The URL can be used to link to this page

Home My WebLink About002-133-02-0701-SAN-2022-095 �'� �" Industry Services Division County � � " � _ 4822 Madison Yards Way ��t1r�Y G� .�� _ .. =p - Madison,WI 53705 Sanitary Permit Number(to be filled in by } ';, � _ ;!' P.O.Box 7302 C_ �'�-- ' Madison,WI 53707 LQ �� (��S State Transaction Number � Sanitary Permit Application � In accordance with SPS 383.21(2),Wis.Adm.Code,submission ofthis forrn to the appropriate govemmental unit I is required prior to obtaining a sanitary permit.Note:Application forms for state-0wned POWTS are submitted to Project Address(if different than mailing 0 the Department of Saf'ety and Professional Services.Personal information you provide may be used for secondary � purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. �,�� 43 W Ginc�e a✓� � 1.Application Information—Please Print All Information Property Owner's Name � Pazcel# D 7n Soh � o�"„e 1'��.h / Uv2 i3 302 / Property Owner's Mailing Address Property Location �gss �.�,a.,�s �r.,s Ciry,State Zip Code Phone Number �!'�or� �� l/V ,�'5�,31 2 <, Section �Z II.Type of Building(check all that apply) � Lot# � T 3 / N R �� E or or 2 Family Dwelling—Number ofBedrooms_. Subdivision Name Block# � OrE i� �a S �" K �ublic/Commercial—Describe Use � �City of ❑State Owned—Describe Use CSM Number illage of 37�1YS` #�$Sb�7 ��,�f 44ss �ak,e 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 a licable. `�' ew System nReplacement System ❑Other Modification to Existing System(explain) ❑Additional Pretreatment lJnit(explain) lJ B' �olding Tank �In-Ground �4t-Grade �Mound Individual Site Design Other Type(explain) ��a (conventional) C• ❑Renewal Before �Revision hange of Plumber �I'ransfer to New Owner �st Previous Permit Number and Date Issued Expiration -- IV.DispersaUTreatment Area and Tank[nformation: Design Flow( d) Design Soil Application RaRe(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation �� r--- Capaciry in Total #of Manufacturer Tank Information Gallons Gallons Units s, � o ,b, � New Tanks Existing Tanks � c � " � � � � 0 r� U va �, cia w C7 Gi. Holding Tank �$00�`��(J�I�o Z�UO t/'�t-t f'�� Dosing Chamber Q � V.Responsibility Statement- I,the undersigned,assume responsibility for installadon of the POWTS shown on the attached plans. Plumber's Name(Print) PlumbePs Signature MP/MPRS Number Business Phone Number Dylan Schultz 1516129 715-558-5904 Plumber's Address(Street,City,State,Zip Code) 7076N Stone Lake RD, Stone Lake, WI, 4876 VI.C u ty/Department Use Only �Ap r e ❑Disapproved Permit Fee Date Issued Issuing Agent Signature �v✓ ❑Owner Given Reason for Denial $-I��'�D � ! � � �� '" I'�-�'�"`-"^� Conditions of ApprovaUReasons for Disapproval D 5��r�� y I;I" i�f; (� �% �J � �e �� cs� a� -- �� JUN 0 3 2022 Q . SA�'JYER CG�.S�iTY ZONING ADMlNISTRATION Attach to complete plans for the system and submit to the County only on paper not less than 81n a 11 inc6es in size NO REFUNDS AFTEA SBD-6398(R.02/22) ISSUE OF PEFiM(T Sawyer County Zoning & Conservation Administration �� 10610 Main Street,Suite 49 � , 1� Hayward,Wisconsin 54843 � �I (715)634 8'88 � �� FAX(715)638 3277 .w � . i �. � p ♦ � . _.,__s:,1 �� N �.:�t � �Cg t� Ot.t� �-�� / E Ill�ll�./UIt I _t;lt 1c.�tillt t ;�f_? � �.' . `. .�. __ � �� .. Toll Free Courthouse/General Informahon 1-877-699-4110 / � /t��\�� Holding Tank Approval Checklist I. Sanitary Cover Sheet Date Stamp ��o / 03 / a � Parcel ID# d � � - ( .? 3 -o a- 0 1 a � li. Plot Plan � Property Lines �Benchmark BM ♦ nSite Address � North Arrow �(Structure �Scale fC Well �G<25' to Service Road �Legal Description �'Nearest Road Intersection � Setbacks to: Property Line, Well, Structure, Water bodies, Roads III. Required Plans �Index Page with Original Signature Manageinent Plan/Contingency Plan ervicing Contract olding Tank Agreement fonn IV. Holding Tank Specifications �Cross-section— Manufacture, Gallons: wi�er� �$�/��°D C Tank Anchor Calculations [SPS 383.43 8) g)] '�Locking device, chains/locks �Alann and Electrical per NEC 300, SPS 316 & 383.43 (9) (e) and State Statutes 10l.862(2) and 101.862(3) � 3" Bedding Material < 1/2 " V. Holding Tank Plans per Component POWTS Manual �l. �Version 2 SBD-10855-P (R.3/07)„ , � � . Owner: `rc� �� 1 Plumber: ��'`'��Z' Application Review Date: d6 �a6��--� POWTS Reviewer: �� N��„� 6�S�i� ��«�,s�a Revised 4/ll/2013 PAGE 1 OF 4 Holding Tank Plan Index & Cover Sheet Com on nt Manual Design References: Version�SBD-10855-P (N. 03/07; R 01/12),,, a�� Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan 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 applicable) Holdin Tank Pum in Contract if a licable) Holdin Tank A reement (if applicable) Project Name/ Description OwnerName(s): ��n E �`�`�� °`�x�`�N� Phone: - - Owner Address: g�s� �L9��S G�� Dr �r��er INI�i M�/ Z�p; SS 3 7 Z Project Address:�l S I 9 3�l ��^�� Dr Govt. Lot: 1/4 of 1/4, Section O 2 , T 3 � N-R �9 E Q or W� Township: ��SS (�� County: S�,wy�� Project Parcel ID#: (�2.- 133�d 20��I Designer Information Designer Name: Phone: / �s - S s� _ �IC� Dytan Schuiffi —� Designer Address: _ .,,,,, �.._ , ,,,,o � Zip: E-mail: Stone Lake,�� rChis space reserved for approval stamp. License Number: Remarks: Signature: Date: �'2g �2--Z-- Original ' ature r ed on each submitted copy. CHECK 00X AS APPLICABLE. CHECK BOX AS APPLICABLE. � SOIL EVALUATION o sca�e: �so so� 90 120 � SYSTEM PAGE 2 OF SITE MAP PLOT PLAN PROJECT NAME: 152 DESIGN FIOW: ?�v GPD Attach design flow calculations for commercial plans. PROJECT ADDRESS:�(��3 w 4'�`�` d� Pipe Material!ASTM Standard(Tables 384.30-3&384.30.5) N Sanitary Sewer. s`� Y° l BM mbd: �- BMElevation: ��'� FT �p � SGP�W 3C�� c�t� Oti�, Force Main: �°S / BM DescripUon: Indicate narth by IMPORTANT: Slope Gradierrt(i6) Well Symbd(if applicable): � drawing an arrow Show ground elevation contours at suitable intervals. of Tested Mea: on the approprfte line. � fYQ WG lI G�r��. �r 1 � � 1 � � � � � v � �, < < (�„��'-cketil�e.5 ��` � C l 2��.n. � � �M'`o � � I�� ; � ; cs�.., � �b7 � `, 3�� s � ' � �,i c�/ f ; l��Yad��ea �� (' o � � � 0 � 1 � �-- � �os�� , � � �ad"� � kqoa/ � �i N� / � O / � � �..�J � _� � — — — ' � � � �/ � �v L, qG Co��fc 8fc'�(c� WLP1800/1100 � ,5�-4• TANK SPECIFICATIONS � � 71" DIMENSIONS: '&' o WALL: 3' a a ------------------- ----------� BOTfOM: 5" 1'�- ��I�- r cov�: e• j 4" CAST-A-SEAL I fl I 4� CAST-A-SEAL� MANHOIE: 24� I.D. PRECAST CONCRETE RISER a I ii i i HdGHT: 62 3/4' �n� � LENGIH: 75•_4• , ��,-�� m�',�yp� ��-��i ii i �,-�� WID1H: 8'-8' � ;� ! ` �� ' � BELOW INLET: 50' � � � � �-� � L1WID LEVEL: 43' o � -'�1 rl i � � _. M�EIIGHT: BOTTOM 18,017 LBS - a g 8 i�_� i ii i� �i � COVER 9�300 LBS. " � o � i FILTER OR j�i i� i INLET AND OUTLET: � 'm o � BAFFLE i i i i i� i 4' CAST-A-SEAL B00T OR EWAL GASKET � � � � ,� i i i i ,� � a � .. r ----��}"-----------i , INLET AND W7LET BAFFLE AND FlLiER: S'i o o � WISCONSIN, SEE DETAIL /10 W� (OiHER STATES SEE CHARi) !„�� 7S��OE� L1WID CAPAqTY: 41.88 GAL/IN (SEPi1C) �� 25.58 GAL/IN (PUMP) �� LOADING DESIGN: 8'-0' UNSATURA7ED SqL ��a�o �w TANK CAN BE USED AS: <N Q� s�nc/s�nc, s�nc/PUMP. �o� � 4" VENT OR SEPiIC/SIPHON n�o + � COVER: MIX DESIGN /8 (NO FlBER) �� ____ TANK: MIX DESIGN /8 (SMALL FlBER) =� � ---- ' ---- ---- � CUSTOMIZED TANKS: �n INLE7 OUTLET FOR CUSTOM TANKS CONTACT MAESER CONCREiE 3 � � - --��-- � .zv N N aU I � e�f � 1 aa I rU . � � � a. `° 'on �v i c v' i.� ac� F �c � p Q 3� t`.�' I I'�� a i � � j I i /� I " � ;L_-.T__'_1__' ______�_�J .L�________�_J � � � -1. REIAEWED BY ao U � REVIEW DATE � a DRAWINGS SUBMITTED N SIDE VIEW FOR APPROVAL APPROVED BY: SHEET N0. AFPROVAL DATE: � � PRODUCTS NEEDED BY: � TANKS ARE MANUFAC7URED TO MEET OR EXCEED ASTM C-1227 REOUIREAIENIS � � PAGE 3 OF 4 HOLDING TANK SPECIFICATIONS (No Scale) 4"0 VentPipe Weatherproof >10 ft from Junclion and Alartn Box Approved Building A roved Lockin Manhole Vent Cap �2"Min.or 2.0 ft above Electrical must comply with PP 9 Established Flood Elevation q^Min.or 2.0 ft above SPS 316 and NEC 300 W�th Waming Label Attached ��YP��) Established Flood Elevation (rypical) Conduit �ryP��l) Airtight Seal � � � Finished Grede � 18"Min. ��YPical) . ''; ', • � �•,'4�.• , • •a .. . , , . , • : . ,„ ' • ' , 1. • T . , �, Inlet Inlet Invert Watertight Approved Joints with Plug Approved Pipe 3 ft onto Max.12"or 90°�of total volume ' Solid Ground if more than one tank �� tyP�� Alartn-0n 4, i• Compartment 1 Vol= � "vVgal Comparlment 2 Vol= I I Uv gal . ��• TOTALHOLDINGTANK •� VOLUME = 2-9 d d gal . : . •�. . • . . , . � . . ,,., . , . . , • 3"Approved Bedding Material Beneath Tank TANK MANUFACTURER: � � e S e� 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 Ibs/cu.ft)- Ibs]x 1.5= Ihs PAGE40F4 Holding Tank Management Pian 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= �__C�� gpd Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system 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 (i.e., wiring, connections, switches, controls, timers, alarms, efc.) o surface discharge of effluent or sewage back-up into structure served SERVICING FRE(IUENCY 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: ��/�"'� S`�''!� Z Phone: 7�'r�'5�� s �uY Local government unit: S4 w�/�� ^�y 2°'��^) Phone: ��s'" 6 3�/-g Z gg Local government unit address: h�«v wN'� �''� ZIP: �`f�`�3 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 witlh 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. Continctencv 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. Svstem Abandonment If use of this tank(s) is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. HOLDING TANK SERVICING CONTRACT Contract Date: ,s l l$ l ZD 2Z This contract is made between the Holding Tank Owner and the Pumper. Holding Tank Owner's Name: Pumper's Name: . I ' Tan � '� iw1e I�-x� � SCd�" �s P(�� Parcel Identification Number: (12 Digit Legacy ID) �� 2 -�3 �j -� 2- _ � � 0 � 1. The owner agrees to file a copy of this contract with the governmental unit, Sawyer County, which has accepted and recorded with the Office of the Register of Deeds, the Maintenance Agreement for a Holding Tank required under the Sawyer County T'rivate Sewage System Ordinance for the issuance of a Sanitary Permit for the installation of a holding tank(s). 2. The owner agrees to have the holding tank(s) serviced by the pumpe,r 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 all-weather 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 charges incurred in servicing�fie holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the Governmental Unit, Sawyer Coimty, a report for the servicing of the holding tank(s)as required under SPS 383.55,Wisc�nsin Administrative Code and the Sawyer County Private Sewage System Ordinance. The pumper fiuther agrees to include the following in the 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 site address of the holding tank; d. The date the holding tank was serviced; e. The volumes in gallons of the contents pumped from the holding tank for each servicing; £ 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 tt�is contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with Sawyer County within ten (10) business days from the date of change to this service contract. Owner's Name: (Print) OWriel''S Slg[11t111'e: (Only one owner signature required) �� ,� � N T �D �-f-f � �---� ,-� �-' Pumper's Name: (Print) Pump ignature: S��- Q�� Pumper's Registration Number: g1813 Rev.03/26/13 - USE BLACK INK ONLY - I I I I II I III IIIII IIII�I II I� II I � 0 � 9 6 8 6 POWTS MAINTENANCE AGREEMENT Tx:403846� For Holding Tanks 439499 Owner's Name(s)as shown on deed: PAULA CNISSER REGISTER OF DEEDS SAWYER COUNTY, WI Tl.e Son 0. � '�;hne 3, ��,,�.1 ��.�o�.b�� ws�- osiQsizoz� Q$;�g �ar� Parcel Identification Number: RECORDING FEE 30.00 (12 Digit Legacy ID) Q 0 Z - � 3 � - � Z - � � �1 PAGES: 3 Legal Description of Property: -SEE ATTACHED SHEET - We acknowledge that application is being made for the installation of a holding tank(s)on the property described on the attached sheet. Return To:Sawyer County Zoning and Conservation Administration 10610 Main St.Suite 49, Hayward,WI 54843 As an inducement to the County of Sawyer to issue a sanitary permit for a holding tank on the above-described property, the owner is responsible for the operation and maintenance of the holding tank, locking device, alarm and access, and agrees to conform to all applicable requirements of SPS 383,Wis. Adm. Code relating to holding tank management, including the following: 1. The owner agrees to contract with a person who is licensed under Ch. NR 113,Wis.,Adm. Code, except as provided by Section 281.48 (3) (d), Stats.,to have the holding tank properly serviced and to file a copy of the service contract with the governmental unit. 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 governmental unit within ten (10)business days from the date of change to the service contract. , 2. The owner agrees to contract with a person licensed under Ch. NR 113,Wis.Adm. Code,who shall submit pumping reports to the governmental unit in accordance with SPS 383.55,Wis.Adm. Code,for the servicing of the holding tank. In the case of exemption under Section 281.48 (3) (d), Stats.,the owner shall submit the report to the governmental unit. The governmental unit may enter upon the property to investigate the condition of the holding tank when pumping reports may indicate the holding tank is not being properly maintained. 3. If the owner fails to have the holding tank properly serviced in response to orders issued by the governmental unit to prevent or abate a human health hazard as described in Section. 254.59, Stats.,the governmental unit may enter upon the property and service, or cause the tank to be serviced. Pursuant to Section 145.20(4)Wis. Stats., a governmental unit may assess the owner of a private sewage system for costs related to the pumping of a septic or holding tank.The charges will be assessed as prescribed by Section 66.0703, stats. The owner agrees to pay all charges and cost incurred by the governmental unit 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. 4. This agreement will remain in effect only until the governmental unit responsible for the regulation of private sewage systems certifies that either a soil absorption system that complies with SPS 383,Wis.Adm. Code, or a municipal sewer serves the property. 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. 5. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit the 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. -O wner signature requir ACKNOWLEDGMENT Owner's�'gnatur . State of: lJ �SC o�S � �'� L__". . i County of: _�r,.�ye�' Owner's N e (Print): Subscribed and sworn to before me on this '^ {�„� �, l�✓) G�'�'1 �� s � day of �� , 20 :�� Date: �y""�rN By ��0'��:,, �c�/� c�� Z— No�B�t��ui�lic'S�igf�tGr,e: Drafted by: 'q� �G�v /j� P�ib'h�•N��I-�►��e (f'r�nt): � l-f� Z(:��,,�v � y �T - . I�y cor�i�oa expires3�n: i , �• pUB�-�G 'y?;. . �., .••�. Personal information you provide may be used for secondary purposes[Privacy Law,��tF(�fri��lj,�c�G�••� Rev.03/26/13 F V� � ��1�1111�11N��', Lot z as �recard�d i� 'Vc�lume 37 a�'C�rti�ed Survay �aps, pa�e �4S, Surv�y l�a. 85�' as �ooum�nt h�a, �32874, locat�d in tha Town af�ass Lat�e, Sa�yer �ount�, W a$cpnst�n, be�n� a pa�t of�.ots 7.and S, B1Q�k � in Court �ueeilles Park S�eond Addit�dn, esm �5�� . 0 0 IIIIII I�II IIIIIIIII�IIlllll 432870 $ PAULA CHISSER Tx:4030447 REGISTER OF DEEDS SAWYER COUNTY, WI 06/24/2021 09:43 AM RECORDING FEE 30.00 PAGES: 2 VOL: 37 PAGE: 145 SAWYER COUNTY CERTIFIED SURVEY MAP CSM MAP #: 8567 A DlV/SlON OF LOT 3, CSM#7994, DOCUMENTlR391477, VOL 33,PG. 149-159„ LOCATED/N PART OF LOT 7&8, BLK 2, !N COURT OREILLES PARK 2ND ADDN, GOVT LOT 1, SECTION 2, T39N, R9W, TOWN OF BASS LAKE, SAWYER COUNTY, W/SCONSIN. 589'46'16"f - 2023.04' FD.ll/4"/RON ROO N2-NOTE 1 f0.4"CAP/P SET IRON ROD SI]"IS OS"£.73; CI-CURVE 1 NW CORNER W.C.TO M.C. FROM TRUE CORNER POS?/ON CB-N71'1731"W SEC 1,T39N-R9W SEC.1,T39N-R9W qN0 SOUTH R-0-W, CD-57.94' s CORNERFA(LSlNATRfE RR136.638 j�16S9� \ DA-24 28$3" N z 4�8 E �� `\ CURVE 1) � O = .ysNsi y1,j�� C9-572`32'2 7"£ O � ' l q4l S 9y �sii ci�avF�o rn-s�sa• ~ y � �CO]�j 8 9�'��j �CLFpR� ARC-5833' o�W = 1 ��Sj,� ��. l�l? �-w,,i,,�ce._ rs-iss.sz I . DA-24 4134•, Z -i io � NI M�' �c�r � TODD C. �` �=v c� GOOLD . �� —_ � �`' m � 5-2489 � ` -- I iy Q �n 2 � r' I� � r--- iz.sa' . . c1 � � HAY�T�7�j� O I SEP.T/C I �j W L_____ . y� �f ? Oi O�, .��j� WI�•� ;q ' ' . ' . r - oQ l'� Oc � i/� I� ' ' . . n C F' Z > M �.J �U� \ . . � . _. q Q q � � p ' . . w . WOmQQ ._..._ . . O . mZF- �n 2 . q"' . . � \ . NOTE2: ;v ,\ � . �, WI-236.?O,PL1T71NG[ANO � 3 � ' . . (6)PUB(IC7RUST 1NFORMAT/OK `��'y . �. ' ' 11NYlANDBELOW7HEOFDINARYHIGHWATERMARK ^ ' � OFAlAKfORA .o o m � � N . � � NAVIGABLE STREAM lS SUB1fLT TO THE PUBL(CTRUST - fNNAVIGABIEWA7ER5 ^N : ' o� � � �. �� THAT IS ES7ABLISHFO UNOfR ARTIClE IX,SECTION 1,OF �a � �a w THE57ATECONSTITUTION." � � . -�'_ � m`r�:. 'o ORDINARYHIGHWATERMARKANOWA7ERSE�GE : ' � � � � � INUICATEDON7HISSURVEYDOQ/MENTIS ' LOTI � -� APPROXIMATEAND FOR REFEFEN�ONLY. LOT� � ' LANOS 40,�126 SQfT+- � �7 047 SQFT+- � �Ds �ori .92qCRESt- •85ACRE5+- COTI CSM N8286 CALC TO WATERS FQGE Z C'9LC TO WATERS EDGE csrH a�s�s �A �1 W GRAPHICSCALE � � 75 O 3]S ]5 .. - . . � " ; �581�2 E I36.23' N87'S7'31"E� 1 inch= 75 ft ^ ' - lqz.8q' � � � ��' LEGEND — —J � WATERS EDGE/ �KE OHWM � ser s/s^x is"SQ/RON ROO,N/L=1328p/FT LAC CO URT O FOUND 1 Z/4"O.D.IRONPIPE TOTAL AREA ��1sz sQ�'a- OREILLES $ PL55 CORNER(AS NOTED) 1.77 ACRES+- CALC.TO WATERS EDGE CtlENPSMARONKA6£F SCAlE-f INCH-]5' PROPER7YL/NE Mnvoare.�G��s/tou fIElO WORK�G/IQ/SAL (XXXX) RECORDED M£ASUREMEM � � FILE:0339Q9Qwg � FOUND 5/8"ROUND lRON ROD SURVEY BY: ��1��i\_ �j � . . . _ . BUICD ABCE AR£A TODD C GOOLD-RL5�9 i�'o �.t Norf.S LOT Z-14,425 SqFi+- DATED THIS:JUNE 187H,2021 "` LOT 2-16,147SQFT t MoywaN,Hn ns.me.cei� rodd@poiMnorthlaMmnr SHEET 7 OF 2 SHEETS 432870 � of 2 5/31/22, 5:47 PM Real Estate Sawyer County Property Listing Property Status: Current Today's Date: 5/31/2022 Created On: 6/28/2021 8:45:41 AM �Description Updated: 6/28/2021 � Ownership Updated: 7/22/2021 _______.._____ ��__._---------- -. __ ____..�___. ..__m._._. __�___ ----- ----. .__._.. _.---- __ _------ - -.____ _ ._.___ _____.__. Tax ID: 44236 70N R&DIANE)TAXDAHL REV TRUST PRIOR LAKE MN PIN: 57-002-2-39-09-02-5 15-170-020701 Legacy PIN: 002133020701 Billing Address: Mailin9 Address: Map ID: 70N R&DIANE)TAXDAHL JON R&DIANE)TAXDAHL Municipality: (002)TOWN OF BASS LAKE REV TRUST REV TRUST STR: S02 T39N R09W 8855 LEGENDS CLUB DR 8855 LEGENDS CLUB DR Description: COURT OREILLES PARK 2ND ADDN LOT P�OR LAKE MN 55372 PRIOR LAKE MN 55372 1 CSM 37/145 #8567 Recorded Acres: 0.850 � Site Address *indicates Private Road Lottery Claims: 0 __e_------.__ .,..__.- ------______.__ ___._____ ,...______ _..__z___._.___ 15193W CIRCLE RD HAYWARD 54843 First Dollar: No Waterbody: Lac Courte Oreilles Zoning: (RR1) Residential/Recreational One � Property Assessment Updated: N/A ,___ _ __- - ------�---�—�_---- -___ - __---- _._--._ ---- ESN: 407 2022 Assessment Detail Code Acres Land Imp. � Tax Districts Updated: 6/28/2021 N/A _�_ �_----____�______.____---------_e.------------ 1 State of Wisconsin 2_Year Comparison 2021 2022 Change 57 Sawyer County �nd: 0 0 0.0% 002 Town of Bass Lake Improved: 0 0 0.0% 572478 Hayward Community School District Total: 0 0 0.0% 001700 Technical College i Recorded Documents Updated: 5/11/2011 �properly History _ _._____ _ _ _.. _ ____ .__.___ ___ _ ______��--.--____ � WARRAN7Y DEED _----_e______ .-------- ____.___� _.._,__,___---._.�_------ Date Recorded: 7/20/2021 433391, Parent Properties Tax ID 57-002 2-39-09-02-5 15-170-020405 41883 0 CERTIFIED SURVEY MAP Date Recorded: 6/24/2021 432870 0 QUIT CLAIM DEED Date Recorded: 12/12/2018 415762 � WARRANTY DEED Date Recorded: 12/10/2018 415734 0 EASEMENT RELEASE Date Recorded: 3/9/2018 411384 0 CERTIFIED SURVEY MAP Date Recorded: 7/30/2014 391477 0 PERSONAL REPRESENTATIVES DEED Date Recorded: 4/13/2011 372123 HISTORY 0 Expand All Histon! White=Current Parcels Pink=Retired Parcels O Tax ID: 919 Pin: 57-002-2-39-09-02-5 15-170-020402 Leg. Pin: 002133020402 Map ID: -2i).2.4.2-2.8 0 Tax ID:41 83 Pin: 57-0 2-2-39- 9-02-5 1 -170-020405 Leg.Pin: 002133020405 https://tas.sawyercountygov.org//Access/REAL%20ESTATE/listi�g.asp?tid=0&pid=44236&tyr=0 Page 1 of 1 �� '`"``';, PRIVATE ONSITE WASTE TREATMENT county �' � SYSTEMS Sawyer ; DS ,�� Ps ,� ( POWTS) \;�<�='% �''�""v�'' INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �� _��- Personal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)� Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#: 5�0� �- taahe �'a,��,� �ss (�k� — Insp BM Elev: BM Description: Parcei Tax No: 10 0.p � �► Q.� a`� s i�' g►�1�� = 9 �'-°`".�,�' o°a —(33- 6� -0 7� ) TANK INFORMATION �; ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Benchmark � (OD,f�� Dosing �►�a fj �00.6 ' Aeration Bldg. Sewer �7 4 r Holding w;�- l aop 'gb0 LP St/Ht Inlet �7.6� TANK SETBACK INFORMATION St/Ht Outlet �7 Y ' TANK TO P/L WELL BLDG vENr ro ROAD Dt Inlet AIRINTAKE Septic NA Dt Bottom 4Y�a' Dosing NA installation Contour Aeration NA Header/Man. Holding 3` '�-�.. � �-5' �S Dist. Pipe PUMP 151PHON INFORMATION Infiltrative Surface Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS W � #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav ° Conv ❑ Aggregate INFORMATION P/L Bldg Well Waters o GP ❑ Chamber Model Number: ❑ EZFIow CELL TO ❑ Mound o Other _ - -- --- -- --__-- - ___ -- DISTRIBUTION SYSTEM X Pressure Systems Only — -- _— �--- - Header I Manifold Distribution Pipe(s) X Hole Size ; X Hole Observation Pipes Length Dia Length Dia Spac__ i, Spacing ❑Yes ❑ No SOIL COVER _ ----— —_— -- — Depth Over Depth Over Depth of-- � Seeded/Sodded � Mulched � Celi Center Cell Edges II Topsoil ❑Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present,etc.) �� r(3o�� '� � � '�� Pian revision required?�Yes❑ No � � �3 I z3:, ; , G��I� � — � _--�� --� Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AOOITIONAL COMMENTS ANO SKETCH SANITAqY PEFMIT NUMBER�. a�-�'�IS ..��._�.O �n�.l ti- �� . L/ 3� q �� Yo� . 5,.rnyQ- 1 z��tn �` i , s'i�� . ��4'3�� w��°��/�� t ��`� a � � � � IS��3� Q�. `� �';� r-P�— 5�� , _