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HomeMy WebLinkAbout26-0194CS- 00159 ZE ED BAYFIELD COUNTY Q(o tc:o4-do-2-51-17(,-27 yo, SANITARY PERMIT APPLICATIO 001. - 3ooup Zoning District Lakes Class PLICATION INFORMATION - L(�Plase Test PnntAf lnkamathn) Noo:l Perm No: c*G" 0 I q Pro arty OJwne%m, / n �Q Pr County: Bayfield Xf�/ d l/ry! Y C(C2 Address ofProperty (� �( Property Location: / _ r �J i J CLCI- �i/(e ( klzat lfxn lq rv+ V. 'Va, S T N, R E (or) W Property Owner's Mailing `�Address :f` 548 T sh' : Gov. Lot #: 429 iktS�I calrt&I soJ Ci , State^ ( Zp Code io I Phone Number 9' Lot # I Block # ICSM #: CSM Doc # Subdivision Name I cud !� ti 5 -2v�= S'I II. TYPE OF BUILDING: (Check One ❑ State Owned Tax ID#: {iW ❑ Public (Explain the use/purpose ) 7 7�4/ 2026 1 or 2 Family Dwelling - No. of Bedrooms ( MAY 18 4111. - TYPE-OFPERMiT:-'Checkonl one boxuniine-A; Check box orr line o, if applicable) fed UU A) gNew ❑ Replacement ❑ County Private Interceptor Bay-;,x„A;enc.' ❑ Reconnection ❑ RepairTransfer of Owner (List Previous Owner below) Revision( f�b❑ `�"" tut❑ NCSt2. I rliS i, 6L[nkC4 Cr..7t✓i. 5thks. l�)D B) ❑ A Sanitary Permit was previously issued. Previous Permit Number. Date Issued: IV. TYPE OF NON -PLUMBING SYSTEM: (Check One) * Replacements need previous permit number and date filled out above C) ❑ Pit Privy ❑ Vault Privy (Vault size: gallons or ______cubic yards) `-L vi 1 y"r/!- 5 CSC.vW ❑ Portable Privy ❑ Camping Transfer Unit Container Composting Tdllets ❑ Incinerating Toilet V. ABSORPTION SYSTEM INFORMATION: 1. Gallons 2. Absorp. Area I 3. Absorp. Area I 4. Loading Rate I 5. Perc. Rate I 6. System I 7. Final Grade Per Day Required (Sq.Ft.) Proposed (Sq. Ft.) (Gals. / Day / Sq.Ft.) (Min. Inch) Elev.(Feet) Elev. (Feet) VI. TANK INFORMATION: Capacity In Gallons Total Gallons # of Tanks Manufacturer's Name Prefab. Concrete Site Constructed Steel Fiber - glass Plastic Exper. App. New Existing Tanks Tanks Septic Tank or Holding Tank Lift Pump Tank/ Siphon Chamber VII. RESSPONSiBiLITY STATEMENT: I the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Owner's Name(s): (Print) If hg for-SectionC above Own s Sig atur (s): (No Stamfp'��) v Ce, r .e� f/ Plumber's Name: (Print) if app;y*ig for sactfon A Or B) above Plumbers Signature: (N Stamps) MP/MPRSWNo: Plumber's Address: (Street, City State, Zip Code) Home Phone: Business Phone: VIII. COUNTY! DEPARTMENT USE ONLY ❑ Disapproved I Sanitary Permit/Transfer Fee: Date Issued: Issuing Agent's Signature /pate: ©l Approved ❑ Owner Given Initial I C-'Cci Adverse Determination IX. CONDITIONS OF APPROVAL! REASONS FOR DISAPPROVAL: Gel u�JC (nc iz' i&S Plot Plan on reverse side Lot Line `L- CejVE6 MAY 18 2026 Planning and Z/on Co. Name of Frontage Road ( ) 0 1. Name the frontage road and use as a guideline, fill in the lot dimensions and indicate North (N) 2. Show the approximate location and size of the building. IMPORTANT DETAILED PLOT PLAN 3. Show the location of the well, septic tank and drain field. IS NECESSARY, FOLLOW STEPS 1-7 (a -o) COMPLETELY 4. Show the -location of any -lake, river, stream or pond if -applicable. -- -- - 5. Show the approximate location of other existing structures. 6. Show the approximate location of any wetlands or slopes over 20 percent. 7. Show dimensions in feet on the following: a. Building to all lot lines i. Privy to building b Building to centerline of road j. Privy to lake, river, stream or pond c. Building to lake, river, stream or pond k. Drain field to closest lot line d. Septic! holding tank to closest lot line I. Drain field to building e. Septic/holding tank to building m. Drain field to well f. Septic / holding tank to well n. Drain field to lake, river, stream or pond g. Septic / holding tank to lake, river, stream or pond o. Well to building h. Privy to closest lot line Submit To: Bayfield County Zoning Department, PO Box 58, Washburn, WI 54891 u/forms/sanitary/bayfieldcountysan itaryappl ication Revise: June 2018 Proofed by: RECEIVED MAY 18 2026 Bayfield Co. Planning and Zoning Agency i message Emily Macgllllvray<emily.macgillivray@bayfeldcounty.wi.gov> To: William Yudchitz <bill@revarch.com> Hi Bill. The feels $396.20. Checks should be payable to Bayfield County Zoning. Our address is. 117E5th street POBox 58 Washburn, WI 54891 For the County Sanitary Fri. May 1, 2026 at 9:31 AM are $150. 1 will not be able to approve the fr/Here's a link to approved composting toilets in the state of Wiscpnsin: in f. /Certified/wastewater/Listings asp?TradeName=&Standard=041 We don't need a plumber to sign County Sanitary applications for composting toilet, but the make and model of the composting toilet need to be listed. As part of that, you wig need A Privy agreement that is notarized and recorded. You can fill out the leg description on the form, however, a lot of property owners find it easier to get a copy of the deed from the Register of Deed, and then they write "see attached deed" in the box that says "Legal Description." You can obtain an electronic copy of the recorded deed via this link, hips://landsharkbbayfieldcountv.wi.gov/LandShark1#/login or through contacting the Bayfield County Register of Deed's office, III! /www.bavfieldcounty yj gov/148/Register-of-Deeds. There are notaries in the County Clerk's office and the Clerk of Courts In the Bayfield County Courthouse building. W are alsovy agreemen pays e o e Register o ee S. I also recommend people familiarize themselves with recording requirements. eeplf - a- ec% l�ludec� A1 ✓'k p r, ✓ rle ern wctinclac/ � Necor d �e - da& I cSc.cl PRIVY AGREEMENT IATTACHED TO THE SANITARY PERMIT APPLICATION; DOCUMENT NUMBER 2026R-612191 Property O%nerisI David Grace and Heather Grace Mailing Address. Pro Address 429 Pascal St S. SL Paul MN 55105 89365 Jack Pine Road Cornucopia WI Legal Descnption See Deed Attached Vol 1. NO PLUMBING will be installed In the habitable building. N,RW Return To. DANIEL J. HEFFNER REGISTER OF DEr LUS BAYFIELD COUNTY. WI RECORDED 05/18/2026 AT 8:00 AM RECORDING FEE: $30.00 PAGES: 3 ZONING 2. NO PLUMBING includes water closets, sinks, bathtubs or showers, laundry facilities, a any other fixture or receptacle receiving domestic waste. will be installed in the premises served by the pay unless a code compliant sod absorption system or holding tank exists. or a valid sanitary permit to install such a system has been issued 3. A privy vault! pit shal maintain minimum setbacks as specified in Table 1. Table I Well Building Additional County Setbacks RED►_ Stream/ OPEN PIT 50 FL 15 FL Ain. 75 FL MAY 1 SEALED VAULT 25 FL 15 fl Min. 75 Ft. 4. Privies for pubic baldings shat♦ comply with SPS 353.63. 2026 Co. Planning and Zoning Agency 5. Privies used for one- and two-family purposes shall be constructed in such a manner so as to exclude flies, rats and other vermin. Doors should be self -dosing and vault ventilators should terminate at least one foot above the roof. 6. Privies as per SPS 391.12 (1) states as follows: (a.) The storage clamber of a vault privy shall conform with the requirements of s SPS 384.25 relating to holdwig tanks and shall have a minimum storage capacity of 200 gallons or one cubic yard. (b.) The storage chamber of a pit privy shall be sited and located in sal recognized to provide treatment and dispersal in accordance with s. SPS 383.44 (4 Xb). 7 The privy shall be kept clean and sanitary [he contents of the per or vault snali be disposed in accordance with NR i i3. Wis Mm Code 8. This agreement shall be binding on the owner, their heirs and assignees This document shall be recorded by the Register of Deeds in a manner. which allows its existence to be determined by reference to the property where the privy is installed srintod Ownertsl Name(s) This instneM was signed before nn David Grace inM State of HeatherGrace / County of 5 - 's 1'siol of pr 20 2/, My commission expires ow Droned byl David Grace l '-+ust be {tied all by person wiMrdllhg loran) 2012 ANDREW MICHAEL STEENS0N Notary Public -Minnesota My Commission Expires Jan.31, 2030 WARRANTY DEED This deed, made between Chicago Trust Administration Services„ LLC FBO Brossard IRA a/k/a Chicago Trust Administration Services, LLC FBO Brossard IRA, 40 E. Chicago Avenue #148, ChIcagq, IL 60611, Grantor, and David H. Grace and Heather M. Grace, a married coup!®,, as joint tenants, Grantee, - Witl esseth, That -the said -Grantor, fora vaivahl onside n conveys to Grantee the following described real estate In Bayfleld County, State of Wisconsin: As Described in Attached Addendum/Exhibit A Parcel No. 04410-2-51-06-v-4 05-002-30000 By executing this dew, the undersigned certifies that he is the Administrator and Managing Member of Chicago Trust Administration Services, LLC, and is duly qualified and authorized to execute this deed on behalf of said LLC. This Is not homestead property. DOCUMENT NuMBER 2024R-605899 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 12/ 13/2024 AT $:00 AM RECORDING FEE: $30.00 TRANSFER FEE: $945.00 PAGES: 2 ELECTRONICALLY RECORDED Rewm to: David H. Grace and Heather M. Grace 429 Pascal Street South St Paul, MN 55105 file No. 252507 Together with all and singular the hereditaments and appurtenances thereunto belonging; And the said grantor warrants that the tide is good, indefeasible in fee simple and free and dear of encumbrances except exceptions, reservations, easements and restrictions of record, and will warrant and defend the same. Dated this 11th day of December, 2024. Chir gn Tnret Administration S.rvicee, LLC FBO Brossard IRA _i t---_----- ---- - --- - ___ By: Steven M. Misskowicr, Administrator and Managing Member RAO4EI KRING ttsea d State of Michigan ) n My CcmiIon s.sC Waim .St. Clair County ) 9 A �• ot,do n1 Personally came before me this 11tH day of December, 2024, the above named Steven M. MiNskowiez, to me known to be the person(s) who executed the foreoobw instrument and hereby acknowledge the same. This Ir>stnm r t dratted by: Mctsad S. erandnor Go wey Abstract & Tale QmWny Is N:tar:zed rerotc:y v:a aud:c./v:doc ccrr in:cet ion ;Rachel Kroening Notary Public, State of Michigan My Commission Expires: 02/04/2029 tictor:rwd v:a Dovorso. :no a State of N:cfl:qln approved vor►1or affective » /22/19. Ba'�leldCowly R�Ster or Deeds Document •2024R605899 Page 1 of 2 File Number; 252507 ADDENDUM/EXHIBIT A Lot One (1) of Certified Survey Map No. 001043 as recorded in Volume 6 of Certified Survey Maps on Page 374, as Document No. 450172, located in and being part of Government Lot Two (2), Section Twenty-seven (27), Township Fifty-one (51) North, Range Six (6) West, Town of Bell, Bayfield County, Wisconsin. sa,igela Coufly Register N Deeds Docurnert b2D24R-605893 Pape 2 N 2 N I O 4EWX4 N 88° 47 is° wK COY 0104 — 831.57' z 1 0 s•os ..F „ _ .. `S E>ETMDMHIIIC G LL m•.m✓16 w6w6¢v6Tx 16' rov°6av • vmacu c I Q 1 �I aFanixcrnixTD mwvra6DE _�. v'-"� .1�--.,/' _ _ tl A LAKE WDM a "GR�EATERTHaN 2s`"�'.w"as \ �Th-— wznap ,'+� CC Q I€ fl' us6n Dca FT TO WEMND" . 6 G m SUPERIOR 1 ���e 25QF< _..`' o I O �•ey ial �Ixc _ — CS _- —532' FROM LOT LINE TO CLOSEST OVERHAN v 1 # 222' E66 Fr j I • ,. � 6urcxeW EEa.Tww. w, � salm sml DF D6rvE E N I --_ — �' NpWEtEnRIC 800.48' .. f~61 �DrraMlmmm RIBBON ON TREE 63-0 I N NOTING PROPERTY LINE o'o I O (FROM NELSON SURVEYING INC) g I v Wm Cn RLCEIVEUa fl /1� U APR 292026 [ n Bayfield Go. Li \Ll SITE PLAN Planning and Zoning Agency 1 SITE PLAN SCALE: 1" = 80'-0" A100 VJI°mromlAuoM: ZONING 1NFDRMATIGX: 210505 �emAl"µ-q omen: DAVID a IIFATNG CA.6LE vmfIXtt Rm55J sSI YM 0REVNN.2V I93OGIUeOMMxE Mat Iar mMWumvµ w9 smv 005 OP0D. TOMOF°wN•15' RD -82 Dwlasst°sllaslmmo wtluro.a(3'sEm<a wm®nx 6160M61£6nFA ) TAX I TA`{m: J)A 0FEDEDKflB: V0DMTm A: 4D266 BUILDING IN/DMMATIDNI D[5°IIVIIIXI: MNDLWw460 SQ PT. i. NNEW EW DWK IOD01 1969°Fr. W21°F M01W3 IN WL 61 TS 3746660371 NEW DEIX: 6921Q FT LIFTS III EIWMNIT LOT 20F$TCN 27. T. 6w SIN.. L NW. OP GrF0D .IN ThTOh 1[if6L°n1DLVO NEYDIT eaxrc,w 00564MI LOWST aABE m 6CC£ PWL 16'? BAYFIELD COUNTY ,LCEIVED CHECKLIST FOR SANITARY APPLICATONS MAY 18 2026 Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) Bayfeld Co. ❑ Check List Planning and Zoning Agency Original Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.) kJ I% ❑ Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) O I) ❑ Original Plot Plan (383.22(2)2. 3. & 4.a) Ni ❑ Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer ❑ Pump Tank Diagram, Alarm and Pump Curve (when applicable) el' ❑ Contingency Plan / Management Plan (383.22-3(2)(b)1.f.) j ii ❑ Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) I;; ❑ 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 Bayfield County Zoning) (383.21(2)(c)7) ❑ 2 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.) ❑ State Plan Review (when applicable) ❑ Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) t4 -o(-- 2 -S7 -6(n.Z 1-y cc1 I Application Information must include: 0 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) 002 'Project Address or Road Name where driveway is/will come off of) (Owners Phone Number) 30000 ❑ II Type of Building ❑ III Type of Permit ❑ IV Type of POWTS System ❑ V Dispersal / Treatment Area Information ❑ VI Tank Information ❑ VII 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) ❑ Bench Mark (Location, Elevation and Description) ❑ Component Manual Version El Address Number and Road ❑ North Arrow ❑ Contour Lines ❑ Structures and Driveways ❑ Boring Locations ❑ Property Lines ❑ Well Locations ❑ Legal Descriptions ❑ Piping Material Information (conveyance line, building sewer line, material type and diameter) Turn Over ► Cross -Section and Over -Head Profile of the System: ❑ Surface and System Elevation ❑ Position of Observation and Vent Pipes ❑ Dimensions and Depths El Make, Model & Number of Chamber Units in each Cell Property Information RECEIVED MAY 18 2026 Bayfield Co. Planning and Zoning Agency El How many systems will there be on this parcel of land? O Has this property been split? (Property Statement shows Property History) Fees: ❑ 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) u/forms/checldisis/checklistforsanitaryapps (10/2009);(p7/2011);(®2/2012)(®5/2/2012 -dc) Proofed by: B^YFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-4010 Property Owner: Submission Number: CS -00159 Transaction Number. CS-00159-45F2C Description Amount County Sanitary Permit:1 $150.00 Total: $150.00 Payment Amount: $150.00 Reference: 5166 Paid by: David H or Heather M Grace Payment Type: Check Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. Town, City, Village, State or Federal Permits May Also Be Required LAND USE - SANITARY - Composting Toilet SIGN - SPECIAL - CONDITIONAL - BOA - No. 26-0194 Tax ID: 7754 Issued To: GRACE, DAVID H & HEATHER M Location: S27 - T51 N - R06W Town of BELL BAYFIELD COUNTY WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Legal Description: LOT 1 OF CSM#1043 V6 P376 BEING A PAR OF CSM V5 P240 BEING A PAR IN GOVT LOT 2 IN DOC 2024R- 605899 Residential Structure in R-1 Zoning District For: Sanitation Permit — New [Composting Toilet] (Disclaimer): Any future expansions or development would require additional permitting. Condition(s): Maintain as required. Get UDC inspections as required. You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the department of natural resources wetlands identification web page or contact a department of natural resources service center (715) 685-2900. NOTE: This permit expires two years from date of issuance if the authorized construction Emily Macgillivray, AZA work or land use has not begun. Authorized Issuing Official Changes in plans or specifications shall not be made without obtaining approval. This permit may be void or revoked if any of the application information is found to have been misrepresented, erroneous, or incomplete. May 20, 2026 This permit may be void or revoked if any performance conditions are not Date completed or if any prohibitory conditions are violated.