The URL can be used to link to this page

Home My WebLink About26-138SI Department of Safety County a ti & Professional Services, Sanitary Permit Number (to be filled in by Co.) SS- 00`6 q % I Industry Services Division a�-i33s 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 Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forts for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(l)(m), Slats. ) 5 S S S S+o r m o e c+ Lv, L Application Information —Please Print All Information PropertyOwner's Name Parcel N TAX 1A. 34 513 Gus+ave O4�Fo ~ 3ulie Mae V.rKaS TfAfD df Y o7�8.500•340-)loon Property Owner's Mailing Address Property Location '] 9 \art by', Govt.Lot City, State Zip Code Phone Number 5t Loins ParK Mt'! 554Q(0 9sa- Soo-onw A' '/.,Section _& T y3 N R 6-1 Go IL Type of Building (check all that apply) Lot # Subdivision Name j or 2 Family Dwelling -Number of Bedrooms 3 ❑ Public/ComiP6,rleieG 6iia e Te l e r+ar H;fls Pipse i Block # ❑City of I. ❑ State Owned scrib>r W50f12C L I L O Village of CSM Number ,t,' �Townof CLble r?;;fiald Cc. - 111. Type oVIPOWTS Permit: ( eek either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i a licable. A. ,t1ew System y ❑ Replacement System p y ❑ Other Modification to Existing System (explain) y ( p ) ❑ Additional Pretreatment Unit (explain) B' 0 Holding Tank n -Ground ❑ At -Grade ❑ Mound 0 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 IV. DispersaliTreatment Area and Tank Information: u:cl.-4 u e...L of s ana—S Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sl) Dispersal Area Proposed (sf) System Elevation '/St) o.7 refs G5a Ac 9a.00 Capacity in Total 4 of Manufacturer Tank Information Gallons Gallons Units U E U .2 New Tanks I ExistingTanks W C Sy Ce 0.O in na N CO F. Septic or Holding Tank cc - 000 I O Pre 0. + X Dosing Chamber V. Responsibility Statement— I, the undersigned, assn pottsibility r i s lation of the POWTS shown on the attached plans. Plumber's Name (Print) s S Plumbe namrc MP/MPRS Number Business Phone Number rta,t t s u++er Ffe lei I (PS 8 9 715 - - 817G Plumber's Address (Street, City, State, Zip Code) ly3 LW Road '77 I -1a ward WI- sy8Y3 V1. County/Department Use Only pp,yoved ❑ Disapproved Permit Fee Date Issue tt/t Isom gcn Signature ❑ Owner Given Reason far Denial $ q 26 Conditions of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than 8 12111 inches in size SBD-6398 (R. 03/22) SR • aoSIS Wisconsin Department of Safety & Professional Services Page 1 of Division of Industry Services O SS L TEST # SOIL EVALUATION REPOR j3- v 4v In accordance with SPS 385, Wiis. Adm. Code County �ay � Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, 39 13 but not limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. TA 7c 'O scale or dimensions, north arrow, and location and distance to nearest road. o+d-pl - .3• - -3 -340- 11 C 04 Please print all information. Reviewed by P'°"9t IDate Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04(1)(m)). �pQ /'z4 Property Owner Property Location ❑ J V G O r Govt. Lot %. 1h S a$ T 113 N R 0 7 E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: t } an Lrt TE LEMARK I4 tL.L PHi'S6 I City, State, Zip I Phone Number ❑ City ❑ Village Town Nearest Road i5$$5 Q.)_%,,..c P...1 _ Mlei 4.t_ I (9S )300.64JW I Si-orrncen Ln NewConstruction Use: Residential/Numberof bedrooms 3 Code derived designflow rate �GPD ❑ Replacement ❑ Public or commercial— Describe. Flood Plan elevationMLNTEREB ft. Parent material .owc i r, +i. & f h General comments apd commendations: �' ��0`'`0 ❑ Boring Baiir't9 # c �C3 Ground surface elev. 95•0'%ft. Depth to limiting factor 10b in.! elev. ft. Sail Anolication Rate Horizon ni Depth` in. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eff#i Eff#2 L o. 1. t -o 1oCRY1 -- 51 J d.(. P.O 3 7. , fg V — �d. 7 r. L w -too 7.s s/ M - , I.e. • h• T Boring # Boring 9 S8 J �Pi Ground surface elev. ft. Depth to limiting factor iO D in. I elev. ft. Soil Annlicatinn Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 04 IOCR/a iir o i. b J O 7 r� 5% 4' . -y S �.'7 "C. - ZSYRS/ — 5 1 -- o.? t.C, CST Name (Please Print) I SigneW CST Number 1C-av;S I 5P-CR0000O0 Address I Da Evaluation Conducted Telephone Number �31bw5RTi O i IoI /0)G 7/5 -G341 -B) 7 * Effluent #1 = BOD >30 5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = BOD, S 30 mg/L and TSS 5 30 mg/L SBD-8330 (R03/22) O Boring Li] Boring # g'Pit Page of _ Ground surface elev.9s33ft. Depth to limiting factor IC b in. / elev. ft. I Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cant. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIFt2 *Eff#1 *Eff#2 e- -S -- Y) -- ak o . ce 1.0 .3 >>-45 7.SYAY -- r_l ).4 y 'I5 - lob .SrR rd o' i+.G wf: II Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. I Soil Annilcation Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 II Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in.! elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 5 220 mg!L and TSS > 30 5150 mg/L � �pti6 ,VVO• ��nC; * Effluent #2 = BOD, s 30 mglL and TSS 5 30 mg/L i!i I- 0 40 Proposed 3 Bdrm Dwelling SCALE = 1:40 15855 Stormoen Ln Lot 2 Telemark Hills Phase 1 Sec. 28, T43N, R07W Town of Cable Bayfield County Tax ID: 39513 BM = Nail w/ ribbon in 12" Oak ELEVATIONS BM -1 o0.0oft B 1 - 95.67ft B2 - 94.58ft B3 - 95.33ft Property Owners: Gustave Otto & Julie Mae Virkus 8730 Westmoreland Ln St Louis Park, MN 55426 (952) 300-0924 CST: Travis Butterfield 14346W State Road 77 Hayward, Wl 54843 (715) 634-8176 BM 96.50' 95.50' 5% B1 Slope B2 94.50' • B3 n� o 00003 S 091 1 pi 1 �� Page 3 of 4 1 • SOIL PROFILE SHEET OWNER: G.'o►ct O * 3&i k ) tae 1I: r14v S SOIL TESTER: trci. s13y}-ter A ! c� SYSTEM ELEVATION: LOAD RATE: 0.7 •7 /%(a SYSTEM RANGE: 9 0.33 to q a . 1 j 8 tai tea 133 4ri __ __ __ __ __ 96 _- _- Recae - =_-- -- --> Sys -- -- -- -- ) E,€R -- 89 -- I 3q- -- s sT ----- 2026 __ -- )?4 _- -- S�-Q 2 -- -- -- 6O'L -- a• nc1 -- -- £ ' I • '7 3 7.00 Sc Page of PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: Version 2.0, SBD-10705-P (N.01101, R. 10/12) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map SU 2 A 2UL° F")dI ldun n9 F�encY on and Z Project Name / Description Virkus - Stormoen Ln Owner Name(s): Gustave Otto & Julie Mae Virkus Owner Address: 8730 Westmoreland Ln; St Louis Park, MN Phone: 952 - 300 _0924 Zip: 55426 Project Address: 15855 Stormoen Ln Govt. Lot: 1/4 of 1/4, Section 28 , T 43 N -R 07 E❑or W ❑✓ Township: Cable Project Parcel ID #: 04-015-2-43-07-28-5 00-340-11000 County: Bayfield Designer Information Designer Name: Travis Butterfield Designer Address: 14346W State Road 77; Hayward, WI E-mail: office@butterfielddrilling.com License Number: 652879 Remarks: Phone: 715 -634 8176 Zip: 54843 Lot 2 - TELEMARK HILLS PHASE 1 Signature: vLccj Date: 09 I 5 /a to riginal signature required on each submitted copy. PLOT PLAN N SEP 212026 �ay&=;R d co- Pl;rnnlrJ.ra Proposed Well Proposed 3 Bdrtn Dwelling SCALE = 1:40 15855 Stormoen Ln Lot 2 Telemark Hills Phase 1 Sec. 28, T43N, R07W Town of Cable Bayfield County Tax ID: 39513 BM = Nail w/ ribbon in 12" Oak ELEVATIONS BM - 100.00ft B 1 - 95.67ft B2 - 94.58ft B3 - 95.33ft ST = 1000gal prefab concrete septic tank made by Superior Precast wl Lifetime LT -1 Filter AA= Absorption Area consisting of two cells, spaced >3ft apart, containing a total of 32 Quick -4 Plus Chambers BM A 95.50' p y B2 0 40 L--- n STlo e B1 S 4" PVC Sch ASTM F891 0 B3 AA Page 2 of 4 IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) iill�ll� 12" min. trench depth (typical) Septic Tank(s) Manufacturer: Superior Precast Septic Tank(s) Volume(s): 1000 gal gal gal gal Effluent Filter Manufacturer: Lifetime Filter LLC Effluent Filter Model #: LT -1 /8 ' TYPICAL TRENCH CROSS SECTION VIEW ic....\,I? (typlca0 a .. . .. (No Scale) System Elevation = 92.00 ft (typical) Qulck4 Standard -W wl End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) f-.-- r-- -------------��--- g= 67 ft (typical) INSTALL PER TRENCH: 16 Quick4 Std -W @ 20 ff EISA/chamber = 320 ft2 + 1 Pairs of end caps @ 6 ft2 EISA/pair = 6 ft2 Provide minimum 3 ft separation between trenches. Observation Pipe (typical) Install per manufacturers / instructions. TA 3.0 ft (typical) TYPICAL TRENCH PLAN VIEW (No Scale) "—Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. = Proposed EISA per trench = 326 ft' Required Infiltration Area = 643 ft2 Distribution Method: x 2 trenches = Proposed Total EISA = 652 ft2 branched manifold C) m W O n a PAGE 4 OF 4 In -ground Gravity Management Plan IMPORTANT: The owner of this in -ground gravity system 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 system 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. Maximum Dispersal Area Operating Limits: Design Flow = 450 gpd; BOD5 ≤ 220 mgL-1; TSS ≤ 150 mgL^; FOG ≤ 30 mgL-' 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 solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Scats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids accor,�ljng to manufacturer's specifications. A servicing period will always be greater than 12 months. SEP 2120' 3�Y5y�d Go. ��anCl System maintenance' reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc, Admin. Code. Report any component failure or malfunction to: Name of individual or company: Butterfield Inc Local government unit: Bayfield County Planning & Zoning Phone: 715-373-6138 Phone: 715-634-8176 Local government unit address: 117 E 5th Street, PO Box 58; Washburn, WI 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 treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. SUPERIOR 1,0001 -Compartment Tank rSUPERIOR PRECAST CONCRETE TOP VIEW s9-12" Weight (in 1b s) 83-1 tr Tank: £.312 Lid: 3,683 Total: 9,49$ Volume of Concrete Total : 2.4 Yd' Gallons Per Inch: 24.4 73" 79" 1825 Gallons Dc A'nL1 SIDE \9} \\T 28" Enlarged Detail Conditionally 4" OlalS APPROVED ,,., 9" Air Space DEPT. OF SAFETY AND PROFESSIONAL 4" SERVICES r1lIP.G DIVISION OF INDUSTRY SERVICES /da1. £i4 42' 42. �I" Depth SEE CORRESPONDENCE 1 I 2 Manhole Openings /\ �-1,_,.. Taper Polyethylene Baffle f,Tt�`r Produced by Superior Precast Concrete, LLC PO Box 1390 f" Hayward, WI 54843 212026 C"jiield Co. and Zoning AgE°� SUPERIOR PRECAST CONCRETE Design contorms to AS IN (21227, 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 Fite No: I This Is Proprietary Information, and remains the property of Superior Precast Concrete, LLC, I 8.3 O5.1920241 BAYFIELD COUNTY CHECKLIST FOR SANITARY APPLICATONS Submit the Following (Use Permanent Ink) (Title 15, Section 15-1-10(e)) 'Checklist R'Original Sanitary Application (Submitted in Deed Holder's Name — not prospective buyers) (383.21(1)1.) IS'Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) IiOriginal Plot Plan (383.22(2)2. 3. & 4.a) NI' Cross -Section, Overhead Profile of the System and Schematic of Tank from Manufacturer -8-Pump Tank Diagram, Alarm and Pump Curve (when applicable) gcontingency Plan / Management Plan (383.22-3(2)(b)1.f.) 'Maintenance Agreement (Owner's Original Signature(s)) (383.21(2)(c)(6) (Recorded at Reg. of Deeds) -B-Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) -B-Hbolding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) .-P-MU Servicing Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) 11' Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) El 1 Complete Set of Plans (Note: Sanitary Application - Maintenance Agreement & Service Contract are to be included in the copy packet) / P� Soil and Site Evaluation Report (383.22-3(2)(b)1.e.) -8--State Plan Review (when applicable) Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) C�I Application Information must include: 1'(4 or 5 digit) Tax ID# -- (do not use 12 digits anymore --obsolete) [Project Address or Road Name where driveway is/will come off of) &((Owners Phone Number) III Type of Building f 'III Type of Permit M IV Type of POWTS System lS'v Dispersal / Treatment Area Information SEP 212026 E(vi Tank Information / Bayfield Co. Planning and Zoning Agency I'J VII Responsibility Statement (Plumber's Information) *Date Stamp* Plot Plan: (To Scale or To Dimension) ❑ Signature and Plumber Information (on %^�e" PGjt' [Y// Address Number and Road 'B -Surface Elevation of Body of Water li/North Arrow 'Direction and Percent Land Slope S' Contour Lines l 'T'ank and Filter Information and Location Structures and Driveways -6 Wetlands / Navigable Bodies of Water H/Boring Locations S'Absorption Area (Proposed and Existing) f Property Lines B"/Bench Mark (Location, Elevation and Description) S', Manual Version dwell Locations IH Legal Descriptions omponent S,Piping 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 E Position of Observation and Vent Pipes Dimensions and Depths (Make, Model & Number of Chamber Units in each Cell Property Information L "How many systems will there be on this parcel of land? % ["Has this property been split? '?e5 (Property Statement shows Property History) Fees: Private Sewage System (Septic Tanks) ❑ Private Sewage System (Holding Tanks) $ 400.00 ❑ Mounds or Systems requiring Pre -Treatment $ 500.00 El Sanitary Revisions $ 25.00 El Private Sewage System Reconnection $ 50.00 and Private Interceptor ❑ Return Inspection $ 50.00 H'Maintenance Agreements ♦ $ 30.00 (check should be made out to Reg of Deeds) n Examples: located in part of Gov't Lot 4, Section 1, Township 23 N, Range 4 W, Town of Bayfield, described as a parcel in the NE'/. of the SE '/<, Section 1, Township 23 N, Range 4 W, Town of Bell u/forms/checklisWchecklistforsanitaryapps (®8/5/2026) BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): Wcheck List dex Page / Title Sheet (Optional) 'Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) l "Original Plot Plan Beross Section Soil Profile Sheet (optional) VAdditional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) l!11Parcel Identification Number (must be 23 3 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used dProperty Owner's Information not prospective buyer's name) ig Property Location (Accurate Legal Description with Sec/Twp/Range) ff Road Name (where driveway is/will be coming off of) .8Floodplain Elevation, Flow Rate, Comments and Recommendations E!"Complete Soil Boring / Pit Information ff [date Soil Evaluation was conducted IE1J�ST Name, Signature, Number, Address and Phone Number *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) liBench Mark (Description, Elevation and Location) EI'Contour Lines (Example = 98.0' /96.0' /94.0') l 'Property Location (Sec/Twp/Rang% Accurate Legal Description) @"Borings (Locations and Elevations) I 'Percent and Direction of Land Slope IIWell Location (Including Neighboring Wells, if applicable) .B -Location of Wetland Areas, Floodplain and Navigable Waters Buildings, Driveways, and Structures (Location and Descriptions) i!Location of Property Lines €-�Scisting System Location 'Address Number and Road Name —9- Current Surface Elevation of Wetlands and Navigable Waters IiCST, Owner and Property Information 'North Arrow SEP 212026 8aviield CO. AgenCI 7Certified Fee: Soil Tests - Review & Filing Fee $ 50.00 u/forms/sanitary/checklist/checklistforests Real Estate Bayfield County Property Listing Today's Date: 9/8/2026 - Description Updated: 4/8/2025 Tax ID: 39513 PIN: 04-012-2-43-07-28-5 00-340-11000 Legacy PIN: Map ID: Municipality: (012) TOWN OF CABLE STR: S28 T43N R07W Description: LOT 2 TELEMARK HILLS PHASE 1 IN DOC 20258606333 Recorded Acres: 2.260 Calculated Acres: 0.000 Lottery Claims: 0 First Dollar: No Zoning: (R-RB) Residential -Recreational Business ESN: 108 >� Tax Districts Updated: 2/18/2025 1 STATE 04 COUNTY 012 TOWN OF CABLE 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE Property Status: Current Created On: 2/18/2025 4:46:51 PM Ownership _ _ Updated: 4/8/2025 GUSTAVE OTTO & JULIE MAE VIRKUS ST LOUIS PARK MN Billing Address: Mailing Address: GUSTAVE OTTO & JULIE MAE GUSTAVE OTTO & JULIE MAE VIRKUS VIRKUS 8730 WESTMORELAND LN 8730 WESTMORELAND LN ST LOUIS PARK MN 55426 ST LOUIS PARK MN 55426 Site Address * indicates Private Road 15855 STORMOEN LN * CABLE 54821 Property Assessment Updated: 7/27/2026 2026 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 2.260 63,900 0 2 -Year Comparison 2025 2026 Change Land: 0 63,900 100.0% Improved: 0 0 0.0% Total: 0 63,900 100.0% • Recorded Documents Updated: 2/18/2025 14 Property History O WARRANTY DEED Parent Properties Tax ID Date Recorded: 4/4/2025 2025R-607082 04-012-2-43-07-28-1 01-000-14000 39511 O CORRECTION INSTRUMENT Date Recorded: 2/19/2025 2o25R-606597 O WARRANTY DEED Date Recorded: 1/28/2025 2025R-606344 O PLAT Date Recorded: 1/27/2025 2025R-606333 HISTORY O Expand All History White=Current Parcels O Tax ID: 9100 Pin: 04-012-2-43-07-28-1 04-000-10000 Lt O Tax ID: 9095 Pin: 04-012-2-43-07-28-101-000-10000 L[ Pink=Retired Parcels 39513 This Parcel T Parents t Children Private Sewage System Maintenance Agreement Gustave Otto & Julie Mae Virkus 8730 Westmoreland Ln; St Louis Park, MN 55426 15855 Stormoen Ln '"39513 As owner, I (we) do hereby certify the private sewage system will be installed in accordance with the certified soil tester's report and approved plans and specifications on file with Bayfieid County Planning and Zoning Department The system will be operated in such a manner as to meet the designed plans. I (we) agree to maintain said private system at the below listed location in accordance with rules established in the WI Adm. Code, as from time to time amended. (COMPLETE Legal Is required) 1/4 of 114 Section 28 Township 43 N. Range 07 W. Additional Legal Description: Town of Cable IN DOG 2025R-606333 (Acreage) 2.26 Gov't Lot Lot 2 Block_ Subdivision TELEMARK HILLS PHASE 1 Lot _ CSM # Vol. _ Page _ CSM Doc # DOCUMENT NUMBER 2O26R-6 1 3833 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 09/21/2025 AT 1 1 :05 AM RECORDING FEE: $30.00 PAGES: 1 Return To: Planning and Zoning Department SFP 2 Z 2026 2.d LiAWw'." ® In -ground gravity ❑ In -ground dosed ❑ In -ground pressure distribution Sewage System: ❑ Mound ❑ At -grade Sewage System ❑ Other Area Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (113) of the volume occupied by sludge and scum. Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall he visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds, At-orade, and Inaround Pressure System Laterals (system types C, D and F): The laterals shall be flushed out and swabbed if needed when the wastewater distribution cell component Is inspected as provided above. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system. Sayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thkty (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 bylaw. The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future owners of such property. Owner(s) Name(s) — PI Print i � Mae \i tv 1 dulL4k1S 42- ic D Vk Subscribed and sworn to before me on this date: r tarized a) —Sig s) Notary Publ�Lw My Comm' slon Expires: 31 Z Drafted by Ronald Spreckels Jr Date: 09/08/2026 Proofed by: ulformslsanitary/septicmaintenceagreement Revised July 2020 FIELD 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: VIRKUS, GUSTAVE OTTO & JULIE MAE 8730 WESTMORELAND LN ST LOUIS PARK, MN 55426 Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00515 Transaction Number: SR-00515-55FB3 Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 5582 Paid by: Butterfield, 14346W State Rd 77, Hayward WI 54843 Payment Type: Check Transaction Date: 9/23/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. P 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: VIRKUS, GUSTAVE OTTO & JULIE MAE 8730 WESTMORELAND LN ST LOUIS PARK, MN 55426 Description Private Sewage System (Septic Tanks) Submission Number: SS -00848 Transaction Number: SS-00848-55FFC $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 5582 Paid by: Butterfield, 14346W State Rd 77, Hayward WI 54843 Payment Type: Check Transaction Date: 9/23/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-138S STATE SANITARY PERMIT OWNER: GUSTAVE OTTO & JULIE MAE VIRKUS GOVT LOT: LOT: 2 BLK: SUBDIVISION: Lot 2 Telemark Hills Phase 1 1/4 1/4 SEC: 28, T 43 N, R 7 TOWNSHIP: Cable SOIL TEST: 136-26 NEW SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: TRAVIS BUTTERFIELD SCOTT ROUSH DATE: 9/23/2026 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: # 652879 Condition: Properly Maintain System Per Recorded Agreement THIS PERMIT EXPIRES 9/23/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION