HomeMy WebLinkAbout26-0538CS-ob I-i
BAYFIELD COUNTY b Zoning District
SANITARY PERMIT APPLICATION `� lakes Claw
I, APPLICATION INFORMATION
Soil Test I County
a 6 - 3$
(Please Print All Information)
No: Permit
No: 05
Property Owner's Name:
Wilderness Inquiry, Inc.
Count': Bayfield
Address of Property:
Property Location:
33095 Little Sand Bay Rd, Bayfield, WI 54814
SW Y, NW re, S 33 T 52 N, R 4W E (or) W
Property Owner's Mailing Address:
Township:
I Gov. Lot #:
930 E 80th St
Russell
City, State
I Zp Code
I Phone Number
Lot # Block #:
I CSM #:
CSM Dec # I Subdivision Name
Bloomington, MN j
55420
612-676-9400
1 I
11745
RECIVED
1I. TYPE OF BUILDING: (Check One)
State Owned
❑ Public (Explain the use/purpose I
Tax ID#:
36212 AUG 0, 4 2026
❑ 1 or2 Family Dwelling - No. of Bedrooms
Baycl Ca.
'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)
Composting Privy #7 (,MULLS V'jt(I rt,t in
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)
❑ Portable Privy ❑ Camping Transfer Unit Container ® Composting Toilets ❑ Incinerating Toilet
V. ABSORPTION
SYSTEM INFORMATION:
1. Gallons I
2. Absorp. Area
I 3. Absorp. Area
I 4. Loading Rate
5. Perc. Rate
I 6. System
7. Final Grade
Per Day
Required (Sq.Ft.)
Proposed (Sq. Ft.)
(Gals. I Day / Sq.Ft.)
(Min. Inch)
Elev.(Feet)
Elev. (Feet)
VI. TANK
Capacity
FiberINFORMATION:
In Gallons
Total
Gallons
# of
Tanks
Manufacturers
Name
Prefab.
Concrete
Site
Constructed
Steel
glass
Plastic
Spar'
gyp'
New
Existing
Tanks
Tanks
Septic Tank or
Holding Tank
Lift Pump Tank!
S' hon Chamber
VII. RESPONSIBILITY STATEMENT:
I the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Owners Name(s): (Print) #eppyingrorsemm, cabove I
Owners Signature(s): (No Stamps),
Wilderness Inquiry, Inc.; Erika Rivers
Plumbers Name: (Print) r/appryingrursearonAa9)ahove
Plumber's Signature: (No Stamps)
MP/MPRSWNo:
Plumber's Address: (Street, City State, Zip Code)
Home Phone:
Business Phone:
VIII. COUNTY! DEPARTMENT USE ONLY
Disapproved I
Sanitary Permit/Transfer Fee: I
Date Issued:
Issuing Agents Signature / Date:
Approved
❑ Owner Given Initial I
10/ G/a,&
Adverse Determination
f
IX. CONDITIONS OF APPROVAL! REASONS FOR DISAPPROVAL:
k r
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Y\�ln�Cltf� `^, ca rS sy
riot clan on reverse swe
Lot Line
See Attached Plot Plan
RECEIVED
AUG 0 4 2026
Bayfield Co.
Planning and Zoning Agency
Name of Frontage Road (
1
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.
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 1.
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/formslsandary/bayfieldcou ntysanitaryapplication
Revise: June 2018 Proofed by:
RECEIVED
AUG 042026
Bayfield Co.
Planning and Zoning Agency
S 89'29'22 E
1310.24'
0
sr�
SIEUER
PICNIC m
Iwood
ing privy
s¢o
' O
e�
I
95.52'
omposting privy #2
o
®®Sf
®ii
tomposting privy #1
®ems
omposting privy #7
Moved from existing
location
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X
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i
BEARINGS ARE BASED ON
THE SOUTH UNE OF THE
NW 1/4 OF SECTION 33,
BEING N 8923'09" W
PRIVY AGREEMENT
(ATTACHED TO THE SANITARY PERMIT APPLICATION)
Wilderness Inquiry, Inc.
Mailing Address: Property Address
30 E 80th St, Bloomington, MN 5542q 33095 Little Sand Bay Road, Bayfield, WI
SW 1/4, NW 114, s 33 T 52 N, R4 W
GoVt Lot I I Lot # I CS M# Vol & Page I CSM Doc. #
1 1745 I
10-194 2011R-53799
Return To:
36212 19/22/2026
1. NO PLUMBING will be installed in the habitable building.
DOCUMENT NUMBER
20268-613925
DANIEL J. HEFFNER
REGISTER OF DEEDS
BAYFIELD COUNTY. WI
RECORDED
09/28/2026 AT 1 1 : 1 0 AM
RECORDING FEE: $30.00
PAGES: 1
ZONINJECEIVEC
SEP 291026
Planning and Zoning Agency
2. NO PLUMBING includes: water closets, sinks, bathtubs or showers, laundry facilities, or any other fixture or receptacle
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.
3. A privy vault / pit shall maintain minimum setbacks as specified in Table 1.
Table 1
Well
Building
Lake/Stream
ake / Stream
Additional County Setbacks
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)
Erika Rivers
I Executive Director I
Owner(s) Signature:
This Instrument was signed before me
In the State ofII'' 1 �✓1ykPS 61&\
County of 4 en1ViQc",r'
On this d 3 day SH ,20 -�
by: \
Notary Public My commission expires on: '10 h _3(__O,.10
Drafted By: Bryan Karban (must be filled out by person submitting form) =�, � AN'%A H p/, o December 2012
Wrorms/sanaary/privyforn- Soctobar2019 , �.-:TTEt,
IjJ Notay Fn:::-M:naso°sota a
B4YFIELD 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: 2-5
Submission Number:
CS -00173
Transaction Number:
CS -00173-4B548
Amount
$300.00
Total: $300.00
Payment Amount: $307.14
Reference: 1397485895
Paid by: JustinMortenson To OOVfir CS-ca17SJooilS/ooY76I$oo\77
Payment Type: Credit Card
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 —
No. 26-0538 Tax ID: 36212
Issued To: WILDERNESS INQUIRY INC
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Location: S33 - T52N - R04W
Town of RUSSELL
Legal Description: LOT 1 CSM #1745 IN V.10 P.194 (LOCATED IN SW NW)
Residential Structure in R-RB Zoning District
For: Sanitation Permit — New [Composting Toilet]
(Disclaimer): Any future expansions or development would require additional permitting.
Condition(s): Maintain as required per SPS 391.
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 (71S) 685-2900.
NOTE: This permit expires two years from date of issuance if the authorized construction Emily Macgillivray, AZA
work or land use has not begun.
Authorized Issuing Official
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. October 06, 2026
This permit may be void or revoked if any performance conditions are not Date
completed or if any prohibitory conditions are violated.