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Home My WebLink About26-59SCS I Industry Services Division County r= I 4822 Madison Yards Way Bayfeld Sanl Permit Number (to be filled in by Co.) i Madison, WI 53705 P.O. Box 7302 S2-O0%rj6 Madison, WI 53707 - 5� g 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 Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. 10160 County Hwy H. Iron River, WI RECEIVED I. Application Information — Please Print All Information Property Owner's Name Parcel k Brad & Sally Wilson 20066 Property Owner's Mailing Address Property Location 5018 Otter Lake Rd. 4 Co. Band Govt. Lot PlanningZo ng Agency City, Stale I Zip Code Phone Number White Bear Lake, MN 55110 651-600-9766 ¼. %, Section 34 T47 N ROB E or W II. Type of Building (check all that apply) Lot # I or 2 Family Dwelling— Number ofBedrooms 3 Subdivision Name Public/Commercial — Describe Use Block ii Cityof ❑State Owned — Describe Use M Number vdlageof ETosvn of Iron River Ill. Type ofPOWTS Permit: (Check either "New" or"Replacement" and other applicable on line A. Check one box online B. Complete line C if a licable .A. ITTe' System IZiReplacement System ❑other Modification to Existing System (explain) Additional Pretreatment Unit (explain) B' Holding Tank In -Ground ❑4t -Grade Mound 3 Individual Site Design Other Type (explain) (conventional) C. ❑ Renewal Before Revision JChange of Plumber jfransfer to New Owner List Previous Permit Number and Date Issued Expiration NA IV. Dispersal/freatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) I Dispersal Area Required (sf) I Dispersal Area Proposed (st) I System Elevation 450 0.7 1642 650 96.0 Capacity in Total k of Manufacturer Tank Information Gallons Gallons Units o $ v New Tanks Existing Tanks .� Vo y a v a ra a V in y Ls,V Septic or Holding Tank 1000 & 320 1320 1 Superior Precast 1121111 Dosing Chamber 600 600 1 Superior Precast ✓ \. Responsibility Statement- 1, the undersigned, assume responsi I'lunrbcr's Name (Print) Plumber's Signature Jason Kuettel Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 VI. unty/Department Use Only Approved 0 Disapproved Permit Fee $ ❑ Owner Given Reason for Denial T/l/ — Conditions for installation of the POWTS shown on the attached plans. MP/MPRS Number Business Phone Numbe 675751 715-798-3355 GIi��Acth c. Attach to complete plans for the system and submit to the County only on paper not less Slain S tQ x v6C0Q/Ju2b SBD-6398 (R. 02/22) Soil Evaluation Report _.:3T in accordance with SPS 385 , Wis.Adm Code SRR OO \�� —•. Wisconsin Department ofSatetyandProfessionalSeMses Attach complete site plan on paper not less than 8% X 11 inches in size Page: 1 of 6 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: Bayfleld Parcel I.D. 20066 R dew d By: Date. Q Property Owner: Bradley R & Sally A Wilson Property L8dation S34,T47N,R08W Property Owners Mailing Address: 5018 Otter Lake Road Site Address or CSM and Lot # 10160 County Road H City White Bear Lake State MNI I Zip Code Phone Number: 0 Town Iron River Nearest Road: County Road H rNew fv Residential Number of Bedrooms: 3 Code derived design flow rate: 450 Flood Plain if applicable f✓ Replacement j"'" Public or Commercial - Describe: Parent Material: Flood Plain if Applicable: 72.9 AY 2 9 2O26 Bayfield Co. General Comments & Recommendations: Planning and Zoning Agen System Elevation: 96 Load Rate' 0 7 =i _ F�a ge _ To 0 Ground surface Elev: Depth to Limiting Factor: Boring #1 r Bor At 100.1 Ft. 100 in. Elev. 91.77 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 7.5YR2.5/2 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 10-24 7.5YR4/6 N/A SL 2MSBK MFR CS 3F 0.6 1.0 3 24-110 7.5YR4/4 N/A GRMS 0SG ML N/A N/A 0.7 1.6 4 5 6 7 Boring # 2 r Bor.f� At Ground surface Elev: Depth to Limiting Factor: 89.95 Ft. 110 in. Elev. 90.78 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 0-12 7.5YR2.5/2 N/A SL 2MSBK MFR CS 3CO 0.6 1.0 2 12-26 7.5YR4/6 N/A SL 2MSBK MFR CS 3F 0.6 1.0 3 26-110 7.5YR4/4 N/A GRMS 0SG ML N/A N/A 0.7 1.6 4 5 6 7 *Effluent #1 = BOD 5>30<220 mg/1 SS> 0 ≤ 0mg4 * ent #2= BOD 5<30 mg/l and TSS ≤ 30 mgfl CST Name (Please Print) Mark S. Thompso gn r EICST Number: 877598 Address: 12006 N US Hwy 63 Hayward, WI 54843 Date al i Con u d: Thursd , May 14, 2026 Telephone Number 715/699-4081 SBD-8330 (R04f21) Property Owner: Bradley R & Sally A Wilson Parcel I.D. 20066 Page: 2 of 6 Boring # 3 W/ Pit Ground surface Elev: Depth to Limiting Factor: i•" Bor 99.98 Ft. 110 in. Elev. 90.81 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 0-8 7.5YR2.5/2 N/A SL 2MSBK MFR CS 3CO 0.6 4;0 2 8-22 7.5YR4/6 N/A SL 2MSBK MFR CS 3F 0.6 1;0 3 22-110 7.5YR4/4 N/A GRMS 0SG ML N/A N/A 0.7 9_6 4 5 6 7 Boring # 4 r- Borr Pitt 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/ft2 *Eff#1 Eff#2 2 3 MAY 2czo2 iii 4 5 P qflning and Zo ing Agen 6 7 Boring # 5 f' Borr Pit Ground surface Elev: Depth to Limiting Factor: 0 Ft. 01n. 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 # 6 r Borr 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/ft2 *Eff#1 Eff#2 1 2 3 4 5 6 7 *Effluent #1 = BOD 5>30 < 2 20 mgi and TSS>30 < 150mg/1 *Effluent #2= BOD 5< 30 mgA and TSS < 30 mg/I 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.07100) Soil Profile Sheet Page: 3 of 6 Owner: Bradley R & Sally A Wilson Soil Tester: Mark S. Thompson System Elevation: 96 Load Rate: 0.7 System Elevation: 94.77 To 101 lid 101 B3 101 92 100 --------------- 100.1 100 --------------- 100 --------------- System ------•--------8 Elevation 99 --------------- 99 --------------- 99 --------- --•- 0.6 ------------- 98.95 98 ------------• --------------- --------------- 0-7 --------------- QsZ --------------- 97 -----•--------- 97 --------------- 97 -------•------- 4,5 ----------- --------------- --------------- 96.78 96 --------------- 96 --------------- 9�I 95 --------------- 95 --------------- 95 -------_------- --------------- 94.77 94 --------------- 94 --------------- 94 --------------- --------------- --------------- 93.81 93.78 93 --------------- Tom' 93 93 92 -----------•-- 92 --------------- 92 --------------- 91.77 91 --------------- L.E. 91 --------------- 91 •-------------- --------------- 90.81 90.78 90 --------------- 90 --------------- LE. 90 --------------- LE. 89 --------------- 89 --------------- 89 --------------- 88 --•------------ 88 --------------- 88 --------------- R C I V E D 87 87 87 --------------- It1AY 29 2026 86 --------------- 86 --------------- 86 --------------- Bayfieid Co. Planning and Zoning Agency 85 ------•-------- 85 --------------- 85 --------------- 84 --------------- 84 --------------- 84 --------------- 83 --------------- --------------- 83 ------------ --------------- 83 --------------- 82 82 82 --------------- 81 --------------- 81 -------------- 81 80 80 80 --------------- 79 --------------- --------------- -----------•--- 79 --------------- --------------- 79 --------------- --------------- Owner Information• Name: Bradley RB Sally A Wilson Location: $34 T47N.R08W Township: Iron River County: ,aytleid Address: 10160 County Road H Shed 10 B3 1"= 40Onlyin TestedArea n LA BM=100: Nai1W/ Ribbon on the base of tree near R't I� Twm Bear Lake Existing System Ground Elvation = 87.15 B2 81 County Road H 10160 B3= 1001 B2= 8995 B3 = 99 98 Lake= 72.9 MAY 2 3 2016 Sayfield Co. Planning and Zoning Agency PAGE 1 OF 5 In -Ground Dosed -Gravity Plan Index & Cover Sheet Component Manual Design References: Version 2.0, SBD-10705-P (N.01/01, R. 10/12) Pg 1 of 5 Index & Cover Sheet Pg 2 of 5 Plot Plan Pg 3 of 5 Dispersal Area Cross -Section & Plan View Pg 4 of 5 Pump Tank Specifications RECLINED Pg 5 of 5 Management Plan MAY 292026 BayfieId Co. g and Zoning Agency Attachments: Enclosures: Planni^ Pump Curve POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Wilson - 3 Bedroom Owner Name(s): Bradley & Sally Wilson Phone: 651 600 9766 Owner Address: 5018 Otter Lake Rd. White Bear Lake, MN Zip. 55110 Project Address: Govt. Lot: 6 10160 Cou 1/4 of Township: Iron River Project Parcel ID #: 20066 Designer Name: Jason Kuettel Hwy H. Iron River, WI 1/4, Section 34 , T_47 N -R 08 E Liar W ❑✓ County: Bayfield Designer Information Designer Address: PO Box 66 Cable, WI E-mail: Jason@andryras.com License Number: 675751 Remarks: Phone: 715 -798 -3355 Zip: 54847 Signature: '`,✓ ..:," Date: 5 2_ origiqdnature required on each submitted copy. Ownetlnformadon Name: Bradley R &SattvAvWilson Location: S34 T4ZN.ROBW Township: ImnRiver County: &ayfield Address: 10160 COunWRoadH 1 1'= 40' n County Road H Only in TestedArea BM=100: Naif WLBiUben oathe base oftreeneat9.3 Tp Twin Bear Lake 'to H, JvPEO-kui P17-Gc4rr • W/ 022R/CC /=ILTtll 4>oL'1 C_ t>L Z° Df ZC' f old e'- 0 2P \ �l MPG7S7St ,5/ 26/2,(0 B1= 1001 B2= 89±95 B3= 99.98 Lake= 729 10160 RECEIVED MAY 292026 Plannin BaY6eld CO. g and Zoning Agcy IN -GROUND DOSED -GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3 -ft Trench (down -sizing credit) min. 1Y Geotextile I (typical) TYPICAL TRENCH Cover SOIL COVER CROSS SECTION VIEW 12" (No Scale) min. trench > . OBSERVATION PIPE DETAIL de th w- (No Scale) (typical) I.a Screw -Type or Finished Grade Slip Cap (loose) •� :w• :: %• (mulched 8 seeded) System Elevation = 96.0 ft. 4"0 PVC Pipe j;, Topsoil Cover Provide minimum 3 ftmin. 1 foot Top of pipe to terminate <•• - ( ) (typical) at or above finished grade separation between trenches. TYPICAL TRENCH (Show location of inlet / outlet pipe conneft L CkY1LVEQ PLAN VIEW MAY 2 6 shall be (No Scale) 9 20? Orr 0 Observation p pe Installed ion between two units. Perforated a� Lateral PlanningandZen n)Pipe (typical) al ----------------'-------- B= 65 ft (typical) INSTALL PER TRENCH: 6 10 -ft bundles @ 50 ft' EISA/unit= 300 ft' + 1 5 -ft bundles @ 25 ff EISA/unit = 25 ft' = Proposed EISA per trench = 2 ft' (4)1/4"-17 X 6" Siots @9D apart 10 ft Anchoring Device I Bundle (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. A=3.0 ft (typical) Required Infiltration Area = 642 ft' x 650 trenches = Proposed Total EISA = 650 ft' Infiltration Surface Distribution Method: distribution box U m w O n rs PAGE 4 OF 4 In -ground Dosed -Gravity Management Plan IMPORTANT: The owner of this in -ground dosed -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 = 450 gpd; BOD5 5220 mgL"1; TSS ≤ 150 mgL"1; FOG ≤ 30 mgL-' Inspection Checklist INSPECT EVERY 3 YEARS RECEIVED o type of use o age of system MAY 29 2026 o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) Bayfield Co. o material fatigue (i.e., leaks, breaks, corrosion, etc.) planning and Zoning Agency 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(s) 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 manufacturer's 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 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 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. PAGE 5 OF 6 SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4"0 Vent Pipe >10 ft from Building 12" Min. or 2.0 ft above Established Flood Elevation (typical) IMPORTANT: Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) Finished Grade CAPACITIES @ 14.85 gaUn Depth (in) Volume (gal) A 20.5 304.4 B 2.0 29.7 [C] 7.5 112 D 12 175.2 4 1.. *T IA *Pump Tank Liquid Level = 42 in Force Main Diameter = 2 in Force Main Length = 135 ft Force Main Void Volume = 22 gal Electoral must comply vdllt SPS 316 and NEC 300 jI Weatherproof Junction Box Seal Extend manhole riser as necessary. Approved Locking Manhole with Warning Label Attached (typical) 4" Min. or 2.0 ft above Established Flood Elevation (typical) Quick Disconnect 1 18" Min. (typical) Hole ApWeep prorved Pipe 3 ft 6ir 1� y E AVE Solid Ground (typ'ca° MAY 2 9 2026 Alan on Bayfleld Co. Planning and Zoning Agency PUMP -OFF Pump —Off ELEVATION = 82 ft Block 3" Approved Bedding Material Beneath Tank [C] Total Dose Volume (TDV) = 112 gal/dose L (5X total lateral void volume < TDV < 0.2X design flow) + (force main drainback volume) MIN. PUMP DISCHARGE RATE = 40 gpm PUMP TANK: Volume = 600 gal Manufacturer: Superior Precast Pump Manufacturer: Champion Pump Model: CPES3 (See attached pump curve.) Controls/Alarm Manufacturer: SJE Rhombus Controls/Alarm Model: HW101 Float switches containing mercury are prohibited. INSIDE BOTTOM ELEVATION= 81 ft Vertical Head = 15 ft + Min. Supply Head = - ft + FM Friction Loss = 2.31 ft + Fitting Loss* = - ft *(min. supply head x 0.3) = TOTAL DYNAMIC HEAD = 17.31 ft SEPTIC TANK(S): Total Volume = 1000 gal Manufacturer(s): Superior Precast Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: Orenco Filter Model: FT0822 0 1 FEATURES/BENEFITS PERFORMANCE Heads up to 37 TDH Flows up to 72 GPM MOTOR High efficient, 115v, oil filled, permanent split capacitor motor with upper and lower ball bearings and thermal overload protection -Constant bearing lubrication - Maximum motor cooling - Runs cooler and lasts longer - Internal overload protection - Quiet operation - Fasteners and shaft made from rugged, corrosion resistant stainless steel SEAL DESIGN Mechanical with secondary dynamic lip seal -Provides added leakage protection IMPELLER DESIGN Mon -clog style vortex impeller Designed to help reduce clogging by foreign • material PERFORMANCE CURVE POWER CORD Sealed entry quick disconnect power cords - Prevents water from entering the motor housing through a cut cord - Easy to replace in the held -Available in lengths up to 100' SWITCH Piggy -back switch design - Defective switches can be diagnosed over the phone - Pump can be operated manually or supplied with other piggy -back switches - Switch can be replaced without having to replace the pump APPLICATIONS Basements, dewatering, septic systems, residential and commercial developments and elevator pits RECEIVED MAY 292026 .,r Wide -Angle Float Li Vertical Float Bayfleld CA 1/3-1/2 HP submersible pumps that handle up to Planning and Zoning Agency 3/4" solids with 2" discharge with 11/2" adapter Champion Pump Company, Inc • P.O. Box 528 • Ashland, OH 44805 Phone 419-281-4500 • Fax 419-616-1100 • www.champlonpump.com REV ests Private Sewage System Maintenance Agreement iO 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 3`1 Township 4N. Range ______W. Additional Legal Description: SEC fvtat Town of I r 114' &- (Acreage) Za 1 i Gov't Lot Lot Block Subdivision Lot _ CSM # _ Vol. _ Page _ CSM Doc # DOCUMENT NUMBER 2026R-61 2338 DANIEL.J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 05/29/2026 AT 1:50 PM RECORDING FEE: $30.00 PAGES: 2 Recording Area Return To: PlanninrQaye1dment JUN 012026 R:umpkl Un Planning and Zoning Agency ❑ In -ground gravity [$1 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 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS 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 -grade, and In -ground Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and 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: Q'W13ok m II, 2OZCv Notarized Owner(s)'Signature(s) Notary ublic My CommissionExpires ate °t`„ Drafted by: / rALl Date: S/llflh K�TARY PUBLIC r' MINNESOTA My Commission Expires Jan. 3i.2027 Proofed by: u/forms/sanitary/septicmalntenceagreement Revised July 2020 EXHIBIT A That part of Government Lot Six (6), Section Thirty-four (34), Township Forty-seven (47) North, Range Eight (8) West, Town of Iron River, Bayfield County, Wisconsin, described as follows: Commencing at the Southwest corner' of Section 34, thence East along the south line of Section 34, 395 feet to an iron pipe in the northerly right of way of present and existing.County Trunk"H' ; thence. northeasterly and along the north right of way 57 feet to an iron pipe for a point of beginning. Thence N. 34° W. 304 feet more or less to an iron pipe at the water's edge of Twin Bear Lake; thence northeasterly following the curie of the lakeshore 330 feet to an iron pipe; thence S.37° E., 315 feet to an iron pipe in the northerly right of way of present and existing County Trunk "H"; thence southwesterly and along the north right of way of said Highway 339 feet to the point of beginning. RECEIVED JUN 012026 Bayfield Co. Planning and Zoning Aaamay 13M 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: WILSON, BRADLEY R & SALLY A 5018 OTTER LAKE RD WHITE BEAR LAKE, MN 55110 Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00424 Transaction Number: SR-00424-46BBB Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 15062 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 6/10/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. 13 AYFIELD 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: WILSON, BRADLEY R & SALLY A SS -00756 5018 OTTER LAKE RD WHITE BEAR LAKE, MN 55110 Transaction Number: SS -00756-478A1 Description Private Sewage System (Septic Tanks) Amount $400.00 Total: $400.00 Payment Amount: Reference: 15062 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 6/10/2026 $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)-26-59S STATE SANITARY PERMIT OWNER: BRADLEY R & SALLY A WILSON GOVT LOT: 4 LOT: BLK: 1/4 1/4 SEC: 34, T 47 N, R 8 W TOWNSHIP: Iron River SOIL TEST: 50-26 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: JASON KUETTEL EMILY MACGILLIVRAY DATE: 6/10/2026 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: Old System needs to be properly abandoned per SPS 383. Properly Maintain System Per Recorded Agreement. THIS PERMIT EXPIRES 6/10/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION