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HomeMy WebLinkAbout024-741-30-5416-SAN-2022-120 � ` ` Industry Services Division County � 4822 Madison Yards Way SeV�/ef � - �S' - Madison,WI 53705 Sanitary Permit Number(to be tilled in by Cc � t P.O.Box 7302 � Madison,WI 53707 � j�� � � �-� t Sanitary Permit Applieation State Transaction Number c, \ X-� In accordance with SPS 38321(2�,Wis.Adm.Code,submission of this form to the appropriate governmental unit �- G is required prior to obtaining a sanitary permit.Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing addri the Department of Safety and Professional Services.Personal information you provide may be used for secondary �O�O�N FIIt@r Ba Rd. Ha ard WI purposes in accordance with the Privacy Law,s- I�.04(I)(m),Stats. y � , I.Application Information-Please Print All Information Property Owner�s Name Parcel# Eric & Beverly Knoernschild 024741305417 & 024741305416 Property Owner's Mailing Address Property Location 2220 Oak Valley Dr Uovt.Lot 4 City,State Z,ip Code Phone Number Muscatine, IA 52761 715-462-4063 '�, '%, se�t+o� 30 II.Type of Building(check all that apply) Lot# T 41 N R �� E or W �/ I or 2 Family Dwelling-Number ofBedrooms 2 � Subdivision Name Block# ❑Public/Commeroial-Describe Use �City of ❑State Owned-Describe Use CSM Number Village of 33/26 Q✓ Tow„or Round Lake III.Type of POWTS Permit: (Check either"New"or"ReplacemenY'and other applicable on line A. Check one box on line B.Complete line C i a licable.) �� �New S stem Re lacement S stem Other ModiYication to Existin S stem ex lain Additional Pretreatment Unit ex lain Y � p Y ❑✓ g Y ( P ) ❑ ( p ) Add Pump Tank&drainfeld to Existing Holding Tank B' �Holding Tank �ln-Ground �At-Grade �Mound Individual Site Design Other Type(explain) (conventional) C• ❑Rene���al Before �Revision Change of Plumbcr �I'ransfer to Ne���O���ner Li;t Previous Permit Number and Date Issued Expiration �7-3�$ (0 �Q � IV.Dispersal/Treatment Area and Tank Information: Design Flow(gpd) Desien Soil Application Rate(gpd/s� Dispersal Arca Required(st) Dispersal Area Proposed(s� System Elevation 300 0.6 500 500 100.66 Capacity in Total #of Manufacturer Tank[nformation Gallons Gallons Units � � o 'g � Vew Tanks Existin�Tanks ,.'�- " U �' '� u �' ` 0 � � y � cG @ n. U rn � v� i,. U a sePdc o�Hoid���Tank 3000 2000 1 Rasmussen ✓ Dosing Chamber 500/800 1300 1 Wieser � Q � ✓ V.Responsibility Statement- 1,the undersigned,assume responsibil'ty for installation of the PON'TS shown on the attached plans. Plumber's Name(Print) Plumber's Signat MP/MPRS Number f3usiness Phone Number Jason Kuettel 675751 715-798-3355 Plumber's Address(Street,City,State,Zip Code) PO Box 66 Cable, WI 54821 Vl.Coun �/Department Use Only � Ap ro�e ❑ Disapproved Permit Fee Date[ssued Issuins Agent Sianature � � � �� � � ��� ❑Owner Given Reason for Denial ���• ���� (�� ���r 1 V f�_,(,�y'f;�,-�' ��=� Conditions of Approval/Reasons for Disapprova( r � t-�.�`-�'� ! ��.-��� - -� ` �! � `� ��1`��� :� I` t.�• �U c��l--.�: �l 1 ;� CS � a-�, — � �� � J U N 1 7 2 0 2 2 � � �- �� '� , �r �� ,�r ��l��Soc 7l� a�,-2-��-T� C� �- SAWYER GO ,,-. � ZONWG ADidtiPdlS"��i:1��Ti�;. Attach ro complete plans for the system and submit to the County only on paper not less than S Irz x 11 inches in size sB�-639a�R.ozizz� NO REFUNDS AF'TER iSSUE OF PE.�tMIT PAGE 1 OF 5 In-Ground Dosed-Gravity Plan Index & Cover Sheet Component Manual Design References: Version �, SBD-10705-P (N.01/01, R. 10/12) . , . 4,l 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 Knoerschild - 2 Bed Lift Owner Name(s): Eric & Beverly Knoerschild Phone: 715 _462 _4063 Owner Address: 2220 Oak Valley Dr. Muscatine IA ZiP: 52761 Project Address: 10101 N Filter Bay Rd. Hayward, WI Govt. Lot: 4 1/4 of_ _ 1/4, Section 30 T 41 N_R�� E ❑or W❑✓ Township: Round Lake County: Sawyer Project Parcel ID #: 024741 30 541 7 Designer Information Designer Name: �ason Kuettel Phone: �15 _798 _3355 Designer Address: PO Box 66 Cable, WI Zip; 54821 E-mail: Jeff@andryras.com License Number: 675751 Remarks: Signature: Date: f��/L`2z Origi s' nature required on each submitled copy. CHECK BOX AS APPLICABLE. C!^ECK BOX AS APPLICABLE. ❑ SOIL EVALUATION o s`�1e: ao 40 so 80 � SYSTEM PAGE 2 OF SITE MAP PLOT PLAN PROJECT NAME: ��o ft gnd) ��z DES�GN FLOW: 3�C GPD KNOL�,k.4-��L� Z �t� Attach design flow calculations for commercial plans. PRO,lEC7 ADDRESs Pipe Materiai / ASTM Standard (Tables 384.30-3 8 384.30-5) /eo �, ' `� Sanitary Sewer: y �J�G� �-fU / BM Symbol: � BM Elevalion: FT Force Main: Z SG°t'`'� � / BM Description: l�t' cC-f.=�-"��-�— �L � SlopeGradient (%) r Indicatenorthby IMPORTANT: a ld Well Symbol (if applicable): � drawing an arrow Show ground elevation contours at suitabie intervals. of TeSt2d ,4rea: on the approprite line. O�.1 N�- : C2lC � t3 Eu�-�-�` �Cr.�c `�Sc ��(L1J __ , _ _ � ��A,C-�S ` 1 0 ►o S N F , L��� �� �� `t ,Z-,� - 4�- Y � �-� , w� I � ; a I , I _____r___-�---�+ � . ; , ; LC�Z_ < -��Z' �n 'J_ L�t J `� � fj-�c.�'Z. � Cs �--^ j /Z`31 � 2/ � � � _ ' � ; � � � S � o � y- 1 N � b� �..� —;� �_�, _ ; ; ; i _ -�----: � � - , ;-r-�-�_ � � � a `- c� Ly � � 1 �3 65 � ) � � .O �Z �-1 �7 �-1 I � OSy I �7 ; ' ( � ! __ � — , � fi�-��� , , I , _ u,ccr'S ?,2c:[ui�( p>.�I ___r_T �_ ' -_ � I � �; ,. � i i �—� ; ; - — - , : � � � � � __..__.r � � � _.._ . . . . . . . . . � f I t � . . . .. .- - - - �- i— _... I i � f G G ) i � i ! � u�r ` . , • � � � � ! i . I , ._�_..r.__.,..__ __ _ .. . _ . .. . . . . . . . !j .. . . .. ... � I __ . , � � t3z , �--T--�—;--f-----�— � i � i ; Q ', ; � i } . i � j � i I ' � ' : � I t-T� , ; ; , � , ; � � '- � -�—�--- � , � � - -- . - . �._.. . . . . . . ��-. I _ . -�-i.-.. � . . . � �.V�U " . �Z� � �u ' . .�. I . '.i___.. . 1� � �QG' . Q i I ` � ' ' � Q� . .. . . . � � �.. �� Ezs=� ' 1;� i ' JG �I � ZI I --�--�-.- i I � ` I � ; _ � _ 6�Z � �° `f . `'3 ' � --�- - � / � __ !O IC�N _ l� 3 ` � UZ • 6 �. I I J � r i � I _� _ _. N,Q t7 __ ' _._ '-�.q-Y � �`t��M �L ' /OU 66 I --r - - ,.\ � aj -__ i _ . �' � ?��'-tv G' ;'/= �- PiS. v I I , � o - �- � ___ ��s ►GN � O•� I I �a��.�rr ,__ � in � t�`� �k�5n�6 I _ � � -- - _ -: _ . _ : _ S'�2✓t7v�L � I � � � � 1 I J ! � , � � t . . . --- � �— r -t--�. r ._��._ _ .I I � � '3:� _lU J: l ' � ; ' , �yJ ��tC7st-�L � i _-1—_ I �/ � � �c�. - . � I �� " � `_''j'Y gz FC ���N _ ( � ► o� � I I � I rl �zz �'YY ��� I � T T � ... .. . -.. : .. �. �� ; � . ;.__.... .i . � � I I � � ! � . . ,- _'_' .�-�_ I : �i� I . � i.----��--f-� - �� - -F— i---�-i- - � � u ' � ...i C v.�S�u� �Jv. i-c� � I � i � ; ( I � � � � - �- ' . � ,_ 7_._ ; �_ ! ' ' � �7S7s' I __� ; __i _ ot,�u� : i ; � � �„[_fc�t._ t- __ __, _ _. , I ' /,� yZ y ; , � /-L.Pt t_ t .._ .. I �GL/���v � � t. � ` . I -- � -- - �- - - -- i I f y.�� v�6nco tX�Cr�c� �. , i ---T. .�-_ � __ � _ .. ; , , � , , - r, �rz� Z IN-GROUND DOSED-GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down-sizing credit) � m��. ,z• Geo�eztile I I cnP��o TYPICAL TRENCH Cover SOILCOVER CROSS SECTION VIEW 12• (No Scale) OBSERVATION PIPE DETAIL min. trench depth (No Srale) (�ypical) L — r — — � ,', Screw-Type or SIiD Cap(loose) ,� �"':.r'� Finis�etl Grdde (mulchetl 8 seedetl) SystemElevation/100.66g • • •. �� 4"OPVCPipe `'.� ToP�aco�a� (typical) � � Pfovideminlmum3ft Topolpipeto�emiinate (mi�. irooq at or above finisM1etl g2de separation between trenches. (4)V4•'-1/2••X 6"Sbis @9b apa� TYPICAL TRENCH (Show loca[ion of inlet/ outlet pipe connection on plan view.) qnclionnq �eviw i�rua�b� PLAN VIEW - S��a� (No Sca le) 4u � Observalion pipe shall�e installetl aljunciion betweentwo units. "�Q Perforated Lateral Ohservation Pipe ft (typical) (rypicaq OyP�cap - - - �f - - - - - - - - - - - - - - - �—� � - - - - - � � "____' ______° '--" _'_ '_'____ � A — 3.0 ft D -- ------ � - - - - - - - - - - - - - - - - - - _ J (�YPicaq - �� - - - - - - - - - - - - - � � B - so n �� m (typical) W INSTALL PER TRENCH: EZ1203H Bundle 0 (typical) � 5 10-ft bundles @ 50 fl' EISA/unit = 25� ft' (mfd by Infiltralor Systems, Inc.) � Install pursuant to manufactureYs instructions. + 5-ft bundles @ 25 ft� EISA/unit = ft' = Proposed EISA per trench = 250 R' Required Infiltration Area = 500 {�' Distribution Method: x 2 trenches = Proposed Total EISA = 500 ft� branched manifold RESET PAGE40F4 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 Dispersal Area Operatinq Limits: Design Flow = 300 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 panding in distributian 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 Septic 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(sl 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. RepoR any component failure or malfunction to: Name of individual or company: Alldf�/ R8Sf71USS@Il 8c SOI1S, IIIC Phone: 715-798-3355 Local government unit: SaWyel" CoUllty Z011lllg Phone: �15-634-8288 �oca� govemment unit address: 10610 Main St. #49 HayWard, WI Z�p 54843 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 Plan In the event that any failed treatment component of this POWTS cannot be repaired, i� 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. PAGE50F6 SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4"0 Vent Pipe >ronr�m Building Eleclncal musl comply wilh 1Y'Min.or2.Oflabove SP5316andNEC300 Es�ablished Flood Elevation Wealherpmof Exlend manhole nser as necessary. - (typical) Jurction Box Approved qpproved Locking Manhole IMPORTANT: Ventiap wilh Wam(gPLa;elAttached t i�l Anchor tank(s)as necessary pursuant to SPS 383.43(8)(g) ---cona�a a^Min.or z.o n anove Es�ablished FIooC Bevalion (typical) �Airtigh�Seal Finishetl Grade � Quick Discoanect 18"Min. CAPACITIES @ 11.82 gal/in . � _. avv��o Depth (in) Volume (gal) • d � A 23.3 275 'r � Wel p ��Appmved Joinls wi�h B 2.� 23.64 A i Hale "PP'sotlaPc�o�a°n�� � (typicap [C] 5.7 67.71 I _Alarm D 12 141.84 B 8_0� I [c] PUMP-0FF * 43 � P°mP �—off ELEVATION = $9 � ft Pump Tank Liquid Level = in � ° INSIDE BOTTOM Force Main Diameter = Z in c°"Ce`a ai°°k ELEVATION = $$�� ft Force Main Length = ��� ft 3'^PP�o°e�aeaa��9 nnaie�ai ae�eam ra�k Vertical Head = 11.66 n Force Main Void Volume = 2�•�� gal + Min. Supply Head = NA ft [C] Total Dose Volume TDV = 67.71 gal/dose + FM Friction Loss = 5.61 ft (5X total la[eral void volume <TDV<0.2X tlesign flow) +(force main drainback volume) + Fitting LOSS"' = NA ft "(min.supply heatl x 0.3) MIN. PUMP DISCHARGE RATE = 4� gpm = TOTAL DYNAMIC HEAD = �7•2� ft PUMP TANK: SEPTIC TANK(S): Volume = 500 gal Total Volume = 3000 gal Manufacturer: Wieser Manufacturer(s): Rasmussen (Existing) Pump Manufacturer: Champion Install approved effluent filter at the seotic tank outlet Pump Model: CPES3 immediatel u stream of the um tank inlet (See a�tached pump curve.) Y P P P Controls/Alarm Manufacturer: SJE Rhombus Filter Manufacturer: Orenco Controls/Alarm Model: HW 101 Filter Model: FT-0822 Float switches containina mercury are prohibited. hd111 1011 �� 1/3-1/2 H P p - � EFFLUENT/SUMP � �. _o: �� ..,�_ � .: .,�-__...'.' �,_ pEvery pump tesied in water to ensure pump 1 meets peformance curve. ., � � � • , � '""` - . � • � �,.,�. .',,,.,. _ • • � ' � -� .�..�' :>;� �'� , ; : , � , -. - . . . .. . • �,. , r: , . �:_,_q,, � � � "'•��, ; .� • • � � � • � • . . • ' �. -• • • • • . � • � � 1� . F;_: � •• •- • .�. • • � ��' � • �. .-. • . • - •. • • � - • • • �. •- • ��. • • �- ' •- � . � -� � 3 _.--__ • • •• • • ' •� ' � • • � •- •�' '• • . • • •.• � • � � �� -� • r • �. �' '� . •� • • • ��- • • .� • • -� -• . - � � • • • - � � � � , y� - s �_�� :. - - �- . - � ��� � - • • . - • �. • • � • • - •• • • • � � • �• .��'• ' • • • ' • r ' ' � t , 1 • •• • �• ' . .. �' '• • ' � "• •• • • • • - �_ _ �_ .. � � • ' � � � ' • • � � � � . � . � � • • • � � � � ���������������������������������������� ���������������������������������������� ���������������������������������������� \��������������������������������������� ���������������������������������������� � ���������������������������������������� �����\���������������������������������� ���������������������������������������� \������\�������������������������������� ���������������������������������������� � � ����������\����������������������������� �����\������.\��������������������������� ���������������������������������������� ��������������\������������������������� ���������������������������������������� ' ���������������������������������������� ������������\�����\\�������������������� ���������������������������������������� ���������������������������������������� � � �������������������\�������������������� ��������������������lA\������������������ ���������������������i������������������� ��������������������.►1������������������� �������������������IL� ��� ���\����������� . �������������������:��������\������������ ��������������������i��������\����������� ��������������������������������������� ���������������������������r����\�������� . . �������������������������������\�\������ ����������������������������������������� ��������������������������������A�������� �������������������������������I�ii�\\����� ���������������������������������J���� ������������������������������IiL..�� � ��������������������I������������G�������� ���������������������������������������� ��������������������'�������������������� ��������������������I�������������������� ��������������������I������� ������������ . . ��������������������la������������������� � � � � � . ,. . :� • • • � � • . ' • : • : � • • � � I � ■ � - � • ; � / � � • • • 1 � . • • • • • �. : — opii�io�i��`ei/����iii����Ciii U 'J U U L U 'J Tx:4038825 A�39787 RESTRICTIVE COVENANTS pAULA CHISSER IN RE: �EGI�TER dF DEEDS �AWYER �C3UMTY, W� ��I20/2022 02:57 PM RE�ORC�ING FEE 3�.fl0 PAGES: 2 �S�eQ a-�+�� �99�d�.s�s,`�'���. Retum to: Sawyer County Zoning Dept. 10610 Main Street, Suite #49 Hayward, WI 54853 STATE OF WISCONSIN ) ) § COUNTY OF SAWYER ) a�y��y�_30-Syl7 Parcel NoS. o1y-�YI- 30- SY/b ��2.t c A'1. LC/VB G 6L'NSC E4<<--�� , being first duly sworn on oath depose and state that they are the owners of the property described hereinabove, and fiuther state that the following restrictive covenants shall run with said property described herein: 1. The above described parcels may not be sold separately without permission from the Sawyer County Zonir�Officc.��,5�;�sys�eqsew�e�'�"" � Dated this�d day of 5�-� , 2p Z Z � ��� . Owner Owner ACKNOWLEGEMENT STATE OF WISCONSIN ) ) § SAWYER COUN1'Y ) � Personaily came before me this, �,'O day of� ,20��the above namod individuals, �.�i Ce �� 1`�'1�>� ✓ r' �jC.. � � ����_;���q�e lrnown to be the persons who executed the foregoing instnunerrt and acl+nowledg�d the same. ��e`N'�Y C����s,,>, � ��o� ••i�,�4 •";r,�:,n. � , j� • --� �7, (Print Notary Name) �� .�;�i����° .`s n Notary Public,State of Wisconsin / ;��j� ���7"�����5�,�,>�-� This document drafted by: My commission expires: � �� �• `���.� =s=,. ,.-•. �jSj••�. ,. ���;E;` �c'i c w2�14kQ'r' ,,' L,0• '� !�� ��a��l 1110`�� �!�tarial Offtcer by Wis. Stats. ``+��i� (�) (f) and (2)County Clerk Parcel#1- Part Gov't lot 4,Lot 1,CSM 33/26#7946 poc a�3���3 Sec.30,T41N,R07W Sawyer County 024-741-30-5417 Parcel#2- Part Gov't lot 4,Parcel A,CSM 1/291#214 poc��3769� Sec.30,T41N,R07W Sawyer County 024-741-30-5416