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HomeMy WebLinkAbout26-110SSS -0o 03 Industry Services Division County 4822 Madison Yards Way Bayfield Madison, WI 53705 Sanitary Permit Number (to be filled in by Co.) P.O. Box 7302 — 0 0 8 �3 Madison, WI 53707 '— fl I �5 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 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary 48525 S Lake Owen Dr. Cable, WI purposes in accordance with the Privacy Law, s. 1 S.04(1)(m), Srats. RECEIVED I. Application Information — Please Print All In formation Property Owner's Name Parcel # Windmark North LLC JUL 152026 13931 Property Owner's Mailing Address Bayfield Co. Property Location 555 Main St. STE 450 Planning and Zoning Agenq Govt. Lot City, State Zip Code Phone Number Racine, WI 53403 414-331-7856 % %, Section 22 II. Type of Building (check all that apply) Lot # T44 N R 07 E or W ❑✓ I or 2 Family Dwelling — Number of Bedrooms 3 Subdivision Name Block # ❑Public/Commercial — DescribeUse Cityof State Owned— Describe Use CSM Number Village of Town of Drummond III. Type of POWTS Permit: (Check either "New" or"Replacement" and other applicable on line A. Check one box on line B. Complete line Cif applicable.) A. IZINew System ❑Replacement System lllOther Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B. Holding Tank jIn-Ground fAAt-Grade Mound 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 NA IV. Dispersal/I'reatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) I Dispersal Area Required (so I Dispersal Area Proposed (st) I System Elevation 300 NA NA NA NA Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units V New Tanks Existing Tanks o "+ y ' `" O r ,°a a. 1 CJ VI v. VI [t t.i L Septic or Holding Tank 3000 3100 1 Superior Precast ✓ Dosing Chamber V. Responsibility Statement- I, tire undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) I Plumber's Signatur MP/MPRS Number Business Phone Number Jason Kuettel 675751 715-798-3355 Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 VI. County/Department Use Only II Approved ❑ Disapproved Permit Fee I Date Issued Issuin ge Signature I ❑ Owner Given Reason for Denial S 24 2b "ZO Conditions of Approval/Reasons for Disapproval Cc wed Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2,x II inches in size SBD-6398 (R. 02/22) PAGE 1 OF 4 Holding Tank Plan Index & Cover Sheet Component Manual Design References: Holding Tank Version 2.1 (May 2022-2027) RECEIVED Pg 1 of 4 Index & Cover Sheet JUL 15 2026 Pg 2 of 4 Plot Plan Bayfield Co. Planning and Zoning Agency 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 appt Holding Tank Agreement (if applicable) Project Name I Description Windmark North LLC Holding Tank Owner Name(s): Windmark North LLC Owner Address: 555 Main St. STE 450 Racine, WI Phone:414 _331 Zip: 53403 Project Address: 48525 S Lake Owen Dr. Cable, WI 54821 Govt. Lot: Township: Drummond Project Parcel ID #: 13931 ilLl.31 Designer Name: Jason Kuettel Designer Address: 42940 US I E-mail: tim@andryras.com License Number: 675751 Remarks: plicable) cable) 7856 1/4, Section 22 , T 44 N -R 07 E❑or w1 County: Bayfield Designer Information 63 S. Cable, WI Phone: 715 _798 _3355 Zip: 54821 iii,, space rc.crvcd hi apps'cal e[,ury.. Signature: ; Date: 7Jt f/zG Original g ature required on each submitted copy. OUN'ES : w1Nt�M+i�'L NQC-T h C-LC- CCGa-c Szz TlYN (Z o71J LAKE OWEN S0 _-- BSVEOETATNE BUFFER ZONE WETLAND TS $HORELANO --_- SETBACK y.� ------------------ ---- ____ _ L (iJEV¢JT 01 SITE LAYOUT PLAN Pzo us6 G�tT— , tl'ORNE RELANO /' rmcN RECEIVED JUL 15 2026 Hayfield Co. Planning and Zoning Agency 77 WETLAND 35WETlAND SETBACK 715 �2 F PAGE 3 OF 4 HOLDING TANK SPECIFICATIONS ;EIVED (No Scale) JUL 152026 Bayfield Co. Planning and Zoning Agency 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 and NEC 300 SPS 316 40 Vent Pipe with Warning Label Attached Conduit >10 ftfrom (typical) 4" Mn. or 2.0 ft above Building Established Flood Elevation (typical) \ \J/ Airtight Seal {j . Finished Grade 18" Min. (typical) .: a: " . .. e 4 Inlet Inlet Invert Approved Joints with —Watertight Plug Approved Pipe 3 ft onto Max. 12" or of total volume than one tank " Alarm -On e HOLDING TANK VOLUME = 3100 gal 3" Approved Bedding Material Beneath Tank TANK MANUFACTURER: Superior Precast Anchor tank as necessary pursuant to SPS 383.43(8)(g) Ballast Weight = [(cu.ft.tank.vol x 62.4 lbs/cu.ft) - lbs.tank.wt] x 1.5 Ballast Weight = [( cuff. x 62.4 lbs/cu.ft) - Ibs] x 1.5 = 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 = 300 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 (to., wiring, connections, switches, controls, timers, alarms, etc.) o surface discharge of effluent or sewage back-up into structure served SERVICING FREQUENCY RECEIVED; JUL 15 2026 Bayfield Co. Planning and Zoning Agency 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: Andry Rasmussen & Sons Phone: 715-798-3355 Local government unit: Bayfield Co. Zoning 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. [5' SUPERIOR LP30001-Compartment Tank SUPERIOR PRECAST CONCRETE PRECAST CONCRETE Weisht (in lbs) Tank: 19.127 Lid: 9,77: Total: 24,902 Volume of Concrete Total : 6.: Yd' Gallons Per Inch: 70.9 Lid TOP VIEW 184" 178' i LCCt:1VED JUL 15 2026 Bayfield Co. Planning and Zoning Agenri 3029 Gallons -L1-- \ SIDE VIEW Enlarged Detail L— ____�� Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES 50" SEE CORRESPONDENCE 9" Air Space • 33" uid Depth De 96" 102" --------------------- J ____ ] Thor Ti'ck's" Manhole Opening- _ _ I -12 ? Taper / Produced by Superior Precast Concrete, LLC ( PO Box 1390 ^ Hayward, WI 54843 C) Polyethylene Baffle Mastic Rope S 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, consult with SPC. Product File No: I This is proprietary lnrounatIon, and remain[he propnry of Superior Precast Concrete, LLC. I 0. 3 0519.20 241 HOLDING TANK SERVICING CONTRAC≤p"oTARrA"�'o' *„ j••. SEAL. Contract Dates.�Pf i Jis%�6 This contract is made between the Windmark North LLC Pumper's Name (Print) Pumper's Signature Pumpers' Regi: Cri i*JM.. ($ESP `. CcC �O1 Q.'�� L qc' •r— .-t.. CSo4,��4�/._1. ^JQ JACOB ELLIOTTCRIDER Notary Public for the State of Montana Residing at: Bozeman, Montana My Commission Expires: June 4, 2029 We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT Legal Description• Tax ION 3 9 3 LOCATION jUse Tax statement), - -- -- 1 • 1 1/6• 1/4, Section LZ N, Range D Z Town of: i Lot Size I Acreage ,Township w t _v MA -01 3S- 2.1 GoVt Lot Lot N CShM N Vol. Page CSM Doc N Lots) No. Block(s) No. Subdivision: 1. The owner agrees to file a copy of this contract with Barfield 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 axe ' n ypJ xis. The pumper further agrees to include the following in the semiannual report: flttatl V CL) a. The name and address of the person responsible for servicing the holding tank; JUL 152026 b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; sayeeld Co. d. The sanitary permit number issued for the holding tank; Planning and Zoning Agency 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. 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. Owners) Name(s) (Print) Owner's Signature(s) =y: rn to me: i Windmark North LLC Authorized Represetative Notary Public Scott Weas I es on: ZLfkt. Ll 7,029/ Revised: May _016 (: ),day 201E) use,t„ Personal inrorrnalion you provide may 1', d for Sc,,,, ,n, la Drafted by ry Purposes IPm•aey Law, x.15.0.1 P),^t)I lffnlHlmRir_nIItKt17TL tjfl1 DOCUMENT NUMBER 2026R-6 12947 Document Number WINDMARK NORTH LLC Document Title JUL 16 2026 gayfield Co. A9e.� planning and Zoning DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 07/15/2026 AT 1:44 PM RECORDING FEE: $30.00 PAGES: 3 Recording Area Name and Return Address ZONING Parcel Identification Number (PIN) THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE. This information must be completed by submitter: document title, name & return address, and PIN (if required). Other information such as the granting clause, legal description, etc., may be placed on this first page of the document or may be placed on additional pages of the document. WRDA Rev. 12/22/2010 """"^• JACOB ELLIOTT•CRIDER � 4 EWoT?c`'• Notary Public ,o. 2a, Document Number/Plan I.D. No. HOLDING TANK AGREEMENT v Tna1 a X0_._44 for the State of Montana -'�: : * •, SEAL r z Residing at: Bozeman, Montana Owner Name(s) Owner(s) Mailing Address Winorrerk Nat LLC 1345 N Jefferson St P.O. Box 387 ` iA•• ••'•c °` My commission 4,2 Expires: 4, 2029 '�•,,,,°' June Milwauke, W153202-2657 Parcel Identifier Number (PIN) Agreement Date (same as Notary Date) 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, Ws Stats. 114 of 1/4 Section i? Township ______N. Range 6) W. Town of ' MZIA A,_4n Return To: Additional Legal Description: f& 4 T77C .'- RECEIVED G ZON 1N G RECEIVED Gov't Lot - Lot_ Block_ Subdivision Lot CSM # Vol JUL 16 2026 Page CSM Doo# As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above -described proper,�°��}@r?0RPrdo 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 property 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, Scats., 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, Scats. 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 of 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. Stab., 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 of 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. Scats., 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 Subscribed and sworn to before me on this date: Windmark North LLC -7 /10/oz Co Notarized Owner(s) - Signature(s) �VD Notary Publ- lJ� Scott Weas My C mission Expires: Authorized Representative 7u n c.. y t" Z.c 29 Drafted by: 7TA" CJL_14 __ Date: 7J/0/24, Personal information you provide may be used for secondary purposes IFiuery Law, s.15.04 (fi(m)] Wb,ms/aauta Modi TenkA ry ng greemant 4.2026 Oct 22 2008 7:39 JOE ZIRN SOIL TESTING 715 765 4608 p_1 1Mscorebl Deparmenlol Camnerce SOIL EVALUATION REPORT Pegs_Lot 3 Divisi not Safetyand Buildings In accordance wan Comm 85. was. Adm Code County &, Fwd Incl dr, big note site plan ci,verticall and horizontal efeenoe point (BM), direction and Parcel I.D. D - 0IQ- 2- YY- o'%- a- peril slope, scab or dlmenalona. north arrow, and location end distance to nearest road. Of 0c7- 20oo0 Yr y6 sw?S� Please print all Information. Reiewed by Date Mann SfMraIbn you premed may be used ter woondary purposes (Pxsucy Low. x 1 S.os (1) mm. Propwty0vsI& Tl ProperryLocallon S,4,,J: -( j_0AA1 Son( Govt. Lot v< NE1a s2. T Vf ( N R 7[ya t w Propertyowmers Mailing Address Lola Bloch $ Subd. Name or CSIJte SSS /Pfa, C/.S.., f o City Stats Zip Code Phone Number ❑ City ❑ Village ® Town Nearesl Road &I'lc wr 53Yo3 (962).2r<r-2134 .LP S. L4 Oc.'t,jDr ❑ NewConslmdlon We:®Resldenbsl/ Number of bedrooms ,TI Code derived design flow rate /So GPO ® Repleoemerd ❑ Pa •• ,blirNynr ••••..._i_t-Describe: R;Z_f aa. S2 Peril resetlsl G /cC(r/ 17r/ Flood Plain elevation If applicable rr�/4- %/B/ a. General mmn eit Hodi , lc ../Crc orn n2e... Ord - W. -' Y - k ca5r </[ p!rr7ct st S7't••<L✓L and dons: L� e>x t..e u.+.r r..i 'a6% .(- zen�ex �•..-{ sys r="1 <•/ �J•+'. `��Y .y ern r-. f<l/e -C.'- ..,- #f -goads / ❑ Bo ug Bod q a ❑ pit Ground __dace etev. r 1• ft. Depth to limiting factor in. Sol IIr]lion Ruleboring, Depth In Doninanl Color Munsef Radar Description Ou. Si. Cont. Color Texture Structure Gr. Si. Sh. Consistence Boundary Rooe 'EMI 'Efa4 I Tr. Sy,23)I name SI- 2AL4 kW#v es ca &. I•o L -t4 syR4(Lp tw^c SI_" J sLL C5 if i 3 lY-bo SyQ41y C1cQ % L SCL CMI — — O .O F Bg• ❑ BodS rg _ t 2.( orin1R pit Ground surlaceelev. II0. ' ft. Depth to limiting factor 1 in. eSI annrmrttnn IsIs Horizon Depth in. Dominant Color Mines! . Redo_ Desaipgon Cu. Si. Cont. Color Texture Structure Sr. Sr. Sh. Consistence Boundary Roots GPDIR 'Effa1 'EIfa2 � O- SYR 3%( ... SL Q s / lnJty GS /� /�r4 oc Cp 1.0 S-rS SY2 `f/3 fl2nC SL I-Es6E d1i' /� 2( ca 7 3 is 4o SYR k/L OI SV2 7/z cc~,�.t. 01)1 - 5 I O .O Cf 40-72 R•i! C3d 5Y'e7/2 Sct O✓'l — G5 — O .0 5 a -loo p S—/ Cto1 SYRG16 1 -PS I(s4 — • $— I•o -Bnu"ta1at >JU_ttu.ngr�nmiw-av_w.y..-...-_...__JE CST Nam (Place Pri i) 6'tgnalue � _/ Address . Date g� Conducted s i761s Z8Z80 E Attamont RdY(-OR Oct 22 2008 7:39 JOE ZIRN SOIL TESTING 715 765 4608 P.3 PmpertyOveer 'Soh Partial IDR cf— oo7- ;2ac d u Page ;2 0l ��--��� O Boerq I I ri f M ou Ground surtew ale¢ 11. Depth ro Ilmltlng (actorcdi Anrthnn Rats Marton Depth Dominent Color Redox Deacdpdon Texture Structure Consistence Boundary Roots GPDR In. Munsell Cu. 6z Cont. Color Gr. Sz. Sh. 'Etta 'Ette2 o-�R 311 1 newt- SL Fs_ 1•nu4, cs 21 -cc L (-o ,-fl �y,cdc, ,r.A.C SLs Ibtk M cc (f —ca ,q . -7 3 36- d 5- K 57y rR ?l2 g5 0rvl - - I� . C (-A (}ylVv[:K 0.7 L.�I' Boring0 C Boring n .. Gmund surface elev.._ . R. Depth to limiting Fader in.eni1 A______;;•,eIM aa7 1 Hofhan Depth Domino% Color Redox Deediption Texture Structure Consistence Boundary Roots GP01? h Mansell Gu. Sz Cant. Color Or. Sz. Sh. trial 'Ef112 0 p Borip r1 _ Ground surface elev. M1. Depth to limiting fads In. etii a.,�s� Horizon tpth DornWnt Color Retlox Dasdtplion Texhae Swdure Consistence Boundary Roots P In. Munsell Cu. Sz. Cont. Color Or. Sz. Sh. 'EM101 csy;i=_e • Ef lu nl 01 s BCD, > 30 S 220 mg7L and'TSS >30 ! 150 mg&L ' Elnuent 02 - GOD. ≤ 30 mg/L and. TSS _ 30 mglL The Department of Commerce is an equal opportunity service provider and employer. I Iyou need asslztance to access services or need material in an alternate format. please contact the department at 608-266.3151 e( TCY.608-264-8777. ;�.'. pD•p11ta.0LWj . • . Oc,t 22 2008 7:39 I I ! I I I _ -I '- overt i I LLL JOE ZIRN SOIL TESTING 715 765 4608 p.2 I I I it 1:4t 111H1L 1: JL\± 4j I I ! ' w.. . . I .-, I I ) , 1 . I I .: I I _.;.._j_._lG ;_I_JUL._..15-! .2026-- -...;_. _ : i - Planning andzonig Age nq - ........._..j_..1_._.__L.._.1.....4.......... I I' HJJLH tiiT' r�Qe{fa%—_i I.I.: m:::: __ !... i__ ... State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number II Document Name THIS DEED, made between Lake Owen Shores L.L.C., a Delaware limited liability company ("Grantor," whether one or more), and Windmark North, LLC, a Delaware limited liability company ("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): A parcel of land located in Government Lot Seven (7), Section Twenty-two (22), Township Forty-four (44) North, Range Seven (7) West, in the Town of Drummond, Bayfield County, Wisconsin, described as follows: Beginning at a 2 inch brass capped itnn pipe at the East 1/4 corner of Section 22, thence N. 01° 3700W. along the East line of said Section 22, 1124,83 feet to a 1 1/4 inch iron pipe; Thence N. 80° 44' 00" W. 434.97 feet to a I inch iron pipe near the Westerly shore of Lake Owen; Thence along a meander line near said Westerly shore of Lake Owen, S. 58° 03' 24" W, 1649.97 feet to a 5/8 inch iron rod; Thence leaving said meander line, S. 780 25' 41" E., 1901.49 feet to the Point of Beginning. For Informational Purposes Only Address: 48525 South Lake Owen Drive, Cable, WI 54821 DOCUMENT NUMBER 2026R-613247 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED O8/O7/2O26 AT 8:OO AM RECORDING FEE: $30.00 TRANSFER FEE: $22500.00 PAGES:1 ELECTRONICALLY RECORDED Recording Area Name and Re urn Address I lostak, Henzl & Dickler S.C. Attn: Jessica Grandberg 840 Lake Avenue, Suite 300 Racine, WI 53403 04-018.2.44.07.22.1 05.007-20000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: municipal and zoning ordinances and agreements entered tinder them, recorded easements for the distribution of utility and municipal services, recorded building and use restrictions and covenants, and general taxes levied in the year of closing. RECEIVED CE _ IVED Dated February 12, 2026 Lake Owen Shores L.L.C.Is AUG 202026 MACKENZIE TENUTA. Bayfield Co. Notary Public Planning and Zoning Agency (SEAL) in • Robert Kirby. riz Signer State of Wisconsi AUTHENTICATION ACKNOWLEDGMENT atgnamrcts) STATE OF WISCONSIN ) ss. authenticated on RACINE COUNTY ) TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Jessica Grundberg Hostak Henzl & Bichler S.C. Personally came before me on j (ar[ the above -named Qo1Oe€# IGrbj to me known to be the person(s) who executed the foregoing instrument �,r/r'/Iand acknowled ed the same. fr1t1ckA4c TG.. -4s Notary Public, State of Wisconsin My Commission (is permanent) (expires:_____________________ (Signnmres nay be authentlented or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TOTHIS FORM SHOULD DE CLEARLY IDENTIFIED. WAltRAN'rY DEED 4) 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 • Type name below signatures. Bayfield County Register of Deeds Document #2026R-613247 Page 1 of 1 EXHIBIT "A" LEGAL DESCRIPTION A Parcel of land located in Government Lot Seven (7), Section Twenty-two (22), Township Forty- four (44) North, Range Seven (7) West, in the Town of Drummond, Bayfield County, Wisconsin, described as follows: Beginning at a 2 inch brass capped iron pipe at the East 1/4 comer of Section 22, thence N. 01' 37' 00" W. along the East line of said Section 22, 1184.83 feet to a 1 1/4 inch iron pipe; Thence N. 80' 44' 00" W. 434.97 feet to a 1 inch iron pipe near the Westerly shore of Lake Owen; Thence along a meander line near said Westerly shore of Lake Owen, S. 58' 03' 24" W, 1649.97 feet to a 5/8 inch iron rod; Thence leaving said meander line, S. 78 25' 41" E., 1901.49 feet to the Point of Beginning. Tax Key No.: 018-1023-05 RECEIVED Address: Town of Drummond Bayfield County, Wisconsin JUL 16 2026 Bayfield Co. planning and zoning Ag8110Y Tax Key No. 018-1023-05 V1057 P608 ONUS 5230618-1.022358.0010 I3 1YFIELD 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: Submission Number: LAKE OWEN SHORES LLC SS -00803 555 MAIN ST RACINE, WI 53403 Transaction Number: SS-00803-4C94F Description Private Sewage System (Holding Tanks) Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 15114 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 8/ 20/ 2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. HAYFIELD COUNTY SANITARY PERMIT (#04)-26-11 OS STATE SANITARY PERMIT OWNER: WINDMARK NORTH LLC G OV'T LOT: LOT: B L K: 1/4 1/4 SEC: 22, T 44 N, R 7 TOWNSHIP: Drummond SOIL TEST: NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: JASON KUETTEL SCOTT ROUSH Authorized Issuing Officer DATE: 8/21/2026 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: # MP 675751 Condition: Properly Maintain System Per Recorded Agreement. Must be within 25 ft of an all- weather road. THIS PERMIT EXPIRES 8/21/2028 MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION