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Home My WebLink About24-159SRRequest for Sanitary Inspection (24 Hrs. in Advance) Fax or email this form to Zoning Dept (24 Hrs.) prior to when you want an inspection Fax (715) 373-0114 or Email zoninci(a)bayfieldcounty.wi.clov Note Time Change fl Discrepancy fl Other Phone Number Plumber: Fax Number Homeowner: I<,e Email Address, Immediate Phone Number So Zoning Sanitary I �n C J Dept can call you right back (if needed) Permit #: c? I I Plumber's Choice Zoning Dept No Inspection(s) during this time Date: B �� p �;30 �� Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zoning Dept Time: 4Pcss a fI l � �i Township: Sao Address # & Road Name: W 2O2 s CWv l i or II2 cSkk LV I ' Sy 801P q &� Directions ja�pS To Site: Comments: ** Plumbers you must verify any change(s) by fax or email ** Notes from Zoning Dept: July 2025 5 Sts. Industry Services Division General Information P� Private Onsite Wastewater Treatment Systems (POWTS). Inspection Report (Attach to Permit) KEITH E & ANTONIA M WILBER TRUST 20255 COUNTY HWY G ASHLAND WI 54806 TanTtlnformation TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Se ticjP7t4cA(/d L9Ic7 N/A Dosing N/A Aeration ,4&t D ? N/A Holding setback to: County Sanitary ennit No: Z'/-/575 State Plan'Transactlon ID#: Parcel Tax No: Pump I Siphon Information mp Manufacturer Pump Model Demand GPM Filter Manufacturer Filter Model TOH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well Dispersal Cell Information DIMENSIONS Wi th Lt (i elJsen#ofC did SETBACK FROM I Pr p . Line I Building I jffj Well O Type of Cell I Manufacturer: Model Number. Pretreatment Unit Manufacturer: Model Number: Dia Dia Elevation Data STATION BS HI FS ELEV Benchmark 5.2 /05, , I7D SY Bldg. Sewer °• / g- g.s Tank Inlet %/io S, n y Tank Outlet Dose Tank Inlet Dose Tank Bottom , 1 (t , o s/ / 2 / Inst. Contour Header/ Manifold Distribution Pipe Infiltrative Surface 1 y a Final Grade 3.17 D2, X Pressure X Hole Size ❑ No 7u11 Nuvcl Depth Over j Depth Over I Depth of I Seeded / Sodded I Mulched Cell Center I Cell Edges I Topsoil J❑ Yes ❑ No I ❑ Yes ❑ No COMMENTS: (Include code discrepancle , persons present, etc.) VAX M0W&Pa ofd 4//3 wra,, j 9et1 l 144741 elieeNa l- 44v w /1kS d G6r4%6/� 4/I tiyy M W4S ceevej i f 70 66 s Ian revision required? ❑ Yes O No I �s 0 (37/J ie other side for additional information. Date 2RrLR79n rR nVr99ii POWTS Inspectors Signature License Number 4' Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zoning(gbavfieldcountv.org Web Site: www.bavfieldcounty.orpf47 KEITH E & ANTONIA M WILBER TRUST 20255 COUNTY HWY G ASHLAND WI 54806 Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 As you know (l'i'C fit_(/ N —A' was contracted by you to install a private onsite wastewater treatpnt system on your property (Tax ID# above). To know when your system will be due for servicing please go to www.septicsearch.com Notes: Abandonment of Old System to meet all applicable code requirements: LII Tank was pumped by: • Tank was crushed / removed and pipes disconnected by: on at AM/PM On v at (AM P)'1he above -mentioned plumber contacted our office to conduct a pre -cover inspection as required under DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. YF� 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: WformslsanitarypropertyownerAnput April 2019 ,V.�© J7 ,�i.- 7 � .� Industry Services Division 4822 Madison Yards Way Madison, WI 53705 County Sanit Permit Number (to be filled in by Co.) Madison, WI 5302 1 -- l 5 9 5 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 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 purposes in accordance with the Privacy Law, s. 15.04(i)(m), Stats. 1c3iitJxmataon Pant MflfGi Lion _: Property Oer's Name Lt Parcel # r 3 �i 7 �' Pr perry wner's Mailing Address Property Location ��(( © O tlVrw Govt. Lot City, Sin I Zi iCodde Phone Number #sLtaL ) 1-.._c'( (� O 0 P 1(s -2-o- Q V,- V4, Section T N R E o/ II: Tyke of BTzifdt i `(check all at apply) ..:...... = ..._ =..... Lot # t or 2 Family Dwelling — Number of Bedrooms a ,. Subdivision Nme ` , ,. Block # ❑ Public/Commercial — Describe Use 0 9 2023- 0 State Owned — Describe Use 0 Village of CSM Number f9.Town of _540 - b4r. ..: I, + �f` ,N.. •rz- :r- ter. .::- Type kewySrPer it.: F eek ti the `1Vew o* l la atilt'; n other ble on _: ` TYP >.s x P....4) .... k limo A. Che +fie boxon l Complete ;IM7 '°I.. P.r,.,, • l :7,.: .�:„� •�.<< spy 'le L'.N_t•..* '2' ... t-, .:`wJ i.�'Y y :.y C.: �1%i �..�: «Ytro �•>i, 4.t {}+NY -�� 1` t _ �. r. _�:. ei ..> . .... t. -:Lu, .� :rir:,�+Yrsw:7=.. a .:� ..... ........ ......._ .. .. .. ...... -....a . ..� ..s .. .. ,. .. .ice .. ' •.. - .', r....: A. New S stem Replacement System '.,.- ❑ Other Modification to Existing System (explain) Additional Pretreatment Unit (explain) B. Holding Tank In -Ground At -Grade 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 /57.5 W1nsp�iaW��rAP and Tankinfor nation: - a Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Ar Z 1red (sf) Dispersal Area Proposed (sf) System Elevation Capacity in Total # of Manu adorer Tank Information Gallons Gallons Units +y New Tanks Existing Tanks '� a U a in o ; (a eti R. w C7 a Septic or Holding Tank W boo! 6 e SL r Dosing Chamber 06 Y.:Res Responsibility Statement- p. sJ C?�1!:...� the undersigned, assume 'r on lfi=1i or installation �� :..� �:...+��,� �1�t�� bthe ��.i �� $i�Q'{YIP� ._ i �Itt�C�lCEIB 11�.� Plumber's Name tint) Pl is Si MP/MPRS Number Business Phone Number ��. w (A — 6 7_s~-�2ea —al Plumber's dress (Street, City, State, Zip Code) re(T— 'jjet1JselQn1y.2!' : •.x-.� :P' 7..tiC �. t '4 �. �":L r- Uitr�'71 Jit =y; I L{t..t.. Approved ❑ Disapproved Permit Fee Date Issued L i g t Si lure , --_.. ❑ Owner Given Reason for Denial - A5 Conditions of Approval/Reasons for Disapproval � ocC2 u4c/. Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way Madison, WI 53705 July 7, 2025 CUST ID NO.: 699374 GREG BROWN 13660 CO HWY H IRON RIVER, WI 54847 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES:7/7/27 MUNICIPALITY: TOWN OF KEYSTONE BAYFIELD COUNTY SITE: WILBUR 20555 COUNTY G ASHLAND, WI 54806 FOR: Design Wastewater Flow Value: 450 Bedrooms: 3 Limiting Factor(s): 19" Maintenance Required: Effluent Filter Phone: 608-266-2112 Web: httn://dsns.wi.aov Email: dsys a.wisconsin.gov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-072501388-C Application No.: DIS-062526739 Site ID No.: SIT -147167 Please refer to, all identification numbers tin'each correspondence with the.I)�epartment Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Manual - Version 2.1 (May 2022-2027) L 09 0?5 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: • The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the Mound site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. • Components and soil removed from an existing drain field shall be properly disposed of so that there is no risk to public or environmental health. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. OWNER RESPONSIBILITIES • 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, Joshua Rowley Division of Industry Services Phone: Email:joshua.rowley@wisconsin.gov Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 Refund Expected: $0.00 JUL 092iJ?5 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: New Mound System Conditionally APPROVED Owner's Name: Keith and Antonia Wilber DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Owner's Address: 20255 County Hwy G Ashland, WI SEE CORRESPONDENCE Legal Description: S 20, T 47, R 06W Township: Keystone County: Bayfield Subdivision Name: NA Lot Number: NA Block Number: NA Parcel I.D. Number: 37969 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Tank page Page 10 Filter Info Page 11 Soil Test Page 12 Soil Test Designer: Greg Brown License Number: 699374 Date: 05/01/25 Phone Number: 7152090161 Signature: Greg Brown Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) and Pressure Distribution Component Manual Var. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 12 Mound and Pressure Distribution Component Design Design Worksheet Site Information .(R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 30000 Estimated Wastewater Flow (gpd) Table 383.44-3 in -situ soil treatment for 1.50 Peaking Factor (e.g. 1.5=150%) fecal coliform of <= 36 Inches. 450.00 Design Flow (gpd) 10.00 Site Slope (%) 98.00 Contour Line Elevation (ft) 19.00 Depth to Limiting Factor (in) 0.70 In -situ Soil Application Rate (gpd/ftz) � __ _ Distribution Cell Information J U L 09 2025 75.00 Dispersal Cell Length Along Contour (ft) = I 6.00 Cell Width (ft) 1.00 'Dispersal Cell Design Loading Rate (gpd/ft2) II 'Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) E Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 3.50 Estimated Orifice Spacing (ft) = 10.23 ftz/orifice 2.00 Forcemain.Diameter (in) 120.00 Forcemain Length (ft) Does the forcemain drain back? Y 91.00 Pump Tank Elevation (ft) Enter Y or N 4.551 System Head (ft) x 1.3. Vertical Lift (ft) Friction Loss (ft) In -line Filter Loss (ft) Total Dynamic Head (ft) 8.08 1.501 0.00 14.14 Lateral Diameter Selection in. dia.' options _ choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information i000�I Septic Tank Capacity (gal) Wieser Manufacturer Dose Tank Information 600.00 Dose Tank Capacity (gal) 1&76f Dose Tank Volume (gain) Wieser Manufacturer 1.97j Forcemain Drainback (gal) 67.44 5x Void Volume (gal) 87.01 'Minimum Dose Volume (gal) 23.69 System Demand (gpm) Manifold Diameter Selection in. dia. options choice 1.25 x 1.50 x x 2.00 3.00 Gallons/Inch Calculator (optional) Total Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) gal/in (enter result in cell B49) Effluent Filter Information Polyok Filter Manufacturer PL 525 Filter Model Number Project New Mound System Page -2 of 12 Mound Plan and Cross Section Views L Mound Component Dimensions A 6.00 ft E 24.20 in B 75.00 ft F 9.50 in D 17.00 in G 0.50ft 450.00 (ftz) Dispersal Cell Area 6.00 (gpd/ft) Linear Loading Rate Finished Grade 99.42 (ft)—►♦ Dispersal Cell Elevation H 1.00 ft I 14.18 ft J 6.25 ft K L 10.53 ft 96.05 ft W 26.43 ft 1513.39 (ft2) Basal Area Available 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area 101.21 (ft) Shading Key . 1❑ Topsoil Cap Subsoil Cap ASTM C33 Sand , Tilled Layer ©rsc: Aggregate Dispersal Cell G I I H —••• ♦♦99.92 (ft) Lateral Invert 98.00 (ft) Contour Elevation 10.0 % Site Slope v Q I— Dispersal Cell U 15ff v2 Ill 05ff ; F hTypical Lateral A `Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). Project: New Mound System Page 3 of 12 End Connection Lateral Layout Diagram atgr: centered oe 0. • a _T:u n -up ba 1 afva.ar o!enoutptug . s AQ lateralsare i ientical — o d,I l nn ott+ i tFwtaateral .S V Pmemai� aonn+esorfon t taa crocc stamar tl at:ams t ti ` Lamn Sch 4th P\fC'pe SPS Te lS 384.E Number of Laterals 2 i Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.50 ft Lateral Length (P) 73.50 ft Orifices per Lateral 22 Lateral Spacing (S) 3.00 ft Orifice Density 1 10.23 ft!orifice Lateral Flow Rate 11.85 gpm Manifold Length 3.00 ft IL 9 2 025 System Flow Rate 23.69 gpm Manifold Diameter 1.50 in Total Dynamic Head 14.14 ft Forcemain Velocity 2.42 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -� SPS 316.300 WAC Disconnect _____41n. min. Tank component is properly vented F-- Alternate outlet location Wieser Ca act 600.00 Volume 16.76 Dimension Inches Gallons A 18.61 311.87 B 2.00 33.52 C 5.19 87.01 D . 10.00 167.60 Total 35.80 600.00 Forcemain diameter Manufacturer 2 in. Gallons gal/inch A Weep hole or anti - siphon device Pump off elevation (ft) 1 91.83 �B C ii Dose tank elevation. (ft) 3" Bedding uncTer tank. J 91.001 Alarm Manuafacturer SJE I I Note: Switches Alarm- Model Number Tank Alert AB I containing mercury j may not be used in Pump. Manufacturer Goulds I this system. Pump Model Number EP04 Pump Must Deliver I 23.69 gpm at r 14.14 ft TDIl Project New Mound System Page 4 of 12 Mound System Maintenance and Operation Specifications Service Provider's Name J Phone POWTS Regulator's Name Bayfield County Phone 715-373-6138 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank CapacityL 1000 gal Maximum TSS 150 mg/L Soil Absorption Component sizeL 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test monthly Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ••., .• •••••• •........I••so. Grade v1 •' 6-8" Diameter Lawn Sprinkler Valve Box A Distribution Threaded Cleanout Plug or Ball Valve Lonci Sweep 90 or Two 45 l e ree Bends Same Diameter as Lateral Project: New Mound System Page 5 of 12 Mound System Management Plan Pursuant to SPS 383.54. Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Pubilaatlon 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD•10706-P (N. 01/01)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be Inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure- must be replaced. Exposed access openings greater than 8 -inches in diameter shall be secured by an effective locking device to'prevent accidental or'unauthorized entry into a tank or'component. Septic Tank The septic tankshall be maintained by an Individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by Inspect€on. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made.to retain solids In the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped -with an alarm, the filter shall be serviced if the alarm Is activated continuously. Intermittent filter alarms may Indicate surge flows or an impending continuous alarm. The septic tank shag have its contents removed when the volume of sludge and scum In the tank exceeds.1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of.a triennial assessment, maintenance personnel shall advise the owner. of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation In the tank. The addition of biological or -chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shag be approved for septic tank use by the Department of Commerce. , c 02 5 Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is Installed within the tank It shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound.is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction In the winter will promote frost penetration. Cold weather installations (October -February) dictate that the mound be- heavily mulched as protection from freezing. influentquality into the mound system may not exceed 220 mg/L BOD5,150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODE, 30 mg/L TSS,10 mglL FOG, and 104 cfu1100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure*dlstrfbuiion system €s provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the €nitia€ test when the system was Installed to determine If orifice clogging has occurred and If orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, mote frequent monitoring. Continency Plan If the septic tank or any of its.components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. lithe dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shaft be immediately repaired or replaced with a component of the same or equal performance. if the mound component falls to accept wastewater or begins to discharge wastewater to the ground surface, It will be repaired or replaced In its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related, piping, and replacing said components as deemed necessary to.bring the system Into proper operating condition. See Page 5'of this plan for the name and telephone number of your local POWTS regulator and service provider. P eatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project Page 6 of 12 TECHNICAL BROCHURE B3871 R1 EP04,-&-E Model 3871 SUBMERSIBLE EFFLUENT PUMPS 5 Series GOULDS WATER TECHNOLOGY a xylem brand Wastewater FEATURES EP04 Impeller: Thermoplastic semi -open design with pump out vanes for mechanical seal protec- tion. EP05 Impeller: Thermoplastic enclosed design for improved performance. Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resis- tance. Motor Housing: Cast iron for efficient heat transfer, strength, and durability. APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: l4" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1W' NPT. • Mechanical seal: carbon-rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104° F (40°C) continuous 140° F (60° C) intermittent. • Class B Insulation • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. Power Cable: Severe duty rated oil and water resis- tant. Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTINGS Tested to UL 778 and CSA 22.2108 Standards By Canadian Standards Associationc�lus File #LR38549 Motor. • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EPOS Single phase: 0.5 HP, 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 SJTW with three prong grounding plug. Optional 20 foot length, 16/3 SJTW with three prong grounding plug (standard on EPOS). • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. PERFORMANCE RATINGS Total Head (ft.of water) I Gallons Per Minute EPO4 EPOS 5 53 - 10 46 62 15 _ 36 55 20 21 46 25 0 33 30 - 17 Wastewater METERS I FEI 101' 8 7 6 5 4 3 2 1 0 30 ._.-- 2.5Ff 25 I i 20 15 — — �— — — EPOS — 10E — EP04 5 —1—_ 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 ma/h CAPACITY MODEL INFORMATION Minimum Float Switch I Cord Discharge Minimum On Minimum Off Minimum Basin Maximum Solids Shippin Weight Order No. HP Volts Amps Circuit Breaker Phase Style Length Connection Level Level Diameter Size lbs/kg EP0411 .4 115 12 20 1 Plug / No Switch 10' 1½" Manual Manual 15" 34" 20/ 9.1 EP0411A Piggyback/ Wide -Angle 10 1½" 12" 6' 15" .21/9.5 EP0411F Plug / No Switch 20' , 1k" Manual Manual 15" 20/9.1 EP0411AC Piggyback/ Wide -Angle 20' 1h" 12' b' 15" 21/9.5 EP0412 230 6 10 - Plug/ No Switch 10' 1'h° Manual Manual 15" 20/9.1 EP0412F Plug / No SwitchEP0S11F 20' 1%" Manual Manual 15" .5 115 13 20 ug / Switch 20' 1½"Manual Manual 15"No EP0511AC Piggyback/ Wide -Angle 20' 1 h" 12' ' 6" 15"EP0512F M22/910 230 6.5 10 Plug / No Switch 20' 1 ½" Manual Manual 15" PAGE 3 DIMENSIONS (All dimensions are in inches. Do not use for construction purposes.) COMPONENTS Item No. Description 1 Impeller 2 Base 3 Pump casing 4 Mechanical seal 5 Ball bearings 6 O -rings 7 Power cord 8 Oil filled motor 9 Motor housing/stator assembly 10 Motor cover xylem Let's Solve Water Xylem, Inc. 2881 East Bayard Street Ext., Suite A Seneca Falls, NY 13148 Phone: (866)325-421O Fax: (888) 322.5877 www. g o u l d swa to rte ch n o l o g y. corn Goulds is a registered trademark of Goulds Pumps, Inc. and is used under license. C 2012 Xylem Inc. 83871 R1 April 2013 10 JPT 2.00 [5.1 cm] OUTSIDE DIAMETER ACCEPTS 4" SCHD 40 SOCKET OPTIONAL BUSHING (FOR 4' THIN WALL PIPE) PART NO. 30142-R OR (FOR 110 MM. PIPE) PART NO.30142-EUR OUTLET BUSHING ACCEPTS 4"SCHD40&6"SCHD40 ..&- .AN loss%% VII %a PREVENT FILTER FROM FLOATING PL -525 -625 FILTER HOUSING PART NO. - 30142-525 30142-625 11.59 [29.4 cm] CEPTS 6" HD 40.PIPE :R INLET TENSION G ' BALL CHEK 10.52 [26.7 cm) 8.10 [20.6 cm] 5.23 [13.3 cm] 33.02 [83.9 cm] 18.31 [46.5 cm] II�IOOI L NO. PIi. 26&C5 IFIFLLI I1T IFOLTR P O. yamm3O - aN USA RAT.PIQ- LABEL ILLUSTRATION Document Number/Plan I.D. No. HOLDING TANK AGREEMENT Owner Name (s) Owner(s) Mailing Address s sh/,d WE Parcel Identifier Number (PIN) Agreement Date (same as Notary Date) We acknowledge that application is being made for the installation of (a) holding tank(. on the following property or that continued use of the existing premises requires that a holding tank be_installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. SPS 383, Wis. Adm. Code or Ch. 145, Wis Stats. JVE 1/4 of S I% 1/4 Section aV Township N. Range w. Town of Je)/sl le Additional Legal Description: 5 Sao' pi itf iV.J OeSG ipi bac 2Otge- Gov't Lot Lot Block Subdivision CSM# Return To: ZDv rv► DOCUMENT NUMBER 2025R-608368 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 07/18/2025 AT 1 1 :28 AM RECORDING FEE: $30.00 PAGES: 2 Lot CSM # Vol Page CSM Doc# I As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding tank installation and maintenance. If the owner fails to have the holding tank properly serviced in response to orders issued by Bayfield County or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats., Bayfield County may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. 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. 3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Stats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NRI 13, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the county within 30 days from the date of change to the service contract. 4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis. Stats., and Ch. NR 114, WI's Adm. Code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained. MILL, h', 5. This agreement will remain in effect only until Bayfield County certifies that the property Is served sewer or a private onsite wastewater treatment system that complies with Ch. SPS 383, WI's Adm. Code. In additi �hfa' agre nt r1tiay s�cancelled by executing and recording said certification with reference to this agreement in such manner q i wiU�?hiit these s fence of the certification to be determined by reference to the property. _ j O i t N =Cal Z �• 'ii� '= 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of tbedo*ner. ownef submit this agreement to the register of deeds, and the agreement shall be recorded by the register of duds 1t'}•a manner ,'$i dill permit the existence of the agreement to be determined by reference to the property where the holding tank is ttj'.••.....••••'• f,.�`� •., . '4 TE OF ,,a Owner(s) Name(s) — Please Print Subscltbed and sworn to before me-810ttieWa Notari ed — Signatures) Notary Public My Commission Expires: D L (d (j 1f Drafted by- Date: 7 hql&Oa��A JUL 2:1 2025 Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (I)(m)] ulforms/sanitary/hotdingtani Vf,&, iWg Dept. EXHIBIT "A" Parcel 1: The South 300 feet of the Northeast Quarter of the Southwest Quarter (NEB/4SWV4), lying South of County Road G, Section Twenty (20), Township Forty-seven (47) North, Range Six (6) West, Town of Keystone, Bayfield County, Wisconsin. 11 JUL 2:1 202` Bayfield Co. Zoning Dept. .2 x . ""ru�Y� l�lfis ohsin De iartmentofSat*and Pmfessiona[Senrices Page. .. Qkvis;onof tndustN`Senrices. SOIL EVALUATION REPORT in acwith.SPS 385. V0, Adm. Code -Bayffeld Attach completesite plan:on paper not.iess-than.B 112-x 1.1, inches in size: Plan rt rst laclude, parcel l+E but not Eimlted to; :vertical and horizontal reference point (AM), direction and percentslape. &iJ�hTX620-3 01-0OA�14000 scale drdlmensions.- north -aneW, and -I ion rtnddlsfarloh to merest toad.. Pls'ase-printaii information. eyteed by Date ersonal Information you provide may be used forsecandary bses:(Pricy Law. st 15.04(1)(m) Property Owner Property t ccagOon I Keith and Antonia Wilber Goer: Lot �i r s . 0 T 47 N R. 06 E (or). w Property Owner's: Mailing Address Sfe Address or CSM and, Lot# 2055 County. Hwy 3 Tax 10 37969 City State Zip Cade. Phone Number. El qty 13 Village Q Town Nearest Road :Ashland flu[ 54806 Keystone C0Uf / G ° -NewConstrtrcoofl User J Resfderttial/Numberofbedraoms 3 Cede derived dasignflaw rate Q.;_GPD a []Repiaoement, 'D.p d Uicorcomrndal--Describe: Flood Plan -elevation, .4ppUUCabia, ft. Parent maieitaiClaYeY till .over underlying trrtif General conanettts and recommendations Site issuitable for mound. system: RedoX.found at j9" on :B1` Eli ng Bo # Ground swface�ejev Depth is srnitin�fecUo _ Horizon Depth: Iii A 0-9 B 049 C 19-24 Dominant Color . Redox Description Munseit Qu. Az. Cant. Color 5yr.312 Syr 416 2:5ycr /6 f-2 i 5yr $/8 Texwre Stntdime Grp Szt Sri: L5: t1•sg-vf LS.. 0 g .vf SC abk-c Consistence ' Hflundary: Roots dfr ow v1 dfr as - dvh - - : `S "cagn Rde 1D1Ft2 *C 1' `fl 07 07 0.2 16 1.6 0.3 liiiBorir�q.# Horizon Depth In . i?orn!nantCcMr 1Vtrr$eti Redoz Description Qu=Az.. Cont Coipr Tektare : uduro GA, SL Sh. .Conslstertce Boundwy Roata Soil-Adpiication Rate OPDiFt? *E_tf1 1Eff#Z A 0-1t1 Syr 312 '00$ 'I yr ass -2-d. yr 8 L5 LB SC ':3,abkcr O$g-vf {l-�s -v1 a -vf dir dir df! dvh c++f c w ss - 3vf a- - - Ot a 7 07 0.2 16 1s 16C 013 E B' j0-13 15-24 442., 2:hyr CST Name.(Prease:Pnnt) Ttm Address 1.0620 Eagle .L Ke Rd: Irot .Rlyec W# Dato EvatUBtto FCondUct$d 7128/2025 t Cm er _115v Telephone Number T1 209=S148 {]Baring 24 ®Pit. Ground surface.elev__._ft. Depth-to-iiniitiflg?factor . . In. ! elev:... .. it *Effluantfrl =,Boo.> 30 5 220 ir�1L acrd TSS * 300 M50 mg1L * Efiiueni#2 t: BCD, 5 30•ma/L and TS8: s 3Qrng!L SBD 8330 (R04i21) [] Bodng Boritiq # ® Pit. Page 2 o€ De thte ftmltln lector tn; / elev ft. •Ground auriace� dlev.:,_ ftP 9 .-.._ q Anril� ftan Rate 1 Horizon Depth trr. Daminattt Color lGr M�fl t : E�edtAc Desc�tptigtt Qu. Az. ContColor f Texture Structure & Sb Cdnststatice Boundary Roots GPD ' -- . A 0-1.0: 5yr3/2 LS 0- g-vf dfr acv 3v1 01 i,6 B 10Q2. Syr4/6 LS 0-sg-vf dfi :as 0.7 't6 C 2240 25yr3I6 f d Syr 618 SC 9-at3k-z dvh - - 0.2 D:3 Boring 0 p eortrig. ON�Grourtd surfaceeievy _ -ft. Depth:to thn1t1ng factorin.-/elev,ft. S#lf, ppttCetton;oe Dominant Color Redox Description Texture Structure Cai$lstence Boundary Roofs GPD!Ft2 Ho1¢on Depth *Efrgi .ff 2 try: luuflsefl c.�u. Az..Cotr;. Color C,r= SZ. fit. 'F ?UL Q Boring v Q UL Boring 0 Pit Ground surface elev.^_ft. Depth=todfmiting factor ln. elLey.;,,___,_ft. Snt it AVtnitrat[ Horizon Depth 16. Domiflatit°Color : Muns+etE RedoX Description Qu.-Az, Cont. Color 'e tune ate Gr Sz.Sh� Consistence: Boundary : Roots Gl'D1Ft2.. . i *'Eiffuent#i •- BOD s'30 5,220 nigfLend TSS' 30.s 75O mgIL " -:Efft.0o it - BQl s 3O rrigfi, a nd TSS :*3Q rs* C-. (0 CD CAk .A So • £ C5r44 tt�s" it .tjfj7jff at Ij1J 3786 ir o4 I •j 1~ ,j• (t1 • 5PS 3 8Z &y A,e- Si lot •� � 1#}lam.-_ . • �•�, �1,��- • : rffi. 7qq 12'-6" 4" CAST —A —SEAL--\ 1 -------------' ;I I >k" i• 11 � 1 r j FILTER OR I I BAFFLE '1 I 1 I F-•��i�SfT••�l�-r T_ w w INLET cr) '1- a M sl M U � � I1 �`i• 3" 3 _r�..Jr,l:_T J. •r '-: ( q1 r TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227' L N O c� 4" CAST: A —SEAL 4" VENT OUTLET . o a .- V Oi PUMP PAD WLP1 0O0/600 -MR TANK SPECIFICATIONS DIMENSIONS: WALL: 3" BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 51" LENGTH: 12'-6" WIDTH: 7'-O" BELOW INLET: 42" LIQUID .LEVEL • 36" WEIGHT: BOTTOM 9,500 LBS. COVER 5,470 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: 27.88 GAL/IN (SEPTIC) 16.76 GAL/IN (PUMP) LOADING DESIGN: 8'-O" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC/SEPTIC, SEPTIC/PUMP, OR SEPTIC/SIPHON 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: PRODUCES NEEDED BY: Q 7PJ � a o o Z O o F N 1 OF /1 13A FIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: WILBER TRUST, KEITH E & ANTONIA M 20255 COUNTY HWY G ASHLAND, WI 54806 Description Additional Fee Amount Submission Number: AP -00039 Transaction Number: AP -00039-3196C Amount $25.00 Total: $25.00 Payment Amount: $25.00 Reference: 3868 Paid by: Greg's Plumbing, 13660 County Hwy H, Iron River WI 54847 Payment Type: Check Transaction Date: 8/5/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. C O U N T Y Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: WILBER TRUST, KEITH E & ANTONIA M 20255 COUNTY HWY G ASHLAND, WI 54806 Description Other Submission Number: SS -00596 Transaction Number: SS -00596-2F871 Amount $100.00 Total: $100.00 Payment Amount: $100.00 Reference: 3850 Paid by: Greg's Plumbing, 13660 County Hwy H, Iron River WI 54847 Payment Type: Check Transaction Date: 8/4/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-24.-159SR ' STATE SANITARY PERMIT OWNER: KEITH E &ANTONIA M WILBER TRUST GOVT LOT: LOT: BLK: NE 1/4 SW 1/4 SEC: 20, T 47 N, R6 W TOWNSHIP: Keystone SOIL TEST: 148-24 NEW SYSTEM SYSTEM TYPE: Mound ≥ 24 in. of suitable soil PLUMBER: GREG BROWN TRACY POOLER DATE: 818/2025 Authorized Issuing Officer CHAPTER 145.135(2) WISCONSIN STATUTES a. The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. b. The approval of the sanitary permit is based on regulations in force on the date of approval. c. The sanitary permit Is valid and may be renewed for specified period. d. Changed regulations will not impair the validity of a sanitary permit. e. Renewal of the sanitary permit will be based on regulations In force at the time renewal is sought, and that changed regulations may impede renewal. f. The sanitary permit Is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #: 24-1 LICENSE: # 699374 Condition: Must file the correct maintenance agreement within 30 days of issuance. THIS PERMIT EXPIRES 8/8/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION L 55 �© Industry Services Division 4822 Madison Yards Way County t r$\� Sanitm Permit Number (to be filled in by Co.) Madison, WI 53705 P.O. Box 7302 Madison, W15302 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 Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS arc 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. T. Application Information - Please Print All Information Property Ow er's Name II Parcel # -ex&J ,4L4ovu& 1 Lc►-- 37 t6q p perry bwner's Mailing Address Property Location ,,t( (�.{�-. 2 0 Co L i W `� Govt. Lot City,IS-la I zijjCode Phone Number w S`{ 80S1 --2041-0 '/.. Y., Section 20 T 1 N R 6 ndb II. Type of Building (check all that apply) Lot # LfT or 2 Family Dwelling -Number ofBedroams________________ Subdivision N� p Block # ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use ❑ Village of CSM Number /I ].Town of___________________ 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 if applicable.) A. New S star Rc lacement System p y ❑ Other Modification to Existing System (explain) Additional I'rctrcaunent Unit (explain) B. Holding Tank In -Ground At -Grade Mound Individual Site Design Other Type (explain) (conventional) C. Renewal Before yr, Revision Change of Plumber Transfer to New Owner ist Previous Permit Number and Date Issued Expiration W. Dispersal/Treatment Area and TankInformation: Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Art a,Rc aired (st) Dispersal Area Proposed (sf) System System Elevation sv 01 Capacity in Total # of Manufacturer 'Tank Information Gallons Gallons Units .o d o $ `o B New Tanks Existing Tanks20 m 9J .fi a U in E s. i. 0 n. Septic or Holding Tank 1000/I_— O 6 '� e S e r-- ,,� Dosing Chamber 0 V. Responsibility Statement- I, the undersigned, assmne responsibility for installation of the POWTS shot,n on the attached plans. Plumber's Nome (Print) I Plu is Sign MP/MFRS Number Business Phone Number rc wv. �--- 6 ?ts -Zea-6(� Plumber's dress (Street, City, Stall, Zip Code) C —_ o (^-( ✓' P J 1 'l. County/Departnient Use Only Approved 0 Disapproved Permit Fee Dale Issued suing t Sig azure m6 {I f O Owner Given Reason for Denial L I) $ 7 Conditions of Approval/Reasons for Disapproval Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way Madison, WI 53705 July 7, 2025 CUST ID NO.: 699374 GREG BROWN 13660 CO HWY H IRON RIVER, WI 54847 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES:7/7/27 MUNICIPALITY: TOWN OF KEYSTONE BAYFIELD COUNTY SITE: WILBUR 20555 COUNTY G ASHLAND, WI 54806 FOR: Design Wastewater Flow Value: 450 Bedrooms: 3 Limiting Factor(s): 19" Maintenance Required: Effluent Filter Phone:608-266-2112 Web: httn•//dsos.wi.eov 0S!3 m Email: dsosfalwisconsin.eov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-072501388-C Application No.: DIS-062526739 Site ID No.: SIT -147167 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Manual - Version 2.1 (May 2022-2027) JUL U 9 2025 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: • The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the Mound site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. • Components and soil removed from an existing drain field shall be properly disposed of so that there is no risk to public or environmental health. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. OWNER RESPONSIBILITIES • 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 6 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 (JAA4' nn, �,. a i l a Balance Due: $0.00 -' d Refund Expected: $0.00 Joshua Rowley Division of Industry Services D) l : I Phone: Email: 'oshua.rowle wisconsin. ov r l YG)° 8 IJUL 0 a 2025 Department of Safety and Professional Services rr r g,r i Division of Industry Services SOIL EVALUATION REPORT t•`°+s, r In accordance with SPS 385, WNs. Adm. Code Attach complete site plan on paper not less than 8 112 x 11 inches In size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. rsonal Information you provide may be wed for secondary purposes (Pnvacy Law, S. 15.040)(m)). Page of� I.D. -0.47-06-20.9 01-000-14000 Date �/IT-Art 1 Property Owner Property Location U U Keith and Antonia Wilber Govt. Lot '4 % s 20 T 47 N R 06 E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: 20255 County Hwy G Tax ID 37969 City State Zip Code Phone Number ❑ City ❑ Village 0 Town Nearest Road Ashland WI 54806 715-292-713 Keystone County Hwy G Q New Construction Use: Q Residential/ Numberofbedrooms 3 Code derived designflow rate 450 GPD ❑Replacement Cl Public or commercial —Describe: Flood Plan elevation If applicable R Parent material riavev till over underlvino stratifies General comments and recommendations: Site is Suitable for mound system. Redox found at 19" on B1 EliBoring # Boring nPit Ground Surface elev_It. Depth to limiting factor_ in. / clay.______ ft. Bnil Annliratinn Rate Horizon Depth In. Dominant Color Murrell Redox Description our. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' ff#1 • Eff#2 A B C 0-9 9-19 19-24 5yr 3/2 5yr4/6 2.5yr 3/6 f -2-d 5yr 6/8 LS LS SC 0-sg-vf 0-sg-vf 3-abkc dfr dfi dvh cw as - 3vf - - 0.7 0.7 0.2 1.8 1.6 0.3 Boring # oBoring 24 ®Pit Ground surface elev.ft. Depth to limiting factor in. / elev.ft. Rnil Anntiratinn Rate Horizon Depth In. Dominant Color Murrell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIFt2 •Eff#1 *Eff#2 A 0-10 5yr3/2 LS 0-sg-vf dfr cw 3vf 0.7 1.6 E B C 10-15 15-24 24-32 5yr5/1 6yr4/6 2.5yr 3/6 f -2-d 5yr 618 LS LS SC 0-eg-vf 0-sg-vf 3-abk-c dfr dfi dvh cw as - - - - 0.7 0.7 0.2 1.6 1.6 0.3 CST Name (Please Print) Signat CST Number 1213855 Tim Dykstra Address Date Evaluation Conducted Telephone Number 715-209-5748 10620 Eagle Lake Rd Iron River WI 7/28/2023 • Etguent #1 = SOD > 30 S 220 ngIL and TSS > 30 5150 mg/L ' Effluent #2 = SOD, s 30 mg/L and TSS s 30 mg/L SBD-8330 (R04/21) Page 2 of 2 Boring # ❑ Boring ® Pit Ground surface elev. _ft. Depth to limiting factor 22 in. / elev.ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cord. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Fe *Eff#1 'Eff#2 A 0-10 5yr 3/2 LS 0-sg-vf dfr ow 3vf 0.7 1.6 B 10-22 5yr4/6 LS 0-sg-vf dfi as - 0.7 1.6 C 22-30 2.5yr 3/6 f -2-d Syr 6/8 SC 3-abk-c dvh - - 0.2 0.3 Boring # ❑ Boring ❑ Pit Ground surface elev._ft. Depth to limiting factor in. / elev._ft. Sall Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD1Ftz 'Eff#1 +Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev._ft. Depth to limiting factor in. / elev._ft. Soil Application Rate Horizon Depth In. Dominant Color Munseli Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 -Eff#2 • Effluent #1 = BOD > 30:5 220 mg/L and TSS > 30 s 150 mg/L ' Effluent #2 = BOD, £ 30 mg/L and TSS 5 30 mg/L o ao L 1t14oiwc otk\aar 47-06-aO- 3 DI-o-/NBcb 7g6q I }�. ar� Ryy�s�iti Gl,�beJ a- yZ fb 37968 1_�% o, k js4me- 12'-6" 4" CAST -A -SEAL FILTER OR-' BAFFLE � U n N a �d a1 a- 1-, 1f u " VENT OUTLET IFT t 0U I � }. a a` I. PUMP PAD TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS WLP1000/600-MR TANK SPECIFICATIONS DIMENSIONS: o! WALL: 3" BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 51" LENGTH: 12'-6" WIDTH: 7-0" BELOW INLET: 42" LIQUID LEVEL 36" WEIGHT: BOTTOM 9,500 LBS. COVER 5,470 LBS. I INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET Q INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 ISI a W 8 (OTHER STATES SEE CHART) I ^. LIQUID CAPACITY: 27.88 GAL/IN (SEPTIC) 16.76 GAL/IN (PUMP) co art LOADING DESIGN: 8'-O" UNSATURATED SOIL ro TANK CAN BE USED AS: SEPTIC/SEPTIC, SEPTIC/PUMP. = o OR SEPTIC/SIPHON 0 COVER: MIX DESIGN /8 (NO FIBER) s °D TANK: MIX DESIGN #10 (STRUCTURAL FIBER) � e CUSTOMIZED TANKS: 9 FOR CUSTOM TANKS CONTACT WIESER CONCRETE 1 J oQ o a r 2 I 0 F REVIEWED BY REVIEW DATE O 0. a Lu IA1n1TAMCC CIIRMTT- s=n FOR APPROVAL APPROVED BY: SHEET NO. APPROVAL DATE: 1 OF PRODUCTS NEEDED BY: 1 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: New Mound System Conwuonally APPROVED Owner's Name: Keith and Antonia Wilber DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Owner's Address: 20255 County Hwy G WI SEE CORRESPONDENCE Legal Description: S 20, T 47, R 06W Township: Keystone County: Bayheld Subdivision Name: NA Lot Number: NA Block Number: NA Parcel I.D. Number: 37969 Plan Transaction No.: Page 1 Page 2 Index and title Data entry , L L Page 3 Mound drawings IIF,1 Page 4 Lateral and dose tank 1111 JUL 092025 Page 5 System maintenance specifications Page 6 Management and contingency plan Bay^iald '; ,1r ;; _; - J Dept. Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Tank page Page 10 Filter Info Page 11 Soil Test Page 12 Soil Test Designer: Greg Brown License Number: 699374 Date: 05/01/25 Phone Number 7152090161 Signature: Greg Brown Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) and Pressure Distribution Component Manual Var. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 12 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in -situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of <= 36 inches. 450.00 Design Flow (gpd) 10.00 Site Slope (%) 98.00 Contour Line Elevation (ft) 19.00 Depth to Limiting Factor (in) 0.70 In -situ Soil Application Rate (gpd/ftz) Distribution Cell Information JUL 09 1025 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution j Pressure Disribution Information network? Enter Y or N (C or E) E Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0 0.156 Orifice Diameter (in) 3.50 Estimated Orifice Spacing (ft) =j 10.23 ftz/orifice 2.00 Forcemain Diameter (in) 120.00 Forcemain Length (ft) Does the forcemain drain back? 0 91.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 19.57 Forcemain Drainback (gal) 8.08 Vertical Lift (ft) 67.44 5x Void Volume (gal) 1.50 Friction Loss (ft) 87.01 Minimum Dose Volume (gal) 0.00 In -line Filter Loss (ft) 23.69 System Demand (gpm) 14.14 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1000.00 Septic Tank Capacity (gal) Wieser Manufacturer Manifold Diameter Selection in. dia. options choice 1.25 x 1.50 x x 2.00 3.00 Gallons/Inch Calculator (optional) Total Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) gal/in (enter result in cell 849) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) Polyok Filter Manufacturer 16.76 Dose Tank Volume (gal/in) PL 525 Filter Model Number Wieser Manufacturer Project: New Mound System Page 2 of 12 Mound Plan and Cross Section Views 1 L Mound Component Dimensions -t J -4 A _1. JUL 0 9 2025 A 6.00 ft E 24.20 in B 75.00 ft F 9.50 in D 17.00 in G 0.50 ft 450.00 (ft2) Dispersal Cell Area 6.00 (gpd/ft) Linear Loading Rate Finished Grade 99.42 (ft)-* F Dispersal Cell Elevation H 1.00 ft K 10.53 ft 1 14.18 ft L 96.05ft J 6.25 ft W 26.43 ft 1513.39 (ft2) Basal Area Available 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area 101.21 (ft) Shading Key o. Topsoil Cap o a 2Q %• Subsoil Cap N a ASTM C33 Sand v it B Tilled Layer c 3j Aggregate a o Dispersal Cell GIIH 99.92 (ft) Lateral Invert 98.00 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover t— Dispersal Cell See lateral details on 1.5 it ^ sr -,.>• Page 4 for number, size, 5 �,, ,� and spacing oflaterals.. ��"' Laterals are equally 0.5 ft T icel Lateral F spaced from the : * „ distribution cell's centerline in the A « distribution cell (AxB). Project: New Mound System Page 3 of 12 End Connection Lateral Layout Diagram Laterals centered over theA&Bdimension ♦=Turn -up v4ballvalveor cleanout plug E-- P All laterals are Identical IE X-41 Holes drilled on thebottom of the lateral equally spaced Force main connection via tee or cross to manifold at anp point. Laterals &forcemain Sch 40 PVC per SPS Table 384.30-6 Number of Laterals 2 Orifice Diameter Lateral Diameter 1.50 in Orifice Spacing (X) Lateral Length (P) 73.50 ft Orifices per Lateral Lateral Spacing (S) 3.00 ft Orifice Density Lateral Flow Rate 11.85 gpm Manifold Length System Flow Rate 23.69 gpm Manifold Diameter Total Dynamic Head 14.14 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -le SPS 316.300 WAC DDisconnect Tank component is properly vented Wieser Capacity 600.00 Volume 16.76 Manufacturer Gallons gal/inch Dimension Inches Gallons A 18.61 311.87 B 2.00 33.52 C 5.19 87.01 D 10.00 167.60 Total 35.80 600.00 Alarm Manuafacturer SJE Alarm Model Number Tank Alert AB Pump Manufacturer Goulds Pump Model Number EP04 A iB C Pump Must Deliver 23.69 gpm at 14.14 ft TDH j! 092025 !/'!Ij Co. Zoning Dept. Locking cover with warning label and locking device and sealed watertight 4 in. min. C Alternate outlet location Foroemain diameter flu 2 in. Weep hole or anti - siphon device Pump off elevation (ft) 91.83 Dose tank elevation (ft) 91.00 Note: Switches containing mercury may not be used in this system. Project: New Mound System Page 4 of 12 Mound System Maintenance and Operation Specifications Service Provider's Name ( Phone POWTS Regulator's Name I Bayfield County Phone 715-373-6138 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test monthly Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished Grade vi 6-8" Diameter Lawn Sprinkler Valve Box Distribution Threaded Cleanout Plug or Ball Valve Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: New Mound System Page 5 of 12 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with Its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.8(01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than flinches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter Is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have Its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of to be to maintain less than maximum scum and sludge accumulation in the tank. 1L - — g' when the next service needs performed L,J The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such III products are used they shall be approved for septic tank use by the Department of Commerce. J 0 9 9 fl25 J Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper , i ��l� —L �J�f. operation. If an effluent filter is Installed within the tank It shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound Is not recommended since soil compaction may hinder aeration of the Infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOOS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mglL BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu1100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified In the permit for this installation. The pressure distribution system Is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the Initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning Is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 Inches considered as an Impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shag be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in Its' present location by Increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project Page6of of 12 TECHNICAL BROCHURE B3871 R1 EP04. &-E-P05 Series Model 3871 SUBMERSIBLE EFFLUENT PUMPS Ui It ' JUL 0920/b Dept. GOULDS q VM ER TECHNOLOGY v a xylem brand Wastewater FEATURES EP04 Impeller: Thermoplastic semi -open design with pump out vanes for mechanical seal protec- tion. EPOS Impeller: Thermoplastic enclosed design for improved performance. Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resis- tance. Motor Housing: Cast iron for efficient heat transfer, strength, and durability. APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering • Solids handling capability: 3Yo" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1 ½" NPT. • Mechanical seal: carbon-rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104° F (40°C) continuous 140° F (60° C) intermittent. • Class B Insulation • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. Power Cable: Severe duty rated oil and water resis- tant. Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTINGS OtTested to UL 778 and CSA 22.2 108 Standards By Canadian Standards Association us File #LR38549 JUL 9LI:(i Motor. • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EPOS Single phase: 0.5 HP, 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 SJTW with three prong grounding plug. Optional 20 foot• length, 16/3 SJTW with three prong grounding plug (standard on EPOS). • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. PERFORMANCE RATINGS Total Head (it. of water) Gallons Per Minute EP04 EP05 5 53 - 10 46 62 15 36 55 20 21 46 25 0 33 30 - 11 Wastewater METERS 10 9 8 O 7 v_ 6 2 z 5 4 O 3 2 1 0 EE U0 10 20 30 40 50 GPM 0 2 4 6 8 10 � 12 m3/h CAPACITY 0')L , ` !] L I; I JUL 0 9 20`r.'i MODEL INFORMATION Minimum Float Switch Cord Discharge Minimum On Minimum Off Minimum Basin Maximum Solids Shippin Weight Order No. HP Volts Amps Circuit Breaker Phase Style Length Connection Level Level Diameter Size lbs/kg EP0411 .4 115 12 20 1 Plug / No Switch 10' 1'h" Manual Manual 15" 3'." 20 / 9.1 EP0411A Piggyback/ Wide -Angle 10' 1h" 12" 6' 15" 21/9.5 EP0411 F Plug! No Switch 20' , 1 P" Manual Manual 15" 20/9.1 EP0411AC Piggyback/ Wide -Angle 20' 1'h" 12" b" 15" 21/9.5 EP0412 230 6 10 Plug / No Switch 10' 1W Manual Manual 15" 20/9.1 EP0412F No Switch Plug / 20 1½" Manual Manual 15" 20 / 9.1 EP0511F .5 115 13 20 Plug/ No Switch 20' 1%:" Manual Manual 15" 22/10 EP0511AC Piggyback/ Wide -Angle 20 , ., 1 fi 12' 6' 15" 23 / 10.4 EP0512F 230 6.5 10 Plug / No Switch 20' 1'/x" Manual Manual 15" 22 / 10 PAGE3 DIMENSIONS (All dimensions are in inches. Do not use for construction purposes.) COMPONENTS Item No. Description 1 Impeller 2 Base 3 Pump casing 4 Mechanical seal 5 Ball bearings 6 O -rings 7 Power cord 8 Oil filled motor 9 Motor housing/stator assembly 10 Motor cover 10 8 6 9 5 4 3 )C),( tern. Xylem, Inc. JJ Let's Solve Water 2881 East Bayard Street Ext., Suite A Seneca Falls, NY 13148 Phone: (866) 325-4210 Fax: (888) 322-5877 www.gouldswatertechnology.com Goulds is a registered trademark of Goulds Pumps, Inc. and is used under license. O2012 Xylem Inc. 83871 Rl April 2013 IPT JUL 0 9 2025 �'ayrielr C.. _,i1h1g Dept. 2.00 [5.1 cm] 14.34 [36A an] OUTSIDE DIAMETER ACCEPTS 4" SCHD 40 SOCKET 11.59 [29.4 cm] OPTIONAL BUSHING (FOR 4" THIN WALL PIPE) PART NO. 30142-R OR (FOR 110 MM. PIPE) PART NO. 30142-EUR OUTLET BUSHING ACCEPTS 4" SCHD 40 & 6" SCHD 40 PREVENT FILTER FROM FLOATING PL -525 -625 FILTER HOUSING PART NO. - 30142-525 30142-625 CEPTS 6" •HD 40 PIPE R INLET TENSION BALLCHECK 10.52 [26.7 cm] 8.10 [20.6 cm] 5.23 [13.3 cm] 33.02 [83.9 cm] 18.31 [46.5 cm] No. HOLDING TANK DOCUMENT NUMBER AGREEMENT 2025R-608368 )wner Name (s) Kew, fAh}mk Wf Mailing Address 1AW v as Notary Date) We acknowledge that application is being made for the installation of (a) holding tank(s) on the following property or that continued use of the existing premises requires that a holding tank be Installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be sewed by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. SPS 383, Wis. Adm. Code or Ch. 145, Wis Stats. NE 1/4 doff S L1 1/4 Section J0 Township 97 N. Range 06 W. Town of I /I Additional Legal Description: 5 3twr of /VC SUJ beSL {N ©ac adf9Q- 759V8 Gov't Lot _ Lot_ Block_ Subdivision CSM# Lot_CSM # Vol _Page _CSM Doc# DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 07/18/2025 AT 1 1 :28 AM RECORDING FEE: $30.00 PAGES: 2 Return To: ZOnrv�.q As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding tank installation and maintenance. If the owner fails to have the holding tank properly serviced in response to orders issued by Bayfield County or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats., Bayfield County may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. 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. 3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Stats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NR113, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the county within 30 days from the date of change to the service contract. 4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis. Stats., and Ch. NR 114, WI's Adm. Code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained.�rr`�ry �9 5. This agreement will remain in effect only until Bayfield County certifies that the property is served b$' eQ�he,r.e'ttNh'reT{ suer or a private onsite wastewater treatment system that complies with Ch. SPS 383, WI's Adm. Code. In additi 4js' agre nth y &cancelled by executing and recording said certification with reference to this agreement in such manner: q wil it the t a_ nce of the certification to be determined by reference to the property. - O ai N 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of t% a 3 ner. powne �� submit this agreement to the register of deeds, and the agreement shall be recorded by the register of d4ds ih,a manner _.\ III permit the existence of the agreement to be determined by reference to the property where the holding tank is 8ti5ta,q ' ............ * ,: .Kffr1 €. w'fbe,r It s4ae be - Notary swom to 7/14 Drafted by: 2 ! 3_4 CcD Date: 7 J1(-1 (coo & __ll U JUL 21 2025 L Personal infornalion you Provide may be used for secondary purposes (Privacy taw, s.15.04 (p(m)) u/torms/sanilaryAdtlinglan '�fi�l�'�6"�OIYli9g Dept. EXHIBIT "A" Parcel 1: The South 300 feet of the Northeast Quarter of the Southwest Quarter (NE'/,S W Y,), lying South of County Road G, Section Twenty (20), Township Forty-seven (41) North, Range Six (6) West, Town of Keystone, Bayfield County, Wisconsin. JUL 2.1 202) Bayfleld Co. Zoning Dept. BYFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: WILBER TRUST, KEITH E & ANTONIA M 20255 COUNTY HWY G ASHLAND, WI 54806 Description Additional Fee Amount Submission Number: AP -00039 Transaction Number: AP -00039-3196C Amount $25.00 Total: $25.00 Payment Amount: $25.00 Reference: 3868 Paid by: Greg's Plumbing, 13660 County Hwy H, Iron River WI 54847 Payment Type: Check Transaction Date: 8/5/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. V' = -VFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: WILBER TRUST, KEITH E & ANTONIA M 20255 COUNTY HWY G Submission Number: SS -00596 ASHLAND, WI 54806 Transaction Number: SS -00596-2F871 Description Amount Other $100.00 Total: $100.00 Payment Amount: $100.00 Reference: 3850 Paid by: Greg's Plumbing, 13660 County Hwy H, Iron River WI 54847 Payment Type: Check Transaction Date: 8/4/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-24�1 59SR STATE SANITARY PERMIT OWNER: KEITH E & ANTONIA M WILBER TRUST GOVT LOT: LOT: BLK: NE 1/4 SW 1/4 SEC: 20, T 47 N, R 6 W TOWNSHIP: Keystone SOIL TEST: 148-24 NEW SYSTEM SYSTEM TYPE: Mound >24 in. of suitable soil PLUMBER: GREG BROWN TRACY POOLER DATE: 8/8/2025 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 #: 24-159S LICENSE: # 699374 Condition: Must file the correct maintenance agreement within 30 days of issuance. THIS PERMIT EXPIRES 8/8/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION Industry Services Division 4822 Madison Yards Wa County t '¼"\Madison, l', i- WI 53705 San' ry Pe it Number (to be filled in by Co.) 'c). P.O. Box 792 Madison, Wf 2 S196u \{\c4 IS9 Sanitary Permit Application OCT 07 70 tatransactionNumber In accordance with SPS 383.21(2). Wis. Adm. Code, submission of this form to the appropriate governmental unit j3 t Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POnt$(L5"O(yiEM1* the Department of Safety and Professional Services. Personal information you provide may be u d for secondary purposes in accordance with the Privacy Law, s. I5.04(1)(m), Stats. Please Print All Information. 1. Application information — Property Owner's Name Parcel # KL e+owJkrTr✓ 37 9 Property Owner's Mailing Address Property Location loicy C T Govt. Lot — NEr1A 4 1., 10 Zip Code Phone Number ACity,fState -{ C- 1. J .r Q t S -' S .2. Z Section T N R O (D F. or QS H. Type of Building (check all that apply) Lot # Subdivision Name �l or 2 Family Dwelling — Number of Bedrooms 3 Block N ❑ Public/Commercial — Describe Use ❑ City of ❑ State Owned — Describe Use Village of CSM Number , rpTown of )'Q)S+OV\Q 111. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box an line B. Complete line C if applicable.) A. /New System y Replacement System p y. ❑ Other Modification to Existing System (explain) Additional Pretreatment Unit (explain) B' 1/ X Holding Tank X' ` In -Ground At -Grade 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. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) DesignSoil Appl' ' ion Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation Capacity in Total # of Manufacturer 'lank Information Gallons Gallons Units o 'gau O New Tanks Existing Tanks ` o 2 y .00 e.,U rn v en iZ V c. Septic or Holding Tank — Loot - r Cd mac, Dosing Chamber V. Responsibility Statement- I, she undersigned, assume respot ability for installation of the: POWTSshown on the attached plans. Plumber's Name (Print) I Mu r s SienI MP/MPRS Number Business Phone Number 37 s -2-o1 b Plumhe(s ddress (Street, City, State, Zip Code) /366 w if, r, t. r (,>Z. 5 g+{ VI. County/Department Use Only Approved O Disapproved Permit Fee ale Issued S wn ¶!(to(2Lf Is uing Agent Signature �� I f8/ ❑ Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval .14 `L k r9c4 oil EPtJ t,rs G n4 LC Jiecl W 1S r\ ZS o P Qn xmr 14 if rAty Plan to Q(/4.cr _n _ n.,. /, r�A,j O Ieer6. " or fTAri)raly) 0y&-ttm r l4r 1 k.. , Uk-1 Page 4 of 4 Holding Tank Management Plan nD E C [ ( I e 11 IMPORTANT: 1111 OCT 07 ?OZ4 U The owner of this holding tank(s) shall be responsible for its perpetual operation and maintenancq` u(sYant,tgririg Dept. requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this holding tank(s) 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. Estimated Daily Wastewater Flow = 300 gals per day 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 neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o surface discharge of effluent or sewage back-up into structure served SERVICING FREQUENCY o The tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the wastewater in the tank(s) reaches a level of one foot below the inlet invert of the tank(s). Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. Tank pumping reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wis. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Greg's Plumbing Phone: 715-209-0161 Local government unit: Bayfield County Zoning Department Phone: 715-373-6138 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, Wis. 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, Wis. Admin. Code. Contingency Plan In the event that any failed component of this holding tank(s) cannot be repaired, it shall be replaced pursuant to a plan submitted to the Department of Safety and Professional Services for review and approval. System Abandonment If use of this tank(s) is discontinued, it shall be abandoned in accordance with SPS 383.33, Wis. Admin. Code. OCT 0720Z4 20'Z4 HOLDING TANK — MANAGEMENT PLAN Bayfield Co. Zoning Dept. The Private Onsite Waste Treatment System (POWTS) has been designed and is to be installed and maintained according to SPS 383, Wisconsin Administrative Code, Holding Tank Component Manual for Private Onsite Waste Treatment Systems (SBD-10571-P)(R.6/99) and the Bayfield County Zoning Department Sanitary and Private Sewage Ordinance. This POWTS has been designed to accommodate a maximum daily flow of gSD gallons of domestic wastewater per day. 2. The owner of this POWTS is responsible for system operation and maintenance, locking device, alarm and access. 3. The owner or owner's agent is required to submit reports as required by SPS 383.55(1), Wis. Adm. Code, to the Bayfield County Zoning Department. 4. Design approval and site inspections before, during and after the construction are accomplished by the county or other appropriate jurisdictions in accordance with SPS 383 of the Wis. Adm. Code. 5. Maintenance Cycle. The holding tank must be serviced by licensed pumpers. An alarm system is to be installed to activate when the tank is < 90% full. 6. Performance monitoring. At the time of servicing, the service provider files a report with the department of designated agent. 7. A User's Manual will accompany the component. It will include the names and phone numbers of local health authorities, component manufacturer or POWTS service provider to be contacted in the event of component malfunction or failure. 8. In the event that this POWTS or a component of this POWTS fails and cannot be repaired the owner will find in the User's Manual the names and telephone numbers of property licensed individuals to contact for such repairs. This agreement shall be binding on all assignees and heirs NE 1/4 of 3W 1/4 Section 0W Township4') N. Range 06 W. Town of iL4yslsae Govt. Lot Lot Block Subdivision CSM# Additional Legal roperty Owners u/fors/mana gementplan Revised: July 2013 ate HOLDING TANK SERVICING CONTRACT OCT 072014 Contract Date This contract is made between the Bayfield Co. Zoning Dept. We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) P Legal Tax ID# )'//� 1 4, S t..1 1 4 � ♦ ) W � CATION LOCATION TaxStatement) (Use Tax Statement) 3 796 1f.� /� 7 Section.. ,Township % N, Range Q6.. W Town of: Lot Size ,3�grgga sv Acreage O Q. p5 Gott Lot Lot # GM Vol. Page J GM Doc Lot(s) No. Block(s) No. Sub ivision: I9R-s7 ,/ 1. The owner agrees to file a copy of this contract with Bayfield County as required in SPS 383.55, Wis. Adm. Code. 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local government unit which has signed the pumping agreement required by 383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding tank(s) on a semiannual basis. pumper further agrees to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service ci with the local government unit and the County named above within (10) business days from the date of change service contract. Y�9 Revised: May 2016 (®May 2018) Drafted by Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (I)(m)] SS_�J�GZ Document Number/Plan I.D. No. HOLDING TANK 37q9 9 AGREEMENT Owner Name (s) Owner(s) Mailing Address KeiW f hI, r 7k W, l be — ao;cr col- Mty Cr as We acknowledge that application is being made for the installation of (a) holding tank(: on the following property or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. SPS 383, Wis. Adm. Code or Ch. 145, Wis Stats. N1/4 of S h/ 1/4 Section ao Township _____N. Range O6 W. Town of /Cey dm tt //!1 Additional Legal Description: 5 3004 of it/if SA/ blest- Co ©DG 2oicE- 754`!8 Gov't Lot _ Lot_ Block_ Subdivision CSM# Lot CSM # Vol Page _CSM Doc# DOCUMENT NUMBER 2O24R-6O5O24 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 10/08/2024 AT 12,17 AM RECORDING FEE: $30.00 PAGES: 2 L5lyL5uV " 111 __ oning Dept. As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above described property, we agree to do the following: 1. Owner agrees toconform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding tank installation and maintenance. If the owner fails to have the holding tank properly serviced in response to orders issued by Bayfield County or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats., Bayfield County may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. 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. 3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Slats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NR113, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the county within 30 days from the date of change to the service contract. 4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis. Stats., and Ch. NR 114, WI's Adm. Code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained. 5. This agreement will remain in effect only until Bayfield County certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment -system that complies with Ch. SPS 383, WI's Adm. Code, in addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. OwnerT(s)'Name(s) — PleasePrint Subscribed a orn to befor e on this date: .VcIT r �_ uil -rr`v54YC5 otar' nature(s) Notary Public My Commission Expires: - IL�y�i, Drafted by: //fl—tDate: NErrALyMQaALEs ~ �� .._!.- Personal Inlornnliun you provide may be used Ior secondary purposes (Privacy Law, a.15.04 (I)(m)1 ullormslsanita Nl tienLdoc ©June 20 Connececticuticut My Commission Expires Oct 31, 2025 DII OCT 092UL4 Bayfield Co. Zoning Dept. Legal Description Parcel 1: The South 300 feet of the Northeast Quarter of the Southwest Quarter (NE'AS W'h), lying South of County Road G, Section Twenty (20), Township Forty-seven (47) North, Range Six (6) West, Town of Keystone, Bayfield County, Wisconsin. 10110/24, 2:39 PM CarmodyTm BAYFIELD COUNTY SANITARY PERMIT (#04)-24159S STATE SANITARY PERMIT OWNER: KEITH E & ANTONIA M WILBER TRUST GOVT LOT: LOT: BLK: NE 1/4 SW 1/4 SEC: 20, T 47 N, R 6 W TOWNSHIP: Keystone SOIL TEST: 148-24 NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: Greg Brown ALESSANDRO HALL Authorized Issuing Officer DATE: 10/10/2024 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: # 699374 Condition: Tank to meet all setbacks and be located within 25' of all-weather road. Management plan to owner. Maintain system per recorded agreement. THIS PERMIT EXPIRES 10/10/2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION https://www.carmodyinc.com/PermitApp/Permit_Sign.aspx?Print=l &permitappid=7396 1/2