HomeMy WebLinkAbout026-939-27-5407-SAN-2020-151Safety and lluiltlines Division201 W, Washineton Ave,. P.O. liox 7162Madison. WI 53707-7162<2sr^^CountySawyerSanitary Permit Number (to be flilcd in by Co.)hSanitary Permit ApplicationIII nccontaiicc wjlh n Coitiiii 8.t.2l(2i. Win Aclm Code, iiubiiiis.11011 ut (liis tonn 10 the npprupriutc poveniinenln! iiiiil mreijuircd poor (o otitjiiniiip ii Mmlmy pvmiil Note Appllcntion Ibniis tor sliile-owncc! IK)W!S arc siibiniUod lo (liel)cp.iniiienl of C^iiiiiiicrcc. I^irsiniiil inroinialion you provide may be used Tor secondary purposes 111 accordance wiih Ihe-• '« oi'iv...' ei.i..Slate 'rransacllon NumberI. Application Information — Please Print All InformationProject Addrcs-s (il'dill^-tu than mailing address)( 7 5375NProperly Owner's NameDavid SchiitelingParcel Hi?26939275407Property Owncr'.s Mailing Address2075 Bunker BlvdCity, SlateRush City.MNZip Code55069II. Type of Building (check all that apply)a I or 2 l-amily I>weUing • Number of Bedrooms 2O Public/Commercial - Describe UseD Slate Owned - IX-scribc UsePhone NumberLot#Property LocationOovl. I.0I 4'A. 'A. Section 27T 39 N; R 9 WSubdivision NameBloc);#CSM Number□ City ofQ Village ofIII. Type of Permit: (Check only one boa on line A. Complete line B if applicable)A.U New SystemH Rcplacemciii System 3 Treatment/Holding Tank Replacement OnlyD Other Modification to lisisting System (explain)H.^ Permit RenewallleAire I xpirutioii3 Permit Revision3 Change of Plumber3 Permit Transfer to NewOwnerList Previous Permit Number and Date Issued■iIV. Type of POW l'S Systcm/Comuoncnt/ncvlce: (Check all that apply)^Non-ITcssurizcd fn-Oround D Ihvs.surized In-Oround D Al-Grade D Mound >24 in. of suitable soil D Mound < 24 in. ofsuitable soilD Holding l ank D Other Disper.sal Coniponenl (explain) D PreirealmenI Device (explain)V. Dispersal/Treatment Area Information:SE't.Design I'iow (gpd)300IXsigji Soil Applicalion Katetgpdsf)0.5Dispersal Area Required Isl)6011Dispcr.sjj^Arca J'roposed (sf)tUr-'rOWIfWKwrSyslcm iilevalionVJ. Tank InfoCapiicily inGallonsNew TanksIcxisiing TanksTolalGallons#ofUnitsManufactureraa.O(JoSeptic or Boldmg Tank84(1840WicscTDosing Ctiaiiiher500500IWiescrVII. RcsttonsihllUv StatcmenI- I. the undersiened. assume reapoasibilitv forlBsriHiHon of the POW l'S shown on the attached plina.I'luiiibcr's Name (IVinl)Travis BuilcrfieidPlumber's SMP/MPRS Number652879Business Phone Number715 634-8176i'lumbcr's Address (Street. City, Stale, Zip Code)14346 W State Kd 77 llayward. WI 54843VIII. Counly/Dennilnient Use Only□ Dtsanorovcd f "w"D Uwniif Gi\L'D Reason for Dcnifll rc (&sucdIssuing Agcni SignAluttIX. Conditions of Approval/Reasons for DisapprovalOiSBEzr'RIGINALNO REFUNDS AFTERISSUE OF PERMITjui, go imAR«bh>s«f»4rtcplao»kxihs(vmaBdB#raBbyifaBCd«w<«iK>«>turvinid k'v<lhui«b 1/2x11 iislrxn w*SAWYER COUNTYgONiNG AQMINISTRATIONSBD-6398(R. 10/11)
David Schmeling5375N{726939275407SawyerProperty Owners NameProperty AddressTax Parcel NumberCounty827T39NR9WTravis Butterfield652879(715) 634-817607/19/20Gov Lot or Qtr-Qtr/QtrSectionTownRangePage Index1 Property Information2 Data Entry3 Plot Plan4 Drainfield Cross-Section5 Dose Tank6 Maintenance Plan7 Contingency Plan8 County Parcel ListingPlumber's NamePlumber's SignaturePlumber's License NumberPlumber's Phone NumberDateNot an endorsement, written or implied for ttie following companies and products; DelZotto Concrete, WIeser Concrete ProductsInc., Skaw PreCast Co.. Huffcutt Concrete Inc., Zabel Environmental Technology, ITT lndustrles(Goulds>, The Penlair PumpGroup(Myers), Infiltrator Systems, ADS Products, Polylok Inc., Orenco Systems Inc.. SimfTech Filter Inc.. Sta-Rite Industries,Page 1 of 8
7 20y) Office ofCounty Zoning AdministrationMVW^^10610 Main Street Suite 49Hayward, Wisconsin 54843(7l5)634-82Xt(FAX (715)638-3277\cww.s;i>vvcrcmiiilvL'i>v.iireK-mail: /nnine.secto sjwvercoimiveov.cirnToil Free Couritiousc/Gencral Information 1-877-699-4110•! "7 / ',^0N-oorv—ORIGINALSAWYER COUNTY SANITATION DEPARTMENTTEiVlPORARV EMERCKNCV TANK INSTALLATION APPROVALPROPERTY OWNERS NAME:TOWN OF; _$ADDRESS: 5~3 75~ /, / jfJ-/TO^ ef, a WisconsinLicensed Plumber, authorized by the owner, do hereby acknowledge that I am receivingtemporary approval to install a septic tanlc/holding tank without a soil and site evaluation,or existing system evaluation, and private sewage system plan review due to inclementweather and/or health and/or safety emergency.Further, I acknowledge that a soil and site evaluation, or existing system evaluation, andprivate sewage system plan review will be conducted by the deadline stipulated by thepennit issuing agent, or as soon as weather conditions or circumstances permit. If theprivate sewage system is found to be failing as defined in s. DSPS 381.01 (92), Wise.Adm. Code, corrective measures will be taken as such that the private sewage systemcomplies with all applicable requirements of chapter DSPS. 383, Wis. Adm. Code,within 91) days of this agreement.1 further acknowledge that failure to comply by obtaining all necessary pennits afler thedeadline date may result in the issuing of a citation, under Section 11.3 {2) SanitaryPermits], of the Sawyer County Citation Ordinance.DEADLINE FOR THIS AGREEMENT SHALL BE:Signed:Date: *^0^0Accepted by:Date of temporary emergency approval: j 3jRev. 03/26/13
In-Ground Sot! Wjsorption SBD-10705-P (N.01/01) Version 2Component Manual Used2Number of Bedrooms5Percent Slope (%)108Depth to Soil Limiting Factor (in.)0.5In Situ soil application rate200Estimated Wastewater Flow (gpd)300Design Wastewater Flow (gpd)Number of System ElevationsProposed System Elevation #1Proposed System Elevation #2Proposed System Elevation #3Original Grade #1Finished Grade #1Original Grade #2Finished Grade #2Original Grade #3Finished Grade #3Infiltrator Quick 4 StandardChamber Type15Height of Chamber (in.)20sq.ft. per chamberA"-./- •Rows of Chambers5.1sq.ft. per pair of end capsJ " 'Distance Between Cells (ft.)Proposed Number of Chambers Used600.0Minimum Distribution Cell Area Required (sq.ft.)ERRORDistribution Cell Area Proposed (sq.ft.)Wieser 840/500Septic TankDose I ank (if applicable)! |Polylok PL-525Effluent Filter"select only if NOT using combo tankSoil BoringNumberSurfaceGradeElevation (ft.)Depth toLimitingFactor (in.)LowestElevationHighestElevationSystemElevationAcceptable198.0010892.0096.75FALSE23.00-1.25FALSE33.00-1.25FALSE45Page 2 of 8
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•pprov<»<J Mpnnoie i.ovp^ wtf we— — ; _.Li- .ond L0Cl<i"5 Dsvice / ■*" M'n Above ^'-Ql C^cdc4" Sch, 40 Venl> Of — to 1?"Above Finol GfodoInlet 11BaffleDIseoniPolylok PL-525Wieser 840/500Weothef Proof Junction Bo*eieetr>c per ^EC 300 Se COMM.16.28 WACAlternate Outlet Locotlonw/Approved 4" SleeveForcemain Diameter (in.)'eep Hole or Ar>ti Siphon Device20521800.921.6653.66Flow in GPMVertical Difference Between Pump Off and Inlet to ChamberLength of Forcemain(ft.) InchesForcemain Diameter (in.) AFriction Factor per 100ft. BFriction Loss 0Total Dynamic Head DTOTAL5.1Gallons6029.3489.3475020.28Numt>erof Doses per DayGallons per Dose (Not to exceed 20% of Daily Design Flow)Volume of Forcemain BackflowTotal Dose VolumePump Tank Capacity (Gallons)Pump Tank Volume (Gallons / Inch)200240.564.489.3420.7420.1032.2750JPump Type20|Minimum Discharge Rate (Gallons per Minute)SJE Rhombus - Tank Alert 1 | Alarms§iPUMP PERFORMANOT CURVEl400EL1St'1S2f1S314 ''5)N17-\lU\•f1stS.\\§ ,•N.\>\\4-N\\3-\\NMiCNSha ?0 30 40 M «0 r» B0 «0 1QDKOWPffl WMVTC
Service EventService FrequencyInspect condition of tank{s)At least once every3|Year |Pump out contents of tank(s)When combined slueqe and scum = 1/3 of tank volumeInspect dispersal cell(s)At least once every3YearClean effluent filterAt least once every3YearInspect pump, pump controls & alarmAt least once everyDavid Schmeling5375N2.69E+10Number of BedroomsEstimated Flow (average) gallons / dayDesign Flow (peak). (Estimated x 1.5) gal/daySoil Application Rate gal/day/ft^2003000.5Influent I Effluent QualityFats, Oil & Grease (FOG)Biochemical Oxygen Demand (BODs)Total Suspended Solids (TSS)Monthly Average30 mg/L220 mg/L150 mg/LSeptic TankWieser 840/500Effluent FilterPolylok PL-525Pump TankWieser 840/500Pump TypeIINOTEIIMaintenance ScheduleServicing frequency of 12 months or less requires theManagement Plan be recorded with the Register of Deeds.Maintenance InstructionsInspections of tanks and dispersal cells shall be made by an individual carrying one of the followinglicenses or certificationsiMaster Plumber, Master Plumber Restricted Sewer, POWTS Maintainer, SeptageServicing Operator. Tank inspection must include a visual inspection of the tank(s) to identify any missingor broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum andto check for any backup or ponding of effluent on the ground surface. The dispersal cell(s) shall be visuallyinspected to check the effluent levels in the observation pipes and to check for any ponding of effluent onthe ground surface. The ponding of effluent on the ground surface may indicate a failing condition andrequires the immediate notification of the local regulatory authority.When the combined accumulation of sludge and scum in any tank equals 1/3 or more of the tankvolume, the entire contents of the tank shall be removed by a Septage Servicing Operator anddisposed of in accordance with ch. NR 113, Wisconsin Administrative Code.A service report shall be provided to the County Zoning Department within 30 days of any serviceevent.Start-Up and OperationFor new construction, prior to use of the POWTS check treatment tank(s) for the presence ofpainting products or other chemicals that may impede the treatment process and / or damage thedispersal cell(s). If high concentrations are detected have the contents of the tank removed by alicensed Septage Service Operator.System start-up shall not occur when soil conditions are frozen at the inflttrative surfoce.Page 6 of 8
Do not drive or park vehicles over tanks and dispersal cells.Reduction or elimination of ^e following from the wastewater stream may improve the performance andprolong the life of the POWTS: antibiotics, baby wipes, cigarette butts, condoms, cotton swabs,degreasers, dental floss, diapers, disinfectants, fat, foundation drain (sump pump) water, gasoline,grease, oil, painting products, pesticides, sanitary napkins, tampons, and water softener brine.AbandonmentWhen the POWTS fails and I or is permanently taken out of service the following steps shall be taken toinsure that the system is properly and safely abandoned in compliance with Wisconsin AdministrativeCode SPS 383,33;- All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.- The contents of all tanks and pits shall be removed and properly disposed of by a Septage ServicingOperator.- After pumping, all tanks and pits shall be excavated and removed or their covers removed and the voidspace filled with soil, gravel or another inert solid material.Continoencv PlanIf the POWTS fails and cannot be repaired the following measurers have been, or must be taken toprovide a code compliant replacement system: (Check One)^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS asoil and site evaluation shall be performed to locate a suitable replacement area. If no replacement areais available a holding tank may be installed to replace the failed POWTS.A suitable replacement area has been evaluated and may be utilized for the location of a replacementsoil absorption system. The replacement area should be protected from disturbance and compaction andshould not be infringed upon by required setbacks from existing and proposed structures, lot lines andwells. Failure to protect the replacements area will result in the need for a new soil and site evaluation toestablish a suitable replacement area. Replacement systems must comply with the rules in effect at thattime.r"A suitable replacement area is not available due to setback and/or soil limitations. A holding tank maybe installed to replace the failed POWTS.I'WARNING!!Septic, pump and other treatment tanks may contain lethal gasses and/or insufficient oxygen. Do notenter a septic, pump or other treatment tank under any circumstances. Death may result. Rescue of aperson from the interior of a tank may be difficult or impossible.POWTS InstallerNameTravis ButtertieldPhone #(715)634-8176POWTS MaintainerNameButterfieid Inc.Phone #(715) 634-8176Septic PumperNameScott PoppePhone#(715) 634-1450Local Regulatory AuthorityAgency1 Sawyer County ZoningPhone #715-634-8288Page 7 of 8
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Office of v�
��� � � �� yer County Zoning Administration � �
��ER CO� T� 10610 Main Street Suite 49 1'� ti,�s�
���Q�l��� Hayward, Wisconsin 54843
��R COG�, (715)634-8288
�S1 .L I� FAX(715)638-3277
�,Q .�� www.sawyercounty o� v,org
�y ; - ' _ �� E-mail:zonin .�sec(a�sawyercountygov.org ,
/ o -\ - 'o / ToII Free Courthouse/General Information 1-877fi99-4110
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SAWYER COUNTY SANITATION DEPARTMENT
TEMPORARY EMERGENCY TANK INSTALLATION APPROVAL .
PROPERTY OWNERS NAME: dq�'� Sc`jnit�//��r
TOWN OF: S��l,��p
ADDRESS: .�-3 7.� �k..t�yV ��.,CP �`t/
:.
I, ��;,(� ��e�-_-, e ( , a Wisconsin
Licensed Plumber, authorized by the owner, do hereby acknowledge that I am receiving
temporary approval to install a septic tank/holding tank without a soil and site evaluation,
or existing system evaluation, and private sewage system plan review due to inclement
weather and/or health and/or safety emergency.
Further, I acknowledge that a soil and site evaluation, or existing system evaluation, and
private sewage system plan review will be conducted by the deadline stipulated by the
permit issuing agent, or as soon as weather conditions or circumstances permit. If the
private sewage system is found to be failing as defined in s. DSPS 381.01 (92), Wisc.
Adm. Code, corrective measures will be taken as such that the private sewage system
complies with all applicable requirements of chapter DSPS. 383, Wis. Adm. Code,
within 90 days of this agreement.
I further acknowledge that failure to comply by obtaining all necessary permits after the
deadline date may result in the issuing of a citation, under Section 11.3 [2) Sanitary
Permits], of the Sawyer County Citation Ordinance.
DEADLINE FOR THIS AGREEMENT SHALL BE: �� �� �o a'�
Signed: ,��� �
Z �
Date: 5v—\�� ��� �a-d
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Accepted by: ��%,%� � ,.-.���,�.__.__`
Date of temporary emergency approval: ?� ���
Rev. 03/26/13
'F"'"'"`�� PRIVATE ONSITE WASTE TREATMENT cou�ty
=����a _ SYSTEMS Sawyer
;,1 �s ( POWTS)
..�.lN`R.�___:.�:;.
-`'���'"�-` INSPECTION REPORT Sanitary Permit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION S
Personal inYormation you provide may be used for secondary purposes[Privacy Iaw,s. 15.04(()(m)] �v \ `
Permit Holders Name: ❑City ❑ Village Town of: State Plan Transaction ID#:
�c-.� .Ci JC.�n \,-�c �C�
Insp BM Elev: BM Descrip n: Parcel Tax No:
i,�U t�Cv �•—v C.�'r C��t�-e� c�,.c.s��e���. U�� ,C1�� -a�- �`I G'7
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic � .,,z�� �S`�u �� Benchmark \.—;� \��7'�
Dosing
Aeration Bldg. Sewer �j7
Holding St/Ht Inlet cj�, ���.
TANK SETBACK INFORMATION St/Ht Outlet �{� 7S
TANK TO P/L WELL BLDG VENTTO ROAD Dt inlet
AIR INTAKE
Septic x�� �/�t ��' NA Dt Bottom Cj 3,�;�
Dosing NA Installation
Contour
Aeration NA Header I Man.
Holding Dist. Pipe '
PUMP 1 SIPHON INFORMATION Infiltrative
Surface
Manufacturer 2`,��, Demand Final Grade
Model Number ��� GPM
TDH Lift Friction Loss Sys Head TDH Ft
Forcemain L Dia Dist.To Well
DISPERSAL CELL INFORMATION
DIMENSIONS W � #of Cells Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav ° Conv ❑ Aggregate
INFORMATION P I L Bidg We�� Waters o GP ❑ Chamber Model Number:
❑ EZFIow
CELL TO ❑ Mound o Other
___— _ _ _ — -- --—
DISTRIBUTION SYSTEM x Pressure Systems Only
9 ' 9 p X Hole Size X Hole Observation Pipes
Header/Marnfold Distnbution Pipe(s) '
Len th Dia�Len .th Dia S ac _ _ '', Spacing ❑Yes ❑No JI
SOIL COVER
Depth Over Depth Over ! Depth of Seeded/Sodded Mulched
Cell Center �Cell Edges Topsoil ❑Yes ❑ No ❑Yes ❑ No
COMMENTS: (Include code discrepancies, persons present,etc.)
��.� � ,�,_� �.�.5��,���.�., --�/����:��:
_ �
Plan revision re wred.❑Yes❑ No ' �� � i ��� \� `�
q � � � �� � �., ��: . ,
� -
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
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Real EState Sawyer County Property �isting PropertyStatus: Current M
Today's Date: 7/7/2020 Created On: 2/6/2007 7:55:49 AM �
�Description , Updated: 8/23/2010 � Ownership Updated: 8/23/2010
-- -____ __ __---_ --__ __-- _.___ _ _ ___—_—_.__._.______.----
Tax ID: 29080 DAVID R&GISELE T SCHMELING RUSH CITY MN
PIN: � 57-026-2-39-09-27-5 05-004-000070
Legacy PIN: 026939275407 Billing Address: Mailing Address:
Map ID: :4.7 DAVID R&GISELE T DAVID R&GISELE T
Municipality: (026)TOWN OF SAND LAKE SCHMELING SCHMELING
STR: 527 T39N R09W 2075 BUNKER BLVD 2075 BUNKER BLVD �
RUSH CITY MN 55069 RUSH CITY MN 55069
Description: PRT GOVT LOT 4 LOT 3 CSM 4/222 #786
Recorded Acres: 1.500 •
Calculated Acres: 1.443 � Site Address * indicates Private Road
_ __ _----_.
Lottery Claims: 0 5375N HUNGRY LAKE LN STONE LAKE 54876
First Dollar: Yes
Waterbody: Hungry Lake �.� Property Assessment Updated: 9/28/2017
_ _ _
Zoning: (RRl)Residential/Recreational One 2020 Assessment Detail
ESN: 423 Code Acres Land Imp.
G1-RESIDENTIAL 1.500 105,200 104,800
� Tax Districts Updated: 2/6/2007
___ --- _ _ _ _._. __
1 State of Wisconsin 2-Year Comparison 2019 2020 Change
57 Sawyer County Land: 105,200 105,200 0.0%
026 Town of Sand Lake Improved: 104,800 104,800 0.0%
572478 Hayward Community School District Total: 210,000 210,000 0.0%
001700 Technical College
: Recorded Documents Updated: 9/23/2014 �Property History
_ __- _ ___ __ ------- ------
WARRANTY�DEED _ _ _ _ __. N/A
Date Recorded: 8/26/2005 332907