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010-840-03-3202-SAN-2022-231
_ Department of Safety c°°°ty � �� � - & Professional Services, � - . _ - Sanitary Permit Numb (to be filled in by� �s _ Industry Services Division � .. _ (� 3 q �a-o R, Sanitary Permit Application State Transaction ivumbe� �J ln accordance with SPS 38321(2),Wis.Adm.Code,submission ofthis form to the appropriate governmental unit �- � is rcquired prior to obtaining a sanitary permit.Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing (� the DepaRment of SaCety and Pro(essional Services.Ycrsonal information you provide may be used for secondary � purposes in accordance���ith the Privacy Law,s. 15.04(I)�m),Stals. �a�� I.Application Information-Please Print All Information Q�t� — �{� -b3—320� Property Owner's Namc Parcel# � S�—dlC���-4-D-a�S��3'3 t� � � a - p Property er's Mailing Address Property Location NL �Y�.tet--� City,State 'Lip Code Phone Number N W y.,, -SW '/�, Section� � ��3 - ❑.Type of Building(check all that apply) ►-��t� 7 `7�� N R E o 1�,1 or 2 Family Dwelling-Number ofBedrooms 1 Subdi�ision Name �.� Block# � ❑Public/Commercial-Dcscribc Use r �City of ❑StateOwned-DescribeUse CSM Number ❑Villageof �- �1'own of �{�� 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 iT a licable.) A. ❑ New System �Replacement System ❑ Other Modification to Existing System(explain) ❑ Additional Pretreatment Unit(explain) B' g ❑ Mound ❑ Individual Site Design ❑Other Type(explain) ❑ Holdin Tank (�i ln-Ground ❑ At-Grade (conventional) C• ❑ Renewa]Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner / List Pre�ious Permit Number and Date lssued Expiration O D ��l.t� ��Y 1 0 O l IV.DispersallT'reatment Area and Tank Information: Desi�,m Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Arca Proposed(sfl System Iilevation , � 5 � � O � Capacity in ToCal #of Manufacturer I ank Information Gallons Gallons UniLc � L o � � New Tanks Existing Tanks � � � � � � � � o N a U cn v� v. O G. tiepticorHoldingTank � S_� � ������, � Dosing Chamber 75'O Ltr� �s�. � V.Responsibility Statement- 1,the undersigned,assume responsibility for installatian of the POWTS shown on the attached plans. Plumber's Name(Print) Plumbe'�Signature MP/ti1PRS Number Business Phone Number � CUl `�,'UZ�� � � p i -- fa7 Plumber's Address(Street,City,State,Zip Code) C�J l /� ' ��- ��'u- l�� Qu2� L2�� S� VI. o nty/Department Use Only � ry ❑llisapproved Permit Fee Date lssued ]ssum�A�ent Signature �3'✓ ❑Owner Given Reason for Denial $ `��'� � I� I a� � � Conditions of Approval/Reasons for Disapproval �c �,�� ,,�� � � r� NO REFJNDS AFTER � I� aa i� � , �. � �,11� a ' . I�SUE OF P�1'f- __._._ � � D '� � C.-- :t:� 1.�5 AUG 3 0 2022 C J , �V ' v�-�� �: �Zw(�Jtior.ld � 33�D SAWYER COIJP�JTY M l'1� zON1NG ADMJNIS;-FtATIOM Attach to complete plans for lh .ystem and submit to the Counly only on paper not Iess thao S 1/2 x 11 inches in size SBD-6398(R.03/22) PAGE 1 OF 5 In-Ground Dosed-Gravity Plan Index & Cover Sheet Component Manual Design References: In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) 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 Owner Name(s): '��� 1'Y�Ci.� ��l�eh ��-e�-S Phone: - - Owner Address: g � �S'h1 �Ulr.�3l �� �C�c� � Rc�� Z�p: J���'� Project Address: �x-�� w�� � Govt. Lot: .1/4 of 1/4, Section�_, T �I O N-R �S� E ❑or W� Township: �.�U�`3QYz� County: ���,2./' Project Parcel ID #: �`7-(��0� vt���- C��S-U3-'3 a�- - �oo �- C�00(� �.0 Designer Information Designer Name: � � �"1 Phone:�l�-�>S�= /�_ Designer Address: I (�7l N. �Ti►�.'Y����u�`��'t'� �G�-�/l�� 2�_� _ Z�P� ����� E-mail: �"�''�� �� ,.�.t�, ,,� .�i ,���,�,t, License Number: '�GI��( Remarks: � .___._. Signature: Date: ' —3C� �a-� Original signature required on each submitted copy. � ( � § ! s � > } i � s x E � 4 � � ; �f� , ,�_�._a___�___..._ �. _ _ ;--- , _ p ___. F � �w�. 4` ' � � i � ^ %`f� _s"_,..., _� ��, �'V2�' ..._ .. ._._. `-.� r.`� :� _ . � - �+{ - ___ � � t .�'�� C3 Cl ----.^"°"`.`^.�� �� � �/��f 3;+�f� /�.S�f��t::.�t � F7 c.'�r.. � �,,�ti `, � � � N !�;' fr �i''«,:�„(�'. (� ' n # L �,/�,'t J' �. p',� .Y.�- 4.✓' � '�i��� �� `��� ��'� 1 '---� �—`.��'� � � �✓ — ' � 1'� /' � ��� ,r,., � �� � � * ; rf �'. jf�� ��` � � �/ r ,f'� ✓ - �t f ,�,.�r'1 �.d �. A � �� i �ut�± '� ��fy���f �� � � F � `'�� � � � —� � � � C � � � � � t � � �p t � f . � ' � ' _ � _= '- ��{3� � �� � � - � E __ _= .` ' __ _ - � .` � t � 'v ; `s c S � ' � . � � � _ s � c � i t?.! �::, ___�j�'� C v ��1 � i � •=`,'' �. C , � � c e�y i � 'j�1.1.. I ;`,��;j� _ � � _ � � � � � ' _ �ti::T' cc ' c .'..t'—,' " V = . = II ' � Tv ===_ = � v = � (\�\_1 _ f� V _.. � _ > _6 I U � _ \� . �. � "'� � { �= S== �_ = . . M+ r� = . �. �� Vi Lc ; ` _� _ < ` { .�1! _ � .+ ; `� 1 � ., ' c` „ y`•'� i' � �`� _ �1�� s Q i = i �.^_ ?i�� Fi � i� T _ ��y �H V �>` ' �� '� ! `i1 .'r�-_.= � i � �= i � ': �v ' �� �i�! . i i v = E�` ^. 1� � �' � �= � f�� �( { _ � � {rt!�.� � z � `_ � — . ,? 't'� i't � � V L � � � � - = ;��' �1 s = i._ 1 � .r , ;. i � � � � _r = � il !1 � � � � � L O � ^ ^ _� _ =` `��� t� � U � � � r ?� _ _ .. I} (ii: ?: ! ':: :!? � �I� �... •> — > >, i Si . C a � vJ y �s � _ � t: �i �=�F `; i = � � � � y��. � �^ - = = v v �� ;'�' i �' ` `L � 1` ,�-r�"'`+ � LY s = '_ : : i; . •:' ;� � � � � J = = j � � � - � � � r � r U �' _= - . -. � � � � � T . - ' - 1 , � _ �T r�t .�i �+ � � •� �!� .,' — - •=e." � • ,V}� L J � ; +1V6 � � ♦� � . .� ( _ � , `j�f ``� �; ,V�i V� �f • • �,�tt_r��""I"'�� . . v € v ~ '3 �{ � � � � � i �`:� f'il 1• _ ' ;J � :i i{ tl• !3 X � O �? i�.; `� -- � -� � � � --� _ i � � (, L 3 � v i\ ' = c '-'+ . i G � i C' � � �. , �� _ � = � � � Ul G� '. � � ,� � tt, — � '; � � w 1=[ � G � � V : �y� ` � il '��,.1 ;` . J �: ; f � � � � .= - " ' ;. i =� � `\ � t �3 � ' > � s � i ` '' � C3� �' ��i �s�r"1 � � r--�: � - ��� �. s ! � � � I ' • ' ��� � f�....n::,eS_1: : �j v J ; �`r�'.' .� � � �' � == J �,`7 ` �� _... � — � � ' _ �v �' ;�i ��(�; �� i �. ` � � �S; j ... = � . i l.i �•. ; r��. � � ' 'tl �LI J+ I i .�! u.n t � � 1 � : !s�: �� � �: � %n � � j�.; ,� � i; ;� �t�t ' =1 3 y� � � `= i— � J !'� i�� � �� �1�€ �i 4 � � --� � �'�} ;:;� 'v.i R j: � ,�. — � � '� j I;' �: = ' �.- � _F G ��j � -� n [,�'", � i` i; ` � T �_ �... '_�:iJi ._._ �.�f i;= s._.. � � t:n— W1250/750—MR TANK SPECIFICATIONS � o o � a � 12'-11" DIMENSIONS: � o WALL: 2 1/2" a � 4" CAST-A-SEAL 4" CAST-A-SEAL BOTTOM: 3" COVER: 6" w ,,__________��___—_ \\ MANHOLE: 24" I.D. PRECAST CONCRETE RISER o „%' i i i i � ��� HEIGHT: 66" �i� i i i i � ��� LENGTH: 12'-11" � �� i i i i �' �� WIDTH: 7'-2" � i i _ �'L�` -� �i i i� r �---� �� BELOW INLET: 53" � ' `� �yP� i'/ � i i� �' �� LIQUID LEVEL: 48" � E �I � � � j � a WEIGHT: 14,860 LBS. I � o0 0 r / � Y II� � / u c� � � ��� �--' � -' ��� �`-�'�j INLET AND OUTLET: � � o 0 \�� FILTER OR i i i i „� 4" CAST-A-SEAL BOOT OR EQUAL GASKET � m o N \\ IIII // w Z � 3 �� BAFFLE ���� „' INLET AND OUTLET BAFFLE AND FILTER: a Q � w � �'' �l �-- _ ______��_____,,' WISCONSIN, SEE DETAIL #10 � o a � (OTHER STATES SEE CHART) W o 1� � LIQUID CAPACITY: 27.66 GAL/IN (SEPTIC) TOP VIEW 16.12 GAL/IN (PUMP) � � � U � LOADING DESIGN: 8'-0" UNSATURATED SOIL CQ � � o TANK CAN BE USED AS: C9 0 � � SEPTIC/SEPTIC, SEPTIC/SIPHON, � � N Q� 4" VENT OR SEPTIC/SIPHON '� w � I �� _ COVER: MIX DESIGN #8 (NO FIBER) � _ � � TANK: MIX DESIGN #10 (STRUCTURAL FIBER) �, �, � --- --- --- � CUSTOMIZED TANKS: � `° INLET - - OUTLET FOR CUSTOM TANKS CONTACT WIESER CONCRETE � � I =�.,�' i - - - I i �--r i f � � � � 1 � � _ � � �� cp d_ I j� � � �p J I �° �,,� �� I ap �n I I � C�J G �� - � J �n I � � � a_ � �n � Q I � � �� I I � � � I I � p Z 2 � � i i I � Q �`--- ----------� ----�- -J� I� � REVIEWED BY p c� � PUMP PAD REVIEW DATE N a 3 � DRAWINGS SUBMITTED SIDE VIEW FOR APPROVAL APPROVED BY: SHEET N0. APPROVAL DATE: � � OF PRODUCTS NEEDED BY: / � TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS PAGE 4 OF 5 GRAVITY-DOSED - SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4"9 Vent Pipe >10 ft hom Builaing Electnnl must comply wiM t Y Mm.or 20 R a6ove SPS 316 and NEC 300 Established Flood Elevation W��hem� �#end manhole nser as nef�ssary. �h�"a�> �unction eoz AP�� Appoved Loticiig Mantwle IMPORTANT: ve"�� wiU�Wam�ng tabeiAuacnea Anchor tank(s}as necessary � � �ry��l� c«�auit pursuant to SPS 383.43(S)(g) a'Min.or 2.0 ft above Esla6lished Flaod Elevation (Ha�O TAWghlSeal�. Finisfred Grade � Quick�iswnned 18'Min. CAPACITIES @ %�,. �gaUn y,. �hw�'> Depth(in) Volume(gal) � *T A 30.3/ �I(f9. WeeP '�APPrwed.ldntswilh Hole Appoved Pipe 3 R anto B 2.� 3�' � A Sdid GrourM (h'W��) �C� L, y 7�. � � 1 _Alarm � �15— s—, „ B � _a, � ��� PUMP-OFF / * + 7ump �_� ELEVATION= �p,O L ft Pump Tank Liquid Level=�in } .�� I ° INSIDE BOTTOM Force Main Diameter= in �°"°'�`e � B1o� ELEVATION= ��ft Fo�ce Main Length= y� ft 3'Appmved 6edding Matenal Benealh Tank Force Main Void Volume= �.5'z gal [C]Total Dose Volume TDV = 77�Z gal/dose (<02X design ilow+force main void volume) Verticai Lift= �,� ft PUMP TANK: SEPTIC TANK(S): Volume=� 7S"Q gal Total Volume= /7 S�Q gal � Manufacturer: Gsii P�' v/' Manufacturer(s): u/`e�> t°,� Pump Manufacturer. �O� 1��,� install approved effluent filter at the septic tank outlet Pump Model: 9� (�y attaG�ed pumpcurve.) immediately upstream of the oumo tank inlet. Controls/Alarm Manufacturer. S'j� �i'�rv�bvs FiRer Manufacturer. G���„�,�„ /�_�.� - %=�.�i Controls/Alarm Model: /D/ f/��� ��-- ���� Filter Model: Floatswitches containing mercury are arohibited. C �„ t1CNU I,HYH:.IIY I.UHVt � " '" �� � ?. I'dODE: "98" - 7- 5�� � __- i i � _ . _. __ � ' + � ?__ _ � 3 5/B 2. .1" i-___� _'____' _' �-�- � J ��. � ., a / � Z; ; � a_ . � . i.. � . . .ti �. . ' __'_ � i ' ' ; _. FS\`. �y��/ . r 15_ _-�— I _._- � _ _ - _ �___' �\ :� l2���1�'\ / }�tfi �'._',_--_ f � 1 �� � �� H! \'� ���� \\ � I i : - �. - �i o- - - �-- --- - i � � i . .�z_. .�Z ya- -. � .._j_. . ._'__�� � —�_ � j _� � 5_ i_'_'. {__ __ -_ I i I -'"� I I ` � I � � � ' Instali per manufacturers j-- � , �I; CALLONS � m z� ao _ _.o� _so____so �_ ..�c_ s requirements. .----�--- - _._.__ - ..;cRS I 1 � I .^.7 160 240 0 FIOW PER MINUTE � � -- -. -I..�C / /J-._., '� �:=i=.:=�---J��'� ' roiraorxwicnEN�tPvn�unllfE! ,� � �. [rywfNienODEM4FAY— � i i .. CAPAC�iY �. '.[ — �-.) `y \f I MFAP j UHfTlM.4 . "— —' I _-- t � � FEET YETERS f OAL1 lTP9 i � . � 3 L52 I Y1 t)) �, .. -,—. �� �o aw I m mi �. , . _ _�� , �� -� "'i N •.9 45 f PJ :� -- -_ \ . �I 2o alo I TJ GS • .� �j�,��/-� ! 5/lE . �. :..___:__. .. I. �"':_'..�� _� '� '_ l ' IO�CkVN�_ __?]� , �-. ._. _.. .. . . _______. _�. CONSULT FACTORY FOR SPECIALAPPLICATiONS . c�zcuicai attema:ors,lo!duplex systems,are evailab',e anC • h10fLU^/1;021 SY�':Ch85 9'a zva��.!abie fcr ccntro�lfng sngie�and supp;:etl wah an alarm. ;^ree phase syse.;s � • �.!echanlcat a.".amators,lor duplex sysems,are availaCle with or • Doubie piggyback ne:wy:'•.oa:swl:ches ara availabls fa wrho�t a�arm sv,•uches. v2rlable Isvei Icng c�c'?c�-•.•cs SE.E�"�.�rvGUOE Standaidalfmotlels-1Yel ht�91b8,.Y� H.P. �- '"'earelco�vopereiee2po�.a-ec':an:w!sw;m•tncaqarna!wnvo�re��i�ec . _. .-.'____-'_-___ _ __. __.� 2. S�npleV�B6YCeckmerc�himisw;:chwEcuC1eW00YCnckme:cury.11oa� 995�do r Ca.^voi SdMlon -I sw;cRPalet:ofM0177 Ax . . Yo11�Ph Motl 1 Am�l Sim��x � Oupl�y_yl �. MecMn.:alt�a�nem 10-00)2c. .�}0075. �. 1.15 1 ' Auto 9.0 0�1 6 7 i T �� �0 f M0)1Y,b�eOnael moEe.a°IttViee AI:a�M1alor. 'cPak'. �_ tt5 1 � lo� I 90 2or28fi 9oi1d5_ 5. Mert�ry »ru« Ibsi a+�ic`. �.x715 usee ss � m^ual na �+ior. spacity duptaa p)w(�)Ibe syct_r ^x �2'�. t � A lo I �.5 1 ot 1 6; I 6 Fam p)�o.a"J�Pnil.luncbon�c�':�•wateNah:con'�ecLon w nireE�in s.m� "c33 '230 t � Non �.5 �2w28E � dtt�65 � plexorCupbropamiion,tP:.{Cz_ . _ . ___.-" '-:___�_-_'_'_ —_' � ) '�;'<'�A;'e••J.�e�'.Ia..e'e^��^yMce^^.ec:onersD'.:ce. CAo1.0M FJ:'.G.Tin�n.ana'k.UpW Zul:.arp%�x'irel�:blJl�lv�'iM(�.MALIiMS�a:Y.F4�:31� /����ruY�4'vm d[m.iou.WclM.o� Ce�ice����.��.t�ry�Fwlq G<em OY � Vw��. "�c:.�s.. u��:.}S.n�nn. Fu:.c)),E+c�iW Marn�ln.FMO�EB:Marfr.0 A'sr.uar. �..e �c�n..a.:�c+ncun AL.w��ul .w r�.�Y coE.�Ma.M e. te�iwM �M�„o- i4�'.aa5 M•^C��ye �µ'h': �,�.f�`_yW�r����In�.FND�L):�'�C$�TWf[G�'�P gC5 I��N� aWl �Kanl N�Ibn�)[YtU�t COC� IMCG� .w w ok�w�+�5�1�1� �r!J -4�•.A ..u.., Ae �OSn+; RESERVE POWERED DESIGN For unusual condltions a reserve sa'e,y fac[or is eng;neered into the aesiyn c! every Zoei�er p�m�. ___ _____ ----- - ---- _ ----- -- _ —s------------ MAIL T0:P.0 80X l63d7 � ta's.,±e.xr<oisa o�u ��a.�utacroiers o! � ZOELLE!'_� Sn�P�e::?es oa N.se:s�a�e P s• �.�.�9 L[.'Sri::y, KN�1'6 QU�!/7Y UM.�S /NC! . .., "'r � ::n:n;� nt.;::�i PAGE 4 OF 4 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 382384, 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 Disqersal Area Operetina Limits: Design Flow= �/�C� gpd; BODs � 220 mgL''; TSS 5 750 mgL''; FOG 5 30 mgL'' Insoection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance fadors (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 ponding in distribution cell prior to dosing o dosing irregularities-if applicable(i.e., pump r�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 tankls)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, wsc. Admin. Code. o Effluent filterlsl 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. Report any component failure or malfunction to: Name of individual or company: �� �J� Phone: ��S��c�$'�(p�7� Local government unit: ' Phone: �[S�O?J�'�� Local govemment unit address (.E Z�p: S��.('� 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, Nlisc.Admin. Code. Continaencv 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. Ye�. � . w.� .- . y .. � f .� \ . , [�} ��� � L � �y z : �..A ' -..,,. 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'',�.�. r..+f"+ ♦ ��r:=� --tr �'�h� -j...i 7/7/22,525 PM Novus-Wisconsin Access rev.'13.1108 Real Estdte Sawyer County Property Listing Property Status:Current Today's Date:7/7/2022 Created On:5/1/2008 12:54:49 PM �Description Updated:1/24/2013 �Ownership Updated:6/5/2019 TazID: 39876 DOUGLAS&MAE ELLEN MEYERS HAYWARD WI PIN: 57-010-2-40-OS-03-3 02-000-000020 Legacy PIN: 010840033202 Billing Address: Mailing Address: Map ID: .10.2 DOUGLAS&MAE ELLEN DOUGLAS&MAE ELLEN Mu�icipaliry: (010)TOWN OF HAYWARD MEYERS MEYERS STR: 503 T40N R08W 9488N ROUND LAKE SCHOOL RD 9488N ROUND LAKE SCHOOL RD Desaiptlon: PRT NWSW HAYWARD WI 54843 HAYWARD WI 54843 Recorded Acres: 19.920 Lottery Claims: 1 w Site Address *indicates Pnvate Road Firs[Dollar: Yes 9488N ROUND LAKE SCHOOL RD HAYWARD 54843 Zoning: (A-1)Agricultu210ne ESN: 496 „J� Updated:4/18/2022 pefty Assessment 2022 Assessment DeWil �Tau Districts Updated:5/1/2008 Code Acres Land Imp. 1 SW[e ot Wisconsin Gl-RESIDENTIAL 1.500 16,500 167,100 57 Sawyer County �q-qGRICULTURAL 10.700 1,600 0 O10 Town of Hayward (;g-qGRICULTURAL FOREST 7.720 6,600 0 572478 Hayward Community School District O01100 Technical College 2-Year Comparison 2021 2022 Change Land: 24,900 24,700 -0.8% + RecordedDocLmenis Updated:N/A Improved: 167,100 167,100 0.0% O 7RUSTEES DEED Total: 192,000 191,800 -0.1% Date Recorcled:5/29/2019 417956 O EASEMENT (� Date Recorded:5/10/2019 417657 ,•�Property History O QUIT CLAIM DEED Parent Properties Tax ID Date Recorded:12/7J2015 396958 57-010-2-40-OS-03-3 02-000-000010 10553 O WARRANTY DEED Date Recorded:7/28/2000 285470 711/363 HISTORY O Expand All History ���Whrte=Current Parceis Pink=Retired Parcels O Tax ID:10553 Pin:57-010-2-40-08-03-3 02-D00-000010 Leg.Pin:010840033201 Map ID:.10.1 39876 This Parcel Parents Children https:/Itas.sawyercountygov.org/Access/master.asp ��� t''"'"'F%;� PRIVATE ONSITE WAS�E TREATMENT Counry ,y.-,- ,-r ,��� ,,,�,, �j � o�� ������ SYSTEMS SaW er �i��� ps y �:�., ,.w; ( POWTS) ��h�F.�-��. ==s'�,�,=':y INSPECTION REPORT sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFC�RMATION �-.� _ 2� � Personal infonnation you provide may be used for secondary putposes[Privaey Law,s. 15.04(1)(m)] Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#: H � a—�/l�Q, G�I'2 -�(S �a wal� Insp BM Elev: BM Description: Parcel Tax No: �oO,Q � � C��w+✓1 /1/ .,.. 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Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St I Ht Outlet TANK TO P/L WELL BLDG AIRNNTA�KE ROAD Dt Inlet �j,s� � Septic NA Dt Bottom �S;�-' Dosing � � � , NA Installation Contour Aeration NA Header/Man. -�•7�� Holding Dist.Pipe PUMP/SIPHON INFORMATION Infi�trative Surface �•�� , Manufacturer Demand Final Grade �SS� Model Number `�� GPM �; {�� � TDH '� Lift Friction Loss Sys Head TDH Ft Forcemain L ���,� Dia ,�'� Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS �N � L � / #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate INFORMATION P/L Bldg Well Waters � IGP ❑ Chamber Model Number: ❑ AG � EZFIow CELL TO -�-(�� �_ _� N ❑ Mound o Other - - - _ _ - ----_-- ----_ _--- DISTRIBUTION SYSTEM X Pressure Systems Only I Header/Manifold �istribution Pipe(s) � X Hole Size X Hole Observation Pipe� � Length Dia Length Dia Spac L _ Spacing ❑Yes ❑ No -- -- --- - — -- SOIL COVER - --- De th Over De th Over De th of Seeded/Sodded Mulched Cell Center l Cel�l Edges � Topsoil � ❑Yes ❑ No � ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) �.�,��� 9 �2���-� � `�p\��� c�-�1s a�� Plan revision required?❑ Yes ❑ No �3 O� 2� �__�7_ � 6�l'��� � Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) ADDITIONAL COMMENTS AN� SKETCH SANITAAY PERMIT Nl1MBER: a� --�3 I - - -� --�-- •- • - -. ._ __. ,__- - . _.,-- � - - : . _ : . - --- .._.__i --- . ;_. , :__. : . _.. -- ._ _ , _ v�L� � . . , _ . ��. . _. , . . /,j `T'e fl�-�`i� ' _ ; , � / .�� ,� �� ���SP� ;C�;w( e''�''��� L`�b N ew b� 1 ���� �� � W` 'y I `C�D �'� �_ � �� � � � ���� � � � �.��(�l � — C� E.� ��a � (y� �ar'� ,�S�-G'��°'^�� ��c�,Ls't�1� � - � � ; �