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HomeMy WebLinkAbout008-273-00-0800-SAN-2022-240 ,� t� �•"r"°,s Industn�ervice;s 17i��isiori t:ounty `� � • . �� 140Q t?�'tishingt.m Ave 58W�/@r � l,� � � ''�; l �� � �� P.O.Aos 71G2 Sanitauy}'cm�it N�mtier(to befilled ui Gy � '�, I� Madist�n.W� 53707-...71ti2 � �� � 3 � � �.� � b .�� ,,� � .'�9%=w3ti 5�� �cJ.I11t3I"� p�I Cll I� A���1Ce��10T1 State Tr;ir�s;rcticm Numt+cr � 1 3n accordance with 5PS 383 27(2},Wfs.Adm.Caie,submission of thrs form Co tlic appropnatc�ovemrne3iial unit `- � is required priur ttr obtaining a sanitary permit.Note:Apy�Iication forms fnr stete-owneLi POWTS are submitted to Projcct Address(if'different than mailing G ,he Depurnnent nf Safeiy and Professiona(Services.Persooal informatio�i you provide m�y be used for secondu� u fses in accordance with the Privac Law.s I S.Od(i Nrn.Stats i. A lica�tion lnfoemation-Pfease Print:�TI Infnrmation � Yroperir•Owner's Name Parczi k 0O$ „ 27,3-QO- �--C�'.'�'/ Jon & Karen Schroeder 5 -008 -3 -09-27516-688-000100 Property Owner's Mailing Address Ar{r�,erty t.�e3noar 29257 230 th ave �rr.�--.._ ('ity'.Saate Zip Codc- Phone Number _�y�._._ , 5ection�� Hoicombe WI 54745 � 715-577-8460 ���r���t�,e> --•-,�� r..__38_'�: R.�. 9 .._E:�,r�y [1.'1`ypc of Buildieg�c6eck all that aP��Y) [_ot� UM� _ �n�� �( 1 ar2f'amilyDwelling- Numbero£Rednmm.�2 cabin # J� g 5i����isionName --�_.._.__._____... g���� Rid e view � ��� ❑PubliclCnmmer�i�i-Describe t)se �_ __�._...._�.___ ...__ - Citv nf -_ _._�._._.__ __ � ❑State(h�ned--Describe Use C'Sh4 Niunber ❑Villnoe of ---....___�__.._______._..___.._...___ ____..... � . .�_�........,,..__�.._......__..,...._.�.�_.........._... � 1 j �— Q To��n of.___��Q�(atE�. ---- I1I.'I'ype of Permit: (C`heck only o�e box an line A. C'omplete line B ifapplicable) a. �New 9yst�m �Replaccment Systern ❑"I'reetmenVNoldiaig"1'ank Rrplace�vent Only ❑CJther Modiliontioh to Existing Systetn(�xp(airi) � 3 � �� ❑Chan e�f Plumber 1.isr Previous Pennit Numtx;r aixl 17ate Issued � ❑Permit Renewal ❑ Permit Revision g ❑Permit"Cransfer to Nc��� Before Expiration <)����� ����� iV.'f= oENOR''TS System/Coni onestlDevice: (:l�eek all thai a lti � �No�7-Pr�ssurized In-tirnand ❑Prcssurizeti[n-Ground ❑At-Grade �Mound>2d in.ot"suitabte soil ❑}�toi�nd<24 in oFsuiWbie soil � � ❑ }loiding'i'ank ❑Chlter Dispersal Compauni(expla�n)� _��µ .�W ❑Pretreatment Deti�ice(explain).�._� ' . _._..____._.�..---__._._---.._ i V.llis ervs�t/Trcat�t�ene Area Informatioa: — __ _—__.. _ ._�.._____....._....-� Desi¢;n f'(o�v(�pci) Uesig��St�ii Applicatitin i3:rteigpdsf) Dispersal Ar�;a Required(s(� Dispersai 1re�}'ro�osed{sf� SystNm Flevntion 300 0.7 428.b � _,__�_-� - 98.40'-- ��-1 "4'�I.TBnklnfo CapttCiryin Potal %of' �fnnufricturer t;allons Galtons t;nrts � o'o �� �_.____ ;� u U � r — Vew�Tmiks Caistin�T'enka � � u � Y � � ��� � 0 c. C� i7s �' r «. t� c. Septic or Holding TarJ; X ��� � � 1000 skaw p� O'a X (3osing Chambcr ��"�"-"' i �'II.ltespunsibility�Ststement- l,ihr undersigncd,essumc reaponsibility for inst�llation of the C'041'TS show�n an tfie aftached piao�. � P'lumber's Name{Print) Plumb�:r's Sir�naiure �1PIM;'KS�uiaaber [3usiness}'hone Number � 221253 David C. Laird �, a��...�_ 715-239-6194 ( Plumt�er's Acidress(Street.C'ity,Str�tc,Zip Cvc1e) ��'� "� ""� ' 20165 Co. Hwy. "Z" Cornell WI 54732 C '4'III.t' u �1De artnient l�se Unl� ___ �_ _.___ _� 9 Permit Pcc E�ati Issue Iv,uin�A�ent Sik�natu e i �Ap ,e c ❑ llisapprocrd � �f �� . � �QW��erGrven Reasc�n ft�r Ite�uai � -1��� ��� �a � � - 1 I�.Conditi�ns of Approva!/�2eax�ns for Disapproval �I a a�.__ ...��_, � yF , ii�ate � ��GI _ �- _ , _M � �;` �,` C srt- a-� � (� S �,r�,�#i 3y�a i �llew (�lo r l d �__33� �tcpt# _ . Attpch tn completc pinrw fnr tAc systcm and eubn�i!to thc C'nanry only on pa�ur aot leas d�an A 113 x 1 I inches in sir.e f f' �; �� � ' ��.� � �� � � sa�-n_svx�R.os�ia> NO R�FllNDS AFTER � S�P Q � Z4�2 ISSUE OF PEfi�MIT �� o� SAWYER C��sa i Y � �,0�lINC ADMIt�lISTRATEON Private Onsite Wastewater Treatment System Title and Index Page Project Name: Ridge view cabins --- Cabin # 3 (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: � Town, ❑ Village, ❑ City of Egdgewater County: Sawyer Subdivision Name: Ridge view Lot Number: 3 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�2� Designed Pursuant To The Following POWTS Component Manuals And Comm 81 -85 In-Ground Soil Absorption Component Manual (Version �) SBD-10705-P (N.O1/O1 ), , �� N/A Page 1 of g l �_� � Av `? Qj �F�� �'n � � � � -- -- __�_ .._._. ---_ —_ __� � �-t� i -- - _ __ ___ ___. � �- �� � t- � i �� n �� � '`� ` ' _ ' O o'� ,/" � � ♦ � � iy I , ��` a � .. t� � � 1 ='�T ti, F tsi" �u � � j � i;-� W � ��i���8 `���. � � � s Cl` C }- d� �' ' V � � _ �� -, , � I � , � �_ � � � �s . : ;�7 i 1�� ` =:�',___..----� r 'LL. � �� � � 1 ' � � I < i i 'r\y' �1��"=� �c7 k,�� �1 , I� " � � C�, � � �� � Y �< <6 N� i T..V�'J. f , L \l � �� �`�� s � _ , +� �.. :i l. . 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O�D-1070�P 0't�L01)'YmwQe DLqr�m Compmmt Ma�eP'Vaam 20 Oerr- MAII�l�APiCi E[Ol�il1'O�II�IG BCileDULS- CE AND MANiAG&MENr , S�nio�E��st , 3avb � s csb�810m At]sd moe 13 moo�s 3 OILr- � wit At leedt aoce moods 0 3 NA P�haod fwtl�Aolt Atlwtaooe moo�s. 3 Far nvw cm�uaim.;priar�o irp of the POWT'S cLs�c nermoo�c t�drls)foc the pa�aooe a� P�sP'��a ai:ahemiwh d�mp'hupede�el�eema�t D�'�s�°��mye 9�s�pssal oei�(s�Ithi�oaooeoaaEioos ae dM�elediae�s eoamaoa dthe mot(s)�ovad bY a s�e�a�nY��I�m� gya�em a�t np�irll mt occ�svheu sal caodida�f re 5aam at the mSlnauve s�faca '1Le poogo[growaa is reipam�lo 5oc tbe opewum md me�omoe of the POW'I'S md m�an�io�pmedmpata.7Lo q�tiY aod qa�tlty ot�e aa�aoa0a'trt+am wm affieot the par�oRmmoe aod LmIIevvy ofya�POWT3.'Ihe mhllman a�v+6�avioQ appB�w sd IIduw�ImQ w�RomPt�pc a�ledm}e�ces the wasoewata'wl�a ALo 1Le 6cmm a wawe from wa6r pem.i�mnmoval�b,aPoac ciee waear aaatmmt devicas m�Somdetim�s aLaald be dLcLeyed�u�e�o�d aa&oe w6dvar yor�ia Naec�is does mt ier]ude 1�d[Y w�xo4 elpe►m.diehwater,atc. '!�syr�em it d�riaond o�L�odle domatic mm�t4 vrreeewaoer,howoover tha dispawl of food baecd�es aod als.ve�e�bla�hurt prb�d aed�.baor.md food wl��aah as 9�o�e Prodo�bd bY a yacb�e�epwsl�ould be�sd To�et ti.os 3s me an� p�pr�t ahaeid bs Qi�sd'moo 1Le sYaoem.OthR nou-biode�afLbb iDm��m 1�S Wi�s.Lm�°°4�S'� ooed�,ai�eM�s 1+�.d�d 9or.�nd o�Amn avra6s iLooid mt e.poer tl�e sycum-Chem3als a�h r D����P�.P�C pa�,7 oe� ���l,�..r.�...,y............o,a,a.........e,......,�.....�..,..,..,�,.u�uw ww wc�ysww m muy wn srnousry o�D Yoiu POWTS eod`ao�e Ya¢�m1m8 weoer supply Ma�m a mg�'soe�dY�'bY�8�Y�mB duoughout the wxk Avoid vehicle haffic over all ayet+��, Comp�u of mow ova the dispasal imit may cause it to frem�up. :Inepecaaa shall be mede by�individual cmxying ooe of tLe folbwmg tkmeas� caetiecaliow:Mmer r�,Mr�Ph�br Res�icrea sawe,Powzs Main�roa or St�e Sevicros�(Pa���chea M�ao�ooe 9d�edule). Taok mspocCaoa mi�mcLdc a visual ro�poctioa of 8x t�1c ro idm�y'anY�mB��hmdw�e, ida�i$'acp'ctadrs or leeka,meae�ae the volama of combmod sh�dge and scum and c�ck fa mry becimp or po�g of a�ueot w the gio�d emrfsoe ad teat all ekch�ical eqiopmeot auch se p�ps md slacros.Any defocta shall be�tiy carocoo�Hxpoeed apea� QceatQ dmn 8�rbes ia diamot�shall ba sec�ued with effecave loclong devices tn pmvmt accidmtal o�imeamarixed�y the mul�. Whan 1Le aomh�an of sludgF aod sa�m�y mnk axccods aoo-third(1/3)or mae of t6e unlc vohrma,tLe ootue c,�tmb of the rat.h.n be:emovea by e septa�e savicrog oparabor aoa a;epoeea of m a�dance wim c�NR113.w�uooa�nrhn;n;ahapve Cada 1Le atlat SIOa(s)ahsll bo uupec6ed�d cloe�d w ramove mry accumuleted solids sccad'mg to manufecarter's speci�aa�,Solida waohed fiom the fl�c ahsll be nKaroed'm the tank.Fiha cleanrog may be�ssazy at moce froqumt im�vals tLen staoed m the me�oeoma achefiila to la�tlse aysoem opa�mg. Alos e600ld be tedsd an a xe�l�besia by tl�e home oava.If mm alarm so�mds,comtact an iodivi�el licamed to savice POW'I'S, 'Ihae is m�lly a 1 dty tmwe�md�mgular oPeratro8 conditioos.however watm�should be c�served imL1 aq}'Paobleme with the sy�6em a�e ome�tod to provaot bedc up of aewa�e mto the dwellmg�s�s&cmg. �:Wierm tlu POW I'S�ils md/or is petme�uently taken out of savice the follotviog staps shall be minm to me�ua tlmt the sysl[m'm p[opezly md sa£ely abmdomd'm comp#�mx whh CL.SPS 383.33,Wiscamcin A�mi�4ve Code. - All p�ing to t�lrs�d pits s6ell be disoaoaoctad md ti�abeodoaed P4k�mL&+� - - 1ue�of eu�ana pi�s.hau bo removea,ma propair�a�a of br 8 S�d�e Savi�IDe OpaaDor• - A�ar�g,all taolm and piu andl be mccavated and removed or thaa covas ramovod and tha wid apace Slled with �7,pFavel a dl�a inar[so}id mabxlal. :if the POW'IS fsils�d cmna be repsued tho following�meee�ves Lave beea,ac mus[be pkm.to povide � a COdO 00�]�I�1�Sy�: � A adhbb replee�aron haa beea evaluatad md may be utilized for the location of a xeplacea�mt soil absapbon syatem '!be ceplarommt azea ahould be pcotec6ad from�z aad co�action�d should not be mfrmged upau by tequand satbacb fiom e�etmg and p�npoeed etucnuo.lot lines md wells.Fail�s to p�oDoct iha mplac�ot ama:mdrr rt imusabla �$Y���tY wuh the tulea m effect at the trme of repl�. ❑ A a�abh teplaoement sea is m4 avm'lable�o to eatback and/or soII limitatia�s.Beaing advmces m POF+1S mchouology a hpld�imk may be ro&alled as a last resor[to mplaca tLe fsilad POWTS. O 1Ls sme�s mt bem avaluaoed to identify a euimbk repJaoemmi area Upm�iliun of the PO W1S a soil aod si�e evaluaam mwt be paYamed to locatc a witablo ropl��ea.If no ieplaceme��m is availabk a hold�g tanlc mey be matalled ae a IM rosort ro replece Hm fe�led POVv1'S. ❑ Mamd and d-grade soa sbaorpteo�sysroms may be recametructed'm p7ace followmg removal of the biomat a2 the infilaarive e�&ee.Recoo�na of wch systems muat comply with the rules m effxi at diaz t�e. «WAgNIINp> �TjG�IMP AND OTHER TAEATMBNT TANICS MAY COIVTIAN LETHAL GASSES AND/0R INSUFFICIENT OZYG�L DO NOT RNT&R A SBPTIC,PUMP OR OTHES TSEATMENT TANK UNDBB ANY CIRCUMSTANCFS D&ATH MAY BBSIJLT.RE8CIJ&OF A PERSON FAOM THI:INTERIOR OF A TANK MAY BB DIFFiCULT OR IbIPO88I6[.& , ADD1TiONAL COD�IIKENTS PO�YISINSTAI.I.ER POW151NAIIV'I'AIPIER N�e Dr7�� [.Al RD Name o 7 `�/FF1lYofER Rlme 7i5-,Z39- bl �Py P�e S-8 9- 3'o c 9�TAGH 3&itViCII�IG OPERATOH(Pamper L,OCAL REGULATORY A ORITY PTm � AS��Y�A�J�yE� Co�,n•rry ?aiviN6 Fhaoe ( Phone 7/5--�34- S�S W Page 8 ofL "�T"E` PRIVATE ONSITE WASTE TREATMENT county ,,.--_,,;; �;�" y_ (`�� � o$p � ���;�', SYSTEMS -,� � i., ( POWTS) SaWyer �4� ,_�, � �_— _�� \ --�� °"s' INSPECTION REPORT Sanitary Permit No: ,_.,,,�..�� Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �� � �,Y�O Personal infonnation you providc may be used for secondary purposes[Piivacy L.aw,s. 15.04(I}(m)J Permit Holder's Name: ❑City ❑ Village � Town of: State Plan Tra�saction ID#: �a�n k(�e.v� S��'ae� � �.., ^ Insp BM Elev: BM Description: Parcel Tax No: ��o�� ' ��r.► o`�s�d��. w�- �73 - Oo-ogoc� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic o 3po Benchmark �p,o ' Dosing Aeration Bidg. Sewer �,�' Holtling St/Ht Inlet 9r7,g ` TANK SETBACK INFORMATION St/Ht outlet `t7.7 ' TANK TO P/L WELL BLDG vENrro ROAD Dt Inlet AIR INTAKE Septic fi�{a' .(-�ot,` ` .�g' NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. � Holding Dist.Pipe PUMP 1�IPHON INFORMATION Infiltrative � Y r 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 W 3 L ` #of Cells Type of System Distribution Media Manufacturer: � Conv ❑ Aggregate SETBACK P/L Bidg Well OHWM of Nav � IGP � Chamber �� INFORMATION Waters � AG o EZFIow Model Number: CELL TO �--��� �p r -}(o� _S�_ ❑ Mound o Other —�� _ _--- _ _---- - DISTRIBUTION SYSTEM X Pressure Systems Only IL ngthr I Manifoltl Dia _�L�eng hution Pipe(s) Dia Spac -- X Hole Size Spa�ing ❑Yes atio❑n Pi�pe�� SOIL COVER Depth Over Depth Over 1 Depth of Seeded!Sodded Mulched Cell Center Cell Edges � Topsoil _ ❑Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) ��,,5��� ���.��z3 � ��c�- Plan revision required?❑Yes ❑ No / � o� a � --��� __--- 69 S� (,� Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AO�ITIONAL COMMENTS ANO SKETCH SANITAAY PEAMIT NUMBEA:___ e22' �-`l0 __ �- GI��.� � k . �-, . __ ...�, ... ._._ .. . .. ...... .........: . . �.. � . . . . . _ . . .. �� . __.._ . . .. . F . . .' .. . i . i . . . . ; : . i , . : . : � � : � � �i : : . . . . : ._ _ . ' . . . ': ' . . _. _ ...... . . .�. . . . : . . ' � p . .. ... _ ., ._!.. _� ._ , . - ._� _._. .... ._.-- . .. __."_'_...1. . ..-l_.. � '� I � __......_...._ : . .�.. . .t . . . , . . ' . '. .. . ' i � . �lil . . . ... .. .. . . _•. '___. .. :.._. .. t.. ..... .I. � .. .j.._. .. i ..... ...._._...� ._..... .... _ .:. _ .. . .. ... �:.. ' �._.. � . . . � � i . ', . . I . : �� ��" .�k � UA �� �— �o ----t � �o'---� � �� . a $. u �� � ,� O tD �`'��� � 3 � E-��,.,�,.e,�, n ��Cd '�� �, .p�br. � �f�L '.JA`� �^S`" I` �loa � ��� � ��,rt. w � , n� I