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HomeMy WebLinkAbout26-8SRequest for Sanitary Inspection (24 Hrs. in Advance) Fax this form to Zoning Dept (24 Hrs.) prior to when you want an inspection — (715) 373-0114 If you do not have a fax and must email the inspection; you must email all staff members. Note fl Time Change fl Discrepancy fl Other Kt v 7�2 Lc� Phone Number „ - (w½ Plumber: ,t l ✓ fi r 1..-t"tC - Fax Number Email Address Homeowner: I/ViS�.n ( ! t f � � o jFi C. C 0 u v -h e l€4 I I I Pn5 Immediate Phone Number So Zoning Sanitary Z�-- Dept can call you right back (if needed) Permit#: , Nq2_ lOZI Plumber's Choice Zoning Dept No Inspection(s) during this time Date: Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zoning Dept Time: 2'.30 Township: (� i V , -CuD Address # & Road Name: 14 1Lj Z ci —r .'ii7 f t DLr5 UZ 1/ - ��S�� or L1✓"liicui Directions To Site: Comments: * Plumbers you must verify any change(s) by fax or email ** Notes from u/forms/sanitarytrequestforinspection Zoning Dept (©4/12104); ® June 2023 roAa -Private Onstte Wastewater Treatment ( POWTS),Inspection Report y��rt KRISTOFER J & PATTI B LEAF (Attach to Permit) lndue 8072 TERRACEVIEW LN N Gen MAPLE GROVE MN 55311 — - - Tank TYPE IMANUFACTURER CAPACITY Prop. Line Well Building, Air Intake Road Se tic e'i sf/ O Q ' N/A Dosing N/A Aeration N/A Holding setback to: County eJcL Sanitary ermit No: State Plan'Transaction ID#: Parcel Tax No: Pump I Siphon Information Pump Manufacturer ump Model Demand GPM Filter Man ctprprr Lrf 4M"t2 Filter Model (•,'7 TOH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well / ) Disaersal Cell Information DIMENSIONS Width Len th # of Cells SETBACK FROM Prop.. Line Building Weil OHWM Type of Cell GeV MO3 Manufacturer: Model Number. Pretreatment Unit Manufacturer: Model Number: Elevation Data STATION BS HI F5 ELEV Benchmark ) 0 /0 O Bldg. Sewer S° • '• . Fj Tank Inlet Z 3• Tank Outlet Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/Manifold Z y - Distribution Pipe InfiltrativeSurface ' Q Final Grade V stribution System X Pressure Systems Only Header! Mapifold Length 4 Die //� V Distribution Pipe(s) Length _ Dia_ Spac_ X Hole Size X Hole Spacing ' Observation Pipes ,kYes 0 No Soil Cover Depth Over Cell Center Depth Over Depth of Cell Edges Topsoil Seeded / Sodded . 0 Yes 0 No Mulched El Yes 0 No COMMENTS: (Include code discrepancies, persons present, etc.) p J C a II�� �J , „ J_ ri I 74 N/jc vtvi II' .Lor✓�� Ga�-I Ian revision required? 0 Yes jKNio r I �1 b ae other side for additional inforn tlon. J Date •4 Uev \-S POWTS Inspector's Signature License Number iRn_R79n rR n9171', Property Owner Information As you know BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zoninolalbavfieldcountv.oro 117 East Fifth Street Web Site: www.bavfieldcountv.orof147 Washburn, WI 54891 KRISTOFER J & PATTI B LEAF 8072 TERRACEVIEW LN N MAPLE GROVE MN 55311 was contracted by you to install a private onsite wastewater treatment 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: 1 o Tank was pumped by: :• Tank was crushed! removed and pipes disconnected by: on at_ AM/PM On 2O at 1' 3y (AM / )the above -mentioned plumber contacted our office to conduct a re-cover inspection as required un r DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. flSystem 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. flSystem 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: Ulfotms/sanitarypropertyowner-input April 2019 MTyrt Department of Safety County ECE & Professional Services, San tary Perm t Number (to be filled n by Co.) clloca Industry Services DivisionJlAb4' p g 202 SS- oo 69S o7 - g g Sanittdl r Application 1_q d6 State Transaction Number un 1 W 11aIb Q , submon of this form to the appropriate v it N accordance with SPS 383.2submission Project Address (if different than mailing address) is required prior to obtaining a nanitaiy permit. Note: Application forms for state-owned POWTS are witted 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), Slats. 47 quo T&sc. P;nos L., I. Application Information —Please Print All Information Property Owner's Name Parcel # n'Ida lot 39561 Kc.s}c�cr ' 4 Pa��; SI LeaQ 1-Z•v . •J9• s ao . Property Owner's Mailing Address Property Location 07lra N Govt Lot City, State I Zip Code Phone Number Mc le (,rave, MN 55311 %, v., Section ,9 T 4'/ N R d(o t'*o U. Type of Building (check all that apply) Lot # X1or2Family Dwelling — Number ofBedrooms Subdivision Name Block # ❑ Public/Commercial — Describe Use 0 City of ❑ Village of ❑ State Owned — Describe Use CSM Number C5Mis ,BlTownof Grandvteta v. 13 .'/aS 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 ]cable. A. ❑ New System y � Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B. ❑ HoldingTank M In -Ground C, Cw+.ak ❑ At -Grade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of PlumberList g ❑ Transfer to New Owner Previous Permit Number and Date Issued Expiration IV. DispersaVrreatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (s I Dispersal Area Proposed (s I System Elevation coop 1.4 / e1. o 375 1300 4YG.s /346,5 9o.S0 Ff Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units w o 'n o New Tanks I Existing Tanks p 2° " v h m` LU rn ih C7 p. Septic or Holding Tank 1 50 d r. ias' I r� ri r prec&s /Vy Dosing Chamber V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu er's Signature MP/MPRS Number Business Phone Number 1 ravls v erAe1.4 GsJ879 7/-G3y-B1T Plumber's Address (Street, City, State, Zip Code) j 3 yb w 5M4C %lacd 77 J -(r•. ward, 6JS 5y g y3 County/Department Use Only Approved ❑ Disapproved $ermit Fee Date Issued nip Issuing at Si azure 0 Owner Given Reason for Denial �E/�� Conditions of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 8 in x II Inches In size SBD-6398 (R. 03/22) GeoMat IN GROUN ID DOSING DISTRI DESIGN Residential Application INDEX AND TITLE PAGE All Water Treatment Systems To Be Removed From System Owner Info 9 Project Name: Leaf - 47420 Twin Pines Ln Owner's Name: Kristofer J & Patti B Leaf Owner's Address: 8072 Terraceview Ln N RECEIVED Maple Grove, MN 55311 JAN 00 2026 Bs 'Property Info Property Address: 47420 Twin Pines Ln Legal Description: S 29 T 44 N R 6 W Township Grandview County: Bayfield Subdivision Name: Lot Number: 1 Block Number: CSM#: 2391 Parcel I.D. Number: 04-021-2-44-06-29-4 05-001-33000 Plan Transaction No.: 1rrudgeS Page 1 Index and title Page 2 Data entry Page 3 GeoMat dist. cell drawings & calculations Page 4 Lateral and cell cross section Page 5 Management & contingency Page 6 Maintenance & specifications Page 7 Distribution media Page 8 Plot plan Travis Butterfield License Number: 652879 Date: 01/05/26 Phone Number: 715-634-8176 Signature: p✓� Designer Stamp: State of Wisconsin Approval Stamp: Designed Pursuant to the GeoMat In Ground Component Manual May 2024 Page 1 of 8 In Ground and Dosing Distribution Component Design Design Worksheet All Water Treatment Systems To Be Removed From System R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 12.00 Site Slope (%) 90.50 Prop. System Elevation (ft) Sand & Native soil Contour 108.00 Depth to Limiting Factor (in) 1.60 In -situ Soil Application Rate (gpd/1t2) 94.42 Lowest Original Grade Ele. In System Area (ft) 95.08 Highest Original Grade Ele. In System Area (ft) 85.91 Limiting Factor Elevation (ft) 3.08 Depth Below Grade NN ISD Required? RECEIVED JAN 082026 BayfieldCo. Planning and Zoning Agency Distribution e n rma ton 3.25 Cell Width (ft) 21 Number of Cells 2.00 Dispersal Cell Design Loading Rate (gpd/1t2) 2 Influent Wastewater Quality (1 or 2) Distribution Information E Center or End Manifold, Dist. Box or Drop Box 2 Number of Laterals System dosed N 4.25 Lateral Spacing (ft) System not dosed Manufacturer Information Treatment Tank Information Effluent Filter Information 1250.00 Se tic Tank Ca aci gal) Lifetime Filter LLC Filter Manufacturer Su erior Concrete Manufacturer LT 1/8 Filter Model Number Project: Leaf - 47420 Twin Pines Ln Page 2 of 8 In Ground Plan View 2 cell GeoMat • • •• o°o°o°000°o°o°o°o°o°o°00000°o°o°o°o°000°o°o°o°o°o°o°000°o t000000000. 000°0°0°000000000000000°0°0°0°000°000°0°0°00000000000°000 m� gg 0000000°000000000 ty®l�Yll61L ,• 00000000 0000 000000000000000 °°°°°0°°°.• 00000000°00000°000000000000000 00000000 �•••o•••o•0000.•♦0o•00000o•o•00••.;oo♦oo•.o0000o..•o•• . 0 0000o000 • o°o°o°o°o°o°o°o 000 2,000 o o°0°0°0°0°0°o°o°,0000 0• a 000 a000000a a 0 000000 g 00000000000000+ 0o°o°o°o°o°o°0°0°00°0000000°000000000 000000000 .� . 00000 000000000000000000000000000000-000000000 000000000000000000000-00000000000000000000 , RECEIVED JAN 082026 Bayfiekf co. pUming and Zoning Agency Calculations I 1.00 K 1 S 1.00 Ft ft Ft A 3.25 B 47 L 49 W 9.50 Basal Area Calculation GPD Loading Rate 600 1.6 gal/sq ft/day Totall 375 ft2 Number of Cells 2 Cell Length 47.00 Min. Cell Length 46.2 Cell Spacing 1.00 ft ft ft ft ft It Ft Basal Area Required 375 Basal Area Proposed 446.5 Lineal Feet of GeoMat Required 92.3 Lineal Feet of GeoMat Proposed 94 System Elevation 90.5 Limiting Factor 85.91 Separation 4.59 NOTE: Min S dimension = V ft ft Ft 2' Min ft ft2 Directions: Play with cell length to get desired cell spacing, length and width. Remember system SHOULD be longer than it is wide. It must also Satisfy basal loading rate and GeoMat cell loading rate. Project: Leaf - 47420 Twin Pines Ln Page 3 of 8 i - t al Layout Dia r - Hole spacing is every 12" , 1/2" hole at 4 & 8 O'clock, starting 4 O'clock 6" from end and 8 O'clock Holes at 12" from end. 4" Perforated pipe may be used. Pipe Length = GeoMat Length Lateral Spacing H 4.25 Pipe Diameter 04 in RECEIVED JAN 013 2026 Bayfieki Co. Planning and Zoning Agency Distribution Cell Cross Section tt:1•l.l•:'-Y:•is 'n •.:V. •) J♦:..;•�•t '.•...5 µr.y LIDYLGid 3.08 ft — SmdConteoowmmded 4"inFipew".••.≥.�utw .',.��..• Fdxie -_—s.. _� Pipe �_GEDMAT of geomat to be at or w originalgrade ••` z AASTM 333m I r r Caepotc III I I l - 14 1a5laative Surfs Lmitm¢FWv 108in ti Observation Pipes 12" Min. 42" Max. 90,5.. Project: Leaf -47420 Twin Pines Ln Page 4 of 8 Notes/ Maintenance Requirements RECEIVED MANAGEMENT PLAN OUR,This private onsite wastewater (POWTS) has been designed, and is to be installed and maintained in accordance with is. Admin. Code, the in -Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0 S�! A Q P (N.01/01). GeoMat in ground Component manual April 2019 Version. pjaaidng and Zoning Agency 1. This POWTS has been designed to accommodate a maximum daily flow of 60�QRons of wastewater per day. The quality of influent discharge into the POWTS treatment or dispersal component shall be equal to or less than all of the following. A monthly average of 30 mg/L fats, oil and grease A monthly average of 220 mg/L BOD5 A monthly average of 150 mg/L TSS Wastewater shall not discharge to the POWTS in quantities or qualities that exceed these limits or that result in exceeding the enforcement standards and preventative action limits specified in ch. NR 140Tables 1 & 2 at a point of standards application, except as provided in DSPS 383.03 (4), Wis Admin. Code. 2. The owner of this POWTS is responsible for system operation and maintenance. 3. Defects or malfunctions identified during maintenance described above shall be repaired in conformance with SPS383 Wis. Admin. Code, and the pertaining county Private Sewage Systems Ordinance. The user's manual, provided to the owner of the POWTS includes the names and telephone numbers of the properly licensed individuals to contact for such repairs. 5. No product for chemical or physical restoration or chemical or physical procedures for POWTS may be used unless approved by the Dept. of Commerce in accordance with SPS. 384, Wis. Admin. Code. 6. If the POWTS is replaced, or its use discontinued, it shall be abandoned in accordance with SPS 383.33, Wis. Admin. Code. NOTES Two Effluent Filters to be installed where possible 1 to be installed in ST, and or 1 in pump tank in order to insure particle size less than or equal to 1/8". Filters should be cleaned once in spring, and once in fall. Also, strainers in sinks in the building shall be maintained, so that solids and fats are minimized to flow into system. A minimum of 2 observation pipes per cell shall be installed. These pipes shall be located approximately at the end of each cell. The plumber, or county shall see to it that a copy of these plans including this page, maintenance folder, and maintenance agreement is given to the homeowner. This system may contain a dose chamber. If a pump, float, electrical outage causes the dose tank to fill, the homeowner should see to it that the effluent level in the tank is brought down gradually and not all dosed to the system at once. One large dose could cause damage. Contact a pumper or your installer if this problem occurs. The homeowner is responsible for formulating a water conservation plan that will ensure the system is rarely overloaded. I.E. spread laundry out over time, not 6 loads in 2 hours, while everybody showers, and uses the toilet, ETC. CONTINGENCY PLAN FOR COMPONENT FAILURE A. Septic Tank. Any structural failure resulting in cracks or leaks in the tank must be corrected by replacement of the septic tank component. Leaks in the joints between manhole risers or covers shall be repaired by replacing faulty seals with approved materials to make joints water- tight. B. Outlet Filter. The outlet filter shall be replaced or repaired when it is either no longer capable of preventing the discharge of particles larger than 1/8 inch or when it has become permanently degraded by clogging so as to interfere with the design flow out of the septic tank. C. Dosing chamber and pump. The dosing chamber shall be replaced if any structural failure is found. Leaks in joints between manhole risers or covers shall be repaired by replacing faulty seals with approved materials to make joints water -tight. The pump and controls shall be replaced when they are no longer capable of functioning according to the design plan. D. Pressure Distribution Piping. Partial clogging of the distribution network may result in unduly long dosing cycles. The ends of the distribution laterals may be exposed and the threaded end caps removed. The piping can be disconnected on the outlet end of the pump. The distribution piping may then be back flushed to cleanse any accumulated matter from the piping. It is recommended that the dosing chamber then be pumped by a licensed plumber. E. Soil Absorption Cell. The discharge of sewage or wastewater to the ground surface is strictly prohibited due to the human health hazard created by the effluent. All failures created by surface discharge shall immediately be reported to the appropriate county. The pump shall then be immediately disconnected to prevent further discharge to the ground surface via the soil absorption cell. The existing septic tank and dosing chamber shall be used as a temporary holding tank until the necessary repairs to the soil absorption cell can be achieved. The replacement shall be initiated only after any necessary plan approvals have been obtained from the appropriate plan review authority and the required sanitary permit is obtained from the county. Project: Leaf - 47420 Twin Pines Ln Page 5 of 8 Ground System Maintenance and Operation" ifications Service Providers Name Butterfield Inc Phone (715) 6348176 POWTS Regulator's Name Bayfield County SPIA - Zoning Department Phone (715) 373-6138 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in EstimatedFlow- Average 400 gpd Maximum BOD5 30 mg/L Septic Tank Capacity 1250 gal Maximum TSS 30 mg/L Soil Absorption Component Size 152.75 ftz Maximum FOG 10 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 In Ground Inspect and/or service once every 3 years Insect and clean as necessary at least once every 3 years Test once every 3 years Should test periodically Laterals should be flushed and pressure tested every 3 years Insect 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 GeoMat In Ground Component Manual Ver. April 2019. 2. Dispersal cell media conforms to GeoMat products approved for use with the GeoMat In Ground Component Manual Ver April 2019. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Scarification of basal area is accomplished with a rake or other tool. 5. All disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetratiolRECE VED 6-8" Diameter Lawn Sprinkler Box Lateral Ends at Last Orifice Where Lateral Turn -up Detail 90.5 Feet Threaded Cleanout Plug or Ball Valve Vent if itisrfot Dosed SIa Long Sweep 90 or Two 745 Degree Bends Same I Diameter as Lateral JAN 0 8 2026 Bayfiekl Co. Planning and Zoning Agency Project: Leaf - 47420 Twin Pines Ln Page 6 of 8 RECEWED 0 8 2026 3.25 ICell Width (ft) I 2.63 Sidewall to Lateral (ft) Planning and Zoning Ag°`1 Distribution Cell Cross-section Arrangements S 0 Distribution Pipe GeoMat is covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 3.25 I Cell Width - A (ft) I 47.00 I Cell Length - B (ft) End Connection Lateral Layout Diagram Typical Dispersal Cell Finished 12-42 eeckco '_ z_ Ifo:el%evel �f_. 2"AS11vS33Sav I l I, I t I l III1.— See details on page 4 for number, size, and spacing of laterals. Project: Leaf - 47420 Twin Pines Ln Page 7 of 8 // SCALE = 1:40 /./ PLOT PLAN o - o 47420 Twin Pines Ln Diamond Wetland Lot .1 CSM#2391 v.13 p.425 Lake / Sec. 29, T44N, R06W // Town of Grand View / / Bayfield County Tax ID: 39561 , f Property Owners: Kristofer & Patti Lead/ Proposed Well • // o 0O1 lb / Proposed /� 46drm , / �� w/ Garage ,C �� /old cabin'to 1te remQGed ��` ELEVATIONS aft B1 = 94.92ft B2= 95.08 ft B3 = 94.42 ft BM = Nail w/ Ribbon in 18" Hemlock ST= 1250ga1 prefab concrete septic tank made Superior Precast w/ Lifetime LT -1/8 Filter AA = Absorption Area consisting of a 9.5' x 49, containing 94 feet of Geomat 3900 Garage Existing system is to be properly abandoned Page 8 of 8 SUPERIOR I 1250 1-CompartmentTank 5SUPERIOR PRECAST CONCRETE PRECAST CONCRETE RIECEW Weft cm lbs) JAN U 8 202 Tank 6$37 Bayfield Co ltd: 4,238 Total: 100,77 Planning and Zoning 1 Volume of Concrete Total : _.7 YcP Gallons Per inclu 28,1 1 liLt wan TOP VIEW 103" - 97rr SIDE VIEW 2$n Enlarged Detail 24" Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES g / a"* SEE CORRESPONDENCE Kim . i Manhole Openings 3" Taper 8" Air Space 45DEpth 3 73" 79 I Produced by Superior Precast Concrete, LLC PO Box 1390 Hayward, W1 54843 Po a lene Baffle Gasket (Poured in Place) SUPERIOR PRECAST CONCRETE Design conforms to ASTM C1227, Specification for Precast lr2s& Concrete Septic Tanks and WISPS 384.25, POWTS Holding Rope Components or Treatment Components. The information provided on any Superior Precast Concrete (SPC) drawing or document shall be verified by the purchasers licensed professional engineer for suitability of use. Configuration may change from drawing, consult with SPC. Product File No: File NoIThis is proprietary information. and remains the property of Superior Precast Concrete. LLC I R.3 05-19-20241 is proprietary information. and remains the property of Superior Precast Concrete. LLC I R.3 05-19-2024 Si,. o°69S Private Sewage System Maintenance Agreement Owner(s) Name Kristofer J Leaf Owner(s) Mailing Address 8072 Terraceview Ln N; Maple Grove, MN 55311 Site Address 47420 Twin Pines Ln Tax ID # 39561 As owner, I (we) do hereby certify the private sewage system will be installed in accordance with the certified soil tester's report and approved plans and specifications on file with Bayfleld County Planning and Zoning Department. The system will be operated In such a manner as to meet the designed plans. I (we) agree to maintain said private system at the below listed location in accordance with rules established in the WI Adm. Code, as from time to time amended. (COMPLETE Legal Is required) 1/4 of 114 Section 29 Township 44 N. Range 06 w. Additional Legal Description: Town of Grand View Lot Block Subdivision (Acreage) 14.49 Gov't Lot Lot _L....CSM # 2391 Vol. 13 Page 425 CSM Doc #2025R606677 DOCUMENT NUMBER 2026R-6 10829 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 0 1 /27/2026 AT 10:50 AM RECORDING FEE: $30.00 PAGES: 1 Recording Area Return To: Planning and Zonin tgp`�r LY,ED rEWERE�b JAN 282026 PI nninC 7 e _ Q 1n -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: O 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 of the date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank Is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be Inspected and maintained as necessary and in accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds. At -grade, and In -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 Subscribed and sworn to before me on this date: i2 • li• -15r V • L Notarized Owner(s) — Signature(s) Notary Public My Commission Expires: �'-3l •20� Drafted by: _9v%r4lol SA+cY4 s *5� Date: I Zf t' /a S� ALLISON H CRESS Notary Public Minnesota My Commission Expires Jan 31, 2030 Proofed by: Revised July 2020 D Wisconsin Departmentof Safety& Professional ServicRECEIVED j�R¢0 PageI of / Division of Industry Services /SRoo377 S0ILEVALU4jVWMKDRT __SOILTES4S In accordance with SPS 385 lQgt. Code County �,C )d Attach complete site plan on paper not less than 8 1/2 x 11 inches in siAPlmtleni04tTrfI8f9Ogem . 395 (af but not limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. TAX ,o scale or dimensions, north arrow, and location and distance to nearest road. -o Please print all information. Review by Dat /' Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). 7 I AZ �f _ Property Owner Property Location ❑ '1 5 r Pc.}a-; (3 Lca.Q Govt. Lot v ≥. S 9 T &1LJ N R 0Co E(or) W Property Owner's Mailing Address Site Address or CSM and Lot #: City, State, Zip Phone Number U City U Village IXI Town Nearest Road MGCIr rre..n. MN ≤5311 (&IJ)g6N-11-71- C-,resnA..Tw:r. P:..,c Ln ® New Construction Use: Residential/Numberofbedrooms Code derived designflow rate (.00 GPD ❑ Replacement ❑ Public or commercial - Describe: _ Flood Plan elevation if applicable — ft. Parent material Sandy TS % I General comments and recommendations: See ne4t Boring# ❑Boring ®Pit Ground surface elev.95.Og ft. Depth to limiting factor '-I% O in. / elev. 85.9%ft. Soil Aoolication 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 1 0-7 by 3 — 1 n..14r 3S ttt o.7 I.ta - .2 7 -DO s — U'S f,� e. to. S 1. 0 3 .0.3(, )oMQ N - C o`1 u.r, V 3lw 51 r. s"+fi y/ — lF °'S' 1. o SI-IIU y.syRt/'I S O•T t V Boring # ❑Boring Pit Ground surface elev. R'i. ' ft. Depth to limiting factor L %lO in. / elev. P5.7 ft. Soil Aoolication 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 'Efft O-C.eoi R3/Q — n -j .ALt o. . 4 -17 o as7 — U ro nv(f- o. 1.0 I7- b -MS 9J`t — s ... c9tn as £0 »-Ii -1.SM%R y;'H - IS n+1 o.7 r -111O -r.sMR s/`1 - 5 1 - - ofl i.e. CST Name (Please Print)/� Sign re CST Number SP- 090060003 b f3.+iau ise td 65879 Address Date Evaluation Conducted Telephone Number I'3 td 54R 77 kkytce.r�, tor 9 MS I I / a u /a S' 7f5 (.3q 817 Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L ' Effluent #2 = SOD, 5 30 mg/L and TSS 5 30 mg/L SBD-8330 (R03/22) ❑ Boring # Page of ❑ Boring Pit Ground surface elev.g9•'a ft. Depth to limiting factor >_ 108 in. / elev. ft. I Soil Annlication 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 - 3 %D'$'i) -- 10 4Y'41 O5- ) . O 33- 7.S`eR'1 J -- ti ro rr►1 cl 7 I • Co s -,n a 7.SY S/4 -- 5 - a 1 . Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. I Soil Aoolication 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 Boring Boring # ❑ ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Annlication 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 * Effluent #1 = BOD > 30 ≤ 220 mg/L and TSS > 30 ≤ 150 mg/L * Effluent #2 = BOO, ≤ 30 mg/L and TSS 5 30 mg/L REC!W ® JAN 06 2026 Bayfleld Co. Plannln9 and Zoning A8encY SCALE = 1:40 47420 Twin Pines Ln Diamond Lot 1 CSM#2391 v.13 p.425 Lake / Sec. 29, T44N, R06W // Town of Grand View Bayfield // County // Tax ID: 39561 / Property Owners: Kristofer & Patti Lead/ /1' f N // w//z R / /1 l 'bid cabin o lie rem9Ged O 3raji5 So er-4e1d 5Q-046000003 CSI %+,65x979 Wetland 0 0 O O ELEVATIONS BM = 1 00.00ft B1 = 94.92 ft B2= 95.08 ft B3 = 94.42 ft BM = Nail w/ Ribbon in 18" Hemlock pa3e3aV `� RECEIVED SOIL PROFILE SHEET JAN 08 2026 OWNER:j, ; s o�ec S t Pam 1 13 l-eo.,p SOIL TESTER: Tr'av : s JS-eg.QS f3Co. Zoning , ency SYSTEM ELEVATION: LOAD RATE: o.7 1• SYSTEM RANGE: 8 % . 91 to 0.83 £7 4s ______ gq.�a -- __ L-( L/ -- Qy--- -- -- --- 93 ------ -- -- --- -- ___-o,839 y ,. -- --- --- -- 2°r -38.) - .39 -- -- 3� ---- -- --- -- ------- N S �? V -- --- ------ 87 jO1L -- �, -- -- ----------- --- -- 8L1 83 Page JL of JL . 7 Real Estate Bayfield County Property Listing REC�V Property Status: Next Year Today's Date: 12/11/2025 Created On: 3/31/2025 3:25:30 PM JAN O . WZB Updated: 3/31/2025 Owners i Updated: 3/31/2025 39561 KRISIMAPLE GROVE MN 04-021-2-44-06-29-4 05-001-33000 Billing Address: Mailing Address: KRISTOFER J & PATTI B LEAF KRISTOFER J & PATTI B LEAF (021) TOWN OF GRAND VIEW 8072 TERRACEVIEW LN N 8072 TERRACEVIEW LN N S29 T44N R06W MAPLE GROVE MN 55311 MAPLE GROVE MN 55311 LOT 1 CSM 2391 DESC IN DOC 2025R- 606677 Site Address * indicates Private Road 14.490 0.000 0 No 114 Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: ESN: Tax Districts 1 04 021 041491 001700 , al Recorded Documents © CERTIFIED SURVEY MAP Date Recorded: 2/27/2025 © CERTIFIED SURVEY MAP Date Recorded: 6/13/2023 © WARRANTY DEED Date Recorded: 7/1/2022 © CONVERSION 47420 TWIN PINES LN GRAND VIEW 54839 47435 TWIN PINES LN GRAND VIEW 54839 B Property Assessment Updated: N/A 2025 Assessment Detail Updated: 3/31/2025 Code N/A STATE COUNTY 2 -Year Comparison TOWN OF GRAND VIEW Land: SCHL-DRUMMOND Improved: TECHNICAL COLLEGE Total: Updated: 3/15/2006 20258 606677 If Property History Parent Properties 04-021-2-44-06-29-4 05-001-31000 2023R-599341 V.13 P.178 04-021-2-44-06-29-4 05-001-32000 2022R-595351 Date Recorded: 476347 776-686;830-295;835- 285 HISTORY © Expand All History White=Current Parcels Pink=Retired Parcels © Tax ID: 16800 Pin: 04-021-2-44-06-29-4 05-001-03000 Leg. Pin: 021106307000 © Tax ID: 39057 Pin: 04-021-2-44-06-29-4 05-001-32000 © Tax ID: 16800 Pin: 04-021-2-44-06-29-4 05-001-03000 Leg. Pin: 021106307000 ® Tax ID: 39056 Pin: 04-021-2-44-06-29-4 05-001-31000 39561 This Parcel 1 Parents Children Acres Land Imp. 2024 2025 Change 0 0 0.0% 0 0 0.0% 0 0 0.0% Tax ID 39056 39057 1 BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): 'Check List VIndex Page / Title Sheet (Optional) C9'Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) f9' Original Plot Plan E9/Cross Section Soil Profile Sheet (optional) l "Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) RECEIVED JAN 082026 eayflokt co. Pgamthg and Zoning Agency Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used l 'Property Owner's Information (not prospective buyer's name) i'Property Location (Accurate Legal Description with Sec/Twp/Range) [Road Name (where driveway is/will be coming off of) ❑ lood1 i-E1eatiur�Flow Rate, Comments and Recommendations Complete Soil Boring / Pit Information Date Soil Evaluation was conducted Q"CST Name, Signature, Number, Address and Phone Number '*Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) ["Bench Mark (Description, Elevation and Location) Contour Lines (Example = 98.0' /96.0' /94.0') WProperty Location (Sec/Twp/Range/, Accurate Legal Description) Borings (Locations and Elevations) L9 Percent and Direction of Land Slope Well Location (Including Neighboring Wells, if applicable) L"Location of Wetland Areas, Floodplain and Navigable Waters "Buildings, Driveways, and Structures (Location and Descriptions) l3"Location of Property Lines E!l'Existing System Location C�Address Number and Road Name Current Surface Elevation of Wetlands and Navigable Waters (CST, Owner and Property Information C� North Arrow Fee: L�Certified Soil Tests - Review & Filing Fee 50.00 U/forms/sanitary/checklist/checkiistforests BAYFIELD COUNTY SANITARY PERMIT (#04)-26-8S STATE SANITARY PERMIT OWNER: KRISTOFER J & PATTI B LEAF G OV'T LOT: LOT: 1 B L K: CSM: 2391 V.13 R425 1/4 1/4 SEC: 29, T 44 N, R 6 TOWNSHIP: Grand View SOIL TEST: 6-26 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: TRAVIS BUTTERFIELD TRACY POOLER Authorized Issuing Officer DATE: 1 /28/2026 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. Old System needs to be property abandoned per SPS 383. THIS PERMIT EXPIRES 1/28/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION