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HomeMy WebLinkAbout012-739-02-2308-SAN-2022-180 '`� � � Department of Safety c°"nry � � � � - & Professional Services, Sanitary Permit Num r(te Ue filled in by C Z � �, S � �` i ;� Industry Services Division � � � t � � � Sanitary Permit Application State Trensaction Number � L�accordance with SPS 383.Z1(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit � 1 is required prior to obtaining a sanitary perrnit Note:Application forms for state-o«med POWTS are submitted to Project Address(ifdifferent than mailing adi �- the Department of Safety and Professional Services.Per;onal information you pro��de may be used for secondary , �� �i_ .� �+ � purpases in acwrdance«rith the Privac}'La�v,s.i�A4(!xm),Stats. ���Q� u' ti'�l/ I.Application Information-Please Print AlI Information � �� Property Owner's Name Parcel# �v.�Cia � f C?t�- ?39'-0�---�3v$ Property Owner s Ylailing Address Property Location a �!"1 , �s�,� City,State Zip Code Phane Number /l�L��(Yl ' �{C.�'�L 0 � " l a2' �-�.e�l —5��'! �w �'. N w �/,, se�uon r?� II.Type oTBuitding{check ali thaf appl��) Lot# T 3� N R �� E or �i or?Fami}y ihvclling-Number of Bedrooms �____ Subdi�ision Nan�e�_ Block� � ❑PubliclCommercial—Describe[Jse ^ ❑City of O StaEe Owned—Describe Use CSM Number ❑Village of r- C�,Town of�l.n,`��� _ III.Type of POWTS Permit:(Check either"New"or"Replacement^and other applicable on line A. Check one boa on line B.Complete line C if a licable.) A. ❑ Ne�v System �Replacemeat Systetn ❑Other i4Foclification to Existing System(expiain) ❑Additiona!Fretreatment Unit{explain) S. ❑Holding Tank (�,ln-Grontxl ❑At-Gride ❑ Mound ❑ Individuai Sitc Design ❑Other"fype(eacplain) (cam�entional) C• ❑Renewai Before ❑ Re�ision ❑ Change of I'3umber ❑Transfer to New Owner �����ous Permit Number and Date lssued Expiration ��_ I�� lO ' IV.DispersaUTreatment Area and Tank Information: Design!►o��•(�d} I)esign Soii Applic-ation Ratc(�Qd'st) Di:pecsal Ana Required(s� Di�persal Arza Proposed(sfl System Ele�ation �3, 5� Capacity in Total �of Manufaccurer Tank Infonnation Gallons Gailons Units Q � o � � Ne�;�Ta�tks U , Existinc Tanl;s � � � , a�. � � u�- � .f � c'�S — �J C/] n V1 Cz. v �-^�+ Septic or Noiding Tank !� Q ) ( � �5�4 � Uasing Chambcr V.Respon5ibilih Statement— I,t6e undersSgned,�ssame responsibilitt�for installation of the PO«`'TS shown nn the attached plans. Plumber's Name(Pri�E) P1 ' Sienature MPI"MPRS Number B�ine��Phoi�e\uminr � r/t — P umber s Address(Street,City,State,`Lip Code) ������ ` J �b�' � � �' " �L���f-�� �l� y�[ -l�- VI.County/Department Use Only � �' ❑llisappro�•ed Percnit Fee Date Issued Issuine Agent Signatum ❑Owner Given Reason lor Denial ���„� �(3�a a � Canditions of ApprovaUReasons for Disapproval ,__.� . r-:�-^,� D ��l(��,�,�, ' ' ''`i �' Date g N ��- x�.___ ._ _ - ,�_�,��� w, , G ;� IN � 50 __ cnk# � � �uL 2 s 2022 �--� CS� aZ� - ��(o Rcpt#N'e�� w�r1�1�.�.��1, � � ��� ZQNM!(�ADMIIS STE�ATION ` Attach to complete pla¢s fnr the system and submi�to ihe Couaty only on paper not►ess than 8 1/2 x ll inc6es in size ' NO REFIINDS AFTER SBD-6398(R.03'22) ISSUE OF PETy1A1'i' �`"/b.S�i PAGE 1 OF 4 In-Ground Gravity Plan Index & Cover Sheet Component Manual Design References: In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross-Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Owner Name(s): G,Qy�/�.��-. �'rv1'i/1 SucY�� ��c.� `��f Phone: �ca -�o� -5a�g Owner Address:;�b�-� �r�,� Lv�1 �fxr1,��h (�Cwk-��L- Zip: {,�4l3� Project Address: 1(�.�j C�(01,v �d� l:-4t�.+� � �u�Cc.bt�L � c�,�j��-,� Govt. Lot: ���1/4 of �41� 1/4, Section�, T��N-R 07 E❑or W Q Township: ��cu,l°�,��1"� County: ��C'�t..�,d�' Project Parcel ID #: � (,�.��3Cf� C7�-- vZ30� Designer Information Designer Name: ��1L�.d1. �1i'�1c..I'� Phone:��5 S$�S -l(��_ Designer Address: �(��"7� l�`Tl►U- � Gc.QpCc�k-2e9, ��iP: 5�-�� E-mail: �� , License Number: ���?�/ Remarks: Si natur • � — 9 e• Date: ���..7 �o-� O� inal sign t required on each submitted copy. State of Wisconsin DEPARTMENT OF NATURAL RESOURCES Tony Evers, Governor 101 S.Webster Street Preston D. Cole,Secretary Box 7921 Madison WI 53707-7921 Telephone 608-266-2621 Toll Free 1-888-936-7463 WISCONSIN TTY Access via relay-711 DEPT.OF NATURAL RESOURCES ;�\ "�I)�G;; , August 3, 2022 rfil�\��t�,� �, �� -"� �����' � ��, _ �,`�f Sav�ryer County Zoning and Conservation Department ` 03 � 10610 Main Street, Suite 49 �`, �y�k�,;:�,iM1� �.`���'? � Hay�vard WI 54843 ' ^-' �' '',-. ,�, tJ Dear Sawyer County Zoning and Conservation Department: � [ have reviewed the POWTS permit application submitted for the property located at 10506W County Hwy CC in the To�vn of Hunter, Sawyer County, Wisconsin. The property is fiu-ther identified as having Sa�ryer County Tax iD#14504. This property is not covered by a Chippcwa Flowage buffer�one restriction. All other county and state codes and permits apply to the subject property and must be applied for and adhered to. Please coutact me if you have any questions. Sincerely, ___-_ C���,�� Roy Kcnast Chippewa Flowage Property Manager 715-634-7433 d n r.wi,g ov ��PqIN1FD wisconsin.gov Naturally WISCONSIN °"AEc"E` YAPER tJ'u: E�"'- � Sauvt�s��mrc�c� 54ck.� Re�Tr�s-4- Saw�ev- Co� Hv.,�'e.•-Tw�. 3ozz tlde� ?� {��rJ: GtZ-'�34-OZ-Z3DQ; �v'a��l�� {� r�C�SL (oDl3� SG�/tJW � DL T3R^� R D� W f-3�z_4oK_sZiq s:��= IoSo�Ow Co �Fw� ��CC" � ��y��s S(o�gG�-�— _� � �, , � � � ��± I�S�� --- � l� S�e �`�_�Fo' � �� N S�ee� �_ �— � � � o ,o zo � wn. �,��s:� �a C�n-��� i � _ Ex Z6� ;� ♦Sruoo ro� o�tale[� � +� p�op l B 1. 4�.23' Li h�� I � Z, q7.�1' � � i 3_ R�.I4` 0 I � St�l��o ,(�Sd,�S�5�.e l. 43.$� � I - �w�ll C r4•.12. �t 2.5�—4Y'� 3 4 4 _„�so��'c a 9 ye — £s-F ST.;n1 a5.5� Lg� .3 • gu�z n� � _v � a � •z � b � �p 5 s � � �lD�O(�jw Ca !�w CC I - } =� j= �a�� 3 a� � . ^ � _ _ , � _ �� � _� _ _ _ ; i � i= �- `J � ; � ! � �,= F✓ � - � ; .. � � � v ._ � � � i P . r ? i`I : -_�� � � J Q j , � � . +� ....�i.�.. ,`..� � V � � � I � j � �j : : 1'. -r. � C ; � � } � l.i •j - v: >i,�J . � � i � � i � z �'�:..: .. ! =J,;l �=- � � ' � .x �, ; Q i ( . : ..�-? 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T � . i , t �, ..^.. ..^.. ! .� � T r ii f � (� M ;% ` " � T i{ 1 �: � s � -' � i! j :. � � : �' W j , `;— � �1 �� I •, , !' �� O y/J � � � � � �� � �� �� r� � � 5 � i � „ � i �f , , �a/ t j � � U �% !: . �i"'_�� ` `� � �i t � �. � ;i � �: : ': ' {iJ i � p :t i � � � c ¢ � Z ; � j: ; � i Z� , f ; _ � � �, —� � :�; `-� � ,,,, � , :� I : � . .�-r,�: �' `f'�s^J�� � I � I f r-t � PAGE 4 OF 4 In-ground Gravity Management Plan IMPORTANT: The owner of this in-ground 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 adivities shall be performed by a registered POVYTS Maintainer in accordance with SPS 353.52(3),Wisc.Admin.Code. Maximum Dispersal Area Operating Limits: Design Flow= �/S� gpd; BODS<_220 mgL"'; TSS<_150 mgL"'; FOG<_30 mgL"' Insaection 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 treatrnent tank(s)and any distribution appurtenance(s)(i.e.,distribution/drop boxes) o neglect or improper use(i.e.,exceeding design capacities,prohibited adivities,etc.) o extent of ponding in distnbution 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 Seotic and dose ta�k(sl 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 fiiter(s)shall be inspected every 3 years and shall be deaned 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: Name of individual or company:��CJ�./11 _3�v(,t.Y`ES� Phone:����S�—{��T� Local govemment unit: �(1!A��(9� A ��(]�� Phone:���--�iE�LQ�� Local govemment unit address:�l�j���il,Y���" ����? � Yi1L�, ZIP:�l.�c��_ 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. Contingencv Plan 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. Fteal Estate Sawyer County Property Property Status: Current Listing Today's Date: 6/6/2022 Created On: 2/6/2007 7:55:25 AM Description Updated: 6/14/2017 Ownership Updated: 10/10/2019 _ _ _. _ _ _ _ Tax ID: 14504 JAMES & MARCIA FRANKLIN PARK IL P�N: 57-012-2-39-07-02-2 03-000- SUCHY REVOC 000080 TRUST Legacy PIN: 012739022308 Map ID: .7.8 Billing Address: Mailing Acldress: Municipality: (012) TOWN OF HUNTER JAMES & MARCIA JAMES & MARCIA STR: 502 T39N R07W SUCHY REVOC SUCHY REVOC Description: PRT SWNW TRUST TRUST 3022 ELDEN LN 3022 ELDEN LN Recorded 2.150 FRANKLIN PARK IL FRANKLIN PARK IL Acres: 60131 60131 Lottery 0 Claims: Site Address * indicates Private Road First Dollar: Yes �OUN7Y HWY COUDERAY Waterbody: Chippewa Flowage �� 54828 Zoning: (RR1) Residential/Recreational One Property ESN: 412 Assessment Updated: 9/26/2016 2022 Assessment Detail Tax Districts Updated: 2/6/2007 Code Acres Land Imp. 1 State of Wisconsin G1- 57 Sawyer County RESIDENTIAL 2•150 209,100 45,100 012 Town of Hunter 572478 Hayward Community 2-Year 2021 2022 Chan e School District Comparison g 001700 Technical College Land: 209,100 209,100 0.0% improved: 45,100 45,100 0.0% Recorded Totai: 254,200 254,200 0.0% Documents Updated: l0/10/2019 _ WARRANTY DEED Date Property History Recorded: l0/2/2019 �` ' - N/A TRUSTEES DEED Date Recorded: 4/24/2001 -=---- i `� Q -� f�e.w �errt�a,��h-� c.c�d�ess: �DSD� w Co -F}w� CG Co� dera� � Lc� i .Sy gZ-g p�. 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Sewer ��c'�` Holding St/Ht Inlet ci5- Y � TANK SETBACK INFORMATION St/Ht 0utlet .� ' TANK TO P/L WELL BLDG VENT TO ROAD Dt Inlet AIR INTAKE Septic �' �2 ' ' .}-6 ' NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. q7�t�' Holding Dist. Pipe PUMP 1 SIPHON INFORMATION Infiltrative �� � Surface Manufacturer Demand Final Grade Modei Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist. To Well DISPERSAL CELL INFORMATION DIMENSIONS �N ,3 L?� -� � #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav 1� Conv ❑ Aggregate INFORMATION P/L Bldg Well Waters � IGP o Chamber ❑ AG m� EZFIow Model Number: CELL TO p � .�-�s�� ❑ Mound o Other -__ - - -- — - _— - ---- -- - __ DISTRIBUTION SYSTEM X Pressure Systems Only -- _ __ _ _— — ---- ----- Header I Manifold Distnbution Pipe(s) � X Hole Size X Hole Observation Pipes� Length_ Dia Length Dia Spac L Spacing ❑Yes ❑ No ------- SOIL COVER -- - --- -- - -- — De th Over De th Over ! De th of Seeded(Sodded Mulched P p P Cell Center Cell Edges I Topsoil _ _ ❑ Yes ❑ No ❑Yes ❑ Nc 1 COMMENTS: (Include code discrepancies, persons present, etc.) ���►r(,� : �- , j��s��-3 .s�rs = � 1► Y ��-3 Plan revision required?❑Yes ❑ No p� �� �Y � � —� �� �� Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3101) A�OITIONAL COMMENTS ANO SKETCH SANITAAY PERMIT NUMBEA.___��__ �.—G�,,� ,�to w � . . 3�� � � � ; _ . _ . , _ _ __; ' __ ,___ , -�- -.�_ _ ..-- : � ; , ; . , � ;.__ . ; _ _ __ . � �b � _.+ . �S� �.. —j— ���c'� � . _ �\�a � � ' � �� � i —� ► --� � �� � � � �(�� ����. i � - I i � i � � � �c�d��` _` � � �� � � I a� � ,��5' �,�,C.. . I �� r ����� ' I � � -�— �o�b� . ���. �� -r CJ D cre�=