Loading...
HomeMy WebLinkAbout22-120SRequest for Sanitary Inspection Fax this form to Zoning Dept when you want an inspection — 373-0114 RECEIVED SEP 2 2 2022 If you do not have a fax and must email the inspection; you must email all stad ff merpt ...8a''Co. —�.,.,.,.� and zoning Agency Note fj Time Change fl Discrepancy fl Other Phone Number Plumber: Fax Number 715 -gs- rl7 Home Owner: L!� L d u r; e m a- y �1 �✓�t� k') '1 Sanitary _ d 0 G Permit #: Plumber's Choice Zoning Dept No inspection during these times 9' v9:30 am —12:30 pm Tues. (Tracy) Date: 00\1-- 12:00 pm — 2:00 pm Wed. (Todd) 9:30 am —12:30 pm Thurs. (Tracy) Plumber's Choice ZOnln t Immediate Phone Number so Zoning Time: 1 O (T ^ ®� Dept can call you right back (if needed) Township: na r i'/ ress#& Name: r Georaed J or Directions To Site: Comments: Reminder: You must confirm any change(s) that have been made prior to or this inspection will not be scheduled and a memo will be sent voiding the inspection. Thank You! From Zoning Dept Plumber must verify any change(s) by fax or no inspection will be scheduled wtormslsanitarylrequestfod nspection Zoning Dept (©4/12/04) ® August 2021 paALaoaJ T Zb 100 1W TE:17E:TT 1e ZZOZ 'ZZ Jag1a;das Sn1VJS S39Vd NOIIVNna OISJ 31OW3N 03AI3J3N 3WII kn AllndSS3DDns 03AI303N XVd : NOI1VOIdIION ON009NI a IDS a PS y�A�'RbioNn�'�f� Industry Services Division General Information LAURIE M KOEHLER 19181 130TH ST BLOOMER WI 54724 Information Private Onsite Wastewater Treatment Systems ( POWTS) Inspection Report (Attach to Permit) setback to: Co `/'C J Sanitary P /47-429s It No: State Plan Transaction ID#: ParcelTax No: v - ----- ---- - TYPE -------- MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Septic bPL_ 10 (6 yo f' N/A Dosing ieVi Q G N/A Aeration N/A Holding Pump / Siphon Information ump Manufacturer Pump Model Demand GPM Filter Manufacturer Filter Model TDH Lift Friction Loss Head Total Forcemain Length Dia Dist. To Well Dispersal Cell Information DIMENSIONS I Width Le # of Cells SETBACK FROM Pr . Litre Bu> i I 0P Type of Cell Manufacturer: Model Number: Pretreatment Unit Manufacturer: Model Number: Distribution System Elevation Data STATION BS HI FS ELEV Benchmark Bldg. Sewer S g/ Tank Inlet 7 Tank Outlet Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/Manifold , 9f Distribution Pipe Infiltrative Surface %. Final Grade Pr -Ac X Pressure Systems Only Header / Manifold Distributio ipe(s) --77 X Hole Size X Hole Observation Pipes Length _ Dia Length Dia Spec! Spacing 0 Yes ❑ No Soil Cover n3 Depth Over Depth Over Depth of Seeded / Sodded Mulched Cell Center Cell Edges Topsoil 0 Yes 0 No 0 Yes 0 No COMMENTS: (Include code discrepancies, persons present, etc.) Vl/CI i5tcured n/fr'/aj`fiM WOS ih Plan revision required? 0 ve4 No Use other side for additional inform n. 3a � /1;37/3 RRnSJ1 n !R nv911 Date POWTS Inspector's Signature License Number BAYFIEID COUNTY PLANNING & ZONING DEPARTMENT __ Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zoninq(a�bayfieldcountv.wi.gov 117 East Fifth Street = Web Site: www.bayfieldcountv.wi.gov/147 Washburn, WI 54891 Property Owner LAURIE M KOEHLER Information 19181 130TH ST BLOOMER WI 54724 As you know '("t /r qQ S was contracted by you to install a private onsite wastewater treatment system on4ur property described as: Notes: Abandonment of Old System to meet all applicable code requirements: o Tank was pumped by: *- Tank was crushed / removed and pipes disconnected by: on at AM/PM On 7/3€Y% _ at (a (?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. 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 not respond to plumber's time constraints. Comments: UHDim s/sanitaryProp ertyowneninput April 2019 ..savl%ICR Department of Safety County 2022 s BAYFIELD SanitaryPennitNnmher(tobe� in by Co.) AUG 26 i D' l0- Co. c'a'sMfi1ftit Application SmlcTmnsaci ANwnba In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this faro to the appropriate governmental unit Project Address (ifdiffamt than mailing address) is required prior to obtaining a sanitary permit Not: Application forms for state-owned POWTS are submitted to the Deparment of Safety and Professional Services. Pam-nal information you provide may be used for secondary purposes in accordance with the Privacy law, s. 15.04(Ixm), Stats. GEORGE LAKE DRIVE 1. Application Information— Please Print All Information Property Owner's Name Parcell 7A foil - LAURIE MAY KOHLER 04-004-2454)9.18-400-264-21000 Property Owner's Mailing Address Property Location 19181 130TH STREET Govt Lot NA City. State I Zip Code Phone Number BLOOMER,WI 54724 715-828-3233 — '. SB V.., Section 18 T 45 N R 09 *orW iL Type of R. (ebeek altlmt apply) Lmq Subdivision Name litl or2 Family Dwelling—Numbaof Bedrooms 3 61 REDFOXS ADON TM POTAWATOMI Black f! ❑ Public/Cammercial—DescribeUse NA ❑Cityof 0 Village of ❑ State (honed —Describe Use CSM Number NA 0 Town of BARNES M. Type of POWTS Permit (Check either "New" or "Replxemeet" and other applicable an Into A. Check alone bust on Meet Conaplek UK C A. I X New Replacement System Other Modification to Existing System ❑ Additional Preteamml Unit (explain) SY (explain) ' ❑ Holding Tank yyn-Gnlmn 0 At -Grade I ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ❑Revision 0 Change ofPlumber ❑ Transfer to New Owra is Previous Permit Number and Date issued Expiration IV. ' rsal!Frat uncut Area ad Tank laformation: Design Flow (gpd) Design Soil Application Rate(gpdfsf) Dispersal Area Required (s0 I Dispersal Mn Proposed (at) Elevation 450 0.7 642.86 652 95.00 FT. if Capacity in Total #01 Manufacturer Tank Information Gallons Gallons Units s e "Y o t? n Tanks lExisiingTrdta New k 4 6 U rn A V Seprs orllokkag Tack 1060 1.060 1 INFILTRATOR X Dosing CTwber V. Reapoasibitity Statement- L the saiessigsM, aawwr respossibUhy tar luhllatio. of the POWTS shows a the attached puss. Plumber's Name (Print) Plumber's MP/MPRS Number Business Phone Number KEITH HARINGS 224037 715-579-2856 Plumber's Address (Street City, State, Zip Code) 10182 178TH STREET, BLOOMER, WI 54724 Cwnty rtmeat Use Only Approved 0 Disapproved Pemrit Fee T qa217igDHY Issued /1237)3 ) ❑ Owner Given Reason for Dnial I Conditions of Approval/Reasons for Disapproval Attach w e mpkb run far Sc crab gadwwa w Sc 4:arry wry n raps as. sw ass a tr_ a ii meta m case SBD-6398 (11 03/22) /l,4RECEIVED vasconsm ueparvnent or ,wety and rroressionai services / ^� rage 1 or , Drvsion of In&,stry Services -�if-r1• ; SOIL EVALUATION REPORT AUG 26 2022 In accordance with SPS 385. Ws. Adrn Code horizontaAYF[�TntyFID i Sayfield . Attach complete see plan on paper not less than 8 12 x 11 inches in size Plan must include. ^^ 9 Agency but not xmeed to vertical and l reference Pontpont (BM). direction and percent slope. Parael I.D. � �y scale or dxnensions. north arrow, and location and distance to neatest road 0400444509'18-400'264.21000 V Please print all information. Reviewed by I Date Location ❑ KEViNryKkRINGS LAU RjF-MAY rO"LFFZ. Govt. Lot % SE % S 18 T 45 N R 9 E (or) W Property Owner's Mailing Address Lot a 8bck a Subd. Name or CStM 10184 CO HWY C 61 REDFOXS AWN TO POTAWATOMI p(y State Zip Code Phone Number 0 City I ❑ vi9age I ®Town Nearest Road I c on [ii New Corstruaim ....Use: 0Residential/Numbefofbedroom 3 Code derived design Bow cab '9N GPD Replacement 0 Public or commercial - Descobe Parent material QJACIAL OUTWASH Flood Plan elevation a appbcaole n. a. 8. General convnents and recommendations: RECOMMEND A SYSTEM ELEV BETWEEN 94.5 & 96-V ❑ Boring 1 I Boring a ® Pit Ground surface elev. 98.5 ft Depth to Weektg factor 09 in. al A Ii Cation Rate Horizon Depth Domnant Color Munsef Redox Description Ou. Az. Cott Cola Texture Structure Gr. Sz. Sh.'E1fi1 Consistenceoots GPD1FI'In. 'E#21 0.4 7.5YR 2.52 — is 089 f 0.7 1.62 434 7.5YR 516 — s os9 "Conswenoe ce 0.7 1.63 34-56 7.5YR 416 — s 059 0.7 1.64 5666 7.5YR 51'4 — s osg 0.7 1.67.5YR514 — grs Osg — 0.7 1.6695-105 7.5YR 514 — s 0sg 0.7 1.6 Il_ZJI 2 1 Bating e ❑ Boring © Pn Ground surface eleviL n Depth to binding facto. i2 —"n Cnai Anntrnhnn Rate Horizon Depth In, Dominant Color Morsel Redox Description Qu Az. Cont. Colo Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPDrfi' •E8a1 •Efl2 1 0-5 7.5YR 2.52 s 059Wn-Adw 2f 0.7 16 2 5-33 7.5YR 516 — s os9lm 0.7 1.63 3338 7.5YR416 — s Dag1m 0.7 1.6 4 38-40 7.5YR 4/4 — Ifs 059— 0.5 1.0 $ 40.101 ZSYR 514 — s 0s9 — 0.7 1.6 -- Effluent i soD >30s220 mglt. and TSS>305ISO muttR=80D >305220 not and 155>3051WCST Name (MM Print) CHRIS AddDate 4boA 1/2 Ave. Clavton. WI 54004 _._ Signature = Evaluat Conducted I S 11.12022__ CST Numbs 71618 Telephone Number 715.419.0127 emM1A-tv'rtLtt/15f RECEIVED UX90 ® Pit U 'xC Ground surface elev. 98.6 11 Depth to fling factor 1 - in. AUG 26 2022 Soil Application Rate bqynela (,p. g Agency Horizon Depth In. Dormant Color Murael Redox Description Cu. Az Cont. Color Texture Structure Cr. Sz. Sh. Conststenext Boundary Roots •Efl111 •€11112 1 04 7.5YR 2.52 — Is Osg nil gw 21 0.7 1.6 2 4-28 7.5YR 5+6 — s Osg ml dw tm 0.7 1.6 3 28-38 7.5YR416 — s Osg ml dw Im 0.7 1.6 4 38-46 7.5YR 5/4 — grs Osg ml gw — 0.7 1.6 5 46103 7.5YR 5/4 — s Osg ml — — 07 1.6 Dsoring ❑ P4 Ground surface elev. R Depth to hireling factor _ In. Sad Annlir.21w Rate Horizon Depth In. Dominant Color Munsell Redox Description Cu. Az. Corn Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPO/FF •Eltet •E11a2 ❑ Boxing S ❑ Boring ❑ P2 Ground surface elev — It Depth to Writing factor_._ in. sod Amfrateat Rate I Horizon Depth In. Dominant Color Munsefl Redox Description Qu. Az. Coin. Color Texture Structure Cr SL Sit Consistence Boundary Roots GPD/Ft2 •Efl11t •€8112 Effluent1 = BOD. > 30 s 220 rrglL and TSS > 30 5 150 mg/L - Effluent e2 = BOD. > 30 s 220 rg/L ant TSS > 30 s 150 ng/L RECEIVED AUG 262021 say eId C. pl M1ng and zoning Age. , .ne ti.!i usa- sJe o' % l \\ 'Q It.F Sti ,4AP•A __ ±_ 9 Zo 'M % std G Sr ?iG/f 8-/oZ — Xt HAAI 4 S r GI - (/EDFvx's kDfiN ,o Pint t1Mri riJi �E ry tg `f'Yre 8 c°eo#y 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 Pg2of4 Pg3of4 Pg4of4 Attachments: RECEIVED AUG 262022 Bayfield Co. Index & Cover Sheet Planning and Zoning Agency Plot Plan Dispersal Area Cross -Section & Plan View Management Plan POWTS Application for Review Soil Evaluation Report & Site Map Project Name I Description Owner Name(s): LAURIE MAY KOHLER Phone: 715 - 828 - 3233 Owner Address: 19181 130TH STREET, BLOOMER, WI Zip: 54724 Project Address: GEORGE LAKE ROAD Govt. Lot: NA 1/4 of SE 01 /4, Section 18 , T 45 N -R 09 E ❑ or W ❑✓ Township: BARNES County: BAYFIELD Project Parcel ID #: 04-004-2-45-09-18-400-264-21000 Designer Information Designer Name: MARY JO HUPPERT Phone: Designer Address: 25720 FIREFLY LANE, WEBSTER, WI E-mail: hollisterdesign@outlook.com License Number. 1859-007 ' �' 4, MARY JO * * ' HUPPs"tT D 1059 ;RIVER FALLS/ WI Remarks: 715 - 426 - 1775 Zip: 54893 Signature: 'Vi /iGCS X?i1t1 Date: _i�iT2q,' 20`22 Organ i naWe required 61 each subn,Uad copy. £^34 RECEIVED AUG 262022 Baia Co. Planning and Zoning A�eoc/ �'N+IN 4 pit. C � 1t•' FY: ? A W'EU. TC i5E yz5� FP' y�7iie"frti?�+r. FRG h1 pRAiNPiEt� gtv,N NMLIN4 s c.o r G 1 - pcbraX 5 IS&J *'� Posfw{Mfar+/ rci� ele y� Sc '8 IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER min. 17 (typical) Septic Tank(s) Manufacturer. INFILTRATOR Septic Tank(s) Volume(s): 1060 gal gal gal gal Effluent Filter Manufacturer. LIFE TIME Effluent Filter Model #: LT 6 12" min. trench depth (typical) TYPICAL TRENCH CROSS SECTION VIEW I (y. to (No Scale) System Elevation = 95.00 ft (typical) Quick4 Standard -W w/ End Cap (Show location of inlet/outlet pipe connection on plan view.) (typical) r - ----------- B= 66 ft (typical) rn CD qrc in 'o in tv Provide minimum 3 ft N O separation between trenches.. 2 Observation Pipe (typical) Install per manufacturers / Instructions. IA=3.0ft (typical) TYPICAL TRENCH PLAN VIEW (No Scale) 450 GPD DIVIDED BY 0.7 LR=`wulcK4 otanaaru-vv i,namoer (typical) INSTALL PER TRENCH: 642.86 FT. 2 DIVIDED BY 20 (mfd by Infiltrator Systems, Inc.) EISA/UNIT =32.15 OR 32 Install pursuant to manufacturers instructions. 16 Quick4 Std -W @ 20 ff EISA/chamber = 320 ftUNITS X 4 FT = 128 FT. + 1 Pairs of end caps @ 6 fP EISA/pair = 6 ftDIVIDED BY 2 = 64 FT. TRENCHES 3' X 66' = Proposed EISA per trench = 326 ft Required Infiltration Area = 642.86 ft2 Distribution Method: x 2 trenches = Proposed Total EISA = 652 ft2 branched manifold 0 m w 0 ii PAGE4OF4 In -ground Gravity Management Plan IMPORTANT: RECEIVED The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance u2r8t2022 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 plgs o Ba Co. Anln and Zning Agency Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Main fa rnergin accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 450 gpd; BODS ≤ 220 mgL-'; TSS ≤ 150 mgL-'; FOG ≤ 30 mgL 1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (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: Local government unit: BAYFIELD COUNTY ZONING Local government unit address: WASHBURN, WI KEITH HARINGS Phone: 715-579-2856 Phone: 715-373-6138 ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383-51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. I Reset Paie 9,8/22, 1,: 9 AM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 9/8/2022 Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN: Property Status: Current Created On: 3/15/2006 1:14:52 PM Updated: 3/12/2019 Ownership Updated: 3/12/2019 4022 LAURIE M KOEHLER BLOOMER WI 04-004-2-45-09-18-4 00-264-21000 004131903000 (004) TOWN OF BARNES S18 T45N R09W REDFOXS ADD TO POTAWATOMI LOT 61 IN DOC 2019R-576641 2217 0.459 0.459 0 No (R-1) Residential -1 104 Billing Address: Mailing Address: LAURIE M KOEHLER LAURIE M KOEHLER 19181 130TH ST 19181 130TH ST BLOOMER WI 54724 BLOOMER WI 54724 Site Address * indicates Private Road N/A 01 Property Assessment Updated: 10/4/2016 2022 Assessment Detail Code Acres Land Imp. Gi-RESIDENTIAL 0.460 3,200 0 Tax Districts Updated: 3/15/2006 2 -Year Comparison 2021 2022 Change 1 STATE Land: 3,200 3,200 0.0% 04 COUNTY Improved: 0 0 0.0% 004 TOWN OF BARNES Total: 3,200 3,200 0.0% 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE 4 Recorded Documents ® WARRANTY DEED Date Recorded: 3/8/2019 © CONVERSION Date Recorded: 2 WARRANTY DEED Date Recorded: 9/7/2005 Updated: 3/15/2006 2019R-576641 501681 926-824 2005R-501681 926-824 is Property History N/A https://novus.bayfieldcounty.wi.gov/access/master.asp 1/1 w-flI Pr Department of Safety County & Professional Services, BAYF(to Sanitary Permit Number (b be filled in by Co ) AUG 26 2022 Industry Services Division f _ d Co. Plang�m rfnit ApplicationNA StabTareaerwnNumbe In aceordorce with SPS 383.21(2). Wis. Adm. Code, submixston of this Corm to the appropriate governmental unit Project Address (ifdfferent than mailug address) is ru u rod prior In obtaining a sanitary permit. Now. Application Gauss for state-owned POWFS tie 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 Xm), Sons. GEORGE LAKE DRIVE 1. Application Information — Please Print All Information Property Owner's Name Pmcel 0 7R qo z7^ LAURIE MAY KOHLER 04-004-2-45-09-I 8-400-264-21000 Property Owner's Mailing Address Property Location 19181 130TH STREET Govt Lot NA City. State Zip Code Phone Number BLOOMER -WI 54724 715-828-3233 — '/. SE '/., Section IS T 45 N R 09 *aW IL Type ofBaiiffing(cbeek alldent apply) Loa Subdivision Name a I or 2 Family Dwelling -Number of Bedrooms 3 61 REDFOXS ADDN TO POTAWATOMI Black H ❑ Public/Commercial - Describe Use NA ❑Cityof ❑ State Owned-Docnbe Use ❑Vdlageof CSM Number Town of BARNES _ NA 111. Type of POWTS Permit (Check either "New" or "Replacement" and office applicable en line A. Check Dane box en line B. Complete line C applicable.) A. X New Replacement System Other Modification to Existing System ❑ Additional Pretreatment Unit (explain) Sy (explain) 11. 0 Holding Tank [,/On -Ground ❑ AI -Grade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C. ❑ Rene ual Before ❑ Revision ❑ Change of Pimnber ❑ Transfer to New Owxier List Previous Permit Number and Date Issued Expiration IV. Dip rsaVfreatmeut Ara and Tank Information: Design Flow (gpd) Design Soil Application Rme(gpd/sl) Dispersal Area Required (all I Dispersal Area Proposed (at) ISystem Elevation 450 07 64286 652 95.00 FT Capacity in Gallons Total Gallons #01 Units Manufcturer Tank Information $ ' }2 Ncw Taota Existing Tads n i_ ry V d Septic or Hulduu Tad 1,060 1,060 1 INFILTRATOR X Dazing Climber V. Responsibility Statement -I, the aadenigaed, assume responsibility for iutaaatiw attk POWTS sYowa on the attacked plans Plumber's Name (Print) I Plumber's : MP/MPRS Number I Business Phone Number KEI"III FIARINGS .7 /. - °—''w37 715-579-28-s6 Plumber's Address (Stn. City. State. Zip Code) 10182 178TH STREET. BLOOMER, WI 54724 (' V County/Department Use Only Approved❑ DL.Ppmvd Permit Fee f Doe Issued Lssu' 8 A i , ❑ Owner Given Reason for Denial y� — /�/p'�f 71 ( / Conditions of Approval/Reasons for Disapproval Atariammpkee plan Sr Sc ayares sea abmita r4 Cooiy gayvpaper nit less burn as II Sara bate SBD-6398 (8.03/22) C1 8 �� (is✓`/) y 11111 flU 11111 UII 111111111 Uhll llll 1 lll UlHhll sZ0]]A-59fitOJ 1s Private Sewage System Maintenance Agreement 2022R596103 a(s) Name L�ui ' DANIEL J. HEFFNER BAYFIELD COUNTY, WI oersJ&tothngss 12 -` t 5L0 J A Z U = 54 72-q REGISTER OF DEEDS 08/26/2022 11:29AM Site Address LN IF EXEMPT #: RECORDING FEE: 30.00 PAGES: 1 Tax tD # As owner. I (we) do hereby certify the p system will be it d in accordance with the certified soil tester's report and approved plans and specifications an tae with Baylleld County Planning and Zoning Departtnerd. The system will be operated in such a manner as to meet the designed plans. I (we) agree to maintain said private system at the below location in accordance with rules established in the WI Adm. Code, as from time to time amended. (tLETE Legal Is required) '•- 114 of 114 Section Township fi N. Range A_W. Recording Area Return Retum To: Planning and Zoning Department Additional Legal Description: _ — Town of_____________ -5 (Acreage) Gov't Lot Lot tG f(. Block h k Subdivision REDFc>:s AttM TG POT A td ctCM l Lot '— CSM # Vol. -- Page -' CSM Doc # fR In -ground gravity O In -ground dosed O In -ground pressure distribution Sewage System: O Mound O At -grade Sewage System O Other Senor 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 one-third (113) of the volume occupied by sludge and scum. Pump Chamber (system types B, C. D. and E): The pump chamber shall also be rinsed and pumped out when the septic tank Is serviced as provided above. The switches and pump controls shag also be Inspected and maintained to ensure operably of said components. S tic Tank Effluent Fitter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and In accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55. Mfrs. Admin. Code. Private Sewage System Disoersal_Ceg (system types A through E): The private sewage system distribution cell shag be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or of fluent from the system is pending on the ground surface. Mounds. At -credo. and IMgRWd Pressure System L (system types C, D and E): The laterals shell be flushed out and swabbed if needed when the wastewater dlstributlon cell component Is inspected as provided above. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs Incurred by aaytleld County for inspection, pwnping, hauifng, or otherwise mewling and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system. Bay#eld County shell notify the owner of any costs which shall be paid by the owner within th fly (30) days from the date of notice In the event the owner does not pay the costs within thfrty (30) days, the owner spodilcally agrees that all the costs and charges may be placed on the tax roil as a specist assessment for thhe abatement of a human health hazard, and the tax shag be collected as provided by law. The terms and conditions of the agreement shall be binding upon and Inure to the bone/It of all current and future owners of such property. Owner(s) Name(s) — Please Print Subscribed and sworn to before me on this date: Notarized Owners) — Signatwe(s) Notary I� . v My Commission Expires: - ., Drafted by N -L} N u P1 T Date: N/-. 24 "7.2t.. en •t'• Revised .fit y 2020 allpaid 7820 Innovation Boulevard. Suite 250. Indianapolis, IN 46278 I Customer Service: 1-888-604-7088 Payment Confirmation AttPaid! Your transaction was successful. An automated notice of payment has been sent to Bayfield County Planning and Zoning. Your next statement will show the total amount of your payment plus any processing fee(s). Transaction Information Status: Approved APD Reference It: TX 6684670 Date: 09/01/2022 12:12 PM Approval #: 878976 Pay Amount $50.00 Service Fee: $1.75 Total Amount $51.75 Payment Information Property Owner: Ldaurie Koehler Tax. ID#: 4O1 , -L Payment Amount $50.00 Billing Information N Ending in 0681 Kevin Harings 10184 County Hwy C Bloomer, WI 54724 us (715) 828-3233 kharings32@gmaiLcom d 2007-2022 ALlPaid, Inc. All Rights Reserved. (NMLS ID #1434636: Licensed by the Georgia Department of Banking and Finance #61205) An Aventiv Technologies Company 1/2 ,3/22, 1't9 AM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Status: Current Property Listing Today's Date: 9/8/2022 Created On: 3/15/2006 1:14:52 PM Description Updated: 3/12/2019 a2 Ownership Updated: 3/12/2019 Tax ID: 4022 LAURIE M KOEHLER BLOOMER WI PIN: 04-004-2-45-09-18-4 00-264-21000 Legacy PIN: 004131903000 Billing Address: Mailing Address: Map ID: LAURIE M KOEHLER LAURIE M KOEHLER Municipality: (004) TOWN OF BARNES 19181 130TH ST 19181 130TH ST STR: S18 T45N R09W BLOOMER WI 54724 BLOOMER WI 54724 Description: REDFOXS ADD TO POTAWATOMI LOT 61 IN DOC 2019R576641 2217 T Site Address * indicates Private Road Recorded Acres: 0.459 N/A Calculated Acres: 0.459 Lottery Claims: 0 0N ® Property Assessment Updated: 10/4/2016 First Dollar: Zoning: (R-1) Residential -1 2022 Assessment Detail ESN: 104 Code Acres Land Imp. G1 -RESIDENTIAL 0.460 3,200 0 I Tax Districts Updated: 3/15/2006 2 -Year Comparison 2021 2022 Change 1 STATE Land: 3,200 3,200 0.0% 04 COUNTY Improved: 0 0 0.0% 004 TOWN OF BARNES Total: 3,200 3,200 0.0% 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE Property History Recorded Documents Updated: 3/15/2006 ® WARRANTY DEED Date Recorded: 3/8/2019 ® CONVERSION Date Recorded: 2 WARRANTY DEED Date Recorded: 9/7/2005 N/A 2019R-576641 501681 926-824 2005R-501681 926-824 https://novus.baytieldcounty.wi.gov/access/master.asp 1 /1 BAYFIELD COUNTY SANITARY PERMIT (#04)-22-120S STATE SANITARY PERMIT OWNER: LAURIE M KOEHLER GOVT LOT: LOT: 61 BLK: CSM: SUBDIVISION: Redfoxs Add To Potawatomi 1/4 114 SEC: 18, T 45 N, R 9 W TOWNSHIP: Barnes SOIL TEST: 124-22 NEW SYSTEM 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 #: SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: KEITH HARINGS TRACY POOLER Authorized Issuing Officer DATE: 9/19/2022 LICENSE: # 224037 Condition: PROPERLY MAINTAIN SYSTEM PER RECORDED AGREEMENT. THIS PERMIT EXPIRES 9/19/2024 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION