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HomeMy WebLinkAbout26-18SIII. Type of POWTS Permit: (Check either "i` s licable. A ❑ New System ❑ Replacement Systent B- 0 Holding Tank C7ln-(hound I Ci'ilventlrmrr.IiI C. 0 Renewal Before O Revision Expiration IV. Dispenalfrreatment Area and Tank Infer nesien Flnw tend . Urchin Soil . nnl...:ainn Rao•m 900 Tank Iniormatton Septic or I toidmg Ta boring Chamber V. Responsibil i Plumber's Name 1 0.7 in Department of Safety & Professional Services, Z P_ Industry Services Division sr-aa�OS Sanitary Permit Application In accordance with SPS 353 211_21. Wis Mm Code. submission of this form to the upprnpnule eovanrncntal urn is required print to obtauung a santwn' Petal it None Appltcatnm forms fin state -,rimed I'I )W i 5 are subnmled to the Department of Si few and Pmtissrnnal Services Personal mnin mauun puu provide Oil' he used iin sceondap' nut noses in accordance with the Privies- taws 1 i 1141 I II n,1. Sens. Todd M. & Mary B. Bertelson Property Owner's Mailing Address 6155 Deer Ridge Ciq'. Slate Zip Code Plume Number Shorewood MN 55331 �18-3y3' II. Type of Building (check all that apply) Lot 0 I or 2 Family Dwcllme — Numhet offledroonu 6 Block 0 I'ubhic/Cotnmercial — Describe l Use _._ ❑ CncoY_ ❑Bute Owned—Ihwrihe lice CSht Number U V,It:urew' Itnw, of Barnes or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i U` Udu•r \loil tier si I to [dating S, stem tc:,plain) ❑ Additional Pretreatment Unit(explain) Expansion of drainfield. addition of pump tank ❑ At -Grade ❑ \found 0 Individual Site Design 0 Other Type (explain l ❑ C'hznge or Ii um her 1 Trwrsi'tr to New tubers List 'rev 14rmt \uni her and I)ate Issued 10-1285 11/3/2010 Bayfield 1% Permit Nwnhcr Ito he Illicit at by a�-iss Ptutect Add, ss f if daiinent than mailing address: 50535 Martin Rd Parcel 04-004-2-44-09-10-1 05-005.07000 Property I.ocauori Govt Lot 4&5 .. Section 10 44 xi r, 09 1:...AM Set Area Iceguired 151) Dispersal Area Proposed Isfl I System Flevation 12857 1295.6 96.32' Tout ;,..l rmulheiuiet Gallons I Pmts - —', 1250/750 2000 1 1 Huffcutt 1250 f — 1250 1 1 Wieser tent- 1, the undersigned, assume responsibility for installation of the PORTS shown on the attached I Plumber s Siyad ire NIP. \II'RS Number rtuniner s address (Slicer. City. Sync. 7 p ('ode, —° — �660 - W C s $ VI ouaty/Department Use Only Approved ❑ rnsappmved Permit Fee FDate Issued_ p,I I Iss tog _en -ietwturc I L7 Owner Grvan Reason fur Denial '3 ( I 2 Conditions of Approval/Reasons for Disapproval RECEIVED C a d/ u' _ FEB 09 2026 Bayfield Co. Planning and Zoning Agency .attach In complete plan. tar the system and xnhn,it to the ('nunw ooh an rarer not less ma,.! in. I, r... h..:".:.- • SOIL TEST Wisconsin Department of Commerce SOIL EVALUATION REPORT nivisinn of Safety and Buldinos Page of? in accordance twin Comm ad, vws. "mm. UUU0 County 13ayfietd 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 (SM). direction and Parcel I.D. 04-004-2-44-09.10-I 05-005-07000 percent slope, scale ordimensions, north arrow, and location and distance to nearest road. Re `eve b Dal Please print all information. Personal information you provide may be used for sernndary purposes (Privacy Law. s. 15.04 (t) (mp Personal - ��,ila 3444,1 Property Owner Property Location Or© Lee (Lamar) & Karen Somnsen Govt. Lot 4&5 114 114 S 10 T 44 N R 9 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 10610 Prairie Lane NA City State Zip Code Phone Number ity ❑Village own Nearest Road Hanover MN 55341 { 7)5-795-3213 Barnes Martin Road Q New Construction Usefl Residential I Number of bedrooms 3� Code derived design how rate 450-600 GPO © Replacement O Public or commercial - Describe: Parentmatenal outwash Flood Plain elevation if applicable ft. General comments it is not yet known if there are to be 3 or 4BR's. The soil test was done to allow for 4 BR. The soil was very and recommendations good, although there are a few fa hands. These are not very thick. 3 and shouldpose no limit to effluent passing ( °1> P 8 downward. I Boring # D Boring ❑ n pit Ground surface elev. 9922 it. Depth to trailing factor >90 in. c nil Ano� llrafinn Rate_ I Horizon Depth in. Dominant Color Munsell Redox Description Qu Si Cont. Color Texture Structure I Gr. Sz. Sh. Consistence Boundary Roots GPORf 'Eff#1 'Eft#2 1 0 -ti 7.5YR 2.52 - Is Iccr j mvfr aw 3c 0.7 1.2 2 6-30 7.5 YR 4/4 - Is lmsbk mvfr es 2c 0.7 1.2 3 30-90 7.5 YR 5/4 - ms Osq ml - 1 nl 0.7 1.2 #3 has layers of 4/4 me mixed with are 514. and 1 3" band of'5/4 is @958S rY.. r'27 ______ _____________I___________ ___ ___ ______ 2j Baring# © Boring pit Ground surface elev. It. Depth to limiting factor ln. Sail Aoolj Sol Rate Horizon Depth in. Dominant Colorj Munsell Redox Description Qu Sr. Cont. Color Texture 1 Structure Gi. Sr. Sh. Consistence Boundary Roots GPO/IF 'Eff#1 'Eff#2 1 0-6 7.5 YR2.5/2 - Is leer mvfr aw 3c 0.7 (.2 2 0-27 7.5 YR 4/4 Is lnisbk mvfr es 2c 0.7 1.2 3 27-90 75 YR 514 - ms Osg ml - 1 nt 0.7 1.2 #3 has some 4/4 ms mixed with 514, mtd 2 bends of 5/4 E+ @55-58 & 82-85 _ _ __ ____ 1 __ ___ _ H Effluent#1=BfJD>30<220rog/L and TSS '30c 150mgfL ' Et1uem a2 = uuu <aurmylane laa≤ au mgtL CST Name (Please Print) .� Signature CST Number Gary Johnson 2?- /1d..,/1dPt-_la,c.. 222295 Address Date Evaluation Conducted Telephone Number 15022W Co. Rd. K, Hayward, WI 54943 10/1112010 715-634-3259 FEB 092826 Bayfc!d Co. Planningand Zen:iu Agency Property Owner Sorensen Parcel ID # 04-004-2-44-09-10-1 05-005- Borin # Boring g Pit Ground surface elev. 98.12 ft. Depth to limiting factor >90 in. 2 5 Page of I Sniil Annlinn Roto El Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 • 'Eff#2 1 0-6 7.5 YR 2.5/2 - Is lccr mvfr aw 3c 0.7 1.2 2 6-37 7.5 YR 4/4 - Is lmsbk mvfr cs 2c 0.7 1.2 3 37-90 7.5 YR 5/4 - ms 0sg ml - 1 m 0.7 1.2 #3 has some 4/4 ms, but no #s Boring # 11 Boring DPit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 - f j Boring Boring # Ground surface elev. LI Pit ft. Depth to limiting factor in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fi: in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 Eff#2 * Eftiuent #1 = BOD, > 30 5 220 mglL and TSS >30 ≤ 150 mgiL * Effluent #2 = BOD, ≤ 30 mg/L and TSS ≤ 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3 151 or TTY 608-264-8777. san-U33OT«1 (a.07100) LC VED FEB 092026 Bayfield Co. Planning and Zoning Agency P30f5 - � - it '�'•' .. :� . r . c3ary Johnson U 222295 drawing scale Ifiv -- 4O to Martin Rd. drl• i of to scale /' Upper Eau Claire Lake is about. 50' away and 30' lower >4d to road >5O' to lot line LLCUVEb FEB 092026 Bayiield Co. Planning and Zoning Agency Bertelson (6 bedroom) Lift to Gravity n -Ground Plot Plan TODD M & MARY B BERTELSON 50535 Martin Rd PAR IN GOVT LOT 4 & 5 IN DOC 2021R-592615 552B S10 T44N R09W Town of Barnes 04-004-2-44-09-10-1 05-005-07000 2.562 acres 006tnivuJ A cLM' C7/ North drawing scale -1 = 40a to Martin Rd. Existing �, - l uffcutt 1250/750 drive-'• n6110 scale w/ polylok 525 filter / / New //' 9 New One row of 19 Infiltrator Quick4 Standard chambers Wieser W3250LP pump tank w/Goulds EPO 4 pump / P cabin deck Upper Eau Claire 50' away and 30' Pit 2 - BM - n�.in double uffcutt 1250/710 97.88' C) S 20`° 91k tree - 100.00 mbo tank Pit - 1-9 .82 e23 3 two 9 f 4. 1' tren es @97.O' >4 to road Zcleaut about -line 4" ASTM 0.1785 2" farcemain ASTM 01785 Slope is variable and nearly level - 1-2% 1-c. a -Gat 32 0 t"1 Existing One row of 22 Infiltrator Quick 4 Standard chambers & one row of 23 Infiltrator Quick 45tandard chamber ntt:EIVEU FEB 092026 aayfeld co. Page 3 of 7 Planning and Zoning Agency B. Bertelson II 04-004-2-44-09-10-1 05-005-07000 IN GOVT LOT 4 & 5 IN DOC 2021R -59261E M Keith Property Owners Ni Property Address Tax Parcel Number County Legal Description Section Town Range Page Index 1 Property Information 2 Data Entry 3 Plot Plan 4 Drainfield Cross -Section 5 Tank Information 6 Maintenance Plan 7 Contingency Plan Designer Name Designer Signature D2388PSS Designer License Number 218-451-2611 Designer Phone Number 11/10/25 Date FEB 0 0 2Q26 Co. Planning and Zoning Agency Page 1 of 7 In -Ground of sorption Version 2.1 (May 2022-2027) Component Manual Used 6 Number of Bedrooms 1 Percent Slope (%) 84 Depth to Soil Limiting Factor (in.) 0.7 In Situ soil application rate 600 Estimated Wastewater Flow (gpd) 900 Design Wastewater Flow (gpd) 1 Number of System Elevations 96.32 Proposed System Elevation #1 96.32 Proposed System Elevation #2 96.32 Proposed System Elevation #3 99.8 Original Grade #1 99.02 Finished Grade #1 98.1 Original Grade #2 99.02 Finished Grade #2 97.8 Original Grade #3 99 Finished Grade #3 Wieser 1250LP !Combo tank or pump tank Polylok PL -525 ?Effluent Filter Infiltrator Quick4 Plus Standard Chamber Type 12 Height of Chamber (in.) 20 sq.ft. per chamber(ESIA) 5.2 sq.ft. per pair of end caps (EISA) 4 laying length of chamber(ft.) 1.5 length of endcap(ft.) 34 Chamber width(in.) 3 Rows of Chambers 3 Distance Between Cells (ft.) 22 Number of chambers in first row 23 Number of chambers in second row 19 Number of chambers in third row 64 'Proposed Number of Chambers Used 1285.7 Minimum Distribution Cell Area Required (sq.ft.) 1295.6 ,Distribution Cell Area Proposed (sq.ft.) Page 2 of 7 FEB 092026 B Planning aand Zoning Agency Cross Section of a Three Cell Inground Component Using Leaching Chambers Finished Grade 99.02 Original Grade 98.10 Top of Chamber 97.32 Typical Observnian/Vmt Pipe - \ system Elevation 96.32 Finished Grade j99.02 O Slope 19.80 Origine 17.32 Too of �r�r®ems 1% Grade ; .y, / r,; ,r � i_.�" y.'f __]/ � Or a Grade 97.80 r :„! 91 Chamber 97.32 Y. ..:. � ` ice` Top of '� .' �� �'�•'�•� System Elevation 96.32 mo—. _ 3 • ` oemvatlm/vmt pipet is be roustuatad and capped with approved mater" far the puGeulr use, Elevation Feet 91 feet inished Grade 99.00 / Vent Pipes to be located at the ends of the distribution cells E:e:a:�a: t ED FEB 092026 3 feet between cells Page 4 of 7 hayfield Co. Planning and Zoning Agency ApnrnVM Mnnnn.e nvr≤ wcn w —^ Weather Proof Junct'on rnx E'ertnc for NEC 300 & COMM '6 29 Wm_ JA�W�—,M-le �ect Alternate Outlet Location W/Approved A' Sleeve 2 inch forcemain Polylok PL -525 or Anti Siphon Device Weser 125OLP Vertical Difference Between Pump Off and Inlet to Chamber Length of Forcemain(ft.) Inches Gallons Forcemain Diameter (in.) Friction Factor per 100ft. Friction Loss Total Dynamic Head A 17.5 610.6 B 2 69.6 C 4.5 155.3 D 12.0 417.7 TOTAL 36.0 1253.2 Number of Doses per Day Gallons per Dose (Not to exceed 20% of Daily Design Flow) Volume of Forcemain Backflow Total Dose Volume Pump Tank Capacity (Gallons) Pump Tank Volume (Gallons / Inch) Liquid Level (in) Pump Type FEB 092026 Bayfield Co. Planning and Zoning Agency Page 5 of 7 4" CAS U.] i9 o a N S O C7 o0 vN I 3.cu ,LiI i m m" m 4" CAST -A -SEAL 1 OUTLET r V a m WLP1250-MR TANK SPECIFICATIONS DIMENSIONS: m O WALL: 2 1/2" BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 52 1/2" LENGTH: 10'-0 1/4" WIDTH: 7'-0" rc BELOW INLET: 41" LIQUID LEVEL: 36" WEIGHT: BOTTOM 4,945 LBS. COVER 3,865 LBS. n k INLET AND OUTLET: m a 4" CAST -A -SEAL BOOT OR EQUAL GASKET �a a INLET AND OUTLET BAFFLE AND FILTER: N o 0 WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) s IW LIQUID CAPACITY: 34.81 GAL/IN Lu HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1,323 GALLONS P.i 0 LOADING DESIGN: 8'-0" UNSATURATED SOIL s TANK CAN BE USED AS: W SEPTIC / HOLDING / PUMP OR SIPHON y z W COVER: MIX DESIGN #8 (NO FIBER) � m TANK: MIX DESIGN #10 (STRUCTURAL FIBER) 9 CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE J oI Z U REVIEWED BY REVIEW DATE a DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: SHEET NO. APPROVAL DATE: 1 Z PRODUCTS NEEDED BY: / OF 1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 6_ot? FILE INFORMATION ownetTodd M. & Mary B. Bertelson Permit # DESIGN PARAMETERS Number of Bedrooms 6 0 NA Number of Public Facility Units ® NA Estimated (average) flow 600 gal/day Design (peak) flow = (Estimated )< 1.5) 900 gal/day In Situ Soil Application Rate 0.7 al: da ff 2 Standard InfluenUEffluent Quality Monthly average - Fats, Oil & Grease (FOG) s30 mg/L Biochemical Oxygen Demand (BOD5) <220 mg'L ❑ NA Total Suspended Solids (TSS) ≤150 mg. L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BOD5,) ≤30 mg/L Total Suspended Solids (TSS) ≤30 mg'L ® NA Fecal Coliform (geometric mean) 510' cfu. t 00m( Maximum Effluent Particle Size 'e in dia. ❑ NA Other: ( ra NA Values typical for domestic wastewater and septic tank ellluent. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once ever y ❑ month(s) 3 2 year(s) (Maximum 3 years) 0 NA Pump out contents of tank(s) ® When combined sludge and scum equals one-third ('6) of tank volume ❑ NA 0 When the high water alarm is activated Inspect dispersal cell(s) At least once every: 3 ❑ month(s) year(s) (Maximum 3 years) ® 0 NA Clean effluent filter At least once every: 3 O month(s) ® year(s) 0 NA Inspect pump, pump controls & alarm At least once every: _ _ 3 0 year(s) month(s) ® NA Flush laterals and pressure test At least once every: ❑ month(s) ❑ year(s) ® NA Other: At least once every: ❑ year(sl 0 month(s) sl ® NA Other: ® NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer: POWTS Inspector: POWTS Maintainer: Septage Servicing Operator (pumper). Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks. measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third (I5) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units. and any servicing at intervals of ≤12 months, shall be performed by a certified POWTS Maintainer. SYSTEM SPECIFICATIONS Tank Manufacturer Huffcutt 0 NA ® Septic 0 Dose 0 Holding vol. 2000 gal Tank Manufacturer Wieser ® NA ❑ Septic ® Dose 0 Holding vol. 1250 gal Effluent Filter Manufacturer Polylok 0 NA Effluent Filter Model 525 Pump Manufacturer Goulds O NA Pump Model EPO 4 Pretreatment Unit li NA ❑ Sand/Gravel Filter 0 Peat Filter ❑ Mechanical Aeration 0 Wetland ❑ Disinfection 0 Other: Manufacturer Dispersal Cell(s) ❑ NA ® In -Ground (gravity) 0 In -Ground (pressurized) ❑ At -Grade 0 Mound ❑ Drip -Line 0 Other: Other: ® NA Olhcr NA A service report shall be provided to the local regulatory authority within 10 days of completion of any service event, QMW (12/02) FEB 092026 Bayrrold co. Planning and Zca:nn Aer„- Page' of ' START UP AND OPERATION - For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other bnem-cals that may impede the treatment process and: or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics: baby wipes; cigarette butts: condoms; cotton swabs: degreasers; dental floss: diapers: disinfectants; fat: foundation drain (sump pump) discharge: fruit and vegetable peelings: gasoline: grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins: tampons: and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33. Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil. gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure. lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. El A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMM POWTS INSTALLER POWTS MAINTAINER Name r-'.11 Nork 2 S�u`- Phone'flS_ oY -cilb Phone Ig_3 3_3 g SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY [me.4t Sp4, C' Name Bayfield County Zoning Phone icPhone 715-373-6138 This document was drafted by the staffs of the Green Lake. Marquette and Waushara County Zoning and Sanitation agencies in�c Ya a pier Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1). 121 & I3). Wisconsin Administrative Code. FEB 092026 Bayfie!d co. Planning and Zoning ;1.=nn., C' Private Sewage System Maintenance Agreement Owner(s) Name Taw 4/jlpcy &cbs(sM Owner(s) Mailing Address COISS Ne(t i?Jabc S esvJcab, IMF (S13 DOCUMENT NUMBER 2O26R-6 10954 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED f 1 tttl/n 24 Y>AI.At.j W 1 02/09/2026 AT 9:46 AM RECORDING FEE: $30.00 PAGES: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: 5 e- - Town of Lot_ Block Subdivision Lot CSM#_____ Vol._ ❑ In -ground gravity ❑ Mound (Acreage) Gov't Lot Page _ CSM Doc # ❑ In -ground dosed Recording Area Return To: RECEIVED ENTE EU Planning and Zoning Department c a6 FEB 10 2026 Bayfield Co. ❑ In -ground pressure distribution Sewage System: El 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. 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 Sewaae 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 -around 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. Owners) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfreld 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. Bayheld 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 maybe 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 ben o Curren err rtyr�r o suc party. e Owner(s) Name(s) — Please Print �AA 0IC. t%SIM mnm y SEIL. sdti. Subscribe 1 - to b MI N My Comm ssan Expires 01131!2030 Notarized s Notary Public My Commission Expires: Drafted by: r% Date: ° NOTARYIPUBLIC MINNESOTA My Commission Expires 0113112030 Proofed by: _ Revised July 2020 Real Estate Bayfield County Property Listing Today's Date: 2/9/2026 1Z Description Updated: 1/21/2022 Tax ID: 1818 PIN: 04-004-2-44-09-10-1 05-005-07000 Legacy PIN: 004109504000 Map ID: Municipality: (004) TOWN OF BARNES STR: 510 T44N R09W Description: PAR IN GOVT LOT 4 & 5 IN DOC 2021R- 592615 552B Recorded Acres: 2.562 10 Site Address * indicates Private Road Calculated Acres: 2.562 50535 MARTIN RD BARNES 54873 Lottery Claims: 0 First Dollar: Yes Property Assessment Updated: 5/19/2025 Zoning: (R-3) Residential -3 ESN: 104 2026 Assessment Detail Code Acres Land Imp. ` G1 -RESIDENTIAL 2.500 210,000 297,400 Tax Districts Updated: 3/15/2006 1 STATE 2 -Year Comparison 2025 2026 Change 04 COUNTY Land: 210,000 210,000 0.0% 004 TOWN OF BARNES Improved: 297,400 297,400 0.0% 041491 SCHL-DRUMMOND Total: 507,400 507,400 0.0% 001700 TECHNICAL COLLEGE Property Status: Current Created On: 3/15/2006 1:14:46 PM A Ownership Updated: 1/21/2022 TODD M & MARY B BERTELSON SHOREWOOD MN Billing Address: TODD M & MARY B BERTELSON 6155 DEER RIDGE SHOREWOOD MN 55331 Mailing Address: TODD M & MARY B BERTELSON 6155 DEER RIDGE SHOREWOOD MN 55331 Recorded Documents 13 WARRANTY DEED Date Recorded: 12/15/2021 ® WARRANTY DEED Date Recorded: 9/11/2012 91 CONVERSION Date Recorded: 3/15/2006 1/7/2022 EN Property History 2021R-592615 N/A ECENED 2012R-545632 1090-434 . 10 2026 258-389;652-200;767-156+ Bayfield Co. Planning and Zoning Agency EXHIBIT "A" A parcel of land within Lot Four (4) and Lot Five (5), Section Ten (10), Township Forty-four (44) North, Range Nine (9) West, Town of Barnes, Bayfleld County, Wisconsin, described as follows: Commencing at the Southeasterly corner of said Lot Five (5) which is identical with the Northeasterly comer of said Lot Four (4), (which corners are identical with the Quarter corner), thence due West a distance of 400 feet on the North -South line between said Lots 4 and 5 which is the point of beginning; thence due North a distance of 100 feet; thence due West to the shore of Upper Eau Claire Lake; thence Southerly along said Lake Shore a distance of 200 feet; thence due East to a point 100 feet due South from said point of beginning; thence due North 100 feet to said point of beginning, it being intended hereby to convey a rectangular area 200 feet North and South by 461.5 feet East and West, the North one-half being in said Lot 5 and the South one-half in said Lot 4. RECti1VED FEB 10 20?6 Bayfiehd CO. planninu and zoning Agency Bayfield County Register of Deeds Document # 2021 R-592615 Page 4 of 4 13'! YFIELD 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: BERTELSON,TODD M & MARY B 6155 DEER RIDGE SHOREWOOD, MN 55331 Description Private Sewage System (Septic Tanks) Submission Number: SS -00705 Transaction Number: SS-00705-3DB1F Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 3988 Paid by: Greg's Plumbing, 13660 County Hwy H, Iron River WI 54847 Payment Type: Check Transaction Date: 3/12/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-18S STATE SANITARY PERMIT OWNER: TODD M & MARY B BERTELSON GOVT LOT: LOT: BLK: 114 1/4 SEC: 10, T 44 N, R 9 W TOWNSHIP: Barnes SOIL TEST: 144-10 OTHER MODIFICATION SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: GREG BROWN TRACY POOLER DATE: 3/12/2026 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 #:10-128S LICENSE: # MP699374 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 3/12/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION SANITARY INFORMATION (NEEDED) DATE: TO: RUTH DEB FRANKI T MCKENZIE ERICA WHICH INSPECTOR / PERSON MADE THE C LL / ADDT'L CALL DATE CONTACTED: HONED [_3 IN -PERSON U ANSWERING MACHINE 0 MAIL 0 E-MAIL SPOKE WITH: PLUMBER U OWNER 0 CONTRACTOR ❑ SOIL TESTER U OTHER IN REGARDS TO: U AS -BUILT L' CONTOUR LINES O FEE ❑ HOLDING TANK AGREEMENT (Recorded) [1 HOLDING TANK SERVICE CONTRACT 9 MAINTENANCE AGREEMENT (Recorded) MISSING PAPERWORK Cl DEADLINE U COMMENTS 0 PLOT PLAN SOIL TEST 0 REINSPECTION ❑ REINSPECTION FEE 0 REVISION 0 REVISION FEE 0 SOIL INFO 0 OTHER NI �EC IO�ji/ °• Ruth Hulstrom From: Tracy Pooler Sent: Thursday, March 12, 2026 2:59 PM To: Ruth Hulstrom Subject: FW: B dimension 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: trace._poolerCQbavfieldcountywi.2oy I3-YFIELD Fraudulent Billing Alert: Be aware that individuals submitting applications to our department have received scam emails. Bayfield County will NOT ask applicants to wire any funds. Please contact our office atzoning@bayfieldcounty.wi.gov or 715 373-6138 with any questions or concerns. From: Petzel, Katie - DSPS <katie.petzel@wisconsin.gov> Sent: Tuesday, February 24, 2026 10:28 AM To: Tracy Pooler<tracy.pooler@bayfieldcounty.wi.gov> Subject: RE: B dimension Hi Tracy, The dose volume is the C dimension. I'm assuming this is a dose to gravity system, so the max dose is 900/5 + FM drainback, which would be 180+ 3.26 = 183.26. The C dimension must be less than that, but still achievable by a pump switch float system. The 4.5 inches is achievable by the double master or a similar pump switch. Typically, they will have the dosing pump switches (commonly a double master or similar) and then the normally open control float that controls the alarm condition (that you linked). These two float systems operate independently and do not affect one another. The control float for the alarm must be set to activate at the B dimension, which is a minimum of 2 inches above the C dimension. Since its only function is to trigger the alarm (not control dosingvolume), the exact tether length is less critical. According to the manufacturer's literature, the float will activate when it reaches a near or slightly above -horizontal position. There is no reason to add the B and C dimensions together except for when checking that all the A -D dimensions add up to the correct volume/depth for the specified tank. Hope that helps, Katie Petzel I POWTS Plan Reviewer - Field Division of Industry Services Department of Safety and Professional Services Field Office — District 4 POWTS kat�netzel@wisconsin.govICell: 608.574.1189 .dSns.wi.eov The information and response presented above is a general code answer based on the question submitted. This response should not be construed as a formal code interpretation. To view approved plumbing product listings, search under the "Plumbing Products" tab using this link: https:O.esLLwi.govlapex/11ublcloakup From: Tracy Pooler ctracy.pooIer@baeldcounty.wi.gov> Sent: Tuesday, February 24, 2026 9:52 AM To: Petzel, Katie - DSPS <katie.oetzel(a?wisconsin.gov> Subject: RE: B dimension Katie, Attached is the info sheet that I received, and a copy I scribbled up with my notes, Below is a Rhombus spec sheet. Please help me understand the numbers. 1 ����� •1 •IA_.• •�_ 1• • ' • •. 1 11.1. i. 11 •: 1 11. 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: tr-cy..Paoter.@bayAeld=ounty..wLgov J34YFIELD Fraudulent Billing Alert: Be aware that individuals submitting applications to our department have received scam emails. Bayfield County will NOT ask applicants to wire any funds. Please contact our office atzoning@bayfieldcoun •wi.gov or 715 373-6138 with any questions or concerns. From: Petzel, Katie - DSPS <katie.petzel@wisconsin.gov> Sent: Tuesday, February 17, 2026 3:49 PM To: Tracy Pooler <trace.Pooler@bayfieldcounty.wi.gov>; coyotesepticworks@gmaiI.com Subject: B dimension Hi Tracy, I got a call with questions about the pump dimension requirements. This was actually something we had planned to cover at last week's POWTS chat, since I've been getting similar questions from elsewhere around the state. Unfortunately, since we had to cancel, no one got to hear that. SJE RHOMBUS has a really good visualization of pump and float settings in this video: https://www.voutube,cnm/embed/BAhVx14s20c The first half walks (starting at 1:25) through a simplex demand setup using a double float and an alarm float, and it does a nice job showing how the floats should be positioned relative to each other and howthe levels in the tank affect the on and off of the pump and alarm. They show them as free-floating, but typically, we'd see them on a float tree, and the concept is the same. When we talk about verifying a minimum depth for the volumes that floats can achieve, we're really talking about the C dimension on the pump cut sheet. The float has to be able to "sense" that number of inches in order to accurately dose the field. In their example that number of inches would be between when the pump turns on (middle float up) and turns off (first float down) The B dimension (pump on to alarm on), on the other hand, isn't practically governed by minimum tether length. That dimension isn't tied to dose volume; we're simply concerned that the alarm will activate at a set point. As long as the tether isn't getting tangled with the other floats (which it shouldn't), it isn't affected by the dosing volumes and can be any length (within reason) as long as the float trips the alarm at least 2" above the pump on switch. Once the alarm float drops back down, the alarm should shut off, so there's no need for a specific "sensing" range beyond that. Two inches is the minimum and is widely used, though some people prefer 3 inches to provide a bit more buffer before the alarm activates. Thank you, Katie Petzel I POWTS Plan Reviewer - Field Division of Industry Services Department of Safety and Professional Services Field Office — District 4 POWTS katie.petzelra�wisconsin.gnv I cell: 608.574.1189 www.dsps.wi.gov The information and response presented above is a general code answer based on the question submitted. This response should not be construed as a formal code interpretation. To view approved plumbing product listings, search under the "Plumbing Products" tab using this Link: https:LLeFLa.wi.gQv/apeKLWbkictopkup Apnrovea Aonnme •aver. W,rn x-^•-i and Lacktrgg Dev!ce i 4" Mtn Apove r?... U a v "•� Weather Proat Junction enx Electric oer NEC 2lOU & COMM. 1629 WC Alternate Outlet Location W/Approved 4- Sleeve 2 inch forcemain Polylok PL -525 A eep Hole or Anti Siphon Device B C Weser 1250LP - D Vertical Difference Between Pump Off and Inlet to Chamber Length of Forcemain(ft.) Inches Gallons 2 Forcemain Diameter (In.) A 17.5 610.6 Friction Factor per100ft. B 2 69.6 Friction Loss C 4.5 155.3 Total Dynamic Head D 12.0 4177 1.39 0.28 5.28 1O I .2 AL 36.0 1263 6 Number of Doses per Day = /50-' 152 Gallons per Dose (Not to exceed 20% of Daily Design Flow) 3.26 Volume of Forcemain B�ack-0o_w'' / 155.26 Total Dose Volume Pump Tank Capacity (Gallons) Pump Tank Volume (Gallons / Inch) Liquid Level (in) Pump Type Alert 1 "•— '////J a •� uv 4 �. 1. u .i.• 11 FEB 0 9 2026 Page 5 of 7 Hayfield Co. Planning and Zoning Agency