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HomeMy WebLinkAbout26-52SRequest for Sanitary Inspection (24 Hrs. in Advance) Fax or email this form to Zoning Dept (24 Hrs.) prior to when you want an inspection Fax (715) 373-0114 or Email zoning(cDbayfieldcountv.wi.gov Note fl Time Change fl Discrepancy fl Other Phone Number Plumber: � � 1 es 71 s- a� - isa1 Fax Number Homeowner: eC`.y j' Email Address Immediate Ph ne Nurthber So Zing Sanitary _ s. S Dept can call you right back (if needed) Permit #: -71S po1_ -7Sa1 Plumber's Choice Zoning Dept No Inspection(s) during this time Date: Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zoning Dept Time: 8'• 004 n,, �a W Township: ( 1 �SY�fJu Cn Address # & Road Name: 11SOS W . J°`n \c p\e \\ or �spvPn) `VII a iR \ j1t0 Directions To Site: RECEIVED Comments: AUG 07 2026 Bayfield Co. Planning and Zoning Agency ** Plumbers you must verify any change(s) by fax or email `* Notes from Zoning Dept: July 2025 Pump! Siphon Information Elevation Data Pump Manufacturer , Pump Model Demand GPM filter Manufac er Filter Model ,.-c_ i TDH Lift Friction Loss Head Total Forcemain Length Dia Dist. To Well /OCR Pretreatment Unit Manufacturer: Model Number. STATION BS HI FS ELEV Benchmark Bldg. Sewer ?' p Tank Inlet , l 1) Tank Outlet Z 2, D Dose Tank Inlet Dose Tank Bottom iII. RPJJ Inst. Contour Header/Manifold x11( 't8•_i� Distribution Pipe Infiltrative Surface S, � 0 76 Final Grade /t, J stribution System X Pressure Systems Only Header/ Manifold Distribution Pipe(s) X Hole Size X Hole J Observation Pipes Length Die Length Die Spec Spacing ' t es 0 No 'oil Cover �-r Depth Over Depth Over Depth of Seeded / Sodded Mulched ,._n n_.a,. cos r a oTnnsnil ❑ Yes ❑ No ❑ Yes ❑ No JOMMENTS: (Include code discrepancies,AAersons present etc.) P^i g#1//7 ?/ ptd -oi/2t'A32i3 [pc) i- GA,.: 014 T ktliQ an revision required? ❑ Yenta[ No Q Q `� :eother side hradditional informaddddon, v l Date PCcS Inspector's Signature (00 License Number ;Rn-Ri71n /R nq/v1) Property Owner Information BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zonino(aabavfieldcountv.ora 117 East Fifth Street Web Site: www.bavfieldcounty.orol147 Washburn, WI 54891 TERRY A BUTLER 215N ISTAVEE,UNIT122 DULUTH MN 55802 As you know I ") LAY1Z_-_ f t' (' 5 was contracted by you to install a private onsite wastewater treatmerd system on your property (Tax ID# above). To know when your system will be due for servicing please go to www.septicsearch.com Notes: Abandonment of Old System to meet all applicable code requirements: Tank was pumped by: C. Tank was crushed! removed and pipes disconnected by: on p / a On D Zct LI ( M PM) the above -mentioned plumber contacted our office to conduct a r-coveiIinspection as require under DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. fl System System was inspected and appears to meet all applicable code requirements; however, a plan revision is necessary because the installation was substantially different than the original approval. ❑ System could not be inspected because plumber covered prior to scheduled time of inspection. ❑ System could not be inspected because plumber was not ready at scheduled time of inspection. County was unable to return to complete inspection. ❑ System could not be inspected because plumber was not ready at scheduled time of inspection. A re -inspection and $50 fee are required. System could not be inspected because County could not respond to plumber's time constraints. Comments: ❑/forms/sanilarypraperlyowner-input April2019 >y P ty De Department of Safe & County Bayfleld County i * p t • Professional Services, Sanitary Permit Number (to be filled in by Co.) Industry Services Division Sanitary Permit Application State Transaction Number PWTS-052600862-C In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different 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 77505 W Maple Rd purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. I. Application Information —Please Print All Information Property Owner's Name BUTLER, TERRY A Parcel # 31101 MAY 222026 Property Owner's Mailing Address � Property Location 215 N 1 ST AVE E Bav a�.d Co. Ptanrin .. ,::_ Agency Govt. Lot_ City, State Zip Code Phone Number DULUTH,MN 55802 7152096414 NW V4, SE ¼, Section 29 149N N R 5E or W IL Type of Building Lot # 1 or 2 Family Dwelling Subdivision Name If 1 or 2 Family Dwelling — Number of Bedrooms 3 Block # Municipality If Public/Commercial — Describe Use If State Owned — Describe Use _ Washburn CSM Number III. Type of POWTS Permit. (Check either "New".or "Replacement" and other applicable on line A. Check one boa on line B. Coinplete line C - if A. New or Replacement System: Other Modification to existing System (explain) Additional Pretreatment Unit (explain) New System B. System Type: Other Type (explain) Mound C. Application Type: List Previous Permit Number Previous Permit Date Issued undefined undefined :IV. Dispersal/TreattnentArea and Tanklnformations. Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 450 0.7 642.86 643 96.50 Capacity in Gallons Total # of Tank Information Gallons Units Manufacturer Material Source New Tanks Existing Tanks Septic or Holding Tank 1200 0 1200 1 Wieser Prefab Concrete Septic or Holding Tank 0 0 Dosing Chamber 800 0 800 1 Wieser Prefab Concrete V. Responsibility Statement= I, the undersigned, assume responsibilityfor installation of the POWTS shown on the attached plans Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Mike Wroblewski 1288503 (715) 373-0566 Plumber's Address (Street, City, State, Zip Code) 1491 County Hwy C, Washburn, WI 54891 VI. Coon "/De artnientUse.On1 Permit Fee Date Issued ] Issuing Age ign 5Db-- 5 l X37/3 Conditions of Approval/Reasons for Disapproval 'ei Wt±achd, Attach to complete plans for the system and submit to the County only on paper not less than 81/21 11 inches in size SBD-6398 (R. 03/22) .r T SBD=6398,, Sanitary Permit Application 5/5/2026 6:24:11 AM Introduction Wisconsin Department of Safety and Professional Services In accordance with Wis. Admin. Code sec. SPS 383.21 (2), submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Upon completion, you will be emailed a copy of the completed form for submittal. Include a complete plan on paper not less than 81 /2 x 11 inches. Check with your local POWTS authority about additional requirements and fees. Note that applications for state-owned POWTS are submitted to the Department via esla.wi.gov. (Rev. 02/26/2026) General Information Applicant Name: Michael Wroblewski Email: mike@biglakeplumbing.com RECEIVED Owner Name: Terry Butler Email: Phone Number: (715) 209-6414 Mailing Address Address Line 1: 215 N 1st Ave E Address Line 2: Unit 122 City: Duluth State: Minnesota Zip: 55802 Project and Site Parcel ID: 31101 MAY 222026 Bayfield Co. Planning and Zoning Agency State Transaction Number: PWTS- Project Address Address Line 1: XXXXX W Maple Hill Rd Address Line 2: City: Washburn State: Zip: 54891 CSM and Lot Number: Subdivision: Block and/or Lot: Legal Description: Government Lot X PLSS 1/4 of NW 1/4 of: SE Section: S29 Township: T49N Range (E or W): R05W Municipality Type: City X Town Village Municpality Name: Washburn County: Bayfield Building Type: X 1- or 2 -Family Dwelling Public/Commercial State -Owned Number of Bedrooms: 3 POWTS Permit REC VE i MAY 222026 Bayfieki Co. Planning and Zonir:c Agency Permit Type: X Nev System Replacement System Other Modification to Existing System Additional Pretreatment Unit POWTS Type: Holding Tank In -Ground (conventional) At -Grade X Mound Individual Site Design Other Is there a previously issued permit?: Yes X No Dispersal/Treatment Area and Tank Design Flow: 450 GPD Design Soil Application Rate: 0.7 GPD / SF Dispersal Area Required: 642.86 Dispersal Area Proposed: 643 Square Feet System Elevation System Elevation: 96.50 Feet Tank Information Type: X Septic Holding Dosing New or Existing: X New Existing MAY 222026 Bayiield Co. Planning and Zoning Agency Material: X Prefab Concrete Site Constructed Steel Fiberglass Plastic Manufacturer: Wieser Concrete Septic Tank Capacity: 1200 Gallons Type: Septic Holding X Dosing. New or Existing: X New Existing Material: X Prefab Concrete Site Constructed Steel Fiberglass Plastic Manufacturer: Wieser Concrete Dosing Tank Capacity: 800 Gallons Total Capacity of Septic Tanks: 1200 Gallons Total Capacity of Holding Tanks: 0 Gallons Total Capacity of Dosing Tanks: 800 Gallons Total Capacity of All Tanks: 2000 Gallons Total Number of Tanks: 2 Responsibility Statement Signature Plumber Name: Michael Wroblewski MAY 222026 Bayfield Co. Punning and 7o;.ir:g Aeny Plumber Email: mike@biglakeplumbing.com Phone Number: (715) 209-7521 ., Ir Plumber Credential Type: X Master Plumber Master Plumber Restricted Service Credential Number: 1288503 - PM Address Address Line 1:1491 County Highway C Address Line 2: City: Washburn. State: Wisconsin Zip: 54891 REC V E L MAY 2 2 2026 Bayfie!d Co. Planning ano Z,agency By inserting my typed signature below, I attest that the information provided is complete and accurate to the best of my knowledge and belief. I, as the licensed plumber, assume responsibility for installation of the POWTS shown on the submitted plans. Electronic Signature of Plumber: Michael Wroblewski Date: 5/5/2026 Wisconsin Department of Safety and Professional Services " ro�, Phone: 608-266-2112 Divi'ion of Industry Services ,1 Web: htta://dsns.wi.aov 4822 Madison Yards Way t 8 g Email: ds�s c wisconsin.aov Madison, WI 53705 7 p� Tony Evers, Governor Dan Hereth, Secretary May 15, 2026 CUST ID NO.: 1288503 MICHAEL J WROBLEWSKI 1491 COUNTY HIGHWAY C WASHBURN, WI 54891 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/15/2028 MUNICIPALITY: TOWN OF WASHBURN BAYFIELD COUNTY Identification Numbers Plan Review No.: PWTS-052600862-C Application No.: DIS-052618644 Site ID No.: SIT -159271 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL MAY t' �i1�� SERVICES L U DIVISION OF INDUSTRY SERVICES SITE: - Bayfiel;i Co. Planning and Zoning Agency BUTLER MOUND SYSTEM XXXXX W MAPLE HILL RD WASHBURN, WI 54891 SEE CORRESPONDENCE W1/2 NW SE TOG WITH EASE IN DOC 2023R-601434 S29 T49N R05W FOR: Design Wastewater Flow Value: 450 Eljen GSF Mound Component Manual - 1-9-2025 Edition Bedrooms: 3 Limiting Factor(s): 33 inches Maintenance Required: Effluent Filter SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and the "Eljen GSF Mound Component Manual for POWTS (Version 1-9-2025)". • The pressure network is to be constructed in accordance with publications "Pressure Distribution Component Manual for POWTS (Version 2.1); (May 2022-2027)" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81)". • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Prior to the construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a'/4 -inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state -approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (1 1)(c) Y T • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacturer's requirements. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per the approved plan. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the POWTS Dispersal Area must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. • With new construction, it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Provide surface water diversion around the treatment tanks and mound dispersal component. OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code & SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 /Z,, Refund Expected: $0.00 Timothy Zoromski Division of Industry Services Phone: MAY 22 2026 Email: timothy.zoromski@wisconsin.gov Bayfield Co. Planning and Zoning Agency GSF WI MOUND DESIGN PROGRAM INDEX AND TITLE PAGE Project Name: Terry Butler - Mound System Owner's Name: Terry Butler Owner's Address: 215 N 1st Ave E, Unit 122 Duluth, MN 55802 (715) 209-6414 Legal Description: W1 /2 NW SE tog with Ease in doc 2023R-601434 S29 T49N R05W Township: Town of Washburn County: Bayfield Subdivision Name: Lot Number Block Number Parcel I.D. Number 31101 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 GSF mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Plot Plan Page 10 Soil Test Page 11 Tank Cross Section Page 12 Mound System Maintenace Agreement Designer. Michael Wroblewski License Number. 1288503 Date: 5/5/26 Phone Number (715) 209-7521 Signature: Designed Pursuant to the 1-9-25 GSF Mound Component Manual (N-00116), and SSWMP Publication 9.6 Design Pressure Distribution Networks for STSAS (01 /81) GSF Mound Version 2.5 Pagel of 11 Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES MAY 2 2 2026 Bayfield Co. PNcy lanning and Zoning Ag SEE CORRESPONDENCE GSF WI MOUND DESIGN PROGRAM DATA ENTRY Project: Site Information R JResidential or Commercial Design 450 JDesign Flow (gpd) 2.0% Site Slope (%) 96.50 1lnstaltation Contour Line Elevation (ft) 33 Depth to Limiting Factor (in) 0.7 1 In -Situ Soil Application Rate (gpd/ft2) EFF #2 I jNumber of Bedrooms (optional) I- Contour Length Available (ft) Distribution Cell Information B43 lUnit Used Cell Width (ft) 3, 4, 5, 6, 8, 9 or 10 I 33 = Dispersal Cell Length (ft) 11111 8 2.0 Dispersal Cell Design Loading Rate (gpd/ft2) 2 Influent Wastewater Quality Are the laterals the highest point in the distribution L Y Pressure Distribution Information network? EnterY or N C Center, End, No Manifold (Pump to Gravity), or Gravity (No Pump) 4 Lateral Spacing If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) (e.g. 0.25) Orifice Spacing (ft) = F 13.20 j ft2/orifice 3 Estimated 1.5 Forcemain Diameter (in) Forcemain Length (ft) Does the forcemain drain back? E Y 40 90 Inside Pump Tank Elevation (ft) 3.25 I5ystem Head (ft) x 1.3 7.08 IVeica1 Lift (ft) 0.68 J Friction Loss (ft) 0.25 Add'i Fitting Friction Loss (ft) 11.26 Total Dynamic Head (ft) Lateral Diameter Selection in. diam. options choice 0.75 x 1.00 x 1.25 x 1.50 x x 2.00 x 3.00 x Se tic Tank Information 1200 Se tic Tank Capacity (gal) Weser Concrete J Manufacturer Dose Tank Information [_8QQj Dose Tank Capacity (gal) 22.22 IDose Tank Volume (gal/in) Wieser Concrete Manufacturer Terry Butler - Mound System RCEED MAY 2 2 ZUZ6 Bayfield Co. planning and Zoning AganCY 3.67 Forcemain Drainback (gal) 26.59 f5x Void Volume (gal) 30.26 IMinimum Dose Volume (gal) 13.1 tj System Demand (gpm) Manifold Diameter Selection in. dia. options choice 1.25 1.50 2.00 x 3.00 Gallons/Inch Calculator 800 Total Tank Capacity (gal) 36 ►Total Working Liquid Depth (in) 22.22222 gal/in Effluent Filter Information Polylok Filter Manufacturer 525 I Filter Model Number Page 2 of 11 MAY 22 2026 GSF WE MOUND DESIGN PROGRAM GSF MOUND DRAWINGS Bay field co. Aency Mound Plan View iviounu omponeni uimensions A 8.00 ft E B 33.00 1.48 ft L 48.98 ft D 12.00 ft G 10.50 ft J 15.90 ft W 25.38 ft 264.00 (ft2) Dispersal Cell Area 642.86 (ft2) Basal Area Available 13.64 (gpd/ft) Linear Loading Rate 3.30 (ft) 1/10 B Obs. Pipe Placement Finished Grade 99.08 (ft)# _ . f� I# 2� iat G IH 98.08 (ft) F � "`' 1 a eral Invert 97.50 (ft) �� *♦t "I' - ` Dispersal Cell :: #� ##;Is :i€°6 €11# Elevation Dispersal Cell Elevation T}>> } , } } } r ) :: •: •,.•.: :.>:• ;•:.: •:•. t>e' } T i iS S T >''S< CC.: <<<< S)aSai}`r L} {<) }`St'. } }{S<},}Lt <<<< 96.50 (ft) .<; <<> ' ' <'<"<><<<'<'<'<'` 4 } ' 'i'{'<'<' >< <}<< >) } ) ) -^ } > ) } r') > } Contour } t)i t { { < < 4 < < { < L i i ♦ T S ) } > ) i Elevation 2% Site Slope < Shading Key I Typical Dispersal Cell 1 # Topsoil Cap d .. See Page 5 2 ':', Subsoil Cap o c 2ft Geotextile 3 ASTM C33 Sand " ° Fabric —� 4 Tilled Layer .—t°o Z F 5 .,; GSF Media & N Cell Header 0 [jjj 0.5 ft /Footer SF A See details on page 4 for number, size and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: Terry Butler- Mound System Page 3 of 11 MAY 2220?6 Bay i Co. Float switch page was submitted in plan. SJE Vertical Master would be suitable for low dose Alarm Manufacturer Alarm Model Number Pump Manufacturer Pump Model Number Pump Must Delivery GSF WI MOUND DESIGN PROGRAM LATERAL AND DOSE TANK End Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below All laterals identical, with orifices Force main connection via tee or cross to manifold at any Orrifices point up except every 5th one points down for drainage. Laterals & force main of PVC Sch 40 X X/2 X/2 per SPS Table 384.30-5 WAC) • Turn -up w/ball valve or deanout plug Numbers of Laterals 4.00 Orifice Diameter Lateral Diameter 1.50 in Orifice Spacing (X) Lateral Length (P) 16.00 ft Orifices per Lateral Lateral End (Z) N/A ft Orifice Density Lateral Spacing(S) 4.00 ft Manifold Length Lateral Flow Rate 3.28 gpm Manifold Diameter System Flow Rate 13.11 gpm Forcemain Velocity 14.49 Pump Off Height Dose Tank Information in ft ft2/orifice ft in ft/sec in 0.19 3.22 5.00 13.20 4.00 2.00 2.38 12 Float Options Bectrical as per NEC aril SPS 316 V Locking cover with warning label and locking device. and sealed watertight Tank component is property vented Wieser Concrete Manufacturer Capacity 800 Gallons Volume 22.22 gal/inch Dimension Inches Gallons A 20.64 458.66 B 2.00 44.44 C 1.36 30.26 D 12.00 266.64 Total 36.00 800.00 Mn. 3" Bedding under tank. Sl Rhombus 5JE1067640 Goulds GOUPE51M 13.11 gpm at 11.26 ft 4in.min, tomato outlet location Forcemain diameter L5 in hole or ihon device Pump off elevation (ft) 91 Dose tank elevation (ft) 90 TDH Project: Terry Butler - Mound System Page 4 of 11 GSF WI MOUND DESIGN PROGRAM DISTRIBUTION MEDIA GSF Distribution Cell Media Layout • $ Cell Width (ft) I 2 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements Drag appropriate drawing to space below. 8 ft Wide Component Legend ASTM C33 Sand/Mound Sand A42 or B43 Module Lateral Turn -up (contained in Turn -up Enclosure) Distribution Cell Plan View Layout -Typical $ Cell Width -A (ft) I 33.00 ICe11 Length - B (ft) 8 B43 J Modules Required per Row 16 B43 jTotalModulesRequired Center Connection Lateral Layout Diagram Drag appropriate drawing from left to space below. RECEiVED MAY 222026 Bayfieid Co. P;annin) ar:;r ,-,ref Cy Page 5 of 11 Project: Terry Butler - Mound System GSF WI MOUND DESIGN PROGRAM SYSTEM MAINTENANCE SPECIFICATIONS Mound System Maintenance and Operation Specifications Service Provider's Name Big Lake Plumbing IPhone L (715) 209-7521 POWTS Regulator's Name L Bayfield CountyZoning l Phone L_(715)373-6138 System Flow and Load Parameters Design Flow- Peak 450 gpd Maximum Influent ParticleSize 1/8 in Estimated Flow -Average 300 gpd Maximum GODS 30 mg/L Septic Tank Capacity 1200 gal Maximum TSS 30 mg/L Soil Absorption Component sizel 264 ft2 Maximum FOGL 10 mg/L Maximum Fecal Coliform f 10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test monthly Laterals should beflushed and pressuretested every 1.5 years Insoect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to the standards, have a watertight cap, and are secured in a as shown in the Eljen mound component manual. 2. Dispersal cell media conformsto Eljen products approved for use with the Eljen Mound Component Manual approved August 2016. Eljen media is covered with the manufacturers geotextile fabric. 3. All gravity and pressure piping materials conform the requirements in the state code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail 6-8" DIAMETER LAWN SPRINKLER FINISHED GRADE - - - .` LATERAL ENDS AT LAST 4" PERFORATED PIPE ORIFICE WHERE VARIABLE \ 4" END - LENGTH CLEANOUT BEGINS CAP -�-- DISTRIBUTION LATERAL Project: Terry Butler - Mound System MAY 22 20?6 EayfieCo. P;� nrn; crd .:n ; A.gerCf LATERAL CLEANOUT THREADED CLEANOUT PLUG tl LONG SWEEP 90 OR TWO 45 DEGREE BENDS SAME DIAMETER AS LATERAL Page 6 of 11 GSF WI MOUND DESIGN PROGRAM MANAGEMENT AND CONTINGENCY PLAN Mound System Management Plan General This system shall be operated in accordance with SPS 382-348 Wis. Adm. Code, and shall maintaiinecacor; a� ce, r�;rvy with its' component manuals Eljen Mound Component manual August 2016 and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8 - inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped -with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum ,ar%A elrrrir+n rsna-rrmrrle4inn in }+a f•s I, The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by WI DSPS. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as required by nmrlur.t annmval. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the mound be heavily mulched as protection from frpR7inn_ The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent mnnitnrinn Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into orooer operatina condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Terry Butler - Mound System Page 7 of 11 WLP1 200/800 -MR 13'-8" MAY 22 2026 TANK SPECIFICATIONS Bayfield Co: DIMENSIONS: Planning and Zoning Agency WALL: 3" BOTTOM: 3" _______ _ — COVER: 6" • � II MANHOLE: 24" I.D. PRECAST CONCRETE RISER II 4 I II CAST -A -SEAL I II I iL II 4 HEIGHT: 53" CAST -A -SEAL " I II c� I I LENGTH: 13 —8 I �,Zlk ` I ; WIDTH: 8'-0" r • " t IJ — BELOW INLET: 41" iLIQUID LEVEL: 36" IT WEIGHT: BOTTOM 14,800 LBS. --�/ " COVER 8,170 LBS. I illi l I j FILTER OR I j� I I INLET AND OUTLET: BAFFLE I 1 I I I 4" CAST -A -SEAL BOOT OR EQUAL GASKET I. INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) TOP VIEW LIQUID CAPACITY: 33.46 GAL/IN (SEPTIC) 22.24 GAL/IN (PUMP) LOADING DESIGN: 8'-O" UNSATURATED SOIL TANK CAN BE USED AS: o w SEPTIC / HOLDING / PUMP OR SIPHON ¢ cy 4" VENT COVER: MIX DESIGN fi8 (NO FIBER) CI:: TANK: MIX DESIGN #9 (SMALL FIBER) CUSTOMIZED TANKS: - _:::::_-_._j------_. FOR CUSTOM TANKS CONTACT WIESER CONCRETE INLET - OUTLET Il� T� N I- I �¢ I I UO--� n¢ t al. U io I I M U I aZ i_I___ , � I II D ) REVIEWED BY PUMP PAD REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS 0 w w V) w HEET NO. 1 Z OF 1 TECHNICAL BROCHURE BPE R1 PE FEATURES Corrosion resistant construction Cast iron body Thermoplastic impeller and cover. Upper sleeve and lower heavy duty ball bearing construction. Motor is permanently lubricated for extended service life. Powered for continuous operation. All ratings are within the working limits of the motor. Quick disconnect power cord, 20standard length, heavy duty 16/3 SJTW with 115 or 230 volt grounding plug. Complete unit is heavy duty, portable and compact. Mechanical seal is carbon, ceramic, BUNA and stainless steel. Stainless steel fasteners SUBMERSIBLE EFFLUENT PUMP Gay`. -k Cs. Planning ana Zoning Agar. 3y GOULDS a xylem brand Wastewater APPLICATIONS MOTOR Specially designed for the following uses: • Mound Systems • Effluent/Dosing Systems • Low Pressure Pipe Systems • Basement Draining • Heavy Duty Sump/Dewatering SPECIFICATIONS Pump - General: • Discharge: 116" NPT • Temperature: 104°F (40°C) maximum, continuous when fully submerged. • Solids handling: %z" maximum sphere. • Automatic models include a float switch. • Manual models available. • Pumping range: see performance chart or curve. PE31 Pump: • Maximum capacity: 53 GPM • Maximum head: 25' TDH PE41 Pump: • Maximum capacity: 61 GPM • Maximum head: 29' TDH PE51 Pump: • Maximum capacity: 70 GPM • Maximum head: 37' TDH PUMP INFORMATION Minimum Cord Discharge Minimum Maximum Shipping Order HP Vohs Amps Circuit Phase Float Switch Style Length Connection Basin Solids Size Weight Ibs/kg No. Breaker Diameter PE31 M 0.33 115 12 20 1 Manual / No Switch 20 1.5" 18" .5" 31 / 14.1 PE31 P1 Piggyback Float Switch PE41 M 0.4 7.5 15 Manual / No Switch PE41 P1 Piggyback Float Switch PE42M 230 3.7 10 Manual / No Switch PE42PI Piggyback Float Switch PE51 M 0.5 115 9.5 20 Manual / No Switch PE51 P1 Piggyback Float Switch PE52M 230 4.7 10 Manual / No Switch PE52P1 Piggyback Float Switch General: • Single phase • 60 Hertz • 115 and 230 volts • Built-in thermal overload protection with automatic reset. • Class B insulation • Oil -filled design • High strength carbon steel shaft PE31 Motor: • .33 HP, 3000 RPM • 115 volts • Shaded pole design PE41 Motor: • .40 HP, 3400 RPM • 115 and 230 volts • PSC design PE51 Motor: • .50 HP, 3400 RPM • 115 and 230 volts • PSC design PI-in.,a, b alW Zuibu9'ydr ;y AGENCY LISTINGS Tested to UL 778 and CSA 22.2 108 Standards By Canadian Standards Association cus File#LR38549 Wastewater METER 10 01 S FEET PESI 35 \ 1 30 PE41 259' 0 PERFORMANCE RATINGS PE31 Total Head (feet of water) GPM 5 52 10 42 15 29 20 16 25 0 5 10 15 m3/h CAPACITY PE41 Total Head (feet of water) GPM 8 61 10 57 is 46 20 33 25 16 PE51 Total Head (feet of water) GPM 10 67 15 59 20 50 25 39 30 26 35 8 PIinaig ano cc nnc ;-•5^^%Y PAGE3 ,r Q DIMENSIONS (All dimensions are in inches. Do not use for construction purposes.) 64 /a I, j 1 _�.. `. _ _._•- `� 12.1 `:' _ .•� ,.� i _ . i 2.2 — 12.0 9.6 ,1W NPT DISCHARGE V E MAY 2 2 Z026 Bayfield Co. Planning ano Zoning Agency )Nlem Xylem Inc. Let's Solve Water 2881 East Bayard Street Ext., Suite A Seneca Falls, NY 13148 Phone: (866) 325-4210 Fax: (888) 322-5877 www.gouldswatertechnology.com Goulds is a registered trademark of Goulds Pumps, Inc. and is used under license. ® 2016 Xylem Inc. SPE R1 September 2016 Wide-angle pump switches directly control pumps up to 3 HP at 250 VAC. Each switch features an adjustable pumping range. Type Pump Max Pump PunPumpSwitch Activation Control Run Current Mechanically 1/2 HP, 120V 13A, 120V 8JE PumpMaster° WPS Activated 1 HP, 230V 134, 230V Mechanically 1/2 HP, 120V 13A, 120V SJE FumpMaster° Activated 1 HR 230V 13A, 230V Mechanically 3/4 HP, 120V 15A, 120V PumpMaster° Plus LE Activated 2 HP, 230V 15A, 230V SJE PumpMaster• SPDT Mechanically 1/2 HP, 120V 13A, 120V -=a -P.,, Double Throw) Activated 1 HP, 230V 13A, 230V Douhle Float° Master Mechanically `` Activated t 15 FLAP 9OLRA 120 or 240V 15A, 120V 15A 240V + UST use if dose < 7" o unless using VerticalMaster b e - - Mechanically 11/2 HP, 125V 20A, 125V SJE AmpMastor• Activated 3 HP, 250V 20A, 250V SJE VerticalMaster° Mechanically 1/2 HR 120V naw:c8e=°a Activated 1 HP, 230V Use pump SJE MicroMaster AC/DC Mechanically run and Activated start current Use pump SJE MicroMaster° Plus WS Mechanically run and Activated € start current I 13A, 120V 12A, 230V 10A, 12VDC 10A, 12VDC BA, 250VAC 85A,120V 7-36 in 85A, 230V (18 - 91 cm) 85A, 120V ', 85A, 230V 85A, 120V ° 85A, 230V 7- 36 in (18 91 cm) 7-36mn (18 . 91 cm) 85A,120V -T- 36 in 85A, 230V (18 - 91 cm) 90A,120V :.-48 in 90A, 240V (7.6 -122 cm) 120A, 125V 9 - 24 in 120A,250V (23-61 cm) 604, 120V .75 - 6.5 in 60A, 230V (2 -17 cm) 100A 12VDC 8 - 36 in 60A, 125V (20 - 91 cm) 60A, 250V 13A, 125V 78A, 125V 8 - 36 in 12A, 250V 72A, 250V (20-91 cm) SJE HiTempMaster'" t Mechanically Use pump 13A, 125V 78A, 125V 8- 36 in run and 12A, 250V 72A, 250V (20 -91 cm) Activated start current California Prop 65 requires the following: ®WARNING Cancer and Reproductive Harm - wrw/.P65Wamings.ca.gov 888-DIAL-SJE (888-342-5753) ( Ucustomer.service@sjeinc.com i�Gt_i�r��. www°sjerhomhus.com SJE RHOMBUS° 95001385 07/20 ®2m95JF-IeclJemelk n°°e"e°_ n r ^ eJE C 2018 e9; at Me ofeserInc. r�iaY � c Loy hayfield Co. Ptanning an] Zoning Agency TERRY A BIITLE' MOUND SYSTEM PLOT PLAN XXXXX W MAPLE HILL R W1/2.NW SE TOG WITH EASE IN DOC 2023R-601434 S29 T49N R05W TOWN OF WASHBURN WI SCALE 1- = 60' 22% SLOPE 1200A300 Coral A n Bill 18.OAK, NAIL IN BASE a 100 NORTH LOT LINE Private Sewage System Maintenance Agreement Otianerts, Name Owners) Mailing Address , ' ,- .. E Uy(i 1: . Site Address • 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 oe 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 W! Adm. Code. as from time to time amended. (COMPLETE Legal is required) 1:4 of ._. _1 4 Section 1 -Township jL.� N. Range V' W. Add itional Legal Description: l 1• � � 1 g5e,_ )_ A.. _4..C. Town of ..LL}wr� __ tAcrag _"' Gov't t_ot Lot Block. Subdivision , ._. .. Lot CSM Vol. _._. Page CSlvl Dcc_--__-_-- ❑ In -ground gravity Mound DOCUMENT NUMBER 2026R-612 170 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 05/15/2026 AT 8:12 AM RECORDING FEE: $30.00 PAGES: 1 �Pto orn Tn. BIG LAKE tPLMBIj Recording Area 1481 County Highway C Washburn. W1 34891 O In -ground dosed ❑` In -ground pressure distribution Sewage System: At -grade' Sewage System L✓ Other Septc 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 shalt also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A througn E): The septic tank effluent filler shall be inspected and maintained as necessary and accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55. Wis. Adrnin. Code. Private Sewage System Dispersal Celi ;system types A through El: The private sewage system distribution cell snail be visually inspected by a cer•,ified septage servicing operator. POWTS inspector, or licensed master pikrr:ber witnin 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 it 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 ah charges and costs incurred by Bayfield County for inSAeclion, pumping. hauling, or otherwise servic ng and =ra:raining The pnvata sewage system tank in such a manner as to prevent or abate any human ♦ e caused F t 1+ .Z r.♦ 1the Y n.• s I7� h J 1 'J" owner 'r ! thirty { 0) d^y realm hazard by the system. BSyfield County shall ,.,.,r,� .V✓ner of any costs wh.ic shall be paid by the owne. tIo ?7.n ir2i.: e o from the date of notice. in the event the owner does not pay rho costs within thirty (30) days. the owner spocificafly agrees that all the costs and charley may be placed on the Tax roil as a special assessment for the abatement of a nuran 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(si Name(s) - Please Print f Subscribed and sworn to before me on this date: t -1 - 30 - i-a rr¼j , • Notarized Owners; - Signature(s) _-��— - votary Publi D R G E N E G O ET S H s ___ YwState of Wisconsin Dr�ed oy: -.- /nW _ _ Date: - MAY22 Z026 U-lot^'t5'SSt'1?r3r�fSeptiGRtdlr'•t8�!Ccdti�LBi'ic:(!? Bayfield Co. Ravisec .ii:iy 22C Planning anJ Zuning gency 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 Pump Tank Diagram, Alarm and Pump Curve (when applicable) Contingency Plan / Management Plan (383.22-3(2)(b)1.f.) Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) 0 Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) 0 Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) 0 ATU Servicing Agreement (Recorded at Reg. of Deeds) Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) j 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) 0 Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) J I 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) f (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) )l Signature and Plumber Information 0 Surface Elevation of Body of Water XDirection and Percent Land Slope %Tank and Filter Information and Location 0 Wetlands / Navigable Bodies of Water Absorption Area (Proposed and Existing) LBenc' Mark (Location, Elevation and Description) mponent Manual Version ping Material Information (conveyance line, building sewer line, RECEIVED MAY 222026 Bayfield Co, Planning and Zoning Agency Address Number and Road North Arrow ] Contour Lines Structures and Driveways Boring Locations Property Lines Well Locations ,Legal Descriptions material type and diameter). Turn Over ► Y 7 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? (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) REC 14IV D MAY 222026 Bayfieid Co. Planning and Zoning Agency u/forms/checklists/checklistforsanitaryapps (10/2009);(Q7/2011);(®2/2012)(®5/2/2012 -dc) Proofed by: . CEIVED Wlscoin Department of Safety and Professional Services j • Division of lndu/rYc7v5 SOIL EVALUATION REPORT • Bay field Co. in accordance with SPS 385, Wis. Adm. Code FlanflinU and Zoning Agency 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, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Personal information you provide may be used for secondary nurooses (Privacy Law. s. 15.04(1)(m)). ENTERED f 7' Page 1 of 3 TEST # 1.43- 5 County BAYFIELD Parcel I.D. 31101 by Date //23?/3 I 4 Property Owner Property Location ❑ TERRY A BUTLER Govt. Lot NW 1h SE '/! S 29 T 49 N R 05 E, (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 215N151AVE EUNIT122 __________ City State Zip Code Phone Number 0 City ❑ Village ❑X Town Nearest Road DULUTH I MN 1 55802 I (715) 209-6414 I WASHBURN I W MAPLE HILL RD © New Construction Use: 0 Residential/ Numberof bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial — Describe: Parent material SANDY TILL Flood Plan elevation if applicable NA ft General comments and recommendations: SITE SUITABLE FOR A MOUND SYSTEM 1 CBoring # ❑ Boring - ® Pit Ground surface elev. 97.0 ft. Depth to limiting factor 36 in. Soil Application 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 0-11 7.5YR 4/6 NA ; s 0sg dl cw 2m 0 7 1.6 2 11-24 7.5YR 5/8 NA S Osg dll dw 11 0.7 1.6 3 24-36 7.5YR 614 NA s Osg dl cs if 0.7 1.6 4 3 33-44 t 7.5YR 6/4 f2d 5YR 5/8 ( Is 0sg I mfr cw 1 of 0.0 0.0 5 44-66 ° 2.5YR 414 f2d 2.5YR 6/6 Is 0sg ml NA 1 of ; 0.0£ 0.0-__ij__ D--` ' Boring # ❑ Boring ® Pit Ground surface elev. 96.5 ft. Depth to limiting factor 33 in. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Texture Qu. Az. Cont. Color I Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eff#1 "Eff#2 1 — 1 0-10 ! 7.5YR 4/6 NA s 0sg dl cw 2m 0.7 1.6 2 a 10-24 7.5YR 5/8 NA { s Osg dl dw if � 0 7 1.6 3 24-33 { 7.5YR 6/4 4 ` 33-44 1 7.5YR 6/4 NA s f2d 5YR 5/8 Is 0sg di Osg mfr cs cw if 0.7 1v€ 1 0.0 1.6 i 0.0 5 44-56 ` 2.5YR 4/4 i ₹ f2d 2.5YR 616 Is Osg ml NA 1vf 0.0 0.0 * Pf'slupnt *1 = Rnr) > 30 s 220 mall and TSS > 30 5 150 mall 'Effluent #2 = BOO. > 30 5 220 mall and TSS>30 30 ≤ 150 mall CST Name (Please Print) Signature�r I CST Number EDWARD J WROBLEWSKI ` SP -72000013 _ I Address I Date Evaluation Conducted Telephone Number 84805 HATCHERY RD, BAYFIELD, WI 54814 I 8/8/2025 1715-209-4055 SBD-8330 (R04/15) ' y R Fill]Boring Soil Application Rate Horizon ° Depth Dominant Color Redox Description Texture Structure Color Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 In. Munsell .Qu. Az. Cont. l NA i s Osg di cw 3m 0.7 1.6 0-2 7.5YR 312 2 2-12 7.5YR 416 NA s Osg dl cw 2m 0.7 1.6 3 12-23 7.5YR 5/8 NA s 0sg dl dw if 0.7 1.6 4 23-33 7.5YR 6/4 NA I s Osg dl cs If 0.7 1.6 = 5 33-45 7.5YR 6/4 f2d 5YR 5/8 i Is Osg mfr cw 1 of 0.0 0.0 6 45-60 2.5YR 4/4 f2d 2.5YR 616 Is Osg ml NA 1 of 0.0 0.0 l I S ❑ Boring © Pit Ground surface elev. 86.4 ft. Depth to limiting factor 33 in. Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth In. f Dominant Color I Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 i $ i t i ; 1 l e I i Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon ! Depth Dominant Color Redox Description 1 Texture Structure Consistence Boundary Roots In. Munsell Qu. Az. Cont. Color ( Gr. Sz. Sh. Soil Application Rate GPD/Ft2 *Eff#1 *Eff#2 . Efluent #1 = BOD, > 30 S 220 mg/L and TSS > 30 ≤ 150 mg/L * Effluent #2 = BOD, > 30 ≤ 220 mg/L and TSS > 30 ≤ 150 mg/L JVD MAY 222026 13aykld Co. PI.nninp and ZoringAgency EI WARD J.'1/ OBLEWSKI, CST #SP -72000013 SOIL TEST PLOT PLAN TERRY A B1 LEF pr- XXXXX W WIAPLE HILLR W112 NW SE TOG WITH EASE IN DOC 2023R-801434 S29 T49N R05W TOWN OF WASHBURN WI SCALE 1" = 60' 2.2% SLOPE if2 96.4' 38.5 #7 E'( � ,- ern L 2 ZUZ6 r IrCo. NORTH LOT LINE 3 SDRM HOUSE FUTURE WELL 0 FUTURE I BORM HOUSE 'EM 18' OAK, N?ii. Iid BAS' 100 APPROX 800TO SOUTH LOT LINE SHEET 3 OF 3 BAYFIELD COUNTY SANITARY PERMIT (#04)-26-52S STATE SANITARY PERMIT OWNER: TERRY A BUTLER G OV'T LOT: LOT: BLK: 1/4 1/4 SEC: 29, T 49 N, R 5 W TOWNSHIP: Washburn SOIL TEST: 143-25 NEW SYSTEM SYSTEM TYPE: Mound ≥ 24 in. of suitable soil PLUMBER: MICHAEL WROBLEWSKI TRACY POOLER Authorized Issuing Officer DATE: 5/27/2026 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 1288503 Condition: THIS PERMIT EXPIRES 5/27/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION