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Home My WebLink About22-120SRECEIVED AUG 26 2022 Bavfield Co. Department of Safety & Professional Services, Industry Services Division County BAYFIEI.D Sanitaiy Pennit Number (to be filled in by Co )M-^S Plai 3eftcy.. * - r_^-;rmit In accordance with SP.S 383.21(2), Wis. Adm. Code, submission of this fomi to the appropriate govcmmental unit 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 sccondaiypuiposes in accordance with the Privacy Law, s. 15.04( 1 Xm), Stals State Transaction Number NA 1. Application Information - Please Print All Information Project Address (ii'djfTerent than maUuig address) OEORGE LAKK DRJVB Property Owner's Name LAUR1I; MAY KOHLF.R Parcel* ^fif. If 0%^ 04-004-2-45-09-18-400-264-21000 Propeny Oum-r's Mailing Address 19181 130THSTRE1H- City. State BLOOMER, Wl Zip Code 54724 II. Type of Building (check all that apply) St I or 2 Family Dwelling-Number of Bedrooms D Public/Commercial - Describe Use D State Omcd - Describe Use Phone Number 715-828-3233 Lot» Property Location Govt. Lot NA '/<. Sl; •/,. Section IS forWr 45 N R °9 61 Blockff Subdivision Name REDFOXS AUUN TO POTAWATUMI NA CSM Number NA D City of. a Village of D Town of BARNES in. Type of POWTS Permit: (Chick either "New" or "Replacement" and othtr applkablc on Mne A. Check ofone box on line B. Compkte line ( applicablr.)A Syst^n New Replacement System (explain) Other Modification to Existing System a Additional Pretreatmcnt Unit (explain) B.D Holding Tank O&n-Oruunil (conventional) D AI-Grade D Mound D Individual Site llesign D Olher Type (explain) f.a Renewal Before Expiration D Revision D Change of Plumber D Transfer lo New Owner!Ust Previous Permit Number and Date Tssucd IV. DispenaVTreatment Area and Tank Information: Design Flow (gpd) 450 Design Soil Application Ratc<gpd/st') 0.7 Dispersal Area Required (sf) 64286 Dispeisal Area Proposed (s0 d52 System Elevation 95 00 FT. Tank Information Capacity in Gallons New Tnnks Existing Tanks Total Gallons H of Unite Manufacturer 51 £ 0 Septic or Holding Taiit l,fl60 1.060 INHLTRATOR Dosing Chamber V. Rcspomibility Statement- I, the andtnigncd, •unme rupoiuibility for initiUition of Ike POWTS show on the rtfchcd plans. Plumber's Name (Print) Kli) TH HAKINGS number's ;ijgna}ure •W-- '"x!^,^^ MP/MPRS Number 224037 Business Phone Number 715-579-2S56 Plumber's Address (Street. City, Slalc, Zip Code) 10182 178TH STREET. BLOOMER, WI 54724 T VI, Counly/Dcpartment Ii»c Only^L/Approved D Disapproved D Owner Given Reason for Denial Pcmiit Fee'WOT W-3S.'Date Issued //^7/? ^^ Conditions ofApproval/Rcasons for Disapproval &nri At«*c»lounnplcttpl»B»fcrlktiy3ltinuN)rkBiltot»eCoMi'lyjufyonp«pcrnolla»dwn»l/!i tt mchniniat SBD-6398 (R. 03/22) ^D awji ^.- ^-<^8^^^ ^" Iv ^ /.-; « :.-v '^ ..I; 'X- Private Sewage System Maintenance Agreement Owners) Name LA^W MAY -T^H^ ^ 0(LiA [c^ Owners) Mailing Address \ci[^[ \^C^^\ ^LO^OS, UL ->47^ Site Address (S-bC^s i.^&. DHVS Tax ID # As owner, I (we) do hereby certily the private sewage system wilt be installed in accordance with the certified soil tester's report and approved plans and specifications on file with BayfieM County Planning and Zoning Department. The system will be operated in such a manner as to meet the designed plans. I (we) agree to maintain said private system at the betow listed location in accoretance with mlas astablished in th» W) Adm. Code, as from time to time amended. (COMPLETE Legal Is required) _1/4 of _5£_1/4 Section I<S Township ^c^ N. Range £/-/w. Additional Legal Description: Town of T V\\^\)£A (Acreage)Gov'l LotWK"Lot U ^^ Block N^ Subdivision KE&^e^;. AE»^ TU P^Atu,<i(:Al< Lot .CSM#.Vol..Page — CSMDoc#. !l!ilHPUhli|!|HUIHi -^- ^ -Q - ^ - ^- p- ^-^ ..g- .g ^ -Q-g . - -^ ^ 2022R-596103 DANIEL J. HEFFNERBAYFIELD COUNTY, WIREGISTER OF DEEDS08/26/2022 11:29AMTF EXEMPT #:RECORDING FEE: 30.00 PAGES: 1 Recoiding Area Return To: Planning and Zoning Department In-ground gravity D Mound D In-ground dosed D In-ground pressure distribution Sewage System: D At-grade Sewage System Q 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 teast 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 tess than one-third (1/3) o( the volume occupied by sludge and scuin. Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septfc tank fe serviced as provkled above. "Pie switches and pump controls shall also be inspected and maintained to ensure operabilrty of sakt components. Seotic Tank Effluent_Fi!tei_(system types A through E): Ttie septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specificattons. Filter maintenance reports shall be subnutted to ths County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System DisoersaLCelUsystem types A through E): The private sewage system distributkxi cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date crf installatkin and at toast once every three (3) years thereafter to determine whether wastewater or effluent from the system Is ponding on the ground surface. Mounds. At-arade. and IrMinxind Pressure System Latwate (system types C, D and E): The laterals shall be flushed out and swabbed if needed when the wastewater distribution cell component is Inspected as provided above. Owners) agree thai failure to comply with this agreement will resurt hi action being taken to pay all charges and cosls mcurod by SayfieW County for inspection, pumping, hauling, or othwwise swvfcmg and maintaining the private sewage system tank in such a manner as to prevent or abate anyhuman health hazard caused by the system. Baytield County shall notify the owner of any costs which shall be paid by Ihe owner within thirty (30) days from (he date of notice. In the event tf» owner does not pay the costs within thirty (30) days, the owner spedfvally agrees that aU the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall bo collected as provided by law. The terms and conditions of the agreement shall be binding upon and Inure to the benefit of all current and future owners of such property. Ownerfs) Name(s) - Please Print . )^iAn€. \^e^\\tf Notarized Owner(s)- Signatures)1"^)"'""' Subscribed and sworn to before me on this date: ^ M)^ /<' •^\ My Commission Expires: Drafted by A'VA^' 'Jl} H^^'f"\ Date: !</- /"-4. Sy:.:.-./. 6; M)^y Proofed by:' '\ \ u/fom's/sanllary/seplicmaintenceagrtemenlRevised July 2020 Wisconsin uepanmem or sareiy ana ^roressionai servicesDivision of Industry Services SOIL EVALUATION REPORt. ^age i or ^ RE( In accordance with SPS 385, Wis. Adm. Code Attach complete site plan on paper not less than 81/2x11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Personal infonnation you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). ^ CountyBAYFIELD 'AUG 29 im Parcell.D. -^^^07,1. _ Bayfield Co. 04-004-2-45-09-18-400-264-21 dSOnning and Zoninfj A<j<;nJ Reyiey^d b^^ . . Date.^KlWWV \ %0^- Property OwnerUur^ kff^/^Property Location Govt. Lot % SE y< S 18 T 45 N R 9 D E (or) W Property Owner's Mailing Address 10184 CO HWYC Lot # 61 Block #Subd. Name or CSM# REDFOXS ADD'N TO POTAWATOMI City BLOOMER State Wt Zip Code 54724 Phone Number (715) 828-3233 City D Village [3 Town BARNES Nearest Road GEORGE LAKE RD New Construction Use: ^ Residential/ Number of bedrooms 3 Code derived design flow rate 450 GPD [3 Replacement D Public or commercial - Describe: Parent material GLACIAL OUTWASH Flood Plan elevation if applicable n. a. ft. General comments and recommendations: RECOMMEND A SYSTEM ELEV BETWEEN 94.5' & 96.0' Boring #D Boring Pit Ground surface elev. 98.5 ft.Depth to limiting factor 105+ in. Horizon 1 - 2 3 4 5 6 Depth In. 0-4 4-34 34-56 56-86 86-95 95-105 Dominant Color Munsell 7.5YR 2.5/2 7.5YR 5/6 7.5YR4/6 7.5YR 5/4 7.5YR 5/4 7.5YR 5/4 Redox Description Qu. Az. Cont. Color Texture Is s s s grs s Structure Gr. Sz. Sh. Osg Osg Osg Osg Osg Osg Consistence ml ml ml ml ml ml Boundary gw dw dw gw gw Roots 2f 1 co Soil Application Rate GPD/Ft2 *Eff#1 0.7 0.7 0.7 0.7 0.7 0.7 *Eff»2 1.6 1.6 1.6 1.6 1.6 1.6 Boring #D Boringislpit Ground surface elev. 99.8 ft.Depth to limiting factor 101+ in. Horizon 1 2 3 4 5 Depth In. 0-5 5-33 33-38 38-40 40-101 Dominant Color Munsell 7.5YR 2.5/2 7.5YR 5/6 7.5YR 4/6 7.5YR 4/4 7.5YR 5/4 Redox Description Qu. Az. Cont. Color Texture Is s s Ifs s Structure Gr. Sz. Sh. Osg Osg Osg Osg Osg Consistence ml ml ml ml ml Boundary gw dw gw gw Roots 2f 1m 1m Soil Application Rate GPD/Ft2 *Eff#1 0.7 0.7 0.7 0.5 0.7 *Eff#2 1.6 1.6 1.6 1.0 1.6 * Effluent #1 = BOD, > 30 < 220 mg/L and TSS > 30 S. 150 mg/L * Effluent #2 = BOD CST Name (Please Print) CHRIS FREDERICKS Address 499 4 1/2 Ave, Clayton, Wl 54004 Signature/-^ ,. ^2^fez^>^—^ Date EvaluatiofTConducted 8/1/2022 > 30 ^ 220 mg/L and TSS > 30 & 150 mg/L CST Number 71618 Telephone Number 715.419.0127 SBD-8330 (R04/15) pd f'^ ' CC- 0W^^ Boring #I uonng Pit Ground surface elev. 98.6 ft.Depth to limiting factor 103+ in. Horizon 1 2 3 4 5 Depth In. 0-4 4-28 28-38 38-46 46-103 Dominant Color Munsell 7.5YR 2.5/2 7.5YR 5/6 7.5YR 4/6 7.5YR 5/4 7.5YR 5/4 Redox Description Qu. Az. Cont. Color Texture Is s s grs s Structure Gr. Sz. Sh. Osg Osg Osg Osg Osg Consistence ml ml ml ml ml Boundary gw dw dw gw Roots 2f 1m 1m Soil Application Rdte GPD/Ft2 *Eff»1 0.7 0.7 0.7 0.7 0.7 *Eff#2 1.6 1.6 1.6 1.6 1.6 Boring #D BoringD Pit Ground surface elev.Depth to limiting factor in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr.Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Eff#1 *Eff#2 Boring #D Boring Pit Ground surface elev.Depth to limiting factor _ in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr.Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Ef?1 *Eff#2 * Effluent #1 = BOD, > 30 <, 220 mg/L and TSS > 30 S 150 mg/L * Effluent #2 = BOD, > 30 <. 220 mg/L and TSS > 30 £ 150 mg/L <& n ?>;-! s^'i^: l*:3-\^ s?•^ -»^£- —— t -"»t .5 ^ >-0'^.o ,a»'ft^~ ^^^ c»0 <s In-Ground Gravity Plan Index & Cover Sheet Component Manual Design References: In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg1of4 Pg2of4Pg3of4 Pg4of4 PAGE 1 OF 4 / RECEIVED AU626Z022 Index & Cover Sheet Plot Plan Dispersal Area Cross-Section & Plan View Management Plan Bayfield Co. Planning and Zoning Agency Attachments:Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Owner Name(s): LAURIE MAY KOHLER _ Phone: 715.828-3233 Owner Address: 19181 130TH STREET, BLOOMER, Wl zio: 54724 Project Address: GEORGE LAKE ROAD Govt. Lot: _NA_ Township: 1/4 of SE 01/4, Section 18 , T 45 N-R 09 E D or W [•] BARNES _ County: BAYFIELD Project Parcel ID #: 04-004-2-45-09-18-400-264-21000 Designer Information Designer Name: MARY JO HUPPERT _ phone: 715.426. 1775 Designer Address: 25720 FIREFLY LANE, WEBSTER, Wl zip: 54893 E-mail: holtjsterdesign@outlook.com _ i „ ^.';^i^l!.':"^^ License Number: Remarks: 1859-007 '• ;0/,?;''^^ Signature:'(U^I^UU Originaj^nature required drf each submitted copy. /TOYJO'\*^; HUPP^T ;" |I { D1Q59 S |% \R{VER FALLS^ i\ \.~wr^7 jx$i*^/Da,M»'?%2 ^'•;* 'f <•- ^ {f •^ r (\.' a-, ~c hv <3S ^^ ^ 'r-. >• -s; "Y- "1.^^- •:°h. .?> '< '"0 •J,^ s f.^ \> ^1.£"''i '-»^-.Y-\ ->» ?-! "w.^ -' <.:'-'- ff*-, ^ ?- ~\ ^ 1?^ ,.'<" ^-^^: •^ •k. § 5; "^1^ ^-< ^. ?•1»->^^f\ 'n ff(F ^^t^ g'V, <n — c e 3; -DII V 'i!^ s» '3 2- 7aTl _» ^ ^,& ^ 'y >^ rw. •sn '*-< :.- Y. .- <. 3»~ •„3B "- ^- :n \; -.sJ L'; r \J;J .<? ft IN-GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down-sizing credit) 1 SOIL COVER Septic Tank(s) ManufacturerINFILTRATOR 1060 gal LIFETIME Septic Tank(s) Volume(s): gal — gal Effluent Filter Manufacturer gal Effluent Filter Model #:LT6 12" mln. trenchdepth(typical)TYPICAL TRENCH CROSS SECTION VIEW (No Scale) aa) ^C3 Quick4 Standard-W w/ End Cap (typical) System Elevation = 95.00 ^ (typical) (Show location of inlet / outlet pipe connection on plan view.) Provide minimum 3 ft separation between trenchesgs &iN t-03<0 ^><Q FN305 r-s?0r-<?r~^ spn?'<m0 •--//-• INSTALL PER TRENCH: 16 Quick4 Std-W @ 20 ff EISA/chamber = Pairs of end caps @ 6 ft2 EISA/pair = _^____. B= 66 ft (typical) Observation Pipe(typical) Install per manufacturei's Instructions. A =3,0 ft(typical) TYPICAL TRENCH PLAN VIEW (No Scale) 450 GPD DIVIDED BY 0.7 LR =^Quick4 Standard:W Chamber 642.86 FT. 2 DIVmED BY 20 ^ by Infiltrator Sterns, Inc.) EISA7UNFT =32.15 OR 32 install pursuant to manufacturer's instmctions. i0mco0 = Proposed EISA per trench = ^ ^— ftUNITSX4 FT= 128 FT. _6 ftDF^IDED BY 2 = 64 FT. 13' X 66' ft2 Required Infiltration Area = 642.86 ft2 ^ trenches = Proposed Total EISA = (.^i ft2 Distribution Method: branched manifold IMPORTANT: PAGE 4 OF 4 In-ground Gravity Management Plan RECEIVED The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance |^U6u3r6t2022 requirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. Admin. Code, this system shah be considered a human health hazard if not maintained in accordance with this approved mana9ementPl^gnnin(^i)^zOTCiogAomcy Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Mainfamerln accordance with SPS 383.52 (3), Wise. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 45° gpd; BODs ^ 220 mgL-1; TSS S 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 (/.&, pumps, valves, switches, floats, etc.) o material fatigue (/.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 (/.&, exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (/'.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 efftuent 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, Wise. 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 Wise. Admin. Code. Report any component failure or malfunction to: Name of individual or company: KEITH HARINGS _ phone: 715- 579 - 2856 Local government unit: BAYFIELD COUNTY ZONING p^ne: 715-373-6138 Local government unit address: WASHBURN, Wl _ ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wise. 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, Wise. 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, Wise. Admin. Code. [ResetPage] ,(1) I; .? ;• .,'1 S/3/22, 11:^9 AM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 9/8/2022 Si> Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN: Tax Districts 1 04 004 041491 001700 l'*' Recorded Documents Updated: 3/12/2019 SA Ownership Property Status: Current Created On: 3/15/2006 1:14:52 PM Updated: 3/12/2019 4022 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-l) Residential-1 104 Updated: 3/15/2006 STATE COUNTi/ TOWN OF BARNES SCHL-DRUMMOND TECHNICAL COLLEGE Updated: 3/15/2006 a WARRANTY DEED Date Recorded: 3/8/2019 63 CONVERSION Date Recorded: S3 WARRANT/DEED Date Recorded: 9/7/2005 2019R-576641 501681 926-824 2005R-501681 926-824 LAURIE M KOEHLER Billing Address: LAURIE M KOEHLER 19181 130TH STBLOOMER WI 54724 BLOOMER WI Mailing Address: LAURIE M KOEHLER 19181 130TH ST BLOOMER WI 54724 y Site Address * indicates Private Road N/A Property Assessment Updated: 10/4/2016 2022 Assessment Detail Code Acres Land Imp. Gl-RESIDENTIAL 0.460 3,200 0 2-Year Comparison 2021 2022 Change Land: 3,200 3,200 0.0% Improved: 0 0 0.0% Total: 3,200 3,200 0.0% 1!*B* Property History N/A https://novus.bayfieldcounty.wi.gov/access/master.asp 1/1 BAYFIELD COUNTY SANITARY PERMIT (#04)-22-120S STATE SANITARY PERMIT OWNER: LAURIE M KOEHLER GOVJiLOT: LOT: 61 BLK: CSM: SUBDIVISION: Redfoxs Add To Potawatomi 1/4 1/4 SEC: 18, T 45 N, R 9 W TOWNSHIP: Barnes SOIL TEST: 124-22 NEW SYSTEM PREVIOUS PERMIT #: SYSTEM TYPE: Non-Pressurized In-Ground PLUMBER: KEITH HARINGS LICENSE: # 224037 TRACY POOLER DATE: 9/19/2022 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. 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