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HomeMy WebLinkAbout25-145SRequest 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 zonino(o)bayfieldcountv.wi.aov Note fl Time Change fl Discrepancy Other Phone Number / Lnq -:7 Plumber: IRr 3-n Fax Number ,k)Ois _1+ Homeowner: I J ,oni L Email Address Immediate Phone Number So Zoning Sanitary Dept can call you right back (if needed) Permit #: Plumber's Choice Zo ' Dept No Inspection(s) during this time Date: ti Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zonin ept Time: ' fEG Township: Address #& & Road Name: h2/&o S"l, r G I7tu y- U or Directions To Site: Comments: fUS9 r 01. G&?r 1 O/ T7v42c ** Plumbers you must verify any change(s) by fax or email ** Notes from July 2025 Request 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 zoninnc bayfieldcountv.wi.gov Note fl Time Change fl Discrepancy fl Other Phone Number Plumber: Dlc,.)Aj :;i) LS 0zy rs Fax Number Homeowner: SJs-,J L.0 osi A Email Address Immediate Phone Number So Zoning Sanitary - Permit#: #OL) r ≤i c/S5 Dept can call you right back (If needed) Plumber's Choice fling Dept No Inspection(s) during this time Date: jpf � Tuesday (9:30 am - 12:15 pm) (Tracy) Time: Plumber's Choice �Z Wing Dept e' Township: Address # & Road Name: 1 1 (p i (op ,S rkrE I W`1 13 or Directions To Site: Comments: ** Plumbers you must verify any change(s) by fax or email ** Notes from Zoning Dept July 2025 Private Onsite Wastewater Treatment C� �s Systems ( POWTS). Inspection Report (Attach to Permit) DEAN & CHERIE L LUOMA TRUSTEES 12114 336TH AVE otypuzposes[Privacy Law, s. 15.04 1 m TWIN LAKES WI 53181 []City Village jjTownot Tank Information setback to: TYPE MANUFACTURER CAPACITY Pro . Line Well J Building r Air Intake Road Se tic N/A Dosin N/A Aeration N/A Holding CountyJ/� /�, Sanitary ennit No: State Plan'Transaction ID#: Parcel Tax No: Pump! Siphon Information Elevation Data to/ rK,ey,.�e,w rs .7 I Y /AlNAIA V tl I�.� Pump Manufacturr UI a IPurnpJodeI I/ errand J GPM Filter Manufacturer Filter Model TDH Lift Friction Loss I Head Total Forcemain Length Dia Dist To Well Disnersal Cell Information DIMENSIONS Width f Lengfhsi # of Cells SETBACK FROM Prp .. Line Building i el f OH M Type of Cell I Manufacturer: 4Ix(' 1 L l Unda! kr�imho Pretreatment Unit Manufacturer: Model Number: p I Distribution�ipe(s) t I r_ tr STATION BS HI FS I ELEV Benchmark / oa far o, Bldg. Sewer Tank Inlet Tank Outlet Dose Tank Inlet / Dose Tank Bottom 13 inst eorttcur >< Header/ Manifold Distribution Pipe Qa Infiltrative Surface Final Grade X Pressure Systems Only II X Hale $ize j X Hole ' ( Ob rvation Pipes J/ l (s I Spacing I671' es ❑ No Depth Over I Depth Over I Depth of I Seeded Yes ❑ t Sodded deNo I ❑ Yes ❑ No Mulched Cell Center Cell Edges Topsoil COMMENTS: (Include code discrepancies, persons present, etc,) �n + kale C'\ t Sn1\ G�� At cut1 -�Lo dc�� — a r1 -I& 4i4 ktkrutS t. Lf gVrlUf haukn G/tC -}i\i lhS\ci\\ P & -r tSt es /rV1 AVM J ^ t I tXIID ( C I � t✓1 Son down 5 ( C IV\ �'11��1� p , I . � �ilG jr (thQ 3f) A `'1a -t4, LGCVI'U*i( h�f� I"1 bbl ej I .G1\\N tiv I Ian revi on require ❑ Yes No I I/ aeothersideforaddltlonalInformation. Ito / Date POWTS Inspector's S' nature License Number :Rn_a71n (P nm7+\ Property Owner Information As you know BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zonino(a�bavfieldcountv.ora Web Site: www.bayfieldcounty.oro/147 DEAN & CHERIE L LUOMA TRUSTEES 12114 336TH AVE TWIN LAKES WI 53181 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: LII Tank was pumped by: Tank was crushed I removed and pipes disconnected by: on at AM/PM On at (AM / PM) the above -mentioned plumber contacted our office to conduct 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. System could not be inspected because County could not respond to plumber's time constraints. Comments: I\fPi1F0B pt(*u o1CV dlxa'1 4 /iffi /txPve (ycn y �ztIC�C,/ n�C\ ( YVl / n9'(4 -u U/forms/sanitarypropertyowner-input Apri12019 TafE+? 3 . Department of Safety County $ S -O% 7 O & Professional Services, Industry Services Division Sanitary Permit Number (to be filled in by Co.) 5 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 1, —o32≤1 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 14Prrp0 s ►'4-rE }!W'( L purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. ' LtiJ- Please Print All Information I. Application Information — e≤V Property Owner's Name Parcel # �- �`iUM 2 113 Property Owner's Mailing Address Property Location }{ A ____________ Govt Lot E%pR City, State Zip Code Phone Number Zt%1J = g rj _ ifl� S& `/., S 1a '/,, Section 0,7 T N R II: Type of Building 4�ck all that apply) Lot// Subdivision Name 1 or 2 Family Dwelling — Number ofBedrooms Block/I ❑ Public/Commercial — Describe Use O City of ❑ State Owned — Describe Use O Village of CSM Number ❑ Town of C ^/� &Q&_) M. Type of POWTS Permits (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C If a licable. A. 0 New System y Replacement System p y ❑ Other Modification to Existing System (explain) y ( p ) ❑ Additional Pretreatment Unit (explain) B' ❑ Holding Tank El In -Ground 0 At -Grade � Mound ❑ Individual Site Design g ❑ Other Type (explain) (conventional) C. ❑ Renewal Before El Revision El Change of Plumber El Transfer to New Owner ist Previous Permit Number and Date Issued Expiration IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (sf) I Dispersal Area Proposed (sf) I System Elevation .So 1,v 50 qg e Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units i w " 4Uo New Tanks Existing Tanks i a.0 rn ti to Septic or I Ic] Rk f'r1�, Dosing Chamber J l , V. Responsibility Statement- T, the undersigned, assume responsibility fdr installation of the'POWTS shown on the attached plans. Plumber's Name (Print) Plumb Signature MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) P f2 l3ox �, ks�tkpa, tOr Sy/'eq j VI. County/Department.Use Only Approved O Disapproved Permit Fee :� """ Date Issued Issuing Agent Si atrrre• O Owner Given Reason for Denial /O /i Conditions of Approval/Reasons for Disapproval ,�•dr� Joef e to 0791 CGrs1 di I,'), e W4,fe / R!C!VED 4 OCT 1 3 025 Bayfield Co. 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 Iii"..__ SBD-6398 (R. 03/22) Wisjonsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way Madison, WI 53705 September 19, 2025 CUST ID NO.: 1469067 DALE A SCHLIEVE 312 CONRO ST RHINELANDER, WI 54501 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/19/2027 MUNICIPALITY: TOWN OF CLOVER BAYFIELD COUNTY SITE: LOUMA RESIDENCE 16160 STATE HWY 13 HERBSTER, WI 54844 E1/2 SW1/4 SW1/4 S3 T50NR7W FOR: Design Wastewater Flow Value: 450 Bedrooms: 3 Limiting Factor(s): 11" Maintenance Required: Effluent Filter Phone:608-266-2112 Web: hup://dsps.wi.gov Email: dsas wisconsin.gov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-092502214-C Application No.: DIS-092538223 Site ID No.: SIT -150689 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Manual - Version 2.1 (May 2022-2027) Pressure Distribution Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Abandon Existing System per SPS 383.33 • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30(1 1)(c) C�IVED • Tank Installation to follow all manufacture's recommendations. OCT 13 2025 • Verify property line(s) prior to installation. SaYflekt Co. Pnn1n9 and Zoning Agency • `Well setbacks to meet chs. NR 811 & 812. • Areas that are occupied with rock fragments. tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the POWTS Dispersal Area must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. • Install Cleanouts as per SPS 382.35 OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code § SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 Jeff Brewbaker Refund Expected: $0.00 Division of Industry Services Phone: 608-516-6428 Email: jefbrewbaker@wisconsin.gov R!C IVED OCT 13 2025 6ayfid Co. Planning and zoning Agency e ' SR.- c)oZo9 Wisconsin Department of Safety and Professional Services Page 1 of 3 Division of Indusliy Services SOIL EVALUATION REPORT In accordance with SPS 385. Ws Adm. Code County BAYFISLD -- Attach complete site plan on paper not less than 8 1/2 x 11 inches in size Plan must include. - -- -- - _.. bin not limited to: vertical and hor¢ontal reference point (BM). direction and percent slope. Parcel I.D scale or dimensions, north arrow, and location and distance to nearest road f 11330 Please print all information. I Rev' ed Date Personl informs ion r rovide may be used for secondary purposes Privs 15 V� a ti Ysr ! ._..._ tmay Law.. ., W{Urrn11 Property eft •----•- -- ---- -• - -._. _._... _ _ _ . _. _ _..�_ _ p y Owner ( Property Location ❑ [] `DEAN & CHERIE L LOUMA TRUSTEES Govt Lot SW Y, SW Y4 S 03 T 50 N R 07 .___ ... , _. _.._......__ _ ...—....__._.. _--------- -.. _ _. _..- - • - - .._...._._�_ E {oil W Property Owner's Mailing Address Lot # Block fi Subd. Name or CSM# 12114 336x"4AVE -- ... - - -- City State Zip Code Phone Number 0 City ❑ Village ❑ Town Nearest Road TWIN LAKES WI 53181 !(847)502-4008 _jLOVER i STATE t1w' t3 } 0 New Construction Use ❑ Residential / Number of bedrooms 3 Code derived design flow rate 4Q GPO� -- 0 Replacement ❑ Public or commercial— Describe: _ r1 f fj `1 GA Parent material SANDY OUIWASH UNDER1AIN BY SILTY DEPOSITS — Flood Plain elevation if applicable Vft - i� General comments and recommendations: SITE SUITABLE FOR A MOUND SYSTEM FEB 1 1 2025 i 0 Boring Bayfield Co. Zoning Dept. � Boring # 0 Pit Ground surface etev 9_ ; ft Depth to limiting facto, JI in Soil Application Horizon TDepth In i 0.3 2 3-13 r 2 1 Bonng L._ _.a Dominant Color Redox Description Texture Structure Consistence Boundary Munsell Qu. Az Cont Color Gr. Sz Sh. 7 5YR 312 NA sl _—^ 2fabk i ml + cs 7 5YR 4,6 NA s : Osg m° cw 5YR 713 J c2d 5YR 6/8 i sd 12mabk mfi 's NA ❑ Boring Pit Roots Rate GPDIFI' 'Eff#1 I Effe2 3m .[r— 0.6 1 0— Ground surface elev 95 9 ft Depth to limiting factor JL in Horizon Depth Dominant Color Redox Description I Texture Structure Consistence Boundary Roots In Munsell Ou. Az Cont Color Gr Sz Sh 1 0-3 7.SYR 3.'2 - — ! -NA - sl 2fabk ml �-�I cs 3m 2 3-12 7.5YR 416 ITNA s osg ml cvi 21 3 M .. 12-25 5YR 713 Lc2d 5YR 6/8 sd 2mabk mfi NA 11 CST Name (Please Print) EDWARD J WROBLEWSKI Address 84 6O5.HATCHERY RD. SAYFIELD. UI Soil Application 0.6 '10 0.0 0.0 i/L and TSS > 30 S 150 mgrL 7� __' Effluent #2 BOO..>>�3'0 S 220 maIL and TSS > 30 5 150 mq& __ __ I Sistnature�l // /% i CST Number 14 Date Evaluation Conducted Telephone Number 6/26/2024 j 715.209-4055 SBD-8330 (R04/15) PatA $SO.do 2J28/2oZS 1 D Boring # ❑ Boring Pit Ground surface elev. 95.1 ft. Depth to limiting factor jj.. in. 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 1 0-4 7.5YR 312 NA sl 2fabk ml cs 3m 0.6 1.0 2 4-11 7.5YR 4/6 NA s Osg ml cw 2f 0.7 1.6 3 11-25 5YR 7/3 c2d SYR 6/8 scl 2mabk mfi NA If 0.0 0.0 P I1�rl f If1 LL I tJ i M b i ii [Ill FEB 1 1 7n?. L a Boring # ❑ Boring 0 Pit Ground surface elev. ft. Depth to limiting fac gfLe"8., Zoning Dept. 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 U Boring # O Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. 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 5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = BOD. > 30 5 220 mg/L and TSS > 30S 150 mg/L BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): heck List J ndex Page / Title Sheet (Optional) frj) FEB 1 1 2025 Bayfield Co. Zoning Dept. riginal Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) ®'Original Plot Plan -'Cross Section Soil Profile Sheet (optional) Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used ,'Property Owner's Information (not prospective buyer's name) C�lroperty Location (Accurate Legal Description with Sec/Twp/Range) Load Name (where driveway is/will be coming off of) 9,1`oodplain Elevation, Flow Rate, Comments and Recommendations t'Co plete Soil Boring / Pit Information Gate Soil Evaluation was conducted Name, Signature, Number, Address and Phone Number 0 *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) Bich Mark (Description, Elevation and Location) Contour Lines (Example = 98.0' /96.0' /94.0') troperty Location (Sec/Twp/Range/, Accurate Legal Description) L�'Borings (Locations and Elevations) 12'Pe cent and Direction of Land Slope W ll Location (Including Neighboring Wells, if applicable) Location of Wetland Areas, Floodplain and Navigable Waters ®'Buildings, Driveways, and Structures (Location and Descriptions) 21}on n of Property Unes xisti g System Location dress Number and Road Name �Curr nt Surface Elevation of Wetlands and Navigable Waters CST, Owner and Property Information .7'North Arrow Fee: 0 Certified Soil Tests - Review & Filing Fee 50.00 U/forms/sanitary/checklist/checklistforcsts BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) gr Check List E Original Sanitary Application (Submitted in Deed Holders Name — flp.t prospective buyers) (383,21(1)1.) Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) ll Original Plot Plan (383.22(2)2. 3. & 4.a) ,Pj Cross Section, Over -Head Profile of the System aan Schematic of Tank from Manufacturer 'J Pump Tank Diagram, Alarm and Pump Curve (when applicable) Contingency Plan / Management Plan (383.22-3(2)(b)1.f.) Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) ❑ Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) ❑ Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) ATU Servicing -Agreement (Recorded at Reg. of Deeds) Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) tA I Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) Soil and Site Evaluation Report (383.22-3(2)(b)1.e.) State Plan Review (when applicable) 0 Copy of Warranty/Quit Claim Deed (Optional) SanitaryApplication: (Include the following Information) I Application Information must include: 0 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) 0 Project Address gr_ Road Name where driveway is/will come off of) 0 (Owners Phone Number) II Type of Building III Type of Permit IV Type of POWTS System V Dispersal / Treatment Area Information 99 VI Tank Information ) J VII Responsibility Statement (Plumber's Information) ❑ *Date Stamp* Plot Plan: (To Scale or To Dimension) Signature and Plumber Information IX Address Number and Road ❑ Surface Elevation of Body of Water 0f North Arrow Direction and Percent Land Slope Contdur Lines t�S Tank and Filter Information and Location Structures and Driveways ❑ Wetlands / Navigable Bodies of Water ill Boring Locations Absorption Area (Proposed and Existing) ) Property Lines Bench Mark (Location, Elevation and Description) Well Locations OCT 13 2025 Component Manual Version (I Legal Descriptions 6ayfleicj Co SI Piping- Material Information (conveyance line, building sewer line, material type and diameter) 'kV and Zoning Agency Turn Over ► i INDEX PAGE 3 Bedroom Mound septic system for: Dean and Cherie Louma Trustees 12114 336`" Ave Twin Lakes WT 54181 16160 State Highway 13 Town of Clover Bayfield County #11330 Designed from DSPS 3 81-3 84 with reference to Mound Component. Manual and Pressure Distribution Manual V2.1 May 22/27 Page # Description 1 Index Page 2 Soil and Site Evaluation Sheet 3 it LG iL 4 Soil and Site Evaluation Plot Plan 5/6 POWTS Management Plan 7 Pump Curve P1 Plot Plan, Mound Plan, and Calcs P2 Mound Section, Septic/Pump Tank Section, Pipe Distribution and Calculations Dale Sc ilieve D-1011 P 9-6-25 0 Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES 4Qi4/ SEE CORRESPONDENCE R efflveD OCT 13 2025 Sayfield Co. Planning and Zoning Agency i33o POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORM. lION. SYSEM-PECIFICATIQI [Owner : � Septic Tank Capacity Permit# Septic Tank Manufacturer DESIGN.PARAMETERS Effluent Filter Manufacturer Pretreatment, Unit O_ sand/Gravel Filter [] Mechan!cal Aeration O:Disin lion. Dflspersal C�l�(s� O. in -Ground (gravity) At- Grader Page 1 of O 10l NA NA NA r NA �A. ❑ Peat filter QWitland Other: DNA Q to Greund' (Pressure) Mound :Other: DNA O NA Vf1AL ON *Value typical fqr. domestic wastewater arid septic tank effluent. Other; NA MAINTENANCE 5c#EQUlE • Sery Eyent. Service Freqiey` . Inspectconditions of tank (s)At least once every: andi''le b (iYlaictenurr:3 yearn Q.. Pump out contents of tank(s) When c�mbined slu�geanc scuum equa!s on lyd(1/3) o tart otume Inspect dispersal cell(s) ; At feast once every:: fQ "ro+° f a . (Majthum3:years} O NA Clean effluent�fllter At least onco very; (3 O NA Inspect pump, pump controls 9e.alarm . Atleastonce every MionthIsf>.o NA Flush laterals andpressure test: Atl�astonceevery: 3 fj NA At 3sto eiY t:_. DNAs• MAINTENANCE INSTRUCTIONS Inspeotlons of tanks:end dIspersal, ells shai15b n dp by .:err .i db idial ,spa ao :. of ; `e : ! t ris. :.o r certifications: : rite Plumber aetet°P(►l s F:. g 1 r ` ? ` rnsp Maintainer Septage , lr Operator ' ores :music Include- a.visual _Ins Inspection of e pS{s3r. #41'pr cfiaa5rare�. Idendryany cracks pr retImeasure r volume of - combined sludge u " ecic or sit #' as pchdI t on the ground surface. The lisp I° be visually Inspected to check the efiiuenflevelsi '{ t . pipes n to check for arm: ndI► g veal ¢n the • ground u tie 1ho ndi of maize. onthe ;ground a n+l l �' P4 a po .. � . di n and requIres the Immediate notification of 1110 local regulatory authority When the combined accumulation of sludge any e o a e hirdF 7 $ Qr. ,rnora of ° tank vole ₹n entire !�! lionel and � '.,, .:�r and d l � L, �� ., �• �� contents of the k shall e≤ re a e 7 si f e o is o accordence Wisconsin All other services, including but riot limited tothe servicing ofeffiuentflItera,mechanicf or pressvrized mer}t un€ts, and any 3 enricI gatintervatsof '(2months, sh�ilbeperfbrm�d bye CM1Ifl POWTS Maintainer. A service report shall b providedto the tc i r0gu!atp/aLthpdtrwlth..30 dare ofcompletlpn of any se v Y Zotming Agency Number of -Bedrooms , . NA Number of'Public.Fadilty Units :NA is timated low avers } gaff Design flow (peak}, ( Estit3r d x1.5) gal/day Soli ApplicatlonjRate 2 ga(Iday/ft Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (fQG) 530.mgA Biochemical. Oxygen Demand (BODs) S22G MG/L 0] NA Total- Suspended Soldds.(TSS) ,.: S 5Q mg/L Pretreated Effluent Quality Monthly: average Biochemical Oxygen: Demand (SODS) :. >30 mg/L Total Suspended Solids (TSS) - . Sao mg f L NA fecal Conform (geometric mean) Slid mg/L Maximum Effluent Particle Size( die ' [] - .NA Other: A -PMT ONAi:.aOlitN START uP AND OPERATION For new construction, prior to use o€ the POWTS checkk•treatment tank(s) for the presence of paintingproducts or other chemicals that may impedethetreatment process and/or damage the soli -dispersal cell(t), Ifihigh concentrations aredetected have the contento Of the tank(s) removed by a.septage servicing operator priof•to use. System start up _shell • not occur when soil conditions are frozen at the Infiltrative surface. During extended power-cutages pump tanks may fill above normal• highwater levels. When power is restored the excess, wastewater will be discharged to the dispersal .ersal cell(s) in one large dose, overloading the ceil(s) and: may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump rani firer toned by a .SSeptage Servicing Operator arprior to testoringpower tothe effluent ,pump or contact a Plumber or POWTS Maintainer .to assist In manually operating the pump controls to restore normal levelwithin the pump tank Do not drive or park vehicles over tanks and dispersal cells. Do not drive -or park overor otherwise -disturb or compact the area within 15 feet •down slope of any mound or at -grade soil` absorption area. Reduction or elimination of the following from the wastewater stream may improve the. performance and prolong the life of the -POW's: antibiotics; bay wipes; cigarette butts; condoms, cotton swabs; degreasers; dental (toss; :diapers; dielnfectants; fat foundation drain (sump pump) dlacha a .i fruit and vegetable per gasoline; grease, herbicide; meat • scraps; meditations; oil; paining products: g , .fin ss g g , pesticides; sanitary napkins; tampons, and water so€ten'er brine. ABANDONEMENT When the POWTS falls and/or is permanently taken out, oi:serulce.the following steps shall be taken to insure that ht system is properly and safely abandoned in compliance with. chapter SPS 383.33, WiscOnsin Administrative Code • All piping to tanks and pits shall be disconnected and the; abandoned pipe .openings seated. • The contents: ofall tanks and pits shall :be removed and .:properly disposed of by'a Septage Servicing Operator. • Auer pumping, all tanks and. pits shall be excavated and: rernpved.or the) x yet s removed and:tha voldpace tilled with soil, gravel or anQth r inert OIId maferiaf. COl1f f INGY PLAN If the POWTS fails` and cannot be repaired the following measures hair or taken, to :provide the code • compliant replacement s t,. p system: x • o A suttabte replacement ement rea has 1ieen evaluated and maThe replacement area should be bf fo, gJa n a roplocemmi soli absorption system. Y ...: ,. r f td o ° ng ed : by required setbacks M. proposedstructure,` of iii :a � sits F i f :.:. + t e n :... -�.: � +!a:1 will in the need for a new Soil d s eValu oni establish r sores. in effect ei:'irpe feat' +e'≥� tpusfcomply wt the o A'suitable replacement :area is not avallabte dutosetback and/or soil limitations. Bailing advances :.inPi WTS technology, a holding tankmaycbe installed last rsorttrrbplace the failed POWTS O ' The site has -not . een evalua ct toT '.i a s = must be t i y ont area: i pon. aiMS, Q�f.� Pik a Vii: -. : evaluation sV1abIe pOsi1 fl. %J ` .�l�a et#t , Is evai + h : tank may a Installed as a fast -r rt o thefaUht3 , ° t.�'. atIt flttrative 1'E#.' #Qr:1 T T,RESc.UECPA •'Y%+''•try Vii'e?r,'}Y�^� ': rilf':': '".ie;.sn, .�^..-3t [i.._� tc� ^.�yp}rFae-,.r ��sN.�+r,.laxf.7r�#�".f "'�l+�t!!J r. Wstewater' `al,a3' METERS FEET 10 9 30 8 25 7 U 6 20 5- O 15 4 3 10 2 5 1 0 0 I —► 5 GPM 2S FT 1 i ' fr + 1 l EPOS - EPpa � ! J L 0 10 20 30 40 50 GPM 0 2 - - 4 - 6. 8' - 10 12 ms/h CAPACITY RECEIVED OCT 13 2025 Order Minimum Float lard D� Minimum Minimum Minimum Maximum Shipping! Number HP. Volts Amps Circuit Phase. Swheh . Length cortnettlen On eveI -OffLevel Basin Solids Weight Breaker Diameter Sae IWAS. EP0411 No Switch 10` Manual Manual 20/9.1 EP0411A Piggyback/ 10' 1Y '6° 21/9.5 115 12 20 1 Wide -Angle - 1W - 15° 'b" EP0411F Plug/' No Switch 20 Manual Manual 20/9.1 FP0411AC Piggyback/ Wide -Angle. 20' 12' 6' 21/9.5 EP0412 230 6 10 Plug /. No Switch - 19' Manual Manual 20/9.1 EP0412F No.SwiPlugtch / 20' Manual Manual 20/9.1 EP0511F 175 73 20 No Switg/ch' Plu 20' Manual Manual 22/10 EP0511AC .5 Piggyback/ Wide -Angle 20' 12" 6" 23/10.4 EP0S12F 230 6.5 10 wit No sPlugtch - 20' Manual Manual 22/10 PAGES Cu-) ID ui� p 4:J(,✓ Y '. , S? Li �--� ��, ►... I`.y G oft. �/a.. ��a .. . rr 1 5 T Pte_- Cl"ZE. W�fl.� '_ (a,O �( Lam, •�(1 �)j.© ..- 4W 5F (o) 2 ..c () QLL Drn- (F C4p p1 ( C OzFp-(H') Lo' ..}LT: No 4p( (22i f + . o) x:123 L p -k L) 7S .o .- ('a 12.3 = 9°1.6' 1Jp�1 (� CZ -bb 4-+b �' �"� �.�� -�`� _...__.. _. _.. oT j- 13 Spc� 4 °j�-F fi�, .o .�o�S .45o Sr -1S x 4.n +I44)'43 b� e3 9S-1 LL ___ Use, O-'7 1 I Fo 3 .p J Bz 77c _ L T/�, 8S ormA,L 9-7,4C�a. Utz RECEIVED Gi C� �, E(�v�'f orJ �� r �►� e,C .� S 0CT 13 2025 _ € c %h)p and ZoningAQenay X. Tiff C'Ppca~S Turr,� L/c.CT c. `Nmx DALE SCHL,E RHIN 10N = ✓7,IjIrvN"V Tv. of �Lovcr'z i ft_ � 1F�••C1 Co PP-k'r tLCU LA l QS T,o l RL1C- •t Hz. &--• 0 PVL ToL. . 5 /PrT,tFfl Teo I,.. fJ'•J J �i'` �,•,-. 0CT 13 2025 w •. Jr . . . . d 13ayum co. tJl�Ct 24� i,' 2' �`t51C.}'► `' LJ A�� � .(c-o--fJ 4-� -- S • I.r.. Z_ r• -Z5' P rz. Pi t Flow Prue .�i PG �Z���. GPr-ti .. Lit Zo ." F % L . P&t 1OO' (,4 L- a 210 • `�c . 2 i .Tn1Fr �.._..... Do x' V .. ( -k 2 x7z..... L:.. . r Private Sewage System Maintenance Agreement Owner(s) Name Address A -rk L' -s Site Address / &(, tom: %- 2 P i`f As owner. I (we) do hereby 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 thebelow listed locationIn accordance with rules established in the WI Adm. Code, as from time to time amended. (CQMpi1E'fi* °l:egel. is required) 1/4 of 5k 9/4 Section ,p,^ ' Township ≤L7 N. Range 7 W. Additional Legal Descript₹on: Town of (f.LDt-')Z. (Acreage) Gov't Lot Lot Block Subdivision Lot CSM # Vol. Page CSM Doc # DOCUMENT NUMBER 2025R-609262 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED 09/19/2025 AT 8:54 AM RECORDING FEE: $30.00 PAGES: 1 Area Return To: P Qd9- 1 'fr17"J b CO) ?1 ?< o Apo V,+Y r Y O In -ground gravity O In -ground dosed ❑ In -ground pressure' distribution Sewage System: P5 Mound O At -grade Sewage System O Other Septic -Tank (system types A through E): The septic tank 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 onethird (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' pumpedoutwhen 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 -lank Effluent Fier (system types A through E): The septic tank effluent filter shall be Inspected and maintained as necessary and in accordance 'with mariufactuner's specifications. Miter maintenance reports shall be submitted to the County as required by SPS 383.55 Wis. Admin. Code. Private Sewage: System DisperrsaI Cell (system types A Through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, PQWTS 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. A( -grade. -and ln-a ound Pressuna.Svstem Laterals (system types C, O and E): The laterals shall be flushed out and swabbed if needed when the wastewater distribution all component is Inspected as provided above. Owner(s). agree that fal/ure to comply with this agreement will result in action being taken to pay ail charges and costs Inured by Baylleld County for inspoctlon, 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 -caus' d.by the. system. Bay/fold 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. riot pay the costs within thirty (30) days, the owner speclilcelfy agrees that all the costs and charges may be. placod on the tax roll as a special assessment, forthe abatement of a human health hazard. and the tax shell be collected as provided by law. Tire terns and conditions of the variance shell be binding upon and Inure to the benefit of all current and future.owners of such property. Owpf(s)N�me()—.oaae Print Luo m \ 7 , ,- met tilbfttt z�r Subscribed and -sworn to beforei1 ' - I . d Note Own i nature(s) Notary Publ My Commission Expires: ! ' . • �• Drafted b Date: 'ED ;Ulu i�c�Co. 8tfrng-A.g a�" CY Wtorms/sanitarylsepticmaintenceagreemeni Revised June 2018 BAYFIELD COUNTY SANITARY PERMIT (#04)-25-145S STATE SANITARY PERMIT OWNER: DEAN & CHERIE L LUOMA TRUSTEES GOVT LOT: LOT: BLK: SW 1/4 SW 1/4 SEC: 3, T 50 N, R 7 W TOWNSHIP: Clover SOIL TEST: 06-25 REPLACEMENT SYSTEM SYSTEM TYPE: Mound ≥ 24 in. of suitable soil PLUMBER: DENNIS BACHAND TRACY POOLER DATE: 10/17/2025 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 #: LICENSE: # 221446 Condition: Adhere to state conditions. Insulate where required. Old System needs to be properly abandoned per SPS 383. THIS PERMIT EXPIRES 10/17/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION