HomeMy WebLinkAbout26-45SKELtIVtLI Department of Safety
APR 16 2026 & Professional Services,
Industt7ryt Services Division
Sayfield Co. SS- 0 cr PS
anitary rermit Application
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit
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 nay be used for secondary
purposes in accordance with the Privacy law. s 15.04(1)(m)_ Slats.
I. Application Information —Please Print All Information
Property Owners Name II I
b4eva No\� �} 5usorx �-"rctah �EkEgg
Property Owner's Mailing Address
tmomo Ie La 5z/s 71 7/S .3a -c /o
II. Type of Building (checc all that apply) Lot #
I or 2 Family Dwelling— Number of 3
Block #
O Public/Commercial — Describe Use
O City of
O State Owned -Describe Use CSM Number ❑ Village of
Ooo6?-7 X1of Day
Ill. 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 System ❑ Other Modification to Existing System (explain)
y p y y ( p ) ❑ Additional Pretreatment Unit (explain)
B. Holding Tank ❑ 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
-453
Property Location
Govt. Lot
'h, %., Section
T N R O'6 Eort'W)
Design Flow (gpd)
Design Soil Application Rate(gpd/sl)
I Dispersal Area Required (sf)
I Dispersal Area Proposed (sl)
I System Elevation
Tank Information
Capacity in
Gallons
Total
Gallons
# of
Units
Manufacturer
. 2
y c
a U
o
i2 H
a
rn
g
ii o
_
a
New Tanks
Existing Tanks
Septic or Holding Tank
000
O
0-60
a
t
!7 Q
Dosing Chamber
V. Responsibility Statement- I, the undersigned,
assume
responsibility for installation of the
POWTS shown on the attached plans.
Plumber's Name (Print)
'Ic o L1�cb\ews�l
Plumber'
re
MP/MPRS Number
aggs�3
Business Phone Number
CIS aoq 7sa
Plumber's Address (Street, City, State, Zip Code)
IL4c i / 9kLUc4 C_ ,
(.bslnkrn,
WZ 5Y&(
( YAPproved I ❑ Disapproved (,� �fj, /�S/ �
O Owner Given Reason for Denial $ �V —' `"'' /� ' Q7 (J Jl4
Conditions of ApprovalReasons for Disapproval ( Z%
rn� �
Cam, cnc d.
Attachto complete olans for the system and submit to the Count, only on paper not less than 8 in x II inches in size
SBD-6398 (R. 03/22)
RECEIVED
SEP 2 52O E i£HGD
-a7-
Bayfield County
Soil Test #/
Waiver of a Thorough Soil & Site Evaluation
(subject to 15-1 -1 0(d))
I - //l9'I tu`f.<7r'c a certified soil tester determine that in my professional
judgment tfollowing site (see below) Is unsuitable for any treatment component other than holding
tanks. Due to soil & site conditions, a thorough soil and site evaluation is not needed to make such a
determination.
Property Owner 31ep M Nold Contractor
Property Address 37/39 ..4po t} IP Q..1. Ed Authorized Agent
wr s-yB/g/ Agent's Telephone
Telephone Its- SOS /66/ Written Authorization Attached: Y or N
Accurate Legal Description is requested:
1/4 of 1/4 Section 06 Township 5N. Range 03 W. Town of___________
Additional Legal Description:
Govt. Lot Lot Block Subdivision
Lot I CSM#01 137voI. '/ Page aRol CSM Doc # QWO R - 5 SDy66
Volume Page of Deeds Tax I.D# ____Acreage 87
Indicate reasoning
Lfor yourdetermination: Oast 1ctll Se.Jb<,cks Were sA6/clwl, e e
N!Q'S 4'a /'m ,tl/ t T RGNn I'J�V G�}+� /`'�/.S() 82 S`IOWd fC L S )'7� 4o -C /�QGol e^5
?M5sQt J Sys, . Ownea decAL41 f So w /h I _�J�—
liva 45 l a u L--
Signature of County Official
/o1,61 —d3
Date
Signature of Certified Soil Tester
Date
Certification #
(Submit a Plot Plan & Fee)
u/formslsoiltestwaiver(KLK)
June 2018
Pd to a&c_.,
�•^�. Wisconsin DepartmentofSafety and Professional Services
Page of�
•s�� 1i`, Division of IndustryServices
pi
c,;p SOIL EVALUATION REPORT
'• �`
In accordance with SPS 385, Wis. Adm. Code
County
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,
Parcel I.D.
scale or dimensions, north arrow, and location and distance to nearest road.
Please print all Information.
Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)).
Property Owner
Property Location
C ❑
Stephen Nold
Govt. Lot Y..
''h S T N R E (or) W
Property Owner's Mailing Address
Site Address or CSM and Lot #:
City
State
Zip Code
Phone Number
❑ City ❑ Village
❑ Town
j Nearest Road
O New Construction Use: ❑Residential/Numberofbedroor Code derived designfowrate GPD
❑Replacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable ft.
Parent material
General comments and recommendations:
❑Boring 98' Boring # 8
�PII Ground surface elev.fl. Depth to limiting factor � In. / elev.fl.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/FF
Eft#I
'Eft#Z
A
0-6
5YR 2.5/5
LS
D-sg-vf
ds
as
1co-2m3f
0.2
0.6
E
6-12
5YR 3/1
>75% Rock
S
0-sg-vf
ds
as
2m -3f
0.5
0.5
B
12-18
5YR 4/4
>75% Rock
S
0-sg-vf
ds
ow
2f
0.5
0.5
C
18-42
5YR 414
c -2-d 2.5YR 4/6
SL
1-sbk-vf
dvh
as
-
0.4
0.7
D
42-70
5YR 5/4
SL
3-sbk-vf
deli
-
-
0.6
1.0
El Boring #
❑Boring
EPit Ground surface elev._ft. Depth to limiting factor in. / elev.ft.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary
Roots
GPO/FP
Eff#1
tEtf#2
CST Name (Please Print)
I Signature
CST Number
Tim Dykstra
I Z
11213855
Address
10620 Eagle Lake Rd Iron River WI
Date Evaluation Conducted
17/28/2023
I Telephone Number
715-209-5748
Effluent #1 = BOO' 30 s 220 mg/L and TSS > 30 s 150 mg/L
Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L
SBD-8330 (R04/21)
RECEIVED
APR 16 2026
Bayfieid Co.
Planning and Zoning Agency
/` — _ i �, — — -- - \ N
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sy\n i 1 1 1�ia�-11'r I '-rJl.+ / j% I I! I
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Garage _
S�•(s9 oa ; B. Residence wtI,,I/ /i•�
I i :._. I ._I__ Iii � ` ' -,i '11111�11�.�': ;.
— �._. ac •� ��—xa1Ili 'I ,J
_ _ _ _ s I 1 PROPERTY LINE ti •.. 1� ',
I( tee" -T _.-�.-III ' I 'I1 ;; ulllll /
' j l l ..-. � s J � (�/ ICI '1111 /
I ' �
Site Plan ---`— Site Plan Noter. J-----
s<ale: t• = 2O -O' -1 B. mnlour INervals drown
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≥ 0-4 co 3
U N
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CF design ltd
230 Eat SSP®ior Street
Suite 82
DNutM435802
Krone 218.722.1060
Fee 218.722.1086
WWw Mp16n dmm
PROJECT
NOLD<NapNL
RESDEACE
PROJECT ADDRESS:
374391POTLE BAY RD
BAYFIBD• YA 54814
DESIGM DEVELOPMENT
August D. 2)23
CONCRETE HOLDING TANK DESIGN
Two Concrete Tank Option
INDEX AND TITLE SHEET
Project Steve Nold & Susan Lindahl - Holding Tank
Owner Steve Nold & Susan Lindahl
Address 37439 Apostle Bay Rd
Bayfield, WI 54814
Phone: (715) 232-8109
Legal Description Lot 1 of CSM #000637 V.4 P.292,806. T50N, R03W
Township Bayfield County Bayfield
Subdivision Name
Parcel ID Number
Plan Transaction Number
Designer Michael Wroblewski
Lot No.
Index and title sheet
Page 1
Holding tank specifications
Page 2
Site plan
Page 3
Management & Continency Plan
Page 4
Soil Test
Page 5
Soil Test Plot Plan
Page 6
Holding Tank Agreement
Page 7
Holding Tank Servicing Contract
Page 8
Holding Tank Specifications
Page 9
Phone No. (715)373-0566
License Number \a.t SO3, Date 04/07/26
Designed pursuant to:
Holding Tank Component Manual For POWTS (Version 2.0)
SBD-10855-P (N. 03/07, R. 01/12)
Version 7.0 (11/12)
Page 1 of 9
RECEIVED
APR 162026
Baytleld Co.
Planning and Zoning Agency
HOLDING TANK SPECIFICATIONS
Two Concrete Tanks In Series
3 If one- or two-family, number of bedrooms
And/Or....Non-residential estimated flow per day
2000.0 Minimum holding tank volume required
4000.0 Total holding tank capacit proposed (gal)
2000.0 Tank 1 capacity (gal) IIX for round tanks
2000.0 Tank 2 capacity (gal)
tWieser Concrete Products Inc. Tank manufacturer
CSJE Rhombus Alarm manufacturer
TA AB-01TA H lAlarm model number
L, 1.1
Tank in
Information Lig LE
Tank 1 53
Tank 2 53
Anchor weight safety factor
Exterior Dimensions (in
vent
cap
12" min. 4^ mi.
F Vent pipe II
Blind plug to seal
outlet opening , 1
12.0 in
Service alarm on
41.C
2000.0 gal
Tank2
Ibs
lbs
qht Tank Wt
Anchor
66 1537018675
66 15370
HOLDING TANK CROSS SECTION
Manhole cover with locking
and warning label
box
Note: Manhole and
II vent locations may
Tether be reversed.
weight Manhole diameter is
23" min.
2000.0 gal
Tank 1
3 in. min. bedding undertanks.
Anchortanks as necessary to negate buoyant forces.
Electrical as per NEC 300 and SPS 316.
Note: All tankjoints, and joints between tank openings
and piping are sealed watertight.
Finished grade
II�~ 18" min.
Inlet
RECEIVED
APR 16 2026
BaAeld Co.
Planning and Zoning Agency
Project: Steve Nold & Susan Lindahl - Holding Tank
Transaction Number. Page 2 of 9
Steve Nold & Susan Lindahl
Holding Tank Plot Plan
Lot 1 of CSM #000637 V.4 P.292 S06
T50N R03W, Town of Bayfield,
Bayfield County, WI
Scale: 1" = 40'
Page 3 Of 9
W2000 -MR
TANK SPECIFICATIONSDI o
01 0-
oI p
I In
12'-7" DIMENSIONS:
rc o
WALL 2 1/2" ....P -.L
BOTTOM: 4"
COVER: 6"
�;__-----------=_ MANHOLE: 24" I.D. PRECAST CONCRETE RISER
-------------
HEIGHT. 66" O.D.
LENGTH: 12'-7" O.D.
CAST -A -SEAL 4" CAST -A -SEAL ` WIDTH: 7'-2" O.D.
� Ui
BELOW INLET: 53" O.D.
`� LIQUID LEVEL: 46" b
I WEIGHT: BOTTOM 9,430 LBS. O
COVER 5,940 LBS. p 3 o E
2g,
INLET AND OUTLET: m o 0
FILTER OR BAFFLE ii 0
4" CAST -A -SEAL BOOT OR EQUAL GASKET z ;
INLET AND OUTLET BAFFLE AND FILTER: o o It
��- WISCONSIN, SEE DETAIL #10
---- ----------
(OTHER STATES SEE CHART) 1.1.1
LIQUID CAPACITY: 42.92 GAL/IN
TOP VIEW HOLDING TANK: in
OUTLET HOLE PLUGGED C rc 00
o ACTUAL CAPACITY: 2,126 GALLONS z I
a LOADING DESIGN: 8'-0" UNSATURATED SOIL m M
LU
TANK CAN BE USED AS: W f O
SEPTIC / HOLDING / PUMP OR SIPHON
---- ---- COVER: MIX DESIGN #8 (NO FIBER)
INLET TANK: MIX DESIGN #10 (STRUCTURAL FIBER) n
_ _ _ _ _ OUTLET
T;(L
r CUSTOMIZED TANKS:
I IN FOR CUSTOM TANKS CONTACT WIESER CONCRETE
m y
CD I a to I _ j J4 0n
a
I f L I-0 M REVIEWED BY N F
REVIEW DATE 3 0_ w
SIDE VIEWSr.a< DRAWINGS SUBMITTED
c ff4 > N FOR APPROVAL
o
S rn
APPROVED BY: SHEET NO.
APPROVAL DATE: 1 Z
OF
PRODUCTS NEEDED BY:
JKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS / 1
BAYFIELD COUNTY
CHECKLIST FOR SANITARY APPLICATONS
Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e))
Check List
Original Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.)
Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c))
Original Plot Plan (383.22(2)2. 3. & 4.a)
Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer
O Pump Tank Diagram, Alarm and Pump Curve (when applicable)
r" Contingency Plan / Management Plan (383.22-3(2)(b)1.f.)
O Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds)
] Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds)
Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5)
ATU Servicing Agreement (Recorded at Reg. of Deeds)
Fee (Make Check Payable to Bayfeld County Zoning) (383.21(2)(c)7)
1 Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached
to all copies)
Soil and Site Evaluation Report (383.22-3(2)(b)1.e.)
O State Plan Review (when applicable)
O Copy of Warranty/Quit Claim Deed (Optional)
Sanitary Application: (Include the following Information)
NP'
Application Information must include ❑ 23 digit Parcel ID# -- (do not use 12 digits anymore--obsolete)
Project Address or Road Name where driveway is/will come off of) (Owners Phone Number)
Type of Building
Type of Permit
Type of POWTS System
Dispersal / Treatment Area Information
Tank Information
Responsibility Statement (Plumber's Information)
*Date Stamp*
Plot Plan: (To Scale or To Dimension)
Signature and Plumber Information
Surface Elevation of Body of Water
❑ Direction and Percent Land Slope
Tank and Filter Information and Location
Wetlands / Navigable Bodies of Water
❑ Absorption Area (Proposed and Existing)
O Bench Mark (Location, Elevation and Description)
Component Manual Version
i3
RECEIVED
APR 16 2026
BaYfieid Co.
Planning and Zoning Agency
Address Number and Road
North Arrow
1d1 Contour Lines
Xl Structures and Driveways
Boring Locations
Property Lines
Well Locations
Legal Descriptions
Turn Over ►
Cross -Section and Over -Head Profile of the System:
❑ Surface and System Elevation
❑ Position of Observation and Vent Pipes
❑ Dimensions and Depths
❑ Make, Model & Number of Chamber Units in each Cell
Property Information
How many systems will there be on this parcel of land?
Has this property been split? KIN (Property Statement shows Property History)
Fees:
O Private Sewage System (Septic Tanks)
$ 400.00
Private Sewage System (Holding Tanks)
$ 400.00
❑ Mounds or Systems requiring Pre -Treatment
$ 500.00
❑ Sanitary Revisions
$ 25.00
❑ Private Sewage System Reconnection
$ 50.00
and Private Interceptor
❑ Return Inspection
$ 50.00
❑ Maintenance Agreements +
$ 30.00
(checks made out to Reg of Deeds)
RECEIVED
APR 16 2026
Bayfield Co.
Planning and Zoning Agency
u/forms/checklists/checklistforsanitaryapps (I0/2009);(p7/2011);(p2/2012)(O5/2/2012-dc) Proofed by:
HOLDING TANK MANAGEMENT PLAN
This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and
maintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P
03/07, R.1 1/12), and the Bayfield County Sanitary Ordinance.
1. This POWTS is designed to accommodate a wastewater flow of 60.0 to 800.0 gpd.
2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in
the attached Holding Tank Servicing Contract and Maintenance Agreements.
3. Each time the wastewater in the second tank reaches a level of 12" below the inlet invert (at which time the
alarm will activate), the pumper listed in the current Servicing Contract must be called to empty the tank's
contents and dispose of them in accordance with NR 113, Wis. Adm. Code.
4. At each service event, the service provider should visually inspect the condition of the tank, risers and
manhole cover(s) and verify that the alarm system functions and manhole locking devices are present.
Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions
shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code.
5. All service events or inspections of this POWTS shall be reported to the county within 30 days.
6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be
removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes
from this holding tank to the ground surface, including intentional discharges and discharges caused by
neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the
county or state.
7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may
be installed in the same location (a new sanitary permit is required for such a replacement). Connection to
municipal services would also be considered at this time if they are deemed available to the property.
9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in
accordance with SPS 383.33 Wis. Adm. Code.
10. If there is a problem with, or question about this installation, the following persons should be contacted:
a. Installer ...........................Big Big Lake Plumbing Phone: (715)n 209-7521
b. Service Provider ................Birch Birch Street Excavating & Septic Phone: (71'5) 373-5683
c. County Zoning or Health Dept. Bayfield County Zoning Phone: (715) 373-6138
11
Project:
Transaction Number:
Page 4 of 9
RECEIVED
APR 16 2026
Bayfield Co.
Planning and Zoning Agency
Document Number/Plan I.D. No.
HOLDING TANK
AGREEMENT
Owner Name (s)
S}e��he� MM
Owner(s) Mail'ng Address
I'�IS/�1 c�wc� R k.
SKSo1 LacAa
/He LLL.31571
Parcel Identifier Number (PIN)
�a 7
Agreement Date (same as Notary Date)
�l(4ha ab
on the following property or that continued use of the existing premises requires that a
holding tank be installed on the property for the purpose of proper containment of
sewage. Also, the property cannot now be served by a municipal sewer, or any other
type of private onsite wastewater treatment system as permitted under Ch. SPS 383,
Wis. Adm. Code or Ch. 145, Wis Stats.
1/4 of 1/4 Section. Township SC) N. Range_ 03 W.
Town of J -----._. _. _ ---
Re'
Additional Legal Description:
Gov't Lot l Lot Block Subdivision -7 CSMN
t�,
LoCSM #6 3'7 Vol 20 Page CSM Doc# / 3
DOCUMENT NUMBER
2026R-61 1 480
DANIEL J. HEFFNER
REGISTER OF DEEDS
BAYFIELD COUNTY, WI
RECORDED
03/23/2026 AT 8:23 AM
RECORDING FEE: $30.00
PAGES: 1
BIG LAKEt
PLYMBING IJ
1491 County Highway C
Washburn, WI 54891
As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above described property, we agree to do the
following:
1. Owner agrees to conform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding tank installation and
maintenance. If the owner fails to have the holding tank properly serviced in response to orders issued by Bayfield County or the
Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats., Bayfield County may enter upon
the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a
special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats.
2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and
maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the hId
County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice he
owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be laced on the tax
roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided bM 1 6 2026
3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Stats., and chapter NR 114 Wt39yl(b$drn�ode, to
have the holding tank serviced in accordance with Ch. NRI13, Wis. Adm. Code, and to file a copy of the contr@MttP)hp Sd1r1'relfh
The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the countywithin
30 days from the date of change to the service contract.
4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis, Stats., and Ch. NR 114, WI's Adm. Code who shall
submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property 1O
investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being
properly maintained.
5. This agreement will remain in effect only until Bayfield County certifies that the property is served by either a municipal sewer or a private
onsite wastewater treatment system that complies with Ch. SPS 383, WI's Adm. Code. In addition, this agreement may be cancelled by
executing and recording said certification with reference to this agreement in such manner which will permit the existence of the
certification to be determined by reference to the property.
6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The ov,
agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner
existence of the agreement to be determined by reference to the property where the holding tank is installed.
Owner(s) Name(s) - Pease Print
t6sar4 L���lti�
C. ,t/O4-
Subscribed and sworn to before me on this date.;
Mavt..P) Icily" alp*:
A
Nota ized Owner(s) - Signat re(s
Notary Public
My Comm ssion Expi s:
lll o
Drafted bK ;\TQ.. 4J M u ski Date: 3 ;0a.
Personal information you provide maybe used for secondary purposes (Privacy Law, s.15.04 ('(m)) ulloan,Isaniterymoldingtankagreement,d aJune 2018
HOLDING TANK SERVICING CONTRACT
Contract Date
1t6��a This contract is made between the
Holding Tank Owner(s) Name(s) f
�C pllP t\ N c'�S� `.,c� '� U n L:Lk
k
We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions)
PROJECT
Legal Description:
Tax IDN
L(
LOCATION
(Use Tax Statement)
1/4, 1/4,
r /
Section
, Township . C ) S
1�
N, Range G w
Town of:
Lot Size
Acreage
� Y; L
I-).
Godt Lot
Lot H
CSM if
Vol.
Page
CSM Doc it
Lot(s) No.
Block(s) No.
Subdivision:
i-..).
/
/
Z� ,I
L-1,�. c
_
1. The owner agrees to file a copy of this contract with Bayfield County as required in SPS 383.55, Wis. Adm. Code
2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have
access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain
the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner
further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by
the owner and pumper.
3. The pumper agrees to submit to the local government unit which has signed the pumping agreement required by SPS
383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding tank(s) on a semiannual basis. The
pumper further agrees to include the following in the semiannual report:
a. The name and address of the person responsible for servicing the holding tank: RECEIVED
b. The name of the owner of the holding tank;
c. The location of the property on which the holding tank is installed; APR 16 2026
d. The sanitary permit number issued for the holding tank;
e. The dates on which the holding tank was serviced; Sayflekl Co.
f. The volumes in gallons of the contents pumped from the holding tank for each servicing; Planning and Zoning Agency
g. The disposal sites to which the contents from the holding tank were delivered.
4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this
contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract
with the local government unit and the County named above within (10) business days from the date of change to this
service contract.
-............... .-. �,rn//1 aII vwurn a oiyna wrelsJ Subscribed and Sworn to me:
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_ 7�A ' l cottsionexpireson: ) �lD�oi1
Revised: May 2016 (®May 2018) 'Zj•OF W1SG�``Drafted by / Vv/
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Personal information you provide may be used for secondary purposes [Privacy Law, s.ie!batlJMHf1
p Y F I E LD 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:
NOLD, STEPHEN C
1915 MIDWAY RD
MENOMONIE, WI 54571
LINDAHL, SUSAN E
1915 MIDWAY RD
MENOMONIE, WI 54571
Description
Private Sewage System (Holding Tanks)
Submission Number:
SS -00725
Transaction Number:
SS -00725-440E2
Amount
$400.00
Total: $400.00
Payment Amount: $400.00
Reference: 2964
Paid by: Ed's Mechanical, 1491 County Hwy C, Washburn WI 54891
Payment Type: Check
Transaction Date: 5/14/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
BAYFIELD COUNTY
SANITARY PERMIT (#04)-26-45S
STATE SANITARY PERMIT
OWNER: NOLD, STEPHEN C & LINDAHL, SUSAN E
G OV'T LOT: 1 LOT: 1 B LK:
CSM: 000037
1/4 1/4 SEC: 6, T 50 N, R 3 W
TOWNSHIP: Bayfield
SOIL TEST: 148-23
NEW SYSTEM
SYSTEM TYPE: Holding Tank
PLUMBER: MICHAEL WROBLEWSKI
EMILY MACGILLIVRAY DATE: 5/14/2026
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: # MP 1288503
Condition: Properly Maintain System Per Recorded Agreement. Must be within 25 ft of an all-
weather road.
THIS PERMIT EXPIRES 5/14/2028
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION