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Request for Sanitary Inspection (24 Hrs. in Advance) Fax this form to Zoning Dept (24 Hrs.) prior to when you want an inspection — (715) 373-0114 if you do not have a fay; and must email the inspection; you must email all staff members. Note Time Change fl Discrepancy fl Other Phone Number Plumber. Fax Number fKOZL (Xt bod8e, WG Email Address Homeowner: } �J Immediate Phone Number So Zoning Sanitary ) ( _ 3rz C O�Y/ ✓✓ o Dept can call you right back (If needed) Permit #: Plumber's Choice g Dept pi7L e r " No inspection(s) during this time Date: ��J 3� Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zoning Dept Time: C 11'.30 � Township: Address # & Road Name: fl _4 5 l SE £cthte Lo -t c. or C 4l5Q Directions To Site: Comments: Pk hers you must verify any c Earge(s) by fx air email Notes from Zoning Dept: u/loans/sanitary/requestforinspection Zoning Dept (®4112/04); ® June 2023 ,Private Onsite Wastewater Treatment S 4 Systems ( POWTS). Inspection Report (Attach to Permit) ROSA LAKE LODGE LLC 2557 MILLER AVE u uses[Privacy Law, s. 15.04 (fl(m)] RIVER FALLS WI 54022 City Village fl Town of. Tank infnrmafinn setback to: TYPE MANUFACTURER CAPACITY Pro . Line Well Building Air Intake Road ?,Q / D o 35 N/A Dosing N/A *Holdin N/A County PJ Sanitary ermlt No: State Plan'Transactlon ID#: Parcel Tax No: Pump! Siphon Information mp Manufacturer ump Model Demand GPM IlterManufacturer Filter Model TOH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well Pretreatment Unit Manufacturer: Model Number. Elevation Data STATION BS HI FS ELEV Benchmark ,y 8 Bldg. Sewer Tank Inlet 5-1j 4 Tank Outlet _ Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/ Manifold Distribution Pipe Infiltrative Surface BS Final Grade tribution System X Pressure Systems Only leader/ Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes ength Dia Length Dia Spac_ Spacing ' ❑ Yes 0 No ioii Cover . I Depth Over I Depth Over I Depth of I Seeded / Sodded Mulched Cell Center I Cell Edges I Topsoil I ❑ Yes ❑ No I 0 Yes ❑ No ;OMMENTS: (Include code disc epancies, persons present, etc.) 7KK emac, ✓, v /✓ l hk r�j k61�,{ r~K fa�t�. TVc�rc�r ���' y4 Lab( )e�l FL r d- M lut$e,1 an revision required? ❑ Yes ❑ NoI�'J� a other side for additional information. L lJ LAS L S� tc0 Date POWTS Inspector's Signature License Number ;RRR71n IR n71911 Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zonine(a)bavfeldcountv.org Web Site: www.bavfieldcountv.oro/147 ROSA LAKE LODGE LLC 2557 MILLER AVE RIVER FALLS WI 54022 Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 As you know �� s � 9 , was contracted by you to install a private onsite wastewater treatment system on your property (Tax ID# above). To know when your system will be due for servicing please go to www.septicaearch.com Notes: Abandonment of Old System to meet all applicable code requirements: Tank was pumped by: on at AM/PM Tank was crushed / removed and pipes disconnected by: On at ('?d Afi/ PM) the above -mentioned plumber contacted our office to conduct a pre -cover inspection as required under DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. ❑ System was inspected and appears to meet all applicable code requirements; however, a plan revision is necessary because the installation was substantially different than the original approval. System could not be inspected because plumber covered prior to scheduled time of inspection. System could not be inspected because plumber was not ready at scheduled time of inspection. County was unable to return to complete inspection. System could not be inspected because plumber was not ready at scheduled time of inspection. A re -inspection and $50 fee are required. System could not be inspected because County could not respond to plumber's time constraints. Comments: W forms/sanitarypropertyowner-Input Apri12019 �tirnx'�r ` Industry Services Division County (2Jd 4822 Madison Yards Way L ' ; �� j� Madison, WI S374S Sanitary Permit N er (to be filled in by Co.) �► _ P.O. Box 7162 .._33 3 S `•�,,�«<ti,%�-� S� ��� a''G Madison, WI 53747-7162 Sanitary Permit Application State Transaction Number In accordance with SPS 38321(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required priorto obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary u�� /r+ /sue �, I� �j� p _/1• purposes in accordance with the Privacy Law, s. 15. 04(1)(m), Stats. —jr IJ t,(H!1► ki 1`'Cir L Application Information —Please Print All Information Prouerty Owner's Name , .. Mailing m(i City, Code It Type of Building (check all that apply) ❑l or2 Family Dwelling —Number ofBedrooms /49 [jubliclCommerciai _ Describe Use City of State Owned— Descrr'beUse CSM Number Village of Down of IiII .Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C a 'cable. [Jldew System jRelacement System DOther Modification to Existing System (explain) PIndividual Additional Pretreatment Unit (explain) OHolding Tank DgIn-Gmund QAt-GradeMouad Site Design Other Type (explain) (conventional) C. ❑ Renewal Before DRevision Change of Plumber Oransfer to New Owner ist Pnwious Permit Number and Date Issued Expiration _________ _________ _________ 3 '7 Gi / -" IV. Dispersal/TreatinentArea and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (so Dispersal Area Proposed (sf) System Elevation 29 9z_ Capacity in otal # of Manufacturer Tank Information Gallons Gallons Units w: a New Tanks Existing Tanks APR 16 2026 Bayfield Co. Planning and Zoning Agency Phone Number �/) 1 r / I Lot # 0 Govt. Lot/ ''/o, Section_____ T N R C) E ore) Subdivision Name SeptieorHolclingrank s-- / 00 % rrt Dasing Mmbcr ----r— -- :v •••�••••••••••• ., ._•� .aLc..c.ans.acu, ...c r.atn ii wu Ey rar msmuation or me ruw13 shown on the attached plans. Plumber's Name (Print) PI s SiI MP/MPRS Number I Business Phone Number of I1'5 -/b7 P s Address (Strect, City, State, Zip Code) I07I T'w i4i.zWra-Q 7u'0- Lqwa tzt ottnty/Department Use Only Approved ❑ Disapproved Permit Fee Date Issued L Issuing Ages Sionatuin a Owner Given Reason for Denial /gz3 Conditions of Approval/Reasons for Disapproval f� t / Attach to cmmnlete n!nnc rnr th . evetn.., a...l ....A...:a �_ .L_ n__ _•__ - -. ---- ------------ -- .-•- -..-.j ,....J v.s pwpca ava sca..uuu o uc s £ a accuse rn size SBD-6398 (R. 03/21) PAGE 1OF4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) RECEIVED Pg 1 of 4 Index & Cover Sheet APR 162026 Pg 2 of 4 Plot Plan Bayv Co. Pg 3 of 4 Dispersal Area Cross-S&I ?3d*°P rView Pg 4 of 4 Management Plan Attachments: POWTS Application for Review Soil Evaluation Report & Site Map Project Name 1 Description Owner Name(s): Phone: 1/5-53. Owner Address: a_07 (1 Ik rILU 'iI Zip: Project Address: Y E. h _ LaJ�& Govt. Lot: 1 1/4 of 1/4. Section T L N -R Q E Township: �► �� County:t?zv2/dd Project Parcel ID #: iPW." .t -D 'l 60 Designer Information Designer Name: tM Designer Address: it E-mail: License Number: Remarks: Signature: Phone: Date: L%/0 o ' Enal s store requ€red on each submitted copy. for approval stamp. ,. •p 1026 aaYftSd Co. ancy IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trencfhtes with QuIck4 Standard."N Chambers 3 -ft Trench (down -sizing credit) min.12" j }Ij SOIL COVER (lypinolt I47ll:� ire him u tranoh daplb (typloaq a' System Elcvatlon ,7 !" ft (typical) Saptio Tenk(s) Manufactuian Septic 'I'ank(e) Volumo(e); gal `�. gel /gal ,.�.g...,�.,, gnl Effluen Filter Manuf oturar' IEffivant Flitar Model v: 4 , 2 p .... RECEIveo TYPICAL TRENCH CROSS SECTION VIEW (No Scale) Ptanni9 n and Co. Zoning Agency Provide minimum a ft separation between trenches. ! Qlulolt4 Standard -W w(typloaij d Cp (Show location of Inlet / ou(lst pipe Connection on plan view,) rt __ IIIIT1TITT • (typical) INSTALL PER TRENCH Qulalc4 Std -W @ 20 fP IEISAlchamber =, fe, rt :45 Pairs of end caps @ d�CttEISA/patr= mw fta = Proposed EISA per bench zu o fta Obaarvatlon Plpe (typical) Install per hranufaohgai'e / Inolruallopa, TYPICAL TRENCH PLAN VIEW (No Scale) JA Iz- 310 ft (typical) --H APR 16 2026 '--Qulok4 Standard -W Chamber (typion l) (mid by inflitrator EyaIema, ins') brafall purauanhlo manufaclumr'e inafruoilona. Required Infiltration Area = „,a ft' x trenchesProposed Total EISA l ftx Distribution Method: co 0 ///t< 1 .n a,n - A. .n . • In ground PAGE . OF 4 Gravity Management -�l� The oertsfthis in -ground - _ - n gravity system shah be respens l r- s Actual © Q gwremet is of SPS 382-384, Wisp Admin. Code_ Pursuant to SPS 383.52 (2), Wise. Ad> r;.- d pursuant to this system : lit be consldererf a human health hazard if not.i�riaintained in accordance with this approve w? a Purtrennoo, aft inspection and maintenance ages shall be erfor med b a A went plan: accordance with SPS 383.52(3). Wisc. Admin. Code. F �". register POW Maintainer in ll a dMulrn f�as elfin i.il s: Design Flow = 5Vd I . C gFdBOD5 .� n gt. , 15 3G ra ai:1 Ii Pecticn Checkist - " ` L INSPECT EVERY 3 YES G type of use o age of system APR 16 2026.: o nuisance factors (e. odors, user complaints, aim) o mechanical malfunction on (Le., pumps, valves, switches floa€s, etc_) Planning and Zoning Agency o material fatigue (La, leaks breaks; corrosion: etc) o scads volume in anaerobic treatment tank(s) and any d€s hullo Cpl enanre s a e, . ,r o neglect orlrq} peruse (Le., exceeding design capacite% prohibitedi aces, ate.) u n /drop bo res) o event of ponding in distribution cell priorto dosing o dosing irtegulaties -if applicable (La. pump. re -cycling, float switch o electrical components - if applicable (4e., wiringconectians swipes settings, etc.) o dWbufion lateral or lateral office plugging ': colt s= timers, alarms, et.) o surface discharge n g (measure lateral distal pressure --compare to desk st�calivn change of effluent or sewage back-up into structure sewed tenor a Chec * MAJNTpji EVERY 3 YEARS (or when neceasanr o Se tic and dose tan€ f1 shall be pumped by a certified sepiage servicing operator licensed Stets. when the volume of solids €n the tank(s) exceeds one -tamed (113) the liquid volumeunder a anj s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, W€sc. Admin.� e {s or o iuent 11i shall be inspected every 3 years and shall be cleaned Code. acxurnuiated solids according to > nanufactur+er`s sped caAons. A servicing den necessary to remove an months. g period w always be greater than 12 System maintenance repress shall be submitted to the proper local government SPS 383.55 Esc. Adi'nin. Code. Report any.,c©naponent failure or malfunction to: nit in a artce with Name of individual or company: j/ bZt'iC( . Phone:: � t - �?3 Local government unit Ural clove Phone. /$�� 373J rnment unit address_/t/q 9i zip:5 (t/ Any defective part of this system shall be repaired, replaced or removed •-�._.�. Code. Repair or replacement em Ved pursuant to SPS 383.51(13= %rmc. Admin. F of failed or malfunctlloning companan shall con i yrj SPS 383, Wise. Admin. Code. No product for chemicJ or physics restoration of the POWTS may be used unless approved bythe accordance with SPS , Wise. Admin. Code. AA d� in ntincencv Plan In the event that; any failed treatment componenthfthis POWTS cannot be re �a Flan subini#₹ed� lie appropriatepeu�:d, it shall be replaced pursuant to abandoned and replaced by a code for revicew and approval: �4 fafled in -ground dispersal component may be p n9 dispersal component in a pre,.deejned area ofsciifable soils. - System Abandonment If use of this POWTS is discontinued, it shalt be abandoned in accordance h SPS 383.33 Wise. Admin. Code. S. C nQ11I 4" CAST —A —SEAL RECEIVED TOP VIEW APR 16.2026 eld Co. Planningand eZoning Agency E4 E - - - iiIi INLET OUTLET PUMP PAD SIDE VIEW LTANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS W1565 --MR TANK SPECIFICATIONS DIMENSIONS: a a WALL: 2 1/2" BOTTOM: SEPTIC 3" a HOLDING 5" (ADD 1,500 LB.) COVER: 5 MANHOLE: 24" I.D. PRECAST CONCRETE RISER ei HEIGHT: 69 1/2" O.D. •� LENGTH: 109 1/2" O.D. WIDTH: 93" O.D. BELOW INLET: 57" O.D. LIQUID LEVEL: 51 WEIGHT: 10,840 LBS. INLET AND OUTLET: a 4" CAST -A -SEAL BOOT OR EQUAL GASKET, CAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: [oil WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) W ~ tn LIQUID CAPACITY: 30.69 GAL/IN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1,657 GALLONS LOADING DESIGN: 8' 0" UNSATURATED SOIL 'ii . aLO 00 MN TANKS: WILL HAVE ONE VENT OVER OUTLET It) N AND WILL HAVE TWO VENTS IN COVER OVER INLET TANK CAN BE USED AS: SEPTIC/ HOLDING/ o OI r PUMP OR SIPHON o COVER: MIX DESIGN #8 NO FIBER) TANK: MIX DESIGN #10 ISTRUCTURAL FIBER) CUSTOMIZED TANKS: 15 FOR CUSTOM TANKS CONTACT WIESER CONCRETE JOB INFORMATION: CUSTOMER: JOB NAME: DATE NEEDED: APPROVED BY: APPROVAL DATE: -Jo Co U v) w oc SHEET NO. 1 � /Fi Haadt 00flJ1e3 81avae EWuentflr&jas design d to rema+:= 5at�s rlam enuerb leaaing yasiPsrn Omnca's pateai-pending PSG-Seies Bfoiube fluent Fi fer am to smpm a the qurthy of eiiluent Tram Wastsia1 Tanks trnpmxd e�i ueni queUtiextgnth d1a1nfj�j1j fife 7n an5ite uspersal5ys1eau and lmpmvee the peithn.2rimordawnsoyam1anienPIIi�yrfuer! s ^� The 8ioh±e Sliercarlr;de;ds ughlly lathe housing while being easy 81a�he is se nave Thr marienaaee f be passiuey sell -cleaning deign extends �arrldge mabfler a circle totervars R iermesit is available in 1 Thn r 1/I Gin 1;.3'nr Dr1Smn mesh opening spa RLCCE:veeri?eh dl can beeXieridedtw"ihPVGpipe(a�mdud�I h e ccessto theaariddgaA&4fq (t9mm) diartWlee handle is included. APR 16 2025ad`fS PSGSOe21-18 and PSE4V0621 18 are fS,SF4 cediged_ earrew co. a omg and Zoning Aga@ Modes PSGS0621.18, PSciryc627 IS, PSGPS0621-i8, PSGPw0o1_1S Product Code Diann T7e�c�-r.c.ie O 2i7ca PSC-Sgries &'oftEe S5iaeo;FNoF &W348 -em a+; 5::-p�94M-vmnxmanco.can ME n'tiec= :!9 terry P=t�te{F�7 fi ibis $ai's hens . n pie.Ags �fI[S'a211t �2tiildQe Ha¢9egnnemea₹s PV(hs�inf�5eet 0eit�lernlaia �:B.S ne::a©can, Page Y of F -- 4 APR 16 2026 BaY6e$d co. Planning and Zoning Agency "eve PSGSO621-18 PSCPS0621-18 A Ouarall heigfii, in (mm) _ W , r 222-7 (5T?) B. Housing he ght, in (mm) 210'5" 3) 21.0 (533) c- farh(dga height, in (mm) 1;.i5(4-) 17.75 (451) D. OuUet pipe dImete, in (mm) 4.5fl14) E Oullet he(ghtto(mm) 13.5 (343) 4.5(114) 11 l nam r. .nuwm,. in pru°1 8.63(16W 6.83 (166) Mesh size, in (rnm) 118 (3.23 1116(1.6) Filter suriaee area. f (mkt 6.3 (0.59) 6.3 (0.59) Row area, T (air 1.9 (0.18) , n rn , m NW -Fr -F75--2 Hev.3 © 06121 franca Systems3 - 808-348-9843 - =1 541-459-4449 - vwaw,orencn.eam ro'ge2of2 4/15/26, 5:5'I PM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Property Status: Current Today's Date: 4/15/2026 Created On: 3/15/2006 1:15:04 PM Description Updated: 8/21/2025 42 Ownership Updated: 8/21/2025 Tax ID: 8450 ROSA LAKE LODGE LLC RIVER FALLS WI PIN: 04-012-2-43-07-06-2 05-001-40000 Legacy PIN: 012101505000 Billing Address: Mailing Address: Map ID: ROSA LAKE LODGE LLC ROSA LAKE LODGE LLC Municipality: (012) TOWN OF CABLE 2557 MILLER AVE 2557 MILLER AVE STR: S06 T43N R07W RIVER FALLS WI 54022 RIVER FALLS WI 54022 Description: E 240' OF W 738' OF GOVT LOT 1 IN 2022R593202 132E IM 2005R503551 Site Address * indicates Private Road IM 2005R-503439 45815 E CABLE LAKE RD CABLE 54821 Recorded Acres: 2.000 Calculated Acres: 2.237 9 Property Assessment Updated: 6/17/2020 Lottery Claims: 0 First Dollar: Yes 2026 Assessment Detail Zoning: (R-1) Residential -1 Code Acres Land Imp. ESN: 108 Gl-RESIDENTIAL 2.000 73,500 288,400 r� Tax Districts Updated: 3/15/2006 2 -Year Comparison 2025 2026 Change 1 STATE Land: 73,500 73,500 0.0% 04 COUNTY Improved: 288,400 288,400 0.0% 012 TOWN OF CABLE Total: 361,900 361,900 0.0% 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE M Property History Recorded Documents Updated: 3/15/2006 N/A ® QUIT CLAIM DEED Date Recorded: 7/6/2022 2022R-595399 RECEIVED ® PERSONAL REPRESENTATIVES DEED Date Recorded: 1/28/2022 2022R-593202 APR 7 6 2026 ® CONVERSION Date Recorded: 503439 331-114;762- 8� Co. plannin$ g and Zoning Agency 614;933-561 https://novus.bayrieldoounty.wi.govlaccess/master.asp 1/1 C Private Sewage System Maintenance Agreement Owner(s) Name JAgag c eo ALr91 toobc L - Owner(s) Mailing Address 2657Alrttvz A,g, i r-oW —5, .✓Z 5voz-- y�8/5 6, C rt&E L.L. 2b . , C,9-,5LC , vJ t 6 c' Lif laxlug 'y50 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) 1/401 1/4 SectionbCf Township N. Range C) 7W. Additional Legal Description: 24 h OF %3 4 Or sow r ftL(s D Town of C3 (Acreage) Z ' Gov't Lot Lot_ Block Subdivision Lot _ CSM # _ Vol _Page _ CSMDoc# # DOCUMENT NUMBER 2026R-6 12147 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 05/1 3/2026 AT 1 1 :00 AM RECORDING FEE: $30.00 PAGES:1 RECEIvFo MAY 14 2026 Area manning and Zoning Agency Return To: Planning and Zoning Depa Rt"�n�Y ® In -ground gravity O 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. 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. Fitter maintenance reports shall be submitted to the County as required by SPS 363.55, 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 -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. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfleld County for inspection, pumping, hauling, or otherwise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system. Bayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future owners of such property. Owner(s) Name(s) - Please Print Jig Subscribed and sworn to before me on this date: (��b6w���zn� rite - Signature(s) Notary Public LYNN WAKEFIEL D$ ZS ?dZ Netary Public My Commission Expires: State of Wisconsir Drafted by: Jfto6 FWCE- Date: N/Zl /Zto Proofed by: u/formslsanitary/septicmalntenceagreement Revised July 2020 Wisconsin Ctepartment of Commerce PRIVATE SEWAGE SYSTEM S4&ty and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) personal information you provice may be used for secondary purposes [Privacy Law, s)5.04 (1)(m)1 ermit Holder's Name: ❑ City 0 Villa e Q4wnofi F1 ST BM Elev.) Insp. BM Elev.: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. Vent to Air Intake ROAD Septic NA Dosing NA Aeration NA Holding PUMP / SIPHON INFORMATION Manufacturer I Demand Model Number GPM TDH Lift ad Friction System TDH Ft I Loss I H'Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: c c Sanitar State Plan ID No.: Parcel Tax No.: STATION BS HI FS ELEV. Benchmark Bldg. Sewer St/Ht Inlet St/ Ht Outlet Dt Inlet Dt Bottom APF 7t$20 6 Header! Man. Planning ' Dist. Pipe Bot. System Final Grade BED! TRENCH Width Length No. Of Trenches PIT I No. Of Pits I Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manufacturer: SETBACK INFORMATION CHAMBER TypeO Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded! Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes 0 No ❑ Yes ❑ No COMMENTS: (include code discrepancies, persons present, etc.) fit, ss,ta ce V4 !r L.). I ru..� w (arc ke d42.4rn. 7df q,d' 6 Z 3c - Plan revision required? 0 Yes ❑ No ZZu�q S Use other side for additional information. 8 g Jcol CQ,J.Orr.11- SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. SANITARY PERMIT• APPLICATION.:: . In accord wit l� �, j i dm. Cede . -. Safety and Buildings Division '• •Bureau of Building Water Systems 201 E.Washington Ave_ .': P.O_ Box 7969 Madison, W1-537,077969 • ` • Attach completeplans (to the coup. copy.only) ) for the s em on a er.not less .i County p ... PY, Y . t P P •# ti than 8. �.� "n*Fz . APB:=162026•::.::'. : State.Sanita erruit Number for instructions for completing this a li tian �>= , . t. • See reverse side P 9 ' Py Co j� . Planninci and Zoning Aged :.. ::' into ev₹o application e used b other government agency ..rograms:; ::.:::::.....:..:: ;! .:::. _\, O Check i re s o �r pp The information you provide may b.,, y g , .1.t•• .. '.. : . [Privac Law s. '15.04.(1) (m)l- - . . . . State Plan! D . Number T t INFORMATION -• PLEASE PRINT - ALL INFORMATION — .,:... ,::::: ° °.. ';:' ::'::;::•• • :'::.:: ••'• : •'. -'.::: -• • •I. APPLICATION 'WFO_ :. Pro arty Ow0r Name ,Property>_ocation , c.' �A �•. i4 :r HIV kNu Number -1- = Bloc Num ber 1n. Lot N e Address u Owners Mailing Add . o lin n Pr e 9 rty. `r ri 0:77 _ N:Phonea • i? or CSM'Nc mb. r:• - �: Sufi 'vision.. i' t. m.. State Z' City to p. :4 :Li• .i1 . :S State Own. p i _ �,• Nearest Road: k one # Gi ; (check "' - DIN )... . WTYPEOE BUILDING. t D. a VE[ae t:. r=2famil Dwelling - No of bedrooms •' '`'1t� •`TOJ 0F•,t.., ~ : " :::it::.: c t•e Public 1 0 _ . �T•-x P..ar eNumber(s). Fit a li heck all`t a c •i ub c r 'e is P If bu dding in apply) i . E d S .� BUILDING p III Qu .0 L s type \. i' l.' J♦ ti l . \: .:.. .,. t l• „ i-� 'i i i' n\• � Apartment/Condo i1.• i:. L% L% i•;_ 10 al• C li' R a a. _ d r:' �• �: a _�-��•��:�: ••�4 _.} Hall Facility/Nursing bl ., . \ .....5:..:: • -. •• • :'• :: .: .*..;. ' '� `::..:.: uca 'I'Bar.! Dining 7, ' } : Mercharidis .:S to _l.._R..e alr ` *1.1 ' :!testa: _ I :.3Campground.t..; fl ;.. Wash Car: - is .: Station/Car affil P k= i'ice.StatlQi� Y ripe -ar D Ch u rc h%S shoo _......,... Q Mo i. . :5 - 5 . Ho#e /.. Motel ... or- ."- 13 U h specify' . .. n: ab I e •�if -�lic B a 4 Q r line. ) �X n.11 P _ of • ne' i�• t. k o 4 :... Y R I h •.Q . _ °� ... 'O i,:• 5• 111. PE _ �I .v. Y i' 'i• :Reco nn - e' r :Q. Pa. to ` _eta. ::5;. rn' n :�: !ac a f: �:•::�::;`::'- , n Rep lacement .4: - :Q e• t. w: �.. :3: Ale , -S s em Ex�sti.i' S i stem..:... 9 Sstem :t of an r_rr___w��__w!T�_r_Ttr..._r+�_.����•�,�•.i •�.�..,!T .♦+ 7! ., fr T'l• % :t. -..':,: :S•,, •w. , �,•; `. i.'.: e. Issued itNumber i vvs:Issued ..d,;' �P...-.., .�•�[ A �anita=�y`.Permib......:previously.:,.,-;.t.. . V;T ;.yam. :'!;:,',. y. .:•J,t.;. .. «. `•'\:'-•.,: '.1 '••� t .l' TYPE 1 • {t :P O ec n :: •iii,:• VTY i .'i.. a.• •:i'• ::: t nta Ot "me ri uto rr !: b Dist _ :h. '. url A ri utro Pressurized . T. e• u �•ie d Dist b. �No 1 ';• n. s$� r. P t: 't s. _• 1: i' a 4: 1 d k. .:i• .4 9 T :,,. 1T — •-i , L•• 11:: Mound -P . o• 4: 1 n�B. Q ••""ccom�-- .�' r P i} -G •u re•:. .z:::\ }4 4f Iii r s =:' .2 2: o n a• Trench3❑. . Seepage p..9. t .Va�' t 1. Kr• ...: .'-: '.••. ':.•• ..�:' '•�:.'. ••t�• 1- ilk•'• - •?-..._ 13 fl Seepage l' ... ...::.;.;_:...:,\.:.: •': ,.,.. ..- • • - - . . stem ..: :.... 1.4. S 1.. 'r: .ti• A N. T�. SYSTEM NFO Q. Y• INFORMATION PT N=S S_ BS: R. VI A \. . analGrade _ '-Rat System i I: -. R te: 5.`Pe c: e .Area: 4_':I.iadin a ,Y.,• ,. �Gallons.Per Da► 2: 'A rp. A._ �• P. t . v' `Din. i M'' `iracl s . -i -h eft: t Y�5. s t t , fired: l - ::t: : t " -EL LtY tS^ eet e• -• , t iy•. LV i • 'tit �^:ti :.� is-• {J i t..` i : t• +t . :a• 1. .:tint: ,t T{ ,• •a: at i\ , :\ nt ' l\: TA NK r sE e VII. X V A ibe `: ,:: f ..,anti' • 9 'n a .k. 4 t,. ere .p. ,t i 1i •.S , :( +1.. is i, M1tia 5 I \ w Exist t e•,�c ':i•: -•t t t Tan ks Tanks i i . -- ifs: i� =a :'a :D' :.j •' V Septic Tank .di - �' ,:: ,. • o '=f)fi:-:: Y: 5 , JI t' t Lift Pum Tank ISi hon Chamber PD EL :E M E T N I , sRE PD S STATEMENT :III RESPONSIBILITY t 't• the d: pla ns ...gat a •w• �o n:the system n Wiese e.s st o '�-:of: eo st. v� responsibility t:for.installation-......th ?9: Y: 1, the undersigned, assume.. :t 1 -Business Phope liMbew _ P,rint ''l . ers 'g _=71.. ..PS. 5, Plumbers Name: ::• .:;"*. QJ[ 4 i C �fy Mt' -R }: `.� :: •.Jzccs..'� : t: :': c,;, tom.' =1•:; i ::3t.:i: . ..:-ice " . . ;1..::,:i':: :::::.; ::: t •. t `C" to e Ore SS St r' d P. u s tt ^1 ;i 3 P►RTNIENT L IX ��COUN • .i' find• • e Grovndwa er: ,ate.? u Issu[ Agent `Si'••natute.�(N_Stamps)..,.;': Sanitar• Pe it Cee; i a a •roV y. Ds - e. e - ❑ Sur tha r 'F se - ja r=/4g,': . itl • •I . •��; ve e n o G a r w �J PP_. t. Q " " ' •Adverse Determinatlon'Paid IA PR V.AL.. S 5 f.O RDS P Q V� t•�7 R E' N T k"! F.`AP A X: N i�� Q Q :� i Q ;. ti•• •�7 •'`ti' :'t. sit:' �:t ti,,;. .>�,,' .: t�• y i.^ .,�'\:::::tiai „t i ♦ x� ..... ':S. tit . t, . '�i::lt.•r, is �'4t .• .,. '"-Y _ - v.t•, - .,�,.. ` ..>c+c,,..• • •: �•S,• _ ,.: r.: - ..�.�..�..r.l_'�tii.':._�"/•Cr�L-_.;'L`:•_R�.•tl...%::•...o_:`o•::Z..l:wwit{T .lnn"Rwnisf:'Plfs}R1]2lnt. _.!,.,i . .:L+...t•. _ _.L.... _.. :_,^ s•ti I��..�G.��.._r.%ti: _ ..... ___ z? ? aa.lok e, wi s aI T'3 N 9 7 0.-- R C.Ei _ _. -... _ - _/.: ..._ _. _ ..... _ . - __ • . _. _ _.._._ ._._ ._ _ . Taw� o � Ca.�l e _ .. . _ _.... . _ .. - __ _ . _... _% _... __. . _ .-•--- -_ . _.....- ' -1----- •--- • �----- � —-�ayfreld Co. 13$ • Planning and Zonin q / QM 100' . dt,oL'tQ Lv,-bbaned. f 4"' /'� o.vt.e �' above CrraC • B�f'" o ~� _ _ � w� > ... fie$ ..........' . _... .... ... _ � o : .. .. .. o•-Z,Rsvrtu.Se.n ... .... ... 43 = /aD S.T€i ks-- .J� . - -- - .. _. _.. = . qi. Prosec I -- 5 BR t-)opAe. • and __ _ . -- .. _.. WeA ANDRY RASMUSSEN AND SONS . P.O. sox66 Cdbi., Wt 54821 (715) 798-3355 .isconsinSafetymento � •�;, ^,;�', /- ,�; IL AND SITE EVALUATION z� Division o?Safety and Bull I. {L,, �._`r,h 1VI �- r Gureau of Integrated Sery in 'bance with s. ILHR 83.09, Wis. Adm. Code JUN (' 1998 Attach complete site piarJ4paper not less ffian 8 1/2 x 1411Id Ihes in size. Plan must County �G cis include, but not limited to NIC&I-aad,MrizonfaLrakr 1nt (BM), direction and percent slope, scale or dirt f tc(fO ar In and distance to nearest road. Parcel I.D. # UYa- to/sor Page / of H APPLICANT INFORMATION - Please print all information. Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Ravi wed b �, i �-- — Date Property Owner Property Location Govt. Lot / 1/4 1/4,S (, T V3 ,N,R 7 E(or) W Dovu1(a Sher Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# R+( (x9-77 4/ City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road E Ca 4 LaAe /? Clis/P C..9=I svni I( 7151795--3390 Cad. ® New Construction Use: ® Residential / Number of bedrooms Addition to existing building ❑ Replacement . ❑ Public or commercial - Describe: Code derived daily flow 5 0 gpd Recommended design loading rate 7 bed, gpd/fi2 — trench, gpd/f9 Absorption area required 4 tY bed, ft2 sin 3 trench, ft2 Maximum design loading rate 7 bed, gpd/ft - trench, gpd/82 ed Recommendinfiltration surface elevation(s) 1w D = 97.J r y¢/��4,cec.,e"7 - 970 r ft (as referred to site plan benchmark) Additional design/site considerations /, Parent material G/aclt� � IP& Flood plain elevation, if applicable ft _ S = Suitable for system U = unsuitable for system 1s ❑ U I® s ❑ U In7 S ❑ u ®s ❑ u ®s ❑ u ❑ S IS U Boring # Ground eiev. 9.0 ft. Depth to limiting factor >4o in. RI. S Boring # Ground elev. flosjj. Depth to limiting factor !jn.'_ CST Name (Please Print) RR Address Cnll nc@PoloTtnm RFof1RT Horizon Depth in.. Dominant Color .. MunselL... Mottles Qu. Sz. Cont. Color Texture ... Structure Sr. Sz. Sh. Consistence • Boundary .. Roots GPD/ft2 Bed , Trench I o -y 7s- 3/I /tong SL a4bk MJ - a$ ?L rd `/-i9 ZsyR /6 no,rc • c5 of w , 7'_8 ., 3 19-`/u - c'*c c/6 flout cos/cb 0 vn� s . 7 - //e.9O zsry,fdy 4INc S DSO ' �. APR L Ba P n held Co. Pomarkc• 0 f %sY 3/I none SL FSSYC rnd S 2u 3 in 33If 7SYi ylb IoY y/ nrnc noH& LS LP≤ Qsc I.1k m c 5 5 at -co w 7 S.'(� `( 5q.5?, • "c `l/c. norms 5 cc/ah4 p/ 4%/v — I� M . gL v,�t WI 54856 Signature Telephone No. 72s 76 5- `/G.0 —T Date S f23 -9Q CSTNumber-3S SOIL DESCRIPTION REPORT PROPERTY OWNER PARCELLD.t O O S Wig# 3 Ground etev. 1001 % Depth to factor 9mhtng >n. 93.q Boring # El ground e!ev. r . Depth to lng factor Aso tn. Boring # Ground elev. 102. ft Depth to ilmlting Page__of Horton Depth Dominant Color Munson Motes Qu. Sz. Color ContIn. Texture Stare Or. Sr. Sh. Conalstenr:e Boundary Roots Bed . Trench J a -c cY 31 ! naK e- SL 2/ __ , g 7.Syi' Yf� /1O s1 YK c5 pc —O '3 to _________ 1— _ 2stcL vv4 c ______ ( 7) yf( _________ ____ c ( - ___ 7 - s, Remarks: ( o-2 r'y,f'3/r one- sj_ %c c 42 a ' �,?-t$ %s yof Yk nay - L 5 0� w. ( _ -� .. i 1C 10 y! /1ONQ 0c//t-d Y !.€!.° r K t j f /1Qi.tQ - - 7 :- Remarks; Horizon Depth In. Docent Color MunseU ' Mottles Os. Sr. Cont Color Texture Struo e Or. Sz. Sh. Consistencedaay Roots Bed .Trench y(6 - rloh� LS Ds� WI! cs24 r7 _9 o-1so note 5 5G /f c0 7 : S APR 16 2026 sayfiek1 . factor in. Remarks: Boring # oH around elev. it. Depth to limiting factor in. Remarks: SBD-8330 (A. O7/8) • I i 1 ; ' 1r�t�, , t I ._ 1. _. Rr� • t- - i-•-.. i ! � ' ! � � ... � r . of C.4k - CEIVED 1... ii4 eA• pprQ*A. �3 I ••APR 16 2026 `• ! (: j _ F �annlpq ar on o A ' en - EIWTios 4. —_�___:_ •-- - , -JY9?7 L_—i LLt 102 -- - =T1::F1Lr1 tII I. I. F+4T-~ 11 ,H+HH t , - I ov�t Atu�3 [o r�tT�°''�� _s - -i----t-- ,-- --� --�- T tTL:t I► - -j-- • 4H_h-HPF&#t1* -t--- tt I -H--- H4 ::' -: ... �._.f i r�- spa - I �_ - -�" �� _ - �- �-- --i- • - --�- , _'.�.i i � ! .._ i _ - i rtj __ __ - y , Y A'i- ' ___.J-_-_-- I� ` FTI __ ______ __ It 1 1 t 1 t !Tt± - - N.. uuuuuuum ii - iiiihi_=I__:LiT.i__:_ -uumT::±iu,zt, y. I LI ___ -f ____ 4 _ \\' 3 S NITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code Safety and Buildings Division Bureau of Building Water Systems 201 E. Washington Ave. P.O. Box 7969 Madison, WI 53707-7969 • Attach complete pans (to the county copy only) for the system, on paper not less County _A e � than 8112 x 11 inches in size. 1 State Sanitar ermit Numbpr • See reverse side for instructions for completing this application ,1/ 4L government agency programs ❑ Check it revisiorf to previous application The information you provide may be used by other 9 y (Privacy Law, s. 15.04 (1)(m)1. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION P rty Ow r Name � Property Location R ) W o In Ow `t Don 4S S he -v- NaJ 1/4 p/cj 1/4, S ( T �!' 3 , N,7 Pr erty Owner's ailing Address Lot Number Block Number 1 13oicl7 Cncle, Zip Code Phone Number Subdivision Name or CSM Number wJ (7I7 -3(4O II. PE OF BUILDING: (check one) 0 State Owned o tt� Nearest Road S o age A I� ELI „Q_je Low Public 1 or 2 Family Dwelling - No. of bedrooms Town OF --RIO �sK+ III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ A artment / Condo PIECEIVED P 2 ❑ Assembly Hall 6 ❑ Medical Facility! Nursing Horpg 10 0 Outdoor Recreational Facility ❑ Cam pground Cam round 7 O Merchandise: Sales! RepairsMIR 1 6 2OZ6 11 ❑ Restaurant! Bar / Dining 4 0 Church / School 8 ❑ Mobile Home Park Bayfieki C.o 12 ❑ Service Station / Car Wash 5 ❑ Hotel! Motel 9 0 Office / Factory Planning and zonin a en1 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of S 5. ❑ Repair of an stem Tank Only Existing System Existing System __ System ---------y------------------------------------------------------------------------- B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Ij Seepage Trench 22 ❑ In -Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate I 6. System Elev. I 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) I Elevation 01 S� 0 7 � gv .—L g -j Feet t • fo Feet VII. TANK Capacity Site in allOrt5 Total # ofPrefab. - INFORMATION New Existin g Gallons Tanks Manufacturer's Name strutted FiberConcrete Con- Steel glass Plastic Exper. App Tanks Tanks Septic Tank n f ti0a 1100 f LL S 4 ❑ ❑ O lift Pump Tank /Siphon Chamber 0 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum) er's Name: (Print) m is e: (No Stamps) RS MP!MPW'I�b.: Business Phone Number: 4. <�siWusyeal-a&AS ' vim. i3 71s-- Plum r ss Add s (Stye , Cy, statepdt)Le o� 8 ., t4J1 IX. COUNTY / DEPARTMENT USE ONLY 0 Disapproved Sa itary Permit Fee (includes Groundwater at49I ue lssui Agent Signature (No Stamps) . urcharge ee) �_ 0 Approved � ❑-Owner Giveri Initial (� '��� ���J/� Q -� l 99 �. Adverse Determination UlU X. CONDITIONS OF APPROVAL! REASONS FOR DISAPPROVAL: . _ . . . T-. l .1..... O n..:l.l:...0 liv.._inn- Rw....r. PPu,ntaAr rLIi 00 (JUUN I Y OWNER APR 16 2026 gayheld Co. PLUMBER . RB.S MLLSS[y) LIC. #22O/i3 TOWN OF Ot LOCATEDJM.11 C.L. 4 SEC_S_T_.1N;R_7_E AND/OR LOT BLOCK SUBDIVISION MITN° 327214 CHAPTER 145.135 WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the application for permit. (b) The approval of the sanitary permit is based on regulations in force on the date of issue. (c) The sanitary permit is valid for 2 years from original date of issuance and may be renewed for similar periods thereafter. Application for renewal shall be made through the county and shall comply with regulations in effect at the time. (d) Changed regulations will not impair the validity of a sanitary permit until the time of renewal. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought. Changed regulations may impede renewal. (f) The sanitary permit is transferable. A sanitary permit transfer shall be obtained from the county authority. If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. AUTHORIZED ISSUING OFFICER - DATE p4/ z6- • or THIS PERMIT EXPIRES GZ�%*bflI UNLESS RENEWED BEFORE THAT DATE (TWO YEARS FROM ORIGINAL DATE OF ISSUANCE) POST IN PLMN ViEW VISIBLE FROM THE ROAD FRONTING THE LOT SBD-6499(R.04196) DURING CONSTRUCTION Tracy Pooler From: Tracy Pooler Sent: Wednesday, April 22, 2026 2:59 PM To: shawn stolarzyk Subject: 45815 e. cable lake rd - septic questions Red, I had a fellow staff member stop by the proposed septic site at 45815 E. Cable lake Rd. They did not find the reference nail that is indicated in the plans. The distance that they measured from the inspection riser on site did not have enough footage to meet the 50 -foot setback from the OHWM of the lake with the plans as submitted. Please submit new plans and if required a soil test or clarify any misunderstandings we have with this project. Tracy Pooler - AZA Planning and Zoning Department 117 E 5th Street, PO Box 58 Washburn, WI 54891 Phone: 71*5-373-3512 Fax: 715-373-0114 Email: tracy.pooLer@bayfie1dSmtYWLgQM 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 at Toning@bayfieldcounty.wi.gov or 715373-61 38 with any questions or concerns. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-33S STATE SANITARY PERMIT OWNER: ROSA LAKE LODGE LLC G OV'T LOT: LOT: B LK: 1/4 1/4 SEC: 6, T 43 N, R 7 TOWNSHIP: Cable SOIL TEST: 4553 OTHER MODIFICATION SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: RYAN STRAND TRACY POOLER Authorized Issuing Officer DATE: 5/7/2U26 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; 1979c.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 #: 327214 LICENSE: # MP 798301 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 5/712028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION