HomeMy WebLinkAbout032-539-27-3402-SAN-2022-060 .�
���'" '-"ti; . Industry Services Division Ca�tY �
4822 Madison Yards Way �G( (,� ��
; ,�_' : Madison,WI 53705 Sanitary Pertnit Number(o be filled in b N
= P.O.Box 7162 ' 1 �
__ Madison,WI 53707-7162 Ui �� � �`�1 1
Sanitary Permit Application State Transaction Number C
In accordance with SPS 383.21(2),Wis.Adm.Code,submission ofthis form to the appropriate govemmental unit �p �
is required prior to obtaining a sanitary permit.Note:Application forms for state-owned POW"CS are submitted to Project Address(if different than mailing �
the Department of Safery and Professional Services.Personal information you provide may be used for secondary
purposcs in accordancc with the Privacy Law,s. 15.04(1)(m),Stats. _)
L Application Information-Please Print All Information � �3 "'� ��i�� ���i.RL�/' ��
Property Owner's Name Parcel#
;� �- ���0. 1�4 ��� ,1 c�3 -s3c-a 7 3��0
Property Owner's Mailing Address Property Location p'h'y'
1
3� - C'anes-F,�; �� �-- .��
City,State Zip Code Phone Number -7
�j(� ��G� �� � c�t t0 � s ��, � 0S O �� Y,,_�.L%a, Secrion �C 7
II.Type of Building(check all that apply) �ot# T 3� N R � E o W
�l or 2 Family Dwelling-Number ofBedrooms � � Subdivision Name
�1
Block#
�ublic/Commercial-Descri6e Use ^
�Ciry of
❑State Owned-Describe Use CSM Number illage of
�I'own of � '�C�/�
III.Type of POWTS Permit:(Check either"New"or"Replacement"and other applicabte on line A. Check one box on line B.Comptete line C i
s licable.
`�' �New System �Replacement System ❑Other Modification to Existing System(explain) �Additional Pretreatment Unit(explain)
IL�J
B' ❑Elolding Tank rn(In-Ground �At-Grade �Mound Individual Site Design Other Type(explain)
��(conventiooal)
C• ❑Renewal Before �Revision hange of Plumber �T'ransfer to New Owner ist Previous Permit Number and Date Issued
Expiration i� �_ �_a�Q t,
IV.DispersaUTreatment Area and Taak Information: C �L•;;` i,�,,�';-t5 i n ' C�1
Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� � Dispersal Area Proposed(s� Sys em Elevation ']'��n cs C;-�'j
3C /•� ��� 1875- 1`�$ .S£f �17.�o
Capacity in Total #of Manufacturer
Tank[nformation Gallons Gallons Units ��� � V v '$ �
��G�/S-�`� New Tanks Existing Tanks � c " � � ,n � �
0
C ' w v v� �, v� i.=. c7 a
Sep[ic or Holding Tank x '�$l� 1 S 1� �� �'ti`�-�
4ti'
Dosing Chambcr s� � S✓k � �C `� �� �
F
V.Responsibility Statement-I,the undersigued,assume responsibility for installation of the POWTS shown on t6e attached plaas.
Plumber's Name(Print) Plumbe Signature MP/MPRS Number Business Phone Number
C r��: `�.vm �n �' � :��� a��q1b "��'-���-��y�
Plumber's dress(Street, ity,State,Zip Code)
�Sc3�`j— f� '�o � � � a�I,`�t�- �.c�� ��S`��o
VI. ou ty/Department Use Onl
� edZ ❑Disapproved Permit Feeo Date Issued lssuing Agent,�ignature .
❑Owner Given Reason Yor Denial $ `w'o �� 2-�1'L ��"�Ju�"�`�'�J1�
Conditions of ApprovaUReasons for Disapproval ����
•..i�. �
D �
�� �N� C S� �-�-' U �J� � APR 2 2 2022
SAWYER N�TRATION
At[ach ta complete plrns tor the system aod submit to the County only on paper not less thsn 8�2 x ll inches in sfze
NO RC�UNDS AFTER
SBD-6398(R.03/21) ��UE OF PERMIT
� PAGE 1 OF 5
In-Ground Dosed-Gravity Plan
Index & Cover Sheet �
Component Manual Design References:
Version 2.0, SBD-10705-P (N.01/01, R. 10/12) . ..
Pg 1 of 5 Index & Cover Sheet
Pg 2 of 5 Plot Plan
Pg 3 of 5 Dispersal Area Cross-Section & Plan View
Pg 4 of 5 Pump Tank Specifications
Pg 5 of 5 Management Plan
Attachments: Enclosures:
Pump Curve POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
Owner Name(s): �r�C. 7'- �:n�c� �1c��;.�c.5t�/1 Phone:�rs - 3:��r -os
Owner Address: (93a Lr-N C�t�e5-k�s(� j� �i��e� Zip: .S�l�`Z�n
Project Address: �S�3 3-[� L-���C� (,� �n.-�,e- 1��
Govt. Lot: sC 1/4 of s(.c� 1/4, Section�, T 3cl N-R S E ❑or W�
Township: � � i(��el' County: ��-�J�:
Project Parcel ID#: D�a 53�7 � 7 3�l� �
Designer Information
Designer Name: �i''K � � . / /ZC� S Phone:���5 ���o -��L
Designer Address: �v � - /n� Sc�r� L�c,��� �' Z�p: ����SY�
E-maiL• cJ��(t��.c�r�,P.S�o�, ��G/J fiue� Ci�� �! �t, ,, ,,,
License Number: ���D�Sl G�
Remarks:
� � . - ���
Signature: �e �� Date o? �
' al signature requir on each submitted copy.
CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE.
� SOIL EVALUATION o s�1e: ��' � $o �J SYSTEM PAGE 2 OF5
SITE MAP PLOT PLAN
PROJECT NAME: 2 DESIGN FLOW: ��✓V GPD
�
Attach design flow calculations for commercial plans.
PROJECT ADDRESS: S�3.3 � �4ke �i�1�` /��� Pipe Material/ASTM Standard(Tables 384.30-3 8 384.30-5)
N �r� �C
� Santtary Sewer. L /
BM Symbol: � BM Elevation: �� ���`} FT Force Main: � �� /
BM Description: ��1� �(,�lL �n l��� �ec� ��ne
�ndicate nortn by IMPORTANT:
Slope Gradient(%) /�, 1 Well Symbol(if applicable): 0 drawing an arrow Show ground elevation contours at suitable intervals.
of Tested Area: lJ on the approprite line.
�
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- Q�`� �.a r-
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� c��l,j:n cctl �
r 6 �x33�
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► �+'t�J�
� 5���
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o G �.�'�
�-su/s� �
S;Tt- PT
t�3r��;��!
�� �
t�`°��<ra
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1
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IJ(��J�'�C�� -
S�t33--i.J
2�j e 3 ��S
� `.
SEED AND LOAM TO PROTECT FROM EROSION •
��'Y 1 �'i
� GEOTEXTILE FABRIC
MIN 12"OF
CLEAN FILL
7" �
_ , :.= 1g"
�2" <�SPECIFIED SAND SPECIFIED SAND �
6" 24" 12" 24" 6"
72„
2 ROWS OFA42's WITH 6"OF SAND TO SIDES
Figure 3.A42 Dual Lateral in-Ground Cross Section
Table 3
OTHER SPECIFICATIONS
(continued)
Length of distribution pipe >_Equal to length of distribution cell minus 2 feet
for components using
gravity flow distribution
Distance between distribution <_2 feet
pipe end orifice and end of
distribution cell for
components usinggravityffow
distribution
Length of GSF system row Multiple#of 65F units x 4 ft
Number of observation pipes >2
per distribution cell
Location of observation pipes For flexibility in pipe location,see VII.C.5.
Design and installation of 1. Have an open bottom
observation pipes 2. Have a nominal pipe size of 4 inches
3. The lower 19 inches slotted
4. Slots are z 1/4"and<_1/2"in width and located
on opposite sides
5. Anchored in a manner that will prevent the pipe
from being pulled out
� 6. Extend from the infiltrative surface up to or above
j finish grade
� 7. Terminate with a removable water[ight cap,or
S. Terminate with a vent cap if>12 inches above
� finish grade
R-�J 1 c.�.n.:t 5 �c-� ��a �,;-� = �6�a
1�`�
`� �a,c� _ . �c�� `�
Eljen Corporation Page 9 of 34
��- 3.� a� � .
Table 2
SIZE AND ORIENTATION
S 6 feet= Number of product rows x product
width. Product width is shown in Table 2b; two
rows of A42s can achieve a 6 foot width. Units
Distribution cell width (A)a may also use up 18 inches of sand on each side of
the product to achieve a 6 foot width. For
instance, B43 units used with 18 inches of
specified sand can achieve a 6 foot width; refer
to Table 2c for configurations
>_ Design wastewater flow rate=design loading
rate of the fill material=square footage of
Required #of Products product (shown in Table 2b), round up to nearest
whole number; Min 5 B43 units per bedroom or
6 A42 units per bedroom in residential
applications
� Distribution cell length (B)a Multiple#of GSF units x 4 ft+ 1 ft = 3 3
Orientation
Longest dimension parallel to surface grade
contours on sloping sites.
Deflection of distribution cell on concave < 10%
slopes
Design wastewater flow=soil application rate for
the in situ soil at the infiltrative surface or a
Basal area lower horizon if the lower horizon adversely
affects the dispersal of wastewater in accordance
with s. SPS 383.44 (4) (a) and (c), Wis.Adm. Code
The designer may use Effluent#2 in accordance
Soil Application Rate with s. SPS Table 383.44-1 and 383.44-2, Wis.
Adm. Code
Table 2b
APPROVED PRODUCT MODEL NUMBERS AND DIMENSIONS
Product Square Footage Product Width Product Length Product Height
A42 12 square feet per unit 36" 48" 7"
B43 16 square feet per unit 48" 48" 7"
Table 2c
APPROVED PRODUCT INSTALLATIONS AND SQUARE FOOTAGE
Product Square Footage Installation Width Installation Length Install Height
Q 12 square feet per unit 36" 48" 19" - � 3�
A42 16 square feet per unit 48" 48" 19"
20 square feet per unit 60" 48" 19"
16 square feet per unit 48" 48" 19"
B43 20 square feet per unit 60" 48" 19"
24 square feet per unit 72" 48" 19"
Eljen Corporation Page 4 of 33
PAGE40F5
GRAVITY—DOSED
SEPTIC / PUMP TANK SPECIFICATIONS �
(No Scale)
4"D Vent Pipe
>10 fl from
Buiiding Eleclrical must compty with
12"Min.or 2.0 R above SPS 316 and NEC 300
Established Flood Elevation W�therproof Ex[end manhole riser as necessary.
�ryP���� Junction Box
Approved Approved Locking Manhole
IMPORTANT: Vent Cap with Waming Label Attached
Anchor tank(s)as necessary t (ryP"���
ursuant to SPS 383.43 8 "�—�nduit
P ( )(g) 4`Min.or 2.0 ft above
Established Flood Eleva6on
(lypical)
�Airtight Seal � �
Finished Grade �
Quick Disconnect
CAPACITIES ��/ ,�3 . � ,. ° �s'Min.
@ /, � gaVin �= � - � .. � � � c�vn��q
a. � � . �
Depth(in) Volume(gal)
A � ` � � ��•:7�� *� Weep �Approved Joinls wilh
Hole Approved Pipe 3 fl onto
B 2.� � �� q Solid Ground
r`✓� (�1lPicaq
� SO �1 l5 �
C� �.j Alarm
� �, l ���• (� B �_On
* �c� PumP . PUMP-OFF
Pump Tank Liquid Level = 3 �D in � —� � ELEVATION = �`���,� ft
° INSIDE BOTTOM
Force Main Diameter = � i� Concrete
. B�°�* ELEVATION = �(. (� ft
' � ' � e ..
Farce Main Length = ��5 ft 3"Approved Bedding Material Benealh Tank
Force Main Void Volume = ��.� gai D�
� ��
[C] Total Dose Volume TDV = � , �� gal/dose q p �
R �� Zg D
(_ . ' +force main void volume) S Q[?
3�,�c,�5 p� �4 Y� �b x 3 =�c�, ZoN►N py pM�OVNn
Vertical Lift= ft STRAT�p�'
PUMP TANK: SEPTIC TANK(S):
Volume = S �c� gal Total Volume = �-1�� gal
Manufacturer: �K`�� r�'�e ��5� Manufacturer(s): 5�� P��- �-S�
Pump Manufacturer: �v�,�5
.� Install approved effluent filter at the septic tank outlet
Pump Model: P� 3 l ��attadiedpumpwrve.} immediately u�,stream of the pump tank inlet.
Gontrols(Ala�m Manufacture�: T�1� ��e�t Filter Manufacturer: ��-S�
Controls/Alarm Model: �D /
Filter Model: �-� �� - �
Float switches containingmercury are prohibited.
�` _ ,_ r. . . ,. :� � . .� --r.
� � � • . � �° o
Wastewater
METERS FEET
40 -,.___. _. ____ .,_ _�__. ____ .._... ...___ _
. .. � . _ . _ . _ . ___
_. _ _ . .
MODElS:
PE51 ` � �,___ . .�, - PE31,PE41,PE57
_ _. � #-_ �- HP .33,.40,.50
35 ___. _.:�.. . __._ _�__�_�__,_�.�_,.�.�. .
� �
. ;
, ,
. - -_ __ _- ,-f-., -
- ,
10 _ , -- _ . _ : ; .,
i —► 2 GPM _`
� �_ .__.. __ _ _ _{
; ' - $ � -
,..._...�..�.�'
+ '
30 , .PE�'��.;..�.. ___� . _. s„_ ._, —
1 FT - - ---
0 ' - - --
.
,
_ __ - � - , �
� � PE31 , — -
�-
_ ' � , ,
.
25 '
. .�_._... __...._.__ �.�__,__ . _a._. _ . _�:._.. . � . .�..�...ae.a._. .
. :
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__'_.."_ .'""'___' T.__ _..'._ ___.__."'..._ . .. . .'.'. ""'.. ._..'__.. .._ ...._"_'i ' ", '.' _ ._. __.. . . ""
._.___. ._.._ . . . _ ...._ ..... _... ... ..,- . _._ _ . ._. .
OO ...�r_.� -......._.�_d..._ ...�.. ___.,.,.._.__»..�. -.... . _�.. . _......... . " "" :._ __ ...<_._ ,__�..'_. .«_.....: .........._.-;
0 10 20 30 40 50 60 � 70 C,pM 80
� � � �
0 5 10 15 m3/h
CAPACITY
PERFORMANCE RATINGS
PE31 PE41 PE51
Total Head GPM Total Head GPM Total Head GPM
(feet of water) (feet of water) (feet of water)
5 52 8 61 10 67
10 42 10 57 15 59
15 29 15 46 20 50
20 16 20 33 25 39
25 0 25 16 30 26
35 8
Effluent5
PAGE �OF �
In-ground Dosed-Gravity Management Plan
IMPORTANT:
The owner of this in-ground dosed-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 Disaersal Area Operatinq Limits:
Design Flow= .�Cs�� 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 Seatic 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(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code.
o Effluent filter(s)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:
Nameofindividualorcompany: �O(� ��M�) � -Si7�L7 ��L L�L Phone: �j��_����' ��L��
Local government unit:��t�Y�:� �Jcc,���! �r;/L�✓�� Phone: 715^�3��� �����
Local govemment unit address: l0(�,/Cy �u��l S"�., Su.�e �(� t�-��t,�u%z� ZfP: S�l�
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 Ptan
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.
"1 I s- 3 a�.- o�gLl
Real Estate Sawyer County Property Listing Property Status: Current
Today's Date: 3/21/2022 Created On: 2/6/2007 7:55:59 AM ,
�'Description Updated: 8/25/2020 � Ownership Updated: 2/23/2022
Tax ID: 35415 ERIC L&LINDA A MAGNUSON WINTER WI
PIN: 57-032-2-39-05-27-3 04-000-000020
Legacy PIN: 032539273402 Billing Address: Mailing Address:
Map ID: .12.2 ERIC L&LINDA A MAGNUSON ERIC L&LINDA A
Municipality: (032)TOWN OF WINTER 6324N CANESTORP RD MAGNUSON
STR: S27 T39N R05W WINTER WI 54896 6324N CANESTORP RD
Description: PRT SESW WINTER WI 54896
Recorded Acres: 4.000
Lottery Claims: 0 � Site Address *indicates Private Road
First Dollar: Yes 5933W LAKE WINTER RD WINTER 54896
Waterbody: Winter Lake
Zoning: (RRi) Residential/Recreational One ,�,.) property Assessment Updated: 10/10/2016
ESN: 428 __ _ _
2022 Assessment Detail
Code Acres Land Imp.
� Tax Districts Updated: 2/6/2007 G1-RESIDENTIAL 4.000 123,300 38,500
1 State of Wisconsin
57 Sawyer County 2-Year Comparison 2021 2022 Change
032 Town of Winter Land: 123,300 123,300 0.0%
576615 Winter School District Improved: 38,500 38,500 0.0%
001700 Technical College Total: 161,800 161,800 0.0%
,� Recorded Documents Updated: 3/12/2021
� WARRANTY DEED _______- �Property History
. _
Date Recorded: 2/il/2022 437562 N/A
0 EASEMENT
Date Recorded: 12/31/2020 428973
O TERMINATION OF DECEDENTS INTEREST
, Date Recorded: 3/24/2014 389720
O QUIT CLAIM DEED
Date Recorded: 10/7/2002 303987
� WARRANTY DEED
Date Recorded: 8/14/1981 179080
�l 3 ,3
�,n-���0 5 i l t L��.,�
�c.n�� d� �f�t����� G'�l� �S�
� "^ PRIVATE ONSITE WASTE TREATMENT co�nty
��� ���
'k ° Saw er
���7 SP �1 SYSTEMS
\��ii� ( POWTS) Y
�"�rss'��•'' INSPECTION REPORT Sanitary Permit No:
�_-.,..
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION �-�..— a�O
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#:
�r c .�-��� V�la u o w�k �-
Insp BM Elev: BM escription: Parcel Tax No:
l oo,a` �a � �' i �, " �.�1 'P,� 0 3z-S�9-�7--�Yd�
TANK INFO MATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic (,[�.w- rp Benchmark �p�.O'
Dosing — tow.�oo �O
Aeration Bldg. Sewer R'�( �(4/f
Holding St/Ht Inlet �j y, '
TANK SETBACK INFORMATION St I Ht Outlet q ,gs�
TANK TO PIL WELL BLDG VENTTO ROAD Dt Inlet -
AI R I NTAKE
Septic ��S � ` � .�--��� NA Dt Bottom gp 7T�
Dosing a � a Y NA Installation
Contour
Aeration NA Header/Man. �����
Holding Dist. Pipe yg.S3'
PUMP I SIPHON INFORMATION Infiltrative �6,��
Surface
Manufacturer b� �, Demand Final Grade
Model Number �3� GPM C33 q 7 6S�
TDH Lift Friction Loss Sys Head TDH Ft �t� f$,QS'
Forcemain L �be Dia �� Dist. To Well
DISPERSAL CELL INFORMATION
DIMENSIONS W (� L �, #of Cells ( Type of System Distribution Media Manufacturer:
� Conv ❑ Aggregate �J e
SETBACK OHWM of Nav �
INFORMATION P I L Bldg Well Waters � IGP ❑ Chamber Model Number:
❑ AG ❑ EZFIow �
CELL TO �'3b �-to ti N (p ❑ Mound pC �ther — /� ��S
13
DISTRIBUTION SYSTEM X Pressure Systems Oniy
- -- - — --- _ _ _
Header I Manifoltl 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 Mulched
Cell Center f Cell Edges Topsoil __ ❑Yes ❑ No ❑Yes ❑ No
COMMENTS: (Include code discrepancies, persons present,etc.) .
�ao� ���I� �I� 91��
���I;�.�, ,q-�c�'S
Plan revision required?O Yes ❑ No I �,� �l �3 � ., � 6�`� ��
� � _
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
AOOITI AL C�MMENTS AND SKETCH
N SANITAA ERMIT NUMBEA; �.�— O6� �3'�VJ
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