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Home My WebLink About028-642-19-3107-SAN-2022-073 ;��_`` '� � Industry Services Division Counry � 4822 Madison Yards Way S(�V] er �� - Madison, WI 53705 Sanitary Permit Number(to be filled in by Co.) � _ > P.O.Box 7162 � ,,;�„— •�� Madison,WI 53707-7162 � �j �� V i (;,' Sanitary Permit Application State Transaction Number N �--- In accordance with SPS 38321(2),Wis.Adm Code,submission ofthis form[o the appropriate govemmental unit r 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 �a�� RC� � purposes in accordance�vith the Privacy Law,s. 15.04(1)(m),Stats. ��d0(p �� ..0.�1�� I.Application Information-Please Print Ali Information U'' Property O�cner's Name� Parcel# �n�.+ni�l P E Pc�r►�ela� L. F'��ck. o�SC.yz «3��"� Property Owner's Mailing Address Property Location /S`j► E�o�e na Rc.� �o�t.Lot City,State Zip Code Phone Number �ixo+n , SL (ol��( g�S'-`/�lo - G$�O`� �ia, �i<, se�c�o„_�_— IL Type of Building(check all that apply) Lot# T �� N R �L E or �1 or 2 Famil} Dwelling-Number oY Bedrooms .� Subdivision Name Block# ❑Public/Commercial-Describe Use PLL 3 ❑c��of ❑State Owned-Describe Use CSM Number ❑Villa�e of ��33� #y3�A �ToWp of ' �e� Lake 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 if a licable.) A �Replacement System ❑ New System ❑ Other Modification to Existin�System(explain) ❑ Additional Pretreatment Unit(explain) B' ❑ Holding Tank � In-Ground ❑ At-Grade � yp ( p ) ❑ Mound ❑ Individual Site Desi�n ❑ Other T e ex lain (conventional) List Previous Permit Number and Date Issued C• ❑ Renewal Befom ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner � Expiration (,(y�� IV.Dispersal/Treatment Area and Tank Information: Design Flo�v(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System E(evation 3�0 o .s �oo GI�.L q3. �y Capacity in Total #of Manufacturer Gallons Gallons Units ` o � � Tank Information � v a�, New Tanks Existing Tanks � c � Y � � � c ' � U �n � cn i�. U C. Septic or Holding Tank �� />� I /`_Nu = � �.a.�l t°Sl,°r 1..0 Dosing Chamber V.Responsibility Statement- I,the undersigned,ass e responsibility for installation oT the POWTS shown on the attached plans. P bers Name(Print) Plum rs �gnature MP/MPRS Number Business Phone Number �o� �> �a� e �23b?Z2 ?I s - �.3 t-�SL Y Plumber's dress(Street,City,State,Zi Code) P� � �9 c� ��,�.o�� W z str� 3 VI.County/Department Use Only � S� Permit Fee Date Issued Issuing Agent Signature Ap o ❑Disapproved $ ��•� � �� < <- ��,'�_' 1 � ❑Owner Given Reason for Denial � 2_�. d_4 � �.��i _ Conditions of Approv�UReasons for Disapproval v � -� �.� - 3� � r._ J,. - - ' S ,' ` '` ._.. ..._.. 4y ..�1 �� ' ' � �.S . . � �` i�+ .. �- _: ��. , �: :'..i � . � � . �( �^ AA�� ... .i '.f ( . Attach to complete plans for the system and submit to the Counry anly on paper not less than 8 1/2 x 11 inches irt size sB�-639g�R.o3i2i> NO RE�UNDS AF7ER ISSUE OF PERMIT � c ; Daniel P. and Pamela L. Rick Property Owners Name 13006N Landing Camp Rd u Property Address 28642193107 Tax Parcel Number Sawyer County Legal Description 19 Section 42N Town 06W Range Page Index 1 Property Information 2 Data Entry 3 Plot Plan 4 Drainfield Cross-Section 5 S�p��Tank Info �O Maintenance Plan � Contingency Plan 8-1� Soi ► T�S} Douglas E. Manthey Plumber's Name Plumber's Signature MP 30722 Plumber's License Number 715-739-6868 Plumber's Phone Number ��3/10/22 �Date Not an endorsement,written or implied for the following companies and products;DelZotto Concrete,Wieser Concrete Products Inc.,Skaw PreCast Co.,Huffcutt Concrete Inc.,Zabel Environmental Technology, ITT Industries(Goulds),The Pentair Pump Group(Myers), Infiltrator Systems,ADS Products,Polylok Inc.,Orenco Systems Inc.,Sim/Tech Filter Inc.,Sta-Rite Industries, Page I of Il SQQ - 1pnOS (N•o��ot; � ��/is�,_ . Component Manual Used 2 Number of Bedrooms <1 Percent Slope (%) 66 Depth to Soil Limiting Factor (in.) 0.5 In Situ soil application rate 200 Estimated Wastewater Flow (gpd) 300 Design Wastewater Flow (gpd) 1 Number of System Elevations 93.74 ��Proposed System Elevation #1 93.74 Proposed System Elevation #2 93.74 Proposed System Elevation #3 96.14 Original Grade#1 96 Finished Grade #1 95.94 Original Grade #2 96 Finished Grade #2 95.74 Original Grade #3 � 96 Finished Grade #3 Infiltrator Quick 4 Standard Chamber Type 12 Height of Chamber (in.) 2b sq.ft. per chamber 2 Rows of Chambers 5.8 sq.ft. per pair of end caps 3 Distance Between Cells (ft.) 30 Proposed Number of Chambers Used 600.0 Minimum Distribution Cell Area Required (sq.ft.) (oll.(o Distribution Cell Area Proposed (sq.ft.) Wieser 750 Septic Tank Orenco 12" Biotube �� Effluent Filter Surface Depth to System Soil Boring Grade Limiting Lowest Highest Elevation Number Elevation (ft.) Factor (in.) Elevation Elevation Acceptable 1 96.14 72 93.1 95.1 TRUE 2 95.94 74 92.8 94.9 TRUE 3 95.74 66 93.2 94.7 TRUE 4 3.0 -1.0 FALSE 5 � 3.0 -1.0 FALSE Page�of f l �� D0 I.oSTLa.� Td P o.�' ��ab .'n �UGJ Corvlc�^ L.�t�G a.�-' G�vx.J�c�oo r ?�Z`� QI 9�,1� a2 g sqY �� , �� P � 9� G-� a-i� �2e c✓ ST �.D� �� 9rvc,cr�� La�� , qD..ZY S�sf� Ra.�e g y,t Y- I3.Z'f 5 Y S�c� ��• `�3.7Y , S 6�r ' �°4,5� �+�d . V 82 �- �'D ��i hf �u�•,o 8 � � 7 Ip S IO�`O . --' DGv�2r� ��--__. �r • l�aK��l f� � �Kr.s1e 1q �. �iG� ��.��C `S�( �'�des�a, ��.- d'� � n��Co�-t �� Cac o� � _ �eyQ� r'o w� o� s�'i d e.r� /�k'e- � 1� �'�z�tl �Z aG w p�T NFsw � S�' S�J, r'c� � � s� ��33� ��3z � S� 'f'e �y� c cZ tTir�° �!�• � �3 av� N �a� • S �!a`,,�,are� s`�� /3 - �S(� asa� 1.�1�eS��- C��cr�� Tc�w.�,G �� C� — ��.�n c.m I�I Q �� r t( � ��'� � ��/e: l =yo - �Il co�..��yo�.Kc� p; �;KoJ � �e S�I�.�to o � SL�Q 3S QUL r _� 0 _ R��R - 0.5 gpd�� 2 c�l�S co�.�a„+ni►�Jc JS G�.�c�C `i ��,aw,�,er-s �,�,�, ��0� rn P .230�?.2. � Pag� � o � I� Cross Section of a Two Cell In Ground Component Using Leaching Chambers Observation/Vent Pipes � � 96.00 Finished Grade - �_-__-----_-_— Finished Gjade _. 96.00 Sbpe #VALUE! /I Ceil��eration � , j > � ,' ;> 3 ��t �, � ,' . . . , ; ,- �,�' `, ,�; � �: �� , 96.14 Ori inal Grade _� �, � i�` � , ' , ,� bti inal Grade 95.94 y �' 94.74 Top of Chamber �ti�'�\ , y�� j - k p 9 _,,�_� '"T'o of Chamber 94.74 ------ �, �- � , : � � -- ,, , ' 93J4 System Elevation ��+. , , ` System Elevation 93.74 , -- --- • . ------• � _- �' .. . , • . . � - .T"reatrr�ent'pnd'Dtspersol,Zor�e. ' I ,. • , , ' .. �, • " •• • � ••. •' .• ,. . - ' ' Limiting Factor Observation/Vent pipes to be constucted and capped with approved materiols for the particular use. Diagrams Not To Scale — --- -- � � - �, _ .—_� � � � i a � a --� � r �.��",.,a�.��,..��. - ,. � : , �_: %�-��` x�,��"4i�� "��. r �� .�,;p�x, , ,..'�^�` .::��_ �_ #N/A Page�of 1� � D Z � � D � �7 = m AS n � 54" REQUIRED cDn D � Z � � D � 42�� z (� � m m c � —7' D oUP 52„ r � 4" CAS O N �z� � i �I m , � . r==-- -_ �� O '� � I I i�//'� \\\\��\ � I I .l� I � � � � I I i� 1 / �� / � C� � �37�� i � � � ji �, ��,_ � �� o � I � •�i �o m �'�`'sz: �I D < 3„ i 46„ 5,. < ii y� ,o il cn r� I rr, �� r�-o j� � � i� � � �\�\ fT��7 r/ _ \, �/, I I I I '�\ �/ \ /� � �.�j � � �r I � � � � � i� N �� I I �\ �\ � i� N �_ i J i. J -- _ _ t � __- �_ _ � C . m � I O � C � D UP 72„ � m � 4" CAS n z o D � c cn N � I 40" � D � m v � � -, � � � _ � z z o C D O D C � O C> r r �� r��, � � o noo � �� ?� �r �oo = � � a� � rr, O� A r� - (�C- � � - r*t p � C m y O O D z �� y � c�C� n = C�Z � Z S C O � S S m � � � � �m x � c� z o D�� o � o �� o � o � � z D o - � � � N v� o X ��o cmi� =z D cn "-'o � o m z r'� 0� r� o = m � D o� c� � z� D � o�� o cn cn _, z _w � a �z c� � � � z Dm � m �m �i� � om � � � � `v- � � � z c� r� - o v D � D� z o 0 0� c�� N cn r�-i y � r W � -r - Cn � � � � z � z i �c o cnom �- ��!Nm o � n o Dc < < c�i� � � � c�n � � � r�r�i �D CD `n � � � � tn r < � G \.. - J m y�l rJ J � � � "' � H � m o �z � z o o c� _ �m `�i I � � (J� m � o0 70 Z o o Z � � C c� D D�D o n — O o m < � � � C � � y D �7 O � Y (/1 -� O7 n � CD � r Z ��0 .Z7 N � I m � m r � < � � A� � D � � � � D � 7v C I � D N m �, � D z � � � o � � c� -i �, � < 3 � � o o .. D m � D �""� C� A r � Z � � r � � � � m � �' � o, ; \ � = WLP7`JO-MR ��I�� C��CAETE SCALE: 1�4' = 1'-0" REV. DATE: PRE-POUR: � � DRAWN BY: WCP � Z sEPTic MaNun� W3716 US HWY 10, MAIDEN ROCK, WI 54750 DATE 00/00/00 POST-POUR � � 800-325-8456 F��E: W�P�So-m� �ge S a� C1 Daniel P. and Pamela L. Rick 13006N Landin Camp Rd 2.86E+10 Number of Bedrooms 2 Septic Tank Wieser 750 Estimated Flow(average)gallons/day 200 Effluent Filter Orenco 12" Biotube Design Flow(peak), (Estimated x 1.5)gal/day 300 Pump Tank Wieser 750 Soil Application Rate gal/day/ft2 0.5 Pump Type Influent/Effluent Qualit Monthl Average Fats, Oil & Grease (FOG) 30 mg/L Biochemical Ox gen Demand (BODS� 220 mg/L Total Suspended Solids (TSS) 150 mg/L !!NOTEi! Servicing frequency of 12 months or less requires the Management Plan be recorded with the Register of Deeds. Maintenance Schedule Service Event Service Frequency .:...�,_.�..�_.w_...�,,.�,,.. Inspect condition of tank(s) At least once every Y 3 Year Pump out contents of tank(s) When combined slud e and scum = 1/3 of tank volume Inspect dispersal cell(s) At least once every 3 Year Clean effluent filter At least once every 18 Month Inspect pump, pump controls & alarm At least once every Rn��V��A Maintenance Instructions Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer, Septage Servicing Operator. Tank inspection must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals 1/3 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. A service report shall be provided to the S��rCounty Zoning Department within 30 days of any service event. Start-Up and Operation For new construction, prior to use of the POWTS check treatment tank(s)for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank removed by a licensed Septage Service Operator. System start-up shall not occur when soil conditions are frozen at the infiltrative surface. Page�of �1 Do not drive or park vehicles over tanks and dispersal celis. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fat, foundation drain (sump pump)water, gasoline, grease, oil, painting products, pesticides, sanitary napkins, tampons, and water softener brine. Abandonment When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with W�sconsin Administrative Code Comm. 83.33; -All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. -The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. -After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. Continqencv Plan If the POWTS fails and cannot be repaired the following measurers have been, or must be taken to provide a code compliant replacement system: (Check One) � The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation shall be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed to replace the failed POWTS. A suitable replacement area has been evaluated and may be utilized for the location of a replacement ;.�.I absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structures, lot lines and wells. Failure to protect the replacements area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. A suitable replacement area is not available due to setback and/or soil limitations. A holding tank may be �ctalled to replace the failed POWTS. �f1NF�F�NIi�J��! Septic, pump and other treatment tanks may contain lethal gasses and/or insufficient oxygen. Do not enter a septic, pump or other treatment tank under any circumstances. Death may result. Rescue of a person from the interior of a tank may be difficult or impossible. POWTS Installer Septic Pumper Name Douglas E. Manthey Name HK Septic Phone# 715-739-6868 Phone# 715-798-3494� POWTS Maintainer Local Regulatory Authority Name HK Septic Agency Sawyer County Zoning Phone# 715-798-3494 Phone# 715-634-8288 Page�of�l J/�- ' ` PRIVATE ONSITE WASTE TREATMENT county ,"� ,�H,, ,.\,ly\ ��j � �oSp .��1�� SYSTEMS SaWyer �.y�`� s /�-; ( POWTS) \�Sll�),��%p/ INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �a�� Petsonal 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#: �c1n i Z� �l'��'+��\� 4`�i c� 7 i� �� Insp BM Elev: BM Description: Parcel Tax No: lob.�` �-�-s 1�1� �r r�rv.� �.�- e�..��Q� ��-��_1q 31�7 TANK IN RMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic �,�,��f `]� Benchmark 100�0� Dosing ,8,�d � �,q ' Aeration Bldg. Sewer $,$� Holding St I Ht Inlet 46,Q � TANK SETBACK INFORMATION St I Ht Outlet cc 6,�� TANK TO P/L WELL BLDG VENT TO ROAD Dt Inlet AIRINTAKE Septic + ` {-�S� �'x� �-�.5-� NA Dt Bottom Dosing NA Instaflation Contour Aeration NA Header I Man. ��{,'�r Holding Dist.Pipe PUMP/SIPHON INFORMATION Infiltrative Q3,.� ' Surface Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFOR ATION DIMENSIONS V�1 3 L (�b` b� #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate ��I INFORMATION P/L Bldg Well Waters o GP �Chamber Model Number: , ❑ EZFIow CELL TO .�-�p� �-S' +$b� -t-� � ❑ Mound o Other Q� DISTRIBUTION SYSTEM X Pressure Systems Only Header/Manifold � Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length Dia Length Dia Spac Spacing ❑Yes ❑ No SOIL COVER ----- ------ — — Depth Over Depth Over Depth of Seeded/Sodded Mulched Cell Center Ceil Edges Topsoil ❑Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present,etc.) ��.S��c� .�r1�� Plan revision required?❑Yes❑ No o� a� �3 � • ��'� �� Use other side for atlditional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) A�OITI�NAL COMMENTS ANO SKETCH SANITAAY PEAMIT NUMBEA: �'oZ�-�73 ti / �� L�t� (..R�/�e.i�.- ' ; ` ; i ; : , I . . . . , . . _ . _ _ . � _ _ . _.,_ ._._ . .. . . . ; . I i , � , , , . ___ . . , . . . : _ _. . . _ _ . . ' ` : 'I -- -- . -,.. _- --- _ _ ..._ � - - - • - ' - �_-- -- - _ _ .-- -- __ I -- .-•- :. ... � .. , �µ , � g� 10 . I � i_ ; _ . - - � � .. . - -- - __ , }$ C , ' F . _ _ _., � � � ' � i5 . ..__.. _ , . �._.. ' F. I ;___ . t I ` � . , , ,o . . . : ' � � ._ _ !..._. , :..__ _ 3 �5g, � � � �c• �� c(� � ' r,,;e.ss� s � i �Sb � w\b�o $� � � � C� � s�° �3D�� ,� ��'`Q,� �� , � � ��, • � � l��` � � ' ,/�D r„�Q�X% � i �i � � � �p/ � � � �/ � `�-- 5�1ttf--t�