HomeMy WebLinkAbout25-117SRequest 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(a.bayfieldcountv.wi.gov
Note
flTime Change fl Discrepancy fl Other
Phone Number
715-682-6050
Plumber:
Blakeman Plumbing & Heating, Inc.
Fax Number
Email Address
Homeowner:
Wilderness Inquiry
steven.waby@blakemanplumbing.com
Immediate Phone Number So Zoning
Sanitary
Permit #:
Un e w J-5—/(79
Dept can call you right back (if needed)
715-685-4128
Plumber's Choice
Zoning Dept
No Inspection(s) during this time
Date:
9/8/2025
p. Y�
Tuesday (9:30 am - 12:15 pm) (Tracy)
Plumber's Choice
Zoning Dept
Time:
10:30am
Township:
Russel
Address # &
33095 Little Sand Bay Rd
Road Name:
or
Bayfield, WI 54814
Directions
To Site:
Comments:
Holding Tank Inspection
** Plumbers you must verify any change(s) by fax or email **
Notes from
July 2025
)LDING TANK INSPECTION REPORT
WILDERNESS INQUIRY INC
930 E 80TH ST
BLOOMINGTON MN 55420
TANK INFORMATION
TYPE MANUFACTURER/MODEL# CAPACITY
SETBACKS
Property Line
Well
Water Senrice
Building
All -Weather
Road
OHWM
Swimming Pool
DEVIATIONS FROM APPROVED PLAN
COMMENTS (Persons present, discrepancies, etc.) 336
- oui vtf i11l6,S pum perr ) 4a or\ cxUoc -, p« *a h 4 d awn
H eoei a Net gruv
�4l^r� aWg W)�►�I�e
—-Junk�n IIIPry'i
Io
'-C }PS of\,
trcA aao ptuc(r•
COMPONE TS NO INSPECTED
Plan Revist Required
❑ Yes No
I Date:
Signature of In ect
qMIc.(
r:
V
SKeicn on oiner sine
10 of 13
J U J
BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT
Telephone: (715) 373-6138 Bayfield County Courthouse
Fax: (715) 373-0114 Post Office Box 58
e-mail: zonina(aibavfieldcounty.wi.aov 117 East Fifth Street
- Web Site: www.bayfieldcountv.wi.gov/147 Washburn, WI 54891
Property Owner
WILDERNESS INQUIRY INC
Information 930 E 80T11 ST
BLOOMINGTON MN 55420
As you know was contracted by you to install a private
onsite wastewater treatment system on your property described as:
Notes:
Abandonment of Old System to meet all applicable code requirements:
1
Tank was pumped by:
C. Tank was crushed I removed and pipes disconnected by:
on
at AM/PM
On at (AM I PM) the above -mentioned plumber contacted our office to
condu 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.
fl System was inspected and appears to meet all applicable code requirements; however, a plan revision
is necessary because the installation was substantially different than the original approval.
System could not be inspected because plumber covered prior to scheduled time of inspection.
❑ System could not be inspected because plumber was not ready at scheduled time of inspection.
County was unable to return to complete inspection.
System could not be inspected because plumber was not ready at scheduled time of inspection.
A re -inspection and $50 fee are required.
System could not be inspected because County could onot respond to plumber's time constraints.
Comments: �Y qW WS (_\(fV1� \\c 'b'U`r
Ulfoons/sanilarypropertyowner-input
Apri12019
55-L9OcW
owr^sral�vr
Industry Services Division
4822 Madison Yards Way
County
Bayfield
p�`
Madison, WI 53705
P.O. Box 7302
Sanitary Permit Number (to be filled in by Co.)
_ ' j
Madison, WI 53707
I
Sanitary Permit Application
State Transaction Number
In accordance with SPS383.21(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
3 3 0 9 5 Little Sand B a Rd
Y
purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats.
I. Application Information = Please Print All Information
Property Owner's Name
Parcel #
Wilderness Inquiry
36212
Property Owner's Mailing Address
Property Location
930 East 80th Street
Govt.Lot
WI/2-
City, State
Zip Code
Phone Number
Bloomington, MN
55420
612-676-9400
SW �vNW �'A, Section 33
T52 N R 04 E or
II. Type of Building (check allthat apply)
Lot #
Subdivision Name
❑ 1 or 2 Family Dwelling — Number ofBedrooms I
1
❑ Public/Commercial— Desciibe Use Campground Showers Only
Block #
City of
lllState Owned — Describe Use
Village of
CSM Number
1745
pTown of Russell
M. Type of POWTS Permit; (Check either "New" or "Replacement" and other applicable on line'L Check one boa on line B. Complete line C ii
a livable.:.
A.
❑New System
Replacement System
❑Other Modification to Existing System (explain)
Additional Pretreatment Unit (explain)
B.
FV Holding Tank
E]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
08-69S 6/19/08
,
"IV..Dispersal(teattnentAreaand
Tank Informations
Design Flow (gpd)
Design Soil Application Rate(gpd/sf)
Dispersal Area Required (sf)
Dispersal Area Proposed (sf)
System Elevation
510
Capacity in Total I # of Manufacturer I ,
Tank Information Gallons Gallons I Units o v
New Tanks Existing Tanks
rl~ U rn i lulCs,
Septic or Holding Tank 3000 2000 5000 2 Skaw Precast/Rasmussen U I I
Dosing Chamber
V Responsibility Statement- I, the undersigned,, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) ber's Sign MP/MPRS Number Business Phone Number
Dean Blakeman 1092768 1715-682-6050
Plumber's Address (Street, City, State, Zip Code)
44941 State Hwy 13, Ashland, WI 54806
VI. County/Department Use: Only
Approved O Disapproved Permit Fee Date IssuedJ6Issui Ag ign
O Owner Given Reason for Denial 4'OO cI/3
Conditions of Approval/Reasons for Disapproval
RECEIVED
≥:e-- a;t*LCJWJ_ AUG 21 2025
wnacn ro compiere plans ror me sysrem ann suomn ro me .ounry oniy on paper nor less man a to x ti rncnes Ilng and Zoning Agency
SBD-6398 (R. 02/22)
PAGE 1 OF 4
Holding Tank Plan
Index & Cover Sheet
Component Manual Design References:
Holding Tank Version 2.1 (May 2022-2027)
Pg 1 of 4 Index & Cover Sheet
Pg 2 of 4 Plot Plan
Pg 3 of 4 Holding Tank Specifications
Pg 4 of 4 Management Plan
Attachments:
Enclosures:
POWTS Application for Review
Soil Evaluation Report & Site Map (if ap
Holding Tank Pumping Contract (if appli
Holding Tank Agreement (if applicable)
Project Name / Description
Wilderness Inquiry Holding Tank Replacement
Owner Name(s): Wilderness Inquiry
Owner Address: 930 East 80th Street, Bloomington, MN
plicable)
cable)
Phone: 612 676 9400
Zip: 55420
Project Address: 33095 Little Sand Bay Rd
Govt. Lot: SW 1/4 of NW ,1/4, Section 33 , T 52 N -R 04 E Llor w Fv
Township: Russell County: Bayfield
Project Parcel ID #: 36212
Designer Information
Designer Name: Dean Blakeman
Designer Address: 44941 State Hwy 13, Ashland, WI
E-mail: dean@blakemanplumbing.com
License Number: 1092768
Remarks:
Replace failing 2,000 -Gallon holding tank w/3,000 -Gallon tank
Signature:
Phone: 715 _ 682 6050
Zip: 54806
This space reserved for approval stamp.
RECEIVED
AUG 212025
1ayfleldco.
aanlng and Zoning Agency
Date: cgzj 1&-z5
Original signature required on each submitted copy.
CHECK BOX AS APPUCABLE. CHECK BOX AS APPUCABLE.
[EVALUATION Scale: 1" = 40'[X]SYSTEM PAGE 2 OF SOIL EVAL U
SITE MAP o 4o 60 80 PLOT PLAN
PROJECT NAME: (10 ft grid) DESIGN FLOW: Jr'I O GPO
/J)1Ideffti //Itt4f'i
0 Attach design flow calculations for commercial plans.
PROJECT ADDRESS: c( N Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5)
Sanitary Sewer. /
BM Symbol: 4i. BM Elevation: t oU Fi
Force Maln: /
BM Description: 'TC C& <hOwer b )(Lb
Indicate north by IMPORTANT:
Slope Gradient (°r6) Well Symbol (if applicable): 0 drawing an snow Show ground elevation contours at suitable intervals.
of Tested Area: on the approprite line.
L.41e ≤cA-J iG j
A P °
(j?E; S4)15 .k
I..
t over B�` /of I,�e
n '
1 o Irte
I o f-ievit (�D0DGrb 5 it
v �
I..
L .
AUG 212025
Bayfield Co.
Planning.arzd Zoning A
PAGE 3 OF 4
HOLDING TANK SPECIFICATIONS
(No Scale)
Weatherproof
12" Min. or 2.0 ft above
Junction and
Approved
Established Flood Elevation
Alarm Box
Vent Cap
(typical)
Electrical must comply with
Approved Locking Manhole
SPS 316 and NEC 300
4"0 Vent Pipe
with Warning Label Attached
�—Conduit
X10 ft from
(typical}
4" Min. or 2.0 ft above
Building
Established Flood Elevation
(typical)
Airtight Seal
Finished Grade
18" Min.
(typical)
'•
< ,
Inlet
Inlet Invert
—'—Watertight
Approved Joints with
Plug
Approved Pipe 3 ft onto
• Max.
12" or 90% of total volume
Solid Ground
a
if more than one tank
Alarm -On
a
a
•
HOLDING TANK
•
VOLUME =
2998 gal
a•'
3" Approved Bedding Material Beneath Tank
TANK MANUFACTURER: Skaw Precast Co, Inc. RECEIVED
AUG 21 2025
Anchor tank as necessary
Bayfie
pursuant to SPS 383.43(8)(g) pkMbV o Co.
Ballast Weight = [(cu.ft.tank.vol x 62.4 Ibs/cu.ft) - Ibs.tank.wt] x 1.5
Ballast Weight = [( 400 cu.ft. x 62.4 lbs/cu.ft) - 17,930 Ibs] x 1.5 = 10.545 lbs
PAGE 4 OF 4
Holding Tank Management Plan
IMPORTANT:
The owner of this holding tank(s) 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 holding tank(s)
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.
Estimated Daily Wastewater Flow =
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 neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.)
o surface discharge of effluent or sewage back-up into structure served
SERVICING FREQUENCY
o The tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wisc. Stats.
when the wastewater in the tank(s) reaches a level of one foot below the inlet invert of the tank(s).
Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code.
Tank pumping reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wis.
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, 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 component of this holding tank(s) cannot be repaired, it shall be replaced pursuant to a
plan submitted to the appropriate agecy for review and approval.
System Abandonment
If use of this tank(s) is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code.
RECEIVED
AUG 212025
Bayfield co.
Pimping and Zoning Agency
• HOLDING TANK SERVICING CONTRACT
Contract Date
5-14-08 This contract is made between the
Holding Tank Owner(s) Name(s) and Pumper's Name
Wilderness Inquiry, Inc. BIRCH STREET SEPTIC
DOUG BELANGER
We acknowledge the installation or (a) holding tanKks) on me rouowing property: trruviue 1cgai ucscnpuuiss:)
W21 SW, NW, 33-52-4W
Town of Russell
Bayfield County
1. The owner agrees to file a copy of this contract with Bayfield County as required in Comm 83.55, Wis. Adm. Code.
2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to
enter upon the property for the purpose of servicing.the holding tank(s). The owner agrees to maintain the access road or drive so
that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees t pay the pumper for all
charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper.
3. The pumper agrees to submit to the local government unit which has sibmned the pumping agreement required by Comm 83.55, Wis.
Adm. Code, and the County, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees to
include the following in the semiannual report:
a. The name and address of the person responsible for servicing the holding tank;
b. The name of the owner of the holding tank;
c. The location of the property on which the holding tank is installed;
d. The sanitary permit number issued for the holding tank;
e. The dates on which the holding tank was serviced;
f. The volumes in gallons of the contents pumped from the holding tank for each servicing;
g. The disposal sites to which the contents from the holding tank were delivered.
4. This agreement will remain in effect until the owner of pumper terminates this contract. In the event of a change in this contract,
the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the local government
unit and the County named above within (10) business days from the date of change to this service contract.
Owner(s) Name(s) ()Print)
Owner's Signature(s)
Subscribed and sworn to me on this date:
Wilderness Inquiry, In
.
Gregory J. Lais
i s
r
Today's Date
Puamper's Name (Print)
DOUG BELANGER
Pumper's Signature
Notary Public Signature
LEE M. FRIEDMAN
Public
Jan 31, 201
Pumper's Registration Number
Commission xpuation
01203
Drafted by D. L. Bachand RECEIVED
Ravised. March2002 (Bayficld County Zoning -alas)
Panama informadan you provide maybe used forseeondary purpose (Privacy Law, s.15.W (IXm)]
AUQ .212025
8eYfield Co.
Planning and Zoning Agency
Document Number/Plan I.D. No. I HOLDING TANK
PATRICIA A 0LS0N
AGREEMENT
HAYFIELD COUNTY, WI
REGISTER OF DEEDS
This agreement is made pursuant to Comm
83.21(2)(c)(5). Wis. Adm. Code
Owner Name (s)
®5/2®/2@®8 . ®9:2@A
Wilderness Inquiry, Inc.
TF EXEMPT 9:
Gregory J. Lais
Parcel identifier Number (PIN) I Agreement Date
AIL FEE: 11.0
4-046-2-5;-04-33-2 03-000-15000 5-14-08
piles: t
Legal Description of Property:
Wz, SW, NW, 33-52-4W
Town of Russell
RetumTo: Dennis L. Bac an cF
Bayfield County
P. 0. Box 56
Washburn, WI 54891
As an inducement to the county to issue a sanitary permit for a holding
tank on the above described
property, we agree to do the following:
1. Owner agrees to conform to all applicable requirements of Comm 83, Wis. Adm. Code relating to
holding tanks and the maintenance requirements of such.
2. The owner agrees to have the tank properly serviced and, except as provided by s. 146.20(3) (d),
Stets., agrees to contract with a person who is licensed under Ch. NR 113, Wis. Adm. Code, to
have the holding tank serviced and to file a copy of the contract or the owner's registration with
the governmental unit. The owner further agrees to file a copy of any changes to the service
contract, or a copy of a new service contract, with the governmental unit within ten (10) business
days from the date of change to the service contract. •
3. The owner agrees to contract with a person licensed under Ch. NR 113, Wis. Adm. Code, who
shall submit -to the governmental unit and the county in accordance with Comm 83.55, Wis. Adm.
Code, for the servicing of•the'holding tank. In the case of registration under s. 146.20(3)(d),
Stets., the owner shall submit the report to the governmental unit and the county. The
governmental unit or county may enter upon the property to investigate the condition of the
•holdding tank when pumping reports may indicate the holding tank is not being properly
maintained.
4. This agreement will remain in effect only until the governmental unit responsible for the regulation
of private sewage system''certifies that the property is served by either a municipal sewer or a
soil absorption system that complies with Comm 83, Wis. Adm. Code. In addition, this agreement
may be cancelled by executing and recording said certification with reference to this agreement in
such manner which will permit the existence of the certification to be determined by reference to
the property.
This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the
owner. The owner shall submit the agreement to the register of deeds, and the agreement shall
be recorded by the register of deeds in a manner, which will permit the existence of the
agreement to be determined by reference to the property where the holding tank is installed.
GregoryJ. . Lais
Owner(s) Name(s) — Please Print Subscnibed aand sworn to before me on this date:
Wilderness Inquiry, Inc. 51141%
Notarized Owner ls) — Sionaturels) A Notary Public
/4
47My Commission Expires: R C!IV!®
Drafted by:. D. L. Bachand LEE M.M. �F'�ffEpiltiy f AUG 2 1 2025
?ersorW infonmilon you provide may be used for secondary purposes (Privacy Low. s.15.04 (t)(m)1 tt ;
Revised:-Bayfi.ld County Zonhv Depertmerd (February 2005) 27.,
"",■�� Bald Co.
V0, 99 5 pAGE7 fl312012 'Planning and Zoning Agency
INLET
-
4 INCH PRESS SEAL GASKET
POURED INTO 1 FOOT RISER.
RISER IS THEN POURED
INTO TANK COVER.
INLET
WARNING DEATH MAY OCCUR IF TANK IS ENTERED
WITHOUT PROPER EQUIPMENT
0
NOTE: SEE INNER WALL PHOTO ON THE "EXCLUSIVELY A T SKA WS" PAGE.
TOP VIEW OF MANHOLE COVER
4.00
1 4"PVC SCHEDULE 40 COUPLING (VENT)
i 5.00
1.00J
56.00
3.00J SECTION VIEW OF TANK AND COVER
Model Number: 3000 HOLDING
Approved for: HOLDING
Weight Inlet Dim. Outlet Dim. Liq. Depth Gal. / In. Max. Cap.
17,930 lbs. 67" N/A" 56" 53.54 2998 gal.
3.00
69.00
72.00
173.50
182.50
Il
176.50
I I
78.00
TOP VIEW OF TANK (TAPERED)
SKAW 3000
O
71.00
� I
I I
I
I
I I
I I
L -------------------------
OUTLET END VIEW OF TANK
SKAW PRE -CAST
26255 105th Street, New Auburn
Wisconsin 54757
www.skawprecast.com
Phone: (715) 967-2277
Toll Free: 1-800-924-8625
Fax: (715) 967-2707
BAYFIELD COUNTY
SANITARY PERMIT (#04)-08-69S
STATE SANITARY PERMIT
OWNER: WILDERNESS INQUIRY, INC
GOV'T LOT: LOT: BLK: 0
CSM:
SUBDIVISION:
SW 114 NW 114 SEC: 33, T 52 N, R 4 W
TOWNSHIP: RUSSELL
SOIL TEST: 498
OTHER MODIFICATION
SYSTEM TYPE: Holding Tank
PLUMBER: Dennis Bachand LICENSE: # 221446
CeCe Tesky DATE: 6119/2008 Condition: Subject to conditions on state approval
Authorized Issuing Officer
THIS PERMIT EXPIRES 61/9/2010
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 #: 10329
POST IN PLAIN VIEW
a ;�I
M MUST BE VISIBLE- FROM ROAD FRONTING THE LOT DURING CONSTRUCTION
N M
• r
"" `' `S fety`and Billldings Dtv�lsi f )
j County
201 W. Washington Ave., P.Q. Box 7162
F 7
s'C sln
Madison, WI 53707 — 7162
Sanitary Permit umber (to be filled in by Co.)
Department of Commerce
(608) 266-3151
Sanitary Permit Application
t State Plan J.D. Number
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide- r
— ,
may be used for secondary purposes Privacy Law, s15.04(1Xm)
Project Address (if different than mailing address)
Xr Application Information —Please Print AU Information —
t' rz
; .:&)
Property Owner's Name f "'
OIL )6 , i JUN 1 7 2008 1
cel # Lo # Block #
II �t= _ scm
Property Owner's Mailing Address t ! I
Property Location
S
r"i -`
SA) �'/. ��., Section !3
City, State
� Zip Code "Ph-oneumber
4/co
T N (ci le
• _
U. Type of Building that
(check all apply)
Ior2Family Dwelling —NumberofBedrooms OA)f
Subdivision Name CSM Number
Public/Commercial-Describe Use e AiPG £a L ≤b/ Q/t,) &!A)L f
O State Owned —Describe Use
❑City ❑VillageI'ownship of s,,
M. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
O New System
0 Replacement System
❑ Treatment/Holding Tank Replacement Only
Other Modification to Existing System
'CTh9P LI
B.
O Permit Renewal
❑ Permit Revision
❑ Change of
j O Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration
Plumber
Owner
1 03 R9 g- -77
r /
IV. Type ofPOWTS System:
(Check all that apply)
O Non —Pressurized In -Ground O Mound ≥ 24 in. of suitable soil ❑ Mound <24 in. of suitable soil O At -Grade ❑ Single Pass Sand Filter O
Constructed Wetland O Pressurized In -Ground I Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit O Recirculating Sand Filter O
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line O Gravel -less Pipe 0 Other (explain)
V. Dispersal/Treatment Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsf)
Dispersal Area Required (at)
Dispersal Area Proposed (st) System Elevation
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Selft or Hotdiog Tank 'h n r-lr� 'n n ter, —17 n — - - 1 /'t_ - ._..
VII. Responsibility Statement- 1, the undersigned, assume responsibility (or installation of the POWTS shown on the attached plans.
Plumber's Name (Print) P 's SignMP/MPRS Number Busin
ess Phone Number
Dennis L. Bachand 221446
715-373-2070
Plumber's Address (Street, City, State, Zip Code)
P. 0. BOX 56 Washburn WI 54891-0056
VIII. County/Department Use Only
Approved O Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issu' A t Si o S ' ps)
charge Fee)
❑ Owner Given Reason for Denial Id p ,Q (k\- aI6/,q/
IX, o ditions of Approval/Reasons for Disapproval y�
AUG 212 Zt
Bayfeld Co
and Zonln Agency
Attach complete plans (to the Corm y only)(or the system on paper not ins than 8Ul1 x 11 inehas Insist
Rec'd for Issuance
SBD-6398 (R. 01/03) n
JUN '1 s zoI�
Secretarial Staff
x92023
Ba ,field Counh, ,
Soil Test # 3� ��
:..:r::cl(t C•v.
Waiver of a Thorough Soir'& SfteVrai'r�"tion
(subject to 15-1-10(d))
1 a certified soil tester determine that in my professional
judgment the following site (see below) is unsuitable for any treatment component other than holding
tanks. Due to soil & site conditions, a thorough soil and site evaluation is not needed to make such a
determination.
Property a Owner Li) i e ) `t$5 Tty�4u�2�/
Contractor
Property Address -4 33095 L .Jr2 E- 54Ua Authorized Agent
Telephone
iLI Lt.4.
&2( -67&-9y/0
Accurate Legal Description is requested:
Agent's Telephone
Written Authorization Attached: Y or N
S% 114 of �1 G�� 1!4 Section 33 3 Township 5a N. Range 'V Town of vt55'it- L.
Govt.
Lot Lot Block Subdivision CSM#
Volume Page of Deeds Parcel I.D# 3b I oZ Acreage 37
Additional Legal Description:
Indicate reasoning for your determination: L- ASS N " -S4S °'V'4c
3 # 7g12, ram .
Signat re of County Official
� a3
Date
Ottic� Lo/W,14t6k_
Signature of CeI3ified Soil Tester
Date
Certification #
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AUG 21 2025
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gayfield Co. February 2005
Planning atld Zoning AgencY
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RECEIVED
AUG 21 2025
eayffeid Co.
Phrasing and Zoning Agency
BAYFIELD COUNTY
SANITARY PERMIT (#04)-25-117S
STATE SANITARY PERMIT
OWNER: WILDERNESS INQUIRY INC
GOVT LOT: LOT: 1 BLK:
CSM: 1745
SW 1/4 NW 1/4 SEC: 33, T 52 N, R 4W
TOWNSHIP: Russell
SOIL TEST: 35-23
REPLACEMENT SYSTEM
SYSTEM TYPE: Holding Tank
PLUMBER: DEAN BLAKEMAN
Tracy Pooler DATE: 9/3/2025
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 #: 08-69S
LICENSE: # 1092768
Condition: Insulate where required. Properly Maintain System Per Recorded Agreement. Must be
within 25 ft of an all-weather road.
THIS PERMIT EXPIRES 9/3/2027
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION