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Home My WebLink About26-80SRequest 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 zonincua!bavfieldcountv.wi.nov Note riTime Change fl Discrepancy fl Other Phone Number 715-682-6050 Plumber: Blakeman Plumbing & Heating, Inc. Fax Number Email Address Homeowner: Eric & Amy Missinne steven.waby@blakemanplumbing.com Immediate Phone Number So Zoning Sanitary Dept can call you right back (if needed) Permit #: 26-80S 715-685-4128 Plumber's Choice Zoning Dept w No Inspection(s) during this time Date: 9/01/2026 Tuesday (9:30 am - 12:15 pm) (Tracy) Plumber's Choice Zoning Dept Time: 1:00pm KO Township: Clover Address # & Road Name: 15615 Beeksma Rd Herbster, WI 54844 or Directions UX To Site: (/758' Comments: Holding Tank Install Inspection ** Plumbers you must verify any change(s) by fax or email ** Notes from Zoning Dept: July 2025 ERIC M & AMY E MISSINNE ( I118 FAXON ST SUPERIOR WI 54880 ( I N11 PA1 IM RIIAATillM )LDING TANK INSPECTION REPORT Permit Holder's Name ❑ City 0 Village ❑ Town of Sanitary Permit No. Plan ID No. Tax Parcel No. Property ddress if A able TANK INFORMATION TYPE MANUFACTURER/MODEL# CAPACITY oU SETBACKS Property Line Well Water Service Building All -Weather Road OHWM Swimming Pool L� 5O -f /* - DEVIATIONS FROM APPROVED PLAN - aobr oarri -c q COMMENTS (Persons present, discre ancies, etc. 1 • COMPONENTS NOT INSP CTED -11 \eth\\ *XAkr Ini ci Plan Revision squired Signatur of 'T55 Cer. Nr�r IP Yes o r f'A // / I/%cGtlIi(lt/1 / �-f Sketch on other side 10 of 13 t BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT j A Telephone: (715) 373-6138 Bayfield County Courthouse Fax: (715) 373.0114 Post Office Box 58 e-mail: zonino(a)bayfieldcountv.wi.aov 117 East Fifth Street _-_- Web Site: www•bayfieldcounty wt gov/147 Washburn, WI 54891 Property Owner ERIC M & AMY E MISSINNE Information I 1 IS FAXON ST SUPERIOR WI 54880 As you know was contracted by you to install a private onsite wastewater treatment system on your property described as: Notes: Abandonment of Old System to meet all applicable code requirements: 4• Tank was pumped by: Tank was crushed I removed and pipes disconnected by: at AM/PM On at (AM IPM) the above -mentioned plumber contacted our office to conduct re-cover inspection as required under DSPS 383. One of the following applies: System was inspected and appears to meet all applicable code requirements. ❑ 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 couldnotbe inspected because County could not respond to plumber's time constraints. Comments: U/formslsanitarypropenyawnenlnput Apn12019 Department of Safety unty Co feld aSanitary (f - O o7 1, #Spj & Professional Services, 7�d�gi Industry Services Division Permit Number (to be filled in by Co.) �- ADS 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 wI Application Infornxat►on;,; —Please Pant All Information Property Owner's Name Parcel # Eric Missinne & Amy Missinne -7 11758 Property Owner's Mailing Address Property Location 1118 Faxon St Govt. Lot City, State Zip Code Phone Number Superior, WI 54880 715-919-4371 NW �', SE 'r,, Section 21 T 50 N R 07 E o II .`Type ofMR iink (ci�eck all'that;apply) Lot # Subdivision Name IN 1 or 2 Family Dwelling — Number ofBedrooms 2 Block # ❑ Public/Commercial — Describe Use ❑ Cityof ❑ State Owned — Describe Use O Village of CSM Number 2022R-596933 n Town of Clover III: a ofEO: S Permifc Clieck eltheir "New" or``:`Re"lacement" and other's' licatiIe,on Lne A Check:one box"On, neB 'Com Iete TYPhne e�' : - f A. El New System ❑ Replacement System ❑ Other Modification to Existing System (explain) O Additional Pretreatment Unit (explain) B. n✓, Holding Tank ❑ In -Ground ❑ At -Grade O Mound O Individual Site Design ❑ Other Type (explain) (conventional) C. Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner List Previous Permit Number and Date Issued Expiration IV_ ispefrsallll'reatuient Arca4and>Tan"klnfo"r nation:. Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) I System Elevation 300 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units w o '$ a> N v New Tanks Existing Tanks k o eUi iw C7 c fs. Septic or Holding Tank 2100 2100 1 Superior Precast ✓ ❑ Dosing Chamber O 1J Responsibil�fyAStStement _I, the undersigned;.ass_ume-y nsibi�lity fofi_ns ailation of thePo�V'f3;sh6 on the'atfac7iea.gl8iis� w Plumber's Name (Print) is Signa S MP/MPRS Number Business Phone Number Dean Blakeman 1 1092768 715-682-6050 Plumber's Address (Street, City, State, Zip Code) 44941 State Hwy 13, Ashland, WI 54806 . g onnMJDepartienij Us'eao�nlly .;� _ _- - Approved ❑ Disapproved Permit Fee $ Date Iss ed jIr TVUU Issuing Agent Signature ❑ Owner Given Reason for Denial '/1)1) 7/'? 4 f(\accj 1(Iw Conditions of Approval/Reasons for Disapproval S-e'c vtitach,d� - a - 11111 fl. 9ii9 Attach to complete plans for the system and submit to the County only on paper not less than 8 112 x 11 inches in size Rayfreld Co. SBD-6398 (R. 03/22) 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 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 1 Description Missinne Holding Tank Owner Name(s): Eric Missinne & Amy Missinne Phone: 715 -919 Owner Address: 1118 Faxon St, Superior, WI Zip: 5488O Project Address: 15615 Beeksma Rd, Herbster, WI 54844 Govt. Lot: NW Township: Clover plicable) cable) ;4371 1/4 of SE .1/4, Section 21 T 5O N -R 07 E ❑ or W Q✓ Project Parcel ID #: 11758 county: Bayfield Designer Information Designer Name: Dean Blakeman Phone: 715 -682 -6O5O Designer Address: 44941 State Hwy 13, Ashland, WI Zip: 548O6 E-mail: dean @blakem an pl u m bi ng. com This space reserved for approval stamp. License Number: 1O92768 Remarks: Rl ClEI New holding tank for new proposed building. Existing 2000 gallon tank for existing building to be left separate. JUL 0.6 2026 Bayfieid Co. Planning and Zoning Agency Signature: I Date: 7/Z,/202.6 Original signature required on each submitted copy. CHECK BOX AS APPLICABLE. CHECK BOX AS APPUCABLE. Elil SOIL EVALUATION 0 Scale: 1"40' 60 80 Q✓ SYSTEM PAGE 2 OF4 SITE MAP PLOT PLAN PROJECT NAME: (10 ft grid) M DESIGN FLOW: 300 GPO Missinne Holding Tank Attach design flow calculations for commercial plans. PROJECT ADDRESS: 15615 Beeksma Rd, Herbster, WI 54844 Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) N Sanitary sewer. 4 pvc ! D3034 BM Symbol: BM Elevation: 100 FT Force Main: 1 BM Description: Nail in tree Indicate north IMPORTANT: Slope Gradient (°%) Well by of tArea: Symbol (if applicable): 0 drawing an arrow Show ground elevation contours at suitable Intervals. on the approprite One. i i i I l I I ._.._ i Beeksma Rd - ' � ._......._ .. Pr: posed 2 Bedr 1 ".._._ to - - oom ii - Building_ 01 I Woods O1 _.. Existing.2o00_H-oJding"Tank__ __'__._ __ f4" pvc 3034 pipe Proposed 2100 Holding Tank - Existing - - - - --- 130'_to E iodine -- - - - - ; _._>. 15§'+j- to W_lotline _ _ _ _ Building - - ----- (line not -to scale) Well Woods-__-. - i yea , lea �1 --- Ni V �I C RECEIVED JUL 00 2026 1 . Bayfield Co. Planning and Zoning Agency__ PAGE 3 OF 4 HOLDING TANK SPECIFICATIONS (No Scale) Weatherproof 12" Min. or 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"m Vent Pipe with Warning Label Attached —'---Conduit >10 ft from (typical) 4" Min. or 2.0 ft above Building Established Flood Elevation (typical) } Airtight Seal 1 d •• Finished Grade 18" Min. (typical) '• ' d V Inlet Inlet Invert Approved Joints with Watertight Plug Approved Pipe 3 ft onto Max. 12" or 90% of total volume Solid Ground if more than one tank 4 Alarm -On a a HOLDING TANK VOLUME = 2105 gal a d V d 3" Approved Bedding Material Beneath Tank TANK MANUFACTURER: Superior Precast JUL 0.6 2026 Anchor tank as necessary Bayfleld 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 cu.ft. x 62.4 Ibs/cu.ft) - 16216 Ibs] x 1.5 = 1978 lbs 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: 715-682-6050 Local government unit: Bayfield County Zoning Administration Phone: Local government unit address: 117 E 5th St, Washburn, WI 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. RECE(WO JUL 062026 Bayfield Co. planning and Zoning Agency MSUPERIOR I 2100 1 -Compartment Tank SUPERIOR PRECAST CONCRETE PRECAST CONCRETE • Weight (in lbs) Tank: 9,4_7 Lid: 6,789 Total: 16.216 Volume of Concrete Total : 4.1 YcP Gallons Per Inch: 46,8 lid wan TOP VIEW 165" ...... 159 II 2105 Gallons SIDE VIEW 2$r. Enlarged Detail 24 Conditfonally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE ?fit 50' Manhole Openings 3" Taper a m I $" Air Space 45"Depth 3 4"mod J62" 48' 1 Produced by Superior Precast Concrete, LLC PO Box 1390 Hayward, WI 54843 Polyethylene 5 Baffle SUPERIOR PRECAST CONCRETE Design conforms to ASTM C1227, Specification for Precast Mastic Concrete Septic Tanks and WI SPS 384.25, P0WTS Holding Rope Components or Treatment Components. The information provided on any Superior Precast Concrete (SPC) drawing or document shall be verified by the purchasers licensed professional engineerfor suitability of use. Configuration may change from drawing, consi . Gasket (Poured in Place) Product File No: I This Is proprietary information, and remains the property at Superior Precast Concrete, LLC. yield Co. no LOflTfl R.3 HOLDING TANK SERVICING CONTRACT Contract Date This contract is made between the Holding Tank Owner(s) Name(s) thG k-S5;,,*JAE , A -L Pumper's Name (Print) Pumper's Signature Pumpers' Registration # We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT Legal Description: Tax II3# ' / r LOCATION ,,�,J r )114, J 7. 1/4, - (Use Tax Statement} f � 7,7 8 Ton: LotS[u Acreage. Section 1 Township �o N, Range C2 o ve" )rj Gov't Lot Lot !i CSM$I Vol Page : CSM Dot # ' `Lot(s) No. Block(s) No. Subdivision ivision: 1. The owner agrees to file a copy of this contract with Biyfield 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 fotlring in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; RECEIVED 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; JUL 0 6 2026 e. The dates on which the holding tank was, serviced; I f. The volumes in gallons of the contents pumped from the holding tank for each servicing; Bayfield Co. g. The disposal sites to which the contents from the holding tank were delivered. 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) 01111 11 1 111 Fri ,subscribed and Sworn to meJAii/vNE : � �••.`•��1.� •K �,��'% � day of 1 J-rOTa , ,'j Mr D�U 5c�t h -C - ci N tary Public N UB L\ v'c�anl fission expires on: :, I i b) I Revised: May 2016 (®May 2018) '��,1 WISC`�•• Drafted by ri/G ', ii 1 Personal information you provide may be used for secondary purposes [Privacy Law, .igb&�lflm)] • Document Number/Plan I.D. No. HOLDING TANK AGREEMENT Owner Name (s) Er�- ' t5sl IJNE Owner(s) Mailing Address 1SG/S l Mailing Address QJ. A,.t i ss;NNjF Perbclir, 54q4 Parcel Identifier Number (PIN) Agreement Date (same as Notary Date) f f 75 -21a0/ao a(. We acknowledge that application is being made for the installation of (a) holding tank(s) 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. 1/4 of 1/4 Section Township N. Range W. Town of Additional Legal Description: SteAL1 e -W Gov't Lot_ Lot Block Subdivision CSM#. Lot CSM # Vol Page CSM Doc# DOCUMENT NUMBER 20268-6 12818 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED O7/O6/2O26 AT 1O:O8 AM RECORDING FEE: $30.00 PAGES: 2 RECEIVE® JULo:.72028 Return To: Bayfield Co. Agency 117 6 S (,Urs1bvrNI wI &`t 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, Stats., 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. NR1 13, 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 K CL.' Sig Subscribed and sworn to before me on this date: /'rtes SS•a;u Notarized Owner(s) — Signature(s) : ; nor t� y Public G % ommi n ire 11a ' OFDrafted by: "'c 1'l r 55 r �Uw! ��' '''�h,.r+�,i+,+, +.. /23(24�•• Date: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (I)(m)] u/forms/sanitarylholdingtankagreement.doc #June 2018 Parcel 1 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 Sever' 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 BPlanningand�Zoning Agency SR- oO 136 Soil Test # Bayfield Count Y Y Waiver of a Thorough Soil & Site Evaluation (subject to 15-1-1Q(d)) I I 51�� rv. L)I./((.f7& 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. iiirn RECEIVED CLi'77 JUN 0 9 2 026 Property Owner rldMVrs s► n Contractor eayfield Co. Property Address /56/c ,r'ee/S, jQ Authorized Agent Planning and Zoning Agency Me,'L6�gr k/T `S-elfyG/ Agent's Telephone, Telephone 7i S 91'3 .''/3 71 Written Authorization Attached: Y or N Accurate Legal Description is requested: AVIV' 1/4 of 5E1/4 Section(_Township ) N. Range 0 ? W. Town of C-1Ow" Additional Legal Description: 1x 1A # ( I `2 S'S Govt. Lot Lot Block Subdivision Lot CSM# Vol. Page CSM Doc # ' 69'33 Volume Page of Deeds Tax I.D# /% 7'S Acreage l) Indicate reasoning for your determination: S 1 k eves uk! iiA 1 Signature Certified Soil Tester 6A/n6 Date P4'ik 411(t?,ei..1 /(0c5 Signature of bounty ficial Date Certification # (Submit a Plot Plan & Fee) RECE1V I JUL 062026 u/forms/soiltestwaiver(KLK) June 2018 Bayfield Co. Planning and Zcr►!n?.Agency Wisconsin Department of Safety and Professionargervices Page of � ,� "� Division of lndustryServices P SOIL EVALUATION REPORT ''• A 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 jr Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). ( (1 V S'% I L1Il1r1) �` Property Owner Property Location V ❑ Eric+Amy Missinne Govt. Lot NW r 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 ❑ City ❑ Village [I Town Nearest Road Superior WI 54880 71599 943 Clover Beeksma Rd 0 New Construction lase: Q Residential/ Number of bedrooms 2 Code derived designtlow rate 300 GPD ❑Replacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft. Parent material Loamy water -laid deposits and u General comments and recommendations: Site not suitable for treatment system. Holding tank required a Boring # ❑Boring 99.5 0 QPit Ground surface elev. ft. Depth to limiting factor in. / eiev. ft. Snil Annliiatinn 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 A 0-1.5 5YR 3/3 f -2-d 5YR 6/8 SCL 2-pr-vc mfi cw f1 0.4 0.6 B 1.5-12 2.5YR 3/6 C 3-pr-vc mefi - - 0.2 0.3 ______ _____ ________ __________ JN ?R ____ ______ .fr?i _____ _____ Zonirir Agency ❑ 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 JUL 02p2 6a fleidCo. I . i CST Name (Please Print) Tim Dykstra Signature CST Number 1213855 Address 10620 Eagle Lake Rd Iron River WI I Date Evaluation Conducted 6/8/26 Telephone Number 715-209-5748 Effluent #1 = BOO > 30 s 220 mg/L and TSS > 30 5150 mglL ' Effluent #2 = BOO. 5 30 mg/L and TSS 530 mg/L SBD-8330 (R04121) ncy Page of ❑ Boring Boring # ❑ Pit Ground surface eiev. ft. Depth to limiting factor in. / eiev. ft. I Soil Aootication 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 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Annticatinn 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 R� .9 2026 7afrn1ng andZoning Agen D Boring # O Boring ❑ Pit Ground surface eiev, ft. Depth to limiting factor in. I eiev. ft. SniI Annticatinn Rafa 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 s 220 mg/L and TSS > 30 5150 mg/L 'Effluent #2 = BOD, s 30 mg/L and TSS s 30 mglL R CEIYf t5 JUL 0 6 2026 Planning Co. S and Zoning Agency • Er' 4Awty MLssrh�.e 1s6/S &k q&b6f,O,r wt• cq€ # ' �k Ion -owh ce Glr RECE\J,ED JUN g 2026 a Well 6ayfietd Co. ntng and Zoning Agency y 5o/ 106x0 Eck L P9 Try Ri r it ''i7 C1k )L'39 6121,26 x Pot too' Rail « Tnge @iSi. `: 9q.5' utIVED JUL 062026 Planning and toning Agency m BAYFIELD COUNTY SANITARY PERMIT (#04)-26-80S STATE SANITARY PERMIT OWNER: ERIC M & AMY E MISSINNE GOVT LOT: LOT: BLK: CSM: 2022R-596933 NW 1/4 SE 1/4 SEC: 21, T 50 N,R7W TOWNSHIP: Clover SOIL TEST: 67-26 NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: DEAN BLAKEMAN EMILY MACGILLIVRAY 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