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Home My WebLink About26-124SSS- oog6 O SBD-6398, Sanitary Permit Application 8/31/2026 6:40:58 AM t Introduction Wisconsin Department of Safety and Professional Services In accordance with Wis. Admin. Code sec. SPS 383.21(2), submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Upon completion, you will be emailed a copy of the completed form for submittal. Include a complete plan on paper not less than 8 1/2 x 11 inches. Check with your local POWTS authority about additional requirements and fees. Note that applications for state-owned POWTS are submitted to the Department via esla.wi.gov. (Rev. 02/26/2026) General Information Applicant Name: Michael Wroblewski Email: mike@biglakeplumbing.com Owner Name: Gerald & Patricia Arndt Email: Phone Number: (920) 207-7004 Mailing Address Address Line 1: N593 Lone Point Rd Address Line 2: City: Random Lake State: Wisconsin Zip: 53075 Project and Site Parcel ID: 7159 RECEIVED AUG 31 2@7.6 S — Ban S WCo plynning and Zoning Agenq 9ald/(ssu-e a/q/2b ryzL 1f1h cfDt State Transaction Number: PWTS- Project Address Address Line 1: 87805 Stage Road Address Line 2: City: Cornucopia State: Wisconsin Zip: 54827 CSM and Lot Number: Subdivision: Block and/or Lot: Legal Description: Government Lot X PLSS 1/4 of: NE 1/4 of: NW Section: 502 Township: T50N Range (E or W): R06W Municipality Type: City X Town Village Municpality Name: Bell County: Bayfield Building Type: X 1- or 2 -Family Dwelling Public/Commercial State -Owned Number of Bedrooms: 3 POWTS Permit RECEIVE® AUG 31 2026 Bayfield co. Planning and Zoning Agency Permit Type: X New System Replacement System Other Modification to Existing System Additional Pretreatment Unit POWTS Type: X Holding Tank In -Ground (conventional) At -Grade Mound Individual Site Design Other Is there a previously issued permit?: Yes X No Dispersal/Treatment Area and Tank Estimated Flow: 300 GPD Tank Information Type: Septic X Holding Dosing New or Existing: X New Existing Material: X Prefab Concrete Site Constructed Steel Fiberglass Plastic Manufacturer: Wieser Concrete Holding Tank Capacity: 2000 Gallons RECEIVED AUG 312026 Sayfield Co. Planning and Zoning Agency Total Capacity of Septic Tanks: 0 Gallons Total Capacity of Holding Tanks: 2000 Gallons Total Capacity of Dosing Tanks: 0 Gallons Total Capacity of All Tanks: 2000 Gallons Total Number of Tanks: 1 Responsibility Statement Signature Plumber Name: Michael Wroblewski Plumber Email: mike@biglakeplumbing.com Phone Number: (715) 209-7521 Plumber Credential Type: X Master Plumber Master Plumber Restricted Service Credential Number: 1288503 - PM Address Address Line 1: 1491 County Highway C Address Line 2: City: Washburn State: Wisconsin Zip: 54891 RECEIVED AUG 312026 Barfield co. Planning and Zoning AgencY By inserting my typed signature below, I attest that the information provided is complete and accurate to the best of my knowledge and belief. I, as the licensed plumber, assume responsibility for installation of the POWTS shown on the submitted plans. Electronic Signature of Plumber: Michael Wroblewski Date: 8/31/2026 Soil Test #/ Q / Bayfield County Waiver of a Thorough Soil & Site Evafita(a5S VED (subject to 15-1 -1 0(d)) SEP 14 2021 EDWARD J WROBLEWSKI a certified soil tester determine;thatin my professional judgment the following site (see below) is unsuitable for any treatment, Component other than holding tanks. Due to soil & site conditions, a thorough soil and site evaluation is not needed to make such a determination. Property Owner GERALD H & PATRICIA A ARNDT Contractor ED'S MECHANICAL LLC Property Address 87805 STAGE RD Authorized Agent EDWARD J WROBLEWSKI CORNUCOPIA, WI 54827 920-207-7004 Accurate Legal Description is requested: Agent's Telephone 715-2094055 Written Authorization Attached: Y or ND NE 1/4 of NW_1/4 Section 2 Township 50 N. Range 06 W. Town Additional Legal Description: S1/2 OF NE 1/4 OF NW 114 V.087 P.66429 BELL Govt. Lot Lot Block Subdivision Lot CSM# Vol. Page CSM Doc # Volume Page of Deeds Tax I.D# 7159 Acreage 16 Indicate reasoning for your determination: CLAY SOILS AND EVIDENCE OF SEASONAL HIGH GROUNDWATER Signature of County Official -e2q-2/ Date Signature of Certified Soil Tester 9/i 2O2/ bate SP -72000013 Certification # (Submit a Plot Plan & Fee) u/forms/soillestwaiver(KLK ) June 2018 DAirt-9ail-;J- EDWARD J WROBLEWSKI, CST #SP -72000013 SOIL TEST PLOT PLAN V GERALD H & PATRICIAAARNDT 87805 STAGE RD S1/2 OF NE1/4 OF NW1/4 V.1087 P.664 29 S02 T50N R06W TOWN OF BELL, WI SCALE 1'=40' 0 BORING #2 0 >100' TO LOT LINE BORING #1 O BORING #3 >100' TO LOT LINE/ STAGE ROAD >100' TO LOT LINE SOUSE DRIVEWAY >100' TO LOT LINE 1 2 3t 40 FT SHEET 3 OF 3 CONCRETE HOLDING TANK DESIGN Single Tank Option INDEX AND TITLE SHEET Project Gerald & Patricia Arndt - Holding Tank Owner Gerald & Patricia Amdt Address N593 Lone Pine Rd Random Lake, WI 53075 (920) 207-7004 Legal Description 51/2 NE NW V.1087 P.66429502, T50N, R06W Township Bell Subdivision Name Parcel ID Number 7159 Plan Transaction ID Number Designer Michael Wroblewski County Bayfield Lot No. ReeeivL® AUG 312026 Index and title sheet Page 1 Plannl Bam zoning Agency Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Soil test Page 5 Soil test plot plan Page 6 Holding tank agreement Page 7 holding serviicing contract Page 8 Holding tank specifications Page 9 Signature 7b /U/ // Phone No. 715-373-0566 License Number 1288503 Date 08/31/26 Designed pursuant to: Holding Tank Component Manual For POWTS (Version 2.0) SBD-10855-P (N. 03/07, R. 01/12) version7.0(11/12) Page 1 of 9 HOLDING TANK SPECIFICATIONS Number of e bedrooms Non-residential estimated flow (gpd) 2000.0 Minimum holding tank volume required (gal) RECEIVED 2000.0 IProposed holding tank capacity al) AUG 312026 Wieser concrete Tank Manufacturer W2000MR Tank model number Baayffea Co. SJ Electro systems Alarm manufacturer Planning and Zoning Agency WH101 lAlarm model number Tank Dimensions and Data X for round tank 53.0 Liquid depth below inlet invert (in) 8.0 Maximum de th of soil cover (ft) 66.0 Height (in) Outside 151.0 Length (in) Dimensions 86.0 Width (in) Only junction box, conduit blind pl ig to sea) outlet Tank Anchor Calculations 13540 Ibs Weight of tank and cover 1.10 Safety factor 20505 Ibs Weight of anchor required 27.3 in Soil cover req. for anchor or 5.1 Iyd3 Concrete counterweight HOLDING TANK CROSS SECTION manhole cover with locking device and finished warning label grade 4min. 4 23 in. ------�3S3... " Manhole and vent locations may be reversed. tether weight service alarm on Electrical as per NEC 300 and SPS 316 3 in. bedding under tank. t120 in. 41.0 in Note: All tankjoints, and joints between tank openings and piping are sealed watertight. All pipe and vent materials comply with SPS 384. Tank is anchored as necessary to negate buoyancy. vent cap 12" min. vent pipe t 18" min. building sewer inlet Project: Gerald & Patricia Amdt - Holding Tank Transaction Number. Page 2 of 9 GERALD H & PATRICIAAARNDT HOLDING TANK PLOT PLAN 87805 STAGE RD S1/2 OF NEI/4 OF NW1/4 V.1087 P.664 29 S02 T50N R06W TOWN OF BELL, WI SCALE 1'=40' RECEIVED AUG 312026 Bayfield Co. Planning and Zoning Agency >1001O LOT LINE 'k{OL SE 4" pvc cleanout Well 4" pvc sch 40 pipe Insulated > 30' from house >100'TO LOT LINE >100'TO LOT LINE Gallon Holding Tank ,DRIVEWAY N T >100TO LOT LINE/ STAGE ROAD 1 2 3 40 FT SHEET 3 OF 9 HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and maintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-1 0855-P N. 03/07, R. 01/12), and the Bayfield County Sanitary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 60.0 to 400.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed in the current Service Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are presCEIVED Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actin shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code. AUG 312026 5. All service events or inspections of this POWTS shall be reported to the county within 30 days. Baysew Co. Planning and Zoning Agency 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Con- nection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with SPS 383.33 Wis. Adm. Code. 10. If there is a problem with, or question about this installation, the following persons may be contacted: a. Installer .........................Big Big Lake Plumbing Phone: (715) 209-7521 b. Service Provider ............... Birch Street Sepiic Service Phone: 715-373-5683 c. Co. Zoning or Health Dept. Bayfield County Planning & Zoning Phone: 715-373-6138 11 Project: Gerald & Patricia Arndt - Holding Tank Transaction Number. Page 4 of 9 W2000 -MR TANK SPECIFICATIONS 12,_7„ CAST -A -SEAL 4" CAST -A -SEAL M'SNA1 �� FILTER OR BAFFLE iI RECEIVED TOP VIEW AUG 3 7 2026 o Wenning and Zon A Q?Y 0 INLET OUTLET J Irip d s 1 I 21" �" TANKS REQUIREMENTS DIMENSIONS: WALL: 2 1/2" BOTTOM: 4" COVER: 6" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 66" O.D. LENGTH: 12'-7" O.D. WIDTH: 7-2" O.D. BELOW INLET: 53" O.D. LIQUID LEVEL: 46" WEIGHT: BOTTOM 9,430 LBS. COVER 5,940 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 42.92 GAL/IN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 2.126 GALLONS LOADING DESIGN: 8'-0" UNSATURATED SOIL TANK CAN BE USED AS: SEP11C / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: n W In I W s U (O Otero Q o 0M yo x a0 W_ t OF HOLDING TANK SERVICING CONTRACT Contract Date This contract is made between the Holding Tank Owner(s) Name(s) Geot (x Ac.ktcNcc\dft Pumper's Name (Print) Pumper's Signature Pumpers' Registration # to `JQ\C e ( 4j-- \;o3 We acknowledge the installation of (a) holding tank(s) on the following property: (Provide COMPLETE legal descriptions) PROJECT Legal Description: Tax ID# _ a 1/4, 1/4, LOCATION (Use Tax Statement) I S Sec on .Township 7) N, Range D� w Town of: Lot Size I Acreage _ � Gov't Lot Lot # CSM # Vol. Page CSM Doc # Lot(s) No. Block(s) No. Subdivision: 1. The owner agrees to file a copy of this contract with Bayfield 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 a semiannual basis. The pumper further agrees to include the following in the semiannual report: RECEIVED a. The name and address of the person responsible for servicing the holding tank; AUG 312026 b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; Ba 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. Revised: May 2016 (®May 2018) Drafted by Personal Information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (I) (m)] HOLDING TANK AGREEMENT DOCUMENT NUMBER 2026R-61 3391 Document Number 11 Document Title GERALD ARNDT & PATRICIA ARNDT DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 08/18/2026 AT 1:02 PM RECORDING FEE: $30.00 PAGES: 2 Recording Area Name and Return Address BIG LAKE PLUMBING 1491 COUNTY HIGHWAY C WASHBURN WI 54891 Parcel Identification Number (PIN) RECEIVED AUG 312026 Bayfield Co. Planning and Zoning Agency 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 uogument Numoenrfan 1.u. No. HOLDING TANK AGREEMENT 6et.c'I&t Fc*r\c hr,\" S zs L,a 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, Wis Stats. liE X1/4 of 114 Section L1_3, Township S C N. Range ____w HELEN LAVRENZ NOTARY PUBLIC STATE OF WISCONSIN Town of \ \ N rr *— , I R Additional Legal Description: S 1 \� V U f� ! et BIG c�- Gov't Lot _. Lot_ Block_ Subdivision Lot r- 1491 CountyHighway C PLM61NG Washburn, WI 54891 CSM #_ Vol Page _CSM Doc# __ As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above -described property, we agree to do 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 properly 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, Stats., 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, Stets. 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. Stats., and chapter f�g�}q�4fis. �ryCode, to have the holding tank serviced in accordance with Ch. NR113, Wis. Adm. Code, and to file a copy of the cot 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. AUG 312026 4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis. Stats., and Ch. NR 114, WI' ,code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County T Drooerty to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the o ing a l being property 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. ner(s) Name(s) — Please Print I a r) c1c r kjq -e r o1ld AV 1.1 od Subscribed and sworn to before me on this date: Nozed wner(s) �Signa 4tre(s� Notary Public My Commission Expires: Drafted by: I"\'C . \ \cra`"J\ 1 C Date: \ \\ \'t 1 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] ulforms/sanitary/HoldingTankAgreement 4.2026 BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) Checklist Original Sanitary Application (Submitted in Deed Holder's Name — not prospective buyers) (383.21(1)1.) btu Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) RECEIVED J Original Plot Plan (383.22(2)2.3. & 4.a) ] Cross -Section, Overhead Profile of the System and Schematic of Tank from Manufacturer AUG 312026 0 Pump Tank Diagram, Alarm and Pump Curve (when applicable) Bayfieb i3 Contingency Plan / Management Plan (383.22-3(2)(b)LC) and Zonm9 Agency planning ❑ Maintenance Agreement (Owner's Original Signature(s)) (383.21(2)(c)(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 (383.21(2)(c)(5) (Recorded at Reg. of Deeds) Ip Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) )\ Soil and Site Evaluation Report (383.22-3(2)(b)l.e.) ❑ State Plan Review (when applicable) ❑ Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) I Application Information must include: �(4 or 5 digit) Tax ID4 -- (do not use 12 digits anymore --obsolete) Project Address or Road Name where driveway is/will come off of) ,(Owners Phone Number) kl ll Type of Building III Type of Permit IV Type of POWTS System V Dispersal / Treatment Area Information VI Tank Information �]\ VII Responsibility Statement (Plumbe(s Information) k*Date Stamp* Plot Plan: (To Scale or To Dimension) Signature and Plumber Information %Q Address Number and Road ❑ Surface Elevation of Body of Water North Arrow ❑ Direction and Percent Land Slope I,1�Contour Lines jQ Tank and Filter Information and Location X] Structures and Driveways O Wetlands / Navigable Bodies of Water Boring Locations ❑ Absorption Area (Proposed and Existing) jl Property Lines ❑ Bench Mark (Location, Elevation and Description) ,k' Well Locations Component Manual Version Ay Legal Descriptions kiping Material Information (conveyance line, building sewer line, material type and diameter) Turn Over ► Cross -Section and Overhead Profile of the System: ❑ Surface and System Elevation ❑ Position of Observation and Vent Pipes https://www.bayfieldcotintywi.gov/DocumentCenter/View/329/Checklist-for-Sanitary-Apps?bidid= 8/31/26, 6:17 AM Page 1 of 2 O Dimensions and Depths O Make, Model & Number of Chamber Units in each Cell Property Information How many systems will there be ron this parcel of land? Has this property been split? �y b (Property Statement shows Property History) Fees: ❑ Private Sewage System (Septic Tanks) $ 400.00 Private Sewage System (Holding Tanks) $ 400.00 RECEIVED ❑ Mounds or Systems requiring Pre -Treatment $ 500.00 ❑ Sanitary Revisions $ 25.00 AUG 312026 O Private Sewage System Reconnection $ 50.00 and Private Interceptor Bayfield Co. Planning and Zoning Agency O Return Inspection $ 50.00 O Maintenance Agreements $ 30.00 (check should be made out to Reg of Deeds) IG (A full legal description is required at the Register of Deeds Office). If you have a legal description that states "parcel in or part of" you must attach a copy of your deed showing the metes and bounds description in order to be recorded. Examples: located in part of Gov't Lot 4, Section 1, Township 23 N, Range 4W, Town of Bayfield, described as a parcel in the NE % of the SE ¼, Section 1, Township 23 N, Range 4W, Town of Bell Wrornsslcheckis&checkistrorsanilaryapps (®WWSQUM) https:llwww.bayfieldcounty.wi.gov/DocumentCenter/View/329/Checklist-for-Sanitary-Apps?bided= 8/31/26, 6:17 AM Page 2 of 2 I3 YFIELD 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: ARNDT, GERALD H & PATRICIA A N593 LONE PINE RD RANDOM LAKE, WI 53075 Description Private Sewage System (Holding Tanks) Submission Number: SS -00830 Transaction Number: SS -00830-4D628 Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 3070 Paid by: Ed's Mechanical, 1491 County Hwy C, Washburn WI 54891 Payment Type: Check Transaction Date: 9/4/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-124S STATE SANITARY PERMIT OWNER: GERALD H & PATRICIA A ARNDT GOVT LOT: LOT: BLK: NE1/4 NW1/4 SEC: 2,150 N,R6W TOWNSHIP: Bell SOIL TEST: 181-21 NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: MICHAEL WROBLEWSKI EMILY MACGILLIVRAY LLIVRAY DATE: 9/4/2026 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. 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 1288503 Condition: Properly Maintain System Per Recorded Agreement. Must be within 25 ft of an all- weather road. THIS PERMIT EXPIRES 9/4/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION