The URL can be used to link to this page

Home My WebLink About26-92SDepartment of Safety County Bayfield & Professional Services, Sanitary Permit Number (to be filled in by Co.) Industry Services Division Ss -007613 (9i2—gaS 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 SIT -159899 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(l)(m), Stats. 58875 Roy Anderson Rd I. Application Information — Please Print All Information Property Owner's Name Parcel # Dane C & Julie Fischer NiE ED 21559 Property Owner's Mailing Address Property Location 27925 Brown Rd Govt. Lot City, State I Zip Code Phone Number Mason, WI 54856 715-663-1122 NE ,,, NE ,,,, Section 33 T 46 N R 05 EorW IL Type ofBuilding(checkallthatapply) Lot# FltCs_IVEC� Subdivision Name 01 or 2 Family Dwelling— Number of Bedrooms 3 ❑ Public/Commemial — Describe Use Block # JUN 16 2026 O City of ❑ State Owned —Describe Use CSNt4thffilikf and Zoning Agency Village of fa Town of Kelly Ill. 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 ipnlicable4 A. 0 New System y ® Replacement System 0 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) ❑ Change of Plumber ist Previous Permit Number and Date Issued C. ❑ Renewal Before ❑ Revision g ❑ Transfer [o New Owner Expiration I 06-87S 06/12/2006 Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sI) I Dispersal Area Proposed (st) System Elevation 450 1.0 450 450 103 Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units u N New Tanks Existing Tanks 6 U co lz. C7 0. Septic or Holding Tank 1 000 1 000 1 Wieser Concrete X Dosing Chamber I_500,,,500 V. Responsibility Statement- I, the undersigned, a um responsi ai or inste of the POWTS shown on the attached plans. Plumber's Name (Print) Plu er's ignalur 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 pproved I O Disapproved I Permit Fee I DaateeIIssueY Issuing gnature O Owner Given Reason for Denial $ "�ll l / , 7��•�` &,u ac/f4 d , Attach to complete plans ror the system and submit to the County only on naner not less than a lax SBD-6398 (R. 03/22) Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way Madison, WI 53705 June 3, 2026 CUST ID NO.: 230722 DOUGLAS E MANTHEY P.O. BOX 196 DRUMMOND, WI 54832-0196 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/03/2028 MUNICIPALITY: TOWN OF KELLY BAYFIELD COUNTY SITE: FISCHER 58875 ROY ANDERSON ROAD MASON, WI 54856 NE NE S33 T46N R05W FOR: Design Wastewater Flow Value: 450 Bedrooms: 3 Limiting Factor(s): 12" Maintenance Required: Effluent Filter Phone: 608-266-2112 4.:'Web: hnp://dsos.wi.gov ®! ti Email: dspsao wisconsin.gov p5 ^µ Tony Evers, Governor to- Dan Hereth, Secretary Identification Numbers Plan Review No,: PWTS-062601024-C Application No.: DIS-052621117 Site ID No.: SIT -159899 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE JUN 16 2026 Bayfield Co. Planning and Zoning Agency Mound Component Manual - Version 2.1 (May 2022-2027) Pressure Distribution Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Prior to construction of the dispersal area. check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Pump Floats to be set and verified per approved plan. Any cha Specifications. • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30 • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. _I in pump resizing to meet TUH and GPM • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the POWTS Dispersal Area must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code & SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per a.145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, Jeff Brewbaker Division of Industry Services Phone: 608-516-6428 Email: jeffbrewbaker@wisconsin.gov Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 Refund Expected: $0.00 RECEIVED JUN 16 Z026 Bayfield Co. Planning and Zoning Agency '��'�4"',r Wisconsin Department of Safety and Professional Services }�'jL Page / of __ -'c-- Division of Industry Services B ' I I asps. SOIL EVALUATION REPO " 1k -Co In accordance with SPS 385, Wis. Adm. Code County ' �d Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, Parcel I.D. but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. % X /J /S -S 9 Please print all information. RevSe l Date/ . Personal information you provioe may be usea for secondary purposes tvnvacy Law, S. 1n.u4(lgmp. i l '-y,'' " Property Owner Property Location �� •2 d;' C , g /4 fr/J-(Jpr Gov[. Lot 'A Y. S 3 j T y6 N R 05- E (or) W Property Owner's Mailing Address Site Address or CSM and Lot It Pan An tt.9Y7 Pc)'? 2292 .S"— 4'°'-'M ieJ bc-SL(Cf , Opc s^ F- 609 Pit sSS >s eCh, ,d>dr.,„ City I State Zip Code I Phone Number ❑ City ❑ Village aTown I Nearest Road Ak≤oi�i Wr S YS fL ( ) // rC n i Q / ❑ New Construction Use: ❑ Residential/Number of bedrooms Code derived designflow rate GPO EfVT ,® Replacement /// ❑ Public or commercial —Describe: Flood Plan elevation if applicable ft. i �/ Parent material (≤'h ,* T // _ D General comments and recommendations: ,'MMO ✓E •rte cc,•r" Oil ��'old+s Icy s�+'t�. flS `' �' I t l Boring # Boring IIII___� ❑P% Ground surface elev. /o/ ft. Depth to limiting factor''d in. / elev._-Mt. Cnil ennnner:.n vole Horizon Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/Ftr -Eff#1 •ER#2 it Wj-2,je SG 4s,Gr- ntv .P tv fcor-1, -4 s 'f≤ o — — ,7 so ❑ Boring# ❑Boring I � 352026 ❑Pd Ground surface elev. R. Depth to limiting factor in. / elev._R. Soil Soil Anolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/Ftz Eff#1 •Eff#2 CST Name (Please Print I Signaturer CST Number fA- el-? ( cZ oc 1 GtY Address //.? io ,* #5G.tJ Pci Date Evaluation Conducted Telephone Number Gu/e W 2' rozs I 7/C-60 1- / Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 s 150 mg/L • Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L SBD-8330 (R04/21) TZ- jc 63 • G/CS% 5io- c7 /-' It ' 7/-s- !S1 (190 P4ne C & J -"l i� f/≤c.4c e.r .2 77a -s /9rowr^ ld raasca wz. s3/ ,≤-& lax7D..2/SS-g air fawn c9�/c(effp ≤ 3 r'i N ROsw ps/fi �sc'n far %.l /►(E A7c i .� v 9Y 7 the .z o2 -/e- GO`? (.z G r Yk . /00 g/°( Sv5+t. ia3 �wlld,� Wit= 88 3becJ\ PvPk 36 LULU PAGE 1 OF 6 Mound Plan Index & Cover Sheet Component Manual Design References: Mound Version 2.1 (May 2022-2027) & Pressure Distribution Version 2.1 (May 2022-2027) Pg 1 of 6 Index & Cover Page Pg 2 of 6 Plot Plan Pg 3 of 6 Mound Cross -Section & Plan View Pg 4 of 6 Distribution Network Specifications Pg 5 of 6 Pump Tank Specifications Pg 6 of 6 Management Plan JUN 16 2026 Attachments: oayneJd Enclosures: Flarnln9 andZo Pump Curve POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Fischer Replacement Mound Owner Name(s): Dane C & Julie Fischer Owner Address: 27925 Brown Rd Mason, WI Project Address: 58875 Roy Anderson Rd Co. tingAgency Phone:715 663 1122 Govt. Lot: NE 1/4 of NE 1/4, Section 33 T 46 Township: Kelly Project Parcel ID #: 21559 Zip: 54856 N -R 05 E ❑ or W ❑✓ County: Bayfield Designer Information Designer Name: Doug Manthey Designer Address: PO Box 196 Drummond, WI E-mail: norpines@chegnet.net License Number: MP230722 Remarks: Signature: Phone: 715 -739 _6868 Zip: 54832 This space resz� n`dibona'roval stamp. APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Date: 05/20/26 Narrative for Fischer Mound Relocate Dane C & Julie Fischer 58875 Roy Anderson Rd Town of Kelly Bayfield County Tax ID 21559 533 T46N R05W Original Mound was installed in 2006. At that time the North Property line was assumed to be the fence line. During the sale of the property last year a survey was completed revealing a portion of the Mound System was on neighbor's property. We are proposing moving the Mound South Easterly to accommodate new property boundary. One Soil Boring was completed to verify soils in the direction of the movement. JUN 16 2026 Bayfield Co. Planning and Zoning Agency fk5 zo$(o Plol Plan WQ 250 ft. /JiP 22072-Z Town of Kelly Parcel in NE 1/4 NE 1/4 S 33 T46N R5N Scale 11n. = 80 ft. unless marked BM = Nail approx 20 ft. above ground level on ribboned soft maple =100ft Elevations 81=98.7 82 = 98.7 83= 101.0 Proposed Homesite = approx 880 ft. 3 Bedroom Home 450 Gpd 10 — Dane c e iA e FiscLe r 10B8 - SS75 Roy Aholersor Qt 88 tax t0 - ,2►ssq JUN 16 2026 Bayfield Co. 1% Planning and Zoning Agency <--Weser 1 oo1Sbo Ta.J. ta4 z0J ( er CO A" eowveyance PT;' 5 - be SCL tk PVC - s tee ctcoorr� -i.o ?lo,h aPpvo l by S��r SINGLE -CELL MOUND DISPERSAL AREA 0.5" TO 2.5" WASHED AGGREGATE (min. 6.0' beneath distribution pipe - mm.2.0" over distribution pipe and covered with approved synthetic fabric) ASTM C-33 SAND FILL min. 0.5 ft T_ r t.. D Plowed Surface 8.0 % Slope Surface Contour Elevation= 101 ft MIN. 6.0" OF TOPSOIL COVER (Show force main, manifold, and flush valve locations on plan view.) min. 1.0 ft 1,5 " 0 Schdl40 PVC Lateral (typical) r— ------- — ------ L-------------- =----- - w= 27.93 ft r B= 85.0 ft Bend as necessary to follow contour DOWNSLOPE TOE L= 109.0 ft JUN 16 2026 Plannin sa "`Ic Co. 9 and Zoninn a,.... D= 2.0 ft E= 2.42 ft System Elevation = 103.00 ft Lateral Invert Elevation = 103.5 ft CROSS SECTION VIEW (No Scale) PLAN VIEW (No Scale) = 7.96 ft 8.5 ft ---------------- ------------J Prohibit disturbance and vehicular traffic within 15 feet of downslope toe. Reset Page 14.67 ft K= 12.01 ft (typical) C) l71 W O m rn DISTRIBUTION NETWORK SPECIFICATIONS FLUSH VALVE DETAIL (No Scale) Orifice in — Valve Box Center of Threaded Cap \ (insulation optional) for Head Testing (optional) \ \ I I \ Ball Valve (optional) / (No Scale) RECEIVED JUN 16 2026 eayfield Chateral Spacing Planning and ZoQngAgerTY65 ft Shield orifices for gravelless applications o \ I Lateral Length (P) = 83.43 ft (riser pipes optional) 1.5 "0 Schdl 40 PVC Manifold 2.0 "0 Schd140 PVC Force Main (slope to pump tank for drain -back) Laterals to be level irst Orifice (typical) 40 PVC Lateral 0 = 1.5 in (typical) Number of Orifices per Lateral = 28 n f ices equally spaced, \ (check a) OR b) below] _ a) j.. along bottom of lateral Orifices equally spaced Flush Valve along bottom of lateral b) along top of lateral Assembly with every _ th hole (typical - see detail) facing down Last Orifice (typical) Orifice Spacing (X) = 3.09 in LATERAL INVERT ELEVATION = 103.5 ft (typical) (typical) Orifice Diameter = .156 in OBSERVATION PIPE DETAIL (No Scale) Screw -Type or -�, `� , Finished Grade Slip Cap (loose) W (mulched & seeded) 4"0 PVC Pipe '' f -4 ----_-Topsoil Cover • Top of pipe to terminate j' t, ` (Mn. 1 foot) at or above finished grade rt. (4) 1/4"-1/2" X 6" Slots @ S0 apart Anchoring Device Infiltration Surface Orifice Discharge Rate = .54 gpm Number of Laterals= 2 Lateral Discharge Rate = 15.08 gpm TOTAL DISCHARGE RATE = 30.16 GPM (typical) First Orifice (typical) END MANIFOLD ltyv 11) ✓0 CONNECTION Check applicable box. Manifold First Orifice (riser pipe optional) (typical) I. x--E--w2-- x --� rn (typical) (typical) Manifold ® CENTER MANIFOLD O (riser pipe optional) CONNECTION rn PAGE 5 OF 6 SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 40 Vent Pipe >10 ft from Building Electrical must comply with 12" Min. or 2.0 ft above SPS 316 and NEC 300 Established Flood Elevation Weatherproof Extend manhole riser as necessary. (typical) Approved Junction Box IMPORTANT: Vent Cap Approved Locking Manhole with warring Label Attached Anchor tanks) as necessary + (typical) pursuant to SPS 383.43 8 ( )(g) --Conduit 4" Min. or 2.0 ft above Established Flood Elevation (typing __jj__J Airtight Seal Finished Grode Quick Disconnect CAPACITIES @ 9.8 gal/in Depth (in) Volume (gal) A 31.0 303.8 B 2.0 19.6 [C] 12 117.6 D 6 58.8 *T A T a [c] *Pump Tank Liquid Level = 51.0 in Ti Pump _ Force Main Diameter = 2 in ` e' .18"Min. . RECEIVED (typing JUN 16 2026 Bayfield Co. Neap Approved Jointspning and Zoning Agency Hole Approved Pipe 3 ft onto Solid Ground (typical) PUMP -OFF ELEVATION = 80.5 ft INSIDE BOTTOM ELEVATION = 80 ft Force Main Length = 240.00 ft 3"Approved Bedding Material Beneath Tank Force Main Void Volume 39.12 gal Vertical Head = 23ft [Cl Total Dose Volume TDV = 117.6 gal/dose + Min. Supply Head =_____5ft total lateral void volume < TDV < 0.2X design flow) + FM Friction Loss = ��(5X ft + (force main drainback volume) + Fitting Loss* = 1.05 ft '(min. supply head x 0.3) MIN. PUMP DISCHARGE RATE = 30.16 _gpm = TOTAL DYNAMIC HEAD = 3 225ft PUMP TANK: Consider Goulds 5HH pump Volume = 500 gal Manufacturer: Wieser Concrete Pump Manufacturer: Goulds Pump Model: WEO5H (See attached pump curve.) Controls/Alarm Manufacturer: SJE Rhombus Controls/Alarm Model: 101 Float switches containing mercury are prohibited SEPTIC TANK(S): Total Volume = 1000 gal Manufacturer(s): Wieser Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet Filter Manufacturer: Zabel Filter Model: 1800 PAGE 6 OF 6 Mound Management Plan IMPORTANT: The owner of this mound 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 = 450 gpd; BODs ≤ 220 mgL"'; TSS S150 mgL'1; FOG ≤ 30 mgL"' Inspection Checklist INSPECT EVERY 3 YEARS - o type of use Ki_CEIVED o age of system o nuisance factors (i.e. odors, user complaints, etc.) JUN 16 2026 o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) Plannin Bayfield co. o solids volume in anaerobic treatment tanks and any distribution a oa `, 'i A tank(s) ppurtenance(s)gi.e., aistn8Mn / 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 (i.e., pump re -cycling, float switch settings, etc.) o electrical components (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 tank(s) 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 (1/3) 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 filter(s) 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. o Distribution laterals shall be flushed once every 3 years or when necessary. 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: Local government unit address: PO Box 58 Wahburn, 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 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 mound dispersal component may be re -constructed within the originally approved area after removal of all failed components. $ stem Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code Cq GOULDS PUMPS APPLICATIONS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools • Hospitals • Industry • Effluent systems SPECIFICATIONS Pump • Solids handling capabilities: 1/;' maximum. • Discharge size: 2• NPT. • Capacities: up to 140 GPM. • Total heads: up to 128 feet TDH. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • See order numbers on reverse side for specific HP, voltage, phase and RPM's available. ■ Shaft: Corrosion -resistant stainless steel. Threaded design. Locknut on three phase models to guard against component damage on accidental reverse rotation. ■ Fasteners: 300 series stainless steel. ■ Capable of running dry without damage to components. ■ Designed for continuous operation when fully submerged. MOTORS ■ Fully submerged in high- grade turbine oil for lubrication and efficient heat transfer. ■ Class B insulation. FEATURES ■ Impeller: Cast iron, semi - open, non -clog with pump -out vanes for mechanical seal protection. Balanced for smooth operation. Silicon bronze impeller available as c an option. ■ Casing: Cast iron volute type for maximum efficiency. 2" NPT discharge. ■ Mechanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces. Stainless steel metal parts, BONA -N elastomers. FEET 130 120 110'. 100 904 80�V 70� 60 40 20 3b 40 50 60 70 80 90 100 110 120 130 140 150 160 GPM __t_ I ___j----------- 1 ....J_ 5 10 15 20 25 30 35 m3/hr CAPACITY Submersible Effluent Pump PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. Single phase: • Built-in overload with automatic reset • All single phase models feature capacitor start motors for maximum starting torque. •'h and '/I HP —16/3 STTOW with 115, 208 and 230 Volt three prong plug. • 1/4-2 HP— 14/3 STOW with bare leads. Three phase: • Overload protection must be provided in starter unit. •'/,-2 HP -14/4 STOW with bare leads. ■ Designed for Continuous Operation: Pump ratings are within the motor manufacturers recommended working limits, can be operated continuously without damage when fully submerged. ■ Bearings: Upper and lower heavy duty ball bearing construction. ■ Power Cable: Severe duty rated, oil and water resistant. Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket damage and to prevent oil wicking. Standard cord is 20'. Optional lengths are available. ■ 0 -ring: Assures positive sealing against contaminants and oil leakage. AGENCY LISTINGS S�e C5A.108Sandd CSA 22.2 lo uL l 8 andds By Canadian standards c us Association File #1838549 Goulds Pumps is ISO 9001 Registered. .i r .. ;JUN Goulds Pumps 0 2002 Goulds Pumps Effective October, 2002 83885 www.gaulds.com 432 ITT Industries Apr 26 2006 7:34PM JOE ZIRN SOIL TESTING 715 765 4608 p.1 1Wledonabr Deparimem of Commerce SOIL EVALUATION REPORT Pag0Joi 3 Division of Safety and BdldYga in accordance with Comm 85. M. Adm. Code Attach complete site plan on paper not less than 8112 z 11 Inches in size. Pan muse CountyBay /2t1/ - Indude, but not limited b: vertical and horizontal relevance point (SM), dbedion end Parcel I Pereaot slope, scale OrdMensbns, north arrow. and location end distance to nearest mad. ,Cv 0f Ool' - /V(y7-O'...-Ci (7 • Please print elf /A/ORIfBBtm. 9.'T3( R t vts viewed by Dale Paradnatl badnasscn you praslde may be used for sawMwy gapaaea (PrWery Lee, e.1804 (1) (m)).Dan or j tipn Properly Caption avmI`]4J� BYela Qovl.L.C1 NE tl4/v 45114331T'Il9 N R S Propstr Owners MMang Mtkess Lot Xfty Block X Sad. Name or CSMX l2o7 EZ E1er1W c r) �¢ Phone (es C(f T,4 �oGt6 l�Yl ) IYBG Number ❑Gly ❑Ke!/ �f( Town Nearest �ArGr/� Re New 0oneDdbn Use: Residential I Number of bedrooms 2 Code derived design flow mle fl Repmewnam Punic sir e.1 • Dead8le: ?a n at. GPD General � ✓ 4S � /Flood Plain elevelbn a applicable end reddnngndalbne; mO1n�Na(ic t`1'/S,lS 7E tii Z�(d¢VL7cOk = 'ecomrneh.c(e GteSf�} /oJesi�^ rcfc-_S3pd/54 cJJ emrg X ❑ Bori• ng 7 Fl pa Ground surfacestev. a Ho&en DepDepthDcntinant Cob Redwt Deacdplon Texture Structure Consistence Boundary Roofs OPIaYN flan Rata In. Cu. Sz. Pont CO(a Gr. sz. Sn. .E1(sy 0—(, SR 3/l bht SL 4Qfs64 Mo c.S QZ�, 1.0 6-t? SYR city /cox¢ LfS 5& nw c.5 1%wt ,co f.0 3 +- Eb 5YR ct cad S`r2 h. Lut On - y IRIBoflig X ® wB a Ground surface slev. 7ff a n_. ... v_,.�_ ��__ /D . - fl0rtaon l 2 Oepvi M. 0-3 —I DmkiwgCobr Muneeu SY (( yf3 RedoxOenlplbn Cu. Sr. Cont. Color rLo no•t_ Tezbrre SL [ $ Structure Or. Sz. St. Consistence Boundary Roots Soil O GPOnts cetlon Rate HMt •Ett#2 3 e?4(. 26 S 2 R S/ L.F 5v2 cd2 'Idl 2'7/.Q Lo s L u Name Fleece Pn } OFr�*Y •,••O • av ngrt �i Y Signature �. „ CST Number none„ Y.$!.� as 3 989 Address j'i C.." Date Evaluation Conducted Telephone Number Mason, Wt 548 cfQ -oG tr7gt. `fo8 SRII-Ri1O flint/nn Apr 26 2006 7:34PM JOE ZIRN SOIL TESTING 715 765 4608 p.3 Propertirowner r_Y'PAecl parW'" fed �__ . del 10 a ® Babg A ❑ eodne ® pit Ground sudare etay. 101.0 it Depth to limiting (actor a 15 in. .Hot to Depth In. Deadnant Color Waited •Redox Description ou. Sa. Cont. Coley Texture Structure Gr. Sz.Sh. Consistence Boundary Roots CPD/t' •Ef#1 •ER#2 I 0-7 ≤YR3I ( 10ISt L ,2 S j}(Js... fLQ iv /J3 a -ya2o *ncr1 L S a sS ,4W1v cc (f -c0 „r 1A 3 36 SY yf(. _ot�t_ W QCe(8 5 c71 45 S' '-a o Rr/ fl s(R '7/Z L0fs o7 —" — — .c &vtoYwthv KI.3G" __J saws ❑ Borow { [] pit Ground surface elev. t Depth U Ilnien0 factor In. Stll� Aodlrallon Rate] Hodmn Depth M. Do,S,MCbIoiV Munson Redox Description Oa Sr. Cont. Color Texture Structure Or. Sr. Sh. nStence Boundary Rods GPD/W -ER#t 'ERC2 `` [[..��,, L.IJb Bayfield o. page _90? 3 stir si .max.., anm i ❑ Bodng# ❑ Boring 0 pit Ground surface elev. ft. Depth torlmlMg factor In, Soa AaWrason Rate Hatton Depth In. DorninantColo Mrnsell Redox Description Cu. Sr. �att Cal" Texture Structure Gr. Sr. Sh. Censiatenm Boundary Roots GPDff •Erhar •Efra2 Effluent tut • SOD, > 30c220 220 mgr! and TSS '3D< 150 ngpL • Eiauent *2 • BOD, c 30 mg/t and TSS c 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608.266.3151 or TTY 606.264-8777. SIMLG tnaa0i Apr 26 2006 7:34PM JOE ZIRN SOIL TESTING 715 765 460B p.2 • d W �l O.. Ka (( avct h /✓�-��-33'T4�ivA/-1Q15IA� AKAw Rd - S►N'J e� /YlC: (: _........... ' O • •1Q tlt1.ON. .IOnQ� sOK VN6Kllr '.�Q�� — .. _. . (41/:0. 6pt'IS ... ..._ -._. .... .. RECEIVED e3fo[.0 _.�.. -�.. .a' nse� v�ne�c=gq?�.8�0� _._ JUN 16 2026 1' - ..... lannngAgency. spa 1 - 3 6n �C �y — 1 Cyr �I V��ehc� l��a.�- j/fit ar QpQ`�S�k W !`Wl,/JI'✓!aw-hOl C� 1 . S4.. st"& llaco"7snt je BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) heck List Original Sanitary Application (Submitted in Deed Holders Name — not prospective buyers) (383.21(1)1.) index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) C3Original Plot Plan (383.22(2)2. 3. & 4.a) Dross Section, Over -Head Profile of the System and Schematic of Tank from Manufacturer Iiiimp Tank Diagram, Alarm and Pump Curve (when applicable) ixfntingency 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) ee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) Complete Sets of Plans (383.22(2)(2.) (Note: Sanitary Application and Maintenance Agreements are to be attached to all copies) m�oil and Site Evaluation Report (383.22-3(2)(b)1.e.) RECEIVED 2'State Plan Review (when applicable) JUN 162026 ❑ Copy of Warranty/Quit Claim Deed (Optional) Bayfield Co. Sanitary _niApplication: (Include the following Information) Planning and Zoning Agency la I Application Information must include: 0 23 digit Parcel ID# -- (do not use 12 digits anymore --obsolete) ❑ Project Address or Road Name where driveway is/will come off of) EnI Type of Building ETTII Type of Permit 81V Type of POWTS System Dispersal / Treatment Area Information Tank Information E-ciI Responsibility Statement (Plumber's Information) ❑ *Date Stamp* Plot Plan: (To Scale or To Dimension) R'≤ignature and Plumber Information ❑ Surface Elevation of Body of Water i D rection and Percent Land Slope La'fank and Filter Information and Location ❑ Wetlands / Navigable Bodies of Water 0bsorption Area (Proposed and Existing) IBench Mark (Location, Elevation and Description) 2mponent Manual Version ,p -(Owners Phone Number) PAddress Number and Road 2-go—rth Arrow 0 -Contour Lines la'Structures and Driveways 2' ring Locations Ioperty Lines a'iell Locations Turn Over ► Cross -Section and Over -Head Profile of the System: rface and System Elevation Isition of Observation and Vent Pipes Dimensions and Depths ❑ Make, Model & Number of Chamber Units in each Cell Property Information allow many systems will there be on this parcel of land? 1 ❑ Has this property been split? Q)o (Property Statement shows Property History) Fees: ❑ Private 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 REt:E)VED ❑ Return Inspection $ 50.00 JUN 16 Z�26 ❑ Maintenance Agreements + $ 30.00 (checks made out to Reg of Deeds) hayfield Co. Planning and Zoning Agency u/Farms/checklists/checdistforsanitaryapps (10/2009);(®7/2011);(®2/2012)(®5/2/2012 -dc) Proofed by: -W315 Private Sewage System )Name 27925 Brown 58875 Roy Anderson Rd Agreement VAbef 1.11*1.1 As owner, I (we) do hereby certify the private sewage system will be installed in accordance with the certified soil tester's 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) NE 1/4of NE 1/4 Section 33 Township 46 N.Range 05 w. Additional Legal Description: Town of Kelly (Acreage) 7.82 Gov't Lot See Attached Deed Lot Subdivision Lot — CSM # Vol. _ Page CSM Doc # DOCUMENT NUMBER 2026R-61 2909 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 07/14/2026 AT 8:00 AM RECORDING FEE: $30.00 PAGES: 4 Planning and Zcr t12P JUL 157026 ❑ In -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ® Mound ❑ At -grade Sewage System ❑ Other Area 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 (1/3) 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 -around 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 Bayfield 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 roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. 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 _ �u f/fty CL Subscribed and sworn to before me on this date: a- 1ujt F,scAz.,- 13DCA, o4' i—� ►y, aaaID Notarized Owner(s)— Signature(s) Notary Public I J)enrse j1LJ-Z Denise M. Lutz Public, My Commission Expires: 0b Wiscoc 05-I5'aoa7 a] Drafted by: Doug Manthey Date: 07/10/2026 Proofed by: u/forms/sanitarylsepticmaintenceagreement Revised July 2020 State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number 11 Document Name THIS DEED, made between Jessica A. Breitbach and Charnell J. Breitbach ("Grantor," whether one or more), and Dane C. Fischer and Julie Fischer, husband and wife, as survivorship marital property ("Grantee," whether one or more. Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in BAYFIELD County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): See the annexed Exhibit A. REG tVED JUL 15 2026 Bayfield Co. Planning AO and Zoning �� DOCUMENT NUMBER 2O25R-6O9126 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED 09/11/2025 AT 10:13 AM RECORDING FEE: $30.00 TRANSFER FEE: $750.00 PAGES: 3 ELECTRONICALLY RECORDED Recording Area Return Address Dane C. mid Julie Fischer 6997<_n ny Anderinn Road 29425 `,1t7 -t Mason, WI 54856 i 20340-25 04-026-2-46-05-33-I 01-000-40000 Parcel Identification Number (PIN) This IS NOT homestead property Grantor warrants that the title to the Property is good, indefeasible in the simple and free and clear of encumbrances except: EASEMTFS, RESERVATI NS AND RESTRICTIONS OF RECORD, T Dated fd 4Th Zp 25 AUTHENTICATION Signature(s) authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: ACKNOWLEDGMENT STATE OP M'SSo ti /, ) cIy COUNTY jss. Personally came before me oil !f/I+Faa.Air N, 2t)Lc the above -named Jessica A. Breitbach to me known to be the person(s) who executed the instrument and acknowledged the same. r (�_ATTORNEY MAX T. LINDSEY, SB#I 112865 No Anich, Wickman & Lindsey, S.C., Ashland, WI 54806 My Co mis i matsate permanent) a -x My Commission (is permanen�(ex (Signatures mny be authenticated or acknowledged. Both are not necessary.) NOTE: THIS ISA STANDARD ORM. ANY MODIFICATIONSTO THIS FORM SHOULD BE CLEARLY IDENTIFIED, WARRANTY DEED O 2003 STATE BAR OF WISCONSIN FORM NO. • 1 'pe name below signatures b4X Bayfield County Register of Deeds Document #2025R-609126 Page 1 of 3 Dated this 3= day of 2025. Charn II . Breitbach ACKNOWtEDGMENT State of V e` ) ss. County of'�� &) Personally came before me this 0 day of , 2025, the above -named Charnell J. Breitbach, to me known to be the person who executed the foregoing instrument and acknowledged the same. -__ Notary Public, State of 0Wo' 1 AMANDAD*ttg Myexpires: rr 11 ,, Commission Num@sr8�85 F commission fires: ( LA C ICJ My Ccmmisstan Expires 1p�1► Match 4, 2027 Bayfleld County Register of Deeds Dgcument #2025R-609126 Page 2 of 3 E,XF IBIT "A" A parcel in the Northeast Quarter of the Northeast Quarter (NE'/4 NEY), Section Thirty-three (33), Township Forty-six (46) North, Range Five (5) West, Town of Kelly, Bayfield County, Wisconsin, described as follows: The Point of Beginning is the Southeast corner of said NE''A NE%,; Thence West on the South line of said forty 750 feet to a point; Thence North 737 feet parallel with the East line of said forty to a point; Thence East 167 feet, more or less, to a point on the West side of a parcel described in Volume 751, Page 177, said West line is 550 feet West of the Westerly right of way of Roy Anderson Road; Thence South 250 feet, more or less, to the Southwest corner of the parcel in Volume 751, Page 177; Thence East on the South line of said parcel 583 feet, more or less, to the East line of said NE''h NE'/,; Thence South to the Point of Beginning, LESS the former railroad right-of-way as described in Volume 153, Page 628. 5 2026 sa'oel6 G9 Psenay Planning and Zon Bayfield County Register of Deeds Document #2025R609126 Page 3 of 3 13 LYFIELD 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: FISCHER, DANE C & JULIE 27925 BROWN RD MASON, WI 54856 Description State Approved Plans (Mounds, Systems Requiring Pre -Treatment, etc.) Submission Number: SS -00768 Transaction Number: SS -00768-47D53 Amount $500.00 Total: $500.00 Payment Amount: $500.00 Reference: 5465 Paid by: A -Z Enterprises, Nor -Pines Plumbing, PO Box 196, Drummond WI 54832 Payment Type: Check Transaction Date: 7/17/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-92S STATE SANITARY PERMIT OWNER: DANE C & JULIE FISCHER G OV'T LOT: LOT: BLK: K: NE1/4 NE1/4 SEC:33,T46N,R5W TOWNSHIP: Kelly SOIL TEST: 21-26 REPLACEMENT SYSTEM SYSTEM TYPE: Mound 224 in. of suitable soil PLUMBER: DOUGLAS MANTHEY SCOTT ROUSH DATE: 7/17/2026 Authorized Issuing Officer 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. 1 b8; 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 #: 06-87S LICENSE: # MP 230722 condition: THIS PERMIT EXPIRES 7/17/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION