HomeMy WebLinkAbout26-150S--"'s,
- 00% 63
Industry Services Division
4822 Madison Yards Way
County
Bayfield
Madison, WI 53705
Sanitary Permit Number (to be filled in by Co.)
P.O. Box 7302
Madison, WI 53707
/ (7
b — l5oJ
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
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to
Project Address (if different than mailing address)
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
TBD- Silver Birch Dr. Cable, WI
purposes in accordance with the Privacy Law, s. I5.04(1)(m), Suits.
17 a-50
1. Application Information —Please Print All Information
Property Owner's Name
Parcel #
Barbara Grevich
10897
Property Owner's Mailing Address
Property Location
17255 Silver Birch Dr.
Govt. Lot
City, State
Zip Code
Phone Number
Cable, WI
54821
715-222-9887
¼. A. Section 23
T43 N R 07 For W
II. Type of Building (check all that apply)
Lot #
❑✓ I or 2 Family Dwelling —Number of Bedrooms 2
1
Subdivision Name
Woodcrest Addn to Wildriver
Block #
�ublic/Commercial — Describe Use
ENTERED
❑City of
❑State Owned - Describe Use
Village of __
CSM Number )fl (y
Town of Cable
III. Type of POWTS Permit: (Check either "New" or"Replacement" and other applicable on line A. Check one box on line B. Complete line C i
applicable.)
A
New SYsreni
Re lacement System
lilOCher Modification to Existing System (explain)
Additional Pretreatment Unit (explain)
❑Holding Tank
lIn-Ground
I�t-Grade
Mound
Individual Site Design Other Type (explain)
(conventional)
C.
❑ Renewal Before
❑Revision]Change
of Plumber
jfransfer to New Owner
List Previous Permit Number and Date Issued
Expiration
NA
IV.
Dispersalfl'reatment Area and 'Tank Information:
Design Flow (gpd)
Design Soil Application Rate(gpd/st) I
Dispersal Area Required (sf)
I Dispersal Area Proposed (sf) I
System Elevation
300
0.7
428
500
93.75
Capacity in
Total
# of
Manufacturer
Tank Information
Gallons
Gallons
Units
a
o $
V
9
New Tanks
ExistingTanks
'.e°-
y
u
aO
H
r
ii, D
n.
septic or Holding Tank
750
750
1
Superior Precast
✓
Dosing Chamber
V. Responsibility Statement- I, the undersigned,
assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
I Plumber's Signatur
MP/MFRS Number
I Business Phone Number
Jason Kuettel
675751
715-798-3355
Plumber's Address (Street, City, State, Zip Code)
PO Box 66 Cable, WI 54821
fl County/Department Use Only N.
Approved
0 Disapproved
Permit Pee
S
I Date Issued
Issuing ent Si azure
❑ Owner Given Reason 1'or Denial
� —
o� Zb
tO�
/oo5 ` ( f
Conditions of Approval/Reasons for Disapproval
f/ (aJ
R—LCEWCAN' �o2fl9R
Attach to complete plans far the system and submit to the County only on paper not less than 8 in a II inches in size
Bayfield Co.
SBD-6398 (R. 02/22) Planning and Zoning Agency
S R-ooS3o
SOIL TEST # /8o) -
f�4 Soil Evaluation Repo
in accordance with SPS 385 ,WW&Adm Code
WlsconsinDepartmertto}SatetyandProteuiortalServtses
Attach complete site plan on paper not less than 8'/2 X 11 inches in size. Page: 1 of 6
Plan must include but not limited to: Vertical and horizontal reference
point (BM), direction and percent slope, scale or dimensions, north arrow,
location and distance to nearest road.
Please Print All Information
Personal information you provide may be used for secondary purposes.
(privacy Law,s.15.04(1)(m)).
County:
Bavfleld
Parcel I.D.
10897
Reviewed4B,,,
S,
Date:
I 1"/1, 3 4
Property Owner: sar /tt/
Eric & Karla Turner j�gru3 A ' (7 W'4
Property Location
S23,T43N,R07W
Property Owners Mailing Address:
PO Box 184
Site Address or CSM and Lot #
17250 Silver Birch Drive
City
Elk Mound
IState
WI
I Zip Code
I 4739
Phone Number:
0
Town
Cable
lNearest Road:
Silver Birch Drive
Number of Bedrooms: 2
r New I Residential Code derived design flow rate: 300
Flood Plain if applicable
r Replacement j" Public or Commercial - Describe:
Parent Material: Flood Plain if Applicable: 0 EM7EaE0
General Comments & Recommendations:
System Elevation: 93 Load Rate
Bor. Ground surface Elev: Depth to Limiting Factor:
Boring #1 r r PIt 99.96 Ft. 120 in. Elev. 89.95 ft
Soil Application Rate:
Horizon
Depth in.
Domm.Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr.Sz.Sh.
Consistence
Boundary
Roots
GPD/ft2
*Eff#1
Eff#2
1
0-4
7.5YR2.5/1
N/A
SL
2MSBK
MFR
CS
3M
0.6
1.0
2
4-24
7.5YR4/4
N/A
SL
2MSBK
MFR
CS
2M
0.6
1.0
3
24-120
7.5YR4/4
N/A
COS
0SG
ML
N/A
N/A
0.7
1.6
4
5
H2 = < 35% 3-8" Rock
6
7
r Bor ji Plt Ground surface Elev: Depth to Limiting Factor:
Boring # 2 98.45 Ft. 106 In. Elev. 89.62 ft
Soil Application Rate:
Horizon
Depth in.
Domm.Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr.Sz.Sh.
Consistence
Boundary
Roots
GPD/ft2
*Eff#1
Eff#2
1
0-8
7.5YR2.5/1
N/A
SL
2MSBK
MFR
CS
3M
0.6
1.0
2
8-28
7.5YR4/4
N/A
SL
2MSBK
MFR
CS
2M
0.6
1.0
3
28-102
7.5YR4/4
N/A
COS
0SG
ML
N/A
N/A
0.7
1_6
4
5
H2 = < 35% 3-8" Rock
6
7
*Effluent #1 = BOD 5>30< 220 mg/! and >30 < 950mg/1
*Effluent #2= BOD 5< 30 mgR and TSS
< 30 mg/l
CST Name (Please Print)
Mark S. Thompson
Si ure
CST Number: 877598
' ixK
cn
Address: 12006 N US Hwy 63
Hayward, WI 54843
Date E 'o and cted:
Tue , October 6, 2026
Telephone Number
715/699-4081
SBD-8330 /2
VD
2026
Bayfield Co.
Planning and Zoning Agency
Property Owner: Eric & Karla Turner Parcel I.D. 10897 Page: 2 of 6
Boring # 3
Bor �/ Pit Ground surface Elev: Depth to Limiting Factor:
I 96.49 Ft. 105 in. Elev. 87.74 ft
Soil A Rate
pp
Horizon
Depth in.
Domm.Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr.Sz.Sh.
Consistence
Boundary
Roots
GPD/ft2
*Eff#1
Eff#2
1
0-10
7.5YR2.5/I
N/A
SL
2MSBK
MFR
CS
3M
0.6
1.0
2
10-30
7.5YR4/4
N/A
SL
2MSBK
MFR
CS
2M
0.6
9_Q
3
30-105
7.5YR4/4
N/A
COS
0SG
ML
N/A
N/A
4
5
H2 = < 35% 3-8" Rock
6
7
Boring # 4
Ground surface Elev: Depth to Limiting Factor:
r Bore' >.t t
0 Ft. 0 In.
Soil App. Rate
Horizon
Depth in.
Domm.Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr.Sz.Sh.
Consistence
Boundary
Roots
GPD/ft2
*Eff#1
Eff#2
1
2
3
4
5
6
7
Boring # 5
v' Pit Ground surface Flev: Depth to Limiting Factor:
r BorP
0 Ft. 0 In.
Soil App. Rate
Horizon
Depth in.
Domm.Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr.Sz.Sh.
Consistence
Boundary
Roots
GPD/ft2
*Eff#1
Eff#2
1
2
3
4
5
6
7
Boring # 6
r Bores Pit Ground surface Elev: Depth to Limiting Factor:
0 Ft. 0 In.
Soil App. Rate
Horizon
Depth in.
Domm.Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr.Sz.Sh.
Consistence
Boundary
Roots
GPD/ft2
*Eff#1
Eff#2
1
2
3
4
5
6
7
*Effluent #1 = BOD 5>30 < 2 20 mg/! and TSS>30 < 150mg/! *Effluent #2= BOD 5< 30 mg/I and TSS < 30 mg/l E
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access
services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777OCT 0 9 2026
SBD-8330(R.07100) Bayfield Co.
Planning and Zoning Agency
Soil Profile Sheet Page: 3 of 6
Owner: Eric & Karla Turner Isoti Tester: Mario S. Thompson
System Elevation: 93 Load Rate: 0.7 System Elevation: 92.95 To 93.99
101
1}1
101
S2
100
---------------
��
100
--------------
---------------
99
99
98
Qfi
98
---------------
97
Q2
97
--
-------------
96
---------------
96
--------------- 96.12
95
95
94
94
---------------
/
93
---------------
93
--------------�
------------=--
92.95
---------------S2�62
92
---------------
92
---------------
91
---------------
�--
91
---------------'
90
90
---------------
---------------
89.95
$�62
89
---------------
LE .
89
L.E1
88
88
---------------
87
87
---------------
86
------
86
85
---------------
85
84
84
83
--------------
--------------
83
82
------------
82
81
---------------
81
---------------
80
---------------
80
---------------
79
---------------
------------
79
---------------
---------------
101
100
99 --------------- System
l
98
$ 9 ------- ------- 96.49
95 ---------------
94 Q,S
93.99 t
93 --------------- 01
92 ---------------
91
90.74
90
89 ---------------
88
87.74
87
86
85
84
83
82
81 ---------------
80 ---------------
79 _
R :CEIVED
OCT 09 2026
Baylield
Planning and Zon ng Agency
Owner Information:
Name: Eric & Karla Turner
Location: S23.T43N,R07W
Township: Cable
County: BayfieLd
Address: 17250 Silver Birch Drive
BM=100: Nail w/ribbon on the base of tree across from B3
111*
B1= 99.95
B2 = 98.45
B3 = 96.49
Lake= 0
CST: Mark S. Thompson
,D
#87
O
�! 1"= 401 Only in TestedArea 715/ 9-408
ON
rr
o a
5.0
E
(O
N
a
�'`
PAGE 1 OF 4
In -Ground Gravity Plan
Index & Cover Sheet
Component Manual Design References:
In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027)
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:
POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
Grevich 2 Bed
Owner Name(s): Barbara Grevich
Owner Address: 17255 Silver Birch Dr. Cable, WI
Project Address:
Govt. Lot:
Township: Cable
Phone: 715 -222 9887
Zip: 54821
TBD - Silver Birch Dr.
1/4 of 1/4, Section 23 T43 N -R 07 E ❑ or W 12
County: Bayfield
Project Parcel ID #: 10897
Designer Information
Designer Name: Jason Kuettel
Designer Address: PO Box 66 Cable, WI
E-mail: tim@andryras.com
License Number: 675751
Remarks:
Phone: 715 -798 3355
Zip: 54821
This space reserved for approval stamp.
RECEIVED
OCT 092026
Bayfield Co.
Planning and Zoning Agency
P
� ( %
Signature: ;,�,�-,<� Date: I
Original si a re required on each submitted copy.
Owner Intermatlon;.
Name: 13r.- GXL-u1Ur
Location: $23.T43N R07W
Township: Cable
County: Sal Held
Address: 17250 Silver Birch Drive
96'
Only in TestedArea
BM=100: Nail w/ribbon on the base9itreeacrwssjcom-B3
•1'
BM (e ) ea pw
4,. 98' � 100'
1
7B2 CCLEmptylo[
No Well
B1= 99,95
B2 = 98.45
63= 96.49
Lake= 0
IN -GROUND DOSED -GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with EZ1203HP Bundles
3 -ft Trench (down -sizing credit)
min. 12'
G
I (ypidaq
TYPICAL TRENCH
SOIL COVER
Coveile
Cover
T
CROSS SECTION VIEW
12' J
(No Scale)
min. Uench
• ; .
depth
1 --..,,�.
',•
(typical) T
System Elevation =
ft �•'
(typical)
Provide minimum 3 ft
separation between trenches.
TYPICAL TRENCH (Show location of inlet / outlet pipe connection on plan view.)
PLAN VIEW
(No Scale) 4„0 Observation pipe shall be Installed
at junction between two units. 10
Perforated Lateral Observation Pipe
(typical) (typical) (ty
EI±HT}fIII III III IEEEE ---
B= 45 ft
(typical)
INSTALL PER TRENCH:
4 10 -ft bundles @ 50 ft EISA/unit = 200
ki 1 5 -ft bundles @ 25 if EISA/unit = 25
OBSERVATION PIPE DETAIL
(No Scale)
Screw -Type or
Slip Cap (loose)
4"0 PVC Pipe ,'
Top of pipe to terminate
at or above finished grade
(4)1/4"-1 "%6"Sbls
aped
Anchoring Device
ft
I A=3.0 ft
J (typical)
EZ1203H Bundle
(typical)
ft2 (mid by Infiltrator Systems, Inc.)
Install pursuant to manufacturer's instructions.
ft2
171
C) = Proposed EISA per trench = 225 ft2 Required Infiltration Area = 428
rtf
x 2 trenches = Proposed Total EISA = 500
O
— Finished Grade
(mulched & seeded)
— Topsoil Cover
An.
1 foot)
In61tratbn
Surface
ft2 Distribution Method:
ft' branched manifold
G
m
w
O
TI
O1
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 = 300 gpd; BOD5 S 22 mgL'; TSS 5150 mgL"'; FOG ≤ 30 mgL'
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors (Le. 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 (113) 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 according to manufacturer's specifications. A servicing period will always be greater than 12
months.
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: Andry Ra8mu8sen & Sons
Local government unit: Bayfield Co. Zoning Phone: 715-373-6138
Local government unit address: 117 E 5th St. Washburn, WI
Phone: 715-798-3355
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
RECEIVED
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. CoctT 092026
Bayfield Co.
Planning and Zoning Agency
S=PTIr TP`IK Co 5?CT:ON AND S?ErI:ICATIONS
4" SC4,'IOPVC INSP- PTDC 6 " H_TN. ABOVE
(When role+ Ine...%Voke 4s �iuriza PI.�
APPROVED
MANHOLE
FINISHED GRADE
--WfFRJ�ve "66L
IIdV 4" HIll.
Ie" NIN.
I HILET
OUTLET
APPS 0 SA -F -L E-
� O FILTER
APPROVED
S' PIPE 3' I MPG. OFence
ONTO sOLrol I model rt T092 -z -
SO IL Ii
3" APPROVJ D BEDDING UNDER TANK
SPECIFICATIONS
S EPT$C
TANK 11c( ItC.C
TANK SIZES. SE?TIC ')50 CAL,
NOTES:
RECEIVED
OCT O9?U?
Bayfield Co.
Planning and Zoning A:.,ency
Private Sewage System Maintenance Agreement
'/ r J, lie v/c,,
Owner(s) Mailing Address
ZSS S ( viii- l rc L, Ori t --e C�Ste hl Sti
Site Address
Sf"fri
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 Bayfield 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 1/4 1Section L3 _______Township
3,N. Range W.
Additional Le al Description: !rvw d 04 jk A JAR, "1)49 '(14' (/(i
Town of C- �/l✓JK (Acreage) 3 Gov't Lot
Lot I Block Subdivision
Lot _ CSM # _ Vol. _ Page _ CSM Doc #
DOCUMENT NUMBER
2026R-6 14125
DANIEL J. HEFFNER
REGISTER OF DEEDS
BAYFIELD COUNTY. WI
RECORDED
10/12/2026 AT 8:00 AM
RECORDING FEE: $30.00
PAGES: 1
Return To:
Planning and ZotRi a�tvLmE)
OCT 13 2026
Bayfield Co.
nning aoning Agency
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 (1/3) 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 be visually inspected by a certified
septage servicing operator, POWTS Inspector, or licensed master plumber within three (3) yearsof 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 -grade and In -ground Pressure System Laterals (system types C, D and E): 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 Hayfield 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. Bayfield 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 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.
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) NalIme(s) — Please Print ``//
�VlGf,i�Gi �I /G-\
Subscribed and sworn to before me on this date:
t 1 1 I
\�;gP'�':NA
V t � U
_
Notarized Owner(s)—Sig ature(s)
Note Publ
t1OTAR
_*
��
PUBLIC
My o i Sion Expires:
dad
rti ,
- T •....,.....
�/� Cf
1'IISG
Drafted by: _L(A.. LL -fl"-$----- Date: __
Proofed by:
u/fo rms/sanitaryisepticmain tenceagreement
MFi ELD 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:
GREVICH, BARBARA j
17255 SILVER BIRCH DR
CABLE, WI 54821
Description
Certified Soil Tests - Review & Filing Fee
Submission Number:
SR -00530
Transaction Number:
SR-00530-57ABA
Amount
$50.00
Total: $50.00
Payment Amount: $50.00
Reference:15210
Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821
Payment Type: Check
Transaction Date: 10/13/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
B A-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: Submission Number:
GREVICH, BARBARA J SS -00863
17255 SILVER BIRCH DR
CABLE, WI 54821 Transaction Number:
SS-00863-57ABE
Description
Private Sewage System (Septic Tanks)
Amount
$400.00
Total: $400.00
Payment Amount: $400.00
Reference: 15210
Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821
Payment Type: Check
Transaction Date: 10/13/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
BAYFIELD COUNTY
SANITARY PERMIT (#04)-26-150S
STATE SANITARY PERMIT
OWNER: BARBARA GREVICH
GOVT LOT: LOT: 1 BLK:
1/4 1/4 SEC: 23, T 43 N, R 7 W
TOWNSHIP: Cable
SOIL TEST: 152-26
NEW SYSTEM
SYSTEM TYPE: Non -Pressurized In -Ground
PLUMBER: JASON KUETTEL
SCOTT ROUSH DATE: 10/13/2026
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 675751
Condition: Properly Maintain System Per Recorded Agreement
THIS PERMIT EXPIRES 10/13/2028
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION