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HomeMy WebLinkAbout26-154SDepartment of Safety County: % [' I S P S -i (` (� - OO J SS & Professional Services Industry Services Division RECEIVED Bafield Sanitary Permit Number (to be filled in by county) Sanitary Permit Application StateTransaction. Number /� ���r� ppmit�r&it O bWit., accordance with s. cocain 83.21(2). Wit. Adm. Code,.,i,,, ,c,unithut, m am up hut, cowntS/n.WIZis m nbnininyn v iurypenni,.Nom: Application Pmts forxutu-owned POWTS are suhmirt<dtoJe'tanmt <loff commerce. PeerrsonW information you pmvtde may be 1(x4 fur secondary porpusea +,anrdnnawith privacy .. i,w :Co. Project Address (if different than mailing address) 46763 Funnys Lane I. Application Information - Please Print All Information Property Owners Name: ENTERED Kathy & Charles Lederer Parcel # 16993 Property Owners Mailing Address: Property Location 2291 40th Street Govt Lot NE1/4 NW1/4 S34 T44N R06W City, State: I Zip Code Phone Number: Somerset -WI 54025 612.760.6615 II. Type of Building (check all that apply) Lot# 0 Subdivision Name: � 1 or 2 Family Dwelling - # of Bedrooms 2 ❑ ❑ Public/Commercial - Describe Use Block# 0 ❑ City ❑ Village ❑ State Owned - Describe Use CSM Number 0 ❑� Township Grand View Ill. Type of Permit: (Check only one box on line A. Complete Line B if Applicable) A � New System ❑ Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit B. ❑✓ Holding Tank ❑ In -Ground (Conventional) ❑ At -Grade ❑ Mound ❑ Individual Site Design ❑ Other Type (explain) C. ❑ Permit Renewal Befo❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner Expiration List previous Permit Number and Date Issued IV. Dispersal/Treatment Area Information: 0 O4 Chmbers Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(sf) Disp. Area Proposed(sf) System Elev. 300 gpd 0.00 gpdsf 0.00 Feet' 0 Feet' 0 Capacity in Gallons I Total # of Units I Manufacturer Prefab I Site Steel / Fiber. Tank Information New Tank I Exist Tank Gallons I Concrete I Constructed or Plastic Septic or Holding Tank 1800 I 1800 Superior X Dosing Chamber 1100 I I 1100 Superior X V. Responsibility Statement - I the and , s sponsibility for instalation of the POWTS shown on the attached plans. Plumber's Name (print) PI s gn ur MP / PRS Number Buisness Phone Number: Mark S. Thompson 877598 7151699-4081 Plumbers Street Address (Stree , S e, Code) 12006 N US Hwy 63 Hayward, WI 54843 VIII. County/Department Use Only roved ❑ Dissaproved [I]Owner Given Reason for Denial Permit Fee: ` Date Issued. ' 0/i q I --lo Issuing A t ignature g Conditions of Approval/Reasons forDisapproval n - Attach complete plans(to the county only) for the system on paper not less than 8'A x 11 inches in size SBD - 6398 (R03/22) Wisconsin Department of Commerce SOIL EVALUATION REPORT Pages. f✓ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must Include, but not limited to: vertical and horizontal reference point (SM), direction and Parcel IA_ - - percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Oa! — J (iQ — O ( — o O3 Please print all lnfonoation. Reviewed by Date, Personal tnfomea6an you provide may be used ea.rpj Property Owner // — ..` - — rty Location ITCan5o 2 MAY .`.03 Lot /t/E 1/4 NW/4 S 3/T '/VNR R G, -E(egW Property et's Mailing //Address # Block # Subd. Name or CSM# 11,,20 L7l v c/t EDnt'c sayliald Co. Zoning Dept City ,/ State ziP Code Phone Number ❑ qty ❑ Village � /] Town Nearest Road 6.4 Art, W-q5-5r/o/(o (7,$)3ge-a3/y Gva.,p{VrPw' fnn &yLane_ ,® New Construction Use: ® Residential f Number of bedrooms o? Code derived design flow rate 3o 0 GPD 0 Replacement Pubic or commerdal - Describe: Parent material G/czee c�1'?" - I - Rood Plain elevation if applicable General comments - BS. o? - - ft:. RECEIVED and recommendations: y ou„G( r+J�`%'04../ t2LlG, o !JQ �'I _/ 7 J y�Qc�tyl.yl.e�pee dl(esej:k /oSc i.o4 rkle = _ 31 fsf ( ae�ua l - vo J jr...e n c -I°L. {e:....t1t &ti 'a_ SEP 28 2026 . VhUK �rt$]�VY C'rr U'h 1 - - .... Phmina and 2onina a,,,.,�, I oern® rl• Pit - Ground surface elev. T2 ft Depth to limiting factor l c`f In. Soli Appticetlon Rate Horizon Depth - 0on nant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ft2 in. Mansell Ou. Sz. Cont Color Gr. Sz. Sh. I 'Peal -1 •cren ( 0-7 7cy,�3il 5L 0k-4 J7 .7-(5 75i/z.vr5 Yfu.'a._ SL /M U1 t 3 r 2SYgv/3 OT31° ny,r7/2 CL /csM ,nd C( X8.5'2 Yg. / , p ' �srrr la 5'1 S C5 '° CS O(' r•o — r ICc,.,ctol�f'w aij sa" (9. Boring # ❑ Being _._. ... E4. Pg., ,...Ground surfacealev. 7 fl. Depth to limiting factor in. O-:1 n... .�1 Horizon Depth In. Dominant Color Munsell Redox Description Ou. Sz. Cant Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots - •Eff#t: 'Eff#2 / 0.7 7S/fe3/( /I- SL 2 ,JL.. aLc.v s' 2 7 flY!'. Wont 415 i4-ilc4. co ,c/.. r Cn 3 `/` S i// .QDJ? ps ie ?/2 SL vnl — aai (FM: 3 5'• Y y - _ ca 7-YY2 rs(- LS o f — — .r ,.7 Gvo"KI � r� of W 5 cmuranw.- 56u,.0U aUIng(Laee IAJ a4U<75U Please P`JOE ZIRN c- S" ' Effluent #2 = BOD, c 30 mnlL and TSS < 30 mg1L Address on Date Evaluation Conducted Telephone Number Mason, WI 54856 S -c —o3 —//5--76S y4o$ RECEIVED SEP 282016 Bayfield Co. Planning and Zoning Agency Property Owner j7C-saS_� Parcel ID# Q�t - tr)rYt'' - (}i Boring # Boring /? ❑ Pit Ground surface elev. <7` '?iy $% „ . o?epth to limiting factor -�' in. .Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sr. Cont Color Texture Structure Gr. Sr. Sh. Consistence Boundary Roots - GP S Eff#2 Y 7<Y2E i 12o, t sb (-/ zS.PY/2 3 /-)I ?/RC n=nom_ `LS .arc fl o L>ts ✓ 3b isYRY/G 7 Page —c of 'a, Soil Molication Rate I ❑ Boring # ❑ Boring pit Ground surface elev. It. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sr. Cont. Color Texture Structure Gr. Sr. Sh. Consistence Boundary Roots GPD/ftz 'EfH#1 Eff#2 Boring # ❑ Boring pit Ground surface elev. ft Depth to limiting factor in. Soil Appliption Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sr. ConL Color Texture Structure Sr. Sr. Sh. Consistence Boundary Roots GPO/R' , 'Eff#1 Eff#2 Effluent #1 = BOD, > 30c 220 mg/L and TSS >30 < 150 mg/I. • Effluent#280D5<30 = SOD, e 30 mg/I. and TSS < 30 mg/L I The Department of Commerce is anequal opportunity service provider and employer. If you need assistance to access services or r' need material in an alternate format, please contact the department at 608-266-3151 or IT? 608-264-8777. SDDAUO(a.O7 O( Property Omer ❑3 © Boring Boring # ❑ Pit Ground surface elev. Horfzon I Depth I Dominant Color Redox Dr in. Munseli 7s'Y2. 3fl Qu. Sr Cont. __ __ o:rL / �-( ' RECEIVED SEP 282026 Parcel lD # - 101'Q - gtAurid� btidYoning A~ ofTL epth to limiting factor in• Soil Application Rate a �.A yr on Texture . Structure Consistence Boundary Roots GP t92 1 Color LGr. Sz. Sh. E1#( I Ef1#2 }L 7• % S U Boring Boring # in. pit Ground surface eiev. ft. Depth to limiting ��°r Soil Application Rate Horizon Depth Dominant Cotor Redox Description Texture Structure Consistence Boundary . Roots GPD E in. Munsell Cu. Sz. Cant Color Gr. Sz. Sh. .E ff#2 n Boring # ❑ Boring t-1 Ground surface elev. ft. Depth to limiting factor 1°• Snil Aoniintien Rate rte+ Horizon •__• Depth in. ... Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPO E ffl Eff#2 Effluent #1 c BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = 8OD5< 30 mg/L and TSS < 30 mg/L 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 6O8-264-8777. 51/04330 (e.OJMOr 8? Gv&s,:c VZ[.) ru e.k t� N nl�✓ 3q- i tiynl-R t v- &ZA- sn r<6rnr • SEP 28 — i ,fYUOS"i f"u� CcsS �r..La'n' /- gcofl?n?ejQ ch3Ljn /Odd) — J'ziou^�(7�52cormi2d tcP —�SS✓17i11+i5'ecr c� J.',e✓w/�P..� N.cx.n t/l'.PJP✓ 42tt. Vccon•+-rexcQe�. 715-790-3451 I1cXI*EY REALTY 123 P03 PR 02 '03 17:07 SHEET I OF 2 ELD COUNTY CERTIFIED SURVEY Mar IiU•- A PARCEL OF LAND LOCATED IN GOVERNMENT LOT 2 AND THE NE I VIEW TOWNSHIP..W. � BAYFIELD COUNTY, WI. SCALE IN FEET 0 W 160' LEGEND a = IRON PIPE FOUND O s IRON PIPE WEIGHING U3Ibf. PER UN. FOOT SET y L % ALDER LWE P ALDER V, V 1 �'A A i �� `' $61• TW r 1 h LI 3900! 4\� .90 serlo•1 F NoeBItIL {t M w\ C 1 eta\ sUR RECEIVED SEP 282026 Barfield Co, PWm*W and ZonkV Apenq E 1/4 SEC. 33 T.44 N. R6 W. -7 wh o� G�,6~X %eta f ✓t ( I� N& .1- 3Y-TS's'nl-R6iv' Yc�sepL Z✓.1 ID e 223 1 REC�NED SAP � � 2725. N•'I l ec5 /o4d j fi�ecorn > c.t�z� esr J /Cc., ?4'e cy f3L "'s // w he.,.. ✓o...cY -Pvf✓ PAGE 1 OF 4 Holding Tank Plan Index & Cover Sheet Component Manual Design References: Holding Tank Version 2.1 (May 2022-2027) RECEIVED Pg 1 of 4 Index & Cover Sheet SEP 282026 Pg 2 of 4 Plot Plan Bayfiefdco. Plenninp and ZaungAQeoky Pg 3 of 4 Holding Tank Specifications Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map (if ap Holding Tank Pumping Contract (if appl Holding Tank Agreement (if applicable) Project Name / Description Lederer Project / Holding Tank Owner Name(s): Kathy & Charles Lederer Owner Address: 2291 40th Street, Somerset, WI Phone:612 _760 Zip: 54025 plicable) cable) 6615 Project Address: 46763 Funnys Lane Govt. Lot: NE 1/4 of NW 1/4, Section 34 T 44 N -R 06 E ❑or W 0✓ Township: Grand View County: Bayfield Project Parcel ID #: 16993 Designer Information Designer Name: Mark Thompson Designer Address: 12006 N US Hwy 63, Hayward, WI E-mail: dighayward101@gmail.com License Number: 877598 Remarks: Sig on each -gab d copy. Phone: 715 699 4081 Zip: 54843 This space reserved for approval stamp. Date: 09/24/2026 Owner Information: Name: Kalhy&Chartes Lederer Location: NEl/4 NW1/4 S34 Tom, 0GW Township: Grand View County: Bafield Address: 4az6aEunnys Lane Only in Tested Area BM=100: NaLapcox20IabOVe$round on ribboned balsom BM 1800/1100 Combo Tank B1= 912 B2= 92.2 B3 = 99.2 Lake= 84,5 46763 Easment to Funnvs Lane > M P Mark S. Tho X #7 8 715/699-4081 m C) m m a PAGE 3 OF 4 HOLDING TANK SPECIFICATIONS (No Scale) Electrical must comply with SPS 316 and NEC 300 1B Mm. (typical) Approved Joints with - Approved Pipe 3 ft onto Solid Ground (typical) p Weatherproof —Junction and Alarm Box Approved Locking Manhole with Warning Label Attached (typical) p —Airtight Seal nisdehed Gra . .LE Inlet Invert FMax.Fi1 T or 90% of total volume if more than one tank 40 Vent Pipe >10 ft from Building 12" Min. or 2.0 it above ablished Flood Elevation Compartment 1 Vol = 1 809 gal Ind Compartment 2 Vol = 1125 gal TOTAL HOLDING TANK VOLUME = 2934 gal 3Approved Bedding Material Beneath Tank 4" Min. or 2.0 ft above Established Flood Elevation / (typical) TANK MANUFACTURER: Superior Anchor tank as necessary pursuant to SPS 383.43(8)(g) Ballast Weight = [(cu.ft.tank.Vol x 62.4 Ibs/cu.ft) - Ibs.tank.wt] x 1.5 Ballast Weight = [( cu.ft. x 62.4 lbs/cu.ft) - Ibs] x 1.5 = lbs ;!JRI LP1800/11002-Compartment Tank SUPERIOR PRECAST CONCRETE FRECgSTCONCRETE RECEIVED TOP VIEW 16-T SEP 28 Tank: 16,366 Lid: 97'5 aayfeld Total • 26,141 Pl vift and Zo Volume o€ C: on crete Total : 6.r Yd' Gallon.: Per Inch: 7O.E NL+aic lid R'aIl Enlarged Detail Condllloni lly APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE i84 69', 96" 1 C`'- 1399 Galion; I 11126 Gallons 42.06 GPI J) 26.16 GP N. SIDE VIEW ,s 4" Dudes 9" Air Space -f hi -a" 4IY' Liquid f i l e I 4; ., .. moor 3is �.J Manhole Openings rir Taper i �n� Produced by Superior Precast Concrete, LLC it PO Box 1390 2cm � Hayward, WI 54843 Pob-ethylene Elnffle 31a :tic Rope SUPERIOR PRECAST CONCRETE Design conforms to ASTM C1227, 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. I Product File Na: I This ispmprielaryintotmolion.ondrempim lhep,upeny of Superior Precast Concrete.LLC. I R.305-19.20241 PAGE 4 OF 4 Holding Tank Management Plan IMPORTANT: The owner of this holding tank(s) 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 holding tank(s) 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. Estimated Daily Wastewater Flow = Inspection Checklist INSPECT EVERY 3 YEARS SEP 282026 o type of use aayfiea co. o age of system ptwKp and Zoning Agenq 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 neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o electrical components (Le., wiring, connections, switches, controls, timers, alarms, etc.) o surface discharge of effluent or sewage back-up into structure served 300 RECEIVED SERVICING FREQUENCY o The tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wisc. Stats. when the wastewater in the tank(s) reaches a level of one foot below the inlet invert of the tank(s). Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. Tank pumping reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wis. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Northern Roots Septic Solutions Phone: 715.699.4081 Local government unit: Local government unit address: eld County Zoning Phone: 715.373.6138 117 E 5th Street, 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 component of this holding tank(s) cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agecy for review and approval. System Abandonment If use of this tank(s) is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. Real Estate Bayfield County Property Listing Today's Date: 9/24/2026 Description Updated: 6/30/2009 Tax ID: 16993 PIN: 04-021-2-44-06-34-2 05-002-30000 Legacy PIN: 021108001003 Map ID: Municipality: (021) TOWN OF GRAND VIEW STR: 534 T44N R06W Description: LOT 3 CSM #738 V.5 P.130 (LOCATED IN GOVT LOTS 1 & 2) IN V.859 P.378 TOG WITH EASE IM 2003R-482792 Recorded Acres: 1.000 Calculated Acres: 1.314 Lottery Claims: 0 First Dollar: No Zoning: (R-1) Residential -1 ESN: 114 1 Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 021 TOWN OF GRAND VIEW 041491 001700 SCHL-DRUMMOND TECHNICAL COLLEGE .}. Recorded Documents Updated: 3/15/2006 0 CONVERSION Date Recorded: 482792 797-629;797- 631;859-378 Property Status: Current Created On: 3/15/2006 115:27 PM S Ownership Updated: 6/30/2009 KATHY A JONES-LEDERER SOMERSET WI CHARLES A LEDERER SOMERSET WI Billing Address: Mailing Address: JONES-LEDERER, KATHY A & JONES-LEDERER, KATHY A & LEDERER, CHARLES A LEDERER, CHARLES A 2291 40TH ST 2291 40TH ST SOMERSET WI 54025 SOMERSET WI 54025 i Site Address * indicates Private Road 46763 FUNNYS LN CABLE 54821 U Property Assessment Updated: 11/28/2007 2026 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 1.000 93,500 0 2 -Year Comparison 2025 2026 Change Land: 93,500 93,500 0.0% Improved: 0 0 0.0% Total: 93,500 93,500 0.0% WProperty History N/A RECEIVED SEP 282026 Bayfield Co. Planning and Zoning Agency n fl � * 1 •� Fk - .1�, y .. C Yr� 1 <L rix t ___ hk ;% 1 MII` y . fi t HOLDING TANK SERVICING CONTRACT Contract Date /0-iy-ZoZ G Holding Tank Owner(s) Name(s) CLA7i,-0 A. L& Rf� This contract is made between the RECER/ED OCT 14 2026 eaync _I Planning Pumper's Name (Print) Pumper's Signature Pumpers' Registration # 1 I We acknowledge the installation of (a) holding tank(s) o e following property: (Provide COMPLETE legal descriptions) PROIECr Legal Description: Tax IDg 1/4, LOCATION (Use Tax Statement) 16993 _NE_1/4, _NW_ Town of: I Lot Size I Acreage Section _______34_ , Township 44 N, Range _______06___ W Grand View 42,099 sq ft. 1.314 Gov't Lot Lot U CSM U Vol. Page CSM DecU Lot(s) No. Block(s) No. Subdivision: 1. The owner agrees to file a copy of this contract with Bayfield County as required in SPS 383.55, Wis. Adm. Code. 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local government unit which has signed the pumping agreement required by SPS 383.55, Wis. Adm. Code, and the County, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the local government unit and the County named above within (10) business days from the date of change to this service contract. II, Owner(s) Name(s) (Print) Owner's Signature(s) SKbk , ed'al1d• girOoo me: onthis 4 _4,y C i-tk✓ o2/. c . , of•lr�ni�es fl , LeAee OYL,L � °" otery Public My EJtSisslbF2ElcQir�s on: y Revised: May 2016 (®May 2018) Drafted by Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (I)(m)] HOLDING TANK — MANAGEMENT PLAN The Private Onsite Waste Treatment System (POWTS) has been designed and is to be installed and maintained according to SPS 383, Wisconsin Administrative Code, Holding Tank Component Manual for Private Onsite Waste Treatment Systems (SBD-10571-P)(R.6/99) and the Bayfield County Zoning Department Sanitary and Private Sewage Ordinance. 1. This POWTS has been designed to accommodate a maximum daily flow of _300__gallons of domestic wastewater per day. P2EG•elveo 2. The owner of this POWTS is responsible for system operation and dcr 1 4 2026 maintenance, locking device, alarm and access. Plann.9,,B .aayfield Co. 3. The owner or owner's agent is required to submit reports as required by Jr'1 Z0"ingAgency 383.55(1), Wis. Adm. Code, to the Bayfield County Zoning Department. 4. Design approval and site inspections before, during and after the construction are accomplished by the county or other appropriate jurisdictions in accordance with SPS 383 of the Wis. Adm. Code. 5. Maintenance Cycle. The holding tank must be serviced by licensed pumpers. An alarm system is to be installed to activate when the tank is < 90% full. 6. Performance monitoring. At the time of servicing, the service provider files a report with the department of designated agent. 7. A User's Manual will accompany the component. It will include the names and phone numbers of local health authorities, component manufacturer or POWTS service provider to be contacted in the event of component malfunction or failure. 8. In the event that this POWTS or a component of this POWTS fails and cannot be repaired the owner will find in the User's Manual the names and telephone numbers of property licensed individuals to contact for such repairs. This agreement shall be binding on all assignees and heirs / a -p ID /G9Q3 _NE 1/4 of _NW_1/4 Section_34 Township_44_N. Range_06_W. Town of Grand View_ Govt. Lot Lot Block Subdivision CSM# Additional 1 // / a u/fonns/managementplan Revised: July 2013 i4 2�2JO Date )current Number/Plan I.D. No. HOLDING TANK AGREEMENT DOCUMENT NUMBER Nner Name (s) Owner(s) Mailing Address G / l 2O26R-61 41 7 1 eJ Qty CVW/k5 ZZQI 4O%L V'0/v\ 11�� DANIEL.. HEFFNER REGISTER OF DEEDS Ertel Identifier Number (PIN) Agreement Date (same as Notary Date) BAYFIELD COUNTY. WI We acknowledge that application is being made for the installation of (a) holding tank(s) RECORDED on the following property or that continued use of the existing premises requires that a 1 0/ 1 4/2O26 AT 1:O5 PM holding tank be installed on the property for the purpose of proper containment of RECORDING FEE: $30.00 sewage. Also, the property cannot now be served by a municipal sewer, or any other PAGES: 1 type of private onsite wastewater treatment system as permitted under Ch. SPS 383, Wis. Adm. Code or Ch. 145, Wis Stats. 1L1/4 ofnn At 1/4 Section Township 44-N. Range cW Town of ` rn.n A,t>r,� II Re Return To: Additional Legal Description: L 'c+ 2 G<xA 1 -7 3 a V6 P. 2O Gov't Lot — LotBlockSubdivision Lot '—as ttce CSM # %3Vol j_Page I3b CSM Doc# 3 4l., o4' pcT 152026 As an inducement to Bayfield County to issue a sanitary permit for a holding tank on the above -described following: 1. Owner agrees to conform to all applicable requirements of Ch. SPS 383, Wis. Adm. Code relating to holding tank installation and maintenance. If the owner fails to have the holding tank properly serviced in response to orders issued by Bayfield County or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, State., Bayfield County may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. Owner agrees to pay all charges and costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. Bayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days of 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. 3. The owner agrees to contract with a person who is licensed pursuant to s.281.17 (3) Wis. Stats., and chapter NR 114 Wis. Adm. Code, to have the holding tank serviced in accordance with Ch. NR113, Wis. Adm. Code, and to file a copy of the contract with Bayfield County. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the county within 30 days of the date of change to the service contract. 4. The owner agrees to contract with a person licensed pursuant to s. 281.48 (3) Wis. Stats., and Ch. NR 114, WI's Adm. Code who shall submit to the county within 30 days a report detailing the servicing of the holding tank. Bayfield County may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained. 5. This agreement will remain in effect only until Bayfield County certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. SPS 383, WI's Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. Owner(s) Name(s) — Please Print Subscribed and sworn to before me on this date: L- v/les r`. Lao ever — Notarized Owner(s) — Signature(s) NotaryPublic a > /---- •+' My Commission Expires: ' c ✓ .. Drafted by: ('3Z /¢ Date: "1 —ZO.Z. Personal information you provide may be used for secondary purposes Irmacy L u/forms/sanilaryMoldingTankAgreement 4.2026 13A 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: JONES-LEDERER,KATHY A 2291 40TH ST SOMERSET, WI 54025 LEDERER, CHARLES A 2291 40TH ST SOMERSET, WI 54025 Description Private Sewage System (Holding Tanks) Submission Number: SS -00851 Transaction Number: SS -00851-5827B Amount $400.00 Total: $400.00 Payment Amount: $400.00 Reference: 5441 Paid by: Northern Roots Septic Solutions, 12006 N US Hwy 63, Hayward WI 54843 Payment Type: Check Transaction Date: 10/19/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-154S STATE SANITARY PERMIT OWNER: JONES-LEDERER KATHY A LEDERER CHARLES A GOVT LOT: LOT: BLK: NE1/4 NW1/4 SEC:34,T44N,R6W TOWNSHIP: Grand View SOIL TEST: 35-03 NEW SYSTEM SYSTEM TYPE: Holding Tank PLUMBER: MARKS THOMPSON SCOTT ROUSH Authorized Issuing Officer DATE: 10/20/2026 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: # 877598 Condition: Properly Maintain System Per Recorded Agreement. Must be within 25 ft of an all- weather road. THIS PERMIT EXPIRES 10/20/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION