Loading...
HomeMy WebLinkAbout25-93SRequest for Sanitary Inspection (24 Hrs. in Advance) Fax this form to Zoning Dept (24 Hrs.) prior to when you want an inspection — (715) 373-0114 If you do not have a fax and must email the inspection; you must email all staff members. Note Time Change Discrepancy Other Phone Number Plumber: iQf1d(Y l' Mf!j1sen &-I)S ____________________ Fax Number ry //.5 ' 7` s7 —_Y 7n Homeowner: Email Address —nm(� ncPy;u'S.Fcvr( Immediate Phone Number So Zoning Sanitary Permit #: a Q3 Dept can call you right back (if needed) Plumber's Choice Zoni ept No Inspection(s) during this time Date: a Y Tuesday (9:30 am - 12:15 pm) (Tracy) Time: Plumber's Choice Zoni t 1: ooprn Township: 'US Se// Address # & Road Name: & or 773 '4o Directions us+ nor4h. 43370 ilyde iOf. To Site: Comments: ** Plumbers you must verify any change(s) by fax or email '* Notes from Zoning Dept: ulformslsanitarylrequestforinspection Zoning Dept (©4112/04); @ June 2023 yy,wrtrnq? P Private Onsite Wastewater Treatment Systems ( POWTS). Inspection Report y„E (Attach to Permit) EZRA SMITH 1214 MACARTHUR AVE ASHLAND WI 54806 — — msRnm Gev: — Tank Infnrmafinn TYPEI MANUFACTURER CAPA TY Prop. Line Well Building Air Intake Road Se tic LeptcN/A u i //� N/A Dosin Aeration N/A Hong .setback tn' &-WICL Sanitary ermlt No: State Plan'Transaction ID#: Parcel Tax No: Pump / Siphon Information Pump Man cturer L 1, Pump Model C Demand I GPM Filter ManufacSr IFilter Model TDH Lift Friction Loss Head Total Forcemain Len Dia Dist To Well Dispersal Cell Information DIMENSIONS Width Leggtly, #of Cells SETBACK FROM P p. Line Bujl�c gg/r it OHWM Type of Cell ul a?tI1 u Manufacturer: Model Number. Pretreatment Unit Manufacturer: Model Number: Elevation Data STATION BS HI FS ELEV Benchmark r O Bldg. Sewer r47 Tank Inlet TankOutlet Dose Tank Inlet Dose Tank Bottom ?f, t' �r Inst. Contour Header/Manifold 3 1 g' Distribution Pipe Infiltrative Surface C y5 Final Grade X Pressure Length Die I Length Die Spec IV I I Spacing 0 Yes 0 No coil Cover Depth Over Depth Over Depth of Seeded / Sodded Mulched Cell Center Cell Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) aK U/ R,≤/is JoeI.4Chet,'ns .—..ayTirn4 / r4 4/K P,a,,ie"t pi4Sr !an revision required? O Yes N No a 7 25 se other side for additional information. 3I/r773 Date ;Rn1J9n /R n7/21 POWTS Inspector's Signature License Number As Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-61$8 Fax: (715) 373-0114 e-mail: zonino(a bavfieldcounty.oro Web Site: www.bavfieldcountv.oro/147 EZRA SMITH 1214 MACARTHUR AVE ASHLAND WI 54806 Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 As you know /2i74MU�' aid 4 ��// j was contracted by you to install a private onsite wastewater treatment system on your property (Tax ID# above). To know when your system will be due for servicing please go to www.septicsearch.com Notes: Abandonment of Old System to meet all applicable code requirements: 1 Tank was pumped by: :• Tank was crushed! removed and pipes disconnected by: on at AM/PM On at / (AM /he above -mentioned plumber contacted our office to conduct pre -cover inspection as required under DSPS 383. One of the following applies: g'm�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. td System ccould not be i ysinspected 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. U/forms/sanitarypropertyowner-input April 2019 ,,Yannrsrt�, �� 0C2�J/�0 Industry Services Division 4822 Madison Yards Way County Bayfield 1 0 $ P' $ J E� Madison, WI 53705 P.O. Box 7302 Sanitary Permit Number (to be filled in by Co.) n � '---a-�2 Madison, WI 53707 � Q � t J `��FJ1tO�ia•� anitary 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 TBD - 'Hyde Rd purposes in accordance with the Privacy Law, s. 15.04(l)(m), Slats. . I. Application Information — Please Print All Information Property Owner's Name Parcel # Ezra Smith 28947 Property Owner's Mailing Address Property Location 1214 MacArthur Ave. Govt. Lot City, State I Zip Code Phon Number, Ashland, WI 54806 715-413-0715 NW ,,,. SW r,,, Section 04 T 51 N R 04 E or W U. Type of Building (check all that apply) Lot # Subdivision Name ❑✓ 1 or 2 Family Dwelling — Number of Bedrooms 3 Opublic/Cornmercial — Describe Use Block # ❑Cityof State Owned — Describe Use Village of CSM Number QTown of Russell -III. Type,of POWTS Permit: (Check either "New" or "Replacement" and other applicable online A. Check one box.on line B: Complete line C'i applicable. A. aNew System IFIReplacement System Other Modification to Existing System (explain) i1IAddo11 Pretreatment Unit (explain) B. ❑Holding Tank �In-Ground []At -Grade Mound Individual Site Design JOther Type (explain) (conventional) C. ❑ T Renewal Before Revision Change of Plumber ransfer to New Owner List Previous Permit Number and Date Issued Expiration NA IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) I Dispersal Area Proposed (sf) I System Elevation 450 0.7 642 678 96.0 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units 2o New Tanks Existing Tanks w a U v0 v) is. C7 O. Septic or Holding Tank 1000 1000 1 Superior Precast LLJ Dosing Chamber 600 600 1 Superior Precast LI Q Q V. Responsibility Statement- I, the undersigned, assume responsibility for installation of.the POWTS:shown on the attached plans: Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Jason Kuettel 675751 715-798-3355 Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 .VI_ .County/Department Use Only Approved ❑ Disapproved PermitFee Date Issued 'n ent ' ature O Owner Given Reason for Denial $ '4o0— ii 10 c . 272 5711 Conditions of Approval/Reasons for Disapproval S-e� C a.rol . fl1 JUL 2 5 2025 Attach to complete plans for the system and submit to the County only on oaoer not less than 8 112 x 11 inches in siz SBD-6398 (R. 02/22) PAGE 1OF5 In -Ground Dosed -Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 5 Index & Cover Sheet Pg 2 of 5 Plot Plan Pg 3 of 5 Dispersal Area Cross -Section & Plan View Pg 4 of 5 Pump Tank Specifications Pg 5 of 5 Management Plan Attachments: Enclosures: Pump Curve POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Smith - 3 Bed Owner Name(s): Ezra Smith Owner Address: 1214 MacArthur Ave. Ashland, WI Project Address: TBD - Hyde Rd. Bayfield, WI Govt. Lot: NW 1/4 of SW Township: Russell Project Parcel ID #: 28947 Designer Name: Jason Kuettel Phone: 715 -413 -0715 Zip: 54806 1/4, Section 04 , T 51 N -R 04 County: Bayfield Designer Information Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 Remarks: E ❑or W Phone: 715 - 798 - 3355 Zip: 54847 This space reserved for approval stamp. ff5fl9 11 JUL 252025 hayfield Co. Zoning Dept. Signature: Date: Ongi I gnature required on each submitted copy. Owner Information: BM=100: Nail with ribbon on the base of tree between 131 & 83 I'UP Name: Ezra Smith Location: NW1/4SW1/4.S04.T5lN,R04W 61= 9785 Township: Russell B2 = 97.55 County: Bayfield B3 = 98.05 Lot #: Hyde Road B4= 0 98 97' 131 BM 135' Ground elevation by house = 91.33 7 t W . ' 8V'c cnfl (uor`doo u/ o><-c.+.co r-rt_rz'+` B2 *-y..5CN 40 �v. No Well on property 0 _T N W E S n _ r.. 160' Only in Tested An:a .n m I5SUPER0OR 1000/600 2 -Compartment Tank SUPERIOR PRECAST CONCRETE ~ PRECAST CONCRETE Weight (in lbs) Tank: 0,160 Lid: 58S4 Total:1330-I-I Volume of Concrete Total: 3.8Ycd Gallons Per Inch: 40.6 Lad wan Enlarged Detail SIDE VIEW 1 TT47 ' 1Htt Ji e TOPVIEW 1.43" 2" -----S3-1/---•- 51-1P_"-1 " 19"I951AirSPace Liquid Tim Depth 3 Manhole Openings n -1/2Taper P d d b S 731; 7951 4t' Outlet r cf�il 3 ro uce y uperior Precast Concrete, LLC PO Box 1390 Hayward, WI 54843 Polyethylene affle / SUPERIOR PRECAST CONCRETE Design conforms to ASTM C1227, Specification for Precast Mastic Concrete Septic Tanks and WI SPS 384.25, POWTS Holding Rope Components or Treatment Components. The information provided on any Superior Precast Concrete (SPC) drawing or document shall be verified bythe purchasers licensed professional engineer for suitability of use. Configuration may change from drawing, consult with SPC. IProduct Fite No: I This is proprietaryinformation, and remains the property of Superior Precast Concrete, LLC, I R.3 05-19-20241 IN -GROUND DOSED -GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER 2" min. trench depth (typical) I 34" j -- (typical) ;'a IflVED uU JUL252025 52025 Bayfield Co. Zoning Dept. min. 12" (typical) TYPICAL TRENCH CROSS SECTION VIEW (No Scale) .Q a System Elevation = 96.0 ft (typical) Quick4 Standard -W w1 End Cap (Show location of i (tinlet / outlet pipe connection on plan view.) ypical) r-------------------��--- t------------�j_--------��--- B= 46 ft (typical) INSTALL PER TRENCH: 11 Quick4 Std -W @ 20 ft2 EISA/chamber = 220 ft2 + 1 Pairs of end caps @6 ft2 EISA/pair = 6 ft' Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) �A=3.0ft (typical) "—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. = Proposed EISA per trench = 226 ft' Required Infiltration Area = 642 ft2 x 3 trenches = Proposed Total EISA = 678 ft' Distribution Method: branched manifold D C) m W O m cii I. RESET 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 = 450 gpd; BOD5 ≤ 220 mgL"'; TSS ≤ 150 mgL"'; FOG ≤ 30 mgL"' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Andry Rasmussen & Sons Local government unit: Bayfield Co. Zoning Local government unit address: 117 E 5th St. Washburn, WI Phone: 715-798-3355 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. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved b the deparnqir" accordance with SPS 384, Wisc. Admin. Code. 2 E Contingency Plan JUL 2 52025 In the event that any failed treatment component of this POWTS cannot be repaired, it shall be a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal �W bnJe%it may e 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. PAGE 5 OF 6 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 Cap Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) Finished Grade CAPACITIES @ 14.85 gal in 411 Depth (in) Volume (gal) A 20.5 304.4 B 2.0 29.7 [C] 7.5 112 D 12 178 A B I [C] * Pump Tank Liquid Level = 42 in D Force Main Diameter = 2 in Force Main Length = 135 ft Force Main Void Volume = 22.00 gal Electrical must comply with SPS 316 and NEC 300 fl Weatherproof I ,!unction Box Conduit Airtight Seal 11111 Weep Hole _Alarm —On Pump _Off Extend manhole riser as necessary. Approved Locking Manhole with Warning Label Attached (typical) 4" Min. or 2.0 ft above I T/Established Flood Elevation (typical) Quick Disconnect i• 18" Min. (typical) f l�////// ' Block 3" Approved Bedding Material Beneath Tank [C] Total Dose Volume (TDV) = 112 gal/dose (5X total lateral void volume <_ TDV < 0.2X design flow) + (force main drainback volume) MIN. PUMP DISCHARGE RATE = 40 gpm PUMP TANK: Volume = 600 gal Manufacturer: Superior Precast Pump Manufacturer: Champion Pump Model: CPES3 (See attached pump curve.) Controls/Alarm Manufacturer: SJE Rhombus Controls/Alarm Model: HW101 Float switches containing mercury are prohibited. [ J I Approved Pi 3 fttoo Solid nd (typi JUL 252025 .f Bayfield Co. Zoning Dept. PUMP -OFF 4 ELEVATION = 86 ft INSIDE BOTTOM ELEVATION = 85 ft Vertical Head = 10 ft + Min. Supply Head = - ft + FM Friction Loss = 4.5 ft + Fitting Loss* = - ft '"(min. supply head x 0.3) = TOTAL DYNAMIC HEAD = 14.5 ft SEPTIC TANK(S): Total Volume = 1000 gal Manufacturer(s): Superior Precast Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: Orenco Filter Model: FT0822 /2 HP JT/SUMP H. waterto ensure pump Private Sewage System Maintenance Agreement £z- 5 fss + r �� Owner(s) Mailing Address 1 Z 1 L% Ac. t2 i -. • Ai ti Site Address 'r3. f1Etcb, Tax 10 # _ r _ 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) 'Iz. N! 1.J 1/4 of S t^i 1/4 Section O `l Township 5J N. Range a L( W. Additional Legal Description: Town of Lot Block Subdivision (Acreage) Gov't Lot Lot CSM # Vol. Page CSM Doc # Return To: /ti( i4 )3�rVst€�f� GA. 2025R-608604 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED O8/O1/2O25 AT 2:14 PM RECORDING FEE: $3O.OO PAGES: 1 Recording Area Planning and Zoning Department ❑ In -ground gravity ] In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound O At -grade Sewage System ❑ Other Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturers specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code, Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds. At -grade, and In -ground Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbed if needed when the wastewater distribution cell component is inspected as provided above. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system. Bayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. The terms and conditions of the agreement shall be binding upon and i to the benefit of all current and future owners of such property. Owner(s) Name(s) — Please Print � 4ed and sworn to before me on this date: -►s L Z lZA SM I 'Th X00 f 1/�1� Notarized Owners — Signature(s) ' ;¢ M� to i C th4*jW\&o Ission Expires: . l — 2o'8 Drafted by: 7?A\ (.L/ J&. Date: ZZ 2s Proofed by: utformslsanitary/septicmaintenceagreement Revised July 2020 • e Wisconsin Department of Safety and Professional Services Attach complete site plan on paper not less than 81, X 11 Soil Evaluation Report in accordance with SPS 385,WisAdm Code s�-oo�vz inches in size. Page: 1 of 5 • 541! TEST Plan must include but not limited to: Vertical and horizontal reference County: point (BM), direction and percent slope, scale or dimensions, north arrow, Bayfleld Parcel l.D. location and distance to nearest road. Please Print All Information 28947 i d Date: Personal information you provide may be used for secondary purposes. (privacy Law,s.15.04(1)(m)). .7 Property Owner. Property Location Ezra Smith NWII4SW114,S04,T51N,R04W Property Owners Mailing Address: Site Address or CSM and Lot # 1214 Macarthur Ave Hyde Road City State I Zip Code Phone Number: Town Nearest Road: Ashland WI 54806 0 Russell Hyde Road Number of Bedrooms: 3 r New r Residential Code derived design flow rate: 450 Flood Plain if applicable '-` Replacement rPublic or Commercial - Describe: 1t II t:~ i Parent Material: Outwash Flood Plain if Applicable: 0 ' I) !1►Jt.. 2 : t c UZ5 General Comments & Recommendations: Mound BaYfield Co. Zoning Dept. System Elevation: 96 Load Rate: 007 Elevation Range: 95.85 To 96.55 Boring #1 r Bor. pit Ground surface Elev: Depth to Limiting Factor: Soil Application Rate: 97.85 Ft. 60 in. Elev. 92.85 ft Horizon Depth in. Domm.Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 Munsell Qu. Sz. Cont. Color Gr.Sz.Sh. 1 0-6 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 0.6 96 2 6-14 7.5YR4/6 N/A LS 0SG ML CS 3M 0.7 1.6 3 14-24 7.5YR4/6 N/A LS 0SG ML CS IF 0.7 1.6 4 24-60 7.5YR4/4 N/A MS 0SG ML N/A N/A 0.7 1.6 5 6 7 Boring # 2 r Bor.�Pit Ground surface Elev: Depth to Limiting Factor: ' Soil Application Rate: 97.55 Ft. 59 in. Elev. 92.63 ft Horizon Depth in. Domm.Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 Munsell Qu. Sz. Cont. Color Gr.Sz.Sh. 1 0-8 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 06 1.0 2 8-12 7.5YR4/6 N/A LS 0SG ML CS 3M 0.7 1.6 3 12-20 7.5YR4/6 N/A LS 0SG ML CS IF 0.7 1.6 4 20-59 7.5YR4/4 N/A MS 0SG ML N/A N/A 0.7 1.6 5 6 7 *Effluent #1 = BOD 5>30 < 2 20 mg/I an FSS� < 150m `'`\ "Effluent #2= BOD 5<30 mg/I and TSS ≤ 30 mg/l CST Name (Please Print) Sin CST Number. 877598 Mark S. Thompson Address: 12006 N US Hwy 63 Da valu on C9 dpcte : Telephone Number Hayward, WI 54843 Wedne-e-QCs ay, June 25, 2025 715/699-4081 SBD-8330 (804/2.9) Property Owner. Ezra Smith Parcel I.D. 28947 Page: 2 of 5 Boring # 3 Ground surface Elev: Depth to Limiting Factor: '" Bor. 98.05 Ft. 64 in. Elev. 92.72 ft Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox x Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 0-10 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 10-16 7.5YR4/6 N/A LS 0SG ML CS 3M 0.7 3 16-26 7.5YR4/6 N/A LS 0SG ML CS IF 0.7 1.6 4 26-64 7.5YR4/4 N/A MS 0SG ML N/A N/A 0.7 1.6 5 6 7 Boring # 4 Ground surface Elev: Depth to Limiting Factor: F'" Bor.P Pitt 0 Ft. 0 in. Elev. 0 ft Soil App. Rate Horizon -Depth in. Domm.Color Munsell Redox Description Qu. Si. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 5 "' Bor. d At Ground surface Efev: Depth to Limiting Factor: 0 Ft. 0 In. Soil A Rate pp. Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 6 Bor�v Pit Ground surface Elev: Depth to Limiting Factor: 0 Ft. 0 in. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 --- ______ *Effluent #1= BOD 5>30 5 2 20 mg/l and TSS>30 5 150mg/I *Effluent #2 = BOD 5< 30 mg/1 anj<rS4 g/,J The Department of Commerce Is an equal opportunity service provider and employer. If you need a stangVj0%"RD25 services or need material in an alternate format, please contact the department at 608-266-3151 or 6677` Bayfieid Co. Zoning Dept. SBD.8330(R07/00) Soil Profile Sheet Page: 3 of 6 Owner: Ezra Smith JSoiL Tester: Mark S. Thompson System Elevation: 96 Load Rate: 0.7 System Elevation: 95.85 To 96.55 101 101 B1 101 B2 100 --------------- 100 --------------- 100 ------------- System Elevation 99 --------------- --------------- 99 --------------- --------------- 99 ------------- ---------- 98 --------------- ------ 98.05 98 --------------- =-------------- 9j/< - ------------ ------- - 97.85 ------------- 97.55 97 2Z 97 _ 97 ------------- -922$ 96.55 96 2 96 Z 96 ------------- 0sZ ------------- 95.72 ------------- 95.85 ------------- 95.63 95 --------------- 95 -------------- 95 --------------- 94 - ------------- 94 ------------- T3' 94 ------------- P_ 93 --------------- --------------- 93 --------------- --------------- 93 --------------- -------------p222------------- 92.85 ------------- 02.63 92 --------------Lf± 92 ------------- U. 92 ------------- LE 91 --------------- 91 -------------- 91 90 --------------- --------------- 90 --------------- --------------- 90 --------------- --------------- 89 --------------- --------------- 89 --------------- --------------- 89 --------------- --------------- 88 --------------- 88 --------------- 88 (J 87 87 87 2.52025 --------------- -------------- ---------------'JUL 86 --------------- 86 ____ --------------- 86 _____ --------------- 38yfieid Co. Zoning Dept. 85 --------------- 85 - 85 -------------- 84 --------------- 84 --------------- 84 83 --------------- --------------- 83 --------------- --------------- 83 --------------- --------------- 82 --------------- --------------- 82 --------------- --------------- 82 --------------- --------------- 81 --------------- 81 ------------- 81 80 --------------- --------------- 80 --------------- --------------- 80 --------------- --------------- 79- 79 79--------------- Owner Information: Name: Ezra Smith Location: NW114SWI/4S04T51NR04W Township: Russell County: Baytield Lot #: Hyde Road BM=100: Nall with ribbon on the base of tree between 61 & 93 91 = 97.85 B2 = 97.55 B3 = 98.05 B4 = 0 `°•B n CST Mark S.�'hom S XC , jc7 -N F . 598 1"=60' Only in Tested Area Qc o ray 715/699-4081 © O /.= ;• 55 D v cl Industry Services Division 4822 Madison Yards Way County Bayfield \7\ '• ` P EH '< j �$Z Madison, WI 53705 P.O. Box 7302 Madison, WI 53707 Sanitary Permit Number (to be filled in by Co.) as 9 3 S anitary 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), Scats. TBD —'Hyde Rd. y 1. Application Information — Please Print All Information Property Owner's Name Parcel # Ezra Smith 28947 Property Owner's Mailing Address Property Location 1214 MacArthur Ave. Govt. Lot City, State I Zip Code Phoni5 Number. Ashland, WI 54806 715-413-0715 NW %•SW ¼, Section 04 T 51 N R 04 E or W II. Type of Building (check all that apply) Lot Ii ZI or2 Family Dwelling —Number of Bedrooms 3 Subdivision Name ❑Public/Commercial — Describe Use Block # ❑City of State Owned — Describe Use Village of CSM Number l7lTown of Russell 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. jNew System Replacement System Other Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B. ❑Holding Tank ZIn-Ground (conventional) DAt-Grade fl Mound Individual Site Design Other Type (explain) C. ❑ Renewal Before Expiration ❑Revision Change of Plumber JTransfer to New Owner List Previous Permit Number and Dale Issued NA IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 450 0.7 642 678 96.0 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units P U° '� v New Tanks Existing Tanks o = v a a U `n y N ii. C7 P. septic or holding cans 1000 1000 1 Superior Precast 1 V 1 " Dosing Chamber 600 600 1 Superior Precast r/ LIII] Q Q V. Responsibility Statement- t, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature ,9 MP/MPRS Number Business Phone Number Jason Kuettel f_- 675751 715-798-3355 Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 Permit Fee Date Issued n ent ature pjL fr&Approved ❑ Disapproved // ^ ❑ Owner Given Reason for Denial $ 4l Jo— LiItI a Ci p\ /Nv, JUL 2 52025 on paper not SBD-6398 (R. 02/22) 02 �r:sn7.y e r�r : o� . N1 • `\� p tN Wisconsin Department of Safety and Professional Servises Attach complete site plan on paper not less than 8% X 11 Soil Evaluation Report in accordance with SPS 385, Wi&Adm Code SK-Oo�vZ inches in size. Page: 1 of 5 Sai TEST Plan must include but not limited to: Vertical and horizontal reference County: point (BM), direction and percent slope, scale or dimensions, north arrow, Bavfield Parcel I.D. location and distance to nearest road. Please Print All Information 28947 Personal information you provide may be used for secondary purposes. i d Date. (privacy Law,s.15.04(1)(m)). Property Owner: Property Location Ezra Smith NW1/4SW1/4,S04,T51N,R04W Property Owners Mailing Address: Site Address or CSM and Lot # 1214 Macarthur Ave Hyde Road City State I Zip Code Phone Number: Town Nearest Road: Ashland WI I54806 0 Russell Hyde Road Number of Bedrooms: 3 J7 New P Residential Code derived design flow rate: 450 Flood Plain if applicable rReplacement r Public or Commercial - Describe: fl Parent Material: Outwash Flood Plain if Applicable: 0 rti General Comments & Recommendations: Mound Ba yfielcl Co. Zoning Dept. System Elevation: 96 Load Rate: 007 cle�at,on Rance. c� 85 To 96 55 Boring #1 r- Bor. pit Ground surface Elev: Depth to Limiting Factor: Soil Application Rate: 97.85 Ft. 60 in. Elev. 92.85 ft Horizon Depth in. Domm.Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 Munsell Qu. Sz. Cont. Color Gr.Sz.Sh. 1 0-6 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 6-14 7.5YR4/6 N/A LS 0SG ML CS 3M 0.7 1.6 3 14-24 7.5YR4/6 N/A LS 0SG ML CS IF 0_7 1,_6 4 24-60 7.5YR4/4 N/A MS 0SG ML N/A N/A 0.7 1.6 5 6 7 Boring # 2 r Bor.v At Ground surface Elev: Depth to Limiting Factor: Soil Application Rate: 97.55 Ft. 59 in. Elev. 92.63 ft Horizon Depth in. Domm.Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 Munsell Qu. Sz. Cont. Color Gr.Sz.Sh. 1 0-8 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 0.6 1_0 2 8-12 7.5YR4/6 N/A LS 0SG ML CS 3M 0.7 1.6 3 12-20 7.5YR4/6 N/A LS 0SG ML CS IF 91 1.6 4 20-59 7.5YR4/4 N/A MS 0SG ML N/A N/A 0.7 1.6 5 6 7 cLS 30 ≤ 150m *Etiluent #1 = BOD 5>30.220 mg/1 anT- —_�` *Effluent #2= BOD 5<30 mg/l and TSS < 30 mg/l CST Name (Please Print) Sin CST Number: 877598 Mark S. Thompson / Address: 12006 N US Hwy 63 Da lu on C ducts Telephone Number Hayward, WI 54843 We ne ay, June 25, 2025 715/699-4081 SBD-8330 (R04/2.1) Property Owner: Ezra Smith Parcel I.D. 28947 Page: 2 of 5 Boring # 3 Ground surface Elev: Depth to Limiting Factor: J'" Bor.;w' Pit 98.05 Ft. 64 in. Elev. 92.72 ft Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 0-10 7.5YR2.5/1 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 10-16 7.5YR4/6 N/A LS 0SG ML CS 3M 0.7 9_6 3 16-26 7.5YR4/6 N/A LS 0SG ML CS 1 F 0.7 1.6 4 26-64 7.5YR4/4 N/A MS 0SG ML N/A N/A 0.7 1.6 5 6 7 Boring # 4 Ground surface Elev: Depth to Limiting Factor: 1 Bar. Pitt 0 Ft. 0 in. Elev. 0 ft Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 5 Ground surface Elev: Depth to Limiting Factor: i"" Bor.P Pit 0 Ft. 0 In. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/fie *Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 6 r Bor.v pit Ground surface Elev: Depth to Limiting Factor: 0 Ft. 0 In. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 *Effluent #1 = BOD 5>30< 2 20 mg/land TSS>30 < 150mg/I *Effluent #2= BOD 5< 30 mg/ a 1 S , ≤[g4j j n The Department of Commerce is an equal opportunity service provider and employer. If you need a 91stan o �jO2� i services or need material in an alternate format, please contact the department at 608-266-3151 SB 833o(R.onoo) Bavfield Co, Zoning Dept. Soil Profile Sheet Page: 3 of 6 Owner: Ezra Smith 15011 Tester: Mark S. Thompson System Elevation: 96 Load Rate: 0.7 System Elevation: 95.85 To 96.55 101 13 101 R1 101 B2 100 --------------- 100 --------------- 100 -System --------------- --------------- ------------- Elevation 99 --------------- 99 --------------- 99 ---------- --- 98 ----- ------ 98.05 98 98 --------- --------------- --- 97.85 ------------- 97.5 5 97 ------------- 0:Z 97 ------------- 97 ------------- 02 ------------- 96 ------------- ------------- 96.55 96-- 02 96------------- 012 96 ------------- 012 ------------- 95.72 ------------- 95.8595 ------------- 95.63 95 95--------------- 94 ------------- 94 ------------- 94 ------------- 93 --------------- --------------- 93 --------------- -------------- - 93 --------------- --------------- ----2122 92.63 92 ------------- L 92 -------------LE1 92 ------------- L.F. 91 ------------- -------- 91 -- 91 -- 90 --------------- --------------- 90 --------------- --------------- 90 --------------- --------------- . 89 --------------- --------------- 89 --------------- --------------- 89 --------------- --------------- - --------------- --------------- - -------- f 87 --------------- 87 ' 87 --------------- �1 JUL 2 86 --------------- 86 _____ --------------- 86--------------- _____ tie f'eldCo.� v . Zoning Dept. --------------- 85 --------------- 85 --------------- 85 --------------- 84 --------------- 84 --------------- 84 --------------- 83 --------------- 83 --------------- 83 --------------- 82 - 82 --------------- 82 - 81 --------------- 81 --------------- 81 --------------- 80 --------------- 80 --------------- 80 --------------- 79 --------------- --------------- 79 --------------- --------------- 79 --------------- --------------- Owner Information: BM=100: Nail with ribbon on the base of tree between B1 & B3 Name: Ezra Smith 'A" Location: NW1/4SW1/4,S04T51N R04W Township: Russell B1 = 9785 County: Bayfield B2 = 97.55 Lot #: Hyde Road B3 = 98.05 B4 = 0 98' 135Ground elevation by house = 91.33 No Well on prop N WE CST Mark S..Thom iv X C _ 1"=60' Only in TestedArea 715/699-4081 Cr 1r� m a r_� PAGE 1 OF 5 In -Ground Dosed -Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 5 Index & Cover Sheet Pg 2 of 5 Plot Plan Pg 3 of 5 Dispersal Area Cross -Section & Plan View Pg 4 of 5 Pump Tank Specifications Pg 5 of 5 Management Plan Attachments: Enclosures: Pump Curve POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Smith - 3 Bed Owner Name(s): Ezra Smith Phone: 715 413 0715 Owner Address: 1214 MacArthur Ave. Ashland, WI Zip: 54806 Project Address: TBD - Hyde Rd. Bayfield, WI Govt. Lot: NW 1/4 of SW 1/4, Section 04 , T 51 N -R04 E ❑or w1 Township: Russell County: Bayfield Project Parcel ID #: 28947 Designer Information Designer Name: Jason Kuettel Phone: 715 798 -3355 Designer Address: PO Box 66 Cable, WI Zip: 54847 E-mail: tim@andryras.com License Number: 675751 Remarks: IIM JUL 2 52075 Bayfield Co. Zoning Dept. Signature: / Date: ZS origin Anature required on each submitted copy. Owner Information: BM=100: Nail with ribbon on the base of tree between B1 & B3 Name: Ezra Smith Location: NWt/4SW1/4,SO4,T51N,R04W Bt= 97.85 Township: Russell 82 = 97.55 County: Bayfield 83 = 98.05 Lot #: Hyde Road B4 = 0 98' 97 B1 flSco9H 4 c - Ground elevation by house = 91.33 ?(Z 4J- &—Svi{r:.r eCec.fT /000/600 1-+/ nwnco Fr-rz� � 'i"Sc . 40 c 9+++'u� rd" No Well on Drops a m 0 v N W•E � fns ri r G a S p tom: tni+ 0 1"=60Only in Tested Area g. �i Q .,gyp f�-�57St N VV o 7)15 zs m SUPERIOR I 1000/600 2 -Compartment Tank SUPERIOR PRECASTCRNCRETEPRECAST CONCRETE TOP VIEW 143" R'eizht (in Ibs) Tank: 9.160 Lid: 5.884 Total: 15.0-fU Volume of Concrete Total : 3.81 'd' Gallons Per Inch: 40.6 Wall Enlarged Detail Manhole Openings /Lo T-- 2-1l2" Taper Polpethvlene Baffle Mastic Rope 1031 Gallons 24.54 GPI SIDE VIEW 28" 9" AirSpace 4„Livid jJ i Depth 73" 79•' 4" aatlet 160" 45" Produced by Superior Precast Concrete, LLC PO Box 1390 Hayward, WI 54843 S SUPERIOR PRECAST CONCRETE Design conforms to ASTM C1227, Specification for Precast Concrete Septic Tanks and WI SPS 384.25, POWTS Holding Components or Treatment Components. The information provided on any Superior Precast Concrete (SPC) drawing or document shalt be verified by the purchasers licensed professional engineerf or suitability of use. Configuration may change from drawing, consult with SPC. productfile No: Rtls ispruprletarylnformatlon, and remalna thepropertyofsuperlor Pmcast Concrete, 0.C. I x505-19-20241 IN -GROUND DOSED -GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) uu JUL 2 52025 Bayfield Co. Zoning Dept. mIn.,2" TYPICAL TRENCH SOIL COVER (typicaq CROSS SECTION VIEW 12"min. trench (No Scale) depth (typical) . d a 1-. 34' .. .. . (typical) Provide minimum 3 ft separation between trenches. System Elevation = 96.0 ft (typical) Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) ' (typlcaI ) L------ —--------��--- B= 46 ft (typical) INSTALL PER TRENCH: 11 Quick4 Std -W @ 20 ff EISA/chamber = 220 ft' + 1 Pairs of end caps @6 ft2 EISA/pair = 6 ft2 Observation Pipe (typical) Install per manufacturers / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) A=3.0it (typical) `—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. = Proposed EISA per trench = 226 ft2 Required Infiltration Area = 642 x 3 trenches = Proposed Total EISA = 678 ft2 Distribution Method: ftz branched manifold C) m w O n L1 RESET 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 = 450 gpd; BOD5 ≤ 220 mgL-1; TSS ≤ 150 mgL-'; FOG ≤ 30 mgL'' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when 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: Andry Rasmussen & Sons Phone: 715-798-3355 Local government unit: Bayfield Co. Zoning Phone: 715-373-6138 Local government unit address: 117 E 5th St. Washburn, WI ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved bNthe-He�a npr ir}e r1 accordance with SPS 384, Wisc. Admin. Code. �� uu �)ttJJ 1155 II Il Contingency Plan \\\\ JUL 252025 In the event that any failed treatment component of this POWTS cannot be repaired, it shall be a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal br 4ht�r%ay eep 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. PAGE 5 OF 6 SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4°9 Vent Pipe >10 ft from Building Electrical must comply with 12" Min. or 2.0 ft above SPS 316 and NEC 300 Established Flood Elevationrweetroot herpExtend manhole riser as necessary. (typical) ApprovedJunction Box Vent Cap Approved Locking Manhole IMPORTANT: with Warning Label Attached Anchor tank(s) as necessary (typical) pursuant to SPS 383.43(S)(g) Conduit /'' 4" Min. or 2.0 ft above I . • I . . T/ Established Flood Finished Grade CAPACITIES @ 14.85 galfin Depth (in) Volume (gal) A 20.5 304.4 B 2.0 29.7 [c] 7.5 112 D 12 178 * Pump Tank Liquid Level = 42 in Force Main Diameter = 2 in Force Main Length = 135 ft Force Main Void Volume = 22.00 gal Airtight Seal V Quick Diswnnecl 18" Min. • r ..... (typical) * Weep Approved�����1l((((((QQQQQQ��t��t������tt}tt}ls vjµh Il LS Hole Approved P3 ft biito 15 A Solid nd (tyP' JUL 2 5 2025 gi B[c)PUMP-OFF rm Bayfield Co. Zoning Dept. kBiock ELEVATION = 86 ft °INSIDE e BOTTOM _ELEVATION= 85 ft 3" Approved Bedding Material Beneath Tank [C] Total Dose Volume (TDV) = 112 gal/dose L (5X total lateral void volume <_ TDV < 0.2X design flow) + (force main drainback volume) MIN. PUMP DISCHARGE RATE = 40 gpm PUMP TANK: Volume = 600 gal Manufacturer: Superior Precast Pump Manufacturer: Champion Pump Model: CPES3 (See attached pump curve.) Controls/Alarm Manufacturer: SJE Rhombus Controls/Alarm Model: HW101 Vertical Head = 10 ft + Min. Supply Head = - ft + FM Friction Loss = 4.5 ft + Fitting Loss* = - ft "(min. supply head x 0.3) = TOTAL DYNAMIC HEAD = 14.5 ft SEPTIC TANK(S): Total Volume = 1000 gal Manufacturer(s): Superior Precast Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: Orenco Filter Model: FT0822 Float switches containing mercury are prohibited. FEATURES/BENEFITS PERFORMANCE Heads up to 37' TDH Flows up to 72 GPM MOTOR High efficient, 1i5 oil filled, permanent split capacitor motor with upper and lower ball bearings and thermal overload protection -Constant bearing lubrication - Maximum motor cooling - Runs cooler and lasts longer - Internal overload protection -Quiet operation - Fasteners and shaft made from rugged, corrosion resistant stainless steel SEAL DESIGN Mechanical with secondary dynamic lip seal Provides added leakage protection IMPELLER DESIGN Mon -clog style vortex impeller - Designed to help reduce clogging by foreign • material PERFORMANCE CURVE POWER CORD Sealed entry quick disconnect power cord; - Prevents water from entering the motor housing through a cut cord Easy to replace in the field • Available in lengths up to 100' SWITCH Piggy -back switch design - Defective switches can be diagnosed over the phone - Pump can be operated manually or supplied with other piggy -back switches -Switch can be replaced without having to replace the pump APPLICATIONS Basements, dewatering, septic systems, residential and commercial developments and elevator pits JJ I 2 5 2p25 D vw,y u3 vertical Float gayfield Co. ZOntnq Dept 1/3-1/2 HP submersible pumps that handle up to 3/4" solids with 2" discharge with 11/2" adapter Champion Pump Company, Inc ' P.O. Box 528 , Ashland, OH 44805 Phone 419-281-1500 Fax 419-515-1100 , ,vway.ch 3 nt pionpurnp. com Pevoeu AU& 4 Private Sewage System Maintenance Agreement Owner(s) Name DOCUMENT NUMBER £ Z tZa S f- T w• ` 2025R-608604 Owner(s) Mailing Address 1Z1L5 M c, Th J iZ EVE. AS>'i Z'tt S— - DANIELJ.HEFFNER . REGISTER OF OF DEEDS HAYFIELD COUNTY. WI Site Address . t-1-cbE cZ�. /1&%¼'L, w RECORDED O8/O1/2O25 AT 2:14 PM Tax ID # O t 'fig 1_% As owner, I (we) do hereby certify the private sewage system will be installed in RECORDING FEE: $30.00 PAGES: 1 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) - — - - — J rya Ml N 1/4 of S I'3 1/4 Section 0 L/ Township 5 f N. Range d tl W. Recording Additional Legal Description: Return To: Town of (Acreage) ' c) Gov't Lot Planning and Zoning Department Lot Block Subdivision Lot _ CSM # _ Vol._Page_ Page _ CSM Doc # Area El In -ground gravity f in -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter unless, upon Inspection by a licensed master plumber or other person authorized to make such inspection, the tank Is found to have less than one-third (1(3) of the volume occupied by sludge and scum. Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's spec cations. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, W's. 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 Hayfield 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. Hayfield 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 even( the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges maybe placed on the tax roll as especial assessment for the abatement of a human health hazard, and the tax shall be collected as provided bylaw. The terms and conditions of the agreement shall be binding upon and in ce to the benefit of all current and future owners of such property. . W0_1:. _ flu. Owner(s) Name(s)-Please Print a P ≥bs }fed and sworn to before me on this date: Notarized Owners - Signature(s) ��aNAit TqT f D to Ea fission Expires: Drafted by: T/n.. LL' eY-. Date: Z2 __ Proofed by: ulformsrsanilaryisepticmaintenceagreement Revised July 2020 Vw�YFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: SMITH,EZRA 1214 MACARTHUR AVE ASHLAND, WI 54806. Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00302 Transaction Number: SR -00302-323A2 Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 14776 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 8/11/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. l3 -MFIELD 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: SMITH,EZRA 1214 MACARTHUR AVE ASHLAND, WI 54806 Description Private Sewage System (Septic Tanks) Submission Number: SS -00609 Transaction Number: SS -00609-311B1 Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 14776 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 8/11/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-25-93S STATE SANITARY PERMIT OWNER: EZRA SMITH G OV'T LOT: LOT: B L K: NW1/4 /4 SW1I4 /4 SEC: 4, T 51 N, R 4 W TOWNSHIP: Russell SOIL TEST: 97-25 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: JASON KUETTEL TRACY POOLER DATE: 8/11/2025 Authorized Issuing Officer CHAPTER 145.135(2) WISCONSIN STATUTES a. The purpose of the sanitary permit Is to allow installation of the private sewage system described in the permit. b. The approval of the sanitary permit Is based on regulations In force on the date of approval. c. The sanitary permit Is valid and may be renewed for specified period. d. Changed regulations will not Impair the validity of a sanitary permit. e. Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. f. The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #: LICENSE: # MP 675751 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 8/11/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION