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HomeMy WebLinkAbout25-8SR^-oo^s^ffl^ IndusUy Services Di\'ision 4S22 Madison Yards Wny Madison. WI 5.^705 P.O. Box 730;! Madi-.on, WI 53707 (.'oumyBayfield Sdiiil.iry Pemiil Nunibtfr do be tilleil in >'y Cr )AT- ^ Sanitary Permit Application Stiite Tfiuu.iction NlUtiber Ill .u'roitliUKc v.'ith Sl'S 3K^.Jli^t. \\'i^ Adiu. Code. subniissiuil of tins tunn to tin; apprdpn.ne 2o\'t:nuncntal unit r. miuunl ptin tu ubl.unuie .1 ^.unt.m' pcmut. Note: Applicauon lonn'i tor sl.ite-owncd POWTS ace subuiilted 10 Ihe Dcpiiilitienl ut S.itcty ;iinl Protcsjiondl Scn'ices. Pcrsoual lufonnation yuu provide nuy be used tbr sCt'und.iQ' purpo'ic-i in iii.'i.'orA'inre i.vnli tin: Priv>iry Law, s. 15.04( I Kin). Suis. Projeci Aildreis (it'dit'fereul tlnui in.nline address)16855 St. Hwy13Herbster I. Application Information - Please Print All Information I'ropnty Owner':; N.uncMatthew & Tryst Anderson Parcel =11338 I'lopeity Owiit-r'-. Miiilnn! Aildre.-,..1471 140th St. niv s.t,nc New Richmond, Wl Zip ( tklc54017 II. Typt of Building (check all that apply) •|l 01 -' F.nuily Dv.'t-Uui.L' - Ninutier utBcdioouis 3 t'ublir.t.'ousisieici.ll - De-.cnlx-I.'ic IStiilc On'ncd - UCATIIH: I'si: Property Lor.idon Ciuvl. Lot Phone Nnnibcf651-468-1908 Lnl ' NEL_<sl_..s..,,,,ui r50_ N ftT_gy,n. Subdivi^fou NiUne Block s C SM Number L'llvol \ |\'illnge ot l^ovvn of CLOVER lit. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if, applicable.) • IN'cw .Sy-.lein D.cpl.n.'ciucnt 'iyaleili Hlicr Mothfic<»IluH lo Exislulff System (rxpliiui Ltldilional Pf<ftr<;nui><;ut I-'nn (expl.un) B,IJHoldiii.a T.iuk nin-Grouutl —Jcgai;gn50Ean~~ )JAI-Grade ID--Mound Individual Site Design lOtherType (expl.i (.Renewal Birfuic Expiratm 'lianee ot Plumber rausfcr to New Owner[List Previous Permit Number iind Dale Issued IV. Dh{»«rsal/Treatment Area ami Tank Information: Uc.sii.in Flow Igpdl450 DfMtfn Suil Appln'.ttion Ralc((lpd/'si'l .7 Disper-xil Arc.) Requirnl (st)642 Dispnsal Area Proposeil (st'l678 Svslem EleViinon 100.5-101.5' I,ink inti)nn.i(ii)ii ( apacity in U.lllon-, Nc» T.iul^EXiittUj,! r.Ut^-i Toldl dittliwa flat' t "Hits Miinufaclurer .^ e is. Scptle »» HniJltli; T.ttJ:1000 Wieser Concrete DOMUU I ll.uill>a A ^» V. Responsibility Statement- I. tbr undfntgned, asium? icspoaitblUh' for Instnllation of the POWTS ihown on the ntlnrhcil plans. ('luiulw\ N<une (Print) I Plumber', SiBn.mu Edward B. Redinger Plinubi:!'-, Aililre.^ (Slrnl. Cny. Swtc. Zip t'ode) 1015 11th Ave. E. Ashland, Wl 54806 MP/MPR.S Kiunber221939 Business Phone Number 715-292-6670 VI, Cuuuty/D^partment V<x Only^Appiaveil U Oii.ippuivof U t >\vnci <nvcu Rc,i^>n lut Dcutitl Permit Fn s ,35- Dale l-isnrd iy\K>L\ Issuipc Ajisytl^ian.inir^ ^} C'/'v^./.^^hl^ ^^^^^/^^ / C'tiixlitiuns oi ApprovnlRensons. for Disapproval fifffl&^S 55^^/z^5/!^-^!D) I (g I 1 j MAY 2 9 2025 Bayfie!d Co. Zoning Dept. Ailurh >u n>ni|it»i<. (ilnni fur thr <MI<-ln nuil tulnull lu (hr C uuul.v oul.l un |inpn' nnl Iro than 8 1/2 i II lnrbft In liif ,SH])-(i.<'^(R.(».\22) PAGE 1 OF 5 In-Ground Dosed-Gravity Plan Index & Cover Sheet ^ p,,j^j ^ i^ j? f? !j<; ,^Component Manual Design References: ilJj E fe g !! l!;f ^ ,'f;) u. zoning Depf In-Ground Soil Absorption for POWTS Version 2.1 (May 2022f0p27) MAY ^^ Pg 1 of 5 Index & Cover Sheet eayf/e/c' Q 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 ir: Attachments: Pump Cun/e Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description 3 Bed System with lift - .7 Loading / stepped trenches or W • owner Name(s): Matthew & Tryst ANderson phone: 651 .468 .1908 Owner Address: 1471 140th St. New Richmond, Wl zip: 54017 Project Address: 16855 St. Hwy 13 Herbster, Wl GovtLot:_NE 1/4 of SE 1/4, Section^_, T^O_N-RT_E Township: Clover _ County: Bayfield Project Parcel ID #: 11338 Designer Information Designer Name: Edward B. Redinger _ phone: 715 .292 .6670 Designer Address: 1015 11 th Ave. E. Ashland, Wl _ Zip: 54806 E-mail: ed@superiorpmw.com License Number: 221939 Remarks: Signature: /^^A5CT^^— _ Date: 5/23/25 signature required on 6ach submitted copy. SUPERIOR PUWINO MKCNANICJU. (715)278-3456 Customer Name: Matthew & Trvst AndTton Adress. «72 IWt^St.New Richmond. Wl 54017 SITE; 16855 St. Hwv 13 Htfbster. Wl Phone«: 651-468.1908 Email: archiveifnusicOvaho.com 7 A/ CST«;?1939 Scale 1 « 40 PIN i ins 5 At rei N( '»f S3 'SONS7W ly^n ot Cluvn W>»ld Co ^^/ ^5^;w ^>fy ^& (.1^ A 'J.rt? . /do- %p^ ^(» ^}^^^J. > T5rfr f^^SA s^l^1 ^ ''S. rt ^m(. « 9/f^J'^ ^ 7r<^A^S ^^^^b<^5 /do.5-->tol9' ^,<^-^ ^-^ /^//s H^u l^i^^ ^ D) MAY 2 9 2025 Bayfield Co. Zoning Di &' <^€. ^.3> u-vA T»*^ dun-*-^ IN-GROUND GRAVITY DISPERSAL AREA Stepped Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down-sizing credit) 1 SOIL COVER TYPICAL TRENCH CROSS SECTION VIEW (No Scale) 12" mi n. trench depth(typical) Septic Tank(s) Manufacturer: Wieser Concrete 1000 Septic Tank(s) Volume(s): gal ______ gal Effluent Filter Manufacturer: gal Effluent Filter Model #:, 525 (typical) Provide minimum 3 ft separation between trenches. Highest Trench System Elevations = ,103.5 ft; >Ws- ft; Lowest Trench (as applicable) ft; _ ft; Quick4 Standard-W w/ End Cap (typical)(Show location of inlet / outlet pipe connection on plan view.)Observation Pipe(typical) Install per manufacturer's instructions. TYPICAL TRENCH PLAN VIEW (No Scale) (typical) INSTALL PER TRENCH: 11 Quick4 Std-W @ 20 ff EISA/chamber = 22° Pairs of end caps @ 6 ft2 EISA/pair = 18 ft2 ft2 A =3.0 ft (typical) -Quick4 Standard-W Chamber (typical) (mfd by Infiltrator Systems. Inc.) Install pursuant to manufacturer's instructions. co0_<T>-0 = Proposed EISA per trench = x3_ ft2 Required Infiltration Area = trenches = Proposed Total EISA = 678 ft2 ft2 Distribution Method: drop boxes Q PAGE 4 OF 5 GRAVITY-DOSED SEPTIC / PUMP TANK SPECIFICATIONS(No Scale) IMPORTANT: Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) 4"0 Vent Pipe >10 ft fromBuilding 12"Min. or 2.0 ft above Eslablished Flood Elevation (typical)Approved Vent Cap Electrical must comply withSPS 316 and NEC 300 Wealherproof •Junction Box Extend manhole riser as n' \i/ \l/ \l/ Finished Grade Approved Locking Manhole with Warning Label Attached(typical) 4" Min. or 2.0 ft above Established Flood Elevation(typical) \1/ \1/ CAPACITIES @ 16.76 gal/in A B [C] D Depth (in) 18 2.0 6 10 Volume (gal) 301 33 100 167 * Pump Tank Liquid Level = ^ Force Main Diameter = ^ 0 Etii I ! NAY 2 9 20Z5 i^ le^%ld Co Zoning Depf. Force Main Length = Force Main Void Volume = 50 ft 3" Approved Bedding Material Beneath Tank gal [C] Total Dose Volume (TDV) = 100 gal/dose ( < 0.2X design flow + force main void volume) 18"Min. (typical) Approved Joints with Approved Pipe 3 ft onto Solid Ground (typical) PUMP-OFF ELEVATION =97.8 INSIDE BOTTOMELEVATION = 97 ft ft Vertical Lift =ft PUMP TANK: Volume =600 gal Manufacturer:Wieser Concrete SEPTIC TANK(S): Total Volume = 1000 gal Manufacturers):Wieser Concrete Pump Manufacturer: Pump Model: EP0411F Goulds Controls/Alarm Manufacturer: Controls/Alarm Model: (See attached pump curve.) SJ Rhombus PS Patrol Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: Filter Model: Poly Lock 525 Float switches containing mercury are prohibited. PAGE 4 OF 4 In-ground Gravity Management Plan IMPORTANT: The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. 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). Wise. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 450 gpd; BODs ^ 220 mgL-1; TSS <. 150 mgL-1; FOG $ 30 mgL- Inspection Checklist INSPECT EVERY 3 YEARS ^ ^ ^ ^ f] ^ go type of use [ui ^ ^ t5 U I!/ iS o age of system |l [| ^,,, ,,,,,,. o nuisance factors (/.e. odors, user complaints, ete.) uu i^AY ^ 9 Z025 o mechanical malfunction (;.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) '-'aywc' u' Zuning uep?, o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (/.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (/.e., pump re-cycling, float switch settings, etc.) o electrical components - if applicable (/.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 affluent 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, Wise. 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 Wise. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Superior Plumbing & Mech. Inc. p^e; 175-292-6670 Local government unit: BayfJeld CQ Zoning _ phone; 715-373-6138 Local government unit address: 117 5th St. E. Washbum, Wl ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wise. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wise. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wise. Admin. Code. , 0»^- UU 110 ID) 1^ "? E i! W E Ill JUL 1a^O'Z4 Page.1Wisconsin Department of Safety and Professional Services DivisionoflndustrySen/ices _ ^ ^ ^ ^ ^ ^ ^ ^^ ^ _ ^ gg^g^ ^ ^^ Q^SOIL EVALUATION REPORT""'""'" "" ^'""3 "r // •%§^ •'':v,,..;i •"' In accordance with SPS 385, Wis. Adm. Code Attach complete site plan on paper not less than 81/2x11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow. and location and distance to nearest road. Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. l5,04(1)(m)). Property OwnerMatthew & Try st Anderson CountyBayfield 7~ Parcel I.D.11338 Rqviewedby 1^ i i_l \ , Qfit^J'^-^o HQH |^/^ Property Location Govt.LotNE '/< SE '/-s3 T 50 N R D E E (or) W Property Owner's Mailing Address1471 140th St 651-468-1908 Site Address or CSM and Lot S:16855 St. Hwy 13 Herbster, Wl CityNew Richmond StateWl Zip Code54017 Phone Number ( ) D City Clover D Village H Town Nearest Road St. Hwy 13 IJIJNewConslniction Use: ffj Residential/Numberof bedrooms Public or commercial - Describe: Parent material SandV Outwash Code derived designflow rate 450 GPD Flood Plan elevation if applicable_ft. General comments and recommendations: Conventional System WJth .7 loading Step trenches as needed 103.9'-100.5' 1 Boring #QBoring[•Ipit 105.3 Ground surface elev. ft.Depth to limiting factor.60 100.3 in. / elev. ft. Horizon 1 2 3 4 5 Depth In. 0-9 9-32 32-60 60-64 64-72 Dominant Color Munsetl 5yr 6/2 5yr 5/6 5yr 6/3 5yr4/4 5yr 5/4 Redox Description Qu. Az. Cont. Color c2d 5yr 6/8 Texture Is s s Is s Structure Gr.Sz. Sh. 0 Osg Osg 0 Osg Consistence dl ml ml ml ml Boundary cw gw cw cw Roots Sco 2m 1f Soil Application Rate GPD/Ft3 •Eff#1 .7 .7 .7 .7 .7 •Eff#2 1.6 1.6 1.6 1.6 1.6 Boring H DBOTin9 105.9 'it Ground surface elev,_ ft.Depth to limiting factor 88 98.6 in. / elev. ft. Horizon 1 2 3 Depth In. 0-8 8-33 33-88 Dominant Color Munsetl 5yr 6/2 5yr 5/6 5yr 5/4 Redox Description Qu. Az. Cont. Color Texture Is s s Structure Gr.Sz. Sh. 0 Osg Osg Consistence dl ml ml Boundary cw gw Roots Sco 2m Soil Application Rate GPD/Ft3 •Eff#1 .7 .7 .7 "Effff2 1.6 11.6 1.6 CST Name (Please Prinl) Edward B. Redinger Address 1015 11th Ave. E. Ashland, Wl 54806 Siaoature /i ^ . ,^L-^3^Z^^-^- Date Evaluation Conducted7/15/24 CST Number221939 Telephone Number 715-292-6670 • Effluent S1 = BOD > 30 s 220 mg/L and TSS > 30 < 150 mg/L Effluent #2 = BOD, 5 30 mg/L and TSS < 30 mg/L SBD-8330(R04/21) Pr-1 ^50 /f-;^^ y&^ Boring # [~] Boring B Pit 102.5_Ground surface elev. ft. ^ K -JJL 1& u','ZUZ4 ^1 Depth to limiting factorBayfield Co. Zoning Dept. 88 Page 2 .3of 95.2.Jn. / elev. ft. Horizon 1 2 3 Depth In. 0-4 4-28 28-88 Dominant Color Munsell 5yr 6/2 5yr 5/6 5yr 5/4 Redox Description Qu. Az. Cont. Color J Texture Is s s Structure Gr. Sz. Sh. 0 Osg Osg Consistence dl ml ml Boundary GW gw Roots Sco 2m Soil Application Rate GPD/Ft2 •Eff#1 .7 .7 .7 •Eff#2 1.16 1.6 1.6 Boring #D BoringD Pit Ground surface elev.n.Depth to limiting factor.in. / elev.ft. Horizon Depth In. Dominant Color Munsell Redox Descnption Qu. Az. Cont. Color Texture Structure Gr.Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 •Eff#1 •Eff#2 Boring #D BoringD Pit Ground surface elev.Depth to limiting factor.in. / elev. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az- Cont. Color Texture Structure Gr.Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 •Eff#1 •Eff#2 ' Effluent #1 = BOD > 30 < 220 mg/L and TSS > 30 s 150 mg/L • Effluent #2 = BOO, •S 30 mg/L and TSS s 30 mg/L D) EtElII ffl .un 'i 9yny4 SUPERIOR PLUMBING MECHANICAL (715)278-3456 ^AS.TZ^-T- 9//J/3^ Customer Name: Matthew & TrvstAnderson Adress: 1471140th St. ^ New Richmond, Wl 54017 SITE: 16855 St. Hwy 13 Herbster, Wl Phone #: 651-468-1908 Email: archivesmusic@yaho.com Bayfield Co. Zqning Dept'if CSTtt 221939 Scale: 1" = 40' PIN:11338 5 AcresNE SE S3 T50N R7W Town of Clover Bayfield Co. C^ i ^e^\ /^<r/^«. / $y f/S./r? ^/"&t> 'Tc^^-c-f^^S <»s /l«i^</«J /<S^? '-/AS.^j .9 JL^f^^ ,4 -Q.^^166' -Top A^ ^U Jr^([\<-^. » t5dr/-^i$ ^1 ^^1 y^o|.^lfl ^<t<//.^ ^^ 'DrA^t-^ /fiJ-^j ^^'^(L^• "- ^"^^--Tl i^-y \;>rw^a./^y U^-i -^>«-f <9.A->/i-<-< - A 6.5" (16.51cm) SEALED BALL MATERIAL-HOPE 33.02 l83.9cm: —————- - — 20.71 [52.6 cmj ,4" (10.16 cm) B/^y.1 ' TRAVEL FILTER CARTRIDGEMATERIAL - FILLED POLYPROPYLENE HOUSING MATERIAL. POLYPROPYLENE BALL PUSH ROD FACTORY INSTALLEDMATERIAL - FILLED POLYPROPYLENE POLYLOKPL-525-625CUTAWAY 4"AND 6" FACTORYINTALLED PIPE OUTLET MATERIAL - PVC —" OPTIONAL BUSHING — ' (FOR 4" THIN WALL PIPE) PARTN0.30142.R OR OPTIONAL FLOAT SWITCH(FOR 110 MM. PIPE) PARTN0.30142-EUR i1I !I OD£U••<fQ:00' ^3 CQ 0 '(D-0 -5;^-< rv> •<0 f0C3rsj<-n ^=^ G=in} <^3) Fur] GVT] 4" CAST-A-SEAL 4" CAST-A-SEAL TOP VIEW 4" VENT WLP1000/600-MR TANK SPECIFICATIONS DIMENSIONS: WALL: 3" BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 51" LENGTH: 12'-6" WIDTH: 7'-0" BELOW INLET: 42" LIQUID LEVEL: 36" WEIGHT: BOTTOM 9,500 LBS.COVER 5,470 LBS. INLET AND OUTLET: 4" CAST-A-SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL #W(OTHER STATES SEE CHART) LIQUID CAPACITt': 27.88 GAL/IN (SEPTIC) 16.76 GAL/IN (PUMP) LOADING DESIGN: 8'-0" UNSAWRATED SOIL TANK CAN BE USED AS: SEPTIC/SEPTIC, SEPTIC/PUMP,OR SEPTIC/SIPHON COVER: MIX DESIGN #6 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETE PUMP PAD SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: QL2I00<£> 000 <=) uF= Q.Ldw SHEET NO. 1 OF 1 ou Wastewater METERS, FEET 10 QI us 0 s raTen^cFmoTogy 'Dj i £ i| |? | MAY 2 9 2025 Co. Zoning Deot. 25 20 15 10 5 10 20 30 40 50 GPM L0 10 12 m3/h CAPACITY MODEL INFORMATION Order Number EP0411 EP0411A EP0411F EP0411AC EP0412 EP0412F EP0511F EP0511AC EP0512F HP .4 .5 Volts 115 230 115 230 Amps 12 6 13 6.5 Minimum Circuit Breaker 20 10 20 10 Phase 1 Float Switch Style Plug/ No Switch Piggyback /Wide-Angle Plug/No Switch Piggyback/Wide-Angle Plug/No Switch Plug/No Switch Plug/ No Switch Piggyback / Wide-Angle Plug/ No Switch Con) Length 10' 10" 20' 20' 10- 20' 20- 20' 20' Discharge Connection 1 y Minimum On Level Manual 12" Manual 12- Manual Manual Manual 12" Manual Minimum Off Level Manual 6" Manual 6" Manual Manual Manual 6" Manual Minimum Basin Diameter 15" Maximum Solids Size y," Shipping Weight Ibs.kg 20/9.1 21/9,5 20/9.1 21/9.5 20/9.1 20/9.1 22/10 23/10.4 22/10 PAGE 3 pAy FIELD Bayfield county Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn,WI 54891 Phone: 715-373-6138 Fax: 715-373-4010 Property Owner: ANDERSON,MATTHEW A & TRYST M 1471140TH ST NEW RICHMOND, WI 54017 Description Sanitary Revisions Total: Payment Amount: Submission Number: SS-00508 Transaction Number: SS-00508-2CEEA Amount $25.00 $25.00 $25.00 Reference: 10286 Paid by: Superior Plumbing & Mech Inc., 1015 llth Ave E, Ashland, WI 54806 Payment Type: Check Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. 6/4/25, 2:54 PM Carmody™ BAYFIELD COUNTS SANITARY PERMIT (#04)-25^SR STATE SANITARY PERMIT OWNER: MATTHEW A & TRYST M ANDERSON GOVTLOT: LOT: BLK: NE1/4 SE1/4 SEC: 3, T 50 N, R 7 W TOWNSHIP: Clover SOIL TEST: 117-24 NEW SYSTEM SYSTEM TYPE: Non-Pressurized In-Ground PLUMBER: EDWARD B REDINGER TRACY POOLER Authorized Issuing Officer DATE: 6/4/2025 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 #: 25-8S LICENSE: #221939 Condition: SYSTEM ELEVATION SHALL BE > OR = TO 1' BELOW GRADE AND < OR = TO 2' BELOW GRADE OF ORIGINAL CONTOUR. MAINTAIN PROPER SEPARATION FROM WELL AND EDGE OFSTEEP SLOPE. PROPERLY MAINTAIN SYSTEM PER RECORDED AGREEMENT. REVISION TO 25-8S ISSUED 3/12/2025. THIS PERMIT EXPIRES 6/4/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION htfn<:-//wwwrl?rmnrfvinr: r'nm/PprmitAnn/P^rmit ftinn aRnY'?Print==1Anprmitannir!=74Q1 1/9