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HomeMy WebLinkAbout26-14SI Department of Safety County 6a eto; c & Professional Services, a , Sanitary Permit Number (to be filled in by Co.) SS - 0o7 o% Industry Services Division _ fr/S 9 rb�rxyaxt.�h Sanitary Permit Applieati&l EIVED State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to th at rural unit is required prior to obtaining a sanitary permit. Note: Application forms for state -race_ A3AdLWbmitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary Q'r 65 �er 5k ore. purposes in accordance with the Privacy Law, s. 15.04(I)(m), Slats. V I I. Application Information — Please Print All Information ..—ptannlng and Zoning Agency Xr 5. 5 8 Property Owner's Name IIflrIParcel # Lnaatn w. -rrao-rr- -3&.! -As4 a3 sc.;sc.;c oriv'e it. '' Lac9 'GSM f a?►S3 City, State Zip Code Phone Number Vo t, I;1 - Pgses 333334 Tlnn Rlver w S409 2ie-3611,a4 a h,A A. action I1. Type of Building (check all that apply) Lot if r W IK I or 2 Family Dwelling - Number of Bedrooms_ Block# QaQF",j -1 ❑ Public/Commercial - Describe Use ❑ Cityof ❑ State Owned - Describe Use CSM Number ❑ Village of 2153 Townof Xr , Qivar 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. 9 New System y ❑ Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B. ❑ Holding In -Ground ❑ At -Grade Tank � ❑ Mound ❑ Individual Sitc Design ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner List Previous Permit Number and Date Issued Expiration Design SI 7 I (aN3 I6s 95.0a Capacity in I Total I # of I Manufacturer Tank Information Gallons I Gallons Units I I o $ v New Tanks Existing Tanks V a R a U in rn c. U i V. Responsibility Statement- I, the undersigned, assume responsibility for installati a of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Mlaoikosk DooqO IS-afl-9!c Plumber's Address (Street, City. State. Zip Code) Po gox SL2 .Iron Rive) wa s-94-7 VI. County/Department Use Only Approved O Disapproved Permit Fee Date Issued Issuing A Sign e y /, J� iC ❑ Owner Given Reason f'or Denial gLj'(J//� '�j kj')L �A A /V2 d. attach to complete plans for the system and v,hmit In the fmmty nnty nn n.ne. not t.a th.n a In . SBD-6398 (R. 03/22) SOIL TEST # /3 -?(p S R • oo3d 1 ENTFREo WisconsirrDepartment of Safety & Professional Services Division of Industry Services • SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code County Attach complete site plan on paper not less than 81/2 x 11 Inches In size. Plan must include, but not limited to vertical and horizontal reference point (BM). direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road.S • Please print all information. ' • we $ Personal Information you provide may be used for secondary purposes'(Privacy Law, s_ 15.04(1)(m)). PrpplrRY Owner'. • 4 . • . .. Property Location • Lt L " C Tv atrP�i� •33 Property per's Mailing Address Site Address or CSM and Lot #: 10 Vp 5 S c. Dr v75iVorrtSL%Orc Dtr;t e City, State, Zip Phone Number 0 City 0 Village J Town W NewConstruction Use: I ResidentialINumberofbedrooms S 0 Replacement 0 Public or commercial — Describe: Parent material 5a O r ! &jO..5 General comments and recommendations: nBoring # ❑ Boring ED Pit Ground surface elev: l 1 ft. Page J of4 (over) Planning aa� ng A ,4'24s.. . p :S*#- flO! sqL� Nearest Road / Code derived designflow rate 95QGPD Flood Plan elevation If applicable ft. Depth to limiting factorein./ eteb4Aft. Snil Aonlfratinn 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 I o-- t 10 R L k a5 7.S&114 S a v S i• 6 nBoring # ❑Bonng i Pit Ground surface etev Depth to limiting factors ln. / elev DJ ft. Soil Aeolication 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 I d R 1 m a Q'.M. .. -- a v -C CST Name (Please Print) 5� Signatupr,�� CST Number z I c8 -ST Address Date Evatu tion Conducted I Telephone Number I IJ . — 25 71St— I 31 Cl • Effluent #1 = BOD > 30 s 20 mglL and TSS > 30 s 150 mg1L • Effluent #2 = BOD, 5 30 mglL and TSS s 30 mg/L SBD-8330 (R03122) •, ❑Boring JJ• Pit Baring # 7 Page a_ of 2... Ground surface eievq_ft. Depth to limiting factors Cf n. / etevgO• fL SM Anniira4rnh D Horizon Depth In. ' Domiriant•Color Munseil, • • Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD!Ft2 *Eff#1 "Eff#2 /� a Ib!/L �. ______ S v.iJk 4 Lo 2 7.$'?&'Lfl. _______ 1$ viaI,k rvf .s .7 .a Boring # ❑ Boring , O Pit Ground surface elev. 'ft. Depth to limiting factor In.! elev. ft. . Soil l Annfiratln Horizon Depth In. Dominant Color Munseil Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIFt2 •Eff#1 •Eff • • r . . '• • • • • • •❑ Boring . Boring # O Pit Ground surface elev. ft. Depth to limiting factor in.! elev. ft. Safi Annlieatlnn Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •EII#I •E " Effluent #1 a SOD > 30 s 220 mg/Land TSS > 30 s 1 S0 mg/L • Effluent #2 = SOD, s 30 mg/L and TSS s 30 mg/L Soil Evaluation Site Map - System Plot Plan In -Ground Soil Absorption for POWTS Component Manual V_2.1 Site Owner: Logan W. Trautt Site Address: 8765 North Shore Drive, Iron River, WI 54847 Legal Description: LOT 4 CSM 2153 IN V12 P333 (LOCATED IN GOVT LOT 2) IN DOC 2024R-606027 Tax ID: 38423 �EG��V�® CST: Tony Polkoski 11068 - ST Plumber: Allan Polkoski - PMRS 220090 FEB 2 4 2026 Bayfield Co. planning artd Zoning Agency 205' r 0 40 80 ft o wells on property N o neighboring wells < 50' from property lines a) 0 O V z U, 0) N oho Absotpt�° e ~ SBf f' �o .SB • • SB31015.5 '. 1016 • ank- Wieser WLP-1000MR Pipe Material /ASTM.Standard Filter- PolyLoc PL -525 Effluent Filterf' ' ' ' ' ' ' ' 'Ei.. i I p (Tables 384.30-3 & 384.30-5) SaltaSewer. ASTM F789 Proposed 3 Bedroom Home w 0 C,) Driveway ® BM - Nail in Red Pine - Elevation 100' A SB 1 - Elevation 97.95' SB2 - Elevation 98.05' SB3 - Elevation 98.1' Property_Line Elevation Contours 205' PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) RECEIVED Page 1 - Index & Cover Sheet Page 2 - Plot Plan FEB 242026 Page 3 - Dispersal Area Cross -Section & Plan Page 4 - Management Plan Bayfield Co. Planning and Zoning Agency Enclosures: ,�tv1�Tp/y Pe�,H� T Applt Cwi i on,ScU RI' -toe RtjofV, W iCS4,r TOSnle- SpcciC: corrin&Goan o PS5M AT ah a -C Deed Soil TeS-c c ke.c_%lis C. So.r; eara c lnec/c li ST $ 9Sa check Project Name / Description Owner Name(s): LooL'r W _ -Truo TT Phone: 210-39) --9q80 OwnerAddress: I077S Scey do DAst,ttronRiirnl,WUip: SyBt 7 ProjectAddress: , rpo,n Kiyer_, c r ≤Y3'ri Govt. Lot: 4-csma153 $ 0I I2 , irP 37-3.31M* Township: Sr•o,R iye,r County: €cety i e lcA - CSJVI QoG4 o oR- Project Parcel ID #: _ 3g g a 5V59 6 Designer Information Designer Name: -A I (4 n F 4" - s Phone: % S = z9L f S Designer Address: ?L ! - K ≤ — J-- , ° ^ R• � &V w1 Zip: S `l2 / E-mail: tG ( y +� E S_ �(.,' U / �2 vt c,..7tt, G c 9. y'u [i ,ipproc.il ,i r,q'. � License Number: IF rv2 �S z -2 v r o 0 Remarks: Signature: GC�I/( -- Date: � Original signature required on each submitted copy. IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers L 3 -ft Trench (down -sizing credit) (t YPical) min. 12' SOIL COVER (typical) 12' min.lrench (Vocal) i TYPICAL TRENCH CROSS SECTION VIEW r 34" (typical) (No Scale) gSystem Elevation = ft (typical) Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) Septic Tank(s) Manufacturer: Wieser Septic Tank(s) Volume(s): gal gal gal gal Effluent Filter Manufacturer: Polvloc Effluent Filter Model #: B = ____ ft (typical) INSTALL PER TRENCH: Quick4 Std -W @ 20 ff EISA/chamber = G 7 y ft2 + _ Pairs of end caps @6 ft2 EISA/pair = _..� __ ft2 = Proposed EISA per trench =3 (n ft' 5 T 3 (r1 `n ow C N rai N m 3 rn 2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) TA = 3.0 ft (typical) "—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. Required Infiltration Area = (t43 ft2 x� trenches = Proposed Total EISA = �a ft' Distribution Method: D 17 m W O m a RESET WLP1000-MR TANK SPECIFICATIONS 4 CAST - f9=1 INLET a 7 a{ TANKS ARE MANUF DIMENSIONS: WALL: 2 1/2 CAST -A -SEAL BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53 1/4" LENGTH: 8'-8" WIDTH: 7-2" BELOW INLET: 42" LIQUID LEVEL: 36" WEIGHT: 6,790 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.83 GAL/IN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1,085 GALLONS LOADING DESIGN: 8'-0" UNSATURATED SOIL TANK CAN BE USED AS: SEP11C / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) ---- ' �"I iT CUSTOMIZED TANKS: --- • ---- .�- '�° m m Dl FOR CUSTOM TANKS CONTACT WIESER CONCRETE - OUTLET --fl f a Na A C�r) 1x11 w _ na N a M nU I M 3o N O fl j a VJ REVIEWED BY ;..� PUMP PAD REVIEW DATE SIDE VIEW APPROVED By Glen Schlueter at 8:20 pm, May 30, 2022 TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: 0 PAGE 4 OF 4 In -ground Gravity Management Plan RECEIVE® IMPORTANT: FEB 242026 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.jo a tiSfttem shall be considered a human health hazard if not maintained in accordance with this approved managerii �t'O� . in9Agency 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 = 4 SC7 gpd; BOD5 5 220 mgL-'; TSS 5 150 mgL"'; FOG 530 mgL"' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: z:'1 ?,t' Ve t r. Phone: 71S- 37 + IS,6 Local government unit: 4ouY-C eat %nwn.'M Z.c r„nA Phone: ZIS-3] 3 — 6,.3g Local government unit address: LUaSk 6tlry(.471. ZIP: ✓cyg 9 1 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. State Bar of Wisconsin Form 3-2003 QUIT CLAIM DEED Document Number THIS DEED, made between Patrick M. Trautt Document Name one or ("Grantee," whether one or more). Grantor quit claims to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in BAYFIELD County, State of Wisconsin ("Propertyj') (if more space is needed, please attach addendum): Lot Four (4) of Bayfield County Certified Survey Map No. 2153 as recorded in Volume 12 of CSM on Pages 333-334 as Document No. 2020R-585946, located in the Town of Iron River, B�ay�fi ld County, Wisconsin. - E?iEC/"u R11-0 1133 i [NTIII [17►i ACKNOWLEDGMENT Signature(s) authenticated on NOTApk TITLE: MEMB (If not, _ authorized 'rttllit'' THIS INSTRUMENT DRAFTED BY: FEB 242026 Bayfield Co. Planning and Z.DAUW Recording Area Name and Return Address Logan W. Trautt 10775 Scenic Drive Iron River, WI 54847 File No. 04-024-2-47-08-08-4 05-002-24000 Parcel Identification Number (PIN) This IS NOT homestead property. (is) (is not) STATE OF WISCONSIN ) ss. ASHLAND COUNTY ) Personally came before me on Fe bY/AOtYlil /2, 202&, CONSIN the above -named Patrick M. Trautt Attorney Max T. Lindsey SBN 1112865 Anich, Wickman & Lindsey, S.C., Ashland, WI 54806 to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. * Abigail E. Elza Notary Public, State of Wisconsin My Commission (is permanent) (expires: 07/04/2026 (Signatures maybe authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. QUIT CLAIM DEED C 2003 STATE BAR OF WISCONSIN FORM NO. 3-2003 * Type name below signatures. Private Sewage System Maintenance DOCUMENT NUMBER 2026R-61 1168 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI S lax we, 39M2►3 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 Township _N. Range W. Additional Legal Description: Town of r roy1 IUQr (Acreage) II . 91 Gov't Lot Lot_ Block Subdivision Lot CSM #3 Vol. La, Page CSM Doc RECORDED O2/24/2O26 AT 1 1 :03 AM RECORDING FEE: $30.00 PAGES: 1 Recording Area _I Return To: KCVGI�"� Planning and Zopjaq D2el Bayfield Go.ng AgenCY planning and 06 In -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. Pumo 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, Wiis. 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, POWIS 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. �1111111111//I The terms and conditions of the agreement shall be`(yrl aI. IMijy to the benefit of all current and future owners of such property. .`.IN _t Owner(s) Name(s) - Please Print �t0 . ' .� ' , tiylbscribed and sworn to before me on this date: Notarized Owner(s) - Signature(s) ', BL ,' t�Etary Public e� GiyL _._.�� 0111i111OFrryyttSG�0% My Commission Expires: Drafted by:Toyiy Po' k e'ck Date: 07 ^ 1 i - a 6 B —('Lift Cs'. w �• Proofed by: u/forms/sanitary/septicmai ntenceagreement Revised July 2020 BAYFIELD COUNTY r . LI ED CHECKLIST FOR CERTIFIED SOIL TESTS FEB 242026 Submit the Following (Use Permanent Ink): Bayfield Co. Planning and Zoning Agency Check List Index Page / Title Sheet (Optional) Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) 1 I Original Plot Plan lon IF Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) c I Parcel Identification Number (must be digit Tax ID#) DO NOT USE 12 digit, they are no longer being used 19 Property Owner's Information not prospective buyer's name) 11p Property Location (Accurate Legal Description with Sec/Twp/Range) Road Name (where driveway is/will be coming off of) 9 Complete Soil Boring / Pit Information $9 Date Soil Evaluation was conducted 11 CST Name, Signature, Number, Address and Phone Number *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) Il Bench Mark (Description, Elevation and Location) 1 Contour Lines (Example = 98.0' /96.0' /94.0') 9l Property Location (Sec/Twp/Range/, Accurate Legal Description) VI Borings (Locations and Elevations) IF Percent and Direction of Land Slope 1A Well Location (Including Neighboring Wells, if applicable) e aers l Buildings, Driveways, and Structures (Location and Descriptions) W Location of Property Lines l Address Number and Road Name D.Guirenf Surface ers rCST, Owner and Property Information 1P North Arrow Fee: I Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checkl ist/checklistforests 13AYFiELD 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: TRAUTT, LOGAN W 10775 SCENIC DR IRON RIVER, WI 54847 Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00384 Transaction Number: SR-00384-3FBE9 Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 2502 Paid by: Polkoski Soil 2 Septic, 5115 County Highway B, Iron River WI 54847 Payment Type: Check Transaction Date: 3/5/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. '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: TRAUTT, LOGAN W 10775 SCENIC DR IRON RIVER, WI 54847 Description Private Sewage System (Septic Tanks) Submission Number: SS -00708 Transaction Number: SS-00708-3FBEB Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 2502 Paid by: Polkoski Soil 2 Septic, 5115 County Highway B, Iron River WI 54847 Payment Type: Check Transaction Date: 3/5/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-14S STATE SANITARY PERMIT OWNER: LOGAN W TRAUTT GOVT LOT: LOT: 4 BLK: CSM: 2153 1/4 1/4 SEC: 8, T 47 N, R 8 TOWNSHIP: Iron River SOIL TEST: 13-26 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: ALLAN POLKOSKI TRACY POOLER DATE: 3/5/2026 Authorized Issuing Officer CHAPTER 145.135(2) WISCONSIN STATUTES a. The purpose of the sanitary permit Is to allow Installation of the private sewage system described in the permit. b. The approval of the sanitary permit is based on regulations in force on the date of approval. c. The sanitary permit is valid and may be renewed for specified period. d. Changed regulations will not impair the validity of a sanitary permit. e. Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. f. The sanitary permit is transferable. History: 1977 c. 168;1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #: LICENSE: # 220090 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 315/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION