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HomeMy WebLinkAbout25-114SRequest for Sanitary Inspection (24 Hrs. in Advance) Fax or email this form to Zoning Dept (24 Hrs.) prior to when you want an inspection Fax (715) 373-0114 or Email zoning@bayfieldcounty.wi.gov Note fl Time Change fl Discrepancy fl Other Phone Number 715-682-6050 Plumber: Blakeman Plumbing & Heating, Inc. Fax Number Email Address Homeowner: Wendy Marty steven.waby@blakemanplumbing.com Immediate Phone Number So Zoning Sanitary 25-114S Dept can call you right back (if needed) Permit #: 715-685-4128 Plumber's Choice om Dept e No Inspection(s) during this time Date: 10101 /2025 Y Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice ing Dept Time: Cl iTb9km 1 Township: Iron River Address #& & 64555 HartLake Rd Road Name: Iron River, WI 54847 or Directions To Site: Comments: Conventional gravity in -ground Eljen trench system installation inspection ** Plumbers you must verify any change(s) by fax or email ** Notes from Zoning Dept: July 2025 l?Q Private Onsite Wastewater Treatment y 1&Systems ( POWTS),Inspection Report (Attach to Permit) WENDY J MARTY REV TRUST DTD 1/9/2025 2626 LOUISA AVE tiy purposes fPx±vaoy Law, s. 15.04 (fl(m) MOUNDS VIEW MN 55112 City flVniage Town of. setback to: County iLJ ► V Sanitary ermlt No: State Plan'Transaction ID#: Parcel Tax No: TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road septic It1 PMF.t≥P'— — — N/A Dosing N/A Aeration N/A Holding Rump! Siphon Information mp Manufacturer pump Modell. I Demand GPM Flier P�crfr Filter Mode c TDH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well Dispersal Cell Information DIMENSIONS Widjhh i l Leg��dllingt`l� #of Cell SETBACK FROM P ine Buill I OHWM Type of Cell Manufacturer: Model Number. Pretreatment Unit Manufacturer: Model Number. Elevation Data STATION BS HI I FS ELEV Benchmark �( (p tAH , (Q / a Bldg. Sewer Tank Inlet Tank Outlet D Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/ Manifold gg�a Distribution Pipe Qg,i Infiltrative Surface qe6 '( Final Grade ;tribution System X Pressure Systems Only Header/ Manifold Distributio;('ipe(s) 1 X Hole Size X Hole Observation Pipes ength Dia Length I% Dia Spec_ Spacing ❑Yes 0 N Cell Center I Cell Edges I Topsoil 0 Yes 0 No 0 Yes ❑ No COMMENTS: (include code discrepancies, persons present, etc.) -6 Stia '►�.` r.1 coolA flf►(C(�t� 'is- telow esS 'foP"b fio4St•, 44C ?RM\ &' Sa(�h(� 3�c'-� I vc.na•% � � l�"44W lb �unl�. � l G►�_w�tkv. — io cu.c�C Ian revision required? ❑ Yes Iq No >e other side for additional information. Date tl P.c ilu (o0LfG, POWTS Inspector's Signature License Number 3Rn1371n /R nl911 Property Owner Information As you know BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zonino(a�bavfieldcountv.oro Web Site: www.bavfieldcounty.org/147 WENDY J MARTY REV TRUST DTD 1/9/2025 2626 LOUISA AVE MOUNDS VIEW MN 55112 Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 was contracted by you to install a private onsite wastewater treatment system on your property (Tax ID# above). To know when your system will be due for servicing please go to www.septicsearch.com Notes: Abandonment of Old System to meet all applicable code requirements: LI LI C• Tank was pumped by: r Tank was crushed! removed and pipes disconnected by: on at AM/PM On at (AM / PM) the above -mentioned plumber contacted our office to con ct a pre -cover inspection as required under DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. ❑ System was inspected and appears to meet all applicable code requirements; however, a plan revision is necessary because the installation was substantially different than the original approval. ❑ System could not be inspected because plumber covered prior to scheduled time of inspection. ❑ System could not be inspected because plumber was not ready at scheduled time of inspection. County was unable to return to complete inspection. ❑ System could not be inspected because plumber was not ready at scheduled time of inspection. A re -inspection and $50 fee are required. LIISystem could not be inspected because County could not respond to plumber's time constraints. U/(arms/sanitary prop arty owns r -Input April2019 55- ©'Oh'? Department of Safety County Bayfield (c1_.)) & Professional Services Industry Services Division Sanitary Permit Number (to be filled in by Co.) Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(l)(m). Stats. 64555 Hart Lake Rd, Iron River, WI 54847 I. Application Information — Please Print All Information Property Owner's Name Parcel # Wendy J Marty Rev Trust DTD 20092 Property Owner's Mailing Address Property Location 2626 Louisa Ave Govt. Lot 4 City, State Zip Code Phone Number Mounds View, MN 55112 612-310-3861 ¼, ¼, Section 34 T N R 08 E o II. Type of Building (check all that apply) Lot # Subdivision Name 0 1 or 2 Family Dwelling— Number ofBedrooms 3 Block # O Public/Commercial — Describe Use O City of ❑ State Owned — Describe Use O Village of CSM Number 0 Town of Iron River 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 i a licable. A. ❑ New System 0 Replacement System 0 Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) Replace drainfield w/Elgen B. ❑ Holding Tank El In -Ground ❑ At -Grade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration 298188, 6116198 IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (sf) Dispersal Area Proposed (sf) I System Elevation 450 1.6 281.3 410 101.4 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units V100 y ,� New Tanks I Existing Tanks c aU in c wC7 a Septic or Holding Tank 1000 1000 1 Weiser Concrete ❑ Dosing Chamber ❑ ❑L. V. Responsibility Statement -I, the undersigned, assume responsibility _r installation of he POWTS shown on the attached plans. Plumber's Name (Print) ber's Signal P/MPRS Number Business Phone Number Dean Blakeman 1 1092768 715-682-6050 Plumber's Address (Street, City, State, Zip Code) 44941 State Hwy 13, Ashland, VIII 54806 VI. County/Depairtlaent Use Only Approved O Disapproved Fee I Date Issued 1y%b Issui g A t Si ature 2K5' O Owner Given Reason for Denial $Permit /74 /).S Conditions of Approval/Reasons for Disapproval Se' -C (rc/ C"d - RECE WED AUG 21 2025 Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size Bayfid CO. Planning and Zoning Agency SBD-6398 (R. 03/22) PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) 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: El'' modal S .tc e 4 POWTS Application for Review -y, 1 ≤pa )4 Soil Evaluation Report & Site Map Pc&vou J'I- Pe ii4 T Project Name 1 Description Wendy Marty In -Ground Elgen Owner Name(s): Wendy J Marty Phone: 612 -310 -3861 Owner Address: 2626 Louisa Ave, Mounds View, MN Zip: 55112 Project Address: 64555 Hart Lake Rd, Iron River, WI, 54847 Govt. Lot: 4 1/4 of 114, Section 34 , T47 N -R 08 E ❑ or W Fv] Township: Iron River County: Bayfield Project Parcel ID #: 04-024-2-47-08-34-2 05-004-04000 Tax ID 20092 Designer Information Designer Name: Dean Blakeman Phone: 715 -682 -6050 Designer Address: 44941 State HVVY 13, Ashland, WI Zip: 54806 E-mail: dean@blakemanplumbing.com This space reserved for approval stamp. License Number: 1092768 RECEIVED Remarks: AUG 212025 Barfield co. Planning and Zoning Agency Signature: Date: 202 _ Original signature required on each submitted copy. CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. SOIL EVALUATION Scale: 1" =40 ✓ SYSTEM PAGE 2 OF 4 SITE MAP 0 40 60 80 PLOT PLAN PROJECT NAME: 10� DESIGN FLOW: 450 GPO (10 ft grid) Wendy Marty In -Ground Elgen Attach design flow calculations for commercial plans. PROJECT ADDRESS: 64555 Hart Lake Rd, Iron River, WI, 54847• Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) BM Symbol: BM Elevation: 100 FT N Sanitary Sewer 4" / 3034 Force Main: BM Description: Top of garage slab Slope Gradient (%) 15 Well Symbol (if applicable): Q Indicate north by drawing an arrow IMPORTANT: Show ground elevation contours at suitable Intervals. of Tested Area: on the approprite line. L I C J ZN O � a 0 Wooded Site 0 N C1 Existing Well 0 0 EXIStIng.-___ 65 to Hart Lake Rd. 2 Bedroom 35' to Hart Lake W e- room Addition = House Existing 4" 3034 Pipe 0) Hart Lake Existing 1000 -Gallon o WeiserTank 7 (add Effluent Filter) Existing gravity - drainfield Replace w/Elgen Modules its . _. 15'/o Slope REC IV Existing Garage A 12U� S Lot Line f 1d CO. oning 9 eljen Eljen GSF System WI Design Program Date: 15 -Aug -25 Client Name: Wendy Marty Site Address: 64555 Hart Lake Rd, Iron River, WI 5484] Designer: Dean Bbkeman wore: This wmkaieet Is protidedso assist site Plannerin sizing the number of[IXn 6SF Modules mquimdfara aped pra/erc rite cakulatbm herein art eaplolnedfar each output. The s urreaa of the overall design I, baud an the Flannery Inputs and romldeearlans outside a/this worksheet. System Siting (Total Number of Eijen GSF Modules Required) Design Notes and Comments 3.1 Site Characteristics: Total Number of Bedrooms 3 DDF per eedmom (Daily Design Flow per Bedroom) 150 gpd EHluent#1 Application Rate 0.7 ga(/fta DDF(Daily Design Flow) 450 gpd Equivalent Effluent h2 Application 1.6 gal/ftt Application Rate 1.6 gal/ft' Required Basal Area (DDFIAppgudcn find 281.3 ft' Unk Used ( Usually 643) 643 Unit install Width 5 ft Square Footage per Unit 20 ft'/unit 1.2 Module Quantity Analysis: Minimum Number of Ellen CdF Modules Required Required Basal Area 4 Square Footage per Unit or Bedrooms a 15 for 943s or 6 for A42); whichever ISBreateq 15 units Amount of Ellen GSF Modules Used Must be greater than or equal to Minimum Number of Ellen GSF Modu Ws Required 20 units 13 Distribution Call Denies: Number of Distribution Cells /Trenches (Program supports up to 4 Trenches or 1 Cell) 1 Number of laterals inside Cell (Program supports up toe) 2 a oisWbutlon CellWtlth llf cellbred. CellWidth isgreater than IDhand reeds to be revised.) 10 It S. Dindbu[bn Cell Length 4] it C. lateral to Lateral Spacing I Multiple lateral systems) 5.00 ft D. Lateral to Edge Spacing (Multiple lateral systems) 2.50 ft Units per Row (if red, adjust number of modules to make roes equal) 10 Total Square Footprint 410 ft' A. Width it S. Length 41 C. Lateral to La s.00 Spacing (ft) _ 250 D. Lateral to Edge Spacing (ft) = A. Width , 111 C. Lateral to La 5.00 Spacing (ft) = 2.50 D. Lateral to Edge Spacing (ft) = MIN 17 OF CLEAN FILL In n 6' PAGE 3 of 4 RECEIVED AUG 21 2025 Bayfieid Co. Planning antl Zoning 'AQefy PAGE 4 OF 4 In -ground Gravity Management Plan IMPORTANT: The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow 450 gpd; BOD5 ≤ 220 mgL-1; TSS ≤ 150 mgL"1; 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 (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Blakeman Plumbing & Heating, Inc Phone: 715-682-6050 Local government unit: Bayfield County Zoning Administration Phone: 715-373-6138 Local government unit address: 117 E 5th St, Washburn, Wl 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 pursit a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component g abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. 12025 AUO2 System Abandonment eayficw Co. Planning and Zoning Agency If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. B43 Eljen Geotextile Sand Filter The Eljen GSF (Geotextile Sand Filter) is an alternative onsite septic leachfield system. Each GSF Module is made up of geotextile fabric and a plastic core material that work together to provide vertical surface area and oxygen transfer. The GSF System applies secondary treated effluent to the soil, increasing the soil's long-term acceptance rate. A Specified Sand layer provides additional filtration, and prevents saturated conditions. INSTALLATION Installation shall comply with the latest installation instructions published by Eljen Corporation and abide by local regulations. Eljen Modules are installed along their 4 -foot lengths on a base of stabilized Specified Sand, with the painted stripe facing up. A 4" perfor- ated pipe is centered on top of the Modules, and is secured with supplied metal clamps (one per Module). Cover fabric is supplied by Eljen and substitutions are not allowed. Specified Sand is placed along both sides of the Module, and at the beginning and end of each row once the cover fabric is in place. For more specifications and detailed installation instructions consult the appropriate Design and Installation Manual. eljen CORPORATION Innovative Onsite Products and Solutions Since 1970 Tel: 800-444-1359 • Fax: 860-610-0427 Email: info@eljen.com www.eljen.com Patented ©2019 Ellen Corporation 1933A-05/19 SEED AND LOAM 10 PROTECT FROM EROSICN CLEANRLL CEOTE> ILEFPBRIC � PER DESIGJ PER PER DESIGN '. DESIGN SFECIRED SAW MN PERDESI( l EXAMPLE INSTALLATION RECEIVED AUG 212025 aayfsQ 1 nMo o"4 � PDL4OKInc Innovations in Precast Drainage Zabel° & Wastewater Products ® A OMslon at PoWk Inc. PL -525 Filter The PL -525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL -122, the Polylok PL -525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. I J& PL -525 Effluent Filter Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. PL -525 Installation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL -525 filter into its housing. 5. Replace and secure the septic tank cover. PL -525 Maintenance: The PL -525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL -525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is properly aligned and completely inserted. 7. Replace and secure septic tank cover. 1/16" Filtratit 10,000 G Accepts 4" & 6" SCHD 40 pipe NSF Outdoor SmartFilterO Alarm Polylok Zabel & Best filters accept the SmartFilter® switch and alarm. Alarm Switch (Optional) Accepts 1" PVC Extension Handle Rated for { 10,000 GPD 525 Linear Ft. of 1/16" Filtration Slots Certified to NSF/ANSI Standard 46 Gas Deflector Automatic ShRECEIY`y ED AUG 212025 aApenty Extend & Lokrm Easily installs into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com i t�j JUN 11 1 ®�� - SANITARY PERMIT APPLICATION (per 201 Safety shingtonand A e. S in - «�_.. P.O. Box l 0065 In accord with ILHR 83.05, Wis. Adm. Code 7969 Department of Commerce ; j rj 7,�,,,Z,I� tMadison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. c' • See reverse side for instructions for completing this application State Sanitary Permit Number The informationyouprovide may be used by othergovernment agency programs ?I 9 Y P 9 ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Prope Owner Name roperty Location _i3- 1 l� lea 1/4,5 34 T L7,N,R E (or)( Property Owner's M'ling Address tIiumber I Block Number City, State Zip Code Phone Number (Subdivision Name or CSM Number I1M ► �. on r1r.1 t1 II. 1.`I'E 0BUILDTNG: (check one) 0 State Owned ❑ cit� Nearest Road ❑ Vil age Public 1 or 2 Family Dwelling - No. of bedrooms _ " Town OF iV III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/Condo 1 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office / Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Chet my one box on line A. Check box on line B, if applicable) . eplacement 3. ❑ Replacement of A) 1. ❑ New ----System-----Tank 4. ❑ Reconnection of 5, ❑ Repair of an SXrstem System TankOnly Existing System __Existin�S�stem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressur' ed Distribution Pressurized Distribution Experimental Other 11 ❑ S page Bed 21 in Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 eepage Trench 22 ❑ In -Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation 300 / 1 1D / 1/ Feet % W4 17 Feet VII. TANK INFORMATION Capacity in gallons Total Gallons # Of Tanks , Manufacturers Name Prefab. Concrete Site Steel Fiber- glass Plastic Exper. App. New Existin strud- SepticTank or Holding Tank I U[ t✓lJ U U U U U Lift Pum Tank /Siphon Chamber 0 0 ❑ I ❑ I ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumb s Sign ture: ( Stam��P/IVIPRSW No.:i I Business Phone Number: Plumber's Address (Street. City. State, Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved San' ry Permit Fee (tndudcs Groundwater rate e Issued Issuing Agent Sign ure (N ps) Sur arge Pee) Approved ❑ Owner Given Initial - — r144 �, Adverse Determination _ CCxf X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: AUG 21202b Bayfeld Co. 530-6398 (R.1 DtSTRIBUflON: Original to County. One copy To: Safety & Buildings Division, Owner. Plumber OWNER 'e,td COUNTY PERMIT • 1� I • I TOWN OF 1.r4er LOCATED SECT 4_ N;RA___C AND/OR LOT _4 BLOCK SUBDIVISION N? 298188 CHAPTER 145.135 WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the application for permit. (b) The approval of the sanitary permit is based on regulations in force on the date of issue. (c) The sanitary permit is valid for 2 years from original date of issuance and may be renewed for similar periods thereafter. Application for renewal shall be made through the county and shall comply with regulations in effect at the time. (d) Changed regulations will not impair the validity of a sanitary permit until the time of renewal. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought. Changed regulations may impede renewal. (f) The sanitary permit is transferable. A sanitary permit transfer shall be obtained from the county authority. If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. t_Srth f h0_AUTHORIZED ISSUING OFFICER - DATE (/O - /6-11 0 THIS PERMIT EXPIRES 06-14 -00 UNLESS RENEWED BEFORE THAT DATE (TWO YEARS FROM ORIGINAL DATE OF ISSUANCE) N m VISIBLE FROM THE ROAD FRONTING THE LOT SBD-6499(R.04196) DURING CONSTRUCTION Wisconsin"Department of Industry �+:1—��-1�--.�, D SITE EVALUATION Labor and Human Relations :ijjl J? ; 77 jI Division of and Buildings +f ""^, =''--:. .: ,•.�n.;a..,., a with s. ILHR 83.09, Wis. i,: JUN �1 ie0 Attach complete site plan on papJ'rigt less an 1 I hesfi ze. Plan must I county include, but not limited to: vertical and•hodzoptaJ,Wd;rence pain direction and percent slope, scale or dlmensionsz. Jo °i,f LUfia io dtathnce to nearest roa/ Parcel VU Y7 APPLICANT INFORMATION - Please print all information. i� Revlp„ Personal information you provide may be used for secondary purposes (Privacy Law, a. 15.04 (1) (m)). c/ct Page ).,.. of -1 'OO rrop b Ier • led Ju d I Govt. Lot -V y 1/4 1/4,S V L l T t/7.N,R E (ore I—Prnnerty owner's Mallino Address • Lot # I Block# I Subd. Name or CSM# JI l I1Ctnf5/rn /lam City State Zip Code Phone Number ❑ City ❑ Villages �• pwn Nearest Road ,PVnor! o%s l IV 35f/ s (/9)711-1//t tune- Ge'7 1?vall ❑ New Construction Use: [Residential / Number of bedrooms Addition to existing building `m Replacement '�,� ,� ❑ Public or commercial- Describe: —1 O Code derived daily flow JO O gpd Recommended design loading rate _( / bed, gpd/19 r D trench, gpd/p2 Absorption area required bed, ft2 X7`5 trenchh,,, ft 2 Maximum design loading rate 17 bed, gpd/f i trench, gpd/fi2 Recommended infiltration surface elevationt s) /d a. ft (as referred to site plan benchmark) Additional design/site considerations nn Parent material 16LL/6' it P t Flood plain elevation, if applicable �A ft Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank S Suitable for system U = Unsuitable for system s ❑ u �J s ❑ u iR s ❑ u ® s ❑ u $Rs ❑ u ❑ s u Boring # 0. Ground elev. /eft Depth to limiting factor 90 in. Boring # Ground ele . /01y% anlf ncef_nlDT1f1N flFPf1RT n. Dominant Color Mansell Mottles Cu. Sz. Cant. ColorGr. Texture Structure Sz. Sh. Consistence Boundary Roots GPD/1t2 Bed , Trench ?sY63,2 �_ Ds5 rLc Ids 4Hofizonpth ao 2r'fl`�Y -- .Qr5 05 wtc cS 0 ,7, ,75D 7. SY13 4/1 05 rtC. - Remarks: i o3 25YRs2 S rtc es /� 7:•a 5r5 Cis e C7 ,-7:,V 3 IY 7.sy S Os p R CIiY!D Au; 21:2025 yfield Co. Depth to limiting 1 /f qe /,�/ f`7O r in Remarks: M. �J '' Q W // � CST Name (Please Print) S• nature Tele h ne No. STeuesn C. 'Tabe7go'4 eYe- __— �7/S)e�1�Y $575 Address c // /� Date CST Nu�xb� 7 . / `jllf OD sr �nC rSo��'l �r`n%`� Gti�- 5Y87Y / 41-`e6 NcJ Cy T�r�/0�� SOIL DESCRIPTION REPORT PROPERTY OWNER PARCEL I.D.# Boring # DI Ground Depth to limiting factor �IU in. Boring # Ground elev. Depth to limiting factor in. Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. n. Depth to limiting factor In. Page of Horizon Depth in. Dominant Color Munsell !Mottles Ou. St.r�te Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots 2 Bed , Trench 7.5 Y632 - 0s r'c cs 7 ___03 , r5 055 , C e5 v _ Remarks: Remarks: Horizon Depth In. Dominant Color Munsell Mottles Ou. Sz Cont Color Texture - structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 Bed , Trench Remarks: Remarks: gr,ION W. Plarming and Zoning Agency SBDW-8330 (R. 08/95) t r E /eyc, l io L4 5 ar 52 /oZ.9' aC = / •:j' IBS= 3o F3 _ 00 IJ - - -- ------ - - - --- - _Ftt1 i _ :t ! i_. .=-i___ _ __ H H I I - 1 1/ RECEIVED / I� Kc � = �!� •�'�?` ..H AUG 212025 / I Sv�Tc = J� -� c� say"m co. %C' l PlBmkv and Zoning AgeM �u�ARrue.yr _ T `-3g ��r Industry Services Division 4822 Madison Yards Way Madison, WI 53705 P.O. Box 7302 Madison, WI 53707 County Bayfield Sanitary Permit Number(to be filled in by Co.)� Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 64555 Hart Lake Rd, Iron River, WI 54847 I. Application _ nformation —Please Jnnt All information Property Owner's Name Parcel # Wendy J Marty Rev Trust DTD 20092 Property Owner's Mailing Address Property Location 2626 Louisa Ave Govt. Lot 4 City, State Mounds View, MN Zip Code 55112 Phone Number 612-310-3861 T47 N R 08 E o W Type ofButlding (check all that apply) Lot # Subdivision Name �✓ I or 2 Family Dwelling — Number of Bedrooms :3 Public/Commercial — Describe Use D_______________________ Block # City of State Owned — Describe Use Village of CSM Number Town of III. Type of-P.OTS Permit: "Replacement" and otheraPP ' " Iicableon line A. Check one box on pine°B. Com fete line C i Q ( Check either "New" or P likable: °: A. QNew System replacement System Other Modification to Existing System (explain) Peplacedrainfield w/Eljen Additional Pretreatment Unit (explain) B' Holding Tank ❑✓ In -Ground ❑At -Grade Mound Individual Site Design Other Type (explain) (conventional) C. ❑ Renewal Before E✓ Revision Change of Plumber ❑I"ransfer to New Owner List Previous Permit Number and Date Issued Expiration Disperse[/treatment Area and :Tank'Ziformatton Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 450 1.6 281.3 330 101.4 Capacity in Total # of Manufacturer v c Tank Information Gallons Gallons Units „ c U New Tanks Existing Tanks ar cc ci o ii) y r%1 c C7 a Septic or Holding Tank 1000 1000 1 Weiser Concrete [f 0 Dosing Chamber fr Responsib111ty$jatement, I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plttns: Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Dean Blakeman 1092768 715-682-6050 Plumber's Address (Street, City, State, Zip Code) 44941 State Hwy 13, Ashland, WI 54806 :Couuty/Depaitment:Use Only ❑ Approved O Disapproved Permit Fee Date Issued Issuing Agent Signature O Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 02/22) eljen Eljen GSF System WI Design Program Date: 15Aug35 CliemName: WendyMarty Site Address: 64555 Mart Lake Rd, Iron River, WI 54841 Designer: Dean Blakeman Nate: This worksheet is provided to assist the Planner in sizing the numbers/Ellen 6SF Modules requIred fora specific project. The caleuledern herein are eaplvinedfor earl. output. the success of the overall design Is based on the planners inputs and considerations outside o/thin worksheet. System Sizing (Total Number of Ellen GSF Modules Required) Design Notes and Comments 1.1 Site Characteristics: Total Number of Bedrooms 3 DDF per Bedroom (Daily Design Flow per Bedroom) 150 gpd Effluent #1 Application Rate 0.7 gal/ft'i DDF (Daily Deign Flow) 450 Bind Equivalent Effluent R2 Application 1.6 gal/ft' Application Rate L6 gaVft° Required Basal Area (DDF + Application Rare) 281.3 it2 Unit Used ( Usually B43) B43 Unit Install Width 5 ft Square Footage per Unit 20 ft'/unit 1.2 Module Quantity Analysis, Minimum Number of Ellen GSF Modules Required (Required Basal Area t Square Footage per Unit or Bedrooms a (5 for B43s or 6 for A42(; whichever Is greater) 15 units Amount of Ellen GSF Modules Used Must be greater than or equal to Minimum Number of Eljen 65; Modules Required 16 units L3 Distribution Cell Design: Number of Distribution Cells / Trenches (Program supports up to 4 Trenches or 1 Cell) Number of Laterals Inside Cell (Program supports up to 4) 2 A. Distribution Cell Width (If cell is red, Cell Width is greater than l0ft and needs to be revlead.) 10 it B. Distribution Cell Length 33 ft C. Lateral to lateral Sparing (Multiple lateral systems) 5.00 ft D. Lateral to Edge Spacing (Multiple lateral systems) 2.50 ft Units per Row (if red, adjust number of modules to make tows equal) 8 Total Square Footprint 330 ft' A. Width 10 B. Length 33 C. Lateral to L: 5.00 Spacing (ft) = 2.50 D. Lateral to Edge Spacing (ft) = A. Width , la C. Lateral to Le 5.00 Spacing (ft) = 250 D. Lateral to Edge Spacing (ft) _ MIN 12" OF{i CLEAN FILL 611Lfl ��D C D� BAYFIELD COUNTY SANITARY PERMIT (#04)-25-114S STATE SANITARY PERMIT OWNER: WENDY J MARTY REV TRUST DTD 1/9/2025 GOVT LOT: 4 LOT: BLK: 1/4 1/4 SEC: 34, T 47 N, R 8 TOWNSHIP: Iron River SOIL TEST: 4562 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: DEAN BLAKEMAN TRACY POOLER DATE: 8/26/2025 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 #: 298188 LICENSE: # 1092768 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 8/26/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION