HomeMy WebLinkAbout026-939-23-3206-SAN-2022-205 ��'�`' '3' s, Department of Safety �°""�' ��w � �
� �'�_"
• 9 `-t & Professional Services,
" � i�i Sanitary Permit Number(to be filled in by �
���' �' �'� ,� Industry Services Division
, �
_ � L,;'�n � c�S 4J
�
State Transaction Number �
Sanitary Permit Application ^ �
In accordance with SPS 38321(2),Wis.Adm.Code,submission ofthis form to the appropriate governntental 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 `n
the Department of Safet}'and Professional Services.Yersonal information�-ou provide ma� be used for secondan° �ry� �,,,,:t��_ �� "�
purposes in accordance w�i[h the Pri�ac��I.a���.s. 15 04(1)(m),Stats. �
I.Application Information-Please Frint Al1 Informatiou
Propert��O�vner's:�ame Parcel# �
. 7� � IQe�1 L LC._ 0�6 -�3q—,23 — 3�0�
Property Owner's Mailing Address Property Location
�G ��- G< /`-/'S Govt.Lot
City,State Zip Code Phone Number � �
� S c� `7 '/<, '/a, Section
����,.�i 'C`� �....ct -'�, C.t.J�— - � �
II.Type n�$ti�dtg(check all tbat sFPiY) Lot N C 3 c N R � E or�
$il or 2 Family Dwelling-Number ofBedrooms � 2, Subdivision Name —
Block#
❑Public/Commercial-Describe Use
�- ❑City of
❑State Owned-Describe Use CSM Numbe r_� ❑Village of
��JS
3 g �o�of �:,�-c �����.
8
III.Type of POWTS Permit:(Check either"New"or"Replacement"and other appiicable on line.��. Check one box on line B.Comptete line C if
a licable.
� New S stem
� y ❑ Itcplacement System ❑ (�ther Modification to f?xistmg System(explain) �.� Additional Pretre�tment Unit(explain)
B.
�Holding Tank ❑ In-Ground ❑ At-Grade ❑ Mound ❑ Individual Site Design ❑ Other Type(explain)
(comentional) •
C. ❑ Renewal Before ❑ Revision ❑ Chanee of Plumber ❑ 'rransfer to New Ow ner
ist Previous Permit Number and Date Issued
Expiration �
��: ` r r�ahnent Ar�a�r�td'��nl�.Iut'ormation:
Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(sfl System Elevation
3 GV - � -- �
Capacity in Total #of Manufacturer
�
Tank Information Gallons Gallons Units � U U � �
New Tanks Existing Tanks L o � � � � � �
a. U v� �, v� ii. C7 f1.
Septic or Holding Tank �sCj�j �-_ '�,�:�C�'� � (,� (F, � �
-4r
Dosing Chamber
... . . . , . . . . . . . ....
V.Re9p�i� �, ,� ��8tement-I,�lie,+��deraigned,asaume responsibility for installati�r».�t`hhe�'UWTS shawn on the attaehed plaus.
Plumber's Name(Print Plumber s Signature MP/D,9PRS Number� Busincss Phone Number
Jerry Ruid �xcavating, LLC � � �.�� �.�� Z �,� �-< <�z _ z��,7
Plumber s d s . i , t t , ip Code)
Stone Lake, WI 54876
VL CountylDepart�nent Use Ooly
�A o ed'� ❑Disapproved Pcrmit Pee D.ite Issucd Issuing Agent Signature
�LJ oo �
�b✓ ❑Owner Given Reason for Denial (��' �� ��J r�-t � �!�"
Conditions of ApprovaUReasons for Disapproval - ,�`�'�c,;�ti in��rr,:`ry�--
�s 1 c� a� ���� �j;�� e���, \'�' ��i n
�� Date � � (�
'� hk# - AUG 1 —
�' c �`�� 2 2022
�
1 Wu r f� �` ���1�{' J
CS� Iv ' ) �2��t#0�_�5�.'....�._._. . ..�. SAWYER COU�f�Y
� �, � � � �C�NING ADMINISTRATIOrd
Attac6 to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size
NO RE�JNDS AFTER
SBD-6398(R.03/22) ISSUE OF PE'F�MtT '�ys� �
Sawyer County Zoning & Conservation Administration
```"� , , 10610 Main Street, Suite 49
� , � ,-, 1 � Hayward, Wisconsin 54843
� % ,� , �I (715)634 8288
� ��„�. � � '.���� �� FAX (715)638 3277
� 4 � , � ` *
� /
� 1 i , �,....y � � � �i��_t_�t � tt�tc cou } 1���'—�`t�'
� � �� _� ,, � � �_ i E mail zi �i3u� ��c r ,a i}3����cc�u»i�s a�.rir�7
�� `� �: � Toll Free Courthouse/General Informatwn 1 877-699-4110
�� :,:- -:.�`..
� ( \ 3 P �
� ' 1`,`�"``�
Holding Tank Approval Checklist
I. Sanitary Cover Sheet Date Stamp t> g / � � / � �
Parcel ID# C� � �O- c13 �- � 3 - 3 a � �O
II. Plot Plan
/� Property Lines x Benchmark BM ♦
� Site Address %� North Arrow
Structure Scale
� Well �< 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
� Management Plan/Contingency Plan
Servicing Contract
� Holding Tank Agreement form
IV. Holding Tank Specifications
� Cross-section — Manufacture, Gallons: �^' �eS-e� �.��
�Tank Anchor Calculations [SPS 383 .43 8) g)]
Locking device, chains/locks
�Alarm and Electrical per NEC 300, SPS 316 & 383.43 (9) (e) and
State Statutes 101 .862(2) and 101 .862(3)
� 3" Bedding Material < 1/2 "
V. Holding Tank Plans per Component POWTS Manual
� Version �, SBD-10855-P (R.3/07), . ,
�_ \
O��ner: � ���_
Plumber: 5 �'�^ � �
Application Review Date: g � c s 1 a z Cg'l 6 (2 �)
POWTS Reviewer: ��- (-�
Name �� � ��
Liccnsc #
Revised 4/11/2013
PAGE 1 OF 4
Holding Tank Plan
Index & Cover Sheet
Component Manual Design References:
Holding Tank Version 2.1 (May 2022-2027)
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 a licable
Project Name/Description
Owner Name(s): 5�-��,v �;,�.�y Phone: - -
Owner Address: P ��k i yS 5;�:v� <«ke «'L Zip: s`�'�76
Project Address: H4r.. LaY� t„�
Govt.Lot: Nw 1/4 of s� 1/4,Section 2 3 ,T 3`� N-R `'� E 0 or W❑k
Township: s��.,,,�� l.�kc� County:
Project Parcel ID#:
Designer Information
Jerry Ruid Excavating,LLC
DesignerName: W208Co��nt��HWY11 Phone: 7�5� -44�-2Ko�
Designer Address: Stone Lake,WI 54876 Zip:
E-mail: � ��•C�(���C c:vY2����'�� N�i This space reserved for approval stamp.
License Number: z N 2`�� �
Remarks:
n r�, .�
Signature: a�� " Date: f i 3-z z.
-��ti inal signature required on each submitted copy.
v
Reset Page
. CHECK BOX AS MPI,K'J1BLE CNECK BO%AS APPl1UBLE.
� SOIL EVALUATION o sm�e: ,�ao� � � Q SYSTEM PAGE 2 OF
SITE MAP PLOT PLAN
PROJECT NAME: , DESIGN FLOW: 3Gri' GPD
'� , t y 10
�5�.� Attech design flow calculationa tor commercial plans.
PROJECT ADDRE36: K4fvl �-���C'-. �-ti Pipe Material I ASTM Stand,prd(Tables 364.363&364.3QS)
i ,
��, � 90nlfery SBWEr L/ ' '��L`C- � ScG�ct{✓`P YO
BM 8ymbd: � BM Dev�on: FT Force Mein: /
eMoeecapfwn: �Z\' Nnyr�l� lN ..<G. Sc re_c.J
Indifare norN by IMPORTANT'
Slope Gredbtd(%) -- WellBymbd(RappllddeJ: Q erawmp en armw Show ground eleva6on wnfours at sui�ble intervals.
d Teded AIBi: p�Ne apptvprite lire.
� Sl3 � UrerS:�;� 2_ (
� /v`z�"S- 1�_ �� . 3��7
�
25vo �iir�SGo- � 11n; �
1-lo��,s �. ' `C`i��
3 ��f i�.,k s�t� — �� �<�
` R o�,.ti-,
1��� (�
��z
s�
w
I
i
� �i
� /
I
,� �/
N4.+7 ��� L.,,
Jerry Rutd Excavating, LLC �a�' Z'
W208 County HWY A �. s..-, - �ss
StOne Lake.WI 54876 V� ��.xe_ 3�
/J?/�j('S - z�/z`�6z /'� �
�, ` �� 23 � 3� •�
�' � �w1 s��„�.
� y
Rns�
PAGE30F4
HOLDING TANK SPECIFICATIONS
(No Scale)
Weatherproo( 12"Min.or 2_0 ft above
Jundion and qPP�� Esfablished Flood Elevation
Alartn Box Vent Cap (�YPical) .
Electiical mual comply with 1 Approved Locking Manhole
SPS 316 and NEC 300 4'O Vent Pipe � with Waming Label Attachad
Conduit >10 ft from (typinl) 4"Min.or 2.0 ft abwe
Building Established Flood Elevatlon
(�YPical)
Airtight Seal
. Finished Grade
78'Min.
(rya��0 ';: ' .. ' .
. y , . '
. .- �� ° �
Inlet Inlet Imrert Watertight
Appioved,binffiwiMi . Plug
Apprwed Pipe 3 ft onto � Max. 12"or 90�0 of total volume
Sdid Ground if more than one tank
a
" Alarm-0n
i
i
HOLDING TANK
VOLUME _ <��� gal
.
. a . . , � . . ..
3'Approved Bedding Matenal Beneath Tank
TANKMANUFACTURER: G-"�S�`�
Anchor tank as necessary
pursuant to SPS 383.43(8)(g)
Ballast Weight= [(cu.ft.tank.vol x 62.4 Ibslcu.ft) - ibs.tank.wt]x 1.5
Ballast Weight= [( 'z � cu.ft. x 62.4 Ibs/cu.ft) - � �"" Ibs] x 1.5 = 12.��� Ibs
Reset Pa e
PAGE40F4
Holding Tank Management Plan
IMPORTANT:
The owner of this holding tank(s)shall be responsible for its perpetual operation and maiMenance pursuaM to
requiremerrts of SPS 382-384,Wisc.Admin. Code. Pursuant to SPS 383.52(2),Wisc.Admin. Code, this holding tenk(s)
shall be considered a human health hazard'rf not maintained in accordance with this approved management plan.
Furthertnore,all inspection and mairrtenance acKivi�es shall be perfortned by a registered POWTS Maintainer in
accordance with SPS 383.52(3),Wisc. Admin. Code.
Estimated Dally Wastewater Flow= 3� gpd
insoectlon Cheeklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance faGors(i.e. odors, user complaints, etc.)
o mechanical malfunction (i.e., pumps,valves, switches,floats, etc.)
o material fatigue(i.e., leaks, breaks, cortasion, etc.)
o neglect or improper use(i.e., exceeding design capacities, prohibited adivities, etc.)
o electrical cbmponerrts(i.e.,wiring, connec5ons, switches, controls,timers, alarms, etc.)
o surface discharge of efFluent or sewage back-up into structure served
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 roports shall be submiCed to the proper local govemment unk in aeeordanee wkh SPS 383.55 ws.
Admin. Code. RepoR any eomponent failure or malfunctlon to:
Name of individuai or company: SGo7T'S S�pY� G- Phone: 7�S-C�`trj- 72 7 q
Local govemment urrit 5�w y�t' �o . Z o,•� r.:.,� Phone: -7/S- C"��{- $?.�$'
Localgwemmentunitaddress: }(3C�IO W�A.t�v Si SucTp� �1c( �yWa('aZIP: �ti8�(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 maliunctioning components shall comply with SPS 383,Wisc.Admin. Code.
No product for chemicaf or physical restoration of the POWTS may be used unless approved by the department in
accordance wfth SPS 384,Wisc.Admin. Code.
Corrtinaenev 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 shail be abandoned in accordance with SPS 383.33,Wisc.Admin. Code.
HOLDING TANK SERVICIIVG CONTRACT
Conuact I)�ate: o / fa/ 012
'Phte contract G made between the Holdiog Tank Owner and the Pumper.
Holding Tank Owner's Nrmme: Pumper's Name:
S<q.�.: 1�:� �t Y scc''Gf S S�ra �`t �
�v.*do,4.� I,,, � Y
Par�cel IdentiH�xtion Nnmber: o a _ � 3 �- 3 3 2 `v �a
(12 Digit Legacy ID) --�o --� -------
1. The owaer agcas to Sle a capy of�is wnuact with the govemmental imit,Sawyer CoimtY,
which has acxepted and rxorded with the Office of the Re�stet of Dads,the Maiatwmcx
Agcxment for a Hold'mg Tank requiced under the Sawyer Couniy Private Sea�age 3yatem
Ordinance for tl�e issannce of a Saaitary Pe�it for the installarion of a holding tank�(e).
2. The owner agcees to have the holding ffink(s)aerviced bY�e P�er�d Su�n�s to
pecnrit the p�er to Lav�e accese and w enur upon the property for the ptapoee of eerviciag
the holding tanl�s). The ownec egrees to maiatain the all-weatha��accees road or drive eo
thffi the pumper can savicx tl�e holding tanlc(s)with the P�P�B�t• The ownec
fiuther agcxs w pay t�pumper fa�r charges incurred'm servicing the holdiag tnnlc(s)as
mu�llY a�ced u�bY the ownc and pumper.
3. The pumper agras to submit W the Govemmeatal Uait,SavvYer Crnmty,a:eport for the
aervicing of the holding tank(s)ae raluired imder SPS 383.55,Wiecon�n Adminis�tive
Code and the Sawyer Cou�y Private Sewage System Ordinance. The piunper fiather
agrees to include the following in the report:
a The na�e and addteas of tix pason�ble for servicing t}ce holding tan15
b. The mme of the owner of the holdiag tank;
c. The ffite addcems of the hold"mg tank;
d The date the holding tenk was aervixd;
e. The wlumes in�llone of the contenffi pimiped fi++om the holding taalc for each secvicin�
f. The disposal sitea to which the contenffi from the holding tanlc were delivaed.
4. This agroemeat will remain in effcct until tbe owaer or pumper temssnates this ca�hact. In
the cvent of a change in this coa�act,the owner a�ees to fi1e a copy of any changes to tbia
aervice contract or a cwpy of e aew secvice conuact with Sawryer Caunty within ten(10)
busineas days from the dax of change to this scrvice caatxact
Owaer's Name:(Print) i o.e ew.r a�r�o.eeyde.a)
�d ir��;l-Y� ���--�`� �—�
Amtper's Na�e:(Pr�t) 's Signa4m�
�C�'�I�"�Ci�' ���� ����'�
P�per's Regiahati�Number:
c�l � �
Rev.03/2Ni3 .
I'��il!lillll'�II I.I'�III!I'�IIII'I
� � � 5 2 3 0 9
"F:4040093
•!�E BLACK MK ONLY- 440811
PAULA EHISSER
�Q�$ �IANCE M�REEMENT REGISTER OF �EEDS
SAWYER COUNTY, WI
For Holding Tanks 08/16/2022 08:44 AM
�����: RECORDING FEE 30.00
� �J��Y pex2�o�w�¢h�� LLL, PAGES: 2
c,:o�o�wor�m � o a (�- 9 3 9 -�.�- 3 3�4z
�
-�A7TACH�S}I�T-
w..rbnwi.ao.uruva��r e�tn�.a.r«er e,.e.w�,ar.xomw+w�.)m n,s
po�.q�e.wb.d a,9..�wiw aMet.
R�m Ta Mlr Ceog�oednY�ed Cawwwllan AdmYd�tlon
10M0 Y�ft�dY M.►b�41N1 SIW
Ir�n 6iduo��wit b tlr Ca+iy of 8�wy�r So bw�ard�ry Dennit tor�hd�rq trdt an th��bov�ds�ab�d P�oP«tY.tlr owrrr b
rupaMW,ror tu op«.ua+.a nrinw,.b.or uu holdna Lnk�a�,r�rm.na.m..�.na ay...a oonlbne ro■n
�PPbbM rp�rtrt�d d 8P8 3ai.W1s.11dm.Cod�tNNlnp Oo hoNflnD��O�L��d�dk�O 1M foibw�p:
1. TTr awrr��b mn4att vdlh�pwwn who k Ilarnad uM�r Ch NR 113,Wis.Adm.Cods,el�pt f�pw�d�d bY
8wlen 28t A8(�(d�81ab..b 1rw ths hddinp fenk v�DehY ssrviad�nd to tfls a ooPl�af tlr�ervke mntraet w9h tha
powrmwrtd u�it. T}r awrrr NAFrr�s to 1B�a oopy of e�r ctwq�s�o tlr�srvbs mntr�ct a s aopy d a nww�erNw
aon6�ak wllh tlr powmrtrnhl urdt wMMn bn(10)businea dM ftom Vw�9s d ctr�ps 90 ths�etvla cameat
2 TTr oaMr qNs b mntrad Wth�penon Aoawd undsr Ch.NR 113.Wk.Adm.Cod�.wAo drN wrbrt�pianpt�p�potb b
tlr po�mrrnW uiR in�000�dria wMh 8PS 389.66.Wk.Adm.Cod�.for ths�rvfdrp d ths hwl6np ta�lc. M tlr eaM d
u�inlr�D��O�t�o)(�1M coMMbn d the Iwldirq tr�ik vA�f PumWnC�urrNf'kd'�wb0�'
hol�rp SWc k noR baYq piop�rly nrirtlatr»d.
3. If tlu a�rtrr f�b hNs ths hddtp bNt ptop�tfy a�rvlc�d In rwporw to aWn iNusd by Vf�po�wt�vrrnW urdt b P�
or�6�Y a humrf lr�4h Fuard a�d�d tr�Secllon.254.�,9t�s.,Uis pov�rnrisnW iatlt eMY Mtbr upon ttr D�D�Y
rW�vlo�.a�iw tlr LNc b b�MrMad. Piaw�nt bo 8�etlon 1,5.7D(4)Wb.80�t�..a porrrurwtl�l uNt mry��r ths
awr d�PAwY�wrp�sy�Ym kr mW�Y1�d to ths D�d a s�ptic or noltltry tink.Th�d�nqw w�b��wd
.p�etb�d by 9�im EE.o'r09.aLts. Tf,e owner.Qiea.to pey ai awqss end oo.t awvnsd by tn.0ov«rrnrml uMt for
�P�PtiO.�.Or dhMwiM wvlekfp ad rtr�q 1M hddhp tr�it In WEh�rtanMr�b p�verK or�b�ls
�ry hutmn hwl6�hmed ers�d by tl�s holdhq Lmk
4. Thk�p�nwK w�nrtrh In affat ady uMH ths pousmnf�l inR rsporw'his tor ths npulNbn d phaM�w0��y�m
o�rtlht tlrt Wtrr��oA�o�plion sy�brn tlrt cortiPBes vMlh SPS 383�VYY.Adm.Cod0.a�rrwrddpd�r Mrv�s tln
�o�ny.m.a�,,uu.a�.«,r�a m.y w�by.�,n�o.�,a�s�dm�.m caronanon win��er«anca co ae.
�ptMmsrrt in wch m�rwr whiM wIN p�rmlt ths eodeM�s d ths artlflcatlon to bs de0smdnsd bY�Maice to tfN qap�Ay.
5. Thb apw�Mrt Nrl b�btr�np upo�ths owner�ths hNn of tlq awrrr��nd rrpr�s of ths owner.Th�ownw Nidl wibmR
ths�pn�rrrntm ths�Wr of dsWs,�d�s a0resmx�t Nell be record�d by ttr npbor ot deed�In a m�rcwr whfch wIN
prrmR 1hs eod�brxe of ths�pieement to bs d�lxmkied b7l�90 ths pioperty wlars ths hddNp taik is irn4Asd.
n �r in w nd-
Owr�afs Sqrmturo: _� Staee ofi �1;����-,��.-,
''" Cotmty of; •_�ci.+,.;r j_�.✓'
Ownara Name �` � Subecribed and swom to before me on tlds
��� c�v1 V �-� � �day of A� c,.:�c .20 a 1
D�Es: � `� BY(Ownera Name): . `:��w� �,F 4 -
C -����`- Nolary Pub9c Sipnah�,rt��.;�c���� °
Draft�d bY .� \ (� Pubitc Notuy Narttslr-rm. ._ S�'% < �n-��e r
.�v�.d(�^ �c-'-'PC� �,�y `� ' \�- , "� 3
cornmission_ . 900��e=-
'Vi a � � S _
=-1: ,p �� -
wnor ura„reon ra+a�m•r a u..a rar..00��a.r w�la�r Pt( b „c��`•. GB(1C
Law�f 16.04 m ti �Wv.08�1lN3
0q94O� :' ��
`°'a,�1SCON5�����
Lot 2 of Certified Survey Map No. 8655 recorded in Volume 38 of Certified
Survey Maps, page 8 as Document No. 440370, located in the Town of Sand Lake;
Sawyer County, Wisconsin, being a paR of the NWY4SWY<, Section 23, Township 39
North, Range 9 West.
8/15/22, 3:42 PM Real Property Listing Page
R2al EState Sawyer County Property Listing Property Status: Next Year
Today's Date: 8/15/2022 Created On: 8/15/2022 3: 13: 19 PM
�' Description Updated: 8/15/2022 � Ownership Updated: 8/15/2022
__._ _ -- ----- _ _— — -- ------
Tax ID: 44561 DUFFY DEVELOPMENT LLC STONE LAKE WI
PIN: 57-026-2-39-09-23-3 02-000-000060
Legacy PIN: 026939233206 Billing Address: Mailing Address:
Map ID: DUFFY DEVELOPMENT LLC DUFFY DEVELOPMENT LLC
Municipality: (026) TOWN OF SAND LAKE PO BOX 145 PO BOX 145
STR: S23 T39N R09W STONE LAKE WI 54876 STONE LAKE WI 54876
Description: PRT NWSW LOT 2 CSM 38/8 #8655 �p
Recorded Acres: 0.520 �` Site Address * indicates Private Road
--- -------- --- - - - _____--- ___
Calculated Acres: 0.000 N/A
Lottery Claims: 0
First Dollar: No l.� Property Assessment Updated: N/A
Zoning: (RRi) Residential/Recreational One 2022 Assessment Detail
ESN: 423 Code Acres Land Imp.
N/A
� Tax Districts Updated: 8/15/2022
__ -----.
1 State of Wisconsin Z-Year Comparison 2021 2022 Change
57 Sawyer County Land: 0 0 0.0%
026 Town of Sand Lake Improved: 0 0 0.0%
572478 Hayward Communiry School District Total: 0 0 0.0%
001700 Technical College
•� Recorded Documents Updated: 8/15/2022 � Property History
_ _. _ _ _ _ _ _ _ _ _ _ _
WARRANTY DEED Parent Properties Tax ID
Date Recorded: 8/9/2022 440653 57-026-2-39-09-23-3 02-000-000020 28914
CERTIFIED SURVEY MAP
Date Recorded: 7/25/2022 440370
MAP OF SURVEY
Date Recorded: l2/27/2021 23399-24
CORRECTION INSTRUMENT
Date Recorded: l/26/2021 429577
CONVEYANCE RECORDED NOT USED
Date Recorded: 1/22/2021 429493
EASEMENT
Date Recorded: 1/Z4/2007 344285
WARRANTY DEED
Date Recorded: 7/8/1994 242785
�hi1d History Record Count: 1 -
HISTORY � Expand All History White=Current Parcels Pink=Retired Parcels
� Tax ID: 28914 Pin: 57-026-2-39-09-23-3 02-000-000020 Leg. Pin: 026939233202 Map ID: .10.2
44561 This Parcel Parents Children
https://tas.sawyercountygov.org/system/frames.asp?uname=Eric+Wellauer ��1
O __ _ 0
I I I IIIII III I IIII�IIIII 440370
8 �x64039553 � PAULA CHISSER
REGISTER OF DEEDS
SAWYER COUNTY, WI
07/25/2022 01:18 PM
RECORDING FEE 30.00
PAGES: 2
VOL: 38 PAGE: 8
SAWYER COUNTY CERTIFIED SURVEY MAP CSM MAP #: 8655
A D/VISION OF DEED DOC#4295T7
LOCATED/N THE NW 1/4-SW 9/4,
SECT/ON 23, T39N, R9W, TOWA!OF SAND LAKE,
SAWYER COUNTY, WlSCONSlN.
SMN NE COR.
WEST Z/4 COR. WI/2-NW 1/4-SWl/4
SEC 23 739N R9W
� � � W
4 ~ LANDS
O � ^��+ �m --� (589"49'49"W 643.53 J a�
�++ p m o�'�i � CSMq5393 N89"56'34"E 643.08' �o
Z � � o.-. i 30'WIDE,CSMJt5393 p�
ev 0 op ACCESSEASEMENT N89'S6'34"E 656.30' ��I �
� a ¢ �n N89"56'34"E 21823' �
� a�,� � POB 438.08' 205.OD 1323' � I
Z
LOT3 3 �
� � i 'y� N 22,476.42 SQFT m y�j'N W I
O z z = „�i � .51 ACRES .o'D„o�i�o iz l I
m U' O ,�„ o^� `" �� I
wF�m- = W� o N �y N89"56'34"E220_34' `^ I �g) �
Z °� %v 205.38' Z4.96� �
w z � Q 3.,o ¢ z�'„ ,11� � '.�� � ¢ �
4 O C7 �om" c S�� �lllc e � LOT2 0�0 �=I I
"' � � � �O' o "� 22,692.39SQFT �'^ � I
w v z S�� o � � � � .52 ACRES ^".�� � �
Q 4 � p Z 2 a 3�L � � N�) �
'''� p V �~ N 205_00' S 7 44% � � �
?�� ��� W � N89'S6'34"E222.44' � I
. Q � � W�p � � � 501�3'06'W U N _ �� {
. m � � ¢",G„ � a 1� 21.20' u�oo� �
3 a.,' a 1�t x� `��� 1 ►
2 W�i 1 � �
=0 U � a m �
H
�z�� „� � � C6=512 52'19'f \ � \
�Q¢m� � � C�71.80'��\\ �
u o='�—^� o '111c �11f� '� rs 190.47' 33\3•
w '� DA=21 43'42" �
C�W.g, � Sx � � \ `\
��m�Q zo a, � ,� \
Nc,zmW o� � �
�'gQ.., zW 3 `
W N�9.,�_ g� b � �
o— ZQq� � m � o
z3eQzti 3� o � LOTI �� ��
g � � 535,624.89 SQFT � $ z�`�`�
� z � 12.29ACRE5 � � ���
� � o �
� � o
� � N � y ,
�
g � 1 �
TODD C. � �
� � / � .
GOOLU � s�
C., s-2as9 � , �,
w � � .�. HAYWARD 0 i 3/
� ^ � N ,�jA WIS. ' /
� N � 1�
� � � �Z '
= o �� ey CB=506 35'34'1A/ 1 / /
� � o Co-101.48' � 1 �
Q c � L-101.G0'��i� � �
R=597.80'
� ~ 2 � —1� C/� DA=9 44'17" � N� I
2 `GRA`Fl'4 3 � � �
O ���'40
� � ��AY N I I
� �� `�_ v,e„I I
.. t._ '
(588"25'39"E _—__—__—___________—__— _��_--��-m 3� 33'I
80.54 J 33'W/DE EASEMENT OOGf 344285 636_53' lq_Zg? �
N88 58'11^W MONUMENTED � 589 30'S6"W 650.82' MONUMEMED
80_53' �SOUTH 1/16TH COR. SE COR.WI/2-NW 1/4-SWI/4
LANOS LEGEND
DOCli 407612 � SET 5/8"X 28"SQ lRON ROD,WT.=1.328N/Fr
TOTAL AREA 580,793.58 SQFT 13.33 ACRES, � pLSS CORNER (AS NO7ED)
Cf/ENT.'/OROANOUFN ALL AREAS L07S 1,2,3/NCWDlNG TOWN
su���rNCH=us• ROAD R-PW O FOUND 1 1/2"O.D./RON PlPE
DATF:]/1$2Ou 31/4"ALUM.CqP ��PROPERTY LINE
oareoFr�em woxK�ipo/zozz SOUTN WESTCOR. XXXX Rf[ORDED MEASUREMENT
Fit�:2339os.a�.y SEC 23 T39N R9W ( 0 CqLCU[ATED POS1TlON
SURVEY BY: 0 FOUND 5/8"ROUND IRON ROD
��"t,��9't�' TODD C.GODLD- LS 24 �ll7c APPROXlMATE WE7ZANO5-NOT TD B£USED AS AN
H�rwoA un DATED TH/5: ISTN DAY OFJULY, 2012 OFAC/AL WE7ZAND DELINEATION OR SAWYER
�Is.r�s.ca�� COUN7Y BUILD/NG SETBACKS.OTHER WET2AN0.S
rodd@ooincnoahlo.d.pm SHEET�OF 2 SHEETS /NSIDE THE BOUNDAR/ES OF THlS SURVEY�MAY EXIST.
440370 � of 2
� � "`-''fl; PRIVATE ONSITE WASTE TREATMENT cou�ty
��'���$ � SYSTEMS SaWyer
�;���� PS ,'� ( POWTS)
�"�;•�,�,,,�;r�,�.
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#:
D� �J�GV. LL C, sq � �
Insp BM Elev: BM Description: Parcel Tax No:
(��,� ' -}� �`F'c��c- a�, � b�-!o -cr3�,�3 -�2 0�
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic Benchmark �pp, b �
Dosing
Aeration Bldg. Sewer G�.
Holding �,�„�- �� � �/Ht Inlet q�-�(, �
TANK SETBACK INFORMATION S�l Ht Outlet 9�,06'
TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet
AIR INTAKE
Septic NA Dt Bottom
Dosing NA Installation
Contour
Aeration NA Header I Man.
Holding � ti �a� ��a` L 2S� Dist. Pipe
PUMP 1 SIPHON 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 I L Bidg Well Waters � GP ❑ Chamber Model Number:
❑ EZFIow
CELL TO ❑ Mound o Other
- -- - - --
DISTRIBUTION SYSTEM X Pressure Systems Only
--- -
Header I Manifoltl 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
Cell Center � Cell Edges Topsoil______ � ❑Yes ❑ No ❑Yes ❑ No
COMMENTS: (Include code discrepancies, persons present,etc.)
��-�.,s��l� �dl�J ��
� �T�
,—� -; --- _ -- ---,
Plan revision re uired?❑Yes❑ No 3 '' � �
q �o o� �-3 i___ � �� ���
--- ----- -- --
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
ADDITIONAL COMMENTS AND SKETCH
SANITAAY PEAMIT NUMBER: �-o� ��S�
3 Q�� •
�� � �
�
.
. � ,
PI� �� � �a
w�� 6rY►• ��
�a,o�P
�1P��r. , �
�� �
.,�-`\ ?
��
�� ��
�
����, .�,�'
T� �
—A�---
s�rE-r„--