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HomeMy WebLinkAbout25-89SRequest for Sanitary Inspection (24 Hrs. 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 fl Time Change fl Discrepancy fl Other Phone Number 715-413-0122 Plumber: Superior Plumbing & Mech. Inc. Fax Number Email Address Homeowner: Bridget & Forrest Mann ed@superiorpmw.com Immediate Phone Number So Zoning Sanitary Dept can call you right back (if needed) Permit #: 25-sss Plumber's Choice ing Dept ■ No Inspection(s) during this time Date: 1016024 c9 Ie Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zoning Dept Time: fpm Ca 1�,7mt�► to Township: Washburn Address # & Road Name: 30835 Sky Rd. Washburn they would like to dig the basement this week, tank needs to go in before hand due to limited access on or site. Directions To Site: Comments: f� )W f'r uc k /{a2 T/e✓oa 5 J a )n !QF - lU' J� Pi f5O 57�ar 3 5 ** Plumbers you must verify any change(s) by fax or email ** Notes from u/fonns/sanitary/requestfonnspection Zoning Dept (©4/12104); ® June 2023 Private Onsite Wastewater Treatment Systems ( POWTS). Inspection Report (Attach to Permit) industry Services Division General Information F BRIDGET B & FORREST A MANN 29945 WANNEBO RD F WASHBURN WI 54891 Pump / Siphon Information city I I Village '/ / Pump Manufacturer Pump Model Demand GPM Titer Manufacturer Filter Model TDH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well Dispersal Cell Information Prop.. Line Manufacturer: - y ,40 p, Model Number. Pretreatment Unit Manufacturer: Model Number: strihution System _ 14d,A Header! Manifold rar` " �/ Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length /7/la I Length Dia Spac Spacing 0 Yes ❑ No Soil Cover V • , Depth Over Depth Over j Depth of Seeded / Sodded . Mulched Cell Center Cell Edges L Topsoil ❑ Yes 0 No 0 Yes ❑ No ;AMMENTS: (Include code discrepancies, persons present, etc.) ./ (OrsT¢*lii/'rscleof `S$ vk'—a!A Yrtsll of < �r sGfi-u./�Sssc/in 9 a Yo//rs,t ry ;Y //sr af... d.'s3/i: rr. bar ll CJ 1%� n/os7 yre...+%,s t 3 ■[]➢Wu Elevation Data Town of. County ((}}� ,,,ennit Sanitary No: State Plan'Transactlon lDP. Parcel Tax No: N/A N/A X Pressure Systems Only Ian revision required? 0 Yes'jNo i /��_� aeother sidefor additional Informtion. ��J Date POWTS Inspector's Signature / X37 3 License Number :Rn-R71a (P na/9t1 41 Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zonino(a).bavfieldcountv.ora Web Site: www.bavfieldcounty.orol147 BRIDGET B & FORREST A MANN 29945 WANNEBO RD WASHBURN WI 54891 Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 As you knew A4�C"(/—y /r�cf li was contracted by you to install a private onsite wastewater tr ate ment system on your prope y (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: on at AM / PM ❑•e Tank was crushed / removed and pipes disconnected by: On ❑ at � (AM the above -mentioned plumber contacted our office to conduct a pie -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. LLLJJJ���III 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 could not be inspected because County could not respond to plumber's time constraints. U/forms/sanitarypropertyowner-input April2019 �)�TApV5j �� O ��:� SS - (/.(t =p Industry Services Division p 822 Madison Yards Way 7 u Z Madison, WI 53705 P.O. Box 7302 Madison, WI 53707 County Ba�eld Sanitary Permit Number (to be filled in by Co.) _ ' ' I 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). Stars. State Transaction Number Project Address (if different than mailing address) Sky Rd. Washburn 30 8 35 I. Application Information — Please Print All Information Property Owner's Name - Bridget B & Forrest A Mann Parcel # 31299 Property Owner's Mailing Address 29945 Wannabo Rd. Property Location Govt.Let5-6 +a' y.• Section 92 T48 N R 5 E or W City. State I Washburn, WI Zip Code 54891 Phone Number 715-209-1400 U. Type of Building (check all that apply) Z1 or 2 Family Dwelling— Number ofBedrooms 3 []i'ubhc/Commercial — Describe Use nSlate Owned — Describe Use Lot # Subdivision Name Block # flCityof illage of CSM Number Iy[JTowaof Vila5nDurn 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 applicable.) A. ✓, ew System replacement System [1 Cher Modification to Existing System (explain) E]Additionel Pretreatment Unit (explain) B. jioldmng Tank �In-Ground Ejt-GradeMound Individual Site Design Other Type (explain) (conventional) C. U Renewal Before LJRevision hange of Plumber Urmnsfer to New Owner """"'""'""`"`• """'"" """ """" "'"`" Expiration IV. Dlspersal/freatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 450 .7 642 738 104'-106'-108' Capacity in Total #of Manufacturer Tank Infonuatiou Gallons Gallons Units `u Nen•Tanis t.xisdag Teats I 0 s 2 a _ 0.0 in " H i+. U Septic or Holding Tank x i000A 1 Wieser Concrete I✓ r-i rI V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Siemmre �. MP/MPRS Number Business Phone Number Edward B. Redinger � 221939 715-292-6670 Plumber's Address (Street. City. State. Zip Code) 1015 11th Ave. E. Ashland, WI 54806 Approved 17 Disapproved $IcIa1rnal "`"'""`MlDt—' K ft ❑ Owner Given Reason for Denial -7vQ r) .�O '' Conditions of Approval/Reasons for Disapproval Se4 JUL 232025 to complete oiam for the system and submit to the Conan only on owner not less than 8:121 11 inches in size SBD-6398 (R. 02/22) PAGE 1 OF 5 In -Ground Dosed -Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 5 Pg2of5 Pg3of5 Pg4of5 Pg5of5 Index & Cover Sheet Plot Plan Dispersal Area Cross -Section & Plan View Pump Tank Specifications Management Plan Attachments: Enclosures: Pump Curve POWTS Application for Review Soil Evaluation Report & Site Map Project Name I Description 3 Bed System with lift - .7 Loading / stepped trenches Owner Name(s): Forest & Bridget Mann Owner Address: 29945 Wannabo Rd. Washburn, WI Phone:715 -209 Zip: 54891 Project Address: Sky Rd. Washburn Govt. Lot: 5-6 .1/4 of 1/4, Section 12 T48 N -R5 E for W Q✓ Township: Washburn County: Bayfield Project Parcel ID #: 31299 Designer Information Designer Name: Edward B. Redinger Designer Address: 1015 11th Ave. E. Ashland, WI E-mail: ed@superiorpmw.com License Number: 221939 Remarks: -1400 Phone: 715 -292 -6670 Zip: 54806 This space reserved for approval stamp. ,. L' lj "' . ,�- ) `� iU5 havfield Co Zoning Dept. Signature: Date: Original signature required on each submitted copy. "A SUPERIOR PLUMBING MECHANICAL (715)278 3456 CST# 221939 Scale: 1"=40 y , PIN: 31299 4.5 Acres Lot 5&6 512 T48N R5 W Town of Washburn Bayfield Co. Customer Name: Kevin &Jacqueline Tetzner/ Bridget Mann Adress: 29945 Wannabo Rd. Washburn, WI 54891 SITE: Sky Rd Washburn/ no site address Phone #: 715-209-1400 Email: bridget.b.mannCa�gmail.com NO SITE ADDRESS YET ,IBM.,' tJ.J,i 2y '/�1q le 6"dZove. lrrctp on sf�p 45 ,U«'d 3 -710k4 £ / A 4'i., , vi' rEjjb Comps G"/a II a k )'\ ] L 3� �� JUL 2 3 2025 Bayfield Co. Zoning Dept. IN -GROUND DOSED -GRAVITY DISPERSAL AREA Stepped Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) �fl EUUIF[ JUL 23g 2025 Ll Bayfield Co Zoning Dept min. 17' SOIL COVER (typical) is T Highest Trench Lowest Trench (as applicable) minepth . trench j_ jt'T'\: •d • a. (typical) , a a System Elevations= 108 ft. 106 ft. 104 ft; ft; Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) r- ------------�-------- --- r ., : B= 48 ft (typical) INSTALL PER TRENCH: 36 Quick4 Std -W @ 20 ft2EISA/chamber = 720 ft2 + 3 Pairs of end caps @ 6 ft2 EISA/pair = 18 ft2 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) Provide minimum 3 ft separation between trenches. ft Observation Pipe (typical) Install per manufacturers / instructions. TYPICAL TRENCH PLAN VIEW T (No Scale) IA=3.0ft (typical) "—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. D C) m W O ii O1 = Proposed EISA per trench = 246 ft' Required Infiltration Area = 642 ft2 Distribution Method: x 3 trenches = Proposed Total EISA = 738 ft2 distribution box El PAGE 4 OF 5 • GRAVITY -DOSED SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4"0 Vent Pipe >10ftfrom Building 12" Min. or 2.0 ft above Established Flood Elevation (typical) Approved IMPORTANT: \ Vent Cap Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) Finished Grade CAPACITIES @ 16.76 gal/in Depth (in) Volume (gal) A 18 309 B 2.0 33 [C] 5.4 90 D 10 167 4I I Electrical must comply with SPS 316 and NEC 300 Weatherproof Junction Box Airtight Seal Extend manhole riser as necessary. Approved Locking Manhole with Warning Label Attached (typical) 4" Min. or 2.0 ft above /'- Established Flood Elevation 9 T/ (typical) • Quick Disconnect 3• 18"Min. (typical) _ -I Weep I •• Hole f > Alarm -On * Pump Tank Liquid Level = 36 in Pump N-° D Force Main Diameter = 2 in CBla Block Force Main Length = 60 3" Approved Bedding Material Beneath Tank ft Force Main Void Volume= 10 gal [C] Total Dose Volume (TDV) = 100 gal/dose ( ≤ 0.2X design @ow + force main void volume) Vertical Lift = 8 ft PUMP TANK: Volume = 600 gal Manufacturer: Wieser Concrete Pump Manufacturer: Goulds Pump Model: EP0411 F (See attached pump curve.) Controls/Alarm Manufacturer: SJE Controls/Alarm Model: Power Post Float switches containing mercury are prohibited. -Approved Joints with Approved Pipe 3 ft onto Solid Ground (typical) PUMP -OFF ELEVATION= 99.55 ft INSIDE BOTTOM ELEVATION= 100 ft 1 V J(2 3 2025 3ayfield Co. Loin 9 Dept. SEPTIC TANK(S): Total Volume = 1000 gal Manufacturer(s): Wieser Concrete Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: Poly Lock Filter Model: 525 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 5 220 mgL''; TSS 5150 mgL''; FOGS 30 mgL-' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) 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 (113) 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 necessa,y to remove any accumulated solids according to manufacturer's specifications. A servicing period will ajo to ltl�an months. J vU II!; 1�1 JUL 2 3 zaz5 System maintenance reports shall be submitted to the proper local government unit in a6ee�LSeAr'#Ag Dept. SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of Individual or company: Superior Plumbing & Mech. Inc. Phone: 175-292-6670 Local government unit: Bayfield Co Zoning Phone: Local government unit address: 117 5th St. E. Washburn, WI 715-373-6138 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. Wastewater METERS FEET 9 30 ( ++ -�I hf- 5 GPM 8 4-_2.5FF 25 !. L1 Q W x _U 6 20 _ Q 5 ci 15 J 4- EP05 3 10 EP04 z 5 1 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m3/h CAPACITY ftl JUIL 2 3 2025 IIJI MODEL INFORMATION Bayfield Cc Zoning Dept. Order Minimum Float Cord Discharge Minimum Minimum Minimum Maximum Shipping Number HP Vohs Amps Circuit Breaker Phase Switch Length Connection On Level Off Level Basin Solids Weight Style Diameter Size lbs.kg EP0411 'lug'' No Switch Manual Manual 20/9.1 EP0411A Piggyback / Wide -Angle 10, 12" 6" 21/9.5 115 12 20 EP0411F Plug/ No Switch 20 Manual Manual 20/9.1 4 1 1y:" 15" %" EP0411AC Piggyback/ Wide -Angle 20' 12" 6" 21/9.5 EP0412 Plug/ No Switch 10' Manual Manual 20/9.1 230 6 10 EP0412F Plug/ No Switch 20' Manual Manual 20/9.1 Plu / No Switch 20' Manual Manual 22 / 10 .5 115 13 20 EP051 Piggyback/ Wide -Angle 20' 12" 6" 23/10.4 230 6.5 10 Plug/ No Switch 20' Manual Manual 22/10 PAGE 3 The newly enhanced PS Patrol' system features all the same functions you have come to expect, plus so much more over other traditional pedestal -style alarms. The PS Patrol® features a built-in high water alarm and provides a convenient location to connect all wiring required for a pumping station application. It employs a receptacle for easy connection of a 120V pump and piggy -back pump switch. The sleek, angled design of the clear enclosure Includes a removable cover for easy access for field wiring and viewing components. All Internal components are sealed within the cover for protection from the elements. The red LEDs illuminate the top of the cover in an alarm condition for easy 360° visual identification. Available with or without 32" mounting post. FEATURES • Enclosure meets Type 3R water -tight standards • Innovative design allows alarm to accept a 5" square plastic post or 4" pipe/conduit for mounting • Automatic alarm reset and green power on indicator • Flush mount horn silence/alarm test switch • Auxiliary alarm contacts included for easy attachment of remote devices • Includes cord seal for sealing switch and pump cables • Electrical potting cavity to provide easy, reliable method to seal power cables (electrical duct seal not included) • Options include various switch cord lengths, riser assembly adapter, dual alarm, and elapsed time meter PART# DESCRIPTION 1022728 PSP2120V, no pump switch, with post 1019021 PSP2 120V, no pump switch, 20A breaker, with post 1022575 PSP2120V, ETM, with post 1022577 PSP2 120V, DUO alarm, ETM, with post 1037095 PSP2 120V, Wisconsin, assembly kit (2.5 inch) 1067640 PSP2120V, Wisconsin, assembly kit (2.0 inch) 1018434 PSP2120V, TAAB indoor alarm, with post 1011551 Assembly Kit (riser extension coupling and washers) C ll JUL 232025 SJ E R H O U I I�V'SJ ept. C. U.S Patent No. 9472,932 v SAR and D780,703 LRYia5 Removable Cover Incoming Alarm Power Incoming Pump Power Pump Plug Pump Float Plug PSP Cord Receptacle Optional Assembly Kit WLP1 000/600 -MR TANK SPECIFICATIONS 12'-6" 4" CAST -A -SEAL-\ r4" CAST -A -SEAL I H a II II U I1. 1i'11 1I � I II 11 II 1r: •11 FILTER OR 1F�1 1 BAFFLE-� ,� J. O3 TOP VIEW � rC�vti .. N 9VT � a Iry 4" VENT w a rl�v ---- N • ---- , .�•I::::f' INLET - _ OUTLET n- or _ I I•a M a 1: 1' b a U s i_i_______ I ds M . r PUMP PAD (TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS DIMENSIONS: La o WALL: 3" a a BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER o HEIGHT: 51" LENGTH: 12'-6" WIDTH: 7'-0" w BELOW INLET: 42" LIQUID LEVEL: 36" o 0 WEIGHT: BOTTOM 9,500 LBS. 0 COVER 5,470 LBS. n 3 0 INLET AND OUTLET: m o 0 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: a v0i 4 =' 0 WISCONSIN, SEE DETAIL #10 1- 0 (OTHER STATES SEE CHART) r- LIQUID CAPACITY: 27.88 GAL/IN (SEPTIC) La Lo 16.76 GAL/IN (PUMP) U c.o 0 LOADING DESIGN: 8'-O" UNSATURATED SOIL Q z 0OOO TANK CAN BE USED AS: a 'n SEPTIC/SEPTIC, SEPTIC/PUMP, F F') OR SEPTIC/SIPHON d •- W�o = COVER: MIX DESIGN #8 (NO FIBER) 0O 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: 1 V OF 4/1/25, 11:42 AM Bayfield County Land Records and GIS 1.3 yfv'dCou-4sI r J n1. Hcir,dGIS V Name, Address, Parcel# etc Q J G a jTFTil r U Y W SUSAN MILLER JAMES„^;I& MARY L NELSON Tax ID#;31285• L...D1_S6,"' 1 : •(Z O -gip, Y" 9'• ' y•'.. t *. ` x' _ Qti. t as I ___ ' — t\2- BR"AN 0ON J & KAILEE I 1 h :,".,R EN •" `�' RD\CCt1On I _ SCOT ' Te IDr+•31298� t - 2 !143j „[p ,.J-; •..�\ "' }Tar IC C J.'.. 1F o2i o'. •. js App State V Ufl m ~ .;@650 SKY R[JG Click to rest the map extent and layer) B 80 I) visibilitywh!r yotJ@Qnf2P.32025 C 806,342 5361 482,099.7475 Feet J RCSHEJOSEPH-EWRQK https:llmaps.bayfieldcount)fwi.gov/BayffeldWAB/ VnSO C 1 aninq eP . 1/1 ('ViCOi1 (fr\c:)) Private Sewage System Maintenance Agreement DOCUMENT NUMBER Owner(s) Name 2025R-608460 d (res- f'lAn DANIEL J. HEFFNER Owner(sMailing Address REGISTER OF DEEDS BAYFIELD COUNTY, WI .2g9�!S ,An bo � rn .�'�1 i1 Site Address RECORDED 30 G 3S C v Wak�bwrn Wei 6 Lt,�07/24/2025 AT B:OO AM o J!� �_ l 1 RECORDING FEE: $30.00 Tax ID# 3i2"1� PAGES:2 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 (COMPLETE Legal is required) 114 of 1/4 Section Township 9%' N. Range W. Additional Legal Description:j'e /?4t ? Lg) Town of (Acreage) Gov't Lot Lot Block Subdivision Lot CSM # Vol. Page CSM Doc # Recording Area Return To: Planning and Zoning Department ❑ In -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds. At -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. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system. Bayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future owners of 7h 4p4ty.E J J Owner(s) Name(s) — Please Print Subscribed and sworn to before me on this dateti II JUL 2 25 t1D�h 6 rrss - M& n Bayfield Co. Zonr Notarized Owner(s) — Signature(s) ('16vd Notary PubliILd4IA' ___________________________ My Commies' n pi a o g g Dept. Drafted by: 6 e-" 44A Date: i �a o�� Proofed by: JENNIFER A KORPELA rms/sanitary/sepUemaintenceagreement Notary Public Revised July 2020 Qiw&w ..s The East Twenty-four (24) feet of the North One-half (N 1/2) of Lot Four (4) AND all of the South One-half (S 1/2) of Lot Four (4), EXCEPT the South 264 feet thereof; The South One-half (S 1/2) of Lot Five (5) and all of Lot Six (6) LESS the South 264 feet of Lot Five (5) and the East One-half (E1/2) of Lot Six (6); Lot Seven (7), all being located in Block B, Textor's Addition to the Town of Washburn, Bayfield County, Wisconsin, V J1J JUL 2 52025 Bayfield Co. Zoning Dept. Wisconsin Department of Safetyand Professional Services l Divisional Industry Services t j' i ! `l • SOIL EVALUATION REPORT In accordance vilh SPS 385. Wis. Adm. Code County Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include. 8ayfield but not limited to: vertical and horizontal relevance point (BM), direction and percent slope. Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road 31299 Please print all Information. Revi� y ; ! Page of Date Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04(1)(m)). L-LiL.-'/'- 1 14.1131C.� Property Owner Property Location Q✓ Kevin & Jacqueline Tetzner/ Bridget Mann Govt. Lot 5-6 v s 12 148 N R 5 E (or) W Properly Owners Mailing Address Site Address or CSM and Lot rf: 29945 Wannabo Rd. 715-209-1400 No Address yet: Sky Rd. Washburn City State Zip Code Phone Number ❑ City O Village IN Town Nearest Road Washburn WI 54891 ( ) Washburn Sky 0 New Constructlon Use:I1 Residential) Numberaf bedrooms 3� Code derived designflow rate 450 GPO ❑Replacement ❑ Public or commercial — Describe: Flood Plan elevation it applicable ft. Parent nrateriai Sand/ Outwash General comments nod recommendations: 4.5 Acres) Conventional System with lift- 103.8' -111.8' Step as needed install on contours 112.8'-108.8' 1 i 1 Boring f; ❑Boring 1030.25 97.65 a Pil Ground surface elev. fl. Depth to limiting factor • in. I elev. ft. Rail Anntir..tinn R'.t.. Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDlFl Eff#1 'Eff#2 1 0-4 5yr 312 - sl 2mabk ml cw 3co .6 1.0 2 4-8 5yr 5/2 - $ 0sg ml cw 3co .7 1.6 3 8-68 5yr 416 - s 0sg ml ow 2m .7 1.6 4 68-72 5yr 414 c2d 5yr 6/8 + 7/2 scl 1 fabk mvff - - .2 .3 2 Baring i7 Boring 103.25 26 101.5 ®Pit Ground surface etay. it. Depth to limiting factor in.! elev. ft. Anil Ar.ntirntinn Rnlu I Horizon Depth In. Dominant Color Munsell Redox Description On. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft� •Eff#1 Elf#2 1 0-4 5yr 312 - sl 2mabk ml cw 3m .6 1.0 2 4-10 5yr 5/2 - s Osg m1 cw 3C6 .7 1.6 3 10-26 5yr 416 - s 0sg ml cw 2m .7 1.6 4 26-40 5yr 4/4 c2d 5yr 712 sot 1 fabk mvf - 1 of .2 .3 CST Name (Please Print) I Signature I CST Number Edward S. Redinger 4.-:r . 221939 Address Date Evaluation Conducted Telephone Number 1015 11th Ave. E. Ashland. WI 54806 12/2/24 f 715.292.6670 Effluent #1 = SOD > 30 s 220 mg1L and TSS >30 s 150 mgtL - Effluent #2 = SOD. s 30 mglL and TSS 5 30 rnglL SBD-8330 (R04!21) Wisconsin Department of Safety and Professional Service _�1 �)4 " f Page of 0 _ Division of industryServices I I I U` • $P SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include. Bayf eld 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. 31299 Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04(1)(m)). Property Owner Property Location ❑ Q Kevin & Jacqueline Tetzner/ Bridget Mann Govt. Lot 5-6 `/. V. S 12 T 48 N R 5 E (or) W Property Owners Mailing Address Site Address or CSM and Lot #: 29945 Wannabo Rd. 715-209-1400 No Address yet: Sky Rd. Washburn City State Zip Code Phone Number ❑ City O Village E Town Nearest Road Washburn WI 54891 c 1 Washburn Sky 0 New Construction Use: 0 Residential/ Numberof bedrooms 3 Code derived designiow rate 450 GPD ❑ Replacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft. Parent material Sandy OutwaSh General comments and recommendations: 4.5 Acres! Conventional System with lift- 103.8' -111.8' Step as needed Install on contours 112.8'-108.8 [iiI] Boring # ❑Boring [Pit 1030.25 97.65 Ground surface elev. it. Depth to limiting factor in.! elev. ft. Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 'Eff#1 'Eff#2 1 0.4 5yr 3/2 - sl 2mabk m1 cw 3co .6 1.0 2 4-8 5yr 5/2 - s 0sg ml cw 3co .7 1.6 3 8-68 5yr 4/6 - S 0sg ml cw 2m .7 1.6 4 68-72 5yr 4/4 c2d 5yr 6/8 + 7/2 sd lfabk mvfl - - .2 .3 [Ii1Z Boring # ❑Boring 103.25 26 101.5 EJPit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. C--1 A ------.--- �..... Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots •rr• GPO/Ft2 'Eff#1 Eff#2 1 0-4 5yr 3/2 - sl 2mabk ml cw 3m .6 1.0 2 4-10 5yr 5/2 - s 0sg ml cw 3co .7 1.6 3 10-26 5yr 4/6 - s 0sg ml cw 2m .7 1.6 4 26-40 5yr 4/4 c2d 5yr 7/2 scl lfabk mvfi - 1 of .2 .3 CST Name (Please Print) Si nature '4VJ221939 CST Number Edward B. Redinger Address Date Evaluation Conducted I Telephone Number 101511th Ave. E. Ashland, Wi 54806 j 12/2/24 1715-292-6670 'Effluent #1 = BOD>30 30 S220 rag/L and TSS > 30 s 150 mg/L " Effluent #2 = BOD, 530 mg/L and TSS 530 mg/L SBD-8330 (R04121) Boring # Page of ❑ Boring 108.85 ► 96 100.85 ® Pit Ground surface elev. ft. Depth to limiting factor r , in. I elev. ft. LlL'. Cw:u A...r ...4:..- r..l... Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIFt2 •Eff#1 Eff#2 1 0-4 5yr 3/2 sl 2mabk ml cw 2m .6 1.0 2 4-10 5yr 5/2 - s Osg ml gw 3co .7 1.6 3 10-26 5yr 4/6 - S Osg ml gw 3m .7 1.6 4 26-96 5yr 5/4 - s Osg ml - 2m .7 1.6 4_J Boring # ❑ Boring 112.85 0 Pit Ground surface elev. ft. 108.5 Depth to limiting factor 2 In. I eiev. _ ft. Cnil As.wliwnNww t7wM Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots - - - ter- ----- - ---- GPD/Ft2 'Eff#1 Eff#2 1 0-4 5yr 3/2 - sl 2mabk ml cw 2m .6 1.0 2 4-12 5yr 5/2 - s 0sg ml cw 3co .7 1.6 3 12-52 5yr 4/6 - s 0sg ml cw 3m .7 1.6 4 52-63 5yr 4/4 c2d 5yr 7/2 scl lfabk mvfi - - -.2 .3 5 J Boring # ❑ Boring 112.85 ® Pit Ground surface elev. ft. 100.85 Depth to limiting factor in. / elev. ft. c. .t, A..._IS__.,_._ r._._ Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots - •ter•'-------- GPD/Ft2 •Eff#1 Eff#2 1 0-4 5yr 3/2 - si 2mabk ml cw 2co .6 1.0 2 4-8 5yr 5/2 - s 0sg ml cw 3m .7 1.6 3 8-40 5yr 4/6 - s 0sg ml gw 2m .7 1.6 4 40-96 5yr 6/3 - s Osg ml - .7 1.6 Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 5150 mg/L ' Effluent #2 = BOD, 530 mg/L and TSS s 30 mg/L SUPERIOR PLUMBING MECHANICAL (715)278-3456 is/i7-' y CST# 221939 Scale: 1=40' t 4'a' PIN: 31299 4.5 Acres Lot 5&6 512 T48N RSW Town of Washburn Bayfleld Co. Customer Name: Kevin & Jacqueline Tetzner/ Bridget Mann Adress: 29945 Wannabo Rd. Washburn. WI 54891 SITE: Sky Rd Washburn/ no site address Phone #: 715-209-1400 Email: bridget.b.manntagmail.com NO SITE ADDRESS YET ,l 43.Ih1. =/aaI /Ja.'l.'n y,"/rlgQ// 6 "% ve Gro,ori 1,4 —ham o 119' 3!a12 uodd//e.4 5;4- O) s1h„ e l'u, /63,1 /,'i. C 5 ep 2 s )JeeCIP jr.oc-May '76 styzt. 5 - �(� d S = '" ...,� \ Industry Services Division 822 Madison Yards Way % 75 Z Madison, WI 53705 P.O. Box 7302 Madison, WI53707 County Bayf eid Sanitary Permit Number (to be filled in by Co.) q 5- B I $ Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law. s. 15.04(1)(m). Sorts. Project Address (if different than mailing address) Sky Rd. Washburn 3 0 g 35 I. Application Information — Please Print All Information Property Owner's Name Parcel # Bridget B & Forrest A Mann 31299 Property Owner's Mailing Address Property Location 29945 Wannabo Rd. Govt.Lot5-6 v. %. Section 12 City, State I Washburn, WI Zip Code 54891 Phone Number 715-209-1400 T48 N R 5 E or W U. Type of Building (check all that apply) R11 or 2 Family Dwelling — Number ofBedrooms 3 Lot # Subdivision Name ❑Public/Commercial — Describe Use State Owned — Describe Use Block # City of Village of rim.,., .,Washburn CSM Number III. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line Cif ✓New System I (Replacement System uather Modification to Existing System (explain) LJAdditional Pretreatment Unit (explain) B. [Holding Tank ❑✓ In -Ground Qkt-Grade IDMound Individual Site Design Other Type (explain) (conventional) C. ❑ Renewal Before ❑Revision Change of Plumber ❑Transfer to New Owner ist Previous Permit Number and Date Issued Expiration IV. Dlspersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) I Dispersal Area Required (sf) Dispersal Area Proposed (sf) I System Elevation 450 .7 642 738 104'-106'-108' Capacity in I Total I # of I Manufacturer Tank Information Gallons Gallons Units . e o o New Tanks Existing Tanks W e u m i s m S U rn w H 'u. V a I septicornond,ngTant I x I 11000 11 I Wieser Concrete II ✓ III I Ir1Ir1I I II nosing camnuerI I I I IIIIL........JIC LJ u � I V. Responsibility Statement- I, the undersigned, assume responsibWty for Installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature �. MP/MPRS Number I Business Phone Number Edward B. Redinger 4_ws13T2aet..y 1221939 715-292-6670 Plumber's Address (Street, City, State. Zip Code) 1015 11th Ave. E. Ashland, WI 54806 Approved 0 Disapproved 3`•�„" " "">"`"MCI t— ❑ Owner Given Reason for Denial Q r) so z'S Conditions of ApprovaVReasons for Disapproval ye ,cit (� - r,// &/ L//12_, i5 %e 7o�e tie.- /cnve,2 D l� flfl pp 7 c'hed 0of • JUL 232025 SBD-6398 (R. 02/22) rry 1Nrsconsin Department of Safetyand Professional Services 'II/ Division of lnduslry Services P. SPS SOIL EVALUATION REPORT In accordance v.4th SPS 385, Wis. Adm. Code County Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include. Bayfield but not limited to: vertical and horizontal reference point IBM), direction and percent slope. Parcel I.D. scale or dimensions, north arrow, and location and distance to neatest road 31299 Please print all Information. Revr1vdYA /r Personal information you provide may be used for secondary purposes (Privacy Law s. 1504(1 Umti ( 1.' Patio of_______ Property Owner Property Location ❑✓ Kevin & Jacqueline Tetzner/ Bridget Mann Govt. Lot 5-6 ). :. 512 i48 N R 5 E(o) W Properly Owner's Melling Address Site Address or CSM and Lot #: 29945 Wannabo Rd. 715-209-1400 No Address yet: Sky Rd. Washburn City State Zip Code Phone Number ❑ City O Vllinge I9 Town Nearest Road Washburn WI 54891 I 1 Washburn Sky ;❑� New Construction Use:❑ Residential/NumberoIbedrooms 3 Code derived designfow rate 450 GPD QReplacement ❑ Public or commercial —Describe: Flood Plan elevation it applicable ft. Parent material Sandy Outwash General comments and recommendations: 4.5 Acresl Conventional System with lift- 103.8'- 111.8' Step as needed install on contours 112.8'-108.8' �I Boring p Darng 1030.25 5.6 97.65 -- — Pit Ground surface elev.II. Depth to limiting factor in.! elev._ 11. call Anal canna P:.r„ I Horizon Depth In. Dominant Color Munsell Redox Description Cu. Az. Cont. Color Texture Structure Gr. Sz. Sit. Consistence Boundary Roots GPDIFP •Erica 'E0p2 1 0-4 5yr 3/2 - sl 2mabk ml cw 3co .6 1.0 2 4-8 5yr 5/2 - s Osg ml cw 3co .7 1.6 3 8-68 5yr 416 - s Ogg ml cw 2m ,7 1.6 4 68-72 Syr 4/4 c2d 5yr 6/8 + 7/2 scl lrabk mvfi - - .2 .3 2 Boring P []Boring 103.25 26 101.5 ®Pit Ground surface eluv.ft. Depth to trading factor m. I elev.ft SoilArrnticatlon Rote Horizon Depth In. Dominant Color Munsell Rodox Description Cu. Az. Cont. Color Texture Structure Gi. Sz. Sh. Consistence Boundary Roots GPO/F1' 'Ell#1 -EIfp2 1 0-4 5yr 3/2 - sl 2mabk ml cw 3m .6 1.0 2 4-10 5yr 5/2 - S Osg ml Cw 3co .7 1.6 3 10-26 5yr 4/6 - s 06g ml cw 2m .7 1.6 4 26-40 5yr4/4 c2d5yr7/2 scl lfabk mvrt - lvf .2 .3 CST Name (Please Print) signs are 1 CST Number Edward B. Redinger 0 cr-'/ 221939 Address Date Evaluation Conducted Telephone Number 1015 11th Ave. E. Ashland, WI 54806 12/2/24 715.292.6670 Ellluent C1 = BOD >305220 mgtL and TSS > 30 s 150 mg'L - Effluent #2 = BOD. S 30 mgll and TSS 5 30 mgrL SBD-8330 (R04121) - Quack r;alnl Wisconsin Department of Safatyand Professional Services B Division of IndustryServices :SPS SOIL EVALUATION REPORT In accordance with SPS 385. Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 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. Please print all information. Personal Information you provide may be used for secondary purposes (Privacy Law s 15 04(1)(m)) Reviewed by LO7074 Page of______ �= Date Property Owner Property Location D ✓❑ Kevin & Jacqueline Tetzner/ Bridget Mann Govt. Lot 5-6 v. . s 12 T 48 N R 5 E (or) W Property Owners Mailing Address Site Address or CSM and Lot It 29945 Wannabo Rd. 715-209-1400 No Address vet: Sky Rd Washbum City State Zip Code Phone Number ❑ City ❑ Village 9 Town Nearest Road Washburn WI 54891 ( ) Washburn Sky 01 New Construction Use: Residential/ Numberofbedrooms 3 Code derived designflow rate 450 GPD TIReplacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable ft. Parent material -Sandy Outwash General comments end recommendations: 4.5 Acres/ Conventional System with lift- 103.8'- 111.8' Step as needed install on contours 112.8'-108.8 a Boring ❑Boring [Pit 1030.25 5.6 97.65 Ground surface elev. ft. Depth to limiting factor —in. I elev.ft. ..a n.,.'r,,.en.,., Horizon Depth In. Dominant Color Munsell Redox Description Cu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/F12 'Eff#1 Eff#2 1 0-4 5yr 3/2 - sl 2mabk ml cw 3co .6 1.0 2 4-8 5yr 5/2 - S 0sg ml cw 3co .7 1.6 3 8-68 5yr 4/6 - S Osg ml cw 2m .7 1.6 4 68-72 5yr 4/4 c2d 5yr 6/8 + 7/2 scl lfabk mvri - - .2 .3 2] Boring# ❑Boring 103.25 26 101.5 •Pit Ground surface elev. ft. Depth to limiting factor in. I elev. ft. Ie Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cant. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' Eff#1 'Eff#2 1 0.4 5yr 3/2 - sl 2mabk ml cw 3m .6 1.0 2 4-10 5yr 5/2 - s 0sg ml cw 3co .7 1.6 3 10-26 5yr 4/6 - s 0sg ml cw 2m .7 1.6 4 26-40 5yr 4/4 c2d 5yr 7/2 set lfabk mvri - 1vf .2 .3 CST Name (Please Print) Sifgnature CST Number Edward B. Redinger 221939 Address Date Evaluation Conducted Telephone Number 1015 11th Ave. E. Ashland, WI 54806 12/2/24 715-292-6670 • Effluent #1 = BOD >30 s 220 mg/L and TSS > 30 s 150 mg/L 'Effluent #2 = BOD. S 30 mg/L and TSS 5 30 mg/L SBD-8330 (R04/21) 1-i—i Boring # Page of Boring 108.85 , 9.6 100.85 ® Pit Ground surface elev. ft. ; '1 Depth to limiting factor in. I elev. ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cant. Color Texture Structure Gr. Sz. Sh. Consistence Boundary . Roots GPD/Ft2 •Eff#1 •Eff#2 1 0-4 5yr 3/2 sl 2mabk ml cw 2m .6 1.0 2 4-10 5yr 5/2 - s 0sg ml gw 3co .7 1.6 3 10-26 5yr 416 - s 0sg ml gw 3m .7 1.6 4 26-96 5yr 5/4 - S Osg ml - 2m .7 1.6 aBoring # ❑ Boring 112.85 ® Pit Ground surface elev. ft 108.5 Depth to limiting factor 2 in. / elev. ft. Cnil Annlinfllinn Onln 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 0-4 5yr 3/2 - sl 2mabk ml cw 2m .6 1.0 2 4-12 5yr 5/2 - s 0sg ml cw 3co .7 1.6 3 12-52 5yr 4/6 - s 0sg ml cw 3m .7 1.6 4 52-63 5yr 4/4 c2d 5yr 7/2 SCI 1 fabk mvfi - - .2 .3 LI1 Boring # ❑ Boring 112.85 ® Pit Ground surface elev. ft. 96 100.85 Depth to limiting factor in. I elev. ft. Cnll Annln.Iwn O..►e Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cant. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 •Eff#2 1 0-4 5yr 3/2 - sl 2mabk ml cw 2co .6 1.0 2 4-8 5yr 5/2 - s Osg ml cw 3m .7 1.6 3 8-40 5yr 4/6 - s Osg ml gw 2m .7 1.6 4 40-96 5yr 6/3 - s Osg ml - - .7 1.6 • Effluent #1 = BOO > 30 s 220 mglL and TSS > 30 s 150 mg/L • Effluent #2 = BOO, s 30 mg/L and TSS 5 30mg/L Customer Name: Kevin &Jacqueline Tetzner/ Bridget Mann SUPERIOR PLUMBING MECHANICAL (715)278 - 3456 4/ CST# 221939 Scale: 1"=40 ,4'�' PIN: 31299 4.5 Acres Lot 5&5 S12 T48N RSW Town of Washburn Bayfleld Co. Adress: 29945 Wannabo Rd. Washburn, WI 54891 4 SITE: Sky Rd Washburn/ no site address Phone II: 715-209-1400 Email: bridget.b.mann@gmail.com NO SITE ADDRESS YET ( on ✓en r On O. 1515h1 5h 1 ..�/I• �� GJoadeA ≤ c A'U.M. =168' Na:I,'n 2`/ "M4Q/c ,4l&&ie �irou.d 1/ 1 A T..s�r,l1 on sylftrl e%✓, /63,fr'- ///. S' Q s ,U,r«lod PAGE 1 OF 5 In -Ground Dosed -Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 5 Pg 2 of 5 Pg3of5 Pg4of5 Pg5of5 Index & Cover Sheet Plot Plan Dispersal Area Cross -Section & Plan View Pump Tank Specifications Management Plan Attachments: Enclosures: Pump Curve POWTS Application for Review Soil Evaluation Report & Site Mao Project Name / Description 3 Bed System with lift - .7 Loading / stepped trenches Owner Name(s): Forest & Bridget Mann Owner Address: 29945 Wannabo Rd. Washburn, WI Project Address: Govt. Lot: 5-6 1/4 of Township: Washburn Project Parcel ID #: 31299 S Phone:715 _209 Zip: 54891 1400 Rd. Washburn 1/4, Section 12 T48 N R5 E for W ❑✓ County: Bayfield Designer Information Designer Name: Edward B. Redinger Designer Address: 1015 11th Ave. E. Ashland, WI E-mail: ed@superiorpmw.com License Number: 221939 Remarks: Phone: 715 -292 -6670 Zip: 54806 flU l' his space reserved for approval stamppp.pp 2a2025 Bayfield Co. Zoning Dept /C 3hC Signature: �� Date: 4 Original signature required on each submitted copy. Customer Name: Kevin & Jacqueline Tetzner/ Bridget Mann ISAdress: 29945 Wannabo Rd. Washburn, WI 54891 • SUPERIOR SITE: Sky Rd Washburn/ no site address PLUMBING MECHANICAL (715)278-3456 ee- Tr 1-- /a/�/may CST# 221939 Scale: 1" = 40ya' PIN: 31299 4.5 Acres Lot 5&6 512 T48N R5 W Town of Washburn Bayfield Co. Phone #: 715-209-1400 Email: bridget.b.mannPgmail com NO SITE ADDRESS YET 4 i3a11. =/be' Ma:/,a a9 "Ap/c 4"nli„/e ccrOu A Lon✓MhoAcl/ 45h'ri ✓/%U 4)oe4ec4 £ 4-C Syn4 i eleil. Jo3,f' ///5'' SAS 4 s ,U«id 3 -7 _I "s / 1$' rfjia 1Ps r✓.' /6`i -/CG'-/6'Z' f iS a// a rot °P" x'.31 JUL 232025 /S9a Bayfield Co. Zoning Dept. DP.J C..lay '(a sKy lzd. IN -GROUND DOSED -GRAVITY DISPERSAL AREA Stepped Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) IEf lfl JUL 2 3 2025 a BaYrield Co. Zoning Dept. min. ,2" SOIL COVER (typical) TYPICAL TRENCH z' CROSS SECTION VIEW min. trench deem (No Scale) (typical) 3.4" .,...•• , (typical) . < . . 47 Provide minimum 3 ft Highest Trench Lowest Trench (as applicable) separation between trenches. System Elevations = 108 ft; 106 ft; 104 ft; ft: Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) INSTALL PER TRENCH: (typical) 36 Quick4 Std -W @ 20 ft' EISA/chamber= 720 ft' + 3 Pairs of end caps @ 6 ft2EISA/pair= 18 ft' = Proposed EISA per trench = 246 ft2 C:I Observation Pipe (typical) Install per manufacturers / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) I A=3.0ft (typical) `Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturers instructions. Required Infiltration Area = 642 ft2 Distribution Method: GD m W O TI fs x 3 trenches = Proposed Total EISA = 738 ft2 distribution box a PAGE 4 OF 5 GRAVITY -DOSED SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4"0 Vent Pipe >10 it from Building 12" Min. or 2.0 ft above Established Flood Elevation (typical) IMPORTANT: \Approved Vent p Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) T Finished Grade CAPACITIES @ 16.76 gal/in Depth (in) Volume (gal) A 18 309 B 2.0 33 [C] 5.4 90 D 10 167 *Pump Tank Liquid Level = 36 in Force Main Diameter = 2 in Force Main Length = 60 ft Force Main Void Volume = 10 gal [C] Total Dose Volume (TDV) = 100 L(≤0.2X design flow + force main void volume) Vertical Lift = 8 ft PUMP TANK: Volume = 600 gal Manufacturer: Wieser Concrete Electrical must comply with SPS 316 and NEC 300 �ll Weatherproof Junction Box *t Weep Hole A it _Alarm B —On Pump _orf Concrete Block Extend manhole riser as necessary. Approved Locking Manhole with Warning Label Attached (typical) 3" Approved Bedding Material Beneath Tank gal/dose Pump Manufacturer: Goulds Pump Model: EP0411 F (See attached pump curve.) Controls/Alarm Manufacturer: SJE Controls/Alarm Model: Power Post Float switches containing mercury are prohibited. 4" Min. or 2.0 ft above Established Flood Elevation (typical) Quick Disconnect 18" Min. (typical) I -Approved Joints with Approved Pipe 3 ft onto Solid Ground (typical) PUMP -OFF ELEVATION= 99.55 ft INSIDE BOTTOM ELEVATION= 100 ft "A 232025 a Bayfield Co. Zoning Dept. SEPTIC TANK(S): Total Volume = 1000 gal Manufacturer(s): Wieser Concrete Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: Poly Lock Filter Model: 525 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; GODS S 220 mgL'1; TSS S 150 mgL"'; FOG 530 mgL"' Inspection Checklist INSPECT EVERY 3 YEARS type of use age of system o nuisance factors (i.e. odors, user complaints, etc.) 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. Scats, 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 ra it drra- f 11an months. 1LJ1111% 0 15 ti JUL 2 3 2025 System maintenance reports shall be submitted to the proper local government unit in aBegfe�9 Dept. SPS 383.56 Wlsc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Superior Plumbing & Mech. Inc. Phone: Local government unit: Bayfield Co Zoning Phone: Local government unit address: 117 5th St. E. Washburn, WI 175-292-6670 715-373-6138 ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wlsc. 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. Wastewater METERS FEET 10 ��f-5GPM 8 2.5 FT 25 Q w 2 U 6 20 Q } O 15 J 4 EP05 O 3 10 2 EP04 1 5 0 0 0 10 20 30 405 GPM 0 MODEL INFORMATION 2 4 6 8 10 12 m3/h CAPACITY liii JUL 231025 Bayfield Co. Zoning Dept. Order THpVIts Amps Minimum Circuit Phase Float Switch Cord arge Discharge Minimum Minimum M MSoI Shipping pp g Number Style Length Connection On Level Off Level Basinm dsm Diameter Size lbs.kg EP0411 Plug/ No Switch 10 Manual Manual 20/9.1 EP0411A Piggyback / Wide -Angle 70, 12" 6" 21/9.5 115 12 20 EP0411 F Plug / No Switch 20' Manual Manual 20 / 9.1 4 1 1 Y." 15" '/," EP0411 AC Piggyback/ Wide -Angle 20' 12" 6" 21/9.5 EP0412 Plug! No Switch 10' Manual Manual 20 / 9.1 230 6 10 EP0412F Plug / No Switch 20' Manual Manual 20/9.1 EPOS 11 F Plug / No Switch 20' Manual Manual 22 / 10 .5 115 13 20 EP0511 AC Piggyback/ Wide -Angle 20' 12" 6" 23/10.4 EP0S12F 230 6.5 10 Plug / No Switch 20' Manual Manual 22 / 10 PAGE 3 The newly enhanced PS Patrol` system features all the same functions you have come to expect, plus so much more over other traditional pedestal -style alarms. The PS Patrols features a built-in high water alarm and provides a convenient location to connect all wiring required for a pumping station application. It employs a receptacle for easy connection of a 120V pump and piggy -back pump switch. The sleek, angled design of the clear enclosure includes a removable cover for easy access for field wiring and viewing components. All Internal components are sealed within the cover for protection from the elements. The red LEDs illuminate the top of the cover in an alarm condition for easy 3600 visual identification. Available with or without 32" mounting post. FEATURES • Enclosure meets Type 3R water -tight standards • Innovative design allows alarm to accept a 5" square plastic post or 4" pipe/conduit for mounting • Automatic alarm reset and green power on indicator Flush mount horn silence/alarm test switch • Auxiliary alarm contacts included for easy attachment of remote devices Includes cord seal for sealing switch and pump cables Electrical potting cavity to provide easy, reliable method to seal power cables (electrical duct seal not included) Options include various switch cord lengths, riser assembly adapter, dual alarm, and elapsed time meter PART# DESCRIPTION PSP2 120V, no pump switch, with post 1022728 1019021 PSP2 120V, no pump switch, 20A breaker, with post 1022575 PSP2 120V, ETM, with post 1022577 PSP2 120V, DUO alarm, ETM, with post 1037095 PSP2 120V, Wisconsin, assembly kit (2.5 inch) 1067640 PSP2 120V, Wisconsin, assembly kit (2.0 inch) 1018434 PSP2 120V. TAAB indoor alarm, with post 1011551 Assembly Kit (riser extension coupling and washers) C[II] JUL 232025 SJ E RH OMBijSDept. U.S Patent No. 9472,932 ern: and D780,703 't �1P Removable Cover a Incoming Alarm Power Pump iI-Incoming Power Pump Plug Pump Float Plug PSP Cord Receptacle Optional Assembly Kit WLP1000/600-MR TANK SPECIFICATIONS ' o o a. a I 12'-6" DIMENSIONS: I -. WALL• 3" 4" CAST —A —SEAL 4" CAST —A —SEAL BOTTOM: 3" COVER: 5" • MANHOLE: 24" I.D. PRECAST CONCRETE RISER a j�----1------------� --------- HEIGHT: 51. 0 j I ti a i LENGTH: 12'-6" 'ii' WIDTH: 7'-0" � Iryl a C BELOW INLET: 42"1 LIQUID LEVEL: 36" `t E TWEIGHT: BOTTOM 9.500 LBS. � • --� -� lilT COVER 5,470 LBS. ! 3 O0 II 0 0 HI INLET AND OUTLET: m o FILTER BAFFLE L 4" CAST -A -SEAL BOOT OR EQUAL GASKET W II i4 II C a ---------------------•-t---� INLET AND OUTLET BAFFLE AND FILTER: m 0 0 WISCONSIN. SEE DETAIL #10 (OTHER STATES SEE CHART) •jJN TOP VIEW LIQUID CAPACITY: 27.88 GAL/IN (SEPTIC) 16.76 GAL/IN (PUMP) g c- a L LOADING DESIGN: 8'-0" UNSATURATED SOIL C ro 0 r G.7 W I 9 IV TANK CAN BE USED AS: a N w o 4.) o SEPTIC/SEPTIC. SEPTIC/PUMP, F') OR SEPTIC/SIPHON d 1 a o 4" VENT m W w °COVER: MIX DESIGN #8 (NO FIBER) `° TANK: MIX DESIGN #10 (STRUCTURAL FIBER) ___-- ---- CUSTOMIZED TANKS: ---- ---- ---- FOR CUSTOM TANKS CONTACT WIESER CONCRETE INLET - _ OUTLET N I -- �- j a fi na i �� LI v r ¢ d' Q J M I I D.= If d= M OI I I1 �a I' �4 0 Z 3" L.� I J 1 I 1O ¢ 7 I REVIEWED BY p U PUMP PAD REVIEW DATE a w DRAWINGS SUBMITTED V) SIDE VIEW FOR APPROVAL APPROVED BY: - SHEET NO. APPROVAL DATE: ) - OF PRODUCTS NEEDED BY: 1 TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS 4/1/25, 11:42 AM Bayfield County Land Records and GIS 13 Bayfield County Land Records and GIS 1.3 rt + r Name, Address, Parcel# etc Q 4 " ', } A S. tsr 4. 806,342.5361 182.099.747' f,'., •J.. J https://maps.bayfieldcounty.wi.gov/Bayfield WAB/ SKY RD6 ROSH E a. 30775 SKY RDSC'CI1O11 1 rip sltil� U U' l�J P� II U' the n1np Cy4:nt Md 1u 1 .KII,ihR %mJU'.3 2025 '--__ JOSEPH EWSRP5MEK 3 neera-cc oning ept.v1 Private Sewage System Maintenance Agreement Address 45 30135 SK7 a \,J(t-thhbiLr.t Wz 6cIxt Tax ID#T 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. (COMPLETE Legal is required) 1/4 of 1/4 Section y h _______Township V V/ N. Range rS W Additional Legal Description: SFP slaG Loo9 Town of (Acreage) Gov't Lot Lot Block Subdivision Lot _ CSM # _ Vol. _ Page _ CSM Doc # E iEt ED 72 DOCUMENT NUMBER 2025R-608460 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 07/24/2025 AT 8:00 AM RECORDING FEE: $30.00 PAGES: 2 Return To: Planning and Zoning Department ❑ In -ground gravity E'in-ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturers specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds. At -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. 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 bylaw. The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future owners of gpph t4 p jy.E QED 2 25 Owner(s) Name(s) — Please Print Subscribed and sworn to before me on this date JUL 2 5 FvrrGs ' f`1&nn Bayfield Co. Zonir Notarized Owner(s) — Signature(s) Notary Publi BG My Commiss' n rpi : Drafted by:2rea( /Tenn Date: 3ka S g Dept. Proofed by: JENNIFER A KORPELA m'y�nitary/septicmaintenceagreement Notary Public Revised July 2020 State of Wisconsin The East Twenty-four (24) feet of the North One-half (N 1/2) of Lot Four (4) AND all of the South One-half (S 1 /2) of Lot Four (4), EXCEPT the South 264 feet thereof; The South One-half (S 1/2) of Lot Five (5) and all or Lot Six (6) LESS the South 264 feet of Lot Five (5) and the East One-half (E1/2) of Lot Six (6); Lot Seven (7), all being located in Block B, Textor's Addition to the Town of Washburn, Bayfield County, Wisconsin. ' JUL 2 5 2025 Bayfield Co. Zoning Dept. 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: MANN, BRIDGET B & FORREST A 29945 WANNEBO RD WASHBURN, WI 54891 Description Private Sewage System (Septic Tanks) Submission Number: [.�.$1IIb111:1 Transaction Number: SS -00608-3114C Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 10375 Paid by: Superior Plumbing & Mech Inc, 1015 11th Ave E, Ashland WI 54806 Payment Type: Check Transaction Date: 7/30/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-25-89S STATE SANITARY PERMIT OWNER: KEVIN M & JACQUELINE A TETZNER REV LIVING TRUST GOVT LOT: 5-6 LOT: BLK: 114 1/4 SEC: 12, T 48 N, R 5 W TOWNSHIP: Washburn SOIL TEST: 184-24 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: EDWARD REDINGER TRACY POOLER DATE: 7/30/2025 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: # 221939 Condition: Properly Maintain System Per Recorded Agreement. Fill uphill trenches before the lower trench. THIS PERMIT EXPIRES 7/30/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION