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HomeMy WebLinkAbout25-103STINE RECEIVED REMOTE CSID September 22, 2025 at 8:29:05 AM CDT 7153724159 Sep 11 2025 04:22 HP Faxpolkosld Plumbing 7153724159 DURATION PAGES STATUS 39 1 Receiv page 1 Request 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 ail staff members. Note fl Time Change fl Discrepancy Other ion7 ojosk Phone Number J Plumber: ` 15 m J [1 u6 Fax Number -7IS 3-72—L/(S7� Homeowner: /�vNo� t17 mlih 1 Email Address Lc I k �'oveYP tj cL J' �hcr'�' �JY1ctiDCv 1er, Immediate Phone Number So Zoning sanitary S- 1 ��✓ 5 Dept can call you right back (If needed) Permit#: 7 1 Plumber's Choice Dept •r Y Date: Plumber's Choice Z pt Time: • ; 00 pm �Y Township: Address#& )<row�=�oa qtr —7'.k? CTi("F- .ov*4 For Road Name: u ice? Z f e s. 1 u r h L i' a 7 f h e iru L e 6 c or art l�yw �e5 r 7h oh av I Lo Directions rt2— APP f : ( e c TV r ;2 T 1 ti f e e -1 r , ✓ = �`7. �, rc'Fly S91 To Site: I 4R'"tL kcc Comments: ** Plumbers you must verify any change(s) by fax or email Notes from Zoning Dept: ufonns/sanilaryIraq ueslforinspectlon Zoning Dept (®4/12104): ® June 2023 ter.. Private Onsite Wastewater Treatment >� �s Systems ( POWTS). Inspection Report (Attach to Permit) IT C WHITMAN, ARNOLD M & P V oses Priva Law, s. 15.04 1 m F LUNDOTERRI L City Village Town of. 7820 LOOUT UT DR ' LA JOLLA CA 92037 msp r vit iev: -- Tank 7YPE MANUFACTURER CAPACITY Pro . Line Well Building Air Intake Road Se tic f 7 O K N/A Dosing r7p.ta N/A Aeration N/A Holding orviu uipuun. 111 qp ,bbi n Arse. (at setback to: County Sanitary ermlt No: State Plan'Transaction ID#: Parcel Tax No: Pump / Siphon Information Pump Manufacturer p Model Demand GPM I an cb1r Filter MOde� TDH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well Dispersal Cell Information DIMENSIONS Width Leng t //of Galls SETBACK FROM Pr ..L' e uild g W IIQ� OHWM Type �ofCell ` I Manufacturer: (pwpovv ) kc `A &UJ Model Number: Pretreatment Unit Manufacturer: Model Number. stribution Header/ Ma Die Dia Elevation Data STATION BS HI I FS ELEV Benchmark Lr L 100 Bldg. Sewer q4 QScc. tq /. e ' Tank Inlet ,afSC& Tank Outlet 444 Dose Tank Inlet Dose Tank Bottom . .,l Inst. Contour k h Header/ Manifold Distribution Pipe Infiltrative Surface , -L, g. Final Grade 3 . (o ( X Pressure Observation Pipes ❑ Yes ❑ No Soil Cover Depth Over Depth Over Depth of Seeded / Sodded . Mulched Cell Center Cell Edoes Toosoii ❑ Yes ❑ No 0 Yes 0 No I� COMMENTS: (Include code discrepancies, persons present etc.) LPV\<. iC.l4L5 &QP�GJ C�cueo(c/ t.l)Qa�vt� IO(KSI Cl�tatA - C11 IS� t "kvt`4rW'5 flfl.t Ic1I\'t eln YCw S VP.n\ 4' 171r1 7Gt1y f tfUny J r on ≤ f . Ian revision required? 0 Yes td'No �U rd� 'C Q ` ' /00 le other side for additional information. l Date POWT nspector's Signature License Number 2Rrla71n rR ng1911 BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zonina(a bavfieldcountv.org 117 East Fifth Street Web Site: www.bavfieldcountv.orol147 Washburn, WI 54891 Property Owner WHITMAN, ARNOLD M & Information LUNDBERG, TERRI L 7820 LOOKOUT DR LA JOLLA CA 92037 As you know 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.septiesearch.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 I PM) the above -mentioned plumber contacted our office to conduc a pre -cover inspection as required under DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. ❑ System was inspected and appears to meet all applicable code requirements; however, a plan revision is necessary because the installation was substantially different than the original approval. ❑ System could not be inspected because plumber covered prior to scheduled time of inspection. ❑ System could not be inspected because plumber was not ready at scheduled time of inspection. County was unable to return to complete inspection. System could not be inspected because plumber was not ready at scheduled time of inspection. A re -inspection and $50 fee are required. System could not be inspected because County could not respond to plumber's time constraints. Comments: Q� s.cl?yo. k rcw<� , (Pr p Co LAld (LA IG� jM cc q(t.,lw(�O rah((I I)i) /a 11 Ulfcrmsfsanilarypropertyowner4npul April 2019 YM,�Taarillt ` - & Professional Services, Sanitary Permit Number (to be filled in by Co.) (• Department of Safety County Industry Services.Division Sanitary Permit Application State £nnnsactionNumber 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 Project Address (if different than mailing 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), Stars. g -c7 l �a r+ L ( Jc ,� r I. Application Information - Please Print All Information Property Owne 's Name Parcel # Ar o/ (Jyt T rn ei ti "i- v V, I L O1,1 L v' T14 v T Q. +e S Property Owner's Mailing Address ,\1 Property Location 7 ZG7 oo .oV _ f Govt. Lot Z'3 less LZS— City, Stale Zip Code Phone Number 4 / Z 0% ¼.'A, Section 7 II. Type of Buildl g (check all that apply) .� oy—S `z1 Lot # T 7 N R t5 • 'o I or 2 Family Dwelling —Number of Bedrooms i »j Subdivision Name Block # D Public/Commercial — Describe Use O City of ❑ State Owned — Describe Use CSM Number O Village of •`Zg' l9 Town ofy`a' A ' qtr III. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if a licable- A. 00 New System • ❑ Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B. ❑ Holding Tank ®- In -Ground ❑ At -Grade I ❑ Mound ❑ Individual Site Design 0 Other Type (explain) (conventional) p ) C. ❑ Renewal Before ❑ Revision 0 Change of Plumber ❑ Transfer to New Owner List Previous Permit Number and Dade Issued Expiration f 3 _ 7 L} ' I7 .IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Ratc(gpd/sf) Dispersal Area Required (s) Dispersal Area Proposed (sf) System Elevation __ I 1 i.___ Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units w tn New Tanks Existing Tanks U _J 3() to w7 Septic oI4eMMg Tank Z' 75 tSo-0 2 U) 5•e tr Cc v1., � . V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's lName (Print) r, Plumber's Sign re 3'/MFRS Number Business Phone Number Al l 0.1'1 '' p`` s -,.• 2. 0 O g O '7 l S Z Z -- /s-tP Plumber's Address (Street, City, State, Zip Code) VI. County/Department Use Only Approved 0 Disapproved Permit Fee Date Issued m , L Issuin Ag ign roc O Owner Given Reason for Denial 1Q 5 Conditions of A pprova easons for Disapproval ,Qc 5(z%" /iiraW#J a c/ L4c RECEIVED Attach to complete plans for the system and submit to the County only on paper not less than $ 1/2 x 11 Inches In size AUG 0 7 2025 SBD-6398 (R 03/22) Bayfie!d Co. Planning and n y 'May. 5: 2017.10:41AM BAYFIELD CO PLANNING & ZONING No. 9975 P. 3 PAGE I OF '7 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: Version 2.0, SBD-1 0705-P (N.01/01, R. 10/12) Pg I of 7 Index & Cover Sheet Pg 2 of --1 Plot Plan Pg 3 of I e p -,e1 k. Co Section & Plan View Pg 4 of 7 Management Plan Attachments: Enclosures; 5 ,f POWTS Application for Review SaH� 2 Soil Evaluation Report & Site Map &' Project Name I Description Y 0-f y Owner Name(s): o/ w11 4 h I r r v Phb�e: "7-70 - 3 3 a- q 100 Owner Address: 112-0 Loo kou4 t>v- L4To / 14 Zip: ? z73 3 Project Address: &. 9 I .S- I44 Y4 Lctke K ►• o .. � ev c.1,l - ''-(4P c 7 e Govt. Lot:3 LofJfrJqz,'l L ess Z,5'ection, T 7 N -R S E ar W Township: e v County: 3c -CIA . Project Parcel ID #: �kx,� Z� 1'i 0 Designer Information Designer Name; A 1/et a 7c, / ko s k Phone: 7/( - 77 - / Desi ner Address: P -a. 3 a �Saz �- v -e g �r r" � L� r' LLI 2 Zip: _S/''7 E-mail: 4o n y e- LJ ems. . i Ate- o v +A p e- o Pvi This space reserved for approval stamp, License Number: Z2-0 0g SEC E IVED Remarks: AUG 07 2025 Bayfield Co. Planning and Zonirrc, Agency Signature:. l Date: '7 _ 3 —2 gi a1 ' naturo required on each submifted copy. G BAYFIELD COUNTY • CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): F0 Check List I Index Page / Title Sheet (Optional) lI Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) E Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report; (Include the following Information) m Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used l?J Property Owner's Information (not prospective buyer's name) I Property Location (Accurate Legal Description with Sec/Twp/Range) d Road Name (where driveway is/will be coming off of) l l Floodplain Elevation, Flow Rate, Comments and Recommendations Cl Complete Soil Boring / Pit Information 0 Date Soil Evaluation was conducted E1 CST Name, Signature, Number, Address and Phone Number O *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) RJJ Bench Mark (Description, Elevation and Location) U Contour Lines (Example = 98.0' /96.0' /94.0') m Property Location (Sec/Twp/Range/, Accurate Legal Description) I1 Borings (Locations and Elevations) A Percent and Direction of Land Slope W1 Well Location (Including Neighboring Wells, if applicable) iJ Location of Wetland Areas, Floodplain and Navigable Waters 0 Buildings, Driveways, and Structures (Location and Descriptions) ld Location of Property Lines 16 Existing System Location IZ( Address Number and Road Name Wi Current Surface Elevation of Wetlands and Navigable Waters WI CST, Owner and Property Information C6 North Arrow AUG 072025 Bayflold Co. Planning and Zoning Agency Fee: RI Certified Soil Tests - Review & Filing Fee $ 50.00 u/forms/sanitary/checklist/checklistforests BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) ff1 Check List t1 Original Sanitary Application (Submitted In Deed Holders Name — nnt prospective buyers) (383.21(1)1.) EEl Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) l Original Plot Plan (383.22(2)2. 3. & 4.a) It Cross Section, Over -Head Profile of the System -.pd_ Schematic of Tank from Manufacturer ❑ Pump Tank Diagram, Alarm and Pump Curve (when applicable) 9 Contingency Plan / Management Plan (383.22-3(2)(b)1.f.) Lf Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) ❑ Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) ❑ Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) ❑ ATU Servicing Agreement (Recorded at Reg. of Deeds) I1 Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) l. Cc Ip eta Set: of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) 1' Soil and Site Evaluation Report (383.22-3(2)(b)1.e.) ❑ State Plan Review (when applicable) ❑ Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) l l I Application Information must Include: O 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) l Project Address or Road Name where driveway is/will come off of) EEl (Owners Phone Number) EEl' II Type of Building ( III Type of Permit %i IV Type of POWTS System L�1 V Dispersal / Treatment Area Information EEl VI Tank Information l' VII Responsibility Statement (Plumber's Information) 13 *Date Stamp* Plot Plan: (To Scale or To Dimension) fsignature and Plumber Information 10 Surface Elevation of Body of Water ® Direction and Percent Land Slope I' Tank and Filter Information and Location ' Wetlands / Navigable Bodies of Water EEl Absorption Area (Proposed and Existing) 19 Bench Mark (Location, Elevation and Description) V Component Manual Version graan"o��e1�!e_iln���bi RE CE VED AUG 07 2025 Bayfield Co. Planning and c.nirg Agency l' Address Number and Road Cif North Arrow @f Contour Lines ®' Structures and Driveways [f1 Boring Locations ( Property Lines EEl Well Locations ['l Legal Descriptions Turn Over ► \ t•, n Q air 6 G7/t IA `''' t :�6i U L'b f'( C:L'1 f: �15OE+ •U' /�� 1 GL. tr. „ f&.1c!*rn1z#n? ( l�ir ��, • � o � � � f� �� Jr� ir��.J. . ` 6,rs°� ffirL 4r �J d'"� '�+G�J �� � L3 f� � I: � � .,i �. J,".. �j crest 94 r � affi, rf l 1 F Z 1 e�e. ; .O1 . � 3 1)/ � '•�1 � � ,, ���d � l r �'� Sys' e# C! e%/o T7,s�. • C sr Zz'Od>t/C " � ' a tf" L.fd' : h ` � o ��P`r' c��� r. s 5 b � 1 �� yt due �5F C,fa�t�wtr,$ �• 0 74� °''��•� .'.g� q�,, �+ 1 a �Z '•-��y� � �r^._ � �.���� e �-�IJ� ��! .• of ��, Y K a �'"��. lfJtct�Z i �ra i � "f'. r �. �iL9� f,,. s� ✓'�).j 411f�" � r• ' �rq►��}iV'..rtr. 1 0 '7 / C.v lC� f/I I9 I T I I �fiG.7ri�'. � G1. • � �'� ' f �'j �� f 4� P t s 1Ci i :r' '� V� !:!.{��+0 �l�L ri Iy) `" �6'l ..e f ..� A S P S l �'f C r r mode / ' (: '.sTAT� a �jpta a •.► . '� 1® H fie,. a +d tl 4 L ': p�. ,, A i'JOl ID I -Y fda �. �► .� ►�, ' +� ' �, C. o . A d. o 1 s bya Q� �l t� r l-� a r 4 cs Al f/ \ - 0A� bDI'NAG `O c /5.) ' d\/ .:' N ' © 1/o •'5, Har,4 Lake. J1ev: Prr1 AVA614 we i-f VIA ;.r�s •��es' Tyr r' LL1 C 1 '5 . 1f20 Loo ©ti.sft-� La. sThI (a1 C.c, 9z0 31 f!4 2' J 3 16 ,tea p-.— ch,: • t FzECEWED w u+ I- 0 AUG 07 2025 Bayfield Co. PIanr n;; ond, Waning Agency �1D�•er �oo�to P. tit ---L.w z Jj: Lo.g a r�� ��'a d� ...;,_ • �,J I r°.'P 6o �*L'f3 zS27-ry7N rg wd fig Lmf'tJ Cs i Zgi Le5�. �•Th�r�o 0 �a� Sri r• any Sew% l�hJra•d Y R ; v L r 1 •. a� �l � ' d�C1; y7e (t 46tfrt 94; rtiM r�•s Ii a TOP VIEW CD MI SIDE VIEW N WLP750-MR D 6 TANK SPECIFICATIONS _;, O ', 0 DIMENSIONS: WALL: 2 1/2" BOTTOM: 3" 4 COVER: 4" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: DOME COVER 61" O.D. FLAT COVER 53 1/4" O.D. OUTSIDE DIAMETER: 84" O.D. BELOW INLET: 42" O.D. 4" CAST -A -SEAL LIQUID LEVEL: 37" WEIGHT: 6,150 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET, CAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 20.28 GAL/IN HOLDING TANK: ACTUAL CAPACITY: 790 GALLONS OUTLET HOLE PLUGGED LOADING DESIGN: 8' 0" UNSATURATED SOIL OPTIONAL FLAT COVER TANK CAN BE USED AS: IS AVAILABLE FOR EXCHANGE SEPTIC/ HOLDING/ PUMP OR SIPHON FOR DOME COVER. COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) OUTLET CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: W 0 - i Bib (O 8 to z 00 I o ILIc� N .J3 Q DN Q r U d w (/) w > U) w Ix SHEET NO. OF. "Z 1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN 'FILE INFORMATION Owner t1 D 1 pIiljhJ r ' r rr L e,evc Permit # DESIGN PAPAMrTcDQ Number of Bedrooms a ❑ NA Number of Public Facility Units X NA Estimated (average) flow Z- o d gal/day Design (peak) flow - (Estimated x 1.5) 3 al/da In Situ Soil Application Rate . 7 ga /da /ft2 Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) ≤30 mg/L Biochemical Oxygen Demand (BOD5) ≤220 mg/L CM NA Total Suspended Solids (TSS) ≤150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BOD5) ≤30 mg/L Total Suspended Solids (TSS) ≤30 mg/L ® NA Fecal Coliform (geometric mean) ≤104 cfu/100m1 Maximum Effluent Particle Size '4 in dia. gg NA Other: � NA - ----- vr• .........,.�«O vva 'ww�iwr dna Septic tanK effluent. MAINTENANCE SCHEDULE Service Event Inspect condition of tank(s) Pump out contents of tank(s) Inspect dispersal cell(s) Clean effluent filter Inspect pump, pump controls & alarm Flush laterals and pressure test SVSTfrM CDRr'!ICIr%ATie uio Page I of Z Tank Manufacturer 1JJi o S.se r ( 4C.. 0 NA ❑ Septic 0 Dose 0 Holding vol. ? S O gal Tank Manufacturer 29 NA ❑ Septic 0 Dose 0 Holding vol. gal Effluent Filter Manufacturer Pc 1 Y 1 c C. ❑ NA Effluent Filter Model PL. 52 ≤ Pump Manufacturer NA Pump Model Pretreatment Unit P§ NA ❑ Sand/Gravel Filter ❑ Peat Filter ❑ Mechanical Aeration 0 Wetland ❑ Disinfection ❑ Other: Manufacturer -r fV E Dispersal Cell(s) C1 In -Ground (gravity) �1 0 NA AUGCiiW' A (pressurized) ❑ At -Grade 0 Mod ❑ Drip -Line d1tlP� Agency Other: I NA Other: �I NA Service Frequency At least once every: year(s onth(s) (Maximum 3 years) 0 NA When combined sludge and scum equals one-third (1) of tank volume !J When the high water alarm is activated ❑ NA At least once every: .3I year(s)s) (MaxImum 3 years) 0 NA At least once every: ® year(s()s) ❑ NA At least once every: ® year(s,�s) 0 NA At least once every: o ymo ear(s)nth(s) ® NA At least once every: omo yearts(s) Ii NA IN NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an Individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator inspections must include a visual inspection of the tank(s) to identify any missing or brokn ardware, ientify any (cracks ror leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third ('f3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at Intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (12/02) S-9O(g2-Z Private Sewage System Maintenance Agreement Owner(s) Name Owner(s) Mailing Address —124? 1...uo kou l*r� -c. C cl Site Address CIS'-lo�r-�-l.� Tax ID # 19 7 -o 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 114 Section 2 Township ,7 N. Range W, Additional Legal Description: _ .S e e 4':::: I/ I l k P,c f Town of 'TV-. K •i." v -er (Acreage) Gov't Lot Lot Block Subdivision Lot CSM # Vol. Page CSM Doc # DOCUMENT NUMBER 2025R-608690 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED O8/O7/2O25 AT 1 1 :37 AM RECORDING FEE: $30.00 PAGES: 4 AUG 082025 Bayfiel'J Co. Planning and Zor. ng Agency Recording Area Return To: 'Z'iia'1 tF* In -ground gravity O In -ground dosed O 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, 0, 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 pending 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. Owner(s) agree that failure to comply with this agreement will result In action being taken to pay all charges and costs Incurred by Sayfield 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. Bayfleld County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. The terms and conditions of the agreement shall be binding upon and Inure to the benefit of all current and future owners of such property. �t,�1t11 ItN/lye Owner(s) Name(s) — Please Print Subscribed and sworn to before me on this date: J, 2?]!,, Z0Z.s , • oT Not ed Owner(s) Ignat a{s) -� .--� Notary P My m Sion Expire • C s • . ��i�rr�iOF Drafted by: (ro 1./c o5 K-.' Date: `� - Proofed by: rf informs/sanitary/septicmaintenceagreement Revised July 2020 PLAT OF SURVEY o� o 91r LOT t OFCSM#281 LESS SECTION 27 7'OrY SHI ORT t LOTS z 6 3, N ` p� TOWNOF IRON RIVER BAYFJF.L D COUNTY. WISCONSIM ins t T BEARINGS AREGRIDB4SED WCCS-BAVRE D COUNTY-NAD83 (2011) WITH TIES L NE OF TI ENVY. MEASURED TO BEAR \\ NOIt7HY CORNER IZa a SOEI5m'E FO. 1' OD. IRON PIPE �• . \\\ SLR Hx 23 � CL a °s N. ` \\ S90001 O'W � cq \\ 482.31' U 03 ASPHALN� C ORNEw"TY A ' ,�,, •0 PARCEL 1Ij 293,700 Sq.FL t ' 674Acrmst I �n CENTERY. CORNER SEC. 27, T47NL R8W PD. rAIQESHAFT SURVEYOR'S CERTTRCATE. 1, PA772Ap(A MCKU9V, WISCONSIN PRO�IONAL LAND SURVEYOR 5,2892 DO HEREBY CERTIFY THATTHIS MAP WAS MADEAT THEDIRECTION OFADAM YLASATY, AGENT FOR THE Uw$ �w 1 ABOVE DESCRIBED AND MAPPED PARCELS, AND THE INFORMATION SHOWN ON TEAS MAP IS �I o CORRECTANDACCURATE TO THE BEST OFMYIWOWLEDGEANDBEUEFANDMEETS THE o MINIMUM STANDARD REQUIREMENTS FOR SURVEYS UNDERAE-7 OF WISCONSINADMINISTPATTYE CODE c DATED THIS DAY OF � a QTIES SE PINE RIDGE LAND SURVEYING, 0 LLC. PATPJCKA MCKUEN WI PLS. S,2902 SEED O W aF L.P.TANIIJ LINE TABLE n I LINE I BEARING I DISTANCEN N LEGEND o L7 S58'19'35'E 214.70' Isspic L2 I.J aLL O t0 —FD. 1 1/4r O.D. IRON PIPE • Z p • �x 982'11'401Y 199.78' > F- o z li (UNLESS NOTED OTHERWISE) f7$ L2 HOUSE LU spur -PAIL g a Rg ( ) -PREVIOUSLY RECORDED AS " Fa r o.D. IRON PIPE 6 8 . K 3o' TEYB lat+HwAT13ihIARKBMPftOJmfATEANO FORRI r- T'nC APPRCE200' SBJOOILY. i 0 200' 400' 600' ;„ � ALAICEOORW1�VIGAZLE �EThE WJECTTTOl � S(iALE FEET I MARC EMAS TRUSTtNDERARBIEwATFRBTHATis TED UIiDFRARTICLE OI, SECTION I OFTHE ESATE VI CO 8TATECOHSTRUfgK NO. OF 1 Number I QUIT CLAIM DEED Arnold M. Whitman and Terri L. Lundberg. husband and wife. Grantors, quit claim to Arnold Whitman and Terri' Lundberg, as Trustees of the Whitman -Lundberg Estate Planning (Revocable) Trust dated August 2, 2019, Grantees the following described real estate, together with the rents, profits; fixtures and other appurtenance interests in Bayfield County, State of Wisconsin: Lot One (1) of Certified Survey Map No. 000281 as recorded in the Hayfield County Registry, in Volume 3 of Certified Survey Map on Page 72 as Document No. 329352, LESS the Easterly 25 feet thereof, being a part of Government Lots Two (2) and Three (3), Section Twenty-seven (27), Township Forty-seven (47) North, Range Eight (8) West, Town of Iron River, Bayfield County, Wisconsin. This is not homestead property. Dated this 5 day of ` 1 l.AJL - 2020. *2020R-583182 1* 20208-583182 • DENISE TARASEWICZ BAYFIELD COUNTY, WI REGISTER OF DEEDS 07/17/2020 09:38AM IF EXEMPT #: 16 RECORDING FEE: 30.00 PAGES: 1 Mitchell A. Routh Torvinen, Jones, Routh, Torvinen & Saunders, S.C. 823 Belknap Street. Suite #222 Superior, WI 54880 04-024-2-47-08-27-2 05-002-02000 (Parcel Identification Number) This transfer is • mpt fro! the Wisconsin Real Estate Transfer Fee per §77.25(16), Wis. Stats. Id M. Whitman, Grantor State of Gm fenrlr` w OnrtS tm ) ) ss. County of `.1 ) erri L. Luuprg, Q#tor ACKNOWLEDGMENT On - 5 , 2020, before 4,a� t, Notary Public, personally appeared, Arnold M. Whitman and Terri L. Lundberg, proved to me on the basis of satisfactory evidence to be the persons whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their authorized capacities, and that by their signatures on this instrument the persons, or the entity upon behalf of which the persons acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. TNES S my h n_dc� id aoflie ial seal. gE C �V E D �'trO Signature --� _ (Seal) AUG Q- 8 2025 `'•cptf.a.. Sayfieli Co. This instrument was drafted by: planning and zoning Agency Mitchell A. Routh PAMELA M HEGSTROM Torvinen. Jones, Routh, Torvinen & Saunders, S.C. Notary Public 923 Belknap Street, Suite 222 State of Wisconsin Superior, Wisconsin 54880 Firefox https://novus.bayfieldcounty.wi.gov/access/REAL%2OESTATE/listin... Real.Estate Bayfield County Property Listing Today's Date: 8/7/2025 Property Status: Current Created On: 3/15/2006 1:15:34 PM i Description Updated: 8/4/2020 Ownership Updated: 8/4/2020 Tax ID: 19740 ARNOLD M WHITMAN TRUSTEE LA JOLLA CA PIN: 04-024-2-47-08-27-2 05-002-02000 TERRI L LUNDBERG TRUSTEE LA JOLLA CA Legacy PIN: 024106801000 Map ID: Kling_Address- Mailing Address: Municipality: (024) TOWN OF IRON RIVER WHITMAN, ARNOLD M & WHITMAN, ARNOLD M & STR: S27 T47N R08W LUNDBERG, TERRI L LUNDBERG, TERRI L Description: LOT 1 CSM #281 IN V.3 P.72 LESS E 25' 7820 LOOKOUT DR LA JOLLA CA 92037 7820 LOOKOUT DR LA JOLLA CA 92037 THEREOF (LOCATED IN GOVT LOTS 2 & 3) IN DOC 2020R-583182 540 (WHITMAN-LUNDBERG ESTATE ,P Site Address * indicates Private Road PLANNING REV TRUST DTD 08/02/2019) 65915 HART LAKE RD IRON RIVER 54847 Recorded Acres: 7.500 Calculated Acres: 6.782 Pro erty Assessment Updated: 8/19/2024 Lottery Claims: 0 First Dollar: Yes 2025 Assessment Detail Zoning: (R-i) Residential -1 Code Acres Land Imp. ESN: 118 Gi-RESIDENTIAL 7.500 336,300 709,100 Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 024 TOWN OF IRON RIVER 163297 SCHL-MAPLE 001700 TECHNICAL COLLEGE Recorded Documents Updated: 5/11/2012 O QUIT CLAIM DEED Date Recorded: 7/17/2020 2020R-5831.82 ® SPECIAL WARRANTY DEED Date Recorded: 1/11/2013 2013R-547700 1099-189 ® SHERIFFS DEED ON FORECLOSURE Date Recorded: 1/25/2012 2012R-542140 1075-800 ® JUDGMENT Date Recorded: 2/11/2011 2011R-537244 1057-811 ® CONVERSION Date Recorded: 3/15/2006 426-358;500-409;519-390 2 -Year Comparison 2024 2025 Change Land: 336,300 336,300 0.0% Improved: 709,100 709,100 0.0% Total: 1,045,400 1,045,400 0.0% tilil' Property History N/A BaY11eid CO eoc j ptannin9 and'onu cj �;g _r I R/7/2025. 11.37 AM ` t a Wisconsin Department of Safety and Professional Services • r Division of industryServices 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. SEMI TEST Page l of 3 Sg - Q3IL County.7ft f Parcel I.D. ` .FcekT1 197LI0 Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). ✓ / AI Property Owner < �, Property Location r n o 14 UJ A r �m41Z Q t/Irr L Jva 4 ltr I lr"Vftee Govt. Lot Z$, +/ '/ S Z? T tf 7 N R E (or) V) Property Owner's Mailing Ad ress Site Address or CSM and Lot #: gD Loo !Co rt- b r L.of -'01 4Si z8( Lass F z5'Tf1erye of I £ity / State Zip Code Phone Number ❑ City ❑ VillaQe ® Town Nearest Road �o�lal Lea 77.b37 (-71),& ' .rofr ?g(J V 1,14r+LaL tic ® New Construction Use: [9 Residential/ Numberof bedrooms 2_ Code derived designflow rate..?0 a GPD J Replacement , ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft. Parent material 6j.L,.a' ( 1'8 11 9 bi 5 ewf- hDn ���s�"d�12 so %j vt3 Z 3�c rm.. 4s SIZ��� General comments and recommendations: 8o p h ( y Boring # OBoring Spit Ground surface eiev./deft. Depth to limiting factor) ' © in. / eiev. ft. h 4.`ai3 n i ._afinn Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots AUG GPD/Ft2 * *Eff#2 L I /U�° LS # t ( ?fl4:v. .� I�'t a id Zf,,Trg A. enk, 5$! 10 5 Y g. a"f s rn L• -- /4 Boring # Boring J JPit Ground surface elev.j'.0ft. Depth to limiting factor in. / eiev. ft. Anil Annifnatlnn 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 I O-≤' Jo /'/i o,' $L � 1q ♦ �w P3 v 7`' 4.s .{ & 3 2 �U7jy4 art.! c k t -S ! w« M J r c S 2• 7 _ 3 217 SIX 6/ /''' S l n .._ r 7 �• (O CST Name (Please Print �/ Signature CST Number 22 90 ifs � Address •P O. BE, k. CZ -2- JDate ir�.n Revev to C ≤'(V' Evaluation Conducted �— v -z -.S~ Telephone Number 'i'a- Zg2P *d≤"a ` Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = BOD, S 30 mglL and TSS 530 mglL SBD-8330 (R04/21) ! Z 1 .o '�� a .� I &�� 3a�; ;I j ,.:Gd'iU t�l tt:c•�e,". ,%use a=� �•` ;' j r l ,, 6 7 j/ttQ 6i�t n n e I `Jv6t �:i 1:1: ;C..f.�lp "' "7® �L �� i/'�� I 1 G 1�`'a b 'i "-� _ � � a i � �elv i`. �E, w✓��%�v� �2.cg Y' ll ��� ��i I D tci '„'�,Ja.dh ' • j ►Zvi •.� {' .� 11i.h,. s �I r• : I71d JJk p {i:i`�!f• i/�[dho��" !(�,`" . �a S b 'n" C• C,•.r' (S/�''�rL7f9�(Ktf►+ 6���) v 1e 1 1 I1 1 p,qi s� 0.�r l J (' l' '! F"? 5 0 ' • � g-��� �d •ems : q'7 , 5" %y �s�b gQ lI b1 we asew ,Gve.4e n gP'" L4�"vM ' /� 1� �r L�� / •� �l�+ 4�Lii+N�31d�`. 'f I 'JCi�''�t'�'�1"" 1 �P!'8�7r `" 1s„' 3f'A ' L.. FilanI ,-a.IcL. "ye+ f Gty) Ile— i��1 7 / I t�[w tii�o�V1+L! �.k 7 t`i+! �a f� r.i /-�"! �'Y ) �t 4� tiita'fi. f3 S a 1 ' i' lei ��� 'o • e MID•• t ac.� i�r� i�c�o-Zi tC��.� v =ir�eGa6©M9 �'tt.61c� lat/ ; }� �e► A - . / s' k w d e. l -P r ..�' iii C"i �•I 'F: '3 �'1%t� 4. �r � ir•'-1 1 'F• <<+. o�d !•r•, �'�W���® t p �k sji q P J E. �• P ' e `a M r d'67 i ua � � L► °� � i K . a er Cp p o 4 r lry7 *3i c.L 'P� v"t� !.a . r +2'''' �. // \O ,/1 /1'q' C���4w,\V VC JCV 7 i4r4 Lake 51e✓- �6©& crvioIA pro LooIA' i+' •b , ,.Cf. J oI I a, Cc., c11037 3.7 S, a YP.c v f,, t 3 Ja 9 slope Nr .... VED Ai.ji7 0,7 2025 Bayrield Co. Pwnfjand Zoning Agency ST r, e$ "f' ( �lyw -••• db,,,•'r'tttt1► ')'M �«. �M, �r:l r.r'" . 5 r 1, •t'� • � • c t-' ..� V �. �4 ••S,J � p. d p.4.';P*IdJ/d " G•�.. L''. ��� 1r v Fi, ,- w •t• � •i}: SL 6a s'ec.27"" fl 7N R sf W a r: , ►� ,�.._ 'w" �... �, _ L'f i LSM Zg/ LES .E J J-.�7 ' se. s' 6rrZ0 ��1 •try � �� J r� i' I� l ( �✓� �"t CCC ��`� ��' A'� (.xL4;16�� a� 11+E.`.�i qY 6 1 V �. � � � C! ► �• .i�'�" o aim •'�f��� n �' B� •� ' Department of Safety County a a `_.-� ` & Professional Services ° Sanitary Permit amber (to be filled in by Co.) Industry Serviices.Divvission a Sanitary Permit Application Smtu arnnsaction 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 Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary F/cc I purposes in accordance with the Privacy Law, s. 15.04(1)(nr), Stats. &51 1 s-F/cc r'+ k'e I. Application Information —Please Print All Information Property Owner's Name Parcel N r 0�� �"I "('err;LjJ9e !✓-vs4et?S la1`l7'{0 Property Owner's Mailing Address Property Locu(ion� 00G�j - f - b ZS City, Loo �L oU Govt. Lot Zf3 Less F y Zip Code Phone Numberl-ci—r— TGsC rC e F fO/le Cc !7Z0'73 770 3-30-1f100 i, Section 27 1I. Type of Builds g (check all that apply) Lot 4 T N R IK I or Family Dwelling —Number of Bedroom. I'a 1 l Subdivision Name O Public/Conumercial— Describe Use - Block!? ❑ State Owned — Describe Use ❑ City of CSM Number ❑ Village of CC zOl 09 Townof A J•el _ III. Type of PO�VTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if a livable. A. ® New System y ❑ Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B. El Holding Tank ff in -Ground ❑ At -Grade I ❑ Mound ❑ Individual Site Design I ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber 8 Transfer to New Owner List Previous Permit Number and Dn Issued Expiration i3 -%s 9/)77 003 IV. DLsnnrsnllTranrmnnt A..,- ,.-a T__r. r_e—_..___ _ t 3 e o • % '� 3 O --...__ o r_ow ,,., qs ,•, ,,, cinva,ran 913_ Tank Information Capacity in Gallons Total Gallons II of Units Manufacturer `? New Tanks Existing Tank, c V O m Septic er 4eMMg Tank 2-7 .50 — lSOv 2 t,flt.set, Co✓kL2 U ✓ iii en iz o n. V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Ailah ToI t05k' Plumber's Sig re ifP/MPRS Number Business Phone Number 2200/O 71Szya-4l, Plumber's Address (Street, City, Slate, Zip Code) JD. Box $-zv y ✓drl `RL ✓ter [ S f8Y7 Approved O Disapproved Permit Fee Date Issued rap L Issuin • Ag Ign rc ❑ Owner Given Reason for Daniel fr'G) Conditions of Approval/Reasons for Disapproval Scx- a -a -&c4 A4 - Attach to SBD-6398 (R. 03/22) RECEIVED system and submit to the Cannly only on paper not less than 111/2 x II Inches In ei,e nub U I LUZ5 Bayfield Co. Planning and Zcoi;;g Agency ��xnArar�,� I Wisconsin Department of Safety and Professional Services Page of 3 Division of industry Services Per SOIL EVALUATION REPORT - 0031 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, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. 4(� 7 l� scale or dimensions, north arrow, and location and distance to nearest road. 1 c. 4k Please print all information. Revi we Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). / I Property Owner < .� Property Location r no 1 lrvtQrt/10-,IrrVi i' v� rev I iruftee Govt. Lot Zf3 +/ '/4 S 7i4' 7 N R E_(or) lS Property Owner's Mailing Ad ress Site Address or CSM and Lot #: �1 o Loo /Co v-" D r t, of j,1 _S j'►�i 2 S ( L ss ;E 25 Tit vie o f ity State I Zip Code I Phone Number ❑ City ❑ Vii lane ® Town I Nearest Road Jo fal C a_I'?-037 (7'!p )'4 Dry f r a +� tl €. v' LINewConstruction Use: Residential/Number of bedrooms Z. Code derived designflowrate...?0 GPD D Replacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft. Parent material 6.d.. d 4 ( e II I General comments and recommendations: Bo b (+4 Q 5 o v S i v► j Z 3£ r w%•S R S S 2 ti o&-Il Boring I Boring # pit Ground surface elev.f0Zft. Depth to limiting factor)' 0 in. / elev. ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots AUG `.,/+-AVM VII I �Y•V GPD/Ft2 O*?O2*Eff#2 D JVo N•P _ , 7�,\ Z 'z- t2 a N L' � 2 qrvi- 3_5!1O S'-4 °eve s O Y)1 U 14 1 I_aBoring # ❑Boring / `T jJPit Ground surface elev. ft. Depth to limiting factor, 1 _in. / elev. ft. 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 I O-≤' 1O I 3 G Sl- q -fa rit y V 4.5 3C0 r ,-7 . Z 7.I'l�- L4 I� Once -5 J v'- M J r C -S Z 7 1- 3 2 1-i7 -519- $-lS' j 1 S K o --i, F £7 /• ( CST fume (Please „Print) I k s k Signature ( ?.A-1 CST Number f ( i Address po &2<Z. u' w W' C ≤ .',. Date Evaluation Conducted 7_ o— z .S~ I Telephone Number 7I≤_ a.9z-- *1 S ' * Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2= BOO, 5 30 mg/L and TSS 5 30 mg/L SBD-8330 (R04/21) /'i'+' d F} 11 b Pl r*w.4�... JI b1►:�tu /re: �w.p I w • ✓l 14i Of,f P fj «+ ;. '�•-rte .•Jsy E,�� l% t's69 �" ai ( C. C 1 ^r���• ' • r rG,•+ ,.� �; .� �+�.�,r . K, •ty �•' _ .p 8 d V 'A p •"r Ellen. f cvcf� (!� ����+'+ -n. C. �"' G1 �'' If�Yt`=•7f��i.� ? IvjjZ) 5 5- e#n 6!i •Lv J7.-' C sr 2dcic, $ o g¢P4`Y 14 75?� gs j Je�� +uui r�sep t4e m (P" L4f" I v► y• .� f Q L., J �[ ?►�?' G. Ne:w1c�1�/'.SS%�12G',S'•°oIf�Lr�'-'(�"FL• r'+�u',�+ ,.ra,rs'. r�,'�"v8'�•:.,•+e,+.o��"o q�T 1 ;� D� YO'� 7 ( f/✓fi. tija Ii18 '� rJ C7+� sF9 e^�i �•�GI+ {9n{+'i f Gr4E 1 +'+fr 4C�1:r"r�'�' v o(1(�; y1}f►d� i7R) /n :�lyj 4.Q W 1 •.t A sps . .d ./��.' /i E r ' . 1 rr. ej �� El �•\-• ri". '..� t' i'.."' t�2 G�, 0.1.' r'i� 7 ~ {r •'�•�''• Cap `. j}p ! 1.• v �'•p�ly V� /rF #p . '& 7r '•d • '/f Lh pis . f' • %t. i�,� A i-rnl i •.. 4a'�,tt pa f, �� �r vrL 6�.�~�� o s s th' 0 .I'm 3 � �L(`'�vt:+ � e c.• ,rvbC$'�'t t�d�+�.���• Lae tc� F 1/�a ♦ .vv /f t+ v v 40/' : - c. (? \X :'\J /1 14a r4 La, j,C2 Pf©p riy Ou er �orv�o�� k��►���h i�r�s�'��eS' 7a Loo ©Lrt .fit 9x•03,7 �dS �(� c j %'�'•c nr ,'r( y°:,, 2 � `�•C5 4 W,`�r 94 -`r A681 07 2025 8ayfield Co. frn:_, 2nd 'onir,g Agency mss" `iiiGOj•• f` f.s ,. • -'' _'1,%Ic.4cry:�,�a:e Gaf',. �rC J*I4Th≥1 5e- 27-ry N R s' w `k .t "�'W-• `4 � .. ,� cr Laf ff s' Zg/ Less'.E a. 'T f c i of J-- a v r l k jq41 •� -st.�' �,:✓r.3 � �' � f / J �'fI d'd C�J61���vfL�,:,' '� y f • C �r... r.A + ...0 n 'May. 5. 2017 10:41AM BAYFIELD CO PLANNING & ZONING No.9975 P. 3 PAGE I OF "7 In -Ground Gravity Plan Index & Cover Sheet Component Manuel Design References: Version 2.0, SBD-10705-P (N.01/01, R. 10112) PgIofi Pg 2 of i' Pg3ofI Pg 4 of -7 Index & Cover Sheet Plot Plan h. s C4'ot Section & Plan View Management Plan Attachments: Enclosures: 5- ,f POWTS Application for Review ( Set K: ic Soil Evaluation Report & Site Map ' a 4�ti a k -e. Project Name / Description Y e, e12 r -- � �vv 5fi 5 Owner Name(s): rn ° 1 - �� S 4 s1/i. Y r � �v n �6 Pho e: "770 - 331) - L( /00 Owner Address: 712-0 Loo ko4 11c L4To 1 i Zip: 9 Z& `7 3 Project Address: to $ 9 I .S- /4c r -LLI-e, p. 1 ' a &n . i.- e v tLT cJ' V '7 P. Govt. Lot 7- s3 brk'.. i3i79/ tess2 "Section ? T 7 N -R t E ❑ ar W Township: i.ey County: 'e- Q Project Parcel ID #: �- : D j q `7 Y! 0 Designer Information Designer Name: A 1(' 7© / ICo s k . Phone: 7/ 4- - lZ - rip Designer Address: _Po. v�J 3 aK S?? yrp� `Rec� '..J'..J2:� _V1 -o Zlp:SY'`'"7 E-mail: 4o -/ e- b ems, rrc, w e o e�f `� n o w� This spare reserved for approval stamp. License Number: ??0 o 910 RECEIVED Remarks: AUG 072025 Bayfieti Co. Planning a^d Zun;irc Agency Signature:. "`' l Date: gt l " nature required on each submiaed copy. BAYFIELD COUNTY • CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): 16 Check List l Index Page / Title Sheet (Optional) m Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) E1 Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Rein (Include the following Information) E Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used Il Property Owner's Information (not prospective buyer's name) ® Property Location (Accurate Legal Description with Sec/Twp/Range) 2I Road Name (where driveway is/will be coming off of) Rl Floodplain Elevation, Flow Rate, Comments and Recommendations t�J Complete Soil Boring / Pit Information E?J Date Soil Evaluation was conducted L CST Name, Signature, Number, Address and Phone Number O *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) iJ Bench Mark (Description, Elevation and Location) Si Contour Lines (Example = 98.0' /96.0' /94.0') m Property Location (Sec/Twp/Range/, Accurate Legal Description) 9 Borings (Locations and Elevations) Lii Percent and Direction of Land Slope Si Well Location (Including Neighboring Wells, if applicable) U Location of Wetland Areas, Floodplain and Navigable Waters Si Buildings, Driveways, and Structures (Location and Descriptions) IZI Location of Property Lines C( Existing System Location i2( Address Number and Road Name Si Current Surface Elevation of Wetlands and Navigable Waters Ed CST, Owner and Property Information (?1 North Arrow AUG 07 2025 Bayfi&J Co. Planning and Zcnjrg: Agency F Fee: Eli Certified Soil Tests - Review & Filing Fee $ 50.00 u/forms/sanitary/checkiist/checkiistforests C o ,' J 'e_'n. -r' o vI ci ( BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) Idi Check List Cd Original Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.) Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) B' Original Plot Plan (383.22(2)2. 3. & 4.a) 06 Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer ❑ Pump Tank Diagram, Alarm and Pump Curve (when applicable) III Contingency Plan / Management Plan (383.22-3(2)(b)1.f.) GT Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(S),(6) (Recorded at Reg. of Deeds) ❑ Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) ❑ Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) ❑ ATU Servicing Agreement (Recorded at Reg. of Deeds) Gtt Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) Q . Comlete Set of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all conies) Q' Soil and Site Evaluation Report (383.22-3(2)(b)1.e.) ❑ State Plan Review (when applicable) ❑ Copy of Warranty/Quit Claim Deed (Optional) Sanitary ADDlication: (Include the following Information) [2< I Application Information must Include: O 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) O Project Address Q Road Name where driveway is/will come off of) fT II Type of Building lif III Type of Permit 56 IV Type of POWTS System f V Dispersal / Treatment Area Information d VI Tank Information 121 VII Responsibility Statement (Plumber's Information) O *Date Stamp* Plot Plan: (To Scale or To Dimension) Cif Signature and Plumber Information I Surface Elevation of Body of Water I i Direction and Percent Land Slope 10' Tank and Filter Information and Location 5 Wetlands / Navigable Bodies of Water 9 Absorption Area (Proposed and Existing) Q Bench Mark (Location, Elevation and Description) O (Owners Phone Number) ,EC ED AUG07 7 2025 hayfield Co. Planning and Zoning Agency 9 Address Number and Road @1 North Arrow 21 Contour Lines 9 Structures and Driveways l Boring Locations I Property Lines Ef Well Locations d Component Manual Version E] Legal Descriptions ❑ Piping Material Information (conveyance line, building sewer line, material type and diameter) Turn Over ► Cross -Section and Over -Head Profile of the Syste : d Surface and System Elevation Q Position of Observation and Vent Pipes O Dimensions and Depths 0 Make, Model & Number of Chamber Units In each Cell Property Information ❑ How many systems will there be on this parcel of land? I ❑ Has this property been split? (Property Statement shows Property History) F es; O Private Sewage System (Septic Tanks) $ 400.00 ❑ Private Sewage System (Holding Tanks) $ 400.00 ❑ Mounds or Systems requiring Pre -Treatment $ 500.00 O Sanitary Revisions $ 25.00 ❑ Private Sewage System Reconnection $ 50.00 and Private Interceptor ❑ Return Inspection $ 50.00 O Maintenance Agreements $ 30.00 (checks made out to Reg of Deeds) u/farms/checklists/cheddistforsanitaryapps (10/2009);(®7/2011);(®2/2012)(®5/2/2012 -dc) Proofed by: •{,i • {7{ es. Safi Oomcjh�.;, J� .¢.• / ` I !J'h�e••��e�`r Dtr"o., '�`r AOIr< I r t�Ge �Go 1'�=+^/OI+id fG5v b'EJ�G�CA (>�61 V•Cv1 (t.`1 (: due f4 ,� " n y=A�% Pl CK STnZ �� ! r •'N . ` K= y a ✓YI. /b;b.¢,x..i'a'/" i'E'ua•i. L"ua / dl a'c. �n ( c✓wa tree HB'I? ern, g JRP= /cv leso.o!(ahbri, Still —1c O5'4C'. l/Afs oflz). ;flQ$. $. 2goeg0 S'ys4'ea GI e"✓:qi,5' C. ST d Lau e5C. �.�• , S; 5PkTa ;tn6/s e5 'LSD ga!!°,i �w;eser coiiGve•be- 8K" LriCf "n✓, �.,, d b° /?1/o %/7 L7 ° / to Cl.cetLarSjx�B.f "eyed+h'-X187"L¢.nat-/w.O/4e1'od �" �. �•,: .,;;: f. t a <.la�f Ay7TI( IT '�f''E 101 �eI' 4 ?ifta,�l y;d&.-J. lt e'd � �i , H�a� / . i;��1 lea�Ia,• � ,n u'c� o.✓�+ecau�mf+(•,c�a�e wr, /' SP53313 5'ed.¢.c ov Juer'J.a,.,r - rSr. r .sfafea4 a./Prove G Ies,{�dfiokn ed€/ ,. mpj_f3 " pp/i Sj1 yD i,vC. W•j'�e. ay t�7-rni ni ,'0.a it. (1 ^a iJ l�tl a•� .eL P;("Jd 's 4$,6L7 b�<93q mac.. d4. tN �a /#'Y & -r Ha r -r- Le-tke -_ Prorarr-#y OWttr�er �rND�cI, wHt'Tv41a✓II�ruS'f,eeS. flrr. Lindje Y4/ i,zo LOohcou` 1b•r LetSO1(A/ cl'Z037 _ ,.CAP.. . r-- a t�� Q,_ o f LctI 2sG�tp*i oat° 6D.tLclszr3 Sev✓z7-rp)14 RS W of Lat J LSn'1 at 1.s5S.C'L$' Tkcreof Ic.;a or i-rot lever C -,llMje1 t3ay,-f'iela s$ pr &//r 'PL.I 's- RECEIVED AUG 072025 Bayed Co. planning and Zoning Agency Cape 1r•�vnta4 er Preef c.� P. iprv,`,N,•h. b$ ert.��rl�� �mae 1,_ iii W ¢'fcin a f n` TOP VIEW a LC) 4 o oc N U 4 N- �N �[ j CCUc N V T C o ma Ty Q c a a 4" CAST —A —SEAL WLP750—MR TANK SPECIFICATIONS DIMENSIONS: WALL: 2 1/2" BOTTOM: 3" COVER: 4" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: DOME COVER 61" O.D. FLAT COVER 53 1/4" O.D. OUTSIDE DIAMETER: 84" O.D. BELOW INLET: 42" O.D. LIQUID LEVEL: 37" WEIGHT: 6,150 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET, CAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 20.28 GAL/IN HOLDING TANK: ACTUAL CAPACITY: 790 GALLONS OUTLET HOLE PLUGGED LOADING DESIGN: 8' 0" UNSATURATED SOIL OPTIONAL FLAT COVER TANK CAN BE USED AS: IS AVAILABLE FOR EXCHANGE SEPTIC/ HOLDING/ PUMP OR SIPHON FOR DOME COVER. COVER: MIX DESIGN (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) OUTLET m M PUMP PAD SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: ZI � OF n POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION Owner vnoI WICn rQrrr Lew Le Permit # DESIGN PARAMETERS Number of Bedrooms Z O NA Number of Public Facility Units NA Estimated (average) flow Zoo gal/day Design (peak) flow = (Estimated x 1.5) 3 dp gal/day In Situ Soil Application Rate % al/da /ftz Standard Influent/Effluent Quality Monthly average' Fats, Oil & Grease (FOG) ≤30 mg/L Biochemical Oxygen Demand (BODs) ≤220 mg/L 59 NA Total Suspended Solids (TSS) ≤150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BOD5) 530 mg/L Total Suspended Solids (TSS) ≤30 mg/L I l NA Fecal Coliform (geometric mean) ≤104 ofu/100ml Maximum Effluent Particle Size % In dia. E NA Other: jJ NA ,u, uu„,esuc wastewater and septic tank effluent. Service Event Inspect condition of tank(s) Pump out contents of tank(s) Inspect dispersal cell(s) Clean effluent filter Inspect pump, pump controls & alarm Flush laterals and pressure test SYSTEM SPECIFICATIONS Page C of Z Tank Manufacturer UJ r e.Ser C.cr1C, ❑ NA ❑ Septic O Dose O Holding vol. 7 CO gal Tank Manufacturer IS NA ❑ Septic ❑ Dose ❑ Holding vol. gal Effluent Filter Manufacturer Ptr y 1° c. ❑ NA Effluent Filter Model P L S2 5 Pump Manufacturer K NA Pump Model Pretreatment Unit 21 NA ❑ Sand/Gravel Filter 0 Peat Filter ❑ Mechanical Aeration ❑ Wetland ❑ Disinfection ❑ Other: Manufacturer Dispersal Cell(s) O NA R In -Ground (gravity) f1��ff, AUGEOlr7-GN&% (pressurized) ❑ At -Grade ❑ Drip -Line Pg Agency Other: 9 NA Other: JKI NA At least once every: 1 When combined slu, IJ When the high water At least once every: At least once every: At least once every: At least once every: At least once every: Service and scum equals one-third 'm is activated (Maximum 3 years) ❑ NA fl) of tank volume ❑ NA (Maximum 3 years) ❑ NA ❑ NA ❑ NA E7 NA ® NA R NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank inspections must Include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually Inspected to check the effluent levels In the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third (%) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of ≤12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (12/02) Page P..- of 2. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals that may Impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting In the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist In manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS falls and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another Inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. POWTS INSTALLER POWTS MAINTAINER A Name ljcf,f� �� 1�Si'a E �a��� v��ai�a z, Name/kc'S 1 /kcS?Lv -: Phone • 71 5- 7,di Z-- Q 5 Phone ! ' SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name mho AA a,3 ?� 1 i . kA £re- 4 Name Phone 115 37 2- Phone 7! .c 37 " (9it 38 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. EI EDD CC_ mo/ 22 �11 JJ V to DOCUMENT NUMBER Private Sewage System Maintenance Agreement 2025R-608690 Name DANIEL J. HEFFNER ��� �.y�t.�I f(J�.��•,fJ� I REGISTER OF DEEDS )'Mailing Address WLL-- �t T r�wa BAYFIELD COUNTY. WI L o F'u+ j fL �Vp1kvL C cj RECORDED ress 08/07/2025 AT 11:37 AM I5 1 _ f� t I b� ��r RECORDING FEE. $30.00 K4 Qs � S'r'{g PAGES:4 1`f-7 t{ -O As owner, I (we) do hereby certify the private sewage system will be Installed in accordance with the certified sell testers report and approved plans and specifications on file with Bayfeid 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 2? Township'I-1 N. Range_!_,,W. W. Additional Legal Description: See I/o w / s<f s4 e,.C'I Town of 1 -Iv RZt U tr (Acreage) Gov't Lot Lot _ Block Subdivision Lot _CSM#______ Vol._Page_ CSM Doc RECFIVE2 AUG 082025 Bayfield Co. Planning and Zoning Agency Recor Return To: * ® 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 end 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 (allure 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. Bayfleld County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. The terms and conditions of the agreement shall be binding upon and Inure to the benefit of all current and future owners of such property. 1tlitllllll/1 Owner(s) Name(s) — Please Print � ` a2\ LvNDC-3cPS: Subscribed and sworn to before me on this date: ```kk . . Plr=N �,� � ��--r«.�.�.✓ 3ly Z9}h, ZC1ZS a ``.•�oT Not ed Owner(sy ) ignat e(s) Notary P m GI/p�� t �GG(II^ G,G� ? ��. S �n • B My m slop Ezpire . l..____ ✓✓��-- s �p1jfN�p Drafted byT Yr rf✓ fp / KOS K i Date: 7 —'v9 — Zt I , Proofed by: utforms/sanitary/sepacm a intenceagreement Revised July 2020 N 4 s BEARJBEJS ELD&& EGRIDfll5® IEEE IINECFTNENWy MEASURED 10 BEAR SW'ISDfE SURVEYOR'S CERnFCME: 1. PAIRICKA MGNEN, WISCONSIN PROFESSIONAL LAND SURVEYORS2592 DO HERESY CERTIFY THAT THIS MAP WAS MADE AT THE DIRECTION OFADMI VLISATY. AGENT FOR TIME ABOVE OESCWSED AND MAPPED PARCELS, AND THE INFORMAIIOH SHOWN ON THIS MAP IS TWIIO ACCURATE TOWS BEST OF MY KNOWIEDiEAND SELIEFMID MEETS THE MINIM UM STANDARD REOUIREAIENTS FOR SURVEYS UNDER AE -1 OF WISCONSIN ADMIMSTR CODE PINE RIDGE LAND SUIIVEYSIG, tic. PATRICKA MGRIEN WI P.1 -S. S2Xr2 LEGEND • -PD. 1 1/4' O.D. IRON PIPE (UNLESS NOTED OTHERWISE) ( )-PRE`AOUSLY RECORDED AS 200' 0 200' 400' 600' SCALE FEET LOTI OF CEM 0281 LESS INSEAST2 ThEREOF` LOOCCA� IN aovswMENTLDIS2 :s SECI1Ni27, TOWNSHIP 4? NORTH, RANGES WEST, TOWN OFIRON RIVER, 84 WIELD COUNTY, WISCONSIN. LINE TABLE LINE BEARING DISTAN LI 8589925'2 214.79 Ii N82.11'49W 189.78 BVRYEYORB NETS: THE ORpMAY MON WATERYMK MMPRDYJMAISAlW FOR RE EREIYE CM -V. NW LMO BElDN THE CRCIN1AY(ION WATER TWO: OF ALMS OR NAVIGABLE STREAM IS BUSIER TOTRE FIJSUCTRIAST IN MNCJBLF WATOM THAT L5 FSTFBIl61IEOLCERARTYOERSECICN T OFTLE STATEfIXBRVIRMI OF 1 QUIT CLAIM DEED Arnold M. Whitman and Terri L. Lundberg, husband and wife. Grantors, quit claim to Arnold Whitman and Terri Lundberg, as Trustees of the Whitman -Lundberg Estate Planning (Revocable) Trust dated August 2, 2019, Grantees the following described real estate, together with the rents, profits; fixtures and other appurtenance interests in Bayfield County, State of Wisconsin: Lot One (1) of Certified Survey Map No. 000281 as recorded in the Hayfield County Registry, in Volume 3 of Certified Survey Map on Page 72 as Document No. 329352, LESS the Easterly 25 feet thereof, being a part of Government Lots Two (2) and Three (3), Section Twenty-seven (27), Township Forty-seven (47) North, Range Eight (8) West, Town of Iron River, Hayfield County, Wisconsin. This is not homestead property. Dated this 3 day of 1,L; � , 2020. *2020R-583182 1* 2020R-583182 DENISE TARASEWICZ BAYFIELD COUNTY, WI REGISTER OF DEEDS 07/17/2020 09:38AM IF EXEMPT U: 16 RECORDING FEE: 30.00 PAGES: 1 Mitchell A. Routh Torvitten, Jones, Routh, Torvinen & Saunders, S.C. 823 Belknap Street, Suite #222 Superior, WI 54880 5AS6 04-024-2-47-08-27-2 05-002-02000 (Parcel Identification Number) This transfer sxi mpt frothe Wisconsin Real Estate Transfer Fee per §77.25(16), Wis. Scats. M.tct t4c$cS Whitman, Grantor Ferri LLLu rg, r for ACKNOWLEDGMENT State of.G&W nnrr�t o c tovv %m ) County of 3e.j fl.LLt ) ss On 1p • S , 2020, before me & K. - Notary Public, personally appeared, Arnold M. Whitman and Terri LLLundb g, proved to me on the basis of satisfactory evidence to be the persons whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their authorized capacities, and that by their signatures on this instrument the persons, or the entity upon behalf of which the persons acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. RECEIVED R'%t&t.l0.1v- N% roi Signature — — (Seal) AUG 08 2025 4\1 Ga CIAA9S1 'tgtuss Bayfield Co. This instrument was drafted by: Planning and Zoning Agency Mitchell A. Routh PAMELA M HEGSTR0M Torvinen. Jones, Routh, Torvinen & Saunders, S.C. Notary Public 823 Belknap Street, Suite 222 State of Wisconsin Superior, Wisconsin 54880 Firefox https://novus.bayfieldcounty.w i.gov/access/REAL"/u20ESTATE/listin... Real Estate Bayfield County Property Listing Today's Date: 8/7/2025 Description Updated: 8/4/2020 Tax ID: 19740 PIN: 04-024-2-47-08-27-2 05-002-02000 Legacy PIN: 024106801000 Map ID: Municipality: (024) TOWN OF IRON RIVER STR: S27T47NR08W Description: LOT I CSM #281 IN V.3 P.72 LESS E 25' THEREOF (LOCATED IN GOVT LOTS 2 & 3) IN DOC 2020R-583182 540 (WHITMAN-LUNDBERG ESTATE PLANNING REV TRUST DTD 08/02/2019) Recorded Acres: 7.500 Calculated Acres: 6.782 Lottery Claims: 0 First Dollar: Yes Zoning: (R-1) Residential -1 ESN: 118 J Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 024 TOWN OF IRON RIVER 163297 SCI -IL -MAPLE 001700 TECHNICAL COLLEGE y' Recorded Documents Updated: 5/11/2012 ® QUIT CLAIM DEED Date Recorded: 7/17/2020 2020R-583182 ® SPECIAL WARRANTY DEED Date Recorded: 1/11/2013 2013R-547700 1099-189 O SHERIFFS DEED ON FORECLOSURE Date Recorded: 1/25/2012 2012R-542140 1075-800 ® JUDGMENT Date Recorded: 2/ 11/2011 2011R-537244 1057-811 ® CONVERSION Date Recorded: 3/15/2006 426-358;500.409;519-390 Property Status: Current Created On: 3/15/2006 1:15:34 PM Ownership Updated: 8/4/2020 ARNOLD M WHITMAN TRUSTEE LA JOLLA CA TERRI L LUNDBERG TRUSTEE LA JOLLA CA l₹l g Address: WHITMAN, ARNOLD M & LUNDBERG, TERRI L 7820 LOOKOUT DR LA JOLLA CA 92037 Mailing Address: WHITMAN, ARNOLD M & LUNDBERG, TERRI L 7820 LOOKOUT DR LA JOLLA CA 92037 10 Site Address * indicates Private Road 65915 HART LAKE RD IRON RIVER 54847 91 Property Assessment Updated: 8/19/2024 2025 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 7.500 336,300 709,100 2 -Year Comparison 2024 2025 Change Land: 336,300 336,300 0.0% Improved: 709,100 709,100 0.0% Total: 1,045,400 1,045,400 0.0% Is, UProperty History N/A RECEIVE° AUG 0 8 2025 6,0eld Go. n Planning and Zoning A9'' I of I 8/7/2025, 11:37 AM 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: WHITMAN TRUSTEE, ARNOLD M 7820 LOOKOUT DR LA JOLLA, CA 92037 LUNDBERG TRUSTEE, TERRI L 7820 LOOKOUT DR LA JOLLA, CA 92037 Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00314 Transaction Number: SR -00314-324A8 Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 6231 Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847 Payment Type: Check Transaction Date: 8/15/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. $'FIELD 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: WHITMAN TRUSTEE, ARNOLD M SS -00622 7820 LOOKOUT DR LA JOLLA, CA 92037 Transaction Number: LUNDBERG TRUSTEE, TERRI L SS -00622-32C69 7820 LOOKOUT DR LA JOLLA, CA 92037 Description Amount Private Sewage System (Septic Tanks) $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 6231 Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847 Payment Type: Check Transaction Date: 8/15/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-25-103S STATE SANITARY PERMIT OWNER: WHITMAN, ARNOLD M & LUNDBERG, TERRI L G OV'T LOT: 2&3 LOT: 1 B LK: CSM: 281 1/4 1/4 SEC: 27, T 47 N, R 8 W TOWNSHIP: Iron River SOIL TEST: 103-25,80-13 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: ALLAN POLKOSKI TRACY POOLER Authorized Issuing Officer DATE: 8/15/2025 CHAPTER 145.135(2) WISCONSIN STATUTES a. The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. b. The approval of the sanitary permit is based on regulations in force on the date of approval. c. The sanitary permit Is valid and may be renewed for specified period. d. Changed regulations will not impair the validity of a sanitary permit. e. Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may Impede renewal. f. The sanitary permit Is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #:13-76S LICENSE: # MPRS 220090 Condition: Properly Maintain System Per Recorded Agreement. No sleeping planned. THIS PERMIT EXPIRES 8/15/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION