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Home My WebLink About26-0505BAYFIELD COUNTY Zoning District cs 6O/ ry SANITARY PERMIT APPLICATION OO / Lakes aria I. APPLICATION INFORMATION (Please Print All Information): Soil Test No: Permit County C — O O No: a Property Owners Name: rI I✓r�t OE Jt County: Bayfield Address of Property: Property Location: iTh Pit. /1 tw/pP. 1�l/15, NO'/ SW V..,S j(p T 49 N,R pg E (or)W Property Owner's Mailing Addre s: Township: I Gov. Lot #: Po&x S -iP? City State Zip Code Phone Number Lot# Block 1k CSM M. CSM Doc # Subdivision Name S53 9 os.e#t-za II. TYPE OF BUILDING: Check One) ❑ State Owned Tax ID#: ❑ Public (Explain the use/purpose ) ❑ - (, 5 5 7 �> �� t I or 2 Family Dwelling - No. of Bedrooms Sf 2� `GX I/ nn III. TYPE OF PERMIT: (Check only one box on line A. Check 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. Date Issued: 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) �nma✓ k<_€_P. ❑ 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 I 7. Final Grade Per Day Required (Sq.Ft.) Proposed (Sq. Ft.) (Gals. / Day / Sq.Ft.) (Min. Inch) J Elev.(Feet) Elev. (Feet) VI. TANK Capacity Fiber INFORMATION: In Gallons Total Gallons # of Tanks Manufacturer's Name Prefab. Concrete Site Constructed RE Ely! Besvc E er. xp New Existing App. Tanks Tanks Bass Septic Tank or SEP 0 3 2 26 Holding Tank Lift Pump Tank / ea a Siphon Chamber Zonin A en 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) it applying for Section C above a Si re(s): (No Stamps) oc. Plumber's Name: (Print) if applying (or Section A orb) above Plumber's Signature: (No Stamps) I MP/MPRSW No: Plumber's Address: (Street, City State, Zip Code) Home Phone: Business Phone: VIII. CO I DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit/Transfer Fee: Date Issued: Issuing Agent's Signature / Date: Approved ❑ Owner Given Initial Determination q I d'I',t 6 164Adverse I ( 11 IX. CONDITIONS OF APPROVAL I REASONS FOR DISAPPROVAL: lA n OS fQutrrd' 11kt'(k 1n� ea -(o1 Plot Plan on reverse side Lot Line Rwl?ok 1 fl Y s 5o0l � froL lor/,NE A PP x r�rd��l zoo' EnSY wEc—t` 1(fi ) ►�-�, &2L is ►oxzo. �— sv No vt2 g-rizvet2GS 2xfs 5 (�� (s f oc,hQM 54 aost7ji , I67' Name of Frontage Road ( (>IH. Hiv✓1 H ) 0 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 -o) COMPLETELY 4. Show the location of any lake, river, stream or pond if applicable. 5. Show the approximate location of other existing structures. RECEIVED 6. Show the approximate location of any wetlands or slopes over 20 percent. SEP 032076 7. Show dimensions in feet on the following: Bayfield co. a. Building to all lot lines I. Planning and Zoning Agency 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(formstsanitarylbayfieldcountysanitaryapplication Revise: June 2018 Proofed by: __ ArcGIS Web Map �X�' ' f1 8/31/2026, 10:06:34 AM Survey Map Comer Tie Sheet 0 Highway and RR ROW O On File • Address 0 Map of Survey All Roads County Driveway Buflding Footprint Existing New Approximate Parcel Boundary Municipal Boundary Section Wetlands River RECEIVE {- 1:9,028 0 0.05 0.1 0.2 ml SEP Q37076 2026 0 0.07 0.15 0.3 km f;ayfield Co. Planning and Zoning Agency Exhibit A The Northeast Quarter of the Southwest Quarter (NE'/aSW'/<), Section Sixteen (16), Township Forty-eight (48) North, Range Eight (8) West, Town of Tripp, Bayfield County, Wisconsin. AND The Northwest Quarter of the Southwest Quarter (NW'/<SW%<), Section Sixteen (16), Township Forty-eight (48) North, Range Eight (8) West, Town of Tripp, Bayfield County, Wisconsin, LESS highway right-of-way. AND LESS: A parcel of land located in the Northwest Quarter of the Southwest Quarter (NW'/45W¼), Section Sixteen (16), Township Forty-eight (48) North, Range Eight (8) West, Town of Tripp. Bayfield County, Wisconsin, more particularly described as follows: Commencing at the West '/< comer of said section; thence S. 89°09'39" E., along the E -W '/< line a distance of 33.02 feet to the point of beginning, which is located along the East right of way of C.T.H. "A", thence S 89°09'39" E., and continuing along said '/< line a distance of 738.31 feet; thence S. 01°14'37" E., a distance of 590 feet, thence N. 89°09'39" W., a distance of 738.31 feet to the East right of way of C.T.H. "A", thence N. 01°14'37" W., along said right of way a distance of 590.00 feet to the point of beginning. REGEIVEG SEP 0 3 2026 Barfield Co. planing and Zoning Agee PRIVY AGREEMENT (ATTACHED TO THE SANITARY PERMIT APPLICATION) Property Owner(s): ((//��''cL(t Moen Mall'' ina Address44 VUMTkII->t. lw J SS389 Legal Description: f / Ui1/4, 1/4, S2Pi &4-fo obeI Gov't Lot Lot # CSM# Lot(s) # Block(s) # Subdil Tax ID # 3Sh s s Sito T____N,R 09W s 1. NO PLUMBING will be installed in the habitable building. Pbnn- SaYfreld Co. 2. NO PLUMBING includes: water closets, sinks, bathtubs or showers, laundry facilities, or any other Ti9t%ZB'NtPcle receiving domestic waste, will be installed in the premises served by the privy unless a code compliant soil absorption system or holding tank exists, or a valid sanitary permit to install such a system has been issued. DOCUMENT NUMBER 2O26R-6 1 3620 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 09/03/2026 AT 11:58 AM RECORDING FEE: $30.00 PAGES: 2 Return To: ZONING RECEIVED 3. A privy vault / pit shall maintain minimum setbacks as specified in Table 1. Table 1 Well Building Additional County Setbacks Stream OPEN PIT 50 Ft. 15 Ft. Min. 75 Ft. SEALED VAULT 25 Ft. 15 Ft. Min. 75 Ft. 4. Privies for public buildings shall comply with SPS 353.63. 5. Privies used for one- and two-family purposes shall be constructed in such a manner so as to exclude flies, rats and other vermin. Doors should be self -closing and vault ventilators should terminate at least one foot above the roof. 6. Privies as per SPS 391.12 (1) states as follows: (a.) The storage chamber of a vault privy shall conform with the requirements of s. SPS 384.25 relating to holding tanks and shall have a minimum storage capacity of 200 gallons or one cubic yard. (b.) The storage chamber of a pit privy shall be sited and located in soil recognized to provide treatment and dispersal in accordance with s. SPS 383.44 (4)(b). 7. The privy shall be kept clean and sanitary. The contents of the pit or vault shall be disposed in accordance with NR 113, Wis. Adm. Code. 8. This agreement shall be binding on the owner, their heirs and assignees. This document shall be recorded by the Register of Deeds in a manner, which allows its existence to be determined by reference to the property where the privy is installed. Printed Owner(s) Name(s) kOE, Ow4r )Signature: This Instrumentwassigned before me In the State of 1r111V\f50 T Ut County of ))1t'e !0 r On this _ I day Auiiurl .20 by: % Notary Public �rr� My commission expires on: -iqava�lo ,t, JUbHUA GREGORY STREIT Drafted By: t °`er 2019 t be filled out by person submitting form) Notary Public -Minnesota December 2012 ulfonnslsanftarylpnvyrorm -®October 2019 -----1WMyCM"ftSiwExPImjan.3I,2o3I Exhibit A The Northwest Quarter of the Southwest Quarter (NW'/4SW%a), Section Sixteen (16), Township Forty-eight (48) North, Range Eight (8) West, Town of Tripp, Bayfield County, Wisconsin, LESS highway right-of-way. AND LESS: A parcel of land located in the Northwest Quarter of the Southwest Quarter (NW%aSW'/,), Section Sixteen (16), Township Forty-eight (48) North, Range Eight (8) West, Town of Tripp, Bayfield County, Wisconsin, more particularly described as follows: Commencing at the West'/4 corner of said section; thence S. 89°09'39" E., along the E -W'/4 line a distance of 33.02 feet to the point of beginning, which is located along the East right of way of C.T.R. "A", thence S 89°09'39" E., and continuing along said'/4 line a distance of 738.31 feet; thence S. 01°14'37" E., a distance of 590 feet, thence N. 89°09'39" W., a distance of 738.31 feet to the East right of way of C.T.H. "A", thence N. 01°14'37" W., along said right of way a distance of 590.00 feet to the point of beginning. RECEIVED SEP 0 42026 gayfield Co. planning and Zoning Agency Bayfield County Register of Deeds Document #2025R-610394 Page 2 of 2 B4-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: Description County Sanitary Permit:1 Payment Amount: Reference: 5789 Paid by: Mitchell K or Lynette C Moe Payment Type: Check Submission Number: CS -00187 Transaction Number: CS -00187-4D772 Amount $150.00 $150.00 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 - Composting Toilet SIGN - SPECIAL - CONDITIONAL - BOA - BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION No. 26-0505 Tax ID: 39655 Issued To: MOE, MITCHELL K & LYNETTE C Location: S16 - T48N - R08W Town of TRIPP Legal Description: NW SW LESS 0.39A HWY IN V.933 P. 33 & LESS PAR DESC IN DOC 2025R-610394 184A Residential Structure in A-1 Zoning District For: Sanitation Permit — New [Composting Toilet] (Disclaimer): Any future expansions or development would require additional permitting. Condition(s): Maintain as required. Get UDC inspection as required. 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. Emily Macgillivray, AZA Authorized Issuing Official September 21, 2026 Date