HomeMy WebLinkAbout25-159S' nrurViyry�'ii Department of Safety County t pD �f --
1 V lie fJ/tsi
& Professional Services,
- Sanitary Pemlit umber (to be filled in by Co.)
1 �s ' NOV 2 5 2025 Industry Services Division o
`-' SS'-out€S hs
A"esu..na" Co.
PIrstfftdo unit Application 4�.d
StateT ansaction Number
In accordance with SPS 38321(2), Wis. Aden Code, submission of this form to the appropriate gdveis required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS arProject Address (if different than mailing address)
the Department of Safety and Professional Services. Personal information you provide may be used for secondary i Y �i0 /N r e! /.,1,� ,1 /iL,� /i
purposes in accordance with the Privacy Law, s. 15.04(1 Xm), Stars. Y //t' cU-Il✓W,r/t. L/a"
f. Annliention Information —Please Print All Information
Govt. Lot 11CC L r.%y Section 19
IL Type of Building (check allthat apply) Lot 4 T `1 N R EorbLj
I or 2 Family Dwelling —Number of Bedrooms Subdivision Name
Block 4
❑ Public/Commercial — Describe Use
0 City of
❑ State Owned — Describe Use CSM Number (j,I ❑ Village of
VIAIMI Rn) "'4 � %Townof S
DL Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i
a licable-) tttyyy
A. ❑ New System �qam-af/rReplacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain)
B' ❑ Holding Tank ya Its -Ground ❑ At -Grade 0 Mound ❑ Individual Site Design ❑ Other Type (explain)
(conventional)
C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner List Previous Permit Number and Date Issued
Expiration
System Elevation
"• """"""_...._.
Tank Information Gallons Gallons Units C —
New Tanks Existing Tanks
y O
6 U in ,n ti rL C7 F.
Septic or Holding Tank boo
l! OOO /
Dosing Chamber { If/ lam'
V. Responsibility Statement- 1, the undersigned, assume nsibiity for installation of the POWTS shown on the attached plants.
Plumber's Name (Print) P1 er's Si a MP/MPRS Number Business Phone Number
n u 4/m i� /7Wfl / 15 ssc-&7 3
IumBei's Address (Street, City, State, Zip Code)
Approved ❑ Disapproved $.��..�.../�..,. .................. _ a p..... .--1,'237/-3 [
/ ❑ Owner Given Reason for Denial ((/V ' 2h M m� /i/gyf
I Conditions
SLL dacuea Md -
hunch to emmnlrte nisna for the system and suhmit to the Caunty only on naner not less than a 1/2, TI inches I.
SBD-6398 (R. 03/22)
SOIL TEST ## / 50 ` a 5 fD
l •,' "`-'=,� ; {soon�rn rat of Safely &Professional Services S R 3 66
Divisibrtbf
1 �. ervices
`_!=pa '% 2025 SOIL EVALUATION REPORT
�... _ ! NOV Z 5 In accordance with SPS 385, Wis. Adm. Code coup ty
Attach complete site plan ohr�sf3an 8112 x 11 inches in size. Plan must include,
but not limited to vertica aMliariitintie
ret"erence point (BM), direction and percent slope, Parcel I
scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Re ew
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)).
Property Owner t
rL A. ' A,v�uu.SY rAL
Property Owner's MailingAddress
City, State, Zip t� Phone Number
Mme► t/1AA AAI t -E _ Ltlr_' - 1 75(116 ) 4
Property Location
Govt -Eet 55 % N ¼S
Site Address or GSM and Lot#:
444'710 MULLEJ
O City ❑ Village
Page 1 of 'T
Py! E.L,D
4X LDDate
t
T 1 NR
Yro�5, P3`f1 61
Nearest Road
•❑ New Constriction User Residential/ Number of bedrooms - Code derived designflow rate— GPO
Replacement 0 Pubflc or commercial —Describe: Flood Plan elevation if applicable_JWt ft.
Parent material .)J£LXT WA5
General comments and recommendations: ( J9 U0A - t)M ®7 '"`1
�� []Baring
U Boring # Pit Ground surface etev.t. Depth to limiting factor �$ in. ! elev.�.
� yam.
Snil Annlication Rate
I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD!Ft2
In. Munsell Qu. Az. Cont Color Gr. Sz. Sh. *Eff#1 *EfI##2
-.7 .5 n O• r0
Z. 1-31 7.,4J4 — 1.3 d1 35 .7 1'
3 3iS to -- s Q7 •
—2 C
F .j Bonn # ❑Boring
Boring ,Pit Ground surface elev. •OS ft. Depth to limiting factor go in. f etev.9•5 ft.
7.5a-4.
Snll Annlic ation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu. Az. Corti Color Gr. Sz. Sh. *Eff#1 *Eff#2
-1v 5V .,�b U CA1es o A1 1.1v
7,� tI s J c1 s LV144 f17 I.(' n
.. ��� r V �� p► 1. V'
CST Name (Please Print) Sigma CST Number
MARY JO HUPPERT (Holllster's Soil Testing 6 Deign) 048900002 -SP
Address Date Evalua n Conducte Telephone Number
25720 Firefly Lane, Webster, WI 54893 I !' - 7 2Q 715-426-1775
-S* Effluent #1 = BOD > 30 s 220 mg/Land TSS > 30 5150 mglL * Effluent #2 = BOD. 5 30 mg!L and TSS 5 30 mg/L
SBD-8330 (R03122)
.i /,2thaJ n
Wearing
. Boring #
QED
I Page of..L.
d`
Ground surface elev. ft. NOV €uniting factor Ri in. / elev. f/4ltt.
sC0. '•
Soil Anotication Rate
Horizon
Depth
In.
Dominant Color
Munsefl
Redox Description
Cu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
*Eff#2
L
-S
--
Is
--
a •7
I.
2.
3
iq -qty
p m
-•
$
1
I
—
`-
--
• 7
o• 7
i.1'
T1Borin9#
o
O Boring
Pit Ground surface elev. fl. Depth to limiting factor in. / elev. ft.
Snit Annlication Rate
Horizon
Depth
In.
Dominant Color
Munseil
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eff#
*Eff
L__i
Boring #
0 Boring
0 Pit Ground surface etev. ft. Depth to limiting factor in. /'elev. ft.
I Snil Anntication Rate
Horizon
Depth
In.
Dominant Color
Munseil
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Effffl
*Efg
* Effluent #1 = BOO > 30 5 220 mglL and TSS > 30 s 150 mglL * Efluent#2 = BUD, 5 30 mg/L and TSS 5 30 mg/L
NOV 252025 Plot Plan Page
BayfiE!d Co.
�i
f'I'Pi11r'� cCi 2G;':.Ci'.'�Y'
= = 40 E1 A 1A FT.
PROPERTY OWNER: M ��� e
(except where noted)
Legal oescription: 5E� 4i O Tart ` '1 V3 1U3L t = lsacichoe pit,
jAA 3i'jcth ii&ty t4Y
V�S61 ?3' t 1016 Q ham/ C..pEEt TObJ
North
to utcrG�W �
(,`W 1
Bayfield County, WI
i. +a. �'~M` �' .ry .i•. it _ !_'..
a a1
� s y.y r y '� � � s•, .
f
r-$
�y,�
t y
+ ,� •� >r �.�7+ / �' 9" Fllrn Et ��If?Hu5b'� tE i+F, �!�.-. �•
♦ � 0
11/15/2025, 2:00:56 PM
Rivers Approximate Parcel Boundary All Roads
Lakes-- Section Lines Town
I I Survey Maps
Building Footprint 2009-2015
Changed
Driveways
0 0.01
0 0.01
PAGE 1 OF 4
RECEIVED In -Ground Gravity Plan
N0V 25 2025 Index & Cover Sheet
Component Manual Design References:
Bayfield Co.
P!annmg round Soil Absorption for POWTS Version 2.1 (May 2022-2027)
and Zoning A0p-,P?
Pg 1 of 4 Index & Cover Sheet
Pg 2 of 4 Plot Plan
Pg 3 of 4 Dispersal Area Cross -Section & Plan View
Pg 4 of 4 Management Plan
Attachments:
Enclosures:
Tank Specs
POWTS Application for Review
Filter Specs
Soil Evaluation Report & Site Map
Tax Statement
*** *** ni
Project Name / Description application)
Owner Name(s):
Owner Address: E2642 C.T.H. P, MENOMONIE, WI
Project Address: 49710 MULLIGAN CREEK ROAD
Govt. Lot: NA SE 1/4 of NE 1 /4, Section 14 , T 44 N -R 09 E ❑ or W ❑✓
Township: RARNFS r-„,mnr,.• BAYFIELD
MICHAEL A. & ANN HUSBY, ET ALL
Phone:lfrr-fl-
Zip: 54751
tary
Project Parcel ID #:
Designer Name:
Designer Address: 25720 FIREFLY LANE, WEBSTER, WI
E-mail: hollisterdesign@outlook.com
04-004-2-44-09-14-1 04-000-10000 TAX ID: 1937
Designer Information
License Number:
Remarks:
MARY JO HUPPERT
1859-007
Phone: 715 - 426 - 1775
Zip: 54893
Fl
Signature: tp- Date:
Ori nal sign lure ui on cn submma copy.
MARY
H0FPE'T
;rVER F".'.. , :
:
: arCE vED
NOV 252025
Eayfclo Co., A
Legal
Site location: `
Plot Plan
Axi,J l isM .et
t9 J
cp
p F
345 ±%
NV1Uj" CRPEK &tV ^n
I,OAD Ra-2°
1".,== 40 FT.
(except where noted)
Cl = backhoe Pit,
11p!s
t
North
IN -GROUND GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard -W Chambers
3 -ft Trench (down -sizing credit)
SOIL COVER
min. 12"
(typical)
Septic Tank(s) Manufacturer:
WIESER
Septic Tank(s) Volume(s):
1000 gal gal gal gal
Effluent Filter Manufacturer
ORENCO
Effluent Filter Model #:
12"
min. trench
depth
(typica) TYPICAL TRENCH
CROSS SECTION VIEW
I (tya
pic) ^. ... .. (No Scale)
Ic
System Elevation = 95.00 ft
(typical)
Quick4 Standard -W
w/ End Cap (Show location of inlet / outlet pipe connection on plan view.)
(typical)
F-------------------��---
L------------7
B= 66 ft
(typical)
INSTALL PER TRENCH:
16 Quick4 Std -W @ 20 ftEISA/chamber = 320
=
rro
w
O
p
ry
>
a
Provide minimum 3 ft a
0
separation between trenches. Q
Observation Pipe
(typical)
Install per manufacturers
/ instructions.
TA = 3.0 ft
(typical)
TYPICAL TRENCH
PLAN VIEW
(No Scale)
450 GPD / 0.7 LR = 642.86 FT. 2"—Quick4 Standard -W Chamber
642.86 / 20 EISA = 32.15 UNITS OR 32 (typical)
32 X 4 FT. = 128 FT. (mfd by Infiltrator Systems, Inc.)
3 (2) 3 FT. X 64 FT. TRENCHES Install pursuant to manufacturers instructions.
ft
+ 1 Pairs of end caps @6 ft2 EISA/pair = 6 ft2
= Proposed EISA per trench = 326 ft2
Required Infiltration Area = 642.86 ft2 Distribution Method:
x 2 trenches = Proposed Total EISA = 652.00 ft2 branched manifold
C)
171
CA)
O
TI
a
MICHAEL & ANN BUSBY LE, ET AL
PAGE 4 OF 4
N0V 757025 In -ground Gravity Management Plan
IMPORTANT: e. °-' c
The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall
be considered a human health hazard if not maintained in accordance with this approved management plan.
Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow =
450 gpd; BOD5 220 mgL"'; TSS ≤ 150 mgL''; FOG ≤ 30 mgL'
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors (Le. 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 I 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: RYAN STRAND
Local government unit:
BAYFIELD COUNTY ZONING
Local government unit address:
WASHBURN, WI
Phone: 715-558-1673
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.
WLP1 000
TANK SPECIFICATIONS
4" CAST -
0-a 90 a
I n
2r ---J-------
DIMENSIONS:
WALL: 2 1/2"
4" CAST -A -SEAL BOTTOM: 3"
COVER: 5"
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
HEIGHT: 53 1/4"
LENGTH: 8'-8"
WIDTH: 7-2"
BELOW INLET: 42"
LIQUID LEVEL: 36"
WEIGHT: BOTTOM 6,790 LBS.
COVER 3,195
INLET AND OUTLET:
4" CAST -A -SEAL BOOT OR EQUAL GASKET
I
OUTLET
na
U
a,
PUMP PAD
;
o
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN SEE DETAIL #10
(OTHER STATES SEE CHART)
Z
ti
a
c
o
C
1.1:
-
Cr
LIQUID CAPACITY: 27.83 GAL/IN
0o
N
�1HOLDING TANK:
C Lo
v
cryC
OUTLET HOLE PLUGGED
ACTUAL CAPACITY: 1,085 GALLONS
�
LOADING DESIGN: 8'-O" UNSATURATED SOIL
a N
o �
'
TANK CAN BE USED AS:
SEPTIC / HOLDING / PUMP OR SIPHON
W o
y = 00
COVER: MIX DESIGN #8 (NO FIBER)
—'o
TANK: MIX DESIGN #10 (STRUCTURAL FIBER)
- n
3
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
O
OQ
REVIEWED BY
REVIEW DATE
DRAWINGS SUBMITTED
FOR APPROVAL
APPROVED BY: SHEET NO.
APPROVAL DATE: 1
OF
PRODUCTS NEEDED BY: 1
ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227
Extendable Applications
S. ,. tee handle
Orenco® 4 -inch Biotube' Effluent Filters are designed to remove sal-
fl'- Vented top plate, ids from effluent leaving residential septic tanks. They can be used in
standard new and existing tanks at flows of up to 1200 gpd.
tie
Biotubes
NOV 252025
Bayfield Co.
Biotube® filter Panning and Zoning Agency
cartridge
Biotube® filter
vault
S
Flow modulation
plate (optional)
_ ff
Vault
• p Inlet holes
General
Orenco 4 -inch Biotube Effluent Filters (U.S. Patents No. 4,439,323 and
5,492,635) are used to improve the quality of effluent exiting a septic tank
in a residential septic system. Increased effluent quality improves system
performance and extends drainfield life.
The Biotube cartridge fits tightly in the vault and is removable for
maintenance. The tee handle can be extended for easy removal of the
cartridge.
Standard Models
FTS0444-36, FTS0444-36M, FTW0436-28, FTW0436-28M
FTW0444-36, FTW0444-36M
Product Code Diagram
FT[][I04❑-❑-T❑
Flmv modulator and Mat switch bracket option:
Blank = no options selected
M = flow modulation plate installed
A = float switch bracket installed
Cartridge height, in. (mm):
2B = 28(711), standard
36 = 36 (914), standard
Filter housing height, in. (mm):
36 = 36 (914), standard
44 = 44(1118) -standard
4 -in. (100 -mm) fitter diameter
Outlet tee:
W = tits Type 3034 outlet tee
5 = fits Schedule 40 outlet tee
Filter mesh option:
Blank = 'A -in. (3 -mm) filter mesh
P = 'Is-tn. (1.6 -mm) filter mesh
Biotubeeffluent titter
Materials of Construction
Vault PVC
Biotube® cartridge Polypropylene and polyethylene
Handle components PVC, polyethylene, stainless steel
Orenco Systems m Inc. , 814 Airway Ave., Sutherlin, OR 97479 USA • 800-348-9843 • 541-459-4449 • www.0renco.com NTO-FT-FTS-1
Rev. 3.0, ® 05/18
Page 1 of 2
n optional flow modulation plate)
NOV Z 5 2025
orifice (on optional flow modulation plate)
Bayfeld Co.
Planning and Zoning Agency
Specifications
Model
FTS0444-36, FFW0444-36
FTS0436-28, FFW0436-28
A - Vault height, in. (mm)
44.00 (1118)
36.00 (914)
B - Cartridge height, in. (mm)
36.00 (915)
28.00 (710)
C - Inlet hole height, in. (mm)
21.25 (540)
19.25 (489)
D - Nominal diameter, in. (mm)
4.00 (100)
4.00 (100)
Number of inlet holes
8
8
Inlet hole diameter, in. (mm)
1.13 (29)
1.13 (29)
Discharge orifice diameter, in. (mm)
4.00 (100)
4.00 (100)
Discharge coupling diameter, in. (mm)
4.00 (100)
4.00 (100)
Filter surface areas ft' (m2)
5.1 (0.50)
3.9 (0.40)
Flow area, fill (ml
1.5 (0.15)
1.2 (0.12)
Flow Modulation Plate (Op
Number of discharge orifices
Discharge orifice diameter, in. (mm) 0.50 (12.7)
Nimhnr of air vents
Air vent diameter. In. (mm) 0.50 (13)
Inlet hole height can vary depending on the configuration of the hank. Optimum hole height is 70% of the minimum liquid level.
Riter area is defined as the total surface area of all individual Biotubese within the filter cartridge.
Flow area is defined as the total open area (or area of the mesh openings) of all the individual Biotubes within the filter cartridge.
taro-FT-FTS-1 Orenco Systemst Inc. , 814 Airway Ave., Sutherfn, OR 97479 USA • 800-348-9843 • 541-459-4449 • www.orenco.com
Rev. 3.0, ® 05/18
Page 2 of 2
o ZJ
q�gk'p�, ggito A'U&C-L4aM C�EjC RMb.
NOV 252025
Ciayfield Co.
F nring and Zoning Agency
Real Estate Bayfleld County Property Listing
Today's Date: 11/15/2025
.%. Description
Updated: 11/7/2013
Tax ID:
1937
PIN:
04-004.2-44-09-14-1 04-000-10000
Legacy PIN:
004110509000
Map ID:
Municipality:
(004) TOWN OF BARNES
STR:
S14 T44N R09W
Description:
SE NE IN V.1085 8.341616 (MICHAEL &
ANNS S HUSBY LIFE ESTATES)
Recorded Acres:
40.000
Calculated Acres:
37.638
Lottery Claims:
0
First Dollar:
Yes
Zoning:
(F-1) Forestry -1
ESN:
104
Tax Districts Updated: 3/15/2006
1
STATE
04
COUNTY
004
TOWN OF BARNES
041491
SCHL-DRUMMOND
001700
TECHNICAL COLLEGE
• Recorded Documents
93 QUIT CLAIM DEED
Date Recorded: 6/28/2012
O CONVERSION
Date Recorded: 3/15/2006
Updated: 7/13/2012
'g 5.7Gr_ 15G2 1085-341
460.166;608.217
j° Ownership
MICHAEL A & ANN HUSBY LE
KENNETH HUSBY
CARIBRAHMER
LYNN STARKEY
Property Status: Current
Created On: 3/15/2006 1:14:46 PM
Updated: 11/7/2013
MENOMONIE WI
MENOMONIE WI
MENOMONIE WI
MENOMONIE WI
BIIIIn9 Address:
Mailing Address:
MICHAEL A & ANN HUSBY
(LE) MICHAEL A & ANN HUSBY
ET AL
(LE) ET AL
E2642CTYRDP
E2642CTYRDP
MENOMONIE WI 54751
MENOMONIE WI 54751
i0 Site Address * indicates Private Road
49710 MULLIGAN CREEK RD BARNES 54873
� Property Assessment Updated 5/19/2025
2025 Assessment Detail
Code
Acres
Land
Imp.
G1 -RESIDENTIAL
1.000
55,000
115,500
G5 -UNDEVELOPED
6.190
1,000
0
G6 -PRODUCTIVE FOREST
32.810
44,300
0
2 -Year Comparison
2024
2025
Change
Land:
100,300
100,300
0.0%
Improved:
94,200
115,500
22.6%
Total:
194,500
215,800
11.0%
Eli Property History
N/A
to
SS- OO6`tS
Private Sewage System Maintenance Agreement
DOCUMENT NUMBER
2025R-6 10197
Owner(s) Name
//t M`r
DANIEL J. HEFFNER
Owner(s) Mailing Address
iz �t 2 OMQn is %l
REGISTER OF DEEDS
S/ BAYFIELD COUNTY. WI
Site Address
Q j� /p �y
�re2
RECORDED
p��"',`
Wi /�(/ u
12/05/2025 AT 11:05 AM
RECORDING FEE: $30.00
Tax ID # /,g . 7
7 /
PAGES: 1
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 the below listed location in accordance with rules established in the WI
-
Adm. Code, as from time to time amended. (COMPLETE Legaall is required)
cy
114 of 1/4 Section / '7 Township WV N. Range W.
SE IVE !N U. /69S p. 3tl-)6
Recording Area
Additional Legal Description: Lb
Return To:
Town of 8A V A10 (Acreage) g 0 Gov't Lot
Planning and Zoning Department
ENT�EqRED
Lot Block Subdivision
I j jS
Lot_CSM# Vol._ Page CSMDoc#
b
LW 081025
Ba
frIannLrI'J:...
In -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System:
❑ Mound ❑ At -grade Sewage System ❑ 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 one-third (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 pumped out when 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 Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance
with manufacturers specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code.
Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall 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 effluent from the system is ponding on the ground surface.
Mounds At -grade, and In -ground Pressure System Laterals (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.
Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfield County for
inspection, 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 caused by the system. Baytield 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 not pay the costs within thirty (30) days, the owner specifically agrees that all 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 be collected as provided by law.
The terms and conditions of the agreement shalt be binding upon and inure to the benefit of all current and future owners of such property.\\\\ittl Illlltttrrrrr/
Owner(s) Name(s)—Please Print
Subscribed and sworn to before me on this date:
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otarized Owner(s) — Signature(s)
Notary Public
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u/forms/sanitary/septicmaintenceagreement
Revised July 2020
AFIELD Bayfield County
Planning & Zoning Department
117 E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner: Submission Number:
HUSBY LE, MICHAEL A & ANN SR -00366
E2642 CTY RD P
MENOMONIE, WI 54751 Transaction Number:
SR-00366-38FC3
HUSBY,KENNETH
E2589 CO ROAD P
MENOMONIE, WI 54751
BRAHMER,CARI
E2333 COUNTY TRUNK P
MENOMONIE, WI 54751
STARKEY,LYNN
N4310 COUNTY TRUCK V
MENOMONIE, WI 54751
Description Amount
Certified Soil Tests - Review & Filing Fee $50.00
Total: $50.00
Payment Amount: $50.00
Reference: 3138
Paid by: Red's Septic Service & Repair, 41855 Namakagon River Rd, Cable WI 54821
Payment Type: Check
Transaction Date: 12/8/2025
Receipt of payment does not guarantee eligibility of
1E3-4YFIELD Bayfield County
Planning & Zoning Department
117 E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner:
Submission Number:
HUSBY LE, MICHAEL A & ANN
SS -00685
E2642 CTY RD P
MENOMONIE, WI 54751
Transaction Number:
HUSBY,KENNETH
SS -00685-38F82
E2589 CO ROAD P
MENOMONIE, WI 54751
BRAHMER,CARI
E2333 COUNTY TRUNK P
MENOMONIE, WI 54751
STARKEY,LYNN
N4310 COUNTY TRUCK V
MENOMONIE, WI 54751
Description Amount
Private Sewage System (Septic Tanks) $400.00
Total: $400.00
Payment Amount: $400.00
Reference: 3138
Paid by: Red's Septic Service & Repair, 41855 Namakagon River Rd, Cable WI 54821
Payment Type: Check
Transaction Date: 12/8/2025
Receipt of payment does not guarantee eligibility of
BAYFIELD COUNTY
SANITARY PERMIT (#04)-25-159S
STATE SANITARY PERMIT
OWNER: MICHAEL A & ANN HUSBY (LE) ET AL
G OV'T LOT: LOT: B LK:
CSM: V.1 085,P341 616
SE1/4 NE1/4 SEC:14,T44N,R9W
TOWNSHIP: Barnes
SOIL TEST: 150-25
REPLACEMENT SYSTEM
SYSTEM TYPE: Non -Pressurized In -Ground
PLUMBER: RYAN STRAND
TRACY POOLER DATE: 12/9/2008
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: # MP 798301
Condition: Properly Maintain System Per Recorded Agreement. Old System needs to be properly
abandoned per SPS 383.
THIS PERMIT EXPIRES 12/9/2010
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION