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Home My WebLink About024-741-30-5228-SAN-2020-216WA jJIndustry Services Division1400 E Washington AveP.O. Box 7162Madison, Wl 53707-7162CountySawyerSanilaiy Pennil Number (to be filled in by Co.)Sanitary Permit ApplicationSuite Trentui-iion NumberIn nceordunce uilh SI'S 38.V2I(2), V/i&. AOm. Code, submission ol'ilus (onn to ihc eppropriule governmental unitis rc(|uircil prior to ohiniuing a snnilary pcmiil. Note: Applicnlioii forms I'or stnlc-owned POWTS arc submitted tothe Department of Safety and Professional Serv'ics. Personal infomiation you provide may be used for secondarypuntories in accordance with the Privacy Law, s. l5.Q4(l)(nt), Stats,Project Address (if dilierent than mailing address)Sandy Beach Rd1. Appliciition Infoi'mation - Please Print All InfortitalionProperty Owner's NameBareis Family TrustParcel H024741305228Property Owner's Mailing Address815 N KensigntonProperty LocationGovl. Lot ^City. SlateLa Grange ParkII. 'I'ypc of Bulliling (check all (hat apply)1^1 or 2 I'amily Dwelling-Number of Bedrooms _Zip CodeIL□Public/Commercial - Describe UseaSlate Owned - Describe UsePhone Number'/a.Vi. Section 3®41Lot#2N: R 7 WSubdivision NomeBlock#CSM Number36/142Qcily ofQvilbgeof] Town of LakeIII. Type of Permit: (Check only one box on line A. Complete line ]) if applicable)A.jNew Systemn Replacement System O Trcalmeiit/IIoldingTaiik Replacement Only[^Oilier ModiCcnlion lo Existing System (explain)B.I~l i'cnnil RenewalBefore Kxpiiatinnl~l Permit Revisionl~lciianBc of llumber[3]Petniil Transfer to NewOwnerList Previous Permit Niunber and Date IssuedIV. Type of POWTS System/Compopcnt/Dcvlce: (Check all that annlyNon-Pressurized In-Ground DPressurized In-Ground l~Ui-C;rBde ^^Mound >24 in. of suitable soil Q Mound < 24 in. of suitable soilI illolding Tank ^Doiher Dispersal Component (explain) ^nPretreatineoI Device (explain)V. Dispersal/Treatment Area Information:I>esign llnvv (gpd)450Design Soil Application Riile(gpdsf)0.7Dispersal Area Requited (sf)643Dispersal Area Proposed (sf)652System Ltcvalion96Vi. l ank iDfuCapacity inGallonsNew TanksExisting TanksI'oUlGallons«orUnitsManufacturer:ua 28^ §CSeptic OS Holding Tnnk10001000WieserXDosing C'hambnVII. Rcspoiisiliility Statement- 1. the undcrifgncd,rcspuniiblllly for fintnllatfon of Iho POWTS shown on the attached plans.I'lunibcr's Nnmc (Prinl)Travis ButterfleldPlumiigneturoMP/MPRS Number852879Business Phone Number715-634-8176Plumber's Address (Street, City, Slate. Zip Code)14346W state Rd 77. Hayvigrd, Wl 54843Vm. t-'ouiitv/Depnrtinent Use OnlyD DisuppnjvcdD OvsTicf Gi\ en Reason for DenialPcnnil FeeSDale IssuedIssuing Agent SignatureIX Conditions of ApprovaL/KeasonsJoi^iiapprovalTTAtlaeh lo (ompleie plans for thr system and submit lo tbr County ost}- on paper not less Iban 8 1/2It ' ■ ■■SBD-6398 (R0313)SEP 1 0 2020SAWYER COUNTYZONING ADMINISTRATION PAGE 1 OF 4In-Ground Gravity PlanIndex & Cover SheetComponent Manual Design References:Version 2.0, SBD-10705-P (N.01/01, R. 10/12)Pg1 of 4Pg2of4Pg 3 of 4Pg 4 of 4Index & Cover SheetPlot PlanDispersal Area Cross-Section & Plan ViewManagement PlanAttachments:Enclosures:POWTS Application for ReviewSoil Evaluation Report & Site MapProject Name / DescriptionOwner Namefs): Bareis Family Trust Phone:Owner Address: 815 N Kensington, La Grange Park, IL zip: 60526Project Address: Sandy Beach RdGovt. Lot: 21/4 ofE [~Township: Round Lake.1/4, Section 30 t41 n.r7County: Sawyerl or wl^Project Parcel ID #: 024741305228Designer InformationDesigner Name: Travis Butterfieid Phone: 3 .634 .8176Designer Address: 4346W State Rd 77, HaywardE-mail: office@butterfielddriiling.eomLicense Number: 652879Remarks:Zip:.54843This space reserved for approval stamp.Signature:Original signature required on each submitted copy.Date: f CHECK BOX AS APPUCABLE.□ SOIL EVALUATIONSITE MAPCHECK BOX AS APPUCABLE ^g SYSTEM page 2 OF YPLOT PLANScale: 1" = 40'40 60PROJECT NAME:V//////V/10'%DESIGN FLOW:GPDPROJECT ADDRESS:BM Elevation:BM Symbol:BMDescripbon: 34 OAk./Oo ,oFTAttach design flow calculations for commercial plans.Slope Gradient (%)of Tested Ares:Well Symbol (It applicable): OIndicate north bydrawing on snowon the opproprtte One.Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5)iJSanltaiy Sewer H /Force Main: /IMPORTANT:Show ground elevation contours at suitable Intervals./Oo'Ha.-I rV 3L,"Do?^ I 1 . ' • 1 > r i/aJd(/irn(> 1 ^j^/»1 - /OO.Oi)h nofi—''y TV-j'-%(<5" a'U ^ •Sec SOfr+ C.0+i4<r- /r«(Jmpa's c>s-?<8'yilooo <;<l( C»'^e'P^CLiAi'eA M8esf F/A'^'-fj i'lH/fy AJt. IN-GROUND GRAVITY DISPERSAL AREAUniform Elevation Trenches with Quick4 Standard-W Chambers3-ft Trench (down-sizing credit)Septic Tanl<(s) ManufacturerWieser Conrete1000Septic Tank(s) Voiume(s);Effluent Filler ManufacturerSOIL COVEREffluent Filter Model #: 10~812'min. Irencndepth(typical)34" _(typical)TYPICAL TRENCHCROSS SECTION VIEW(No Scale)Quick4 Standard-Ww/End Cap>— (typical)System Elevation = 96^_(typical)(Show location of inlet / outlet pipe connecfion on plan view.)Provide minimum 3 ftseparation tjetween trenches.Otjservaiion Pipe(typical)Install per mahufactinei's/ Inslruclions.B= 64 ftIA = 3.0ft(typical)TYPICAL TRENCHPLAN VIEW(No Scale)(typical)INSTALL PER TRENCH;Quick4 Std-W @ 20 ff EISA/chamber = 620_ Pairs of end caps (@ 6 ft^ EISA/pair = 6= Proposed EISA per trench = 626^Quick4 Standard-W Chamber(typical)(mfd l)y Infiltrator Systems, Inc.)Install pursuant to manufacturers mstructions.ft^ Required Infiltration Area = 643 ftz Distribution Method;trenches = Proposed Total EISA = 652 ft= branched manifold PAGE 4 OF 4In-ground Gravity Management PlanIMPORTANT:The owner of this In-ground gravity system shall be responsible 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 Malntalner inaccordance with SPS 383.52 (3), Wise. Admin. Code.Maximum Dispersal Area Operating Limits:Design Flow = gpd; BOD5<220mgL ^ TSS<150mgL ^ FOG^SOmgL-Inspection Checklist INSPECT EVERY 3 YEARSo type of useo age of systemo nuisance factors {i.e. odors, user complaints, efc.)o mechanical malfunction (i.e., pumps, valves, sv\rftches, 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 cell prior to dosingo dosing Irregularities - If applicable {i.e., pump re-cycling, float switch settings, etc.)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 tankfst 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 NR 113, Wise. Admin. Code.o Effluent filterfsl shall be Inspected every 3 years and shall be cleaned when necessary to remove anyaccumulated solids according to manufacturer's specifications. A servldng 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: TraviS ButtcrfiGld Phone: 715-634-8176Local government unit: Sawyer County Zoning & Conservation phone: 715-634-8288Local government unit address: 1Q61Q 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 failed or malfunctioning components shall 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.Contingency 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-determlned 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.