HomeMy WebLinkAbout026-939-20-5202-SAN-2020-158■%Industry Services Division1400 E Washington AveP.O. Box 7162jison.WI 53707-7162 _^1) C5=t fcf- jSanitary Permit Ap^cationIn aecorcluncc wilh SPS 183.21(2). Wii. Adiii. Ccxic. submission orthU timii to iheupproprinte governmental unitis fttjiiircd prior lo oblaintiig a siinilnry permii. Note: Application I'omvH I'or slnlc-ownixl POWTS are submineil tothe Ocparttncnl of Safely and Professional Scrvies. Personal informaltoii you pnrvidc may be used for secondarypurposes in uccordancc with the Privacy Law, s. IS.lMdXm). Slats.I. Application Informatiop - Please Print All InformationCountySawyerSanitary Permit Number (tu be filled in by Co.)State Transaction NumberProject Addnsss (if dilTcrent than mailing address)i916N West Shore Ln.OOProperly Owner's NameTim AudettePaitel«026939205202Property Owner's Mailing Address29177 Hilltyest Dr.Property IxxaiionCity. StateStacy MN_LZip Code55079II. Type of Building (check all (hat apply)I'J I or2 Kiimily Dwelling Number of Bedrooms 3j Public/Commercial - Descrilw Use; State Owned - Describe UsePhone Niunber'AVi, Section 2039UtHN; R 9(circle otKEofit)Subdivision NomeBlocict)CSM NumberU City of _□ VlUagc of,a Town of Sand LakeIII. Type of Permit: (Check only one box on line A. Complete line B if applicable)A,I. ! New SystemReplacement Systemrreutmeni/Holdlng Tank Rcplacctiient Only^^Other ModiHcalion to Existing System (explain)B.f] Permit RenewalBefore ExpirationIJ Permit Revisionn Change of Plumber[_! Permit Transfer to NewOwnerList Previous Permii Number imd Date IssuedfoJil^^-133IV. Type of POWTS System/Component/Device: (Check all (hat applyI'1 Non-Presstiri/ed In-Ground [7 Pressurized In-Ground I ' At-Grsde [..I Mound >24 in. of suitable soil D MQund<24in.ofsuiiablesoi1Ll' Holding Tank 1 OlJicr Dispersal Component (explain) H PnMn-amicni rv-virc (.-xplam)V. DIsperial/Trcalroent Area Information;iun flow (gpd)450 3^Design Soil Appliealion Ratcfgpdsf)Dispersal Area Required (sf)Dispersal Area Proposed (sf)System Elevation'Vl.Vank InfoCapacity inGallonsTout!Callorts^pooWofUnitsManufacturerPrefebConcrete! SteelbiFer ,GlasslPasticNewTiuiksExisting Tanks.Septic or lIuldingTank2p00oi-kr\i^1WieserXDosing Clismtvrf ) i • • t •VII. RespoPslblHty Statement- J, the undersigned, assume responsibility for Initallalloii of (he POWTS shown on thealtaclied plans.Plumber's Natite (Print)Rick BrownPlumber's SignutnrjMP/MPRS Number231251Business Phone Number715-419-0739Plumber's Address (Street, City. State, Zip Code)PO Box 637 Spooner W! 54801VIII. CounlyfPepartment Use Only>u^ T5j»&iS2^K' Disapproved: Owner Given Reason for DenialPermit Pec' YcO.Date ls.suedIs.suing Agent Signature_ huiuJc^'^fr\ojimmi2 8 2026IX. Conditions of Approval/Reasons for DisapprovalORIGINALNO REFUNDS AFTERISSUE OF PERMITAnacb to complete [daai for Ibc system and lebmlt to the County only on paper not less Iban 8f,AW"tER COUViTYZOI^iNG ADMltiiLtii'hA'i'lON
Sawyer County Zoning & Conservation Administration10610 Main Street, Suite 49^ \ 1't-P CqHayward, Wisconsin 54843(715)634-8288tax (715)638-3277E-niail: zoning.seaatsawvcrcoumvtfov.oruToll Free Courchouse/General Information I-877-699-4II0Sanitary Cover SheetPlot PlanHolding Tank Approval Checklist/er Sheet Date Stamp 0~T/ 2^/Parcel ID# ^ 2.4.-_2 A A ^ AK Property LinesX Site AddressjC, StructureX, WellX Legal DescriptionX Benchmark BM s•f. North Arrow~X Scale25' to Service Road><^earest Road Intersectiony Setbacks to: Property Line, Well, Structure, Water bodies, RoadsTIL Required PlansIndex Page with Original SignatureXManagemcnt Plan/Contingency PlanServicing ContractHolding Tank Agreement formIV. Holding Tank Specifications5<j.oX Cross-section - Manufacture, Galtons:C^X-AP®^ ^ 'K Tank Anchor Calculations [SPS 383.43^ g)]K Locking device, chains/locksSc Alarm and Electrical per NEC 300, SPS 316 & 383.43 (9) (e) andState Statutes 101.862(2) and 101.862(3)X 3" Bedding Material < 1/2 "Holding Tank Plans per Component POWTS ManualVersion 2 SBD-10855-P (R.3/07)...Owner;Application Review Date:POWTS Reviewer:Plumber:License#Revised 4/11/2013
CONCRETE HOLDING TANK DESIGNSingle Tank OptionINDEX AND TITLE SHEETProject AudetteOwner Tim AudetteAddress 29177 Hiilcrest Dr.Stacy MN 55Q79Legal Description Gov lot 2 Sec 20 Town 39 N Range 09WTownship Sand Lake County SawyerSubdivision NameParcel ID Number 26939205202Plan Transaction ID NumberLot No.Index and title sheetHolding tank specificationsSite planMaintenance and contingency planPage 1Page 2Page 3Page 4Designer Rick BrownSignatureLicense Number231251Phone No. 715-419-0739Date 07/05/20Designed pursuant to:Holding Tank Component Manual For POWTS (Version 2.0)SBO-10855-P (N. 03/07, R. 01/12)Version 7,0 (11/12)Page 1 of 4
HOLDING TANK SPECIFICATIONS2000.0Number of bedroomsNon-residential estimated flow (gpd)Minimum holding tank volume required (gal)2000.0 I Proposed holding tank capacity (gal)WiTeserW2000-MRSJEHW101JAlarm model numberank ManufacturerTank model numberAlarm manufecturerTank Dimensions and DataX for round tankLiquid depth below inlet invert (In)Maximum depth of soli cover (ft)46.08.066.0151.086.0Height (in)Length (in)Width (in)OutsideDimensionsOnly15370Tank Anchor Calculationslbs Weight of tank and coverSafety factorlbs Weight of anchor requiredin Soil cover req. for anchor or1.503105541.37.7yd Concrete counter weightHOLDING TANK CROSS SECTIONjunctionboxconduittether weightalarm onblind plugto sealoutletmanhole cover withlocking device andwem'mg labelfinishedgrade/vent capiManhole and vent locationsElectrical as perNEC 300and SPS 31612.0 in.34.0 in.Note; All tank joints, andjoints tietween tankopenings and piping aresealed watertight. Allpipe and vent materialscomply with SPS 384.12"mm.vent pipe"T~18*min.IIIDbuilding sewerinlet3 in. ixedding under tank.Tank is anchored as necessary to negate buoyancy.Project: AudetteTransaction NumberPage 2 of 4
HOLDING TANK SITE PLANProject: AudetteLegal Description: Gov lot 2 Sec 20 Town 39 N Range 09WSubdivision Name:Scale: 1" = 40ftParcellD: 26939205202Lot No.:J-Pa--'/'LV■O —D ^iis' /?Transaction I.D.:4^|y\ -- [oo.^ ?^5^ ^oO<~Page 3 of 4
HOLDING TANK MANAGEMENT PLANThis Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed andmaintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-PN. 03/07, R. 01/12), and the Sawyer County Sanitary Ordinance.1. This POWTS is designed to accommodate a wastewater flow of 60.0 to 400.0 gpd.2. The owner of this POWTS Is responsible for system operation and maintenance, including all provisions inthe attached Holding Tank Servicing Contract and Maintenance Agreements.3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet(at which time the alarm will activate), tira pumper listed in the current Service Contract must be called toempty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code.4. At each service event, the service provider should visually Inspect the condition of the tank, risers andmanhole cover(s) and verify that the alarm system functions and manhole locking devices are presentDiscrepancies are reported to the owner in a timely manner for corrective action. All corrective actionsshall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code.5. All service events or inspections of this POWTS shall be reported to the county within 30 days.6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to beremoved by any person not autiiorized to do so under Oh. 281, Wis. Statutes. The discharge of wastestank to the ground surface, including intentional discharges and discharges caused by n^lect, constitutesa filing POWTS and may result in issuance of correction orders or a citation by the county or state.7. No one should enter a holding tank for any reason without being in full compliance with OSHA standardsfor entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescueof a person from the interior of the tank may be difficult or impossible.8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tankmay be installed in the same location (a new sanitary permit is required for such a replacement). Connection to municipal services would also t)e considered at this time if they are deemed available to theproperty.9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned inaccordance with SPS 383.33 Wis. /Vdm. Code.10. If there is a problem with, or question about this installation, the following persons may be contacted;a. Installer Rick Brown Phone; 715-419-0739b. Service Provider Phone:c. Co. Zoning or Health DepL Sawyer County Phone; 715-634-828811.Project; AudetteT ransaction Number: Page 4 ol 4
1151"4" CAST-A-SEAL 4" CAST-A-SEALRLTER OR BAFFLETOP VIFW-J-OUTLETW2000-MRTANK SPECIFICATIONSDIMENSIONS:WALL: 2 1/2"BOTTOM: SEPTIC 3"HEAVY DUTY 5" (ADD 2,050 LBS.)COVER: 6"MANHOLE: 24" I.D. PRECAST CONCRETE RISERHEIGHT: 66" O.D.LENGTH: 151" O.D.WIDTH: 86" O.D.BELOW INLET: 53" O.D.□QUID LEVEL: 46"WEIGHT: 13,540 LBS. SEPTIC15,370 LBS. HOLDINGINLET AND OUTLET:4" CAST-A-SEAL BOOT OR EQUALGASKET, CAST-A-SEAL BOOT OR EQUALINLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL #10(OTHER STATES SEE CHAR^UQUID CAPACITY: 42.92 GAL/INLOADING DESIGN: 8' 0" UNSATURATED SOILHOLDING TANK:OUTLET HOLE PLUGGEDACTUAL CAPACITY: 2,146 GALLONSTANK CAN BE USED AS:SEPTIC/ HOLDING/ PUMP OR SIPHONCOVER: MIX DESIGN #8 (NO RBER)TANK: MIX DESIGN #10 (STRUCTURAL RBER)CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIE^R CONCRETEac3Oa.Vy<uI/)(£3oa.(/)Oa.>|iu <eg Qa.ffl<KO%<oIRI COI 3g(Om00ImC\lroIoo00ocsIoooSIDE VIEWTANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTSDRAWINGS SUBMITTEDFOR APPROVALAPPROVED BY:APPROVAL DATE:PROOUaS NEEDED BY:<Z<OI-Q.UJCOSHEET NO.1.OF1
Real Estate sawyer County Property ListingToday's Date: 7/29/2020Property Status: CurrentCreated On: 2/6/2007 7:55:48 AM-1DescriptionUpdated: 2/19/2018^ OwnershipUpdated: 11/21/2017Tax ID:28720TIMOTHY M ft BARBARA M AUDETTESTACY MNPIN:57-026-2-39-09-20-5 05-002-000020Legacy PIN:026939205202Biiiina Address:Maiiino Address:Map ID::2.2TIMOTHY M & BARBARA MTIMOTHY M 8i BARBARA MMunicipality:(026) TOWN OF SAND UKEAUDETTE29177 HILLCREST DRSTACY MN 55079AUDETTESTR:S20T39NR09WMlLLLKtSI UKSTACY MN 55079Description:PRTG0VTL0T2Recorded Acres:1.380Site Address * indicates Private RoadCalculated Acres:1.245Lottery Qalms:05916N WEST SHORE LNSTONE UKE 54876First Dollar:YesWaterbody:Sand LakeProperty AssessmentUpdated: 7/26/2019Zoning:(RRl) Residential/Recreational One2020 Assessment DetaiiESN:423CodeAcresLandImp.^ Tax DistrictsGl-RESIDENTIAL1.380112,20096,900Updated: 2/6/20071State of Wisconsin2-Year Comparison20192020Change57Sawyer CountyLand:112,200112,2000.0%026Town of Sand LakeImproved:96,90096,9000.0%572478Hayward Community School DistrictTotai:209,100209,1000.0%001700Technical CollegeRecorded DocumentsUpdated: 2/19/2018CORRECTION INSTRUMENTDate Recorded: 1/11/2018410612MAP OF SURVEYDate Recorded: 2/9/20182399-20CONVEYANCE RECORDED NOT USEDDate Recorded: 8/21/2017408228QUn CLAIM DEEDDate Recorded: 12/23/2015399222QUIT CLAIM DEEDDate Recorded: 12/31/2001296833 784/385PERSONAL REPRESENTATIVES DEEDDate Recorded: 10/23/1997263942 616/273WARRANTY DEEDDate Recorded: 10/20/1971138540' Property HistoryN/A
0'o9J9205205025939205204n ^ 'f'fHYDRO026939205203026939205202C2693S2052I4: 30202e93t2052l5<^5113 0702S9392057.IO