HomeMy WebLinkAbout26-0541Os -00/77
BAYFIELD COUNTY
Zoning olamct_
SANITARY PERMIT APPLICATION
Lakes Class
I. APPLICATION INFORMATION
Soil Test
_ as "1
(Please Print All Information)
No: Permit
No: C'
_
Property Owner's Name:
Wilderness Inquiry, Inc.
County: Bayfeld
Address of Property:
Property Location:
33095 Little Sand Bay Rd, Bayfield, WI 54814
SW 'it NW Y, Is 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 Zip Cade
I Phone Number
Lot # I Block #:
I CSM #
CSM Doc #
I Subdivision Name
Bloomington, MN
55420
612-676-9400
1 I
1745
UP
WED
II. TYPE OF BUILDING: (Check One)
❑ State Owned
Tax ID#:
❑ Public (Explain theusetpurpose I
36212 AUG 0�4 2026
1 or 2 Family Dwelling - No. of Bedrooms
III.. TYPE OF PERMIT: (Check only one box on line A Check box on line B. if applicable) Bayfleld Co.
A) ® New ❑ Replacement ❑ County Private Interceptor Planning and Zoning Agency
❑ Reconnection ❑ Repair ❑ Revision •• ❑ Transfer of Owner (List Previous Owner below)
Composting Privy #2
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
I 5. Pero. Rate
I 6. System
7. Final Grade
Per Day
Required (Sq.Ft.)
Proposed (Sq. Ft.)
(Gals.! Day / Sq.Ft.)
(Min. Inch)
Elev.(Feet)
Elev. (Feet)
VI. TANK
Capacity
Rber
INFORMATION:
In Gallons
Total
Gallons
#of
Tanks
Manufacturer's
Name
Prefab.
Concrete
Site
Constructed
Steel
g
Plastic
Ewer.
App.
New
Existing
Tanks
Tanks
Septic Tank or
Holding Tank
Lift Pump Tank /
Siphon Chamber
V0. RESPONSIBILITY STATEMENT:
I the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Owner's Name(s): (Print) gappytngtcsemoncabove I
Wilderness Inquiry, Inc.; Erika Rivers
Owner's Signature(s): (No Stamp
IfL•t/
-
Plumber's Name: (Print) trappymgfor secrionAore)above
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:
I Issuing Agent's Signature / Date:
❑ Approved
❑ Owner Given Initial
U b
v / I I /'ii
( 1 Ia
Il
Adverse Determination
DL C NDITIONS OF APPROVAL! REASONS FOR DISAPPROVAL:
44\6tN 1%0MQ d �)c spa q\.
Plot Plan on reverse sloe
Lot Line
See Attached Plot Plan
RECEIVED
AUG 042026
Planning aarl 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 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
ulfonns/sanitarylbayfieldcountysanitaryappllcation
Revise: June 2018 Proofed by:
RECEIVED
AUG 0-4 2026
Bayfield Co.
Planning and Zoning Agency
S 8929'22" E
1310.24'
sxw ca
' SHELTEI
N
jAVIWN
PICNIC m
('
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w000am o
ing privy #
cs
ett
95.52'
I a
x
I
ro
jm
®®
z4o3.:.;
omposting privy #2
omposting privy #1
omposting privy #7
Moved from existing
location
;
I
I y
,
1;
I
I
BEARINGS ARE BASED ON
THE SOUTH LINE OF THE
NW 1/4 OF SECTION 33,
BEING N 89'23'09' W
PRIVY AGREEMENT
(ATTACHED TO THE SANITARY PERMIT APPLICATION)
Inc.
E 80th St, Bloomington, MN 5542q 33095 Little Sand Bay Road, Bayfield, WI
36212
SW 1/4, NW 1/4, I S 33 T 52 N,R4 W
1745 110-194 12011
9/22/2026
1. NO PLUMBING will be installed in the habitable building.
DOCUMENT NUMBER
2O26R-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
Return To: �RECEIVEO
ZONIN
SEP 29 2026
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
r
This instrument was signed before me
in the state of
'I Irl i✓tyw So+c-.
Countyof He VIy1SL �n
On this 23J day _.5e4ewJer.2o cL
by:
Notary Public �1
My commission expires on: 3 Cs r)-
h f 3 ( Or)
Drafted By: Bryan Karban (must be filled out by person submitting form) I :yi'i : !i M. 51tT-'i (fiTA ° December 2012
Wforms/sanitary/privyfonn- SOctober 2019 + c r�r
• My C:-,:n'.s!,-Sx;ana Ian 31, 2O2S
IYFIELD 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 -00173
Transaction Number:
CS -00173-4B548
Description Amount
County Sanitary Permit: 2-5 $300.00
Total: $300.00
Payment Amount: $307.14
Reference: 1397485895
Paid by: Justin Mortenson lo Co'J t f GS — O o 17 S OO `7S ` OO l7 01 $. Q\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. 26-0541 Tax ID: 36212
Issued To: WILDERNESS INQUIRY INC
Location: S33 - T52N - R04W
Town of RUSSELL
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
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 (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.
Emily Macgillivray, AZA
Authorized Issuing Official
October 06, 2026
This permit may be void or revoked if any performance conditions are not
completed or if any prohibitory conditions are violated.
Date