HomeMy WebLinkAbout26-40SDepartment of Safety
County
p$
PS
n Professional Services,
Industry Services Division
Sanitary Permit l umber (to be filled in by Co.)
�BAwXYv�1 SS
�� -00736
Sanitary Permit Application
State Transaction Number
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this fort to the appropriate governmental unit
Project Address (ifditTerent 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 provide may be used for secondary
6^1 ) SL W t I(S RGA
purposes in accordance with the Privacy Law, s. U 04(l)(m), Stats.
u 8 p 2 Q
13'r -U I e i= __ _
I. Application Information - Please Print All Information
Property Owner's Name
Roonc5 MAY 052026
-pereat# toJC -
.1 S u0.
Iess6
Property Owner's Mailing Address Beyfield Co.Property
Location
q I-IAk cre's't LA.' Planning and Zoning Agency
Govt. Lot
Q
'' SE ' Section 1�
T '47 N R 9 E o
City, State
8 ook.l (-01-(-01-SkSZ
I Zip Code
I
Phone Number
bob -33 s---i ss—
H. Type of Building (check all that apply)
Lot #
Subdivision Name
1$I or 2 Family Dwelling— Number ofBedrooms Z
Block# ENURED
❑ Public/Commercial — Describe Use
❑ City of
❑ State Owned — Describe Use
❑ Village of
CSM Number
II
W Town of H U A ___
M. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if
a licable.
A.
New System
❑ Replacement SystemExisting
❑ Other Modification to ex lain)
System (explain)
❑ Additional Pretreatment Unit (explain)
B.
❑ Holding Tank
10 In -Ground
❑ At -Grade
❑ Mound
❑ Individual Site Design
❑ Other Type (explain)
(conventional)
C.
❑ Renewal Before
❑ Revision
❑ Change of Plumber
❑ Transfer to New Owner
List Previous Permit Number and Date Issued
Expiration
IV.
Dispersal/Treatment Area and Tank Information:
Design Flow (gpd)
Design Soil Application Rate(gpd/sf)
I Dispersal Area Required (sf)
I Dispersal Area Proposed (sf)
System Elevation
6'13
S2...(e_
I^/
e
Capacity in
Total
# of
Manufacturer
-
0
Tank Information
Gallons
Gallons
Units
6 , Torn
�
m 5z
�
P'.
a
.o A
0
a
New Tanks
I Existing Tanks
Lo eYtiR
.2
P.
Septicn,ToTdng7'aT�k
4{
—
13w
I
W i ese
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 Sign a
hfR/MPRS Number
Business Phone Number
)41k.�,v\ (?olko5ki
2 2oo90
�s'2g2etljn
Plumber's Address (Street, City, State. Zip Code)
PC? FOX saz zco„ j ve.rt,.'a SY3 Y
VI. County/Department Use Only
❑ Approved
0 Disapproved
Permit Fee I
$
Date Issued m
Issuing Agent Signature
❑ Owner Given Reason for Denial
71t-
) 6
Conditions of Approval/Reasons for Disapproval
�(/f
Ste/ V
Attach to complete plans for the system and submit to the Count' only on paper not less than 9 1 x 11 inches in size
SBD-6398 (R. 03/22)
® sz-0ogo EST #3y-a�
GENE
as►er�rEYr
Wisconsin Department of Safety & Professional Services Page of Z
Division o t
\O
SOIL EVALUATION REPORT
7'a Bayfield Co.
Wisconsin
Planning and Zoning Agtt cordance with SPS 385, Wis. Adm. Code County Q D0.
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include,
but not limited to vertical and horizontal reference point (BM), direction and percent slope, !=er6QI I.D.
scale or dimensions, north arrow, and location and distance to nearest road. " ( 8 S
Please print all Information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). C I 7/l 1
Property Owner Property Location ❑ ❑
rpi V 0.• ^t`o ,ci S Govt. Lot≤(4) y. S E Y. S T 41 N R E (or)
Property Owner's Mailing Address Site Address or CSM and Lot #:
L l W%11S Rol
City, State, Zip Phone Number ❑ City ❑ Village E Town I Nearest Road
9 ro a klv v� . L) S35'41 (o275' 1-� V 1q 4► eS W G t1 S � �
1 NewConstniction Use: Residential/Number of bedrooms Code derived designflow rate30O GPD
❑ Replacement 0 Public or commercial — Describe: Flood Plan elevation if applicable ft.
Parent material u Mud. ileaw 5 i mev,'1s
General comments and recommendations:
Boring #
U �.�] Pit Ground surface elevI.
Depth to limiting factor7Q__in. / elev .3.
Snil Annlir Linn 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
o- S
IO
--
51
my-Cr
Gw
3wt
2
r9
7.
I-'
.�
GS
. Co
3
413
SYR414
ros
sK
w L
G S
i.c
-
-
Qb kySc
--
. "t
1
2-I Boring # ❑Boring Q I&
Pit Ground surface elev.- V. +eft. Depth to limiting factor _in. / elev.
I Soil Anolication 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
1
Oi
I O 311
_
S
nn r
�. w
''�
7.J
.._
('-F
i �
s
3
2
Yt'4
_
3roScbk
Wt t
c. S
(W%
.
. t
/
S
b
Inn r
I
•.
T Name (Ple Print) f _�
CSTmow tI�►o
Signature
CST Number 1 s
1
Address 51 t$' C 'i'( Hwy $
I_r New,, w s`'Sk
Date Evaluation Conducted
—z •o
Telephone Number
R l--?U9s'
* Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 s 150 mg/L * Effluent #2= BOO, s 30 mg/L and TSS s 30 mg/L
SBD-8330 (R03122)
G
Page Z of 2-
❑ Boring QQ '3Boring #
Pit Ground surface elev 8�ft. Depth to limiting factor 1n. / elev9a.8( ft,
Snil Annlir_atinn 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
I
--
s
aMV(
Gw
•
2
-2(0
?.5
—
SiGS
-
rco$bZc
9.
-7
�"S
3t1k
—
{
Boring #
❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft.
Soil Annlicatinn 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
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.! elev. ft.
Soil Aonlication 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
* Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 s 150 mg/L * Effluent #2 = BOD, s 30 mg/L and TSS 5 30 mg/L
Soil Evaluation Site Map - System Plot Plan 0 10 20 ft
In -Ground Soil Absorption for POWTS Version 2.1 N
Owner: Joshua Rounds
Site Address: 67152 Wills Rd, Brule, WI 54820
Tax ID: 18556
Legal Description: SW1/4 of the SE1/4, Section 18, Township 47N,
R�C�11/ E®
Range 9W, Town of Hughes, Bayfield County, WI
Benchmark to North Property Line - Approx. 687'
MAY 05 2026
Benchmark to South Property Line - Approx. 622'
Bad td Co,
Co.
Benchmark to East Property Line - Approx. 683'
Ptann�n
Benchmark to West Property Line - Approx. 656'
OSB3 \)..\�
oo° �° s
OSB2
O.
.
BM
\ \ OSB;
C)
\ __
Proposed
New Home
Benchmark -Nail in Maple tree -Elevation 100'
..__... Suitable Absorption Area
o Soil Borings:
SB1 - Elevation 98.38
SB2 - Elevation 98.96
SB3 - Elevation 98.89
Tank - Wieser W840/500 -MR
Filter - PolyLoc PL -525
Pipe Material / ASTM Standard
Tables 384.30-3 & 384.30-5)
No Wells on Property
PAGE 1 OF 4
RECEIVED In -Ground Gravity Plan
MAY 0 5 2026 Index & Cover Sheet
aaytieid co. Component Manual Design References:
pianningand Zoning Agency In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027)
Page 1 - Index & Cover Sheet
Page 2 - Plot Plan
Page 3 - Dispersal Area Cross -Section &
Plan Page 4 - Management Plan
Enclosures:
SD.vL',Cyr12e,rrA,TApp Ihcwrtloll Soil C'valuativrKe9olT WieSe1
q, rn+641 'In c -c c c Yc�_t te_L
Ll
Project Name / Description
Owner Name(s): J osl1 v0. R o U hv.A S Phone: �0R_-33S - 76SS'
Owner Address: H96 6 Ht llcre sT LM, &rook lyT Zip: S-3,SZ I
Project Address: (off 1SZ WittS Ro� t?r'ulc., WZ S' -1 sac
Legal Description: SW '/.j, SE Yu , Se-cTi o✓\ 18 ! To L v2Ps ', P 47A/
elrl Couvft'-t L.J
Township: lyh2 S County: i -cI? e l c
Project Parcel ID #: I a SS
TAK
Designer Information
Designer Name:
AIIc&y,
OIkosk',
Phone:7/S -Z°I2-
Designer Address:
Po lYox
SZZ , .=1'!'vr--
R� &".,Zip: S'j87
7
E-mail: l oAx
Q bcoLr&uidev\o rt_\ .Covh
License Number:
?M.S
Z Z, OQ Q ()
Remarks:
Signature: a Date
ri al ignature r uired on each submitted copy.
PASEtoFLA
Soil Evaluation Site Map - System Plot Plan
In -Ground Soil Absorption for POWTS Version 2.1
Owner: Joshua Rounds
Site Address: 67152 Wills Rd, Brule, WI 54820
Tax ID: 18556
Legal Description: SW1/4 of the SE1/4, Section 18, Township 47N,
Range 9W, Town of Hughes, Bayfield County, WI
Benchmark to North Property Line - Approx. 687'
Benchmark to South Property Line - Approx. 622'
Benchmark to East Property Line - Approx. 683'
Benchmark to West Property Line - Approx. 656'
0 10 20 ft /^\
RECEIVED
MAY 052026
Bayfield Co.
Planning and Zoning Agency
O563 `•• A Benchmark -Nail in Maple tree -Elevation 100'
Suitable Absorption Area
ft o Soil Borings:
7yto 9Q SB1 - Elevation 98.38
OSB2 SB2 - Elevation 98.96
SB3 - Elevation 98.89
BM'•.
Tank - Wieser W840/500 -MR
Filter - PolyLoc PL -525
Pipe Material / ASTM Standard
(Tables 384.30-3 & 384.30-5)
Proposed No Wells on Property
New Home
IN -GROUND GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard -W Chambers
3 -ft Trench (down -sizing credit)
SOIL COVER
min. 12
(typical)
Septic Tank(s) Manufacturer.
Wieser
Septic Tank(s) Volurne(s):
1340 gal gal gal gal
Effluent Filter Manufacturer:
Polvloc
Effluent Filter Model #: PL -525
12"
min. trench
depth
(typical) TYPICAL TRENCH
CROSS SECTION VIEW
(typical) (No Scale)
System Elevation = q ft
(typical)
Quick4 Standard -W
w/ End Cap (Show location of inlet / outlet pipe connection on plan view.)
(typical)
-----------77--------�f---
- — — — — — — — — — — — �II—
B= 67 ft
(typical)
INSTALL PER TRENCH:
16
Quick4 Std -W @ 20 ff EISA/chamber =
320
ft2
+ 2
Pairs of end caps @6 ft2 EISA/pair =
6
ft2
= Proposed EISA per trench = 326 ft2
-u
O
cI,
m�
g
o
N
Provide minimum 3 ft
rn
separation between trenches. 2
Observation Pipe
(typical)
Install per manufacturers
/ instructions.
TYPICAL TRENCH
PLAN VIEW
(No Scale)
TA
(typical)
"—Quick4 Standard -W Chamber
(typical)
(mfd by Infiltrator Systems, Inc.)
Install pursuant to manufacturers instructions.
Required Infiltration Area = 643 ft2
x 2 trenches = Proposed Total EISA = 652
RESEIJ
ft2
Distribution Method:
Gravity
C)
m
('3
O
T1
4A
73
rn
C)
m
::CE)v~tD
MAY052026 5 2026 PAGE 4 OF 4
gayfield Co. In -ground Gravity Management Plan
planning and Zoning Agency
IMPORTANT:
The owner of this in -ground 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= 450 gpd; BOD5 ≤220 mgL-'; TSS 5 150 mgL"'; FOGS 30 mgU'
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 I 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: Iron River Septic
Local government unit: Bayfield County Planning & Zoning Phone: 715-373-6138
Local government unit address: 117 E 5th Street, PO Box 58, Washburn, WI Zip: 54891
Phone: 715-372-4006
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.
4" CAST -A
W840/500 -MR
TANK SPECIFICATIONS
DIMENSIONS;
CAST -A -SEAL WALL: 2 9/16"
BOTTOM: 3"
COVER: 5"
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
HEIGHT: 59 1/2"
LENGTH: 9'-5 3/4"
WIDTH: 7'-9"
BELOW INLET: 48"
LIQUID LEVEL: 43"
WEIGHT: 11,150 LBS.
INLET AND OUTLET:
4" CAST -A -SEAL BOOT OR EQUAL GASKET
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN, SEE DETAIL #10
(OTHER STATES SEE CHART)
LIQUID CAPACITY: 19.61 GAL/IN (SEPTIC)
11.82 GAL/IN (PUMP)
LOADING DESIGN: 8'-0" UNSATURATED SOIL
0
4" VENT
OUTLET
1 II N
a a .t ll dU
PUMP PAD
ARE MANUFACTURED TO MEET OR
TANK CAN BE USED AS:
SEPTIC/SEPTIC, SEPTIC/PUMP,
OR SEPTIC/SIPHON
COVER: MIX DESIGN #8 (NO FIBER)
TANK: MIX DESIGN #10 (STRUCTURAL FIBER)
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
SIDE VIEW
APPROVED
By Glen Schlueter at 10:18 pm, May 30, 2022
REVIEW DATE
DRAWINGS SUBMITTED
FOR APPROVAL
APPROVED BY:
APPROVAL DATE:
PRODUCTS NEEDED BY:
OF 1
Private Sewage System Maintenance Agreement
DOCUMENT NUMBER
Owner(s) Name -
2O26R-61 1899
DANIEL J. HEFFNER
Owner(s) Melling Address
41' -/; r ) c v f- L_r 3' c, �-1 Z x352
REGISTER OF DEEDS
s
BAYFIELD COUNTY. WI
SiAddress
Site ,J r
Sz
(p /' f/ S f`�A 3 ✓ (,2 j r tO
RECORDED
O4/27/2O26 AT 8:00 AM
Tax ID It
RECORDING FEE: $30.00
As owner, I (we) do hereby certify the private sewage system will be installed in
PAGES: 1
accordance with the certified soil testers report and approved plans and specifications
on file with Bayfield County Planning and Zoning Department. The system will be
CR
RCCENGV
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)
�1y _T�r5 [
' ir11 0 5 L 2D
S 1/4 of $ 1/4 Section Township N7 N. Range 9W.
BaS Ca Recording Area
Adoll d;:wnogal Doscdplicn: - _
iWlnntn(hen0 ienin Alton r
'II �.
Town of n t/ 5 'e- S (Acreage) (40 Gov't Lot
Return To: //,�.
- YL ?d / K- O S /L r
�'3
Lot _Block Subdivision
F O ,Ic 5—Zt—
Lot_CSM#_Vol._Page CSMDoc#
r
y� C �� , Ir viL S `f S 7
® 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 end 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, 0, 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 septc 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 -around Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbed if needed when
the wastewater d!stribution 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 Bayfeld 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. Bayfleld 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
maybe placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected aspaVIN(VbJtrlsw,.
The terms and conditions of the agreement shall be binding upon and Inure to the benefit of all current and future owners
Owner(s) Name(s)—Please Print
2ods
Subscribed and sworn to before me on this date: :
C toc '18th 2'01A/
NotarizzeedDmowper(s)-31 s)
Notary Public
�OI#,,
�'�
My Commission Expires:%
u,•
Drafted by: 0 n e, /Cc's (CI' Date: 2 — Z V -Z fo
Proofed by: ICE
utforms/sanitary/seplicmaintenceagreement
Revised July 2020
A- - -. iELD Bayfield County
FPlanning & Zoning Department
117 E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner:
ROUNDS, JOSHUA C
498 HILLCREST LN
BROOKLYN, WI 53521
WARRINER, AMANDA L
498 HILLCREST LN
BROOKLYN, WI 53521
Description
Certified Soil Tests - Review & Filing Fee
Submission Number:
SR -00404
Transaction Number:
SR -00404-4578C
Amount
$50.00
Total: $50.00
Payment Amount: $50.00
Reference: 6303
Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847
Payment Type: Check
Transaction Date: 5/12/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
J3AyFIELD 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:
ROUNDS, JOSHUA C
498 HILLCREST LN
BROOKLYN, WI 53521
WARRINER,AMANDA L
498 HILLCREST LN
BROOKLYN, WI 53521
Description
Private Sewage System (Septic Tanks)
Submission Number:
SS -00736
Transaction Number:
SS -00736-453D3
Amount
$400.00
Total: $400.00
Payment Amount: $400.00
Reference: 6303
Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847
Payment Type: Check
Transaction Date: 5/12/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
BAYFIELD COUNTY
SANITARY PERMIT (#04)-26-40S
STATE SANITARY PERMIT
OWNER: JOSHUA C ROUNDS
G OV'T LOT: LOT: B LK:
SW 1/4 SE 1/4 SEC: 18, T 47 N, R 9 W
TOWNSHIP: Hughes
SOIL TEST: 34-26
NEW SYSTEM
SYSTEM TYPE: Non -Pressurized In -Ground
PLUMBER: ALLAN POLKOSKI
EMILY MACGILLIVRAY LLIVRAY DATE: 5/12/2026
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 #:
LICENSE: # MPRS 220090
Condition: Properly Ma€nta€n System Per Recorded Agreement
THIS PERMIT EXPIRES 5/12/2028
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION