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Home My WebLink About010-841-29-1408-SAN-2022-200 '` "' Industry Services Division County ;'� �� 4822 Madison Yards Way SAWYER � ._�:' = Madison,W I 53705 Sanitary Permit Number(to be filled in by f, �. = P.O.Box 7162 Z __ _ Madison,WI 53707-7162 �p 3� � �� Sanitary Permit Application state Transaction tvumber � , In accordance with SPS 383.21(2),Wis.Adm.Code,submission ofthis form to the appropriate govemmental unit � is required prior to obtaining a sanitary permit Note:Application forms for state-0wned POWTS are submitted to Project Address(if different than mailing a � the Departrnent of Safety and Professional Services.Personal information you provide may be used for secondary SER�NITY OAKS LN � purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. I.Application Information-Please Print All Information Property Owner's Name Parcel# AVERY&MICHELLE UHLENHOPP 010841291408 Property Owner's Mailing Address PropeRy Location PO BOX 608 Govt.Lot City,State Zip Code Phone Number SPOONER, Wl 54801 SE '/.,NE '/a, Section 29 II.Type of Building(c6eck all that appiy) Lot# T 41 N R S E o� 7 �1 or 2 Family Dwelling-Number ofBedrooms 3 Subdivision Name ❑Public/Commercial-Describe Use Block# ❑City of ❑State Owned-Describe Use CSM Number ❑Village of 26/272 #6951 �Town of HAYWARD III.Type of POWTS Permit:(Check either"New"or"ReplacemenY'and other applic961e on line A. C6eck ooe box on line B.Complete line C i a licable. A. �New System ❑ Replacement System ❑ Other Modification[o Existing System(e�lain) ❑Additional Pretreatment Unit(explain) B' ❑Holdin Tanlc �-Ground ❑ At-Grade g ❑Mound ❑ Individual Site Design ❑Other Type(explain) (conventional) C• ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑Transfer to New Owner "��vious Permit Number and Date Issued Expiration IV.DispersaUCreatment Area aed Tank Information: Design Flow(gpd) Design Soil Applicaiion Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation 450 .5 900 . c�1� 93 Capacity in Total #of Manufacturer Tank Information Gallons Gallons Units ` o '� � New Tanks Existing Tanks � o � � � � � � a U cn v, rii w C7 0. Septic or Holding Tank �ppp 1000 1 IESER Dosing Chamber V.Respoosibility Statement- I,t6e undersigned,assume responsibility for installatioo of the POWTS shown oo the attac6ed plans. Plumber's Name(Prin[) Plumber's MP/MPRS Number Business Phone Number GERAI..D FROEMEL /'/ 950111 715-558-1138 % Plumber's Address(Stree�City,State,Zip Code) 13502W FROEMEL RD Haywazd,Wt 54843 VI.C n /Department Use Only �App � � ❑Disapproved Permit Fee Date Issued lssuing Agent Signature ❑Owner Given Reason for Denial $ !�'�� f��I aa � � Conditions of Approval/Reasons for Disapproval . , �_: . 8(��aa _ _. �� LL ��1�, ---„� �� G�. �� - �__� '; W��!� �a�a.� �� 0 s Zo�2� (CST aa- 1��/� � t�e.� � � �f�'JVY�R COJNTY ADt�JINiSTRATlOt� Athc�to cempkte plaas for the system aad sabmit to the Couaty onty oa paper not kss than 8 t/2:11 inches in size NO R�FJNDS AFTEp SBD-6398(R 03/21) ISSUE OF P��n- ��$��a Avery&Michelle Uhlenhopp Property Owners Name serenity oaks In Property Address 010841291408 Tax Parcel Number Sawyer County � SE/NE Gov Lot or Qtr-Qtr/Qtr S29 Section T41N Town R8W Range Pagelndex 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 endorsement,written or implied for the following companies and products;DelZotto Concrete,Wieser Concrete Produc[s Inc,Skaw PreCast Co.,Huffcutt Conaete Inc.,Za6el Environmental Technology,ITT Induslries(Goulds),The Pentair Pump Group(Myers),Infittrator Systems,ADS Products,Polylok Inc.,Orenco Systems Inc.,Sim/Tech Fitter Inc.,Sta-Rde Industries, Page 1 of 7 In-Ground Soil Absorp6on SBD-10705-P (N.01/01) Version 2.� Component Manual Used 3 Number o Bedrooms Percent Slope (%) 102 Depth to Soil Limiting Factor (in.) 0.5 ;In Situ soil application rate 300 Estimated Wastewater Flow (gpd) 450 Design Wastewater Flow (gpd) 1 Number of System Elevations 93 Proposed System Elevation #1 Proposed System Elevation #2 Proposed System Elevation #3 Original Grade #1 96.3 Finished Grade #1 Original Grade #2 Finished Grade #2 Original Grade #3 Finished Grade #3 Infiltrator Quick 4 Standard Chamber Type 15 Height of Chamber (in.) 20 sq.ft. per chamber 3 Rows of Chambers 5. 1 sq.ft. per pair of end caps 3 Distance Between Cells (ft.) 45 Proposed Number of Chambers Used 900.0 Minimum Distribution Cell Area Required (sq.ft.) 915.3 Distribution Cell Area Proposed (sq.ft.) Wieser 1000LP �Septic Tank ose an (if applicable) Lifetime Effluent Filter "`select only if NOT using combo tank Surface Depth to System Soil Boring Grade Limiting Lowest Highest Elevation Number Elevation (ft.) Factor (in.) Elevation Elevation Acceptable 1 96.30 102 90.80 95.05 TRUE 2 96.30 102 90.80 95.05 TRUE 3 96.2 1 2 90.75 95.00 TRUE 4 5 � Page 2 of 7 pu,i�er: L�: I�172f�i J� �u�,IG�elle„ R. Ui��2✓��el�� SqWy2r l,F>� C[4�rW4N� Lw� �o B k 6D8 � P�,�' o�b - $`l(� ZR- �40�r S�oor�e�� Wl S�FSS�I sC�,,�� s' z4 i�C�N �--o8w �'(2, �L¢�j-.�l`-E-665(� L.,o-t `7 CS f'I zb,Z'iz st69Sl o�t: Ser�,2�� Da�s Ln. S J t y8t � ' 3 � � a � Sca�e t"=3C> -t�� i� �owt2 g So;�Tes-�f-��e�. S Z . uT N o i�� y N t^ Levc� �K So:�Z��'{re4 �v - IJU �ph'TovcS� J� N in t� ,�� '� i+l a � . sn�od -��o�:.�^�y�� 0 I d�-�'�e �Pro� 3 6� � +a�x48 � � � . p�e�� well � sM roo'�na.l�c;bEmn �.1-s.'de 20"�l�.i'�� B�. 46.3 � 2. R63' 3, `�bLS' •S Sp".�S 5�5�( 2�e�. �13.5� �''�'a"`� q1'- q�t' �'��/� �5-f -ro o-F s�4h 9�.3, I � �'L///�S�ysa��/ Cross Sxtian of a Three Cell inground C;omponent Using Leachiag Cbambers Finished Grade Original Grade ,�� Top of Chamber 94.25 / �System Elevation 93.00 Finished Grade 96.3 /� Slope C Y5'-epara ion ___ .Finished Grade 96.50 ''�-�� 3 Feet Original Grade `,t` ' � � ��` 94.25 Top of Chamber 'r� `J � y � %��`�� Original Grade ..•••......... . . ,^,', • , . - � �•' � ' 1� ;'� � ' ;�' Top of Chamber �' . ✓ .. ;' .'- ... . ..�.,...._. 93.00 System Elevation �- '�:.:..y, 'Y �` • • • �' System Elevation 93.00 ..,, �. . : . .. :. . .,. . . .... . ... �.: : . ;;�. �'[4e.�ot�i+e�if�e[w�l'IqJi �., . . ,.:: : i ' ; . ' :� .. �r.-r. . .�':: � .. •. �..,•., •:r•' •� .� • � .•�.. .� :.a ., ..�. .r.�...' . T:• ''•• •.: . . •'�,•, :'�:� . • �•. � L.,;.v. �.i .;..: .�1 1'.: '�,�� : � y �� : . . .. v.. %.••.. ' .. •.� .,r.:'' . . .�• -� ... •�..., ''! ' �' ' . . . � "�: ,•�1.. . ;..•.. . ' i '�'�.. •i. ;. : _�.:'.':t . . :.: .�; . � �. w�. .�� ' .Y: .� .ni.. '� .< � � .� �Vi1�0YN��M b 60 000��C�Od�fb�IOYOd��/E7[!60�V�R U�C. Dia rams Not To Scale __ _ �— _ �� _ -- -- _-. ��, _ , --. � � � � ��o � � �' �lIMIII►' y:. ',d�R�,�ll�.�`,�� _ _._. ��'�s � I � __ ( R /� \) �i � ^_.iai.O , ' O ' O. 6 O \/ O \ � . � i R . __ . . .._ ._ . � .. _ .. / / . �/ O , `/ O ' O V, V �i. , ..__. . .� ... . .. . . . . � �� \__" —. _._ __—.i bservation /Vent Pipes to be located 1/5 to 1/10 the length of the distrution cell measured from the end of the cells ve 8 Michelle Uhlenhopp sereni oaks In 1.08E+10 Number of Bedrooms 3 Septic Tank Wieser 1000LP EStitil8t2d FIOw(average)gallons/day Effluent Fiiter i etime DeSl9l1 FIOW(peak),(Estimated x 1.5)gallday 4 Pump Tank / Soil Application Rate gaVday/ft2 0.5 Pump Type Influent/Effluent Qual' Monthl Average Fats,Oil&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 Maintenance Schedule Management Plan be recorded with the Register of Deeds. ervice Event ervice Frequency Inspect condition of tank(s) At least once every ear 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 ear Inspect pump,pump controls&alarm At least once every Maintenance Instructions Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following lice�ses 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 surtace. The dispersal cell(s)shaii 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 surtace 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. Start-Uo and Oceration 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 infiRrative surtace. 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 pertormance 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 permanentty taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance 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 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. Continaencv 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 pertormed 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 soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infinged upon by required setbacks from existing and proposed structures, lot lines and welfs. 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 installed to replace the failed POWTS. �!WARNING!! Septic, pump and other treatment tanks may contain lethal gasses and/or insufficient ouygen. Do not enter a septic, pump or other treatment tank under any circumstances. Death may result. Rescue of a person from the interior ot a tank may be difficult or impossible. POWTS Installer Septic Pumper Name Gerald Froemel Name Scott Poppe Phone# 715-558- Phone# 5) 34-145 POWTS Maintainer Local Regulatory Authority Name Jays Septic Agency Sawyer ounty Zoning Phone# 7 5-55 - t Phone# 715-634-8288 Page 7 of 7 -'�'=="T"'=°�� PRIVATE ONSITE WASTE TREATMENT county �y��- ,�. �,:�" � � = r o `�'; SYSTEMS ;�:1$ps ;`~' ( POWTS) Sawyer �� t��; �"s�z.;,.-��. '°=� INSPECTION REPORT Sanitary Permit No: Safety and Buiidings Division (ATTACH TO PERMIT) GENERAL INFORMATION �� -�Q� Personal infonnation you provide may be used for secoudary purposes[Privacy Law,s. IS_04(1)(m)] Permit Hoider's Name: ❑City ❑ Village �Town of: State Plan Transaction ID#; �!- �. w��,.e,ll�. U�►le�,�,�� a �,,, � Insp BM Elev: BM Description: Parcel Tax No: t �p� .c� Nq;` 1-n ��,, �.., s��. �� w�;� i� o)o-g l — o�-`��( Y a� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic �,�,�Q 000 Benchmark (pU.o � Dosing Aeration Bldg. Sewer q`(�9�' Holding St/Ht Inlet RY,�,2 ` TANK SETBACK INFORMATION St/Ht Outlet � , ` TANK TO P/L WELL BLDG vENr To ROAD Dt Inlet AIR INTAKE Septic +,�` N nJ �/ NA Dt Bottom Dosing NA Installation Contour Aeration NA Heatler/Man. �)`��p� Hoiding Dist.Pipe PUMP 1 SIPHON INFORMATION Infiltrative , Surface �3�� 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 3 � � �' ba� #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav Conv ❑ Aggregate �J,�I, P/L Bidg Well o� IGP Chamber �` �� INFORMATION Waters � AG � EZFIow Model Number: CELL TO f.�s'� /V N /V ❑ Mound o Other --- -____._- -------- -- -- __ __ DISTRIBUTION SYSTEM X Pressure Systems Only Header/Manifold � Distribution Pipe(s) TX Hole Size - XP oleg Observation Pipes � Length Dia Length Dia Spac i , S acin ❑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.) ��5�� S��.� �� ; � ' � Plan revision required?0 Yes❑ No , D 310� �.31 --1�� — - - J �� '(o Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AOOITIONAL COMMENTS AN� SKETCH SANITARY PERMIT NUMBER:__—�� , : . , _ , : . , , . : , : ; . s : : _ �� \ � ��5 � - - � � �3�Q�� x�� PNP � t ;��1'�� 3� � -�� -�� — � `� _ � �o� (� 2 ,'.i�:r- ,�,a,�l � � � a � �c b��nl � 13� ��7 �a� �� S -