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Home My WebLink About022-738-25-4101-SAN-2022-051 _�Y�" Industry Services Division County • . = - 4822 Madison Yards Way ,S W ' ��f� - Madison,WI 53705 Sanitary Pcr t Number([o be fillccl in by Co_) \ ` s r.o.a�X��62 'x;, �;'� Madison,WI 53707-7162 �3[�d 5' 7 (� Sanitary Permit Application S�`e T�°�°"°°N°"'ber � In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit � is requircd prior to obtaining a sanitary peanit Note:App(ication forms for state-owned POWTS are submitted to Pro ect Addr ss(if different than mailing address) the Departmcnt of Safety and Profcssional Scrvices.Personal information you pmvide may be used for secondary �/�jf�L(E� /C'd/Z putposcs in�iccordancc with thc Priv�cy Law,s. 15.04(1)(�n),Stats. 1.Application Information—Plcase Print All Information �� ,� ,� Property Owncr's Name Parcel# I'o/ sd .�J d.T o Property wner's Mailing Address Property Location �/.� N 'a �o�c.r.�t City,State Zip Code Phone Number � r � �� '/<,�L' '/<, Section �.� Ii.Type of Building(check all that appty) L�r� _ 'I' 3�f N R 7 �or � �l or2 Family Ihvelling-NumbcrofBedrooms� SubdivisionName F31ock# '— �Public/Commercial-Describe Usc � ❑City of �State Owneci Describe Use_ — CSM Number illage of — �Town of_�4[�i'SI o�_._--- III.Type of POWTS Permit:(Check either"New"or"ReplacemenY'and other appticable on line A. Check one box on line B.Complete line C if a licablc.) A' ew S stem Rc lacemeot S stem ther Moditication tu Existin�S stem ex lain Additional Prctreatment Unit �x lam � Y � P Y � b Y � P ) ❑ (' P ) �' �Holding'I'ank ❑In-Ground �At-Grade �Mound Individual Site Desi�m Other Type(explain) (conventional) ��• ❑Rencwal Rcfore �Rcvision ❑Changc of Plumber �Cransfer to New Owner ist Previous Pcrmit Number and Datc Issued F.xpiration IV.Dispersal/1'reatment Area and Tank`Information: Design Flow(gpd) Design Soil Applicatio�Rate(�cUs� Dispersal Area Required(s� Dispersal Area Proposed(st) System Elevation b •✓ N .!/if Capacity in Total #of Manufacturer � Tank Information Gallons Gallons Units p � U ,'O, � Ncw Tanks Existing Tanks y o a� � � � ' `�' �a as n. U cn �, cn ii, C7 0. Sep[ic or olding�I�:�nk / 60 ...� �O� � /c Q � Dosina Chambcr � � � V.Responsibility Statement-1,the undersigned,assume responsibility for iesWllation of the POWTS shuwn on the attached plans. Plumber's Name(Print) Plumbei's Signaturc MPRS Number Business Phonc Number u�t uz r No� o rs � 7Y3 � 3 �� Phimber's Addross(Strcct,City,Statq Zip Codc) �y7 � Sr w � � ws s � VI.C unty/Department Usc Only '�Ap �ov��` ❑Disapproved Permit Fee Date Issued Issuing Agent Signaturc ❑Owner Given Reason for Denial $ `�O"ao �-�3�oZ �GQ/ Conditions of ApprovaUReasons for Disapproval � � �� _� � _ � ;� ,�� N C� ��'� �$'"'�`'e� AFR 1 2 2022 � SAWYER COUNTY Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 z il inches in size ssD-639s�R.o3i2>> NO REFUNDS AFTER lSSUE OF PERMIT Sawyer County Zoning & Conservation Administration �� 10610 Main Street,Suite 49 � 1� Hayward,Wisconsin 54843 � �;�� (715)634-8288 � �� FAX(715)638 3277 � i �� . �'�� ,..� ii,c•,1 ,�.�:�r� 3 3 �-i)y,<�(�` � � .,� � i F,ma�l. ��,n i ��r.t �� _ ,. �'::. � � � Toll Free Courthousc/General Informat�on 1-877-699-4110 ` . ,' � ',��\�� Holding Tank Approval Checklist I. Sanitary Cover Sheet Date Stamp O�f / �2 / aa Parcel 1D# O .2 a - ? ,3 $ - .2 S- ( D � — -- -- �— II. Plot Plan �Property Lines �Benchmark BM ♦ ��) �Site Address �North Arrow �Structure �Scale �Well �A <25' to Service Road �Legal Description �Nearest Road Intersection Setbacks to: Property Line, ell, Structure, Water bodies, Roads III. Required Plans � Index Page with Original Signature Management Plan/Contingency Plan Servicing Contract �Holding Tank Agreeinent form IV. Holding Tank Specifications �Cross-section— Manufacture, Gallons: S�vJ �200(7S� �Tank Anchor Calculations [SPS 383.43 8) g)] �? Locking device, chains/locks �Alarm and Electrical per NEC 300, SPS 316 & 383.43 (9) (e) and State Statutes 101.862(2) and 101.862(3) � 3"Bedding Material < U2 " V. Holding Tank Plans per Component POWTS Manual � Version 2 SBD-10855-P (R.3/07) Owner: �• S'�+�i� Plumber: ' �- Application Review Date: �`t� t � ��-� POWTS Reviewer: �` � �� Namc G�r�, (� u��„s�u Revised 4/11/2013 CONCRETE HOLDING TANK DESIGN INDEX AND TITLE SHEET Project Brody Suzan Holding Owner Brody Suzan Address 4351 N Helsing Rd Ojibwa, WI. 54862 Legal Description NE1/4-SE1/4-S.25-T.38N-R.7W Township Radisson County Sawyer Subdivision Name Lot No. Parcel ID Number 22738254101 Plan Transaction ID Number Index and title sheet Page 1 Holding tank specifications Page 2 Si�e plan Page 3 Maintenance and contingency plan Page 4 Tank Drawing Page 5 Servicing Contract Page 6 Maintenance and contingency plan Page 7 Designer Bruce Vitcenda Signature J� Phone No. 715-943-2382 License Number M.P. 220498 Date 04/08/22 Designed pursuant to: Halding Tank Component Manual For POWTS (Version 2.0) SBD-10855-P(N.03l07) ,•. Version 7.0(03/12) Page 1 of 7 HC)LQING TANK SPEClFICATtONS 3 Number of bedrooms Non-residential estim�ted flow(gpd) '��Minimum holding tank volume required (gal) Side A Side B Total 754.0 1254.0 �Proposed tank capacity(gal) Skaw Tank manufacturer 1200/750 Tank model number SJE Rhombus Alarm manufacturer 09-H Alarm model number Tank Dimensions and Data Tank Anchor Caiculations X for round tank 13050 ibs Weight of tank and cover 47.0 Liquid depth below inlet invert(in) 1.20 Safety factor 6.0 Maximum depth of soil cover(ft) 18295 Ibs Weight of anchor required 61.0 Height(in) , 26.7 in Soil cover req. for anchor or 154.0 Length (in) 4.5 yd' Concrete counter weight 77.0 Width(in) HOLDING TANK CROSS SECTfON Electrical complies with NEC 300 and SPS 316 optional �. vent pipe vent pipe manhole cover with finished focation locking device and • junction � wamirtg label grade box � �. � �4"min. �, 4"min. E--23 in. �-'y—� conduit 18"min. thether - �weight Note: All tank joints, and joints - � between tank openings and building sewer blind plug alar►n on piping are sealed watertight. All inlet to seal pipe and vent materials camply o�tiec with SPS 384. Manholes with 90% Full 34.5 in locking device are typical for each manhole opening . 754.0 gal 1254.0 gal 3 in.bedding under tank. Tank is anchored as necessary to negate buoyancy. Project: Brody Suzan Ho(ding Transaction Number: Page 2 of 7 - �= dWu�� P��mb�r �rody Svzq�/ �fUG�G�/�tCe,✓,(q N�SI�✓ - ly�y.v S>Hw�f�ro kcla;,✓s Rd �J�b"'4�w1 6'186� �xC14N1� w,y.39�35 n 7i�',�3frx M.P.aloyly Pl� »zo't" �� . � 'o � r h O o t � t�i = r o M ti e - �bdr G.ra < : � — — —,33 �' > , � � I '� � � I I e � I � I W r �� Pr1 ,vl y.s f�r � i f, 1S ' 7So'�. i � r. Ii� I R• �w ��I P4rCy it p1:73 y2S'Nlol I row,v � I R4�!fSO.V �� A./00.p'T� ( ��4'��t cOUCI � � I SI(lW 1.I00/1SO � _ .��_ R'lcrf M ;, ,vv �u'�:uLeck Irc�I To dsYt � a��wtathcr�sx.� C.tS�ror'i,✓k s 3�s�f. .. 970't" HOLDING TANK MANAGEMENT PLAN This Private Onsite Wasteyrater Treatment System (POWTS) has been designed, and is to be installed and maintained according to SP 383, Wis. Admin. Code, the Holding Tank Component Manual(SBD-10855-P N. 03/07), and the Sawyer County Sanitary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 60 to 401.6 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including ali provisi�ns in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each 6me the uvaste�nrater in the tank rEaches 90% of the tank(s)capacity or a level of 12" betou�the inlet (at which time the alarm will activate), the pumper listed in the current Servicing Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113,Wis. Adm. Caie. 4. At each seroice event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s)and verify that the alarm system functions and manhole locking devices are present. Oiscrepancies are reported to the o�nrner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and SPS 383 and 384 Wis.Adm. Code. 5. AII service events or inspeciions of this POWTS shalt 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 be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes #ank tA the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7_ No one should enter a hotding tank for any reason without being in fuU comptiance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult o�impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Con- necUon to municipal senrices would also be considered at this time if they are dsemed available to the property. 9. lf this POWTS is replaced, or its use discontinued,components na longer in use it shatl be abandoned in accordance with SPS 383.33 Wis. Adm. Code. 10. If there is a problem with, or question about this instaltation, the foUo�ving persons may be contacted: a. Installer.............................A-1 Plumbing Phone: 715-943-2382 b. Service Provider.................. Northwest Sanitary Phone: 715-943-2650 c. Co. Zoning or Health Dept. Sawyer County Zoning Phone: 715-634-8288 11. Project: Brody Suzan Holding Transaction Number: Page 4 Qf 7 WARNING DEATH MAY OCCUR IF TANK!S ENTERED i SKAW 1200l750 i O WITHOUT PROPER EQUIPMENT i � O i � 70.00 I NOTE:SEE lNNER WALL PHOTO ON THE"EXCLUSIVELY AT SKAW S"PAGE. j j i i i i i i i i i i i i i i t i i i i i i i i i i i i i 3.00 i i � I 4.00 i i �-----------------------------� 27.00� �27.DO {----27.00 � 24.00 24.00 ��-24.00� OUTLET END VIEW OF TANK 5.00 i 16.00 1.00 J �2.00 2.00 �INLET / 9.00 \ OVrLET /� �-� ` P.00 18.00 V 41NCH 41NCH PRESS � PRESS SEAL GASKET SEAL GASKET INSTALLEO WHEN POURED BAFFLE FILTER / 47.00 s.00 SECTION VIEW OF TANKAND COVER �--s.00 Model Number: 1 ZOO � 7.SO SKAW PRE-CAST Phone: (715) 967-2277 Approved for.� SEPTIC/SEPTIC,SEPTIC/PUMP,SEPTIC/SlPHON OR HOlDING Toll Free: 1-800-924-8625 eig n e �m. ut e �m. �iq. Depth Gal. /In. Nom. Cap. 26255 105th Street, New Auburn Wisconsin 54757 Fax: (715) 967-2707 16,1001bs. 52" 50" 47" f 6.05 754.35 gal. www.skawprecast.com HOLUING"I'AtiK SERVICItiG CON7'RAC7' Contract Date: / l ZoZ� "I'his contract is made beh+een the Holding Tank O��ner and the Pumper. Hc>Idin��l�ank Owncr's Name: Pumper'� N�imc: Northwest Sanitary, Inc. S�z�� PO BOX 155 rU Radisson,WI 54867 Parcel Identification Number: (I? Digit Lcgacy ID) O ��- 7 3 �- .? ,�-�` / O / 1. Thc owncr a�;recs to tilc a copy of this contract with thc govcrnmental unil, Sawycr Count�•, which has accepted and rea�rded with the Office of the Re�ister<�f Deeds, thc Maintenancc n�;reemcnt ror a Holdin�Tank required under the Sawyer County Privatc Se��age System Ordinancc for thc issuancc of a Sanitary P�rmit for thc installation of a holdinb tank(s). 2. Thc owncr agrccs to havc thc holding tank(s) scrviccd by thc Pumper and guarantecs to pcnnit thc pumper to have access and to cntcr upon the property for the purr+ose of scn�icing thc hulding tank(s). Thc owncr agrccs to maintain thc all-wcaihcr acccss road ordri�c so that the �umper can service thc holding tank(s}with the pu►nping cquipment. The owncr furthrr agrccti to}�ay thc pumper for a chargcs incurrcd in servicing thc holdin��tank(s)as mutually agrccd upon by the o��mer and pumper. 3. "I�hc pumPcr a�*rcc� to submit to thc Govcrnmcntal Unit, Sawycr County, a repori for the se�-�icing of the holding tank(s)as required under SPS 3K3.55, V4'isconsin Administrative Code and the Sawyer Cuunty Pri��ate Sc��age System Ordinance. Th� pumper further a�*rces to include the following in the rcport: a. Thc namc and address of thc pers�n responsiblc for scr��icing thc holdin�tank; b. 'T'hc namc of thc owncr of thc holdin�tank; c. �I'hc sitc address of thc holdin�*tank; d. '['hc d��tc thc l�olding tanl:was scrviccd; � c. The volumes in gallons of d�e contents pu�l�ped from the holdin�tank for each servicing; f. 'fhe disposal sites to which the contcnts from thc holdin� tank wcre deliver�d. 4. This agreement ��ill remain in eftect until the owner or pumper terminates this contract [n the event of a change in this contract,the owner agrees to tile a copy��f any changes to this seiti�ice contrlct or a c�py of a new service contract with Sa�vyer County within ten (10) business days from the date of change to this service contract. n��1Cr's Namc: (Print) nwrlCt''ti SI€?ilalUl'l': (()nt� nne owner signaturc required) �TC� �!� SvZqN J PinnE�cr's N��me: (Print) Pum�er�s Siznati . Ronald L Vieceli, owner Northwest Sanitary,lnc ��ll � � Puin�cr'� Rrgistratiun Numhrr: #2389 R�v.03;?h 13 . -.....�1.. � ��i�!5��I�� i�l�� . i�ii�i�iiii�ii��iii!i�i��ii� - USE BLACK INK ONLY- � ,,, � 7 g � ;; Tx:�03i34'r POWTS MAINTENANCE AGREEMENT 438592 For Holding Tanfcs �.._«�., riiuii� �.ni��crt Owners Name(s)as shown on deed: REGISTER OF DEEDS . SAWYER COUNTY, WI 04/12/2D22 11:23 AM �� `► RECORUING FEE 30.80 Parcel Identification Number: (12 Digit Legacy ID) o a �-2�g-�s- y�� PAGES: 2 Legal Description of Property: -SEE ATTACHED SHEET- We acknowledge that application is being made for the installation of a holding tank(s)on the property described on the attached sheet. Retum To:Sawyer County Zoning and Conservation Administration 10610 Main St.Suite 49,Hayward,WI 54843 As an inducement to the County of Sawyer to issue a sanitary permit for a holding tank on the above-described property, the owner is responsible for the operation and maintenance of the holding tank, locking device, alarm and access,and agrees to conform to all applicable 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 ticensed under Ch. ►VR 113,Wis.Adm. Code, except as provided by Section 281.48 (3)(d), Stats.,to have the holding tank properly serviced and to file a copy of the service contract with the governmental unit. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract,with the govemmentat unit withm ten(10)trusiness 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 to the govemmental unit in accordance with SPS 383.55,W is. Adm. Code,for the servicing of the holding tank. In the case of exemption under Section 281.48 (3)(d), Stats.,the owner shall submit the report to the governmental unit. The governmental unit may enter upon the property to investigate the condition of the hotding tank when pumping reports may indicate the holding 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 prevent or abate a human heafth hazard as described�n Section.254.59, Stats.,the govemmerttaf unit may enter upon the property and service, or cause the tank to be serviced. Pursuant to Section 145.20(4)Wis.Stats., a govemmental unit may assess the owner of a private sewage system for costs related to the pumping of a septic or holding tank. The charges will be assessed as prescribed by Section 66.0703,stats. The owner agrees to pay all charges and cost incurred by the governmental unit for inspectian,pumpmg, haulirtg,or otherwise servicing and maintaining the holding tank irr such a manner as to prevent or abate � any 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 systems certifies that either a sait absorption system that complies with SPS 383,Wis.Adm. Code,or a rrrunic�paf sewer serves the property. In addition,this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 5. This agreement shalt tre b�nd'mg upon the owner,the he�rs ofi the owrTer, and ass�gnees of the awner.The owner shalf submit the agreement to the register of deeds,and the agreement shall be recorded by the register of deeds in a manner which will permit the existence ofi tt�e agreemerrt to be determined by reference ta the property where the hofding tank is instaffed. -Only one owner signature required- ACKNOWLEDGMENT ; O nw er s Signature: State of: L,�-.�- �"'� "`� � County of: ,. wc �/' Owner's Name ( rint): �, Subscribed and swo n to before me on this r'c,l-r� S� qc� � �day of ✓�� , 20 �z. DaLe: `,,��,,;��nu��,,,�. BY�O�nrner's Name): ��<<� CS� r�-.— ��. //rY/�? Z ,.� R. K/ '••,'"`�, Nota Public Si nature: ; ry 9 "�� 17 Drafted by: // [ '� �� '•._��' Public Notary Name (Print): v�o,,,,,,,�/,� � „y.s�l/ � " ��u� V��.�TARr � My commission expires on: � � ,Zy-23 �.� : . "�r'.PU�3L�G �� Personal information you provide may be used fo�tlda[y,paupq�,EPnvaEy Law,§15.04(I}(m)} _ Rev.03126/13 F �F ,,��\5�'� - � , . The Northeast Quarter of the Southeast Quarter (NE'/4SE'/), Section 25, Township 38 North, Range 7 West, located in the Town of Radisson, Sawyer County, Wisconsin. . � 4/12/22, 11:05 AM Real Property Listing Page Real EStat2 Sawyer County Property Listing PropertyStatus: Curtent � Today's Date: 4/12/2022 Created On: 2/6/2007 7:55:38 AM �Description Updated: 9/7/2017 � Ownership Updated: 4/12/2022 Tax ID: 22771 BRODY GW SUZAN OJIBWA WI PIN: 57-022-2-38-07-25-4 01-000-000010 Legacy PIN: 022738254101 Billing Address: Mailing Address: Map ID: .13.1 BRODY GW SU2AN BRODY GW SUZAN Municipality: (022)TOWN OF RADISSON 4351N HELSING RD 4351N HELSING RD STR: 525 T38N R07W OJIBWA WI 54862 OJIBWA WI 54862 Description: NESE t� Recorded Acres: 40.000 r Site Address * indicates Private Road � Calculated Acres: 40.105 N/A I Lottery Claims: 0 I First Dollar: No �m.� Property Assessment Updated: 10/24/2011 i Zoning: (A-1)Agricultural One 2022 Assessment Detail ESN: Code Acres Land Imp. G5-UNDEVELOPED 16.000 4,000 0 � Tax Districts Updated: 2/6/2007 G6-PRODUCTIVE FOREST 24.000 31,200 0 1 State of Wisconsin 57 Sawyer County 2-Year Comparison 2021 2022 Change 022 Town of Radisson Land: 35,200 35,200 0.0% 576615 Winter School District Improved: 0 0 0.0% 001700 Technical College Total: 35,200 35,200 0.0% ' �� Recorded Documents Updated: 4/12/2022 II _ QUIT CLAIM DEED ' Property History - . _ Date Recorded: 3/30/2022 438379 N/A QUIT CLAIM DEED Date Recorded: 3/6/1998 266225 PERSONAL REPRESENTATIVES DEED Date Recorded: l/23/1995 246224 https://tas.sawyercountygov.org/system/frames.asp?uname=Eric+Wellauer 1/1 �i� n 4-. � �-'G'1 � ' I �- yt J•,q �� 7 �"�c-:i... � P � � •r . � �^'� a i. �'�-i:�- 'r'� x � t �'"". r :.�, s s... a r "�: 1.� �o . t+.t r1�7 :�. ...,��,8 5 �� v 5`�i` �`' - `.+ . 4 �t � t- .' � y,.�'<�' 's ., �" �;e _`�v- � y g+, K. . '�„ � � .. F �] '�' �� }i, � �` - ..r�'A`�.�r P�. 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'�� „, � � ��.� : � Fax:(715)638-3277 _---_�.._._._-------- URL:http:!/sawvercount�„��ov.org - � ,� � EID311:Z011lil�'.S0C�S8WVel"COUIIiVQOV.01'a �� ';�4 �f ,.,: [i.�i iv�� Toll Free:Courthouse/General Information 1-877-699-4110 Sawyer County Zoning and Sanitation "As - Built" Form Property Owner's Name �/'oary S v zR� Fire Number and Road Name .30�3�/ �a,fj'l u.d�� Plumber's Name �RUCe U/TC�,u�� Date of Installation �/��-,�� County Sanitary Permit Number .�,��O�'/ 12 Digit Parcel Number _�j,?7,;�.�s'y/6/ _ Description and Elevation of Benchmark rT��coud�/qr�w/�Cor,dt�'of�Q/��yovft Tank Manufacturer and Capacity fi�'q rN /1 do,�,s o Setback-Tank to Nearest Lot Line �,�D�f Setback-Tank to Nearest Well Iy0 ' Setback-Tank to Building �.j � Cell Width � Cell Length ^ Number of Cells J Setback-Cell to Nearest Lot Line —" Setback- Cell to Nearest Well � Setback-Cell to Building � Setback-Cell to Navigable Water " Make and Model of Dispersal Unit -� Make and Model of Filter '—' Make and Model of Pump '� . , �,,odyS�La,J ' . 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