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HomeMy WebLinkAbout26-64SRequest 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 zoninci(cDbayfieldcountv.wi.aov Note fl Time Change fl Discrepancy riOther Phone Number 715-739-6868 Plumber: Doug Manthey Fax Number Email Address Homeowner: Bradley L & Debra J Nelson norpines@cheqnet.net Immediate Phone Number So Zoning Sanitary Dept can call you right back (if needed) Permit #: 26-64S Plumber's Choice Zoning Dept No Inspection(s) during this time Date: 09/14/26 g G'' a �t! Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zoning Dept Time: 11:00 Township: Drummond Address # & Road Name: 48745 Longview Rd or Directions To Site: Comments: ** Plumbers you must verify any change(s) by fax or email ** Notes from July 2025 .Private Onsite Wastewater Treatment SRS Sv-qtnms ( POWTS). Inspection Report (Attach to Permit) I BRADLEY L & DEBRA J NELSON 11855 HOLLY LAKE RD uses Pm I DRUMMOND W1 54832 City Town -,o oK f /A 6 vc County SanitaryPermit No: State Plan'Transactlon ID#: Parcel Tax No: 141111 /111 V1111OtIU11 TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Set T , N/A N/A Dash N/A Aeration Holding Pump! Siphon Information ump Manufacturer Demand GPM Filter Manufacturer (9v evl Go TOH Lift ;F111terMoydel Fdd Total Forcemain LengthTo Well Pretreatment Unit Manufacturer. Model Number. ttevanon ualia STATION=t4 J ELEV Benchmark7'/o2.'7 Bldg. SewerI( Tank Inlet Tank Outlet Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/ Manifold 1'? /00. Distribution Pipe Infiltrative Surface e g q Final Grade 1.' X Pressure Header! Manifold Distribution Pipe(s) A riore Alze A rile servuuun rips Length Die Length Dia Spac Spacing es Q No Soil Cover Depth Over Depth Over Depth of Seeded /Sodded Mulched n„u r•,..,+,,, (.Ro PdnR,; Topsoil ❑ Yes ❑ No ❑ Yes ❑ No ;OMMENTS: (Include code discrepancies, persons pfresent, etc.) dOL) fv"5CL-l7 Co vr:✓ wilt Lc. ,Sr/owe� Gam• an revision required? ❑ Yes CI No q s 1I ;e other side for additional information, l Date POWYS Inspector's Signature License Number 7 mn-n71n (P nv911 Property Owner Information BAYHELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-6138 Fax: (715) 373-0114 e-mail: zonina(Mbavfieldcountv.orn Web Site: www.bavfIeldcounty.org/147 BRADLEY L & DEBRA J NELSON 11855 HOLLY LAKE RD DRUMMOND WI 54832 Bayfield County Courthouse Post Office Box 58 117 East Fifth Street Washburn, WI 54891 As you know O4 14U H T �/ was contracted by you to install a private onsite wastewater treatment system on your p operty (Tax lD# above). To know when your system will be due for servicing please go to www.septiesearch.com Notes: Abandonment of Old System to meet all applicable code requirements: LI Tank was pumped by: ❑ w Tank was crushed / removed and pipes disconnected by: on at AM/PM On `t m Lc at 1/ (AM / P1the above -mentioned plumber contacted our office to conduct a pre ove inspection as required under DSPS 383. One of the following applies: P : System was inspected and appears to meet all applicable code requirements. fl 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: Utforms/senitarypropertyowner-Input April 209 ��ARTaIe'T �� --- Q Department of Safety County Bayfield � & Professional Services, Si"�' Permit Number (to be filled in by Co.) ss - Industry Services Division 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 are 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. 48745 Longview Rd Print : 1, Application —Please Alllnformatlon:.:: Property Owner's Name Parcel # Bradley L & Debra J Nelson 14713 Property Owner's Mailing Address Property Location 11855 Holly Lake Rd Govt. Lot City, State Zip Code Phone Number Drummond, WI 54832 715-580-0600 SE ,,, NE ¼, section 23 T 44 N R 08 E or W IL � YP of, ti lding (check all that apply) : = Lot # Subdivision Name ® I or 2 Family Dwelling —Number ofBedrooms 1 R...C .,�. Block # ❑ Public/Commercial — Describe Use JUN 16 2026 o Cityof ❑ State Owned — Describe Use 0 Village of CSM Number Bayfield Co. Town of Drummond Planning and Zoning Agen Ill. . a of POWTS`Per nits:(Check .either "N : " ar "Replacement!! and other applicable -ofl IineA. Cheek one boz:on tine B. Coin lets Tine :C ' a livable: A. New System 0 Replacement System System (explain)(explain) ❑ Other Modification to Existing lain 0 Additional Pretreatment Unit lain B. ❑ Holding Tank In -Ground ❑ At -Grade 0 Mound 0 Individual Site Design 0 Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner List Previous Permit Number and Date Issued Expiration `IV.DispeiaaUreatment-Areaand TankInformahon Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 150 0.7 214.28 226 94.0 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units 2 ' 8 o 'g v New Tanks Existing Tanks Ur,i ;L' a Septic or Holding Tank 500 500 1 Infitrator Systems X Dosing Chamber Vsibli Statement- I, the made , s 2.a.,Pn h' ;e;i. a nsi rr installation of the POWTS shown on the attached leas. .,_ lam !_. Plumber's Name (Print) Plu is Si afore MP/MPRS Number Business Phone Number Doug Manthey MP 230722 715-739-6868 Plumber's Address (Street, City, State, Zip Code) PO Box 196 Drummond, WI 54832 'VI.,iCtunty/De 1 1 , �artmeritUse.Only '... .. proved 0 Disapproved Permit Fee $ DT Issued Issuin g Agent I (ID (P -O r Denial Owner Gtven Reason fo De Conditions of Approval/Reasons for Disapproval ) f c 9 a7fti cfe4 euitAd, Attach to complete plans for the system and submit to the County only on paper not less than S 112111 inches in size SBD-6398 (R. 03/22) S�o ORIGINAL __ __ Wisconsin Department of Safety& Prgfessional Services 117 Page ( of I Division of industryServices SOIL EVALUATION REPORT TEST #3- 4' In accordance with SPS-385, Wis. Adm. Code CountyAq, `6(Attach complete site plan on paper not less than 8 112 x 11 Inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. /i7/3 Please print all information. Rev��� (t� � Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)), J b Property Owner Property Location Zr / Govt. Lot _'h S_23T �f' �� N R $'E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: SP *'1i v'• /1 y1 P. 713 (3? f/4I M. /ed !K 4v fry _.2s -)City, State, Zip Phone Number ❑ City ❑ Village Town Nearest Road o New Construction Use: I4 Residential/Numberof Numberof bedroomsI Code derived designflow rate GPD ❑ Replacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft. Parent material f f [fi r 4uTis General comments and recommendations: j vlG ' q ' /� f �,� t 1 t qc j ? s a , l� 7 /7 Boring # ❑ Boring On Ground surface elev.fta Depth to limiting factory O in. / elev. . 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 i O— ?.S)W ¼ 15 .z*jr rlvFrr ,(�-�✓ /coup . 7 i. G - ?.S" "77 sL zoix1P 4 ,'fl,? k.' fvvi '6 to 3 2i-.5.7:S A y $ G .? 6 a F.e &" /vp_ , t'. O JUN 162026 Boring # ❑Boring Bayfield Co. IMPlt Ground surface elev .� ft Plannir© ftpin titlgdacjo/,Z in. / elev .2 ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots ara... r�rrUaxaala.., ,�ua� GPD/Ft2 *Eff#1 *Eff#2 E%-' L.5 24r r Ar1,i Ftr 6zt./coup ,7 . 2 f - If 2flvC 73 $ 4 tf EL RR &i G w 4ov &,c G .� 1• d !.O 3 tic .:,'C 44f S c .M Si -/.0 ?S'YAli' s'y ..J& 44L — .? CST Name (Please Print) /ea Signature CST Number f�--Ql2IAdt.(p r' Ga Date Evaluation Conducted Address W 3 ?D i3� y O Telephone Number * Effluent #1 = BOO >30 5 220 mg/L and TSS '30 5150 mg/L * Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 mg/L SBD-8330 (R03122) Page of ❑ Boring 3 Boring # © Pit Ground surface elevfi''2 ft. Depth to limiting factori'Ke in. / elev.i I Sail 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 —.Z f .7.r e Y .ws b'#( G w GdNA . �D /• $rf YV 2 v".CX ' M v"C C'*' /va . I• P sw-I2o r /y d -S& �� •2 C ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Snil Annlicatinn Ratp Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 JU 1 fi Planning nd Zoning Age iAgi icy * Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 s 150 mg/L G STS Si°- dla loacr,l 7'S-6$'( "190 * Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L 30'/3 5c41e-; ( `':c�ps __ H welt' '9 - "as, 9Y Qdd:4,4„ Dw�c•^ b� I Cst Oleh !l r�- Io � N'�1 sow Ill £4,�e oP. PPbl4tl5D4fJ w.. SY;3 . . s/'Pe RCiJVED JUN 16 2026 Bayfield Co. Planning and Zoning Agency 9 v Pe- l d w.r \& ess . yS1)Ks �;e� Qd row . Dat►r,7 Od �w, rti►aw� $�3 7'qy// go I w v. /I Y3 P. 7/ 713 31 I#cd'cJ 4FL .4S lrs G/o$e l yr d4' �kf�r-wars-) day 2-Iil 119R i,3 m /c 3 'r'vP �o-� S IQ � a.T& fn 4. Jiav r iiiZ f 13317.? )'$ K4 4:-i. ? q e '? w/eI( �' 1- E, BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): Check List 1dex Page / Title Sheet (Optional) .[Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) .-Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used Property Owner's Information not prospective buyer's name) Property Location (Accurate Legal Description with Sec/Twp/Range) 0 oad Name (where driveway is/will be coming off of) RC1VED ❑ Floodplain Elevation, Flow Rate, Comments and Recommendations E Complete Soil Boring / Pit Information JUN 1 s 2026 Date Soil Evaluation was conducted Bayfield Co.Planning and Zoning Agency CST Name, Signature, Number, Address and Phone Number mate Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) lX ench Mark (Description, Elevation and Location) 'ntour Lines (Example = 98.0' /96.0' /94.0') 2roperty Location (Sec/Tw,/Range/, Accurate Legal Description) Borings (Locations and Elevations) rcent and Direction of Land Slope Well Location (Including Neighboring Wells, if applicable) ❑ Location of Wetland Areas, Floodplain and Navigable Waters eBuildings, Driveways, and Structures (Location and Descriptions) [itocation of Property Lines ❑ Existing System Location la Address Number and Road Name 0 Current Surface Elevation of Wetlands and Navigable Waters 4TMr, Owner and Property Information 0'l forth Arrow Fee: •lertified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checldlsi/checklistfoncsts PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan JUN 162025 Attachments: Enclosures: Septic Tank Specifications POWTS Application for Re6 U1ir and Zoning Ac Soil Evaluation Report & Site Map Project Name I Description Nelson Cabin Conventional Owner Name(s): Bradley L & Debra J Nelson Owner Address: 11855 Holly Lake Rd Drummond, WI Project Address: 48745 Longview Rd Govt. Lot: SE 1/4 of NE 1/4, Section 23 , T 44 N -R 08 E U or W [LI Township: Drummond County: Bayfield Project Parcel ID #: 14713 ancy Designer Information Designer Name: Doug Manthey Designer Address: PO Box 196 Drummond, WI E-mail: norpines@chegnet.net License Number: MP 230722 Remarks: Signature: Phone: 715 - 580 -0600 Zip: 54832 Phone: 715 - 739 .6868 Zip: 54832 This space reserved for approval stamp. Date: 06/10/26 a Y o% P1bp4 Iodres: c.'i(& I" cfe' I L/�'7L5 Lora e 4 - I p '1 Pro: well' fJr4.Me Y Ck Deh (I Sys- McIs°� f!v /l7 L4,�� o 1e. ArU tk afd W . Sy83 L e9.c1 rowf .a -A 7)r.�,47 NvWl $3TYYieaiw s t v. If Y3 P. 7 773 39 ,cb'c 1 4p( L ?S)"5 /aSeJ yr ray z -I d 'r?'3 e �e r�o.WIb`n RECEI ED JUN 16 2026 bL. Bayfield Co. Planning and Zoning Agency flu C vs.Ut1O1-Ct q%?'V-5 7r� �xw�► sa;l brp\ 8mr/cc Out 70��.� Sl4 j&�h fry cle a3( 9f. v33TY.? 5Y5le&tz ^C Q Q Y .7 w(Q i c 4 1 r N IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) bflillfl SOIL COVER 12" min. trench depth (typical) min. IT (typical) .4 4; N34" < .. (typical) ::, . a. System Elevation = 94.0 (typical) Septic Tank(s) Manufacturer. Infiltrator Septic Tank(s) Volume(s): 500 gal gal gal gal Effluent Filter Manufacturer. Orenco Effluent Filter Model n: PSCS0621-18 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) ft Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) 1 am --------77- Br ft (typical) RECEIVED INSTALL PER TRENCH: 11 Quick4 Std -W @ 20 If EISA/chamber = 220 ft2 JUN 16 7026 l3ayfield Co. + 1 Pairs of end caps @ 6 ft' EISA/pair = 6 ft2 P ammng acct ,; Agency Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) TA= 3.0 it (typical) \--Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. C) m W 0 m = Proposed EISA per trench = 226 ft2 Required Infiltration Area = 214.28 ft2 Distribution Method: x 1 trenches = Proposed Total EISA = 226 ft2 branched manifold RESET PAGE 4 OF 4 In -ground Gravity Management Plan 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 150 gpd; BOD5 S 220 mgL''; TSS 5150 mgL 1; FOGS 30 mgL'' Inspection Checklist INSPECT EVERY 3 YEARS ME.L,E.IVED o type of use o age of system JUN 16 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 tanks) 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 (113) 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 filters) 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: HK Septic Phone: 715-798-3494 Local government unit: Bayfield County Zoning Phone: 715-373-6138 Local government unit address: PO Box 58 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. LIFTING STRAP (TYPICAL) ►`'III�I�IIIIIII�IIGIIiIjjlllll�' !;;T ' II'Ii� • �jj U�.�li� .. `Ii►� II �IIII �)' 0 U C 64.9 [1649[ EXTERIOR LENGTH —1 TOP VIEW _.._.... _.,---.-....�.....,, ,...9 LOCIONO LID SECTION A - A' tNV VICW NOTES 1. ALL DRAWING DIMENSIONS IN INCHES [MILLIMETERS] OR AS NOTED. 2. EXTERIOR OF ACCESS OPENING UD INCLUDES THE FOLLOWING WARNING IN ENGLISH, FRENCH & SPANISH: 'DANGER DO NOT ENTER: POISON GASES." 3. TANK MARKINGS WILL INCLUDE: MANUFACTURER NAME. MODEL NUMBER. LIQUID CAPACRY, DATE OF MANUFACTURE CODE, MAXIMUM BURIAL DEPTH, INLET, AND OUTLET. 4. MAXIMUM BURIAL DEPTH IS 49 In [1219 mm]. 5. MINIMUM BURIAL DEPTH IS 61n (162 mm]. 6. TANK IS FOR NON -TRAFFIC APPLICATIONS. 7. NOMINAL WALL THICKNESS IS 0.20 In 15 mm]. JUN 16 2026 8ayfl&d Co. Planning and Zoning Agency TRAP tI Tm AL) DRAINAGE SOLUTIONS, INC (317) 346-4110 www.drainagesolutionshic.com ISOMETRIC VIEW irefox https://novus.bayfieldcounty.wi.gov/access/REAL%2OESTATE/listin... Real Estate Bayfield County Property Listing Today's Date: 6/12/2026 V' Description Updated: 1/14/2025 Tax ID: 14713 PIN: 04-018-2-44-08-23-104-000-10000 Legacy PIN: 018110305000 Map ID: Municipality: (018) TOWN OF DRUMMOND STR: S23 T44N R08W Description: SE NE IN V.1143 R84 833 (39 ACRES MFL 25 YRS CLOSED YR OF ENTRY 2025) Recorded Acres: 40.000 Calculated Acres: 0.000 Lottery Claims: 0 First Dollar: Yes ESN: 74 Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 018 TOWN OF DRUMMOND 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE Recorded Documents Updated: 8/11/2011 ® MFL ORDER Date Recorded: 11/15/2024 2024R-605512 ® MFL TRANSFER ORDER Date Recorded: 7/16/2015 2015R-559560 1145-621 ® WARRANTY DEED Date Recorded: 5/27/2015 20158-558891 1143-84 ® QUIT CLAIM DEED Date Recorded: 8/1/2011 2011R-539578 1065-996 ® PERSONAL REPRESENTATIVES DEED Date Recorded: 8/1/2011 2011R-539577 1065-995 ® CONVERSION Date Recorded: 3/15/2006 300-161;775-285 Property Status: Current Created On: 3/15/2006 1:15:21 PM SR Ownership Updated: 6/4/2015 BRADLEY L & DEBRA J NELSON DRUMMOND WI Billing Address: Mailing Address: BRADLEY L & DEBRA J BRADLEY L & DEBRA J NELSON NELSON 11855 HOLLY LAKE RD 11855 HOLLY LAKE RD DRUMMOND WI 54832 DRUMMOND WI 54832 Site Address * Indicates Private Road 48745 LONGVIEW RD DRUMMOND 54832 ® Property Assessment Updated: 5/5/2025 2026 Assessment Detail Code Acres Land Imp. Gl-RESIDENTIAL 1.000 10,000 6,600 W6-MFL - CLOSED AFTER 39.000 58,500 0 2004 2 -Year Comparison 2025 2026 Change Land: 68,500 68,500 0.0% Improved: 6,600 6,600 0.0% Total: 75,100 75,100 0.0% M Property History N/A k1 GEIVED �IUN 162026 Bayfield Co. Planning and Zoning Agency c117Mn'16 G.M A" Private Sewage System Maintenance Agreement Owner(s) Name Bradley L & Debra J Nelson Owner(s) Mailing Address 11855 Holly Lake Rd Drummond, WI 54832 48745 Longview Rd ID # 14713 As owner, I (we) do hereby certify the private sewage system will be installed in accordance with the certified soil testers 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) SE 114 of NE 114 Section 23 Township 44 N. Range 08 W. Additional Legal Description: Town of Drummond V.1143 P.84 833 Lot Block Subdivision (Acreage) 39 Gov't Lot Lot CSM # Vol. Page CSM Doc # DOCUMENT NUMBER 2O26R-612554 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 06/15/2026 AT 1 1: 1 2 AM RECORDING FEE: $30.00 PAGES: 1 Recording Area Return To: RECEIVED Planning and Zoning Department JUN 16 2026 Planning and Zoning Agenc ® in -ground gravity ❑ 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 (113) 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 Bayffeld 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 ml! 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) — Please Print G$Y MI Subscribed and sworn to before me on this date: 7brca. Z• Ncfsav1.1 �..,�!.�. ..;,� �(� � � 2DZC.P -L Jae l� i '. r �J �..`�l .:r, s Notarized Owner(s) — Signature(s) M. : " .; Pubica4 LZL i1 ji44, g1yn;) •'•..� • ; _ ; Co mi ion Expires: Drafted by: Doug Manthey Date:�'i Proofed by: u/forms/sanitary/septicmaintenceagreement Revised July 2020 BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) //Check List a Original Sanitary Application (Submitted in Deed Holders Name — nQ 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) 0 Cross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer 0 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) ❑ Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) ❑ Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) ❑ ATU Servicing Agreement (Recorded at Reg. of Deeds) Vee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) dI Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) Voil and Site Evaluation Report (383.22-3(2)(b)1.e.) RECEIVED Cl State Plan Review (when applicable) JUN 16 2026 ❑ Copy of Warranty/Quit Claim Deed (Optional) Ba/fieid Co. Sanitary ADDlication: (Include the following Information) Plannin;; Agency Application Information must include: 0 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) E Project Address or Road Name where driveway is/will come off of) e'11 Type of Building ❑ III Type of Permit Ca'1V_ Type of POWTS System irc Dispersal / Treatment Area Information 1 -Vf Tank Information oar! Responsibility Statement (Plumber's Information) 0 *Date Stamp* Plot Plan: (To Scale or To Dimension) nature and Plumber Information ❑ Surface Elevation of Body of Water a' iirection and Percent Land Slope la'fank and Filter Information and Location ❑ Wetlands / Navigable Bodies of Water l2"Absorption Area (Proposed and Existing) Tench Mark (Location, Elevation and Description) B -(Owners Phone Number) 2ddress Number and Road North Arrow 2Contour Lines .0'Structures and Driveways ring Locations E1roperty Lines L3'`ell Locations Manual Version Descriptions Turn Over ► • Cross -Section and Over -Head Profile of the System: •I�Surface and System Elevation C� Position of Observation and Vent Pipes (Dimensions and Depths QiMake, Model & Number of Chamber Units in each Cell Property Information iiow many systems will there be on this parcel of land? 1, Comas this property been split? (Property Statement shows Property History) Fees: ff' rivate 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) JUN 16 2026 Bayfield Co. Planning and Zoning Agency u/forms/cheddists/checldlstforsanitaryapps (10/2009);(®7/2011);(®2/2012)(05/2/2012 -dc) Proofed by: BAYFIELD COUNTY SANITARY PERMIT (#04)-26-64S STATE SANITARY PERMIT OWNER: BRADLEY L & DEBRA J NELSON GOVT LOT: SE LOT: BLK: NE 1/4 1/4 SEC: 23, T 44 N, R 8 W TOWNSHIP: Drummond SOIL TEST: 63-26 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: DOUGLAS MANTHEY SCOTT ROUSH Authorized Issuing Officer DATE: 6/17/2026 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 230722 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