HomeMy WebLinkAbout010-840-25-2113-SAN-2022-052 Industry Services Division Counry
4822 Madison Yards Way Sawyer
� Madison,WI 53705
:P Sanitary Permit Number(to be filled in by Co.)
= P.O.Box 7302
Madison,WI 53707 ��gD�'�
Sanl+a� PeY,ml+ A„„liCa*l�n State Transaction hwnber
1. L �l�J 6 -c,3�.�oc,sY'7-L
L�accordancc with SPS 383.21(Z),Wis.Adm.Codc,submission of this form to thc appropriatc govcmmcntal unit
is required prior to obtaining a sanitary permit.Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address) �
the Department of Safety and Professional Services.Personal information you provide may be used for secondary Dream Catcher Rd �
purposes in accordance with the Privacy I.aw,s. 15.04(1)(m).Sta[s. �
I.Application Information-Please Print All Information
Property Owner's Name Parcel# ���' p ��S_�l 1
Daniel Bieurance 57 010 2 40 08 25 2 01 000 000130
Property Owner's Mailing Address Property Location
9796 Vale St NW
Govt.Lot
City,State Zip Code Phone Number
Coon Rapids MN 55433 NE ,,,,rvw �,,, 5���;0� 25
II.Type of Building(check all that apply) Lot# r40 N R 08 E W
�l or 2 Family Dwelling-Number otE3edrooms 4 2 Subdivision Name
Block# --
�ublidCommercial-Describe Use ,,,^
�Ciry of
❑State Owned-Describe Use CSM Number illagc of
a-Y 3�3 �,6�� ❑✓To.n,of Hayward
II1.Type of POWTS Permit:(Check either"New"or"ReplacemenY'and other applicable on line A. Check one box on line B.Complete line C if
a licable.)
`�' ✓ ew S stem e lacement S stem ther Modification to Existin�S etem ex lain Additional Pretreahnent Unit ex laui
� Y� � p Y• b Y� ( P ) ❑ � P )
L�l
B.
❑Holding Tank ❑In-Gro�nd �4t-Grade ✓ Mound Individual Site Design O[her Type(explain)
(conventional)
C• ❑Renewal Before �Revision hange of Plumber �iransfer to New OwnerLis[Previous Permit Number and Uate Issued
Expiration
IV.DispersaUTreatment Area and Tank Information:
Design Flow(6Pd) Design Soil Application Rate(gpd/s� Dispersal Area Required(sf) Dispersal Area Proposed(sf� System Elevation
600 1.0 600 600 101 .75 �
Capacity in Cotal #of Manufacturer
Tank Information Gallons Gallons Uniu � � o � �
New Tanks Eristing Tanks � o y � � L � �
a`. U 'v� �, `n 'w C: a
Scptic or Holdine Tank 1250 1250 1 Wieser ✓
DosingChambcr 75� ]�j� 1 Wieser ✓ � � �
V.Responsibility Statement- I,the undersigned,assume resp ibil y or'nstallation of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumber's Signa e MPiMPRS Number Business Phone Vumber
Dan Burch 253808 715.416.1642
Plumber's Address(Street,City,State,Zip Code)
N5921 County Hwy K Spooner WI 54801
VI.C u ty/Department Use Only
�, � � ❑Disapproved Permit Fee Date Issued Issuing Agent Si natu���
❑Owner Given Reason for Denial $ • �'6� �- �3-c�-
Conditions of Approval/Reasons for Disapproval
_,�-..,�
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�I � N� �s-�- � a � � ;.�,
r_, . APR 0 1 2�22
Vr2t� ,Sa i� 1 0�/�,.�.,. �c'^' �7�/ Y l .Z',� ;:�f�::s��;�� �;�IJ��TY
Attach to cnmplete plans for the s}stem and submit to the Coun[y only on paper nnt less than ri Irz z t 1 i s � ' '
SBD-6398(R.02/22) NO REFUNDS AFTER
ISSUE OF PERMIT
�.�!'""`���, piVISION OF INDUSiRY SL F2VIC�S
10541 N RANCH Rp
, D : NAYWARD WI 54843-6462
_ $ Contad Through Relay
P$ http://dsps.w�.pov/propramWmdustry-semcea
'� www wlscx�ns�n yqv
�.,�,,.,,,_.
Tony Ewn•Oovarnor
_ D�wn Crlm-8scrd�r�r
March 31, 2022
CONDITIONAL APPROVAL -��P RU V E D
PLAN APPROVAL EXPIRES: 2024-3-31
���'�.OF SAFETY AND PROFESSIONAL
Plan Review: PWTS-032200547-C SERVICES
�, ,;c1(�p,� r�c �F�n�i�rqY �FRS/lrcc
Daniel Burch
1118 N Front St �-�^�'� ����'�
Spooner, WI
SITE: _ . ., �
Bieurance
Dream Catcher Rd
Town of Hayward
Sawyer County
NE%NW%S25 T40N R08W
FOR:
--T - -- -
� Description: 4 Bedroom-600 GPD—27"to '
limiting factor- Effluent Filter- Maintenance Mound Component Manual—Ver. 2.0, SBD- ;
I required. Designed for 3 bed (450gpd) plus i 10691-P(N.01/01, R 10/12) �
i
possible learning center and employee... � Pressure Distribution Component Manual—Ver. ;
Verify any expansion with GPD approval � 2.0,SBD-10706-P(N.01/01, R. 10/12) i
-- --- I ---------- —__ J
The submittal described above has been reviewed for conformance with applicable Wisconsin
Administrative Codes and Wisconsin Statutes.The submittal has been CONDITIONALLY APPROVED.This
system is to be constructed and located in accordance with the enclosed approved plans and with any
component manual(s) referenced above.The owner, as defined in chapter 101.01(10),Wisconsin
Statutes, is responsible for compliance with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per
s.145.06,stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminders
• The site shall be properly prepared prior to plowing.Any grasses longer than 6"shall be cut short
and removed.To avoid matting,any leaves or loose organic matter shall be raked up and removed.
Cut trees and shrubs flush to the ground and leave stumps.Avoid operating equipment on the
Mound site. If necessary,use only tracked equipment,during dry conditions,with minimai passes,
to avoid compaction.
• Components and soil removed from an existing drain field shall be properly disposed of so that
there is no risk to public or environmental health.
• A sanitary permit must be obtained from the county where this project is located in accordance with
the requirements of Sec. 145.19,Wis.Stats.
• Inspection of the private sewage system installation is required.Arrangements for inspection shall be
made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis.
Stats.
• A state approved effluent filter is required. Maintenance information must be given to the owner of
the tank explaining that periodic cleaning of the filter is required.
• A copv of the approved plans, specifications and this letter shall be on-site durin�construction and
oqen to inspection bv authorized representatives of the Department,which mav include local
inspectors.
Owner Responsibilities
• The current owner, and each subsequent owner,shall receive a copy of this letter. Owners shall also
receive a copy of the appropriate operation and maintenance manual(s)and be responsible for
ensuring that POWTS is operated and maintained in accordance with this chapter and the approved
management plan under s.SPS 383.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a
health hazard, the property owner must follow the contingency plan as described in the approved
plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s) utilized in the POWTS.
In granting this approval the Division of Industry Services reserves the right to require changes or
additions should conditions arise making them necessary for code compliance.As per state stats
101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe
building, structure,or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or
at the address on this letterhead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the
owner and any others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely,
� � "�`��
Joshua Rowley
POWTS Plan Reviewer, Division of Industry Services
(715) 813-9111
Joshua.rowley@wisconsin.�ov
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
li�siclF�nhr;l/���plieati��n
INDEX AND TITLE PAGE
Project Name: Daniel Bieurance Mound
Owner's Name: Daniel Bieurance
Owner's Address: 9796 Vale St NW Coon Rapids MN 55433
Legal Description: NE 1/4 NW 114 S25 T40 N R08 W
Township: Hayward
County: Sawyer
Subdivision Name:
Lot Number: 2 Block Number:
Parcel I.D Number: 57 010 2 40 08 25 2 01 000 000130
SSIONAL
Plan Transaction No.: vices
Page 1 Index and title ��� ����
Page 2 Data entry
Page 3 Mound drawings
Page 4 Lateral and dose tank ,: :; caR��.��{�,:v�=;ti:-r�
Page 5 System maintenance specifications
Page 6 Management and contingency plan
Page 7 Pump curve and specifications
Designer: Dan Burch License Number: 253808
Date: 03/29/22 Phone Number: 715.416.1642
Signature: {
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SBD-10691-P(N.01l01, R. 10/12),and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and
Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P(N. 01101, R. 10/12)
Version 7.0(R. 11/12) Page 1 of 7
Mound and Pressure Distribution Component Design
D�siqn Worl:shect
Site Information
(R or C) I R Residential or Commercial Design Note Sand fill(D)calculations assume a
! 400.00 Estimated Wastewater Flow(gpd) Table 383-44-3 in-situ soil treatment for
fecal colilorm of<=36 i�ches.
i 1.50 Peakmg Factor(e.g. 1.5= 150%)
600 00 Design Flow(gpd)
8.00 Site Slope(%)
101.00 Contour Line Elevation (ft)
27.00' Depth to Limiting Factor(in)
' 0.40'. In-situ Soil Application Rate(gpd/ft2)
Distribution Cell Information
60.00 Dispersal Cell Length Along Contour(ft) = 10.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate(gpd/ft2
1 Influent Wastewater Quality(1 or 2) Are the laterals the highest point
in the distribution � Y
Pressure Disribution Information network? �ntc;r Y o� N
;C: ��r 1=� E; Center or End Manifold
3.33 lateral Spacing (ft) If N above, enter the elevation (ft)
! 3! Number of Laterals � of the highest point. I !
I 0.188 Orifice Diameter(in)
� 3.50' � �,l�n��_3tc�d Orifice Spacing (ft)= 11.76 �tZ�orifice
, 1.50 Forcemain Diameter(in)
; 60.00, Forcemain Length (ft) Does the forcemain drain back? � Y
88.00 Pump Tank Elevation(ft) Fnter Y u� N
3.25 System Head (ft) x 1.3 5.51 Forcemain Drainback (gal)
13.25 Vertical Lift(ft) 80.60 5x Void Volume(gal)
5.76 Friction Loss(ft) 86.10 Minimum Dose Volume (gal)
0.50' In-line Filter Loss(ft) 33.42 System Demand (gpm)
� 22.76 Total Dynamic Head (ft)
Lateral Diameter Selectio� Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 ' 1.25
1.00 1.50 x � x
1.25 2.00 x ; � j
1.50 x x 3.00 { �`j
2.00 x
3.00 x
Gallons/lnch Calculator(optional)
Treatment Tank Information ; Total Tank Capacity(gal)
j 1250.00 Septic Tank Capaclty{gal) ' Total Working Liquid Depth (in)
'Wieser Concrete Inc Manufacturer � gal/in (enter result in cell B49)
Dose Tank Information Effluent Filter Information
750.00 Dose Tank Capacity(gal) polylok 'i Filter Manufacturer
16.12 Dose Tank Volume(gal/in) j525 �� jFilter Model Number
Wieser Concrete Inc�Manufacturer
Project: Daniel Bieurance Mound Page 2 of 7
Mound Plan and Cross Section Views
—t
1/�* � J
Observation Pipe _�
K .
O � A
W i i —
B
.a I
3
� �
L �
Mound Component Dimensions
L),�v�m sluF,,=t��C� :��:tension mr-icic,
A 10.00 ft E 18.60 in H 1.00 ft K 8.83 ft
B 60.00 ft F 9.50 in i 15.00 ft L 77 65 ft
D 9.00 in G 0.50 ft J 4.94 ft W 29 94 ft
600.00 (ft�) Dispersai Ceit Area 1500.00 (ft2) Basal Area Available
10.00 (gpd/ft) Linea�Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 103.54 (ft) -=
. �;:. � I H
, ,._ . , . .
F Dispersa�Ceu 10225 (ft) Lateral
101.75 (ft)-� — Invert
Dispersal Cell (�: i
Elevation � �
� 1 . ._
o `� a
4
101.00 (ft) Contour Elevation
8.0 % Site Slope
Geotextile Fabric Cover
Shading Key � o, � Dispersal Ceil See lateral details on
0� Topsoil Cap o °� 1.5 ft Page 4 for number,
2� 0 Subsoil Cap �' � � � /''�(� � slze,and spacing of
� ASTM C33 Sand i° 1° � / �" laterals. Laterals are
� 2 Tvplcal Lateral F equally spaced from the
� Tilled Layer � N � 5 ft distribution cell's
Q [� Aggregate � o � 0 � centerline in the
�—A —� distribution cell(AxB).
Project: Daniel Bieurance Mound Page 3 of 7
, �_
End Connection Lateral Layout Diagram
[.•�rrrr�hvl�st..�.I:.�vP�U�v.M.sE�;Jun.•�..n:,n •:: iurn-ut•vwh.�n...�I......r.:1.•an..utCdup
I ..__ ._. . .__ _.. � "__...,__..__'.____..__-____ . _. ...._.._.. ___..... __. ..__. . .. ___ .._..._ _�
'. _ .__.' '_ __.. __...
r� = ---- -- _���--------_ --: +
6111.p.r N �..�.1•nq...�I �. X_-__.I 1�1 I e_.J d1.J :n rhp D.,rr..rt.._.��I..t��a�il i
q�ally C�.e..f �
' _ ._.. . . _'_._..... .�_ _. _'_. .. .._.. .. .___.__ . ..�.� . . _
._.__. . . ___.�.�.�.�_�_.. _ —�
.. -- ( d.�r�1- �T-•r� n .�n '_ I�QU Ptit ��..e '=P T�d:.l� :�1 .:q F, —r.
� - _. .__ ..J_.�
� .�__ _. _._
F:�i o ft a/.lrry I�nr�Y1a Ve �.1..r� ...n�ar��l 11 s M4[ •rr.�
Number of Laterals 3 Orifice Diameter 0.188 in
Lateral Diameter 1.50 in Orifice Spacing (X) 3.66 ft
Lateral Length (P) 58.56 ft Orifices per Lateral 17
Lateral Spacmg (S) 3.33 ft Orifice Density 11.76 ft2/orifice
Lateral Flow Rate 11.14 gpm Man�fold Length 6.67 ft
System Flow Rate 33.42 gpm Manifold Diameter 1.50 in
Total Dynamic Head 22.76 ft Forcemain Velocity 6.07 ft/sec
Dose Tank Information
Locking cover with warning
� label and locking device and
sealed watertight
Electrical as per NEC 300 and—►
SPS 316.300 WAC — �4 in.min-
D�sconnect �_
�
Tank component fs properly vented < E-- Alternate outlet
location
Forcemain diameter
Wieser Concrete Inc Manufacturer 1.5 in.
Capaci 750.00 Gallons �
Volume 16.12 gal/inch A
Weep hole or anti-
Dimensio Inches Gallons B siphon deviCe
A 27.18 438 22
B 2 00 32.24 C Pump off elevation(ft)
C 5.34 86.10 � � 89 00
D 12.00 j 193.44 p
Total 46.53 750.00
Dose tank elevation(ft)
3" Bedding under tank. ~— 88.00
Alarm Manuafacturer SJE Rhombus Note Switchi;s
Alarm Model NumberTank alert 101 � containing mercury
may not be used in
Pump Manufacturer 'Zoeller this system.
�_____._._.._.F._���._ ;
Pump Model Number 152 !
Pump Must Deliver 33.42 gpm at 22.76 ft TOH
Project: Daniel Bieurance Mound Page 4 of 7
Mound Svstem Maintenance and Operation Specifications
Service Provider's Name ; Badger Septic j Phone'; 715.635.7243 '
POWTS Regulator's Name! Washburn County Zoning j Phonei 715.468.4690 ;
Svstem Ftow and Load Parameters
Design Flow- Peak 600 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow-Average 400 gpd Maximum BODS 220 mg/L
Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 600 ft' Maximum FOG 30 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform >10E4 cful100 mL
Service Frequencv
Septic and Pump Tank Ins ect and/or service once eve 3 ears
Effluent Filter Should ins ect and clean at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test monthl
Pressure System Laterals should be flushed and pressure tested eve 3 ears
Mound Inspect for ponding and seepage once every 3 years
;,
Miscellaneous Construction and Materials Standards
1 Observation pipes are slotted and matenals conform to Table SPS 384.30-1, have a watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis.Adm. Code.
3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis.Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5 The mound structure and other disturbed areas wilt be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Lateral Turn-up Detail
Finished ••..........•. ...............
Grade �
6-8" Diameter lawn --� Threaded Cleanout
Spnnkler Valve Box Plug or Ball Valve
. . .
. .
Distribution
� Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Daniel Bieurance Mound Page 5 of 7
Mound System Management Plan
Pursuant to SPS 383.54,Wis.Adm.Code
General
This system shalt be operated in accordance with SPS 382-84 Wis.Adm.Code.and shall maintalned in accordance w�th Its'
component manuals(SBD-10691-P(N.01/01,R. 10/12),SSWMP Publica6on 9.6(01l81),and Pressure Oistnbution Component
Manual Ver 2A SBD-10706-P(N 01l01.R. 10/72)]and local or state rules pertaining to system maintenance and maintenance
reporting
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death
Sept�c and pump tank abandonment shail be m accordance with SPS 383.33,W�s Adm Code when the tanks are no longer used
as POWTS components.
SepGc or pump tank manhole risers,access risers and covers should be mspected for water t�ghtness and sound�ess. Access
opemngs used for service and assessment shall be seaied watertlght upon the compleUon of service Any open�ng deemed unsound,
defective,or subject to failure must be replaced. Exposed access opemngs greater than 8-inches�n diameter shall be secured by an
effecUve tocking device to prevent accidentai or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an ind�vidual certified to service septic tanks under s 281.48,Stats. The contents of the
sepUc lank shall be disposed of in accordance with NR 113,Wis Adm Code. The operating condition of lhe septic tank and outlet
filter shall be assessed at least once every 3 years by inspection
The outlet filter shall be cleaned as necessary to ensure proper operation The fdter cartridge should not be removed unless
provisions are made to retain solids m the tank that may slough off the filter wnen removed(rom its enclosure If the filter�s equipped
with an alarm,the fitter shall be serviced if the alarm Is activated continuously. Intermittent filter alarms may mdicate surge tlows or an
�mpendmg conUnuous alarm
The septic tank shall have its contents removed when the volume of sludge and scum�n the tank exceeds 1!3 the liquid volume of
the tank. If the contents of the tank are not removed at ihe time of a lriennial assessment.maintena�ce personnel shall advise Ihe
owner of when the next service needs to be performed to mamtain less than maximum scum and sludge accumulation in the tank
The adddwn of b�olog�cal or chem�cal additives to enhance septic tank performance is generally not requ�red. However, �f such
products are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump(dosing)tank shall be inspecled at least once every 3 years All switches,alarms,and pumps shall be tested to venfy
proper operation. If an ettluent filter Is mstalled within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution Svstem
No trees or shrubs should be planted on the mound- Plantings may be made around the mound's penmeter,and the mound shail
be seeded and muiched as necessary to prevent erosion and to prov�de some protection from frost penetration Traffic(other than for
vegetative maintenance)on the mou�d is not recommended since soil compaction may hmder aerafion of the infiltrative surface within
the mound and snow compaction in the winter will promote frost penetration Cold weather instailations(October-February)dictate
that the mound be heavily mulched as protection�rom freezmg
Influent quality into the mound system may not exceed 220 mg/L BOD.,, 150 mg/L TSS,and 30 mglL FOG for septic tank effluent or
30 mglL BOD„30 mglL TSS 70 mg/L FOG,and 10'cfu�100 mL for h�ghly treated effluent ln8uent Flow may not exceed maxfmum
des�gn flow specified in the permd for this mstallation.
The pressure distribution system is provided wdh a flushing point at the end of each lateral,and it is recommended that each lateral
be flushed of accumulated solids at least once every 18 months When a pressure test is performed it should be compared to the
imtial test when the system was installed to determine if orifice cloggi�g has occurred and if oritice cleamng Is reqwred to maintain
equal distnbuUon within the dispersal cell.
Observation pipes wdhin the dlspersal cell shall be checked for effiuent pondmg Ponding leveis shall be reporfed to the owner,and
any levels above 6 inches considered as an impendmg hydrauhc failure requuing addit�onal,more frequent momtoring
ConUnqency Plan
If the septic tank or any of its components become defect�ve the tank or component shall be repaired or replaced to keep the
system in proper operating condition.
If the dosing tank,pump,pump controls.alarm or related winng becomes defective the defective component(s)shall be Immediately
repaired or replaced with a component of the same or equal performance
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface,it will be repaired or
replaced in its'present loca6on by increasing basal area if toe leakage occurs or by removmg biologically clogged absorption and
dispersai media,and related piping,and replacing said components as deemed necessary to bnng the system into proper operahng
condition
See Page 5 ot this plan for the name and telephone number of your local POWTS regulator and serv�ce provider
Pretreatment U�its
The information and schedu�e of mananagement and maintenance for pretreatment devices such as aerobic treatment units or
d�smFection units are attached as separate documents and are considered part of the overall management plan for this system.
Project: Daniel Bieurance Mound Page 6 of 7
�
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� � PUMP PERFORMANCE CURVE
MODEL 151/152/153
�o
14 �� 153
�2 __ 40
0 35 --- - _ . _ _ _ _ _ --- ____ __ __: _ _
_ �� _ � 152 __ ___
� 30 __ _ _._ _---
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a
z '
°_ � �_---- ----
0 8 - 25 151 �
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Q � �
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og 20_ _____ __�_ �' �- - _.___- -- - _ __ - -
15 --- ,—
4 �� !
;
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10 - ------�--- - _ _ _-- -- _— _--_ _---_ _ ___ ,
i
2 �
5 �—
�- ------ � �
10 20 30 40 50 60 70 80 90 100
GALLONS
---- -- --
_ _ __
_ _ - -- -- - -
_ _ -
LITERS � 40 80 120 160 200 240 280 320 360
FLOW PER MINUTE ��a'����
�� � ro
Wisconsm De�artment of Satety and Professional 5erv�ces Page 1 ot 3
Divis�on of Indusfry Serv�ces
SOIL EVALUATION REPORT
. __. _ _. ._.. . .
in accordance w�th SPS 385 Wis Adrn Code �ounty
Sawyer
Attach c�mplete site plan on paper not less than 8 tl2 x 11 �nches m s�ze Pfan must�nclude r----- - - - --- - --
but not I�mited to vert�cal and horizontal reference pomt(BM).d�rection and percent slope : Parcei I D
scate or dimensions.north auow.and locatwn and distancc to nearest road ' S7-Q10�?-40•OS-25•7 01-000-000130
Please print ali information. Rewewed Uy Date
Personal mlom�auon you provide m,�Y tk uscU for second�ny, u E,t.::cs:Pnv.u� Law s 15 U4�t;lnn '
.__ . . . _. _. . . .
� property Owner ; Property Locahon ❑ ❑
� Dan�el J Bieurance � Govt Lot Prl NE '4 NW %. S 25 T 40 N R 08 E �or) W
_.. -_ .. ; _ _.
, Property Owner's Maibng Address , l_ot# i Biock tl �, Subd Name or CSMJt
� 9796 Vale St NW 7_ '� CSM 24i323#6636
. . . .-- _
C�ty State Zip Code Phone Num�c;i ❑C�ty ❑Vd�aye '(r},�'. Town Nearest Road
Coon Rapitls A1N 55433 , � • � Hayward � Dream Catcher Rd
-- - - __ .
_ - __ _ --- . __ _ . _._
[� New Construction Use [] ResidenUal�Number of bedrooms 4 Code denvzd design How rate 60U GPO
! ❑ Replacement ❑Public or Commerci�l-Descnbe ._
Parent matenal Loarn alluv_iwn underiain�dense sandY or loamv lodqernent hli Flood Plan elevaUon rf appiicable---R
� General comments and recommendations Frost present 0-7" Samples thawed and evaluated
�---1 Bon�g p �..; Bormy �
____ ` t_)Prt Ground surface elev 10� 1_ft pepth to hmibng facior'1.7 in
----_ . _ _. _ _ . i Sod Appl�cat�on Rale
Honzon Depth � Dom�nant Golor " Redox�escr�pUon Textu�e ' Structure Cons�stence i Boundary ' Roots GPD/Ft�
� ; In. j Munsell Qu Az Conf Coior ' ; Gr Sz Sh {
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Honzon Depth Dommant Color i Redox Description iexture Structure , Cons�stence Boundary Roots � GPD/Ft=
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CST NamP.(Piease(�nnh Signdtuwc��7-' - "'� � CS T Nurnber !
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Address Uate f"valuat�on Conducted � Telephone Number
; 11673 E larson Dr Lake Neba�amon WI 54849 � 3�9/'1.022 Z 18-451-26t 1 �
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SBO-8330 tROnnS�
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3 � Bormg� n p,� Cround surtace elev 701 7 ft Depth to hmfiny factor 52 in
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! Honzon Oepth Dominant Color ; Redox DesuipUon Text;ire , Shucture ' Cons�stence Boundary Roots , GPD/Ft�
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Daniel Bi4urance
Soil Report Plot Plan
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o�'�`� � q#a# Dream Catc.her Rd '
��v�° Vrt NE 1/4 NW 1/4 Lot2 CSM 24/323#�636
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� I 1.y Acres
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L-lev= lUU.U` NOTES�
Scale l:4(l _ N�W�II
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Daniei Bieurance
Soil Report Plot Plan
North a _ .. � .r .. - - �~ " .. - -7
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ot'd` �#q�Oream Catcher Rd �
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cFA� 525 T40N R$W �
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PiN: 57•010-2-40-08-25-2 01-000-000�,30
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Elev= 100.0' �
NOTES:
5cate 1�40 - No we�l
� (77R0 3 of 3
W1250/750-MR
TANK SPECIFICATIONS � �
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� --" —�� —• DIMENSIONS: `.r.'
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� WALL: 2 1/2" .
�-4" CAS�-a-SEAL 4 �AST-t1-S�'�� -�` i BOTTOM: 3" �
i � COVER: 6" ;;�� ! 1
�-- I% ,�--___-_�_ - _�,�- _�-_ ' MANHOLE: 24" I.D. PRECAST CONCRETE RISER 1<� �
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'%'� �i �` ` HEIGHT: 66"
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'. - ,�"� �-, :;, a r��-� �'`. � BEIOW INLET: 53" i
r��� ��, ��`� � �,�� � � �� i UQUID LEVEL: 48" �.'� � i E
��,-� t � � ; O� WEIGHT: 14,860 IBS. ' zI oj o
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- '�i, INLET AND OUTLET: °\; � \j '
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__ 4" A T-A- A BOOT R A ASK
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�% IN�ET AND OUTLET BAFFLE AND FILTER: < �; �� �
� ��� �` � WISCONSIN, SEE DETAIL 10 � a J
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(OTNER STATES SEE CHART) W ^
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LIQUID CAPACITY: 27.66 GAL/IN (SEPTIC) W c
TOP VIEW 16.12 GAL/IN (PUMP) � `�
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LOADING DESIGN: 8'-0" UNSATURATED SOIL C _-, =�-'
O
o TANK CAN BE USED AS: " �- ~
E� -:• _•,T ORPSEPTIC/SIPHONPnC/SIPHON, < `�,;
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COVER: MIX DESIGN jy8 (NO FIBER) �, " `
-�`-- ' TANK: MIX DESIGN �10 (STRUCTURAL FIBER) � �`'
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} --�- _ -���_ � CUSTOMIZED TANKS: � a'
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DRAWINGS SUBMITTED '
si°E wEw FOR APPROVAL
APPROVED BY: __Erc .�p �
;�PPROVAL DATE: � ,�
PRODUCTS NEEDED BY: � � �
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS �
""''�'"``� PRIVATE ONSITE WASTE TREATMENT �ounty
/�� S `\�\� SYSTEMS SaW er
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�F'""-��'"' INSPECTION REPORT sanitary Permit No:
Safety and Buiidings Division (ATTACH TO PERMIT)
GENERAL INFORMATION �� �, 6S�
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#:
�t n:�� 'LS��..lc�lk c� �"�a t��
insp BM Elev: BM Description: Parcel Tax No:
�ao,n' ♦13w� c.����•� L�2, � �� �,��1��' otb- $Yo-�-S= �-1�3
TANK INFORMATION a�S ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic w ^ ^ �a�p Benchmark �,����
Dosing � �o„t,,�o "�S� �Bj..�a � �.?,� `
Aeration Bldg. Sewer 3,o$'
Holding St/Ht Iniet (,•9 �
TANK SETBACK INFORMATION St/Ht Outlet ?,!3 `
TANK TO P/L WELL BLDG vENr ro ROAD Dt inlet
AIR INTAKE
Septic ' N �J NA Dt Bottom I l��S �
Dosing �. .. k c, NA Installation +�,$S�
Contour _
Aeration NA Header/Man.
Holtling Dist. Pipe �, ( '
PUMP/51PHON INFORMATION Infiltrative
�
Surface �7S
Manufacturer �� Demantl Final Grade
Model Number � GPM
TDH Lift Friction Loss Sys Head TDH Ft
Forcemain L a.p� Dia �`� " Dist.To Well
DISPERSAL CELL INFORMATION
DIMENSIONS N1 0` � p' #of Cells ( Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav ° Conv � Aggregate
INFORMATION P 1 L Bldg Well Waters � GP ❑ Chamber Model Number:
❑ EZFIow
CELL TO •fi�S� N _ N __ � Mound
❑ Other
DISTRIBUTION SYSTEM X Pressure Systems Only
--- - - --
Header I Manifold Distribution Pipe(s) << X Hole Size X Hole � Observation Pipes
Length �•6�� Dia l�S���ength�Sb� Dia �5 Spac 3'33 p.�$$ Spacing3' Yes ❑No
- _ �--- .__—
SOIL COVER _
Depth Over ,,� Depth Over / y Depth of ��. Seeded!Sodded Mulched
Cell Center �� Cell Etlges l�' Topsoil ___ p�7 Yes ❑ No Yes ❑ No
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COMMENTS: (Inclutle code discrepancies, persons present,etc.)
`�``..�� I� U�'7 ���
Plan revision required?�Yes 0 No �� a � � ) ��1� �� �
t 3 �_�� —
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3I01)
AO�ITI�NAL COMMENTS ANO SKETCH
SANITAAY PEAMIT NUMBER: �.� -05"�
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