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Home My WebLink About006-146-01-0802-SAN-2022-058 . V, _ �`'"'� Industry Services Division ��tY � = \, �= 4822 Madison Yards Way � C�(,� e `� ; , _ : Madison,WI 53705 Sanitary Permit Number(o be filled in b ' � `'. P: - � P.O.Box 7162 Madison,WI 53707-7162 ��j O�3 (�-� Sanitary Permit Application State Transaction Number � � In accordance with SPS 383.21(2),Wis.Adm.Code,submission ofthis focm to the appmpriate governmental unit C/ is required prior to obtaining a sanitary permit.Note:Application fo[ms for state-0wned POW'I'S aze submitted to Project Address(if different than mailing � the Department of Safery and Profe�.sional Scrvices.Personal infocmation you provide may be used for secondary � purposes in accordancc with the Privacy Law,s. 15.04(1)(m),Stats. I.Application Information-Please Print All Informadoo ��S—� � S'� , Property Owner's Name Parcel# 1��1o�t't �- ��.n �c,��;}zl�r Oo�- I� �-o �-�� Property Owner's Mailing Address Property Location �l 1 � f� � . �o,�.Lo� City,State Zip Code Phone Number '/e, %<, Section � /)"1u ��►el� (-cJ� SL�L 7 S- c�s-�t � ,. II.Type of Building(check all that apply) Lot# �,,�� T 3 N R L E o W �l or 2 Family Dwelling-Number ofBedrooms � � tC/ Subdivision Name l Block# �ublic/Commercial-Describe Use � ❑Ciry of ❑State Owned-Describe Use CSM Number illage of �0 T�—��t �Townof �('�=�"(��'-,T III.Type of POW'TS Permit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C if a licable. `4' New S stem e lacement S stem er Modification to Existin S stem ex lain Additional Pretreatment Unit ex lain � Y � P Y � Y � P ) ❑ � P ) B' �FIolding Tank aIn-Ground �4t-Grade �Mound Individual Site Design Other Type(expiain) �� (conventional) C. �Renewal Before �Revision �Change of Plumber �I"ransfer to New Owner �st Previous Permit Number and Date Issucd Expiration �. ,� �� IV.Dispersal/Treatment Area and Tank Information: Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation a� N �� N � Capacity in Total ti of Manufacturer Tank Information Gallons Gallons Units � ? v 'd � � New Tanks Existing Taaks � o Y � y D ^ ro ��GL`U C+. U �n m v� u, C7 4L Septic or Holding Tank oZcu� -� SK<:�w re C�� Dosing Chamber � � V.Responsibility Statement-I,the undersigned,assume responsibility for iastallation of the POWTS shown on the attached plens. Piumber's Name(Print) Plumy�s Signature MP/MPRS Number Business Phone Number Cr�� '�r� s�� C,' � a��SCa ��s��-ag�1a Plumber's Addtess(Street,Ciry,State,Zip Code) S'v 8�7-1�I �� - �r� �r,Q- �� e2� 1.�.� S� �S`Zl VI.C unty/Department Use Only �A ❑Disapproved Permit Fee Date Issued Issuing Agent Signature �"v � �1•�-��'�' '�- ❑Owner Given Reason for Denial $ �� `� I 22' Z2 r �w` Conditions o�ApprovaUReasons for Disapproval ��5�� o! �� \J � �� 'r��J �✓ � � � ` C� N o� � �,� �s� AP� z 2 zo22 Y V� �� j O / SqWYER Cc�UNTY ING ADMtNISTRATtON Attach to complete plans for the system aod submit to t6e County only on paper not less than 8 12 i 11 Inc6es in size NO REFUNDS AFTER SBD-6398(R.03/21) 1$SU��F P�� Sawyer County Zoning & Conservation Administration � �� 10610 Main Street,Suite 49 � - - 1� Hayward, Wisconsin 54843 �I (7I5)G34 8288 � �� .,� �j FAX(715)638 i277 � r�� ,_-a , �� :r; i� 0�..5,:1:� j "�'tT' , i E mail..o�i � � .�+,,;� �uc��uni c,v cr� � �� Toll Free Courthouse/General Information 1 877-699-4170 �� 1��"``� Holding Tank Approval Checklist I. Sanitary Cover Sheet Date Stainp O� / �� / �� Parcel ID# o � (o - 1 �{ (� - o f -O $ b a, Il. Plot Plan �Property Lines �Benchmark BM ♦ � Site Address �North Arrow � Structure �Scale x Well �<25' to Service Road �C Legal Description �Nearest Road Intersection �Setbacks to: Property Line, Well, Structure, Water bodies, Roads IIL Required Plans �Index Page with Original Signature Management Plan/Contingency Plan Servicing Contract �Holding Tank Agreement form IV. Holding Tank Specifications Cross-section—Manufacture, Gallons: �� a,� Tank Anchor Calculations [SPS 383.43 8) g)] Locking device, chains/locks �? Alann and Electrical per NEC 300, SPS 316 & 383.43 (9) (e) and State Statutes 101.862(2) and 101.862(3) �3" Bedding Material < 1/2 " V. Holding Tank Plans per Component POWTS Manual �Version 2 SBD-10855-P (R3/07),. , Owner: �G�h��"\G�� Plumber: �-�, Application Review Date: `�d2-2�� . I POWTS Reviewer: �� l�l,.i� � � Namc ��I t�j Liccnsc# Revised 4/11/2013 C�nCre�e HOLDING TANK DESIGN Single Tank Uption INDEX AND TITLE SHEET Project Loretta Holding Tank Owner Robert&Shannon Schnitzler Address 414 E 19th St. Marshfield Wi 54449 Legal Description S-3 T-39-N R-4-W Township Draper County Wi Subdivision Name Village of Loretta BLK 1 Lot No. 8&9 Parcel ID Number 006 146 01 0802 Plan Transaction ID Number Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Designer Crai Thom son Signature i ( l� � � Phone No. 715-266-2842 License Number 220810 Date 04/13/22 Designed pursuant to: Holding Tank Component Manual For POWTS(Version 2.0) SBD-10855-P(N.03/07,R.01/12),, • version 7.0(11/12) Page 1 of 4 HOLDING TANK SPECIFICATIONS 2 Number of bedrooms 200.0 Non-residential estimated flow(gpd) �`'�'�' : ;: Minimum holding tank volume required (gal) . ., 2000.0 Proposed holding tank capacity(gal) Skaw Pre Cast Tank manufacturer 2000 Tank model number Tank Alert �� Alarm manufacturer 101 � Alarm model number Tank Dimensions and Data Tank Anchor Calculations 49.0 Liquid depth below inlet invert(in) 16100 Ibs Weight of tank 8.0 Maximum depth of soil cover(ft) 1.10 Safety factor 152.0 Length (in) 10578 Ibs Weight of anchor required 75.0 Wi�h (in)}��tsic.�e Dir��ensior�s 16.0 in Soil cover req. for anchor, or 2.6 yd3 Concrete counter weight HOLDING TANK CROSS SECTION manhole cover with locking device and vent finished junction �—Warning label � grade �x � � cap 12" min. � F 23 " min. � 4" min. �� vent pipe conduit —� tether „ weight 18 min. blind Note: All tank joints, � y p�u9 andjoints between -'---'�---- to seal tank openings and 12 in� service building piping are sealed sewer inlet outlet water tight. Pipe and vent materials comply with SPS 384. 37.0 in. Manhole and vent locations Electrical is as may be reversed. per NEC 300 and SPS 316. 3 in.bedding under tank. Tank is anchored as necessary to negate buoyancy. Because of this tank's rounded surface,soil cover alone may not be adequate to prevent flotation. Project: Loretta Holding Tank Transaction Number: Page 2 of 4 HOLDING TANK SITE PLAN Project: Loretta Holding Tank N Legal Description: S-3 T-39-N R-4-W Subdivision Name: Village of Loretta BLK 1 Scale: 1" = 30 ft Parcel ID: 006 146 01 0802 Lot No.: 8&9 ��,S"�"� lu�'�^ ��G S,/, W � - - - - - � �� T � a� �►:r. a� am � ��.�51� w�`� �� `� Transaction I.D.: � Page 3 of 4 1 (�rn; 13�{�,,� �� 5��e N E C��rN�,^ '�yn= 1u�, HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and maintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P N. 03/07, R. 01/12), and the Wi County Sanitary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 80.0 to 400.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the 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 activates), 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. Code. 4. At each service 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. Discrepancies are reported to the owner 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. Atl 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 be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes from this hold- ing tank to the ground surface, including intentional discharges and discharges caused by neglect, consti- tutes 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 holding tank for any reason without being in full compliance 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 or 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). Connection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with SPS 383.33 Wis. Adm. Code. 10. If there is a problem with, or question about this installation, the following persons should be contacted: a. Installer............................... Don Thompson & Sons Exc LLC Phone: 715-266-2842 __.__ b. Service Provider..................... North West Sanitary Phone: 715-943-2650 c. County Zoning or Health Dept. Sawyer County Zoning Phone: 715 634-8288 11. Project: Loretta Holding Tank Transaction Number: Page 4 of 4 HOLD(NG TANK SER�7CING CON'I'RACT ' C'ontract Datc: / / Thiti contract is madc bchvccn thc Iioldin�Tank O��ncr and thc Pumper. HOIC�llllt I�111IC OW'11Cf's Namc: Ptnnper�s Namc: Northwest Sanitary, Inc. PO BOX 155 R�he�t -� Sh�.nna JL 'n► zler Radisson,WI 54867 Parcel Identi�cation Number: (12 Digit Legacy tD) �Q�'�� v - (��-�� ; � 1. Thc o��ncr agrres to lilc a copy oI'this contract ��ith thc govcrnmcntal unit, Sa�vycr Caunt��, �ti�hich has acccptcd and recordcd ��-ith thc Ofticc of thc Rcgistcr of Dccds, thc'��taintcnancc Agreement for a Hold�ng Tank requued under tlie Sawyer County Pn�-ate Seu�age System Ordinance for the issuance of a Sanitary Permit for tl�e installation of a holdin�� tank(s). 2. Thc o��ncr agrcc;s to havc thc holdin�tank(s) scrviccd by thc pumper and guarantccs to pennit the pinnper to ha�c access and to enter upon the properi_y for the purpose of sen-icin�� thc l�olding lank(s). Thc o�vncr a�!rccs to m,tintain thc all-wcathcr acccss road or drivc so that thc pumper can scr�icc thc holding tank(s)with thc pumping cquipmcnt. Thc o�vncr fiarthcr a�rccs to pay thc pumper for a chargcs incurrcd in scr�icing thc holdin��lank(s) as mutually a��reed upon by the o�i ncr and pumper. 3. "I�hc pumper agrccs lo submit to thc GoF�crnmcntal Unit, Sa��ycr County,a rcport for thc scrricing of thc holding tank(s)as rcquircd undcr SPS 3K3.55, Vl-'isconsin Administrativc Code and the Sa�yer County Pri�ate Se��age System Ordinance. The pumper fiirthcr agrecs to includc the follo��i�g in the report: a. `I'hc name and address of the person responsible for servicing the holding tank; b. The name of the o��ner of the holding tank; c. �nc� site address of thc holding tank; d. �'hc date d1c holding tank w-as scr�iced; e. The volumes in g�llons of the contents pumped from the holding tank for each servicing; f. Tlte disposal sites to�hich the contents from the holding tank w�ere deli�•ered. 4. This agrccmcnt wi11 rcmai�f �n cffcct ur�ti! thc o«�ncr or pumper tcrminatcs this contract. In thc cvcnt of 1 changc in this contract,thc owncr aerccs to filc a copy of any changcs t�this scn icc contract or a copy of a nc�� scrvicc contract with Sawycr County�vithin tcn (10) busincss days from thc datc of changc to this scrvicc contract. ��\k'11C� S Nall1C: (Pflll�� O��'I1CC S SI�IIaLU('C: (�1n1��onc mrnrr ci;;naturc rcyuired) ., S�,�.,�•�z.�;�' /� ��!� Pumper�s Namc: (Print) Pumper's Signaturc:` Ronald L Vieceli, owner Northwest Sanitary,lnc i ///��;(�' !�!� Pumper�s Rc��istrati��n Numbcr: #2389 iZr��.03i 26`13 � �� i�� -USE BI.ACK INK ONLY- 8 0 � 8 1 8 5 POWTS MAINTENANCE AGREEMENT Tx,:40�7545 For Holding Tanks 438758 PAULA CHISSER Owner's Name(s)as shown on deed: REGISTER OF DEEDS SAWYER COUNTY, WI Q4j22/2022 10:52 AM � �� G � z�E RECORDING FEE 30.00 Parcei Identification Number: (12 Digit Legacy ID) O U � -�f"�' �j - U L-��G O� 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. Return To:Sawyer County Zoning and Conservation Administration 10610 Main St.Suite 49,Hayward,W154843 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 licensed under Ch. NR 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 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 to the governmental unit in accordance with SPS 383.55,Wis.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 holding 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 governmental unit to prevent or abate a human health hazard as described in Section.254.59, Stats.,the governmental unit may enter upon the property and service, or cause the tank to be serviced. Pursuant to Section 145.20(4)Wis.Stats., a governmental 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 inspection,pumping, hauling,or otherwise servicing and maintaining the holding tank in 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 soil absorption system that complies with SPS 383,Wis.Adm.Code,or a municipal 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 shall be binding upon the owner,the heirs of the owner,and assignees of the owner.The owner shall 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 of the agreement to be determined by reference to the property where the holding tank is installed. -Onl one owner si nature re uired- ACKNOWLEDGMENT O i a re: State of: �1.� S G S i ►�1 County of: ( ,U�C7 w ' Name (Pri � Subscribed and sworn to before me on this ` c. � Sc.Lln��l.k'/ £�'�' dayof v4`Q�'� \ , 20 � � Date: By(Owner's Name): (�crbe�� Sc,�,r,1 �- Z 1-e- r y /� �� Notary Public Signature:�-GZ,l,,tr, -� 1.ot,,..,-�(.-Q- Drafted by: � � ��s'1'�e,�so.� Public Notary Name(Print): i'C�1��1-, �A ZGr r�- My commission expires on: k- �-1_ �C��,� FAITH A. ZARNKE Personal infortnation you provide may be used for secondary purpos [Privacy La�Q�.�(R�J�iC Rev.03/26/13 State of Wisconsin T�ot 9, Block I �.NU ti�e S�nrh 20 feer oi'Lot 8, Black 1, alI in the'I"or�vnsite of Loretta, Ic�cated i11 the Town of DrnE�er, S�iwyer Cc�untyy lV1SCOi19ltl. Far info�•n�t�li�nc�( pueE�oses only I'��o��ei�ty Addx•ess: fi9�5N rirst Si�, L�rett�, WI 54896 T��Kcy No.: OOG-(4C-O 1�08�2 �R�eal Estate Sawyer County Property Property Status• ��.. Listing Today's Date: 4/12/2022 Created On: 2/6/2007 7:55:11 AM Description Updated: l0/12/2011 Ownership Updated: 8/19/2020 Tax ID: 5736 ROBERT J & MARSHFIELD WI P�N: 57-006-2-39-04-03-5 15- SHANNON M 167-010802 SCH NITZLER Legacy PIN: 006146010802 Map ID: -2.1.8.2 &.2.1. Billina Address: Mailing Address: Municipality: (006) TOWN OF DRAPER ROBERT J & ROBERT J & STR: 503 T39N R04W SHANNON M SHANNON M Description: VILLAGE OF LORETTA PRT SCHNITZLER SCHNITZLER LOT 8 & LOT 9 BLK 1 414 E 19TH STREET 414 E 19TH STREET MARSHFIELD WI MARSHFIELD WI Recorded 0.484 54449 54449 Acres: Lottery � Site Address * indicates Private Road Claims: 6985N FIRST ST WINTER 54896 First Dollar: Yes Zoning: (R-1) Residential One property ESN: 429 Assessment Updated: 8/22/2016 Tax Districts Updated: 2/6/2007 2022 Assessment Detail Code Acres Land Imp. 1 State of Wisconsin G1- 57 Sawyer County RESIDENTIAL 0.484 2,200 39,300 006 Town of Draper 576615 Winter School District 2_Year 001700 Technical College Comparison 2021 2022 Change Land: 2,200 2,200 0.0% Recorded Improved: 39,300 39,300 0.0% Documents Updated: 9/14/2011 Total: 41,500 41,500 0.0% SPECIAL WARRANTY DEED Date Recorded: 8/4/2020 Property History SHERIFFS DEED N/A Date Recorded: i�2��20�0 71S-3�-��11 CORRECTION INSTRUMENT Date Recorded: 8/23/2019 TRANSFER BY AFFIDAVIT Date Recorded: 6/18/2019 PERSONAL REPRESENTATIVES DEED Date �.._.- ;��,s,..r. 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PRIVATE ONSITE WASTE TREATMENT �ounty �'�K, ,�°/B$', �i�, SYSTEMS Sa.W er '�:�� s /�,� ( POWTS) Y \��--/,.,..e% INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION p�� .. �'j�g Personal infonnation you provide may be used for secondary puiposes[Privacy Law,s. 15.04(l)(m)] Permit Holder's Name: ❑City ❑ Village l� Town of: State Plan Transaction ID#� f'� �Mlno�1 �Y1 r�� .V'�f r-- Insp BM Elev: BM Description: Parcel Tax No: .a ' e � bT ��i� �— l�{� --C�( — 6'$�� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Benchmark �, � p , ` pa,p� Dosin9 � ��6 y � o 0,76' Aeration Bldg. Sewer , ' q7,pj� Holding pb p St/Ht Inlet 5S' 9 . ' TANK SETBACK INFORMATION St I Ht Outlet TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet AI R I NTAKE Septic NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. Holding �-a,� .{-�,�' t-�o� '►-�fl l �Z 5 Dist. Pipe PUMP 1 SIPHON INFORMATION Infiltrative Surface Manufacturer Demand Final Grade Motlel Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Weli DISPERSAL CELL INFORMATION DIMENSIONS W � #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav ° Conv ❑ Aggregate INFORMATION P I L Bldg Well Waters o GP ❑ Chamber Model Number: ❑ EZFIow CELL TO ❑ Mound � Other — — --------- ---—- — -- DISTRIBUTION SYSTEM X Pressure Systems Only Header I Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length Dia Length _ _ Dia _ Spac Spacing �Yes ❑ No —__ SOIL COVER Depth Over TDepth Over Depth of — � Seeded/Sodded � Mulched � Cell Center � Cell Edges Topsoil ❑Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present,etc.) ��ll� s�� l�� ,� Plan revision required?❑Yes❑ No � �� a3 - � �c�� Use other side for atlditional information Date POWTS Inspector's Signature Certification Number y SBD-6710(R.3I01) A�OtTIONAL COMMENTS ANO SKETCH SANITAAY PEAMIT NLIMBEA: �-�- �Sg � , . . -_ -;-._ .�_ : _ -•--_ ;____�_ _,.. _ -- - -�__�- _ - - � - - -•--- -T--- ---� - -- - _ __ _ __ _; . ... . _ ; . -- . � ` ��1�� o � �� _ �. �. ; - .-- -.-- �--_ . : � �� . _ . ._ _ _ , __ . . . . , . 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