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HomeMy WebLinkAbout26-0296BAYFIELD COUNTY I Zoning District CS- oo) 6H SANITARY PERMIT APPLICATION Lakes Class I. APPLICATION INFORMATION Soil Test I County _ (Please Print All Information) No: I Permit No: Property Owner's Name: Ida fa ( `(c- County: Bayfieid Address of Property: ' 1 J� 1111 ll S ygy 6bags CO ft "rov,R. e Wc Property Location: NE %SU %,S al T LR.- N,R g E(or) r Property Owner's Mailing A ss: Township: 1 yv R,,W Gov. Lot #: sa City State Zip Code IS48y� Phone Number is X319 Lot # Block #: CSM #: CSM Doc # Subdivision Name for` <-Q{ 393 II. TYPE OF BUILDING: (Check One) ❑ State Owned TaxID#,. RECEIVED ❑ Public (Explain the use/purpose ) I s £ /fi J �r 1 or 2 Family Dwelling - No. of Bedrooms �_ Ill. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) IIKj New ❑ Replacement [I]County Private Interceptor Bayfield Co. Planninn and Zcn;..,a Agency ❑ Reconnection ❑ Repair ❑ Revision " ❑ Transfer of Owner (List Previous Owner below) B) ❑ A Sanitary Permit was previously issued. Previous Permit Number Date Issued: IV. TYPE OF NON -PLUMBING SYSTEM: (Check One) * Replacements need previous permit number and date filled out above C) ❑ Pit Privy ❑ Vault Privy (Vault size: gallons or cubic yards) S) Mar &XC ❑ Portable Privy ❑ Camping Transfer Unit Container Composting Toilets ❑ Incinerating Toilet V. ABSORPTION SYSTEM INFORMATION: 1. Gallons I 2. Absorp. Area 3. Absorp. Area I 4. Loading Rate I 5. Pero. Rate I 6. System I 7. Final Grade Per Day Required (Sq.Ft.) Proposed (Sq. Ft.) (Gals. / Day / Sq.Ft) (Min. Inch) Elev.(Feet) Elev. (Feet) VI. TANK Capacity Fiber INFORMATION: In Gallons Total Gallons # of Tanks Manufacturer's Name Prefab. Concrete Site Constructed Steel - glass Plastic Exper. APp New Existing Tanks Tanks Septic Tank or Holding Tank Lift Pump Tank / Siphon Chamber VII. RESPONSIBILITY STATEMENT: I the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Owner'sName(s): (Print) I!appiyngfor Section Cabove I Owners Signa (s): r m'as) V tii.tam Plumber's Name: (Print) ifapptyingfor Section AorB)above Plumber's Signature: (No Stamps) MP/MPRSWNo: Plumber's Address: (Street, City State, Zip Code) Home Phone: Business Phone: VIII. COUNTY! DEPARTMENT USE ONLY / I ❑ Disapproved I Sanitary Permit/Transfer Fee: I Date Issued: I Issuing Agent's Signature / Date: / Approved ❑ Owner Given Initial /as/a°a6 ' Adverse Determination �'��i1il IX. CONDITIONS OF APPROVAL! REASONS FOR DISAPPROVAL: A(nA-At✓1 aS Get Ubk (utspec4, t.. as Merle q r Plot Plan on reverse side Lot Line �V 3 RECEIVED JUN 16 2026 Bayfield Co. Planning and Zoning Agency Name of Frontage Road ( ) 1. Name the frontage road and use as a guideline, fill in the lot dimensions and indicate North (N) 2. Show the approximate location and size of the building. IMPORTANT DETAILED PLOT PLAN 3. Show the location of the well, septic tank and drain field. IS NECESSARY, FOLLOW STEPS 1-7 (a -o) COMPLETELY 4. Show the location of any lake, river, stream or pond if applicable. 5. Show the approximate location of other existing structures. 6. Show the approximate location of any wetlands or slopes over 20 percent. 7. Show dimensions in feet on the following: a. Building to all lot lines i. Privy to building b Building to centerline of road j. Privy to lake, river, stream or pond c. Building to lake, river, stream or pond k. Drain field to closest lot line d. Septic / holding tank to closest lot line I. Drain field to building e. Septic/holding tank to building m. Drain field to well f. Septic / holding tank to well n. Drain field to lake, river, stream or pond g. Septic / holding tank to lake, river, stream or pond o. Well to building h. Privy to closest lot line Submit To: Bayfield County Zoning Department, PO Box 58, Washburn, WI 54891 u/Form s/sanitary/bayf eldcountysanita ryappl i cation Revise: June 2018 Proofed by: RECEIVE© ± `j t JUN 16 2026 �O © Bayfield Co. Planning and?nairg Agee/ O 7 Premier Buildings PHONE: 8448791468 EMAIL: kyle@premierbuildings.us ORDER SHEET (REQUIRED ON ALL ORDERS) Dealer Name L.miry sidke LLC Customer Name L Building Size lz 3 x ax 3 Building Style Cabin Building Diagram (Please draw placement of options here, Required on ALL Orders): �j�€ pq , C7� C k 5 C k 5 ra NA >s.t t,l> J• 00 �' 1�s7 3X [;:ic `i. Ce,JNnn�4t ��s C 1 � 9oc L•^" .%, 1 3t"j cylao ttt, is ' 4 RECEIVED JUN 16 2026 Bayfield Co. Planning and Zoning Agency Written Directions: SEE DIAGRAM Customer Initials Ornmiar OnAehln Rnllrunne A. FIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-4010 Property Owner: Description County Sanitary Permit: 1 Payment Amount: Reference: 2745 Paid by: Martha C Oie / Susan K Maki Payment Type: Check Submission Number: CS -00164 Transaction Number. CS -00164-48A18 Amount $150.00 $150.00 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. Town, City, Village, State or Federal Permits May Also Be Required LAND USE - SANITARY - Composting Toilet SIGN - SPECIAL - CONDITIONAL - at BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 26-0296 Tax ID: 19605 Issued To: OIE, MARTHA C Location: S21 - T47N - R08W Town of IRON RIVER Legal Description: PAR IN NE SW IN DOC 2026R-612107 473 Residential Structure in R1 Zoning District For: Sanitation Permit — New [Composting Toilet] (Disclaimer): Any future expansions or development would require additional permitting. Condition(s): Maintain as required. Get UDC inspection as required. You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the department of natural resources wetlands identification web page or contact a department of natural resources service center (715) 685-2900. NOTE: This permit expires two years from date of issuance if the authorized construction Emily Macgillivray, AZA work or land use has not begun. Authorized Issuing Official Changes in plans or specifications shall not be made without obtaining approval. This permit may be void or revoked if any of the application information is found to have been misrepresented, erroneous, or incomplete. June 25, 2026 This permit may be void or revoked if any performance conditions are not Date completed or if any prohibitory conditions are violated.