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Home My WebLink About008-213-00-0500-SAN-2020-239/-\ XVIndustry Services Division1400 E Washington AvcP.O. Box 7162^ Madison. WI 53707-7162(fs-PCountysQvvMySanitary Permit Number (to he filled in by Co.)Sanitary Permit ApplicationIn accordance with .SI'S 383.21(2). Wis. Adm Code, submission of this form to the apprc^nale governmental unitis required prior to ohlaming a sanitary permit Note Application forms for siaie-owncd TOWfS are submitted tothe Department of Salely and Professional Serviecs. Personal information you provide may be used for secondarypumrscs in accordance with the Privacy Law, s. 15.04(1 Xm>. Stats.State I'ransaction NumberL Annlication Information - Pieaaie Print All InformationProperty Owner's NameProject Address (if different than mailing address)Co"Jvniy I4viy I-I**• A-^0c/3cy )..sV>am CP-ccU -0i>00oc>8- ^13- 00 -cno oPmpcrty Owner's Mailing AddressCity, Stnlc1*7 (e H M Coory^y V4voy f~13)'trc.hvw30CsA^, UJ'C.Zip Codes"v0 nII. Type of Building (check all that apply)D 1 or 2 family Dwelling - Number of Bedrooms19 Public/Commcrciul-DescribeiisoD Slate Owned- Describe UseProperty LocationGovt. LotPhone NumberLo'" UMirsT 3*1 N: R,_ 14. Section(circle one)Block «Subdivision NameCSM NumberD Ctlyol"n Village ofE^Town of£dcjA.ujft.WT-111. Type of Permit: (Check only one box oti line A. Complete line B if appllcahle)A.B.D New SystemD Permit RenewalBefore ExpirationD Replacement SystemD Permit Revision^ii^realinenl/l lolding 'lank Replucemcnt OnlyCAWvr>.c.D Change of PlumberD Permit Transfer to NewOwnerD Other Modification to Existing System (explain)List Previous Permit Number and Date IssuedTIV. Type of POWTS Svitein/Componcnt/Dcvice: (Check all that apply□ Non-Pressuriaid In-Ground D Pressurized In-Gnnind □ Al-Orndc D Mound >24 in. ofsuitable soil D Mound <24 in. of suiwblesoil□ I lolding 'funk S Oilier Dispersal Component (exnlainl * □ Prctrcatmenl Device (explain)V. Dispersal/Trealmenl Area Information: 3(r ^xciisVl±Design Fiow(gpd)I650 ( WflODesign Soil Application Rate(gpdsf):k on£2-^DispersSt Area Required (sf)iia_Dispersal Area Proposed (sOSystem Elevation2|^VI. Tank infoCapacity inGallOHMTotalGallonstfofUnitsMonulactureruQ ^Site ContsdetcuroNew Tankslixistiiig TaiikiiSteelFiberGlassSISeptic or 1 lolding TackSooo (3*)C0$(7SCi<i«^)37*&HVDosing Chamber( VnK-oS1tjnKr«»-vMN<0Vil. Ke.sponsibility Statement- t. the undersigned, assume rcspunsibllily for iostallation of the POWTS shown on the attached planvPlumber's Name (Print)i (SircelPlumber".s Address (SircelPlumbeclSiiSignalureMP/MPUS NumberBusincM Phone Number, City. Stale. Zip Code) y ' r ^AWVa RoAfij ^ ^kyu^jAT^f COX s5V3V3\'[1[. Couatv/Denartment Use Onlyn DisapprovedD Owner (liven Reason for DenialPermit FeeDate issuedIssuing Agent SignatureIX. Conditions of Approval/Reasons for Duapproval cTE.^ORIGINALAttach locompleM plant for Ihciyitem and lubnil to IbeCovniy only on paper not lest (htn B IASBD-6398 (R. 08/14)SEP 2 9 2D20GAV'-iVCRC'': ■'/ZONiNG ADMiiViii i-./>i ION DaIcas Co»\(1o5nt4M Co «= "B •rcKtOodUJ I S"^Sn-1(5- 35W -3S^O^c^S'^-eu^yyAi \j~1—■C.ot^do S", 4,"yT^is, P1a*1-PIa.vx cc cid r<rs-i,»^2 STJ 4^7P/bt- "fo Q.tfdf«S5 ©y S-fe*/ +«-\ks "for Otui^6 I btj Drk^ioe l| ^3 d-K.i-f A-ll t>u/ 1^2. ,3 /'<^c>d€fc/ ^cidevi^el 81.H '-oKbo-fb>u^ el. ^3.q'^ ^5(xld^ l"«-4o'•w-a&e^aftMioo"P I \ looojO'piMi^tc «jshe.\ WxK* k>f ht^'/h^kcObvMjL!(e^r«i« wt-Va Piltffjft** newyipik^ ts 4o be M^JVCScUWo 4-d^ d««»^Ae4«d by♦««»•<• ®w*obe ptiypcrty abAodmedZ Any b««^b^)^|tc^l«tV t-ei«eaA«da,c Accded^ ''a •««eV!5«4laeClC r«V»t »c*i«»)-ji<DRAJ,6UNtrt tjittI —eSsoNiaU C5';'g -9 •Z. -Z •"c. "£ zr £»\\./ 3I \.- o/.oneOr.".'«i PAGE 4 OF 4In-ground Dosed-Gravity Management PlanIMPORTANT:The owner of this in-ground dosed-gravity system shaii be responsible for Its perpetual operation and maintenancepursuant to requirements of SPS 382-384, Wsc. Admin. Code. Pursuant to SPS 383.52 (2), Wise. Admin. Code, thissystem shall be considered a human health hazard If not maintained in accordance with this approved managementplan. Furthermore, all Inspection and maintenance activities shall be performed by a registered POWTS Malntalner Inaccordance with SPS 383.52 (3), Wise. Admin. Code.Maximum Dispersal Area Operating Limits:Design Flow =1050 (1400 total) qpj. bODs S 220 mgL'; TSSSISOmgL^ FOG^SOmgL'^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 (l.e., leaks, breaks, corrosion, etc.)o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (l.e., distribution / drop boxes)o neglect or Improper use (r.e., exceeding design capacities, prohibited activities, etc.)o extent of ponding In distribution cell prior to doango dosing Irregularities - If applicable (i.e., pump re-cycling, float switch settings, etc.)o electrical components - If applicable (i.e., wiring, conne^ons, switches, controls, timers, alarms, efc.)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 sen/edMaintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)o Septic and dose tankfsl 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 shall be pursuant to NR113, Wise. Admin. Code.o Effluent fllterfsl shall be Inspected every 3 years and shall be cleaned when necessary to remove anyaccumulated solids according to manufacturer's specifications. A servicing period wlil 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 hillure or malfunction to:Name of individual or company: Ronald A Sprcckels Jr Phone: 715-558-6472Local government unit Sawyer County Zoning & Conservation phone: 715-634-8288Local govemment unit address: 10610 Main St., Suite 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 ^lied or malfunctioning components shall comply with SPS 383, Wise. Admin. Code.No product for chemical or ph^ical restoration of the POWTS may be used unless approved by the department Inaccordance with SPS 384, Wise. Admin. Code.Contingencv 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.System Abandonmentif use of this POWTS Is discontinued, it shall be abandoned In accordance with SPS 383.33, Wise. Admin. Code. IM-1060 General Specifications and iliustrationsThe IM-1060 is an injection molded two piece mid-seamplastic tank. The IM-1060 injection molded plastic designallows for a mid-seam joint that has precise dimensionsfor accepting an engineered EPDM gasket. Infiltrator'sgasket design utilizes technology from the water industryto deliver proven means of maintaining a watertight seal.The two-piece design is permanently fastened using aseries of non-corrosive plastic alignment dowels andlocking seam clips. The IM-1060 is assembled and soldthrough a network of certified Infiltrator distributors.Must be backfilled and Installed in accordance withInfiltrator Water Technologies, Infiltrator IM-Series SepticTank General Installation Instructions and for shallowground water conditions reference the Infiltrator IM-Series Tank Buoyancy Control Guidance.Please visit www.infiltratorwater.com/images/pdf/ManualsGuides/TANK01.pdf for the latest information.RSOCONNlCnON/ {TYPICAUUFTDtGlUG(4T0rAU(TVPICAUEXTBQORLBICTHTOP VIEWIM-1060Working Capacity1(»4gal(4141 L)Total Capacity1287 gal (4872 L)Airspace16.5%Length127" (3226 mm)Width62.2" (1580 mm)Length-to-Width Ratio2.3 to 1Height54.7" (13^ mm)Liquid Level44" (1118 mm)Invert Drop3" (76 mm)Rberglass Supports2Compartments1or2Maximum Burial Depth48" (1219 mm)Minimum Burial Depth6" (152 mm)Maximum Pipe Diameter6" (152 mm)Weight320 lbs (145 kg)SEAM CUP /(TYPICAUUnVIG STRAP(TYPtCAU04(102}PVCORAaSmmutf IKLETJt-PBtGOpEEND VIEW024(610] ACOSS OPENINGS WITH LOOONG UDS (2)P-10.2I26QJFRCE80AROi-r'Ttoji/TNAy rvt/Tw~16" j176]lS%^ AIRSPACEILFlBEnGUSS.SUPPORT(TYRCAU440(1118]UQUODEPIHjT-rr\ ( /T>|j /T\ I ^rr\jT^ABSOUTIETTEEOUTin \SUPPORTSIDE VIEWrTANKTOP -HALFTANKINTERIORAUGNMENTDOWELCONTINUOUSGASKET4 Business Porit RoodP.O. Box 768Old Saybnxft, CT 06475880-577-7000 • Fax 860-577-70011-800-221-4436www.infiltiBtor8water.coniSEAM CUPTANK BOTTOMHALFMID-HEIGHT SEAM SECTIONINFILTRATORSwater technologiesU.S. Polenis: 4.759.661:5.017.041:5.156.488; 5.338.017; 5.401.116:5.401.459:5.511,903:5.716.163:5.588.778:5.839.844 Canadian Palsnts: 1.329.859:2.004,564 OlImpalsnlspsfKlng. MlreUir. Eowtoir.QuIcM. and SdeWlndw ore rogistcnxl tiadeniarto o( Infilialw Wolor Ti*ftnokigloo. IntBtnlw Is 0 retfslsrod Iradomarti In Fmneei Willjolw WMw Todinologte Is 0 iSBlsloreid ewlenaiH In MoxtoContour. MltrolaacWna.PolyTuB.Ch3mb«aSpactr.M;41iPeit.PosiljOdt.<>jicl(CuLQiicfcl'loy.SnapLock and SiraiohlLeck ore ttadatnaiksollnlfflmlorWclsrTectxiolonlea:PdyLok is a Iradenoik of PolyLok. Inc. 1UF-TITE is n rogistered trademoik of TUF-T1TE. INC. Ultra411t> is a trademark of IPEX Inc.C 2016 InSlralnr Water TectinotoBiaa LUX AlriBms reserved. Printsd in U.SA .,™. .UnUZ 1116Contact Infiltrator Water Technologies' Technical Services Department for assistance at 1-800-221-4436 Real Estate Sawyer County Property ListingToday's Date: 9/30/2020DescriptionUpdated: 9/13/2011Tax ID:PIN:Legacy PIN:Map ID:792457-008-2-37-09-07-5 16-741-000500008213000500-26.5Municipality:(008) TOWN OF EDGEWATERSTR:S07T37NR09WDescription:DALEN'S CONDO DEa 332088 UNIT 5 &1/11 INT IN COMMON ELEMENTSRecorded Acres:0.215Calculated Acres:0.014Lottery Claims:0First Dollar:NoWatertrody:Chetac LakeZoning:(RRl) Residential/Recreational OneESN:4307 Tax DistrictsUpdated: 2/6/20071State of Wisconsin57Sawyer County008Town of Edgewater650441Birchwood School District001700Technical CollegeRecorded DocumentsUpdated: 9/13/2011WARRANTY DEEDDate Recorded: 3/3/2003^ OwnershipProperty Status: CurrentCreated On: 2/6/2007 7:55:14 AMUpdated: 2/6/2007GENE & NANCYISHAMBIRCHWOOD WIBilling Address:GENE & NANCYISHAM1764N COUNTY HWY FBIRCHWOOD WI 54817Mailing Address:GENE 8i NANCY ISHAM1764N COUNTY HWY FBIRCHWOOD WI 54817Site Address * indicates Private RoadN/AProperty AssessmentUpdated: 2/6/20072020 Assessment DetailCodeAcresLandImp.G2-C0MMERCIAL0.21510002-Year Comparison20192020ChangeLand:1001000.0%Improved:000.0%Total:1001000.0%' Property HistoryN/A308750 840/578 Real Estate Sawyer County Property ListingToday's Date: 9/30/2020Property Status: CurrentCreated On: 2/6/2007 7:55:14 AM650441001700^ DescriptionUpdated: 9/13/2011Tax ID:7925PIN:57-008-2-37-09-07-5 16-741-000600Legacy PIN:008213000600Map ID:-26.6Municipality:(008) TOWN OF EDGEWATERSTR:507 T37N R09WDescription:DALEN'S CONDO DECL 332088 UNIT 6 &'1/11 INT IN COMMON ELEMENTSRecorded Acres:0.215Calculated Acres:0.014Lottery Claims:0First Dollar:NoWaterbody:Chetac LakeZoning:(RRl) Residential/Recreational OneESN:430^ Tax DistrictsUpdated: 2/6/20071State of Wisconsin57Sawyer County008Town of EdgewaterBIrchwood School DistrictTechnical CollegeRecorded DocumentsUpdated: 9/13/2011WARRANTY DEEDDate Recorded: 3/3/2003OwnershipUpdated: 2/6/2007GENE & NANCYISHAMBIRCHWOOD WIBilllna Address:GENE & NANCYISHAM1764N COUNTY HWV FBIRCHWOOD WI 54817Mailing Address;GENE & NANCYISHAM1764N COUNTY HWY FBIRCHWOOD WI 54817Site Address * Indicates Private RoadN/A0 Property AssessmentUpdated: 2/6/20072020 Assessment DetailCodeAcresLandImp.G2-C0MMERCIAL0.21510002-Year Comparison20192020ChangeLand:1001000.0%Improved:000.0%Total:1001000.0%[iB Property HistoryN/A308750 840/578 Real Estate Sawyer County Property ListingToday's Date: 9/30/2020Property Status: CurrentCreated On: 2/6/2007 7:55:14 AM^ DescriptionUpdated: 9/13/2011Tax ID:7926PIN:57-008-2-37-09-07-5 16-741-000700Legacy PIN:008213000700Map ID:-26.7Municipality:(008) TOWN OF EDGEWATERSTR:S07 T37N R09WDescription:DALEN S CONDO DECL 332088 UNIT 7 &1/11 INT IN COMMON ELEMENTSRecorded Acres:0.215Calculated Acres:0.019Lottery Claims:0First Dollar:NoWatertx)dy:Chetac LakeZoning:(RRl) Residential/Recreational OneESN:430^ Tax DistrictsUpdated: 2/6/20071State of Wisconsin57Sawyer County008Town of Edgewater650441Birchwood School District001700Technical CollegeRecorded DocumentsUpdated: 9/13/2011WARRANTY DEEDDate Recorded: 3/3/2003^ OwnershipUpdated: 2/6/2007GENE & NANCYISHAMBIRCHWOODWIBilling Address:GENE & NANCYISHAM1764N COUNTY HWY FBIRCHWOOD WI54817Mailing Address:GENE & NANCYISHAM1764N COUNTY HWY FBIRCHWOOD WI 54817Site Address * indicates Private RoadN/ALJ Property AssessmentUpdated: 2/6/20072020 Assessment DetailCodeAcresLandImp.G2-C0MMERCIAL0.21510002-Year Comparison20192020ChangeLand:1001000.0%Improved:000.0%Total:1001000.0%Property HistoryN/A308750 840/578 005937075t031'jnP n n 9/0089370751010082f3COD0O0Hf un►vvm0089370751 10-Mm008937075105f.008937075111r«4008937073109E—eaelMdc ^7ALfcM6 CQNPQMINIUKfoviih, WiwiHiN. itiKt iHtnWj Ul" I if tirWiil f«»ty 'MVi,VlWrJlJ tn n, 6y»cmmai, t 1 i(h)iiI'(i(J Ik) jvYVi^K iK Hit ihke if Wijiiiwin, kviftiy iixfifjlkl>t ^ hlH miiv 1 krtl kI Ittvukt WHCJ H Jtllttrt llWl IK trt MofllinU ic'iV* tiMjftI'if till WiitKiix AkminiifiiKfi («)». tniK )ki( fiYufitn if ftiiti{Ik fUk kkiv't ViD-n ii i ((iTut if Hit hiiiK iliiiiiri) (iufKiKien k) lk(ijiMlifiMhfi ink Isdfim if dill I'mf tnl Ktc iiifiMiit (.Itnuolt im In ^(lanini) bin H fb).UHM• ftmfu V inn Vir (itn)• fimlM I'lr UK fim)' ^Klllt 4((fl(' iwfI (Anikf t(fii)»iili Icdluniffiflnfjiili^u ^(«ifc4 wihi olfcCJfinilu liilfiu^ Willingf i fl«lf« li«:fll 1111MWf.niOEXSI73r8SCK/7CCO•fiYosuitiitwruAt amiS- UMifi) ciwtM aMA toonfakV• • n AIMI miwwI «*«<— »«it ■* I-***..liWiCUU.fAUIA CVISSfASMfVU CCUVTT, VtUCtSTtH OP KtDd33208907/2V2Oe> ItQO MrUT 30.00twewl-A'il.6I'MM Mrtai«< I »4 X