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Home My WebLink About26-80SI Department of Safety County Bayfield $r_ p o7ty & Professional Services, Sanitary Permit Number (to be filled in by Co.) Industry Services Division aL- $os 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. 15615 Beeksma Rd, Herbster, WI 54844 I. Application Information — Please Print All Information Property Owner's Name Parcel 4 Eric Missinne & Amy Missinne 11758 Property Owner's Mailing Address Property Location 1118 Faxon St Govt. Lot City, State j Zip Code Phone Number Superior, WI 54880 715-919-4371 NW 3, SE , Section 21 T 50 N R 07 E o II. Type of Building (check all that apply) Lot # Subdivision Name e l or 2 Family Dwelling —Number of Bedrooms 2 Block 4 ❑ Public/Commercial — Describe Use ❑ Cityof ❑ State Owned — Describe Use 0 Village of CSM Number 2022R-596933 a Town of Clover 111. 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 applicable.) A. �a New System S ❑ Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B' ❑✓ Holding Tank ❑ In -Ground ❑ At -Grade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration IV. Dispersa Vrreatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) I Dispersal Area Required (s fl I Dispersal Area Proposed (st) System Elevation 300 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units Cs s C o'8 New Tanks I Existing Tanks e . 0 'v. V $ au � y wV a Septic or Holding Tank 2100 2100 1 Superior Precast ✓ ❑ Dosing Chamber ❑ V. Responsibility Statement- I, the undersigned, assume shown respoon the attached plans. nsibility foriustallation of t he POWTS Plumber's Name (Print) is Signat MP/MPRS Number Business Phone Number Dean Blakeman i --- 1092768 715-682-6050 Plumber's Address (Street, City, State, Zip Code) 449A1 State Hwy 13, Ashland, WI 54806 VI. ounty/Department Use Only Approved 0 Disapproved Permit Fee Dat Iss ed fn Issuing Agent Signature ❑ Owner Given Reason for Denial 67ttD� $ yv— 7 9 l u Conditions of Approval/Reasons for Disapproval cji,d e,id. RECEIVED .1111 f16 7fl9g Attach to complete plans for the system and submit to the County only on paper not less than S 1/2 x 11 inches in size Bayfeld Co. SBD-6398 (R. 03/22) Planning and Zoning Agency S R- 001436 Soil Test # Bayfield County Waiver of a Thorough Soil & Site Evaluation (subject to 15-1-10(d)) I l j7"c. a certified soil tester determine that in my professional judgment the f (lowing site (see below) is unsuitable for any treatment component other than holding tanks. Due to soil & site conditions, a thorough soil and site evaluation is not nee ed to make such a determination. mum RECEIVED �4q 6 I� d6 JUN 0 9 2026 Property Owner Eric { 4m�/ Mrss/nn.r Contractor Bayfield Co. Property Address /56lS peck3ync &( Authorized Agent Planning and Zoning Agency /-/{r6 -er )7/L c`/PP/°/ Agent's Teleph Telephone 7t1_ 919, V37/ Written Authorization Attached: Y or N Accurate Legal Description is requested: ,1V!v'114 114 of SL 1l4 Section __Township Sy N. Range 0%W. Town of C.tOW,r Additional Legal Description: Tx TI) # ( f 7'Z.S Govt. Lot Lot Block Subdivision Lot CSM# Vol. « Page CSm Doc # g?t ,2 ft— Sg6933 Volume Page of Deeds Tax I.D# // 7S 3 Acreage 16) Indicate reasoning for your determination: ST k ci Lu Nof MeJJ- 4 1V/ Signature of Certified Soil Tester 6lgl,a6 Date Certification # Signature of ounty �ficialj Date (Submit a Plot Plan & Fee) RECEIVED JUL 082075 u/forms/soilleslwaiver(KLK) June 2018 Bayfield Co. Planning and Zoning Agency \Wisconsin Department of Safety and Pro Page oft •, Division of IndustryServices I'l `ti=� ' SOIL EVALUATION REPORT rnvo In accordance with SPS 385. Wis. Adm. Code County Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, Bayfield 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. 04-014.2.50-07-21.4 02.000-30000 Please print all Information. R viewed b l' ./ f/- /D9ttf, I'^/'YI Personal information you provide may be used for secondary purposes (Privacy Law, a. 15.04(1)(m)). i ✓ S% Property Owner Property Location ❑ El Eric+Amy Missinne Govt. Lot NW 'A SE Y s 21 T 50 N R 07 E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: 1118 Faxon St 15615 Beeksma Rd, Herbster WI 54844 City State Zip Code Phone Number O City ❑ Village 117 Town Nearest Road Suoerior WI 54860 7159A9437a Clover Beeksma Rd Q New Construction Use: Residential/ Numberof bedrooms 2 Code derived designfow rate300 GPD ❑Replacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable ft. Parent material Loamy water -laid deposits and um General comments and recommendations: Site not suitable for treatment system. Holding tank required ❑ Boring # Boring PIt 99.5 Ground surface elev. It. Depth to limiting factor in. / elev. ft. Roll Annlil cation Pala I 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 A 0-1.5 5YR 3/3 f -2-d 5YR 6/8 SCL 2-pr-vc mu i cw 11 0.4 0.6 B 1.5-12 2.5YR 3/6 C 3-pr-vc meft - - 0.2 0.3 Zcnint Agency ❑ Boring # ❑Boring ❑Pit Ground surface elev. ft. Depth to limiting factor in. I elev. ft. Soil Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots CST Name (Please Print) Signature CST Number Tim Dykstra 2 1213855 Address Date Evaluation Conducted Telephone Number 10620 Eagle Lake Rd Iron River WI 16/8/26 715-209-5748 GPO/Ft' Rate Wl Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L ' Effluent #2 = BOD, 530 mg/L and TSS 5 30 mg/L SBO-8330 (R04121) Page2 of 2 ❑ Boring Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor In. I elev. ft. I SoilAnol Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIF12 Eff#1 Etf#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in.I elev._ft. Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIFP 'Ef#N 'Eff#2 NEC JU4 9 2026 P ning and oning Agen ❑ Boring # ❑ Boring ❑ Pit Ground surface elev._ft. Depth to limiting factor in. I elev.ft. Rnil Annlinatinn Rata 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 Effluent #1 = BOD >30' 220 mgiL and TSS >30s150 mg/L • Effluent #2 = BOD, s 30 mglL and 155 S 30 mg/L JUL 0 6 2026 P(annin Bayfield Co. 9 and Zoning Agency art4Amy Mtsstnwe jay Ar,-Oa Soi/ fSfl Is615 Bum yea 106ao E�sk L4kr- P -d W bsfw wr Sq ry 7k tbtt 117x$ Xrvn Riv4r 1s/.r 5`/897 1&y of Cr GST FY 1at38s"� 6/8/.26 taC Ezra'], N 9 2026 a Well______t hayfield Co. and Zoning Agency llppllj.�1o, sec+ t'M loo' Nal;� ire scud -e o it) '10 WA AECEIVEC; JUL 0 6 2026 Bayfield PlanningCo. 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 Pg 2 of 4 Plot Plan Pg 3 of 4 Holding Tank Specifications Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map (if ap Holding Tank Pumping Contract (if appli Holding Tank Agreement (if applicable) Project Name / Description Missinne Holding Tank plicable) cable) Owner Name(s): Eric Missinne & Amy Missinne Phone: 715 919 _4371 Owner Address: 1118 Faxon St, Superior, WI Zip: 54880 Project Address: 15615 Beeksma Rd, Herbster, WI 54844 Govt. Lot: NW 1/4 of SE 1/4, Section 21 , T 50 N -R 07 E ❑ or W ❑✓ Township: Clover county: Bayfield Project Parcel ID #: 11758 Designer Information Designer Name: Dean Blakeman Phone: 715 -682 -6050 Designer Address: 44941 State Hwy 13, Ashland, WI Zip: 54806 E-mail: dean@blakemanplumbing.com This space reserved for approval stamp. License Number: 1092768 Remarks: f L,,GEWED New holding tank for new proposed building. Existing 2000 gallon tank for existing building to be left separate. JUL 0 0 2026 Bayfield Co. — Planning and Zoning Agency Signature: Date: 7 t/nn2ov, Original signature required on each submitted copy. CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. ❑ SOIL EVALUATION Scale: 1 40 60 so ❑✓ SYSTEM PAGE 2 OF4 0 40 SITE MAP PLOT PLAN PROJECT NAME: DESIGN FLOW: 300 GI (toftgdd) 10 d]L Attach design flow calculations for commercial plans. Missinne Holding Tank PROJECTADDRESS: 15615 Beeksma Rd, Herbster, WI 54844 Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) Sanitary Sewer.. 4" PVC / D3034 BM Symbol: BM Elevation: 100 FT Force Main: / BM Description: Nail in tree Indicate north by IMPORTANT: Slope Gradient 1%) Well Symbol (if applicable): 0 drawing an arrow Show ground elevation contours at suitable intervals. of Tested Area: on the approprite fine. Beeksma Rd 'I -o AI E Proposed 2 Bedroom Building m1 01 NI Woods u1 01 Existing 2000 Holding Tank N4'I pvc 3034 pipe Proposed 2100 Holding Tank Existing 130'to E lotline ----------> 155'+ -to W lot line Building <-- --1-----ale)--- (line not to sc Well: Woods 01 COW ateaPtea ._I o m NIu OI 1 Y Q rllC RECEIVED JUL 062026 Bayfield Co. Planning and Zoning Agency PAGE 3 OF 4 HOLDING TANK SPECIFICATIONS (No Scale) Electrical must comply with SPS 316 and NEC 300 18" Min. v (typical) Inlet Approved Joints with Approved Pipe 3 ft onto Solid Ground Weatherproof 12" Min. or 2.0 ft above -Junction and Approved Established Flood Elevation Alarm Box Vent Cap (typical) Approved Locking Manhole 40 Vent Pipe with Warning Label Attached onduit >10 ft from T (typical) 4H Mi or2.0ftabove Building Established Flood El Elevation / (typical) Airtight Seal :: ;:: Inlet Invert Max. i2" or of total volume if mom n: than one tank HOLDING TANK VOLUME = 2105 gal 3" Approved Bedding Material Beneath Tank Finished Grade Plug iki C:L]VEi TANK MANUFACTURER: Superior Precast JUL 062026 Anchor tank as necessary Bayfield co. pursuant to SPS 383.43(8)(g) Planning and Zoning Agency Ballast Weight = [(cu.ft.tank.vol x 62.4 lbs/cu.ft) - lbs.tank.wt] x 1.5 Ballast Weight = [( 281 cuff. x 62.4 lbs/cu.ft) - 16216 Ibs] x 1.5 = 1978 Ibs 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 = 200 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) 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: Blakeman Plumbing & Heating, Inc. Phone: Local government unit: Bayfield County Zoning Administration Phone: Local government unit address: 117 E 5th St, Washburn, WI 715-682-6050 715-373-6138 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 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. rEcEtVPb JUL 062026 Bayfield Co. Planning and Zoning Agency O SUPERIORI 2100 1 -Compartment Tank 'SUPERIOR PRECAST CONCRETE TOP VIEW Weight (in lbs) Tank 9,427 Lid: 6,789 Total, 16,216 Volume of Concrete Total : 4,1 'Id' Gallons Per Inch: 46.8 Ed Enlarged Detail Condtona,IY APPROVED DEPT. Of SAFETY AID PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE SIDE VIEW Inlet rJL SD' Manhole Openings I 3" Taper Polyethylene Baffle Dfastic Rope 165" 159" ;_" 79" 4" Ouch 8" AirSpace 45" 48 62 oCmicbtas Produced by Superior Precast Concrete, LLC PO Box 1390 Hayward, WI 54843 4M SUPERIOR PRECAST CONCRETE Design conforms to ASTM C1227, Specification for Precast Concrete Septic Tanks and WI SPS 384.25, POWTS Holding Components or Treatment Components. The information provided on any Superior Precast Concrete (SPC) drawing or document shall be verified by the purchasers licensed professional engineerfor suitability of use. Configuration may change from drawing, Biy1eld Co. FtaN1InoanaLonIn This is proprietary Informa0on, and remake Iho property of Superlol Precast Concrete, LLC. N.a 05-1416 HOLDING TANK SERVICING CONTRACT Contract Date This contract is made between the Gf"hG A'-55;NME , AAay Mi. Pumper's Name (Print) Pumper's Signature Pumpers' Registration # We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT Legal Description: IMleg 1/a, 6 >/a LOCATION (Use Tax Statement) /175B - ,S Section 2. I,,Township c0 N, Range (77 Town of: I Lot Size I Acreage Gov't Lot Lot a CSM a Vol. Page GSM Dec a Lot(s) No. Block(s) No. Subdivision: 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 folowing 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; d. The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; 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. rt CEIVED JUL 061026 Bayfield Co. Planning and Zoning Agency 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 copy of a new service contract with the local government unit and the County named above within (10) business days from the date of change to this service contract. Owner(s) Name(s) (Print) Owner's Signature(s) „t,,,,n,r„ ,bSubscribed and Sworn tome: 4tria IA (cc ix,v , / ,oTAi ley Q,v,A MIScA(iXh� Inv, = N taryPublic 71 f Y� c� UBt t MycQrntnission expires on: Revised: May 2016 (®May 2018) ", �F WISG°``Drafted �iL ✓r/�JN'vc Personal informationyouprovide may be used for secondary ,' ' by y purposes [Privacy Law, 9.19.ngh)tm)] Document Number/Plan I.D. No. HOLDING TANK AGREEMENT 6n� Mtss', uuc Aµy Niss;u.u•i Parcel IdenMler Number (PIN) Agreement Date (same as Notary Date) 1175-8 7/oa/ao a4 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. /S&fy 17Yf1GSMw IC./. /Ne'I,sler, lti 5y8Yy 1/4 of 1/4 Section Township _N. Range W. Town of Additional Legal Description: See X ekeJ GoVt Lot Lot_ Block Subdivision CSM#_ Lot_CSM # Vol _Page _CSM Doc# DOCUMENT NUMBER 2026R-6 1 2818 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED O7/O6/2O26 AT 1 O:OB AM RECORDING FEE: $30.00 PAGES: 2 RECEIVED JULflJ 2026 Return To: Bayfield Co. g,��fa NL P 9ZoningAgency 117E 5'Sl ��l frMsk6urM, WT 54is41 As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above 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, Slats., 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, Stats. 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 shall 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 Grit 1VilSS°.'" ( C '-' " Y Subscribed and sworn to before me on this date: o Amy �v1(SS(I�h� : mom. �Iala� Notarized Owner(s) — Signature(s) = of ry)Public AUBL\O , gdy, omen pare u e Drafted by: Eric /"I ,FOF Wt„SC 6 123(2C5 fr c 155. -uu r= r„ s Date: Personal infom,auoo you provide may be used for secondary purposes lPdvacy taw, s.15.N UI(mli uaorma/saaiarymaanglankagreerrent.doc ®June 2018 ParcelI The West Half of the East Half of the Northwest Quarter of the Southeast Quarter (W1/2 E1/2 NW1/4 SE1/4), Section 21, Township 50 North, Range Seven West, Town of Clover, Bayfield County, Wisconsin, Together with an easement extending Easterly from the Town Road aka Beeksma Rd, for ingress, egress and utilities, over, under and across the North 33 feet of said Northwest Quarter of the Southeast Quarter (NW1/4 SE1/4) for the benefit of the above described parcel Parcel2 The East Half of the East Half of the Northwest Quarter of the Southeast Quarter (E1/2 E1/2 NW1/4 SE1/4), Section 21, Township 50 North, Range Seven West, Town of Clover, Bayfield County, Wisconsin, Together with an easement extending Easterly from the Town Road aka Beeksma Rd, for ingress, egress and utilities, over, under and across the North 33 feet of said Northwest Quarter of the Southeast Quarter (NW1/4 SE1/4) for the benefit of the above described parcel RECEIVED JUL 072026 Bayrea co. Planning and Zoning Agency 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: MISSINNE, ERIC M & AMY E 1118 Faxon ST SUPERIOR, WI 54880 Description Private Sewage System (Holding Tanks) Submission Number: SS -00784 Transaction Number: SS -00784-49764 Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 34588 Paid by: Blakeman Plumbing & Heating, 44941 State Hwy 13, Ashland WI 54806 Payment Type: Check Transaction Date: 7/ 9/ 2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-80S STATE SANITARY PERMIT OWNER: ERIC M &AMY E MISSINNE G OV'T LOT: LOT: B L K: CSM: 2022R-596933 NW 1/4 SE 1/4 SEC: 21, T 50 N, R 7 W TOWNSHIP: Clover SOIL TEST: 67-26 NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: DEAN BLAKEMAN EMILY MACGILLIVRAY LLIVRAY Authorized Issuing Officer DATE: 7/9/2026 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: # 221123 Condition: Properly Maintain System Per Recorded Agreement. THIS PERMIT EXPIRES 7/9/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION