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Home My WebLink About014-265-00-0200-SAN-2022-201 ;� Industry Services Division Counry � '`, � _ 4822 Madison Yards Way SAWYER � - , = Madison,WI 53705 Sanitary Permit Number(to be filied in by �' �: P.O.Box 7162 � �_- Madison,WI 53707-7162 � 3�' � � I Sanitary Permit Application State Transaction Number � In accordance with SPS 38321(2),Wis.Adm.Code,submission ofthis form to the appropriate govemmental unit � is required prior to obtaining a sanitary peRnit.Note:Application forms for stateowned POWTS are submitted to Project Address(if different than mailing � the Departrnent of Safety and Professional Services.Personal information you provide may be used for secondary i4175N Trekkers Ln � pucposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. — , I.Application Information-Please Print All Ieformation Property Owner's Name Parcel# David Olheiser 014265000200 Property Owner's Mailing Address Property Location 3100 E.Minnehaha Pkwy Govt.Lot 2 City,State Zip Code Phone Number Minnetonk�MN 55406 , , /., /., Section 2 II.Type of Building(check sll that apply) Lot# T 42 N R 8 E or W �! 1 or 2 Farnily Dwelling-Number ofBedrooms 2 2 Subdivision Name Nordic Ridge 1 Block# ❑Public/Commercial-Describe Use ❑City of ❑State Owned-Describe Use CSM Number ❑Village of �Town of lenroot 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 i a licable. `� ❑New S stem �Re lacement S stem y p y ❑ Other Modification to Existing System(expiain) ❑Additional Pretreatrnent Unit(explain) l�x�N�• IQe �c�.»w7 p...�roN�..� R..,� B' ❑ Hold' Tank ❑ In-Ground ❑ At-Grade ❑ Mound ❑ Individual Site Desi u►g gn ❑ Other Type(explain) (conventional) C- ❑Renewal Before ❑ Aevision ❑Change of Plumber ❑ Transfer to New Owner �st Previous Permit Number and Date lssued Expiration I�r� � 3 IV.DispersaUTrestment Area and Tank lnformation: Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation 300 .7 428.6 �A,2 (,f r 94.5 ' Capacity in Total #of Manufacturer Tank Information Gallons Gallons Units � o '� � New Tanks Existing Tanks w = � � a� a� � � � o " � � � a U rn ti �n i�. C7 ci. Septic or Holding Tank 60 60 I S Dosing Chamber V.Respoesibility Statemeat- 1,the uodersigned,assume responsibility for installation of the POWTS s6owo on the attached plans. Plumber's Name(Print) Plumber's Si ur � MP/1�4PRS Number Business Phone Number Gerald Frcemel G 9501]1 715-558-1138 Plumber's Address(Street,City,State,Zip Code) 13502W Frcemel Rd Hayward,Wl 54843 VL Co n /Department Use Only ,�App v ❑Disapproved Permit Fee Dafe Issued Issuing Agent Signatuce �`� $�(!1 ��c°�2� �VI,r,��1..e^}{�v'�";' O Owner Uiven Reason for Denial �/Q.�� Conditions of Approval/Reasons for Disapproval ��.-� �[It�aa_ ._.. . .__.. _.. ~+ � ��'��; �' I ; 1 GI N� ,�::, L ��;: Ic��s � !i`7 AUG a 9 2A22 i--:/ GS "� �a - I 3 7 ti-}�=;,��, w P r �� -�ag - --- � z�rSviAiv�;.-;u��r�-:fi-�;.....��v Atlach to complete plaos for the system aad sabmit to the Coanry oely on paper eot kss than 81rz:11 iec6es in siz¢ NO REFJNDS AFTER SBD-6398(R 03/21) I�SUE OF PE�i1NItT �((,OS David Olheiser Property Owners Name 14175 N Trekkers In Property Address Q14265000200 Tax Parcel Number Sawyer County ,.�_..___�.,� lot2 Gov Lot or Qtr-Qtr/Qtr S2 Section T42N Town R8W Range Page Index 1 Property Information 2 Data Entry 3 Plot Plan 4 Drainfield Cross-Section 5 Dose Tank 6 Maintenance Plan 7 Contingency Plan County Parcel Listing Gerald Froemel Plumber's Name Plumber's Signature 950111 Plumber's License Number 715-558-1138 Plumber's Phone Number 08/10/22 Date Not an endorsemerrt,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),Infittrator Systems,ADS Products,Polylok Inc.,Orenco Systems Inc.,Simlfech Fifter Inc.,Sta-Rite Industries, Page 1 of 7 In-Ground Soil Absorption SBD-10705-P(N.01/01)Version 2.� Component Manual Used 2 ,Number o Bedrooms 4 :Percent Slope (%) 105 ��Depth to Soil Limiting Factor (in.) 0.7 � �In Situ soil application rate 200 Estimated Wastewater Flow (gpd) 300 Design Wastewater Flow (gpd) 1 ;Number of System Elevations 94.5 ��a Proposed System Elevation #1 Proposed System Elevation#2 Proposed System Elevation#3 Original Grade#1 Finished Grade#1 °Original Grade#2 ��Finished Grade#2 Original Grade#3 �F�� Finished Grade#3 Infiltrator Quick 4 Standard Chamber Type 15 Height o hamber (in.) 20 sq.ft. per chamber 2 Rows of Chambers 5.1 sq.ft. per pair of end caps 3 Distance Befinreen Cells (ft.) 22 Proposed Number of Chambers Used 428.6 Minimum Distribution Cell Area Required (sq.ft.) 450.2 Distribution Cell Area Proposed (sq.ft.) Ra3 �750 — E,r,s%�� =Septic Tank ose an (if applicable) � Lifetime �w� ' :EfFluent Filter *�select only if NOT using combo tank Soil Boring SurFace Depth to Lowest Highest System Number Grade Limiting Elevation Elevation Elevation Elevation (ft.) Factor(in.) Acceptable 1 96.69 96 91.69 95.44 TRUE 2 97.58 105 91.83 96.33 TRUE 3 9 .09 92.09 97.84 TRUE 4 5 Page 2 of 7 �w�ve�: L�4 � : l�a.U� c� �. Q��e�se�r- Saw�er Ce-� �enroa�" TW� 3�00 �. ►'►��✓�e�►� �� P��w� P��J o[�_z6.S—oo -- ozo-v �'1��n r�.e��v� '�.� 1`�J k.l SS�ED C� � 0 Z _ T' 4 Z1J R. D 8 � �(1, (o( 2.-�i b g...�19 SS 1`lo r-d i G ��r,�� l L o-�" 2- �Z,5 � 3 � . � �� rM 2 y b� _ . a,� � = 1 °' • UJ��I � $N�op r � ,' � � ` o '"�p� ,,� �1� � -� N � �. sca.�c t"= 4O' `�� /_� �� t� so: � Test � O� `�~V J �y � ho�sG a�� o� l� � �� L L� Q to =p !p 40 ♦ � 3F1►00�� Sw Corh.er o� ga.ra.ge Co✓L. a.�ro� F> i, a6.bq" 2, ��.sg ' �- � 3 `�� ` .'[ sa•ls� s�s� el�v a�.5' ��S��b/// �x�s�,;.5 s:T. o�' 5-►.`lz� Cross Section of a Two Cell In Ground Ccmponen; Using Leachinq Chambers ObservaUo^.�Ve�il Rpes � \ Finished Grade � -- -- Finished�rade--0 Slope 4% '_' /I CeH 8eperation / Original Grado- i //� `�`� '�l,� �`�T Xhiginal Grade 9575 Top W Chamber � � 'Top of Charrber 95.75 '-- 't9- �' '�" . d'- -' ---' �,, 94.50 System Elevation '�• . ,. .System Elevatbn 94.50 � � .Yreotr+�ent�pnd•D�vpe�sal.lo�e. . . . _ '.___�._� . • . . . . _...__� � llm�tmg Factor Obse�vat�o^./Ve�; pipes to be constuctetl and capped with approved matenols �or the partiwiar use. Dia rams Not To Scale �� -�i O�t�r+t�� ..t�i:.i�.�: �� — --- __ _- -- � . _— -_..._� i - _ __� � _ _ � -- -- _ —�"�`r...�i.r �� "��'-~�r'L. �� .�, i bservation/Vent Pipes to be located t/5 to 1/10 the length of the distrution cell measured from the end of the cells Page 4 of 7 David Olheiser 14175 N Trekkers In 1.43E+�0 Number ot Bedrooms 2 Septic Tank Wieser 750 Estimated Flow(a�erage)gauons i day 2 Effluent Filter Li etime De5igfl FIOW(peak),(Estimated x 1.5)gal/day Pump Tank A Soil Application Rate gaUday/ftZ 0.7 Pump Type tnfluent/Effluent Qual' Monthl Average Fats, Oil 8 Grease (FOG) 30 mg/L Biochemical Oxygen Demand (BODS> 220 mg/L otal Suspended Solids (TSS) 150 mg/L !!NOTE!! Servicing frequency of 12 months or less requires the Management Plan be recorded with the Register of Deeds. Maintenance Schedule ervice Event ervice Frequency Inspect condition of tank(s) At least once every ear Pump out contents of fank(s) When combined slud e and scum = 1/3 of tank volume Inspect dispersal cell(s) At least once every 3 Year i Clean effluent fiRer At least once every 3 ear Inspect pump, pump controls &alarm At least once every Maintenance Instructions Inspections of tanks and dispersal cells shall be made by an individual cartying 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 ot combined sludge and scum and to check for any backup or ponding of effluent on the ground surface. The dispersai cell(s) shall be visualiy inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surtace. 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 County Zoning Department within 30 days of any service event. SWR-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 ceil(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 infittrative surface. Page 6 of 7 Do not drive or park vehicles over tanks and dispersal cells. 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 compiiance with Wisconsin Administrative Code SPS 383.33; -All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. -The contents of all tanks and pits shali 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 materiai. Continoencv Plan If the POWTS fails and cannot be repaired the following measurers have been, or must be taken to provide a code compiiant 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 availabie a hoiding 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 soil 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 soif 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 installed to replace the failed POWTS. '�WARNING!! 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 Gerald rcemel Name ?Scott Poppe Phone# 715-55 - Phone# �(7 5 -145 POWfS Maintainer Local Regulatory Authoriry Name Jays Septic Agency Sawyer County Zoni�g Phone# 715-558- Phone# 715-634-8288 Page 7 of 7 '°`�''�T"'��'%; PRIVATE ONSITE WASTE TREATMENT counry ,:,, ,;,, ��,,�$� �, �, SYSTEMS Sa.Wyer s �;' ( POWTS) ��`,� �_,,,�. �k\F�_,<,.rv�� INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �� _ ��' 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#: �� b� �iS�_ �e.r�n,o-� � Insp BM Elev: BM Description: Parcel Tax No: �c�.�' w ��n�• 6� �.rr+ G� . r�� I`�-ZbS�- 6 0-��2a a TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Benchmark Go_O � Dosing Aeration Bidg. Sewer Holding St I Ht Inlet TANK SETBACK INFORMATION St I Ht Outlet TANK TO P/L WELL BLDG VENT TO ROAD Dt Inlet AIR INTAKE Septic NA Dt Bottom Dosing NA Installation Contour Aeration NA Headerl Man. G�S;S-� Holding Dist. Pipe PUMP 151PHON INFORMATION Infiltrative �y S, � Surface , - Manufacturer Demand Final Grade Model Number GPM � TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFORM TION DIMENSIONS W ' � #of Cells Type of System Distribution Media Manufacturer: � Conv ❑ Aggregate ^ ` , SETBACK P/L Bidg Well OHWM of Nav � IGP � Chamber INFORMATION Waters � AG ❑ EZFIow Model Number: CELL TO �� -}� �` /J ❑ Mound o Other �,7� - - — - -___ -- --- — - 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 I Sodded Mulched Cell Center � Cell Edges �_Topsoil_ _ � ❑Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) �C�5�� '�S/�-� � tie.,,.� ce.(l S �� f _ — __ —, --- � Plan revision required?0 Yes❑ No �03 b �-3�, ' � C��9'� � � �-- Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AOOITI�NAL C�MMENTS AN� SKETCH SANITAAY PEPMIT NUMBEA_____�-�_.=�-c�] . W��-IP�� , � -�-co � '�,� �45 t . �� P�� I , i --�O g I � -� 1 � ( ��w��s �(� � � ��Q�r,-Ki� � �°�� I P��-I ^� w � _J � � � Jy1 �c �� r-�r— I bT�� 5?�T---