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HomeMy WebLinkAbout26-26SIndustry Services Division U - 4822 Madison Yards Way g F Madison, WI 53705 8 -0 O] �p P.O.Box 7302 - Madison, W15302 Sanitary Permit Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for slate -owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provid be used for secondary purposes in accordance with the Privacy Law, s. 15.04(I)(m), Stats. 6p- IV l= I) I. Application Information — Please Print All Information Property Owner's Name Mark and Jennifer Ledin ,,,�� MAR 302026 — -- j-/ Planning and Zoning A.3ency 218 E Bayfield St. Washburn 54891 715-209-0679 II. Type of Building (check all that apply) Lot 4 ❑ 1 or 2 Family Dwelling — Number of Bedrooms 3 O Public/Commercial — Describe Blockfl Use 0 State Owned— Describe Use litary Permit Number (to 1 Project Address (if different than mailing addre 214 S Jones road Washburn WI 54891 04-291-2-48-04-06-2 03 -000 - Govt. Lot SW 'A,NW_%y Section 06 Name X City of Wr 0 Village of ❑'town of 111. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i1 a licable. A. New System ❑ Replacement System ❑ Other Modification to Existing System (explain) y p y y ( p ) ❑ Additional Pretreatment Unit (explain) B. ❑ Holdin Tank E In -Ground ❑ At -Grade ❑ Mound ❑ Individual Site Desig n gn ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration 50 .7 I 642.86 650.4 I 96.5 Capacity in Total 4 of Manufacturer Tani: Information Gallons Gallons Units 8 `o v g New Tanks Existing'fmlks a&C.)in y i,.O a Septic or Bolding Tank 1000 0 1000 1 Nieser X Dosing Chamber V. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si ature ` MP/MPRS Number Business Phone Number ADRIEN CADY IXAV%7/_C - L l L^.l3-�i�� 922139 715-373-2378 VI. County/Department Use Only ' %Approved ❑ Disapproved Permit Fee I Date Issued., Iss n Age �rig/njany�yg (�7 i/� . ems ❑ Owner Given Reason for Denial �— $ I(el2(0 Conditions of Approval/Reasons for Disapproval Attach to complete plans [or Inc system ana submit to Inc County only on paper not less than a 1/2' 11 inches an sue Wsconsin Department of Safety and Pr s5taLEi • c>t I___________ Pagel of 2 D'" f rvlslono Industry Sam ces JUN 2 1v ATION REPORT a IIna ajetYwiittWi with 385 s. Adm. Code 'county Attach complete site plan on paper not less th!a1 8'�'inches m siz .(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. 04-291-2-48-04- 00.10000 Please print all information. Review Property Owner Property Locado NJ J L .u'/t P' a , w 7T ' w r-+ ❑ Ruth Oppedahl Govt. Lot a MS (0 T 1" jS N R H E (or)() Property �Oi rrers Mailing Address - r Lot # Block # Subo. Name or CSM# City M , ` State Zip Code Phone Number ® City ❑ Village ❑ Town Nearest Road I I 53 W I 715 292-3872 Washburn I I Jones rd New Construction Use: ❑Residential/Numberof bedrooms — Code derived design flow rate GPO ( V EC.`(v( ❑ Replacement ❑ Public or commercial —Describe: Parent material sandy outwash Flood Plan elevation if applicable _ ft. r 1 i AI ( 30 Z( General comments and recommendations: conventional system recommended 3-/1I'n �T 0[vV \ t'"-'--'_. _ Bayfield Co. H Boring # ❑ Boring V ® Pit Ground surface elev. 100 ft. Depth to limiting factor- in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ftz Eft 1 •Eft 2 A 0-8 5YR 3/1 fsl 0-vt mvfr as 2f -lm 0.2 0.5 E 8-12 5YR 5/3 is 0-vt mfr ci 0.5 1.0 B 12-22 5YR 4/6 is 0-vt mvfi as 0.5 1.0 C 22-50 5YR 5/6 ms 0-vt mfi aw 0.7 1.6 D 50-120 5YR 4/4 ms 0-vt mfi 0.7 1.6 2❑ Boring// ❑ Boring Pit Ground surface elev. 99_17 ft. Depth to limiting factor in. Snil Annll inetinn Rote Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPO/Ft' •Eff#1 -Eff#2 A 0-10 5YR 3/1 fsi 0-vt mvfr as 2f -1m 0.2 0.5 B 10-32 5YR 4/6 fs 0-vt mvft as 0.5 1.0 C 32-120 5YR 4/4 ms 0-vt mfi 0.7 1.6 CST Name (Please Print) ISignature /, CST Number Tim Dykstra 1213855 Address I Date Evaluation Conducted I Telephone Number 420 16x" St east Ashland WI 54806 5112116 715-209-4758 Sbu--dsu (NUgrl of 3 I Boring # ❑ Boring ® Pit Ground surface elev. 100.25 ft. Depth to limiting factor_ in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Fe 'Eff#1 'Eff#2 A 0-10 5YR3/1 fsl 0-vf mvfr as 2f-im 0.2 0-5 B 10-28 5YR 416 fs 0-vf mvh as 0.5 1.0 C 28-120 5YR 4/4 ms 0-vf mu t .07 1.6 ❑ Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor _ in. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/F8 Eff#1 •Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor _ in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. St Sh. Consistence Boundary Roots GPD/Fe .V •EfF#1 'Eff#2 M planing and Zon ng Agen Effluent #1 = BOD, > 305 220 mg/L and TSS > 30 5 150 mg/L • Effluent#2 = BOD, > 30 5 220 mg/L and TSS > 30!r150 mg/L x IG3 '`¶• 1.75 W'4?11Vt ,N 1swNW 506 TN RoN+� V, gfo P Ti7 uv: r:� aai-� �a-cI'6-a o3.c IU9cv r#x i P 3a6301 off" IJa5&L-.— RECEIVED MAR 30 2026, Bayfield Co. 1 �� a 20 Planning and Zoning Agency 0 70 PL 13�•y A Soy I iesh-5 va0 /Lfh St E AsL1e 6Jr S°ggcs l wA i'�7 I i iJ Csr l 1,913$55 S/r)/i6 \\1I I Cg w-1 rn x .—.. Mark and Jennifer Ledin 3 bedroom Conventional septic system PIN 04-291-2-48-04-06-2 03-000-10000 214 S. Jones Rd Washburn WI 54891 RECEIVED MAR 302026 Bayfield Co. Planning and Zoning Agency Page 1: Wisconsin sanitary application Page 2-3: Bayfield Co. checklist for sanitary applications Page 4: Tax statement (for informational purposes) Page 5: Plot plan Page 6: System elevation view Page 7: Tank information Page 8-10: Soil and site evaluation Page 11-12: POWTS owners manual, managment and contingency plan Page 13: POWTS maintenance agreement Reference material; component manual SBD-10705-p (R 10/12) These plans prepared by ; Adrien Cady MP922139 31160 Birch Grove Rd Washburn WI. 54891 phone:715-373 2378 fax:715-373-0646 BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) ❑ Check List ❑ Original Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.) ❑ Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) RECEIVED ❑ Original Plot Plan (383.22(2)2. 3. & 4.a) MAR 302026 ❑ Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer o. ❑ Pump Tank Diagram, Alarm and Pump Curve(when applicable) Band Zoning o 9 � PP ) Planning and Agency ❑ Contingency Plan / Management Plan (383.22-3(2)(b)1.f.) ❑ Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Req. of Deeds) ❑ Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) ❑ Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) ❑ ATU Servicing Agreement (Recorded at Reg. of Deeds) ❑ Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) ❑ 2 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) 0 Soil and Site Evaluation Report (383.22-3(2)(b)1.e.) 0 State Plan Review (when applicable) 0 Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) ❑ I Application Information must include: ❑ 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) 0 Project Address or Road Name where driveway is/will come off of) ❑ (Owners Phone Number) ❑ II Type of Building ❑ III Type of Permit ❑ IV Type of POWTS System ❑ V Dispersal / Treatment Area Information ❑ VI Tank Information ❑ VII Responsibility Statement (Plumber's Information) ❑ *Date Stamp* Plot Plan: (To Scale or To Dimension) ❑ Signature and Plumber Information ❑ Address Number and Road ❑ Surface Elevation of Body of Water 0 North Arrow ❑ Direction and Percent Land Slope 0 Contour Lines ❑ Tank and Filter Information and Location 0 Structures and Driveways ❑ Wetlands / Navigable Bodies of Water 0 Boring Locations ❑ Absorption Area (Proposed and Existing) 0 Property Lines ❑ Bench Mark (Location, Elevation and Description) 0 Well Locations ❑ Component Manual Version 0 Legal Descriptions ❑ Piping Material Information (conveyance line, building sewer line, material type and diameter) Turn Over ► Cross -Section and Over -Head Profile of the System: ❑ Surface and System Elevation ❑ Position of Observation and Vent Pipes ❑ Dimensions and Depths ❑ Make, Model & Number of Chamber Units in each Cell Property Information ❑ How many systems will there be on this parcel of land? ❑ Has this property been split? (Property Statement shows Property History) Fees: ❑ Private Sewage System (Septic Tanks) $ 400.00 ❑ Private Sewage System (Holding Tanks) $ 400.00 RECEIVED ❑ Mounds or Systems requiring Pre -Treatment $ 500.00 ❑ Sanitary Revisions $ 25.00 MAR 30 2026 ❑ Private Sewage System Reconnection $ 50.00 hayfield co. and Private Interceptor Planning and Zoning Agency ❑ Return Inspection $ 50.00 ❑ Maintenance Agreements + $ 30.00 (checks made out to Reg of Deeds) u/forms/checklists/checklistforsanitaryapps (10/2009);(®7/2011);(®2/2012)(®5/2/2012 -dc) Proofed by: Real Estate Bayfield County Property Listing Today's Date: 3/20/2026 Z Description Updated: 7/16/2025 Tax ID: 32630 PIN: 04-291-2-48-04-06-2 03-000-10000 Legacy PIN: 291101510000 Map ID: Municipality: (291) CITY OF WASHBURN STR: 506 T48N R04W Description: N 1/2 N 1/2 N 1/2 SW NW IN TOG WITH EASE IN DOC 2025R-608107 2495 Recorded Acres: 4.858 Calculated Acres: 4.858 Lottery Claims: 0 First Dollar: No Zoning: (R-1) Residential -1 ESN: 102 3 Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 291 CITY OF WASHBURN 046027 SCHL-WASHBURN 001700 TECHNICAL COLLEGE ,y^ Recorded Documents Updated: 3/15/2006 0 WARRANTY DEED Date Recorded: 7/1/2025 2025R-608107 0 WARRANTY DEED Date Recorded: 8/31/2020 2020R-583990 0 WARRANTY DEED Date Recorded: 6/17/2016 2016R-564017 1162-111 0 CONVERSION Date Recorded: 488389 665-41;709-427;876- 1;880-917 0 QUIT CLAIM DEED Date Recorded: 12/30/2003 2003R-488389 880-917 0 QUIT CLAIM DEED Date Recorded: 10/29/2003 2003R-486981 876-1 Property Status: Current Created On: 3/15/2006 1:16:11 PM 49 Ownership Updated: 7/16/2025 MARK S & JENNIFER A LEDIN WASHBURN WI Billing Address: Mailing Address: MARKS & JENNIFER A LEDIN MARK S & JENNIFER A LEDIN 218 E BAYFIELD ST 218 E BAYFIELD ST WASHBURN WI 54891 WASHBURN WI 54891 P Site Address * indicates Private Road 214S JONES RD WASHBURN 54891 ® Property Assessment Updated: 8/28/2023 2026 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 4.858 21,600 0 2 -Year Comparison 2025 2026 Change Land: 21,600 21,600 0.0% Improved: 0 0 0.0% 21,600 21,600 0.0% pTotal: is Property History N/A RECEIVED MAR 302026 Bayfield Co. Planning and Zoning Agency MavrC d-Tetiv!lf&V L eo': i fir+ s TOUes 2d U Jc-s li to uv" (,� 5-g?/ a3-o©o-1O00a 1-(85-8 4ve5 p Lc�c�s��Ovl/vi N Na NSW NW e fC & wi+InEase iM Doc. a©a5 2-6o�(o7 a I; ke v F'vopevty 1 � u e I I I No�r� REV`W D MAR 301076 Bayfield Co. planning and Zoning Agency e� luick 4 Plus Standard ISA= 20.0 sq ft each Cross Section of ° a Three Cell h1ground Component quick 4 All in One End Cap ISA= 2.6 sq ft each a .rows of chambers +2 end caps &X20 = 3 lbX 2 Rows=fO 2X 2.6 = 5.2 X 2 Rows= 10.4 -D + 10.4 =6SO 5croposed sq ft Cell # 1 PinSlhed (3sde Zr ICIsi ng Leaching Chambers Tyapieal obsevvationNent Pipes fsch 40 pvc W11N\ approved caps RECEIVED MAR 307026 Bayfield Co. Planning ar^- Zoning Agency cell # Sriglrtaal Grade 00 Top of chamber_ `77. S System E lev. _ I.5 'j(9p of Chmnbe8 == 2_Ldr \n5 d� y' - �' syatenES. t �'°^.H,' L1t32e. a'° t 4 e, , a, `<°A1av��a�p,4--91.1 •.a .: raa �, 1Q, .'9 J41�¢"i \'f-os�Jd4A4� °tlA 4 • F� V , a• •° ° 4 ..r ' ' 9 ..v 1 6 . J' a ..ry . t d ' 'I � ' a " ' A' i ° • .. '' A a A ;,;q : , : p ' r . ' .'A •1, �'� �� .N� °Q 'd i •. '�, •u." �.�� .n: ' '�.�•a••',. ;2Y JA i n•, T �A9A.��.y�y ��i�7t��� 9 0• i `' °, J�1 ,�: 6aaf as n e�'.i : '°— u`_.u.-aa`�WI'�k9>' `..'`�J,_..t?_-.�..�.�� observatioa,/Vert pipes to be coustucted spud. gapped. vvittk approved materials 1®a the lsax ticul use. WLP1000 TANK SPECIFICATIONS DIMENSIONS: WALL: 2 1/2" 4" CAST -A -SEAL 4" CAST -A -SEAL BOTTOM: 3" COVER: 5" ____- MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53 1/4" •:' �:• LENGTH: 8'-8" `L r�ECE IVEO WIDTH: 7'-2" BELOW INLET: 42" LIQUID LEVEL 36" n t3. MAR 302026 WEIGHT: BOTTOM 6,790 LBS. COVER 3,195 �� /� Bayfield Co INLET AND OUTLET: FILTER OR it Plannin9a'"d T 9 �i� BAFFLE a 'J°°A enq 4" CAST —A —SEAL BOOT OR EQUAL GASKET `- -i INLET AND OUTLET BAFFLE AND FILTER: ------ WISCONSIN SEE DETAIL #10 (OTHER STATES SEE CHART) TOP VIEW LIQUID CAPACITY: 27.83 GAL/IN rn a I M U a I 2 j" CD `n wove 0 F 6 HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1,085 GALLONS LOADING DESIGN: 8'-0" UNSATURATED SOIL �7 TANK CAN BE USED AS: Po�� (ft 5;-15 SEPTIC / HOLDING / PUMP OR SIPHON �( ,)etAf FI ( V COVER: MIX DESIGN #8 (NO FIBER) IPUMP TANK: MIX DESIGN #10 (STRUCTURAL FIBER) - CUSTOMIZED TANKS: OUTLET FOR CUSTOM TANKS CONTACT WIESER CONCRETE LidREVIEWED BY AD REVIEW DATE TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 W 0 - W C v1O 1O =z 0 o � a N � M o I O tCO W_ N J o z o < O a 0- w DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: SHEET NO. APPROVAL DATE: 1 7" OF PRODUCTS NEEDED BY: POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page J_of 'FILE INFORMATION Owner p 'avtt a ucL Ternicev Led i Permit # DESIGN PARAMETERS Number of Bedrooms 30 NA Number of Public Facility Units ANA Estimated (average) flow .300 gal/day Design (peak) flow = (Estimated x 1.5) gal/day In Situ Soil Application Rate , .% aVda /ffz Standard Influent/Eftluent Quality Monthly average' Fats, Oil & Grease (FOG) ≤30 mg/L Biochemical Oxygen Demand (BOD5) ≤220 mg/L O 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 ANA Fecal Coliform (geometric mean) ≤10° cfu/10oml Maximum Effluent Particle Size ,% in dia. O NA Other: ❑ NA `Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 ❑ year(s)s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) X When combined sludge and scum equals one-third ('4) of tank volume O NA O When the high water alarm is activated Inspect dispersal cell(s) At least once every: 3 ❑ month(s) (Maximum 3 years) years) 0 NA Clean effluent filter At least once every: 3 ❑ onth2. .') ) O NA Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ year(s) ' NA Flush laterals and pressure test At least once every: ❑ month(s) r: r year(s) M NA Other: At least once every: month(s) ❑ year(s) Other: t1AF 3U LU/6'NA o 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 (14) 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. SYSTEM SPECIFICATIONS Tank Manufacturer W DES e2 O NA 5�Septic 0 Dose O Holding vol. /000 gal Tank Manufacturer NA ❑ Septic O Dose O Holding vol. gal Effluent Filter Manufacturer f i O NA Effluent Filter Model 575 Pump Manufacturer 'SNA Pump Model Pretreatment Unit IXNA ❑ Sand/Gravel Filter ❑ Peat Filter ❑ Mechanical Aeration O Wetland ❑ Disinfection O Other: Manufacturer Dispersal Cell(s) Zv f ({ut'f oV O.W ctt -/ W O NA F In -Ground (gravity) O In -Ground (pressurized) ❑ At -Grade O Mound ❑ Drip -Line O Other: Other: g NA Other: rdniA 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. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (12/02) 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 chemicals 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: MAR 30 2026 All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. Bayfield Co. The contents of all tanks and pits shall be removed and properly disposed of by a Septage ServiBiri th efa")&o.ning Agency • 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. ❑ 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 COMMENTS POWTS INSTALLER Name AbR.rnf CA159' Phone 715-373 -13 ?8 POWTS MAINTAINER Name kcazai (At 9 Phone7/5-37?-378 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY "NeVick. 'sfrtef Sefrtfc Name Breld Ccv;yLj ZMIVV7 5_ 373,- Phone 7/5-373-Q& This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 0 Bayheld County x tE1 sayheb County. x W Novus-W,sconsv X Ly1 aayheld County X ® Wisconsin UNR x W Sewer ✓Y Waster, x W breg Ledm-Em. X to mumople-boo t x t r - C b cityofwashbumwi.gov/email-contact/node/306/field emaiVsidebar standard Q °oao ® Bayfield County tan... f Bayfield County Zoo... ® Permit Information I-. ® Surface Water Data... v CONNEC1Ezplorer 4 Septic Sea,ch'" S FEMA Flood Map Se... N Bayfield SOIL SURVEY to Shoreline regress,o.. • Greg Ledin - Email Contact Your name * (Tracy Pooler Your e-mail address* Tracy.pooler@bayfieidcounty.wi.gov Subject * 1214 S Jones Road Message Paragraph v B j 1 .— v ,_ = v x2 X2 E ®° . I have a septic system install request in the City of Washburn. Tax # 32630, address 214 S Jones Road. I am wishing to confirm that the property is not serviced by municipal septic now or in the near future, and is allowed to have a POWS at this location. Tracy Pooler Bayfield County AZA tacy.pooler@bayfieldcounty.wi.gov This site Is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Send e-mail fl0 Staff Login 119 Washington Avenue I Washburn, WI 548911715-3734160 Government Websites by CivicPlus® Q Search - a ii S f. ,27'F 648AM "� Cloudy 4flRa26 From: Washburn WI <noreply@civicplus.com> Sent: Wednesday, April 1, 2026 8:50 AM To: Curly Ledin <dpw@cityofwashburnwi.gov> Subject: 214 S Jones Road Name: Tracy Pooler Email: Traoy.pooler@bayfiel oust .wi. ov Message: I have a septic system install request in the City of Washburn. Tax # 32630, address 214 S Jones Road. I am wishing to confirm that the property is not serviced by municipal septic now or in the near future, and is allowed to have a POWS at this location. Tracy Pooler Bayfield County AZA r '' � r L Tracy Pooler From: Curly Ledin <dpw@cityofwashburnwi.gov> Sent: Wednesday, April 1, 2026 9:53 AM To: Tracy Pooler Subject: RE: 214 S Jones Road ' You don't often get email from dpw@cityofwashburnwi.gov. Learn why this is important Hello Tracy There is no sewer or water available at that address. Any questions? Feel free to contact me back. Thanks Greg "Curlie" Ledin Washburn Public Works Director 502 West Bayfield St Washburn, WI 54891 Office: 715-373-6171 Cell: 715-292-1205 Email: dpw@cityofwashburnwi.gov SS- o o719 Private Sewage System Maintenance Agreement DOCUMENT NUMBER Owner(s) Nama 2O26R-611584 av i' + tew'i iFr v L--e-d i vt Owner(s) Mailing Address 1 DANIEL J. HEFFNER E DEEDS 212 r BQ ftet j 54 V5�I_C2vL4 f f� ^,�.,1 LD OUNTY. G U. 1 V.i[A fJ �,(J 'J' `"(�'( HAYFIELD COUNTY. WI Site Address .5. 1OUCC P I �( (_W 5Mq/ RECORDED ✓ 7 r__d (/jam TO _r 03/30/2026 AT 1 0:26 AM Tax ID # RECORDING FEE: $30.00 04- I--4 ov-66-a 03- Oo©- pop0 PAGES: 1 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 — — — — - - Ad``m,.�C'ode, as from time to time amended. /d(COMPLETE Legal Is required) (AJ 1/4 of IV' w 1/4 Section (J C Township {N. Range ©qYW r I r Recordini Additional Legal Description: IVY N'd', Na , yi NW -N I Ul7 DLU4i 0f '160 rr j6 Return To: Ct of �L% _C) UVtt( (Acreage) 14j5 Govt Lot_____ Lot_ Block Subdivision Lot CSM # Vol. _ Page CSM Doc # "In -ground gravity ❑ In -ground dosed Area and Zoning Depar rnent° t ED MAR 31 20?6 ❑ 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. 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 manufacturers 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 Hayfield 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. Hayfield 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 n Mark S• �ftpG�(!H -e( A. Le4its Subscribed and sworn to before me on this date: �tNCRWS�, /17af-Ch cP& I9Oc262r oiht), ya Notarized Owner s) ignature(s) Not ry Public na m My Commis "on Expires: ,J,,' / ,g Cj �L � Drafted by: k1vle (L Date: ____________ Proofed by: ulForms/sanitary/septicmaintenceagreement Revised July 2020 P 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: Submission Number: LEDIN, MARK S & JENNIFER A SS -00719 218 E BAYFIELD ST WASHBURN, WI 54891 Transaction Number: SS -00719-435D9 Description Private Sewage System (Septic Tanks) Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 006720 Paid by: Cady Plumbing and HVAC LLC, 31160 Birch Grove Rd, Washburn WI 54891 Payment Type: Check Transaction Date: 4/6/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-26S STATE SANITARY PERMIT OWNER: MARKS LEDIN GOV'T LOT: LOT: BLK: SW 1/4 NW 1/4 SEC: 6, T 48 N, R 4 TOWNSHIP: Washburn SOIL TEST: 71-16 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: ADRIEN CADY TRACY POOLER Authorized Issuing Officer DATE: 4/6/2026 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: # MP 922139 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 4/6/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION