032-540-14-5506-SAN-2020-201•r ^ Oe'A®PsV ^Safely and Buildings Division201 W. Washington Ave., P.O. Bo* 7162Madison. Wi 53707-7162^c<rra.o- \s\^Sanitary Permit ApplicationIn ucconbncc willi SPS J8J.21(2), Wis. Adiii. Codu. submission of this fonn 10 the approprinic govemtnenial unitis rcquiicd prioi to obtaining u sanilui^' pciTnil. Note: Ajtjtliuatiun forms for state-owned POWTS are submitted tothe Department of Safety and Professional Servies. I'ersoiial infonnation you provide may be used for seeoiidarypurp»>sesinuecocdance with the I'livacy Law, s. l5.Q4(l)(m). Slats.I. Application Information - Please Print All InfonnfttionCoimiytNumljeSanitary Pcnnit Numljer (to be filled in by Co.)State Transacbon NumberProject Address (if different Ibim mailing address)'g5S{/0Property Owner's NameWo^/ls i ^leHcPParcel#0.;2- 6Va- m-ssoj.rojrerly Owner's Mailing AddressBS^O X0Lt5IMC^DProperty Location5"Oovi. LotCitv. StalenioytJV . MA/II. Type of Building (check ail that apply)or 2 Family Dwelling - Numlrer of BedroomsD Public/Commercial - Describe UseD State Owned - Describe UseZip CodePhone Number2/2,-'/>, Section/VLot #5Vo « „ 5-<''circleEdrWSubdivision NameBlock#CSM Number^ho ^L77D City ofD Village of'^Townof \AJ\i/?r^III. Type of Permit: (Check only one box online A. Complete line B if applicable)A.D New SystemD Replaconcnl System'rcaimenlfiMdm^Jaok RepUcemenl Only0 Otitcr Modification to Existing System (explain)B.D Permit RenewalBefore ExpirationD Permit Revisionn Cliange of Plumber D Permit Transfer to NewOwnerList Previous Permit Number and Date IssuedIV. Type of POWTS System/Component/Pevice: (Check all that aopiv)D Non-PreasuriMd In-Ground D Pressurized In-Ground D Al-Grade D Mound>24 m. ofsuiiablesoil D Mound <24 in of suitable soilD Holdii^Tank D Other Dispersal Component (explain) D Pretreaiment Device {Bxplain)__V. Dispersal/Treatment Area information:.SZ.DesignFtow (gpd)nun r tow (5>(D6Design Soil Applicutjpn Rate(gpdsODispersal Area Required (sGDispersal AreaMlSystem ElevationVI. Tank InfoSeptic or Holding TankCapacity mOallonsNew' Tanks7^Existing TsnksTotalGallons# ofUnitsManufacluieridzalTJStU}iZ o0(1fling ChattibcrVII. Responsibility Statement- I, the underslpted, assume responslhllHy forlnitallatlun of the POWTS shown on the attached plans.MP/>#tWNBPlumber's Name (Print)Plumber's Siinlfiiurcumbcr/S/ 2.Z.usiness ITione Number "7/<3377Plumber's Address (Street. Citj', Stale, Zip Code)Vin. County/Depnrtment Use Only.^A^toVja^^rT] Dis.ipptoved ^0 Owner Given Reason for DenialPermit FoeDale IssuedIssuing Agent SignaturelX.ConditlonsofApproval/ReasonsforDisapproval ^^MCtNO BEFUNDS AFTER ' ^ J 'ISSUE OF PERMITORIGINALAlUch tocimplele plans for the system and submit to the County only on paper not Ins Hum 8 liJ * 1SBD-6398(R. 11/11)aAWER COUNTYZONING ADMtMISTRATl''.)N
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FILE INFORMATIONPOWTS OWNER'S MANUAL & MANAGEMENT PLANSYSTEM SPECIFICATtONSPage..of_Tank Manufacturer;□ NAPermit #^Septic □ Dose □ Holding Volume: "^^0(gal)DESIGN PARAMETERSTank Manufacturer:^NANumber of Bedrooms:2. ONA□ Septic □ Dose □ Holding Vdume:(gal)Number of Public Facility Units:□ NAVertical Distance Tank BottiMn(s) to Service Pad:(ft)Estimated (average) Flow:(gal/day)Horizontal Distance Tank(s) to Service Pad:(ft)Design (peak) Flow = (estimated x 1.5);3c>C). (gal/day)Specific servicing mechanics must be provided if vertical Is >15 feet orIf horizontal is >150 feet. Specific instructions to be provided on back.In Situ Soil Application Rate:(gal/day/fl')Effluent Filter Manufacturer□ NAStandard (Domestic) Influent/EffiuentMonthly averageEffluent Filter Mod^:Fats. Oil & Grease (FOG)Biochemical Oxygen Demand (BODs)Total Susoended Solids (TSS1s30 mg/LS220 mg/L □ NAsISO mp/LPump Manufacturer:Pump Model:)e3>High Strength infiuenl/EffluentMonthly averagePretreatment Unitlli>30 mg/L ^>220 mg/L H NA>150mq/LManufacturer□ Mechanical Aeration Q Peat Filler□ Dismfeclion □ Wetland□ Sand/Gravel Filler □ Other."^NAPretreated EffluentMonthly average(BODO(TSS)Fecal Conform foeometric mean)s30 mg/L .fs30mg/L tfiNAslO'Soil Absorption SystemIn-Ground (gravrty) Q In-Ground (pressure)□ NAMaximum Effluent Particle Size% in dia. □ NA□ At-Grade □ Mound□ Drip-Line □ Other;Other:*^NAOther;□ NAMAINTENANCE SCHEDULEService EventService FrequencyPump out contents of tank(s)□ When combined sludge and scum equals one-third (H) of tank volime□ When the high water alaim is activatedInspect condition of tank(s)At least once every:o'Sf (Maximum 3 yeare)□ NAinspect dispersal ceil(s)At least once every:□ S3" (Maximum 3 yeara)□ NAClean effluent filterAt least once every:□ NAInspect pump, pump controls & alarmAt least once every:□ month(s)□ yeaf(s)□ NAFlush laterals and pressire testAt least once every:□ monthfs)□ yearfs)□ NAOther:At least once every:□ mondi(s)□ yeaits)□ NAOther:□ NAMAINTENANCE INSTRUCTIONSInspections of tanks and soil absorption systems shall be made by an Individual carrying one of the following licenses or certifications:Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Malntainer or Septage Servicing Operator (pumper).Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware. idenUfy any cracks or leaks,measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soilabsorption system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluenton the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediatenotification of the local regulatory authority.When the combined accumulation of sludge and scum In any treatment tank equals one-third ()S) or more of the tank volume, the entirecontents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113,Wisconsin Administrative Code.Ail other services, Including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,and any servicing at intervals of s12 months, shall be perfomied by a certified POWTS Maintatner.A service report shall be provided to the local regulatory authority within 30 days of completion of any service event.GUW-006 (02706)
Page ofSTART UP AND OPERATIONFor new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or otherchemicals or sediment that may impede the treatment process and/or damage the soil afcisorption system. If high concentrations aredetected have the contents of the tank(s) removed by a Septege Servicing Operator (pumper) prior to use.Pump tanks may fill above normal Nghwater levels prior to startup or due to pump failures. Start up or restoration of power under theseconditions is not recommended, as the excess wastewater will be discharged to the soil absoiption system in one large dose causing anoverload that may resutt in the backup or surges discharge of effluent and damage to the system. To avoid this situation have thecontents of the pump lank removed by a Septage Servicing Operator (pump®-) prior to restoring power to the pump or contact a Plumtieror POWTS Maintainer to assist in manually operating the pump controls until normal effluent leveis are restored within the pump tank.System start up shall not occur when soli conditions are frozen at the infiitrative surface.Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact, thearea within 15 feet down slope of any mound orat-gredesoil absorption area.Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the lite of the treatmenttanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental fioss,diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meatscraps, medications, oils, painting products, pestiddes, sanitary napkins, solvents, tampons, and water softener brine discharge.ABANDONMENTWhen the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properlyand safety abandoned in compliance with s. Comm S3.33, Wisconsin Administrative Code:• All pHping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed.• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servldng Operator (pumper).• Afl^ punping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,gravel or another inert solid material.CONTINGENCY PLANIf the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliantreplacement system:□ A suitable replacement area has been evaluated and may be utilized for the location of a r^lacement soil absorption system.The replacement area should be protected from disturbance and compaction and should not be infringed upon by requiredsetbacks ^om existing and propos^ structure, lot lines and wells. Failure to protect the replacement area will result in the needfor a new soil and site evaluation to establish a suitable replacement area. Replacement systams must comply wrth the rules ineffect at the time of their permit issuance.□ A suitable replacement area is not available due to setback and/or soil timitatiorts. If the soil absorption system cannot tierehabilitated and barring advances in POWTS technology, a holdirrg tank may be installed as a last resort.□ The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluationmust l» performed to locate a suitable r^lacement area. If no replac^ent area is available a hoidlrrg tank may be Installed as alast resort to replace the failed POWTS.□ Mound and at-grade soil absoq^tion systems may be reconstoicted in place following removal of the biomat at the infiitrativesurface. Reconstructions of such systems must comply with the rules in effect at that time.WARNING TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACKSUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAYRESULT, ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.•iiADDmONAL INSTRUCTIONS:POWTS INMALLER POWTS MAINTAINERNameNamePhone.Vc.a rrs 5<5p^c.PhoneSEPTAGE ^RVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITYName SC>CNamePhone7^^--A 7^79^PhoneThis document was dratted by the staffs of the Greet» Lake. Marquefte and Waushara County POWTS regulatory agencies in compliance with sectionsComm 83.22(2Kb)(lKd)&(f) and 83.54(1). (2) & (3), Wisconsin Administrative Code.
Soil Profile SheetOwner:I SoilTestetTPaulCi U Denm.6System EleviSon:. LoadRate:_ I ^ System^iooqq.Qlfiqsq4q?>qaqiIVx5(p o^-»-2U?'Boy''r.<^ IVOW% n7y n••«7(«>.«>9^.10Au<?b>w'r^- ■'0»i. \+3'■ r•-10.131'Z
Map Unit DescrtpUon: Shanagolden fine sandy iosm, 6(015pertanl slopes, vefy slony—Sawyer County, \MsconsinSawyer County, Wisconsin644C—Shanagolden fine sandy loam, 6 to 15 percent slopes,very stonyMap Unit SettingNalional map unit symbol: IhjbhElevation: 1,100 to 1,650 feetMean annual precipitation: 26 to 33 inchesMean annual air temperature: 39 to 45 degrees FFrost-free period: 90 to 120 daysFannland classification: Farmland of statewide importanceMap Unit CompositionShanagolden and similar soils: 90 percentMinor components: 10 percentEstimates are based on observations, descriptions, and (ransecfs ofthe mapunit.Description of ShanagoldenSettingLandform: DrumllnsLandform position (Iwo-dlmansional): Shoulder, backslopeDown-slope shape: ConvexAcross-slope shape.- ConvexParent material: Loamy alluvium underlain by dense sandy tillTypical proriieA-0to4 inches: fine sandy loamBhs -4 to 9 inches: fine sandy ioamBs- 9to 14 inches: fine sandy loamB/E -14 to 25 inches: fine sandy loam26/ - 25 to 33 inches: sandy loam3BCd - 33 to 58 inches: gravelly loamy sand3Cd - 58 to 80 inches: gravelly loamy sandProperties and qualitiesSlope: 6 to 15 percentPercent of area covered with surface fragments: 1,5 percentDepth to restrictive feature: About 33 inches to densic materialNatural drainage class: Moderately well drainedRunoff class: MediumCapacity of the most limiting layer to transmit water (Ksat): Low tomoderately low (0,01 to 0,03 in/hr)Depth to water table: About 24 inchesFrequency of flooding: NoneFrequency of ponding: NoneAvailable water storage in profile: Low (about 4.8 inches)Interpretive groupsLand capability ciassiTicatlon (irrigated): None speci5ed'■•jSI Nitur»r Rfl#oure«t Vrtb Soil Survey Tmoma^ Conter/iiion Service National Cooperative Soil Survey Page 1^2
OwnerDepartment of Zoning and sanitationSawyer CountyInspection ReportVictor P. Tazzioli* ^ Vincent AlongiAddress * 3051 Dato AvenueHighland Park, XL 6003SKane of businessBuilderAddressPluinber Donald ThompsonAddress Route 2 Box 102Winter, WI 54896Inspection(>r) Private ( ) PublicViolation( ) Sanitary ( ) ZoningPropertyDwellingMobile BHOarageI Privy7^ Sanitary-instalSetback - lakeSetback - roadSetback lot lineGLusCtU Luke11, />«etou) /vat3f' ftu* ttrftf* Ok,Q'lsv T/ia.Discussed with ownerDiscussed with builderDiscussed with plumberDiscussed withDate ^ nc7-yesf 1noyesno'kyesnoyesnoSignature of Officer Uknrr^o*1«JTB-ft OssNMH H'&cl-%?OOIJ ^i ftII MlIIIII %e<y-n»In
Map Unit Oesofptlon: Shenagolden fine sandy loam, 6 to 15 percent slopes, very stony-Sawyer County, WsconslnLand capabil^ dassification (nonirrigated): 6sHydrologic Soil Group: CForage suSabllHy group: Mod AWC, adequately drained(G090AY00SWI)Hydrio SOU rating: NoMinor ComponentsPeeksvillePercent of map unit: 5 percentHydric soil rating: NoButternutPercent of map unit: S percentHydric soil rating: NoData Source InformationSoil Survey Area: Sawyer County, WisconsinSurvey Area Data: Version 18, Jun 8,2020i,M^ Natural Rosourcee Wab Soil Survey 7/27/2020Conservation Service National CooparaOve Soli Survey Page 2 of 2
R6al Estate Sawyer County Property ListingToday's Date: 7/27/2020Property Status: Currentaeated On: 2/6/2007 7:56:00 AM•r. DescriptionTax ID:PIN:Legacy PIN:Map ID:Updated: 1/2/2006 ^ OwnershipUpdated: 2/6/200735933S7-032-2-40-05-14-5 05-005-000060032540145506 n:5.6Municipality:(032) TOWN OF WINTERSTR:S14T40NR05WDescription:PRT GOVT LOT 5 LOT 5 GSM 4/30 #677Recorded Acnes:1.830Calculated Acres:1.873Lottery Qalms:0First Dollar:YesWaterbody:Blue Gill LakeZoning:(R-1) Residential CkieESN:421' Tax Districts'Updated: 2/6/20071State of Wisconsin57Sawyer County032Town of Winter576615Winter School District001700Technical CollegeRecorded DocumentsUpdated: 10/15/2019WARRANTY DEEDDate Recorded: 11/23/2004326930MINERAL CLAIMDate Recorded: 10/10/2019420395THOMAS J &TRACY M BIEHLMOUND MNBIIHna AridrPSSi Mallinn Address:THOMAS J &TRACY M BIEHL THOMAS 1 &TRACY M BIEHL5840IDLEWOOD RD 5840IDLEWOOD RDMOUND MN 55364 MOUND MN 55364Site Address * indicates Private RoadB551N RSHTRAP LAKE RDWINTER 54896Q Property AssessmentUpdated; 10/10/20162020 Assessment DetailCodeAcresLandImp.G1-RESIDENT1AL1.83051,00090,2002-Year Comparison20192020ChangeLand:51,00051,0000.0%Improved:90,20090,2000.0%Total:141,200141,2000.0%' Property Historym
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/rot? njonumenh /cune/- o. Z"X3o" iron fi/aof, ^ 3.CS- /it.///.- oA!/ ope,' Ic^ corners o^oAee/ inii'/k/'Xi-*"tron f>if>es (S^ /./X/is./f/./SearmtfS are axsumej^ referree/ /ep/as///ne aeo ./■/ » x?ue z/or/j?X'ea/a:/"-/oo'1, Prod Alleach, r«glatered londeurvaypr, hsroby certify; miat In fulloomplianc* with the provlaions ofChapter 236 of the nisoonsin Statutes,and the eubdlviaion regulation a of theTown of Winter, and under thedirection of owner ofooid land, I have surveyed, dividedand mapped certified eurvey: thatauoh certified survey correctlyrepreaenta all exterior boundariesand the aubdivlaion of tho landsurveyed; and that thla land islocated in the Southwest Quarterof tho Southwest Quarter of SWj).Section Fourtten (14), Town Forty (40)North, Ronge Five (5) West, Town ofWinter, Sawyer County, to wit;Comr.encing at the Southwest cornerof Section 14, thence North 87®-39' Biat,1316.13 feet, thenoe due North 600.84 feetto the point of beginning; thencecontinuing due North, 200.16 feet; thenoeSouth 870-35' West, 689.80 feat to a point12 feet, more or leas, from the water's edgeof Bluegill Lake, thence along themeander line along tho lake. South 31®-S9' West,121.19 feet; thenoo South 40O-49' West,137.26 feet to a point 25 feet, more or lese,from the water's edge of Bluegill Lake andthe end of tho meqnder lino; thenoeNorth 870-35' East, 843.84 feet to thopoint of beginning. Including all tho landlying between the meander line end thowater's edge of Bluegill Lake.SDated thie,^ dpy of,, 1975'red Aliesoh RES s-102a a- ^-152404WvOfBu'i OIBca VSowyw CeoBli; r^^tiluncoiiOit _^2^d<iyel* 0 ntfaJ/tfoctoe-.P H one recoxiwl to TOl.__W-Of J..., 9 .eeXa?\y'/^ier//r ^eo.>e''TTpxPa/ /^oad