HomeMy WebLinkAbout008-218-00-0100-SAN-2020-112 � �'"` '" Indushy Services Division County <>- (�j�
.� 1400 E Washington Ave .�c�cc..�'� t/�' V �
� •=P - P.O.Box 7162 Sanitary Perm umber(to be filled in t �
= adison,WI 53707-7162
cs� -�� l���024 N
Sanitary Permit Ap ' ation State Transaction Number �
In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit 1 ' ' ' � ^v/ ' I��( `
is required prior to obtaining a sanitary permit.Note:Applicarion forms for state-owned POWTS are submitted to Project Address(if different than mailin�
the Department of Safety and Professional Services.Personal information you provide may be used for secondary e�-I
oses in accordance with the Privac Law,s. 15.04 1 m,Stats. � n � ^-�• . �
I. A lication Information-Please Print All Information �c l
Property Owner's Name Pazcel#
,�� � Sl�.�-e ��;.���.h,hi� 'c�, Uc��'� 'c:�vc�49t�
Property Owner's Mailing Address Property Location
,(��
� � �f 4 �J /1 G'. Govt.I.ot �
City,State Zip Code Phone Number y�, '/., Section G�'�
...�1�C.ei4,%VCC� (.v' ' S_/�/ � II -S� ' C�l -• �rcleone)...
T ��� N; R v� E od�
II.Type of Building(check all that apply) Lot#
�] or 2 Family Dwelling-Number of Bedrooms �� ,3� Subdivision Name
i /� [? ,/
Block# �' S //�r�l/�J�t C'. d1- �� G�C'o�
❑Public/Commercial-Describe Use
❑ City of
❑State Owned-Describe Use CSM Number ❑ Village of
�Town of��Ptv�t�^
III.Type of Permit: (Check only one box on line A. Complete line B if appGcable)
A.
❑New System �Replacement System ❑ TreatmentlHolding Tank Replacement Only ❑ Other Modification to Existing System(explain)
B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑Percnit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner �6_ Q q�
�
IV.T e of POWT'S S stem/Com onent/Device: Check all that a 1
❑Non-Pressurized In-Ground ❑ Pressurized In-Cnound ❑At-Cttade ❑ Mound>24 in.of suitable soil �Mound<24 in.of suitabie soil
❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain)
V.Dis ersaU'I'reatment Area Information:
Design Flow(gpd) Design Soil Application Rate(gpds� Dispersal Area Required(s� Dispersal Area Proposed(sfl System Elevation
/6�v � L! /� 't�
VI.Tank Info Capacity in Total #of Manufacturer
Gallons Gallons Units p � o ,b, �
New Tanks Existing Tanks y o � � « p � `�
� r� U in �� v� w C7 0.
Septic or Holding Tank ��C.n � /,�: �� k
JaD'(: N.
Dosing Chamber � (U� ��� � �,
� `� h
VII.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumber' ignature /MPRS Number Business Phone Number
� �! ��/fi�t i���� ��c��SS 7 -c22�-Cr6S 1
Plumber's Address(Street,City,State,Zip Code)
�cs°� k �i'c�a�<<,�,� /�It'���`� � `� —�
VIII. o n /De artment Use
� p ❑ Disapproved P��t Fee Date Issued Iss ' Age Signature. '
❑ Owner Given Reason for Denial $ `�� �I �Q ZOL�
IX.Condirions of ApprovaUReasons for Disapproval D ���'�„ ��ti
,� ,!j f,.` '
'� . NO flEFUPJDS AFTER �--��'' —�--'�_ '�
�, . ,
I �'=�� � � �' ISSUE OF PERMIT JUN 1 t 2020 t- I
m �� . ���
J
Attach to complete plans for the system and submit to the County only on psper not leas than 8 vx�1�'��ne sg�vNTY
ZONiNG ADMINISTRATION
C�PT � 220 I �),�I 2oz�
1� ►
SBD-6398(R.08/]4)
-�'"""""�� PRIVATE ONSITE WASTE TREATMENT co�nty
�����a : SYSTEMS SaWyer
��-_;� �s ( POWTS)
.I.A�F`_,r��
'��������;` INSPECTION REPORT Sanitary Permit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION 2O � I � 2
Personal inYonnation you provide may be used for secondary purposes[Privacy[.aw,s. 15.04(l)1 m)]
Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#:
�o�S 1-S�� l�d o �`73so� . 'P/Jj3 - 0?1 `�V o1`(D -�-
Insp BM Elev: BM Description: Parcel Tax No:
(v�•d ` N4�1 �-� U�.`�� 12 �,.SGr- •�.a�h oo8-a18-oo - oidc�
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
'�PttC rtii e cor-�,�j n I 2 S� '7�D Benchmark pp,p �
�rt9 1,•.i e �'N-•�o pt>D $o c� S'b;� ST PT" N �7 3 �
�F8�t9fl t�^'�-.3'�' �a1'��a..� �p O'O �.99 �
-He+dirr9 o T 8 7.o�`
TANK SETBACK INFORMATION �T- d�7-- 91.33 �
TANK TO P/L WELL BLDG AiR"NT°KE ROAD Dt Inlet `I'(.5-y '
Septic +co' +�5� �io� ��o� NA DtBottom 8$•35`�
Dosing �o� +Z-'S �'lo yio' NA �,2,3�`(�b� _�N oSi
Aeration NA o`tT $6 .9S
Holding � �.$,$"�
PUMP I SIPHON INFORMATION
Manufacturer 4,,,` Demand �oW� Sys /n3. �
Model Number �^�-'�7� GPM �o� ''k"� IoY.2�
TDH 1'� Lift Friction Loss Sys Head TDH Ft Sys, IoY,SS�
Forcemain L �p Dia 2`� Dist.To Well � n,,�. l�S�3 �
DISPERSAL CELL INFORMATION
DIMENSIONS �N(� ' L (�(p' ( �' #of Cells � Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav ° Conv � Aggregate
P I L Bldg Well ❑ IGP ❑ Chamber
INFORMATION Waters � AG ❑ EZFIow Model Number:
CELLTO � -}-- (o` _ �-� -{-roo' � Mound ❑ Other _— —
DISTRIBUTION SYSTEM x Pressure Systems Only
Header I Manifold Distnbution Pipe(s) X Hole Size X Hole Observation Pipes
Length Dia _ Length Dia Spac ' _ _ _ ' Spacing [�Yes ❑No�
SOIL COVER
Depth Over << Depth Over �� Depth of ,� Seeded/Sodded Mulched
Cell Center �� Cell Edges �� ! Topsoil 6 �(S'es ❑ No � [�Yes ❑ No l
COMMENTS: (Include code discrepancies, persons present,etc.)
��.,s���� °? ��� �� °�
, ��,,�� i �
Plan revision required?�Yes ❑ No !O 3� 2�� 2aj � ^ �9�� 1p
i
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
G� o
�_ . ��I�y��flP
' 92.8 1l
IMPORTANT: WELL � X � 3.���;'� oj S�� `
p t.o.weil �7 �� V /
1. Remove ali exisUng tanks - 89�58 , j�./�\ �/ y i�
pursuant to SPS 383.33. � �� ,� $�, 3"0 FM
�:�� ��,� invert elevation
� 2. Provide bedding beneath all vessels � � �: ;' \ @ PT outlet
and pipes pursuant to SPS 383.45(5). � �.� '�t,�• �� -� = g1.22'+/_0,1'
\"` 94.1 Exlsting
3. Provide a minimum of 12 inches of soil co�Te„k� 2"o F"^ c��'�+
cover over all pipes pursuant to 383.45(5). 88'3 ' 94.6 `���
89.5 / X
4. All exisitng sewer pipe and force main � 92.1 93'� 'N'' ��
DOSE TANK
locations and elevations are approximate �6 s � 94•3 WLP1000-MR �
and inferred-adjust replacement tank 2 gR
��ti,� mfd by Wieser Concrete
location and elevation as necessary during �
installation to accomodate existing pipes. � +; 2�0 FM X. #5 (w/alternating I
��'� 2 BR duplex pumps)
Simplex Pump
in Lift Tank ,�'�� EX�st� --
J � 4"0 SeNtary
SEPTlC/ LIFT TANK �o�� �� euudin9 sewer 94.2
W1250/750-MR 88.9 E�stlng
aW� m#d by Wieser Concrete 2"0 FM ;
w Product File No: 20180050
�U (See cut-sheet details.} ExlsUng
w/GF 10-16 BES7 FILTER 4"R)S�nitary
Bullding S flwer
installed at ST outlet 89�8 TAN K P LA N V I EW
mfd by Polylok Inc 90.6
OHWM of Lake Chetac �N�W� #7 DETAI L 6
greater than 15 ft below � 2 BR Scale: 1"=20� U n its 5 6 & 7
grade at PVC stake 86•4 0 � w � > >
(per LIDAR elevations) pVC-grd �'
I
Ed Taylor Projed Neme: Scale ae Indicated
�u��� m East Shore Condominiums project�i:
p � Replacement Septic System �y��
Consulllog
838 81h Avenue Prepared For. Date: 05/2412019
earaboo,wi 539�a East Shore Condominiums Sh@8t 5 Of 10
�oY�������'*� N2173 OI'Haye Roed,Blrchwood,WI 54817
MOUND PLAN VIEW DETAIL � �
,,,, � ,
N i
� + �Sl��i �
^ c,
NOTE:
Landscape upsiope of mound 6.0 ft x 140.0 ft Upper Dispersal Cell �
area to divert surface runoff System Elevetlon=104.53 ft
�.s•o sa,ai ao BfOUnd @fidS Of fll0Ui1CI 8f28. Lateral Invert Elevation=105.03 ft
PVC Oiatribution laterel �p ;
(�YP�ce�) <
fbW�i) _��o.o'
mfn.7.5(typicaQ 140.0' � (lyPicai)
� Observetion Pipe
(HPical) 8.0' < �tYW��)
�_ /
min.3.0'(typicel)
/;
min.12.0' � ,
��YP��e�? Turn-up I Flush Valve
. / Cover
�� (tYW�e�)
min.15.5'
(ty�ca+) 6.0 fl x 140.0 ft Lower Dispersal Cell
System ElevaUon=103.43 ft
20��`"°�0 Lateral Invert Elevation=103.93 ft
PVC Foru MNn
fC'D�)
Prohibit dfsturbance and vehicular traiAc
within 15 feet oF downsbpe toe.
Observation Pipe Scale: 1" = 12.0'
Detaii Schematic I I I I I
(no Scale) ��TM��
FLUSH N7TN GRWND SlX2fACE OR 3lIP CAP(LOOSE) O.O 'I Z.O Z4.O 3F).O 48.0
/4'0 PVC PIPE
TOP OF AGGREGATE � (IENGTH VARIES)
(4)�'X 4'LON(3
�o� s�ors��nvnRr Ed Taylor Project Neme: Scale es Irblrsted
�TOILETFLANGE WRH Eest Shore Cwidomirdums
7pP OF SAND FlLL 4• '� SaVENT WELD 5011 g�°P�97�um Replacement Septic System Projec19�1
Y.`S�OT Conaultinig
esa eu,nvenue Prepared For: Date: 05l2412019
ev.000,w�sae» East Shore Condomiruums Sheet 6 of 10
taylas2�chanrlwt N2173 OI'Haya Roed,Bkdiwootl,WI 54817
/�_�
�, #2 �M P RC3 P ERTY S ITE MA�,��-- ��5�--
uN l %�� `V�`
�v� � / /
�� � � f��,35;= P
} xaa x"' �, V t �a��
t ��T'�� �� ,�
arta�vrrww— - �
�w,�,�N� .. ..��x' � � � �i �/ ` �
� (^�
�wwwr�+i�a�wni� r�vi. � . r � � . ; .:�� r . � �� \��.�5 �\�i_ ..
,.ww.�. �l��, � �(�, :��"=�m.��", , , , �� �'.i'
OaM ':�.� ��..
•.•.—+war�.... #8 r1J' N .:..: ��� � 1D�
r.�nrr.w»iss
LAKE ,��.� �., �• X' ti".'«:: c�'C ., �"` . ; -�-j ����0� � �
: :,?.:
CHETAC � ,,.,n....��..,�,. _ • � o, ` �� .��'-.' �K,ar•�.......- _... 3S
..s ... � ..-
� _ �A� � - � r���-�''`�� , � �03�
weu Q "' n�.=,-.�"" 2
o�W
� A ia. +�. Ul � Ji� �.., �
av w ^
. w...r. �'• z�ws� � .. �'7
`� n�n..Re Jd�-MII: �" `
,......✓ ,,y
�S, ���.. � ..�+.w , i6o , D eI m � , 1,,.--�..,,�- � ���\ ���'d'
......... ..: , � � A
w • , ...., w , r � �
,,... �, .
N� � 41 ' �/ .'. � �
#8 / 8, � � � . � � �' f _ �� �0;�
�.� ■b+ � . -- \
�wM W.reCw� �
:'"Z��S, #5 ��r „p« r, �".`:.'. �/ /
,.. ;,,; �, ,�, ..' .. } �,1C)
.�w,�.�.� ��: X ,x ((/}� \
' v.ra~��rc a wm • a `,m 7� "� ,J�`�
� . � ��..; �.
�..�.,..,.�., _� g l��' �
' .,m�>�....,�,.,�. � ,
rnmv I �a" � 6 ` ,
•uM^4extic y
I+iM �� �Y&B • iql�� � .
#� �� ;M�.:83�.. . .�
a�u�wdu.ra.m � .
wrrMu�w. — .. ' 'P.
��w�wMr.r�"r� .'� ` . .. ...
r
� .�c�w .. � . ,
w.s���xw.i
"'---.� � 1,880gpd Design Flow
�-�--'-'� 'Two B.0'x 140.0'
���,�n � Mound Dlapersal Cells /�/�j ///////////
� (stepped elevetions- /
alterneteiy dosed�/ //�
/�� i�..d�w��i
/���� '��/j�."�.�
Scale: 1"=60' / //
o so ,za ,eo /
/
Ed Taylor Project Name: Scale as Indlcated
���� m East Shore Condominiums project#:
p � Repiecement Septic System �gpp�
CooBultio` —
eae em nv.rv,e Prepared Fa: Date: 05124/2079
�,�,W��i3 East Shore Condominiuma Sheet 3 of 10
uybn2�ctwter.t� N2173 OI'Heys Road,Bkchwood.WI 54817
/
TANK PLAN VIEW 3 � #R
DETA!L A # #2
��st�„� 2 BR � fl,3S
U��� � � G� �7� �� � � Bu��di g�sewer t.0. deCk
=93.60'
90.7 i .
n ;�3�� � >f 92.2 X 94.2 �
.
�>>
IMPORTANT: * S�np1 ft TankP
SEPTIC/LIFT TANK NeW g1'S
2'0 FM Existing X
1. Remove ail existing tanks W3000/1800 2•�FM � . 93.0
pursuant to SPS 383.33. mfd by Wieser Concrete Nail in UP
90.4 #4, =94.84'
Product File No: 20150214
2. Provide bedding beneath all vessels (See cut-sheet details.) ��f Prop T k 1 BR
and pipes pursuant to SPS 383.45(5). w/GF 10-16 BEST FILTER o�� �� �o t.o. deck
installed at ST outlet * �sa = 94.38'
3. Provide a minimum of 12 inches of soil mfd by Polylok Inc 91.0 (� �
cover over all pipes pursuant to 383.45(5). �NE�� � � X P�mp
4. All exisitng sewer pipe and force main . . 93 House
locations and elevations are approximate *4"Q�sanitary building sewer #$ . .- (�
pursuant to Table 384.30-3, Exlsting
and inferred-adjust replacement tank 2 BR s��m Fnn 92.3
location and elevation as necessa,ry during Wisconsin Administrafive Code X Q
installation to accomodate existing pipes. �NEw� 93,g
DRIVE . Fish Cleaning
Shack
Scale: 1"=20' g1.0 �
o � ,� �
WELL �
p t.o.well
=89.58'
' A � Ed Taylor Project Name: Scale as Indlcated
�-/"�KE �&��S � East Shore Condom�niums project ii:
CHETAC � � � . . �, �° ReplacementSepUcSystem �gpp�
�e�� Prepared For: Date: 051241'1019
�,p�,yyi�p�3 East Shore CondornlNums ShB6Y 4 Of 10
vY��z�«�^� N2773 OI'Heya Road,Birdrvrood,WI 5/817
,�'`ii
�
���
� ��'° \�C`c�
o� �
�
��
��
,
• wr'
��
A��ITIONAL C�MMENTS AN� SKETCH
SANITARY PERMIT NUMBER ____ �O_- � � �
1"' 1 1�9�- 1 c''�' � (�� �ct.?(�r S �.l4�
�(�(v 1 '�G�S �� ���^�s� �
1 '
c�.S� l \ •
�—