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Home My WebLink About26-0411BAYFIELD COUNTY SANITARY PERMIT APPLICATION /� Zoning District �Oons Lakes Class I. APPLICATION INFORM , Soil Test County 1 , (Please Print All Informati No: Permit No: Property Owner's Name: Peter & Ann Brownlee County: Bayfield Address of Property: Property Location: o ❑✓ 89310 E Romans Point Rd, Herbster, WI 54844 %, s 29 T 51 N, R 06 E (or) W Property Owner's Mailing Address: Township: Gov. Lot #: oL 10061 Manning Ave Bell 0 4 City, State Zip Code Phone Number Lot # Block #: CSM #: CSM Doc # Subdivision Name Stillwater,MN 55082 II. TYPE OF BUILDING:, (Ghee Tax ID#: ❑ State Owned ❑ Public (Explain the use/purpose ) 3497 7.773 ❑✓ 1 or 2 Family Dwelling - No. of Bedrooms 2 IlkiXPPF—GEPERMIT: (Check only one box on line,A::Ctteck box on line B. if applicable) A) ❑ New ❑ Replacement ❑ County Private Interceptor ❑✓ Reconnection ❑ Repair ❑ Revision '* ❑ Transfer of Owner (List Previous Owner below) B) ❑✓ A Sanitary Permit was previously issued. Previous Permit Number 10-1 Dos Date Issued: 9/8/10 IV. TYPE OF NON -PLUMBING SYSTEM: (Check One) * Replacements need previous permit number and date filled out above C) ❑ Pit Privy ❑ Vault Privy (Vault size: _gallons or _cubic yards) ❑ Portable Privy ❑ Camping Transfer Unit Container ❑ Composting Toilets ❑ Incinerating Toilet V.,ABSORPTIONSYSTEM-INFORMATIONS _,- ... 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 Septic Tank or ❑ ❑✓ 2000 1 Wieser ❑✓ ❑ ❑ ❑ ❑ ❑ Holdin Tank Lift Pump Tank / ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Si hon Chamber VII. RESPONSIBILITY S . I the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Owner's Name(s): (Print) IfapplyingforSectionCabove Owner's Signature(s): (No Stamps) Plumbers Name: (Print) If applying for Section A or B) above Plumbers Sign turn: (No Stamps) MP/MPRSW No: Edward B. Redinqer 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 VIII. COUNTY i DEflRIMENT USE O' - 'Issuing L2 Approved ❑ Disapproved ❑ Owner Given Initial Sanitary Permit/Transfer Fee: Date Issued: ct!H/?-°�-h Agent's Signature / Date: 1L M(cold((✓'jl �( v Adverse Determination (OJOt-(((�♦7 IX. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: AUG 032026 Bayfield Co. Plot Plan on reverse side Lot Line Name of Frontage Road (I, Ro.Vw .' ".) --► 1. Name the frontage road and use as a guideline, fill in the lot dimensions and indicate North (N). 2. Show the approximate location and size of the building. IMPORTANT DETAILED PLOT PLAN 3. Show the location of the well, septic tank and drain field. IS NECESSARY, FOLLOW STEPS 1-7 (a -c) COMPLETELY 4. Show the location of any lake, river, stream or pond if applicable. 5. Show the approximate location of other existing structures. 6. Show the approximate location of any wetlands or slopes over 20 percent. 7. Show dimensions in feet on the following: a. Building to all lot lines b Building to centerline of road 1,51 c. Building to lake, river, stream or pond 9o' d. Septic / holding tank to closest lot line 70' e. Septic/holding tank to building 25` f. Septic / holding tank to well qt' g. Septic / holding tank to lake, river, stream or pondl3o' h. Privy to closest lot line i. Privy to building /V/14 j. Privy to lake, river, stream or pond Nj!4 k. Drain field to closest lot line A)IA I. Drain field to building /'-'IA m. Drain field to well N/A n. Drain field to lake, river, stream or pond 1111.4 o. Well to building 30' RECEIVED Submit To: Bayfield County Zoning Department, PO Box 58, Washburn, WI 54891 AUG 03 2026 u/forms/sanitary/bayfieldcou ntysan itaryap pl ication Revise: June 2018 Bayfield Co. Planning and Zoning Agency Proofed by: B t FIELD Bayfield County Planning & Zoning Department 117 E 5w Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-4010 Property Owner: Submission Number: CS -00178 Transaction Number: CS -00178 -489 CC Description Amount Private Sewage System Reconnection $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 10862 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 PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 26-0411 Tax ID: 7773 Issued To: BROWNLEE, PETER H & ANN E Location: S29 - T51 N - RO6W Town of BELL Legal Description: PAR IN GOVT LOT 2 IN DOC 2025R-607321 452F Residential Structure in R-1 Zoning District For: Sanitation Permit —Reconnection [Previous Permit # 10-100S (09/08/2010)] (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 oenaltios 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 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. Emily Macgillivray, AZA Authorized Issuing Official August 11, 2026 Date