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Home My WebLink About26-0389GS- Co 170 BAYFIELD COUNTY SANITARY PERMIT APPLICATION Zoning District Lakes Class I. APPLICATION INFORMATION Soil Test County .(Please Print All Information) No: Permit No: U r Property Owner's Name: Carl Schwenzfeier County: Bayfield Address of Property: Property Location: ❑ izi 76395 Church Corner Rd NE v, SE 'A, s 33 T 49 N, R 05 E(or)W Property Owner's Mailing Address: Township: Gov. Lot #: 707 Ash St Washburn City, State Zip Code Phone Number Lot # Block #: CSM #: CSM Doc # Subdivision Name Colfax, WI 54730 II. TYPE OF BUILDING: (Check One) ❑ State Owned Tax ID#: rtCEIVED ❑ Public (Explain the use/purpose ) 31165 // ❑✓ 1 or 2 Family Dwelling - No. of Bedrooms 2 JUL III. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable). ayfield Co. A) ❑ New ❑ Replacement ❑ County Private Interceptor Planning aria Zoning Agency Reconnection ❑ Repair ❑ Revision " ❑ Transfer of Owner (List Previous Owner below) B) ,❑ A Sanitary Permit was previously issued. Previous Permit Number. %2- fOTCCSDate Issued: IV. TYPE OF NON -PLUMBING SYSTEM: (Check One) * Replacements need previous permit number and date filled outAbove C) ❑ Pit Privy ❑ Vault Privy (Vault size: gallons or _cubic yards) ❑ Portable Privy ❑ Camping Transfer Unit Container ❑ Composting Toilets ❑ Incinerating Toilet V. ABSORPTION SYSTEM INFORMATION: I _ 1. Gallons 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System 7. Final Grade Per Day Required (Sq.Ft.) Proposed (Sq. Ft.) (Gals. / Day / Sq.Ft.) (Min. Inch) Elev.(Feet) Elev. (Feet) VI. TANK Capacity Fiber INFORMATION: In Gallons Total Gallons # of Tanks Manufacturer's Name Prefab. Concrete Site Constructed Steel - glass Plastic Exper. App. New Existing Tanks Tanks Septin ❑ � ❑ 1 Wieser ✓❑ El ❑ ❑ ❑ El Holdin Tank Tank Lift Pump Tank / ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Siphon Chamber VII. RESPONSIBILITY STATEMENT: I the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Owner'sName(s): (Print) If applying for Section C above Owner's Signature(s): (No Stamps) Plumber's Name: (Print) If applying for Section A ore) above Plumber's Sign Stamps)- MP/MPRSWNo: Edward B. Redinger 221939 Plumber's Address: (Street, City State, Zip Code) Home Phone: Business Phone: 1015 11th Ave E. Ashland, WI 54806 715-413-0122 715-292-6670 Vill. COUNTY I DEPARTMENT USE ONLY: ❑ Disapproved Sanitary Permit/Transfer Fee: Date Issued: Iss in gent's Signature / D te: �, 1Capproved Approved ❑ Owner Given Initial �fS/ eoa'6 � Adverse Determination / IX. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: Plot Plan on reverse side Lo# l:nt ti �-- + 190' P (fib, i/ (70' — V 1. Name the frontage road and use as a guideline, fill in the lot dimensions and indicate North (N). 2. Show the approximate location and size of the building. IMPORTANT 3. Show the location of the well, septic tank and drain field. 4. Show the location of any lake, river, stream or pond if applicable. 5. Show the approximate location of other existing structures. 6. Show the approximate location of any wetlands or slopes over 20 percent. 7. Show dimensions in feet on the following: a. Building to all lot lines — b Building to centerline of road ZC' c. Building to lake, river, stream or pond)( d. Septic / holding tank to closest lot line (p 3t e. Septic/holding tank to building f. Septic / holding tank to well &0 g. Septic / holding tank to lake, river, stream or pondx h. Privy to closest lot liner DETAILED PLOT PLAN IS NECESSARY, FOLLOW STEPS 1.7 (a -c) COMPLETELY JUL 15 2026 Bayneld Co. Planning and Zoning Agency i. Privy to building," j. Privy to lake, river, stream or pond x k. Drain field to closest lot linex I. Drain field to building x m. Drain field to well % n. Drain field to lake, river, stream or pondx o. Well to building 2.tt Submit To: Bayfield County Zoning Department, PO Box 58, Washburn, WI 54891 u/forms/sanitary/bayfieldcountysanitaryapplication Revise: June 2018 Proofed by: P-YFIELD Bayfield County pp Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-4010 Property Owner: Submission Number: CS -00170 Transaction Number. CS -00170-4A028 Description Amount Private Sewage System Reconnection $50.00 Amount: $50.00 Reference: 10836 Paid by: Superior Plumbing & Mech Inc Payment Type: Check Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. Town, City, Village, State or Federal Permits May Also Be Required LAND USE - SANITARY - Reconnection SIGN - SPECIAL - CONDITIONAL - BOA - BAYFIELD COUNTY WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 26-0389 Tax ID: 31165 Issued To: SCHWENZFEIER, CARL Location: S33 - T49N - R05W Town of WASHBURN Legal Description: PAR IN NE SE IN 2024R-604994 (UNOFFICIAL LOT 2) Residential Structure in AG -1 Zoning District For: Sanitation Permit — Reconnection [Previous Permit # 22-109S (08/31/2022)] (Disclaimer): Any future expansions or development would require additional permitting. Condition(s): You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the department of natural resources wetlands identification web page or contact a department of natural resources service center (715) 685-2900. NOTE: This permit expires two years from date of issuance if the authorized construction Tracy Pooler, AZA work or land use has not begun. Changes in plans or specifications shall not be made without obtaining approval. This permit may be void or revoked if any of the application information is found to have been misrepresented, erroneous, or incomplete. This permit may be void or revoked if any performance conditions are not completed or if any prohibitory conditions are violated. Authorized Issuing Official August 05, 2026 Date