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HomeMy WebLinkAbout26-65SDepartment of Safety County Qd y Fr a 14 & Professional Services, Sanitary Permit Number be filled in by Co.) $ e'S oo-7-70 Industry Services Division (to a/ n SS- Sanitary Permit Application State Transaction Number In accordance with SPS 38321(2), Win. 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 Y �/ 0 9/5l v5 C JWL purposes in accordance with the Privacy Law, s. 15.04(1 )(m), Stats. 0 0 I. Application Information —Please Print All Information Property Owner's Name SParcel ZWje,/ A, Welk # 39873 _ Property Owner's Mailing Address Property Location P. o. &ox x34, 5 Govt. Lot City, State Zip Code Phone Number � (( II / C th&, Yli/ sg'u 7/s" iq.-osa/ SW Y* NW Y+, Section /D T 47 N R 05 E) W IL Type of Building (check allthat apply) Lot # Subdivision Name IS I or 2 Family Dwelling - Number ofBedrooms 3 _ R Block// El Public/Commercial - Describe Use JUN 17 2026 ocityof ❑ State Owned - Describe Use ❑ Village of CSM Number Bayfield Co. Planning and Zoning Agency I&Town of_____e= 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 ii anlicable.) A. Mlew System ❑ Replacement System Other Modification to Existing System (explain) ❑-IA B' ®Holding Tank ❑N -Ground ❑At -Grade 0 Mound Dndividual Site Design ❑Other Type (explain) (conventional) C. [}renewal Before ❑ Revision ❑Change of Plumber ❑fmnsfer 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/st) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation Capacity in Gallons Total Gallons #of Units Manufacturer Tank Information A y New Tanks I Existing Tanks e U iii u rn lE O W P. Septic orHotdmg Tank S JP_O 30tO I p s4 /OrG hcrtJc N FT Dosing Chamber H H H V. Responsibility Statement -I, the undersigned, assume responsibility f Installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Signature MP/MPRS Number Business Phone Number 2YN/S R•43/"l:�SS 21/S/iP %/S"Sec' C)ZS4 Plumbers Address (Street, City, State, Zip Code) 42GZ5 k'A &nAUge/ RD. CAaLE W/ Sifll VL County/Department Use Only Approved ❑ Disapproved Permit ,lFee $ //�� rnIss ed 1'rL Issuing A t/SJ(i��lra�re �J t / ❑ Owner Given Reason for Denial LVV ^ "P b'� ►�, `� 3; Conditions of Approval/Reasons for Disapproval Se-i e cad . Attach to compkte plans for the system and submit to the County only on paper not less than S 1/2' II Inches N size SBD-6398 (R. 03/22) oatf WiisconsinDepartmentofSafety & Professional Services S SOIL TEST Page / of. — _4 \ Division of Industry Services SOIL EVALUATION REPORT T x .Z.a; - 4&ji:e- 3%73 In accordance with SPS 385, Wis. Adm. Code County 8aYAdl4 Attach comFaete site plan on paper not less than 5 112x 11 Inches In size. Plan must Include, but not limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel 1-D- 04—aZo-Z-47.6$ -16 -3 scale or dimensions, north arrow, and location and distance to nearest road. 6Z—ekcO.236c+ Please print all information. Ravi 41- //�3,/ I Date Personal Information you provide may be used for secondary purposes (Privacy Law, a. 15.04(1)(m)). Property Owner Property Location ❑ 1)anie/ 4. i�lelk GouLLet 3w Y. M %S ID ' t47 N RCS E(or W Property Owner's Mailing Address Sfte Address or CSM and Lott /t/. m• 0 3G5 City, state, zip I Phone Number O city ❑ Village ITown I Nearest Road Cab/.. Wr 4 /sz/ (7's ) .1f3-0321 .Ci /ergo I z/s /lwf Z ®NewConseuelon Use: SResidential! Numberofbedrooms _.T Code derived designflowrate 45b GPO ❑ Replacement ❑ Public or commercial —Describe: Flood Plan elevation If applicable ft. Parent material cynY General comments and recommendations ILL c50/LS INEatE s4'z'pA1Pb W17XI W4i3 S /ZY.(k /N 1a14/ SFss5 Boring # ❑Boring 43.20 2. yo �PIt Ground surface ale¢ R Depth to limiting factor 4 in. / efev.h. s A-C:A.r 'w/e: RLL. Sw45 Wb77e S4rQR4TsD r -7 VA DF /AJ3pnTt7Ol Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. St Sh. Consistence Boundary Roots OPD/Ft2 •Etf#f ,Eff#2 4 SYR 2. S z NQ Sc.! L m sM m yW 31 r 2 4-14 Sm 3 ! Y 0 c! 4-62 2.SYR3/ 1 5 Y 44 c!,0 m i flEcuvrg - fjt o ET Y,eLa BortnF: # - ❑aring Planning and Zu er.; A0ency �tPit Ground surface elev. 44 ft. Death to Ilmilna factor i3 iw l elnv_ it. Horizon Depth In. Dominant Color Munsell Redox Description Qu. AZ. Cont. Color Texture Structure Or, Sz. Sh. Consistence Boundary Roots GPD/Pt' 'Eff#1 'Etf#2 o-2 SYRZ5 A sal 2mslk ml; ' 1' $2 a s - is' yy 3i if sya s W C o /5 -Ca YR sYR s 0 cob 0 CST Name (Please Print) Signs CST Number Z 2./ $%!p Address 42625 Ka a 41b I✓' Date Evaluaon C nduclod _ Telephone Number CadlQ 1 S•18L 05/02/24 I 7'5 5O —02,54 IEfluent#1=SOD> 30s 220 mg/L and TSS >30 s150nnglL • Efluent#2= SOD, s 30 mgll. and TSSs 30mg!L SBD-8330 (803/22 �� Baring I 5'7 r Page of ,4 iS I Baring # ® Pit Ground surface elev. eft Depth to limiting factor in.! elevi_2 tt Horizon 2 Depth In. d. "-. /i—/2- 2- Dominant Color Munseg 5YR 2.5 2 Y 3/4 YR 3 Redox Description Pti Qu. Az. Cant Color NA 1 5Yk.f8 l 9 TextureSoil 5 c1 c c1 Structure Or. Sz Sh. 2 mjM< OF m Consistence 'n ; Boundary t✓ Roofs plication Ral OPD/t:t2 ' Eff#1 , 2 TI , 3 o O M b ® Boring# ❑Boring is Pit Ground surface elev. ft Depth to limiting factor 7 In. / elev%D ft Horizon Z Depth In. o -7 - /t Dominant Color Munsell 5YR ZS 2 YR YR / Redox Description Qu. Az. Cent Color d s Texture 5` Structure Gr. Sz. Sh. Z m SGl! Consistence 'nf, Boundary Roofs I m SoIIAGI Application Rau 2 •Eff#1 •Eff#2 : Z 3 O o 3 2.5 y 3 a] Boring # ❑ Boring -F - Pit Ground surface elev '}' �O ft. Depth to limiting factor S in.! elev.`s?' 1 ft Horizon ! . 2 "Depth In. 6-, 9. Dominant Color Munsell VR'-'a 5YR 4 Yk '4 Redox Description Ou. Az. Cent Color Nil I s e / S e s Texture C cl y ctumSoil Or. Sz. Sh. 2rn. C5 Consistence i' C fo Boundary Roots Application Rat, GPD/R' •Etf#1 .2 'EO#2 O O *Effluent#1=SOD>30 s22Dmg/Land TSS>305150 mg!L *EMuent#2= SOD. 530 mglL antl TSSS30mgIL RECEIVED JUN 122026 hayfield Co. Planning and Zoning Agency 17AN/ W P.o. eoX3G3' CaA Lj WZ 549t/ / ZE N6. fl'a5 SW/ NW Sec 14 r47,v ROSW 6QYP1s24 Co, d'/; Pz sw 3So l TO W<s, /,Ac Pa3 vtp LL —y4 T/o)y s A gM41'p0FrTOP%gyp✓G a pq• P/PQr SAsc of 23 "Dia . iw.w P,v. Pz P3 9;�o' P4 /oO,lpo' P5 9S, 9o, /g,90 N Pas REC =IVED p (� JUN 122025 6ayfeld Co. Planning and Zoning Agency PAGE 1 OF 4 Holding Tank Plan Index & Cover Sheet Component Manual Design References: Holding Tank Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet RECEIVED Pg 2 of 4 Plot Plan JUN 7 7 2026 Pg 3 of 4 Holding Tank Specifications Pg 4 of 4 Management Plan Bayfield Co. Planning and Zoning Agency Attachments: Enclosures: POWTS Application for Review a/rteaI a Zonin Soil Evaluation Report & Site Map (if ap Holding Tank Pumping Contract (if appi Holding Tank Agreement (if applicable) Project Name / Description plicable) cable) Owner Name(s): /J/iN/,CL W4 LA Phone: 1,.( - 4/3 -o Z. Owner Address: /P t7 • Sox 36 0 , C &4 , IX// Zip: 54'9' 2/ Project Address: 28095 US HbvV 2 Govt. Lot: X1/4 of MV 1/4, Section /o , T47_N-R G S E ❑or W Township: GL/Lc-ffT/ County: Project Parcel ID #: 398% 3 Designer Information Designer Name: .Oe..nntsC m assn Phone: 7/5 -gsa - oLS4 Designer Address: 4 "2C Kauanattq6 Rd C"le, W/ Zip: S'fBZ/ E-mail: C/cfl n/sr z trnUtlt/I 19 #6 '2 f ma i can This space reserved for approval stamp. License Number: 22/5'! lv Remarks: Signature: _4_-_. Date: Original signature required on each submitted copy. Reset Page C -4 L, W2 544Z/ nzs Na. Zgo85 5W, NW Sec /O, T4- 7,v R L15W Tpov4 / D& L"/L FiV ?dyp/r16 e0, 11/2 a P/ P4/ - I L N pLo r pctSn/ —" 5�ols. Pz 4 3e949 641 flwit /ta�oiy 3Q' -V 7t Wes-/ /'no P43 CLAY A r/oiy s 4 fr7 d'O PT WY 3. PVC P/PE .fir A"L' *P Z3 "PM • 1N/P/7P P•ve P1 T3za P2 P414' P3 9,,go ' P4 /00,4' P5 9s, -pa, PO /00,80, RECEIVED JUN 17 2026 P.S Bayfield Co. R: Planning and Zoning Agency z' - — Avkp r6 czs '/ice `4 Pe ff PAGE 3 OF 4 HOLDING TANK SPECIFICATIONS (No Scale) 23 Weatherproof 12" Min. 01 2.0 ft above Junction and Approved Established Flood Elevation Alarm Box Vent Cap (typical) Electrical must comply with Approved Locking Manhole SPS 316 and NEC 300 4"0 Vent Pipe with Warning Label Attached Conduit >10 ft from (typical) 4" Min. or 2.0 ft above Building Established Flood Elevation -.-_-.—�.� / (typical) Seal Finished Grade 18" Min. v (typical) e' . 1 n 4 _ Inlet Inlet Invert Approved Joints with J/ Approved Pipe 3 ft onto Max. 12" or 90% of total volume JUN 17 2026 Solid Ground if more than one tank Alarm -On Bayfield Co. • Planning and Zoning Agency HOLDING TANK VOLUME= 3ooep, gal 3" Approved Bedding Material Beneath Tank TANK MANUFACTURER: 5QPL�1-Pf PRzcCAs'r Ca*''c,eu72s Anchor tank as necessary pursuant to SPS 383.43(8)(g) Plug Ballast Weight = [(cu.ft.tank.vol x 62.4 Ibs/cu.ft) - lbs.tank.wt] x 1.5 Ballast Weight = [( % ? cu.ft. x 62.4 lbs/cu.ft) //11 - ______ Ibs]Lx 1.5 = '39/81 %/B lbs /yvTG.' lv/ esc s 4 o//At/ Sty S/,'ems rl Na/c s Px..?/4 I SUPERIOR PRECAST CONCRETE LP1800/1100 2 -Compartment Tank 1 eight (in lb:) Tank: 16,366 Lid: 9,175 Total: 26,141 Volume of Concrete Total : 6.5 Id' Gallons Per Inch: 70.5 Lid Wall Enlarged Derail N Condiuonaly APPROVED DEPT.OF SAFETY PROFESSIONAL T I 1. SERVICES '-� DIVISION OF INDUSTRY SERVICES 50" SEE CORRESPONDENCE Manhole OpL�D ening% 7+ e e TOP VIEW is -l" 107" 69" P� /4 5 SUPERIOR PRECAST 1809 Gallons j I1_c Gallons 42.06 GPI 26.16 GPI SIDE VIEW L 9" Air Space Liquid . Dept ----`-I---------__-M H --- 96" 102" ES*3 4[' 2-1P2" Taper ��ri�dl9y Superior Precast Concrete, LLC PO Box 1390 JUN 17 2026 Hayward, WI 54843 BaYOelo P Co4M ning and Zoning Agency Polyethylene 5 Baffle / SUPERIOR PRECAST CONCRETE Design conforms to ASTM C1227, Specification for Precast \Ia.ttic Concrete Septic Tanks and WISPS 384.25,POWTSHolding Rope Components or Treatment Components. The information provided on any Superior Precast Concrete (SPC) drawing or document shall be verified bythe purchasers licensed professional engineerfor suitability of use. Configuration may change from drawing, consult with SPC. IPmtluq Rle No: I TNakpopMlaryiSonna4ou.and itmains the p.opMyol SupaM,P,sa,l Comet. LLC. R30S14]NAI 9 PAGE 4 OF 4 Holding Tank Management Plan IMPORTANT: The owner of this holding tank(s) 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 holding tank(s) 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. Estimated Daily Wastewater Flow = .3oo gpd Inspection Checklist INSPECT EVERY 3 YEARS o type of use RECEIVEL) o age of system o nuisance factors (i.e. odors, user complaints, etc.) JUN 177026 o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) Bayfield Co. o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) Planning and Zoning Agency o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o surface discharge of effluent or sewage back-up into structure served SERVICING FREQUENCY o The tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wisc. Stats. when the wastewater in the tank(s) reaches a level of one foot below the Inlet invert of the tank(s). Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. Tank pumping reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wis. Admin. Code. Report any component failure or malfunction to: Name of individual or company: DL t,Ez W L=am � Phone: 7�S /3 5Z/ Local government unit: 711(yl(! 07" E1 L N✓ Phone: Local government unit address: 2 y/ 3O .SrSta ,4kyV /3[' Zip: S-196& 51// -.-NO, N!% 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 component of this holding tank(s) cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agecy for review and approval. System Abandonment If use of this tank(s) is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. Reset Page HOLDING TANK SERVICING CONTRACT Date F[CLOZtra�cttet Zo2C Holding Tank Owner(s) Name(s) VQf1 iEl, weG 1� This contract is made between the 'umper's Name (Print) I - Pumper's Signature We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT LOCATION Legal Description: (Use Tax Statement) 39$ 7� X1/4, 1/4, Section O ,Township 4, N,Range Oy w Town of: I Lot Size I Acreage CiLEE1V ,� G3 x33 6,08 Gott Lot Lot # GSM # Vol. Page JGSM Doc # Lot(s)No. Block(s)No. Seshdiacion: DOG ZO:q. — fj c, f rf zs 3/0 vI -I - 1. The owner agrees to file a copy of this contract with Bayfield County as required in SPS 383.55, Wis. Adm. Code 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local government unit which has signed the pumping agreement required by SPS 383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; C. The location of the property on which the holding tank is installed; JUN 17 Zo26 d. The sanitary permit number issued for the holding tank; Ba e. The dates on which the holding tank was serviced; Planning a d zo ng Agency f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a op$ rn".gKmt �r ct with the local government unit and the County named above within (10) business days rpm tqp6itA this service contract. C; STATE OF WISCONSIN Owner(s) Name(s) (Print) Owner's Signature(s) //,�Subscribed and Sworn to �me:1 p r\ Ptq'NlFt wH-tc f / LL�I'!'� onthis,�� day ofJa)pI�C�- 9l-U� by: A d4 C �Nh Notary Public zz l My commission expires on: 5 �J 3\u 8 Revised: May 2016 (®May 2018) Drafted by Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (I)(m)) , l- ©0as Document Number/Plan I.D. No. HOLDING TANK AGREEMENT Owner Name (s) Owner(s) Mailing Address 9(1/hi wk p° 9C$. 365 caete t✓) / s Parcel d Identifier Nyube��o^� On,_ Agreement Date (same as Notary Date) Ann —'9 2O#V) 4 11�hP 3 2az6 We acknowledge that application is being made for the installation of (a) holding tank(= on the following property or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. SPS 383, Wis. Adm. Code or Ch. 145, Wis Stats.Te.k It) 3TS 73 SW 1/4of 141/4 Section /O Township 47 N. Range OS W. Town of / /ebn Additional Legal Description: 1 p �-ti /fp f &T&CH Ed Gov't Lot_ Lot_ Block_ Subdivision CSM# Lot CSM # Vol DOCUMENT NUMBER 2O26R-61 2543 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 06/12/2026 AT 1:45 PM RECORDING FEE: $30.00 PAGES: 2 rs i EIVF' Return To: Zonlh& JUN 152026 Bayfield Co. Planning and Zoning Agency ' Wrl As an inducement to Bayfield County to issue a sanitary permit for a holding tank 5h the ve described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding tank installation and maintenance. If the owner fails to have the holding tank properly serviced in response to orders issued by Bayfield County or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Scats., Bayfield County may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Scats. 2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. 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 shalt be collected as provided by law. 3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Stats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NR113, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the county within 30 days from the date of change to the service contract. 4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis. Stats., and Ch. NR 114, WI's Adm. Code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained. 5. This agreement will remain in effect only until Bayfield County certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. SPS 383, WI's Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. Owner(s) Name(s) — Please Print Subscribed and swom to before me on this date: pPN;fG wELt lcnt 3/ oZDco Notarized Owner(s) — Signature(s) N tary AN . KOIVISTO P v6e- My spmmyss'oi Exp•�: E OF WISCONSIN Drafted by: PA ` .TEL V C is Date: Personal informaeon you provide may be used for secondary purposes iPdvacy Law, a.15.04 (p(m)] ulforme/sanitaryfddinglankagreemenLdoc eJune 2018 Real Estate Closings 885 W. Broadway Avenue GOWEY Title Tittle Insurance Medford, WI 54451 www.goweytitle.com File No. G-2601636 ADDENDUM/EXHIBIT A A parcel of land located in the Southwest Quarter of the Northwest Quarter (SW1/4-NW1/4) and the Northwest Quarter of the Southwest Quarter (NW1/4-SW1/4), Section Ten (10), Township Forty-seven (47) North, Range Five (5) West, Town of Eileen, Bayfield County, Wisconsin, more particularly described as follows: Commencing at the West 1/a corner of said section; Thence S89°50'06"E along the monumented north line of the SW 1/a a distance of 135.67 feet to the Point of Beginning; Thence N69°07'56"E along the southerly right of way of U.S.H. "2" a distance of 561.47 feet; Thence S00°51'35"E a distance of 201.39 feet; Thence S00°5754"E a distance of 330.93 feet; Thence N89°49'54"W a distance of 663.45 feet to the monumented west line of the SW 1/a; Thence N00°56'49'1N a distance of 278.95 feet to the southerly right of way of U.S.H. "2"; Thence N69°07'56"E along said right of way a distance of 144.28 feet to the Point of Beginning. Tax ID Number(s): 04-020-2-47-05-10-3 02-000-20000 (Parent) 04-020-2-47-05-10-2 03-000-50000 Bayfield County Register of Deeds Document #2026R-611459 Page 2 of 2 I 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: Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00440 Transaction Number: SR-00440-47AEE Amount $50.00 Total: $50.00 Payment Amount: $51.95 Reference: 1043039645 Paid by: Dylan Ortman Payment Type: Debit Transaction Date: 6/12/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. P 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: WELK, DANIEL A PO BOX 365 CABLE, WI 54821 Description Private Sewage System (Holding Tanks) Submission Number: SS -00770 Transaction Number: SS-00770-47EA0 Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 516 Paid by: Daniel Welk, 1600 Ole Lake Rd, Cable Payment Type: Check Transaction Date: 6/18/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-65S STATE SANITARY PERMIT OWNER: DANIEL A WELK GOVT LOT: LOT: BLK: SW1I4 /4 NW1/4 /4 SEC:10, T 47 N, R 5 TOWNSHIP: Eileen SOIL TEST: 61-26 NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: DENNIS RASMUSSEN TRACY POOLER Authorized Issuing Officer DATE: 6/18/2026 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: # 221516 Condition: Properly Maintain System Per Recorded Agreement. Must be within 25 ft of an all- weather road. THIS PERMIT EXPIRES 6/18/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION