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Home My WebLink About26-0436Cs-ooy3 BAYFIELD COUNTY SANITARY PERMIT APPLICATION Zoning District Lakes Class I. APPLICATION INFORMATION (9iease Print All Information) Soil Test I County No: I Permit No: �l7 - OUJZ 6 Property Owner's Name: David Ramberg & Carolyn Ranbert Trust County: Bayfleld Address of Property: Property Location: 46055 Tahkodah Lake Rd. Cable WI V4 %, S 34 T 44 N, R 7 E (or) W Property Owners Mailing Address: Township: I Gov. Lot #: 1 4937 17th Ave. S Drummond City, State Zip Code I Phone Number Lot # I Block M.# I CSM #: I CSM Doc # Subdivision Name Minneapolis, MN 55417 I I P R_ � ,I` D "- r II. TYPE OF BUILDING: (Check One) ❑ State Owned Tax ID#: $ ❑ Public (Explain the use/purpose ) 14254 AUG 172026 iBoL ❑ 1 or 2 Family Dwelling - No. of Bedrooms Ill. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) ❑ New ❑ Replacement County Private Interceptor Li Reconnection ❑ Repair ❑ Revision " ❑ Transfer of Owner (List Previous Owner below) B) ❑ A Sanitary Permit was previously issued. Previous Permit Number. 04-24-103S Date Issued: 8/2/24 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. ABSORPTION SYSTEM INFORMATION: 1. Gallons 2. Absorp. Area I 3. Absorp. Area I 4. Loading Rate I 5. Perc. Rate I 6. System 7. Final Grade Per Day Required (Sq.Ft.) I Proposed (Sq. Ft.) (Gals. / Day / Sq.Ft.) (Min. Inch) Elev.(Feet) Elev. (Feet) 300 I .7 92.5 VI, TANK Capacity INFORMATION: In Gallons Total Gallons # of Tanks Manufacturer's Prefab. Site Steel Fiber - Plastic Exper. New Existing Name Concrete Constructed glass App. Tanks Tanks Septic Tank or Holding Tank x 760 1 Superior preca x 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's Name(s): (Print) if applying for Section C above Owner'sSignature(s): (No Stamps) Plum jar's Name: (Print) it applying for Sect/on A or a) above Plumber's Signature: (No Stamps) MP/MPRSW No: Bo��.rci u`3.SZedt 9 2a/9,1^q Plumber's Address: (Street, C State, Zip C/ode) Code) Home Phone: Business Phone: 1Djs J/,4'e. c 44j dLI ors -9/3 ojzz ) if -39j L 76 VIII. COUNTY / DEPARTMENT USE ONLY Approved ❑ Disapproved ❑ Owner Given Initial Sanitary Permit/Transfer Fee: I Date Issued: Cba,j /)o lssui nt's Signature / Date: 1i ( Adverse Determination ( r� IX. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: Plot Plan on reverse side Lot Line R� '�.V [q RECE t'_AUG 172026 Bayfield Co. Planning and ZoninoAgency 3 �o l 6 We11 Y z Name of Frontage Road ) 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. DETAILED PLOT PLAN IS NECESSARY, FOLLOW STEPS 1-7 (a -o) 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 i. Privy to building b Building to centerline of road j. Privy to lake, river, stream or pond c. Building to lake, river, stream or pond k. Drain field to closest lot line d. Septic / holding tank to closest lot line I. Drain field to building e. Septic/holding tank to building m. Drain field to well f. Septic / holding tank to well n. Drain field to lake, river, stream or pond g. Septic / holding tank to lake, river, stream or pond o. Well to building h. Privy to closest lot line Submit To: Bayfield County Zoning Department, PO Box 58, Washburn, WI 54891 u/form s/sanitary/bayfleldcountysanitaryapplication Revise: June 2018 Proofed by: 13 YFIELD Bayfield County 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 -00183 Transaction Number: CS-00183-4C4C1 Description Amount Private Sewage System Reconnection $50.00 Total: $50.00 Payment Amount: $51.25 Reference: 8548971705 Paid by: Carolyn Ramberg Payment Type: Other 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 - SAN ITARY - Private Interceptor SIGN - SPECIAL - CONDITIONAL - BAYFIELD COUNTY No. 26-0436 Tax ID: 14254 Issued To: RAMBERG TRUST, DAVID C & CAROLYN S Location: S34 - T44N - R07W Town of DRUMMOND PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Legal Description: S 1/2 OF GOVT LOT 1 LESS V.157 P.361;V.232 P.598 IN DOC 2024R-602688 400 (DAVID C RAMBERG TRUST DTD 2/19/2024)(CAROLYN S RAMBERG TRUST DTD 2/19(2024) Residential Structure in R-1 Zoning District For: Sanitation Permit — Private Interceptor [Previous Permit # 24-103S (08/02/2024)] (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 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. Scott Roush, AZA Authorized Issuing Official August 21, 2026 Date