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HomeMy WebLinkAbout25-81SEva Fax (715) 373-0114 or Email zoning@bavfieldcountv.wi.aov Note fl Time Change fl Discrepancy fl Other Plumber: c k Dsu\• Pho Number_ NNNN Fax Number Homeowner: ['Ov5� iEmail Address j 14 Vs y( iy Sanitary ..b p { [ Qc Immediaf Phone Number So Zoning Dept can call you right back (if needed) Permit #: Q 1 J S kML Plumber's Choice Zoning Dept No Inspection(s) during this time Date: )a ,( -a s- Tuesday (9:30 am - 12:15 pm) (Tracy) Time: Plumber's Choice Zoning Dept lrSs ___________ _________________ Township: CP Address # & Road Name: ( 3') 63 3Y 7S7 or Directions Pe it LX R1> Y To Site: Comments: ** Plumbers you must verify any change(s) by fax or email *' P�A11TAf� Industry Services Division HGL TRUST 13765 PERRY LAKE RD CABLE WI 54821 Information Private Ons.ite Wastewater Treatment Systems (POWTS) Inspection Report (Attach to Permit) City setback to: Town of. County MAUL Sanitary ermit No: State Plan Transaction ID#: Parcel Tax No: TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Se tic W r C5W (oDD N/A Dosing N/A Aeration N/A Holding Pump I Siphon Information 'ump Manufacturer unit Il tel Mau UIdGL 4 0 1 I I,. rn tee Iv Il 0 TDH I Lift I Friction Loss GPM Head I Total Forcemain I Length I Dia I DisL To Well R DIMENSIONS Widtd, Length # of Cells SETBACK FROM Prop.. Line Building Well OHWM Type of Cell Pretreatment Unit Manufacturer. Model Number. stribution Header! M2 Manufacturer: iro •(4146 - Dia Elevation Data STATION BS HI FS ELEV Benchmark Ic Bldg. Sewer 74. ^ Tank Inlet Tank Outlet 9 , Dose Tank Inlet 9 S Z Dose Tank Bottom Inst. Contour Header / Manifold Distribution Pipe Infiltrative Surface � 13 Final Grade t'4'" c {. rr-+t ❑ Yes ❑ No 3oi1 Cover • , Depth Over I Depth Over I Depth of J Seeded / Sodded j Mulched Cell Center I Cell Edges I Topsoil j ❑ Yes ❑ No I ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) L✓J viej- (VeSt r4 ®-1 VCO t— Urq an revision required? ❑ Yes 0 No le other side for additional information. ;i)PcC4.e - dL L. Jeua�.'o.,5 No 242J ayt Date +0 Cc.n 1(-)'Oi p✓¢..I/ Sriti�eQt, le l aPP Ott d� a}.b � , --' Pi€. om, I Pt-# I 0° OWrs Inspector's Signature License Number ;Rnsi71n !R nw911 4: Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Bayfield County Courthouse' Fax: (715) 373-0114 Post Office Box 58 e-mail: zonino(Tbavfeldcountv.ora 117 East Fifth Street Web Site: www.bavfieldcountv.oro/147 Washburn, WI 54891 HGL TRUST 13765 PERRY LAKE RD CABLE WI 54821 As you know PCCL1 was contracted by you to install a private onsite wastewater treatment system on your property (Tax ID# above). To know when your system will be due for servicing please go to www.septicsearch.com Notes: Abandonment of Old System to meet all applicable code requirements: Tank was pumped by: • Tank was crushed / removed and pipes disconnected by: on at AM/PM On at (AM / PM) the above -mentioned plumber contacted our office to conduct 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. ZZSystem could not be inspected becauseCountycould not respond to plumber's time constraints. Comments: 1V) fo v`bd'\' •'1 U/forms/sanitarypropertyowner-input April 2019 Department of Safety Co my & Professional Services, '`�. '':► Sanitary Permit Number (to be filled in by Co.) w s_� Industry Services Division Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application fbrms for state-owned POWTS are submitted to Project Address (different than marling address) 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(i)(m), Stats. I.:,A►P t;ftTj- Pefir d�rAt�ol.:.. Property Owner's Name Parcel # �T(1 T'c fr ��l6iZt 43j 71? ZaG4Zc� Property Owner's Mai1in Address Property Location (5 b Govt. Lot City, State Zip Code Phone Number CAR, ')T, 14?.- d �l� — �� ` 7 �.%. Y4, A —V, Section t f Gltit ( ekfl at41ppJy): Lot # T 3 N ILQ1 Eor • 10 1 0r2 Family Dwelling —Number of Bedrooms 3 Subdivision Name Cl Public/Commercial — Describe Use Blo3ck # ❑ City of Cl State Owned — Describe Use CSM Number O Village of Z Z ( Townof _- (Abi'& w.:� ►vim ,. ',w A. 0 New System Replacement System I ~Other Modification to Existing System (explain) O Additional Pretreatment , Unit (explain) B. ❑ Holding Tank In -Ground ❑ At -Grade 0 Mound 0 Individual Site Design 0 Other Type (explain) (conventional) C. ❑ Renewal Before 0 Revision ❑ Change of Plumber ❑ Transfer to New Owner List Previous Permit Number and Date Issued Expiration /�p}� ••�����.� r Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (st) •.•. • System • •• lion Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units New Tanks Existing Tanks Septic or Holding Tank V J� l3O 1 tiS.r Dosing Chamber ai(t1ii�b1t')c& I._.. Plumber's Name (Print) Plumber's , . RS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) Dju k 5Ooacne r' wi S c , A pp roved ❑ Disapproved Permit Fee Date Issued $ / Iri�L Mal Age gn ❑ Owner Given Reason for Denial (i0 4'9-i'- //71/3 Conditions of Approval/Reasons for Disapproval (i'oL Attach to complete plans for the avatem and anl„ntf f.. s1.. r.,,..w ...ate __. ,___ .L__ .. _ ._ — -- _—_i --• r —r. .."..—o .""68 V ..SA a1 ,ULAQi lid IlIze SBD-6398 (R. 03122) Bayfield Co. Zoning Dept. PAGE 10F4 InwGround Gravity Plan Index & Cover Sheet Component Manual:Des►gn .Reference ln-Ground Soil Absorption for POwTS Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: Enci sores: POWTS Application for Review Soil Evaluation Report & Site Ma Project Name I Description Owner Name(s): J C L TO •1 S;T Phone: - Owner Address: .1374 7 4 ei (t L K120 Zip: 's Project Address: 5444 t Govt lot: w,L11/4ofjtk1I4,Section, T N.. 7 E O or w Q Township: CA P ..:..., .i L- ..�.. County: Project Parcel ID #: a L C71 A '43 O7 t$ o D 1 1 6 O 1 L�- .O Designer information Designer Name: Dan Burch Phone: 715 .416 _1642 Designer Address: N5921 Cty Hwy K Spooner WI Zip: 54801 Email; burchplumbinginc©gmail.com This space reserved for approval stamp, License Number: 253808 0 W Remarks: p I�l��'� JUL 162025 Bayfield Co. Zoning Dept. Signature: Date: Origins signature requfred on each submitted copy. IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER lanai JUL 16 2025 L' Bayfield Co. Zoning Dept. min. 17 (typical) Septic Tank(s) Manufacturer: Wieser Septic Tank(s) Volume(s): 1000 gal gal gal gal Effluent Filter Manufacturer: Polvlok Effluent Filter Model #: 525 12" min. trench depth (typical) : ^ TYPICAL TRENCH CROSS SECTION VIEW (ryptca) •:; , , e• 1. (No Scale) ° 9a.T'— ei System Elevation = ft (typical) Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) r-----------7 ------- �j�---- L------ i ---- ------7�--- I B= 65 ft (typical) INSTALL PER TRENCH: 16 Quick4 Std -W @ 20 ft EISA/chamber = 320 ft2 + 1 Pairs of end caps @ 6 fe EISA/pair= 6 ft2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / instructions. TYPICAL TRENCH PLAN VIEW (No Scale) TA = 3.0 ft (typical) "-Quick4 Standard -W Chamber (typical) (mid by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. D U m W O m a = Proposed EISA per trench = 326 ft= Required Infiltration Area = 643 ft2 Distribution Method: x 2 trenches = Proposed Total EISA = 652 ft2 branched manifold El 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, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. 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), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 450 gpd; BOD5 S 220 mgL"1; TSS 5150 m91;f(rf?o r '' Inspection Checklist INSPECT EVERY 3 YEARS frj o type of use El El JUL 1 6 2025 o age of system o nuisance factors (i.e. odors, user complaints, etc.) Bayfield Co. Zoning Dept. o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.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 (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.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, Wisc. 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 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Dan Burch Local government unit: Bayfield County Zoning Local government unit address: 117 E 5th St Washburn WI Phone: 715.416.1642 Phone: 715.798.4520 ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed 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, Wisc. Admin. Code. RETAINING CLIPS PREVENT FILTER FROM FLOATING 2.00 15.1 cm j f\) OUTSIDE DIAMETER \ ACCEPTS 4" SCHD 40 SOCKET 11.5 `29.4c OPTIONAL BUSHING (FOR 4" THIN WALL PIPE) PART NO. 30142-R �- OR (FOR 110 MM. PIPE) PART NO. 30142-EUR OUTLET BUSHING ACCEPTS 4" SCHD 40 & 6" SCHD 40 PL -525 -625 FILTER HOUSING PART NO. - 30142-525 30142-625 D c E 0 d E `E E1E JULI E202 Bayfeld Co. Zoning Dept. m= ACCEPTS 6" SCHD 40 PIPE FOR INLET EXTENSION 36.4 cm ' � il• • {k I .t 8.10 10.52 26.7 cm IL. r 5.23 'H/;;\I , �;��,.a .--' 13.3 cm (44.(11i � i1 ' ` j_LIQUID LEVEL _i j 1 f 6 1/2" BALL CHECK iii I ' 33.02 [83.9 cm] i ! 18.31 II ;'; [46.5 cm] fii1' ii sEMI'GS9 CX4C. ' { I 6�'tSlt.'� a::'�. Gfi.•�.`'+4w%n .: YF f � � 111 � 1 I iI i cs.?s , s--al.xaw I I I IT 8'-8" 4" CAST -A -SEAL \T=== C v � II ! FILTER OR BAFFLE '7 0 w <8 w m INLET 23"I to o SIDE VIEW ANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 4" CAST -A -SEAL uu Bayfield Co. Zoning Dept. OUTLET I N U a= M PUMP PAD WLP1 000 TANK SPECIFICATIONS g4 a DIMENSIONS: w o WALL: 2 1/2" a- .- BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53 1/4" LENGTH: 8'--8" WIDTH: 7'-2" BELOW INLET: 42" LIQUID LEVEL: 36" o WEIGHT: BOTTOM 6,790 LBS. COVER 3,195 INLET AND OUTLET: I m o 0 a 4" CAST -A -SEAL BOOT OR EQUAL GASKET z o• INLET AND OUTLET BAFFLE AND FILTER: ;; o o WISCONSIN SEE DETAIL #10 (OTHER STATES SEE CHART) il�1 Lo LIQUID CAPACITY: 27.83 GAL/IN HOLDING TANK: U -)j OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1,085 GALLONS M o I LOADING DESIGN: 8'-0" UNSATURATED SOIL 04 TANK CAN BE USED AS: C I W SEPTIC / HOLDING / PUMP OR SIPHON o COVER: MIX DESIGN #8 (NO FIBER) to TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE 0 O O V_ REVIEWED BY a REVIEW DATE 3 J M Z 0 I- 0 U SHEET NO. 17' OF l Private erobic Treatment (ATU) Servicing Agreement Owner(s) Name I4 G-1. 1 rvi Mq,tL 30 2022 Owner(s) Mailing Address 13 �- C5 Site Address et (r7 Lc. Tax ID # 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 WI Adm. Code, as from time to time amended. 1/4 of N E 1/4 Section 1 D Township N. Range W. Town of C A J Gov't Lot Lot 1 Block Subdivision CSM# , CSM Document# (required) 'd (13' A_q f — Y Additional Legal Description: 0 0 Q Type: -ground gravity ❑ Mound DOCUMENT NUMBER 2025R-608323 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 07/16/2025 AT 10:26 AM RECORDING FEE: $30.00 PAGES: 2 Recording Area Return To: Planning and Zoning Department ll JUL 172025 Bayfie!d Co. Zoning Dept. ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ At -grade Sewage System ❑ Other Septic Tank (syst types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed mas er 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 Comm 83.55, 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 -grade, 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. As an inducement to the county to issue a sanitary permit for a POWTS equipped with an aerobic treatment unit on the above described property, we agree to do the following: 1 of 2 1. The owner agrees to conform to all applicable requirements of Ch. Comm 83, Wis. Adm. Code relating to aerobic treatment units and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater Treatment System) technology. 2. The owner agrees to maintain a contract with a licensed POWTS maintainer for the life of the system. The POWTS maintainer will perform periodic inspections and maintenance as required by the manufacturer and the department, including, but not limited to: the blower, electrical controls, treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. The owner agrees to contact the POWTS maintainer immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described in s. 254.59, Stats. 4. The owner recognizes that the county, department or POWTS maintainer may make periodic inspections of the components to complete performance monitoring of the unit. 5. The owner or the owner's agent agrees to report to the department or designated agent at the completion of each inspection, maintenance or servicing event in a manner specified by the department or designated agent within 30 business days from the date of inspection, maintenance or servicing. 6. This agreement will remain in effect only until the county office responsible for the regulation of private onsite wastewater treatment systems certifies that the property is no longer served by the aerobic treatment unit. 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. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the aerobic treatment unit is installed. 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 variance shall be binding upon and inure to the benefit of all current and future owners of such property. Owner(s) Name(s) — Please Print HrTt Tv'c'1' twN ZvSah — Notarized Owner(s) — Signature(s) Drafted by: D9'- /1-44 Date: '7-/15/202.5 Subscribed and sworn to before me on this date: ry Public 3'' c5k'l" rl My Commission Expires: 6 Z Mi 5/ $OTARj i 'Z3 J8LIG .1 •�.'a" u�10M fl JUL 17 2025 u/deb'sdatalforms/sanitary/septicmafntenanceagreement-ATU (MFF) requested (Created 4/20/12); (®May 2018) Bayfield Co. Zoning Dept. 2 of 2 Proofed by: KL.K Sal TEST Wisconsin Department of Safety and Professional Services DNislon Industry Services Page of of OD 2Jj SOIL EVALUATION REPORT In SPS 385, Wis. Adm. Code County accordance with Attach complete site plan on paper not less than 81/2 x 11 Inches in size. Plan must include, Bayfield but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. f 04012243071820011601420 Please print all Information. ,3'? 1G R vi ed Date 7;.•jt9; Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). / -1 Property Owner Property Location El 0 HGL Trust Govt. Lot NE ,v NE 14 S 18 T 43 N R 07 E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: 13765 Perry Lake Rd 13765 Perry Lake Rd CSM 2331 City I State I Zip Code I Phone Number ❑ City ❑ Village fJ Town I Nearest Road Cable I WI I 54821 I( I Cable I Perry Lake ❑ New Construction Use: 0 Residential/Numberof bedrooms 3 Code derived designfiow rate 450 GPD ®❑Replacement ❑ Public or commercial — Describe: Flood Plan elevation If applicable ft. Parent material OUtwaSh General comments and recommendations: a Boring # ❑Boring QPit 94.5 84 87.5 Ground surface elev. ft. Depth to limiting factor In. / elev. ft. I Soil Anollcation Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 1 0-10 10 YR 3/2 Is 0sg ml cs .7 1.6 2 10-36 7.5 YR 4/6 s 0sg ml cw .7 1.6 3 36-84 7.5 YR 4/6 s Osg ml .7 1.6 1.2 1 Boring # ❑Boring 97.5 108 88.5 OPit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. SQii Annlication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 1 0-8 10 YR 3/2 Is Osg ml cs .7 1.6 2 9-28 7.5 YR 4/6 s 0sg ml cw .7 1.6 3 29-108 7.5 YR 4/4 s Osg ml .7 1.6 /'_I Dl I■ CST Name (Please Print) Signature CST Number Dan Burch 080600002-sp Address Date Evaluation Conducted I Telephone Number N5921 County Hwy K Spooner WI 54801 17-15-25 L/ u v u U V * Effluent #1 = BOO > 30 5 220 mglL and TSS > 30 s 150 mg/L * Effluent #2 4oD, 5 30 mg/L and TSS s mg/L 1111 J U L 1 6 2025 SBD-8330 (R04/21) Bziyfleld Co. Zoning Dept. • _'4 .., ❑ Boring 3 Boring # ® Pit Page of Ground surface elev. 96.5ft. Depth to limiting factor 96 In. l elev. 88.5ft. i Soil Aonlicatlnn Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 1 0-9 10 YR 3/2 Is Osg ml cs .7 1.6 2 9-36 7.5 YR 416 s Osg ml ow .7 1.6 3 36-84 7.5 YR 4/4 s 0sg ml .7 1.6 Boring # ❑ Boring 0 Pit Ground surface elev. ft. Depth to limiting factor In. / elev. ft. I Soil Anolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 Boring # ❑ Boring 0 Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. I Soil Anolication Rate I Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = BOD, 5 30 mglL and TSS s 30 mg/L D JUL 1 6 2025 Bayfield Co. Zoning Dept. '1CHECK BOX AS APPLICABLE. SOIL EVALUAI"I0N� Scale: T' = 30' CHECK BOX AS APPLICABLE. SYSTEM PAGE 2 OF 0 SITE MAP 30 45 690 PLOT PLAN PROJECT NAME: 'rh/c DESIGN FLOW: GPD 4___t. t,jBM T 7 sz PROJECIAODRESS: ( � %� ����'�� Attach design flow calculations for commercial plans. 8�.(9 Pipe Material / ASTM Start td (Tables384.30-3& 384.30-5) j (' Symbol: 4 JEM Elevation: . _.�. a �_, FT Sanitary Sewer, 3b BM Dascriptton: wt ` I� 1 A O r� Ps i t 4 e _...� Force Main: 1 Slope Gradient (%) of Tested Area: Well S mbol If a licable : . _ y ( RS ) O Indicate north by drawing an arrow on the epproprito Me. IMPORT V ; Show ground elevation contours at suitable intervals. Pr( (.4c a -s, l qL c 301 04% CA WcAtti _ Ids t000 1 14 C� wee ii; W#J) ll JUL 1 62025 LI Bayf(eid Co. Zoning Dept. i ENiE E9 Department of Safety County -` i �`'I," $ "! & Professional Services ' SanitaryPermitNumber(tote filledinbyCo.) f �! SS Industry Services Division Sanitary Permit Application State Transaction Number in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this fore 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 Project Address (if different than mailing address) purposes in accordance with the Privacy Law, a. 15.04(l)(m), Stats. S I. Applicatkm Information — Please Print All Information Property Owner's Name I N ca,Tt�Sl- Parcel # o46Iv'NSO7(TZc�1lbuiyZ� Property Owner's Mailing Address Property Location X56 City, State Cr Zip Code Phone Number �7 lh�� �� g 4Q LI ��g o�l 61;— -F4— � p{) Govt. Lot �� /liL- � Section II. Type of Burbling (cbeek a tthat apply) Lost O T 43N N 01 101 or 2 Family Dwelling — Number of Bedrooms 3 R E or Subdivision Name ❑ Public/Commercial — Describe Use Block # ❑ State Owned — Describe Use ❑ Cityof CSM Number ❑ Village of 2231 H,P9,Townof__ 4b'G III. Type of POWTS Permit: (Check either "New" or -Replacement" and other applicable on line A. Cheek one box on Hue B. Complete line C applicable.) It A. ❑ New System ,Replacement System I -Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B. ❑ Holding Tank '1P In -Ground ❑ At -de ❑ Mound ❑ Individual Site Design ❑ OdrerT a ex YP (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber 0 Transfer to New Owner ist Previous Permit Number and Date Issued Expiration [V. Dis anal/ 'reatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (st) Dispersal Area proposed (sn System I anon � 3 6501 CIO..r-q� Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units :' • New Tans ExistingTanks (g ° Septic or Holding Tank IuU G / )CCo t W1Sf a U lit ti ii C7 ^y K Dosing Chamber V. Responsibility Statement— 1, the undersigned,assume b n of the POWTS �ewq Plumber's Name (Print) ' on the attached plans. Plumber's a{u P RS Number I Business Phone Number Oa I' Number's Address (Street, City, State, Zip Code) -- -25'v 715 fey? ,N —4LI Gr U k S octet wS 5y¢ e i VI. County/Department Use Only Approved ❑ Disapproved Permit Fee Date Issued )lssui Ag5Signacure ❑ Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval Stt oU0 Attach to complete plans for the system and submit to eh. r,,,,.,. ---------------------- -----' PAGE 10F4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name I Description Owner Name(s): H G fn J S ) Phone: - Owner Address: 1376 S ea P,, ( Lx Zip: _ 3 ( Project Address: .S s1,u c' Govt. Lot: c 1 /4 of t 114, Section, TN -R E ❑ or W lZ Township: ( .A- 3 L- C County: Project Parcel ID #: f>'{ D t A aH 3 O? 18 f o p i 1 6 01 y)O Designer information Designer Name: Dan Burch Designer Address: N5921 Cty Hwy K Spooner WI Zip: 54801 E-mail: burehplumbinginc@gmail.com This space reserved for approval stamp. License Number: 253808 p � g V Remarks: � � U � D JUL 162025 Phone:715 -416 .1642 Bayfield Co. Zoning Dept. Signature: Date: Original signature required on each submitted copy. IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER ACC�VE0 JUL 162025 mmn. 12" (typical) Septic Tank(s) Manufacturer: Wieser Septic Tank(s) Volume(s): 1000 gal gal gal gal Effluent Filter Manufacturer: Polylok Effluent Filter Model #: 525 12" min. trench depth (typical) • ' TYPICAL TRENCH CROSS SECTION VIEW (typical) (No Scale) • qar_ System Elevation = ft ?Of-_a Bayfield Co. Zoning Dept. (typical) Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) if- --------ice -��--- L— ---- ----- —��--- B= 65 ft (typical) INSTALL PER TRENCH: 16 Quick4 Std -W @ 20 ftEISA/chamber = 320 ft2 + 1 Pairs of end caps @6 ft7 EISA/pair = 6 ft2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / instructions. TYPICAL TRENCH PLAN VIEW (No Scale) TA=3.0ft (typical) '—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturers instructions. D C) m W O n a = Proposed EISA per trench = 326 ft' Required Infiltration Area = 643 ft2 Distribution Method: x 2 trenches = Proposed Total EISA = 652 ft2 branched manifold El PAGE4OF4. 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, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. 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), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 450 gpd; BOD5 5 220 mgL"'; TSS ≤ 150 mn�t�5j"1; 2 � 11≤0n Inspection Checklist INSPECT EVERY 3 YEARS f� D o type of use JUL lJ JUL 16 20[5 o age of system o nuisance factors (i.e. odors, user complaints, etc.) Bayfield Co. Zoning Dept. o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.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 (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.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, Wisc. Admin. Code. o Effluent filters) 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 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Local government unit: Bayfield County Zoning Phone: 715.798.4520 Dan Burch Phone: 715.416.1642 Local government unit address: 117 E 5th St Washburn WI ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed 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, Wisc. Admin. Code. 2.00 5.1 cm 1 OUTSIDE DIAMETER ACCEPTS 4" SCHD 40 SOCKET OPTIONAL BUSHING (FOR 4" THIN WALL PIPE) PART NO. 30142-R OR (FOR 110 MM. PIPE) PART NO. 30142-EUR OUTLET BUSHING ACCEPTS 4" SCHD 40 & 6" SCHD 40 I 11.59 29.4 cm 1 10.52 26.7 cm 14.34 36.4 cm 8.10 20.6 cm 1 I 1 LABEL ILLUSTRATION 1 p o L 5.23 13.3 cm i _I 33.02 O 0 RETAINING CLIPS 83.9 cm PREVENT FILTER FROM FLOATING n 0 0 18.31 46.5 cm I ACCEPTS 6" PL -525 -625 FILTER HOUSING SCHD 40 PIPE 1 a PART NO. - 30142-525 = ) FOR INLET 30142-625 D ��d�', EXTENSION liii JUL 1 ELK') 61/2" BALL CHECK H° Bayfleld Co. Zoning Dept. ft U 1 WLP1 000 TANK SPECIFICATIONS 4" CAST a 4" CAST -A -SEAL I ECnnIU JUL 'I r, toz5 Bayfield Co. Zoning Dept INLET N d U I Jill, ;.� PUMP PAD MANUFACTURED TO MEET OR EXCEED ASTM DIMENSIONS: WALL: 2 1/2" BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53 1/4" LENGTH: 8'-8" WIDTH: 7'-2" BELOW INLET: 42" LIQUID LEVEL 36" WEIGHT: BOTTOM 6,790 LBS. COVER 3,195 INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.83 GAL/IN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1,085 GALLONS 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 #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: U I m w OF "1 Treatment I4G-L Ir„si WSJ fl, 5 Puvw� �,41c c d its Address ` (flccc LaLc a ax ID # 3175& 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 WI Adm. Code, as from time to time amended. _ ICE 114 of AlE 1/4 Section I O Township __LN. Range 7W. Town of C Q b 12 Gov't Lot Lot (Block______ Subdivision CSM# ≥23 r CSM Document# (required) VDT, qt- Y Additional Legal Description: �a � a — j '£OS Type: 4g. -In -ground gravity ❑ Mound DOCUMENT NUMBER 2025R-608323 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 07/15/2025 AT 10:26 AM RECORDING FEE: $30.00 PAGES: 2 Return To: Planning and Zoning Department ll JUL 172025 Bayfie!d Co. Zoning Dept. ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ At -grade Sewage System ❑ Other Area Septic Tank (sysjpfn types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed mas er 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 Comm 83.55, 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 -grade, and In -ground 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. As an inducement to the county to issue a sanitary permit for a POWTS equipped with an aerobic treatment unit on the above described property, we agree to do the following: 1 of 2 1. The owner agrees to conform to all applicable requirements of Ch. Comm 83, Wis. Adm. Code relating to aerobic treatment units and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater Treatment System) technology. 2. The owner agrees to maintain a contract with a licensed POWTS maintainer for the life of the system. The POWTS maintainer will perform periodic inspections and maintenance as required by the manufacturer and the department, including, but not limited to: the blower, electrical controls, treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. The owner agrees to contact the POWTS maintainer immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described in s. 254.59, Stats. 4. The owner recognizes that the county, department or POWTS maintainer may make periodic inspections of the components to complete performance monitoring of the unit. 5. The owner or the owner's agent agrees to report to the department or designated agent at the completion of each inspection, maintenance or servicing event in a manner specified by the department or designated agent within 30 business days from the date of inspection, maintenance or servicing. 6. This agreement will remain in effect only until the county office responsible for the regulation of private onsite wastewater treatment systems certifies that the property is no longer served by the aerobic treatment unit. 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. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the aerobic treatment unit is installed. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bay/laid 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 variance shall be binding upon and inure to the benefit of all current and future owners of such property. mnar ta) rvaruotb)— rtease runt HGL Trvd' - 4otarized Owner(s) — Signature(s) Drafted by: Ur V7 Ajr-4F Date: "35/Jots u/deb'sdata/fortes/sanitary/septicmain ten anceagreement-ATU (MFF) requested (Created 4/20/12); (®May 2018) scribed and sworn to before me on this date: rj-15'-7-02_5 My Commission -20 �f NOTAl? s? Nom:, "°JSL1O ECEE VE n JUL 172025 U Bayfield Co. Zoning Dept. Proofed by: KLK 2 of 2 SON TEST ''"�''�"�''• Wisconsin Department of Safety and Professional Services Page of ,g;.. D K Division of Industry Services H L:$P SOIL EVALUATION REPORT 9______________________ � - O6 2- WAdm. Code County �►,, k „�= In accordance with SPS 385, Bayfield Attach complete site plan on paper not less than 81/2 x 11 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. �J Parcel I.D. 04012243071820011601420 Please print all information. R vi ed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). Property Owner Property Location ❑ HGL Trust Govt. Lot NE y NE % S 18 T 43 N R 07 E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: 13765 Perry Lake Rd 13765 Perry Lake Rd CSM 2331 City I State I Zip Code I Phone Number ❑ City ❑ Village ❑® Town Nearest Road Cable WI 54821 ( ) Cable Perry Lake El New Construction Use: 0 Residential / Numberof bedrooms 3 Code derived designflow rate 450 GPD QReplacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft. Parent material OutwaSh General comments and recommendations: D Boring # ❑Boring MPit 94.5 84 87.5 Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Snil Annfeatinn Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 1 0-10 10 YR 3/2 Is Osg ml cs .7 1.6 2 10-36 7.5 YR 4/6 s 0sg ml cw .7 1.6 3 36-84 7.5 YR 4/6 s Osg ml .7 1.6 Boring # []Boring 97,55 108 88.5 ©Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Snil Annliratinn Ratp Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 1 0-8 10 YR 3/2 Is Osg ml cs .7 1.6 2 9-28 7.5 YR 4/6 s 0sg ml cw .7 1.6 3 29-108 7.5 YR 4/4 s Osg ml .7 1.6 CST Name (Please Print) Signature CST Number Dan Burch 080600002-sp Address Date Evaluation Conducted Telephone Number N5921 County Hwy K Spooner WI 54801 7-15-25 IUJ I ID U V 1111 * Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 4rOD, 5 30 mglL and TSS s mg/L 11 Ii J U L 1 6 2025 SBD-8330 (R04/21) Bayfield Co. Zoning Dept. ❑ Boring 1 Boring # 0 Pit Page of 96.5 96 88.5 Ground surface elev. ft. Depth to limiting factor in. I eiev. ft. I Soil Annlication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 1 0-9 10 YR 3/2 Is Osg ml cs .7 1.6 2 9-36 7.5 YR 4/6 s Osg ml cw .7 1.6 3 36-84 7.5 YR 4/4 s 0sg ml .7 1.6 L _] Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor In. / elev. ft. SniI Annfh" fnn Rata Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Cni1 Annlir+.#inn Otjfn Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 5 220 mglL and TSS > 30 5150 mg/L * Effluent #2 = BOO, s 30 mg/L and TSS s 30 mg/L JUL 16 2025 Bayfield Co. Zoning Dept. CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. Scale: 'I" = 30' ® SOIL EVAL UAT'I ON [� SYSTEM PAGE 2 OF 0 30 SITE MAPh1J/19 4560 PLAN eQ PROJECT NAME: L 4 t. Thi c V? sz DESIGN FLOW: ________GPO I Attach design flow calculations for commercial plans. PROJECTADDRESS: I5 7d peg' f r l %� a .92 _()_ Pipe Material / ASTM Stan td ables 384. ----r-- ' -- p 30-3 $ 3$4.3Q-5) BM Symbol: + ,BM Elevation: ? 12 O FT Sanitary Sewer________________ w41 1 " Force Main: BM Descrtpuan: O� li �i �ty� � 1�------------- Slope Gradient (%) WeI! Indicate north by JMPORTANT: of Tested Area: Symbol (if applicable): 0 drawing ancraw r w Show ground elevation contours at suitable intervals. on the approprite tine. Pc.ct( Lc ti r - b' qq- _ ii qLc '5? O' cit (7 G &DI 1 i 1111 JUL 162025 L) Bayfield Co. Zoning Dept. 3° V,�AFIELD 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: HGL TRUST, 13765 PERRY LAKE RD CABLE, WI 54821 Description Certified Soil. Tests - Review & Filing Fee Submission Number: SR -00286 Transaction Number: SR-00286-2FB04 Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 1607 Paid by: Burch Plumbing, N5921 County Hwy K, Spooner WI 54801 Payment Type: Check Transaction Date: 7/22/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. B ' YFI ELD 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: HGL TRUST, SS -00603 13765 PERRY LAKE RD CABLE, WI 54821 Transaction Number: SS -00603-30573 Description Private Sewage System (Septic Tanks) Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 1607 Paid by: Burch Plumbing, N5921 County Hwy K, Spooner WI 54801 Payment Type: Check Transaction Date: 7/22/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-25-81 S STATE SANITARY PERMIT OWNER: HGL TRUST GOVT LOT: LOT: 1 BLK: CSM: 2231 NE 1 /4 NE 1 /4 SEC:18, T 43 N, R 7 TOWNSHIP: Cable SOIL TEST: 76-25 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: DAN BURCH TRACY POOLER DATE: 7/22/2025 Authorized Issuing Officer 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: # 253808 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 7/22/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION