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Home My WebLink About004-839-08-5212-SAN-2020-240V,-6-3Industry Services Division1400 E Washington AveP.O. Box 7162Madison, Wi 53707-7162Q.2TCountySawyerSanitflry Permit Number (to be filled in by Co.)ISanitary Permit ApplicationState Transaction KumberIn accordance with SPS 3S.V21(2). Wis. Adni. Code, submission of this fonn to the oppfopriaic go\'enuncntal unitis ro^uircd prior to obtaining a saiiitary pcmut. Note: Application forms for state-owned POWTS are submitted tothe Deportment of Safety and Professional SerN'ies. Personal information you pro%'ide may be used for secondarypurposes in accordance with the Privacy Law, s. 15.04(l)(ni)> Stats.Project Address (ifdifferent than maiUng address)Lot 15 Jonans RdI. Application Information - Please Print All InformntionProperly Owner's NomeMark ForrestParcel S004830085211 'v iProperty Ovmer's Mailing AddressN6061 Weigand LnProperly IxtationGovt. LotCity, StaleStone Lakezip CodeWIII. Type uf liiiilding (chock nil that npply)1^1 or 2 Family Dwelling - Number of Bedrooms _nPublic/Commetcial-Describe Usel~l Stale Ovned - Describe UsePhone Number54876Lot#'A. A/£ '/<, Section £_-[• 39 R 6 wSubdisision NameBlock ItCSM NumberQ City ofQ Village ofI^TownofIII. Type of Permit: (Check otily one box on line A. Complete line 6 if npplicnblc)A,J New SystemI I Replncement System rnTreatmeni/Holdiny Tank Rcplacanenl Only□oih er Modification to Existing System (explain)B.□ Permit RenewalBefore Expiration□Pemiil Rei'ision^jchangc of PlumberI jPemiil 'J'ransfer to NewOwnerList Presious Pennit Number and Date IssuediV. 'I'vpe of J'OWTS System/Comnonent/Dcviee: (Check all thnt applyNon-Pressurized In-Ground ^Pressurized In-Ground r~Ui-Gmfle nWound > 24 in. ofsuitable soil [|]Mound<24 in. of suitable soiln Holding Tank I^Olhcr Dispersal Component (explain) nPreliealmenl Device (explain)V. Dispersal/Trentnient Area Information:Design Flowjgpd)Design Soil Application Ratc(gpdsl)0.7Dispersal Area Required (si)"IWGallonsDispersal Area Proposed (sf)System Elevation ^X 95.0VI. Tnnk InfoCapacity inGallonsNerv TanksExisling Tanks#ofUnitsManufallurcrS 5a. Uh«-iA M11it. Oa'5Sqnic or Holding Tank1250Wieser ConcreteXDosing (liambctVII. Responsibility StHtcment- 1, the undersigned, «Mum^respiinslhlllty for Inslallntion of the POWTS shown on the attached plans.Plumber's Name (Print)Travis ButterfieldPIumber'>«gnalurcMP/MPRS Number652879Business Phone Number715-634-8176Plumber's Address (Slreel. City. Stale. Zip Code)14346W Slate Rd 77, Hayward, WI 54843VIll. (.'ininty/Di'iiHi'tmuiit tiso OnlyD DisapprovedD Ouner Gi\cn Reason for DenialPermit FeeDate Issued Issuing Agent SignatureIX. Conditicn.s of Approvnl/Rcn.sons for Disapproval,iWr-SEP 25 2020.\tlaeb to coinplele plans for the system and submit to thiSBD-6398 (R0313)Cruiaiy OB|yen.pa|i«r^o| leTSt^ar^^.i'^ I ^ kches in si:OCT 0 1 Z020SAWYER COUNTYZONING ADMINiSTRATiONZONING PAGE 1 OF 4Pg1 of4Pg2of4Pg 3 of 4Pg 4 of 4In-Ground Gravity PlanIndex & Cover SheetComponent Manual Design References:Version 2.0, SBD-10705-P (N.01/01. R. 10/12)Index & Cover SheetPlot PlanDispersal Area Cross-Section & Plan ViewManagement PlanAttachments:Enclosures:POWTS Application for ReviewSoil Evaluation Report & Site MapProject Name I DescriptionForrest/Jonans RdOwner Name(s): Mark ForrestPhone:Zip:Owner Address: N6061 Weigand Ln. Stone Lake, WlProject Address: Lot 15, Jonans Rd, Hayward, Wl 54843Govt. Lot: 1/4 of 1/4, Section 8 , t39 n-R8Township: Couderay County: SawyerProject Parcei iD #: 004839085211. 54876.ECHor w[ZlDesigner InformationDesigner Name: Travis Butterfield Phone: 715 .634 -8176Designer Address: 14346 W State Rd 77, Hayward, WlE-mail: office@butterfielddrilling.comLicense Number: 652879Remarks:Zip: 54843This space reserved for approval stamp.Signature:^ Original signature required on each submitted copy.Date: 8/20/2020 CHECK BOX AS APPLICABLE.□ SOIL EVALUATIONSITE MAPPROJECT NAME:PROJECT ADDRESS:CHECK BOX AS APPUCABLE.Scale: 1° = 40'V////////////////AV/10'13 SYSTEM page 2 OFPLOT PLAN6oo"DESIGN FLOW:GPDBM Symbol:BM Oescripllon: _BM Elevation:/o^.^ FTA 4^^ ' K / S 0 fi'lC.Slope Gradient (%)of Tested Area:Well Symbol (If applicable): OIndicate noith bydrawing on crrawon the appioprlte lino.Attach design flow calculations for commercial plans.Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5)Sanitary Sewer.Force Main: /IMPORTANT:Show ground elevation contours at suitable Intervals.QI?%O-A.SA.0foo'712>?•>0)e>^a*rJ U'^5foxvLiec ^^yo£>.0\) n,' ^7. nCctySJ^ iif^st P, /h- IN-GROUND GRAVITY DISPERSAL AREAUniform Elevation Trenches with Quick4 Standard-W Chambers3-ft Trench (down-sizing credit)Septic Tank(s) ManufacturerWieser Concrete1250Septic Tank(s) Volume(s):Effluent Filter ManufactutenEffluent Filter Model #: GF10-8SOIL COVER. miri. ir(typical)12'min. trenciideptti(tyoicai)— 3i' —(typical)TYPICAL TRENCHCROSS SECTION VIEW(No Scale)System Elevation(typical)Provide minimum 3 ftseparation between trenches.Quick4 Slandard-Ww/ End Capy— (typical)(Show location of inlet / outlet pipe connection on plan view.)Observation Pipe(typical)Install per manufacturei's/ instructions.. B= 88^IA = 3.0ft(typical)TYPICAL TRENCHPLAN VIEW(No Scale)(typical)INSTALL PER TRENCH:Quick4 Std-W (g 20 ft? EISA/chamber = 44^Pairs of end caps (g 6 fl^ EISA/pair = §= Proposed EISA per trench = 446^Quick4 Standard-W Chamber(typical)(mfd t)y Infiltrator Systems, Inc.)Install pursuant to manufacturei's instructions.Required Infiltration Area =trenches = Proposed Total EISA =Distribution Method:branched manifold PAGE 4 OF 4In-ground Gravity Management PlanIMPORTANT:The owner of this in-ground gravity system shail be responsibie for its perpetual operation and maintenance pursuant torequirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. Admin. Code, this system shallbe 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 Maintalner inaccordance with SPS 383.52 (3), Wise. Admin. Code.Maximum Dispersal Area Operating Limits:Design Flow = and: BOD5<220mgL^ TSSSISOmgL'^ FOGSSOmgL"^Inspection Checklist INSPECT EVERY 3 YEARSo type of useo age of systemo 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 solids volume in anaerobic treatment tank{s) and any distribution appurtenance(s) (i.e., distribution / drop boxes)o neglect or improper use {i.e., exceeding design capacities, prohibited activities, etc.)o extent of ponding in distribution ceil prior to dosingo dosing irregularities - if applicable {i.e., pump re-cycling, float switch settings, efc.)o electrical components - if applicable {i.e., wiring, connections, switches, controls, timers, alarms, etc.)o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification)o surface discharge of effluent or sewage back-up into structure servedMaintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)o Septic and dose tankfsi shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.Stats, when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) oras required by local ordinance. Disposal of contents shail be pursuant to NR 113, Wise. Admin. Code.o Effluent filter/si shall be inspected every 3 years and shall be cleaned when necessary to remove anyaccumulated solids according to manufacturer's specifications. A servidng period will always be greater than 12months.System maintenance reports shall be submitted to the proper local government unit In accordance withSPS 383.55 Wise. Admin. Code. Report any component failure or malfunction to:Name of individual or company: Butterfield Inc Phone: 715-634-8176Local government unit: Sawyer County Zoning & Conservation p^one: 715-634-8288Local government unit address: 10610 Main St, SuitG 49, Hayward, Wl 2IP: 54843Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin.Code. Repair or replacement of failed or malfunctioning components shail comply with SPS 383, Wise. Admin. Code.No product for chemical or physical restoration of the POWTS may be used unless approved by the department inaccordance with SPS 384, Wise. Admin. Code.Continaencv PlanIn the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant toa plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may beabandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils.Svstem Abandonmentif use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wise. Admin. Code.