HomeMy WebLinkAbout26-39SS- UO7v/
ndustry Services Division
�g 22 Madison Yards Way
County
ayfeld
RECEIVE
2
adison, WI 53705
P.O. Box 7302
Sanitary
SPermit Number (to be filled in by Co.)
HAY 0720 Madison, WI 53707
�-- 3 3
�Sarntltl�� , t Application
In accordance with SPS 383. Wls. Adm. Co e, submission of this form to the appropriate governmental unit
State Transaction Number
is required prior to 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
purposes in accordance with the Privacy Law, s. 15.04(1 Hm), Slats.
49255 East Shore Rd. Barnes WI
t
Michael & Emily Ertel
Property Owner's Mailing Address
19510 Foxfield Dr
City, State Zip Code
Prior Lake, MN 55372
II. Type of Building (check all that apply)
zI or 2 Family Dwelling— Number of Bedrooms
]Public/Commercial — Describe Use
2078
Govt. Lot 4
Phone Number
218-393-2773 ¼- %, section 2
Lot # T44 N R 09 P nr 1
eState Owned - Describe Use
CSM Number
Village of
QTown of Barnes
In. Type of POWTS Permit: (Check either "New"
or"Replacement" and other applicable on line A. Check one box on line B. Complete line C it'
applicable.)
A.
IZINew System
❑Replacement System
Other Modification to Existing System (explain)
❑Additional Pretreatment Unit (explain)
B.
Holding Tank
I]In-Ground
1]AAt-Grade
Mound
Individual Site Design
Other Type (explain)
(conventional)
C.
❑Renewal Before
❑Revision
Change of Plumber
Jfransfer to New Owner
List Previous Permit Number and Date Issued
Expiration
I
NA
750 0.7 1072 1158 J.5
Capacity in Total # of Manufacturer
Y
Tank Information Gallons Gallons Units a U u
New Tanks Existing Tanks v c v 2 o
C. U vi y iz V
sepdcoe Holding Tank
1800
I
1800
1
Superior Precast
I1✓
Dosing Chan'bee
1100
1100
1 J
Superior Precast
✓
Q
Q
V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) I Plumber's Signature/ MP/MPRS Number Business Phone Number
Jason Kuettel c 675751 715-798-3355
Plumber's Address (Street, City, State, Zip Code) /'
PO Box 66 Cable, WI 54821
VI. County/Department Use Only
Approved 0 Disapproved I Permit Fee I Date Issued Issuing A t Si azure
❑ Otmer Given Reason for Denial $ "I D— rj I g I�✓o m �i� 14� 77/
on paper not less than a In x
Attach to complete plans far the system
SBD-6398 (R- 02/22)
3 R-c04'/o
„�i►rsr�rt,.� YID ty S TEST Page q
,. �, sin a artme a and Professio �� � e�of
Division of Industry e
yl�.;paiAY 0.12026 SOIL EVALUATION REPORT
�`"�»w� Bayfield Co. n accordance with SPS 385, Wis. Adm. Code County
-
nC Attach comptWomW 01l9 9iRoerr not less than 8 112 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. Zo 7 8
Please print all information. vi Dat
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). I i
Property Owner Property Location ❑ Jj
c. g �M l L `( �2--- Govt. Lot 1h % S '? T N R d¶ E (or) W
Property Owner's Mailing Address Site Address or CSM and Lot #:
O oXJ /* L
City I State I Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
X1210 P •Lr4-YL /�Atj S.cr'7Z (Z/9 E, -ST -S r e D
IA New Construction Use: I Residential/ Numberof bedrooms S Code derived designflow rate '7 50 GPD
❑ Replacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft.
Parent material C? '-''P W4 t - S',"cs
efG
General comments and recommendations: S is TL's EL - %yS
Boring # Bop Pit
ang
Ground surface elev. f 7 - o . Depth to limiting factor 73 • in.1 elev5'+ t.
I Sail Annlication RateI
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
O-'
.S ti Z.sj
S L
Zit' 1(-
Mv4.r
Gu
p,(1
1.0
Z
(0-15
'7.5 Y4 4/1
SL
iA b
My -C-..r
Gu
0. c.(
d •'7
tl/'
-
S
b.5Ca
M1
J
1L
or7
,, (o
9
3b-"73
7.5'M. sAi
--
5
___
__
0.)
to
L1Boring #
Boring
Plt Ground surface eiev. • '.17 ft. Depth to limiting factorin. / eiev D %7 ft.
nil Annlinatinn Rate
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
0-00
7.5 YZ-L.s/
L-
Z\..LlrL
frV4.f
1r'1
b.
/.0
�1
G..
(o - / 6
7 .5 Y� N/
^`
S L
I4s , tL
.
v /-r
`, !
� 'W
) i
6,'
o s >
-2
7.&
Sc
OSG
1
-7
1,'
/6
36 - 7g1
r
5 •J Y
S
__
_
/h
—
0,7
it
CST Name (Please Print)
ISignature
CST Number
TM I
-
I� 7/f07/f1600 Z$
Address
ate Evaluation Conducted
I Telephone Number
* Effluent #1 = BOD > 30 5 220 mglL and TSS > 30 s 150 mglL * Effluent #2= BOD, s 30 mg/L and TSS s 30 mg/L
SBD-8330 (R04121)
Boring #
❑ Boring
Pit Ground surface eley( ' O Oft.
Page Z ef. `(
Depth'to:liniitin factor• in. / elev. %•
9 � qIft•
,'`•.,�� nil Annitin R�1c
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
z s b fc-
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
*Eff#2
7. S y/Z '1
._
$
/t.,.
j
O' (P
/; O
Z
9 z3
_
—
s z
f 4,,SA
M.t'
G
ZM 1 f
'1
a s 7
3
z3-1&7.s'1wt/
--
S
016
CL -'14
e'
r.(
`/
`(2- 87
7.5 s
a ."7
'
LIII Boring #
❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft.
nil AnnIiPfnn
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
Lull Boring #
❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft.
nil Annlir�tinn R.tc
I
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
* Effluent #1 = BOD > 30 5 220 mglL and TSS > 30 5150 mglL * Effluent #2 = BOD, s 30 mglL and TSS 5 30 mglL
CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE.
' V'=40' EPAGE 2 OF
®SOIL EVALUATION Scale: o ao 60 80 SYSTEM
SITE MAP PLOT PLAN
PROJECT NAME: (10 ft grid) 10' DESIGN FLOW: 7'S ° GPO
2`rL Attach design flow calculations for commercial plans.
PROJECT ADDRESS: g Z S s (. - 9)4oc c fZ � Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5)
NSanitary Sewer /
BM Symbol: -4-BM Elevation: /0 b' FT
Force Main: /
BM Description: ` 3'" y2cI) I i{NC
a Gradient % 0 Indicate north by IMPORTANT:
Slope ( ) Z Well Symbol (if applicable): p drawing an arrow Show ground elevation contours at suitable intervals.
of Tested Area: on the approprite line.
d--L''
_d_
L
a\/
-r
'v
--
....
r J
?
V
ors
.:S
L
j-IED
t G
w i,�
Cylt�isZL�►tr<`!
_
1
--
1flT
L0'b
in
--
_
S
�
L
]
1
I
11
1
I
__
_
_
_
_
-
-
-
-0 jfL_
Ii
_
- --
I
_.--
--mac
-----
---
__
-
-
I
I
li_i
I
1111i
'T
V
�f�Y G) ZU26 Soil Pro le"Shee
•in Band Z 9 • =�-' t '7L - Sol Tester.
Mann ! �••. c�--�1�.-6�
System Eievatian: Load Rte:O- - 7 S stern Ran S.o '-j 1
• ::::::I:::::: 6 9?.' -1?. ..:::::::::
ct 6c T). og ..... --•-- .....
s �'� y �I s .. sy s �-• 94'
5 ----• S`� sue•, t-`
... ............ •....
q3 ...... ..... .....
as .....: ..... .....
.... ..............
' ::::::I:::::: ti , .-
.L.. 6 :::::: Oto .....
..... - .... .....
.... ..... :......:::" ..
RECEIleE`D
MAY 072026 In -Ground Dosed -Gravity Plan
Barfield Co. Index & Cover Sheet
Planning and Zoning Agency Component Manual Design References:
Version 2.0, SBD-10705-P (N.01/01, R. 10/12)
Pg 1 of 5
Pg 2 of 5
Pg 3 of 5
Pg 4 of 5
Pg 5of5
Attachments:
PAGE 1 OF 5
Index & Cover Sheet
Plot Plan
Dispersal Area Cross -Section & Plan View
Pump Tank Specifications
Management Plan
Pump Curve POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
Ertel - 5 Bedroom
Owner Name(s): Michael & Emily Ertel
Owner Address: 19510 Foxfield Dr. Prior Lake, MN
Phone:218 _393
Zip: 55372
2773
Project Address: 49255 East Shore Rd. Barnes, WI 54873
Govt. Lot: 4 1/4 of 1/4. Section 17 , T 44 N -R 09 E ❑ or w171
Township: Barnes
Project Parcel ID #: 2078
County: Bayfield
Designer Information
Designer Name: Jason Kuettel
Designer Address: PO Box 66 Cable, WI
E-mail: Jason@andryras.com
License Number: 675751
Remarks:
Phone: 715 _798 -3355
Zip: 54847
Signature:'' Date: S z
Origi I signature required on each submitted copy.
CHECK BOX AS APPLICABLE.
CHECK BOX AS APPLICABLE.
fl SOIL EVALUATION Scale: 1"=40'
0 SYSTEM PAGE 2 OF
SITE MAP 0 40 60
80 PLOT PLAN
PROJECT NAME. Vu (10 ft gold) 10' DESIGN FLOW: ms`s O GPD
2 EL S / 'ems
Attach design flow calculations for commercial plans.
PROJECTADDRESS; Q3 -Z Ss L T' SH4v<_2 r2 6
Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5)
NSanitary
BM Symbol: -4. BM Elevation: /0O. O FT
-s,QV C -
Sewer: ti' Scittd
BM Description: /J�t- 1t3 Serf 3(o" R6b P,V
Force Main: Z"JGH't46 IPVC_
Slope Gradient (%) Za Indicate norm by
of Tested Area: Well Symbol (if applicable): drawing an arrow
on the approprlte line.
IMPORTANT:
Show ground elevation contours at suitable intervals.
I !
I
,
L.
— y / C—✓ s L iS r S )fc" -c t
(J kt= -I 6GJ. C>;'T • /.N V 1Q r )I
1
I
I— -I-_ h
_L_
L -H
�I
UL`,ra
--4
CvrL2-/�t2Y
Orr
AY
07206
I
Ian ing Z n0
I �T'
I ( ----I I I
T
( I I
y-.
-
E I
-
-
i
fk+1H:_
�
.iv � at' ?ttcc•tr.7- 1�Zy.v •
_�
---------
-
C'drr S�'mrti �
± 0'
l0O'
_
is 7'7) tr SD'ScH NO PJ
-- — L r) -7q)
/ '
ICE`
C3 SB,G(v
__ —
, /�cL-..
SY�-� iN S y,d z;
._ ._
i
?a�
T- t3 + 131-
ti 1
P_ 'r h.. (� (o'7S i5 ( a,�clzlla yr or ac,'
_ _,
; S/K�v� �0�, LDC ?tto
IN -GROUND DOSED -GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard -W Chambers
3 -ft Trench (down -sizing credit)
SOIL COVER
72°
min. trench
depth
(typical)
mm, it TYPICAL TRENCH
(typical)
CROSS SECTION VIEW
(No Scale)
(typical)
System Elevation = 94.5 ft
(typical)
Quick4 Standard -W
w/ End Cap (Show location of inlet / outlet pipe connection on plan view.)
(typical)
A Ili?I[tflltIIttiLI 111111.11 I\
------t -------1/----
B= 78 ft
(typical)
INSTALL PER TRENCH:
19 Quick4 Std -W @ 20 ft' EISA/chamber = 380
+ 1 Pairs of end caps @ 6 ft2 EISA/pair = 6
ft2
ft2
Provide minimum 3 ft
separation between trenches.
observation Pipe
(typical)
Install per manufacturers
/ Instructions.
TYPICAL TRENCH
PLAN VIEW
(No Scale)
A=3.0ft
i (typical)
`—Quick4 Standard -W Chamber
(typical)
(mfd by Infiltrator Systems, Inc.)
Install pursuant to manufacturer's instructions.
= Proposed EISA per trench = 386 ft2 Required Infiltration Area = 1072
x 3 trenches = Proposed Total EISA= 1158
RESET
ft2 Distribution Method:
fte distribution box
D
m
W
O
m
Cl
rrr
m
v
RECEIVED
PAGE4OF4
-1 MAy U2026 In -ground Dosed -Gravity Management Plan
mil' , AgeOcV
The owner of this in -ground dosed -gravity system shall be responsible for its perpetual operation and maintenance
pursuant 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 management
plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow = 750 gpd; BOD5 ≤ 220 mgL-1; TSS ≤ 150 mgL-'; FOG ≤ 30 mgL'
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 recycling, 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 manufacturers 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: ;Andry Rasmussen & Sons Phone: 715-798-3355
Local government unit: Bayf eld Co. Zoning Phone: 715-373-6138
Local government unit address. 117 E 5th St. Washburn, WI
ZIP: 54891
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.
PAGE 5 OF 6
MAY QY 2026 SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4"0 Vent Pipe
Bayfield Co. >10 ft from
planning and Zoning Agency Building
12" Min. or 2.0 ft above
Established Flood Elevation
(typical) Approved
IMPORTANT: Vent Cap
Anchor tank(s) as necessary
pursuant to SPS 383.43(8)(g) T
Finished Grade
CAPACITIES @ 26.16 gal/in
Depth (in)
Volume (gal)
A
22.95
600.37
B
2.0
52.32
[C]
6.05
158.15
D
12
250
an.
*T
IA
B
[C]
*Pump Tank Liquid Level = 43 in —�
Force Main Diameter = 2 in
Force Main Length = 50 ft
Force Main Void Volume = 8.15 gal
Electrical must comply with
SPS 316 and NEC 300
�fl Weatherproof
F —Junction Box
Seal
Pump
Extend manhole riser as necessary.
Approved Locking Manhole
with Warning Label Attached
(typical)
3" Approved Bedding Material Beneath Tank
[Cl Total Dose Volume (TDV) = 158.15 gal/dose
L (5X total lateral void volumes TEN < 0.2X design flow)
+ (force main drainback volume)
MIN. PUMP DISCHARGE RATE = 40 gpm
PUMP TANK:
Volume = 1125 gal
Manufacturer. Superior Precast
Pump Manufacturer: Champion
Pump Model: CPES3 (See attached pump curve.)
Controls/Alarm Manufacturer: SJE Rhombus
Controls/Alarm Model: HW101
4" Min. or 2.0 ft above
ablished Flood Elevation
(typical)
18"Mtn.
(typical)
-Approved Joints with
Approved Pipe 3 ft onto
Solid Ground
(typical)
PUMP -OFF
ELEVATION= 89 ft
INSIDE BOTTOM
ELEVATION = 88 ft
Vertical Head = 6.5 ft
+ Min. Supply Head = - ft
+ FM Friction Loss = 1.65 ft
+ Fitting Loss* = - ft
"(min. supply head x 0.3)
= TOTAL DYNAMIC HEAD = 8.15 ft
SEPTIC TANK(S):
Total Volume = 1800 gal
Manufacturer(s): Superior Precast
Install approved effluent filter at the septic tank outlet
immediately upstream of the pump tank inlet.
Filter Manufacturer: Orenco
Filter Model: FT0822
Float switches containing mercury are prohibited.
fl'SIJPERIOR LP1800/11002-Compartment Tank SUPERIOR
RECE 1VED
MAY U / '1026
Weight (in 16;)
Tank: 16,366 eayfield Co.
Lid: 9,77+ planning and Zoning Ag9aCV
Total: 26,141
Volume of Concrete
Total: 6.5I"d'
Gallon; Per Inch: 70.+
Lid
wan
Enlarged Detail
alx
Manhole Openings
II \� 2_1�`„ Taper
I
1
TOP VIEW
1&t- 2"
107" ---I1— 69"
0 96" 10_2-
1309 Gallons 1125 Gallons
'±t'
26.16 GPI
Polyethylene
Baffle
Mastic
Rope
SIDE VIEW
9" Air Space
43"Liquid
Produced by Superior Precast Concrete, LLC
PO Box 1390
Hayward, WI 54843
SUPERIOR
PRECAST CONCRETE
Design conforms to ASTM C1227, Specification for Precast
Concrete Septic Tanks and WI SPS 384.25, POWTS Holding
Components or Treatment Components.
The information provided on any Superior Precast Concrete
(SPC) drawing or document shall be verified by the
purchasers licensed professional engineer for suitability of
use.
Configuration may change from drawing, consult with SPC.
Product File No: This Is proprietary lnlonnallon. and remains the properly of Superior Precast Concrete. LLC. I 0.9051920241
FEATURES/BENEFITS
PERFORMANCE
Heads up to 37 TDH
Flows up to 72 GPM
MOTOR
High efficient,115v, oil filled, permanent split
capacitor motor with upper and lower ball
bearings and thermal overload protection
-Constant bearing lubrication
- Maximum motor cooling
- Runs cooler and lasts longer
- internal overload protection
- Quiet operation
-Fasteners and shaft made from rugged,
corrosion resistant stainless steel
SEAL DESIGN
Mechanical with secondary dynamic lip seal
- Provides added leakage protection
IMPELLER DESIGN
Non -clog style vortex impeller
-Designed to help reduce clogging by foreign
• material
PERFORMANCE CURVE
POWER CORD
Sealed entry quick disconnect power cords
- Prevents water from entering the motor
housing through a cut cord
- Easy to replace in the field
-Available in lengths up to 100'
SWITCH
Piggy -back switch design
- Defective switches can be diagnosed over
the phone
- Pump can be operated manually or
supplied with other piggy -back switches
-Switch can be replaced without having to
replace the pump
APPLICATIONS
Basements, dewatering, septic systems,
residential and commercial
developments and elevator pits
REC,E. IVED
MAY I) / Z026
Bayfield Co.
Planning and Zoning Agency
'hrical Float
1/3-1/2 HP submersible pumps that handle up to
3/4" solids with 2" discharge with 11/2" adapter
Champion Pump Company, Inc • P.O. Box 528 • Ashland, OH 44805
Phone 419-281-4500 • Fax 419-616-1100 • www.championpump.com Reve6ts
t,_ooj
Private Sewage System Maintenance Agreement
Michael Ertel
17898 Prairie Way SE Prior Lake, MN 55372
Site Address
49255 East Shore Rd Barnes, WI 54873
I 2078 Parcel ID: 04-004-244-09-17-4 05-004-10000 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
Adm. Code, as from time to time amended. (COMPLETE Legal is required)
1/4 of 1/4 Section 17 Township 44 N. Range 9 W.
Additional Legal Description: PAR IN GOVT LOT 4 IN V.978 P.611 670
.See 4'rrwcvtt
Town of Barnes (Acreage) 7.2 Gov't Lot 4
Lot Block Subdivision
Lot _ CSM # Vol. Page CSM Doc #
DOCUMENT NUMBER
2026R-612068
DANIEL J. HEFFNER
REGISTER OF DEEDS
BAYFIELD COUNTY, WI
RECORDED
05/07/2026 AT 2:15 PM
RECORDING FEE: $30.00
PAGES: 2
Return To:
Planning and Zoning Department
Area
( I 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, Ws. 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 Bayfield 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
Michael Ertel
Subscribed and sworn to before me on this date:
/-z,—z e,
Notarized Owner(s) — Signature(s)
Notary Pu
My Commission Expires:
z7
Droned by'LLA.& Date: --_
w PAUL KEITH OVERN rooted by _
NOTARw P B ICS
MIN$'E OTR eplic intenceagreement
evised July 2020
MYCOMMISSION EXPIRES JANUARYSI, 2027
State Bar of Wisconsin Form 2-2003
WARRANTY DEED
Document Number I Document Name
THIS DEED, made between Kathryn S. Henriksen
("Grantor," whether one or more),
and Michael Scott Ertel and Emily Benetta Ertel, husband and wife, as joint
tenants
("Grantee," whether one or more).
Grantor, for a valuable consideration, conveys and warrants to Grantee the following
described real estate, together with the rents, profits, fixtures and other
interests, in Bayfield County, State of Wisconsin ("Property") (if more
space is needed, please attach addendum):
A parcel of land in Government Lot Four (4), Section Seventeen (17), Township
Forty-four (44) North, Range Nine (9) West, Town of Barnes, Bayfield County,
Wisconsin, described as follows:
Commencing on the shore of Middle Eau Claire Lake at the West end of the South
line of said Government Lot 4;
Thence East to the Southeast corner of said Government Lot 4;
Thence North 200 feet;
Thence West on a line parallel with the South line of said Government Lot 4 to the
shore of said lake;
Thence Southeasterly along the said shore to the Place of Beginning.
PATRICIA A OLSON
BAYFIELD COUNTY, NI
REGISTER OF DEEDS
20078-5 1 6 127
09/06/2807 12:80PM
TF EXBPT #:
RECl1RDIN6 FEE: 11.88
TRRfdSFER FEE: 1288.88
PASM: 1
Recording Area
Name and Return Address
CBT-8473
19510 Fo:Bcid Dr.
Prior Lake, MN 55372
004-1117-05
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Exceptions to warranties: municipal and zoning ordinances and agreements entered under them, easements, restrictions, covenants and
reservations of record, and general taxes levied in the year of closing.
Dated/ 7 do07
* Kathryn StHenriksen
(SEAL) (SEAL)
*
AUTHENTICATION
Signature(s)
authenticated on
r P611
*
TITLE: MEMBER STATE BAR OF VflS
(If not,
authorized by Wis. Stat. § 706.0
THIS INSTRUMENT DRAFTED BY:
Michael S. Hines
WSB # 1002916
la
ACKNOWLEDGMENT
STATE OF WISCONSIN )
) ss.
Bayfield COUNTY )
6 rsonally came before me on
above -named Kathryn S. Henriksen
t e known to be the person(s) who ex red the foregoing
trument and ac ged
Notary Public, State of Wisconsin
My Commission (is permanent) (expires:_
(Signatures may be authenticated or acknowledged. Both arc not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED,
WARRANTY DEED O2003 STATE BAR OF WISCONSIN FORM NO.2-2003
*Type nano below signatures.
OUNTY
Property Owner:
ERTEL, MICHAEL SCOTT & EMILY
BENETTA
19510 FOXFIELD DR
PRIOR LAKE, MN 55372
Bayfield County
Planning & Zoning Department
117 E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Description
Certified Soil Tests - Review & Filing Fee
Submission Number:
SR -00410
Transaction Number:
SR-00410-454FC
Amount
$50.00
Total: $50.00
Payment Amount: $50.00
Reference: 15029
Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821
Payment Type: Check
Transaction Date: 5/8/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
J3MTFIELD 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:
ERTEL, MICHAEL SCOTT & EMILY
BENETTA
19510 FOXFIELD DR
PRIOR LAKE, MN 55372
Description
Private Sewage System (Septic Tanks)
Submission Number:
SS -00741
Transaction Number:
SS-00741-454DB
Amount
$400.00
Total: $400.00
Payment Amount: $400.00
Reference: 15029
Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821
Payment Type: Check
Transaction Date: 5/8/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
BAYFIELD COUNTY
SANITARY PERMIT (#04)-26-39S
STATE SANITARY PERMIT
OWNER: MICHAEL SCOTT & EMILY BENETTA ERTEL
GOVT LOT: 4 LOT: BLK:
1/4 1/4 SEC: 17, T 44 N, R 9 W
TOWNSHIP: Barnes
SOIL TEST: 32-26
NEW SYSTEM
SYSTEM TYPE: Non -Pressurized In -Ground
PLUMBER: JASON KUETTEL
TRACY POOLER DATE: 5/8/202
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 #:
LICENSE: # MP 675751
Condition: Properly Maintain System Per Recorded Agreement
THIS PERMIT EXPIRES 5/812028
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION