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HomeMy WebLinkAbout25-36SRequest for Sanitary Inspection (24 Hrs. in Advance) Fax this form to Zoning Dept (24 Hrs.) prior to when you want an inspection — (715) 373-0114 If you do not have a fax and must email the inspection; you must email all staff members. Plumber: Homeowner: Sanitary Permit #: Date: Time: Township: Address # & Road Name: or Directions Comments: Notes from Time Change El Di ,D .J R 6 ,-0 isnkIA4l ViELS L - 3b5 Plumber's Choice _3Q as — Plumber's I'I:OJ Zoning Dept Zoning Dept 5rv£ Lk I j Other Phone Number -7(5 'lL r`1� Fax Number Email Address C 7•J r'r:l'ICD I�•vhOt+�ct tcQ 7Mttl .C6M Immediate Phone Number So Zoning Dept can call you right back (if needed) Slhyt No Inspection(s) during this time Tuesday (9:30 am - 12:15 pm) (Tracy) RECEIVED Bayfield Co. Planning and Zoning Agency ** Plumbers you must verify any change(s) by fax or email ** u/farms/sanitary/requ astforinspection Zoning Dept (©4/12/04); © June 2023 Private Onste Wastewater Treatment Systems (POWTS) Inspection Report (Attach to Permit) PeI WILLIAM B & BONITA M FRELS Pei 8 BLACK LAKE RD ST PAUL MN 55127-6420 City setback to: Town County jp /L Sanitary ermit No: State Plan Transaction ID#: Parcel Tax No: 251/ TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Se tic 6 7622 3 N/A Dosing N/A Aeration N/A Holding Pump I Siphon Information Pump Manufacturer ump Model Demand Filter Manufacturer Filter Model GPM TDH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well Dispersal Cell Information DIMENSIONS Width Len th of Cells SETBACK FROM Pro . Line Bum lvwp/r Type of Cell Manufacturer: Model Number: Pretreatment Unit Dia Elevation Data STATION BS HI FS ELEV Benchmark 6C Bldg. Sewer p Tank Inlet 3', 5 94/3 Tank Outlet 5, Dose Tank Inlet Dose Tank Bottom Inst. Contour Header / Manifold Distribution Pipe Infiltrative Surface 7 0 Final Grade X Pressure X Hole Size Cell Center I Cell Edges I Topsoil ❑ Yes O No COMMENTS: (Include code discrepancies, persons present, etc.) p 4GE0U/ ot-s e 'Ian revision required? O Yes' No ( —��j� )se other side for additional informatiorril. I / 13o !2 J Date POWTS Inspector's Signature ❑ Yes O ❑ Yes ❑ No /237/3 License Number RRf..n71n /R n1/911 Property Owner BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zoning(a)bayfieldcountv.wi.gov 117 East Fifth Street Web Site: www.bavfieldcountv.wi.gov/147 Washburn, WI 54891 WILLIAM B & BONITA M FRELS Information 8 BLACK LAKE RD ST PAUL MN 55127-6420 As you know JOQfl /la'i'c''{ was contracted by you to install a private onsite wastewater treatment system on your property described as: Notes: Abandonment of Old System to meet all applicable code requirements: Tank was pumped by: Tank was crushed! removed and pipes disconnected by: on at AM/PM On % at ( M) the above -mentioned plumber contacted our office to conduct a pre -cover inspection as required under DSPS 383. One of the following applies: 7System 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: U/torms/sanitarypropertyowner-input AprJ 2019 I i,!.V 'v'M f S5-, Industry Services Division 4822 Madison Yards Way County B 1e�q i U j 11 W� a $ `. Madison, WI 53705 Sanitary Pe Number (to a filled in by Madison, WI 5302 5 S MAY 202025 Sanitary Permit Application State Transactg90Ito. Zoning Dept J In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary 57005 Blue Lake Rd purposes in accordance with the Privacy Law, s. 15.04(1)(m), stats. I. Application Information - Please Print All Information Property Owner's Name William and onita Frels Parcel #04-004-2-45-09-06-4-01-000-10000 Property Owner's Mailing Address 8 BlackBIkL�ke Rd Property Location Govt. Lot City, State Zip Code Phone Number St Paul MN 55127 NE'/., SE'/i, Section 6 T 45 N R 9 E or W II Type;ofBuildiog (check all that apply) Lot # C` -1 -or 2 Family Dwelling — Number ofBedrooms 2 Subdivision Name Block # ❑ Public/Commercial — Describe Use O City of ❑ State Owned — Describe Use O Village of CSM Number V 830 p. 619 956 il.Town of Barnes III. 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 applicable.) A. �Iew S stem y ❑ Replacement p System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B. ❑ Holding Tank In -Ground ❑ At -Grade El 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 IV. Dispersnv reatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required (st) Dispersal Area Proposed System Elevation 300 .7 428 (sf)446 92-96 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units o 'd New Tanks Existing Tanks Q.,Q v� v1 w C7 a Septic or Holding Tank 750 150 1 Wieser Dosing Chamber V. Responsibility Statement- I, the undersigned, assume respo ditty for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signa MP/MPRS Number Business Phone Number Dan Burch 253808 715.416.1642 Plumber's Address (Street, City, State, Zip Code) N5921 County Hwy K Spooner Wi 801 VLF County/Department Use Only I' Approved ❑ Disapproved $ermit Fee Date Issued ►Yb�Z gnature )q;o?L3 ❑ Owner Given Reason for Denial 2) 3 pZS Conditions of Approval/Reasons for Disapproval riuucu w wluplcic prnuD iur u1C JyswCm anu suumli to me l.uuniy only on paper not less man a 112 x 11 Inches in size SBD-6398 (R. 02/22) In4round Gravity Plan r J� Index Cover Sheet MAY 2 �J c01� Component Manual Design References: Bayfield Co. Zoning Dept. in -Ground Soil Absorption for POWTS Version 2.1 (May 2022.2027) Pg I 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: ncl suresq POWTS Application for Review Soil Evaluation Report & Site Map Project Name I Description Owner Name(s): 'I I MAC 4, 1A ! .E/ L( Phone: r .. ■/...IrrJ�rrrrrw/.rrrr rr.lArrrr�rr.rr+��r/wwi�.+r l/rl rrrwrw�wrrrr. .�/.Iiw..rl.wr./II Owner Address: 4 iL,s LK 3i u L !V Zip: 5 S"L.≥ -7 Irr�arr�rr.r. +rr..r r. r..r rri .r Project Address: c 7 z'c 6 ''i Govt. Lot: 1/4 of ' G /4, Section C , 7 -P�E [:1 or w Township: , �i. c County: A �ffi(,C i- 0 Irl-Irr rr r ■// .YI.W �/W�1.�/�.r�r�. IIr/.�r/1/.r�/ �rlr/P.�rtl.ill l.�.rwrl rr�/I.IrIA r. .I..rr//r lrr..lrrwrr.r.. Project Parcel ID #: owl Oo l u s oY 06Ifaf 1000.0 Designer Information Designer Name: Dan Burch Phone; 7.7155 .4� 1842 Designer Address: N5921 Cty Hwy _K Spooner WI Zip: 54801 E-mail! burchpiumbinginc©gmail.com This space reserved for approval stamp. License Number: 253808 Remarks: Signature: Date: f $ r� oiigInal si required on each submitted copy. IN -GROUND DOSED -GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) fiL!hr • • 12' min. &arch depth (typical) iPiwcal)) TYPICAL TRENCH CROSS SECTION VIEW (No Scale) .n System Elevation =______ ft (typical) Quick4 Standard -W w! End Cap (Show location of inlet ) outlet pipe connection on plan view.) (typical) �,t�fa n�t��sinwidt�+lit&/ B (typical) INSTALL PER TRENCH: C� Quick4 Std -W @20 f EISA/charnber= fit I- Pairs of end caps @ 6 ftr EISA/pair = ft� Provide minimum 3 ft separation between trenches. Observation Pipe (typ1ca9 Install per manufacturers / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) 1A = 3.0 It (typical) `—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturers insbuct ons. Proposed EISA per trench = V, ft= Required Infiltration Area = L4ft2 Distribution Method: 1 x trenches = Proposed Total EISA = �l l b ft= C) m Ca) O WLP 750- M R TANK SPECIFICATIONS DIMENSIONS: 4" CAST -A -SEAL TOP VIEW w < 8 c� w INLET En cV O 23" - SIDE VIEW WALL: 2 1/2" BOTTOM: 3" 4" CAST -A -SEAL COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 54" OUTSIDE DIAMETER: 7'-0" BELOW INLET: 42" LIQUID LEVEL 37" WEIGHT: BOTTOM 3,740 LBS. COVER 2,410 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 20.28 GAL/IN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 790 GALLONS LOADING DESIGN: 8'--0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON OUTLET NO CL . O O d PUMP PAD (TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: a w b a II 9" E • 0 0 m oo a w o o W 0 W�' C.7�co D z 0O0 W I aUJ a N o I Woo x 00 IT J a D I < N a Li SHEET NO. 1 V OF 1 PAGE 4 OF 4 In -ground Gravity Management PIa V IMPORTANT: MAY 2 u l U15 The owner of this in -ground gravity system shall be responsible for its perpetual operation and g a urL��to t requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. y , 1s� 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 = 300 gpd; BOD5 220 mgL"1; TSS ≤ 150 mgL''; FOG ≤ 30 mgL'' 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 1 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: Dan Burch Local government unit: Bayfield County Zoning Phone: 715.416.1642 Phone: 715-373-6138 Local government unit address: 117 E 5th StreetP.O. Box 58Washburn,. WI 54891 ZIP: 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. Private Sewage System Maintenance Agreement Owner(s) Name William B & Bonita M Frels Owner(s) Mailing Address 8 Black Lake Rd, St. Paul, MN 55127 Applied for 5/7/2025 Tax ID# 2511 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 Legal is required) 1/4 of 114 Section 06 Township 45 N. Range 09 W. Additional Legal Description: NE SE in V.830 P.619 956 Town of Barnes (Acreage) 40 Gov't Lot Lot Block Subdivision Lot CSM # Vol. 830 Page 619 CSM Doc # DOCUMENT NUMBER 2025R-607532 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, Wi RECORDED O5/2O/2O25 AT 1O:45 AM RECORDING FEE: $30.00 PAGES: 1 Area Return To: Planning and Zo i79ptnn� MAY I '1 2025 baylield uo. Zoning De ® 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 manufacturer's specifications. Fitter 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, POWrS 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 Bayfreld 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. Bayfield 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 maybe 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 bylaw. 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. Owner(s) Name(s) — Please Print n r f � t �e Subscribed and sworn to before me on this date: j 3� M� X25 HARGURSHARAN Notarized Owner(s) — Signatu (s) � y//%� � Ld Yc��� f'7' L2 Notary Publics NOTARY PUBLIC' MIN tl. , $cif :• : � ��{ MY COIAtASSiON EY.PtRES: My Commission pares: 0 t 3t ?e SINGH IESOTA N 312027 wwvw�n Drafted by: Carrie Bender Date: 5/5/2025 Proofed by: ufforms/sanitary/septicmaintenceagreement Revised July 2020 CHECK BOX AS APPLICABLE. SOIL EVALUATION SITE MAP 1 14. .1 wmmra PROJECT NAME:}if •,�A� I�vG LiC, 5yS/' \ 7.5' PROJECT ADDRESS; (5(,iaL� �•f SM Symbol: Y BM Elevation: ff I C FT BM Description: AJ�� Ali\b J:7� j Jl )aN�rtalR�c Slope Gradient(%) 3•/ Well Indicate north by of Tested Area: Symbol ('rfapplicable): ^dra.wiing an anew CHECK BOX AS APPLICABLE. SYSTEM PAGE 2 OF PLOT PLAN DESIGN FL0W:y 3 GPO Attach design flow calculations for commercial plans. Pipe Material / ASTM Sta ndard (T�ables 384.30-3 & 384.30-5) Sanitary Sewer. -5 �'c tIJ/ Force Main: / IMPORTANT: Show ground elevation contours at suitable intervals. "-------- yV Dt,°v i�/kaYf MAY 20'IU25 sus eyfield C': zoning Dept U EE& ?S� �( VJjt'r O v t l '- 5� XUU Industry Services Division 4822 Madison Yards Way County Be 1eI \ Madison, WI 53705 Sanitary Pen Number (to a Ile in by ___Madison P l\ �_ P.O. Box 7302 gi Madison, W15302 �S S MAY 202025 Sanitary Permit Application State Transactgb7ks�eto. Zoning Dept P_� In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used far secondary Blue Lake Rd purposes in accordance with the Privacy Law. s. 15.04(l)(m), Stats. 57005 I. Application Information — Please Print All Information PropertyOwner's Name William and onita Frels Parcel #04-004-2-05-09-06.4-01-000-10000 Property Owner's Mailing Address 8 Black Lake Rd Property Location Govt. Lot City, State I Zip Code Phone Number St Paul MN 55127 NE/., SE'/., Section 6 T 45 N R 9 E or W H. Type of Building (check all that apply) Lot # CI -For 2 Family Dwelling -Number of Bedrooms 2 Subdivision Name Block # ❑ Public/Commercial - Describe Use O City of O State Owned — Describe Use O Village of CSM Number V 830 p. 619 956 f .Town of Barnes Ill. 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. A. $-New System y ❑ Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B. ❑ Holding Tank r��y,ttL'-Ground pyL ❑ At -Grade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration IV. DispersalrTreatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (st) Dispersal Area Proposed System Elevation 300 .7 428 (sf)446 92-96 Capacity in Total ) of Manufacturer Tank Information Gallons Gallons Units 2 New Tanks Existing Tanks cU h & ko ii Septic or Holding Tank 750 50 1 Wieser x Dosing Chamber V. Responsibility Statement- I, the undersigned, assume respon ' tlity for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signal MP/MPRS Number Business Phone Number Dan Burch 253808 715.416.1642 Plumber's Address (Street, City, State, Zip Code) N5921 County Hwy K Spooner WI 801 VI. County/Department Use Only Approved O Disapproved ❑ Owner Given Reason for Denial Permit Fee $ 4/CZ) ^ Date Issued �� 3 pv�j gnoture )q;-.:3 ?L3 Conditions of Approval/Reasons for Disapproval nnaeh to complete plans for the system and submit to the County only on paper not less than 8 '/2x 11 inches in sae SBD-6398 (R. 02/22) '. SR-0OZ i El �.S °Yx . Wisconsin Department of Safety and Professional Services rr�� jj Page of 4om �' Division of Industry Services MAY 2 . u2025 y papa SOIL EVALUATION REPORT '� In accordance with SPS 385, Wis. Adm. Code Bayfield Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. / scale or dimensions, north arrow, and location and distance to nearest road. 04-004-2-45-09-06-4-01-000-10000 Please print all information. Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). �3 I3,�0" Property Owner Property Location ❑ 0 William and Bonita Frels Govt. Lot NE ¼ SE ' 1i. S 6 T 45 N R 19 E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: 8 Black Lake Rd 57005 Blue Lake Rd City State I Zip Code I Phone Number ❑ City ❑ Village 0 Town Nearest Road St Paul I MN 155127 Ir Barnes I Blue Lake Rd J New Construction Use• esidential/Numberof bedrooms L TiReplacement U Public or commercial — Describe: Parent material Glacial OUtwaSh General comments and recommendations: Code derived designflow rate 300 GPD Flood Plan elevation if applicable ft. 11 Boring # ❑Boring 96.5 96 88.5 Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Snil Annficatenn 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 0-6 1 Oyr 3/2 Is 0sg ml ca If .7 1.6 2 7-36 7.5yr 4/6 s Osg ml cw .7 1.6 3 37-96 7.5yr 4/4 s 0sg ml .7 1.6 Boring # ❑Boring 98 1 02 89.5 ]Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Snil Annllrafinn Rafa 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 0-6 10yr 3/2 Is 0sg ml ca 1f .7 1.6 2 7-38 7.5yr 4/6 s 0sg ml cw .7 1.6 3 39-102 7.5yr 4/4 s 0sg ml .7 1.6 CST Name (Please Print) Signature CST Number Dan Burch 253808 Address Date Evaluation Conducted Telephone Number N5921 County Hwy K Spooner WI 54801 5-14-25 715.416.1642 * Effluent #1 = BOD > 30 ≤ 220 mg/L and TSS > 30 ≤ 150 mg/L * Effluent #2 = BOD, ≤ 30 mg/L and TSS ≤ 30 mg/L SBD-8330 (R04/21) • Page of , ❑ 6.5 II 96 • Boring $$,rj a Boring # (!]Pit Ground surface elev. ft. Depth miting factor in., elev. ft. MAY UL5 I Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Si. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 1 0-6 10yr 3/2 Is Osg ml ca 1f .7 1.6 2 7-35 7.5yr 4/6 s Osg ml cw .7 1.6 3 36-96 7.5yr 4/4 s 0sg ml .7 1.6 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. 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 Boring # ❑ Boring O Pit Ground surface elev. ft. Depth to limiting factor in. l elev. ft. nil Annlitinn D f 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 ≤ 220 mg/L and TSS > 30 ≤ 150 mg/L * Effluent #2 = BOD, ≤ 30 mg/L and TSS 5 30 mg/L CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. SOIL EVALUATION Scale: 1" = 30' [;Q -SYSTEM PAGE 2 OF 0 30 45 60 SITE MAP PLOT PLAN PROJECT NAME: s DESIGN FLOW: ' O D GPD -7.5. . Attach design flow calculations for commercial plans. PROJECT ADDRESS: 431.1....'C,_ 4 Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) N Sanitary Sewer: C& faI PbJ � BM Symbol: 4 BM Elevation: ! t! L/ FT Force Main: BM Description: !-- '3 3 indicate north by IMPORTANT: Slope Gradient (%) Well Symbol (if applicable): 0 drawing an arrow Show ground elevation contours at suitable intervals. of Tested Area: on the a gl5prite line. el l� aoo -1 liii MAY 2C1ZUZ5 Bayfield Co. Zoning Dept IdE 7c Ma VtL� In -Ground Gravity Plan ��D4 Index & Cover Sheet MAY 201015 Component Manual Design References: Bayfleld Co. Zoning Dept. In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 7 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: POWTS Application for Review Soil Evaluation Report & Site Map Project Name I Description Owner Name(s): l.J sit/AM- . 6L rA �4E L( Phone: - OwnerAddress: 8 7 - cK LAKE go § &VL- I1, Zip: 5S1J -7 Project Address: S % o'C 6 c�"a L4,ce iL9 Govt. Lot: C 1/4 of S G 1/4, Section , T 4 S-R'E Qor W Township: 3 A rt,NCS County: 13 A Cr C L p Project Parcel ID #: ©'-t oo i ,a uS o9 ol- y /0300 Designer Information Designer Name: Dan Burch Designer Address: N5921 Cty Hwy K Spooner WI Zip: 54801 E-mail: burchplumbinginc@gmaii.com This space reserved for approval stamp. License Number: 253808 Phone:715 -416 -1642 Remarks: Signature: �✓ Date: > f 8 Original sliature required on each submitted copy. 0 a C 6 U a C C o IN -GROUND DOSED -GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) i�t i TYPICAL TRENCH SOIL COVER CROSS SECTION VIEW 12 min. trench (No Scale) depth (typical) Y•. • d ' 4. •.• • a a / Provide minimum 3 ft (9 separation between trenches. System Elevation = R (typical) Quick4 Standard -W WI End Cap Show location of Inlet / outlet pipe connection on plan view.) INSTALL PER TRENCH: 4 t4 Cr Quick4 Std -W @ 20 ff EISA/chanter = + Pairs of end caps @ 6 ft EISA/pair= if' Proposed EISA per trench = observation Pipe (typiceO Install per manufacturels / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) IA=3.0ft (typical) '—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufaclurer's insbudions. Required Infiltration Area = ft2 X. trenches = Proposed Total EISA = , Distribution Method: c) ITt W O Cl WLP750-MR TANK SPECIFICATIONS DIMENSIONS: WALL- 2 1/2" BOTTOM: 3" 4" CAST -A -SF O W a w cc INLET N a �a 272• ______ i7 CAST -A -SEAL COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 54" OUTSIDE DIAMETER: 7'-0" BELOW INLET: 42" LIQUID LEVEL: 37" WEIGHT: BOTTOM 3,740 LBS. COVER 2,410 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 20.28 GAL/IN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 790 GALLONS OUTLET 0 U a: �a v JMP PAD MEET OR EXCEED ASTM C-1227 REQUIREMENTS LOADING DESIGN: 8'-0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE D BY DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: w a 0 tsJ J z N U 0 3 w OF /�I PAGE 4 OF 4 In -ground Gravity Management Plar3) IMPORTANT: MAY 2_U 2025 The owner of this in -ground gravity system shall be responsible for its perpetual operation and i e c ursu nt to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin�g�I 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 = 300 gpd; BOD5 5 220 mgL'; TSS 5150 mgL; FOG 530 mgL' 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 Zoni Dan Burch Local government unit address: 117 E 5th StreetP.O. Box 58Washburn, WI 54891 Phone: 715.416.1642 Phone: 715-373-6138 ZIP: 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. Private Sewage System Maintenance Agreement Owner(s) Name William B & Bonita M Frels 8 Black Lake Rd, St. Paul, MN 55127 for 5/7/2025 2511 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 Legal Is required) 1/4 of 114 Section 06 Township 45 N. Range 09 w Additional Legal Description: NE SE in V.830 P.619956 Town of Barnes (Acreage) 40 Gov't Lot Lot _ Block Subdivision Lot_CSM#_ Vol. 830 Page 619 CSM Doc# DOCUMENT NUMBER 2O25R-6O7532 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED 05/20/2025 AT 10:45 AM RECORDING FEE: $30.00 PAGES: 1 Return To: Planning and Area L�plyl5ntVE D MAY 212025 uaytiela uc. tonlny D t In -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Seotic 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. Puma 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. Seotic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specifications. Fitter maintenance reports shall be submitted to the County as required by SPS 383.55, Wiis. 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, POWrS 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 -around 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 Bayheld 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. Bayfleld 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 shall be binding upon and inure to the benefit of all current and future owners of such property. Owner(s) Name(s) — Please Print Se) nf 14'` r Subscribed and swam to before me on this date: 13 rMi 25 •�,J ' 1nU.)O`" HARGURSHARAN Notarized Owner(s) — Signatus) f' �I jNG[Q/Cr,/^1L/� L.t1�`c�`-`its' �" Notary Public ��1N.YµR + NOTARY PUBLICMIN COME SSIGN E/RIREB'. My Commission xpires: O1 31 Drafted by: Carrie Bender / Date: 5/5/2025 SINGH IESOTA 212021 Proofed by: u/forms/sanitary/septicmaintenceagreement Revised July 2020 BAYFIELD COUNTY SANITARY PERMIT (#04)-25-36S STATE SANITARY PERMIT OWNER: WILLIAM B & BONITA M FRELS G OV'T LOT: LOT: B LK: NE1/4 SE1/4 SEC:6,T45N,R9W TOWNSHIP: Barnes SOIL TEST: 34-25 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: DAN BURCH TRACY POOLER DATE: 6/3/2025 Authorized Issuing Officer CHAPTER 145.135(2) WISCONSIN STATUTES a. The purpose of the sanitary permit is to allow Installation of the private sewage system described in the permit. b. The approval of the sanitary permit is based on regulations in force on the date of approval. c. The sanitary permit is valid and may be renewed for specified period. d. Changed regulations will not impair the validity of a sanitary permit. e. Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may Impede renewal. f. The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #: LICENSE: # 253808 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 6/3/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION