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HomeMy WebLinkAbout26-1Sarm', 4I Department of Safety County Bay field Professional Services, i Sanitary Permit Number (to be filled in by Co.) 61 Industry Services Division by Q b _1�y 7-1s J Sanitary Permit Application 16 State saaction Number �`� a I� In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the approp ental unit S `--� Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned PO 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(I)(m), Stats. 65726 Raspotnik Rd, Mason, WI 54856 1. Application Information — Please Print All Information Property Owner's Name Parcel # Latitude 46 LLC 15996 Property Owner's Mailing Address Property Location 28975 St Hwy 137 Govt. Lot City, State I Zip Code Phone Number Ashland, WI 54806 414-416-4157 SW /., NE 'A, Section 30 T 47 N R 05 E o II. Type of Building (check all that apply) Lot N ® I or 2 Family Dwelling— Number of Bedrooms___ 3 Subdivision Name Block d ❑ Public/Commercial — Describe Use ❑ City of ❑ State Owned — Describe Use 0 Village of CSM Number S Town of Eileen 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 a licable. A. New System y Replacement System ❑ p y ❑ Other Modification to Existing System (explain) 0 Additional Pretreatment Unit (explain) ❑Holdin Tank g ❑ In -Ground ❑ A4Grade Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C. ❑ Renewal Before 0 Revision ❑ Change of Plumber ❑ Transfer to New Owner List Previous Permit Number and Date Issued Expiration IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (st) I Dispersal Area Proposed (sf) I System Elevation 450 1.0 450 450 100.28 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units 1, o c, New Tanks Existing Tanks d y 0,0 r,s ,n m iZ O Septic arllolding Track 1250/ 2000 1 Weiser Concrete 121 ❑ Dosing Chamber 750 V. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) s bet's Signal _ MP/MFRS Number Business Phone Number Dean Blakeman 1092768 715-682-6050 Plumber's Address (Street. City, State, Zip Code) 44941 State Hwy 13, Ashland, WI 54806 VI, County/Department Use Only Approved 0 Disapproved Permit Fee Date Issued rA Issui Ae, ❑ Owner Given Reason for Denial $ 5L I,gpnaytJyyt• Conditions of Approval/Reasons for Disapproval REcEI ED Q�I� DEC 16 2025 Bayfleld Co. Planning and Zoning Agency Attach to complete plans for the system and submit to the County only on paper not less than 8 in x II inches in size SBD-6398 (IL 03/22) Wisconsin Department of Safely and Professional Services Division of Industry Services 4822 Madison Yards Way Madison, WI 53705 December II, 2025 CUST ID NO.: 1092768 DEAN BLAKEMAN 44941 STATE HIGHWAY 13 ASHLAND, WI 54806 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/11/2027 MUNICIPALITY: TOWN OF EILEEN BAYFIELD COUNTY SITE: LATITUDE 46 LLC 3BR MOUND 65726 RASPOTNIK RD MASON, WI 54856 SW NE S30-T47N-R05W FOR: Design Wastewater Flow Value: 450 Bedrooms: 3 Limiting Factor(s): 11 Inches Maintenance Required: Effluent Filter Phone: 608-266-2112 Web: htto://dsos.wi.gov Email: dspsar wisconsin.gov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-12250281 1-C Application No.: DIS-122550311 Site ID No.: SIT -154163 Please refer to all identification numbers in each correspondence with the Department CONDITIONALLY APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES eldehxmvn, 12/1112025 SEE CORRESPONDENT Mound Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If I s, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. Re IYYED • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 DEC 1 6 2025 • Insulate building sewer beyond 30 feet per SPS 382.30(1 l)(c) • Well setbacks to meet chs. NR 811 & 812 Bayfleld Co. Planning and Zoning Agency • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code & SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 / / Refund Expected: $0.00 Heidi Eide Division of Industry Services Phone: Email: heidi.eide@wisconsin.gov 0tU 16 2025 Bayfeld Co. Planning and Zoning Agency RECEIVED JUN 16 2023 t =— ddf ED Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of Division of Safety and Buildings in accordance with Comm 85, Ws. Mm. Code County BAYFIELD Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 15996 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by �Date Personal Information you provide may be used for secondary purposes (Privacy Lew, S. 15.04(1) (m)). IY^ S , In - ')I -72, LATITUDE 46 LLC I Govt. Lot SW 1/4 NE 1/4 S 30 T 47 N R 5DEl E (or) W Property Owner's Mailing Address Lot # I Block # I Subd. Name or CSNW 1 28975 ST HWY 137 ASHLAND I WI 1 54806 1 ( 414) 4164157 New Construction Use[I Residential / Number of bedrooms 3 Code derived design flow rate_ © Replacement O Public or commercial - Describe: Parent material TILL Flood Plain elevation if applicable General comments HOLDING TANK OR MOUND and recommendations: SYSTEM ELEVATION AT 100.08 ON 98.0 CONTOUR DESIGN LOAD RATE =.4 GPD/SQ. FT. TREES TO BE REMOVED STUMPS LEFT IN PLACE 1❑ Boring # 0 Boring El Pit Ground surface elev. 98.2 ft. Depth to limiting factor I t in. Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots eon RpPlicauon Rate GPDHF •Eff#1 •Eff#2 1 0-5 5YR3/2 SIL 3MGR DS CW 3M .6 .8 2 5-11 5YR4/4 SICL 2FSBK DSH CW 3C .4 .6 3 11-13 5YR4/4 CIF5YR5/8 SICL 2FSBK DSH CW 3C .4 .6 4 13-17 SYR4/4 SICL 2FSBK DSH CW 2M .4 .6 5 17-24 5YR4/4 SIC 2CABK DSH - 2F .2 .3 n Nearest Road RASPOTNIK GPD tECE DEC 16 2 25 BayAeld Co. Planning and Zoning Agency 2 Boring# L I Boring 98.2 12 Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots boll F.pplication Rate GPDif 'Eff#1 *Eff#2 1 0-5 5YR3/2 SIL 3MGR DS CW 3M .6 .8 2 5-12 5YR4/4 SIL 2FSBK DSH CW 3C .6 .8 3 12-14 5YR4/4 CIFSYR5/s SIL 2FSBK DSH CW 3C .6 .8 4 14-20 5YR4/4 SICL 2MSBK DSH - 2M .4 .6 _....._...... - ...—.. ,,,.yu a„u , ao -.w _ IOU mg0L • tmuent #z = BOD c 30 mgfl and TSS c 30 mg(L CST Name (Please Print) Signature ---/ re'r M...i.... 64903 CHARLES JOHNSON ROAD ASHLAND, WI 54806 06/09/2023 715-209-2569 �'d 5D 's 6-aJ-�,.G Property Owner LATITUDE 46 LLC Boring ❑ Boring# El pit Ground surface elev. 96.8 ft. Depth to limiting factor 12 in. Horizon Depth in. Dominant Color Munsell Redox Description Qu, Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fF *Eff#1 *Eff#2 1 0-5 5YR3/2 SIL 3MGR DS CW 3M .6 .8 2 5-12 5YR4/4 SIL 2FSBK DSH CW 3C .6 .8 3 12-14 SYR4/4 CIF5YR5/8 SIL 2FSBK DSH CW 3C .6 .8 4 14-20 5YR4/4 SILL 2MSBK DSH - 2M .4 .6 ❑ Boring #JJ Boring pit Ground surface elev. ft. Depth to limiting factor in, Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots PWIJIJL.dtIUII r dle GPD/fF •Eff#1 *Eff#2 ❑ Boring # Q Boring Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots nuanuu roam GPD/ff •Eff#1 'Eff#2 Parcel ID# 15996 Page 2 of 3 Effluent #1 = BOD, > 30 5 220 mg/L and TSS >30 5150 mg/L * Effluent #2 = BOD5 c 30 mg/L and TSS 5 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to accflOVrED need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD433Rrcn(R0)ro0) DEC 16 2025 Bayfield Co. Planning and Zoning Agency fJo .fl/ Pco P. Gzi✓c LTLI�cA� 5o LLC S4a/ili c3 C°/7/v, 5-A/ 4/N oLf €zN, 1374yact11 O/ A-iSW - //nt //" O -Boo'€ G-2autuD .L,✓ Qzj3floav h /fl9PU Ccca/ loo, 7 708'y8 �\ 2 ,vo %z± /i-7 TZS rte . I! �O0hu 9 ` R Pos 1. fan4c loo c 9rex 96.1 Rr ✓'�� ,a 313 RECEIVED DEC 16 2025 Bayfleld Co. Planning and Zoning Agency CONDITIONALLY APPROVED PAGE 1 OF 6 DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Mound Plan Index & Cover Sheet N CORRESP NDEN SEE CORRESPOIIDENCE Component Manual Design References: Mound Version 2.1 (May 2022-2027) & Pressure Distribution Version 2.1 (May 2022-2027) Pg 1 of 6 Index & Cover Page Pg 2 of 6 Plot Plan Pg 3 of 6 Mound Cross -Section & Plan View Pg 4 of 6 Distribution Network Specifications Pg 5 of 6 Pump Tank Specifications Pg 6 of 6 Management Plan Pump Curve POWTS Application for Review Tank Specs Soil Evaluation Report & Site Map Filter Switch & Alarm Specs Project Name / Description Latitude 46 LLC 3BR Mound Owner Name(s): Latitude 46 LLC Owner Address: 28975 St Hwy 137, Ashland, WI Zip: 54806 Project Address: 65726 Raspotnik Rd, Mason, WI 54856 Phone: 414 -416 -4157 Govt. Lot: SW Township: Eileen Project Parcel ID #: 15996 1/4 of NE 1/4, Section30 1 T47 N -R 05 E❑or WH county: Bayfield Designer Information Designer Name: Dean Blakeman Phone: 715 Designer Address: 44941 State Hwy 13, Ashland, WI Zip54806 E-mail: dean@blakemanplumbing.com License Number: 1092768 Remarks: Signature: •r- • -685 -6050 This space reserved for approval stamp. RECEIVEb DEC 16 2025 Bayfizld Co. Planning and Zoning Agency Date: 12 /O2 ( 2o2S Original signature required on each submitted copy. CHECK BOX AS APPLICABLE. ❑ SOIL EVALUATION SITE MAP PROJECT NAME: Latitude 46 LLC 3BR Mound CHECK BOX AS APPLICASI.E. Scale: 1"=40' HSYSTEM PAGE 2 OF6 o 40 60 80 PLOT PLAN (10 If grid) DESIGN FLOW: 450 GPO Attach design flow calculations for commercial plans. PROJECT ADDRESS: 65726 Raspotnik Rd, Mason, WI 54856 N Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) 4" BM Symbol: BM Elevation: 100 FT Sanry Sewer: ' / Force 1.5SCH 40 Main: / BM Description: Nall 11" above ground in Maple Tree p Indicate north by Slope Gradient(%) of Tested Area: 50/ Well Symbol (if applicable): 0 drawing an anew on the approprlte line. N Lot Line 200to N lot line IMPORTANT: Show ground elevation contours at suitable intervals. wczl.]a.. hill 96.1 Z1 n o 96.8 0 2 jProPosedound 7.3 5b/o Slope 98 w 98.2 98.5 x 4 99.1 1.5" SCH40 Force Main Proposed 1250/750 Weiser Tank / —15' of4" 3034 pipe Qi Proposed Well Location Proposed Over 1100' to E lot line 3 Bedroom Home (line not to scale) 1 (Fine tow lot cane (line not to scale) \\// Over 1000' to S lot line RECEIVED — (line not to scale) Ii DEC 16 2025 Planning and Zoning AC' I. SINGLE -CELL MOUND DISPERSAL AREA 0.5" TO 2.5" WASHED AGGREGATE (min. 6.0" beneath distribution pipe - min.2.0"fllll'-itfflMIN. over distribution pipe and covered with ui 6.0" OF TOPSOIL COVER o= 2.083 ft E = 2.383 ft approved synthetic fabric) min. 1.0 ft System Elevation = 100.28 ft ,.: ASTM C-33 SAND FILL min. 0.5 ft Lateral Invert Elevation = 100.78 it CROSS SECTION VIEW f� A = 6.00 ft -I (No Scale) Plowed Surface Surface Contour 5% % Slope Elevation = 98.20 ft W = 27.75 ft 'c s i c a n t on tnC (Show force main, manifold, and flush valve locations on plan view.) 1.25 "0 Schdl 40 PVC Lateral (typical) r— ------------- 0 L --------------------_B = 75.00 ft Bend as necessary to follow contour DOWNSLOPE TOE L= 99.00 it PLAN VIEW (No Scale) t j= 8.75 ft 7.50 ft (typical) Prohibit disturbance and vehicular traffic within 15 feet of downslope toe. Reset Page Ohsarvation � PI - (typical) I 1= 13.00 ft K= 12.00 ft (typical) D G) m W O m rn 3 DISTRIBUTION NETWORK SPECIFICATIONS (No Scale) FLUSH VALVE DETAIL (No Scale) Orifice in — — Valve Box Center of Threaded Cap (insulation optional) for Head Testing N. (optional) � \ Ball Valve I \ (optional) / \ Lateral Spacing 3.00 ft Shield orifices for gravelless applications ( Lateral Length (P) = 36.80 ft (riser pipes optional) 1.25 "0 Schd140 PVC Manifold , 1.5 "0 Schd140 PVC Force Main (slope to pump tank r- for drain -back) irst Orifice (typical) Laterals to be level Schdl 40 PVC Lateral 0 = 1.25 in (typical) Number of Orifices per Lateral = 12 Orifices equally spaced: [check a) OR b) below) — \_ a) 0 along bottom of lateral Orifices equally spaced Flush Valve along bottom of lateral b) C along top of lateral Assembly with every th hole (typical - see detail) \, facing down Last Orifice (typical) Orifice Spacing (X) = 38.40 in LATERAL INVERT ELEVATION = 100.78 ft (typical) (typical) OBSERVATION PIPE DETAIL (No Scale) Screw -Type or WW • Finished Grade y• Slip Cap (loose) W (mulched & seeded) 40 PVC Pipe Topsoil Cover Top of pipe to terminate •s (min. 1 foot) at or above finished grade 114-1/2" X 6" Slots @90 apart Anchoring Device Infiltration M Surface Orifice Diameter = .156 in Orifice Discharge Rate = .54 gpm Number of Laterals = 4 Lateral Discharge Rate = 6.48 gpm TOTAL DISCHARGE RATE = 25.92 GPM (typical) First Orifice (typical) x END MANIFOLD (typical) CONNECTION Check applicable box. Manifold (riser pipe optional) (typical) First (typical) > O I II m I-- x--�—x 2 x)2—�^x -� .t, (typical) (typical) Manifold CENTER MANIFOLD m (riser pipe optional) CONNECTION rn PAGE 5 OF 6 SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 40 Vent Pipe >10 ft from Building 12" Min. or 2.0 ft above Established Flood Elevation (typical) IMPORTANT: Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) Finished Grade CAPACITIES @ 16.12 galftn c. 4 Depth (in) Volume (gal) A 30.5 491.66 B 2.0 32.24 [Cl 3.5 56.42 D 12.00 193.44 *Pump Tank Liquid Level = 48.00 in Force Main Diameter = 1.5 in Force Main Length = 80.00 ft Force Main Void Volume = 7.36 gal Electrical must comply with SPS 316 end NEC 300 �Extend manhole riser as necessary. J]Weatherroof (•Junction Box Approved Locking Manhole with Warning Label Attached (typical) 4" Min. or 2.0 ft above Established Flood Elevation (typical) Seal TrtT Ouick Disconnect ( Min) (tyNPi�q *T T Weep Hole IjA Alarm B 6 —On l [j, Pump IT _off O Concrete Black 3" Approved Bedding Material Beneath Tank [C] Total Dose Volume (TDV) = 56.42 gal/dose L(5X total lateral void volume 5TDV s0.2X design flow) + (force main drainback volume) MIN. PUMP DISCHARGE RATE = 25.92 gpm PUMP TANK: Volume = 750 gal Manufacturer: Weiser Concrete Pump Manufacturer: Gould Pump Model: EP04 (See attached pump curve.) Controls/Alarm Manufacturer: SJE Rhombus Controls/Alarm Model: PSP2 WI PED Float switches containing mercury are prohibited. "--Approved Joints with Approved Pipe 3 R onto Solid Ground (typical) PUMP -OFF ELEVATION = 95.75 ft INSIDE BOTTOM ELEVATION = 94.75 ft Vertical Head = 5.03 ft + Min. Supply Head = 3.5 ft + FM Friction Loss = 4.80 ft + Fitting Loss* = 1.05 ft *(min. supply head x 0.3) = TOTAL DYNAMIC HEAD = 14.38 ft RtCyy SEPTIC TANK(S): Total Volume = 1250 gal DEC yy�fi16 2025 Manufacturer(s): Weiser O icier dzon;°' Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: Polylok Filter Model: PL -122 PAGE 6 OF 6 Mound Management Plan IMPORTANT: The owner of this mound 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 5 220 mgL"'; TSS 5 150 mgL-'; FOG 5 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 / 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 (i.e., pump re -cycling, float switch settings, etc.) o electrical components (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. o Distribution laterals shall be flushed once every 3 years or when necessary. 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 Administration Phone: 715-373-6138 Local government unit address: 117 E 5th St, Washburn, WI ZIP: 54891 Blakeman Plumbing & Heating, Inc. Phone: 715-682-6050 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 mound dispersal component Q0E'VED re -constructed within the originally approved area after removal of all failed components. System Abandonment DEC 14 2025 If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Adr jp. Cotenek Co. Planning and Zorasygg.r,�y. ITT PERFORMANCE RATINGS COMPONENTS Total Head (ft. of water) Gallons Per Minute EP04 EPOS 5 53 — 10 46 62 15 36 55 20 21 46 25 0 33 30 — 11 r.lcrcn5 ccrr 10 9 8 b 7 U 5 Q 4 0 B Item No. Description 1 Impeller 2 Base 3 Pump Casing 4 Mechanical Seal 5 Ball Bearings 6 0 -Rings 7 Power Cord 8 Oil Filled Motor 9 Motor Housing) Stator Assembly 10 Motor Cover 10 8 h 9 5 4 3 1 GOULDS PUMPS Wastewater rw_ •-_� I _ 0 10 0 2 4 20 30 40 6 8 CAPACITY 50 GPM 10 12 m'/h RECEIVED DEC 1 b 2025 Bayfield Co. Planning and Zoning Agency r ITT Goulds Pumps Wastewater EP04 & EP05 Series Model 3871 Submersible Effluent Pumps MGOULDS PUMPS Goulds Pumps is a brand of ITT Residential and Commercial Water. www.goulds.com Engineered for life FEATURES ■ EP04 Impeller: Thermoplastic semi -open design with pump out vanes for mechan- ical seal protection. ■ EP05 Impeller: Thermoplastic enclosed design for improved performance. ■ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. • Motor Housing: Cast iron for efficient heat transfer, strength, and durability. • Motor Cover: Thermoplastic cover with integral handle and float switch attach- ment points. ■ Power Cable: Severe duty rated oil and water resistant. ■ Bearings: Upper and lower heavy duty ball bearing construction. RECEIVED DEC 16 2025 BayfieId Co. Planning and Zoning Agency TOP VIEW W1250/750 -MR TANK SPECIFICATIONS DIMENSIONS: WALL 2 1/2" BOTTOM: 3" COVER: 6" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 66" O.D. LENGTH: 155" O.D. WIDTH: 86" O.D. BELOW INLET: 53" O.D. LIQUID LEVEL 48" 4" CAST -A -SEAL WEIGHT: 14,860 LBS. SEPTIC INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET, CAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.66 GALAN (SEPTIC) 16.12 GAL,'IN (PUMP) LOADING DESIGN: 8' 0" UNSATURATED SOIL TANK CAN BE USED AS: Inc 4" VENT SEPTIC/SEPTIC, SEPTIC/PUMP OR INLET SEPTIC/SIPHON COVER: MIX DESIGN #8 NO ( FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) _ OUTLET CUSTOMIZED TANKS: .II1J _________ FOR CUSTOM TANKS CONTACT WIESER CONCRETE 2ra I. I I I:I TJ PUMP PAD DRAWINGS SUBMITTED C 71 SIDE VIEW FOR APPROVAL P3 E'1I APPROVED BY: n _ -� APPROVAL DATE: ,GI11KS,ARE allFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS PRODUCTS NEEDED BY: SHEET NO. O F/ P3LL 441 Inc Innovations in Precast Drainage " Zabel & Wastewater Products A Division of Polylok Inc. PL -122 Effluent Filter PL -122 Filter The PL -122 was the original Polylok filter. It was the first filter on the market with an automatic shut-off ball installed with every filter. When the filter is removed for regular servicing, the ball will float up and prevent any solids from leaving the tank. Our patented design cannot be duplicated. Features: • Offers 122 linear feet of 1/16" filter slots, which significantly extends time between cleaning. • Has a flow control ball that shuts off the flow of effluent when the filter is removed for cleaning. • Has its own gas deflector ball which deflects solids away. • Installs easily in new tanks, or retrofits in existing systems. • Comes complete with its own housing. No gluing of tees or pipe, no extra parts to buy. • Has a modular design, allowing for increased filtration. PL -122 Installation: Ideal for residential waste flows up to 3,000 gallons per day (GPD). Easily installs in any new or existing 4" outlet tee. 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the outlet pipe, or use a Polylok Extend & Lok if not enough pipe exists. 4. Insert the PL -122 filter into tee. 5. Replace and secure the septic tank cover. PL -122 Maintenance: The PL -122 Effluent Filter will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. 1. Do not use plumbing when filter is removed. 2. Pull PL -122 cartridge out of the tee. 3. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 4. Insert filter back into tee/housing. Polylok offers the only fitter on the market where you can get more GPD by simply snapping our filters together! Patent Numbers 6,015,488 & 5,871,640 Filter Ready Adapter Connects to Septic Tank Wall cepts 1/2" PVC tension Handle Alarm Switch (Optional) 122 Linear Ft. of 1/16" Filtration Slots Iter Housing with ' & 4" Pipe Adapter Filtration Slots 3,000 GPD NSF RECEIVED Deflector ��(� ,matic Shut-Ott`Ba116 2025 Bayfield Co. Planning and Zoning Agency Outdoor SmartFilter® Alarm Polylok Zabel & Best filters accept the SmartFilter® switch and alarm. www.polylok.com 1-877-765-9565 Description of Operation IILIzhwARN1NGzhI The DoubleMax"' pump switch provides maximum accuracy when pumping water or sewage. The DoubleMaxmt includes two mechanical floats that are combined with a relay. On liquid rise, when both floats are up, the relay will activate and pump down to the lower float (reverse order for pump up applications). Features 2" - 60" Pumping Range Flexible SJOOW (UL, GSA), water resistant, rubber (CPE) cable 15 Full Load Amps High Impact PVC Housing Operating Temperature 0.140 F Float Housing 3.25" D x 4.55" L Installation 1. Determine the pumping range (FIg. 1 and Fig. 2). 2. Tighten the Relay Box on the discharge pipe at desired location, see Figure 1 for levels, 3. Tether the bottom float at 3", tighten the clamp on the discharge pipe. 4. Secure excess cable from float operation. 5. Plug the piggy back into the receptacle, then plug the pump into the back of the piggy back. For bare lead models, see Figures 3, 4 and 5 for wiring diagrams. 6. Cycle system to ensure proper operation. Pump Down Model - Pump Activates on Upper Float Pump Up-Model---Purrp's'tctivates-on-Lower.-loat - _ ..__ .-- Pump Up STOP PUMP RANGE 2' to 60" (START) Note: To achieve minimum pump range the bottom float must be mounted as high as possible and clamped on the back side of pipe (Fig. 2) rather than "front side" as shown (Fig. 1). wiring (Fig. 3) - Hard Wire Installation with Bare Leads or Piggy Back Plug Removed KLuW G N Lt WIRE USING POWERSOURCE JUNCTION BOX LACK ....WHITE.._..... . G RED PUMP G T2 T1 (Fig. 2) ECE VED urC 162025 pplIy� r�I B�aMyfield Co. Note: To achieve minimum pump range the bott6r�i"tlagarmLke�g Agency mounted as high as possible and clamped on the back side of pipe as shown above (Fig. 2). (Fig. 4) - Bare Leads by Removing Piggy Back Plug (DoubleMax" must be 230VAC model) ' G L2 L1 WIRE USING POWER SOURCE JUNCTION BOX BLACK —'WHREIRED- G RED PUMP G T2T1 (Fig. 5) - Factory Ordered with Bare Leads 230 VAC L�1% ' rl,Jr�,Jr�a� Alderon Industries • PO Box 821 Hawley, MN 56549 • P: 218-483-3034 • F: 218-483-3036 • alderonlad"com Page 1 of 2 Wide-angle pump switches directly control pumps up to 3 HP at 250 VAC. Each switch features an adjustable pumping range. Pumo Switch TYPeof Pump Max Pump Max Pump Pumping - SJE PumpMaster WPS Mechanically 1/2 HP, 120V I 13A, 120V ryG Activated 1 HP, 230V 13A, 230V Mechanically 1/2 HP, 120V 13A, 120V SJE PumpMaster Activated 1 HP, 230V 13A, 230V 9 Mechanically 3/4 HP, 120V 15A, 120V SJE PumpMaster' Plus Activated 2 HP, 230V 15A, 230V SJE PumpMaster' SPDT Mechanically 1/2 HP, 120V 13A, 120V (Single Pole, Double Throw) Activated 1 HP, 230V 13A, 230V Mechanically 15 FLA, 90LRA 15A, 120V Double FloatMaster Activated 120 or 240V 15A 240V MUST use if dose < 7" unless using VerticalMaster below o Mechanically 11/2 HP, 125V 20A, 125V SJE AmpMaster Activated 3 HP, 250V 20A, 250V SJE VerticalMaster 4 Mechanically 1/2 HP, 120V 13A, 120V ao. rrn.d swco Hour uonel Activated 1 HP, 230V 12A, 230V Use pump 1DA, 12VDC Mechanically SJE MicroMaster' AC/DC run and 1DA,12VDC Activated start current 8A, 250VAC Use pump SJE MicroMaster Plus WS d Mechanically run and 13A, 125V Activated 12A, 250V start current SJE HiTempMaster1' Mechanically I Use pump Activated run and start current by 85A, 120V 7 - 36 in 85A, 230V (18 - 91 cm) 85A, 120V 7.36 in 85A, 230V (18 - 91 cm) 85A,120V 7-36 in 30V (16 - 91 cm) 85A, 12DV 7 - 36 in 85A, 230V (18-91 cm) 90A, 120V 3-481n 90A, 240V (7.6 -122 cm; 120A, 125V 9 -24 in 120A, 250V (23 - 61 cm) 60A, 120V .75 - 6.5 in 60A, 230V (2 -17 cm) 100A, 12VDC 60A, 125V 8 - 36 in 60A,250V (20 - 91 cm) 78A, 125V 8 - 36 in 72A, 250V (20 - 91 cm) 13A, 125V I 78A,125V I 8-36 in 12A, 250V 72A, 250V (20 - 91 cm) California Prop 65 requires the following: ®WARNING Cancer and Reproducgve Harm-www.P65Wamings.ca.gov �E�E� $B"IAL-SJE (888-342-5753) komer.service@sjeinc.com DEC 1 6 9 www.sjerhombus.com 85001360 07/20 SJE RHOMBUS, sayfield Co. O 2018 SJE, Inc.. NI Rights Reserved. Planning and Zoning AgeRHOMBUS Ise trodmnek of SJE, Inc. Provides convenient wiring connection and system monitoring for pump station applications. The PS Patrol ° system features a built-in high water alarm and provides a convenient location to connect all wiring required for a pumping station installation. The PS Patrol" system employs a receptacle to accept a 120 VAC pump and piggy -back style pump switch. The sleek, angled design of the clear enclosure includes a removable cover for easy access for field wiring. All internal components are sealed within the cover for protection from the elements. The red LED Illuminates the cover in an alarm condition for easy 360° visual identification. Available with or without 32" mounting post. Controller meets Type 3R watertight standards and is designed for outdoor use • Built-in high water alarm Removable cover provides greater access for field wiring and service Controller can be purchased with standard 5" square plastic post or can be mounted on 4" schedule 40/80 PVC pipe or conduit (customer supplied) Automatic alarm reset, horn silence and alarm test 360° visual alarm; audible alarm • Red LED illuminates cover in alarm condition Green Power On light Auxiliary alarm contacts included for easy attachment of remote alarm Receptacle for easy connection of pump and piggy -back pump switch • Cord seal included for sealing switches and pump cable • Electrical potting cavity provides easy reliable method to seal power cables. (User to provide duct seal) CSA Certified Five-year limited warranty •[.1 F- • Mercury or mechanical pump switches • Various cord lengths • Riser assembly adapter • Dual alarm (2nd alarm input - Yellow LED illuminates cover in alarm condition) • Elapsed Time Meter (ETM) Pump circuit breaker • Available with or without 32" post California Prop 65 requires the following: ®WARNING Cancer and Reproductive Hann - www.P65Warnings.ca.gov SEE REVERSE SIDE FOR ORDERING INFORMATION. SEE PRICE BOOK FOR LIST PRICE. Shown with Mounting Post U.S. Patent Nos0 790,703 and 9,472,932 ALARM VOLTAGE: 120 VAC PUMP VOLTAGE: 120 VAC ENCLOSURE SIZE: Controller with post 5" X 5" X 39" Controller without post 5" X 5' x 8' RECEPTACLE: 120 VAC - NEMA Type 5-15 AUXILIARY CONTACTS 120 VAC 0.5 amps max., 50/60 Hz (circuit not supervised) ALARM HORN: 82 decibels at 10 feet ALARM FLOAT: SJE SignalMaster° control switch with mounting clamp RECEIVED DEC 16 2025 Bayfield Co. Planning and Zoning Agency 4 SJE RHOMBUS. 1-888-DIAL-SJE • 1-218-847-1317 1-218-847-4617 Fax email: customer.service@sjeinc.com www.sjerhombus.com e.73 PSP2 120V [ MODEL PSP2 MODEL Q 120V STARTING DEVICE 1 = SJE PumpMaster pump switch (0-13 FLA) • 2 = SJE PumpMastere Plus pump switch (0-15 FLA) • 3 = 120 VAC Double Float pump switch (0-15 FLA) 5 = Super Single• pump switch (120V = 0-15 FLA) 6 = No pump switch 7 = 120 VAC Double Float• Master pump switch (0-15 FLA) FLOAT SWITCH APPLICATION R H = pump down (select 17 option) X = no floats OPTIONS Listed below CODE DESCRIPTION Q 1J Duo alarm inputs 0 1V Vertical Reed Switch (must select 1J) 0 BA Elapsed time meter 0 1OX No Mounting Post Q 15_P Pump breaker specify 0 or I after number 15 followed by letter 'P- 0 =15 amp breaker (0-7 FLA) 1= 20 amp breaker (7-15 FLA) (Ex. 151P = 20 amp breaker, 7-15 FLA) CODE DESCRIPTION Q 16A 10' cord in lieu of 20' (per float) (Does not apply for Double Roar orDouble Floor Master pump switch) 16B 15' cord In lieu of 20' (per float) Q 16C 30' cord in lieu of 20' (per float) Q 160 40' cord In lieu of 20' (per float) 17A SJE SignalMaster• / pipe clamp (alarm float) 17J Sensor Float / pipe clamp (alarm float) 22F PSP Assembly Kit •Mechanically -activated A Mercury -activated Part Number Model Number Description FLA Ship Weight 1022728 PSP212OVSH17A PSP2120V, no pump switch, 20 SJE SignalMaster, with mounting post 0-15 13 lbs. 1019021 PSP2120V6H151P17J PSP2120V, no pump switch, 20 Sensor Float' , 20A circuit breaker, with mounting post 7-15 13 lbs. 1022575 PSP2120V6H8A17A PSP2120V, ETM, 20 SJE SignalMaster, with mounting post 0.15 14 lbs. 1022577 PSP2120V6H1.NBA17A PSP2 120V, Duo alarm, ETM, 20' SJE SignalMaster6 VRS. with mounting post 0-15 15 lbs. 1018434 PSP2AB6H16617A PSP2120V,, no alarm, no pump switch; remote TAAB, 15' SJE Signaf'laaster', with mounting post 0.15 16 lbs. 1011551 Assembly Kit Riser Extension Coupling and Washers n/a 10 lbs. RECEIVED DEC 162025 Bayfield Co. SJE RH dM9018onin0 Ag� cy www.sjerhombus.com customer.service@sjeinc.com 95000 C 10/19 Product offering and pricing Rights cing are subject to change without notice. 0 2018 SJE, Inc. An Reserved. B.74 Please visit www,5jelhombus,Com for the most cement information SJE RHOMBUS is a trademark of SJE, Inc. r Private Sewage System Maintenance Agreement LfTsrJ ,E, 14tr Li_C S%. 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 Bayfleld 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 1/4 Section Township _N. Range W. Additional Legal Description: 6(6' Arf—*C4, Eh Town of Lot Block Subdivision (Acreage) Gov't Lot Lot — CSM #_____ Vol. _ Page _ CSM Doc # DOCUMENT NUMBER 20258-610445 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED 12/23/2025 AT 8:57 AM RECORDING FEE $30.00 PAGES: 2 Return To: Area Planning and Zoning D2 1IVED DEC 262025 ❑ 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. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewaae System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWI'S 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 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. 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 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) Name s — lease Print r A44S iiVt�AA. Subscribed and sworn to before me on this date: Nf{fG(,L Jac.f A)iuu N! a —Sign �—v� r Notary Public �] Q /J �// My Commission Expires: ii-a.o-SFr Drafted by: Mt45ocli AIXZ$AZ Date: I 3 S CAROL A. PUFALL Proofed by: NOTARY PUBLIC rmslsanit ryls�cmalntenceagreement STATE OF WISCONSIN Revised July 2020 a r DANIEL J. HEFFNER 1 BAYFIELD COUNTY WI REGISTER OF DEE$S 2021R-592120 State Bar of Wisconsin Form 3-2003 QUIT CLAIM DEED 11/18/2021 12 : 58PM TF EXEMPT #: 15S ! RECORDING FEE: $30:00 Document Number Document Name PAGES: 1 THIS DEED, made between MASO N D. NIEMI AND JODI A. NIBMI, HUSBAND AND WIFE AS SURVIVORSHIP MARITAL PROPERTY Zrarrt w"avha1hr nran nr mnra' and LATITUDE 46 LLC ("Grantee," whether one or more). Grantor quit claims to Grantee the following described real estate, together with the ReeordingArea rents, profits, fixtures and other appurtenant Interests, in BAYFIELD County, Stoto of Wisconsin ("Property") (if rr.ore p e is needed p!eaa a »ttn h Names and Rafim Addm ae addendum): 15882-21 The Southwest Quarter of the Northeast Quarter (SW'ANEV4), Section Latitude 46 LLC Thirty (30), Township Forty-seven (47) North, Range Five (5) West, 28975 State Highway 137 Ashland, WI 54806Town of Eileen, Bayfield County, Wisconsin. U4 -1 u-'l-4/-W-*u-i W -II 0.IUUUU Parcel Identification Number (PIN) This IS NOT homestead property. (Is) (Is not) EDWARD C. SRN %/1 �__ U7 j 8t aofW=mdn Dated 4 (SEAL (SBAL) *rSOND. 7* JO . NIEMI (SEAL) (SEAL) s * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) authenticated on ) s. ASHLAND COUNTY ) TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: M DN' aeon tent Notary Public, State of Wisconsin My Commission (is permanent) (expires: 07/06/2024 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE- THIS 1,4 A STANDARD FORM. ANY MODIFICATIONS TO TEAS FORM SHOUT ) BE CLEARIX IDENTIFIED. QUIT CLAIM DEED O 2003 STATE BAR OF WISCONSIN FORM NO.3-2003 * Type name below signatures. Personolly came before me on / ) 15l aoDJ the above -named MASON D. NIEMI AND JODI A. NIEMI to me known to be the person(s) who executed the foregoing instrument and' knows d d t a * Edward C. Hedican 1—YFIELD Bayfield County Planning & Zoning Department 117 E 5t'1 Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: LATITUDE 46 LLC 28975 ST HWY 137 ASHLAND, WI 54806 Description State Approved Plans (Mounds, Systems Requiring Pre -Treatment, etc.) Submission Number: SS -00692 Transaction Number: SS -00692-3A044 $500.00 Total: $500.00 Payment Amount: $500.00 Reference: 34372 Paid by: Blakeman Plumbing & Heating, 44941 State Hwy 13, Ashland WI 54806 Payment Type: Check Transaction Date: 1/5/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-1 S STATE SANITARY PERMIT OWNER: LATITUDE 46 LLC G OV'T LOT: LOT: B LK: SW1/4 NE1/4 SEC:30,T47N,R5W TOWNSHIP: Eileen SOIL TEST: 62-23 NEW SYSTEM SYSTEM TYPE: Mound > 24 in. of suitable soil PLUMBER: Blakeman Plumbing & Heating, Inc. TRACY POOLER Authorized Issuing Officer DATE: 1 5 2026 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: # 1092768 Condition: THIS PERMIT EXPIRES 1/5/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION