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Home My WebLink About26-48Sow""f"tr. Industry Services Division County 4822 Madison Yards Way Madison, WI 53705 Bayfield Sanitary Permit Number (to be filled in by Co.) P.O. Box 7302 Madison, WI 53707 a G S - Sanitary Permit Application State Transaction Number 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 Project Address (if different than mailing address) the Department of Safetyand Professional Services. Personal information you prov� ViNDundary purposes in accordance with the Privacy Law, s. 15.04(l)(m), Slats. C TBD - Old kennedy Rd. Bayfield, WI 1. Application Information — Please Print All Informatio Property Owner's Name S I� t� 6 O Parcel # Dwayne Truhlsen & Sarah Gasper N. Bayfield 39672 ,J7 co. Property Owner's Mailing Address Planning and Zoning Agency Property Location 1350 Prairie Ln Govt. Let City, State Zip Code Phone Number St Croix Falls, WI 54024 715-338-6480 ¼ Yt, Section 27 T5° N R 04 E orW 11. Type of Building (check all that apply) Lot # ❑✓ I or 2 Family Dwelling— Number of Bedrooms Camper Subdivision Name ❑Public/Commercial— Describe Use Block # Cityof State Owned— Describe Use flVillageof CSM Number _417 V )N q q�. ❑✓ Town of Bayfield 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 applicable.) `t, ❑✓New System ❑Replacement System Other Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B. Holding Tank flln-Ground ❑4t -Grade IDMound jlndividual Site Design OtherType (explain) C. ❑ Renewal Before ❑Revision Change of Plumber Transfer to New Owner List Previous Permit Number and Date Issued Expiration NA IV. Dispersal/I'reatnient Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (sl) i Dispersal Area Proposed (sf) System Elevation 300 NA NA NA NA Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units v o v New Tanks Existing Tanks w H s _ u a r' a U H y in iZ V _ Septic or Holding Tank 3000 3000 1 Superior Precast ✓ Dosing Chamber Do 0 V. Responsibility Statement- 1, the undersigned, assume responsibility for Installationof the POWTS shown on the attached plans. Plumber's Name (Print) I Plumber's Signature I MP/MPRS Number I Business Phone Number Jason Kuettel 675751 715-798-3355 Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 VI. my/Department Use Only Approved 0 Disapproved Permit Fee Date Issued u Issuing Agent Signatur /�t'(�— �iV� I❑OwnerGivenReasonforDenial — Qa6 Conditions of Approval/Reasons for Disapproval Set oa*se,ct. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/i x Ii inches in size SBD-6398 (R. 02/22) �Sl Wisconsin Department of Safetyand Professional SeMses Attach complete site plan on paper not less than 8Y X 11 Soil Evaluation Report S 2 0 0 1 1 3 in accordance with SPS 385. f ls.Adm Code inches in size. Page: 1 of 5 Plan must include but not limited to: Vertical 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. 39672 Reviewed By: (1 Date: Ito r Property Owner: Dwayne K Truhisen Pro rty Loca on S27,T50,RQ4W Property Owners Mailing Address: 1305 Prarie Ln Site Address or CSM and Lot # 0 City St Croix Falls State I Zip Code I I 54024 Phone Number: 0 Town Bavfield iNearest Road: Old Kennedy Road Number of Bedrooms: 3 New I✓ Residential Code derived design flow rate: 0 Flood Plain if applicable RE"CiSIVE j'- Replacement r Public or Commercial - Describe: Slia a AY 12 20 I Parent Material: Outwash Flood Plain if Applicable: 0 ..M'6 Bayfield Co. fanning and Zoning / . General Comments & Recommendations: System Elevation: 0 Load Rate: 0 Elevation Range, 0 To 0 Ground surface Elev: Depth to Limiting Factor: Boring #1 r Bor.r Pit 99.55 Ft. 4 in. Elev. 99.22 ft Soil Application Rate: Horizon Depth in. Domm.Color Munseli Redox Description Qu. Sz. Cont. Color Texture Structure Gr.Sz.Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 Eff#2 1 0-4 7.5YR2.5/3 N/A SL 2MSBK MFR CS 3CO 0_6 1.0 2 4-30 7.5YR4/4 C2P7.5YR5/2 SCL 3CSBK MFI CS N/A N.P. N.P. 3 30-36 7.5YR4/6 C2P7.5YR5/8 SCL 3CSBK MVFI N/A N/A N.P. N.P. 4 5 6 7 Bor Ground surface Elev: Depth to Limiting Factor: Boring # 2 At 99 Ft. 4 in. Elev. 98.67 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 0-4 7.5YR2.5/3 N/A SL 2MSBK MFR CS 3CO 1.0 2 4-24 7.5YR4/4 C2P7.5YR5/2 SCL 3CSBK MFI CS N/A N.P. N.P. 3 24-28 7.5YR4/6 C2P7.5YR5/8 SCL 3CSBK MVFI N/A N/A N.P. N.P. 4 5 6 7 *Effluent #1 BOD 5>30< 2 20 mg/1 an 0 < 150 *Effluent #2 = BOD 5< 30 mg/! and TSS < 30 mg/l CST Name (Please Print) Mark S. Thompson na CST Number: Address: 12006 N US Hwy 63 Hayward, WI 54843 Dat lua i Co ucted: esday, February 17, 2026 Telephone Number 715/699-4081 I SBD-8330 (R04/21) iency Property Owner: Dwayne K Truhlsen Parcel I.D. 39672 Page: 2 of 5 Boring # 3 Ground surface Elev: Depth to Limiting Factor: r• Bore 98.96 Ft. 4 in. Elev. 98.62 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 0-4 7.5YR2.5/3 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 4-20 7.5YR4/4 C2P7.5YR5/2 SCL 3CSBK MFI CS N/A N.P. N.P. 3 20-26 7.5YR4/6 C2P7.5YR5/8 SCL 3CSBK MVFI N/A N/A N.P. N.P. 4 5 6 7 Boring # 4 Ground surface Elev: Depth to Limiting Factor: r Borr Pitt 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/ftz *Eff#1 Eff#2 1 2 R EIV D 3 „ 4 MA 5 yfield C 6 7 Boring # 5 r' Bor d Pit Ground surface Elev: Depth to Limiting Factor: 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/ftz *Eff#1 Eff#2 1 2 3 4 5 6 7 Boring # 6 r" BorW Pit Ground surface Elev: Depth to Limiting Factor: 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/ftz *Eff#1 Eff#2 1 2 3 4 5 6 7 *Effluent #1 = BOD 5>30< 2 20 mg// and TSS>30 < 150mg// *Effluent #2 = BOD 5< 30 mg i and TSS < 30 mg4 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 608-264-8777 SBD-8330(R.07I00) Owner Information: Name: Dwayne KTruhlsen Location: S27.T50.R04W Township: Bayfield County: Bayfield Address: .0 RECEIVE MAY 12 2026 Bayleld Co. Planning and Zoning Agency BM=100: Nail with ribbon on the base of tree near Bi 4P B2' B3 No Well Driveway B1 BM Old Kennedy Road C 1"=40' Onlyin TestedArea B1= 99.55 B2= 99 B3 = 98.95 Lake= Q PAGE 1 OF 4 Holding Tank Plan Index & Cover Sheet Component Manual Design References: Holding Tank Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Holding Tank Specifications Pg 4 of 4 Management Plan CLEWED MAY 122026 Bayfield Co. Planning and Zoning Agent' Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map (if ap Holding Tank Pumping Contract (if appl Holding Tank Agreement (if applicable) Project Name / Description Truhlsen/Gasper Holding Tank Owner Name(s): Dwayne Truhlsen & Sarah Gasper Owner Address: 1305 Prairie Ln. St Croix Falls, WI Project Address: 60525 Highway 63. Mason, WI Govt. Lot: 1/4 of Township: Bayfield Project Parcel ID #: 39672 Phone:715 _338 Zip: 54024 1/4, Section 27 , T 50 N -R 04 E County: Bayfield Designer Information plicable) cable) 48 or W Designer Name: Jason Kuettel Phone: 715 -798 -3355 Designer Address: 42940 US Hwy 63 S. Cable, WI Zip: 54821 E-mail: tim@andryras.com This space reserved for approval stamp. License Number: 675751 Remarks: Signature: Date: Original signature required on each submitted copy. OwnerJntorrnatlon: Name: DwayneliIculttsen Location: 527-TBQ.H04W Township: 8adleld County: 8ayiletd Address: 0 cA.-oe� l t.ef CA�npc d--� 1"=40Onlyin Tested Area n LA BM -100: NaILWltntltr6ot-on.toehaseyLiregnear_Bl 7p B7- DD.55 82- gg 83 Lake= 0 RECEIVED MAY 12 2026 Bayfield Co. Planning and Zoning Agency ,SA-' Rz Necczs,9..'-'l B2 SjP&t-tus— Fxtzc x-t- -couo M-LImnt G 'ipfu-IL B3 No Wet[ Driveway BM %r Old Kennedy Road _� 1.. n1p 4-isls 5/1t /t:4 PAGE 3 OF 4 HOLDING TANK SPECIFICATIONS `' LiCEwED (No Scale) MAY 12Z026 Bayfield Co. Planning and Zoning Agency Weatherproof 12" Min. or 2.0 ft above Junction and Approved Established Flood Elevation Alarm Box Vent Cap (typical) Electrical mustcanply with Approved Locking Manhole SPS 316 and NEC 300 4"0 Vent Pipe with Warning Label Attached Conduit >10 ft from (typi l) 4" Min. or 2.0 ft above Building Established Flood Elevation (typical) , Airtight Seal Finished Grade 16" Min. •' •. c qd4 Inlet Invert Approved Join Watertight Plug Approved Pipe Max. 12" or 90% of total volume Solid Grou If more than one tank HOLDING TANK VOLUME = 3100 gal 3" Approved Bedding Material Beneath Tank TANK MANUFACTURER: Superior Precast Anchor tank as necessary pursuant to SPS 383.43(8)(g) Ballast Weight = [(cu.ft.tank.vol x 62.4 lbs/cu.ft) - lbs.tank.wt] x 1.5 Ballast Weight = [( cu.ft. x 62.4 lbs/cu.ft) - Ibs] x 1.5 = Ibs I.f SUPERIOR I LP30001-Compartment Tank SUPPRECASICONCRETE ERIOR TOP VIEW Weight (in lbs) Taut: 1F,127 Lid: 9,77 Total: 24,902 Volume of Concrete Total: 6.2 Td' Gallons Per Inch: 70.F }taut Lid Enlarged Detail Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF OFFIINIDUSTR�Y SERVICES SEE CORRESPONDENCE \Danhole Openings 'I 184" 178" MAY 122026 Bayfield Co. Planning and Zoning 3029 Gallon - SIDE VIER' 2S" 24" { II 4 ( 9" Ai s ace xlre - Liquid 50" 1 ;1 Depth 2_1''2„ Tam Polyethylene Baffle Mastic Rope 96" 102" 4" &uric Produced by Superior Precast Concrete, LLC PO Box 1390 Hayward, WI 54843 S 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 engineerfor suitability of use. Configuration may change from drawing, consult with SPC. IPmdupt RN No: I n6 IsprepdelarylnlomatIan, and iemalnaNe pmpedyolSupedorPrecaatoorcrete, LLC. I 0.305-19-20241 PAGE 4 OF 4 Holding Tank Management Plan IMPORTANT: The owner of this holding tank(s) 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 holding tank(s) 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. Estimated Daily Wastewater Flow = 300 gpd 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 neglect or improper use (Le., exceeding design capacities, prohibited activities, etc.) o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o surface discharge of effluent or sewage back-up into structure served SERVICING FREQUENCY RECEIVED MAY 12 2026 Bayfield Co. Planning and Zoning Agency o The tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wisc. Stats. when the wastewater in the tank(s) reaches a level of one foot below the inlet invert of the tank(s). Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. Tank pumping reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wis. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Andry Rasmussen & Sons Phone: 715-798-3355 Local government unit: Bayfield 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 component of this holding tank(s) cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agecy for review and approval. System Abandonment If use of this tank(s) is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. %ntract Data HOLDING TANK SERVICING CONTRACT This contract is made between the RECEIVED MAY 12 2026 Bayfield Co. Planning and Zoning Agency Pumper's Name (Print) Pumprr''Sig ature Pumpers' Registration # 'IH We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT Legal Dascrlollon: t 1/4, 1/4, tOCAT10N (Use Tar Statement) 3`1fp / �^�/ Townuf: Lotslae j Acreage Section V' I ,Township N, Range _______ W (o\tfiGIc SS Govttot lot# g�+# Vol. Page CSM Doc #J torts) No. Block(s) No. Subdivision: J,411 1j NfC z-z5)L W o'eez3 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; CHRISTINA A. SIREK b. The name of the owner of the holding tank; NOTARY PUBLIC c. The location of the property on which the holding tank is installed; d. The sanitary permit number Issued for the holding tank; _STATE OF WISCONSIN e. The dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; 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. Ot ci ynr K TnA fst t , otsuscnoeo and Sworn to me: on this day of P ! JGf by: CSI No ary Public My commission expires on: ded: May 2018 (€May 2018) onaf )nformallon you provide may be used for secondary purposes (Privacy Law, 3.15.04 (Igmp Drafted by HOLDING TANK DWAyns Tib..h/Ie-s /30r f'Z'nc (A S 4ascStcrb/ < Aj/s W X101 Parcel Identifier Number (PIN) 7z Agreement Date (same as Notary Date) pc4-af Ib'fq k3`te72- 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. Coda or Ch. 145, Wis Scats. [[[[ 114 of} 1/4 Section 27 Township 50 N. Range 7 W. y Town of*v4 /o/ Return To: Additional Legal Description: Gov't Lot — Lot_Block_Subdivissiio/n CSM#JWLI/ Lot±,CSM # Z I? Vol 1± Page /ECSM Doc# Zc ZS /2- (g o 813 Z? DOCUMENT NUMBER 2026R-61 2126 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 05/12/2026 AT 12:06 PM RECORDING FEE: $30.00 PAGto ES: , REcEN. MAY 13,z - ^B?Yfield CO. .0M%M6 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, Scats., 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, Scats. 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 holding tank. 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. 3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Scats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NR113, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. 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 county within 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. Slats., 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 to 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 owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will the existence of the agreement to be determined by reference to the property where the holding tank is installed. •.•°•�PRRE %. Owner(s) Name(s)— Please Print b wo'LyLAp- thth1Stn Subscribed and swom to before me on this date: �` ' •' S1/`r'\ r Notarized s - nature(s}—.. Notary Public y PV My Commission Expires ^ �/ y NIIIIIg11111 LVV/ Drafted by: 17o Ct-A !— Dater//6/t Personal information you provide maybe used tar secondary purposes IPrtvacy Law, 6.15.04 exm8 Wfomwfaanitarymodinglankagreemant.doc ®June 2018 FIELD 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: TRUHLSEN, DWAYNE K 1305 PRAIRIE LN ST CROIX FALLS, WI 54024 GASPER, SARAH L 1305 PRAIRIE LN ST CROIX FALLS, WI 54024 Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00413 Transaction Number: SR -00413-45E26 Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 15039 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 5/19/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. P YFIELD 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: TRUHLSEN, DWAYNE K 1305 PRAIRIE LN ST CROIX FALLS, WI 54024 GASPER, SARAH L 1305 PRAIRIE LN ST CROIX FALLS, WI 54024 Description Private Sewage System (Holding Tanks) Submission Number: SS -00748 Transaction Number: SS -00748-45E44 Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 15039 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 5/19/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-48S STATE SANITARY PERMIT OWNER: DWAYNE KTRUHLSEN GOVT LOT: LOT: 4 BLK: CSM: 2417 V14 P46 1/4 1/4 SEC: 27, T 50 N, R 4 TOWNSHIP: Bayfield SOIL TEST: 41-26 NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: JASON KUETTEL EMILY MACGILLIVRAY Authorized Issuing Officer DATE: 5/19/2026 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. Must be within 25 ft of an all- weather road. THIS PERMIT EXPIRES 5/19/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION