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008-273-00-0700-SAN-2022-239
. =-Rso.- � �,"`R`��"�� ln�9ustry Sen�ices Uir°isivn Count} �� � � ,' � �- �;,�„� i d0O G tit'ashiagton tive .�aW�/@r � �� �� � �� 1'.O.Aos 7162 Sanitary Pem�it Numher(to be fiQed ii�by � �y ti�� ��� Mad;sc�».W153707-?ifi2 �9 3 � 0�02�.0 � ) � dz .�:;� w;`` Y Sanitary Permit Application st�«Tr;�,wtt�o„�r�,�„t�r - 4.� � �7 acrordance with 5PS 3$321(?),Wis.Adm.Cnde,submission of this torrn tn tiie z�propriote g�vemmeaiTa(unit � is required prior to obtauiing a sanitary permit_Note Appl�cation f'orms for state-t�wned pC)WTS are submiited to Praject Address(il'ditl'erent thun mailing� W .he Depurtment of 5afcty and Prufessionat Services Pcrsooa!information you provide ma}tse used ti�r s�cnndary � u oses in accotdance with the Privacv(.aw,s 1 i3Od I}(m,Stats ,_.__ 1. � lic�tian Information-Please Print A11 lnforrngtian Property()wner's Name Aarcel k ��-��-��,���� Jon & Karen Schroeder 5 -008 -38-0 -27516-688-0001001 Pro�erty Chvner's Mailine Address F'rcr�,erYy[,ueation 29257 230 th ave �wr-r.�rr— ('it,y.S1ate Zip Caie Phone�iumbtr � __�c SeChan�7 Holcombe WI 54745 715-577-8460 �� � t��r���t���> ir.�ry or s�;i��p _ / --��,� T.�_38__ti; R___9__F:���� r� �t��,�k�u tna�$r��r) i_�,t� ` v\hi �( i ar2 iTamilyDwelling--Numberoi'Redremms2 Cabin # � Sutxi'v�s'on Name ( ---____.._..._.__..��...._. /' ' �-(M� � R'�xk� � Ridge view c�-,�L� � ❑Public%Cnmmerual-De;scribe IJse �- ----_._.._.._..__---._.__......_..__. ❑Citv of _..._� _..._ _....__. ��.�_.._ ❑3tate Owned-Describe Use CShi Number ❑Village of� _. ___...._._�.._.... _..._.._ ___�.. � __.___ Q Tu�tm of_�y1l3�EL.--------�____ III.'T��pe of Permii: (Check only ane box on line A. Complete lioe B if�pplicable} ��_ � `W A. L�New Sy�tem �Replaeement 5ystem ❑'I'reatmenUHolding Tank Rrpiacement Only ❑t�ther Modilicntiot�to f acisting Sysiem{explain) � �� Q PermiC Rrnewal ❑Aermit Rcvision ❑Chcin�;e nf 1'lumber ❑1'ermit"1'ra�isfer tc�Ne�v ���si Pre�ious 1'ennit Numtrer and Date issued � Neforc Eapiration Owner ���\ � IV.T� of PU`�3'1`S 5•�tam/Corn nnent/Device: C,heck all that a ly) �Non-P�essurizc:d in-Grnund ❑ Pmssurin�i Cn-Grounti ❑At-Grade ❑Mound>24 in.oi'suunble saii ❑(Nound<2�in.of'suitable snil � ❑}tolding"Pank ❑C?ther Uispersal Compcx�ent(explam) _ �_� ❑Prevea[ment Ues�ite icxplain)....__...._..__ � _____._�.__ �.__Y.�� __.._ � ___...._ __ .W�___�, _.__....__._ __ _..._ � _,.. ______....__.._� V.Dis ers�l)'Ircatmrenf Area Infarmation: I7esign Plo�v(gpi) 1)esign Soil AppGcauon Rattqgpdsf) Uispersa)Area 2equirtd(sf� Dispers:�i Arcu I'roposed(s� System�Iecahon 300 0.7 428 r 1-98.50 Tr 2-98.36 ! _ _--.��__y � _ J --- 1��.1 �'I.7"ank lnfo Capacity in `I'otai J#�f Mtinr�t"��tiirc:r Ciallons (�aliuns i;3iits � � �p �;cw Tank, Ewsting"I'snks �4 � y = -� � � � �� � o „ ;; a. U v; n :r, :c. +'� a _____ . ,__,..w_._.__..._.__._ _..._____. .._...._..._._......_....__ _.___....__ ... ...._........ _.._.... _..._. .... Srptic or Holding Tzail; �( �0�� skaw p X Dosing Chambcr _ ---- -�-�--- - --v � VII.R�espuns`rhility�Statemeht- I,the underxig��td,ossume reaponsibiliry ior iust�rli�ti4in of the PC)WTS sho�n on tfie sttnrNed planr. __ ___.� � � _-----_.._______ ____ � __�___ _______i Piumbe�r's Name{Prtnt) Phimber's Sienature '�4P/:�9pRS Numbcr C3usmess Pt7orie�luml,er David C. Laird ' � _ ���, 221253 715-239-6194 � Pliur�tjer's Aclt�res�(Street,City,Stnte,Zip Code) ��_ `� -----------_ j � 20165 Co. Hwy. "Z" Cornell WI 54732 � ��T(li.(: u tti�IDe�arYment t;sc Only �_v _ ---� ' __._�_---� �Ap v � ❑ C)isapproved �ermu t�ec C)ate issued lssuing�Agent Si�,rnat r �� /� / ��y'� p / � ^ ;�1 i �?�-+ �'��l i 7�►^' ❑OKner(:;iven Reason fc�r ilenial `�`�'' •� l I� / � � � ����� S� . � . / ; � _____. _1..._. . .�. � IX�Conditions��fr�ppr�vaill�eaxr�ns for Uisapprov�l �y�'��`�' �<�—' _ _. � ,�� _ ____ I �ii� � � C S � � �� ��� 0 1 �Q?2 ��� s. � �► �-� 1 c� � � � : �.-:"'. : . -. � ._��J .►ttach to co�nplete plon.for the Rystem�nd�ubmit to tbe C;oanty oaly on s�r�ur aot les.t ti�an N��IiihNxtia.aise:��,:..�:��:,-..,�;`� 4�s�-n3vs��.ost�a> . , . NO R�FUNDS AFTER �J,���.__��� � ��" . tSSUE OF P��iIViiT -�-_..___�_;_,,.._. .. ��nk# i3y�a _._. _. � _� N� (ivor l d �3� t �t�.. t# _ _.: .. _�.._. 8b0�- Private Onsite Wastewater Treatment System Title and Index Page Project Name: Ridge view cabins --- Cabin # 4 (Schroeder owned) Owner's Name: Jon & Karen Schroeder Owner's Address: 29257 230 th ave Holcombe WI 54745 715-577-8460 Legal Description: S 27- 38N- 9W Municipality: 0 Town, ❑ Village, ❑ City of Egdgewater County: Sawycr Subdivision Name: Ridge view Lot Number: 4 Block Number: Parcel I.D. Number: 57-008-38-09-27516-688-000100 Page 1 Title and Index Page Page 2 Soil Data (A) & (B) Page 3 Boring Locations Page 4 Plot Plan Page 5 Septic tank profile Page 6 Infiltrator profile Page 7 Design Criteria Page 8 Contingency Plan Page 9 Name of Designer: Dave Laird Telephone Number: 715-239-6194 License Number: 221253 Date: g-22-2�22 Designed Pursuant To The Following POWTS Component Manuals And Comm 81 -85 In-Ground Soil Absorption Component Manual (Version � SBD-10705-P (N.O 1/Ol) • • , .�, ` N/A Page 1 of g /� ( � � . � �_ �,' �;F}� ,�l ; � — ---- —r ._....,,: I ,_F._. ._. .. ___ __.. ._. _--- ---•- — � ; � i' l -�"�� /�1 I � � , oo _ � , , a - ,y u� ��' � i � ��xi r �i c� � ! � �r v ��� 4-"�: � � = i ' i � � � �` ��� �, ` n;; `� 4 � -� ` ; � � � .i I ? � �� r �. `��� � � � l � � � 1 � � � ., r t 't _ 0 J ,. � $ � � � � � W i� '� t � � i .� ` `{G� , ` � 4-- � ' 4q � i]°� t, � � �• � ✓ �-} `� � ..I � L/ � � � � p � � � � `=� u. 2 �g � I U U_ � r�. ..-� ,,�1 o � � <� � o t � �v N � '; I i -I o 1-_ n � o`�v`�, c� � -m � , ; � � � Q N =' J� �, `� C� �, . \ , � 0. � c„ r`—�—` - O� �;.n' T � ` � �'+Y �'° �;�p �- a,�,A �,� cb � '\ � � * �`�Z , � �� 7 e��rp �� `� p� 1 , , , , � � � � 1 ; � � � ,v .�.__ �, � � � � , , �, , �� �n� � � � j �, � '�� '� � � � �� � u �- , A , �_� ,;� — �1 �� �s 'i `� '� �:., ��� ,\ `; � Yj �_ '1 , '� ` `1 ; ._=1� 1 /_ , �� 1` � i .�— p t� � � � '� +� �' � 'Z ` , ', . . _---- .- 1 .\ l i i j ----�--- � __-��.._---�" �� � `1 ,\ � � , � � , � �, i � � � � �'`'' I -\ Q \ ', ' �' �-..'` ,,�`��\ ` � � 6 � `�� �1 � ; � � ,� � � � �� � �i : �-S � ` _ � , �. � �'1 P � \ ' 1- � Z' � ...a � � � � o �` � �' oJ,% � �Y � � . i - -o,. � ,, �, �i z�� .�� � �. ,, �� a:. �y x �� J�'�u� �� '' -� k� � � � w � r � � >— � � � d � �f�'' \ . � � � pJ � `� � j ' � � � `�� �� tt, . ~ 0 '' c, � ` �� �� � i �� ` �- � I o � � n. � ' � � ' � } c�l T � I � �L , , � � 2 � ' ' � a � - � j ' � �� �� o � � � <a I ' u �' '� � '� � � J � -f � x � ; o c�. �, �y "1 � � � , � u.� �"� �� � �N r ��, i .� y �. t . ( U � +;' Cr � ���' `� '� �1 � i ,� � .� � �3 y i � � �� � � � �- s ly � o �� �� � � � i w 0 � a � �� c... v � � O 'r, � �� t c\ �} 4 ct z oo V U J a` -�---- �. . Q �' � � o .I� � �� � " � � � 'e (lf C ' �-�� � � o �� � `� P' � � � � �, � � �t �� �rt u � � V Z �t`� � � I kV �� �� -�i � �.� �J 4-- � � � �e `ZS � � � � !�' p �' � ��, � i ,.� � c� r :i � ( �� ' I I � oF � ; � �6 _ _ � �mva t c c+N/ '!I�i I/lIEN� St Ptic 7� �'_►�.__Stef�_� � c��`"! � � � v�N� ---� j , f� BAFFc E . . � l?AsfY4 �y�T'�.� �. F Re N r . R[ H R �,. DEun,�J� � • S �'�`��l F!(_AT10.tJ � TA�K• n)^N. i000 __ �Nk 5�Z c s: f��N r 7c►4,- CAL RHAR . �o GAL. a,,��e �s ���nE ,�JvN fffAR�.J�[_-Sc;HRo�.nEiQ f.oc .9T�1',�.�� �G_�V�S' . ca�os sa7-.�8N- 9cJ L r�v� r H _1C� � �.�,n rN G�6„ � ��,� , �. . .. l �Gt�� D � _C���H y� . —__ , . , _ Y _ f �--�a�g - . a Cross Section of a Two Cell Inground Component , Using Leaching Chambers , Observation/Vent Pipes � � __ _ Finished Grade = ' ' '� , Finished Grade = _,_ ,_' _.._ _ - f�.��Cell Slope % _ -� Seperation� / I �% . i � • ,, � ' / �Y�/�`1 _ // i�/, `i j � i Original Grade = �f�� ;���\y�'J '� ,''�� '''�Original Grade = ' i /. �� y/ �-- � ,—�( --j���—��__ I a..� . Top of Chamber=;�� �-� � �' � •' ;� � ,,� ��' Top of Chamber = �' , � , � �, . •; � , � ��� S Elev. _ "�' .-� i�.. , , ,;' ��: ',' �' System Elev. _ � � � - 3'stem �__:._�_ , , ,; �, _-.-.—..--. . . ; <V ,. •�; . • ,, , , �� : ,� • �, ;'' '• ,,. .�. , . ; .' . �.� 'Ti'eatm�n�,�d�ispetsal'�nne.,. :. �. � : ' ;:�. � `�' •' � w,,� ' �' � • ,! , • �� � ,� � �•� . ' ti . . •♦ . � ,, ' '� ' • '�,. , • ,� . .�M �w . . , 1. ' � . ' •' , � ��� � , �#+ • J �' . ♦ � 'e• ' •, . • ; ; . . . , I• •'. �•a. .. . ��' ;., �', .•� '. , A` f � : � .' : : : ; . . �. • Luniting Factor '.• ObservarionlVent pipes to be constucted and capped witb► approved materials for the particular use. o�.. ......���...�.�...� ,.....,.,e,,.......,......,�..,..�......w wu.wu uuu wo ayewm r moy wu eawlmry a�mqpe YoQ POW1S 'sa°O�M 7"0��p'a1s'+�PPkY• Mt�a rq�air�dY�'bY�B�Y��Y�ttb week.Avo1d vahiole uafftc ovs all syroem� Cam�ctim a[roio�r ova the dirpapl imft mry cauae it to fieaae up. :Inepecdan thall be mede by an rodividuai ca�ryinQ aoe of the Sollowioa llaiorea ar a�tl0taliare 1WMr Pi�6er,Mroar Phml�Raticnd SewQ,POW'I'S Maintaiar ar S�puOs 9a�vjcioY��'���uched blelolm�oo�Sahedab). Tadc�pectioos muet inchde a vieud'mapoaion of the tm�c to�t�'aqy mirio�ar 6�olom h�drv�y ��oy aado�a iab,maaue die vol�e of oombroed ehd�e sod ac�a��Leak fior mY�P�P��a�Oc to tl�e �a�d welw�d 6ert all eleca�ic�l equq�mmt rrh a p�mps md al�rau.Any defear ah�l be pram�dy aamaaed.�cpo�ed opmimg� �" �rr O�n t iohe�ia dums6:ahell be�ued wrth effiectiv�e lorJ�g devicee m provmt exide�l ar�mehoria�d mtry the t�. R+1�We oom6io�tian of tpd�e md ec�m mry tml�eo�oaode mo-thud(1!3)a mae of tLe�k vod�q the mOro cmpolr of the 1.t rem 6e i.a�oY.a ey.s.pe.�e serv;ac�openmr.oa di�poeaa of in.coardeooe with c�pOer rlR,l�s.vrrom�A� Coda Tbe oWat SYe�(s)tdll be mipet�ed md cbemd m imove my ea:omuleoed wlids ecoand'o�to m�ouScpaer's�ci�iaoa.Solide wa�tied H+am tlie 8bQ alr0 bo iehmed in the tmk.FiNer clamro�may be neoees�y rt mom$equaot inmetvati th�n euoed iu tlie mdu�ao�oe�ohe�b to lmap tl�e syrtem opecatmg. AL�s�ooW be te�oed m a te�ilr batia by the]foma owner.If a¢olum aoimdg cro�ct m ndivicLrl lio�osed to�avioe POW1'S, 71n L mmdly a 1 dq merve mder nQular oPaatmi�.hovvever wata eLoald be caoesved mtD say Pioblem�wu6 the sy�hm�ro om�c�ed ro}reveot b�drap a�aeora�e r000 ths dwellmQ or�. ,�:Whm tLe POWTS&�7s mN�is pamanmtty tslcm out of sevicq tbe follo�viog aaps�11 be ulmn Do me�ae tlrt 1M sy�l�m L p�operty md�aEety abimdooed iu wmp]3�000 svkh C�3PS 38333,Wi�oao�in Ad�im�tive Cods. - �P�Y�D 4mks md p�ehell be diroa�ec0ed�d the abmdaad pipe oQmio�eakd - - T3s oaouob of all umb and pm�Mll be ramovd�d RnPe�Y�P�d of hY���'��i W��. - AAer pamp�,all hoiu eod p'Ls sLdl be ao�rava0od and ra�oved or their covas ramo'wd�d 16s woid�os Hlled w� �ail.�awl ot oUfa inart eoBd meta[ixl. :If the POWTS 6iL md aomt be ioprued tLo Sollowin��mroWua�have bem,or mu�t be oi�m.to pmvtle 6 C00!00�1O�00C�fy�: ! A wlhbls nnpLoemmt aea Les bem evelmoed md mry be utilimd fix the loation of a ropLoemmt sm7 ab�o�Pr+m sYu�- 'I�trpLommt�tea nLould be pooected 8um diwa6moe and compactim md ahould mt be intl�ed upm bY cequye� .a6�b a�om�g ma ptopa.ea.trucnce,�a ums�a wella.F.�e m pcwea ae rapLoem�t.e.�md�a�ti.eb. R�pbo�mt i)�tamr�t campty wuh tLe nile�!n e$ba at We t�e of mpl�aot. ❑ A aWbls np�Loameot aea is mt av�bk�e to setbs�andlar eoil limfi�eims.Barc�g advmce��POR+'FS oedmoloyy a holdhK tdc may be inwlled at a laet raa:t to mpLro tl�e fa�led POWT'S. O '13s dr Lr nd bsan evaUapd to ideca$�a wifabk raplrammt are�Upm�me of tLe POWTS a soil md�e avah�ioo moR be p�[ffacmed to locaro a iuilabb mpl�cemeffi araa If�tepLcameffi aea is avaihbk a hold�tadc mry be mfallad a�a Let raat oo mp�oe the Riled POWT'S. 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