ Stc i o *fl/7N 9 4W rA v . 1 F- Ict r j- jRr c v bac ic eS51& ryy T : 0 " € 4 F . o4 8t rvrts2 • 5O;! Br��g1.. 1 i5 P1 t ct NCt.v-4.s+ R�: Lya S's !�- Z .z 'oo !Iovt 11J .s.r c rre`+ ._k- io ' 1 g 1 �rL � ��� ,� v -o n.1 b -H-o , r •* ors G�4tAJ It 17 20b Dayf field Co. Zoning Dep 25' lZ.0 weII i'7� j d a►c� j �t�t �� a e.�s oil r -1- n,� k5 CR p� , A. G A 6 o ve, ' ! rt Ct. C im. VgP =3— 5ch +/O PvC J/4?l.7 uv c1 a c1ec4, a'' ti z/aA5T391 D1?'5' "-I'?v-�V !d �a.`��, b►�q+ ittcL !1 dv;JeviQ 1+ Hlk h i viCj" trt Ic Co, aptIdY t L/ ms n v d 1p-' (VT 2�, 2e aZ� a� b crcLi j A PP /kc s k1 P/u. vj . K s z2. rL r!1 Fth' a -t' w j 5"q q? Q6 PROPERTY OWNER: jbLiC �.� A . • ,��r' �ve. K PLUMBER: SIGNATURI DATE: s-3c-7�— LICENSE # 220090 HOLDING TANK SPECIFFICATIG S N ,.+a.aawwma to Z Number of bedrooms Non-residontta! estimated flow (gpd) b08,o Minimum holding tank volume'required (gal) Tank Dimensions and Data for round tank Liquid depth below inlet invert (in) 1X Maximum de th of soil cover (ft) Height (in) Outside :",emoilvaq Length (in) Dimensions Width (in) Only junction box .._. . conduit .— / blind plug to Beal outlet Ii JUN 1 7 2Q25 Manufacturer Rayfield Co. Zoning Dept. model number manufacturer fiber Tank Anchor Cal�cutettone 16840 The Weight of tank and cover i.5o Safety factor 020 lbs Weight of anchor required 40.8 in Soil cover req. for anchor or 9.9 yds Concrete counterweight HOLDING TANK CROSS SECTION manhole coverwith looking device and finished vent cup -7 Warning label grade 4" mm. 241n, 12" min. Manhole and vent locations may be reversed. vent pipe T 18" min. •..... w.. • rr..r.. rr . ro. � , .wn..w , rn ..u. , .r+. . eervlco 12.0 in. building sewer alarm on "`oints Note: All tank a Inlet j c� Electrical as per NEC 300 and Comm 16 joints between tank openings and piping are• 39.0 In. sealed watertight, All pipe and vent materials comply withsp '$3 3 In, bedding under tank, Tank Is anchored as necessary to negate buoyancy. WLP2500 TANK SPECIFICATIONS Id INLET 3" 183k" TOP VIEW cc _ - .QIJ.ILEt Q U U Q a M i+) SIDE VIEW I TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS DIMENSIONS: a o WALL: 3" Q a BOTTOM: 3" HEAVY - 5" COVER: 6" ;. MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 52-3/4" O.D. LENGTH: 183-1/4" 0.0. WIDTH: 101-1/4" O.D. BELOW INLET: 41" O.D. a w a LIQUID LEVEL: 36" WEIGHT: TANK - 3" BOTTOM 12,560 LBS. TANK - 5" BOTTOM 15,527 LBS. N WEIGHT: COVER 9,300 LBS. w y a INLET AND OUTLET: m a 4" CAST -A -SEAL BOOT OR EQUAL z INLET AND OUTLET BAFFLE AND FILTER: o o 0 WISCONSIN. SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 69.44 GAL/IN HOLDING TANK: co OUTLET HOLE PLUGGED = 0 d�- ACTUAL CAPACITY. 2,639 GALLONS ® z o0 LOADING DESIGN: 8' 0" UNSATURATED SOIL tO N TANK CAN BE USED AS: M O - SEPTIC/ HOLDING/ PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) l ? 00 TANK: MIX DESIGN #9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: N a � N N Q F= W 0V) W5 N w fX SHEET NO. oF� 1 J { L! i V[ {I� JUN 1 72025 HOLDING TANK MANAGEMENT PLAN Bayfield Co. Zoning Dept. This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and << maintained according to 3 is. Admin. Code, the Holding Tank ComponentVVR nual w; e.c1 `l o r 'e L �r yp� 2Q) Ll aoZ :ZOL,7/ E o and the � t� County Sanitary Ordinance.�,�/ t� R 20 �c�.y -� l 1. This POWTS is designed to accommodate an estimated domestic wastewater flow of 400.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed in the current Servicing Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and >, PS 383 and384 Wis. Adm. Code. 5. All service events or inspections of this POWTS shall be reported to the county within 10 business days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the Interior of the tank may be difficult or impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Con- nection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with 6PS 9$3.33 Wis. Adm. Code. 10. If there is a problem with, or question about this Installation, the following persons should be contacted: a. installer ........................... ©1 as Plow+ ;�n 1�1.gRS. ZZoojg Phone: 71$' 3-72-- f(., .. a Z Phone: "7i. 37& - Wca fe b. Service Provider ...................c, 5 �: c. Co. Zoning or Health Dept .,nf�y Phone: 7I 11. 1!.. a CO4Awr1L 01 - Project Transaction Number: 2 to 2A 'P SeLfo-F47� 'R toVJ Contract Date HOLDING TANK SERVICING CONTRACT This contract is made between the Holding Tank Owner(s) Name(s) TeJvre.( 8A1 ,4 A CEr`,� Lii JUN i 7 _ 025. . BaflId Co. Zoning Deot Pumper's Name (Print) Pu pr's Signature Pumpers' Registration# We acknowledge the Installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) . PROJECT Legal Dgscripticn• Tax O TaX 10 q� yr i 4 `' 4 4N LOCATION (Use Tax btatement) 1• � ' Y1 T r sactton ,Township N Range w (S I• Gov't Lot < + �' Lot ii c CSM {ik "V61. ' Pa e= t CSM Doc qc; Lot{s) No Block{s} o N .; Subdivlslan=:^ a, ; 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 the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing 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 signed the pumping agreement required by SPS 383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding 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; a. 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 event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the local government unit and the County named above within (10) business days from the date of change to this service contract. CRY OF14 `"IIIIiflfl� 0 Document Number/Plan I.D. HOLDING TANK AGREEMENT owner iPame I JWUtinrta) IVI IIII1 nuuInaa r c h 6-, ..a~' (F S'�2,5'~ I ASA(' Parcel Identifier Number (PIN) Agreement Date (same as Notary Date) 1 2?. 4-z `(S -- 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. , I 1/4 of 1V W 114 Section O Township `1 7 N. Range __W. Town of Additional Legal Description: S'iE.E 4 TTA e 1-E E i) Gov't Lot Lot Block Subdivision CSM# Lot CSM # Vol Page CSM Doc# DOCUMENT NUMBER 2025R-607758 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED O6/O6/2O25 AT 2:32 PM RECORDING FEE: $30.00 PAGES: 2 Return To: ivv►(r Jac i k-�"�Sk• Fc ≤?-L-- ),-o.., ��,�et_-%,J- • 1" Y7 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 falls 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 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. Bayfleld 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. Stats., 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. Tnis 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 man wig chgwill��erl,(��thE existence of the agreement to be determined by reference to the property where the holding tank is installed. �C W A fl Owner(s) Name(s)— Please Print �Z� Subscribed and sworn to before me on this d t : JIi UN 1 7 2 0 2 o(Q0 Bayfield Co. Zoning Notarized Owner(s)-Signatur s) $•••••'••••. % •: Notary. Public �pTAR ' = Ca P LXG 2 vim/ Drafted by: t © 4'1 ° ke.s 1*:........... Personal information you prov da may be used for secondary purposes Date: ulformslsanitarylholdingtankagreement.doo ®June 2018 Dept. CIO V rl_ f JUN 1 7 ?025 ll) Bayfield Co. Zoning Dept. VOL * 56 6 PAGE2 0 Z. DOCUMENT No. . ii ' WARRANTY DEED II STATE BAR OF WISCONSIN FORM 2--1882 401376 MICHAEL' J. WALLSCHLAEGER and FLORENCE JEAN ALLSi ffi GERr.»Husband. and Wife .............................---......-•-..---............«.......... .....-......... ....•-............---............-,...---•-----•--...............----•---•-----•--....... ... conveys and Warrants to ...:TORN_. E . GREK and BARBARA A. GRE Husband and Wife,»as„SurvivorshipMariEal drop ....................•----------.....»..............................--.--...........................-«......._. .THIS SPACE RESERVED. FOR RECORDING DATA • VOL.I[4. OF 'I. PAGE REGISTER OF DEEDS • '32- 0CT 2 1111 1119 REGISTER'S OFFICE/S.. BAYf :EtD- GOUNTY, tarsi ......................•--.......-----------•--'--•--.......... Ba kick.............»_......... . l4, the foUo1, 1; described real estate •in...............«Y..........._..._......»...county, O0 �X OD State of Wisconsin: TaxParcel No:.......................... A parcel of land in the SE} NW},.Section 10, Township 47 North, Range 6 West, described ds follows: Commencing at a point where the south line of County Trunk G. intersects the west line of the Town Road, said intersection being designated at the point o€ beginning; thence running in a southerly direction along the west line of said town road to a point where, the west line of said road intersects the south line of said SE} NW; thence running in a westerly direction along the south boundary of said SE} NW} a' distance of 17 rods to a point; thence running in a northerly direction along a line parallel to the west line of said Town Road to a point where said line intersects the south line of said County Trunk G; thence in an easterly direction along the south line of said County Trunk G to the point of beginning, said parcel containing approximately three acres. • o TR¢�� � fHE EXEMPT RENTAL WE,X i HERJZATION- YES O NOS EXEMPTION 0 is This .......................homestead property. (is) (is not) Exception to warranties: Easements, reservations and restrictions of record. Dad this ........... 9-r. ................day of ACKNOWLEDGMENT STATE OF WISCONSIN Sc. Bayfield .«_ minty Personally comae before me this .............—day of 19...92 the above named ...«Florence»Jean ........... ..._...«_ .i1�t7T.�lAL_.........._....._........_«..... ...«._._ ....SELL.... ...«_......_....... ................. to me kn •• n _ ......... Woo executed the foregoing In*umcnt and dckn ledge the seal. ..._ ....... . Ka en . Frechette Notary Public ..«..Bayfield My Commission is permanent{If not, state exiration date: .......3,.L./14.........................................2 .... Q.) September is. 9 2 Efl? 1 ...:»...1 . .. (SEAL) .Michael J. allschlaeger • E ozence Jean.. ACKNOWLEDGMENT STATE OF WISCONSIN _..._.._...County. ss. Personally came before me this __2 ANA..day of ..._.September ._....-_-._, 19.9?.. the above named .»l�fichael J. Wallschlaeger_......._. _ .....---•»-..»..--_....»_._._............................. to me known to be the person ............ who executed the __ ._ for ag instrument and ackowIedgo the THIS INSTRUMENT WAS DRAFTED BY ATTYANDERSON N�'tAl _. JOHN..P.. .._......--•---•--- I�- _ ..--...«.....-.....-»..«....»...«..«.._.................... �E�o R S U k �'_.( .�__ -. ». r+L . . W HBURN WI 54891 .............................. :«. ___ _ _... , .... .....»_. _.t..........» ....................................« Ngtury Public Doll --- --.Count Wia. (Signatures may be authenticated or acknowledged. Both My Commission is permanent (If not, state expiration are eat a � VOL' � 566 PAGE2 0 2`te: a. a ± ...................«...,19. 6..., •Nsaus of pause s!EstnC in asp-pse{ty thsld be typal or ➢dated I goer tbdr sipealares —. ~ N ~•__ — _ _•�• -- WAHHAIM earn SrATs BAH OB WISCONsu Wisconsin Legal Blink Co., Inc. VCITM 1120. 2—.:•n MIRwsukee.Y/ls;onaln RED S D' C9D 27 O Soil Test # Bayfield County Waiver of a Thorough Soil & Site (subject to 15-1-10(d)) Evaluation 5q TEST A11 adl �' k -o s k d 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. J r Property 0wner4 0L Cs�Y''e_ " e� V- �' `'' t''Ye contractor Property Address 4? s 2s r a S�S cL Authorized Agent A s 1( a, n. W r e o Agent's Telephone J P Telephone `7 1 Jr- ? C( 6 ^ z s -7 Written Authorization Attached: Y or N Accurate Legal Description is requested: 114 of __1/4 Section / 0 Township tf? N. Range' W. Town of ?` /� Additional Legal Description: A �--� I o -f- 1 ti J S-► Govt. Lot Lot __Block Subdivision Lot CSM# Vol. Page CSM Doc # Volume Page of Deeds Tax I.D# Z - f Acreage 3 Indicate reasoning for your determination: '"�-� C. <c.S a, (S : e le T ka J t1 a 0-H--€-- ?L'LJT�S C L -c ;Ea(cJ iL Signature of Certified Soil Tester d i IIU JUN -1 7 2O2 L &tOO Co. Zoning Dept. Signature of Ar-lal Date 0 .. 2 s.--. Date cc -C P-20 ®9 0 Certification # (Submit a -Plot Plan & Fee). u/formstsoiltestwalver(KLK) June 2018 'r9 4 W,`l"/ Cw ►ler cc LL [Cam frt - re e 51S Ls514.. A s L L 4 ') o' -t(o , L.'1 SCr;piV 4 Se.c.ro' 'Y7N 9 4v T w &fa -s (s 'i ��pp nti C..c vt 4�/ ©c: i j e �/`t�s�. i J r . % So.1 l 8arr$n j 1 ,, lv 5Cok . 1' 110,1•tle- ma -fie \)t'.ztr4LT a (Ye SS i ja.!lan uJQS r e�ncre`+ 1i k: k a irio'wLire in1t+ tr•�e. aSS `P2d JUN -17201 f-IJo+e Sayfield Co Zoning Depi e F�► 1 � � a 6a� h vAQ` ri a vti W ell ��vf.l dv� ena• l t tnr 1 r k ftt t�.�'� .1I , •i r, SlEs Cs p5 3 � ) # , tPe -e e;.j _�- u.'e 1 L T� d�.+�l S`. • ✓+ ! kl i�" i2 S c�.►Qvt �-'�. A! w i�OYln. tLY Wvia jgP r _)� ,� Y f it "AST AI p ti i�' cc,�1� v.�, V�'.� t:�• �� v►-<<L.-l-.v-� cc 4 H a ld'i Ptj'7 bl k c0 12t V (vE it a3); ryaza7) �� t re l ti 't ��! a 6�t,N ►S. z ��►y Polkcis.k, P1a`�t iron/''V�..UJw3≤'V 17 BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink):D � JUN 1 7202 0 Check List Bavfield Co Zoning Dept.. I6 Index Page / Title Sheet (Optional) • l Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) C9 Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) l Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used U Property Owner's Information (not prospective buyer's name) ® Property Location (Accurate Legal Description with Sec/Twp/Range) iJ Road Name (where driveway is/will be coming off of) is I Floodplain Elevation, Flow Rate, Comments and Recommendations LI Complete Soil Boring / Pit Information (A Date Soil Evaluation was conducted d CST Name, Signature, Number, Address and Phone Number 0 *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) l Bench Mark (Description, Elevation and Location) 0 Contour Lines (Example = 98.0' /96.0' /94.0') 0 Property Location (Sec/Twp/Range/, Accurate Legal Description) m Borings (Locations and Elevations) L Percent and Direction of Land Slope EJ Well Location (Including Neighboring Wells, if applicable) i! Location of Wetland Areas, Floodplain and Navigable Waters 0 Buildings, Driveways, and Structures (Location and Descriptions) CZi Location of Property Lines 061 Existing System Location E Address Number and Road Name d Current Surface Elevation of Wetlands and Navigable Waters U CST, Owner and Property Information (!1 North Arrow Fee: Certified Soil Tests - Review & Filing Fee $ 50.00 . , u/fgrms/sanitary/checklist/checldistforests -- ... .iiaiN u A.V1Vt1Vu X10, 99/5 P. 2 PAGE 1 OF 8 Holding Tank Plan JUN 1 7 2025 Index & Cover Sheet 1 Bayfield Co. Zoning Dept. component Manual Design Roferencee: i Di M) £Mo Pg "I of Index & Cover Sheet Pg 2 of 9 Plot Plan P9 3 of S Holding Tank Speclf[catl Ins - z- Pg 9 of Management Plan Attachments: I E„If1a«..d�. + 9 POWTS Applicatic o-1 9 Soil Evaluation Re �1-biding Tank Pum (-- ' . Holding Tank A re Project Name I Description for Review cS4� trc Ptv-rn, � A; >rt& site Map of applicable) nc ontract (if a jlcable) ne t (if applicable) Owner Name(s): ,J o L -A (ye- k Ba Y 4 4 v ct Lv�. k Phone : ±/5 - 7'(' 2 S73 owner Address: I 5 2 Leo rs 74L. 5L 14 ,� t L dip: 'Y -� Project Address: S4 r� ice a'F �-a '�. nf l ee S.C 1/4 of 11 u11 /4, Section, T -R 4o E or W Township: ( JcIt County: -e Project Parcel ID #: TAY -6 z -7 Designer Information Designer Name: Jt / /CL ?c, / / - o S /' Phone: Designer Address: •}'_D. ' S-2- .-- � ,tee .....` 11 Zip: Y7_ E-mail: ±ti ham/ .6 c� r,.- u r i e- P- !. Thi space reserved approval ravel stamp. pp p License Number: - p 0 `7 0 Remarks: ,signature: Dat6: Original aignaturo required on each submItted copy. ' I 11oL a6 i vtK BAYFIELD COUNTY ' b )) CHECKLIST FOR SANITARY APPLICATONS JUN 1 7 2025 1) Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) Bayneld Co. Zoning Dept. ET Check List Cs2' Original Sanitary Application (Submitted in Deed Holders Name -- ng.t prospective buyers) (383.21(1)1.) t1 Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) Original Plot Plan (383.22(2)2. 3. & 4.a) I 'Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer 10 Pump Tank Diagram, Alarm and Pump Curve (when applicable) 11 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) ir Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) 0 Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) ❑ ATU Servicing Agreement (Recorded at Reg. of Deeds) icy Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) $6 2 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) 91 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) lT I Application Information must include: 0 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) ® Project Address o: Road Name where driveway is/will come off of) i7 (Owners Phone Number) ii II Type of Building l III Type of Permit Lid' IV Type of POWTS System ❑ V Dispersal / Treatment Area Information [I VI Tank Information 19 VII Responsibility Statement (Plumber's Information) ❑ *Date Stamp* Plot Plan: (To Scale or To Dimension) @f Signature and Plumber Information Address Number and Road 13' Surface Elevation of Body of Water 10 North Arrow ❑ Direction and Percent Land Slope 0 Contour Lines i Tank and Filter Information and Location L Structures and Driveways ill Wetlands / Navigable Bodies of Water d Boring Location 0 Absorption Area (Proposed and Existing) 99 Property Lines 10 Bench Mark (Location, Elevation and Description) iL Well Locations r9 Component_Manual ual Version _ _ 121 Legal Descriptions t ..a Fi2.."� y'S �f ,:4x1 '^ �l Y's '.-. f G`'i. CK +�s. is .;--r~"r. i•r'Y46'�', �^'r r T1'10 k �VX ,r .� "�j� .+'KMC. f' kYlaY iSeG .! .yt.. Rjpt g atariii"`irin ormat�pns �c0 ve ran aline,:bui ing w@c�ling s at�r al �rpe nd arnetr) Turn Over ► / JS —0057-7 °"ar""'• _w, ci 4 Department of Safety County O. r -c T `)Ios & Professional Services, Sanitary Permit Number be PSI Industry Services Division (to filled in by Co.) 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 pennit. 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 Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(I)(m), Stats. I. Application Information — Please Print All Information yP wner's Name I / �VP � 30.V p4YG � Parcel # ,JOPro VLh Erve TGtC lb Property Owner's Mailing Address &Z ZS CVoSS RI Property Location A /Guts City, i�y�State I Zi Coder� / Phone Number /Zip �Rn � r4r�er Govt. Lot I N h C , r SE / � $� lilt = C (1O6 l iS 7�lp 1 S 73 'A,ti Y, Section i O II. Type of Buildin(check all that apply) Lot?! T 7 N R r" I or 2 Family Dwelling — Number of Bedrooms Z o Subdivision Name ❑ Pahlie/Commercial — Describe Use Block # ❑Stott Owned —Describe Use ❑ City of CSM Number ❑ Village of Town of Pr S _ III. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if a llcable. A. ❑ New System ® Replacement System Y p y ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B. Holding Tank ❑ In -Ground ❑ At -Grade 0 Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) ' C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber 0 Transfer to New Owner ist Previous Permit Number and Date Issued Expiration IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (at) Dispersal Area Proposed (sf) System Elevation 3°O - - - Tank Information Capacity in Gallons Total Gallons #of Units Manufacturer °1 '° G e S U I s y d New Tanks I Existing Tanks Fa'Pµeer HolAing Tank zsoo - zsw 1 In ii 0 w V. Responsibility Statement- 1, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si curg� I l n 4RhgMPAS Number Business Phone Number ah oiiCr -- 2Zo09O h'SZiz_4/S6 Plumber's Address (Street, City, State, Zip Code) ifl (3rs)C SL- y✓Osn tt./t V t4J J.. Cfll`'7 VI County/Department Use Only Approved ❑ Disapproved $°ran Dale Issucdm5 L Is$ui Ag lgna re ❑ Owner Given Reason for Denial .... rj Conditions of Approval/Reasons for Disapproval %ISI>! /th W G rv4G�re� cui"b a @a,td I JUN i7?0? Attach to coaralete aloes far the ,vctnm a nd en II In 0.n r....-.. Ba iel Dept .... yo p-. a ..t F 11 lacaea In arm SBD-6398 (R. 03/22) 027O d Soil Test # Bayfield County Waiver of a Thorough Soil & Site (subject to 15.1-10(d)) Evaluation SO$ TEST IA 1/ a.t/1 ?r, )Zos d 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. J1 r / Property Owner4 0L 6r� r e4z a, r �Ye'Contractor Property Address 6? S2-' C V © Si 7 Authorized Agent A s I- ( . , k r `(ff 'o Agent's Telephone g p Telephone '7 1 _S 7 L( 4— z s? Written Authorization Attached: Y or N Accurate Legal Description is requested: �1/4 of l=ul 1/4 Section=1 Township Y'7 N. Range 6 W. Town of ?. ` s `e `I r Additional Legal Description: A ---� 1 0-E /c .-, k, f1I-'C5 Govt. Lot __Lot Block ____Subdivision Lot____ CSM# Vol. _____ Page ____ CSM Doc # Volume Page of Deeds Tax l.D# Z -7 `t - Acreage 3 Indicate reasoning for your determination: '�'�e-+ < � s a", S r ie c 0 O1L-e,- ?o �-~J Ti C Signature of Certified Soil Tester [b) UHllt 1 �l1 JUN 17 2UZ� field Co. Zoning Dept. Signature of CoyritY Offi ial Date Sr- 3 c . Z S'� Date csr zao'90 Certification # (Submit a Plot Plan & Fee) u/forms/soiltestwaiver(KLK) June 2018 P f, l c ! p -f-v o 1 � � ft1a/4 S'cLf C- V� ` a/ S7N 4W 5�1 �.. 1" �00.c.Io'"�" y ' 1 d'}`�'E � � f.�'S � Ap4VL+2! a� 1 I+'� f-�lz,e a 'f%OSS X e, s5 t�� jV�z�r�sf R�, L T��.0 �: ( s� �.Zs O fallow t eser c�ncu-e 1 dc� � .�- � C� 1$ i nio �� .r . v-ovs.i b --1e iv Qf ° � r�tt l�1S'zscVass-P4 JUN171UL5 L J o +e Q 1 a 6 a n d ByfieId Co Zoning Dept tf 32' r. k20 dL � o is ISO wJefj 0 e p tiGJ j l �, Kati �16 HjItK� a`tkine-e.4s o.�j nitrt. se.`1-Lacks �SPs3Is) ��° a jA. F. c. - A b ® ve- 't Ala `� vacs. e -O-' ue-It of4-P.tea S'• A..41 ova rC5a L•Q�.c c A W Coe -v sivi f �1 gp £1eu/co.e.' Sck Vc PvC'lclow 4 e.c.4' c ll q"ASTa j) 17g'c ctl>p wt+ vo-� � • 17 c Y►.le�.tr, c� 1! 0 fl1 'ib I,1 otq Wjc M k Le�ylnEi vt/ (VR aj); (• yzL.aO7) rort � v e.v; w -T BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): ___________ ) JUN 1 7 2025LUJ [ZI Check List i3ayffld fl 7cnno Der m Index Page / Title Sheet (Optional) �• 9 Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) CZI Original Plot Plan O Cross Section Soil Profile Sheet (optional) O Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) ® Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used ✓U Property Owner's Information not prospective buyer's name) m Property Location (Accurate Legal Description with Sec/Twp/Range) l i Road Name (where driveway is/will be coming off of) R1 Floodplain Elevation, Flow Rate, Comments and Recommendations LI Complete Soil Boring / Pit Information [,0 Date Soil Evaluation was conducted WI CST Name, Signature, Number, Address and Phone Number 0 *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) C0 Bench Mark (Description, Elevation and Location) Li Contour Lines (Example = 98.0' /96.0' /94.0') WI Property Location (Sec/Twp/Range/, Accurate Legal Description) 56 Borings (Locations and Elevations) E. Percent and Direction of Land Slope En Well Location (Including Neighboring Wells, if applicable) C5 Location of Wetland Areas, Floodplain and Navigable Waters 0 Buildings, Driveways, and Structures (Location and Descriptions) Wi Location of Property Lines WI Existing System Location WI Address Number and Road Name WI Current Surface Elevation of Wetlands and Navigable Waters EJ CST, Owner and Property Information WI North Arrow Fee: 16 Certified Soil Tests - Review & Filing Fee $ 50.00 u/fpmis/sanitary/cheddist/checklistforests „..„ u ',,, &IflA No. 99/5 P. 2 PAGE 1 OF8 D Holding Tank Plan JUN 172025 Index & Cover Sheet Bayfield Co. Zoning Dept. `t Component Manual Design References: idlreleXal t/pt CJ�•YSianEM; .Yn0.i ZD2-z- Pg 7 of 8 Index & Cover Sheet Pg 2 of 9 Plot Plan Pg 3 of 9 Holding Tank Specifications- z s -/t E��S Pg 4 of 8 Management Plan Attachments: I FMwt..arr..,... 01- s ruvv 1 S A plication for'Review �•� 2 Soil Evaluation Report & Site M 2 Holding Tank Pumoino Contras Project Name I Description &Lrrn, % laps Owner Name(s): J t L r'. (;p -E- k ? v Cr 41,-z 6c Phone: 7/S-- 7 Y6. 2 573 Owner Address: (G 8 Sze [ �� ss 2 5 Lr ��, n L J _ / Zip: 5s-b� P -S roject Address: c A .rc ✓eI of I G vi d i n 1-[t s F 1/401 Township: _P, ( S ti(uJ 1/4, Section / c IT '{7 N_R Cc' EQor W County: i1 4 —R e ( I Project Parcel ID#: i c.r =? tt a7'7 Designer Information Designer Name: A / /cL K Pc / K= a s Phone:? -J'7z - L ! S% Designer Address: p_i3, ox Sza 1 �,ui t,(11 Zip: S4rS Sl7 E-mail: -{—r. •ter -�- ��. u, �/� Thiy space reserved for approval stamp. License Number: IL 0 Remarks: L�/L .r Signature: Date: Original signature required on each submitted copy. S— pp BAYFIELD COUNTY ! 1 U CHECKLIST FOR SANITARY APPLICATONS JUN 1 72025 Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) i Check List Bayfield Co. Zoning Dept. Er Original Sanitary Application (Submitted in Deed Holders Name - nt prospective buyers) (383.21(1)1.) 21 Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) Wr Original Plot Plan (383.22(2)2. 3. & 4.a) fACross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer E Pump Tank Diagram, Alarm and Pump Curve (when applicable) 0 Contingency Plan / Management Plan (383.22-3(2)(b)1.f.) 0 Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) 11 Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) 01 Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) 0 ATU Servicing Agreement (Recorded at Reg. of Deeds) a Fee (Make Check Payable to Bayfleld County Zoning) (383.21(2)(c)7) V 2 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) 91 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) m I Application Information must include: 0 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) ig Project Address or Road Name where driveway is/will come off of) Ii (Owners Phone Number) II Type of Building ® III Type of Permit IIV Type of POWTS System ❑ V Dispersal / Treatment Area Information 01 VI Tank Information i1 VII Responsibility Statement (Plumber's Information) ❑ *Date Stamp* Plot Plan: (To Scale or To Dimension) lt Signature and Plumber Information IB'Surface Elevation of Body of Water ❑ Direction and Percent Land Slope It Tank and Filter Information and Location 14 Wetlands / Navigable Bodies of Water ❑ Absorption Area (Proposed and Existing) Gil Bench Mark (Location, Elevation and Description) 11 Component Manual Version p Legal Descriptions l Piping Material Information (conveyance line, building sewer line, material type and diameter) I9 Address Number and Road 10 North Arrow 0 Contour Lines [ Structures and Driveways l?1 Boring Location Gf Property Lines 10 Well Locations Turn Over ► �m�ed^!y/©w,�er; Lanai Aascr pIE'n oFl3edrryt5� a j� Ser 1 Bev, n9° N cltih ct&k SE $a14 Sec.aoTLY7Ng4°W $cal�:l'�lo'ulabsnole.d� �r°v6etrca G✓e r�pavice�ot`land,�llzes Neitu�S+RJ �voS5l�� CaSfSZS'LvesSRl` /� l _ '/ I j'zs oo gallon ut; eser cencv-eT k= /�S C, rL IiLi .�- .��Q/p �+, /1° l8) N _Jp JJ ° °/ J Cowt� iJ�!✓t_ .e� 1'&nk to 4 Even bsytlowlef 1.XsbZ7g7 a"lewl.:,re inlE+, No° e.old se lrc i- kLt Ptl JC�__j L ' g6ancln�r.r< {' fle✓ tiS 3!. ! r I in JUN 1 7 pPr�a Bayfield Co. Zoning Dept. y a c s L o q.rrcL'1 i2o Z�3e�R' cue WdII G G v"I d v�J�cJ PI �• CPt,C Nbldrnc lQJrkJYI@QTS 0./l n•1n. Se'!"LCkS CSP5.3fl) 2'g)° A6eve ge..ct( 1rcJe - = well r. c1•n/ cn yr2S.cl.•E..a-'E Aft) Gn'vvnr �n9aORP Eleuleo,o,' .1 2 5ch No PVC &./-C 10 w c r rec.4/ , O•v1 - 4"Asrnn D ItS cLtJtyut, pt ntct- k.u•4CL1 li 1-k !d t ,tcjTu, k Con, panel t . n°)Ctnt(.al use-JQ:AtA Lo.>t"' t ° P (VAR ?-J) C aflA/ae Z L- 2®z'7) YJV-au.�'r�Jnk ,//Eiy:17�,P.RS`•. Z2co7 Fe/F'Lr I �LL JL�U°n� R2+,aoK S'22 Src nVve.� wz 5Ye`v7 PROPERTY OWNER: J e Il C Ic- r X 44r4'L-v'P_4 PLUMBER: Allan Pniknclrt/ omit,., r.: SIGNATURI DATE: S — 3 z s LICENSE # 220 90 HOLDING TANK SPECIFICATIONS 4 -Number of bedrooms Non-residential estimated flow (gpd) . 2000,0.x. Minimum holding tank volume'required (gal) Junction box conduit —. blind plug to seal outlet tons and Data for round tank quid depth below Inlet Invert (In) 3xlmum depth of soil cover (ft) :fight (in) 1 Outside ngth (in) rDimensions idth (in) Only till JUN 17 2Q25 Manufacturer Bayfield Co. Zoning Dept. model number manufacturer fiber Tank Anchor Calculations ,w/.pAYYINxCYM 18840 lbs Weight of tank and cover 1.50 Safety factor 40207 Ibs Weight of anchor required 40.8 in Soil cover req. for anchor or 9.9 yd3 Concrete counter weight HOLDING TANK CROSS SECTION In. service alarm on Electrical as per NEC 300 and Comm 16 manhole cover with locking device and finished vent cop warning label grade 4' min. I 1Y 12"min. Manhole and vent locationsII maybe reversed, vent pipe T 18" min. 12.0 in.— —•—.—.—.—.—.—.— .wLo: nn tanKJ0lnts, and Joints between tank openings and piping are 39.0 In. sealed watertight, All pipe and vent materials compig withSFs j9 building sewer Inlet 3 in. bedding under tank. Tank Is anchored as necessary to negate buoyancy. WLP2500 TANK SPECIFICATIONS 183f" 4" CAST —A —SEAL 4" CAST —A —SEAL FILTER OR • BAFFLE a a INLET CD TOP VIEW SIDE VIEW W N III1r M U I TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS J OUTLET M DIMENSIONS: WALL: 3" BOTTOM: 3" HEAVY - 5" COVER: 6" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 52-3/4" O.D. LENGTH: 183-1/4" O.D. WIDTH: 101-1/4" O.D. BELOW INLET: 41" 0.0. LIQUID LEVEL: 36" WEIGHT: TANK - 3" BOTTOM 12,560 LBS. TANK - 5" BOTTOM 15,527 LBS. WEIGHT: COVER 9,300 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL o INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 Q' (OTHER STATES SEE CHART) LIQUID CAPACITY: 69.44 GAL/IN HOLDING TANK: -a OUTLET HOLE PLUGGED ACTUAL CAPACITY: 2,639 GALLONS T LOADING DESIGN: 8' 0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC/ HOLDING/ PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: W 0 W U, "U co z 00 C.7a N Ws l W Do m N QO N o a N a v o F w w /n 1n 5 w 1 fO)ECHV DII JUN 1 7 2025 Li HOLDING TANK MANAGEMENT PLAN Bayfield Co. Zoning Dept. This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be Installed and maintained according to Sf 383 Wis. Admin. Code, the Holding Tank Component Manual wstdp "fvlan va j 'ryPt 'ER 2.o and the 'Say -Pc. (ci County SanitaryOrdinance. 1. This POWTS is designed to accommodate an estimated domestic wastewater flow of 400.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed In the current Servicing Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and SPS 383 and384 Wis. Adm. Code. 5. All service events or inspections of this POWTS shall be reported to the county within 10 business days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Con- nection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer In use it shall be abandoned in accordance with SPS $e3.33 Wis. Adm. Code. 10. If there is a problem with, or question about this (installation, the following persons should be contacted: a. Installer.............................P6J as1G P/Umb;nm.ER.S.tZZOo40 Phone: 7/S 372- W/370 b. Service Provider ...................p e E; . R25 n y Phone: 7L4- 37z - 4vof. c. Co. Zoning or Health Dept. Ba.y4eJJ Coy n5 'Lon: n�/ Phone: 7's 3-n— 6/fl 11 L��gt D&sc!. A Pa•�P/et /anti„ +4c4Mtd Selo 7'17 /J IS lct.J f' ..,. ..C° P:Is2h .,e Project Transaction Number: HOLDING TANK SERVICING CONTRACT H ECELu 0 JUN 1 72025., I II 8ayfield Co. Zoning Dept. Contract Date (Q Z This contract is made between the Holding Tank Owner(s) Name(s) kGtMas P�'►k�s►c 17r -n t✓ev Pumpers' Registration # We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT Legal Description: Taz ID# / �/ s� �V E qzr N LOCATION (Use Tazstatement) ' ','l —r 7 ] 1/4' 114, 1/4• i 1T--r=Tpr-�-- -7 Section 1 Town of: I Lot Size I Acreage ,Township N, Range_ W 7Y' ► San Gov't Lot Lot# CSMN Vol. Page CSM Dac# Lot(s) No. elock(s)No. Subdivision: 1. The owner agrees to file a copy of this contract with BaVfleld County as required in SPS 383.55, Wis. Adm. Code. 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges Incurred In servicing 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 signed the pumping agreement required by SPS 383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding 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; a. 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 event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the local government unit and the County named above within (10) business days from the date of change to this service contract. <1oWI✓G3 `K 11- /54£5A 4 Gtr_"K ��iCLl a,��tk Subscribed and•Swom to me: /,,.(hJr on this (U day of LUIS My commission expires on: Revised: May 2016 (®May 2018) Drafted by Personal Information you provide may be used for secondary purposes [Privacy Law, s.15.04 (I)(m)] DOCUMENT NUMBER 2025R-607758 vwnd, rvdn,n 1sf / vwnnrtdr munn,g nuornnd �� j oLa✓+ 6-,rc . Ipg5 2S Cv'csf 61928HQA G/cc'K I .4s(r(a .[, w2 S"fl04 IParcel Identifier Number (PIN) I Agreement Date (same as Notary -Date) n2c j p'4 .z -74-r-( (--L -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 Scats. S E 1/4 of W t,t' 1/4 Section ) _Township y p N. Range 4 W. Town of f' Is C-1 Additional Legal Description: ,SEE A TTA e t4 E J Gov't Lot — Lot Block Subdivision CSM# Lot CSM # Vol _Page _CSM Doc# DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED O6/O6/2O25 AT 2:32 PM RECORDING FEE: $30.00 PAGES: 2 Return To: T2.tr f -c' c,x 5t -z Voh�.✓e✓rJlc'18Y7 As an Inducement to Bayfleld 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 Bayfeid County or the Department of Commerce to prevent or abate a human health hazard as described In s. 254.58, State., Bayfleld 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, Scats. 2. Owner agrees to pay all charges and costs incurred by Bayfleld 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. Bayfleld 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. Scats., and chapter NR 114 Wis. Adm, Code, to have the holding tank serviced In accordance with Ch. NR1 13, 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. Scats., 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 Bayfleld 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 manrlp w h III a th existence of the agreement to be determined by reference to the property where the holding tank is installed. Owner(s) Name(s) — Please Print tioctn/ GK P_E Subscribed and sworn to before me on this JUN 7 202 It mAEISPAr2A G�c !''t'A - risy�K Bayfield Co. Zoning I Notarized Owner(s)— Signatur s) `$'••,.••••••••••.,• >F . Notary Public �r _�' � :r �pTARY •': /' A MI rlC'�fJ �e �a� l�-YJ�I)I-•tip :. me l�cdd� y Ir1p1ls Ion Aires: //!/0`7c3Si P tG .•`2 Drafted by: 10 h%t/?v C S l��%T '.........•. ' Date: Personal information you re de me be used for seconds ryW$ I� Y D Y secondary purposes IPde�£6YJr}�/fl l lll�� �` —6-zs u/farmNaanitaryrnoldingtenkagreemenl.doe ®June 2018 Dept. ll JUN 172025 Bayfield Co. Zoning Dept. iI VOL 566 PAGE2 0 2 OOCUMENT NO. WARRANTY DEED TWU...c.......so. ,o xeco.vlxv ..,. IIsTATE HAS OF WISCONSIN FORM 2-2202 401376 IIp� VOLL, 0F&,.PAGE¢?Z MICHAEL S. WALLSCsband R and FLORENCE ..................J........................_............ and ..F..ORE....._..........._......... UfLLp /,-ALLSCHLAEGERf .Husband and Wife .......................................__..._......._..... .....................................:...................:..............................._..........._.:....... REGISTER OF DEEDS anveya aad werrente eq.._J0HN__E._ G R.. ca—r—GRE , 'SE 0CT 7 flr! 11 19 . _auaband and Wife, „asSurvivorsTiip_:Man rEal-4rtip '--......:....................-------...-----............................---............._...._....-_- REGISTER'S OFFICE/S.y� .........................................--'--....._.....---......._.............-----............_..... ®AYnELD GOUNTY WISJ. ............._......_......_'-------'-............_....._...---....,..........---..................... the following described rent estate in..........._Bayfleld............... Canty State of Wisconsin: _ Tex Pared No:.._._..._...._, A parcel of land in the SE} NW},.Section 10, Township 47 North, Range 6 West, described as follows: Commencing at a point where the south line of County Trunk G. intersects the west line of the Town Road, said intersection being designated at the point of beginning; thence running in a southerly direction along the west line of said town road to a point where the west line of said road intersects the south line of said SE} NW}; thence running in a westerly direction along the south boundary of said SEI NW} a distance of 17 rods to a point; thence running in a northerly direction along a line parallel to the west line of said Town Road to a point where said line intersects the south line of said County Trunk G; thence in an easterly direction along the south line of said County Trunk G to the point of beginning, said parcel containing approximately three acres. This ...:......__is---------- homestead property. (is) (is net) +TRA• E FEE EXEMPT RENTAL WEATHERIZAT)ON(.1'� YES ❑ NO%L EXEMFflON t Exception to warranties: Easements, reservations and restrictions of Dated this ...........0.L/' ................. day of ............�/.. Septemb'er .......... 19_92: ......sC!1Q1QJ ...,Jl�f!........... ACKNOWLEDGMENT -,� STATE OF WISCONSIN .Michael J. allschlaeger.r, ................................................................. se. ea freldCountyYQXt4rx') Pebsonelly came before me this _...........__day of •F,1or-enge.. Tean__Wallschlaeger, Se-ptember 19...92 oho above named ._.._. -Florence Jean Wallschlaeger ...__.._.. .._.. L........_..._.._......-..- ................. to me kn n ............ who executed the foregoing ins)aament and ark wledge the eeme. .Ra en . Frechette Notary Public..... Hayfield _---Covnh•, Wia. My Commi®on is permanent. (If not, state expiation 1 4 ......................_._...... 19......._.) fa me knowv to be Ne Peeaon ...._._... who aecuted the ._. __ .I fo�e��'vg bas ammrt and owledge the TX. JOHN W/.H DERSa 9Y - fix. —' (d am` NOTARIAL ATTY. JOHN P. ANDERSON..._...._............_.................................._ ......SFAC _................................_......__........_..._......__...._... 1�ELaRSS UKI'�L.L 4891 Notary publ.c......_......_...AS..... ..dented or acknowledged. Both My C Public _..I Qerinument(t...no,..s__. a,"j Wis. (Signatures may b¢ avthwticrtted or admowledged. Both My Commisa)on is Permanat(IS not, state expiration as not necessary.) _ VOL ' 536 PAGE2 0 ate:. -....... _...:.._...... 19.96..) •Mme at a ,e.. SiNb[ is uC es eelb Ymia be Veto ae uH.Ud . 3w t de .,e..�n< wwnnAMr Darn Srwrx Baa or wmeoweln WlvonSn Legal Wink coma ' rcnat ne. r_ :e.^. wnm.w.vm:or>ti ACKNOWLEDGMENT STATE OF WISCONSIN Dou yl a s.._ .............. County. Personally cane bolero me this ..2. P.!t..day of September - --, is_P?.. the above named _Michael _J:_Wallechlaeger _ B-tYFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number: GREK, JOHN E & BARBARA A SR -00270 68525 CROSS RD ASHLAND, WI 54806 Transaction Number: SR-00270-2E5DD Description Amount Certified Soil Tests - Review & Filing Fee $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 6205 Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847 Payment Type: Check Transaction Date: 6/24/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. B=YFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: GREK, JOHN E & BARBARA A 68525 CROSS RD ASHLAND, WI 54806 Description Private Sewage System (Holding Tanks) Submission Number: SS -00577 Transaction Number: SS -00577-2E180 Amount $400.00 Total: $400.00 Payment Amount: Reference: 6205 Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847 Payment Type: Check Transaction Date: 6/24/2025 $400.00 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-25-61 S STATE SANITARY PERMIT OWNER: JOHN E & BARBARA A GREK G OV'T LOT: LOT: B LK: 1/4 1/4 SEC:10, T 47 N, R 6 W TOWNSHIP: Pilsen SOIL TEST: 58-25 REPLACEMENT SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: ALLAN POLKOSKI TRACY POOLER Authorized Issuing Officer DATE: 6/24/2025 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 #: 16720 LICENSE: # 220090 Condition: Properly Maintain System Per Recorded Agreement. Must be within 25 ft of an all- weather road. Insulate where required. THIS PERMIT EXPIRES 6/24/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION