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026-939-23-5108-SAN-2021-323
"'`'R'-`"f�%; PRIVATE ONSITE WASTE TREATMENT county ix;'�asp l��` SYSTEMS Sawyer , , ,�, ,\h�,—is;;' ( POWTS) � INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION � l _ 323 Personal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)] Permit Holder's Name: ❑City ❑ Village �Town of: State Plan Transaction ID#: G�q�t�s �- �7 ►I� � �1�.��-i-- 5��� �� ^ Insp BM Elev: BM Description: Parcel Tax No: �o�.a' �b� J��s;�l�� d �.6-��i-��3—�'rog TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic �,,ie�� o�o Benchmark � .SSt l�l• � f��o� Dosing Aeration Bldg. Sewer .6�' 9 .g7' Holding St I Ht Inlet �(� � �t7�S-' TANK SETBACK INFORMATION St l Ht 0utlet �/,,2 ' R-�.3 � TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet � AIRINTAKE Septic +to` �O' ' {-9� NA Dt Bottom - Dosing NA Instaliation Contour Aeration NA Header/Man. Holding Dist.Pipe PUMP/SIPHON INFORMATION Infiltrative Surface Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Weil DISPERSAL CELL INFORMATION DIMENSIONS W L #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv J�Aggregate INFORMATION P/L Bldg We�� Waters � GP ❑ Chamber Model Number: ❑ EZFIow CELL TO a Mound o Other DISTRIBUTION SYSTEM x Pressure Systems Only Header/Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes� Length Dia Length Dia_ _ Spac � __ Spacing ❑Yes ❑ No J SOIL COVER Depth Over Depth Over Depth of Seeded/Sodded Mulched Cell Center �ell Edges Topsoil ❑Yes ❑ No � ❑Yes ❑ N� COMMENTS: (Include code discrepancies, persons present,etc.) ����¢� �j'�3 al�o�- I � ��T• r�e�qcerwH—� o�„l y Plan revision required?❑ Yes� No I���v7 v1�,J L_ --_��_ - ----� ��'f .� 1 �, Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) . ` ���� O�ce of ` ,� �,x �,�` � Sa er Coun Zonin Administration � j wY tY g �`� , 10610 Main Street Suite 49 �'�-`� ������ � Hayward, Wisconsin 54843 � � , ��� �� � '3�ER C��, (715)634-8288 � �> �� � �� I FAX(715)638-3277 �;; l_� � �� C.Y �Q .+�I www.sawvercountygov.ore C..;i �`�` �tA ',�j E-mail:zonin .g secCn%sawvercoun ov.org S�h � ��� ��o �o� Toll Free Courthouse/General Information 1-877�99-4110 �'" . O �1,� �'�`L'sco��" 2 �c�,S'��l �O?1 `� �....• ?? �- l = ��:�Q�r��UNTy �� � sr,�aT�y SAWYER COUNTY SANITATION DEPARTMENT TEMPORARY EMERGENCY TANK INSTALLATION APPROVAL � � PROPERTY OWNERS NAME: Gl�c,r{�S � �I;T(t►� P��.c��s-( `� . � TOWN OF: �o.w� I--�.L-� ADDRESS: (�c�::,5 N ,��k•� �i l�4 . C'� � ��� I, , �r^y �;> �� _,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 HIS AGREEMENT SHALL BE: �� �� ?I� I I - �,— �' � Signed: Date: ��� 1 Accepted by: � �1�� J Date of temporary emergency approvaL• _ � ��',! ' � � Rev. 03/26/13 .- .� . �DILH� SANITARY PERMIT APPLICATION �a�� •;y_ � R In accord with ILHR 83.05,Wis.Adm.Code A, � CST 82-254 Sa er � � STATE SANITARY PERMfT# -Attach comptete plans(to the county copy only)for the system.on paper rtot less than 151081 8f�x 11 inches in size. ❑CheClc It revialon to prevloua epplicatlon -See reverse side tor instructions for completing this applEcation. STATE PLAN I_D.NUMBER 1. APPUCANT INFORAAAT�ON-PLEASE PRINT ALL INFORMATION. Gov' t L o t 1 �oPearrowNea a les ckaert PR PERTYLOCATION � N s �r+F�-- �'/.�'/4,s 23 r 39,w, R 9 w PROPEA7Y ONMER'8 ILINO ADDRESS LOT# � •1 •$ BLOCK� 3 CITY,8TATE ZIP CODE PHONE NUMBER 3UBDIVI810N NAME OR CSM NUMBER ' O� {I. TYPE OF BUILDINO: (Check one) ❑State Owned v�w+aE� � D L��- NE�Es7��n � ❑ Public �1 or 2 Fam.Dwelling-{�of bedreoms 3 Me ni. BUILDlNO USE: (H bulldtng type Is public,cneck an wat appiy� 0 2 6-9 3 9-2 3-510 8 1 ❑ ApUCondo 2 ❑ Assembly Hall 8 ❑ Medical Facility/Nureing Home 10 ❑ Outdoor Recreatianal Facility 3 ❑ Campgraund 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestauranUBar/Dining 4 ❑ Church/Schoot S ❑ Mobfle Home Park 12 ❑ Service Station/Car Wash' 5 ❑ Hotel/Motel 9 ❑ Oftice/Factory 13 ❑ Other: Specify fV. TYPE OF PERMIT: (Check only one In Iine A. Check Ifne B if appllceble) ' A) 1. � New 2. ❑Replacement 3. ❑Replacement of 4.❑ Reconnectfon oi 5.❑ Repalr of an System 3ystem Tank Only Existing System Existing System B) ❑ A Saniffiry Permit was prevlously issued. Permit# Date Issued V. TYPE OF SY8TEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 � Ssepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trertch 22 ❑ In-0round 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SY8TEM INFORMATION: • 1.QALLONS PER DAY 2,A@SORP.AREA 3.AB30RP.AREA 4. LOADIN(3 RATE 5. PERC.RATE 6, SYSTEM ELEV. 7. FINAL QRADE �iE�UIRED(sq.R.) PROROSEQ(aq.tt.) (Qals/day/eq.ft.) (Min./inch) ELEVATION '�� �/,� 7 00 / �� Feet /� Feet CAPACITY Vtl. TANK Stte in allona Total #of Prefeb. Fiber- Expe�. INFORMATION New isdn Oellana Tanka Manulacturer's Name ancret Con- Steei 91885 Plastic ARp Tanks Tanka structed Se ticTanko d nk �G?� / T Lltt Pum Tank/81 hon Chamber Vlil. RESPONSIBILITY STATEMENT I,the undersigned,asaume respo�ibility for installatton of the onsite sewage system shown on the attached plans. Piumber's Nam inl): PI ar'8 3tpna r • o Stamps) MP/MPR3W No.: 8usiness Phone Number. .,.�.v�. ���r,(,�' �i°,s��� 7�C�S' �S-7�// Plamber's Addreas( troet,City,3t8te,Zip Code): -2,97���r/isio�!' ST Sro�J-'�-L.��, �i{�seo�Is.11 ��76 IX. COUNTYIDEPARTMENT U8E ONLY � Dlsapproved 3anttary Permlt ee(lrutuesa Oroundrvate. e ssue ssuing Agent 3lgnature(No Stampe) �Approved Owner Oiven Initlal ���a�� " � p $115 .00 5-15-91 X. CONDIT�ONS OF ApPROVAUREA30NS FOR DI3APPR�VAL: 36D-8398(tormerly PIb�87)(R.11/88) DISTRIBUTION: Orlginel to CouMv.One Coov To:3aleri 8 Bulldinas Divislon.Owner.Plumber DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAfETY& BU�I.DIN( LABOR & NUMAN RELATIONS PRNATE SEWAGE SYSTEMS u�vis►c p��• B�x ���� BUREAU OF PLt�1AB"� MADISON,WI 53707 • - .C NVENTIONAL L_ iALTERNATIVE s"�����.�� ��; u�m,,.•, ,��.,,�,,,,,.�� [_�Nolcling Tank G� In�Ground Picssurc � . I Mound NA1.1E OF P�11M1!MOLOEH .C)U�1tS5 CIF PF�lA1i 1 1{f)l OEN �'.ti�'F t:71t1y U 11 f c a� t5 Gr — �a — � � ___ _ NENCMMnlir.ifro�m�ne�ii�r�...� rU����+�I VfSCNIHE 1i UifFkNFNt/11f)M11YL�4 HFF PT ELEV. �`��T���� �'� f l!V bc�`Ta� S.d�K a-� �. scc�-� c7t Y1o�S.-e,. Io�I� lo��, N...,<<��v�,.,,.,.., _�.------_ --- __.__--- � — __._ .u��,.,��,s,•,•. �, . ���.�,�.,,, , �. . L�4��. 1����� s(��� ��.. � �- rs/vfs q! - oY� SEPTIC TANK/HOLDIPJG TANK: � M1�:11F,1t:i1111lIt "—'—•. —�—_._ _ ..__ r.__ _.._.. ._._.— t.i(lllll>t nf'.:/:1 f Y t�1'�r I��Lt 1 t I 1 V I 1N�(1111 LL I i t k Y Y1�IIN1 l�f:�flt 1 �.(1CKINl�l:l)VI{I . � ��r�����E�I:i ���i�Viflt li �.TM L S�'�.c � (O�(� 8S " Q 3 �� ''�YE5 _ NO '�'YES _:NO deooiH� �-t.t iira ����i n�a�t � ��•:at�E+ NUMBER OF �rroao � •�+ ve�x1�— c�� uuitoi^.�l c^.t rurke: �� i�; FEET FROM � ���. � , ,�����,��� �YES I _iN0 � C-�- iYES ' INn_ NEAF�EST � z'S 7 Sp 72-5 J g ___ ______1__ .. _ _ _ ____ _ _ _____ .___ ______ ___I�- O�SING CHAMBER: ----��-- tr.:hV�.:l.ruaFu OEUUI��t '.'i�..�OCavnC�t. at 4' �r'vE� v . �_-- �------._. . .. •��;!�'�..':'.:•.:'. � --- r ��41"1Gl 6F.. LOCK�Nc�Cn�EH 1 . . i .. �,....�. � ..__ vr�rrvioFn vHoviort� i_iYES i_1N0� I YES ' _____ _ �'NQ ._iYES _;NO GALLONS PER CYCIE: i�u�.o•nHu cnvru�,i s uNeaniiurani NUMBER OF ���ui>ry��t.' ��iii_�-�`u�,i�uiht, v�^u ru i i.e (DIFFERENCE BETWEEN � - FEET FROM ���'� �'�������� PUMP ON AND OFF) ❑YES !��NO _ NEAREST SOII ABSORPTION SYSTEM.Check the soil mctisture at the de�ptki nf plowing . �� �•.•�r�., .. ,.,... . . ...�..�. ��r e�xcavahon Ilf soii can t�e rollecl intu e wir�,Consuuchon shdli cease urrtil F�RCE thir so�! is diy enough to corttinuc.l MAIN C�NVENTIONA�SYSTEM: � �nut�i �crvr,t�� nn rn uisn� ru� s+�nr�ro< <.�ror�� m,s�ue rnt �_ _. ttrit:� i�.wm BED/TRENCH � � u��r.r��t5 / � � •.it�L;.t PIT i ivn� OIMENSIJNS �,O 3S ^ rj 5T1+.�-�_� `"- --- -- -- _.__ '.•''I" .t ".�l�••r� ,)t�t'1 '1.'1 Li���l �1�( U15TR YIPF �.�..flflit.� "' :� �-� NUMBER O� ... .',L� i .�F:: 1 ��'ll't•.', '! :T fi:FHF or. .. r.� ,q;:.� �4VE/t EtF t'.ttt ELE � '.:i 'FS �� � � � � AU��NLE7 �" �a`I �1__�-1 (o'I.1�_P(IC 303y- �.y- --�_NEAREST�—sl ._.�$�_>SOl--? Z-S -�ys ' MOUND SYSTEM: ------- --- --._. ._____- --_.___-- »--- ---__------i _--- — -- -- --- -___ -- Mound s�te plowed�erpendicular to slope Check the texture of the fill material for ! PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope� mound systems to rnak+� certain that it ON REVERSE SIDE.SHOW ELEVA- mcets the criteria for mecfium s��ncl. TIONS MEASURED, C.�YES �_INQ , _ .___�.__ � ,_YES — r_'.�NO _ � � SOIL COVER rrxt�;��c . -- --.___._� ....__ �Eu�an�t i•.,;. �.� ,,,. •; , YES i_iN0 -— -- __. -— -- f,i,-i�.; .i�: r����.�� �tl�; t ,�f�:i� ���,•. �, ,i; �t,��„� , .� .�� � � .�,:��.� ���tiuin � ��F���!f� r��i F�, . , . ., , a��,�cHFt� �_]vEs (_lrvo C�]vEs l_=1rvo �YEs C.=1rvo PRESSURIZED DISTRIBUTION SYS7EM: ,�„ . ..., ocrr IaT�HALSP:.C�yCI .^f1 .�fPT�.aF���, �., _�____ ._.T �� .;r�•,��:.a�;.� r,,.�� BED/TRENCH � rr+r�:c�+es DIMEIUSiON5 --- ----- -_.— �antiiF���o ��nsn n�nwEuiu t�isttr� i�n*'� rnnr�uiui�n+ntf�»ni r.n �;rlu i�i�.ii� t�ivr :ri��iruin,riovrir� naniiwa�w�.+,v�K�r,c IIIV EIlV Uln I.IfV _1„I�'I': Plh ELEVATION ANO � OISTRIBUTION � INFORMATION ��o:r;�... ..o�c s,�•:.c�•., :�H��z�u�::�,"e�;�� cuv_aa�aTc�uac :r��,�c.:_:��, ,�u�tSFil.'iJjTt).:rVuiivEL t';:��. . ._, l J vEs Li rvo __..�.._ i.;vEs I_.�rvo COMMENTS: vtt�MnNi tir Ma��K�r�s''"V __ <>tasrrwniTur�wtii ____ ._..__ _ _____�_ -- ri�ortntv �vt��- uuii oiNc: NUM6ER OF iiNE I UYES LiNO '_iYES �_?NO----- (NEAREST�---� — -- -^ �— Sketch Systism ori Retuin in county file for audit. Reverse Side. S�,rtar�_r�+e "'— nic.� DI�HR SBD 6710 tR.01/82) ��_ }�t S-�. � � ' k� t`.n v� . � � . a . �u►hers : C-�c��.��ec � l�h..� (... iss �y� �,���- Sa.h� (�.1C� Tc,� S 23 i 3� ,�.� �� t�J P���.b.�� : D�.�� Q���S ►�P �- 5��� �„��n;�-�s�` �1..�-�.�e. ��--� �� _���_ � S, ...��- �— �--- ' �. � � � il � ' I . I � �lo c�,�u y��- � I��={- s�.� aso+ -�.o.. sy s�ew� 3 bd >s.s' �� s.r. New �5' W W � g� 4 ._ s,T �000 TML w N I 20� � I � I Z�f �� 1 c tio � � / I ( r dI .3 iC � ) I ._ pr�.,�,� dc�.rsw4..� .� 'j�o ?o�Z 7 /z wl c.. 9/30/21,7:58 AM Real Property Listing Page Real Estate Sawyer County Property Listing Propertystatus: Current Today's Date: 9/3�/2021 Created On: 2/6/2007 7:55:49 AM �Description Updated: 10/22/2008 '�`� Ownership Updated: 7/17/2013 Tax ID: 28929 RYCKAERT TRUST NO 2008 STONE LAKE WI PIN; 57-026-2-39-09-23-5 05-001-000080 Legacy PIN: 026939235108 Biiling Address: Mailing Address: Map ID: :1.8 CHARLES V&PHYLLIS M CHARLES V&PHYLLIS M Municipality: (026)TOWN OF SAND LAKE RYCKAERT TRUST RYCKAERT TRUST STR: 523 T39N R09W PO BOX 130 PO BOX 130 STONE LAKE WI 54876-0130 STONE LAKE WI 54876-0130 Description: PRT GOVT LOT 1 LOT 2 CSM 9/106 #1878 Recorded Acres: 0.680 � Site Address * indicates Private Road Calculated Acres: 0.865 6055N ROCKY POINT LN * STONE LAKE 54876 Lottery Claims: 1 First Dollar: Yes l.� Property Assessment Updated: 9/28/2017 Waterbody: Whitefish Lake 2021 Assessment Detail Zoning: (RRl) Residential/Recreational One Code Acres Land Imp. ESN: 423 G1-RESIDENTIAL 0.680 211,300 273,000 � Tax Districts Updated: 2/6/2007 2-Year Comparison 2020 2021 Change • 1 State of Wisconsin Land: 211,300 211,300 0.0% 57 Sawyer County Improved: 273,000 273,000 0.0% � 026 Town of Sand Lake Total: 484,300 484,300 0.0% 572478 Hayward Community School District 001700 Technical College 1�:�'Property History . __ _ _ + Recorded Documents Updated: 10/22/2008 N/A WARRANTY DEED Date Recorded: 9/22/2008 355978 WARRANTY DEED Date Recorded: 5/31/1989 213905 434/196 tas.sawyercountygov.org/system/frames.asp?uname=Eric+Wellauer 1/1 / d. � � a 't�s �+�.`fiv "Yi`'N.�' �+i�•$�/,�,�sw�, � �,x X4.i t .„4 �,. ` � . ._. �r. ,, � + w . _ 1� �F� ...'w �.� 1+'. A 7�A `.�1��,4'Y4:4 �\ �p'�� ilF'ry��' �',�'.r'4Y' .. +. i������a r � "W f �y'y� '`� �i 6c . +�?,..� �rM`��( �� .�-,ti! �' �� J � p ��4'�Y �'�• ���{'���: f ff �'�,���y,,:ti'u'��'st���'� �w���a���� yp �h * �Y �.a�..�� �. 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