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HomeMy WebLinkAbout26-47S5s-O073q ����V�Ui ndustry Services Division 4822 Madison Yards Way County Bayfield t Madison, Sanitary PermitNumber(to be filled in by Co.) WI 53705 Box 7302 MAY Ol2026P.O. Madison, WI 53707 / q75 P P �9Sjrmit Application S (nin In accordance with i83. I(2), Wis. Adm. Code, 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 )(m), Stats., 9265 Wheeler Rd. Iron River WI 1. Application Information — Please Print All Information Property Owner's Name Parcel # PSG Pike LLC 36848 Property Owner's Mailing Address Property Location 2730 Northridge Dr Govt. Lot 6 City, State Zip Code Phone Number Duluth, MN 55811 218-591-3651 NW 'A NW ¼, Section 28 T47 N R08 E or 47 H. Type of Building (check all that apply) Lot# ❑✓ I or2 Family Dwelling— NumberofBcdrooms 1 (Gnrge) 2 Subdivision Name ❑Public/Commercial — Describe Use Block! ❑Cityof State Owned — Describe Use Villageof CSM Number #1857 Vii P61 ❑✓ Town of Iron River III. Type of POWTS Permit: (Check either "Nerd" or "Replacement" and other applicable online A. Check one box on line B. Complete line Cif a licable. A. ✓❑New System ❑Replacement System ❑Other Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B. Holding Tank In -Ground !:IAAt-Grade Mound Individual Site Design Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision Change of Plumber Dfransfer to New Owner List Previous Permit Number and Date Issued Expiration NA IV. DispersaVTreatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required (st) Dispersal Area Proposed (sf) System Elevation 150 0.7 ' 214 250 95.5 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units ` 0 v V New Tanta Existing Tanks & -y a` U in SepticorHolding Tank 320 320 1 Wieser ✓ Dosing Chamber I C C V. Responsibility Statement- I, the undersigned, assume responsibil' or instaljition of the POWTS shown on the attached plans. Plumber's Name (Print) I Plumber's Si T�+.y__.s-^— MP/MPRS Number Business Phone Number Jason Kuettel �%``��� 675751 715-798-3355 Plumber's Address (Street, City, Sate, Zip Code) PO Box 66 Cable, WI 54821 VI. County/Department Use Only pproved ❑ Disapproved ❑ Owapprov Reason for Denial Permit Fee _ Date Issued IrItSL Issuing A Agent t� Signature NOV en g Conditions of ApprovaVReasons for Disapproval n/ ,o wu,pnae pmns For me srem ano submit ro n¢ County only on paper not Irss than 8 ]a a II inches in sue SBD-6398 (R. 02/22) '. co11o? :CV0 D ED wtsconsin Department of Safty�andQflssidn keS Attach complete site plan on pipek not less than 8'/z X 11 Soil Evaluation Repo�®IL TEST ##3' J(O In accordance with SPS 385 , WIs.Adm Code inches in size Page: 1 2L6 tay ii Plan must incl ,p Ji as cal and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, location and distance to nearest road. Please Print All Information Personal information you provide may be used for secondary purposes. (privacy Law,s.15.04(1)(m)). County: Bavfleld Parcel I.D. 36848 Flevif d q ,ill � e:i/ j`og —s Property Owner: PSG Pike LLC Property Location S28,T47N,R08W Property Owners Mailing Address: 2730 Northridge Dr Site Address or CSM and Lot # 9265 Wheeler Road City Duluth State I Zip Code MN I 55811 Phone Number: " 0 Town Iron River Nearest Road: Wheeler Road Number of Bedrooms: 1 J New P Residential Code derived design flow rate: 1150 Flood Plain if applicable r Replacement r"` Public or Commercial - Describe: Parent Material: Till Flood Plain if Applicable: 0 General Comments & Recommendations: System Elevation: 95.5 Load Rate: O_7 Elevation Range_- 94.06 To 9643 . Ground surface Elev: Depth to Limiting Factor: Boring #1 r Borl� Fit 99.12 Ft. 100 in. Elev. 90.79 ft Soil Application Rate: Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 0-10 7.5YR2.5/1 N/A SL 2MSBK MFR CS 2CO 0.6 1.0 2 10-24 7.5YR4/6 N/A LS 0SG ML CS 2M 0_7 9_0 3 24-100 7.5YR4/4 N/A CBMS 0SG ML N/A IF 0,^7 1.0 4 5 H3 = > 35% 3-6 inch Rock 6 7 Boring # 2 1- Bor. �. pk Ground surface Elev: Depth to Limiting Factor: r 100.23 Ft. 110 In. Elev. 91.06 ft Soil Application Rate: Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 0-8 7.5YR2.5/1 N/A SL 2MSBK MFR CS 2CO 0.6 1.0 2 8-20 7.5YR4/6 N/A LS 0SG ML CS 2M 0.7 1.0 3 20-110 7.5YR4/4 N/A CBMS 0SG ML N/A IF 0.7 1.0 4 5 H3 = > 35% 3-6 inch Rock 6 7 *Effluent #1= BOD 5>30 < 2 20 mg/1 and < 150mg/! *Effluent #2= BOD 5< 30 mg/! and TSS < 30 mg/! CST Name (Please Print) Mark S. Thompson SI CST Number: t7 83 Q ".O Address: 12006 N US Hwy 63 Hayward, WI 54843 ted: D I =Tuesday, ebruary 17, 2026 Telephone Number 715/699-4081 SBD-8330 (R04/21) Property Owner. PSG Pike LLC Parcel I.D. 36848 Page: 2 of 6 Boring # 3 I Borry Pit Ground surface Elev: Depth to Limiting Factor: 98.6 Ft. 115 in. Elev. 89.02 ft Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 0-12 7.5YR2.5/1 N/A SL 2MSBK MFR CS 2C0 0.6 1.0 2 12-26 7.5YR4/6 N/A LS 0SG ML CS 2M 0.7 1.0 3 26-115 7.5YR4/4 N/A CBMS 0SG ML N/A IF 0.7 1.0 4 5 H3 = > 35% 3-6 inch Rock 6 7 Boring # 4 Ground surface Elev: Depth to Limiting Factor: r BorP' Pit t 0 Ft. 0 In. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 5 g ror Bry Pit Ground surface Elev: Depth to Limiting Factor: 0 Ft. 0 In. Soil App. Rate Horizon Depth in. Domm.Coior Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 6 r• Br Pit Ground surface Elev: Depth to Limiting Factor: or 0 Ft. 0 In. Soil App. Rate Horizon Depth in. Domm.Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 *Effluent #1= BOD 5>30< 2 20 mg/l and TSS>30 < 150mg/i *Effluent #2= BOD 5< 30 mg/l and TSS < 3 hWb-E1VED The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-271J 7 2026 SBD-W30(RA7roo) Bayfield Co. Planning and Zoning Agency Soil Profile Sheet Page: 3016 Owner: PSG Pike LLC Solt Tester: Mark S. Thompson System Elevation: 95.5 Load Rate: 0.7 System Elevation: 94.06 To 96.43 101 B2 101 B1 101 BB 100 - 100.23 100 100 System 99 ------------ --------------- 0.2 99 --------------- --------------- 99.12 99 -------------- Elevation ------------- -------------- 98 ------------- QZ 98 ------------- 98 -------------- 97 --------------- 97 --------------- 9Z.12 97 --------------- -------------- --------------- --------------- QZ 95 ------��-- 95 -------------- 95 94 ---------------94L09 94 --------------- 94 --------------- -------------- 93.79 93 -------_---__ 93 93 --- 92 --------------- 92 --------------- ±. 92 --------------- $2.02 91 -------------- -------------- 91.06 91 ------- --------- 91 --------- --------------- LE --------------- 90.79 --------------- 90 --------------- 90 --------------- L.E. 90 --------------- 89 ------------- --------------- 89 -------------- -------------- 89 ---- ----- --------------- 89.02 -------- --------------- LE. 88 --------------- 88 ------------- 88 87 -------------- 87 --------------- 87 --------------- 86 ------------ 86 --------------- 86 85 --------------- 85 --------------- 85 -------------- 84 --------------- 84 --------------- 84 83 ------------- -------------- 83 --------------- --------------- 83 ------------ 82 -------------- 82 --------------- 82 --------------- 81 ------------- 81 --------------- 81 80 --------------- 80 --------------- 80 --------------- 79 ------------- 79 -------------- 79 -------------- �a / RE CE 1 `/ ED ------ --------------- MAY •072026 Bayfield Co. Planning ar Zoning Agency Owner Information: Name: PSG Pike LLC Location: S26 T47N ROBW Township: Iron River County: flayfletxl Address: 9265 Wheeler Rnid 9 S R fl G 0 o in 4 V= 40Only in Tested Area +IM LA Writ a BM=100: Ton of concrete pad on the SE corner ofgaraee ip FN:9265 1 T o iii B1= 9912 B2= 100,2$ B3= aB.B Lake= 0 • P-_0EIVED PAGE 1 OF 4 .;rU / 2026 In -Ground Gravity Plan Bayfield Co. Index & Cover Sheet Planning and Zoning Agency Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) 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: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description PSG Pike Garaae Owner Name(s): PSG Pike Garage Phone: 218 -591 -3651 Owner Address: 2730 Northridge Dr. Duluth, MN Zip: 55811 Project Address: 9265 Wheeler Rd. Iron River, WI Govt. Lot: 6 NW 1/4 of NW 1/4, Section 28 _,T47 N -R 08 E ❑ or W ❑✓ Township: Iron River County: Bayfield Project Parcel ID #: 36848 Designer Information Designer Name: Jason Kuettel Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 Remarks: Phone: 715 -798 -3355 Zip: 54821 I his space reserved for approval stamp. Signature: Date: s4 /r Original ' n ure required on each submitted copy. Qwner_InMMrmatlnn; Noma: plQ ikei.L& Location: $28 T42t R08W Township: RonMbte1 County: Bay Address: 9265WheelerRoatl BM -100: L2n rsonsrtnatl ontEt;nfner of ¢araee E FN: 9265 / L 81 a aa12 � 3 1.J B2= 1O0.2.3 m y Ra 83 - $$§ m �SSi Lake= --G C n 0 �• M o ►'R wtGCM 7tc w% 0&eNc. PiLTi— Q, 2S' ez- f c_.ow 1"= 40' Onlyin TestedArea „e \ N u,•E�P �s� S IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3 -ft Trench (down -sizing credit) Septic Tank(s) Manufacturer. Wieser Septic Tank(s) Volume(s): 320 gal gal gal gal Effluent Filter Manufacturer. Geoteztile I min. 12" Effluent Filter Model #: FT -0822 ? —z Cover I (typical) SOIL COVER �— () TYPICAL TRENCH o rra min. trench '; CROSS SECTION VIEW. �, N (typical) L_ — — rn depth (No Scale) OBSERVATION PIPE DETA� rn a /T� 'p'•• (No Scale) System Elevation = X5.5 ft. St P y,pe) -.;. Finshad Grade (typical) Provide minimum 3 ft (metched & seeded) separation between trenches. 4"O PVC Pipe '.` jam• Topsoil Cover Top of pipe to teeminate <'•� (min. 1 fool) at or above finished grade . TYPICAL TRENCH (Show location of inlet / outlet pipe connection on plan view.) PLAN VIEW 4e 0 Observation pipe shall be installed (No Scale) Perforated Lateral (typical) --------- -----0f------- B= 20 ft (typical) INSTALL PER TRENCH: 2 10 -ft bundles @ 50 ft= EISA/unit = 100 ft2 + 1 5 -ft bundles @ 25 ftz EISA/unit = 25 ft' (4)1/4"-1/3" X 6 Slots apart Anchoring Device A=3.0 ft (typical) I Bundle (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. = Proposed EISA per trench = 125 ft2 Required Infiltration Area = 214 ft2 x 2 trenches = Proposed Total EISA = 250 ft2 Infiltration Surface Distribution Method: branched manifold -D m W O m a RECEIVED MAYU/1026 7 20'6 PAGE 4 OF 4 ppJ�ayM a�ayqfie�ldCo. In -ground Gravity Management Plan 1Mt'6�2TANT ng Agency 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 = 150 gpd; BOD5 ≤ 220 mgL-'; TSS ≤ 150 mgL-'; FOG 5 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 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(sl 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 Local government unit: Bayfield Co. Zoning Phone: Local government unit address: 117 E 5th St. Washburn, WI Phone: 715-798-3355 715-373-6138 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. Private Sewage System Maintenance Agreement Owner(s) Name19cTtNm r PSvi')u� Gr-nt Owner(s) Mailm Address ,tU £i/ /1 Site Address SSB'( 11,26C v lkiP.,lpi cl 'T om Q: 1I I ax lus 36Fl alp Sygq] 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 Township t4 7 N. Range ______W Additional Legal Description: /R3V _ t Town of N(�d V Cz (Acreage) A mil.61? Gov't Lot Lot a Block________Subdivision ?Vol.tSubdivision Lot 01 CSM # 11" /� Page L. CSM Doc # z2 C}' g(-103 DOCUMENT NUMBER 2026R-612071 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 05/08/2026 AT 8:00 AM RECORDING FEE: $30.00 PAGES: 1 Area Return To: 11 Planning and ZoningRR'DZp�ftlltBhVED MAY 112026 P"nnn and �' 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 363.55, Wis. Admin. Code. Private Sewaoa System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWfS 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 -credo. and !n -around Pressure System L aterals (system types C, D and E): The laterals shall be flushed nut ?nd 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 Subscribed and sworn to before me on this date: ��hn I o Ct WIL r 2t� Notarized Owner(s)— gn (s Publlc ommission Expires: G Jar Drafted by: "7Cn.. «K Date: ° SAVANNA ROSE OLIVER + " Notary Public Minnesota wr3 My Commission EExpiresJan, 31, 2030 Proofed by: 2020 ],3MF1ELD 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: PSG PIKE LLC, 2730 NORTHRIDGE DR DULUTH, MN 55811 Description Certified Soil. Tests - Review & Filing Fee Submission Number: SR -00408 Transaction Number: SR -00408-4547A Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 15031 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 5/18/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. J3.-YFIELD 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: Submission Number: PSG PIKE LLC, SS -00739 2730 NORTHRIDGE DR DULUTH, MN 55811 Transaction Number: SS -00739-45479 Description Private Sewage System (Septic Tanks) Amount $400.00 Total: $400.00 Payment Amount: Reference: 15031 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 5/18/2026 $400.00 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-47S STATE SANITARY PERMIT OWNER: PSG PIKE LLC GOVT LOT: 6 LOT: 2 BLK: NW 1/4 NW 1/4 SEC: 28, T 47 N, R 8 W TOWNSHIP: Iron River SOIL TEST: 39-26 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: JASON KUETTEL EMILY MACGILLIVRAY DATE: 5/18/2026 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 675751 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 5/18/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION