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HomeMy WebLinkAbout22-165S** INBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY ** TIME RECEIVED REMOTE CSID DURATION PAGES STATUS December 13, 2022 at 9:45:42 PM CST 7157983470 37 1 Received —' DEC/13/2022/TUE 09:43 AM Andry Rasmussen & So FAX No, 7157963470 P.001/001 Request for Sanitary Inspection Fax this form to Zoning Dept when you want an inspection — 373-0114 If you do not have a fax and must email the inspection; you must email all staff members Note fjTime Change Discrepancy fl Other Phone Number Plumber: ,q 1 2e�s(lnvlce ' �;—flr� y, S - -'? c7 f f Fax Number 1S-' -3ti'v Home Owner: TOAD 'V C'i--i--IJ4-s"P✓'� Sanitary Permit #: Plumber's Choice Zoning Dept No inspection during these times Date: 1 J i I / � 9:30 am —12:30 pm Tues. (Tracy) 12:00 pm —2:00 pm Wed. (Todd) 9:30 am —12:30 pm Thurs. (Tracy) Time: Plumber's Choice Zoning Dept Immediate Phone Number so Zoning opt — (0f,) Dept can call you right back (if needed) Township: GA Address # & Road Name: or �t I ( S 6 B ,S �%�} H K O L� F I C - &� Directions c_�;LL_ WAN To Site: Comments; 1 Reminder: You must confirm any change(s) that have been made prior to or this inspection will not be scheduled and a memo will be sent voiding the inspection. Thank You! From Zoning Dept ** Plumber must verify any change(s) by fax or no inspection will be scheduled ** of onnsfsanttary/requestforinapactlon Zoning Dept (04112t04) ® August 2D21 D /J '„ly£�iF Industry Services Division General Information Personal information you provi Private Onsite Wastewater Treatment Systems ( POWTS) Inspection Report (Attach to Permit) de may be used for secondary purposes I Privacy Law, s. 15.04(1)0)] City 9 Village 9Town of: JASPER, THOMAS G & ROACH -JASPER, CATHERINE M 45885 TAHKODAH LAKE RD CABLE WI 54821 ranKinrormatlon TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Septic N/A Dosing f i ypv r N/A Aeration N/A Holding setback to: County Sanitary Pe it No: State Plan Transaction ID#: Parcel Tax No Pump! Siphon Information Pump Manufacturer Pump Model Demand GPM Filter Manufacturer Filter Model TDH Lift Friction Loss Head Total Forcemain Length Dia Dist. To Well Dispersal Cell Information DIMENSIONS Width Length # of Cells SETBACK FROM Prop. Line Building Well OHWM Type of Cell Manufacturer: Model Number: Pretreatment Unit Manufacturer: Model Number: Distribution System Elevation Data STATION BS HI FS ELEV Benchmark Bldg. Sewer Tank Inlet Tank Outlet Dose Tank Inlet Dose Tank Bottom !a' Inst. Contour Header / Manifold Distribution Pipe Infiltrative Surface 7C c) Final Grade X Pressure Systems Only Header / Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length _ Dia Length _ Dia _ Spac Spacing 0 Yes ❑ No Soil Cover Depth Over Depth Over Depth of Seeded I Sodded Mulched Cell Center Cell Edges Topsoil 0 Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons p�esent, etc.) ly �pJd 5 tul�6 N° �b �s° 4 ty+ �� d ,y %�f bud Plan revision required? . as 0 No Use other side for additional miormation. yyt3 Date qRn-A71n IR norm POWTS Inspector's Signature License Number BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT _ Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zoning(aWayfieldcounty.wi.aov 117 East Fifth Street Web Site: www.bavfieldcounty.wi.gov/147 Washburn, WI 54891 Property Owner JASPER, THOMAS G & ROACH -JASPER, Information CATHERINE M 45885 TAHKODAH LAKE RD CABLE WI 54821 As you know was contracted by you to install a private onsite wastewater treatment system on your property described as: Notes: Abandonment of Old System to meet all applicable code requirements: *- Tank was pumped by: r Tank was crushed / removed and pipes disconnected by: on at AM/PM On at (AM / PM) the 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. ❑ 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: URormslsanitarypropertyowner-input April2019 ," RECEIVED) Department of Safety Corr`t' 1 S & Professional Services, end. P i%, S ,/ OCT 2.12022 Industry Services Division Sanitary Pe it Number (to 6e filled in by Co.) It Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(I)(m), Stats. L Application Information — Please Print All Information Property Owner's Name Parcel # I S 6. ' Ca-1'he(ni e , i4A - 3'a er- e395 Property Owner's Mailing Address ProppIQ'rty Location /Q� Skkg I akaak (fie ^i^ ' / Govt. Lot 3 City. I Zip Code Phone Number yyState wt ip� 5T� Z( 71S - � Z Y., '/., Section T N R II. Type of Building (check all that apply) Lot # nn f)i]l or2 Family Dwelling—NumberofBedrooms P Subdivision Name ❑ Public/Commemial — Describe Use Block #', ❑ Cityof O Village of ❑ State Owned — Describe Use CSM Number /t qdTownof III. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if a lIcable A. ❑ New System Re lacement5 stem p y ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B' ❑ HoldingTank 931n -Ground C65Er) ❑ At -Grade ❑ Mound ❑ Individual Site Design lo Other Type (explain) (conventional) C- 0 Renewal Before 0 Revision ❑ Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration %u / oq 0 f≥ 1-13 —( IV. DispersaVfreatmentArea and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal`Area Required (sf) I Dispersal Area Proposed (st) I System Elevation s (0 Jd0 500 RtJa6 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units 2 a New Tanks Existing Tanks a 2 g s 0,0 rn H n, IiZQ iY Septic or 4oldyg Tank (qpp ( 0U ( /S2t455I'1 Dosing Chamber s(�0 7( 4 sf0 ( V. Responsibility Statement- I, the undersigned, assume responsibili iostalla 'on of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Sigma MP/MFRS Number Business Phone Number Tnsbh Ku�-H-f-f fo7&751 71S• 7gg-338� Plumber's Address (Street. City, State, Zip Code) D. Ge ff VI. County/Department Use Only Approved O Disapproved Permit Fee Date Issued s ng t ature O Owner Given Reason for Denial2/ Conditions of Approval/Reasons for Disapproval Gee fr tG�6it* Attach to complete plans for the system and submit to the County only on paper not less than 8 Ills 11 inches in size SBD-6398 (R 03/22) oCt. Wi`c sconsi� p�r���nlbf�Illety and Professional Services Page of $ Division OT ndustry Services �V g SP OCT 2.12022 SOIL EVALUATION REPORT U In accordance with SPS 385, Wis. Adm. Code Attach complete site plan ji$c12 x 11 inches in size. Plan must Include, County BAYFIELD but not limited to: vertical addddYTiio"nibntal reference point (BM), direction and percent slope, Parcel I.D.'t&k XL) 4 3 Z S scale or dimensions, north arrow, and location and distance to nearest road. P1 Li C) (Z.1OO L6 OD C) Please print all information. for Law, 15.04(1)(m)). e y Date,,, /1/;37/5 Personal information you provide may be used secondary purposes (Privacy s. 'roperty Owner rtj0 VXcLS (3- - Pte r Property Location ❑ (T r �"' C -a4 &e`' yL �./1 . I�OG�C-✓t,— .14$ Govt. Lot L >1 fl 3 r / �r D3 T 43 N R Q 1 E (or) 'roperty Owner's Mailing Address I Site Address or CSM and Lot#: City I State Zip Code I Phone Number I U City U Village J4 Town I Nearest Road C�%(e Wl 5y92, (11S )'M9C,Z CabV ovt Tal koc41n L4 ❑ NewConstruction Use: ® Residential/Numberofbedrooms 2- Code derived designflow rate 300 GPD IKit Replacement (( ❑ Public oyr1 om rcial — Describe: Flood Plan elevation if applicable — __ ft. Parent material 'q14Lt a.. [ t, �1 General comments and recommendations: • I _ e _ i I S SU _L et eV Q 6- rely 1 TG S P/V jJ I I Boring# ❑ Boring 1[ Pit Ground surface elev.95.0Z ft. Depth to limiting factor/ r(_in. / elev.'96 62ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPO/Ft' Eff#1 Eff#2 Z r30 � y 15 o c tx. l I r 2a1 CC •1 L (o 30 -HI t1 S tt IJtt .Ip I•o I# 46-1006 it uy cs rt Ir -- IucA.L, LU ri r w t c ct .le Boring # M . C ❑Boring Fit Ground surface elev.4s t. Depth to limiting factor 11 _ in. / elev. g` • _t� Soil Application Rate Horizon _ Depth In. Dominant Color Munsell Redox Description Cu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 'Eff#1 'Eff#2 I o-2 '73y'_3Z- 1 S J✓ 5W 24-c- -1 1. 6 'L $ -3 Z Y y — Ii D -S N11 h ZJF1 .7 l• 31-S6 a cj tt tt 4 (dfF iF(- (.o 4 5o -II t y — la se.c Go 4` 4 tL,%, r - S Loa .(p CST Name MERTON MAKI I Signature atL CST Number 224901 Address 10869N SMITH COURT Date Evaluation Conducted Telephone Number p (715) 634-8719 HAYWARD, WI 54843 Ib — I$ -ZZ Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L • Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L ff' j • ❑ Boring Boring # E s4 Pit Ground surface elev. 6. l_ Page of Depth to limiting factor 1�O in. / elevg6 •lZft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 2- ____ £�f �t - t5 irs ______ 1t - (( — 44 -- 7 ___ . 6 L. D BrL 3 S rs 4 Lo4d L-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft_ Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 n es : b 1c iso d . 300 S©: c _ 500 ftcc- 2- Tr- - rz -PL o w "d' x !D0 es s;e . , Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 w Y ' v 15' * Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 : 150 mg/L * Effluent #2 = BOO, 5 30 mg/L and TSS s 30 mg/L •Ttwas fer t: 7-scS- £4o42 p4- L. 1, S 31 i q-3 J1 7L) T©c�n oc Q1� i C-2 ( 3 a 5 A Oto ` & Toe cc $Z 9512 gtif Sey TGM, �nl = aDR1 I • . • jr' -- - la Z �QSiY LLSS'e l • T. tiS Z I T c KoA� 4 1 o' Pt ,� Mems`" Owncr: - CST: - Sys. ��Y a� Sys: Range `pct a o 2_ Be!$ Ci. $ e€.j J I IEEE t ! S-st. __ ^ ::::::O::::E:: .-- L- i.ww. fi1E ll tS irS - 323232 C : ::i:: I ::iI EEE:EE1 _______ EI ,_____ PAGE 1 OF 5 In -Ground Dosed -Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 5 Index & Cover Sheet Pg 2 of 5 Plot Plan Pg 3 of 5 Dispersal Area Cross -Section & Plan View Pg 4 of 5 Pump Tank Specifications Pg 5 of 5 Management Plan Attachments: Pump Curve POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description `Thb v2S 6. 3ascer d Owner Name(s): Co. nna Im, Roach - J&pr Phone: 7i5 - SS'k -q4I<z Owner Address: 4SliS -7-ahkvcW,, %e At iI!aIer wt Zip: S'FBZ( Project S Address: S; Me Qaboy e Govt.'e�Lot: I 1/4 of 1/4, Section 3 , T `tc3 N -R '7 E ❑or W Township: U.-4Jk- County: Project Parcel ID #: '? Designer Information Designer Name: JAtr Vu.eikcI Phone: Designer Address: 40 , Bo>c ( (, Awe, Lu.S E-mail:r License Number: (o7S7.s1 Remarks: 715 -7k8 - 33S5 Zip: SV5a/ ;,r„y .1i. (.S ( r / / COUNTY Signature: Date Original sig ature required on each submitted copy. IRS (n/(8/2Z -O- Tams G . d ' al-kearoe Vvt Roach - iczspev' 4,5825• To�lnkoda4 Lake Rd. Cable,ws 9{-g2-1 7S-Ss8- yot a p4-, o-. G.L. I, S 3, T(13Nd, Q'7W Tawn of cL40 k, ia c, w2 ftv l & 83as. Sc4erb V' =4o'- fZ-eV.str�.# lo4(no I z4zle493 (co.ulhaber) A Om = loo' e floe oC Ga rage slabs se - cc Door 6(; Bat 83= 4G. j2' SMc+e-m (New): q 0.o' Sep cT"v,syL,{-= 4o,g3 pvoposrd pimp iv k a t of6m = glo.is-' ± P°([Pr.'np -hta QSmccsseTIS" 2" PYC �L a� force ma ,, (000 S.T. (EYasi-,) ' z csu c�r.:yz Rome luxll 7 A Appro. L84 -La � B3 3' K 56' Gau.s w 1 a -z flow uni4s Co) -f a�l�-o dale lr,-ke `Rd• �l Jason N& s! IM Po,L9l2z Cross Section of a two cell EZ Flow In -Ground Dispersal Co mponent omponenfi Cell Separation 12" Design Flow 300 / Loading Rate a �o = Required dispersal area©D Required dispersal area. 5dd / 50 (EISA) = to (number of units) Geotextile fabric to meet Comm 84.30(6)(g) �` (22-) Minimum of 12" of cover over top of cell x'15 Two Observation/vent pipes to be provided per cell CLL(,,s Not to scale Cell #1 System Elevation: 90 Final Grade: QS Qlo Cell #2 System Elevation: 9 Final Grade: 9S- QUO 1 e Fabric PAGE 4 OF 5 • GRAVITY -DOSED SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4"0 Vent Pipe >10ftfrom Building Electrical must comply with 12" Min. or 2.0 ft above SPS 316 and NEC 300 Established Flood Elevation Weatherproof Extend manhole riser as necessary. (typical) Junction Box Approved Approved Locking Manhole IMPORTANT: Vent Cap with Warning Label Attached Anchor tank(s) as necessary (typical) pursuant to SPS 383.43(8)(g) ---conduit 4" Min. or 2.0 ft above Established Flood Elevation (typical) Airtight Seal Finished Grade . Quick Disconnect f CAPACITIES @ 1`a5i gal/in `' •• - Depth (in) Volume (gal) A 22,0 21(e.74, B 2.0 a5,« [C] 6.0 rlS,4g D !6 6 1zs 8 ' * Pump Tank Liquid Level = in • Force Main Diameter = Z in Force Main Length = 71S ft Force Main Void Volume = I Z,2 3 gal [C] Total Dose Volume (TDV) = 7Z.23 L.(: 0.2X design flow + force main void volume) Vertical Lift = 3 0 q ft Weep Hole [fl A II _Alan 4B On I Pump _Off D Concrete • Block 3" Approved Bedding Material Beneath Tank gal/dose PUMP TANK: Volume= 5 L&0 gal Manufacturer: Sra6 iii Pump Manufacturer: a(L"1tn Pump Model: P_S 3 (See attached pump curve.) Controls/Alarm Manufacturer: sire Controls/Alarm Model: i 6 ( 4w Float switches containing mercury are prohibited. 18" Min. (typical) • Approved Joints with Approved Pipe 3 ft onto Solid Ground (typical) 1 PUMP -OFF ELEVATION= gr!.64 ft INSIDE BOTTOM ELEVATION= 8(Q.r15 ft QoaeoSed Nay. deo. = 91,0 = 3. r1q (+ 5o tPm) SEPTIC TANK(S): Total Volume=boo bo 0 o gal Manufacturer(s): g-sb)ccsst-) (ay, ch_;Ig) Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: ____ Filter Model: Is 4ksyet r FEATURES/BENEFITS • PERFORMANCE Heads up to 37' TDH Flows up to 72 GPM MOTOR High;efficient, 115v, oil filled, permanent split capacitor motor with upper and lower ball bearings and thermal overload protection - Constant bearing lubrication Maximum motor cooling - Runs cooler and lasts longer - Internal overload protection -Quiet operation • -Fasteners and shaft made from rugged, corrosion resistant stainless steel -SEAL DESIGN Mechanical with secondary dynamic lip seal - Provides added leakage protection IMPELLER DESIGN• Non -clog style vortex impeller Designed to help reduce clogging by foreign material PERFORMANCE CURVE 40.0 35.0 30.0 25.0 O a L I 20.0 15.0 10.c Cos 0.c POWER CORD Sealed entry quick disconnect power cords - Prevents water from entering the motor housing through a cut cord - Easy to replace in the field -Available in lengths up to 100' SWITCH Piggy -back switch design -Defective switches can be diagnosed over the phone - Pump can be operated manually or supplied with other piggy -back switches - Switch can be replaced without having to replace the pump APPLICATIONS Basements, dewatering, septic systems, residential and commercial developments and elevator pits Ass Wide -Angle Float Vertical Float 1/3-1/2 HP submersible pumps that handle up to 3/4" solids with 2" discharge with 11/2" adapter Gallons parminuta Champion Pump Company, Inc • P.O. Box 528 • Ashland, OH 44805 Phone 419-281-4500 • Fax 419-616-1100 • www.championpump.com REV0618 Li" S, -+Q PVC ICISP . pr tt i f ►t �0'J� r - �1 tihe'n to rn � c LLri_a J i FINISHED GRAD- ffr 18tt UlfiN.II I tILET t APPROVED PIPE 3' ONTO SOLI( SOIL 3" a FTP.t W j BEDD r/G Ut �P, T,,-- SPECIFICATION-) S PTILG i A `! H •. W!U F A C TUP, E R T:tIK SIZ S E?TI C Yj GAL. Comas -I?73 .mcFaJkd-ti) NOTES: LAP PROV ED MANHOLE W/ L LA9EL M" Mill. OUTLET Page 1 of I Real Estate Bayfield County Property Listing Today's Date: 10/18/2022 IS Description Updated: 2/9/2022 Tax ID: 8325 PIN: 04-012-2-43.07-03-1 05-001-40000 Legacy PIN: 012100402000 Map ID: Municipality: (012) TOWN OF CABLE STR: S03 T43N R07W Description: N 100' OF S 200' OF N 650' OF GOVT LOT 1 IN 2022R- 593013 SUB) TO EASE 34A1 Recorded Acres: 1.290 Calculated Acres: 1.299 Lottery Claims: 0 First Dollar: Yes Zoning: (R-RB) Residential -Recreational Business ESN: 108 I Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 012 TOWN OF CABLE 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE TAKODAH LAKE a Recorded Documents Updated: 3/15/2006 O TRUSTEES DEED Date Recorded: 1/14/2022 2022R-593013 ® CONVERSION Date Recorded: 474781 271-140;829-1009 Property Status: C Created On: 3/15/2006 1:1! Ownership Updated: 2, THOMAS G JASPER CA CATHERINE M ROACH -JASPER CA Billing Address: Mailing Address: JASPER, THOMAS G & ROACH- JASPER, THOMAS G & R' JASPER, CATHERINE M JASPER, CATHERINE M 45885 TAHKODAH LAKE RD 45885 TAHKODAH LAKE RE CABLE WI 54821 CABLE WI 54821 P Site Address * Indicates Private Road 45885 TAHKODAH LAKE RD CABLE ® Property Assessment Updated: 6/1 2022 Assessment Detail Code Acres Land G1 -RESIDENTIAL 1.290 91,500 1 2 -Year Comparison 2021 2022 C Land: 91,500 91,500 Improved: 128,800 128,800 Total: 220,300 220,300 h J' Property History https://novus.bayfieldcounty.wi.gov/access/REAL%20ESTATE/listing.asp?tid=716816&... 10/18/2022 PAGE 4 OF 4 In -ground Gravity Management Plan IMPORTANT: The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 36O gpd; BODS S 220 mgL"'; TSS 5150 mgL"'; FOGS 30 mgL-' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Scats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or • as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: 4. 1&Qh,(,f Ste) Phone(Z1S^)-AS 3 Sr Local government unit: Phond(S) 373-ff38 Local government unit address: LU&�-b1L1Y1 r ('`}x- ZIP: Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. J Tracy Pooler From: tim@andryras.com Sent: Friday, January 16, 2026 1:27 PM To: Tracy Pooler Subject: RE: Jasper - permit 22-16S Hey Tracy, I see no issue that would've required revision. Existing septic tank stayed, simple 540 pump tank and 2 ez flow cells new. Confirmed EZ flo in our customer account. Pump pad -86.61 System El -90.0 Thanks, Timothy J. Clark PE Manager — Septic Department wdn' Rasmussen &Sons, Inc ' :i Family Owned Business $ince 1946'' From: Tracy Pooler <tracy.pooler@bayfieldcounty.wi.gov> Sent: January 15, 2026 9:52 AM To: 'Missy Check' <missy@andryras.com>; Tim Clark <tim@andryras.com> Subject: FW: Jasper - permit 22-16S Tim & Missy, I do not see that I received any numbers or info about changes made at the site during install? Tracy Pooler - AZA Planning and Zoning Department 117 E 5th Street, PO Box 58 Washburn, WI 54891 Phone: 715-373-3512 Fax: 715-373-0114 Email: tramsp1ooler_@ba iScounty.wi.gov 13,4-YFIELD Fraudulent Billing Alert: Be aware that individuals submitting applications to our department have received scam emails. Bayfield Countywill NOT ask applicants to wire any funds. Please contact our office atzoning@bayffie dcounty.wi.gov or715 373-6138 with any questions or concerns. From: Tracy Pooler <trace.pooler@bayfieldcounty.wi.gov> Sent: Tuesday, February 18, 2025 10:16 AM To: missy@andrvras.com Subject: Fw: Jasper - permit 22-16S Missy I do not see that i received the numbers on this system Tracy From: Tim <tim@andrvras.com> Sent: Wednesday, March 29, 2023 8:34 AM To: Tracy Pooler <trace.Pooler@bayfieldcounty.wi.gov> Subject: RE: Jasper - permit 22-16S Sounds good Tracy. I believe everything went in per the approved plan. I'll get you the numbers. Thanks, Timothy J. Clark PE Manager — Septic Department LUG'. Rasmussen t sons. me ".A Family Owned Bnsiness Since 1946" From: Tracy Pooler <trace.pooler@bavfleldcounty.wi.gov> Sent: March 28, 2023 10:41 AM To: Tim Clark <tim@andrvras.com> Subject: Jasper - permit 22-16S Tim, I am looking for numbers for Jasper permit 22-16S at 45884 Tahkodah road. There was a snowstorm and it was installed over a couple days around 12-14-22. My notes also indicate that there may have been a need for a plan revision Tracy Pooler - AZA Planning and Zoning Department 117 E 5th Street, PO Box 58 Washburn, WI 54891 Phone: 715-373-3512 Fax: 715-373-0114 Email: tray,_poolera.bayfieldcountc.wi.gov RECEIVED Department of Safety Co Id BS & Professional Services, Sanitary Pe tit Number (to be filled i y Co.) PS OCT 2.1 2022 Industry Services Division pwN4 RXaA1it Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. I5.04(l)(m), Stats. 1. Application Information — Please Print All Information Property Owner's Name Parcel # I S 6. { C1-kerL if . ( ich - 30 er 93,95 Property Owner's Mailing Address Proqny Location Swkc fakk do cjte I Govt. Lot City, I Zip Code Phone Number yState wt g/22.( r— 1, 7IS- Jy o - W'r Z Y, Y,, Section 3 T N R r II. Type of Building (check all that apply) Lot # �1 W or 2 Family Dwelling— Number of Bedrooms a Subdivision Name ❑ Public/Commercial — Describe Use Block O Cityof O Village of ❑ State Owned — Describe Use CSM Number Town of l AtOle III. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if a licable. A. ❑ New System y Replacement System � p y 0 Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B' ❑ HoldingTank tln-Ground SEn ❑ At -Grade 0 Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional)I C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber g ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration _ / /oq 0 ,≥. /-i3 -/. IV. DispersaVtreatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (st) I Dispersal Area Proposed (sf) I System Elevation (O Too) 5,00 I�T0,in Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units e o u 2 New Tanks I Existing Tanks v is u 2 v a g n 0,0 ti O.O a Septic or -Fl gTank !�D tacoS 4�e� V Dosing Chamber �a Sao SYO 1'/� V. Responsibility Statement- I, the undersigned, assume responsibili iastalla 'on of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's SigmaI MP/MBRS Number Business Phone Number sln fK' tt4+ts( I (o7S7S1 71, ?48-336 Plumber's Address (Street, City, State, Zip Cu_ . D . G e (✓Its( VL County/Department Use Only Approved ❑ Disapproved $ Permit Fee�b1 Date Issued s ng t azure ❑ Owner Given Reason for Denial / / /Q Conditions of Approval/Reasons �sofor Disapproval //%/dYG i"" ' _ G',vftdiG'/ Armen m complete prom for the system and submit to the County only on paper not less than B Ills 11 inches in size SBD-6398 (R. 03/22) Private Sewage System Maintenance Agreement Owner(s) Name -thomas G. Sas er n Cot-blevine lUt, Coac(rl -Jasper Owner(s) Mailing Address 4cnc To &Vodah Lc.Ue Rd. LIabLSwr 9YB≥-t S885 Takkbdo-(' tae. 126. As owner, I (we) do hereby certify the private sewage system will be installed in accordance with the certified soil tester's report and approved plans and specifications on file with Bayfield County Planning and Zoning Department. The system will be operated in such a manner as to meet the designed plans. I (we) agree to maintain said private system at the below listed location in accordance with rules established in the WI Adm. Code, as from time to time amended. (COMPLETE Legal Is required) 1/4 of 1/4 Section 3 Township 43 N. Range '7 W. Additional Legal Description:14-1 00 'o f S. ZOo'eF t, . (a27'o476- L, I Town of CGUDe (Acreage) IzQ GovOot I Lot Block Subdivision Lot _ CSM # Vol. Page _ CSM Doc #59 3o(3 Document Number 2022R-596858 Daniel J. Heffner Register of Deeds Bavfrcld Count}. WI Recorded 111/21/2022 at 12:31 PM Recording Fee: $30.00 Pages: 2 Return To: Planning and Zoning Department Area ❑ In -ground gravity ®. In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System O Other Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person autho e such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. IV$ Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is servirkr .4 gpvjded above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. •q��ry,�, G ,9 Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary 2flpaince with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Co• Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds. At-orade. and In -ground Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbed if needed when the wastewater distribution cell component is inspected as provided above. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system. Bayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future owners of such property. Owner(s) Name(s)— Please Print rkavnat5 &, 3'aSer C0. -he ni e M, Roadq-fl Nr Subscribed and sworn to before me on this date: t /0- /92a a : \\ G• NAUC�'�s \ Note ed 0wner(s,—Si ature(s) Notary is k ��^"•'"'t "- /.-' YCommissigq Pire �•k N " Drafted i by:'3R'1 C'1"f QCt5PtUSCeA) f Date: b 1iQ(Z2 e W \ Y —r �hr„O„n.nllOProofed byR u/fonns/sanitary/septicmaintenceag ement Revised July 2020 Document Number DEED, in between Is Trustee of The Robert B State Bar of Wisconsin Form 7-2003 TRUSTEE'S DEED Document Named ,.AUO . UaL..0 AJG.GAIAliG1 LAN &VVA (whether one or more), and Thomas G. Jasper and Catherine M. . Roach -Jasper, husband and wife as survivorship marital property _____________________________________('(3rantee," whether one or more . Grantor conveysto Grantee, without warranty, the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in BAYFTELD County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): DANIEL J. HEFFNER BAYFIELD COUNTY, WI REGISTER OF DEEDS 2O22R-593O13 01/14/2022 09:59AM TF EXEMPT #: RECORDING FEE: $30.00 TRANSFER FEE: $1,215.60 I PAGES: 1 Recording Area Name and Return Address Thomas G. Jasper & Catherine M. Jasper W8668 Peninsula Road Minong, WI 54859 The North 100 feet of the South 200 feet of the North 650 feet of 16159-21 Government Lot One (1), Section Three (3), Township Forty-three (43) 04o12 -243 -o7 -03..t os-ooi-4Q000 North, Range Seven (7) West, Town of Cable, Bayfield County, Parcel Identification Number (PIN) Wisconsin, Dated D�/�'��g•�— Signature(s) authenticated on * AUTHENTICATION TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) STEPHANIE LOPEZ Official Seal Notary Public - State of Illinois My Commission Expires Jul 21, 2025 (SEAL) * Sherman T. Cundiff Trustee (SEAL) (SEAL) ACKNOWLEDGMENT STATE OF I Iron' ) V0XI"'t )ss. COUNTY ) Personally came before me on 3ftua �tt LO 2'Z the above -named Sherman T. Cundiff to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: * ATTORNEY MAX T. LINDSEY, SB#1112865 Notary ii State of ) ANICH, WICKMAN & LINDSEY, S.C., ASHLAND, WI My Commission (is permanent) (expires: 2112 -5 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODI%ICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. TRUSTEE'S DEED 02003 STATE BAR OF WISCONSIN FORM NO. 7.2003 * Type name below signatures. BAYFIELD COUNTY SANITARY PERMIT (#04)-22-165S STATE SANITARY PERMIT OWNER: THOMAS G & CATHERINE M ROACH JASPER GOV'T LOT: I LOT: BLK: CSM: SUBDIVISION: 1/4 1/4 SEC: 3, T 43 N, R 7 W TOWNSHIP: Cable SOIL TEST: 157-22 REPLACEMENT SYSTEM 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 #: 10960 SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: A Rasmussen & Sons, Inc. LICENSE: # MP 675751 TRACY POOLER Authorized Issuing Officer DATE: 10/28/2022 Condition: PROPERLY ABANDON OLD SYSTEM PER SPS 383. INSULATE WHERE NEEDED. PROPERLY MAINTAIN SYSTEM PER RECORDED AGREEMENT. THIS PERMIT EXPIRES 10/28/2024 POST IN PLAIN VIEW