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HomeMy WebLinkAbout010-277-00-1800-SAN-2022-049 " �r . Industry Services Division County 4822 Madison Yards Way SAWYER ,�; Madison,WI 53705 Sanitary Permit Number(to be filled in Pg Co.) �= P.O.Box 7162 Madison,WI53707—'7162 �p�gQJ!'J.r � Sanitary Permit Application State Transac[ion Number � ln accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropnate governmental unit NA is required prior to obtaining a sanitary permit.Note:Application forms for state-owned POWTS are submitted to Ptoject Address(if different than mailing address) the Departinent of Safcty and Professional Sen�ices.Personal informatio�you provide may be used for secondary B�p K�� �p n�� p��� purposes in�ccordance�vith the Privacv Law,s. 1�.04(1)(m),Stats. �� R!1 ft I.Application Lnformatian-Please Print Ali Information ---�'� Property Owner's Name Parcel# a����'�'�..(;�O•.�g�p KARL & TAMMY SCHWARTZ 57-010-2-41-08-19-5 15-277-001800 Property Owners Mailing Address Property Location 5237 TERRE BONE TRAIL co��.�o� NA Ciry,State Zip Code Phone Number EAU CLAIRE, WI 54701 '%, '�a, S���on 19 II.Type of Building(check all that apply�) �o�� T 4� N R 08 E or w �I or 2 I'<unily Dwelling-Number ofBedrooms 4 '�8 Subdivision Name B,o�k# HATCHERY CREEK �ublic/Commercial-Describe Use N A ❑Ciry of �State Owned-Describe Use CSM Number illage of _ NA Q✓ T��µT of HAYWARD III.Type of POWTS Permit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C i a licable.) A' �✓ New System �Keplacement System �Other Moditication to Existing System(explain) �Additional Pretreatment L�nit(explain) B� ❑Holding Tank �In-Ground �4t-Grade �Mound Individual Site Design Other Type(explain) (conventional) C• ❑Renewal Before �Revision 'hange of Plumber �i'ransfer to New Owner ist Previous Permit Number and Date Issued f;xpiration IV.DispersaltTreatment Area and Tank Information: Desien Flow(gpd) Desien Soil Application Rate(gpd/s� Dispersal Arcx Required(s� Dispersal Area Propused(s11 System Flc��ation 600 0.7 857.15 892 94.00, 93.00 FT. Capacity in Total #of Manufacturer Tank Information Gallons Gallons Units p � ,o '� y u New Tanks Esisting Tanks � o �, � y p � � i U cn v, cn rs C� a, Septic or Holding Tank 1250 1250 1 WIESER ✓ I)osine Chamber � � V.Responsibility Statement- 1,the undersigned,assume resp sib' or installaHon af the POWTS shown on the attached plans. Plumber's Nalme(Print) Plumber's Sign ire: MP/�1PRS Number Business Phone Number DANIEL BURCH � a�380� 715 - 491 - 1642 Plumber's Address(Street,City,State,Zip Code) N5921 C.T.H. K, SPOONER, WI 54801 VL C u ty/Department Use Only � AY}�'f �'e ❑Disapproved Permit Fee Date Issued Issuing Agent Signature ��W� oo ��I ���� � ) �Z✓ ❑Owner Given Reason for Denial .//—ol /r�21�"e-,a� Conditions of Approval/Reasons for Disapproval -...- � `i ;-� � �I�� ,( �:!I�1 •--- n = `�r�y.�����J 3 j i i � - p3 � � '' �� � ��, c S , � ,,, �.._,, �� � Z��Z �� AP� 0 � �______.--------�' s�w�r=� ;���-r� , ,: Attach to comple[e plans tor the system and submit to the Counh only on paper not tess than 8 1!2 x 11 inches � e SBD-6398(R.03/21) NO REFUNDS AFTER ISSUE OF PERMIT PAGE 1 OF 4 in-Ground Gravity Pian � fndex & Cover Sheet � Component Manua!t?e�gn References: Version 2.0, SBD-10705-P (N.01/01, R. 1Q/12), , . Pg 1 of�t index & Gover Sheet Pg 2 af 4 Plot Plan Pg 3 af 4 Dispersal Area Cross-Section & Plan View Pg 4 af 4 Management Pian Attachments: Enclosures: Tank Specs POWTS Application for Review Fiiter Specs Soi( Evaluation Report & Site Map Project Name ! Description Owner Name{sj: �L & TAMMY SGHWARTZ Phone: - - Qvmer Address: 5237 TERRE BONE TR., EAU CLAfRE, WI �p; 54701 Project Address; BlRK�N TRAIL R4AD Govt Lot: �A 1/4 of 1/4, Sec#ian �9 , T 4� N-R 08 E Q or W�✓ Township: H�1lMEARD County: SAUVYER Project Parcet tD�: 57-010-2-41-08-19-5 15-277-001800 Designer information Designer Name: ��Y JO HUPPERT Phone: 715 _ 42fi _ 1775 Designer Address: 25720 FIREFLY IAN�, W�.BSTER, WI zip; 54893 E-mail: hollisterdesign@outlook.com ,.����������,�F�{-,._ . License Number: '�8�9 - 007 � _ �'� � � �s, � `�, Remarks: ` ,� fl��n�,�g - � . a ._. _, , t _ ; • a ����. -�: • s � :"�'. x � . a ,,� m '.'T.p: E . ti �1-,,._.... ..�..�... �;a' , �f;7� .. �c ,_� •. 4 r4 '✓. � �6�e eu 'f", d!�. '. . •./• ..i-�"�•— . _ . Signature: Date: o�����`i=��2 � - �. � P��t P�3n t�e �,of y � --; PRo�F�nr aw�v��: ��R� � ���,� .Sc+������ �� � �.o�. t������� LegalDescription: �� ��� ���C�iER� ��•�Et: S1d8D• , SEC. 49, -r4+;Ja � =backho�pit � os�w� -�c�� c�+i�yw�� . �►��a� Cc+�rY, tha�sc�sfn�. �.ov ,�c� �7- aJo-Z-�Ft- ��- fQ-5 15-2'7'7- �ib�ao - - �.�._�..R.�vJ �.�a� @ `?�tRK�r��,�.�,.�� �a�:n�. � �: �� � � a t ` . � � . � ' � � ; A � � P- � � ��� � `� � � �� �1�'!`: `� �' `¢ `�� � r �� � '� � "f ;} � � t� � � 6 j � �' r > r ; { �..,�/ .� �, � d j � � ��r `� ��4' . C'�� ,� �w �, ����4.< ,a�11�L !�1 1�lNt�Tl�L� � �'�� Y�\ � ���fB �� ; .9'�' t1�tt� �.��n}I> f �: ����. o w � �� -#: r � i ;��s9i ,�!�F !p�.� � a � y �,. p�� �- � � n ��_'� \� � a � � � �a � � � � a 'g�.p�, �p � F � a .� � � � , f�oZ,7 3' '� K ` (�- ..`�.� y�; � t �r�• e ° �� I � �s �s � V�' �� 4 � in►EU. 'To � : 7 2��F�aM ��►�1K r �� r 4 � SO� F¢..oM � o bR-��N���.�sa �" � o0 29� OFyu . � s� ,�St� �e��.a � � S�t� �QC�I.��1 1. '��a�'j 3�sc++ '!� �oa��KE�) e � _ 7 � . ' i j IN-GRQUND GRAViTY D{SPERSAL AREA SepticTank(s)Manufacturer. WIESER Stepped Eievation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down-sizing credit) Septic 7ank(s)Volume(s): �250 gal gal gat gal Effluent Fitter Marnrfacturer. soi�covER � � POLYLC?K min.17' t�'�`�� Efflu9nt Filter Maie)#: S��J 12° mfn.trench TYPICAL TRENCH dea� CRUSS SECTION VIEW �'�'�Ce" . . `" � . . . '. Pravide minimum 3 ft . .a �, (No Scaie) � �� ,����._.._,..� .� � sep�ration between trenches. , . *. :. . Highest Trench Lowest Trench(as applicabie) System Elevations= �` ft; 43. 0� �; fit; ft; ft Quick4 Standard-W w!End Gap oa8e"a"°"�e TYPICAL TRENCH (typical) (Show location of inlet/outlet pipe connection on plan vfew.) (typica!) instahPermanulacturer's pLAN VIEW �InstrucUons. tN0 SCB�@� � t �R t►�� +� - - - �t- - - - - - - - -�j� � � � --��resa.��.�r+r�.�R��:.� c� �':R��.�T a ` ' A=3.O ft �4 �. � ��k�Kr�°��irr�rl�l��' — — — — �/` — — — — — — — �j�— — — — �r" 3 x�r.r�l�ra����� (�v��4 D U B = �° r� --=; m � � (typlcal) Quick4 Standard-W Chamber W �'' IPVSTALL PER TRENCH: (�p'�i> Q N tmid by Inffltrator 5ystems,lnc.) InsteU pursuant to manufacturer's Instructians. Z?'� �uick4 Std-W Q 20 ft��ISAlchamber= �`�,Y,^ ft� 'P + �,,.�, Pairs of er�d caps @ 6 ftZ EISAtpair= �,,,,,, ft1 = Proposed E1SA psr trench= '��_ ft2 Required Inflliratian Area= ���ft2 Distribution Method: x � trer�ches = Propased Total EISA= �ft2 branched mani�old PAGE40F4 In-ground Gravity Management Plan IMPORTANT: � The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384,Wisc. Admin. Code. Pursuant to SPS 383.52(2), Wisc. Admin. Code, this system shall be 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 Maintainer in accordance with SPS 383.52 (3),Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow= 600 gpd; BODS <_ 220 mgl''; TSS <_ 150 mgL"'; FOG <_30 mgL'' inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors(i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, 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 dosing o 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 served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s)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(sj or as required by local ordinance. Disposal of contents shall be pursuant to NR 113,Wisc. Admin. Code. o Effluent filter(sl shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: ►vame of individua� or company: DAN BURCH PLUMBING Phone: 715 - 416 - 1642 �oca� government unit: SAWYER COUNTY ZONING Phone: 715 - 634 - 8288 �ocal government unit address: HAYWARD, WI ZiP: 54843 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383,Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384,Wisc. Admin. Code. Continqencv Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils. Svstem Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. WLP1254-MR TANK SPE�{F��ATION� 120�.. DIMENSIONS: » � � WALL: 2 1/2 • 8pT'f�A: SERTIC 3" COV�R: d" MANHt�: 24" I.D. PRECAST CpNCRE'fE' RISER ,� HEIf3HT: 82 1/2" O,D. � �-�^ �n+orH: ��o �/a� a.a. �. w�oni: n4• o.o, .. BELOW INLET: 41" p.D. • .� 4" CAST-A-SEAL 4" CAST-A-SEAL ��QwD IEVEI: 38" � WEIOHT: 8,810 LBS. .t �74" � INLET �ND�OU'[L.ET:�u BOOT OFi EQUAI � ��,/ \ GASKET, CAST-A-SEAL BOOT OR EWAL FiLTER OR INl.ET AND t�ITtET BAFFLE MIO FlLTER: � � � BAFFLE WISCON�N, 5EE DETAII �I 0 i (07NER STA7ES SEE CH�R'1� 'k+ • UQUID CAPACITY: 34.61 GAL/IN NflLDiNG TANK: �� WTI.,ET HOLE PLUOOEO ACTUAL CAPAI:ITY; t,3Z3 tiALLONS � I��� LOAOING OESIGN: d' 0" UNSATURATEp SOII �r� � � ( � N TANK CAN 8E USED AS; o '� � � SEPTiC/ WOLDINC/ PUMP OR SIPHON �� � R COVER: MIX DESIQN NO Fl�R) � TANK: MiX DESION � �STRUCTURAL, FlBER) � m � CUSTOMIZED TANK& � � _ - Ff1R CUSTQM TANKS CONfACT YNESER CONCRETE . c�'v • ,'''� � � i�� • � wn t 2�„ ��� � �.� � � 3 . � M DRAW�NGS SUBMITTED � � FOR APPROVAL � '��"�� APPROYED 8Y; �iEET N0, APPROVAI DATE: � YANKS ARE MANUFACIURED T4 �iEET OR EXCEED ASTM C-1227 REWIREMENTS ARODUCTS NEEDED 8Y: �F� � . `�-}°" ^��� � `� � � � ���.»�«. � ��� ���� ����� � �� ' fn� ; ��rrrryy�� ,�1 yg� ' 'u�,hY -�'�. .�...� ` a�..T�'? t t ��u��.�i������ef+'a�� �i . fi`�3S:dl9��..J,.. � .:.Y.�..��.'1':sGJ{M i . ��9R����� � P�.-1221PL-52SfPL-�25 FEATURES � BEN��lT� __.._ `� � e��cHioa co � � ,`' �$a�Ut�S �t Q�i'1��3#5: � "sFrawsi ss��,�a:.a as � ' � � � F _� . � �a� •h� ::��;:, : •;i... �i..a: ^ i.1�.�.�'.. #...� �z`.i t���i�}i �r :� � �'•`�•:a�..�r �. .� e.,..�II..Srf � e- R.. 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' ..... ._ _.. -f' ._.. .. .. ... .... - ..._ '::: -� � _ .. . .. � �- � $ ..... ...... .... -.- . ..... ...... � 9 , r g$.�� ��� �7 `` `"`' PRIVATE ONSITE WASTE TREATMENT county V..� � l,j�sPs l/�'�, SYSTEMS Sawyer �� �/// � ( POWTS) �h�FFssic'_/j:�;; '-"'" INSPECTION REPORT sanitary Permit tvo: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION ��_ ���, Personal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)J Permit Holder's Name: ❑City ❑ Village �Town of: State Plan Transaction ID#: �c` �t'�v.�w� wa� I�la wa� Insp BM Elev: Description: Parcel Tax No: 00 �' S p;�. ,� ���.. �qo'�I�. �� e,o—��r-�o— l gafl TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic �,�,� I �� Benchmark � o� Dosing Aeration Bldg. Sewer 9y � . Holding St/Ht Inlet c� � TANK SETBACK INFORMATION St I Ht Outlet q Y�a' TANK TO PIL WELL BLDG vErvr ro ROAD Dt Inlet AIR INTAKE Septic �p� �..�' ,��` ,� � NA Dt Bottom Dosing NA installation � Contour ����� Aeration NA Header/Man. �y,� � Holding Dist.Pipe PUMP I SIPHON INFORMATION Infiltrative , Surface 4 3�1S Ma�ufacturer Demand Final Grade Madel Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS W � L (�g ,E, ' #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate ���� INFORMATION P I L Bldg Well Waters � G dsc Chamber Model Number: ❑ EZFIow CELL TO � �'�s ` ❑ Mound o Other — QY� _ `�-l_D ___ 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 -- ___ — SOIL COVER Depth Over Depth Over Depth of Seeded/Sodded Muiched Cell Center Cell Edges �Topsoil ❑Yes ❑ No ❑Yes ❑ �l� COMMENTS: (Include code discrepancies, persons present,etc.) �� � � .�' � ���� I°1ci ��� '�,s � � � 7,� �\b� � Plan revision required?❑Yes ❑ No 0 � � � � ��� 6r-�'��� � � Use other side for atlditional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) ADOITIONAL COMMENTS ANO SKETCH SANITAAY PEAMIT NlJMBEA: Z.� .-��(� . : : , . : ' . !_.._ , ; , :_- -_ _; __�__ :_- ,- ...'}- ;.. _ __-:_ �--�- - - -- - - ------ _...�-- -- _ __ ; . . . _ . � : . ; __ ' � _ , ; _ � _ __: __�_. , ___ :___: _ , _- --�_ . . : - - - - --- �- - -- - --- + � -; ; . : � _. �K`-' . ; _. --; � __ _ ,..._ ,..._ _.: ' ' �\�o � � �`w��'\r , 3 ��� � -�� , ;� � . i� 16� � �(o b` �Y �� ��� �� �� ��� ��g�S� � � �o ��� �,�����' .