HomeMy WebLinkAbout26-2SDepartment of Safety
SS- oo ISg7 & Professionaj,$�e�,,_
Industry Servf&s h(EP
Sanitary Permit Application In accordance with BPS 383.21(2), Wis. Adm. Code, submission of this form to t)Sd `0 rental unit
is required prior to obtaining a sanitary permit Note: Application forms for state-o'w�-n e•�d,,11 of 1AAliQ1 to
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats.
T. Annlirnfinn Information— Plrocr Print All Tnfnrmnfnn
h
Mason, W 2 sYBS(o
H. Type of Building (check all that apply)
or2 Family Dwelling —Number of Bedrooms 3
❑ Public/Commercial — Describe Use
❑ State Owned — Describe Use
9o3. W - f,s90
Lot #
Sc'. P e i�a
nit Number (to beef
17 c
S
State
aa`130 Sv+l\erlc...d Rd
Parcel# TNr I DI 3l'J
Govt. Lot
SE /., /, Section a7
0 Cityof
CSM Number 0 Village of
J$I'own of M0.s an
M. 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
a licable.
A. New System ❑ Replacement System (explain)
y p y ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit
B. J-Iolding Tank ❑ In -Ground ❑ At-GradeDesign Type (explain)
❑ Mound ❑ Individual Site ❑ Other
(conventional)
C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner
List Previous Permit Number and Dam Issued
Expiration
and Tank Information:
Capacity in
I Total
I # of
I Manufacturer
I
Tank Information
Gallons
I Gallons
Units
I ,
o $
v
.2
New Tanks
Existing Tanks
o
J
y_
Cc ooT,onK
a.u
in
i= c7
w
Septic or Holding Tank
11f:A nc—T1
--
r1(1h
1
4. :- 1svtnSi-
JC
V. Responsibility Statement- I, the undersigned, nssume,y�Spoasibiity for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber' gnature MP/MPRS Number Business Phone Number
Th.-,:s sw4el- fie Id G5a879 715-43Y-g17(o
Plumber's Address (Street, City, State, Zip Code)
1124(.vi 6+*.+e Aea.z77 u'&rc�, WT Sti$43
County/Department Use Only
pproved 0 Disapproved Permit Fee Date Issued mhL Issuing nt Si ature
0 Owner Given Reason for Denial — �7 / 3
Conditions of ApprovaUReasons for Disapproval
ce a �
Attach to complete plans for me system arm summit to the county only on paper not less loan a tax it inches in size
SBD-6398 (R. 03/22)
E&y&EREU
Soil Test# l�
Bayfield County
Waiver of a Thorough Soil & Site Evaluation RECEIVED
(subject to 15-1-10(d))
JAN 16 2026
ci-nc ld A S?rec4&e is Tc a certified soil tester determine that in rg professional
judgment the following site (see below) is unsuitable for any treatment compong+ntiothThzttthrt f5ording
tanks. Due to soil & site conditions, a thorough soil and site evaluation is not needed to make such a
determination.
Property Owner ands TocK We;ss Co
Property Address' -30 SA'l,erlcAd RA Authorized Ag
Mass.,, Lox 5485- G Agent's Telephone
Telephone 903 -°a - taS99O Written Authorization Attached: Y or N
Accurate Legal Description is requested:
SE 1/4 of 1Jt~) 1/4 Section a"1 Township 4/a N. Range 0(o W. Town of Mascsn
Additional Legal Description: 45'-q (MFL- CL.65ED SO Y(t$ - Y0. OF ENTAY 1999)
%t4 Doc Jo5R- C 2,3(01
Govt. Lot Lot Block Subdivision
Lot CSM# Vol
Volume Page of Deeds
Page CSM Doc #
TaxI.D# a37)y Acreage 5-'Q
Indicate reasoning for your determination: Ct c,y Sc;) s, less j'1, an "A + N " io
i-eaoxir»orpti:G +ea.+urcS
l .7/3
Signaa eeo County Official
Date
Si nature o Certified Soil Tester
l I/ )9 /as
Date
CST 1* ,)a 4bag
SP -611950 0 0 05 -
Certification #
(Submit a Plot Plan & Fee)
u/forms/soi Itestwaiver(KL K )
June 2018
'
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; yk' F, `� Yx
�.�,Y 1, l_. -tC^Wt ,:�
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+
Mason -
REC&vgo
JAN 182026
CONCRETE HOLDING TANK DESIGN PlanningOand Zoning Agency
Single Combo Tank Option
INDEX AND TITLE SHEET
Project Weiss - 22430 Sutherland Rd
Owner Randy Jack Weiss 903-gas-c,sgO
Address 23480 Faith Church Rd
Mason, WI 54856
Legal Description SE 1/4, NW 1/4, Sec. 27, T46N, R06W
Township Mason County Bayfield
Subdivision Name TAX ID: 23714
Parcel ID Number 04-032-2-46-06-27-2 04-000-10000
Plan Transaction ID Number
Designer Travis By Orfield
Signature
License Number 652879
Lot No.
Index and title sheet Page 1
Holding tank specifications Page 2
Site plan Page 3
Maintenance and contingency plan Page 4
Phone No. 715-634-8176
Date 01/12/26
Designed pursuant to:
Holding Tank Component Manual For POWTS (Version 2.1)
May 2022-2027
Version 7.1 (07/22) Page 1 of 4
HOLDING TANK SPECIFICATIONS
3 Number of bedrooms
Non-residential estimated flow (gpd)
2000.0 Minimum holding tank volume required (gal)
Side A Side B Total
1273.0 I 772.0 I 2045.0 IProposed tank capacity (gal)
Superior Precast Tank manufacturer
1250/750 2 -Compartment Tank Tank model number
SJE Rhombus Alarm manufacturer
PS Patrol lAlarm model number
Tank Dimensions and Data
� lX for round tank
45.0
Liquid depth below inlet invert (in)
8.0
Maximum depth of soil cover (ft)
62.0
Height (in) 1 Outside
165.0
Length (in) - Dimensions
79.0
Width (in) J Only
WIN l 62026
Bayfield Co.
Planning and Zoning Agency
Tank Anchor Calculations
17451
lbs
Weight of tank and cover
1.10
Safety factor
14651
lbs
Weight of anchor required
19.4
in
Soil cover req. for anchor or
3.6
yd3
Concrete counter weight
HOLDING TANK CROSS SECTION
Electrical complies with NEC 300 and SPS 316
optional vent pipe
vent pipe manhole cover with finished
location locking device andLi
junction warning label grade
box
j4"min. 4" mi.
23 in. 18" min.
conduit
thether
weight
service
blind plug
alarm on
to seal
outlet
90% Full 33.1 in
Side B 772.0
3 in. bedding under tank.
Note: All tank joints, and joints
between tank openings and
piping are sealed watertight. All
pipe and vent materials comply
with SPS 384. Manholes with
locking device are typical for each
manhole opening .
Side A 1273.0 gal
Tank is anchored as necessary to negate buoyancy.
building sewer
inlet
Project: Weiss - 22430 Sutherland Rd
Transaction Number: Page 2 of 4
RECEIVED
JAN 16 2026
eayfiew co.
.......y aInJ
HOLDING TANK SITE PLAN
Project: Weiss - 22430 Sutherland Rd
Legal Description: SE 1/4, NW 1/4, Sec. 27, T46N, R06W
Subdivision Name: TAX ID: 23714
Scale: 1" = 40 ft I Parcel ID: 04-032-2-46-06-27-2 04-000-1000 Lot No.:
TO
SUTHERLAND
RoAO
I.D.:
1311= Nail tot a. bbay. ;n
P:nc Trtc
Ht. taSn/75O5c1• Cc,...b.nc.4;c.-,
Tan1C r.adc by $„peraer
Prccasf fie be vscd as c
Joao 5ai, lioldrn3 Tnnt<
Page 3 of 4
RECEIVED
HOLDING TANK MANAGEMENT PLAN ,f AN 16 2026
This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be inst &#rsd
maintained according to SP 383, Wis. Admin. Code, the Holding Tank Component Manual (S"���$ ngAgency
N. 03/07, R. 01/12), and the Bayfield County Sanitary Ordinance.
1. This POWTS is designed to accommodate a wastewater flow of 60 to 409.0 gpd.
2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in
the attached Holding Tank Servicing Contract and Maintenance Agreements.
3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet
(at which time the alarm will activate), the pumper listed in the current Servicing Contract must be called to
empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code.
4. At each service event, the service provider should visually inspect the condition of the tank, risers and
manhole cover(s) and verify that the alarm system functions and manhole locking devices are present.
Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions
shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code.
5. All service events or inspections of this POWTS shall be reported to the county within 30 days.
6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be
removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes
tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes
a failing POWTS and may result in issuance of correction orders or a citation by the county or state.
7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards
for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue
of a person from the interior of the tank may be difficult or impossible.
8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank
may be installed in the same location (a new sanitary permit is required for such a replacement). Con-
nection to municipal services would also be considered at this time if they are deemed available to the
property.
9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in
accordance with SPS 383.33 Wis. Adm. Code.
10. If there is a problem with, or question about this installation, the following persons may be contacted:
a. Installer .............................Butterfield Butterfield Inc Phone: 715-634-8176
b. Service Provider ..................Scoff's Scott's Septic Phone: 715-699-7279
c. Co. Zoning or Health Dept. Bayfield County Planning & Zoning Phone: 715-373-6138
11.
Project: Weiss - 22430 Sutherland Rd
Transaction Number: Page 4 of 4
A SUPERIOR
PRECAST CONCRETE
Weight (in lb s)
Tank: 10.662
Lid: 6,789
Total: 17.451
Volume of Concrete
Total : 4.4 Yd'
Gallons Per Inch: 46.8
Enlarged Detail
Conditionally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
SEE CORRESPONDENCE
1250/750 2 -Compartment Tank
J TE+.
50"
/
Manhole Openings
3" Tam.
O
Polyethylene
Baffle
Mastic
Rope
TOP VIEW
165" 2 ,
997' U-- 60"
r SUPERIOR
PRECAST CONCRETE
RECEIVED
N 162026
_i eavfield Co.
73" 79'
1273 Gallons 772 Gallons
28.28 GPI 17.15 GPI
SIDE VIEW L 28"
S" Air Space
4"Lad
I th M
iLr6L
488 I
Produced by Superior Precast Concrete, LLC
PO Box 1390
Hayward, WI 54843
SUPERIOR
PRECAST CONCRETE
Design conforms to ASTM C1227, Specification for Precast
Concrete Septic Tanks and WI SPS384.25, POWTS Holding
Components or Treatment Components.
The information provided on any Superior Precast
Concrete (SPC) drawing or document shall be verified by
the purchasers licensed professionalengineerfor
suitability of use.
Configuration may change from drawing, consult with SPC.
Product File No: I This is proprietarylnformation, and remains the property of Superior Precast Concrete, LLC. I R.305-1920241
RECEIVED
Real Estate
Bayfield County Property Listing
Status: Current
JANProperty
16 2026
Today's Date: 11/25/2025
Created On: 3/15/2006 1:15:45 PM
Bayfield Co.
Description
Updated: 8/28/2025
bUg&i6oningA9ency
Updated:8/28/2025
Tax ID:
23714
RANDY JACK WEISS
MASON WI
PIN:
04-032-2-46-06-27-2 04-000-10000
Legacy PIN:
032105304000
Billing Address:
Mailing Address:
Map ID:
RANDY JACK WEISS
RANDY JACK WEISS
Municipality:
(032) TOWN OF MASON
23480 FAITH CHURCH RD
23480 FAITH CHURCH RD
STR:
S27 T46N R06W
MASON WI 54856
MASON WI 54856
Description:
SE NW 459 (MFL-CLOSED 50 YRS-YR OF
ENTRY 1999) IN DOC 2025R-608369
P Site Address * indicates Private Road
Recorded Acres:
40.000
22430 SUTHERLAND RD
MASON 54856
Calculated Acres:
38.262
Lottery Claims:
0
® Property Assessment
Updated: 4/22/2014
First Dollar:
No
Zoning:
(F-1) Forestry -1
2025 Assessment Detail
ESN:
122
Code
Acres Land Imp.
W7-MFL - OPEN - BEFORE
40.000 52,000 0
2005
Tax Districts
Updated: 3/15/2006
1
STATE
2 -Year Comparison
2024 2025 Change
04
COUNTY
Land:
52,000 52,000 0.0%
032
TOWN OF MASON
Improved:
0 0 0.0%
041491
SCHL-DRUMMOND
Total:
52,000 52,000 0.0%
001700
TECHNICAL COLLEGE
Recorded Documents Updated: 11/29/2012
a MFL TRANSFER ORDER
Date Recorded: 8/19/2025
2025R-608828
® SPECIAL WARRANTY DEED
Date Recorded: 7/18/2025
2025R-608369
O SPECIAL WARRANTY DEED
Date Recorded: 10/5/2012
2012R-546142 1092-406
O CONVERSION
Date Recorded: 3/15/2006
757-303
W Property History
N/A
9v3 4a� C,s9O
ReCENED
HOLDING TANK — MANAGEMENT PLAN m 162026
Bayed co.
The Private Onsite Waste Treatment System (POWTS) has been dgryjg"eMA#ia!I'9� r'�e
installed and maintained according to SPS 383, Wisconsin Administrative Code,
Holding Tank Component Manual for Private Onsite Waste Treatment Systems
(SBD-1 0571 -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
4 o° 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.
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.
Performance monitoring. At the time of servicing, the service provider files
report with the department of designated agent.
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.
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
1/4 of 1/4 Section a7 Township /6, N. Range 0Cc W. Town of i"lasor
Govt.
Lot Lot Block Subdivision CSM#
Additional Legal Description 40 acre p arce I , Ta..e ID: x3'71 H
L4L(l�er
Propert ers Signature
u/forms/managementplan
Revised: July 2013
// -; r
Date
HOLDING TANK SERVICING CONTRACT RECEIVED
JAN 16 2026
Contract Date
Bayfield Co.
11 /Z f/ Zc This contract is made between aMZonin9AQency
Holding Tank Owner(s) Name(s)
Rot K l We— l 5 s
Pumper's Name (Print)
Pumper's Signature
Pumpers' Registration #
S&,,* VoPPc
°'6�r —
Yi k -r 3
We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions)
PROJECT
LegalDescription:
tn:
Tax IOU 'Z
G
1/4, 1/4,
LOCATION
(Use Tax Statement)
Z ` N, Range `� w
Town of:
A
Lot Size
Acreage
Section ,Township �(N _
,A a ,S o N
)lO
—/
GoVt Lot
Lot rt
CSM *I
Vol. Page
CSM Doc U
Lot(s) No.
Block(s) No.
Subdivision:
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 SPS
383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding tank(s) on a semiannual basis. The
pumper further agrees to include the following in the semiannual report: `,,� rmrrr"rrrrns,
�.�
a. The name and address of the person responsible for servicing the holding tank; Mfr. Pll HFY.,�,`p•
b. The name of the owner of the holding tank; •°�p�•' +,
c. The locationtnk
d. The sanitary permitpnumber issued for the holding tanks installed; E } NOTA/�y = 1
e. The dates on which the holding tank was serviced; = COei p(/LIC+ '<
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%.. •e. .
4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event oVa ?il, in his
contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract
with the local government unit and the County named above within (10) business days from the date of change to this
service contract.
Owner(s) Name(s) (Print) Owner's Signature(s) Subscribed and Sworn to me:
d u ) 4 S I on this 4W7day of a rnJJP_y , 7n9.S
RQ U0I " by
ary Public
My commission expires on:
Revised: May 2016 (®May 2018) Drafted by
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (I)(m)]
Document Number/Plan I.D. No. HOLDING TANK
AGREEMENT
Owner Name (s) Owner(s) Mailing Address
RaKei JUCIL wC/ SS 23`190 >'—Ai4 Ct- u. ✓iGI /4/
y Mbsv✓r, W) q2/8 sb
Parcel Identifier Number (PIN) Agreement Date (same as Notary Date)
04.031- L-4&— 06-z7 -Z
n4-nno— / ODOO
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.
i5 if 1/4 of �v i 1/4 Section Township N. Range W.
Town of
Return To:
Additional Legal Description:
Gov't Lot Lot_ Block_ Subdivision CSM#_
Lot CSM # Vol _Page _CSM Doc#
DOCUMENT NUMBER
2025R-610085
DANIEL J. HEFFNER
REGISTER OF DEEDS
BAYFIELD COUNTY, WI
RECORDED
1 1 /24/2025 AT 1 1 :43 AM
RECORDING FEE: $30.00
PAGES: 1
NOV 252025
Bayfield Co.
Planning and Zoning Agency
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.
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.
Owner(s) Name(s) — Please Print
Subscribed and sworn to before me on this date:
avvy 5i)�y we-i'15�•'
°•'mt HEY
Notarized Owner(s)—Signatures)
Notw Public yvonne M Hewi4ah1
e'>. r
.—
s
y Commission Tres:
UbLC
y,
oa
"- s'
Drafted by: 1 i i/r] 4.1,y g Ai w�) 7 S Date: J/
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (g(m)l
a 5 UFW15"
'4�4sgmmuWP
u/forms/sanitarymoldingtankegreement.doc ®June 2018
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:
WEISS, RANDY JACK
23480 FAITH CHURCH RD
MASON, WI 54856
Description
Certified Soil Tests - Review & Filing Fee
Submission Number:
SR -00380
Transaction Number:
SR-00380-3BA19
Amount
$50.00
Total: $50.00
Payment Amount: $50.00
Reference: 4157
Paid by: Butterfield, 14346W State Rd 77, Hayward WI 54843
Payment Type: Check
Transaction Date: 1/16/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
B-AYFIELD 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:
WEISS, RANDY JACK
23480 FAITH CHURCH RD
MASON, WI 54856
Description
Private Sewage System (Holding Tanks)
Submission Number:
SS -00697
Transaction Number:
SS-00697-3BA1A
Amount
$400.00
Total: $400.00
Payment Amount: $400.00
Reference: 4157
Paid by: Butterfield, 14346W State Rd 77, Hayward WI 54843
Payment Type: Check
Transaction Date: 1/16/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
BAYFIELD COUNTY
SANITARY PERMIT (#04)-26-2S
STATE SANITARY PERMIT
OWNER: RANDY JACK WEISS
G OV'T LOT: LOT: BLK:
1/4 1/4 SEC: 27, T 46 N, R 6 W
TOWNSHIP: Mason
SOIL TEST: 3-26
NEW SYSTEM
SYSTEM TYPE: Holding Tank
PLUMBER: TRAVIS BUTTERFIELD
TRACY POOLER
Authorized Issuing Officer
DATE: 1 /16/2026
CHAPTER 145.135(2) WISCONSIN STATUTES
a. The purpose of the sanitary permit is to allow Installation of the
private sewage system described in the permit.
b. The approval of the sanitary permit is based on regulations in force on
the date of approval.
c. The sanitary permit is valid and may be renewed for specified period.
d. Changed regulations will not impair the validity of a sanitary permit.
e. Renewal of the sanitary permit will be based on regulations in force at
the time renewal is sought, and that changed regulations may impede
renewal.
f. The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314
Note: If you wish to renew the permit, or transfer ownership of the
permit, please contact the county authority.
PREVIOUS PERMIT #:
LICENSE: # 652879
Condition: Properly Maintain System Per Recorded Agreement. Must be within 25 ft of an all-
weather road.
THIS PERMIT EXPIRES 1/16/2028
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION