The URL can be used to link to this page

Home My WebLink About024-641-26-2301-SAN-2022-318 � _��'.''=��"`�� industry Services Division Counry � " 45Z2 Madison Yards Way ,s Ct1,L� �- V' Z :`/�_,f P - Madison,WT 53705 Sanitary Permit Numbe (to be filled in by � , . � .'> P.O.Box 730? � . �'�;' � '��a%,,�..;t,'e% Madison,WT 53707 � �3 q �� Sta[c Transaction Number W Sanitary Permit Application _ -� In accordance�y�i[h SPS 3R3.21(2),Wis.Adm.Code,submi,sion of this foi�n to the appropriate govemmental«nit � is required prior to ob[aining a sanitary perniit.Vo[e:Application fomis tor stataowned POWTS are submittcd[o Project Address(if'different than mailing a the Department of Safety and Professional Seivices.Personal inli�rmation you provide may he uscd fbr secondary �� purposes in accordance with the Privacy Law,s. 15.0411)(m),Stats. /O��.J 6 . t � � � I.Application Information-Please Print All information -� N 0 Property Owncr's Namc Parccl# �e r t' � • (.-.�� - 1 • �u e�r tiM.4�t p2�{ - 6�l (- Z6- Z 3� ( Property Ow�ncr's Mailing Address Property Location �l 6 4�8 R e ��' R� �.�,��.L�� City,State "Lip Codc Phone Number Z �(�� vtr �Ci�� (� (,� sw '/<, � " '/a, Section � ii.Type of Building(check all that apply) tot= T 4 � N R �� E o W �I or 2 Family Qwelling-NumberofBedrooms v Subdivision Namc Block N ❑E'ublic/Commercial-Describe Use �City of ❑State Owned-Describe Usc CSM Number Village of _ �T�,��,�f� �o� � l-� C� iIT.Type of POWTS Permit:(Check either"rew"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C if a licable. A' New S stem Re lacement S Stem Other Moditication to F,xistin S etem(ex lain Additional Pretreatment Unit ex lain ❑ Y � P Y� � S Y• P ) ❑ ( P ) B' �olding Tank ❑fmGround �t-Grade �Mound Tndicidual Site Design Other Type(explain) (conventional) C• ❑Renewal Before �Revision ❑Change of Plumber �i'ransf'er to New Owner List Previous Peiniit Number and Date Issued Expiratian (�—a / 9 Op C'� a IV.Dispersal/Treatment Area and Tank InformaHon: Design Flow(gpd) Design Soil Application Rate(�pcUsf) Uispersal Area Required�sf) Dispersal Area Proposed(,� System Elevation 3 00 — — ^— Capsciry in Total #of Manufacturcr Tank Tnf'ormation Gallons Gallons linits � ` o ? u Nck•Tanks Existin�Tankc •� � V � e� `u " m � o �' ' ;+ � r� :o a U v� � v� ii. C7 6. Scptic or ing Ta �7� p-1 Z.�0 Q � �+UQ � W I.G.S��r" Dosing Chambcr � � � V.Responsibility Statement-1,the undersigned,assume responsibility fnr installaHon of the POWTS shown on the attached plans. Plumbers Name(Vrint) mb �' MP/MPRS Number Business Phone Number Rob Lu ��Yc� z�-�vZ�� -t�s_ ��--rs�� Plumber's Address(Streel,City.State,Zip Code) 1�-(��i W `�-- l�w `��i � ;.,v��+r�� l-�( S``-t��`f 3 VI.County/Department Use Only ��p c ❑Disapproved Pennit Fec �I Date Tssued Issuing Agent Signature ❑Owncr Givcn Rcason f'or Dcnial � (w'� � �(3( I .,t vl- �.�"�'rJ W✓�- Conditions of Approval�Reasons for Disapproval o� � � �� 5� ��r,-2�r,7��'`I � �4 � � � � �� -�' �:� _ ,!��.�.�..�.�,�w.. . ._ � � �� ' �� .hk# � � � 2 � OCT 3 1 2022 /�/ O �S^ � , " ;�t�"�-..�� d � SAWYER COUNTY ZON�'NG Ai�t�!lf1�IISTRATION Attach to complete plans fm�the system and submit[o the Caunh�only on paper no[less than R I/2 x I1 inches in size �.LI(vl� SBD-6398(R.02/22) Sawyer County Zoning & Conservation Administration �� 10610 Main Street,Suite 49 � ; "�- �� Hayward,Wisconsin 54843 �"� �,�` " -I� (715)634 8288 ,_ � � �� _•I� FAX(715)638-3277 � ,� � [ `� �t_it�� ,t��c ccm�t� o��i � � - ��i E-mail roai r �� ,cr��.�� cuun ; t»_.or�� Toll Free CourthouselGeneral Informahon 1-877-699-4710 � I� y �- -'�'� /� ,.; ��'°� ��\�� Holding Tank Approval Checklist I. Sanitary Cover Sheet Date Stamp l0 / 3 � / �� Parcel ID# 02 �- � y ( - �(� - 3 �� II. Plot Plan �Property Lines �Benchmark BM ♦ j�Site Address �North Arrow �Structure �(Scale �' Well �<25' to Service Road �Legal Description -�.Nearest Road Intersection �Setbacks to: Property Line, Well, Structure, Water bodies, Roads III. Required Plans �lndex Pa�e with Original Signature �Management Plan/Contingency Plan D Servicing Contract �Holding Tank Agreement form IV. Holding Tank Specifications �( Cross-section—Manufacture, Gallons: �i✓l�e�r' �� '>( Tank Anchor Calculations [SPS 383.43 8) g)] � Locking device, chains/locks �Alarm and Electrical per NEC 300, SPS 316 & 383.43 (9) (e) and State Statutes 101.862(2) and 101.862(3) �3" Bedding Material < U2 " V. Holding Tank Plans per Component POWTS Manual �Version�SBD-10855-P (R.3/07), . , ?•l Owner: ��s-w�c,� Plumber: �a�`l'r-2_ Application Review Date: �� ,�� POWTS Reviewer: �,,.. �1�� Name 6� � l� �;��5�a Revised 4/1 U2013 PAGE 1 OF 4 Holding Tank Plan Index & Cover Sheet Component Manual Design References: Version�, SBD-10855-P (N. 03/07; R 01/12) I ��,��1 �,� � � Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Holding Tank Specifications Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map (if applicable) Holdin Tank Pum in Contract if a licable) Holdin Tank A reement if a licable Project Name / Description Owner Name(s): Se rc�-r Q ve,r ►�.�,� Phone: - - Owner Address: �16y 3 8 R 4 e �3(�E' ��-, B(a�l�-�.o�r �al��Zip: S`fb (S Project Address: I 0 Z�t �v ►J Co � (�� y Govt. Lot: 5�11/4 of .fJ kJ 1/4, Section�, T 4�N-R ab E 0or W � Township: (Zov,�� t,��,<� County: �4w�I e�-- Project Parcel ID #: pZ`-� -- 6�1 - Z� — Z� � � Designer Information Designer Name: �p� � �c�..r�L Phone: ��5 - b�t i - b r�� DesignerAddress: 145�t-Q �v �'�- (-�,,�,,ti `r1 ��,u�},�c� Zip: S�Sy-3 E-mail: T�;� 51��,t;r,,�� io��,�o��d� ��<,,,,��. License Number: �_Z�� Remarks: Signature: Date: /D-Z/- Z 2 Original signature required o e ch submitted copy. ow�er: L�Q4�: �¢� V• ��hC�4 ' 1. �Ufvvh4lr� .S4Wy�er I.D:J �COcir�p, �-a1s-e �� r� b`i 3 8 R y e ��C 2 a PI 1J 0 Z�-{—.d��l(— z�o —z-3 O I Sla�lc (�i�7er -C-�lis� wls`i6�5 sw�r�w �zto`t �1� (La6� s.'Ge: �02.9(o/J C.'o Rc�."5`� � C!� � Pp� 2we� �� '8a �O 60 � +�5�' � /�l o� �v S�� Scc.�� =3� �� 4 6;�. 0.n� w�l f av� 0�1� � c �� re«ti �:r �Kle� +q�� "Gc�„\ z Fxi w��g ��;K„ 0 0 wetl�..s�t��l �N ioo � z,000 ykl Low- �ro �T a ± �, c}ac �ec� '{'O W vs�� 4a'� V' 0 c� 0 � Lo�� g4-!c�, lo z961J PAGE30F4 HOLDING TANK SPECIFICATIONS (No Scale) Wea[herpmof 12"Min.or 2 0 ft above Junc�ion and Approved Es[ablished Flood Elevation Alarm Box Vent Cap (�YPical) Electncal must comply with � Approved Locking Manhole SPS 316 and NEC 300 4"QJ Ven[Pipe wilh Waming Label At�ached � --Conduit >10 it from (typical) 4"Min.or 20 ft above I Building � Es[ablished Flood Eleva�ion , (typical) -_ �AirtightSeal a " � __ Finished Grade ' 18"Min. (�YPical) - ° . � a 9 I a Inlet Inlet Invert t-Wa[ertight Approved Jaints with � Plug Approved Pipe 3 ft onlo � Max. 12"or 90%of[otal volume ' Solid Ground - if more than one tank I a I Alarm-On I HOLDING TANK VOLUME _ � �� gal a � 3"Approved Bedding Material Beneath Tank TANK MANUFACTURER: W� e�� Anchor tank as necessary pursuant to SPS 383.43(8)(g) Ballast Weight = [(cu.ft.tank.vol x 62.4 Ibs/cu.ft) - Ibs.tank.wtj x 1.5 Ballast Weight= [( cu.ft. x 62.4 Ibs/cu.ft) - Ibs] x 1.5 = Ibs PAGE40F4 Holding Tank Management Plan IMPORTANT: The owner of this holding tank(s) shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this holding tank(s) 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 pertorrned by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Estimated Daily Wastewater Flow= a-� gpd Inspection Checklist INSPECT EVERY 3 YEARS o type of use c age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, e[c.) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o surface discharge of effluent or sewage back-up into structure served SERVICING FREQUENCY o The tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wisc. Stats. when the wastewater in the tank(s) reaches a level of one foot below the inlet invert of the tank(s). Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. Tank pumping reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wis. Admin. Code. Report any component failure or malfunction to: Name of individual or company: �J� Ls��r�— Phone: �7t5��4q — O�(3(� ` �� Localgovernmentunit: .�Gw�r� Co, Phone: C�� 63Y- g1S2� Local government unit address: �Obl'o �^'�a�. S�-. S�. � `{� ZIP: S�Y� 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, Wisc. Admin. Code. Continqencv Plan In the event that any failed component of this holding tank(s) cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agecy for review and approval. System Abandonment If use of this tank(s) is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. _ .- --- - __ __._.. ._y. _ � ��.��;:��:.��.��.fl .. ��;�,� ,,. ��v��, ,r,..��,�r��,�,:� . WLP2000— MR TANK SPECIFICATIONS � � � � o o a 164" DIMENSIONS: a ' i � WALL: 3" � o BOTTOM: SEPTIC 3" a a HEAVY DUTY 5" (ADD 2,800 LBS.) o COVER: 6" � MANHOLE: 24" I.D. PRECAST CONCRETE RISER i� HEIGHT: 53" O.D. � LENGTH: 164" O.D. WIDTH: 96" O.D. w � w J H- BELOW INLET: 41" O.D. � � o 4" CAST-A-SEAL 4" CAST-A-SEAL LIQUID LEVEL: 36" � WEIGHT: BOTTOM 11,260 LBS. o �24" \ COVER 8,170 LBS. w � � � INLET AND OUTLET: � � � �Y� � 4" CAST-A-SEAL BOOT OR EQUAL } Z s m Q FILTER OR BAFFLE INLET AND OUTLET BAFFLE AND FILTER: i � � WISCONSIN, SEE DETAIL #10 � Q � (OTHER STATES SEE CHART) � � `` e LIQUID CAPACITY: 56.27 GAL/IN �'�'� o � � LOADING DESIGN: 8' 0" UNSATURATED SOIL W - � � TOP VIEW C� Y �o HOLDING TANK: � o � OUTLET HOLE PLUGGED 0 Z � ACTUAL CAPACITY: 2,138 GALLONS `7 o I '� (��r. �S � C�ICcI� S/ ('i5-� Y` � �� " MN TANKS: � � N WILL HAVE ONE VENT OVER OUTLET � o AND WILL HAVE TWO VENTS IN COVER OVER INLET � � � v� c7 � i O a � TANK CAN BE USED AS: W � � SEPTIC/ HOLDING/ PUMP OR SIPHON � � � COVER: MIX DESIGN �8 (NO FIBER) � � • . TANK: MIX DESIGN #9 (SMALL FIBER) � INLET _ OUTLET — — — CUSTOMIZED TANKS: o N _ � FOR CUS70M TANKS CONTAGT WIESER CONCR[TE Q o lf7 - � U � = � U � � � 3�. � � � M I Q Z � d � d � � Q JOB INFORMATION : � � o � � � CUSTOMER: W � PUMP PAD cn w JOB NAME: � SIDE VIEW DATE NEEDED: 3 �1 ��t_� � ��. � � � �t� � APPROVED BY: SHEET N0. �I � APPROVAL DATE: I nF TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS � � � HOLDING TANK SER�'ICiNG CONTRACT Contract Date: �/�/�� This contract is made behveen the Holding Tank Owner and the Pumper. Holding Tank Owiler's Name: Pumper'� tiail�e: �"e«� O�er m�►� sco�{-{- �o P�� Parcel Identification ��umber: (12 Digit Legacy ID) D Z `—� - � � �- Z(�- �- 3 O ( I. The owner ab-ees to file a copy of this contracr with the ;overnmental unit, Sawyer County, which has accepted and recorded with the Oftice of the Re�ister of Deeds, the Maintenance Agreement for a Holding Tank required under the Sa�ryer County Private Sewage System Ordinance for the issuailce of a Sanitaiy Permit for the installation of a holding tank(s). 2. The owner agrces to have the holding tan]<(�) serviced by the pumper and �uarantees to pei7��it the pun�per to have access and to enrer upon the property for the p�npose of servicing the holdi�lg tank(s). The owner•agrees to maintaiu t11e all-weathet•access road or drive so that the pumper can service tl�e holdii�g tank(s)with the pumping equipn�ei�t The owner further abrees to pay the pumper for a charges incurred in servicing the holdin�tank(s)as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit ro the Go��ernmental Unit, Sawryer Counry. a repo��t for the servicing of the holdintr tailk(s) as requii�ed under Comm. 83.55, Wi�consin Administrative Code and the Sawyer County Private Se��age System Ordinailce. The pumper furtl�ei agrees to include tile following in the report: a. The name and addi•ess of the pei•son responsible foi•servicin`�the holding tank; b. The name of d�e owner of the holding t�nk; c. The site address of the holding tank; d. The date the holding tai�k was ser��iced; e. The volumes in gallons of the content�pumped from the holding tanl< for each servicing; f. The disposal sites to whicll the contents ti-om the holdin�tank were deli�-ered. 4. This agreement will remain ii�effect until the owiler or pumper terminates this contract. In tl�e event of a chailbe in this coiltract, the o�aner agrees to file a copy of any chailges to tl�is service conn�act or a copy of a new service contract with Sawyer County within teu(l0) business days from thc date of change to this service contract. �Wll�l"�S N1(1'lE: �PCIt11� �R�Ilel''S 51�112TUI'E: (Onl�oneo��nersigna[urerequired) �'e r c-.� C� v e`�vn4►� � , i � Pumper's Name: (Print) P�nnper's ignature: �d V' mper's Registration Number: � l � ) 3 Ke� o�i i i i • - USE BLACK INK ONLY- ( iil��I�' I IIII I IIiI�I�II)li!I ��JCiu:��n54�(}� POWTS MAINTENANCE AGREEMENT Tx:4U�i6Jv For Holding Tanks 44Z065 PAULA CHISSER Owner's Name(s)as shown on deed: REGISTER OF DEEDS SAWYER COUNTY, WI �eCc� �_ �VerV►^0.✓��1 10/3i/2022 12:49 PM RECORDING FEE 30.00 Parcel Identification Number: (12 Digit Legacy ID) c��— 6�t L— ?-�— Z 3 b � PAGES: Z Legal Description of Property: -SEE ATTACHED SHEET- We acknowledge that application is being made for the installation of a holding tank(s)on the property described on the attached sheet. Return To:Sawyer County Zoning 8 Conservation Administration,10610 Main Street Suite 49,Hayward,WI 54843 As an inducement to the County of Sawyer to issue a sanitary permit for a holding tank on the above-described property,the owner is responsible for the operation and maintenance of the holding tank, locking device,alarm and access, and agrees to conform to all applicable requirements of Ch. Comm 83,Wis.Adm. Code relating to holding tank management, including the following: 1. The owner agrees to contract with a person who is licensed under Ch. NR 113,W is.Adm. Code, except as provided by Section 281.48(3)(d), Stats.,to have the holding tank properly serviced and to file a copy of the service contract with the governmental unit. The owner further agrees to file a copy of any changes to the service contract,or a copy of a new service contract,with the governmental unit within ten(10)business days from the date of change to the service contract. 2. The owner agrees to contract with a person licensed under Ch. NR 113,Wis.Adm. Code,who shall submit pumping reports to the govemmental unit in accordance with Ch. Comm 83.55,Wis.Adm. Code,for the servicing of the holding tank. In the case of exemption under Section 281.48(3)(d), Stats.,the owner shall submit the report to the governmental unit. The governmentai unit may enter upon the property to investigate the condition of the holding tank when pumping reports may indicate the holding tank is not being properly maintained. 3. If the owner fails to have the holding tank properly serviced in response to orders issued by the govemmental unit to prevent or abate a human health hazard as described in Section.254.59, Stats.,the governmental unit may enter upon the property and service, or cause the tank to be serviced. Pursuant to Section 145.20(4)Wis. Stats., a governmental unit may assess the owner of a private sewage system for costs related to the pumping of a septic or holding tank.The charges will be assessed as prescribed by Section 66.0703, stats. The owner agrees to pay alt charges and cost incurred by the govemmental unit for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazerd caused by the holding tank. 4. This agreement will remain in effect only until the governmental unit responsible for the regulation of private sewage systems certifies that either a soil absorption system that complies with Ch. Comm 83,Wis. Adm. Code, or a municipal sewer serves the property. In addition,this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 5. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner.The owner shall submit the agreement to the register of deeds,and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. -Only one owner si nature required- ACKNOWLEDGEMENT Owner's gnatu e: �, State ofi �ti/�.�J--- _ �� County of: �(,�,�i�l l°�.b'� _ Owner's a e(Print): Subscribed and sworn to before me on this �err v • bc�e�ryv�c'� _��_day of I�C � Lr � 20 � �� , Date: .�`�� ..b.y. F � el�� !� 3 b O a y.Z- ,�,.a .. , ly8tarj�., ;c Signature: ZU. �(,U� Drafted by: 'm�� v N�ry �?�I� Name: r� �i P,�' _O; c ��'� ��C..� C 5"r Z Z`-f�D � =T: �p �y�mcr�s�on expires on: � � '�' =�� `/� -C �-�� ,, C ''••.... •' ,: Personal information you provide may be used for secondary purposes�f3j��.•§ 1,��0�(I)(m)] Rev.06/08/10 '��iuu�� '1'hose parts of Section Twenty-six (26), To�vnsliip Forty-one (41) North, Range Six (6) West (in the Township of Round Lake), Sawycr County, Wisconsin, described as: a) Tl�e Nort'h�vest Quarter of the Southwest Quarter (NW 1/4 - S/W 1/4); b) The South�vest Quarter of the Northwest Quarter (SW 1/4 - NW 1/4). 10/31/22, 12:43 PM Real Property Lis[ing Page Real Estate Sawyer County Property Listing Property5tatus: Current Today's Date: 10/31/2022 Created On: 2/6/2007 7:55:41 AM � Description Updated: 4/27/2020 ''�'l Ownership Updated: 2/1/20ll Tax ID: 24614 ]ERRY V&LYNDA M OVERMAN BIACK RIVER PIN: 57-024-2-41-06-26-2 03-000-000010 FALLS WI Legacy PIN: 024641262301 PETER W&)UIIA A lOHN50N SEYMOUR WI Map ID: .7.1 Municipality: (024)TOWN OF ROUND LAKE Billing Address: Mailing Address: STR: 526 T41N R06W ]ERRY V&LYNDA M JERRY V&LYNDA M Description: SWNW OVERMAN OVERMAN N6438 RYE BLUFF RD N6438 RYE BLUFF RD Recorded Acres: 40.000 BLACK RIVER FALLS WI 54615 BLACK RIVER FALLS WI 54615 Calculated Acres: 39.688 Lottery Claims: 0 First Dollar: Yes Site Address * indicates Private Road Waterbody: West Fork-Chippewa River N�A Zoning: (F-1) Forestry One ESN: � Property Assessment Updated: 7/16/2019 2022 Assessment Detail -� Tax Districtr Updated: 2/6/2007 Code Acres Land Imp. 1 State of Wistonsin Gl-RESIDENTIAL 1.000 96,200 104,800 57 SawyerCounty GS-UNDEVELOPED 6.000 100 0 024 Town of Round Lake G6-PRODUCTIVE FOREST 33.000 49,500 0 572478 Hayward Community School Distric[ 001700 Technical College Z'Year Comparison 2021 2022 Change Land: 145,800 145,800 0.0% Improved: 104,800 104,800 0.0% .� Recorded Documentr Updated: 4/27/2020 Total: 250,600 250,600 0.0% WARRANTY DEED Date Recorded: 1/13/2017 404908 TRUSTEES DEED . Date Recorded: B/28/2014 391994 �� Property History AGREEMENT N/A Date Recorded: 10/I1/2013 387746 WARRANTY DEED Date Recorded: 11/15/2012 381886 QUIT CLAIM DEED Date Recorded: 1/6/2011 370762 WARRANTY DEED Date Recorded: S1/14/1996 257785 591/104 WARRANTY DEED Date Recorded: 1/19/1990 217192 444/444 QUIT CLAIM DEED Date Recorded: 10/30/1989 216210 441/374 WARRANTY DEED Date Recorded: 9/16/1974 149019 254/295 QUIT CLAIM DEED Date Recorded: 9/22/1969 132383 PROBATE Date Recorded: 10/23/1967 126996 212/289 QUIT CLAIM DEED Date Recorded: 6/30/1948 85642 82/571 QUIT CLAIM DEED Date Recorded: l0/2/1946 81776 82/379 QUIT CLAIM DEED Date Recorded: 4/10/1945 77224 73/526 MISCELLANEOUS Date Recorded: 3/29/1945 077223 18/171 DEED Date Recorded: 3/22/1944 75402 77/138 https:/Itassawyercountygov.orgl/systemlframes.asp?uname=Eric+yyellauer �/p -�_�.r+" s,K F:� w f:.[ � 1�L f � S7t 's� � ��." . „(`�i� �� ya. '�...: av �,� r� 'GF�-a+s. `y�`' h JA '" �i i`i'^��;.Fk . .r.rJp� '�'m�- A x dr� +,�.�y,. �� .7f� �,�� '�� _w � � .�. s � -:f1,Q3'r . �� l �,a" v�' � � �Y c�-''� - rt'. x,ti +cb� � ��?'s��;.��rsa" �n � x�e;y :_� �4't�` ,yd.�{ . r �' y`�I �;'�' � i�t '.L t � ��'r4- Ys'µ �' 'C`N TT`„i�+ :.r� a�'`�i«��,??4 �w � f-"�S� � �yye� ." °t.p. . "� : a_��:_�4lT� �r 1lT � C � 'K''��.{ !F�:?'"�.s.{,�,��', f�/"F Y S� �y y a i✓ fi � �� b�� }' x,y�' � # N'i 'yYM T T' r �.,�yf�1'�''f f}.�y �Y'��yW.y^y }�+�� J v'� � � ;� '^ .l � �J !! f $�. ,r e f4� .��L � y'-T $'�. � :�-r� a �� i k k � r�"��y�L4 ��.nEY. . ' . z r�� C x�� ? �Y�+��SY �� i `.• F�,.. °sr .a �,... ,�. l,s� ... � � � � ��f�,� /*n r�, A: r 'A 4,�� 3'� �`'�.. , ��' .c��: � ,y�� `ar�•'iutif� �.` ��4'� > � � `�� ,�`�' �t"'. � ��: „� ji';f.�Q�..�,..>'9�'� �'�t`i.�.Y� .�. ' �.m� �..i��y�F �"° ' � f 'h....�rt�"`L�w�,T� s�'r�,l� �� ' r. , �£r� , .,ly t iF �"� r ��'y' "'"'y�� ys,��7��y�»C�',�X�zY�'`X x< e��.'�'�'Y�' „�.y7 .. �YJQ y ?� �� .t '`K� � �. ,.,e^."c d" .�ti i �+.�'�s��.y3�,�,y'.:n��,:�o� ,�•t�+L �. �^`` ,�.. �, ' .:�h .�;C''� 4,�,+4 y1� •, Y.,� • !1 . ,�{�J°ha,•y� E��x� Y. rr �� F�Y � � . �� ` ;'� ' �. 5f �; )`�. . ��y.�L ,'_ .'j � � , �� ' �,7V' 'q � .� � r� f�'.y,dr3' �.ry :'T �� n,y�`.�"`.F• �r`krY. �ti �� S ^' �� r� -�'a..+�' - t,�+ r y+�rf ''� �_ c ��Y=> � �` � �. ♦ � � . � � F^ . -�-�� " �++� k .c :+� .�. : J'A'W..F. ti �a � * /C '�� '_• _ -w � w�' �+`'�17X.Lr y�.. ' F`^-� . ?Fv x�.:� r �'! n.�� ,r� �� `"�'�� r��J. .. : �- T, ..i�l y�' r, - h�.TaSG�. 7.-� +-wo..f'( - r,y.� . _� V� �.:s .�t.,�¢- e � i,R � �. r.. lr.+�i .,�c`. '��g- .. 'h.�..,:r *0�a�v �'- � """�Q 'p't"�C af'� �Y 1 y�k F ' f a �( y� ] �^� � � . ��9 r, { �:��35\'r I . � �� t^hT=fU� '��v�. _ � w �✓(.�� ' ` J�}I - aF ��t� t� � ��; .n i�ic. ' 9kt, p�+.i 1 ��Y F- �"� m'�g''. t_ .�r�,:,��"��ffi. �� " , : Y � � �� T� ��J' y,.� Sndp��" ��y � � �� '1�!:��.��:.b"'� C9`��t a�', '"q"$G� �..�. f_ �� _ � �� q t >. . �..t .y."�vi, �Y��"f.l'�.� ln`�r �� -�'.�� r;�.. � ��u �k '�•'+yy ,�' � _< : ��,,. +YLi r; y�e�,.�'q � p�-� i��t.'F ,�;. - �s+r ?�` -�7,`' a rr3ttx ."� e'i► �"�./ -..,+-.i, s'dp' . _ � � �'+. ��K"m.,s� �� ` � � rr �' F � ;*�� ti ��.' _ � . .��sa��,�y:+.�'�.;�` � ., � _ �` ,� � ' .7�,� - ± �' §_: `4°�b,� K�K;� "`�-�� '`« r-'"`� µ ,'� F.:,.�_ .,::. � � �,9,s*�c.. . �, s�'..,��,'�� ' -..y�, � a �`'` ,y� �f� � � t �' � .3.�F''L'.J' FYi' —_}.�' ��SM�- +,. 1y. �A ' '�i�� F .'/ �' F .�� " r ' .. `^i. � � '.� S ._�7�y 4> � 1 ��S Y .. �ti' j f- �� 3 � �r Ta'k . � _ �e °� i� -. �` ':� � ��" �;ty .:',�i{�` - � �`w ?'1' � ��.+ �. � }j� - ��j t'. �.�f!.�Av.� � �y�i.f� � t`v� '[ `1�. Y h�J, YY,�� ( . R,�+ . ..�.�� P ��JCliC +1y4 :` - {.. t .Y'� ..',+! _/_ +N1^' .N .M r ✓.' .,P:. :4� `,dp.;yP. '►N.: � �� s � : � �1' A! .� y � �y � `! ��. � � _,' it'Y`" � �"� Yx ' � � i' � � � -. ' iq�,:: S �:� +- � i."^'' .:`'�i" �`d � : > r � _ y� t�+w'�" w'r p � S �,_�# �c.�. ' a .-.f� ,� r ..� !� ��y �v,.. .: '_'fF�` #}'Fy. .�.�? p � �� '�'��"�.-.� � � i �''„?'�1 �t�,i� ��:�%g�� y� .w ✓� .�- .G`. -n �y �i � L .rd. �r F u ^�)� � •�',+� ,�,��,�'� "-.� > .�., , ,�14"' +,a'C �k�.�A .r`4'r�' . ,y'� �� Ket� y�� l .. ,'��.�..� �..�„�,.F'a�'�.h :'�"�,.� •!P Y`°,��'��M'°'e�� y . �'' ��'�� t-$��'✓�ri� �ik:: �' "'1�Yv�a .rt nL� � � �t�g�� 'r� e* �� ,.i Icl �li '`�'`'!�` �y`� � `� i":- ��r ..:� � c+r'� y .. �,<�'y' �.s�s"�r��: � �.,r-=.�- i I i � , ' - ki -cr„ r �,y',. � ; ',�f { �i� y ��y "..vr - . A`-kFy+Af�r � n,; M��,3 .` 'd' �µ,-µS� �`��r��F " �+•C�'��`a,� + 'S.,��d^1'.e�;Y�x' ..-s, , , � M ,�'a e{. F y. � � a _-• . c-i '. ..� .;.'t y dr�1'?�w q'b w ,�'�''+�� y �,yr �-�i� 'S � . �' � �� Sy �,. � •p ;� -. 1� �_y �� v r. f� w�i� +�`' ,y k'"'.��^ .,� �,�t 7' ^'t`��. -:y - #°�`... � S..< Y'" ,.��IY 'a.✓3'�. ..a { 1:'- �'c$' R�>s i '' _.��° -'r 'u ��_ - .n r�' �S r. �a`�, Jx ' g `'� �'= �+ �'` 'di `T""'''� „C �h�. 7rJ.,$�} : � 'S-��wa��^,n��rF � K�r� Y��-� ��-� k 1�.� �� r - � �:' aw�dy �'�Kxf^�Y' P �t' �J� '. �a `j7��'"-�1Lyt f . �� .#P � " N .J� f Y Y. f � �� y T r 7+ �Y . f ^�F4 e1^7`v�'+F �'�� M � .�'� v!Y -.�� d} . �._ � ...�.`> z ,� •..�,'rt Y�t,•d� Y +�� '�.y '�:. _ .F .�,�� aR� $ `�. , , J i �'�: �� 'k'j � a .��.- `��:i '!�`'' � . ',. '�.n�" S�� ;f� rn ' i.: �„ . �- - �' i L,J � i ,� ` 1�'- u �T�S`;�ro�r� � �'+ . -, * .�t.�/��,`1ff�.�k-�,i t� ' : Y� a �' � -t�. �.�' y+�}:�I _}`�Y�Y��y FJ� �e j� ♦ E �r4�T"t � Y' 1 f 'i '2•S 3 � �5 GY'4� Y .� � . �d r-,r-'P r ' `,y�.g � ;:r ,� £4� ,2 �y-��l s'. � �,,��'4+� �. :•�,� t-- �� [';" s s�i' ��ati;''��,'�� '- y'� �� '� _' tl'F �w� '.,dsa '§��f � y` �� :;.t ��""� °.�i�.��: 'JF �ir'��.-�Y"` �i: ' �l'�.t. . iS ,:.�.q�,.��,�'��' �� '��'t �"t � � � " f � , =5-,+� '` ' ti.4 �� s '1 �.'l � t-` �a:`� 3 ��- r 'n � � S�— f.�-s +� {3^ y� t�;�'�•d k��'< �'�Lrs� 6 �{ .4�� v � . �..5_ Y A fiS � -ifF .t ��" .... r �{ � � ' �'j � � � ��.'{Zt.�'.�.i`it� �k- �'�`�}��i��rvi � �'T-n '.' i�.�`j dS..YJ�^;,". y�� q � �'. 5t� ��.f. �j �'��h� 2.. '.�F� y S� y �+µ �If . J '� ~i�. 'R� �AiEn 5-`& �x�• ��i��tt,� i *-y r� � yUtv ''r � ;t') � �y ,, 5� �� ' � ? ,.� ' . . � LL � �{ j ti �. � -. � r F N �i . ..y-.4r�x-'��t ,r� .q.Y � x � F '-�f :3�'" ` , }l�,..`�W-� i�s��il� ft ��.F � �� "t .' J `"��'�s� 4'v F � }��,�f " . � st.f' � j://< r � ; t� � � '�'�! 'YlS��* • - x �. ��`� .,� h- !� �`x,�', � A� � -"r� � �'��.r r. �t.t ��_--Cff`�-. . � 'K' .7. ' �3 +Y 1� �": �}N• c�. T'!'�.,�..,.'�,. , _ � `.� .- ��s ) � , r�!� _�. 3 • .: ��--��`+ � �-�. ,�. �_, - ^'Y � f � •••'�'a }�f 1• ` ~`+{ YA+ �i�- � �A •'3�. -� - (4� -� � � _' �'�a1�.�.. ' . y+iF��y 'nTS C i :—`? 1 @ �'. J +Y �Y �V� t �° . ' �y?�� S µ T � � '. `w s+ �_y.�y� }y • 4 I. J ..f ^1 �'� h 'rJ 3� ` � 3- fr�i rnp �i,3.S' + � 4 r4 � .H }� �� 't� +i �` ¢� :. �Lt - '* 4S l�'' -ha � '- y^ , �'� 4 � y"'�� rt „p�y � � .T' r�y�7•4 � �� %5 ,c y4A� ti f F'�Y,c •.,�.n_..l, y�� : 'r �.n:..�r''��. - �� .�`i�;'� '1t=�f�' -w ' 'S`-. �yt+ � ..� -- ,t..si�_"_- ,�,-'l. .. � Y r�x�' ' _ t}r !�, =1 -' �7 � :' - f .�, ' � s �Lr i v �-..d . .c ,� � x ��"�' �''� �,��' ;�� 'S,¢ s-�il r5 i-�� .c i : x _,�r� C- r .}S � ' � _ �,, ., � � n, t r' �� '- � � 1v '�: � P .'• � .�� r'�.4 .!yy� ' .. i ;- �fi� y .. �'• _ .."�,+ . �,,. � r � �'�,`tie'. Y T y-, '�s r��a��dY f�•" � �(M �. * .. t ' t .Y� 'J"�XE^��E1 � ;�ry'� �yy '�'__.� '..t�- r.�_ � �: �5 �� 4�K �s� . -..�.�� y l�` �r i �_� � * �i 7 f�f . �'.�cy�'� vA _ c.'�' i�� 'r ``}'�I �'`�° a :l.� . .;� � ` �� , k �:. � ��s� i �� „ > � � �~•y�� }��r �, I r��l �'^r��.j�,� t `. �4'� �� ' � � � �_ _. S,'S1 '.E.fY w; �,' � `� «. / ��ix' M!�. -�!�� ti . �F� � i4,. � t 4�� .: , . �a•' R ' .}, J s i �r� v ��-+t�� f�� p" _.�. w� � 1�'l 1 h�k j _ � i i I�.l r! � l r �.i � 3 [ Lr S y�+ � � �� ,�, ' r-- , ." r � �, � �"�' � � � � �- : �'��'' �� i*S' . ''�" � ��'x •' 1 i r k.,�,n_..: � v � e= �T �f_`k7r- ^- F r _{t. , 6 � � .. � t.. _�,�-4 .'. �{ ',� i �♦ .v_: Apy n'4'': ✓` � �/ . �� f. t Sh S% $� ��a - T ' �t .�� 1 tT�lj� r _ 4j�Y ]� t4•{.{ . ^ ��y�� f ry � � �. � �t��'4 S �� { p� w,Fr� X� 1 1I; ',}.�'�� '��t'��f*<P .��: .::�..s jF � .�...h;;�.[.f �� -t4 �� nTy T+�.: '-G ,•�. _ ! ��} � _- ti ��, c r: cc - "r' " Y � ' , �tF Fµ a � �� .��. � � i f',;_. £ � - . � .y -.:h ,0*-.1� ' _.y.:' � r " za�s :c�kn �j�,' '""``' PRIVATE ONSITE WASTE TREATMENT �ounty <,�___� :�=;r� ;� � o$ � ��, SYSTEMS SaWyer ��'� �s � POWTS ,�� /�' ( ) ��';s�-"y� INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION � r-��g 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#: �. L d wi.��,4 �Po..� c.�l,c�. � Insp BM Elev: BM Description: Parcel Tax No: loo.�` ��r, 0 5;�1� o�.y.- 6Y1- �-6- �3�1 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Benchmark (oo.o� Dosing Aeration Bltlg. Sewer �,'7' Holding �,,�� pp St/Ht Inlet �1�.9�' TANK SETBACK INFORMATION St/Ht Outlet 96�?' TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet AIR INTAKE Septic NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. Holding .1-(�0 .}-too � � �-Ya' G� � Dist. Pipe PUMP 151PHON INFORMATION Infiltrative Surface Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS W L #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav ° Conv ❑ Aggregate INFORMATION P�L Bldg Well Waters °� G ❑ Chamber Model Number: ❑ EZFIow CELL TO ❑ Mound o Other ---- --.... ----- -— DISTRIBUTION SYSTEM x Pressure Systems On►y Header/Manifold Distribution Pipe(s) I X Hole Size X Hole Observation Pipes Length Dia_ 1 Length Dia Spac _ � Spacing ❑Yes ❑ No SOIL COVER -- _— — — ---- —— — — _ De th Over De th Over De th of Seeded/Sodded Mulched Cell Center I Cel�l Edges � Topsoil 1 ❑Yes ❑ No � ❑Yes ❑ No l COMMENTS: (Include code discrepancies, persons present,etc.) 7��►5�� l 1 � 3�� „ � ��1� � �,,� l�v i hJ ca�� J ____— Plan revision required?❑Yes ❑ No p 3 I 3 �3 -� �cr�j� / _ -- _ - _ �O Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) A��ITIONAL COMMENTS ANO SKETCH NITAAY PERMIT NIJMBEA:��__=_�___ � , /a� �� 9�� ,�� f , -_ ; . _. _ - . ; _ __ ; _ _ _ ___ -_ _ � � we..l� i , ._. _ ; - -, � ._ . _. � ° � ��-r• �o , ; � . . , . ,...___. � . . .: . . _ _ W��,o , , , . N� , /.� _ . . �' . , . . . . ._ __,_ .. .. . . . Y` . . . `r . .. . .. . , . �� - - - - - - - - -0 tio ;��q�o��l�f y° �� s �'se.so�.l n J�� .N�IV 1•ty a . . Q��- �� \ � ca�0�h ev CG� I �� `� `` �--P�— �°_