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HomeMy WebLinkAbout24-12Si/ Request 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. Note fl Time Change fl Discrepancy fl Other Phone Number Superior Plumbing & Mech. Inc. 715-292-6670 Plumber: Fax Number Email Address Homeowner: Holly Anne Raths Hart Rev Trust ed@superiorpmw.com Immediate Phone Number So Zoning Sanitary Dept can call you right back (if needed) Permit #: 1 Plumber's Choice Zoning Dept No Inspection(s) during this time Date: 4/29/24 6� Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zoning Dept Time: 3:00 PM Township: Drummond Address # & Road Name: 46710 Blue Moon Rd. or Directions To Site: Comments: ** Plumbers you must verify any change(s) by fax or email ** Notes from ulforms/sanitarylrequestforins pection Zoning Dept (©4112104); ® June 2023 y?��ARTAffj.�, Private Onsite Wastewater Treatment Systems ( POWTS) Inspection Report (Attach to Permit) �aw.x Industry Services Division General Information Ma„ he,,c.d a. vPP,.,,d... HOLLY ANNE RATHS HART REV TRUST 9727 PRIMROSE AVE N STILLWATER MN 55082 n oses[Privacy Law, s. 15.04 1 m City LI Village 9 Town of: aM Descri tion, o aL 5. 3r V �g' Sanitary Per No: 0Q -/as. State Plan Transaction ID#: Pa I /jgi Iany. IIIIOr11IGIIVII TYPE MANUFACTURER' CAPACITY `"""'•• "• Prop. Line We Build' Air Intake Road Septic i ±►4%ui/ j7CO N/A fl N/A Dosing Aeration N/A Holding Pump / Siphon Infotmatton Pump Manufacturer Pump Model Demand GPM Filter Manufacturer Filter Model TDH Lift j Friction Loss Head Total Forcemain Length Dia Dist, To Well rlicnarael rail Infnrreatinn DIMENSIONS Wi3h Le t #tCells SETBACK FROM Prop. Building 7 l OHWy Type of Cell Manufacturer: ��1 �• K ty (u 5 Model Number. Pretreatment Unit Manufacturer: Model Number. Dia Dia eievailon uala STATION BS HI FS ELEV Benchmark ), 3 5 /e Bldg. Sewer Tank Inlet �, ' vy— Tank Outlet ,7, y Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/ Manifold Distribution Pipe Infiltrative Surface L 7. Final Grade $ , R (('4/f 3 7..o _•3P 3s 93, A0 X Pressure Systems Only X Hole Size I X Hole ❑ Yes O ft. 75 Soil Cover Depth Over Depth Over Depth of Seeded / Sodded Mulched Cell Center Cell Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: G(Include ode discrepancies, persons rspresent, etc.) 1r I �-0 y �trf I r /llfflG r/ 1VN R wag JI�O�c�7S, R� ��y C , 02;ftOre. Il ne5 - P�4n j��VY16�1 frr fTOu$E r /aAf�4 rail //GrcN r-ry Plan revision required? J� Yes O No C r� Use other side for addltioyr5I information. 7 Date POWTS Inspector's Signature y, v. c,,-_i e License Number RRnSJ1n ER n'L91i Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zonina(&bavfieldcounty.wi.00v 117 East Fifth Street Web Site: www bayfieldcounty wi aov/147 Washburn, WI 54891 HOLLY ANNE RATHS HART REV TRUST 9727 PRIMROSE AVE N STILLWATER MN 55082 �,p f As you know o was contracted by you to install a private ��� i t, �.� � onsite wastewater treatment system on your property described as: Notes: Abandonment of Old System to meet all applicable code requirements: ❖ Tank was pumped by: on at AM I PM Tank was crushed / removed and pipes disconnected by: On % V at ' (AM above -mentioned plumber contacted our office to conduct a pr -cover inspection as required under DSPS 383. One of the following applies: System 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. El 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/tormslsanitarypraperlyowner-input April 2019 RECEIVED 1j • Department of Safety County JAN 2 2 2 fl 24 & Professional Services, Services Division Bayfield Sanitary Permit N ber (to be filled in by Co.) Bayseld Co.Industry Planning and Zoning gamey / Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. I5.04(1)(m), Stats. 46710 Blue Moon Rd. Drummond WI L Application Information — Please Print All Information Property Owner's Name Parcel # Holly Anne Raths Hart Rev Trust 14118 Property Owner's Mailing Address Property Location 9727 Primrose Ave. N. Govt. Lm City, State Zip Code Phone Number Stillwater, MN 55082 651-491-1611 SW /, NE /., Section 31 T 44 N R 7 EorW II. Type of Building (check all that apply) Lot # l I or2 Family Dwelling— NumberofBedrooms 3 - Subdivision Name Block/I ❑ Public/Commercial — Describe Use O City of O Village of 4. ❑ State Owned — Describe Use CSM Number l Town of Drummond 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 it a l'cable. A. ❑ New System y ® Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B' ❑ Holding Tank ❑ In -Ground ❑ At -(Wade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C• ❑ Renewal Before ❑ Revision ❑ Change of Plumber g ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration IV. Du ersaVlreatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) I Dispersal Area Requbed (sf) Dispersal Area Proposed (sf) I System Elevation 450 .4 1125 1200 94-91' Capacity in I Total I # of I Manufacturer Tank Information Gallons j Gallons Units Ia New Tanks jExistingTaoks = c u Si u Septic or Holding Tank x 1060 1 Infiltrator X Dosing Chamber V. Responsibility Statement- I, the undersigned, assume responsibilityfor installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature I MP/MPRS Number I Business Phone Number Edward B. Redinger 221939 715-292-6670 Plumber's Address (Street, City, State, Zip Code) 1015 11th Ave. E. Ashland, WI 54806 VI. County/Department Use Only pproved O Disapproved Permit Fee to Issued Issuing Age Si b' ❑ Owner Given Reason for Denial $ '/ ,C �,2/) nditionsof val/Reasons for Disapproval if o %f reel frr,t. ha%Le - 54t' J te Attach m complete plans for Inc system41—e and ddsubmit to the County only on paper �not tlless stthan 5 in x 11 inches in size SBD-6398 (1- an 03/22) r(/ -, l(J Maw 07 2007 S>5e'j'd�{r.�E ZIRN SOIL TESTING 715 765 4608 JAN 2 2 2024 vdemnsin Deparmaent oDoofnmerze. SOIL EVALUATION REPORT Division ofSaWald Builtlitrya..-. •.7, In eeaarrGnrn uffh rmmfl, tie IA. A.1.., r..we p.1 Page L of 3 mmpkta ale plan an paper not lean dtanBf Plan - Eches Indze.PNn must Cauny ,k e/d lx1t i"Ud Include, but not calico to: vedll�l and horizontal ref ence puire (SM), cn and p� ID. fit)/_ Ct - -n q- it -1 percent dope, crab crdimenaons, north wow, and loflrt end distance to nearest mad. to . � 567/0 b'j- Ode-Lucs Reviewed by Date Please print all 6Aormatlon. PenooSlnfon StnYoupcode maybeusedforweonda7Purpares(prtdv yLa,Z.I D4(t)(m)). y ProperyOeeter Dar ! CAv t Se•t soi1 Property Location Gold. Lot 5I+/ 1r4 n/�/4 S I T t/Y N R 7 Properly owners a6g S 7 L.a,�� Lot a Blocks &S. Name or CSM1 o /5�a�e/ City &ate Zp Co a Phone Number /2 t5o1 ftOtj O City ❑ Village RI Town Nearest Road vsl %€/ae/qu',/QGl/ ❑ New Consbu on Uae:a Readentlel / Number orbedmoms 2. Code derived design flow rate CJf) GPO RReplecemw* Q Publicgr comlmerdat- Desabe: Paronmaterid_ C/4C/ Ti/( Flood Pion eteyed n if applicable g(. C) p, to nnws and recommendations CVhv / 'r'ysT<t+'' 2.Ie✓A 5' — r!)rr cn a✓a� = U.C7r / Gand recommendations ! DQ.N'fla+'LL•' pW( //ion vrepl tee»a er-t-f` = reeovy„'1ende4 cr¢4tsc1 /u�0T/qa5 Ya =.7S yob(/sc f� i�mfl a U norlrg ft Depth to emltng factor /&0 in. ® Pit GYountl austere clog. q. � Horizan I Depth in. 0-$ S -2o Dominant Color Mtnsel ,P3/4 s Ry Redmr Description Du. Sz. Coro. Color ovt� noK� Texture 9L. St Sbueture Gr. Sz. Sh. 2#tC Q, <s5k Consistence rn(1 Boundary cc Roots alLco Sail AlIceom GPDIIF Rate •Efrs1 G .6 •E}la2 'C, to So ,c'a'6 s .t.L C / t+s sn cs 1 -M SRSy fl -C. AS _SG r . r7 !-(o L/J CR PB Ground alafamelev. 76. 1 n. DeoN to ameina fadnr//V in Horizon a 3 Depth In. o -r Sao /.0 Dominant Crier Mrmsell ,y23/? ≤Vii y(6 4Y2 4//y Redox Description Qu. Sz. Cont. Color fle Tear sL ti,. se Y/. Stntdure Gr, Sz. Sh. CJ&Q t cXc Consistence /nv r+C n./ Boundary cc s 3 Roots w cb F SN ApgJition GPDMp Rate •EfMl 6 .io •Eff l2 /.O /.o S (0-7ar .iI Ky/ RSI'( new rlotic s .0_ LS OsG m rnv�i- kf eS — •S 7 1-O /.6 CST Name (Please PtQJL� „Y•� arro as = eu mgrL O ZIRI4 Slgnettxe CST bar Address E r us[IIpAI Ed. (/ //Date Evaluation Conducted Telephone Number Mason, WI 54856 S-7-07 '71c 76S V608 8 0�Yj May 07 2007 5:55PM JOE ZIRN SOIL TESTING 715 765 46O8 p.3 JAN 222024 Bayfi.,!J Co. Plannirvc anti _ arr oV--cnB-?-W-o7-31"r Property DwwLfl✓ 57E.l 50-1 ' Palest ID{ O3 -°0G. acteop Page vx of Bodnga 0 Boring ® Pil Ground surface cloy. 97J fl. Dentb In ame:,,. t..e.. Horizon Depth b. Dominant Color Munsel Redax Desedp8on Texture - Stricture Consistence Boundary Roots Soil lestim GPDkf Rate o-5 30 Ou. Sz. Cant. Color Gr. Sz. Sh. 'Eiftl1 'EIf82 /t one 54— 54 m - � as ® 4 r o S q/ 7 o<+ems ___ L3 ,2JtE ln� S 1 Cp /_o 3 SYR /j D! sf c*,/$4 g — r . 7 cab 'C' Yr /Z-onQ�_tir!4.c2c4aL_m4 SY�Ps �N ,-lo.cc 0% /7 _4-5 _/rG f yI acting i Boling ` ........ t n eu Crn,eM a:rta... d... 4�� . Hbdzon Depth h a'- P-60 Domirrem Color Mansell /? 5wl W Redoa Desaiptio Du_ Sz font Cobr ONL. 4 flOC. Tentas Cr.Sz. a r. Sz. Sh. SG - _ - -.. Cor7aiatence Boundary Roofs SoB iras'on Rare GPDae •E8G7 ftA2 "fob SY2a'I /I�7� GS non Ground eurfamclew. a rbv.,...::�� E04ent Mt a SOD.> 3D < 220 mp& arq TSS >30 _ 150 mg& • EOWem e2. BODr a 30 n& and TSS c 30 mgfL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to aco s services or need material In an alternate format, please contact the department at 608.266-3151 or TTY 608-264.8777. SMD-1370 RM,4P Mary 07 2007 5:55PM JOE ZIRN SOIL TESTING 715 765 4608 p.2 S ECE VED _. _. f4 JAN 2.22024 : 3. ;. ...-._ ih Jai - 3 ( -'?fl yyd't, -----..... .. (4r. - . g:iPdl4.(.j..._; Cia l3=9Z.r' BY=9s" k j{w.r1= g3 S ` 6O -*IsT'e" &i9+faTroKr 89 . ...c a� lam. o . . ceryen =....o R?co»„„e..,dO4 oPest .n lo4dR� et -..CoM' t 4qeriGv ffa , - (tor whe. ina ckils ?Lt /efirrlclCt�2�e� .44S� �� rJrt.wl� 'fl Ylc7'kv-� Lc. S -7--o7. RECEIVED JAN 222024 Bayfield Co. Planning and Zoning Agency In-Gro PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: rid Soil Absorption for POWTS Version 2.1 (May 2022-2027) 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: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Hart Cabin Owner Name(s): Holly Anne Raths Hart Rev Trust Owner Address: 9727 Primrose Ave. N. Stillwater, MN Project Address: 46710 Blue Moon Rd Drummond, WI Govt. Lot: SW LI1/4 of NE U1/4, Section31 , T44 N -R7 E❑or W ❑✓ Township: Drummond Project Parcel ID #: 14118 Phone: 651 -491 -1611 Zip: 55082 County: Bayfield Designer Information Designer Name: Edward B. Redinger Designer Address: 1015 11th Ave. E. Ashland, WI E-mail: ed@superiorpmw.com License Number: 221939 P'C p l itionaily I cond o 1 Phone: 715 -292 _6670 Remarks: Zip: 54806 ibis space IC,erved OI12Wta stamp. Signature: � � -Date: 1/19/24 Original signature required on each sub ted copy. Bayfield Co. Planning and Zoning Agency SUPERIOR PLUMBING MECHANICAL (715)278-3456 CST# 221939 Scale: 1" = 40' PIN: 14118 0.6 Acres SW NE 531 T44N R7W Town of Drummond Bayfield Co. Customer Name: Holly Anne Raths, Hart Rev Trust Adress: 9727 Primrose Ave N Stillwater, MN 55082 A 1 Site: 46710 Blue MMoon Rd. Drummond Phone#: Email: hartstcroix@gmail.cocm Sts /y Lock F, ilcr ioao X-1 ('/f r4 7 q irc- 5 is ,jk Y C; 16// 2 4d j �rAde 9Y' 9�" IN -GROUND GRAVITY DISPERSAL AREA Stepped Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER TYPICAL TRENCH CROSS SECTION VIEW (No Scale) 12" min. Vench ]J L! ':,deptn (typical) 34"..( Highest Trench System Elevations = 94 ft; 93 ft; 92 min. 12" (typical) Septic Tank(s) Manufacturer. Existing is Weiser/ New is Infiltrator Septic Tank(s) Volume(s): 750 gal 540 gal gal gal Effluent Filter Manufacturer: poly lock Effluent Filter Model #: 525 Provide minimum 3 ft separation between trenches. Lowest Trench (as applicable) ft; 91 ft; Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) r-------------------��---- ------------j`---------;_ B=6° ft (typical) INSTALL PER TRENCH: 60 Quick4 Std -W @20 ff EISA/chamber = 1200 ft2 + 4 Pairs of end caps @6 ft2 EISA/pair = 24 ft2 = Proposed EISA per trench = 306 ft2 ft Observation Pipe (typical) Install per manufacturers / instructions. TYPICAL TRENCH PLAN VIEW (No Scale) TA = 3.0 ft (typical) '—Quick4 Standard -W Chamber (typical) (mid by Infiltrator Systems, Inc.) Install pursuant to manufacturers instructions, Required Infiltration Area = 1 125 x 4 trenches = Proposed Total EISA = 1224 D GD m W O ft2 Distribution Method: ft2 branched manifold 0 RECEIVED CM -1060 Gener4lp&ppp¢iions and Illustrations Bayfield Co. mdng The CM -1 060 isfle prassimrgpd two-piece mid - seam thermoplastic tank. The CM -1060 compression molded design allows for a mid -seam joint that has precise dimensions for accepting an engineered EPDM gasket. Infiltrator's gasket design utilizes technology from the water industry to deliver proven means of maintaining a watertight seal. The two-piece design is permanently fastened using a system of molded -in alignment dowels and locking seam clips. The CM -1060 is assembled and sold through a network of certified Infiltrator distributors. TOP VIEW Must be backfilled and installed in ■' F❑ accordance with the Infiltrator IM- and 04(102j PVCORABS 024.0(°10) ACCESS PORT 10.11257) CM -Series Septic Tank General FREEBOARD 4 Installation Instructions. For shallow INLET TEE WITH LOCKING LID (2) 0411021 PVC OR ABS •'• iRar eA I" ' Pe,�,:";, ground water conditions reference NLET OUTLET TEE e . FFEi the Infiltrator IM- and CM -Series Tank Buoyancy Control Guidance. 7,8%AIR SPACE OUTLET e e� 1791 - PER CODE ❑ • L Please visit www.infiltratorwater.com —PER CODE 44.0 61 CI0UI FIBERGLASS or scan OR code for the latest FIBERGLASS DEPTH SUPPORT (TYPICAL) information. SUPPORT (TYPICAL) WITH BAFFLE WALL WHERE I.1 Working Capacity 1,111 gal (4,207 L) Total Capacity 1,309 gal (4,956 L) Airspace 17.8% Length 134.2"(3,409 mm) Width 61.7"(1,567 mm) Length -to -Width Ratio 2.3 to 1 Height 54.5" (1,384 mm) Liquid Level 44" (1,118 mm) Invert Drop 3" (76 mm) Fiberglass Supports 2 Compartments 1 or2 Maximum Burial Depth 46 (1,219 mm) Minimum Burial Depth 6" (152 mm) Maximum Pipe Diameter 4" (102 mm) Weight 331 lbs (151 kg) V INFILTRATOR water technologies 4 Business Park Road P.O. Box 768 Old Saybrook. CT 06475 860-577-7000 • Fax 860-577-7001 1-B°0-221-4436 www.iMiltrato,walx com Info@infiltratarwatercom SIDE VIEW SEMI CLIP L,PICAL) LIFTING STRM (TYPICAL) END VIEW INU TANK TOP ELASTOKIERIC TANK IN1EOR SEAM CLIP CONEL HALF MID -HEIGHT SEAM SECTION U.S. Patents: 8322948:8337119; 8297880; 7914230; 7008138.Other Patents pending_ )Mprdte Oukk4 arcl FSBow are regstered trademarks of IrdillmtGr WaterTectndoges. Intilratar Water Terhndoges is a w4way-owned sWsry of Advanced Drsnage Sstems, Inc. (ADS). 020221nfbator WaterTechnologies, LLC. Not responSde fw any typographc errors. Primed in U.S.A. CM020222 L.UInUUI mtmraior water lecnnoiogles' lecnnlcal services uepartment for assistance at 1-800-221-4436 Tracy Pooler From: Ed Redinger <ed@superiorpmw.com> Sent: Monday, August 4 2025 12:38 PM To: Tracy er Subject: oily Hart Cabin / R Attachments: Revised Plot P 4.3o.24.pdf I may have sent this before? I did have it in the file from 5/1/24 Let me know if anything else. Ed Redinger Superior Plumbing & Mech 715-278-3456 ed@superiorpmw.com Customer Name: Holly Anne Raths, Hart Rev Trust SUPERIOR PLUMBING MECHANICAL (715) 278-3456 CST# 221939 Scale: 1"=40 PIN: 14118 0.6 Acres SW NE S31 T44N R7W Town of Drummond Bayfeld Co. Adress: 9727 Primrose Ave N Stillwater, MN 55082 Site: 46710 Blue MMoon Rd. Drummond Phone #: Email: hartstcroix@gmail.cocm BM = 100' Btm of Siding/top of foundation 2,e.., rccA '3e/ay 525 Poly Lock Filter C 1060 Infiltrator Tank c Abandon Existing tank and fill with Sand froP .LrI..C 5 Trenches 11 Quick 4 Chambers + 1 Trench with 5 Chambers: Install 1.5 - 2' below grade @ .4 loading System Shots: BM / 2.35' Building Sewer: 4.45' T-1/7.7' Tank In: 5.85' T-2/8.2' Tank Out: 6.2' T-3/9' T-4/9.15' T-5/9.8' T-6/10.6 F RECEIVED "'" a'"" , ;'� JAN 2 2 224 11 Department of Safety & Professional Services, County Bayfield _' - s`'Le Sanitary Permit umber (to be filled in by Co.) Industry Services Division Bayfield Co. µ Planning and Zoning gency Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) 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(l)(m), Slats. 46710 Blue Moon Rd. Drummond WI I. Application Information — Please Print All Information Property Owner's Name Parcel # Holly Anne Raths Hart Rev Trust 14118 Property Owner's Mailing Address Property Location 9727 Primrose Ave. N. nR r Govt. Lot • IYu-t City, State Zip Code Phone Number Stillwater, MN 55082 651-491-1611 SW '_ NE I/., Section 31 T 44 N R 7 E or W II. Type of Building (check all that apply) Lot # ® I or 2 Family Dwelling— Number of Bedrooms 3 Subdivision Name ❑ Public/Commercial — Describe Use Block # 0 Cityof O Village of ❑ State Owned — Describe Use CSM Number IRTown of Drummond Ill. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on tine A. Check one box on line B. Complete line C it a licable. A. ❑ New System y ® Replacement System p y ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B. ❑ Holding Tank 0 In -Ground ❑ At -Grade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of PlumberList g 0 Transfer to New Owner Previous Permit Number and Date Issued Expiration IV. DispersaVt'reatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required (s0 Dispersal Area Proposed (s0 j System Elevation 450 .4 1125 1200 94-91' Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units S oog , is e sa L 'rn u `• a A New Tanks Existing Tanks o. U to Septic or Holding Tank x 1060 1 Infiltrator X Dosing Chamber V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) I Plumber's Signature I MP/MPRS Number I Business Phone Number Edward B. Redinger 221939 715-292-6670 Plumber's Address (Street, City, State, Zip Code) 1015 11th Ave. E. Ashland, WI 54806 VL County/Department Use Only pproved ❑ Disapproved Penn it Fee $ ate Issued Issuing Age Sin re Owner Given Reason for Denial Conditions of A proval/Reasons for Disapproval 'I jO/f� fne7 �rr>ti �a%e dHt!/Nl scram m complete plans for me system and submit to the County only on paper not less than 8 112X 11 inches in size SBD-6398 (R. 03/22) t d, I //{J PAGE 4 OF 4 JAN 2270I -ground Gravity Management Plan IMPORTANT: Bayfield co. Planning and Zoning Agency 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 5 220 mgL 1; TSS 5150 mgL 1; 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 - 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: Superior Plumbing & McCh. Inc Phone: 715-292-6670 Local government unit: Bayfield Co. Zoning Phone: 715-373-6138 Local government unit address: 117 5th St. E. Washburn, WI 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. Private Sewage System Maintenance Agreement Holly Anne Raths Hart Rev Trust 9727 Primrose Ave. N Stillwater, MN 55082 46710 Blue Moon Rd. Drummond, WI laxlurr 14118 As owner, I (we) do hereby certify the private sewage system will be installed in accordance with the certified soil testers 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) SW 1/4 of NE 1/4 Section 31 Township 44 N. Range 7 W. Additional Legal Description: Jets Town of Drumond Lot Block Subdivision (Acreage) 0.6 Gov't Lot Lot _ CSM # _ Vol. CSM Doc # RECEIVED DOCUMENT NUMBER 24 2QZ4 2O24R-6O197g' kit.. Planning and ZonireAgency DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 01/23/2024 AT 8:38 AM RECORDING FEE: $30.00 PAGES:2 Return To: Planning and Zoning Department ❑x 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 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 -around Pressure -System Laterals (system types C, D and E): Ttuslaterats shall -be- lushed 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 Bay?leld 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 (mm 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 HOL.&y ANNL RATHS Subscribed and sworn to before me on this date: REv TRv5'T i l� Zu2� Notarized Owner(s)—Signatures) I�I� Note y Publlc_ ' My Commission Exp s: r n /. LINDA KATHLEEN KNUT5ON Drafted by:-etn:..u,.- Date: /"�3"Z! Notary Public Minnesota Proofed by: flt My Commission Expires Jan 31, 2026 ulMrm nitary/septicmaintenceagreement - •' . ,,, Revised July 2020 RECEIVED State Bar of Wisconsin Form 3-2003 QUIT CLAIM DEED Document Number II Document Name THIS DEED, made between Kyle Hart and Holly Hart, husband and wife, as joint " whether one or more), one or Grantor quit claims to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Bayfield County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): The South 10O feet of the North 250 feet of the Southwest Quarter of the Northeast Quarter (SW '/4 NE %), Section Thirty-one (31), Township Forty-four (44) North, Range Seven (7) West, located East of the Town Road right of way, as laid out and traveled May 14, 1980, formerly State Trunk Highway No. 63, located in the Town of Drummond, and West of Picture Lake, EXCLUDING, lands lying East of Picture Lake, a/k/a Pitcher Lake. JAN 242024 DANIEL J. HEFFNER HAYFIELD C WI REGISTIRmM Agency 2022R-594884 06/02/2022 1O:3OAM TF EXEMPT #: 16 RECORDING FEE: $30.00 PAGES: 1 Recording Area Name and Return Address Patrick J. Boley Eckberg Lammers, P.C. 1809 Northwestern Avenue Stillwater, MN 55082 04-018-2-44-07-31-103-000-20000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Dated June 1, 2022 +�..,1 `c (SEAL) (SEAL) * KYLE HART AUTHENTICATION Signature(s) authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Patrick J. Boley ECKBERG LAMMERS, P.C. 1809 Northwestern Avenue Stillwater, Minnesota 55082 * HOLLY HART ACKNOWLEDGMENT STATE OF MINNESOTA ) ss. WASHINGTON COUNTY ) Personally came before me on June 1, 2022 the above -named Kyle Hart and Holly Hart to me known to be the person(s) who executed the foregoing ps�•wnent and acknowledged the same. (< *� ,IADF. IC. KLEMMENSEN N _ ary Public, State of Minnesota My Commission Expires: 01/31./2024 sf4 (Signatures may be authenticated or acknowledged. Both are not nceess; NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD QUIT CLAIM DEED ® 2003 STATE BAR OF WISCONSIN * Type name below signatures. JADE K KLEMMENSEN Bayfield County Register of Deeds Document # 2O22R-594884 Page 1 of 1 BAYFIELD COUNTY SANITARY PERMIT (#04)-2412S STATE SANITARY PERMIT OWNER: HOLLY ANNE RATHS HART REV TRUST GOVT LOT: LOT: BLK SW1/4 NE1/4 SEC:31,T44 N, R7W TOWNSHIP: Drummond SOIL TEST: 52-07 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: Edward Redinger TRACY POOLER DATE: 1 /29/2024 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 #: 07-155S LICENSE: # 221939 Condition: System must meet all setbacks & (50 feet from Ordinary High Water Mark). Management plan to owner. Properly maintain system per recorded agreement. Properly abandon old system per SPS 383. THIS PERMIT EXPIRES 1/29/2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION