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INBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY TIME RECEIVED REMOTE CSID DURATION PAGES STATUS August 29, 2025 at 3:17:03 PM CDT 7153724159 43 1 Received Aug 30 2025 06:37 HP Faxpolkosld Plumbing 71 53 72 41 59 page 1 Request for Sanitary Inspection (24 Hrs. in Advance) Fax this form to Zoning Dept (24 Hrs.) prior to when you want an inspection — (715) 3730114 If you do not have a fax and must email the inspection; you must email all staff members. Note fl Time Change fl Discrepancy fT Other Phone Number Plumber: J/ 1/s Fax Number 7/5 3-7z Homeowner: y7 C —/f i Q 1C1� 1 t�'Q�< < Email Address yr 1/ --+ eLEcr ^fO h�C V 5va C'Q, tt ar7� Sanitary Permit q O f — 7 S Immediate Phone Number So Zoning Dept can call you right back (if needed) #: ! Plumber's Choice Zoni Dept Date: • Time: Plumber's Choice Zon ept • Township: � o , ✓ Address#& Road Name: .0t7 R' tJ -C ` f `�{ T t 1 H s o v or --e a7 3 ,,.. (t S. 7i „� L t o^ vC ( e r r r.t a Jc 0~ Directions To Site: ti q7 tr n'i r C 4 r r L4k. jZ Comments: *' Plumbers you must verify any change(s) by fax or email Notes from Zoning Dept: Go Aj u/tonne/seniteryirequaslfodnspeGion Zoning Dept (®1/12/04); ® June 2023 POINTS HOLDING TANK INSPECTION REPORT PETER P & MARY A STIPETICH 12F HAYES CT SUPERIOR WI 54880-2938 TANK INFORMATION TYPE MAN FACTURER/MODEL # CAPACITY U SETBACKS Property Uric Well Water Service Building All -Weather Road OHWM Swimming Pool DEVIATIONS FROM APPROVED PLAN COMMENTS (Persons preent, discrepancies, etc.LlYwl1�1a?Cc `Skf rS�'V r _ a�uvlm Ifl huI(J Qk A () Ten 110b ii b rS f u%l ✓- KCGu�I �J -F kUu eo( old 6"\C n `f V�L COMPONENTS NOT INSPECTED Plan Revisloruequired ❑ Yes o I Dale: IciC Signature Ins ctor: Cart. Number CU SJ etcn on otner sloe 10 of 13 J U J tot Property Owner Information As you know onsite wastewater treatment system on your property described as: BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zonina(�bayfieldcountv.wi.gov Web Site: www.bayfieldcounty.wi.gov/147 PETER P & MARY A STIPETICH 12F HAYES CT SUPERIOR WI 54880-2938 Notes: Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 was contracted by you to install a private Abandonment of Old System to meet all applicable code requirements: OCMOWaba� C. Tank was pumped by: ((3M PolVo3V'J on at AM/PM 4. Tank was crushed I removed and pipes disconnected by: fI I%c. On at (AM / PM) the above -mentioned plumber contacted our office to cond ct a pre -cover inspection as required under DSPS 383. One of the following applies: 1171 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: VI�V\L \(�5\Ct p AU IV N U/formsrsanilaryproperlyowner-input Apn12019 la�t t, flTlq • . ��r Department of Safety County �+ 3 �1S & Professional Services, �` `r PS Industry Services.Divisio Sanitary Permit Nr nber• (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 governme t is required prior to obtaining a sanitary permit. Note: Application fortes 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(l)(m), Stars. 1 I. Application Information - Please Print All Information 9 7 s^ `/� Property Owner's Namc __[_ ` 6�• •, ' -T t C �+''` Parcel # Property Owner's Mailing Address '— i Z 1' /4 s C -f-. City, State Zip Code J L;r-"°" tr e © (� (,A) ,- L II. Type of Building (cheek all that apply) I� I or 2 Family Dwelling —Number ofBcdrooms i Ic4LD X817O Property Location Govt. Lot 2 ____ Phone Number Z.l Fj Lat # T y % N R ❑ Public/Gomntcrcial — Describe Use Blacic # AS Se ss O r.S OT'W� Jeh O State Owned — Describe Use O City of �• y I1T. Type of PGWTS Permit: (Check either"? applicable.) A. ❑ New System y Replacement System B. Holding Tanic 0 In -Ground (conventional) C. 0 Renewal Before 0 Revision Expiration IV. Dispersal/Treatment Area and Tank Inh DCSIi Flow (gpol Design Soil Application Ratc to I Capacity in Tank Infornrntion Gallons Ses ia.cr Holding Tank a O o o Dee V. Responsibility Statement- I, the un Plumber's Name (Print) • Al/ m'j; Plumber's Address (Street, City, State, Zip c K S� a-'- ---- CSM Number ❑ Village of Town oflV C ! ✓ •� ` or "Replacement" and other applicable on line A. Check one box on line B. Complete line C ❑ Other Modification to Existing System (explain) 0 Additional Pretreatment Unit (explain) ❑ At -Grade 0 Mound ❑ Change of Plumber ❑ Transfer to New on: Dispersal Area Required (sf) Dispel Total #of Mar ed, assume 0 Individual Site Design I ❑ Other Type (explain) I Area Proposed (sty Systen Gallons Units ' ZD O D L U) lbility for installation of the POWTS shown on the attached plans. l/MFRS Number Business Pllortl ode) :try v .� ..Z ≤8Y7 Approved O Disapproved Permit Fcc Date Issued O Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval _T p rECEIVED C AUG 0 42025 Bayfield Co. planning and Zoning Agency Attach to complete plans for the system and submit to the County only on paper not less than 8 112 x 11 inches in she SBD-6398 (R, 03/22) .. ---- Vv I �.t11YIVlIV1! p( LViV jIVU No, 9975 P. 2 • i PAGE I' OF S Holding Tank Plan Index & Cover Sheet Component ManwQal Design ReP®r�nceq: - S10i) 2O2.Z. Pg 1 of $ Index & Cover Sheet # • Pg 2of9 Plot Plan Pg 3 of S Holding Tank Specificati is - ? Pg4of� � Management Plan Attachments-. Enclosures: �`" -� �° PO- WT$ A plication fr�r'Review C_stt - ,�•�,�ir Parr, � o4. ' Soil Evaluation o Report Site Ma (f applicable) HoldIn Tank Nm in entracf if Ilcablei Holdin Tank A reeme t(If.;IPP11 cabie pop"nee 1 Description : 4`Pro ect Na isef j, owner Name(s): 3fe - ≤+ e +i C- Phone: _j-3 s :! Owner Addrees : i thtyt�s C � �; o 4.c-' Zi b P Project Address: 7 5 i c �-.- L4�e� o n ; v �. �✓. S~`� �,�� Govt. Lot: �sEs s n YS ! s' SWS 6 Section, T 7 M -R _ff Etlor w Township: ✓ o r< 4�- tJ '�'t/ County: i _,C, 'e Project Parcel ID #: Vie- K ss . 0 (1 c) Designer Information I Designer Name: r /Cl- F� f k a s- , Phone: l Designer Address: 1'b. o12e�' i ' W:Zlp; Y V. E-mail: `f ' 1,L ,� p ,%�, .,.._'._...Z'_"""_"" r �` LA, Thi j space reserved for approval stamp. License Number; ?- z. n 0 9 0 Remarks: VgeCelver f i AUG042025 4 2025 planning and 7 / 1 Lc !ZirL' AP9ncy pq o� {gyp � p •signatureD aLev. r 7— ( Z Original sfgnaturia require f on each sub wlea copy. 146t31P% any BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Followin4 (Use Permanent Ink) (Title 15, Section 15-1-10(e)) if Check List t r Original Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.) IZI Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) r Original Plot Plan (383.22(2)2. 3. & 4.a) E( Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer Q Pump Tank Diagram, Alarm and Pump Curve (when applicable) f 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) E Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) i7 Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) ❑ ATU Servicing Agreement (Recorded at Reg. of Deeds) V Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) i� 2 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) 9 Soil and Site Evaluation Report (383.22-3(2)(b)1.e.) • 0 State Plan Review (when applicable) 0 Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) C 1 I Application Information must include: 0 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) l Project Address or Road Name where driveway is/will come off of) E1 (Owners Phone Number) Ed II Type of Building ® III Type of Permit Elf IV Type of POWTS System ❑ V Dispersal / Treatment Area Information 9 VI Tank Information 69 VII Responsibility Statement (Plumber's Information) ❑ *Date Stamp* Plot Plan: (To Scale or To Dimension) Cif Signature and Plumber Information Ei3' Surface Elevation of Body of Water ❑ Direction and Percent Land Slope f t Tank and Filter Information and Location 0 Wetlands / Navigable Bodies of Water ❑ Absorption Area (Proposed and Existing) AUU 042025 Bsyflel" Co. Planning and Zoning Agency E' Address Number and Road EJ North Arrow 0 Contour Lines IV Structures and Driveways 96 Boring Location if Property Lines QJ Bench Mark (Location, Elevation and Description) L 3 Well Locations ® Component Manual Version 0 Legal Descriptions Aping Material Information (conveyance 1lne,�building sewer _line, _matenaftype _a th dIameer} Turn Over ► BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following) (Use Permanent Ink): 0 Check List 1E Index Page / Title Sheet (Optional) m Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) 21 Original Plot Plan O Cross Section Soil Profile Sheet (optional) O Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) m Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used l l Property Owner's Information (not prospective buyer's name) l Property Location (Accurate Legal Description with Sec/Twp/Range) m Road Name (where driveway is/will be coming off of) d Floodplain Elevation, Flow Rate, Comments and Recommendations 9 Complete Soil Boring / Pit Information li7J Date Soil Evaluation was conducted d CST Name, Signature, Number, Address and Phone Number 0 *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) ICJ Bench Mark (Description, Elevation and Location) LI Contour Lines (Example = 98.0' /96.0' /94.0') l Property Location (Sec/Twp/Range/, Accurate Legal Description) RI Borings (Locations and Elevations) L5 Percent and Direction of Land Slope 0 Well Location (Including Neighboring Wells, if applicable) i!1 Location of Wetland Areas, Floodplain and Navigable Waters m Buildings, Driveways, and Structures (Location and Descriptions) Ed Location of Property Lines Cif Existing System Location Z Address Number and Road Name M Current Surface Elevation of Wetlands and Navigable Waters Cd CST, Owner and Property Information Cpl North Arrow t r hvJ U 4 LULU say1i k4 Co. Pia Wrung and Zoning AgetrcY Fee: 91 Certified Soil Tests - Review & Filing Fee $ 50.00 u/forms/sanitary/checklist/checklistforests JY ���Vw�l �IJV ✓1�� 0d-1 L PkATb.4'ac' 7© o -f f3`tres rvr1S� L �.g 1 base Et', p +-t epA 4 i J •� S� � � B o v'� r�gS •, Stc W Sk: i' 'Iss A ssessG' S $ vi �� d 4A , a Ew �► f . � �occ jallon W-'Cserr de -1 k: L)''f"L,� W "� i �13.r -P r- rn b e f f -o s i of 'i o 8 cs - `Q i j �:. 6'! k � i_ O lU G v�E', i n 1 �.-1-- { / 7 13 S Mc L� 4 v rr4 La 16-c vctrc* bt p vWf\ £Cg LAJ/)zoc3o �-� ®2' j o t.J , s - L r lG!o 1: r Cr- lb I1fl atc1 i dt k di, l f Asl t ii. •+Lac kS (! 1Ps 3) a. Moe -�• ,`tom t y v -a E. JaP Z e.u/oo.o.' ., 4 4 a = 5cLb revC ps/c 1c c t c: ¶h l l +J"A5Tb''1 D 1795' '-Pj" v .J tom. rye. ALa..4'Ll �►•' c- o;o AUG 0 42025 Platmi 8ayfeld Co. ng and Zoning Agency l -I 11 icj "rc«lk CEt ,Y) `'p1 �.a 1 �� c( (�Q4�ER ato; �qL�. I9` p . 7) brre.wn A3� m PMfR,5. 22codI 'F®lkcsk, Pl�,btiL b" n� 'ro n n.' V ct w2 -'!rM'7 PROPERTY OWNER: 4�cv S+, p PLUMBER: Allan Polkoski/ Polkoski PIumbinc SIGNATURE: (%1 -(-- DATE: ? - Z ( - 2. S�' LICENSE # 220090 _ HOLDING TANK SPECIFICATIONS }:Number of bedrooms ?Non-residential estimated flow (gpd) 2000.0 ~Minimum holding tank volume required (gal) • 2000.0} Proposed holding tank capacity al .. . t,•z.p::r:.:.r� :w.»t:. �•�•r �.:�,..n�•,-: r;apars (gal) ��►vtes�r �..�. r..,.:»�: -,Tank Manufacturer �fYbOO0 •carsnx•�s:..Gr,••rnrnmar.�n�rrran�rxvm.,•rra^a»..ue:rrnr+:r��a:r.:. rr-»r'r^rsasrr,--r^sttaSJ Electrons. Tank model number ��p-✓r.:::sr-zeda OAlarm manufacturer • HW1�1 n�nar..a•,-;-.1—,a•-::sr ...fl.. •.'3-•.. �._ rAlarm model number Tank Dimensions and Data • `' �'X for round tank 47.0 :Liquid depth below inlet Invert (In) 8.0 }Maximum depth of soil cover (ft) 66.0 •:+..:..: Height (in) 1 Outside 951.0 Length (fn rDimensions • 86.0- :Width (in) 3 Only junction box _..__.� conduit --� blind plug •to.seal outlet Tank Anchor Calculations 15370 lbs Weight of tank and cover "kx� 150 '' Safety factor tea.. ..s••r» V.: •' �.Y."xd 31055 ibs Weight of anchor required 36.0 In Soil cover req. for anchor or 7.7 1yd6 Concrete counter weight REC1VED HOLDING TANK CROSS SECTION AUG 0.4 2025 manhole cover with locking device and finished warning label grade 4" min. ME—' 24 in. — Manhole and vent locations may be reversed. ,: service 'i 2.0 In. alarm on Note: All tank joints, and joints between tank openings and piping are Electrical as per 35.0 in. sealed watertight. All NEC 300 pipe and vent mWerials and Comm 16 comply with srns 38;x. Bayfield Co. Planning and Zoning Agency vent cap s 1 Z' min. vent pipe 1I mtn. building sewer Inlet 3 in. bedding under tank. Tank Is anchored as necessary to negate buoyancy. Project: WLP2000-MR TANK SPECIFICATIONS N 164" > o N DIMENSIONS: '" _O WALL: 3" cl BOTTOM: SEPTIC 3" HEAVY DUTY 5" (ADD 2,800 LBS.) L!) _ COVER: 6 Q I MN I D. PRECAST CONCRETE RISER 0. A HOLE: 5324"O LENGTH: 164" O.D. WIDTH: 96" O.D. 4" CAST -A -SEAL 4" CAST -A -SEAL BELOW INLET: 41" O.D. LIQUID LEVEL: 36" �4" WEIGHT: BOTTOM 11,260 LBS. \ COVER 8,170 LBS. 1 INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL FILTER OR BAFFLE INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 56.27 GAL/IN LOADING DESIGN: 8' 0" UNSATURATED SOIL 0 Ix IN It)" TOP VIEW LET st U t1iT SIDE VIEW OUTLET CD M PUMP PAD TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 2,138 GALLONS TANK CAN BE USED AS: SEPTIC/ HOLDING/ PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: 0 a J 0 a SHEET NO. 1 OF/ 1 I HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and �d maintained according to P J 3 Wis. Admin. Code, the Holding Tank Component nual A $e.d �'°�t�1 .s' ua @ /pCL 'DER 2�o and the , �. 14 County Sanitary Ordinance. viR ZI) o 0 . 1. This POWTS is designed to accommodate an estimated domestic wastewater flow of 400.0 _ gpd. - • 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed in the current Servicing Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and P5 383 and:84 Wis. Adm. Code, 5. All service events or inspections of this POWTS shall be reported to the county within 10 business days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Con- nection to municipal services would also be considered at this time if they are deemed available to the property. 9. if this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with CPS 9e3.33 Wis. Adm, Code. 10. If there is a problem with, or question about this pstallation, the following persons should be contacted: a. Installer ............................. oI!(i PJJj 1P, 5 ozaO0 o Phone: 7e b. Service Provider................... , a Z Phone: r- c. Co. Zoning or Health Dept. 3q Phone: •'i,- � 11. I Project Transaction Number: RECEIVED AUG 042025 Bayfield Co. Planning and Zoning Agency HOLDING TANK SERVICING CONTRACT IContract Date -ii - _j This contract is made between the ng Tank Owner(s) Name(s) _,. Pumper's Name (Print) Pump is Signature Pumpers' Registration # We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT Legal Description: lax ID# . SS LOCATION (Use Tax Stat ent) ,J_, � ( �+ ,--.1/4, .�._,. 1/4, Section Town of: I Lot Si:e Acreage , Township N, Range }+y Qav't Lot Lot # CSM # Vol, Page CSM Dec # Lot(s) No. Biock(s) No. Subdivision: • 1. The owner agrees to file a copy of this contract with Bayfield County as required in SPS 383.55, Wis. Adm. Code. 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local government unit which has signed the pumping agreement required by SPS 383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding tank(s) on a semiannual basis, Tb pumper further agrees to include the following in the semiannual report:':G`'I.� a. The name and address of the personresponsible for servicing the holding tank; AUG 0 A 2025 b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; 5ayfie:a co. e. The dates op which the holding tank was serviced; Planning and Zc,-,i►-:0 Agency f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the local government unit and the County named above within (10) business days from the date of change to this service contract. Owner(s) Name(s) (Print) Owner's Slgnature(s) Subscribed and•Sworn tome: on this 25 day of 1_ __2S ? r by: I , s`s L !� Notary Public t� My commission expires one iri # 2.OZ7 Revised: May 2016 (®May 2018) Drafted by 0'TR Personal information you provide maybe used for secondary purposes (Privacy Law, fy LARSON NOTARY PUBLIC STATE OF WIS(;nNStM d III Document Number/Plan I.D. HOLDING TANK AGREEMENT Owner Name (s) Owner(s) Mailing Address /7I4 t7.' es 4 �,., J Parcel Identifier Number (PIN) Agreeme t Date (same as Notary- Date) _c /2 We acknowledge that application is being made for theInstallation of (a) holding tank(s) on the following property or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. SPS 383, Wis. Adm. Code or Ch. 145, Wis Stats. 1/4 of 114 Section Township i IN. Range ______W. Town of rah 1 Ve,Y c Additional Legal Description: 5 ee 4O//Ov+ Gov't Lot Lot Block Subdivision CSM# Lot CSM •t Vol Page CSM Doc# Return To: DOCUMENT NUMBER 2O25R-608649 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. Wi RECORDED 08/05/2025 AT 1 1 :00 AM RECORDING FEE: $30.00 PAGES: 3 As an Inducement to Bayfield County to Issue a sanitary permit for a holding tank on the above described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding .tank Installation and maintenance. If the owner fails to have the holding tank properly serviced in response to orders issueu by Ba:. field County or, the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats.. Bayfield County may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Scats. 2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. 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. 3. The owner agrees to contract with a person who Is licensed pursuant to s.281.17 (3) Wis. Scats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NR1 13, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the county within 30 days from the date of change to the service contract. 4. The owner agrees to contract with a person.11censed pursuant to s. 281.48 (3) Wis. Scats., and Ch. NR 114, WI's Adm. Code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained. 5. This agreement will remain in effect only until Bayfield County certifies that the property Is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. SPS 383, Wi's Adm. Code. in addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner sha�l..,suby..i l�js_ agreement to the register of deeds, and the agreement shall be recorded by the register of deeds. In a manner which vV4iii pePmiCth'W ED existence of the agreement to be determined by reference to the property where the holding tank is installed. Owners) Name(s) — Please Print Subscribed and sworn to before me on this date: go25 Bayed Planning and'c.! Notarized Owner(s)— Signature(s) Notary Public �_ KE11[iN�py iLAR NOTA My Commission Expires: bTATE OF WISCO r• ( ri, Zaz`l Drafted by:%C C &i 7'a I kO S Date; Personal Information you provide may be used for secondary purposes [Privacy Law, s.15.04 (I)(m)] -7g. 5Z u/forms/sanitarylholdingtankagreement.doc eJune 2018 2025 o. nc Agency SIN Robert J. Irwin, Assessor 715/ 235-6941 August 9, 2004 Peter P & Mary A Stipetich 12f Hayes Ct Superior, WI 54880-2938 Notice of Assessment (this is not a tax bill) In accordance with Section 70.365 of the Wisconsin Statutes, you are hereby notified of your assessment for the current vim. ?004on-t prntZrt_y described in the Town of iron River: Tax key number: 024-1108-06-000 Legal description: ASSESSORS PLAT OF GOVT LOT 2 & SW SE SEC 28-47-8 & LOT 5 SEC 33-47-8 PAR IN TRACT 17 IN V.675 P.477 567MM Year Land BId s/Im rovements Total 2004 $25,400 $37,500 $62,900 Reasons for Change Land Revaluation B1dgs/Imprvmts Revaluation Open Book: Sunday, August 22, 2004, 12 Noon to 7 PM at the Community Center AUG 06 2025 Monday, August 23, 2004, 9 AM to 3 PM at the Community Center Board of Review: Saturday, August 28, 2004, 9 —11 AM at the Community Center Objections: Call Jackie LaBelle, Town Clerk — 715/ 372-5457, to receive an "Objection to Real Property Assessment" form. Also read the Assessment Objection Procedure below. We have completed a revaluation for the township. The new assessed value reflects the Current market valued based on sales within the township since the last revaluation in 2000. Assessment Objection Procedure Wisconsin law requires assessors to assess at full market value. In order to determine if your assessment is fair, you must analyze it in relation to the Market. You may accomplish this by comparing your Assessment to Sales of similar properties, available at the Open Book Conferences. If you feel your Assessment is unfair, discuss it with the Assessor. The Assessor can explain the assessment process, answer questions and make adjustments to the Assessment if warranted. If you still wish to object to the assessment, immediately contact the local clerk, file an objection form and arrange a Board of Review hearing. The appeal process is explained in the "Property Assessment Appeal Guide for Wisconsin Real Property Owners". If you would like a copy, please contact the Department of Revenue, Office of Assessment Practices, PO Box 8933, Madison, WI 53708-8933. Boards of Review operate like a court. Their function is not one of valuation, but of deciding the validity of the facts presented orally before them. You or your representative may testify concerning your assessment objection. You must prove that your property is inequitably assessed when compared to market value. h' ::y. •!:f �S•S:,ASP i[""i' :-�� .. t..•ty ~;�•. 1. ;;:}tom ! ry;?.Ice•, �Y.-.�~.:.Y• DOCUMENT NO. ' WARRANTY DEED THIS s►AC R C eIOR R(CO0R*01119 DATA STATE BAR OF WISCONSIN FORM 8-1988l(!j2Of ,,PAGE•l.L! REGISTER OF DEEDS Dennis M. VanNlassenhove and Pamela M. VanNassenhove, ..........husband •slid .wife...................................................................... ..............................•............•...._.........................................................•...... eonvys and •warraAt*e •to •••.•.•.ggggr •p "St pet ch "aiii���I+�M •]��••••••••• ..................•........ ............ ...as..�Iuc���rQxst,a .iia. ......•.**M1 @L'ty.........•..................•................•..................................... ...,.................•.................................•.._.._................................................ ..........................................•...•.....•.•.....•..•....«..«................................... ............ •...................... t............................................... •.......................... ..................................... ...•.........t�aiyfi elf .................................... the following described real estate •in................................................County, State of Wisconsin: '96 JUL 17 fl112.7 R'EC1STER'S OFFICE/S. S; SAY t€I 0a lTX4 WI1i. • RCTNRN TO • " M O r�"'•,yr%,as- dd- Tax Parcel No: ..,Q 1198-06 A pad of Tract Seventeen (17) of the Assessor's Plat of a part of Lot Two (2) and the Southwest Quarter of the Southeast Quarter (SW% SE%) of Section Twtntty eight (28), Township Forty-seven (47) North, Range Eight (8) West and a part of Lot Five (5) of Section Thirty-three (33), Township Forty-seven (47) North, Range Eight (8) Weal, In the Town of Iron River, Bayftcid County, Wisconsin, and as more particularly described as follows Commencing at the iron pipe monument masking the section comer common to Section 27, 28, 33 and 34 of said Township pad Range; thence 589'29'41'W, 700.18 feet on the section line between Sections 28 and 33 toe point which Is masked by an iron pipe driven In the ground and located on the Westerly right of way boundary line of the County Trunk Highway; thence due North 966.25 feet; thence due West 567.48 feet to an iron pipe driven 1n the ground and located at an angle point on the Southerly right of way boundary Has of said County Trunk Highway, thence S83°l3'W, 75 feet along the Southerly right of wayboundary line of Bald highway to the point of beginning; thence continuing on said last desaibed course, a distance of 104.08 feet; thence SI4'l4'40"E,110 feet, more or less, to the mean highwater tine of Lake McTarry; thence Easterly along said mean hlghwater line to a point which is 331°43'20'E, from the point of beginning; thence N31 °43'20"W, a distance of 100 feet, more or less, to the point of beginning. This * ..... nut .... homestead property. (is) (PVAf) Exception to. warranties: $ TRWFM FEE FEE UWpT s AUG 06 2025 Ba�•`i:jj Co. Planning and .Zc•iiirg Agency Dated this ...............12th......................... day of .......7l23f....................................................... l9.•.. ..................................................................... (SEAL) ....�+ �l... . (SEAL) •.................................................................. • ....Dennis.•M...yartMasse ova......... . ....•....................................•......._................... (SEAL,) ..... f ;. •..............•................................................... • .. Pamela M. VanMassenhove ..............................................•......•.......... AUTHENTICATION Signature (s) ............................................... ........»..................•..»........»..................................... authenticated this ........day of.. ........................, ID...... ................................................................................ TITLE: MEMBER STATE BAR OF WISCONSIN (If nott.,...................................»...................... authorized by S ?08.08 Win State ) ACKNOWLEDGMENT STATE OF WISCONSIN as. .......A s .County. ........................ Personally came before me th�t ... 1 ....day of •.... y.. .......................... M.M. the above named .........................•.............................•...... Ii ............ .....Dennis..M. Yams enhQvs..ans�.............. .. :: .....r'alat:la..A..YallMal3at l�ilt7�tl�...•......................... ...................................................•..•................ ' • to me known bet non ..9....... who executed the II foregoing instru ) Wedge the same. •T is INSTRUMENT WAS ORAPTED BY _ Y r nie M. YaMassenhove ��......... -..... Ji.....................................................Nota PubJlc . 1.......................County,Wi:.(Signatures may be ruthenticated or.er8ggty,th My mmission is permanenIt not, :tats expiration aotneeeaaary.) V In IT cz.coja ......... dvter :....................I '�� ra sar apadtr tlwuld b• �Dtd °r Frlaltd below t .!r tteastcm, y p771 r, i� 8TATR 5A8 Ol WtacoHaN �j S tttnrlelee PM. IURn9w T 1 • TrnRT.t Nw t _ tell - - ���-tr.:L-?t��y` fs'� ' i.'.:�isa+a:. iz.�'� �.t�,S.�u£;� ..•:.._ - ...... .4 .. .. . ,._ ...._. _ C i - Wt {\ .itki;l of Ptti+`i ;l+tll.il t It l+ +' - Rvi-tt1!} oS: I 3 ll Will I-1 O If �N R POU 1 page' ol-_ • Ill 1 ,•lid; •!1}1 t,��,: ,lair # t'• tlt N1 At t'1?IIt,llii'(` H + I ;IIIItfly Bayffelclt11 l; i1t:r!: !I f /:'. I I i t$ llitw 1u ':I7i? I'iim I1HI st/�h(•t1T'St't! It% !t'+ItI :}l .li',+1 1}iNlr++lii!t ,?I I"i�`'1:� +• fowl ilZfti!. (lilt't Sill!! :!Siff Ittt'ttl I -C) 04 024 217 O8 2841.1'1;,'t'i ; !Illti`- ;i�'01O N kililtl`:l;.11lON, !TIlllf) ;t!iot ±ji:{! It,r!}Itl,n :imt (illllIce Iu !it',fit' 1 rnlu)3t'Hi(''; r+(f t?y )tile PIc. s.' pr/it ,-lt iriftTlmati<trl. t: ,-;t;.; .+,, :•ii; .i. It+tilt{ :.•..•. •,:\1 ! l( +'+1 :' i• I;:,I:•. pt -'r`.' t:', :•l l'1 ;,;'; ! !1'Z (1' It! ' �.JQ�.�.�...�.... I !±Ta'i P,,TI)f111tf I fit:Ili, -if ri A.ro 11VSIl;i't} r r 28 'r 4 7 N R 08 E tr;r) Ili t !-'Not 14;ttft 0-t1vt Vol 111 1/' I e4 t/ Hint k $1 ^illd NafrIt' (it CSM# Par of tract 17 in V675 o477 567mm 12F !-love's C;'l _-.�------ — __ ��___. Stt}ttt (T Cod f'11t�+tn N1lnthtTl `rty VilfacfF' - rrjrrr} Nc' lrc :1 Fdrtarf 7 4 7 1vkC:arry Lake Ro +" �t\lZci tiro?t�-; it�r V Ii'n!i. I J Nor'mll>str ,'1 fx,lrtlitltt:: S; Code dt'rivo'I (10 itln flow t lfr _ ----- ,-� , {! Debt'i11t+ -- - ---- Ptlt_al+: t,r COI11fti�tl,1 - t ! +,. ,' ►t:,,•> it 11rri1 Flood W;:li►l elr'v;ttinrl if apphcafil(.' kawatel-level--95-4-.__._. \'rrtZittt;Ilti t;t soil is suitable for a mound but due to site size restrictions and slope a holding tank WO , only option. The benchmark = 100'. 25 { end TSS X30 t 150 rrq/L ' Effluent i#2 - BOO Effluent1 BOO, > 0 _ 220 rL gnature i ,• CST Name {Pleas& Print) ! _ �, Nie� en V .Itllulct 11: Data Evaluation Conduct Address 6-30-25 3620 South County Road D Poplar. WI 54864 Agency /J:1: < 30 mg/i_ and TS ≤ 30 nV1 CST Number �,. '227W7 I Telephone Miml.Ter 218-590-6678 . g Pi=ty':. tll tilt:h 04.024 •2-47-08-28..4 Paryn 2 3 P.ry•;:n "•m. Pnrrrl lDM rt. H? / r - cf �—_ jj ll :nnnp n Benin, Pn ,' In L..�J hd '�•rnw surl.! r i:. �. n i U'i u, 'n;ri I I — _—__ Srnl App 7 itiU!i R'e ��i,•nn—� Depth r.'�.L. 17 „i:,,, I lit,. n,,, ,',.' •. Bound:uy Roots GPO/ft'- L. in. trot —en root i ..:, Ni EFtp'I 'ctflr2 1 j 0-5 Syr 3/2 SL 21'4* mvfr Cs 2t .6 1.0 svr 414 -- Si 2fsbb mvlr r•.c (1 F 111 3 26-a6 yr 4,'4 r'.'1) bvr 6/8 SL Itsbk mfr - 0 0 0 Pit Ground surface nlev ft. Depth to irruting factor _— in. Soil Appicatron Ratr, r!-tn; on Depth in. Dortrnant Color Munsell Redox Descnption Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPOrft 'EffdI 'Ell#2 __I_ __ __ _ _ ___ ® Boring i I Eodng R O Pit Ground surface elev. ft. Depth to limling Factor in. Soil Aon'� ur:alinn Rare Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz Sh. Consistence Boundary Roots GPDNF 'Eff#1 Eff#2 Effluent #1 = BOD> 30 ≤220 nVL and TSS >30< 150 rng1L an•IUOerut. I„ 'Effluent #2 = BODE ≤30 mg1L and TSS 'c 30 rngR. t.sG iVED AUG 0 4 2025 Beyfield Co. F.gancf Planning and ?i.iiny ) J r �.. t j Tl(c lj • ,.' •, , Ec, i �"�+ TAY' l rL, e•_ l�jo, �,( bt i e.� �!.r lot, /• .O\ Cfr ___ \ i\ . \ AUG O.4 2025 Plan�►ing and Zonl 4Wiuts'r," l�g Department of Safety County .Z ma'Y"1" cL & Professional Services, P Ind stry Serviees•Divisio oS-u8 Sanitary Permit Nl nber (to be filled in by Co.) Sanitary Permit Application In State Transaction Number accordance with SPS 383.2l(2), Wis. Adm. Code, submission of this form to the appropriate govermne� t 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�)(m), Stats. Project Address (if different than mailing address) I. AplicationInformation — Please Print All Information Property Owner's Q �j _ S �{ 17p Y'rd.g4Vrr 1� . Manic v e.+t v -�-r c Parcel # i"— r ,' r Property Owner's Mailing Address . &k I D Z o I v a Property Location City, State Zip Code Phone Number Su Oovt. Lot 2 .z v, o✓ w1: 5 Y$�O Zi$ '4,_V Section IL Type of Building (clfeclt all that apply) 1/ T N 7 ` 3Lot I or 2 Family Dwelling - Number of Bedrooms N a O o Subdivision Name ❑Pnbiic/Commercial — Describe Use Block# /I Assessors t��a"f"o-�Sb,!$� ❑ Stale Owned — Describe Use ❑ City of CSM Number ❑ Village of F Town of r•'C'.t R; .ek 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 Iicable. A. ❑ New System-.. Replacement System 0 Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) Holding Tonle ❑ In•Ground 0 At -Grade ❑ Mound (conventional) ❑ individual Site Design ❑ Other Type (explain) C. ❑ Renewal Before 0 Revision ❑ Change of PlumberList Previous Permit Number and Date Issued Expiration b 0 Transfer to New Owner IV. Dis ersal/Treatinent Area and Tank Information: Desiian Flow (gpol Design Soil Application Rnte(gpd/sf) Dispersal Area Required (st) Dispersal Area Proposed (at) System Elevation Tunic Information Capacity in Gallons Total Gallons #of Units Manufacturer d New'ronks Fueling Tanks u�". B o $ ti S 2 _ a v is Ssyrivar Holding Tank 2 C o O — 000 1 t.(I e••�S e-vn.C, °' V ✓ rn Li '' rq j+• U a Deaintr6Mwaw, V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) (r '/ Plumber's Si norm J ftdy f�` O � bL ej $ {e.r Y / hfP/MFRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) ey^ ZZ O 9 d -716 Z� $ — ri �" w' T 73c,X SzZ y✓o� tVe.v t.0 L c?'8` 7 VI. Count/Department Use Only Disapproved Permit Fee Date Issue frig+ 1_ lssu' g A , F�713 Sig re Owner Given Reason for Denial O— Conditions of Approval/Reasons for Disapproval nECEWVED � I AUG 04 2025 Bayfeld Co. planning and Zoning Agency Attach to complete plans for the system and submit to the r.,,,,,..,,.m,.,.. _.._.... __. ,.__... __.. .._ ... r ••�. — uuu, a uc x „ mcres in size lcd SBD-6398 (R. 03/22) Wsconsin Department of Safety nr 1 Ptntossmn,tl Gm un:r+, Nt'Sitf Division of Indushv Snrvires j SOIL EVALUAtION REPORT Page of __- I;° in ar�r nrifansr wllh SPS 9R1. V4frs Adnl Grx1n -..._—. (Jointly Bayfiefd Attach complete site plan oil mixil not less than s 112 x II inches in site. Plan must --- ' include. bat not Mnetesi to vertical and ho+imnLd mefenp nr re fkeint (0M1}) dirrctiun and parcel I.D 04-024-2-4 7-0928-4 PeI cunt slope scaled dinitn�t0l Is, no[ Ill 01TOW, aid lo06011 and distance to neaurci'nod Pevrawed by / Dart?Please print all information. Pars ruei inhxmahnn }vii pro -.a may h. n e l Mr ,rrn',dary ptrpose4 (pd may law, c 15 04111 Inn II Property Owner Property tocaftnrr p�-qq ® • Peter & Mary Stipetich Govt t.nl 2 Ir4 114 s 28 7 47 N R 06 E E(or) Property Owner's Marring Address ---_--_---- Lot # Clock # Sidxl Nacre or CSfcW 12F Hayes Ct Par of tract 17 in V&75 D.477 56/mm City Stale Lp Cate Phone Ni nttwi ity ®village • Town Nearest Road Superior I WI I 54880 1218) 390.8457 McCarty Lake Rd aFn 5°C)New Construction UseQ Residential! Numhni or laedrooins _-_ 3 — Code deriver) design flow rate _-.__.— --- — ® Replacement ® Put>hc or cmmnieidal Desenlni —.. -- — -- ve.a -_ #. Parent mateuat — - — far, el l l• ri i flood Plain eluvaflon it nrm tirahlc Lake -water lel95 _.. General comment and recommendahons The soli is suitable for a mound but due to site size restrictions and slope a holding tank c{I4b�tnv p only option. The benchmark = 100'. 25• lI Bongs ® Boning 32' Bayfield Co. l!" (•� Pit Groundsudace elev 99.5__tt. Depth to bunting radon ______in So i gAgenCY Horizon Depth Domnant Color Redox Description Texture. Structure Consistence Boundary Routs G1 PDr Elf#2 in. Munsell On. St Cont Color Sr. Sz. Sh. E#s 1 0-4 Syr 3/2 •- SL 2fsbk mvfr cs 21 6 1.0 2 4.32 5vr 4/4 -- 1 c 0sg ml cs if 7 _16 32-40 6vr414 C205yt611 SL 2fsbk mfr cs 0 0 n «a 2 Boring 99.0 Bo 30. a borings Ground surface elev. a. Depth to uniting iaclor in. Sorl A licahon Rate - . Horizon Depth Dondnanl Color Redox Description Texture Structure Cortsrslence Boundary Eft# Roots GPDEd#22 in Munsell Do. St. Cont. Color Gr. Si. Sh. 2f 1.0 1 0-4 5yr 6/8 - SL 21sbk rrnifr cs .6 4.30 - 5vr 6/8 SL 2fsbk mvfr lr r c 0 ,R 1,n 2 3 30-40 Syr 6/8 C2D5yr618 SL 2fsbk mfr - • s1 - BOD,> 30 c 220 n tpri =30 ` t50 rrrg'L ' Ettluenl s2 - SOD _ 30 loot and TS'u JO nri7" Effluent gnauao CSTNumter . �S CST Mine (Please Print) . SineC .Inhna fie Dale Eralun6on CoMkr[^ td Tebflonno Number Address 3620 South County Road D Poplar, WI 54864 6-30-25 218-590.66-8 Peter Sti lellch 04-024.2-41-011-28-4 2 3 Page of Pooiwiry owner 1 Pnn-nIIDN _... ... - 9anrgl # 12 Bomh1 90.5' 26- Pd GrouiM surface ulev. ft. Doplh In brrntinu factor Irk ..._.._.. _._. - --.--- __ Sal A ,goatioo Rate Honzon Depth D4mwnant Color Rodax D, scd111ton Tetr!ulm Shur.luro Conelslonco Bonn(lary Roots GPDt{f in Mansell On Si Cent. Color (Jr Si Sh. 'Eft#1 'Ef1#2 1 0-5 5yr 3/2 SL 21sbk mvlr Cs 2f 6 10 5-26 Svr 4/4 — SL. 2fsbk mvlr rc n ,R 1, n 3 26-36 5yr 4/4 C2D Svr (3/8 SL I lsbk mfr - 0 0 n Bonr # Bonrtg t_J Pit Ground surface cloy. ^hhnzon Depth in. Dootant Color Munsell Redox Description Co. Si. Cont. Color Texture Structure Gr Si. Sh. Consistence Boundary Roots GPD/ft 'Eff#1 •Efff#2 ® Boring ❑ Bonng # O Pit Ground surface elev. _ fl. Depth to hinting factor in. Honzon Depth in. Dominant Color Mansell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPO/ft 'Eft#1 'Eff#2 ft. Depth to tmiting factor in. cnii Annrtrnn L R ate Effluent #1 = ROD,' 30 ≤ 220 ng/L and TSS >30< 150 mgL o-rswq4mLJ) � r ' v Effluent #2 = BOD, c 30 mg/Land TSS < 30 rng:L F,ECEWVED AUG 0 4 2025 Bayrield Co. planning and 'mina Agency to O(4T r y L 4 i i9/ S�cL� 1 ,ate. v y y ' J-ff c G f &0e J T 4G is Of- rt'C,, C.Ictf Gv( %v ,✓.7ii 10o/t, 'rl, .` Tejo b -x nc cr _�- Gc41$r7 /S(q4 RECEIVED AUG 042025 pWa?jn9 and Zonfnco., .. ___.. I,.,unvaivv IX LVIV.IVU No, 9975 P. 2 Holding Tank Plan Id PAGE 1 OF8 n ex a Corner Sheet Component Manuel Design References: /Yles.nwJ `iVr&'¢rkP'5i®rt oGC i2 Pg I of a Index & Cover Sheet Pg 2 of ' Plot Plan Pg 3 of 9 Holding Tank Specifications - z P4f eJ Pg 4 of 8 Management Plan Attachments: t t'UWTS Application for Soil Evaluation Report i c4 9 Holding Tank Pumnina Project Name I Description Perrnr T A& cM;.t; ro:tlI````\\ Ivef ©$ �e¢bJJ Owner Name(s): je'Fe . S-i-, C+I CL Phone:. z I -3yo - g q s `7 Owner Address: I_z_F µay+?S Ct" S ��` o L o i Project Address; 112C IVY c c y r L4 kz jcl fr- o t v e ,. w.z S`r ?f° Govt. Lot: Z Section e 8 T a y N -R g E or w Township: Sri ,2 , �� �.o.r �a:JeI- —�_® Project Parcel ID #: i k_ D o I -r Designer Information Designer Name: _A / /cL 9-. Pc, i `c a s !c , Phone: ?7 'Y C -,,i 7z - S//r6 Designer Address: '1?t�, ''a o,c SIYi z . �•c, r- c - 'Zip; Sefl'7 r, u rc E-mail: r.-e,-•`�� . <' ` Thil space reserved for approval stamp. License Number: z 2 cc o Remarks: 'REC:rvED AUG 0 4 2025 r~ Planning ardzc'lir9Aoency Signature: �` - ��"� aatis: '7— 2 !c' — z S' Original aignatur6 required qn ®ach submitted copy. j BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) 1 Check List 9 Original Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.) 0 Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) r Original Plot Plan (383.22(2)2. 3. & 4.a) El Cross Section, Over -Head Profile of the System a Ltd Schematic of Tank from Manufacturer Il Pump Tank Diagram, Alarm and Pump Curve (when applicable) Q 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) IZ Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) Gig Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) 0 ATU Servicing Agreement (Recorded at Reg. of Deeds) 56 Fee (Make Check Payable to Bayfleld County Zoning) (383.21(2)(c)7) V 2 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) 0 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) El I Application Information must include: 0 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) 10 Project Address pr Road Name where driveway is/will come off of) 9 (Owners Phone Number) Ill II Type of Building ®III Type of Permit ?1' IV Type of POWTS System ❑ V Dispersal / Treatment Area Information @1 VI Tank Information El VII Responsibility Statement (Plumber's Information) ❑ *Date Stamp* Plot Plan: (To Scale or To Dimension) ? Signature and Plumber Information lii'Surface Elevation of Body of Water ❑ Direction and Percent Land Slope it Tank and Filter Information and Location 9 Wetlands / Navigable Bodies of Water ❑ Absorption Area (Proposed and Existing) M Bench Mark (Location, Elevation and Description) d Component Manual Version IM Legal Descriptions d Piping Material information (conveyance line, building sewer line, material type and diameter) AUG 042025 Bayi?id Co. Planning and Zoning Agency Lv'Address Number and Road l North Arrow ❑ Contour Lines Cvf Structures and Driveways m Boring Location 4 Property Lines l Well Locations Turn Over 0 Cross -Section and Over -Head Profile of the System: Surface and System Elevation i 'Position of Observation and Vent Pipes (Dimensions and Depths li' Make, Model & Number of Chamber Units in each Cell Pronertv Information O How many systems will there be on this parcel of land? 1 O Has this property been split? O (Property Statement shows Property History) Jees i Private Sewage System (Septic Tanks) $ 400.00 O Private Sewage System (Holding Tanks) $ 400.00 O Mounds or Systems requiring Pre -Treatment $ 500.00 O Sanitary Revisions $ 25.00 O Private Sewage System Reconnection $ 50.00 and Private Interceptor O Return Inspection $ 50.00 El Maintenance Agreements $ $ 30.00 (checks made out to Reg of Deeds) u/forms/checklists/checklistfbrsanitaryapps (10/2009);(®7/2011);(®2/2012)(®5/2/2012 -dc) Proofed by: BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): 0 Check List I6 Index Page / Title Sheet (Optional) P1 Original Soil Evaluation Report (Submitted In Deed Holders Name — not prospective buyers) fd Original Plot Plan O Cross Section Soil Profile Sheet (optional) O Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) ® Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used 21 Property Owner's Information (no prospective buyer's name) ❑ Property Location (Accurate Legal Description with Sec/Twp/Range) A Road Name (where driveway is/will be coming off of) RI Floodplain Elevation, Flow Rate, Comments and Recommendations d Complete Soil Boring / Pit Information ® Date Soil Evaluation was conducted l CST Name, Signature, Number, Address and Phone Number O *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) IA Bench Mark (Description, Elevation and Location) Si Contour Lines (Example = 98.0' /96.0' /94.0') RI Pioperty Location (Sec/Twp/Range/, Accurate Legal Description) m Borings (Locations and Elevations) RI Percent and Direction of Land Slope Si Well Location (Including Neighboring Wells, if applicable) 16 Location of Wetland Areas, Floodplain and Navigable Waters Si Buildings, Driveways, and Structures (Location and Descriptions) 16 Location of Property Lines C( Existing System Location 0 Address Number and Road Name RI Current Surface Elevation of Wetlands and Navigable Waters RI CST, Owner and Property Information [VI North Arrow hu i U 4 Z0Z5 Bayli' ' Co. Planning and Zoning Agency Fee: RI Certified Soil Tests - Review & Filing Fee $ 50.00 u/forms/sanitary/checklist/checkl istforests 4c --t-/ ©wrier: Lego, f b scr, pfien t. c -F >3c.tlrnts Peer s'i}��tic, Sec2g Y7N RSW Sc4t:I'=�!o'u�tle.ss no4td 1 NA I2 z% 14''tyeS Gt Assn.sscvs'?4-ofsWsEZrcnR,verNe.ctr s+ cl; DV1c&tvvyLckeIU Si •erioV t) l cte 1 efa 1 - .-t iZrve� vl5SyB� zocegallon Weser cencre4e-?ank= £ouat4'Yef, S y4i.el tank t FiowL41..Finit bo++arreof Thx Tt'b* 1o'7O E ;ate 1 Jo�e: Dl� �a 1 j ser /l:cT 4k .3 't be pu.mpr-t L 4L ie�dtiLptv.p53$3.33 'fi 7C,tl✓1 IAIt,scr GIo C. 0 ld:rf k\ el o \\L e2! vve/ �� eJ - 1≤, LI ("rblnc) ic7sikmtcM ntii ✓ciri, zc4Lncks &P.s3n) AFC: = AL eve 4'%•.ct( v-aJe. -C- — Melt ._ToY of elet_ Z'o\' Bartr Ji;P>Eleulco.o.' 3 i-3 t Scti No PVC ta!/-FIo W c! rem t� ; o -h = q"Asrni D17t$' n.p(7ve V't_d p.pe„ ba(2"i-Gvtctl'S AUG 042025 m eayneid cu atar,n 8 and Zoning Agency 1 -la U; #'q (act k 0cnl1 &te J ( ict vl Ll4l �tse.l; nor .�.�Ct -r pe (vu a. ); C MOV-n nL-ao a7) nrcu,L)n JB /: )YI,P,Ii,5,.UC0701 FeI1Ce.SKt Plu,tit bt rne� Ra k3oK Cia. 1roi Rive -v; w17 sV&Y7 PROPERTY OWNER: �Tey S+• �' c PLUMBER: Allan Polkoski/ Polkoski Plumbing - 9 SIGNATURE: 4�{ - DATE: 7 _ Z (� - S,.-' LICENSE # 220090 HOLDING TANK SPECIFICATIONS • rNumber of bedrooms :Non-residential estimated flow (gpd) 1.2060.f1 1 Minimum holding tank volume required (gal) 2000.0Y'Proposed holding tank capacity (gal) •Wieser "Tank Manufacturer W2000 Tank model number SJ Electro AAlarm manufacturer E:..:, HW101 ,Alarm model number Tank Dimensions and Data X for round tank 47.0 Liquid depth below inlet Invert (In) 8.0 �Maxlmum depth of soli cover (ft) 66.D ;Height (in) Outside 161.0 iLength (in) r Dimensions 86 Width (in) ...1111 Cnfy junction box _> conduit —j blind plug •to seal outlet Tank Anchor Calculations 15370' Ibs Weight of tank and cover 1.60 Safety factor -31055 "' lbs Weight of anchor required 36.0 in Soil cover req. for anchor or 7.7 yda Concrete counterweight HOLDING TANK CROSS SECTION manhole cover with locking device and finished warning label grade 4" min. W 24 In. Manhole and vent locations may be reversed, � service �• 12.0 in. alarm on Al Electrical as per NEC 300 and Comm 16 35.0 in. Note: All tank joints, and Joints between tank openings and piping are sealed watertight. All pipe and vent mnterials comply with 5?5 389. vent cap 12" min. vent pipe FZEC =1VED AUG 042025 hayfield Co. Planning and Zoning Agency 18" min. building sewer Inlet 3 in. bedding under tank, Tank is anchored as necessary to negate buoyancy. Project: WLP2000-MR a TANK SPECIFICATIONS o N W 164" C 0i DIME W WALLSION:: 3" C) C7 10 BOTTOM: SEPTIC 3" C7 HEAVY DUTY 5" (ADD 2.800 LBS.) Ui G COVER: 6' MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53" O.D. LENGTH: 164" O.D. WIDTH: 96" 0.0. 4" CAST -A -SEAL 4" CAST -A -SEAL BELOW INLET: 41" O.D. LIQUID LEVEL: 36" WEIGHT: BOTTOM 11,260 LBS. m2 COVER 8.170 LBS. m INLET AND OUTLET: � 4" CAST -A -SEAL BOOT OR EQUAL FILTER OR BAFFLE INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 56.27 GAL AN LOADING DESIGN: 8' 0" UNSATURATED SOIL INLET TOP VIEW ff OUTLET t V a b is -0 PUMP PAD SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 2,136 GALLONS TANK CAN BE USED AS SEPTIC/ HOLDING/ PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: W I a W C � 0 C & O `70 a O 03 co D J g z z o O N U_ w N OF /i HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and maintained according to 5/S 3$3 Wis. Admin. Code, the Holding Tank Component Manual tustda "Nta.n vei. I -r/per VER 20o and the 'R&y..P e (4 County Sanitary Ordinance. MR ZI) j ( iMcy cZ.a vG?) 1. This POWTS is designed to accommodate an estimated domestic wastewater flow of 400.0 _gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed in the current Servicing Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and SP5 383 andi84 Wis. Adm, Code. 5. All service events or Inspections of this POWTS shall be reported to the county within 10 business days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the Interior of the tank may be difficult or impossible. 8. In the event that this POWTS falls and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit Is required for such a replacement). Con- nection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with SP5 363.33 Wis. Adm. Code. 10. If there is a problem with, or question about this 6I!nstallation, the following persons should be contacted: a. Installer ..............................(a3{G d�luwtb,,a l71Pf2S1ZZ.DoO Phone:7et 3'aa +.(( b. Service Provider ..................Z Rgg a Ra7l Phone: •7/f- 3 -fl... 4000 c. Co. Zoning or Health Dept. LAY ;d Ceunf tz,Ad Phone: 71S _?yn, 6/fl 11. Leaf l)asc°S0uiLot z Sa.(Zg7Lf7AJ gttW Assessors?I4+eISLU5t •To ui i1 of . = r o n iz - V e Rnkr O Project Transaction Number: RECEIVED AUG 0 4 2025 Bayfield Co. Planning and Zoning Agency HOLDING TANK SERVICING CONTRACT Contract Date 9-�J 2-3 ( c�Zll�e—LfG This contract is made between the t� [LPName (Print) Pump4r's Signature ' Pumpers' Registration # g;dtN s , �` z c We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT Legal Description: Tax ID4 S LOCATION )Use Tax Stat ant) 2 p I p 'o 1/4, 1/4, uJ eL ZtYy_ % y/ Section ,Township ( N, Range O Town of: LOt 5128 Acreage w � r � ✓t �l�[ V{.Y Gov't Lot Lot CSM4 Vol. Page CSM Doe Ii Lot(s)No. Block(s) No. Subdlvisleni 1. The owner agrees to file a copy of this contract with Bayfield County as required in SPS 383.55, Wis. Adm. Code. 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local government unit which has signed the pumping agreement required by SPS 383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding tank(s) on a semiannual basis pumper further agrees to include the following in the semiannual renort: RECENt. 6 a. The name and address of the person responsible for servicing the holding tank 0 4 2025 b. The name of the owner of the holding tank;AUG; c. The location of the property on which the holding tank is Installed; d. The sanitary permit number issued for the holding tank; Baylieid Co. e. The dates op which the holding tank was serviced; Planning and Zoning Agency f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the local government unit and the County named above within (10) business days from the date of change to this service contract. Revised: May 2016 (®May 2018) Drafted by a P Personal information you provide may be used for secondary purposes tPdvacy Law, Y PUBSON NOTARY PUBLIC STATE OF WIRr..nNRIN rn -Coi3� AGREEMENT cr �$�; peg►G� �2�*Y�stf '7/2-S /2 on the following property or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. SPS 383, Wis. Adm. Code or Ch. 145, Wis State. 1/4 of 1/4 Section _Township -f 7N. Range '2' W Town of tCr o Additional Legal Description: $CQ'4o//or,),n 3I1eeT I Gov't Lot — Lot__Block_Subdivision CSM#_ Lot_CSM Vol _Page _CSM Doc# t ' DOCUMENT NUMBER 2025R-608649 Return To: DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED O8/O5/2O25 AT 1 1 :OO AM RECORDING FEE: $30.00 PAGES:3 As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding to -k installation and maintenance. If the owner falls to have the holding tank properly serviced in response to orders issueu by Ba Hold County or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, State., Bayfield County may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. 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. 3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Stats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NR1 13, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the county within 30 days from the date of change to the service contract. 4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis. Scats„ and Ch. NR 114, Wi's Adm. Code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may Indicate that the holding tank Is not being property maintained. 5. This agreement %vi!l rcmcin :n cffact only until Bayfield County certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. SPS 383, WI's Adm. Code. in addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shaµ.kttbJztll-Sbls,� agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which w✓IjtrePaiiCd1V existence of the agreement to be determined by reference to the property where the holding tank is Installed. Owner(s) Name(s) — Please Print Subscribed and sworn to before me on this date: AUU Li -r� _ I CZf �`�!1 ��! Gr/ uel"' �V�l� ZS r ZO25 ,SardZo Notarized Owner(s) — Signature(s) Notary Public KENN EDy LAR NOTA My Commission Expires: STATE ri ( li202 OF WISCO Drafted by; 1 O pt ifo i #sos K..r Date; Personal Informallon you provide maybe used for secondary purposes [Privacy Law, s.15.O4 0J(m)I Wfoma/sanllarymoldingtankagreement.doc ®June 2018 2025 :o. ing Agency DN ht [SIN Robert J. Irwin, Assessor 715/235-6941 August 9, 2004 Peter P & Mary A Stipetich 12f Hayes Ct Superior, WI 54880-2938 Notice of Assessment (this is not a tax bill) In accordance with Section 70.365 of the Wisconsin Statutes, you are hereby notified of your assessment for the Tax key number: Legal description: 024-1108-06-000 ASSESSORS PLAT OF GOVT LOT 2 & SW SE SEC 28-47-8 & LOT 5 SEC 33-47-8 PAR IN TRACT 17 IN V.675 P.477 567MM Year Land Bld s/Im rovements Total 2004 $25,400 $37,500 $62,900 Reasons for Change Land Revaluation Bldgs/Imprvmts Revaluation RECE WED Open Book: Sunday, August 22, 2004, 12 Noon to 7 PM at the Community Center AUG 06 2025 Monday, August 23, 2004, 9 AM to 3 PM at the Community Center Planning a d z i g Agency Board of Review: Saturday, August 28, 2004, 9 —11 AM at the Community Center Objections: Call Jackie LaBelle, Town Clerk — 715/ 372-5457, to receive an "Objection to Real Property Assessment" form. Also read the Assessment Objection Procedure below. We have completed a revaluation for the township. The new assessed value reflects the Current market valued based on sales within the township since the last revaluation in 2000. Assessment Objection Procedure Wisconsin law requires assessors to assess at full market value. In order to determine if your assessment is fair, you must analyze it in relation to the Market. You may accomplish this by comparing your Assessment to Sales of similar properties, available at the Open Book Conferences. If you feel your Assessment is unfair, discuss it with the Assessor. The Assessor can explain the assessment process, answer questions and make adjustments to the Assessment if warranted. If you still wish to object to the assessment, immediately contact the local clerk, file an objection form and arrange a Board of Review hearing. The appeal process is explained in the "Property Assessment Appeal Guide for Wisconsin Real Property Owners". If you would like a copy, please contact the Department of Revenue, Office of Assessment Practices, PO Box 8933, Madison, WI 53708-8933. Boards of Review operate like a court. Their function is not one of valuation, but of deciding the validity of the facts presented orally before them. You or your representative may testify concerning your assessment objection. You must prove that your property is inequitably assessed when compared to market value. Y�1�f i 1' r 3 t tf ,; • ''k t. DOCUMENT NO. WARRANTY DEED li STATE BAR OP WISCONSIN FORM I—lOt Dennis N. YanNaasenhove and Pamela N. VanMaesenhove, ..................................................................................... hUSbanr3••eila•.Vife ••.• ..........................................................................................._..._. .............. ................................................................... wnvge and snrnnta to I..........sii(yeticha..ht49band.end.wife..aa..sDzsiXn>;aDiP..R»x�5a�. ..................................:............._...._......................_................_...._......... ..........................................................�..{ .......... I' tM following described real estate in .........₹.'i ..........................County, State of Wisconsin: rN,. VAC I CC O ION .eceKlxe O.T. DF&FACEC REGISTER DEEDS '96JUL17 Ina27 R'EGISTER'S OFFIOE/S.S: BAYEI:E:LD GQ#jgT.y, IwM NaNNN To 1W,e 0O *'Q'TTX'r °o Tax Parcel No:., 02471108' O...... A pert of TractSeventeen (17) of the Assesmse Plal of s pan of Lot Tyro (2) and the Southwest Quarter of be Southeast Quarter (SWV, SRV,) of Section Twenty-eight (28), Township Forty-seven (47) Noah, Range Eight (8) West and spot of Lot Five (5) afseetion Thirty-three (33), Township Forty-seven (47) North, Range Eight (8) West, in the Town of Into River, Bayfleld County, Wisconsin, and a more particularly dmmbed as follows: Commencing at the Ian pipe monument making the section comer couunonto Section 27, 25. 33 and 34 ofsaid Township end Range; thence 519'29'41'W, 700.18 feet on the section fine between Sections 28 end 33 eo a point which Is marked by an Imo pipe dtivm In the ground and located on the Westerly right of way boundary line of the County Trunk Highway; thence due North 96625 feet; then due West 567.48 feet to an iron pipe driven in the ground and located at an angle point on the Southerly right of way boundary line of said County Trunk Highway; thence 58393W, 75 feet along the Southerly right ofway boundary line ofsaid highway to the point of beginning; then continuing on said loss described course, a distance of 104.08 feet; thence S1P14'40'E, 110 feet, mom or leas, to the mean highwster line of Lake McTary; thence Easterly along said mean highwater line to a point which is 531'4370"E, torn the point of beginning; thence N31'4370'W, a diseance of 100 het, mom or leas, to the point of beginning. Thisis not homestead property. (is) (Ncc) c) Exception to.warrantles: fl �S�� �F� fEEEXEMPT RECEIVED AUG 06 2025 Co. Planning as d Zoning Agency Dated this .. .............12th......................... day of ......,I.u1.y ...., t...96. .....................................................................(SEAL) ....P.l.K.O/Jt,L f/ (SEAL) •................................................................. • ....Dennis..M...Y owe................ ....................................................................(SEAL) ......>! ..(Ilan •.................................................................. a Pamela M. VanMassenhove .................................................................. AUTHENTICATION Signatura(a)._._.........._._..._._............_._.......— authenticated this ........day at.,........................ lo.._.. TITLE: MEMBER STATE BAR OF WISCONSIN authorized by 1708.00, Wis. State.) • • - --•• THIS tNBTRDN6NT Wµ DRAFTCD BY „Dgnnie MT.VanMaeaenhove ACENOWLSDO34ENT STATE OF WISCONSIN as. ...OPgg18e .....................county. J Penanaliy came before me tOh4 ... 12Ch.-..day at ....... %................._...... .., 19.....68... the above named ....._......................................................................... .....Dennis..M...XarsMasenhaxa..anA..................... .....Pamela..M...XarfNassaohrnra ............................. to me known bet non ...@....... who executed the faregeing ins eru �� wiedgo the mama, !t..........._......................._................_......_........-_._.. . Notary Pub (Slgnatora, may be ruthentleatd or, aekpowlydgpd4 B th NY Commit - not,DMwarYJi . t '4V Cl IT Q 4o dater ......: "a le any wew14 eawte be t ed as rrlate4 bite. wih eteeatura STAnnVAR 07 WHIc"Na , Stork Mn ISOM ]3A FIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number: STIPETICH, PETER P & MARY A SS -00616 12F HAYES CT SUPERIOR, WI 54880-2938 Transaction Number: SS-00616-31ECB Description Amount Private Sewage System (Holding Tanks) $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 6227 Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847 Payment Type: Check Transaction Date: 8/12/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-25-97S STATE SANITARY PERMIT OWNER: PETER P & MARY A STIPETICH GOVT LOT: 2 LOT: BLK: SUBDIVISION: Assessors Plot of SWSE Iron River 1/4 1/4 SEC: 28, T 47 N, R 8 W TOWNSHIP: Iron River SOIL TEST: 74-25 REPLACEMENT SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: ALLAN POLKOSKI TRACY POOLER Authorized Issuing Officer DATE: 8/12/2025 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 #: LICENSE: # 220090 Condition: Properly Maintain System Per Recorded Agreement. Must be within 25 ft of an all- weather road. THIS PERMIT EXPIRES 8/12/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION