HomeMy WebLinkAbout25-106SRequest for Sanitary Inspection (24 Hrs. in Advance)
Fax or email this form to Zoning Dept (24 Hrs.) prior to when you want an inspection
Fax (715) 373-0114 or Email zoning(bayfieldcounty.wi.gov
Note
Time Change fl Discrepancy fl Other
Phone Number
715-739-6868
Plumber:
Doug Manthey
Fax Number
Email Address
Homeowner:
Brett Gemlo & Elizabeth A Snelson
norpines@chegnet.net
Immediate Phone Number So Zoning
Sanitary
Dept can call you right back (if needed)
Permit #:
25-106S
Plumber's Choice
Dept
No Inspection(s) during this time
Date:
11/20/25
Tuesday (9:30 am - 12:15 pm) (Tracy)
Plumber's Choice
ing Dept
Time:
A
11:30
Township:
Drummond
Address # &
Road Name:
or
47450 Tri Lakes Rd
Directions
To Site:
Comments:
** Plumbers you must verify any change(s) by fax or email **
Notes from Zoning Dept:
July 2025
F
Private Onste Wastewater Treatment
Systems ( POWTS). Inspection Report
(Attach to Permit)
GEMLO, BRETT & SNELSON,
ELIZABETH A d&tputposes t Pdvacy Law, s. 15.04 (fl(m)]
47450 TRI LAKES RD City 9 Viliege Town of:
DRUMMOND WI 54832
vim, vm �,cv. - —r,nbp Dwamw
Tank Information
TYPE
MANUFACTURER
CAPACITY
Prop. Line
Well
Building
Air Intake
Road
Septic
5Th
/0
N/A
Dosing
N/A
Aeration
N/A
Holdin
setback to:
c
County/�
V/lam
Sanitary ermlt No:
State Plan'Transaotion ID#:
Parcel Tax No:
Pump! Siphon Information
Pump Manufaer O
Pump M91/
Demand
GPM
Alter Manufacturer
Filter Model
TOH
Lift
Friction Loss
Head
Total
Forcemain
Len th /
Dia
Dist To Well
Dispersal Cell Information '
DIMENSIONS I Width I Length I # of Cells
Type
Pretreatment Unit
Manufacturer.
Model Number:
stribution System
Header/ Manifold
Distribution Pipe(s)
X Hole Size
X Hole
Observation Pipes
Length _ Dia
Length _ Dia Spac
Spacing
❑ Yes ❑ No
Soil Cover
Depth Over I Depth Over Depth of I Seeded / Sodded I Mulched
Cell Center I Cell Edges i Topsoil ❑ Yes 0 No0 Yes 0 No
COMMENTS: (Include code discrepancies, persons present, etc,) j oLr) ✓I, , rvesCv7/
!vl,/+all 5 !/jat �c�[S <c 17c: old �5sCG ltj p0 j0(.�l3
Gha.�,
Ian revision required? 0 Yes 0 No I`1 �C �� �� l P
>e other side for additional information. `l 7
Date %POWT3 Inspector's Signature License Number
:nnnnin «2 naval
Elevation Data
STATION
BS
HI
FS
ELEV
Benchmark
Z
�n y
Bldg. Sewer
b . Y
Tank Inlet
s;9
Tank Outlet
Dose Tank Inlet
Dose Tank Bottom
Z.
Inst. Contour
Header! Manifold
Distribution Pipe
Infiltrative Surface
6 , Q
Final Grade
X Pressure Systems Only
Property Owner
Information
BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT
Telephone: (715) 373-6138
Fax: (715) 373-0114
e-mail: zonina(albavfieldcountv.org
Web Site: www.bavfieldcounty.org/147
GEMLO, BRETT & SNELSON,
ELIZABETH A
47450 TRI LAKES RD
DRUMMOND WI 54832
Bayfield County Courthouse
Post Office Box 58
117 East Fifth Street
Washburn, WI 54891
As you know C> (/ `1 o VS 1 � 2,5 was contracted by you to install a private
onsite wastewater treatment system on your p operty (Tax ID# above). To know when your system will be due
for servicing please go to www.septicsearch.com
Notes:
Abandonment of Old System to meet all applicable code requirements:
Tank was pumped by:
Tank was crushed I removed and pipes disconnected by:
on
at AMIPM
PM
On (/ O at AI / PM) the above -mentioned plumber contacted our office to
conduct a re-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:
URorms/s a nit aryprope rtyownar-input
April 2019
5-OO&-Z3 _____________
nrttaratr�� County
Department of Safety Bayfield
• & Professional Services, S ZSanitary Permit Number (to be filled in by Co.)
pg Industry Services Division s /
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 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(1)(m), stats. 47450 Tri Lakes Rd
I. Application Information —Please Print All Information
Property Owner's Name Parcel #
Brett Gemlo & Elizabeth A Snelson 36312
Property Owner's Mailing Address Property Location
47450 Tri Lakes Rd Govt. Lot
City, State Zip Code Phone Number
Drummond, WI 54832 612-868-5223 %, ¼, Section 25
H. Type of Building (check all that apply) Lot # T 44 N R 08 E or W
® 1 or 2 Family Dwelling —Number ofBedrooms 3 2 Subdivision Name
Block #
❑ Public/Commercial — Describe Use
❑ City of
❑ State Owned — Describe Use CSM Number 0 Village of
1772 ® Town of Drummond
ILL Type of P0WTS Permits (Check either "New" or "Replacement" and other applicable on i≤ine A. Check one boa on-line B. Complete line C i
a . l*cable.
A. ❑ New System
Sy ❑ Replacement System ® Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain)
Addition of septic/pump tank for garage bathr om
B. ❑ Holding Tank ® In -Ground O At -Grade ❑ Mound ❑ Individual Site Design O Other Type (explain)
(conventional)
C. O Renewal Before O Revision O Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued
Expiration 21-39S 05/18/2021
IV. Dis ersal/TreatmentArea and Tank Information:
Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation
4151) 0 .i 12. 6s %.6
Capacity in Total # of Manufacturer
Tank Information Gallons Gallons Units , o -g v
New Tanks Existing Tanks
Septic or Holding Tank 840 1000 1840 Wieser Concrete X
Dosing Chamber 500 600 1100 Wieser Concrete X
Y. Responsibility State ,the undersigned,. C ` gonsibility: for ins „Ilntie a POWTS ¢hown.on the attached plans..
Plumber's Name (Print) Plum is gna MP/MPRS Number Business Phone Number
Douglas Manthey MP 230722 715-739-6868
Plumber's Address (Street, City, State, Zip Code)
PO Box 196 Drummond, WI 54832
.County/De .artment Use Only
Approved ❑ Disapproved Permit Fee Date Issued Issuing ge
0 Owner Given Reason for Denial 5 ( y ,2 37/3
3 �7
Conditions of Approval/Reasons for Disapproval
�Qc ECEVED
L 2th7 c4 2i AUG 112025
P<anris},l and .''cn ,; icy
Attach to complete plans for the system and submit to the County only on paper not less than 81/2 x 11 inches in size
SBD-6398 (R. 03/22)
PAGE 1 OF y
-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 Al Index & Cover Sheet
Pg 2 of Sl Plot Plan
-Pg 3 -of 5 ----------Dispersal Area Ciu Stion-&-RIan View
Pg of y Pump Tank Specifications
Pg y of i Management Plan
Attachments: [Enclosures:
Pump Curve POWTS Application for Review
Previous Sanitary Permit Packet Soil Evaluation Report & Site Map
Project Name / Description
Gemlo Garage
Owner Name(s): Brett Gemlo
Owner Address: 47450 Tri Lakes Rd Drummond, WI
Project Address: 47450 Tri Lakes Rd
Govt. Lot: .114 of
Township: Drummond
Project Parcel ID #: 36312
Designer Name: Doug Manthey
Phone: 612 _868
Zip: 54832
5223
1/4, Section 25 , T 44 N -R 08 E ❑or W ❑✓
County: Bayfield
Designer Information
Designer Address: PO Box 196 Drummond, WI
E-mail: norpines@chegnet.net
License Number: MP 230722
Remarks:
Phone: 715 .739 .6868
Zip: 54832
This space reserved for approval stamp.
FECJ E'E
AUG 1 1 2025
Bayih Co
Plann:n;, 2nL 7
•7
Signature: Date: 07/28/25
Odgi signature required on each ubmitted copy.
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PAGE 3 OF
• GRAVITY -DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4"0 Vent Pipe
a10 ft from
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
Electrical must comply with
SPS 316 and NEC 300
Il Weatherproof
Junction Box
CAPACITIES @ 11.82 gaVin `= 4 . i ,:. I
Depth (in)
Volume (gal)
A
26.2
309.68
B
2.0
23.6
[C]
2.8
33.1
D
12
141.84
* Pump Tank Liquid Level = 43 in
Force Main Diameter = 2 in
Force Main Length = 40 ft
Force Main Void Volume = 3.6 gal
[C] Total Dose Volume (TDV) = 33.6
E(�S 0.2X design flow + force main void volume)
Vertical Lift = 3.6 ft
Conduit
A
B
U
Pump
D
' a
Airtight Seal
Extend manhole riser as necessary.
Approved Locking Manhole
with Warning Label Attached
(typical)
4" Min. or2.0ftabove
Established Flood Elevation
9T/ (typical)
• Quick Disconnect
18" Min.
t (typical)
. f
Weep
Hole
Alarm
_On
_off
Concrete
Block
3" Approved Bedding Material Beneath Tank
gal/dose
PUMP TANK:
Volume = 500 gal
Manufacturer: Wieser Concrete
Pump Manufacturer:
Goulds
Pump Model: EPO411
(See attached pump curve.)
Controls/Alarm Manufacturer:
SJE Rhombus
Controls/Alarm Model:
1025830
Float switches containing mercury are prohibited.
- Approved Joints with
Approved Pipe 3 ft onto
Solid Ground
(typical)
PUMP -OFF
ELEVATION = 93.4 ft
INSIDE BOTTOM
ELEVATION = 92.4 ft
AUG 11 2025
-
SEPTIC TANKS):
Total Volume = 840 gal
Manufacturer(s): Wieser Concrete
Install approved effluent filter at the septic tank outlet
immediately upstream of the pump tank inlet.
Filter Manufacturer. Orenco
Filter Model: PSCS0621-18
PAGE 4 OF 4
In -ground Dosed -Gravity Management Plan
IMPORTANT:
The owner of this in -ground dosed -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 =
150 gpd; BOD5 ≤ 220 mgL''; TSS ≤ 150 mgL''; FOG 30 mgL'
Inspection Checklist INSPECT EVERY 3 YEARS i:• YV ED
o type of use
o age of system AUG 112025
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.) pnrar
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 tanks) 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 necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local government unit In accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company:
HK Septic Septic
Phone: 715-798-3494
Local government unit Bayfield County Zoning Phone: 715-373-6138
Local government unit address:
PO Box 58 Washburn, WI
ZIP: 54891
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be
abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils.
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code.
9'-5j"
4" CAST -A -SEAL 4" CAST -A -SEAL :T
•':l- i III a �t
7
BAFFLE a ��
TOP VIEW
a
w
cn
Car
w
to
I1LET4Ei
in Qi c w
SIDE VIEW
4" VENT
OUTLET
� U
a
PUMP PAD
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
W840/500 -MR
TANK SPECIFICATIONS
LC
o
a
I -
DIMENSIONS:
a
o
WALL: 2 9/16"
0
a
BOTTOM: 3"
COVER: 5"
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
HEIGHT: 59 1/2"
LENGTH: 9'-5 3/4"
WIDTH: 7'-9"
BELOW INLET: 48"
t
LIQUID LEVEL: 43"
a
WEIGHT: BOTTOM 7,360 LBS.
a,
0
COVER 3,790 LBS.
H
o
INLET AND OUTLET:
m
o
0
4" CAST -A -SEAL BOOT OR EQUAL GASKET
0
INLET AND OUTLET BAFFLE AND FILTER:
N
o
A
WISCONSIN, SEE DETAIL #10
-1i< o
(OTHER STATES SEE CHART)
LIQUID CAPACITY: 19.61 GAL/IN (SEPTIC)
-5
11.82 GAL/IN (PUMP)
g o
LOADING DESIGN: 8'-0" UNSATURATED SOIL
= Z co
�Q
TANK CAN BE USED AS:
SEPTIC/SEPTIC, SEPTIC/PUMP,
rO
o
OR SEPTIC/SIPHON
I
am O
m °0
COVER: MIX DESIGN #8 (NO FIBER)
TANK: MIX DESIGN #10 (STRUCTURAL FIBER)
_____co
CUSTOMIZED TANKS:
M
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
REVIEWED BY
REVIEW DATE
i7
OF
1
GOULDS
APPLICATIONS
PUMPS
Submersible
Effluent Pump
"�- 3871 EP05
*0
Specifically designed for the
following uses:
• Effluent systems
• Homes
• Farms
• Heavy duty sump
• Water transfer
• Dewatering
SPECIFICATIONS
• Solids handling capability:
'/a' maximum.
• Capacities: up to 60 GPM.
• Total heads: up to 31 feet.
• Discharge size: 11/2" NPT.
• Mechanical seal: carbon-
rotary/ceramic-stationary,
BUNA-N elastomers.
• Temperature:
104°F (40°C) continuous
140°F (60°C) intermittent
• Fasteners: 300 series
stainless steel.
• Capable of running
dry without damage to
components.
Motor.
• EP04 Single phase: 0.4 HP,
115 or 230 V, 60 Hz, 1550
RPM, built in overload with
automatic reset.
• EP05 Single phase: 0.5 HP,
115 V or 230V, 60 Hz, 1550
RPM, built in overload with
automatic reset
• Power cord: 10 foot
standard length, 16/3
SJTOW with three prong
grounding plug. Optional 20
foot length, 16/3 SJTW with
three prong grounding plug
(standard on EP05).
® 2002 Goulds Pumps
Effective September, 2002
B3871
• Fully submerged in high
grade turbine oil for
lubrication and efficient
heat transfer.
Available for automatic and
manual operation. Auto-
matic models include
Mechanical Float Switch
assembled and preset at the
factory.
FEATURES
a EP04 Impeller: Thermoplas-
tic Semi -open design with
pump out vanes for mechanical
seal protection.
,vIC,CnJ rd
10�
2
0
■ EP05 Impeller: Thermoplas-
tic enclosed design for
improved performance.
■ Casing and Base: Rugged
thermoplastic design provides
superior strength and corrosion
resistance.
■ Motor Housing: Cast iron
for efficient heat transfer,
strength, and durability.
■ Motor Cover: Thermoplastic
cover with integral handle and
float switch attachment points.
■ Power Cable: Severe duty
rated oil and water resistant.
■ Bearings: Upper and lower
heavy duty ball bearing
construction.
AGENCY LISTING
511" Canadian Standards Association
Goulds Pumps is ISO 9001 Registered.
AUG 1 1 2025
0 2
4 6 8
CAPACITY
10 12 m3/ii
Goulds Pumps
W ITT Industries
Private Sewage System Maintenance Agreement
Owner(s) Name
Brett Gemlo & Elizabeth Snelson
Owner(s) Mailing Address
808 Summit Avenue, St Paul, MN 55105
Site Address
47450 Tri Lakes Rd, Cable, WI 54821
Tax ID # 36312
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 W
Adm. Code, as from time to time amended. (COMPLETE Legal is required)
114 of 1/4 Section 25 Township 44 N. Range 08 W.
Additional Legal Description:
Town of
Lot ______ Block Subdivision
(Acreage) 38.8 Gov't Lot 2
Lot 2 CSM # 1772 Vol. 10 Page 256 CSM Doc #
IUllIll1flh1
*2021R-588612 2*
20218-588612
DANIEL J. HEFFNER
BAYFIELD COUNTY, WI
REGISTER OF DEEDS
05/11/2021 10:29AM
IF EXEMPT #:
RECORDING FEE: 30.00
PAGES: 2
Recording Area
Return To:
Planning and Zoning Department
® 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, 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 Sewaoe_System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified
septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three
(3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface.
Mounds. At-arade. and in -around Pressure System 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.I4/ wp ss 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 coif $Y law.
The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future ownerfof sjrL`'h� Property. \ c.. �0
a i iOT '¼0,
Owner Nam ( ) — P se Print Sub 'bed and sworn to before me on thi dltit$: ,,/,,1/z. I
_i2 Io
!
PUBLIC
r ��
ca
otarize O r
- Sig to re s)
A
Nary Public
fr7LT /''
My Co mi 'ion Expires:.
2dL2.- U.¢...._..�
Drafted byr ,(i�i/P �e- Date: AUG 1 1 2025
Proofed by:
B :.:1 Co.
WOO"saniWy#y epbMpl n ly aot
iseJu
2021E 581819
State Bar of Wisconsin Form 3 - 2003
QUIT CLAIM DEED
Document Number Docutuent Ninue
THIS DEED, made between
valuable consideration: ("Grantor," whether one or more),
and Brett T. Gemlo and Elizabeth A. Snelson,husband
and wife, as joint tenants and not as tenants in
common ("Grantee," whether one or more).
Grantor, quit claims to Grantee the following described real estate, together
with the rents, profits, fixtures and other appurtenant interests, in
HAYFIELD County, State of Wisconsin ("Property")
(if more space is needed, please attach addendum):
Lot 2 of Certified Survey Map No. 1772, recorded
.December 22,.201.1 in Volume 10• of Certified Survey
Maps, pages 256-257 as Document No. 2011R-541699.
Together with an access easement for ingress and
egress over and across Lot 1 o said Certified
Survey Map from Tri Lakes Road to said Lot 2 as set
forth in Certified Survey Map No. 1772.
20218-587879
DANIEL J. HEFFNER
BAYFIELD COUNTY, WI
REGISTER OF DEEDS
04/01/2021 01:10PM
TF EXEMPT #: 8M
RECORDING FEE: 30.00
PAGES: 1
Recording Ana
Name and Return Address
Northwest Land Title
PO Box 520
Milltown, WI 54858
2//o3t ,
Subject to existing highways and subject to
restrictive covenants, easements, restrictions and
-reservations of record. Also subject to all 04-018-2-44-08-25-4 05-002-220.00
governmental zoning, building or land use t'arcet'tilartitictttioo Number(PIN)
regulations. This is not homestead property.
(is) (is not)
DatedL4b5/20ZJ
AUTHENTICATION
Signature(s)
authenticated on
AUG 1 1 2025
6; yid Co.
Pnrn
(SEALP (SEAL)
*Brett Gemlo
(SEAL)
(SEAL)
ACKNOWLEDGMENT
STATE OF M%hhdS--)
COUNTY).
Personally came 1efore sue on .3 "' 2 '' -1-i
the above -named Brett Gemlo
TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the u d t e
( faregoing in spent and Ac o the Qkl L DELLWp
If not,
authorized by Wis. Stat. § 706.06)i4 NOtARYPUgUC.AUHNESOTA
MY Corn
THIS INSTRUMENTDRAFfED.BY:4
; Baca Z�tres
Todd H. Anderson, Attorney at Law Notary Public, State of Wive la t
PO Box 507fl Grantsburg', WI 54840 My Commission (is permanent) (expires. J31s—)
s—)
• (Stgaatures may he authenticated or acknowledged. Roth are not necesshcy.)
NOTE: THIS IS A STANDARD FORM, ANY MODIFICATIONS TO I'll IS FORM SHOULD BE.CLEARLY IDENTIFIED.
QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No.3-2003
*Type name below signatures.
Todd 11 Aadenon laar nmev 11611 Medisee Avg (1"uasbsg. Wt 54)40 ?loci 1113863-S365 l'se (715)463.2074 Ocmto to Oaodo sal
Todd Md.,sea Produced with ZipForma by 2lpt.ogtt. 18070 Fifteen Mb o Read, Fraser. Michigan -48026 t wrzW&gI cAm
Bayfteld County Register of Deeds Document # 2021 R-587879 Page 1 of 1
PAGE 1 OF 4
In -Ground Gravity Plan
Index & Cover Sheet
Component Manual Design References:
Version 2.0, SBD-10705-P (N.01/01, R. 10/12)
Pg1 of4
Pg 2 of 4
Pg3of4
Pg4of4
Attachments:
Index & Cover Sheet
Plot Plan
Dispersal Area Cross -Section & Plan View
Management Plan
F
POWTS Application for Review
� Soil Evaluation Report & Site Map
Project Name I Description
Owner Name(s): S9ETt 6c'iL,o Phone: - -
Owner Address: 'OO AE A O Zip: 5I 105
Project Address: 7 ro • rn i Lv res A1)
Govt. Lot: __ 1/4 of 1/4, Section_, T ` N -R ED or W
Township: D 0 u AA' Otis r) County: _� l E L
Project Parcel ID #: t'y. (t 'i 'I ? - -
Designer Information AUG 1 '12025
Designer Name: Dan Burch Phone: 715 .416 _ Th42_. ;
• . N5921. Cty Hwy K Spooner W1 p: 54801
Designer Address. ZI
E-mail: Burchplumbinginc@gmail.COm This space reserve's for approval tamp.
tJ
License Number: 253808 ' „lsv
Remarks: Cj° r' I \
1(1 iJ
) '
Signature: Date:
original signature required on each submitted copy.
Septic Tank(a) Manufacturer
IN -GROUND GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard -W Chambers
3 -ft Trench (down -sizing credit)
SOIL COVER
tr
mph
IHdaal)
Septic Tank(s) Vaume(s):
1000 gal _ gel _ gel - gal
Effluent Filter Manufacturer.
Polvlok
Effluent Filter Modal #. 525
TYPICAL TRENCH
d ;•, CROSS SECTION VIEW
(No Scale)
Provide minimum 3 ft
System Elevation = 9696=10: ft separation between trenches.
(typical)
Quick4 Standard -W
w/ End Cep (Show location of inlet / outlet pipe connection on plan view.)
(typical)
-----------f-------�i`----
B= 128 ft
(typical)
INSTALL PER TRENCH:
32 Quick4 Std -W @20W EISA/chamber = 640 ft'
+ 1 Pairs of end caps @ 6 ff EISA/pair= 6 ft2
= Proposed EISA per trench = 646 W
Obsenalbn Pipe TYPICAL TRENCH
(typical)
allpermaMaanrets PLAN VIEW
Ireoucuone. (No Scale)
WiiilMkt IA=3.06
p
C)
m
Quick4 Standard -W Chamber
W
(typical)
O
(mfd by InetelorS)abms• Inc.)
-n
Instan pursuant to manufatW,era loetud ons.
Required Infiltration Area= 643
x 1 trenches = Proposed Total EISA = 646
ft' Distribution Method:
ft°
AUG 1 1 2025
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
Electrical must comply with
SPS 316 and NEC 300
fl Weatherproof
Junction Box
CAPACITIES @ 11.82 gal/in • . y - • _'�
4 I.4.
Depth (in)
Volume (gal)
A
31
366.42
B
2.0
23.64
[Cl
6
82.42
D
12
141.84
*Pump Tank Liquid Level = 51 In
Force Main Diameter : 1.5 in
Force Main Length = 125 ft
Conduit
A
B
f[]
Pump
D
7 -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
:IT r (typical)
Quick Disconnect j
e 18" Min.
i* .. (typical)
Weep - Approved Joints with
Hole Approved Pipe 3 ft onto
Solid Ground
(typical)
On
Concrete
Block
3° Approved Bedding Material Beneath Tank
Force Main Void Volume = 11.5 gal
[C] Total Dose Volume TDV = 82.42 gal/dose
L≤ 0.2X design flow + force main void volume)
15
Vertical Lift = ft
PUMP TANK:
Volume = 600 gal
Manufacturer. Wieser
Pump Manufacturer: Zoeller
Pump Model: 152
(See attached pump curve.)
Controls/Alarm Manufacturer: SJElectro
Controls/Alarm Model: tank alert
Float switches containing mercury are Drohibited.
PUMP -OFF
ELEVATION = 91 ft
1 INSIDE BOTTOM
ELEVATION = 90 ft
AUG 1 1 2025
SEPTIC TANK(S):
Total Volume = 1000 gal
Manufacturer(s): Wieser
Install approved effluent filter at the septic tank outlet
immediately upstream of the pump tank Inlet.
Filter Manufacturer: polylok
Filter Model: 525
CL'
Ul W PUMP PERFORMANCE CURVE
MODEL 151/152/153
50
14 45 153
12- 40
�35
= 10 152
30
a 8 25151S\\_____
0 6 20
15
10
2
5
0
10 20 30 40 50 60 70 80 90 100
GALLONS
LITERS 0 40 80 120 6 20 240 280
10 0
FLOW PER MINUTE
320 360
014508
AUG1 1 2025
D5 El, PAGE 4 OF 4
In -ground Gravity Management Plan
IMPORTANT:
The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall
be considered a human health hazard if not maintained in accordance with this approved management plan.
Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Disnersal 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 (Le., 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 necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local government unit in accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company:
Dan Burch
Local government unit: Bayfleld County Zoning
Local government unit address:
PO Box 58 Washburn WI
Phone: 715.416.1642
Phone: 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. cI �n.sCode.:.
No product for chemical or physical restoration of the POWTS may be used unless approved by the deparerit'h'
accordance with SPS 384, Wisc. Admin. Code.
AUd 112025
Continaency Plan
bay licLi
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be repla�ectr�ur§cant to 'v�
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.
Real Estate Bayfield County Property Listing
Today's Date: 8/5/2025
Description _ Updated: 3/6/2024
Tax ID: 36312
PIN: 04-018-2-44-08-25-4 05-002-22000
Legacy PIN:
Map ID:
Municipality: (018) TOWN OF DRUMMOND
STR: S25 T44N R08W
Description:
LOT 2 CSM #1772 IN V.10 R256
(LOCATED IN GOVT LOT 2) IN DOC
2021R-587879
Recorded Acres:
38.800
Calculated Acres:
38.800
Lottery Claims:
1
First Dollar:
Yes
ESN:
111
I Tax Districts Updated: 2/17/2012
1
STATE
04
COUNTY
018
TOWN OF DRUMMOND
041491
SCHL-DRUMMOND
001700
TECHNICAL COLLEGE
Ip
4 Recorded Documents
pdated: 2/17/2012
D QUIT CLAIM DEED
Date Recorded: 4/1/2021
20ZI.R-587879
D QUIT CLAIM DEED
Date Recorded: 4/3/2012
2012R-543188 1080-409
D TRUSTEES DEED
Date Recorded: 4/3/2012
2012R-543186 1080-403
D TRUSTEES DEED
Date Recorded: 4/3/2012
2012R-543185 1080-398
D CERTIFIED SURVEY MAP
Date Recorded: 12/22/2011
2011R-541699 10-256
Property Status: Current
Created On: 2/17/2012 9:17:25 AM
ffi Ownership
Updated: 4/6/2023
BRETT GEMLO
ELIZABETH A SNELSON
DRUMMOND WI
DRUMMOND WI
Billing r :
Mailing Address:
GEMLO, BRETT & SNELSON,
GEMLO, BRETT & SNELSON,
ELIZABETH A
ELIZABETH A
47450 TRI LAKES RD
47450 TRI LAKES RD
DRUMMOND WI 54832
DRUMMOND WI 54832
Site Address__*_indicates indicates Private Road
47450 TRI LAKES RD DRUMMOND 54832
91 Property Assessment
Updated: 8/9/2021
2025 Assessment Detail
Code
Acres
Land
Imp.
Gl-RESIDENTIAL
2.000
276,500
102,100
G6 -PRODUCTIVE FOREST
36.800
55,200
0
2 -Year Comparison
2024
2025
Change
Land:
331,700
331,700
0.0%
Improved:
102,100
102,100
0.0%
Total:
433,800
433,800
0.0%
Property History
Parent Properties Tax ID
04-018-2-44-08-25-4 05-002-20000 14765
HISTORY D -U ap nd All History White=Current Parcels Pink=Retired Parcels
D Tax ID: 14765 Pin: 04-018-2-44-08-25-4 5-002-20000 Leg. Pin: 018110804000
36312 This Parcel Parents Children
AUG 1 1 2025
r .. •;�..
Industry Services Division
County
Bayfield
�fDs `j�
��
1400 E Washington AveSanitary
PermitNumber (to be filled in by Co.)''
$
P.O. Box 7162
Madison, WI 53707-7162
Sanitary Permit Application
State Transaction Number
In accordance with SPS 38321(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
47450 Tri Lakes Rd
purposes in accordance with the Privacy Law s. 15.04 1 m Stats.
L Application Information — Please Print All Information
Property Owner's Name ZCEIVED
Parcel #
Brett Gemlo
11Q'L1
36312 tax ID
MAY
Property Owner's Mailing Address
Property Location
800 Summit Ave NO 2 Saytreki
Govt. Lot
'/., ''/a, Section 25
City, State
Zip Code Phone
Number
St Paul, MN
55105
(circle one)
T44N ; R8EorW
U. Type of Building (check all that apply) Lot
3
/I
I or 2 Family Dwelling —Number of Bedrooms 1
Subdivision Name
❑ Public/Commercial —Describe Use Block
#
❑ City of
❑ State Owned — Descn'be Use
❑ Village of
CSMNumber
1772
® Town of Drummond
III. Type ofPermit: Check onl one box on line A. Corn lete line B if applicable)
A.
❑ New System
® Replacement System
❑ Treatment/Holding Tank Replacement Only
❑ Other Modification to Existing System (explain)
❑ Permit Renewal
❑ Permit Revision
❑ Change of
I ❑ Permit Transfer to New
List Previous Permit Number and Date Issued
B.
Before Expiration
Plumber
Owner
N.
Type of POWTS System/Component/Device: (Check all that apply)
® Non -Pressurized In -Ground 0 Pressurized In -Ground 0 At -Grade 0 Mound ≥ 24 in. of suitable soil ❑ Mound <24 in. of suitable soil
❑ Holding Tank 0 Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dispersal/Treatment Area Information:
Design Flow (gpd)
Design Soil Application I
Dispersal Area Required (sf)
Dispersal Area Proposed (sf) System
Elevation
450
Rate(gpdsf)
643
652
—
.7
VI. Tank Info
Capacity in
Gallons
Total
# of
Manufacturer
w
'ti
ii
New Tanks
Existing Tanks
Gallons
Units
..
U y 2
rn
w t3
a
Septic or Holding Tank
1000
1000
1
Wieser
®
❑
❑
Dosing Chamber
6(X)
6 9O
t J i C c
0❑
VII. Res onsibility Statement- 1, the undersigned, assume res
nsi lily
installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
I Plumber's
I MP/MPRS Number
Business Phone Number
Dan BurchI
253808
I 715.416.1642
Plumber's Address (Street, City, State, Zip Code)
1118N Front Street Spooner WI 54801
VIII. County/Department Use Only
Approved I❑
Disapproved
FPen=nit Fee I
Date Issued
ue
Is g t ' lure
❑ Owner Given Reason for Denial—�
O "�
Cii� �/� r
IX. Conditions of Approval/Reasons for Disapproval
A rmca no compieze pions nor iue syatcuu uuu auuuua w 'uc ..uu..y v. .». ..-.......-»,.....
AUG 1 1 2025
SBD-6398 (R03/14) b':H Co
BAYFIELD COUNTY SANITARY PERMIT (#04)-21-39S
STATE SANITARY PERMIT
OWNER: BRETT GEMLO
GOVT LOT: LOT: BLK: 0
CSM:
SUBDIVISION:
1/4 1/4 SEC:25,T44N, R8W
TOWNSHIP: DRUMMOND
SOIL TEST: 47-21 1 1
REPLACEMENT SYSTEM PREVIOUS PERMIT #:
SYSTEM TYPE: Non -Pressurized In -Ground
PLUMBER: DAN BURCH LICENSE: # 253808
TRACY POOLER DATE: 5/18/2021 Condition:
Authorized Issuing Officer
THIS PERMIT EXPIRES 5118/2023
POST IN PLAIN VIEW
MUST BE VISIBLE FROM ROAD FRONTING THE LOT DURING CONSTRUCTION
AUG 112025
r lrf;n;a
Wisconsin Department of Safety and Professional Services - Page 1 of 3
DiiofJ duS
ry s n o n sury ennces
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,
Bayfield
but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel l.D.
scale or dimensions, north arrow, and location and distance to nearest road. Tax ID 36312
Please print all information. Re tew b Date/'2;7/3
ate
Personal information you provide may be used for seconds u oses (Privacy Law. S. 15.04(1)(m)). ____ 3 %
Property Owner
nett Gemlo
Property Owner's Mailing Address
800 Summit Ave No 2
City State Zip Code
St Paul I MN I 55105
Property Location ❑
Govt. Lot %4 Y4 S 25 T 44 N R 8 E (or) W
Lot # Block # Subd. Name or CSM#
I 1772 V 10 Pg 256
Phone Number ❑ City ❑ Village N Town Nearest Road
Drummond I 47450 Tri Lakes Rd
❑ New Construction Use: N Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD R c EIVED
N Replacement ❑ Public or commercial — Describe:
Parent material Glacial Outwash Flood Plan elevation if applicable_ft. MAY
General comments and recommendations: ZOZj
El Boring # ❑ Boring
® Pit
Ground surface elev. 98.5 ft. Depth to limiting factor 90 in.
r wJ ,w and Zoning Agency
M
/.1
Anil Annlirs�finn Rafa
I
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
*Eff#2
1
0-6
7.5 YR 3/1
is
2msbk
mvfr
cs
3f
.7
1.6
2
7-35
7.5YR 4/6
s
Osg
ml
cw
.7
1.6
3
36-90
7.5 YR 4/4
s
0sg
ml
.7
1.6
a Boring # ❑ Boring
Pit Ground surface elev.105 ft. Depth to limiting factor 100 in.
ISnit,&nnliraffnn Rafa
I
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
*Eff#2
1
0-6
7.5 YR 3/1
Is
2msbk
mvfr
cs
3f
.7
1.6
2
7-28
7.5YR 4/6
$
Osg
ml
cw
.7
1.6
3
29-100
7.5 YR 4/4
s
0sg
ml
.7
1.6
- r-mI lanr wi = 141111 :i,, . Y7u Ring Ann Isa _1u s -I nu nary _ El r CmuFlnr 7s.. = 6uu_ su s izu rnan_ ann as sus -I nu mnn
CST Name (Please Print)
Signature
CST Number
Dan Burch
253808
Address
Date Evaluation Conducted
Telephone Number
N5921 County Hwy K S ooner WI 54801
4-20-21
715.416.1642
AUG 1 1 2025
ti:i'E;;l Co.
ri Boring # ❑ Boring
® Pit
Ground surface elev. 105 ft. Depth to limiting factor 100 in.
Rnil Annnn finn Rata
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Cr. Si.. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
*Efi#2
1
0-6
7.5 YR 3/1
Is
2msbk
mvfr
cs
2m
.7
1.6
2
7-30
7.5 YR 4/4
Is
Osg
ml
ow
2m
.7
1.6
3
31-100
7.5 YR 4/4
s
0sg
ml
.7
1.6
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Cnii Anni'iratinn Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
*Eff#2
Boring # O Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
I Cni1 Annrns*inn
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
*Eff#2
*Effluent#1 = BOD, > 30:9 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = SOD, > 30 5 220 mg/L and TSS > 30 s 150 mg/L
AUG 1 12025
CHECK BOX AS APPLICABLE. CHECK BOX AS APPliCABLE.
jSOIL EVALUA
TION Scale: 1 = 30' Q SYSTEM PAGE 2 OF
SITE MAP 0 30 asi°',,'i, r' so PLOT PLAN
PROJECT NAME. 7 52 DESIGN FLOW. 450 �., GPD
Gemlo System Attach design flow caiculatlons for commercial plans.
PROJECT ADDRESS: 47450 Tl i Lakes Rd Pipe Material ! ASTM Standard (Tables 384.30-3 & 384.30-S)
n( s�,y Sewer. Soh 40 PVC /
BM Symbol: -t - SM Elevation: 100 FT FOtne Matn
BM Dascrtption: nail in 8° Pine
tndtaatanorthby . IMPORTANT:
Slope tsradIsrtt(%) 13 Wett Syr:rbol (lf appticabtex p drawing an an= Show ground elevation contours at suitable intervals.
of Tested Area: on the approprtta brie.
0
1JEiIiiiIiiiiiiiiiiT
►8 _ -
- - ,
�7�las-
� r
1 r�
/;($;.;;
62.04 C1/i0
p�-
AUG 1 1 2025
bav:d Co.
1' ia�r F 3t...✓tll.''
BAYFIELD COUNTY
CHECKLIST FOR SANITARY APPLICATONS
Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e))
E7 check List
TGiginal Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.)
D-tdex Page / Title Sheet (Signed by Plumber) (383.22(2)69(c))
❑.4Figinal Plot Plan (383.22(2)2. 3. & 4.a)
[Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer
L'f Pump Tank Diagram, Alarm and Pump Curve (when applicable)
Contingency Plan / Management Plan (383.22-3(2)(b)1.f.)
'Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds)
❑ 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)
O ATU Servicing Agreement (Recorded at Reg. of Deeds)
JL�Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7)
E3jComolete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached
to all copies)
C'Soil and Site Evaluation Report (383.22-3(2)(b)1.e.)
❑ State Plan Review (when applicable)
❑ Copy of Warranty/Quit Claim Deed (Optional)
Sanjary Application: (Include the following Information)
Application Information must include: O 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete)
crPibject Address or Road Name where driveway is/will come off of)
I�1I Type of Building
Q III Type of Permit
1IV Type of POWTS System
BBC/ Dispersal / Treatment Area Information
Tank Information
[VII Responsibility Statement (Plumber's Information)
D. *Date Stamp*
❑-(Owners Phone Number)
Plot Plan: (To Scale or To Dimension)
La -Signature and Plumber Information ddress Number and Road
O Surface Elevation of Body of Water [5North Arrow
EQ'�rection and Percent Land Slope ETContour Lines
k and Filter Information and Location JC/Structures and Driveways
❑ Wetlands / Navigable Bodies of Water Boring Locations
absorption Area (Proposed and Existing) property Lines
Bench Mark (Location, Elevation and Description) 6'Well Locations
rifomponent Manual Version ategal Descriptions
❑ piny Material Information (conveyance line, building sewer line, mater, .;,
RECEIVED
AUG 1 1 2025
eay*i=,a cc
Turn Over ►
Cross -Section and Over -Head Profile of the System:
• 2Surface and System Elevation
[IPosition of Observation and Vent Pipes
VE7yimensions and Depths
ake, Model & Number of Chamber Units in each Cell
Property Information
CHow many systems will there be on this parcel of land?
❑ Has this property been split? (Property Statement shows Property History)
ees:
d'Private Sewage System (Septic Tanks)
$ 400.00
❑ Private Sewage System (Holding Tanks)
$ 400.00
❑ Mounds or Systems requiring Pre -Treatment
$ 500.00
❑ Sanitary Revisions
$ 25.00
❑ Private Sewage System Reconnection
$ 50.00
and Private Interceptor
❑ Return Inspection
$ 50.00
❑ Maintenance Agreements i $ 30.00
(checks made out to Reg of Deeds)
VD
AUG 1 1 2025
B;yii&:i Co.
Pianrnency
u/forms/checklists/checktistforsanitaryapps (10/2009);(®7/2011);(®2/2012)(®5/2/2012 -dc) Proofed by:
55 -DD& -23.
B = ),
S _
PS ,�
Department of Safety
& Professional Services a
Industry Services Division
County Ba field
Y
Sanitary Permit Number (to be filled in by Co.)
Sanitary Permit Application
State Transaction Number
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit
Project Address (if different than mailing address)
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(I)(m), Stats.
47450 Trl Lakes Rd
I. Application Information —Please Print All Information -
Property Owner's Name
Parcel #
Brett Gemlo & Elizabeth A Snelson
36312
Property Owner's Mailing Address
Property Location
47450 Tri Lakes Rd
Govt. Lot
City, State
I Zip Code
Phone Number
Drummond, WI
54832
612-868-5223
i v+, Section 25
T 44 N R 08 E or W
II. Type of Building (check all that apply)
® I or 2 Family Dwelling —Number of Bedrooms 3
Lot #
2
Subdivision Name
Block #
❑ Public/Commercial — Describe Use
❑ City of
❑ State Owned —Describe Use
❑Village of
CSM Number
1772
® Town of Drummond
Ill. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i
a licable.
A.
❑ New System
y
❑ Replacement System(explain)
p y
® Other Modification to Existing System (explain)
❑ Additional Pretreatment Unit
Addition of septic/pump tank for garage bathr
om
B•
❑ Holding Tank
I In -Ground
❑ At -Grade
O Mound
O Individual Site Design
I ❑ Other Type (explain)
(conventional)
C.
O Renewal Before
❑ Revision
❑ Change of Plumber
❑ Transfer to New Owner
ist Previous Permit Number and Date Issued
Expiration
21-39S 05/18/2021
IV.
Dispersal/Treatment
Area and Tank Information:
Design Flow (gpd)
Design Soil Application Rate(gpd/st) I
Dispersal Area Required (sf)
I Dispersal Area Proposed (sf)
I System Elevation
550
6•) I
692.q
&s
9.d
tank Information
Capacity in
Gallons
Total
Gallons
# of
Units
Manufacturer
3
m
"- co
0.0
U $
a, 2
o0
w
V
c —
iz U
o.
New Tanks
Existing Tanks
Septic or Holding Tank
840
1000
1840
Wieser Concrete
X
Dosing Chamber
500
600
1100
Wieser Concrete
x
V. Responsibility State , the aadersigaed, a
esponsibility for ins Ilatio be POWTS shown on the attached plans.
Plumber's Name (Print) I Plum is gnalur
MP/MPRS Number I
Business Phone Number
Douglas Manthey
MP 230722
715-739-6868
Plumber's Address (Street, City, State, Zip Code)
PO Box 196 Drummond, WI 54832
VI. County/Department Use Only
Approved
❑ Disapproved
0 Owner Given Reason for Denial
Permit Fee I
$/is/z5
Date Issued
Issuin ge am /
�3i 3
Conditions of Approval/Reasons for Disapproval
K RECEIVED
AUG 112025
6Cth2 id.
(� Bayfield Co.
Planning and Zoning Agency
Attach to complete plans for the system and submit to the County only on paper not less than s trz x 11 inches in size
SBD-6398 (R. 0322)
Wisconsin Department of Safety and Professional Services
S K�3
Page 1 of
Division of Industry Services
SOIL EVALUATION REPORT
In accordance with SPS 385, Ws. Adm. Code
County
Bayfteld
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,
I Parcel I.D.
scale or dimensions, north arrow, and location and distance to nearest road.
I Tax ID 36312
Please print all information.
Rexlew_ �w -
Owner
Property Location
❑
BProperty
ttt Gemlo
Govt. Lot V.
%. S 25 T 44 N R 8
E (or) W
Property Owner's Mailing Address
Lot #
Block #
Subd. Name or CSM#
800 Summit Ave No 2
1
1772 V 10 Pg 256
City State Zip Code Phone Number
❑ City ❑ Village
® Town
Nearest Road
St Paul I MN 55105 I
Drummond I
47450 Td Lakes Rd
❑ New Construction Use:® Residential/Numberof bedrooms 3 Code derived design flow rate 450
GPD
RECEIV
r C G
EL)
0 Replacement ❑ Public or commercial — Describe:
Parent material Glacial Outwash
Flood Plan elevation if applicable_ ft.
flAY
I 1
General comments and recommendations:
1 LOLJ
1❑ Boring # ❑ Boring
® Pit
Ground surface elev. 98.5 ft. Depth to limiting factor 90 in.
0111 ng and
Soil Aoolication Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft'
*Eff#1
'Eff#2
1
0-6
7.5 YR 3/1
Is
2msbk
mvfr
cs
3f
.7
1.6
2
7-35
7.5YR 4/6
s
Osg
ml
ow
.7
1.6
3
36-90
7.5 YR 4/4
s
Osg
ml
.7
1.6
2❑ Boring # ❑ Boring
® Pit Ground surface elev. 105 ft. Depth to limiting factor 100 in.
Fnil Annlll eafinn Rate I
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
'Eff#1
*Eff#2
1
0-6
7.5 YR 3/1
Is
2msbk
mvfr
cs
3f
.7
1.6
2
7-28
7.5YR 416
s
Osg
ml
ow
.7
1.6
3
29-100
7.5 YR 4/4
S
Osg
ml
.7
1.6
CST Name (Please Print)
Signature
CST Number
Dan Burch
253808
Address
Date Evaluation Conducted
Telephone Number
N5921 County H K Spooner wi 54801
4-20-21
715.416.1642
RE
._r I.f rRVY/I/
6 h L. G. � r i rrrrr����
AUG 1 1 2025
Bayfeld Co.
Planning end _?c•mmn Anenry
3❑ Boring # ❑ Boring
® Pit
Ground surface elev. 105 ft. Depth to limiting factor 1�0 in.
Soil Anntication Rata
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
tEff#2
I
0.6
7.5 YR S/1
Is
2msbk
mvfr
cs
2m
.7
1.6
2
7-30
7.5 YR 4/4
Is
Osg
ml
cw
2m
.7
1.6
3
31-100
7.5YR4/4
s
Osg
ml
.7
1.6
❑ Boring# ❑ Boring
❑ Pit Ground surface elev. _ft.
Depth to limiting factor _ in.
Snil AnnrwiHon Rafe
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
tEtf#1
,Eft#2
❑ Boring ❑ Boring
#
❑ Pit Ground surface elev. ft.
Depth to limiting factor _ in.
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft'
tEtf#1
¶Eff#2
Effluent#1 = BOD, > 30 5 220 mg/L and 155>30 5150 mg/L * Effluent #2 = BOD, >30S220 mg/L and TSS > 30 5150 mg/I.
REDEZUED
AUG 112075
Bayielo Co.
planning and Zoning Agency
CHECK BOX AS APPIJCABLE CHECK BOX AS APPIJCABLE Q✓ SOIL EVALUATION 0 scale:' 30 so 45 60 R] SYSTEM PAGE 2 OF
SITE MAP PLOT PLAN
PROJECT NAME: T 5� DESIGN FLOW: 450 GPO
Gemlo System Attach design flow calculations for commercial plans.
PROJECT ADDRESS: 47450 Tri Lakes Rd Pipe Material / ASTM Standard (Tables 384.30) & 384.30-5)
N sanitary Sewer. Sch 40 PVC /
BM Symbol: 4- BM Elevation: 1 00 FT Force Ma
ln: /
BM Description: nail in $n Pine
lndlcatenorhb/ - IMPORTANT:
Slope Gradient (%) 13 well Symbol (It apptcable): 0 drawing an anon Show ground elevation contours at suitable intervals.
of Tested Area:on the epprapola tine.
I !? ' Q'-ic y G� -a YL n�Ia�S d. S
Q rJ '✓IG56&#oa O/OO (A^/`
Ex 1' y*JN
P
Oi0 S jSTE'^ ozv 5YSte
0
ac 3g0<3
:`.E:OE;VED
AUG 1 1 Z025
Bavfield Co.
planning and Zoning Agency
BAYFIELD COUNTY
CHECKLIST FOR SANITARY APPLICATONS
Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e))
Check List
E?&iginal Sanitary Application (Submitted in Deed Holders Name — ng_tt prospective buyers) (383.21(1)1.)
EWdex Page / Title Sheet (Signed by Plumber) (383.22(2)69(c))
Ekd?iginal Plot Plan (383.22(2)2. 3. & 4.a)
Er'Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer
L—_ /Pump Tank Diagram, Alarm and Pump Curve (when applicable)
LfContingency Plan / Management Plan (383.22-3(2)(b)1.f.)
L3llaintenance 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)
rfFee (Make Check Payable to Bayfleld County Zoning) (383.21(2)(c)7)
CY(Compiete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached
to all copies)
C -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)
Application Information must include: ❑ 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete)
D"Poject Address or Road Name where driveway is/will come off of)
Type of Building
III Type of Permit
Type of POWTS System
Ca'V Dispersal / Treatment Area Information
Tank Information
ErVII Responsibility Statement (Plumber's Information)
*Date Stamp*
Plot Plan: (To Scale or To Dimension)
[3 -Signature and Plumber Information
❑ Surface Elevation of Body of Water
O'irection and Percent Land Slope
E k and Filter Information and Location
❑ Wetlands / Navigable Bodies of Water
if Absorption Area (Proposed and Existing)
I7iench Mark (Location, Elevation and Description)
Q'fomponent Manual Version
❑/
❑-(OV ners Phone Number)
RECEIVED
AUG 1 1 2025
eayfield Co.
Planning and Zoning Agency
ddress Number and Road
❑ North Arrow
E Contour Lines
ff'itructures and Driveways
Cd Boring Locations
E3Property Lines
PfWell Locations
❑-tegal Descriptions
Turn Over ►
Cross -Section and Over -Head Profile of the System:
O'Surface and System Elevation
C3 Position of Observation and Vent Pipes
limensions and Depths
ake, Model & Number of Chamber Units in each Cell
Property Information
IHow many systems will there be on this parcel of land?
O Has this property been split? (Property Statement shows Property History)
Fees:
'Private Sewage System (Septic Tanks)
$ 400.00
❑ Private Sewage System (Holding Tanks)
$ 400.00
❑ Mounds or Systems requiring Pre -Treatment
$ 500.00
❑ Sanitary Revisions
$ 25.00
❑ Private Sewage System Reconnection
$ 50.00
and Private Interceptor
❑ Return Inspection
$ 50.00
❑ Maintenance Agreements +
$ 30.00
(checks made out to Reg of Deeds)
RPCEsVED
AUG 112025
Bayfield Co.
Plannlny and 7oriru P.ger.c'
u/forms/checklists/checklistforsanitaryapps(10/2009);(07/2011);(®2/2012)(®5/2/2012-dc) Proofed by: _
PAGE 1 OF'
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 Al Index & Cover Sheet
Pg 2 of 14 Plot Plan
Pg 3 of q! Pump Tank Specifications
Pg y of 1 Management Plan
Attachments:
Pump Curve I POWTS Application for Review
Previous Sanitary Permit Packet Soil Evaluation Report & Site Map
Project Name / Description
Gemlo Garaqe
Owner Name(s): Brett Gemlo
Owner Address: 47450 Tri Lakes Rd Drummond, WI
Project Address: 47450 Tri Lakes Rd
Govt. Lot:
1/4 of
Township: Drummond
Project Parcel ID #: 36312
Phone: 612 868 5223
Zip: 54832
1/4, Section 25 , T44 N -R 08 E ❑or W ❑✓
County: Bayfield
Designer Information
Designer Name: Doug Manthey
Designer Address: PO Box 196 Drummond, WI
E-mail: norpines@chegnet.net
License Number: MP 230722
Remarks:
Phone: 715 739 _6868
Zip: 54832
This si*aw resc ved for approval stamp.
RECEIVED
AUG 1 1 2025
Bayfield Co.
Planning and Zoning Agency
Signature: Date: 07/28/25
Origi signature required on each ubmitled copy.
Gevt„ \o C-cta e
'-PV4so Ty, LcWc5 Rnj
Tot." 0; ()+tnw vHoindl
s�S `( qi j RoBW
lax It; 3(,3) 2
Sw3\z I' 3o
0 30
oIO S?fE"`
1--L
t. /ocet co
e Brh - nal I [� 8" :« = loo. o
qc 'o
Gk etc,, ti- 4c -v L = 98.0
QCt5C 2 e -c' y
Igo � j�oliS^3t S
'a W/Sy2/OQ o%%O
PIS
OzDSY-S ti
t.EGE;VE
AUG 1 1 2(
Bayfield Co.
Planning and Zoning
Au Cfnu j;p,,�S-�-O bt
S(t, yo o' SD R 3s PU C.
- Cov�pONcvJ rt^a t v 1 - Gcua4 &d
FtLr4o,
4-
RcA1'S UcrSiot .2.
73o%4Z
PAGE 3 OF y
GRAVITY -DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4"0 Vent Pipe
>10 ft from
Building
12" Min. or 2.0 ft above
Established Flood Elevation
(typical) Approved
IMPORTANT: Vent Cep
Anchor tank(s) as necessary
pursuant to SPS 383.43(8)(g)
Finished Grade
CAPACITIES @ 11.82 gaUn CL
d
Depth (in)
Volume (gal)
A
26.2
309.68
B
2.0
23.6
[C]
2.8
33.1
D
12
141.84
*Pump Tank Liquid Level = 43 in
Force Main Diameter = 2 in
Force Main Length = 40 ft
Force Main Void Volume = 3.6 gal
Electrical must comply with
SPS 316 and NEC 300
Weatherproof Extend manhole riser as necessary.
Junction Box
Approved Locking Manhole
with Warning Label Attactred
(typical)
Conduit .[ ft
4" Min. or 2.0 it above
Established Flood Elevation
(typical)
i Airtlph Seal�I/
I-.
*T
A
I
B
Pump
D
f _ 18"Min.
(typical)
- Approved Joints with
Approved Pipe 3 ft onto
Solid Ground
(typical)
PUMP -OFF
ELEVATION = 93.4 ft
Concrete Li INSIDE BOTTOM
Block ELEVATION = 92.4 ft
4..
3" Approved Bedding Material Beneath Tank
[C] Total Dose Volume (TDV) = 33.6 gal/dose
L< 0. design flow + force main void volume)
RECEIVED
AUG 11 2025
BaVf etd Co.
Planner..,; ,d mac. ng'5enGy
Vertical Lift = 3'6 ft
PUMP TANK:
Volume = 500 gal
Manufacturer. Wieser Concrete
Pump Manufacturer:
Goulds
Pump Model: EPO411
(See altatltetl pump nrrve.)
Controls/Alarm Manufacturer:
SJE Rhombus
Controls/Alarm Model:
1025830
Float switches containing Float switches containing mercury are
SEPTIC TANK(S):
Total Volume = 840 gal
Manufacturer(s): Wieser Concrete
Install approved effluent filter at the septic tank outlet
immediately upstream of the pump tank inlet.
Filter Manufacturer: Orenco
Filter Model: PSCS0621-18
PAGE 4 OF 4
In -ground Dosed -Gravity Management Plan
IMPORTANT:
The owner of this in -ground dosed -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 ODeratino Limits:
Design Flow =
150
gpd; BOD5 5 220 mgL"'; TSS 5150 mgL"'; FOG ≤ 30 mgL"'
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system MW' 12025
o nuisance factors (i.e. odors, user complaints, etc.)
o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) eayFieid Co.
o material fatigue (i.e., leaks, breaks, corrosion, etc.) planning and = n` a `ganry
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 (Le., pump re -cycling, float switch settings, etc.)
o electrical components - if applicable (Le., 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 necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local government unit In accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: HK Septic Septic
Local government unit: Bayfield County Zoning Phone: 715-373-6138
Local government unit address:
PO Box 58 Washburn, WI
Phone: 715-798-3494
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.
4" CAST —A
0
Li
Li
I LET
v 0
A 0..
V
2r—
—T1 -7f--
7 N J
I Ho...
I:t 1
M
SIDE VIEW
OR EXCEED ASTM C-1227
4" CAST —A —SEAL
N �
L J o
�
≥ U 'c
� n
i 5 r N nl
o
3L Co m w
rcc
a
0-
4" VENT
OUTLET
U
0a a
PAD
W840/500- MR
TANK SPECIFICATIONS
DIMENSIONS:
WALL: 2 9/16"
BOTTOM: 3"
COVER: 5"
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
HEIGHT: 59 1/2"
LENGTH: 9'-5 3/4"
WIDTH: 7'-9"
BELOW INLET: 48"
LIQUID LEVEL: 43"
WEIGHT: BOTTOM 7,360 LBS.
COVER 3,790 LBS.
INLET AND OUTLET:
4" CAST -A -SEAL BOOT OR EQUAL GASKET
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN. SEE DETAIL #10
(OTHER STATES SEE CHART)
LIQUID CAPACITY: 19.61 GAL/IN (SEPTIC)
11.82 GAL/IN (PUMP)
LOADING DESIGN: 8'-0" UNSATURATED SOIL
TANK CAN BE USED AS:
SEPTIC/SEPTIC, SEPTIC/PUMP,
OR SEPTIC/SIPHON
COVER: MIX DESIGN #8 (NO FIBER)
TANK: MIX DESIGN #10 (STRUCTURAL FIBER)
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
REVIEWED BY
REVIEW DATE
DRAWINGS SUBMITTED
FOR APPROVAL
APPROVED BY:
APPROVAL DATE:
PRODUCTS NEEDED BY:
1EET NO.
1 1
MGOULDS PUMPS
APPLICATIONS
Specifically designed for the
following uses:
• Effluent systems
• Homes
• Farms
• Heavy duty sump
• Water transfer
• Dewatering
SPECIFICATIONS
• Solids handling capability:
3/an maximum.
• Capacities: up to 60 GPM.
• Total heads: up to 31 feet.
• Discharge size: 1'/2" NPT.
• Mechanical seal: carbon-
rotary/ceramic-stationary,
BONA -N elastomers.
• Temperature:
104°F (40°C) continuous
140°F (60°C) intermittent
• Fasteners: 300 series
stainless steel.
• Capable of running
dry without damage to
components.
Motor:
• EP04 Single phase: 0.4 HP,
115 or230V,60Hz,1550
RPM, built in overload with
automatic reset
• EP05 Single phase: 0.5 HP,
115 V or 230V, 60 Hz, 1550
RPM, built in overload with
automatic reset.
• Power cord: 10 foot
standard length, 16/3
SJTOW with three prong
grounding plug. Optional 20
foot length, 16/3 S1TW with
three prong grounding plug
(standard on EP05).
® 2002 Goulds Pumps
Effective September, 2002
B3871
• Fully submerged in high
grade turbine oil for
lubrication and efficient
heat transfer.
Available for automatic and
manual operation. Auto-
matic models include
Mechanical Float Switch
assembled and preset at the
factory.
FEATURES
.■ EP04 Impeller Thermoplas-
tic Semi -open design with
pump out vanes for mechanical
seal protection.
METERS II FEFT
10Y
Q 7
x
u 6
z5
4
- 3
Submersible
Effluent Pump
3871 EP04
EP05
■ EP05 Impeller: Thermoplas-
tic enclosed design for
improved performance.
■ Casing and Base: Rugged
thermoplastic design provides
superior strength and corrosion
resistance.
■ Motor Housing: Cast iron
for efficient heat transfer,
strength, and durability.
■ Motor Cover: Thermoplastic
cover with integral handle and
float switch attachment points.
■ Power Cable: Severe duty
rated oil and water resistant.
■ Bearings: Upper and lower
heavy duty ball bearing
construction.
AGENCY LISTING
0 Canadian Standards Association
Goulds Pumps is ISO 9001 Registered.
FECEIlFED
AUG 112025
Sayfeld Co.
Planning and Zuning Agency
0 2 4 6 8
CAPACITY
10 12 m3/h
Goulds Pumps
4& ITT Industries
11111 DIV IlDI 1111111111111 IIIIIIIIIIIII III IIIIIIII
*2021R-588612 2*
Private Sewage System Maintenance Agreement
Brett Gemlo & Elizabeth Snelson
Summit Avenue, St Paul, MN 55105
47450 Tri Lakes Rd, Cable, WI 54821
36312
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 25 Township 44 N. Range 08 W
Additional Legal Description:
Town of
Lot_ Block Subdivision
(Acreage) 38.8 Gov't Lot 2
Lott CSM # 1772 Vol. 10 Page 256 CSM Doc #
20218-588612
DANIEL J. HEFFNER
BAYFIELD COUNTY, WI
REGISTER OF DEEDS
05/11/2021 10:29AM
TF EXEMPT #:
RECORDING FEE: 30.00
PAGES: 2
Recording Area
Return To:
Planning and Zoning Department
IN
In -ground gravity
0 In -ground dosed
0
In -ground pressure distribution Sewage System:
O
Mound
❑ At -grade Sewage System
❑
Other
Seotic 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 -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 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 dlLJ Vs and charges
maybe placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be coll¢5 pp(y[jpy law.
The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future
r_7?
Owne Namq(g) — P se Pri
Y �t be m `D ' t' • c Q
rfr 2A �xA-V� �k.C5l�
Subs 'bed and swornto before me on th dtRB: Y r L /
= PUBLIC
7 �1 ,r
adz r —Sig s)
N Public
MyCo ion Expires: RECE ED
Drafted byn-ft ♦ V Date: "/Z-
AUG 112025
Proofed by:
BaYfal9 Co. ment
'�°'fi 2yF.°Pq!Psey 2020
IIHIIll 11111 11111IIII H Blll IfiI II!! IIII liii liii!! l IIII IIIl
t2021R 587879 1*
State Bar of Wisconsin Form 3.2003
QUIT CLAIM DEED
THIS DEED, made between
valuable consideration. ("Grantor," whether one or more),
and Brett T.Gemlo and Elizabeth A. Snelson, husband
common ("Grantee," whether one or more).
Grantor, quit claims to Grantee the following described real estate, together
with the rents, profits, fixtures and other appurtenant interests, in
BAYFIELD Comity, State of Wisconsin ("Property")
(if more space is needed, please attach addendum):
Lot 2 of Certified Survey Map No. 1772, recorded
.December 22,.2011 in Volume 10 of Certified Survey
Maps, pages 256-257 as Document No. 2011R-541699.
Together with an access easement for ingress and
egress over and across Lot I of said Certified
Survey Map from Tri Lakes Road to said Lot 2 as set
forth in Certified Survey Map No. 1772,
2021R-587879
DANIEL J. HEFFNER
BAYFIELD COUNTY, WI
REGISTER OF DEEDS
04/01/2021 01:10PM
IF EXEMPT #: 814
RECORDING FEE: 30.00
PAGES: 1
Name m,d Rclum Address
Northwest Land Title
P0 Box 520
Milltown, WI 54858
2//03(O
Subject to existing highways and subject to
restrictive covenants, easements, restrictions and
04-018-P-44-08-25-4 05-002-220.00
-reservations of record. Also subject to all
governmental zoning, building or land use I'ntedtilmthomenead property.
regulations. This is not homestead ptorp�ep�nay77.�� ` r}�
g (i$(is not) RECE VED
Dated(/25/Z0Z /
AUG 112025
Bayfield Co.
Planning and Zoning Agency
(SEAL (SEAL)
*Brett Gemlo
(SEAL) (SEAL)
a
AUTHENTICATION ACKNOWLEDGMENT
"
Signature(s) STATE OF NJ (k%AV%dok% —)
0" COUN
authenticated on
Personally came afore me on TY)
3 —. —ZV11 ,
the above -named Brett Cemlo
S
TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the u t e
(If hot, foregoing in Ilnent-nd . o the �qf(1 L DELLWO
authorized by Wis. Smt. § 706.06) NOTARYPUBDC-MINNESOTA
M
THIS INSTRUMENT DRAFTED.BY: Com xpires
Todd H. Anderson. Attorney at Law Notary Public, State of Wiseensialf:l t S;"17
PO Box 507 , Grantsburg. WI 54840 My Commission (is permanent) (expires: I— 31-,1)
(Signatures may he aullientles tad or aeknoniedged. Both one not neceuarr.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO T111S FORM SHOULD BE. CLEARLY IDENTIFIED.
QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No. 3.2003
'Type name below signatures.
rclr51Andn10e lawtlmw116 IMdhe MtG,vn,dnp.w154340 t'Se I715N633665- Vat t115N6Y50N nun', wnmoba.d
Roduced x11h Lrm®by xipinah 18010 Fifteen Mie Reed, hew, MltlJaen 46026 vew othi na• l'
Bayfield County Register of Deeds Document # 2021 R-587879 Page 1 of 1
l)56) £ f) PAGE 1 OF 4
In -Ground Gravity Plan
Index & Cover Sheet
Component Manual Design References:
Version 2.0, SBD-10705-P (N.01/01, R. 10/12)
Pg1of4
Pg 2 of 4
Pg 3 of 4
Pg 4 of 4
Attachments:
Index & Cover Sheet
Plot Plan
Dispersal Area Cross -Section & Plan View
Management Plan
POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
Owner Name(s):
Owner Address:
1ba-e I t
c'cfru o
Phone:
�+°�
a 9r^M Zip_
gO0
s j "'tr A � � /JO
Project Address:
L17`IS-J
-ra, Li4K�s a1)
Govt. Lot: 114 of 1/4, Section�S , T_'/YN-R q E U or W W
Township: & County: VAYF)El_P
Project Parcel ID#: ( ��� '�� 31
5-c I35__
Designer Information AUG 1 1 2025
Designer Name: Dan Burch Phone: 715 _416 _1642 -,
Designer Address: N5921. Cty Hwy K Spooner WI Zip: 54801
E-mail: Burchpiumbinginc@gmail.com This space reservedfor approval\stamp.
License Number: 253808 phi • SW
CO dtbor� i ��
Remarks: fl \1
n.
.4T'Z J/ /t&A \, Signature: Date:
Original signature required on each submitted copy.
IN -GROUND GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard -W Chambers
3 -ft Trench (down -sizing credit)
SOIL COVER
min. teeth
rbpe
ma tr
orpmg
Septic Tank(s) Manufar.taer:
Wieser
Septic Tank(s) Volume(s):
1000 gel _ gat _ gal _ gel
Effluent Filter Manufacturer
Polvlok
Effluent Filter Model t 525
TYPICAL TRENCH
''� CROSS SECTION VIEW
(typ ) t�l. .. (No Scale)
System Elevation = 9696_10c ft
(typical)
Provide minimum 3 ft
separation between trenches.
Quick4 Standard -W
wl End Cap obeervatkn Pipe TYPICAL TRENCH
Install per manufacturers PLAN VIEW
(Show location of inlet I outlet pipe connection on plan view.) prplrml
(tYPical)
ImWctbns. (No Scale)
------ - --------It ------ —
A (3)
--------��-------yf-- ---
g = 128 ft �{ m
(typical) Quick4 Standard -W Chamber(tyW
INSTALL PER TRENCH: ltnu SD
(mfd by IMAtretorla Syem, tmw.) —�
Install pursuant In manufacturers krehuobm.
32 Quick4 Std -W § 20 fP EISA/chamber = 640 ft
+ 1 Palrs of end caps @ 6 ft EISA/pair = 6 ft
= Proposed EISA per trench = 646 ft' Required Infiltration Area= 643 ftr Distribution Method:
x 1 trenches = Proposed Total EISA = 646 E lii
ISIJ
REC6rVED
AUG 1 12025
hayfield Co.
planning and Zoning Agency
PAGE 4 OF 5
GRAVITY -DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4" 0 Vent Pipe
>10 ft from
Building
12" Min, or 2.0 fl above
Established Flood Elevation
(typical) Approved
IMPORTANT: Vent Cap
Anchor tank(s) as necessary
pursuant to SPS 383.43(8)(g)
Finished Grade
CAPACITIES @ 11.82 gal/in
Depth (in)
Volume (gal)
A
31
366.42
B
2.0
23.64
[C]
6
82.42
D
12
141.84
*Pump Tank Liquid Level = 51 in
Force Main Diameter = 1.5 in
Force Main Length = 125 ft
Force Main Void Volume = 11.5 gal
Electrical must compty with
SPS 316 and NEC 300
_... Extend manhole riser as necessary.
g ..
*T
l IAj
1_ L
B
II
Approved Locking Manhole
with Warning Label Attached
(typical)
Conduit 4" Min. or 2.0 ft above
Established Flood Elevation
` I (typical)
r—Airdght Seal _ �I/ \I/
16" Min.
(typical)
Weep Approved Joints with
Hole Approved Pipe 3 fl onto
Solid Ground
(typical)
_Alarm
—On
PUMP -OFF
_ofl ELEVATION = 91 ft
3" Approved Bedding Material Beneath Tank
[C] Total Dose Volume (TDV) = 82.42�gal/dose
( 00.2X design flow + force main void volume)
15
Vertical Lift = _ ft
PUMP TANK:
Volume = 600 gal
Wieser
Manufacturer:
Pump Manufacturer: Zoeller
Pump Model: 152 (See attached pump curve.)
Controls/Alarm Manufacturer: SJElectro
Controls/Alarm Model: tank alert
Float switches containing mercury are prohibited.
INSIDE BOTTOM
ELEVATION = O ft
AUG 112025
Bavfeld Co.
Planning and Zoning Agency
SEPTIC TANK(S):
Total Volume = 1000 gal
Manufacturer(s): Wieser
Install approved effluent filter at the septic tank outlet
immediately upstream of the pump tank inlet.
Filter Manufacturer: polylok
Filter Model: 525
LU
LU W PUMP PERFORMANCE CURVE
MODEL 151/152/153
50
14 45 153
12- 40
0 35
\ -
10 152
30
0 8- 25 151
J
6- 20-
15-
4-
10-
2-
5-
0'
10 20 30 40 50 60 70 80 90 10(
GALLONS
LITERS 0 40 80 120 160 200 240 280 320 360
FLOW PER MINUTE 014508
AUG '112025
E: J,a Co.
'Do 5 c rI 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; BODS 5 220 mgL''; TSS 5150 mgL-'; FOG 530 mgL-1
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 (Le., 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 (Le., wiring, connections, switches, controls, timers, alarms, etc.)
o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification)
o surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Stats. when the volume of solids In the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code.
o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local government unit In accordance with
SPS 383.55 Wlsc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: Dan Burch
Local government unit: Bayfield County Zoning Phone: 715-373-6138
Local government unit address:
PO Box 58 Washburn WI
Phone: 715.416.1642
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.
AUO 1 1 2025
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.
Real Estate Bayfield County Property Listing
Today's Date: 8/5/2025
' Description
Updated: 3/6/2024
Tax ID:
36312
PIN:
04018-2-44-08-25-4 05-002-22000
Legacy PIN:
Map ID:
Municipality:
(018) TOWN OF DRUMMOND
STR:
525 T44N R08W
Description:
LOT 2 CSM #1772 IN V.10 P.256
(LOCATED IN GOVT LOT 2) IN DOC
2021R-587879
Recorded Acres:
38.800
Calculated Acres:
38.800
Lottery Claims:
1
First Dollar:
Yes
ESN:
111
P Tax Districts Updated: 2/17/2012
1
STATE
04
COUNTY
018
TOWN OF DRUMMOND
041491
SCI-IL-DRUMMOND
001700
TECHNICAL COLLEGE
y� Recorded Documents
Updated: 2/17/2012
O QUIT CLAIM DEED
Date Recorded: 4/1/2021
2021R-587879
0 QUIT CLAIM DEED
Date Recorded: 4/3/2012
2012R-543188 1080-409
O TRUSTEES DEED
Date Recorded: 4/3/2012
2012R-543186 1080-403
0 TRUSTEES DEED
Date Recorded: 4/3/2012
2012R-543185 1080-398
0 CERTIFIED SURVEY MAP
Date Recorded: 12/22/2011
2011R-541699 10-256
Property Status: Current
Created On: 2/17/2012 9:17:25 AM
Ownership updated: 4/6/2023
BRETT GEMLO DRUMMOND WI
ELIZABETH A SNELSON DRUMMOND WI
Billing Address:
Mailing Address:
GEMLO, BRETT & SNELSON,
GEMLO, BRETT & SNELSON,
ELIZABETH A
ELIZABETH A
47450 TRI LAKES RD
47450 TRI LAKES RD
DRUMMOND WI 54832
DRUMMOND WI 54832
P Site Address * Indicates Private Road
47450 TRI LAKES RD DRUMMOND 54832
® Property Assessment
Updated:
8/9/2021
2025 Assessment Detail
Code
Acres
Land
Imp.
Cl-RESIDENTIAL
2.000
276,500
102,100
G6 -PRODUCTIVE FOREST
36.800
55,200
0
2 -Year Comparison
2024
2025
Change
Land:
331,700
331,700
0.0%
Improved:
102,100
102,100
0.0%
Total:
433,800
433,800
0.0%
Lam' Property History
Parent Properties Tax ID
04-018-2-44-08-25-4 05-002-20000 14765
HISTORY O-Exoand All History White=Current Parcels Pink=Retired Parcels
O Tax ID: 14765 Pin: 04018-2-44-08-25-4 05-002-20000 Leg. Pin: 018110804000
36312 This Parcel t Parents 4 Children
RECEIVED
AUG 1 1 2025
Baylleld Co.
Planning and Zr n Ing Agency
County
Industry Services Division
Bayfield
$P$' ,I
1400 E Washington Ave
P.O. Box 7162
Sanitary Permit Number(to be filled in by Co.)
`;
Madison, WI 53707-7162
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
Project Address (if different than mailing address)
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
47450 Tri Lakes Rd
es in accordance with the Privacy Law. s. 15. 1 m Stats.
L Application information — Please Print All Information
Property Owner's Name
Parcel ii
Brett GeMo
112011
36312 tax ID
NAY
Property Owner's Mailing Address
Property Location
800 Summit Ave NO 2 Bay5ekl
Govt Lot
'1/, %., Section 25
City, State IZip
Code
Phone Number
St Paul, MN
55105
(circle one)
T44N R8EorW
U. Type of Building (check all that apply) e�
Lot q
®Ior2Family Dwelling — Number ofBedrooms J
1
Subdivision Name
❑ Public/Commercial — Describe Use
Block #
0 City of
❑ State Owned — Describe Use
❑ Village of
CSM Number
1772
® Town of Drummond
M.III.Type of Permit: Check only one box on line A. Corn lete line B if applicable)
A.
❑ New System
® Replacement System
I ❑ Treatment/Holding Tank Replacement Only I
❑ Other Modification to Existing System (explain)
❑ Permit Renewal
❑ Permit Revision
❑ Change of
I ❑ Permit Transfer to New
List Previous Permit Number and Date Issued
B.
Before Expiration
Plumber
Owner
W.
Type of POWTS System/Component/Device: (Check all that apply)
® Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade 0 Mound ≥ 24 in. of suitable soil ❑ Mound <24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dispersal/Treatment
Area Information:
Design Flow (gpd)
Design Soil Application
Dispersal Area Required (sl)
Dispersal Area Proposed (sl) System
Elevation
450
Rate(gpdsf)
643
652
/v! —
.7
VL Tank Info
Capacity in
Gallons
Total
# of
Manufacturer
New Tanks
ExistingTanks
Gallons
Units
g
a.
o 8 e
U in
3
h
A
Septic or Holding Tank
1000
1000
1
Wieser
Dosing Chamber
OO
606
1
Ulestr.D_DO.
VII. Res onsibility Statement- I, the undersigned, assume its
msi tity Installation of the POWTS shown on the attached plans.
Plumber's Name (Prim)
Plumber's Si
MP/MPRS Number
Business Phone Number
Dan Burch
253808
715.416.1642
Plumber's Address (Street, City, State, Zip Code)
1118N Front Street Spooner WI 54801
VIII. County/Department Use Only
Approved ❑ Disapproved
Permit Fee
L.Ve�
Date Issued
ue!�
S�
1 g ure _
547 '
0 Owner Given Reason for Denial
$
O Q
IX. Conditions of Approval/Reasons for Disapproval
Attach to complete plans tier roe system ana suomsno me County only on paper nut leu um,' o u.. *41111W Va u,
AUG 112025
SBD-6398 (803/14) Lav: -'A Co.
P;onninG
BAYFIELD COUNTY SANITARY PERMIT (#04)-21-39S
STATE SANITARY PERMIT
OWNER: BRETT GEMLO
GOV LOT: LOT: BLK: 0
CSM:
SUBDIVISION:
1/4 1/4 SEC: 25, T 44 N, R 8 W
TOWNSHIP: DRUMMOND
SOIL TEST: 47-21
REPLACEMENT SYSTEM
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,
a The sanitary permit Is valid and may be renewed for specified
period.
d. Changed regulations will not impair the validity of a sanitary
permit.
a 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 #:
SYSTEM TYPE: Non -Pressurized In -Ground
PLUMBER: DAN BURCH LICENSE: # 253808
TRACY POOLER DATE: 5118/2021 Condition:
Authorized Issuing Officer
THIS PERMIT EXPIRES 5/18/2023
POST IN PLAIN VIEW
MUST BE VISIBLE FROM ROAD FRONTING THE LOT DURING CONSTRUCTION
REc EiVED
AUG 11 2025
Bayfield Co.
Planning and Zoning Agency
31YFIELD 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:
SNELSON, ELIZABETH A
47450 TRI LAKES RD
DRUMMOND, WI 54832
GEMLO,BRETT
47450 TRI LAKES RD
DRUMMOND, WI 54832
Description
Private Sewage System (Septic Tanks)
Submission Number:
SS -00623
Transaction Number:
SS -00623-32779
$400.00
Total: $400.00
Payment Amount: $400.00
Reference: 5326
Paid by: A -Z Enterprises, Nor -Pines Plumbing, PO Box 196, Drummond WI 54832
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)-25-106S
STATE SANITARY PERMIT
OWNER: BRETT GEMLO
GOVT LOT: LOT: 2 BLK:
CSM: 1772
1/4 1/4 SEC: 25, T 44 N, R 8 W
TOWNSHIP: Drummond
SOIL TEST: 47-21
OTHER MODIFICATION
SYSTEM TYPE: Non -Pressurized In -Ground
PLUMBER: DOUGLAS MANTHEY
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 #: 21-39S
LICENSE: # MP 230722
Condition: Properly Maintain System Per Recorded Agreement
THIS PERMIT EXPIRES 8/15/2027
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION