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Home My WebLink About26-0118Q BAYFIELD COUNTY Zoning District CS - 00) H p SANITARY PERMIT APPLICATION Lakes Class 1. APPLICATION INFORMATION Soil Test I County (Please Print All Information) No: I Permit No: lJ Property Owner's Name: ell S G;esre8eh County: Bayfield Address of Property: PropertyLocation: IA %,5j5 T °13 N, R pr) E (or& v, t Property Owner's Mailing Address: Township: I Gov. Lot #: )C s-hx4e P; Dr Cable City State Zip Code Phone Number Lot # Block #: CSM #: CSM Doc # Subdivision Name y�1t l_a . t 915- gq S+O%,e- P;.e. :.II. TYPE OF UILDING: (Check One) ❑ State Owned Tax ID#: ❑ Public (Explain the usetpurpose 1 O Si l7 tZ 1 or 2 Family Dwelling - No. of Bedrooms 3 I III. TYPE OF PERMIT: (Check only one box on-line A. Check box online B, if applicable) A) ❑ New ❑ Replacement County Private Interceptor H 6 APR 062026 ❑ Reconnection ❑ Repair ❑ Revision *' ❑ Transfer of Owner (List Previous iirr fAvIow) Planning and Zoning Agency B) 51 A Sanitary Permit was previously issued. Previous Permit Number. 9oT2 ( Date Issued: s I IV. TYPE OF NON -PLUMBING SYSTEM: (Check One) * Replacements need previous permit number and date filled out above C) ❑ Pit Privy ❑ Vault Privy (Vault size: _gallons or _cubic yards) ❑ Portable Privy ❑ Camping Transfer Unit Container ❑ Composting Toilets ❑ Incinerating Toilet V. ABSORPTION SYSTEM INFORMATION: 1. Gallons I 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System 7. Final Grade Per Day Required (Sq.Ft.) I Proposed (Sq. Ft.) (Gals. / Day! Sq.Ft.) I (Min. Inch) I Elev.(Feet) Elev. (Feet) LS0 693 I GsoI 0.7 I I'"_l992 VI. TANK Capacity Fiber INFORMATION: In Gallons Total Gallons #of Tanks Manufacturer's Name Prefab. Concrete Site Constructed Steel - glass Plastic Exper. App. New Existing Tanks Tanks Septic Tank or Q Boo 1600 %t 1`ASC$9 Holding Tank Lift Pump Tank! Siphon Chamber VII. RESPONSIBILITY STATEMENT: I the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Owner's Name(s): (Print) If applying for -section C above Owner's Signature(s): (No Stamps) Plumber's Name: (Print) if applying for Section A or B) above nat is igNo ps) MP/MPRSW No: ZPlum oe LoI" latc}1t o2309�2 Plumber' ddress: (Street, City State, Zip Code) Ho a Phone: Business Phone: PO Qn 91a mt ,-A rok& 3 9l s- 739'-6,� VIII. COUNTY! DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit/Transfer Fee: I Date Issued: Issui g A Vs Si nature / Date: Approved ❑ Owner Given Initial H/(7!d'aIl' Adverse Determination 0 t X. CONDITIONS OF APPROVAL (REASONS FOR DISAPPROVAL: Plot Plan on reverse side ■ ■■■■■ • RflRflfliflSMflfl ■■■■■■■■■■■■■■ uu ■■��■■■■•■■■■■■ ■\ ■■■■■■■■■■■■■n■■■/■5■\■■■n ■■�■;��■■■■r�■■■ri■ra■�■■■��■MEN■ ■■o��■OO■■■■r�■■■■W■WOMMM■■r�■u�■■■■ ■,■o�■■Err■■■■■■UES":4 ■r,■r�■■rl ■ ■■■ uu■■■■■►�■■�■u1■/■■■►A ■■■■mI■n5■iuAf■u ■■■■■■ �■ruw■■■■■r� 0u •• !fl ■■■■■r rziAun■■■r 1flM■u■■■u �■r :J■RRB■■■■u ___ u �.a■■■ anw 3, E'' 65'j Ccf i5 :4Q.OI / was he f<o�c I i I Planning and Zoning Agency Safety and Buildings Division County ,2 201 W. Washington Ave., P.O. Box 7162 tJ i 2 (iia) ® isconsinI Madison, WI 53707 -1162 Site Address Department of Commercehe Pine Olrt_e Sanitary Permit Application Sanitary Permit Nmber In accord with Comm 83.21, Wis. Adm. Code, personal information you provide A16 io may be used for secondary purposes Privacy Law, sl$. 1 m 0 Check if Revision L Application Information — Please Print All Information f o b9 g rs ( State Plan I.D. Number Property Owner's Name Vv �III Parcel Number Trains - Ta_hmhr RC,6-v-+S 'II MAY 1 d 2dtj3 U 012-1237-10 Property Owner's Mailing Address .. Baylleld GO. Zoning Dept. Property Location '4a50C) Cable Stdvibef Rd St SE u;s 15 T a7W w Cable , w = 5-49 al —J Subdivision Name CSM Number 748— g79q Ae iia-0 SL.6.-te W; JAE /z.v� II. Type of Building (check all that apply) ❑City 15 1 or 2 Family Dwelling - Number of Bedrooms ❑ Public/Commercial - Describe Use ❑Village @1'ownsbi CR b t e Sta ❑ State O Owned Nearest Road S-I-or,e. Pine pride it: (Check only one box on line A (numbering scheme for internal hue). Complete line B If applicable) W 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑. Addition m For County use Tank Only Existing System anitary Permit Previously issued Permit Number Dam 15t,. , - • IV. Type of Permit: (Check all that apply)(ntrmbering scheme is for Internal use) 44 ,® Non -Pressurized In -Ground 21❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Weiland 22 ❑ Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other uesign now (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rare System Elevation Final Grade Required Proposed Race(Gals./Days/Sq.Ft) (Min.Rnch) Elevation /f0 _(13 ipso e — Gallons Gallons of Tanks - " ""° awcs Hoer nasuc Concrete Constructed Glass New Existing Tanks TaNu Septic uJfeldfr,s4znk /Coo - /OOO / a≤en ttSS 1C Dosing Clamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Prim) Plumber's Signature MP/MPR4 Number Business Phone Number mpo u5SetiF &n.s , s S Zoi7 3 L7/C) 75,33sr ddress (Street, City, State, Zip Code 6a'?c (L Cab L (.ter spa/ null !De attment Use Only oved 0 Disapproved Sanitary Permit Fee (includes Grout Surcharge Fee) ❑ Owner Given Initial Adverse — � Determination p%. j � / [1 editions of Aooroval/Baaennc Far flconnrnvnl t- S4//a3 Recd for Issuance MAY 21 2003 -•---- •""•r•••• vw.s tw 'at a.aaoq oemyr ror Inc system on papa' njfl9,-ID5fi'81/?34gllitcbn N size SBD-6398 (R. 05/01) Plec'd for Issuance MAY 1 5 2003 Firefox https://novus.bayfieldcounty.wi.gov/access/REAL%2OESTATE/listin... Real Estate Bayfleld County Property Listing Today's Date: 3/30/2026 4 Description Updated: 7/31/2020 Tax ID: 10657 PIN: 04012-2-43-07-15-4 00-289-22000 Legacy PIN: 012122801000 Map ID: Municipality: (012) TOWN OF CABLE STR: S15 T43N R07W Description: STONE PINE SUBDIVISION LOT 25 IN DOC 2020R-582067 1265 Recorded Acres: 0.680 Calculated Acres: 0.681 Lottery Claims: 1 First Dollar: Yes Zoning: (R-1) Residential -1 ESN: 108 J Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 012 TOWN OF CABLE 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE Recorded Documents Updated: 3/15/2006 0 WARRANTY DEED Date Recorded: 5/11/2020 2020R-582067 0 QUIT CLAIM DEED Date Recorded: 8/28/2015 2015R-560162 1148-96 0 QUIT CLAIM DEED Date Recorded: 8/9/2013 2o13R-5s0831 1112-301 0 CONVERSION Date Recorded: 437-83;758-84 Property Status: Current Created On: 3/15/2006 1:15:10 PM a Ownership Updated: 7/31/2020 MELISSA S GIESREGEN CABLE WI Billing Address: Mailing Address: MELISSA S GIESREGEN MELISSA S GIESREGEN 16895 STONE PINE DR 16895 STONE PINE DR CABLE WI 54821 CABLE WI 54821 P Site Address * indicates Private Road 16895 STONE PINE DR CABLE 54821 ® Property Assessment Updated: 6/17/2020 2026 Assessment Detail Code Acres Land Imp. Gl-RESIDENTIAL 0.680 3,400 134,000 2 -Year Comparison 2025 2026 Change Land: 3,400 3,400 0.0% Improved: 134,000 134,000 0.0% Total: 137,400 137,400 0.0% a Property History N/A APR 062025 Bayfield Co. Planning and Zoning Agency 1 of 1 3/30/2026, 1:13 PM PRIVATE ONSITE WASTE TREATMENT SYSTEMS SCAJid�Si� (POWTS) De nt of commerce INSPECTION REPORT Safety and Division (ATTACH TO PERMIT) . ....-wns1 a TIP1\I TANK TO P/L WELL BLDG VENT Te AIR INTAKE ROAD Septic 3 NA Dosing NA Aeration I NA Holding Pu MP I SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH . Ft Forcemain Length Dia Dist To Well DIMENSIONS Width Length Nocf Cells SETBACK PIL L Bldg Wdl OMNM d Nov wa ers INFORMATION CELL TO Header // ManIf Id l I Distnbution pe(s) I anon, V '1 Dia `'f Length Dia Over I Depth Over COMMENTS: (Include code diiscrepancies, persons present, etc.) BN�_laa Wt1,te p;he, CnCutf erut r t7f'QCC, SYh`��tt'�f e /� �abe� /i'IOv /A'eW sl P 1 tfi County Sanitary Pornit No: STATION I BS I HI I FS ELEV Benchmark g,ct Bldg. Sewer St/Htinle o.o 2 St/HtOufe a /o.ya Dt Inlet DtBottom Installation Contour Header! Man. O1st Pipe e Infiltrative Surface /�� CS� ZZ Final Grade (,a 0 fo Type of System LEACHING CHAMBER Manufacturer: Cony ModelNumher. X Pressure X Hole Si¢e /ors Pipes (atah ks— DOsa� Cl�al �n ert 1 /enc� I Plan revisionrequired7≥&Yeo ao �3 09 l " d Use other side for additional information Dale POWTS Inspector's Signature CertNo Bureau of Field Operations, PO Box 7302, Madison, WI 53701-7302 aansv+n ra vnil II3A.YFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-4010 Property Owner: Description Private Interceptor Submission Number: CS -00148 Transaction Number: CS -00148-4360C Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 5429 Paid by: A -Z Enterprises, Inc Payment Type: Check Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. Town, City, Village, State or Federal Permits May Also Be Required LAND USE - SANITARY - Private Interceptor SIGN - SPECIAL - CONDITIONAL - BOA - BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 26-0118 Tax ID# 10657 Issued To: GIESREGEN, MELISSA S Location: Section 15 Township 43 N. Range 07 W. Town of CABLE Legal Description: STONE PINE SUBDIVISION LOT 25 IN DOC 2020R-582067 1265 Residential Structure in R-1 Zoning District For: Sanitation Permit — Private Interceptor [Previous Permit # 404286 (5/21/2003)] (Disclaimer): Any future expansions or development would require additional permitting. Condition(s): You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the department of natural resources wetlands identification web page or contact a department of natural resources service center (715) 685-2900. NOTE: This permit expires two years from date of issuance if the authorized construction Tracy Pooler, AZA work or land use has not begun. Changes in plans or specifications shall not be made without obtaining approval. This permit may be void or revoked if any of the application information is found to have been misrepresented, erroneous, or incomplete. Authorized Issuing Official April 17, 2026 This permit may be void or revoked if any performance conditions are not completed or if any prohibitory conditions are violated. Date