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* INBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY ** TIME RECEIVED REMOTE CSID DURATION PAGES STATUS May 12, 2025 at 8:25:27 AM CDT 7157983470 36 1 Received MAY/12/2025/M0N 07:02 AM Andry Rasmussen & So FAX No.7157983470 P.001/001 Request for Sanitary Inspection Fax this form to Zoning Dept when you want an inspection - 373-0114 If you do not have a fax and must email the inspection; you must email all staff members Note fl Time Change fl Discrepancy fl Other Phone Number 71 2 F3 '2.3 SS Plumber: A QrLISM�$f lv -(- �a 11 Fax Number ; 7t5 - 8 • 'no Home Owner: ----�n - Sanitary 9Permit #: Plumber's Choice Zoning Dept I No inspection during these times Date: / ! � 9;30 am —12:30 pm Tues. (Tracy) 12:00 pm— 2:00 pm Wed. (Todd) 9:30 am —12:30 pm Thursi (Tracy) Time: Plumber's Choice Z ept Immediate Phone Number so Zoning Dept can call you right back (If needed) Township: Address # & Road Name: ')T7 S S Put LA- , or ( ?4/o-, -..c--- Directions To Site: Comments: Reminder: You must confirm any change(s) that have been made prior to or this Inspection will not be scheduled and a memo will be sent voiding the inspection. Thank You! From Zoning Dept ** Plumber must verify any change(s) by fax or no inspection will be scheduled ** Ultortnslaanitaryhaqueslfonnspecbon Zoning Dept (@4112104) ® August 2021 OtlO\ Industry Services Division General Information Permit Holder's Name: Tank Information TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road s er&&prcr N/A Dosing N/A Aeration N/A Holding Private Onsite Wastewater Treatment Systems (POWTS) Inspection Report (Attach to Permit) av be used for secondary purposes [ Privacy Law, s. 15.04 (1)(m i Village L Town of: TIMOTHY J & STEPHANIE M CLARK 7775 SPIDER LAKE RD IRON RIVER WI 54847 setba�c tt to: - County , (� Sanitary ermltlt]No. 25- -IS State Plan Transaction ID#: Parcel Tax No: Pump / Siphon Information Pump Manufacturer Pump Model Demand GPM Filter Manufacturer Filter Model DH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well Dispersal Cell Information 'tLL at DIMENSIONS Width Length I # of Cells SETBACK FROM P Line T 0Type B it W IdOHW of Cell anufa 4u'44 '1 Model Number. Pretreatment Unit Manufacturer: Model Number: Elevation Data STATION BS HI FS ELEV Benchmark 1(7)4- /OO Bldg. Sewer t/ 3P 4 Tank Inlet _ &, S G( Tank Outlet tc. 17 _ 9e.3 Dose Tank Inlet Dose Tank Bottom Inst. Contour Header! Manifold q Distribution Pipe Infiltrative Surface 70 q Final Grade q istribution System X Pressure Systems Only Header I Manifold I Distribution Pipe(s) I X Hole Size I X Hole I Observation Pipes Length _ Die j Length___. Dia Spec J I Spacing ❑ Yes ❑ No Soil Cover Depth Over Depth Over I Depth of I Seeded / Sodded I Mulched Cell Center I Cell Edges I Topsoil j ❑ Yes 0 No 0 Yes 0 No COMMENTS: discrepancies, (Include code persons present, etc.) i)yf D_,,ktmpPl� c4 1S rai' r 4(tft \ Supenofl '(roof -(-e l(5 �tw w1i" A 3 s o lid I ot/t - 1000 Su lu rld✓' , t , 4I �i Vt+ (Lb &4 f► Y l�� Intr4 It i -,,bah'. Ci1.S" I moo i revision orrequired? 0 Yes 0 No '� �� The Jse other side for additional information. Cntj 4 Ydf\ Date P S Inspector's Signature License Number RRn_F'I, (P n4/951 Property Owner Information As you know BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zoningng.bayfteldcounty.wi.gov 117 East Fifth Street Web Site: www.baVfieldcounty.wi.gov/147 Washburn, WI 54891 TIMOTHY J & STEPHANIE M CLARK 7775 SPIDER LAKE RD IRON RIVER WI 54847 onsite wastewater treatment system on your property described as: Notes: was contracted by you to install a private Abandonment of Old System to meet all applicable code requirements: LI LI e Tank was pumped by: C. Tank was crushed / removed and pipes disconnected by: on at AM/PM On at (AM / PM) the above -mentioned plumber contacted our office to 7System t a pre -cover inspection as required under DSPS 383. One of the following applies: 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. LISystem could not be inspected because County could not respond to plumber's / time constraints. Comments: 'Ii11 ty o1 U e '( , .� rcLJs ( V]Siq (/?l ( U/tormslsanitarypropertyowner-input Apri12019 :n ac e1 A N] Iti frl S S— OO 509 '""^' ••to b u Li Industn' Services Division County 2 2q5C I% �. ip l 2�LJ > 4822 Madison Yards Way Mndiwn. lVl 53705 Bayfield Smtimry 14nnit Numhcr(io he filled in by Co ) FEB a Co. Zoning Do. P.O. Box 7302 iMadison. 15'1 537117 2S- qS of fl Sanitary Permit Application state'inmsaction Number in accordance wills SPS 3812i(2 I. Wis. Adm. Code. submission ni'this lbmt In the appropriate governmental unit is required prior to obtaining u snu0r permit None Application forms for stale -muted POWIS arc submitted to Pritimt Address (ifdiferent than marling addressf the Department orSal'ety and Pmfessinmd Serices. Personal infnmmtion you provide may he used for secondaq Same purposes in accordance wish the Privacy Lou. s 15.04(1 Nm), Stals. I. Application Infonnntton— Please Print All Information Property Owner's Name Parcel 11 Timothy & Steph Clark 19536 Property Owners Mailing Address Property location 7775 Spider Lake Rd. (hat. Lot 3 City. State Zip Cale Phone Number Iron River, WI 154847 715-209-4377 SE ., SE ,; Suction 19 r47 N It 08 U.ij.'rype orilluilding (check nil (but apply) Lot ❑� I or 2 Pamdv Duelling- Number orbedrooms 3 1 SubJivisnm Name ❑1'ubhGCannncrciul - Describe I1st Block a ❑City oY slate Owned - i)e, ripe Use _.._ Village of CSM Number #1346 V8 P154 L7✓ To, td• Iron River Ili. Type of POS% TS Permit: (Check either "New" or"Replacement' and otherapplicable on line A. Check one box on line D. Complete line C i applicable.) A. ❑Neu System aiteplaeement System Dthhcr Alodiiiemion to Existing System (explain) QAdditioiml Pretreatment tint (explain) 0' jiolding Tank DIn-Ground O.11 -Grade Dkfnund Individual Site Design OlherTrpe(cxplain) (mmenuonull C. Reneim1 Before �Revisio, ehatige of Plumber ❑I'rrmsier to New Owner Lis[ Previous knoll Number taxi Dale Issued Expumtiou 137157 6.11.1990 IV. Din ersaVl'reatnlent Area and link Information: Design Flow (gpd) Design Soil Application Itmggpd'sll I Dispersal Area Required 1st) I Dispersal Area I'mposcd (sll I System Glevwmn 450 0.7 1642 1738 95.0 Capacity in 1otall Per %lanulbcturer 'took Inlimnution Gallons Gallons Uniu E 8 Sew 'lanL I i'.ioing'I''I"k. Y = . a. Septte or I Itilding't'nak 1000 1000 1 Roth Plastics v/ IM:inp ('bmnhe( O I� V. Responsibility Statement- 1. time undersigned, nssnme rcspunsiblli v or btstaihufon of file POW -I'S shown on the niladmd plans. l'londrer's Name II'rift) I I'lunlur's Signor hF1'/pI PI(S Number Business Phone Norther Jason Kuettel 675751 J 715-798-3355 ('lumbers Address (Street. Cip•. Slate. Zip Code) PO Box 66 Cable, WI 54821 1Vi. 'ono /D(: mrfntcnt Use Only Approved ❑ Disapproved Permit vc, er Date Issued Issum t Ag �I Stnztt� O Shiner (7i.y i Reason Ihr Drnial ""-• w Conditions ofAppntval/Rcaams for Dlaappruvnl --Set -fOik Q .o1.YAI Ltiei beck1t'r cwi (({cft a'zc�(.c(reiv��ts Tail< sky. s.. L 3w1'ee 14x� y; cz�tc ,. Atlurb to rnmpicir elan, for the a)atem and autimit to rhr (warty ""I) on paper ant la. limo a in • 11 kitties in rirr S t 0 . o0 3112.12° ZS Rt1- SnD-0398 (It. 112? 22) PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet Hun Component Manual Design References: DV FEB 2.5 2025 In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) 3ayneld Cc. Zoning Dept Pg 1 of 4 Pg 2 of 4 Pg 3 of 4 Pg 4 of 4 Attachments: Index & Cover Sheet Plot Plan Dispersal Area Cross -Section & Plan View Management Plan Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Clark 3 Bed Owner Name(s): Timothy & Steph Clark Owner Address: 7775 Spider Lake Rd. Iron River, WI Project Address: Same Govt. Lot: 3 SE 1/4 of SE Township: Iron River Project Parcel ID #: 19536 Phone: 715 -209 -4377 Zip: 54847 1/4, Section 19 , T47 N -R 08 E ❑ or W ❑✓ County: Bayfield Designer Information Designer Name: Jason Kuettel Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 ifihiimlfl Phone: 715 -798 Zip: 54821 -3355 'Phis space reserved for approval stamp. Signature: Date: a r7 zs Original s' n ure required on each submitted copy. CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLEE � zoz5 Scale: 1 " = 30' ACi �T" ❑ SOIL EVALUATION® SYSTEM SITE MAP 0 30 45 60 PLOT PLAN PROJECT NAME: 7S' DESIGN FLOW: _l S O GPO (7.5 ft grid) LAn-t� 3 'Qty Attach design flow calculations for commercial plans. PROJECT ADDRESS: 7775 S 9I t3t'� Lie (Z≥≥ Pipe Material I ASTM Standard (Tables 384.30-5 & 384.30-5) Sani ary Sewer. � K %0o O o� " s �o/ BM Symbol: + BM Elevator: FT Force Main: pt / BM Description: j30'71bA,. S ib\NF cc 4.r' et- ttp vi I Indicate north by IMPORTANT: Slope Gradient(%) o Well Symbol (ifapplicable): 0 drawing an avow Show ground elevation contours at suitable intervals. of Tested Area: 5 tl on the approprite line. 1 S;tS I . `( H z v clkrti nvTT r 3 pu r IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER 12" mi. Wench depth (typical) min, 12° (typical) Septic Tank(s) Manufacturer. Roth Plastics Septic Tank(s) Volume(s): 1000 gal gal gal gal Effluent Filter Manufacturer. Orenco Effluent Filter Model u: FT -0822 LJ'I• ' TYPICAL TRENCH `� :•: CROSS SECTION VIEW (t 34 •. • • (tYPlcal) •.. .. (No Scale) System Elevation = 95.0 ft (typical) Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (tYPical) r---------------��---- -------------;�-------7'�--- s= 50 ft (typical) INSTALL PER TRENCH: 12 Quick4 Std -W @ 20 ff EISA/chamber = 240 ft2 + I Pairs of end caps @6 ft2 EISA/pair = 6 ft2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / instructions. TYPICAL TRENCH PLAN VIEW (No Scale) IA = 3.0 ft (typical) -Quick4 Standard -W Chamber (typical) (mid by Infiltrator Systems, Inc.) Install pursuant to manufacturers instructions. D (n O m m w N U (31 0 O ry c� TI N p car in+ = Proposed EISA per trench = 246 ft2 Required Infiltration Area = 642 ft' Distribution Method: x 3 trenches = Proposed Total EISA = 738 ft2 branched manifold P Lc M '4 O�4 In -ground Gravity Management Plan uU FEB 25Z5 IMPORTANT: Bayfield Co. Zoning Dept. The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 450 gpd; BOD5 ≤ 220 mgL-1; TSS ≤ 150 mgL-1; FOG ≤ 30 mgU1 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 (Le., 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: Local government unit: Bayfleld Co. Zoning Phone: 715-373-6138 Rasmussen & Sons Phone: 715-798-3355 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 by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. SI TES7 S2, - oc22 10Z Z�_ it � I /. Wisconsin Department of Safety& Professional Services [ Page _/ of 3 Division of industry Services 1 FEB [I71G� SOIL EVALUATION RE RT RR r in accordance with SPS 385. Wis. Adm. Gbti�fi� SDh Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must Include, I but not limited to vertical and horizontal reference point (BM), direction and percent slope, I Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. I /53 6 Please print all Information. Rev) f cypy,.. ^^'' Date ersonat Information you Provide may be used for secondary ourcoses (Privacy Law, e. 16.04(1 )(mll. 0., fir•.✓^ I V26/Z° Property Owner Property Location I U /- c h4 ) 'Y— S i m. e N CL.'MIC Govt. Lai '4 '45/5 Tr -l1 N R O'i E (or) W Property Owner's Mailing Address Site Address or GSM and Lot #: 77`S S f , Asti ui-Y•e (2 ?D ) S'.'' �C_ L 2c It -b. L6'T I CJ is I y4 s• city, State, Zip Phone Number ❑ City ❑ Village Q Town Nearest Road )rk+ri j7-IVO.-, W1- Syb-l1 (>r5 ) t..S- yl77 /Pxr )it✓ejz S? , co. torte Z� ❑NewConstruction Use: IN Restdiential/Numberofbadrooms I Code derived designfowrate HSO GPO Replacement ❑ Public orcommercial—Describe: Flood Plan elevation if applicable N_ ) 4 ft. Rarentmatedel nt, fl..si')f Jr 'General comments and recommendations: �tS 1G .J iT 0.) ❑Boring Boring# Pit Ground surface elev.%Z• )7 ft. Depth to limiting factor i ES in. / elev. 0•F88, Soil Anotioation Rate Horizon Depth In. Dominant Color Munsell Redox Description Cu. Az. Cont, Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/Ftz 'Eff#1 'Eff#2 ( b- B LS 0)4 Mt 6a z-F:,r.4 o.? r. B -t6 f a.M)•( 1MZ-E p7 I•&' 3 4-6• $5 >,5 ftt "/ ,. 0S(; - I o.7 I.4 Boring # ❑Boring ®Pit Ground surface eiev. 7•/7 ft. . Depth to limiting factor) 75 in.! elev. L't7h. Soil Aoolicalion Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' 'E##1 'E8#2 I p~!n zt ,S1�1- ( ." LS oSG Mt .5w Z{rtJ6 p.) /•6 Z 6...Ut, 7,5Y' -'r 9 — S oi& M a M14 o.) 1.fo 3 zk' ≥e .J Yt- "/3 — yt o16 /h I v :) /. (o • CST Name (Please Print) Signature CST Number .M C.LFiniC O'?1l p oozy • Address ate Evaluation Conducted Telephone Number d; c)c E L wLe, W 20 ?. )IS•7 b'-T3SS ' Effluent #1 a 800>30 s 220 mg/L and TSS > 30 s 150 mg/L ' Effluent #2 = SOD, 5 30 mg/L and TSS 5 30 mg/L tsc .OO St12►zozs R('a 56D-8330 (R03/22) Page' Z of 7 Boring # Boring r Pit Groundpw eftmv. L, ft. Depth to limiting factor 75 in. / elev.2tt. Soil Aoollcation Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Si. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 Ef1#2 I , ?•5 V/1 �S oSG />-.1 w tf o ,? z � - z( )4- '- my - .3G w J ©•7 t'G' Zb ' S' 5 7A- v 1 f b≤ G if o fl ❑ ❑ Boring Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in./ elev. ft. Soil Aoollcation Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 tEff#1 tEff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Annlicatinn Rata Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Si. Sh. Consistence Boundary Roots GPD/Ft2 tEff#1 •Eff#2 Effluent#1 = BOD> 305220 mg/L and TSS>30≤150 mg/L * Effluent #2 = SOD, S 30mg/L and TSS≤ 30 mg/L LIIICHEC<BOX Aa"APPLICABLE. FEB 2.5 LODE OX ASAPPDCABLE. X 1 SOIL EVALUATION Scale: t^=30' SYSTEM PAGE 2 OF SITE MAP 0 30Ba i8IdC0.Z4-ft PLOT PLAN PROJECT NAME: (7.5 it grid) 75a DESIGDI FLOW: NSO GPD (• LAJ... L- 3 }�e� 111 Attach design flow calculations for commercial plans, PROJECT ADDRESS: )77S SP C>` l C 1 -t SM Symbol: + n SM Elevatbn: /00. D FT SM Description: `IOTTo n_.. S \ ' C (oft -ft £XL ft°`<5l Indicate norm by Slope e Gradient (h ) S< Well Symbol (ifappllcable): 0 drawing an amnv of Tasted Area: on the approprite line. Pipe Material /ASTM Standard (Tables 384.30-3 & 384.305) Sanitary Sewer ) Force Main: -/ IMPORTANT: Show ground elevation contours at suitable intervals. �N O-T14P14C. I I I 1 I 1 L S/ �7• 1-05 U I S 11 `( V f I i H fM I B1 am= I! I tZ- 5'.go I! I I I j I I I I T to . u o f Jj I _ 1 C0___ I I % bra+ 0 09.T)/ �- '�I- 6: G -- WH±44*, --I:*167 I- tfrhHHj4uiJ___ I -t_S_f sy. i I L_ I- I c. I I-- g I� ' I I I i ! I I J RHU Soil Profile -Sheet FEB 2.5ZUb • 0wner:SLp, 9 -5'9b4— GL+gR �� SON Tester: 77,n,� cC,i92, r 3111 Co. Genldlg F?m},? System Elevation: __c7� O LoAd Rate; 6 1 -7 S stem Ran e S.3% Y � t 53 ,b8 1 - ' Q 2 07 too' . ............ ............ :........... ............ ... --.......... • ............ qg `t1,`i7 Ge •ail .: '.l� (,E ... 'Iio ............ • 9T . • •9 S' ......... l t • 93.8g . r{I 53.r 7 • :.: 97Z c 1 ............ ............ ............ • . ............ .............31 ............ ............ °l( go.eec 8s^ ............ ............ U 1 ............ ` C� ............ �tl. i9 Z 'e %.S e r ............ ............ ............ ............ ........... • 3/12/25, 318 PM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 3/12/2025 L Description Updated: 10/21/2016 Tax ID: 19536 PIN: 04-024-2-47-08-19-4 05-003-11000 Legacy PIN: 024105002990 Map ID: Municipality: (024) TOWN OF IRON RIVER STR: S19 T47N R08W Description: LOT 1 CSM #1346 V.8 P.154 (LOCATED IN GOVT LOT 3 & SE SE) IN 2016R- 565760 Recorded Acres: 25.280 Calculated Acres: 25.349 Lottery Claims: 1 First Dollar: Yes Zoning: (F-1) Forestry -1 ESN: 118 V Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 024 TOWN OF IRON RIVER 163297 SCHL-MAPLE 001700 TECHNICAL COLLEGE Recorded Documents Property Status: Current Created On: 3/15/2006 1:15:33 PM a Ownership Updated: 10/21/2016 TIMOTHY J & STEPHANIE M CLARK IRON RIVER WI Billing Address: Mailing Address: TIMOTHY J & STEPHANIE M TIMOTHY J & STEPHANIE M CLARK CLARK 7775 SPIDER LAKE RD 7775 SPIDER LAKE RD IRON RIVER WI 54847 IRON RIVER WI 54847 10 Site Address * indicates Private Road 7775 SPIDER LAKE RD IRON RIVER 54847 ® Property Assessment Updated: 8/19/2024 2025 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 2.000 187,800 193,700 G6 -PRODUCTIVE FOREST 23.280 39,600 0 2 -Year Comparison 2024 2025 Change Land: 227,400 227,400 0.0% Improved: 193,700 193,700 0.0% Total: 421,100 421,100 0.0% Updated: 3/15/2006 '� property History © WARRANTY DEED Date Recorded: 10/17/2016 N/A 2016R-565760 ® TERMINATION OF DECEDENT'S INTEREST Date Recorded: 10/17/2016 2016R-565759 © CONVERSION Date Recorded: 497423 518-220;570-248;911- 871 0 WARRANTY DEED Date Recorded: 2/8/2005 2005R-497423 911-871 0 CERTIFIED SURVEY MAP Date Recorded: 12/28/2004 2004R-496679 8-154 https://novus.bayreldcounty.wi.gov/access/master.asp?paprpid=19536 1/1 55 - CPO 509 zru, qtpED Industry Services Division 4822 Madison Yards Way County Bayfield �sl $ Madison, WI 53705 Sanitary PermitNumber(t6 be filled in by Co.) �(� ( 050 M di IS O( Jam- J J ,II U Sanitary Permit AppIicatiji JUN 1 2 2025 State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state--qq}}�((� RR}}�� S�rp, ll� f�h Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provfdb'tN'b2'ed'15�'Se nVr affyt° Same purposes in accordance with the Privacy Law, s. I5.04(l)(m), Scats. 1. Application Information —Please Print All Information Property Owner's Name Parcel # Timothy & Steph Clark 19536 Property Owner's Mailing Address Property Location 7775 Spider Lake Rd, Govt. Lot 3 City, State I Zip Code Phone Number Iron River, WI 54847 715-209-4377 SE y, SE V., Section 19 T 47 N R 08 E or W II. Type of Building (check all that apply) Lot # zI or 2 Family Dwelling — Number of Bedrooms 3 1 Subdivision Name Public/Commercial — Describe Use Block # ❑City of Village of State Owned — Describe Use CSM Number #1346 V8 P154 Townof Iron River I11. 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 applicable.) A. New System Replacement System IllOther Modification to Existing System (explain) Additional Pretreatment Unit (explain) B. flFlolding Tank ❑� In -Ground O4t-Grade Mound Individual Site Design Other Type (explain) (conventional) C. ❑ Renewal Before Expiration ®Revision Change of Plumber Dransfer to New Owner ist Previous Permit Number and Date Issued 25-9"2.2c &.2025 3 I IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (si) I Dispersal Area Proposed (s0 I System Elevation 450 0.7 642 738 195.0 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units U ` New Tanks I Existing Tanks 'I°- 'v m c,. U Septic or Holding Tank 1000 1000 1 Superior Precast )C II Dosing Chamber D 0 D V. Responsibility Statement- I. the undersigned, assume responsiinstallation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber 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 0 Disapproved Permit Fee $ Date Issued rr,L Issng t Si a[ure 0 Owner Given Reason for Denial a 5 aJ a5 C 7 Conditions of Approval/Reasons for Disapproval c6 C 11 `Y 7 Attach to complete plans for the system and submit to the County only on paper not less than 8th x 11 inches in size SBD-6398 (R. 02/22) PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet JUN 1 2 20[5 D Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2d27 Co. Zoning Dept. Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Clark 3 Bed Owner Name(s): Timothy & Steph Clark Phone: 715 209 -4377 Owner Address: 7775 Spider Lake Rd. Iron River, WI Zip: 54847 Project Address: Same Govt. Lot: 3 SE 1/4 of SE Township: Iron River Project Parcel ID #: 19536 1/4, Section 19 , T47 N -R 08 E U or W U County: Bayfield Designer Information Designer Name: Jason Kuettel Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 Remarks: Phone: 715 798 -3355 Zip: 54821 I his SI' iLc I c,ClUti itlr'd1'I'luvJI fldnitl. Signature: Date: ro__2/zS Original si ature required on each submitted copy. JUN 122026 c�ac<=ox AS A=w :cA3�. C:!S�K OX AS Ap=JC I@Id CO. Zoning Dept. ❑ SOIL EVALUATION Sca'a'''=31TQ SYSTEM PAGE 2 OF SITE NIAP 30 PLOT PLAN PROJECT NAM: p 5;g rd, 7.6: DESIGN FLOW 24 3 3t� 2 A achdes'algn flow calculations n .or comet=rcial plan;, PPOJECTADDPEES. %i 5 ..S I t�C� (/j'CC 12 y� Pipe Material /ASTIMStandard (Tables 3&1.30- 3.38=1.30-5) /O o 9.61 S/m3Jl -- 5M Elevatnn , a FT N San,l3ry Sewa7 l/ 1' J Lit ul y/ B'I Dascr,prn, 13o'�^'� S I\N- CcC.?(L (- �toy}L Force Main /`1 - /� Slope Grddlera (95J a Indicet-_nor, by IMPORTANT; rj Wen Symbol I Iacplicabiel Showground = of ie3ted Area o dra'.rh•3en,rrx:r cn one apprcpute lme elevation con lour, at suitable intervals, W c— T_ I n 4 _9S 7 B ri CL I -IL plc c� /`15 3 o PT T I i I —_T__ --'— — i cofz__ Si /�__�� o,u Lori eLjLzj V S' i — . -Tuw oT Z2- !i2t���.l ! ! I I l l l i l l l i i i i t I I I ( I I� I_ az'%•I� L i J i i L l S (( •! 7—l^ i1 I1IILL te,r44St ItD' IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER min. trench depth (typical) min. 17 (typical) �-- 34•- (typlcap System Elevation = 95.0 (typical) Septic Tank(s) Manufacturer: Superior Precast Septic Tank(s) Volume(s): 1000 gal gal gal gal Effluent Filter Manufacturer. Orenco Effluent Filter Model #: FT -0822 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) ft Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) B= 75 ft (typical) INSTALL PER TRENCH: 18 Quick4 Std -W @ 20 if EISA/chamber = 360 ftz + 1 Pairs of end caps @6 ft2 EISA/pair = 6 ft' = Proposed EISA per trench = 366 ft2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturer's / instructions. A= 3.0 ft (typical) TYPICAL TRENCH PLAN VIEW (No Scale) "—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturers Instructions. Required Infiltration Area = 642 ft2 x 2 trenches = Proposed Total EISA = 732 ft2 w to D C) n M Z P —s ;u w N v a O ry O C ro Distribution Method: branched manifold RESET PAGE 4 OF 4 In -ground Gravity Management Pla,2 IMPORTANT: JUN 122075 The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance ursu (p requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. her ld s � ll' 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 1; 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 (Le., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (Le., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Scats, 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 Phone: 715-373-6138 Phone: 715-798-3355 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 by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. SEPTIC TANS S SECTION AND S?E _; ICAT-!OFIS 4" SCII•'{OPVC INSP. PTE 6 " KIN. ABOVE GRADE.COPT) E C E U (When, tkk+ me .�c1e 4s buried Illl JUN 2 Z0Z5 APPROVED E Ba field Co. Zoning Dept. t hMANLHcOLCE FTN_SHED G?BADE y I dV y q" HT_H. IB" tiIN. I HILET APR D &A -EE[ —E- 0 FILTER)-__� APPROVED I iMFG. OVv)co PIPE]' ONTO SOLIDt model n _Tdl-L SOIL Ii 3" APPRQJaD BEDDING UNDe`R TANK SPECIFICATIONS SEPTbC TANK ?1AMUFACT1tRER: $v/ WL e& c.4P7- TA.NK SIZES: SEEDTIC (boo GAL. OUTLET r 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: Submission Number: CLARK, TIMOTHY J & STEPHANIE M SS -00509 7775 SPIDER LAKE RD IRON RIVER, WI 54847 Transaction Number: SS -00509-2E502 Description Amount Sanitary Revisions $25.00 Total: $25.00 Payment Amount: $25.00 Reference: 14727 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. SS-oos " '•"' °') L •1m.;' ' Indust)' Seniccs Division ('ounn' (} 2025 4822 Madison Yards Way 1 Bayrteld Stanton,Permit Numbcrlto he filled in by C") '•B�p I p FEB 2 5 Madison. \VI 53705 4; i P.O. Ito,, 7302 .+'� co. zoning Dsj t. Madison. \VI 53707 2S- q Sanitary Permit Application Sure Ilansition Number In accordance with SI'S 3%1.21(2). Wis Adm. Code. submission of this fort to the appropriate governmental unit is required prior to obtaining it sari ary permit Note Application films flu sule•onned POWTS are submitted to I'aject Address Iif diflerent than madinu address) the Depanmau ofsarety and Professional Sunices. Personal inlhrmation you provide may he tried for secondary nunwses in accordance with the l'rivaev law. s 15.04(1 unit Stale Same Timothy & Steph Clark 19536 Property Otmet s Mailing Address Property Location 7775 Spider Lake Rd. (Inri 14113 City, State I Zip Code Phone Number Iron River, WI 154847 715-209-4377 SE , SE ,, Section 19 It. Type of Building (cheek all that apply) Lot II .r 47 N B 08 Ii o W JJI or 2 Family Dwelling - Number of 0edrooms 3 1 Subdivision Name ❑Public/Comnierclal - I)escrihe I lie Black H ❑SUte Owned - Iksvrihe the Number city oY CSM Village of #1346 V8 P154 armni'f Iron River Ill. Type of POwTS Permit: (Check either "New" or"Replacement" and other applicable on line A. Check one bus on line B. Complete line ('II u livable, \- ❑New System 1-1'' L/ Replacvmem System LjIIn•Ground Doter MoWilieation to Existing System (explain) ❑Addita mal Pretreatment Unit (explain) ❑IloldingTunk ❑'\tdimdr IDMound QIndivWual Site Designher Ty pcicxplainl teonvenuunal) C. ❑ Renewal Befl're Revision change of Plumber ❑Iroaefer to New Owner Lot Previous Pemtit Number mad Dale lssw'd Expirhon 137157 6.11.1990 IV. pis ersalfrreatnicnt Area and Tank Informalion: Design [low (gpdi Resign Soil Appbcution Rate(gpd.40 I Dispersal Area Required (std I Dispersal Area I'mposcd (s0 I System Elevation 450 0.7 1642 1738 195.0 Capacnv in I Total I n of I Manufacturer 'Tank Information Gallons (iallsm ((nits a u tsew Tniaa I:xi>rinp Tank, v f ):. 3 - — Y d r 7 Svpnk," I lidding Tan. 1000 1000 1 Roth Plastics r'i r1 1121 V. Responsibility Statement- 1. The under>igned, assume responsibili v or Installation of the FONTS show'o on the attached plans. P1undser's Maine C Print) Plumber's Signor , AIPi1dPRS MN.er Business ('hone Number Jason Kuettel 675751 715-798-3355 Plumber's Address(Slrect. City. State. Zip Code) PO Box 66 Cable, WI 54821 VI. 'oun •/Deportment Use Only I APpnwed ❑ Dnsappmeed I' ll Feec " 2 Z Dale Issued Issui A 5 ( ❑ (hvnw ((liven hogs..., hk,;ial Z�✓ Y Conditions offApppruval/Reasons fbr Disapprycal� SP1L 4yl ik (W.'ocOA LE6&' 1 be[UY'5 cvO .jczc%-d vrc�urenncn,(S` Tcvty SL1J-& be.. ' 'V1 hekx��rade .lama no rnmplem porn for dim>l>mm and >ulnnii m Aar t T mry unll an puprr can M. itinn 81/2' II o ' Il142cZs Rti-k SI3D-6398 (R. 02/22) PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: ill FFR 252025 In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Bayfield Co. Zoning Dept, Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Clark 3 Bed Owner Name(s): Timothy & Steph Clark Phone: 715 -209 -4377 Owner Address: 7775 Spider Lake Rd. Iron River, WI Zip: 54847 Project Address: Same Govt. Lot: 3 SE 1/4 of SE 1/4, Section 19 , T47 N -R08 E❑or W ❑✓ Township: Iron River County: Bayfield Project Parcel ID #: 19536 Designer Information Designer Name: Jason Kuettel Phone: 715 -798 3355 Designer Address: PO Box 66 Cable, WI Zip: 54821 E-mail: tim@andryras.com License Number: 675751 Remarks: Signature: —- Date: Originals na ure required on each submitted copy. CHECK BOX As APPLICA3LE. CHECK BOX ASAPPUCABLE J 202L5 ❑ SOIL EVALUATION Scale: 1" =30' ® SYSTEM IANBI?0� SITE MAP ° 30 45 so PLOT PLAN Bay6eld Co. Zoning PROJECT NAME: grid) 7 S= DESIGN FLOW H s o GPO , LAR.r - 3 !fit 1) I Attach design flow calculations for commercial plans. PROJECTADDRESS: 7'7 7 S .S 9 tttM__LPVCt t7≥ Pipe Material / ASTM Standard (Tables 384.30-3 & 384.305) J00 • p SanitarySewer: L/" Said" 4O/ BM Symbol: BM Elevaton: FT Force Main: N__ / BM Description: f3oZ—m# S 1b& c Cc4.-/r ec. Pc vit Slope Gradient (%) a Indicate north by IMPORTANT: Slope Gradient a. S e Well Symbol lif applicable): 0 drawing an anow Show ground elevation contours at suitable intervals. on ;he npproprite lire. _0 W NICK! ' %—I!�o CH/953G W ✓ 'or t- 2c CL _I ir2.r I il2t � I ;�al j I ! LIII I Zt c j I , III ! ! I I tSµliz.lg-- L9lct E — CIO eo, TIILI't IIhI I •.' (2IIILL n5 A o � a 4. rte V 11u $t ! C/LYt4-.. D 13 SI.ci 1, .±i3l5illllcllllp: 111111111 +P cvt rs-t 6.c`I Lo l _.3CJr L IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER min. 12" (typical) Septic Tank(s) Manufacturer. Roth Plastics Septic Tank(s) Volume(s): 1000 gal gal gal gal Effluent Filter Manufacturer. Orenco Effluent Filter Model #: FT -0822 12" min. trench depth (typical)7�� -' TYPICAL TRENCH F- ''.a •. CROSS SECTION VIEW .. (No Scale) Provide minimum 3 ft System Elevation = 95.0 ft separation between trenches. (typical) Quick4 Standard -W wl End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) r- ------------------17----- — -------_-------��--- r= B= 50 ft (typical) II�� r1Rt31i:7 ECN 12 Quick4 Std -W @ 20 ft2 EISA/chamber= 240 ft' + 1 Pairs of end caps @6 ft2 EISA/pair = 6 ft' = Proposed EISA per trench = 246 ft2 Observation Pipe (typical) Install per manufacturers / instructions. TYPICAL TRENCH PLAN VIEW (No Scale) IA = 3.0 ft (typical) Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturers instructions. Required Infiltration Area = 642 ft' a Q „' m m C W N O u ' CO 0 � �_ iJ m F- LmJ Distribution Method: x 3 trenches = Proposed Total EISA = 738 ft' branched manifold } E fl4Uo\4 In -ground Gravity Management Pla r� FEB 252025 IMPORTANT: Bayfield Co. Zoning Dept. The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 450 gpd; BOD5 ≤ 220 mgL 1; TSS ≤ 150 mgL''; FOG ≤ 30 mgL"1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (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 (Le., 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 Phone: 715-373-6138 Phone: 715-798-3355 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 by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. Jxl ?E$T S - O0 2 2 i 10-25 Wisconsin Department of Safety& Professional Services I 4 III PageIof -`, Division of industry Services liiiF ��• aPS SOIL EVALUATION REPORTE� 2 In accordance with SPS 385, Wis. Adm. Cotltf'18 filytofllil.Lpi. Attach complete site plan on paper not less than 8 112 x 11 inches In size. Plan must Include, QTY I- 1 ti Its but not limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. q scale or dimensions, north arrow, and location and distance to nearest road. 1'? $3 6 Please print all Information. Revi a Date Personal Information you provide may be used for secondary purposes(Privacy Law, s. 15.04(1)(m)). 1✓' I Property Owner Property Location 1 ❑ /i'n a fli ) iI— 5'1 e N tc'h4C Govt. Lot Al Y. S /c) T4) l7 N R oc E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: -) S Sr . AC'z 9- e ? f3 )l'S",? &. Liffat I? c? . Le'T I cir-fF ts'l City, State, Zip Phone Number ❑ City 0 Village II Town Nearest Road )I -A-1- (Llvcfl., PJ3 SY$'-Ifl ()IS ) Lr.S- 7?7 /R.cr' )j7.%v )z se. i)if2 4A-rcc ❑ NewConstruction Use: Residential/NumberofbedroomsI Code derived design0ow rate HS0 GPD ❑ Replacement 0 Pubde or commercial -Describe: Flood Plan elevation If applicable— 144 ft. Parent material rn to to /r General comments and recommendations: bZS 1 G .r n O.) Boring# ❑Boring Pit Ground surface elev.%7.77ft. Depth to limiting rectori gSin./elev.5G•ti'ft• Snit Annlicalinn Rala Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Sr. Sr. Sh. Consistence Boundary Roots GPD!Ftz Eff#1 E8#2 U- E .s Y.t1's% •- 1$ O.)G I ( J z-64 0. ? !.G' a iccta.tiM — S tS (1 _ fh G' !v'nt 14 .7 a.7 / • G; /. (a 3 — r- eCC- I > I Boring # ❑boring ®Pit Ground surface elev.? 7.17 it. Depth to limiting factor) 75, In.! elev. O'G7f , Snit AnMI Inallnn Gnln I Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Or. Sr. Sh. Consistence Boundary Roots GPD/Fiz 'E##t -E1#2 I p -!o L1 ,5��- r ._ LS oSG Mt 5 h' Lfty4 p.7 /• 6 Z 6v ).S Y2'r j — S oSG M p.) n^I4 p.) /. (c 3 G-)� .j TeL" 1 — o 0Si;. v:) I•l: CST Name (Please Print) Signature CST Number M ct,'j2/L O'ili ObzP� Address L ate Evaluation Conducted Telephone Number v iJcx 66 ;}3Lf W 7laolrlTS•7 A,-33SS Effluent #1 = BOD > 30 5 220 mg/I. and TSS >305150 mg/I. 'Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 mg/L &SO ,00 ISI12(202.S Rja SBD,8330 (R03122) Page Z of 37 LE Boring # Boring Pit Ground v. �•00ft. Depth to limiting factor 7S in. / elev. 20.• t1 t. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 Eff#2 c - ti -?.S A -s t — cS osG N.� w t.f o i Z g -z ). Y... 4Y1 3G W I ©,_i I,(P Z&-)S7•S% f SG 1f o" ❑ Boring # Boring ❑ ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Or. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eff#1 *Eff#2 ❑ ❑ Boring Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 `Eff#1 •Eff#2 Effluent #1 = BOD > 30 ≤ 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = BOD, ≤ 30 mg/Land TSS 5 30 mg/L n [ HU))(! CHECi BOX AS APPLICA3LE, tIll FEB 2 5 2U`b1E OX AS APPUCABL. O SOIL EVALUATION Scale: 1 =30' PAGE 2 OF 0 ,eIdCo.Zwbng SYSTEM 3o8a SITE MAP PLOT PLAN PROJECT NAME: (7S ft 75' DESIGN FLOW: `/50 GPO CL&LAL- 3 iae� Attach design flow calculations forcommercial plans. PROJECT ADDRESS: ')77S SP i 1± Lr Lm -C i - Pipe Material / ASTM Standard (Tables 384,30-3 & 384.30-5) � • 0 Sanitary Sewer, / SM Symbol: 4- BM ElevatO0 un: FT SM Description: aO tor. _ S \ r�tN (eANt) _t- 3o Force Main: / Slo eGradient % a Indicate north by IMPORTANT: P ( ) 54 Well Symbol (if applicable): Q drawinganerrow Show ground elevation contours at suitable intervals. of Tested Area: cn the epproprite lire. LJwt I I I I I— l!I L. —.I S IE. , s SPt te4t1i-4 a , v4 I I I I___ lax L� I /H 3H I I IH I L � I SI/ (2 bu (+1 HHL I I I! P I II I BEM ' I I 1 z- - S __ •$�I -r___ J_ I I I I I i t I I I I i H-IfI_ I 6 s 4 6 is .o o, tit '4 I a9 .i� i I 3 � •i J- 911 I Sir _tx�� i l i I. _ t s s A- LI—�_i r w t n 6' D �2 `j I I'; I j -)€j r -I r- i L _ II LI I LI - 123 � l �_ t -- I f-- r-�I I tf' 1 , _ f I- •-ry I � I I I _ ._.. _r_ -I I I I I i 1 '[Irk-. � I -�-- I 1 I �I I! I IS I ' - r i CS) LL) 1 ilr-" _-.... L.1f'.)S-j ^ )� Cl:.._ J \ L�'._. 1 L CF I . -. Du Soil Profi]e Sheet . 1111 FEB 2.Z Y4 D • 0wner._]4 fli?eN- G � SoilTester- `Tln^ CL,9IOIPfYflOdCo.Zoning©ept System Elevation: • S . U Load Rate; Q , 7 System Range:l5.37 ft .98 loo' ............ ............ ............ • . .. ... ..: ... ell.il CaE ... I............ ........... _ ............ site _ ............ ............ ............ ............ ............ ..t. .. S•R1`^ S'5. u SYJ72'+l•� ......... ............ `7 o ......... � _ L. _ t ............ ay;..... ... ............ a3 ............. 9 • ............ ............ qa ............ 31 ............ ..............3 4 ............ 3 ,........... ............ ............ ............ do . ............. �y ............ .. ............ • ............ ............ ............ ...... ........... Private Sewage System Maintenance Agreement DOCUMENT NUMBER 2025R-606655 ,o -t, -t1 Lt_frq-2L, LAS rZ�- I (to.,.' 2t 9S7G As owner, i (we) CO nereoy 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) SC 114 of IL 1/4 Section / Township ' -17 N. OS W Additional Legal Description: Town of / /Zo N czu°r'ti (Acreage) ZS • Z 8 Govt Lot 3 Lot_ Block Subdivision Lot / CSM# /3'l(o Vol. 6 Page )S'/ CSM Doc# 2Oe'1R- H7Gt79 'J In -ground gravity ❑ Mound DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED O2/25/2O25 AT 8: 1 5 AM RECORDING FEE: $30.00 PAGES: 1 Area Return To: n ZBvl�$ � �Q (� Planning aid irl J partl�erl6 11111 FEB 2.6 2025 ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ At -grade Sewage System ❑ Other Septic Tank (system types A through E): The septic lank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at.least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. Pump Chamber (system types B, C, D. and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds, At -grade. and In -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 inure to the benefit of all current and future owners of such property. Owner(s) Name(s) — Please Print sworn to before me on this 14Y(ACk•v 1.0 Drafted by: fir,.,, tcset._ Date: L-/t°//zots Proofed by: ulformstsanitary/septicmaintenceagreement Revised July 2020 BAYFIELD COUNTY SANITARY PERMIT (#04)-25-9SR STATE SANITARY PERMIT OWNER: TIMOTHY J & STEPHANIE M CLARK G OV'T LOT: LOT: 1 BLK: CSM: 1346 V8 P154 SE 1/4 SE 1/4 SEC: 19,T47N,R8W TOWNSHIP: Iron River SOIL TEST: 10-25 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: JASON KUETTEL TRACY POOLER DATE: 6/23/2025 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 #: 25-9S LICENSE: # 675751 Condition: SEE TANK APPROVAL LETTER FOR BEDDING AND BACKFILL REQUIREMENTS. TANK SHOULD BE < OR = TO 36' BELOW GRADE. PROPERLY MAINTAIN SYSTEM PER RECORDED AGREEMENT. OLD SYSTEM NEEDS TO BE PROPERLY ABANDONED PER SPS 383. Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 6/23/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION 3/12/25, 3:31 PM Carmody'" BAYFIELD COUNTY SANITARY PERMIT (#04)-25-9S STATE SANITARY PERMIT OWNER: TIMOTHY J & STEPHANIE M CLARK GOVT LOT: 3 LOT: 1 BLK: CSM: 1346 SE 1/4 SE 1/4 SEC: 19, T 47 N, R 8 W TOWNSHIP: Iron River SOIL TEST: 10-25 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: JASON KUETTEL CECE RUDNICKI DATE: 3/12/2025 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 #: 137157 LICENSE: # 675751 Condition: SEE TANK APPROVAL LETTER FOR BEDDING AND BACKFILL REQUIREMENTS. TANK SHOULD BE < OR = TO 36" BELOW GRADE. PROPERLY MAINTAIN SYSTEM PER RECORDED AGREEMENT. OLD SYSTEM NEEDS TO BE PROPERLY ABANDONED PER SPS 383. THIS PERMIT EXPIRES 3/12/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION httnc-llw, w i-armnrlvinn rnm/PArmitAnn/Parmit Ginn ngny?Print-Ignirmitanniri=7AAfi 1/9