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HomeMy WebLinkAbout26-63St ort9 I _I Industry Services Division Court I A. 4822 Madison Yards Way t Sanitary Pe A,, Number (to be filled in by Co.) h�•�j�' p Madison, WI 53705 _� P.O. Box 7302 a' G 3 S en„n„ 5S -0v l 66Q Madison, WI 53707 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 Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS arc submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law. s. 15.04(1)(m), Stats. Q OY3 S. ` vet' fitrcJ Information— Please Print All Information I. Application Property Owner's Name Du ' beoe-Ioi'nie t4 L( -C Parcel # Tax ID Io99z Property Ow er's Mailing Address Property Location PC) 1'X I`O Govt. Lot '.. ,Section 23 T 43 N R E City. State I 51ov,Q lctlee.. t4) Zip Code &196'7 Phone Number 91-69b-7Brz Type of Building (check all that apply) Lot # ���H.. �I or 2 Family Dwelling —Number of Bedrooms '2— Q� SWubdivision Name oadcret% l4Q.40 L lie t de Block # ❑PubliclCommercial — Describe Use g , P. ❑City of State Owned — Describe Use Village of CSM Number Town of Cable III. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i a lilcaable. A. 1 XlNew System I--1_ [Replacement System ❑Other Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B. []Holding Tank Uln-Ground ❑4r -Grade IflMound Individual Site Design Other Type (explain) Y� (conventional) C. ❑ Renewal Before ❑Revision Change of Plumber )Transfer to New Owner List Previous Permit Number and Date issued Expiration IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required 1st) I Dispersal Area Proposed Isf) I System Elevation 0o .42 Soo tp . 532-$ Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units A eo u New Tanks Existing Tanks u _u = r m to = 4. (J m 4 HoldingTank =1 lat(p — �4O to r sin Chamber Sto s� C Li V. Responsibility Statement- f, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number thtl4Vi t.1+- 'cU4 �is�sS�-srroy Plumber's Address (Street. City. State. Zip Code) s+o I -.co k wc'b�(07 77 VI. County/Department Use Only pproved O Disapproved Permit Fee Date Issued M Issuing Agent atu �` ❑ Owner Given Reason for Denial fro/ii /26 ��J Conditions of Approval/Reasons for Disapproval RECEIVED CL e JUN 11 2026 Bayheld Co. Planning and Zoning Agency Attach to complete plans for the system and submit to the County only on paper not less than 8 in x ii inches in size SBD-6398 (R. 02/22) ,o� �o Wisconsin Department of Safety and Professional SerVO0" TEST Page of Division of Industry Services SOIL EVALUATION REPORT Qri . In accordance with SPS 385, Wis. Adm. Code County BAYFIELD E L D Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must i ude, Parcel I.D. but not limited to: vertical and horizontal reference point (BM), direction and percent scale or dimensions, north arrow, and location and distance to nearest road. q aX S 19 Please print all information. Reviewed by n �t Personal informationY P You rovide ma be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). G., 1�+0 I roperty Tj wner Property LocationOt�V beVq't'0PrnC'+L LC Govt. Lot _ 1A S Z3 T 3 N R 0- E (or) (P roperty Owner's Mailing Ad ress Site Address or CSM and Lot #: ( JO ct�e' 4 /d. -gyp iL. (,d Q Ivey. PC) 13 x I (j S o P. 4 z. _9 l q c City I State I Zip Code Phone Number ❑ City ❑ Village Town I Nearest Road ytouc' LaLsvI W I "%7 I%) zgL7 C�ia� o I'.'lUev-lrJi_be- New Construciion Use:se:Residential/Number of bedrooms Cl Replacement 0 Public or commercial — Describe: Parent material Q LQ 4. I U S4 na, b d&t c h General comments and recommendations: - S k 5 . • saS to f61eL 1 I Boring # ❑ Boring (APit cg.oc Ground surface eiev. ft. Code derived designflow rate_3W GPD Flood Plan elevation if applicable 0 A ft. j io`` Clb•S7 Depth to limiting factor in. / elev. ft. 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 0- .S 3 a - 5 2- , Ir- IIH. qtr- 2\3C z.. $ 30 << `1 3 — 51 2- 6L - 1.0 0-.O IfL, s I d C' (� .c ro 4- Ott JUN _1 Boring # ❑Boring �t �•Z3 Spit Ground surface eiev. ft. Planning and Zoning Agency .' 1. 1 S Depth to limiting factor in. / elev. ft. 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 p - `1. 3Z .r cj 2. ALA,- w r .16 4.0 zsd-9 n 4 rf r• SI .t �� rt a •lb 6.0 $c..9 S r 11Mbk M. ? +' .fl \jc- coo s Ss CST Name MERTON MAKI I Signature CST Number 224901 Address 10869N SMITH COURT HAYWARD, WI 54843 Date Evaluation Conducted fo .' ci Z (o Telephone Number (715) 634-8719 Effluent #1 = BOO > 30 5 220 mg/L and TSS > 30 s 150 mg/L * Effluent #2 = BOO, s 30 mg/L and TSS s 30 mg/L SBD-8330 (R04/21) Ij-] Boring # ❑ Boring • gb, $ 5- Pj Pit Ground surface elev. ft. Page of c?b 4 go.S5, Depth to limiting factor in. / elev. ft. Soil Application Rate Horizon Depth In. I Dominant Color Munsell Redox Description: ; Qu. Az. Cont.Color Texture "' f Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 !.b Z B —3 << 3 �' s Z.M. c 6L " k . 4 3 n -C16 .� �r r -s << — i .6 t . o co ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Application o -4e Horizon Depth In. IDominant Color Munsell j Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. I Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 2 X (SA d= - ( so Is sod r x'OO -- �0 :— (Ki s - - I 'rec.- 2- Cptt T' f S4` fi-v r eS J1 e g To ao sr -r l- - _____ ____ ___ _______ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor In. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Texture Qu. Az. Cont. Color Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOO>30 30 5 220 mg/L and TSS > 30 5150 mg/L' RECEIVED JUN 112026 Bayfield Co. Planning and Zoning Agency * Effluent #2= BOD, 5 30 mg/L and TSS s 30 mg/L Du QFy . DeoeLdp vv� et't4 U -C ?o 3x 145- S+o 44 e L e7 t $1&' sot — (F,ctb _ 249LZ L �t S1 [)e�r'ira , cr 5 ( _. 13�rc-1.N i . J --o 19 'Ii. LeI &cet EZC.1 Tex 1o9 2. Z3 t-43 N A. dlw wj;o&cr-es4 /rdd.+o wt- tae- P? t'oe, L-of?o 1-901 pg2lo A aM too (at 1, r 1 bo 3' v P N (.J .le �v,- 1wf: a '41.€. B I . 38.0q , Z. c{g23 t 3 5gs5' ' so a 15 ss�e� Jev q≤ f C ca+t je- q4. l S q ) *- nvifti- �\ovse- .. `ocq.4: � s sStz-e �' �roit Nt- u e i l 4-o ( teel Cale 4iK kt G5T 24b RECEIVED JUN 1 12026 Bayfield Co. Planning and Zoning Agency •' oJ≥2— 1t q A` (j? Z?, m bor c c?cc • � � Qc.00 � � ��v / �n A ri qjo.r ____ / -7 Grp v000�000 % muo i •--bOO - iiti o ' A 3� 1 . 11 � ��q{ pis [q {per RdaC E VVE D • ice® 0COOC.7mOO JUN 1 12026 4 f ?o... f Bayfield Co. • Planning and Zoning Agency _. G(//►11 � S s odOOA00 � • S •.,� +3 +3 i ter!!g=- ? 7n� 1 5/22/26, 8:18 AM Real Estate Sayfiel d CbunW Property Listing Prepeity Status: Current radars Date: 5/21/2026 Created On: 3115/2006 1:15:10 PM ' Descriution Undated: 10111/2004 Tax ID: 10984 PIN: 04-012-2-43-07-23-2 00-319-08800 Legacy PIN: 012128303000 Map ID: Municipality: (012) TOWN OF CABLE STR: S23 T43N R07W Description: WOODCREST ADDITION TO WILDE RIVER LOT 901568 IN V.901 P.926 IM 2004R-494519 Recorded Acres: 0.850 Calculated Acres: 0.891 Lottery Claims: 0 First Dollar: No Zoning: (R-RB) Residential -Recreational Business ESN: 108 Tax Districts _ Updated:. 3/15�ZOQ6 STATE 04 COUNTY 012 TOWN OF CABLE 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE `4r Recorded Documents U cited: 3/15/2006 � CONYERSIt?N 494519 703 -414;765 -2;901 - Date Recorded: 926 3\\S �o Urxlab 0: 3/15/2006 PAMELA L JERGENS ROSEMOUNT MN Bil!End Address: PAMELA L JERGENS 3901 153RD ST W ROSEMOUNT MN 55068 Mailing Address:_ PAMELA L JERGENS 3901 153RD 5T w ROSEMOUNT MN 55068 Site Address * indicates Private Road N/A Assessmenrt Updated _ 6/17/2020 2026 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 0.850 2,600 0 2 -Year Comparison 2025 2026 Change Land: 2,600 2,600 0.0% Improved: 0 0 0.0% Total: 2,600 2,600 0.0% Pr�opert� H ter_ N/A Lo+ C�p o.1 s, Ivey WrcvDr RECEIVED JUN 112026 Planning and Zoning Agency a fieldcounty.wi.90v/access/REAL%20ESTATE/"st'n'.asp?tid="1 516&pid=10984&tyr=2026 https://novus.b y Pad•' - Bayfield County, WI brC'S.. . Ti F,� r try_-- ri I <\.. >! . �_ J.. f •w / _�irf �. r A YtA Ofp�2#� {4fBEf11 IIINIo49E X41111 r+ -Y' ✓ (mow r a ID r19 3 � .+-y ]" C, r., .. j , as Tj , �/ r 1l r, .� �/ 7,rr`• fit,... ^ i ti✓' y( �l'(i ://��fL�l� P�� /Z� „p. _�. ••wry 99 '`!�__'/' /�'! '�� (/" �'..L4I J_' M (.- , _ �,) �� "y �� - ♦ • a� - ..1 s� .• Y '999-�.''^^^iii���-- fIDtl 3e: �• 1, -aS ,/ j `'./ -✓ -r n ` K -, JJ# Sfl '7jH .. <-#...........I ..1 % a vmcrcum, o: 1a:Iq nm 1:500 Tie Lines Section Lines All Roads 0 o.or 0.01 0,02 ml Meander Lines C Municipal Boundary Town / ` ,�-� H 0 a,ol o.ot 0.03 km Approximate Parcel Boundary `'� I <- RECEWED a.mma JUN 1 1 2026 Bayfield Co. Wow County land Ranondi oepwmnl Planning and Zoning Agency nnosnmayseayfewcoumywigovuayfewwnal O O II '.111 e ... c..... N ILL 't Grays Trailer SCHULTZ Court 44 �� G dDRd ' FRANCES) 1' �-- RAYMI E X a 3 LEANN a'- 'WILLIAM T w HILLE a NORINE LEROY Aa XY AAH ""'ae' 20 u VEDEGES 20 p BORSELLUNO�b ' '. N° NC XX K DANDREW 'dO AL 7s TURNBULL O � `. AB ":!'v; TRUSTEES AEA AK AM AV WILDE RIVER ;-.. 20 C ..,W' j'.i MAT AN AU OWNERS D AT AW ASSOCINC Riq� l4 AI A AP 91g n! RB �.L,O srcv RICNMRotl DR T. W ARTHUR I Sit .: Vry ,` CYNEMHus OR DO DP DX RO30 A.. a.'' j . IM eaatNM15 a O CJ CP GQ 1 DI R� _ p "� BW CR T%DDgD Sa rg2! i; CNR\4O� pp BV .�.. IX A EA ED FF )DBIOr STEVEN P a R D GZ G H aLRABETHA Y,. •, Y' "Y BF D BR y' CE CU HD ET R R U EI /0.095T r aIYA I§Ylin� B pH p B °Ail) L pP BO J p2 IX' NV'4_ LWU _ EG EPFW RD RP__ O N MW N; ALLEN D I D i R KI K KF u D U I xG H O NS I u R R G V FPi" SL LEGACY I FARMS I HL IIU P KC G[ GD LLC I AMUNDSON Kw Lc 91Wdr __ II ', 91r HI GO GF KE d 40 G✓'y a D % ry c ° H 187 I ry$^ fGGU f-IANDPAK 19 / Iw Ii GL GI 1 11 -- I<G V �'tl I r E LM pW MP. IIX IG 111 GK �G sW r.. Q 4 N MO MN S ME ' - IIY U g Gj 1L N C CHARLES JUN 1 12026 MOUNT EM LP MI 112 ID IL li $of" SCt& I TELEMA0.K DALE W LN MN ML MG IA IM - 14 IS PARTNERS. MM MK p - - 19 IC IM Bayfield Co. I LLC 20 VOIGT 3 Lo -V. - a - RIV tannin Doing Ag 39 MFL Ut a Mz RAYNELD To IN Kn Z IT LU LV LWIX LY MA / COUNTY IN _ IN I Lake IE Iw I AE R _Fire LET Frills 1Z South a ID to ri ' I ILIdL�a Rd' IT a IP F RICHARD TOWN OF GREGORY A MO. li lu � I R ST CABLE 8[ LESLIE A MR Iw lu Ir TRUSTEE V IX 47 JANSENjANSEN eMW g f 57 39 MS MU MX CHARLES SCHULR MY� L_D{ cP D . 99 L:c- s:1 --e PAGE 1 OF 5 In -Ground Dosed -Gravity Plan • Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 5 Index & Cover Sheet Pg 2 of 5 Plot Plan Pg 3 of 5 Dispersal Area Gross -Section & Plan View Pg 4 of 5 Pump Tank Specifications Pg 5 of 5 Management Plan Attachments: Pump Curve I POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Owner Name(s): lift y Ueuelo'm en4 L L.. Phone: §o7 -b% - 2g I Z Owner Address: ?oBX 145 Slohp l�<<e W t G'#967 Zip: S9 7(o Project Address: ay 5: 1oer [rc1-, br- Cub(P_ Govt. Lot: 1/4 of 1/4, Section 23 , T 43 N -R 07 E Liar w k❑ Township: i e\e County: [3a7 C• kid Project Parcel ID #: tcck YID I D9ri Z Designer Information Designer Name: S Lu E+ Phone: 1(S- SSA S4 oy Designer Address: 10iCo S Bowe 1 & I -i- -Lk uw)( Zip: 1j,1L E-mail: License Number: 15161 LT Remarks: RECEIVED JUN 112026 Bayrield Co. Planning and Zoning Agency Signature: aI sDate: ignatu each submitted copy. pw �12r-. 7u y Detetopvt e 14 L.LC P© (max 845- Sto ie Lcdtej Le7 ( 9t&6Z 501-(C4(c-28[Z onV'- lzl Si�ver l3'rck Dr. c.y- e1cI O".1C'e M.c T" Tax 2b I OR9 2. z3- 43fJ P,01w wcodcrec4 46d. to W t (d e g d ev- (—0fO \I• 90f 2122c .B too n&a,rJkV¼ 3'vr WuJ (. cis.oq' Z. gg.z3 ` 3 9SSS` 'II . &' 56.15 Sslew elev 4 s.� C c.tnjc. gtis- i' ) ceq,,;v.es Du5c_ `oc24:vY1 & = i..Wel l ^Eo Dtee+ Code 546K5 RECEIVED JUN 1 1 2026 BaYfield Co. Planning and Zoning Agency IN -GROUND GRAVITY DISPERSAL AREA Stepped Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER min. 12" (typical) 12" min. french TYPICAL TRENCH depth I CROSS SECTION VIEW (typlCe° (No Scale) 1 . 94" --'t (typical) . e ^ n e. Highest Trench System Elevations= •C5.5- ft; ac. 'r ft; ft; Septic Tank(s) Manufacturer: I ('taer ' o/ScO Septic Tank(s) Volune(s): . r gel gal — gal gel Effluent Filter Manufacturer: Effluent Filter Model tl: S 2- 3 provide minimum 3 ft separation between trenches. Lowest Trench (as applicable) ftI ft flulck4 Standard -W wl End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) n= 5d ft (typical) INSTALL PER TRENCH: k 3l Oulck4 Std -W @ 20 fP EISA/chamber = 2kg ft' . �_ Pairs of end caps @0 iP EISA/palr =�1� ft' —, = Proposed EISA per trench = =1:s ft2 RECEIVED JUN 112026 Obsesvallon Plpn (typical) Install pot mnnulaclumes :flans. --I TYPICAL TRENCH PLAN VIEW (No Scale) TA= 3.0 f1 1 (typical) "--Ouick4 Standard -W Chamber (typical) (mfd by Inllttratar Systems. Inc.) install pursuant to manufacturers Instructions. Bayfield Co. Planning and Zoning Agency Required Infiltration Area = .S00 ft` x Z. trenches = Proposed Total EISA = 53Z Its Distribution Method: Ti 67 m W O TI l31 GRAVITY -DOSED SEPTIC / PUMPTANK SPECIFICATIONS (No Scale) 4"0 Vent Pipe >10 ft from Building 12" Min. or 2.0 ft above Established Flood Elevation (typical) Approved Vent Cap IMPORTANT: Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) Finished Grade CAPACITIES @ gal/in (gal) SsV/y W *Pump Tank Liquid Level = L4 3 is Force Main Diameter = a_ l Force Main Length = ft Force Main Void Volume =®gal Electrical must compy with SPS 316 and NEC 300 Extend manhole riser as necessary. Weatherproof ILLJILll1--Junction Box Approved Lod&ig Manhole vnth Warning Label Attached (typi pl) —Conduit / 4' Min. or 2.0ftabove I II { Established Flood Elevation (typical) Airtight Seal Quick Disconnect 18" Min. a' .. (typical) i W t p. Hole _ Approved Joints with Approved Pipe 3 ft onto Solid Ground A (typical) _Alarm B _on PUMP -OFF 8 g3 tl Pump —Off ELEVATION = g INSIDE BOTTOM concrete Block ELEVATION = S 3 3" Approved Bedding Material Beneath Tank go?c •-;'3--'3.°4-CO [C] T�(� ose Volume TDV = 7 3 . esi gal/dose 0.2X design flow + force main void volume) Vertical Lift= ` . _________ft PUMP TANK: Volume = coo gal Manufacturer: w ° e S Cr Pump Manufacturer: jr -y Pump Model: ® 24 __ Y (See attached pump curve.) Controls/Alarm Manufacturer: p5«�+.1 Controls/Alarm Model: Float switches containing mercury are prohibited. RECEIVED JUN 1 1 2026 Bayfield Co. Planning and Zoning Agency SEPTIC TANK(S): Total Volume = 8® gal Manufacturer(s): (A)tesCt Install approved effluent filter at the septic tans immediately upstream of the pump tank in Filter Manufacturer: 1¼/I I C Filter Model: PAGE OF In -ground Gravity Management Plan s/S IMPORTANT: The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 3h_7 gpd; BODs ≤ 220 mgL"t; TSS ≤ 150 mgL't; FOG ≤ 30 mgL"' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system REC.Ei'l�'ED o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) JUN 1 1 2026 o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (gtgbution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activitimratdy)and Zoning Agency 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 (he., 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. J2y-RReppiort any component failure or malfunction to: Name of individual or company: R€- Id beUe�evtk L -LC, Phone: -o"7 — b96 -20 (Z Local government unit: Re,I tin ZoV,vtc Phone: 719-373-6/33 Local government unit address: 111 E S 1 . (r ) a cut bL vi (A) I ZIP: S tf 35 L 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. t ,' be%je a "a c_t.c i.4- 9 0 Gr'≥. @ k 54e cr? z 5 sewer cu L' sr „a ql.s Vt- -3.S �`1s q6.5 hecde.- 4c 5 sysf e-l.eu + 13•b -1r RECEIVED JUN 1 1 2026 Bayfield Co. Planning and Zoning Agency 4" CAST -A a w aD 0 w 4" VENT W840/500 -MR TANK SPECIFICATIONS DIMENSIONS: CAST -A -SEAL WALL' 2 9/16" BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 59 1/2" LENGTH: 9'-5 3/4" WIDTH: 7'-9" BELOW INLET: 48" LIQUID LEVEL• 43" WEIGHT: BOTTOM 7,380 LBS. COVER 3,790 LBS. ttecejvED INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL CASKET INLET AND OUTLET FL BAFE AND FILTER: JUN 1 12026 WISCONSIN, SEE DETAIL /10 (OTHER STATES SEE CHART) gayfield CO. planning and Zoning A9en0Y LIQUID CAPACITY: 19.61 GAL/IN (SEPTIC) 11.82 GALAN (PUMP) LOADING DESIGN: 8'-0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC/SEPTIC, SEP11C/PUMP, OR SEPTIC/SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN /10 (STRUCTURAL FIBER) ____ CUSTOMIZED TANKS INLET -1- qrz1rOUTLET FOR CUSTOM TANKS CONTACT WESER CONCRETE rn 1 II I, YI= ¢ I N I -c+ tlni_I a I �U 2� I-- I.I 1 REVIEWED BY ;.� PUMP PAD REVIEW DATE I TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: 0 i Lii 0 W C 1O U 1O O z OD G.7w o � a N O4 O Coo I W W_ N iZ OF .e•...o.q �:srq;;.:r,_t:•: r'.1:a•:t.�-^r,•::-a. s'.s+_s0.L'-lx-Y.:r. ..._-:t :�:-: •Irr•,•e... .-�.,�. ..:.-r e2rs:•_•.'�'.a1.:.*:.:af•��:.4.7...r..:.ut�>:... �StaA'�--.: 7ta: �....S�a:.. ._.� It Sf ' �.;� ,�.•'+A_: tit ._; •`l.. •; .:I + r.:.V� .OZ l ��'• ! cn t 1: - (-- S :Gl'-f a h•._._ .1 i ' c C i, s t� '•,� ,, ' r s yr} -. ` _ } F- 3 r; •'.: _ ....•..... r.._.. .r w.--_•�_ •_-_•I'.1 �`<. 11.•.it'• .`t .M.i.-:iM'irl.r..•....a Nor` �{• � - �'� 4' a . :a r . rt �: 1 ...del y S. 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Ow{.1 280 5 cr & ( �W,4 y RECEIVE® JUN 1 1 2026 gayfield Co. planning and Zoning Agency Private Sewage System Maintenance Agreement mexCV LI-C. b DOCUMENT NUMBER 2026R-612529 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI p � RECORDED VC1�Q- C3'\e, k �t-\8DA O6/11/2O26 1 RECORDIINGFEE:$3O OO PAGES: 1 AS owner, I (we) do hereby certify me pnvate 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) 114 of 114 Section Township _N. Range W. Additional Legal Description: Town ofCa.bk2 (Acreage) .8f Govt Lot nn� Lot O Block SubdivisiorU Y M 4 &&A -N r Lot CSM # Vol. Page CSM Doc # Return To: Planning and Zonir� QQpartrneAFtY JUt12 2026 Co. nning and Zonln9 ❑ In ground gravityIn-ground dosed ❑ In ground pressure distribution wage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Area 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 manufacturers specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wiis. 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 -around 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 maybe 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 bylaw. 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) — Plea Print ar . p Print Subscribed and sworn to before me on this d te} rrr ,�o,�, S' ,&O Dw y /, e, t rJ°' f s N zed °er(s) —Signatures) Notary Public _ . SEAL My ommission Expires: ..�'•, Drafted by: Date: L / ii /2 rip- rffffftf l l ll tll W Proofed by: ulfonnslsanitary/septicmainlenceagreement Revised July 2020 ]FIELD A Bayfield County 0 Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: DUFFY DEVELOPMENT LLC 5702 N HAM LAKE LN, PO BOX 145 STONE LAKE, WI 54876 Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00438 Transaction Number: SR -00438-47A30 Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 8952 Paid by: Merton Maki, 10869 N Smith Ct, Hayward WI 54843 Payment Type: Check Transaction Date: 6/17/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. F YFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number: DUFFY DEVELOPMENT LLC SS -00766 5702 N HAM LAKE LN STONE LAKE, WI 54876 Transaction Number: SS -00766-47D98 Description Private Sewage System (Septic Tanks) Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 1259 Paid by: Duffy Development LLC, 5702 N Ham Lake N, Stone Lake WI 54876 Payment Type: Check Transaction Date: 6/17/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-63S STATE SANITARY PERMIT OWNER: DUFFY DEVELOPMENT LLC GOVT LOT: LOT: 90 BLK: 1/4 1/4 SEC: 23, T 43 N, R 7 W TOWNSHIP: Cable SOIL TEST: 62-26 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: DYLAN SCHULTZ SCOTT ROUSH DATE: 6/17/2026 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 1516129 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 6/17/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION