Loading...
HomeMy WebLinkAbout26-34Srfr Request for Sanitary Inspection (24 Hrs. in Advance) Fax or email this form to Zoning Dept (24 Hrs.) prior to when you want an inspection Fax (715) 373.0114 or Email zonlnp bayfieldcountv.wi.aov Note Change Discrepancy ❑ Other jj //�JJTime / G �-05/ k t Phone Number )1C 91% IJOt Plumber: Fax Number Homeowner: �ppn� Email Address ImmediatePhoneNumber So Zoning Sanity Permit#: 6 Dept can call you right back (d needed) Plumber Choice Zoning Dept No Inspection(s) during this time Date: Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zoning Dept Time: I V`1 Township: Address # & ,, f Road Name: 5H ( b t or Directions To Site: Comments: ** Plumbers you must verify any change(s) by fax or email ** Notes from July 2025 a` Private Onsite Wastewater Treatment c -� ms (POWTS). Inspection Report (Attach to Permit) TIMOTHY E & M DR V K HOOPER County Sanitary ermlt No: State Plan'Transaction ID#: Parcel Tax No: roiU TYPE..rr.MANUFACTURER CAPACITY Prop. Line Well J Building Air Intake Road Se tic U C O0 N/A Dosin N/A Aeratlon N/A Holding Pump I Siphon Information Pump Manufacturer um p Model Demand GPM Filter Manufacturer Filter Model TDH Lift Friction Loss Head Total Forcemain Length Dia Dist To Well Pretreatment Unit Manufacturer: Model Number. titivation uata STATION BS HI FS ELEV Benchmark 2, Bldg. Sewer 3 q2 Tank Inlet L tj7 16 Tank Outlet Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/ Manifold o(5S Distribution Pipe Infiltrative Surface �R 3_ Final Grade t -Q z7 stribution System X Pressure Systems Only Header I Manifpld ti Distribution Pip6(s) // X Hole Size X Hole j 0 pservalion Pipes I anath 1 h. Die Li Lenath )t7 Dia iL. Spec Spacing • _ es ❑ No soil Cover • z Depth Over I Depth Over I Depth of j Seeded I Sodded Mulched Cell Center Cell Edges I Topsoil ❑ Yes ❑ No 0 Yes ❑ No JOMMENTS: (include code discrepancies, persons present, etc.) ��r �� 22 l/r $ r of 4i. I 6 Q ` c� ITV�Sti"/ I! J ✓ ekrVCD\G•,ct4' Vek (tes ok( �l.thje. an revision required? *Q: EI No yV )W /oq5( ;e other side for addltionannforrmatlon. Date POWTS Inspector's Signature License Number ZRn.R71n ER ng1911 Al Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Hayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zoninatibbavfieldcountv.orn 117 East Fifth Street Web Site: www.bavfleldcountv.org/147 Washburn, WI 54891 TIMOTHY E & MARY K HOOPER 54160 N SWEDEN RD GRAND VIEW WI 54839 As you know Ot< ✓ c N was contracted by you to install a private onsite wastewater treatment ystem on your property (Tax ID# above). To know when your system will be due for servicing please go to www.septiesearch.com Notes: C. a-. 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 2 u at / (AM /the above -mentioned plumber contacted our office to conduct a pre -co er 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: Uttonnslsanitarypropertyowner-Input Apil2019 ,�t^ � `�"�' �� Department of Safety Coun f 1' & Professional Services, Sanitary P rmit Number (to be filled in by Co.) Industry Services Division SS -00-710 S wit� Permit Application State Transaction Number In accordance with SPS 381'.211 jiii 'A'8 i. ode, submission of this form to the appropriate governmental unit Project Address (ifdiflerent than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provideptt� l ft Didary 66 purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. I. Application Information —Please Print All Information Property Owner's Name APR A4&r, goc� Parcel # �0.� ) 1 10,3 -Qr' Property Owner's Mailing Address � /\" ,O__ Planning oral Zar��ca;; Arancy Property Location 4 1.eJly Govt. Lot f City, State Zip Code s Phone Number O 604J t�O!/ + 04 7 O �`—'—%•,— --/a, Section "f N R AE o W IL Type of Building (Chick all that. apply):: Lot # t.1 or 2 Family Dwelling - Number ofBedrooms_— ETEREP Subdivision Name ❑ Public/Commercial Block # — Describe Use ---, O City of ❑ State Owned — Describe Use O Village of CSM Number VTown of 14&d u. III*. TypeofPOWTS Permit: (Check either- "New or- "Replacement" and other applicable on line A. Check one box on line B. Complete line C it annlicahle-) A. ❑ New System A Replacement System 1 ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) i3. ❑ Holding Tank ln-Ground ❑ At -Grade ❑ Mound ❑ Individual Site Design � ❑ Other Type (explain) (conventional) I C. ❑ Renewal Before Expiration I ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner List Previous Pennit Number and Date Issued �j g 093 i -s Y. uisuersau i rearmenr area ana s anic lniormanon: Design Flow (gpd) Design Soil Application Rate(gpd/sl) Dispersal Area Required (sl) Dispersal Area Proposed (st) System Elevati L4 45 o ya e4 qo.00 Capacity in Total # of Manufacturer t Tank information Gallons Gallons Units v w c -a New Tanks Existing Tanks at c v v cis ct Septic or Holding Tank 00 t Jo1 Q) .C fQ�ti t ST' Dosing Chamber V. -Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown the attached plaits. Plumber's ,Name (Prints Plum) is Signature MP PRS umber Business Phone Number &ry Je jor. ill j'oo Plumber's Mtlress (Street, City, State, Zip Code) - Sao o � � �� �hsa n c�L ggsg VT. Cotlnty/Depai tment Use Only :' pproved O Disapproved Permit Fee a ec Issued y�LJ issui g A t Si ature ❑ Owner Given Reason far.De.nial �V Conditions of Approval/Reasons for Disapproval 4 '�I Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x ii inches in size SBD-6398 (it. (13/22) • ,,���, SOIL TEST #o'?&c Wisconsin Department of Safety& Professional Services 2 fiPage 1 Division of lridustryServices ADD 29 Z0 of ./ SOIL EVALUATION REPORT Bayfeld Co. ►� In accordance with SPS 385, Wis. Adm. Code County n� " Attach complete site plan on paper not less than 81/2 x 11 Inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. ! P7 Please print all Information. Reviews / Personal information you provide may be used for secondary Property Owner 17mdnL 4 cy Law, s. 15.d4(1)(m)). Property Location . t t Govt. Lot(.Qj S Site Address or CSM and Lot #: State, Zip, y Phone Number 1-. V 1, 9 _ I. 11 CCLX' City ❑ Ilaae T, New Construction eplacement Parent material„ General comments an 177 Boring # [I1 Boring f Horizon Use: esidential/Numberofbedrooms Public or commercial -- Describe: �h�c�,nr1 "—'I L�r d recommendations: Boring T ate O NR(O : E(or)W Yearst Road Code derived designflow rate GPD Flood Plan elevation if applicable ft. �Ato )Wit Ground surface elev. fL Depth to limiting factor In. / elev. ??. MPlt Ground surface elev. ft, Depth l J` to limiting factor � in. I elev �, Depth Dominant Color Redox Description Texture Structure Consistence SOII Application Rate In. Munsell Qu. Az. Cont. Color Boundary Roots GPD/Ft2 Gr. Sz. Sh. .1.-- �Q. y'Yl � C, `Etl'#1 *Eff 38 #2(g 7 £/ - (9 PY p -p - 0 CST Name (Please * Effluent #1 =8OO>30 5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2= BOD, 5 30 mg/L and TSS 5 30 m /L g SBD-8330 (R03/22) Page of ❑ Boring r y II r1 — 3] Boring # PIt Ground surface elev. ft. Depth to limiting factod '_in. / elev.S?•e ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 / ff IM 213 cs i'ic _____ri i.€. — ___ $C.i 9L _____ twa. C5 - 6 ___ b r ■ 19 ¶/JOIio? _________ ____ C45 O _m __ I i Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. I elev. ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots 'VII r%lipR LIUI1 male GPD/Ft2 *Eff#1 *Eff#2 L f • Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor In. I elev. ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. ConL Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots aon Hppucazron state GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = B0D > 30 5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2= BOD, 5 30 mg/L and TSS 5 30 mg/L .� ■■.■M■ ■ ■■■. ■MEM®®®M®■® 2/16/26, 2:06 PM, Novus-W€sconsin Access rev 12.0206 Y` `, tie • r Real Esthte Bayfield-County Property Listing , ' Property Status: Current Today's Date: 2/l6/026' Created On: 3/15/2006 1: 15:28 PM Tax ID: PIN: Legacy PIN: Map ID: Municipality: SIR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar. Zoning: ESN: 7 Tax Districts Updated. i/23/2026 Ownershnp Updated, l/23/2026 17403 TIMOTHY E & MARY K HOOPER , GRAND VIEW WI 04-021-2-45-06-19-3 03-000-30000 021112104000 Billing Address: Mailing Address: TIMOTHY E & MARY K TIMOTHY E & MARY K (021) TOWN OF GRAND VIEW HOOPER HOOPER S19 T45N R06W 54160 N SWEDEN RD 54160 N SWEDEN RD PAR IN SW SW IN DOC 2026R-610758 GRAND VIEW WI 54839 GRAND VIEW WI 54839 8706 5.000 Site Address * indicates Private Road 5.017 0 Yes (F-i) Forestry -1 115 2026 Assessment Detail Code Updated: 3/15/2006 G1 -RESIDENTIAL 54160 N SWEDEN RD GRAND VIEW 54839 Property Assessment Updated: 4/2/2019 Acres Land Imp. 5.020 15,000 6,000 1 ' 04 STATE 2 -Year Comparison 2025 2076 Change 021 COUNTY TOWN OF GRAND VIEW Land: 15,000 15,000 0.0% 041491 SCHL-DRUMMOND Improved: 6,000 Total: 21,000 6,000 21,000 0.0% 0.0% 001700 TECHNICAL COLLEGE Recorded Documents Updated: 3/15/2006 1Z property History ® WARRANTY DEED Date Recorded: 1/20/2026 2026R-610758 N/A RECEOVED ® TRANSFER BY AFFIDAVIT Date Recorded: 12/26/2025 2025R-610487 2.9 2026 ® TRANSFER BY AFFIDAVIT Date Recorded: 12/26/2025 202SR-610486 Bayfield Co. pisnning eW ZoningA96RCy 1 CONVERSION Date Recorded: 259-427;784-111 hffne•IInnveea h....fol.d.....,.,h....;.....j............1.......a_____ PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: .9 2026 In -Ground Soil Absorption for POWTS Version 2.1 (May 2022- � Bayf eld Co. Planning and Zoning /Agency Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: C ' e i POWTS Application for Review SO,.^ AP Soil Evaluation Report & Site Map D" s -'-Project Name I Description Owner Name(s): 1 Oo Phone: t_- i -1f3 Owner Address: 5(160 Al ��,,,� aj Zip: SL1 &39 /, 1) Project Address: Govt. Lot: '?4jy JJ 1/4 of 114, Section / c1 , T L% c N -R 06 E Liii or W Township: 2QJI\t 11County: 7I� Project Parcel ID #: j' ( 2 Designer Information Designer Name:L11 )( J4/ Phone: Designer Address: COYcV 4j?I Net'SOK (,2 N/5q/3 -1>00 Zip: SYfS56 E-mail: -Uw�� S 1c.Q) ,� re crvec� tt�; j t f !i. �'Y• - �� :y'1 7j�:i1.' .1 Stilz:i4.). License Number: '`S -. do Remarks: • Signature: • Date: Origin attire required on each submitted copy. 2/18/26, 8:37 AM IMG_3254.jpeg 5 SUPERIOR Lid: 3,683 Total: 9,49:4 GJiloa3 P.rloichs 24.4 1,000 1 -Compartment Tank TOP VIEW 891^" 83-112' INK 29 2026 Bayfield Co. tanning and Zoning Agency(I 7r 79~ 1020 Cis Enlarsod Detail �r APPROVED DEPT. OF SAFETY Tutu PROFESSOKAI. 4' rxWfs ON of INDUSTRY sE"Ces R"AW A.-4 47" GEE OORRE$PoNDEtce ManhokOp.n1ng 2-1R- Taper Pobvdoie e Baffle Mastic Rope Si 't VIEW 2r 9" Air Space qaid Dapth dl SUPEERIOR 160" 4 Produced by Superior Precast Concrete, LLC P4 Box 1390 Hayward, WI 54843 SUPERIOR PRECAST CONCRETE Design contorms to ASI M O1227, Specification for Precast Concrete Septic Tanks and WISPS 384.25, POWrS Holding Components or Treatment Corm onents. The Information provided on any Superior Precast Concrete (SPC) drawing or document shall be verified by the purchasers licensed professionatenglneerfor sultabilityof use. Configuration may change from drawing, consult with SPC. IraisI><opMaryb�fo:rt�Mr4aweam mtraprop"ofsupasWiftecutcaocrato.La https:/lmail.google.com/mail/u/o/?tab=rm&ogbl#inbox?projector-1 .I„ IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3 -ft Trench (down -sizing credit) ��������� •try. ����,�f1���f/�� r r. i. -; • Septic Tanks Manufacture: v -e! ' f Septic Tank(s) Volume(s): `_ gal gal _ gal gal Effluent Filter Manufacturer: /)ciyink_______ Effluent Filter Model #: S �� TYPICAL TRENCH CROSS SECTION VIEW (No Scale) Provide minimum 3 ft separation between trenches. TYPICAL TRENCH (Show location of inlet I outlet pipe connection on plan view.) PLAN VIEW 4" 0 Observation pipe shall be installed (No Scale) Perforated Lateral atiu (typical) B= _ ft (typical) INSTALL PER TRENCH: 10 -ft bundles @ 50 ft2 EISA/unit = C) 0 ft2 + 1 5 -ft bundles @ 25 ff EISA/unit = ________ , ft2 OBSERVATION PIPE DETAIL (No Scale) Screw -Type or •+ • •. Finished Grade Slip Cap (loose) (mulched & seeded) 40 PVC Pipe _ 4.. Topsoil Cover Top of pipe to terminate ''• �, (min. 1 foot) at or above finished grade ' r '�` (4)114"-112" X 6" Slots @ go apart Anchoring Device -o U ) (typia A=3 ft "-- EZ1203H Bundle > o, (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. = Proposed EISA per trench = as_ ft2 Required Infiltration Area == ft2 x = trenches = Proposed Total EISA = O ft2 Infiltration Surface n C) rn a Distribution Method: -0 O m W O m PAGE 4 OF 4 In -ground Gravity Management Plan IMPORTANT: The owner of this in -ground gravity system shall be responsible for its perpetual operation and main n2d po&nt to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved managemen0plar4 Co. Furthermore, all inspection and maintenance activities shall be performed by a registered POW'MI1ri�i9e"� accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 1S° gpd; BOD5 5 220 mgL'1; TSS ≤ 150 mgL"1; FOG S 30 mgL'1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: c, J -�/ Phone: 7/4 J Y/3 % OO Local government unit: �L d c - 2 'r Phone: r 1 c 313 C/3z' z' Local government unit address: 11 / fh5'1r4-4 PO rn u ZIP: 5 7 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. • n'1 oo 2.3 Q ` Private Sewage Sys! Maintenance Agreement Owner(s) Name 1Lloopf Owner(s) Mailing A.�t1ss 59 1 &o rJ S-Aer• Izd J Site Address jI ,i Tax ID# ��7ga3 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 S e 1/4 Section I 1_Township N. Range 4 W. Additional Legal Description: Town of ) rc r-1 tii .e c,.J (Acreage). r Gov't of Lot Block Subdivision Lot CSM # Vol. Page CSM Doc # DOCUMENT NUMBER 2026R-61 13O1 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED O3/O4/2O26 AT 12:34 PM RECORDING FEE: $30.00 PAGES: 2 Recording Area Return To: Planning and Zoning I O iPVED MAR 052026 Bayfield Co. Planning ana tonIng Agency In -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. 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 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 Baytield 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 a# 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 benefit of all current and future owners of such property. Owner(s) Name(s) — Please Print Subscribed and sworn to before me on this date: y Al 2v _Notarized Owners) — Signature( Notary Public •• My Comm sio xpires: ® p� L Zf> AN9�►.•. e�/C u/forms/sanitary/septicmaintenceagreement D...$..,..4 l..w. 11r%nn RECEIVED MAR 052026 gBayfield Co. AA�� DOCUMENT NUl{ViH1ER�oy 2026R-610758 State Bar of Wisconsin Form 1-2003 WARRANTYDEED DANIEL J. HEFFNER REGISTER OF DEEDS Document Number Dow o BAYFIELD COUNTY, WI THIS DEED, made between Kevin K. Kissel ("Grantor," whether one or more), and ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in RAVRiT n County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): Parcel 1: A parcel of land in the Southwest Quarter of the Southwest Quarter (SW'/48W¼), Section Nineteen (19), Township Forty-five (45) North, Range Six (6) West, Town of Grand View, Bayfield County, Wisconsin, described as follows: Commencing at the Northwest corner of Section Nineteen (19), Township Forty-five (45) North, Range Six (6) West, thence South 272'4" to the point of beginning, thence South 418 feet, thence East 523 feet, thence North 418 feet, thence West 523 feet to the point of beginning. Parcel 2: A parcel of land in the Southwest Quarter of the Southwest Quarter (SW%SW%), Section Nineteen (19), Township Forty-five (45) North, Range Six (6) West, Town of Grand View, Bayfield County, Wisconsin, described as follows: Beginning at the Northwest corner of Section Nineteen (19), Township Forty-five (45) North, Range Six (6) West, thence South. 272'4, thence East 805 feet, thence North 272'4", thence West 805 feet to the point of beginning •,, Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances e4�,Y :l� • •.,, , ': EASEMENTS, RESERVATIONS AND RESTRICTIONS OF RECORD. is r�• +•_ • •G- Dated • r. • f. Q , (SEAL)'. : Z * *Kin K. Kissel , (sue) _(SEAL) * * RECORDED O1/2O/2O26 AT 12:O5 PM RECORDING FEE: $30.00 TRANSFER FEE: $75.00 PAGES: 1 ELECTRONICALLY RECORDED Recording Ara demo and Return Address Timothy B. Hooper and Mary K. Hooper 54160 North Sweden Road Grand View, WI 54839 20741-25 04-021-2-45-06-19-3 03-000-30000 04-021-2-45-06-19-303-000-20000 Parcel Identification Number (PIN) This IS NOT homestead property (() (ta nct) AUTHENTICATION Signature(s) authenticated on i TITLE: MEMBER STATE BAR OF WISCONSIN (If not; - authorized by Wis. Stat. § 706.06) ACKNOWLEDGMENT STATE OF 1 ) )sL COUNTY Personally came before me on _ \ _ )" 9 the above -named - Kevin K. Kissel tome known to be the person(s) who executed the foregoing. instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: * _p'- 1\tw_y Attorney Max T. Lindsey SBN 1112865 nieh, Wickman & Lindsey S C., Ashland, WI 54806 Notary Pu 'q fate of A ` My Commission (is pernoanen l expires' ' � - -Q - ) •y r (Signatures may be anthentated or acknowledged. Both are not necessary.) NOTE: THIS 1IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DIED O2CO3 STATE BAR OF WISCONSIN FORM NO. 1-2003 'Typo come below signatures. Bayfield County Register of Deeds Document #2026R-610758 Page 1 of 1 BAYFIELD COUNTY SANITARY PERMIT (#04)-26-345 STATE SANITARY PERMIT OWNER: TIMOTHY E & MARY K HOOPER GOVT LOT: LOT: BLK: SW 114 SW 1/4 SEC: 19, T 45 N, R 6 W TOWNSHIP: Grand View SOIL TEST: 28-26 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: CORY SCHAFFER TRACY POOLER DATE: 5/7/2026 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 #: 20934 LICENSE: # 1037 Condition: Old System needs to be properly abandoned per SPS 383. Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 5/7/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION