HomeMy WebLinkAbout030-737-33-3201-SAN-2020-248lndusir>' Ser\ ices Division-1S22 Madison Yards Way 53705I'O Box 7162Madison. WI 53705-7162C5>CountyS<g !,>>//* >•-Saniiary Pcrmit'Numbcr (to be filled in byCu.)Sanitary Permit ApplicationIn iiecordnnco wiiii SPS .^83.21(2), Wis Adm. Code, suhmission ol'iliis Ibnn lo the appropriate goveniniemal unitis reiiuircd prior to obtaining a saniiary permit. Note: Appliciiiion I'lirnis for siaic-imned POWTS are submitted tothe Deparinieni ot Safety tind Professional Servies. Personal inlbmiation you provide may be used for secondarypurposes in aeeordaiiee with the Privacy Law, s. 15.IH(I Km), SuitsState Plan Review NumberPWTS--C1I. Apiilicnlion Information - Please Print All InforiniitionProject Address (if different tlian mailing address)Fa!.Property Owner's NameParcel#Property Owner's Mailing Address'7yg'/< X///I 97~.Property LocationQovt. LotCity, Slate0 Tl/II. Type of Building (check all that apply)K I or 2 I'amily Dwelling-Number of Bedrooms gj?Zip Code4c>o 3 ^D Ptihllc/Commercial - Describe Use,D State (Jwncd - Describe UsePhone NumberLot #<iit^ '/., Section j ^(circle one)T *7 N; R_2_Ec^Subdivision NameBlock#CSM Number□ City of□ Village of.S Town of UySi f111. Type of Permit; (Check only one box on line A. Complete line B if applicable)A.New System^ Replacement SystemD Trcatmem/i lolding Tank Replticemcm OnlyD Otlter Modilleation to Existing System (explain)B,D Permit RenewalHcPorc HxpirationD Permit RevisionD Change of PlumberD Permit Transfer to NewOwnerList Previous Permit Number and Date IssuedIV. Type of POWTS System/Component/Dcvice: (Check nil that applyn Non-PrrsMin/eil In-firoiind D Pressurized In-Ciround D At-Urade D Mound > 24 in. of suitable soil D Mound < 24 in. of suitable soilHolding I'anp D Oiiier Dispersal Component (explain) D Preireaimcni Device (explain)V, Dispersal/Treatment Area Information:Ojsign blow tgpdlDesisn Soil Application Ratc(gpdsf)Dispersal Area Required (sf)Dispersal Area Proposed (sf)Svstcm ElevationVI. Tank InfoCapacity inGallonsKc» TanksExisting TanksTotalGallons#ofUnitsManufacturer£. it§i/1 7§t/i^ Jil OScpdc of Holdirii TankDnsingCtiamiscrVII. Rv.sponsibillty Statement- 1. the undersigned, nsstiinc responsiliility for Instiillalion of the POWTS sjumn on the atlnehed plans.^WlitMPRS NumberPlumber's Name ll'rini)^<s>j7a'/<7 KPliimbilumbePlumber's Signature/C.lJusincss Phone Numberr's Address (Sircci. City. .State. Zip Code)W ^77^ 5&// /^c/VIII. C^tity71)eimrtment Use Only^/X^lrofei:D DisapprovedD Owner Given Rea.son for DenialPermit FeeDate Is.sucdIX. Conditions of Approval/Reasons for DisapprovalIssuing Agent SignattireAttach to camplcte plans for the sysicm and submit to the County only on paper not less ihSH])-639K(R. 04/19)OCT 0 2 2020SAWYER COiZONING ADMINIS i i-i •• -JN
Sawyer County Zoning & Conservation Administration10610 Main Street, Suite 49Co'li Hayward, Wisconsin 54843(715)634-8288FAX (715)638-3277Toll Free Counhouie/Ccnerat Inrormallon 1-S77-699-41I0Holding Tank Approval ChecklistSanitary Cover Sheet Date Stamp iO / 02./Plot Plan_X_ Property Lines^Site AddressX Structure~^WellYLegal DescriptionParcel ID#_o 3.^?- 3 ^ O I_K Benchmark EM sX North Arrow*XScaleX< 25' to Service RoadNearest Road IntersectionSetbacks to; Property Line, Well, Structure, Water bodies, RoadsIII. Required PlansX Index Page with Original SignatureX Management Plan/Contingency Plan)( Servicing Contract•yC Holding Tank Agreement formIV. Holding Tank Specificationsy Cross-section - Manufacture, Gallons:J^Tank Anchor Calculations [SPS 383.43 8) g)]_)( Locking device, chains/locksy Alann and Electrical per NEC 300, SPS 316 & 383.43 (9) (e) andState Statutes 101.862(2) and 101.862(3)^ 3" Bedding Material < 1/2 "V. Holding Tank Plans per Component POWTS ManualX Version 2 SBD-10855-P (R.3/07)Owner:oVz?Plumber:Application Review Date:lo/or/>03u!POWTS Reviewer:License HRevised 4/11/2013
CONCRETE HOLDING TANK DESIGNSingle Tank OptionINDEX AND TITLE SHEETProject OttoOwner Matt OttoAddress 7906 Franklin St.Harvard, IL 60033608-628-2567Legal Description NW SW Sec.33 T37N R7WTownship WeirgorCounty SawyerSubdivision NameParcel ID Number 030-737-333201Plan Transaction ID NumberLot No.Index and title sheetHolding tank specificationsSite planMaintenance and contingency planHolding Tank agreementSen/ice ContractPage 1Page 2Page 3Page 4Page 5Page 6Page 7Page 8Designer Ronald R YoungSignatureLicense NumberMP 226713Phone No. 715-532-3777Date 09/28/20Designed pursuant to:Holding Tank Component Manual For POWTS (Version 2.0)SBD-1O055-P (N, 03/07, R, 01/12). . .Version 7.0 (11/12)Page 1 of 8
HOLDING TANK SPECIFICATIONS200.02000 0Number of bedroomsNon-residential estimated flow (gpd)Minimum holding tank volume required (gal)3000.0 [Proposed holding tank capacity (gal)Huffcutt3000 HDSJE RhombusTank AlertTank ManufacturerTank model numberAlarm manufacturerJAIarm model number60.0Tank Dimensions and DataX for round tankLiquid depth below inlet invert (in)Maximum depth of soil cover (ft)Height (in) "1 OutsideLength (in) r DimensionsWidth (in) J Only8.075.0156.884.521000Tank Anchor Calculationslbs Weight of tank and coverSafety factorlbs Weight of anchor requiredin Soil cover req. for anchor or1.503282742.88,1yd Concrete counter weightHOLDING TANK CROSS SECTIONjunctionboxmanhole cover withlocking device andvent capfinishedgradeManhole and vent locationsconduitvent pipe18 mlntether weight12.0 in.servicealarm onblind plugto sealoutletElectrical as perNEC 300and SPS 31648.0 in.Note; All tank joints, andjoints between tankopenings and piping aresealed watertight. Allpipe and vent materialscomply with SPS 384.3 In. bedding under tank.Tank Is anchored as necessary to negate buoyancy.building sewerinletProject: OttoTransaction Number:Page 2 of 8
HOLDING TANK SITE PLANProject: OttoLegal Description: NW SW Sec.33 T37N R7WSubdivision Name:Scale: 1" = 40ftParcel ID: 030-737-333201Lot No.:d..B/i. A Lr^as//^et ^PiatfO t/o/V' rish /Fc^'^<3ffc/cr'c/ syp'is.3c3/'^ yAcr-i°ansaction I.D.:Page 3 of 8RL
HOLDING TANK MANAGEMENT PLANThis Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be instaiied andmaintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manuai (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 80.0 to 600.0 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), the 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 present.Discrepancies 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 authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastestank to the ground surface, including intentional discharges and discharges caused by neglect, constitutesa failing 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 be 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. Adm. Code.10. If there is a problem with, or question about this installation, the following persons may be contacted:a. Installer Ronald R. Young Phone: 715-532-3777b. Service Provider Nothwest Sanitary Phone:715-943-2650c. Co. Zoning or Health Dept. Sawyer County Zoning Phone: 715-634-828811.Project: OttoTransaction Number: Page 4 o18
HOLDING TANK SERVICING CONTRACTContract Date: IJiTlThis contract is made between the Holding Tank Owner and the Pumper.Holding Tank Owner's Name:Pumper's Name:^/orThParcel Identiflcation Number:(12 Digit Legacy ID)1. The owner agrees to file a copy of this contract with the governmental unit, Sawyer County,which has accepted and recorded with the Office of the Register of Deeds, the MaintenanceAgreement for a Holding Tank required under the Sawyer County Private Sewage SystemOrdinance for the issuance of a Sanitary Permit for the installation of a holding tank(s).2. The owner agrees to have the holding tank(s) serviced by the piunper and gimrantees topermit the pumper to have access and to enter upon the property for the purpose of servicingthe holding tank(s). The owner agrees to maintain the all-weather access road or drive sothat the pumper can service the holding tank(s) with the pumping equipment. The ownerfurther agrees to pay the pumper for charges incurred in servicing the holding tank(s) asmutually agreed upon by the owner and pumper.3. The piunper agrees to submit to the Governmental Unit, Sawyer County, a report for theservicing of the holding tank(s) as required under SPS 383.55, Wisconsin AdministrativeCode and the Sawyer County Private Sewage System Ordinance. The pumper furtheragrees to include the following in the report;a. The name and address of the person responsible for servicing the holding tank;b. The name of the owner of the holding tank;c. The site address of the holding tank;d. The date the holding tank was serviced;c. The volumes in gallons of the contents pumped from the holding tank for each servicing;f. The disposal sites to which the contents from the holding tank were delivered.4. This agreement will remain in effect until the owner or pumper terminates this contract. Inthe event of a change in this contract, the owner agrees to file a copy of any changes to thisservice contract or a copy of a new service contract with Sawyer County within ten (10)business days from the date of change to this service contract.Owner's Name: (Print)f\MWj c/-l(pOwner's Signature: (Only one owner signature required)Pumper's Name: (Print)A/o/-yU if yePumper's Signature:Pumper's Registration Number: 'vrfRev. 03/26/13
- USE BLACK INK ONLY -8 04023565B 6POWTS MAINTENANCE AGREEMENTFor Holding Tanks427003PAULA CHISSERREGISTER OF DEEDSOwner's Name(s) as shown on deed:SAWYER COUNTY, WI10/05/2020 01:33 PMRECORDING FEE 30.00Parcel Identification Number:(12 Digit Legacy ID) ^ ^ .2. " -3. " 3 ^ /PAGES: 2Legal Description of Property:- SEE ATTACHED SHEET -We acknowledge that application Is being made for the installation of a holding tank(s) on theproperty described on the attached sheet.Return To: Sawyer County Zoning and Conservation /^ministration10810 Main St. Suite 49, Hayward, Wl 54843As an inducement to the County of Sawyer to issue a sanitary permit for a holding tank on the above-described property, the owner isresponsible for the operation and maintenance of the holding tank, locking device, alarm and access, and agrees to conform to allapplicable requirements of SPS 383, Wis. Adm. Code relating to holding tank management, including the following:1. The owner agrees to contract with a person who is licensed under Ch. NR 113, Wis. Adm. Code, except as provided bySection 281.48 (3) (d), Stats., to have the holding tank properly serviced and to file a copy of the service contract with thegovemmental unit. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new servicecontract, with the governmental unit within ten (10) business days from the date of change to the service contract.2. The owner agrees to contract with a person licensed under Ch. NR 113, Wis. Adm. Code, who shall submit pumping reports tothe govemmental unit in accordance with SPS 383.55, Wis. Adm. Code, for the servicing of the holding tank. In the case ofexemption under Section 281.48 (3) (d). Stats., the owner shall submit the report to the governmental unit. The governmentalunit may enter upon the property to investigate the condition of the holding tank when pumping reports may indicate theholding tank is not being properly maintained.3. If the owner fails to have the holding tank properly serviced in response to orders issued by the govemmental unit to preventor abate a human health hazard as described in Section. 254.59, Stats., the governmental unit may enter upon the propertyand service, or cause the tank to be serviced. Pursuant to Section 145.20(4) Wis. Stats., a govemmental unit may assess theowner of a private sewage system for costs related to the pumping of a septic or holding tank. The charges will be assessedas prescribed by Section 66.0703, stats. The owner agrees to pay all charges and cost incurred by the govemmental unit forinspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abateany human health hazard caused by the holding tank.4. This agreement will remain in effect only until the governmental unit responsible for the regulation of private sewage systemscertifies that either a soil absorption system that complies with SPS 383, Wis. Adm. Code, or a municipal sewer serves theproperty. In addition, this agreement may be cancelled by executing and recording said certification with reference to thisagreement in such manner which will permit the existence of the certification to be determined by reference to the property.5. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submitthe agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which willpermit the existence of the agreement to be determined by reference to the property where the holding tank is installed.Owner's Siefnaturej- Only one owner signature required -Owner's Ivame (Pni ,Date:Drafted by:OMvAtACKNOWLEDGMENTState of: (jJ j ^County of: "piiSubscribed and sworn to before me on thisQy day of . 20(Owner's Name): O'H-nSignature:"PL^^otary Name (Print): v. n^^^/..cor^ission expires on: 7~^o^ yPersonal infonrration you provide may be used for secondaryfcfgitees.rRrivacy paw^l^.i.04 (I) (m)]Rev. 03/26/13
The Northwest 5 acres of the Southwest Quarter, Section 33, Township 37 North,Range 7 West, Town of Weirgor, Sawyer County, Wisconsin
Real Estate Sawyer County Property ListingToday's Date: 10/5/2020-1^ DescriptionUpdated: 1/3/2004Tax ID:32426PIN:57-030-2-37-07-33-3 02-000-000010Legacy PIN:030737333201Map ID:.10.1Municipality:(030) TOWN OF WEIRGORSIR:S33T37NR07WDescription:PRTNWSWRecorded Acres;5.000Calculated Acres:4.763Lottery Claims:0First Dollar:YesZoning;(F-1) Forestry OneESN:432^ Tax DistrictsUpdated: 2/6/20071State or Wisconsin57Sawyer County030Town of Welrgor540735Bruce School District001700Technical College3AOwnershipProperty Status: CurrentCreated On: 2/6/2007 7:55:54 AMUpdated: 11/15/2019MATTHEW] OTTOHARVARD ILBiillna Address:MATTHEW] OTTO7906 FRANKLIN STHARVARD IL 60033Mailing Address:MATTHEW] OTTO7906 FRANKLIN STHARVARD IL 60033Site Address * Indicates Private Road278N IRISH RDEXELAND 54835Property AssessmentUpdated: 6/10/20202020 Assessment DetailCodeAcresLandImp.Gl-RESIDENTIAL5.00011,80035,7002-Year Comparison20192020ChangeLand:10,00011,80018.0%Improved:40,00035,700-10.8%Total:50,00047,500-5.0%Recorded DocumentsWARRANTY DEEDUpdated: 11/15/2019421071PERSONAL REPRESENTATIVES DEEDDate Recorded: 4/27/2017406404WARRANTY DEEDDate Recorded: 10/11/1985197615' Property HistoryN/A
030737321401I•-.3D73733?.3n->O'.o7i73j;io:-i 0307373323034 ih^ waL>£ a1O307373332017cwi5c/fW? '0♦!^W-^f--n-'*-7WL—iT T i I i i .\J I "VV03073732-•^030737333202i ' ' ■ W'^JWRfWm1