HomeMy WebLinkAbout26-0574BAYFIELD COUNTY
RECENE®TARY PERMIT APPLICATION
Zoning District
Lakes Class
I. PPLICATION INFORMATION
Soil Test
County l6 _ OS 7 Lj
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(Please Print All Information) pffl p a
No:
Permit No:
Property Owner's Name:
BaYfiekl � -r> 12$cN co.
05 HER F.q Plannin
County: Bayfield
Address of Property:
Property Location:
69g2o-ToQfa6QV-b l;A`fi=/6c'D W\ c11'"(
I'J.EY. SE /•,S27 TSl N,RO9 E(or)
Property Owner's Mailing Address:
Township:
Gov. Lot #:
59Y70 TVPN&r- ei, W
�,USSELi-
City, State
Zip Code
Phone Number
Lo
Block #:
CSM #:
CSM Doc
Subdivision Name
-gbA-1c16.W V1l
5'lgI
i1S?cy'i'73Z
t#
#
1 TYPE OF BUILDING: (Check One)
State Owned
Property owner email:
Tax ID:
❑ Public (Explain the use/purpose )
c+ ''tt1'1Vtt10 Avm@9 tib.i /. ,e,
•�uqs [�
® 1 or 2 Family Dwelling - No. of Bedrooms Svr+wuis
Ill. TYPE OF PERMIT: (Check only one box on line A. Check box on line B if applicable.)
A) ❑ New ❑ Replacement County Private Interceptor ENTERED
❑ Reconnection ❑ Repair ❑ Revision .. ❑ Transfer of Owner (List Previous Owner belo
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
2. Absorption Area
3. Absorption Area
4. Loading Rate
5. Perc Rate
6. System
7. Final Grade
Per Day
Required (Sq. Ft.)
Proposed (Sq. Ft.)
(Gallons/Day/Sq Ft)
(Minuteslinch)
Elevation(Feet)
Elevation(Feet)
VI. TANK
Capacity
INFORMATION:
In Gallons
Total
Gallons
# of
Tanks
Manufacturer's
Name
Prefab.
Concrete
Site
Constructed
Steel
Fiber-
Glass
Plastic
Exper.
App.
New
Existing
Tanks
Tanks
Septic Tank or
0
2000
2000
J
tQs1Sev
✓
c'
-�
r
Holdin Tank
Lift PumpChTanamber k / e
0
We isa
Si hon
VII. RESPONSIBILITY STATEMENT:
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Owner Name(s): (Print) Ifapplying for Section C above Owner Signature(s): 0 Stamps)
._.IOL Nt,q'PF.A 24o N
Plum rName: (Print) If apply (orsectionAor )above
Plumber o tamps)
MP/MPRSWNo:
329
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Plu Liar Address: (Street,City State, Zip Code)
PllumberPhone/Cell:
Plumber Email:
t t6 7 c9 S
J /S - Oci L
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VIII. COUNTY / DEPARTMENT U E ONLY
Approved
❑ Disapproved
Sanitary Permit/rransfer Fee:
Date Issued:
Issuing Agent's Signature / Date: N
�!.
❑ Owner Given Initial
Adverse Determination
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A � ( / ii (U. i
IX. CONDITIONS OF APPROVAL I REASONS FOR DISAPPROVAL:
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Plot Plan on reverse side
Lot Line
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Bayfield Co
I and Zmmc,g Agen
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Name of Frontage Road:
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 anddreirrlleld. IS NECESSARY, FOLLOW
wt�i STEPS 1-7 (a -o) COMPLETELY
4. Show the location of anyJaka, slyer, streaftf 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. W\ c
7. Show dimensions in feet on thg following:
a. Building to all lot lines I �O 4i.� *- f'ifl iA"l l3 i. Privy to building
b Building to centerline of road ) qq - ,,;VLL✓ j. Privy to lake, river, stream or pond
c. Building to lake, river, stream or pond p jj k. Drain field to closest lot line
d. Septic! holding tank to closest lot line (L�oAd4/ I. Drain field to building
e. Septic/holding tank to building ltgS m. Drain field to well
f. Septic / holding tank to well 5'7 n. Drain field to lake, river, stream or pond
g. Septic / holding tank to lake, river, stream or pondMlp� o. Well to building
h. Privy to closest lot line CJt1k
Email to: permits@bayfieldcounty.wi.gov
or Mail to: Bayfield County Zoning Department, PO Box 58, Washburn, WI 54891
ulforms/sanitary/BayfieldCountySanitaryApplication
Revised 91912026
Proofed by: _
Emily Macgillivray
From: Aaron Wszalek- - - <hammertime80@hotmail.com>
Sent: Tuesday, October 13, 2026 1:53 PM
To: Emily Macgillivray
Subject: Pearson tank and setback
[You don't often get email from hammertime80@hotmail.com. Learn why this is important at
https://aka.ms/Lea rnAboutSenderldentification ]
Hi Emily
So the pump tank at turner road farms is a Wieser W320 and the sewer is 25 feet away from the well. Hope this is all you
need but feel free to reach out if there is anything else. Thanks Emily
Aaron -One Guy Plumbing
Sent from my iPhone
4'-2"
4" CAST -A -SEAL
FILTER OR BAFFLE
4" CAST -A -SEAL
0
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INLET t41OUTLET
I I'
I TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
W320 -MR
TANK SPECIFICATIONS
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O
a
DIMENSIONS:
W
N
WALL: 3"
a
a
BOTTOM: 3"
COVER: 4"
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
a
HEIGHT: 58"
LENGTH: 4'-2"
WIDTH: 4'-2"
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BELOW INLET: 46 1/2"
LIQUID LEVEL: 43"
WEIGHT: BOTTOM 3.015 LBS.
COVER 870 LBS.
INLET AND OUTLET:
4" CAST -A -SEAL BOOT OR EQUAL GASKET
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN. SEE DETAIL #10
(OTHER STATES SEE CHART)
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LIQUID CAPACITY: 8.00 GAL/IN
LOADING DESIGN: 8'-0" UNSATURATED SOIL
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TANK CAN BE USED AS:
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SEPTIC / HOLDING / PUMP OR SIPHON
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COVER: MIX DESIGN #8 (NO FIBER)
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TANK: MIX DESIGN #10 (STRUCTURAL FIBER)
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CUSTOMIZED TANKS:
00
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
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REVIEWED BY N
REVIEW DATE
3
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SHEET NO.
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1
P '-3'FIELD 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
Private Interceptor
Amount:
Reference: 0029
Paid by: Josh Pearson
Payment Type: Check
Submission Number:
CS -00195
Transaction Number:
CS-00195-5BC4A
Amount
$50.00
$50.00
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 - Private Interceptor
SIGN -
SPECIAL -
CONDITIONAL -
BOA -
No. 26-0574 Tax ID: 36459
Issued To: PEARSON, JOSHUA L
Location: S27 - T51 N - R04W
Town of RUSSELL
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: LOT 1 CSM #1799 IN V.10 P.314 (LOCATED IN NW SE) IN V.1083 P.292
Residential Structure in A-1 Zoning District
For: Sanitation Permit — Private Interceptor
(Disclaimer): Any future expansions or development would require additional permitting.
Condition(s): Insulate as required.
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 20, 2026
This permit may be void or revoked if any performance conditions are not
completed or if any prohibitory conditions are violated.
Date