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Home My WebLink About032-338-22-5221-SAN-2022-326 _„`"""^�% Department of Safety c°""`Y �a�_ � � � _ & Professional Services, ►� Z _ .� _ � Sanitary Permit Numbe (to be filled in by C ,, �, �_ � Industry Services Division ` , � 3 � 3os � �.�,,,,,,::,..�, Statc Translc[ion Number � Sanitary Permit Application / � In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit � — L r l}J S7 �� is required prior to obtaining a sanitary permit.Note:Application forms for stateowned POWTS aze submitted to Project Address(if different th:ui mailing ad p� thc Department of Safcty and Profcssional Services.Pcrsonal information you provide may be uscd for secondary purposes in accordance with the Privacy Law,s.15.04(1)(m),Stats. /' �� I.Application Informallon-Please Print All Information �C�� Property Owner's Name Parcel# �1.<< 1� �P�e�� << s L l.0 o3�-33�-�� - s�a 1 Property Owner's Mailing Address Property Location �1; 111s—�J C�. �I l.v Go��.�ot � City,State Zip Code Phone Number �� / , ,�1�� / � ,T 'C�r�� Ya, '/,, Section �s(.•s l (�'V-J— �J � Il.Type of Building(check all that appty) Lot# � T N R � E o ❑ 1 or 2 Family Dwelling-Number ofBedrooms _ Subdivision Name �� Block# �Public/Commercial-Describe Use ❑City of ❑State Owned-Describe Use CSM Number ❑V illage of __ �Town of LL,� �n e✓_ III.Type of POWTS Permit:(Check either"New"or"Replacement"and other applieable on line A. Check one box on line B.Complete line C i a ticable. A' ❑ New System �Replacement System ❑Other Modification to Existing System(explain) Additional Pretreatment Unit(explain) B' Holding Tank ❑ In-Ground ❑ At-Grade ❑Mound ❑ [ndividual Site Desi�m Other Type(explain) � (conventional) C. ❑ Renewal Before ❑ Rcvision ❑ Change of Plumbcr ist Previous Permit Number and Date Issued ❑ Transfer to New Owner 6xpiration z� -- � � I�I�( �2 IV.DispersaUTreatment Area and Tank Inform$Non: Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(sfl System Elevation `/�2 S l�l i'� N � N A N �. Capacity in Total #of Manufacturer Y Tank Information Gallons Gallons Units ,D � o b `_' New Tanks Existing Tanks � � � " � � �a c�`"a ,, o � a U 'v� " �n u. U a Septic or Holding Tank L.� � � ��.��-�� Dosin Chamber g � Wo -F t5on V.Responsibility Statement-1,the undersigned,assume responsibility for installation e PO S shown on t6e attached plans. Plumber's Name(Print) Plumber's gnature MP/MPRS Number Business Phone Number �r�� 1.ant ^ ��c.�: �� 02��1a �715��(��`�� P(umber's A ress(Street,City,State,Zip Code) �o �S`1"-� �o� "� IZ Gr,/crl-�e�, j,�..�L S�`�SZIo Vl.Coun /Department Use Only 1, Permit Fee Date Issued Issuing Agent Signature �Ap � ❑Disapproved -�}-�� 7'✓ ❑Owner Given Reason for Deniai $ `��"� I �/� � �� '""""`�/' "" ' " Conditions of ApprovaUReasons for Disapproval �te �t��-( ��- D ��,��.�!�_��1-,'~��j'4; �t i �' '�� .`hk#.�N m e� qq�E ;,`f — /� '?Cfi�'��rLa1 �S?�.�.� ��Ci�l OC� � � L�LL - f...._,� C ✓ 1 �O\' �� :>.`iV�(�'(_�� 1.,��.'ti''S�i"`�t ', J � r.. t C' a '_ Attach to wmplete plans for t system and submit to the County only on paper not less than S t/2 x 11 inches in size y� j 'S ^-� —� 1 SBD-6398(R.03/22) NO REFUNDS AFTER ISSUE OF PEFMtT Sawyer County Zoning & Conservation Administration �� 10610 Main Street, Suite 49 �,�,�,� �, ., �� Hayward, Wisconsin 54843 � ` `�,�� (715)634 8288 � ��,��,� �� I � � ,o �� , ,�� FAX (715)638 3277 / � t SJ y ` � . RAIµ. 11 �1C COI1 ZaOti_c�,i� RaY� / � � .. l� ,�� E-mail �cmi r,� � ,u�a t�uc,rii3�7 �s,o� c3��. � � =�i , , � Toll Free Courthouse/General Information 1-877-699-4110 I� :.:� � � �. . ��r� + 1ti�``�`�� Holding Tank Approval Checklist I. Sanitary Cover Sheet Date Stamp 1 O / 21 / �� Parcel ID# b 3 a - ,3 3� - 2 2 S`'2 � \ ll. Plot Plan �Property Lines � Benchmark BM ♦ �Site Address �North Arrow �C Structure �p Scale �Well �< 25' to Service Road � Legal Description � Nearest Road Intersection � Setbacks to: Properiy Line, Well, Structure, Water bodies, Roads III. Required Plans � Index Page with Original Signature Management Plan/Contingency Plan � Servicing Contract � Holding Tank Agreement form IV. Holding Tank Specifications � Cross-section — Manufacture, Gallons: ��`rC'�w� 3�d"� � � � 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 < 1/2 " V. Holding Tank Plans per Component POWTS Manual � Version SBD-10855-P (R3/07)�,,, � • � Owner: ��_ q � ��tl$ ��C� Plumber: � T< � Application Review Date: �� 2 Y � 2 � � POWTS Reviewer. �i� l�/ Name � �� 5� l Licensc# Revised 4/11/2013 \;�._�KI�!/_�i� Wisconsin Department of Safety and Professional Services Phone:608-266-2112 i��- Division of Industry Services ��% , , Web httn:'dsps��i eo� 4822 Madison Yatds Way I=� � ! _ EmaiL�I,p,u y_i,wn,in •o� PO Box 7302 �; �l�': "' Madison,w[53�07 �,, ;;-` Tony Evers,Governor �;. �..,,,; k �__—,�; Dan Hereth,Secreta �y�11111\��,/ � �__ October 14,2022 CUST ID NO.:220810 Identification Numbers CRAIG S THOMPSON Plan Review No.:PWTS-]02202574-C 5089N N THOMPSON RD Application No.:DIS-092248680 WINTER,WI 54896 Site ID No.:SIT-107836 Please refer to all identification numbers in each conespondence with the Department. CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/14/2024 MUNICIPALITY: CONDITIONALLY TOWN OF WINTER APPROVED SAWYER COUNTY 4'EPT OF SA=ET'Y AND PROFESSIONAL SERVICES GI�;'l�iON OF INDUSFRY SERVICES SITE: PLATH RENTALS 1115W COUNTY HWY W � WINTER,WI 54896 �� C.�• PRT.GOVT LOT 2 S-22 T-38-N R-3-W LOT# 1 SEE CG ESPONDENCE FOR: Design Wastewater Flow Value:426 Holding Tank Component Manual-Version 2.1 (May 2022- Public Use: 50 set bar with paper service meals,2 employees 2p2'7) Limiting Factor(s):NA Maintenance Required: Holding Tank with Grease Interceptor SITE REOUIREMENTS • A full size copy of the approved plans,specificarions,and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The foilowing conditions shall be met during construction or installation and prior to occupancy or use: • This system is designed to serve only the uses indicated on t6e plan.If the use of the building changes,new approvals will need to be done and additional components may need to be installed. • This approval does not include plans for the general plumbing systems or sewer piping leading to the taoks that may be required for this projec�t. • An inlet and outlet baffle as described in SPS 382.34(5)(c)l.f.s6a11 be installed on t6e grease interceptor. • A minimum 4x6 inch permanent label shall be affixed to the manhole cover of the grease interceptor identifying the tank as such per SPS 38234(5)(c)l.i, • All other conditions of SPS 38234(5)(c)shall be followed for the installation of t6e grease interceptor OWNER RESPONSIBILITIES • T'he current owner,and each subsequent owner,shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis.Admin.Code§SPS 383.54(1). • In the event this hotding tank or any of its component par[s malfunctions so as to create a health hazard,the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for confovnance with applicable Wisconsin Adminishative Codes and Wisconsin Statutes. The submit[al has been CONDITIONALLY APPROVED. This system is to be constructed and Iceated in accordance with the enclosed approved plans and with any component manual(s)referenced above. The owner,as defined in chapter 101.01(]0), Wisconsin Statutes,is cesponsible for compliance wi[h all code requirements. No person may engage in or work at plumbing in the state unless licensed[o do so by the Department per s.145.06,stats. All pertni[s required by the state or t6e local municipality shall be obtained prior to commencement of cons W ction/installation/operation. In gmnting Ihis approval,the Division of Indushy Services reserves Ihe right to require changes or additions,should conditions arise making them necessary for code compliance. As per state stats lOL IZ(2),nothing in this review shall relieve the deaigner of[he responsibiliTy for designing a safe building,structure,or component The Division does not take responsibility for the design or cons[ruc[ion of the reviewed items. Inquiries conceming this correspondence may be made to me at the contact infortnation listed below,or at the address on Ihis letterhead. Sincerely, Fee Reqmred:$90.00 Fee Received:$90.00 /'��'� Ti�� /��r�� Balance Due:$0.00 � �t �� Refund Ex ected:$0.00 CeCe Rudnicki Division of Indus[ry Services Phone:6 0 817003 1 8 6 Email:elizabeth.rudnicki@wisconsin.gov �� HOLDING TANK DESIGN Single Tank Option INDEX AND TITLE SHEET Project Conners Lake COh"DITIfJ:�',�LLY APPROVED C`.P7 JF;-:.=.F'�;Y AND PROFESSIONA�SERVICES Owner PWM RCnhals LLC LiiV;S➢.;N OF INDUST0.Y SERVICcS Address 1115W County HWY W i Winter Wi 54896 CQ , �C.k-� �5+—�-SEE CO :tiS�ONDENCE Legal Description PRT.Govt lot 2&22 T�8-N R3-W Township Winter Counry Wi Subdivisbn Name Lot No. 1 Parcel ID Number 032 338 22 5221 Plan Transaction ID Number Index and title shaet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingenq plan Page 4 Grease InOerceptor Cross Sectio� Page 5 Designer Crei TFwm son Signature �T�J� Plrone No. 71S26Cr2842 Lice�se Number 220810 �� 2 Despne0 punuem m: HWding Tank Component Manual For POWiS(Version 2.71 C m� adaa - aoa�) vaswnzo(7in2) Paget of 5 HOLDING TANK SPECIFICATIONS �Number of bedrooms 425.0 Non-resitlential esdmated flow(gpd) 2125.0 Minimum holding Fank volume required(gal) 3000.0 Proposed hoklin fank p aci ( al) Huftcutt Tank manuhacturer 3ppp Tank modelnumber Tank Alert Alarm manufacturer 101 Alartn model number Tank Dime�rebns and Data Tank Mehor Cakuladona � 68.0 Liquid depth bebw inlet invert(in) 20�00 Ibs Weight of tank 8.0 Maximum depth of soil cover(ft) 1.10 Safery factor 785.0 Length(in) 23275 ibs Weight of anchor required 92.0 W icF►1� (in)}Outside Dimensions 28.5 in Soll cover req.far anchor,or 5] yd' Conuete wunter weight HOLDING TANK CROSS SECTION manhole cover wiM locking device and finished �waming labal �P� � 9� �yo�� 12"min. � E 23"min. 4"min. vent pipe cunduit� tether �g•min. weight I b�� Note: All tank joints, � W and pints between --�rv� �� pnk openings and 12 in.� building to seal piping are sealed sewer inlet outlet ��yr tight. Pipe and vent materials comply wiM SPS 384. qg.0 in. Manhole and vent bcalions Electrical is as may be reversed. per NEC 300 and SPS 316. ��. 3 in.beCtlinp undM hnk. 7ank is anchoietl as necesse7 to nepale buoyancy. i Because of Mm tank'a rounEetl aurtace,wG cwer abne may not De atle0uals M prevent Ilafetion. I Project Conners Lake � Transaction Number: Page 2 of 5 � HOLDING TANK SITE PLAN Project Conners Lake N Legal Description PRT.Govt Lot 2 S22 T-38-N R-3-W SubAiviswn Name: Scale: 1"=30 R Parcel ID: 032 338 Y2 5221 Lot No.: 1 seq r"' Nw �� isd I OE/ I � — — — — — — � i �,,.,�:,..� fl�e�. � ��m +�„o J'��"' � I H.?_ y I � H°�^> I P � � r �O I 1a05�uoe� �! G�Yrlt.l�� I � /��/�— /`� �`� �� /`� /�� j� ~ �onne('S �� Trensactbn I.D.: Page 3 of 5 ' �1 � Sp�Ke i n 16" ma.pJe Trce �m= lw D' HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewatw Treatrnent System(POWTS)has been desigrred,and is ro be instalted anC maintained accordirg to SPS 383,Wis.Admin. Cade,the Hdding Tank Component Manual(SBD-10855-P N.03/07, R.01/12),and the Wi Counry Sanitary Ordinance_ 1. This POWTS is designed to accommodate a vrastewater tbw of 85.0 ro 600.0 gpd. 2. The owner of tl�is POVJTS is responsible for system operation and mainffinance,including all provisions in the attached Holtling Tank Servicing Contract and Maintenance AgreemenLa. 3. Each dme the wastewater in the tank reaches 90%of the tank(s)capacity w a level of 12"bebw the inlet (at which time the alartn activates),Me pumper listed in the curtent Setvicing Contract must be called to empty tlie tank's contents and dispose of them in accordance with NR 113,Wis.Adm. Code. 4. At each service event,the service provider should visually inspec[the conditlon of the tank,risers and manhole cover(s)and verify that the alartn system tunctans and manhole bcking devices are present. Discrepancies are reported to the owner in a timely manner for cortective action. PJI correcWe actions shall comply wdh the county sanitary ordinance and SPS 383 and 384 Wis.Adm. Code. 5. All service events or inspections of this POWTS shall be reported to the counry within 30 days. 6. The owner may not remove any of the vrdstes from ihe hdding tank(s},w cause such wastes to be rertwved by any person not autlarized to do so uMer Ch. 281,Wis.StaWtes.The dischar9e of wastes from this hold- ing fank to the ground surface,including inten6onal discharges and discharges caused by neglect,constl- tutes a failing POWTS arW may resutt in issuance of correction orders or a citatan by the counry a state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards tor entering a confined space. The atrrwspha2 wiM�in these tanks may contain IeMal gases, and rescue of a person from the interior of the tank may be difficutt or impossible. 8. In the event that this POWTS fdils and cannot be repaired,a code compliant replacement hdding fank may be installed in the same bcation(a new sanihary permit is required fw such a replacement). Connectbn to municipal services woukl also be cwnsidered at this time'rf they are deemed avaiWble M the property. 9. If this POWTS is replaced,or its use discontlnued,components no bnger in use d shall be abandoned in accordance wilh SPS 383.33 Wis.Adm.Code. 10. If there is a problem with,or question aboul Mis installa0on,the following persons should be contacted: a. Installec......._...........__.._... Don TFampson 8 Sons Exc LLC Phone: 715-266-2842 -- �� ---�� _. . .. — b. Service Provider.... . ............. North West Sanitary . Ptane: 715943-2650_-- —._____----- c.County Zoning or Heatth Dept Sawyer County Zonina Pho�e� 715 634-8288 11. ------. .._.._ _ _._— Project Conners Lake Transac6on Number Page 4 of S" �- ;. � �� 3� � � � j��a� ' � 1''f � � � � � . �, � _� � �, � , �, �� $"= ��' � � =Ea� � � ➢9u � � � A ££ � �j, r f � 1 �f R � t 1 • i ��I� � � q�Is �8�� . � F! I �� F � � q; @ J �� S � � �� € �4 "9 �---- ----- -, � q_ g � � �� ga �� p � �g � � s � � F� �� ,� g � � � q � s � �� a�� I� � � � � s �� RFS� �'a ft � I�j1 M ' � � #� ' � � � � ---------------- �� r-'- A, � ' e I ^ - - � "g � , w � � �� p. � r - - ! �r i i :� 1 i 'm �i� O � - i r �' i )"�� ' 1 1�y �� F� ■ � �} � 1�' �� F I � ��: � � 1 � ' ��; , ; �a; ._. �--------------------- rwac, a w a. �u�. wr. ��CONCREIE. NC. as� izav s�ct I��'� NA.L.A�om Mn 11K.fPrC�RCM0. G�/[W i�LLL N llRf �' �� ' i QFwY p1G1?IIOe Ad f2}1Mf • F4Y T9 lLi-11tl � ��-BL ..�lv I aRtw� '!'� �l1�rt�IIIBI�1i01��Ltl6 __ P�5e 5 (,�oRK �1�� i� �.at l� �er�-��s � a� c� �neals -�/I � S � ic r�+rvn �/v s .�t, f,an 0 Se4t Cti ac. rk S = L o0 a � lo ees I3 � e�( - a� � �� l � � ��•rn4�.0 a r IJkJ �l02� � ��C X �' �u /i.vl��n — c� 13Z� / 1i n�c�� T�� /,�PP,��..�, �} l,uvc� �Sa ll�� ,5�e�.5e G i+��erC' e a�P c� 3� - lldn l��I�,'� �vc,� c�i l �e. �tiS��c`�e� HOLDING TANK SERVICING CONTRACT Contract Date: � / a / � This contract is made between the Holding Tank Owner and the Pumper. Holding Tank Owner's Name: Pumper's Name: Northwest Sanitary, Inc. � ��1 � � � � PO BOX 155 r Radisson, WI 54867 Parcel Identification Number: (12 Digit Legacy ID) � �a - 3 3 � - a � - s � � � L The owner agrees to file a copy of this contract with the governmental unit, Sawyer County, which has accepted and recordcd with the Officc of the Registcr of Deeds, the Maintenance Agreement for a Holding Tank required under the Sawyer County Private Sewage System Ordinance for the issuance of a Sanitary Permit for the installation of a holding tank(s). 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain thc all-weather acccss road or drivc so that the pumper can service the holding tank(s) with the �umping equipment. The owner further agrees to pay the pumper for a charges incurred in servicing the l�olding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the Governmental Unit, Sawyer County, a report for the servicing of the holding tank(s) as required under SPS 383.55, Wisconsin Administrative Codc and thc Sawyer County Private Scwagc System Ordinancc. Thc pumper furthcr agrees to include the following in the report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The site address of the holding tank; d. The date the holding tank was serviced; c. Thc volumcs in gallons of the contents pwnpcd from the holding tank for cach scrvicing; f. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner a�-ees to file a copy of any changes to this service contract or a copy of a new service contract with Sawyer County within ten ( I 0) business days from the date of change to this scrvice contract. �WrieT'S N11rie: �PI7rit� OWriCl''S Sl�riahlTO: (Only one owner signature required) i mcr�l �' ��cc� �l c��' - . - �� Pumper's Name: (Print) Pumper's Signature: Ronald L Vieceli, owner Northwest Sanitary,lnc �✓ �� / ��C�%'c-- ��,�,� L Pumper's Registration Number: #2389 Rev. 03/26/I 3 10124/22,327 PM Reai Property Listing Page R2dl EStdte Sawyer County Property Listing Property5tatus: Current Today's Date:10/24/2022 Created On:5/14/2021 9:57:32 AM �Description Updated:6/20/2022 �Ownership Updated:6/18/2021 ' Tax ID: 44157 PLATH RENTALS LLC PH[LLIPS WI I PIN: 57-032-2-38-03-22-5 OS-002-D00210 Legacy PIN: 032338225221 Billing Address: Mailing Address: MapID: PLATH RENTALS LLC PLATH RENTALS LLC � Municipality: (032)TOWN OF WINTER N9192 ELK RIVER RD N9192 ELK RIVER RD STR: 522 T38N R03W PHILLIPS WI 54555 PHILLIPS WI 54555 Description: PR7 GOVT LOT 2 LOT 1 CSM 37/92 1� #8543 r Site Address *indicates Private Road RecordedAcres: 3.270 ...-.._..-.-.. .. . . . ---..-.--..... . Calculated Acres: 0.000 Lottery Claims: 0 L.�Property Assessment Updated:6/24/2022 First Dollar: Yes Waterbody: Connors Lake 2022 Assessment Detail Zoning: (C-1)Commercial One Code Acres Land Imp. I ESN: qZg G1-RESIDENTIAL 3.270 267,800 11,200 2-Year Comparison 2021 2022 Change ��Tax Districts Updated:5/14/2021 Land: 0 267,800 100.0% 1� State of Wisconsin Improved: 0 11,200 100.0% 57 Sawyer County Total: 0 279,000 100.0"/0 032 Town of Winter 576615 Winter School District 001700 Technical College '.a�property History Parent Properties Tax�ID + Recorded Documents Updated:6/20/2022 57-032-2-38-03-22-5 OS-002-000130 32913 WARRANTY DEED 57-032-2-38-03-22-5 OS-002-000190 42612 I Date Recorded:6/17/2021 432697 � AFFIDAVIT OF CORR CSM I Date Recorded:6/13/2022 439643 CERTIFIED SURVEY MAP Date Recorded:4/30/Z021 431612 CORRECTIONINSTRUMENT Date Recorded:8/S/2018 413751 CORRECTIONINSTRUMENT Date Recorded:8/8/2018 413750 CONVEYANCE RECORDED NOT USED Date Recorded:7/9/2018 413195 CONVEYANCE RECORDED NOT USED Date Recorded:6/19/2018 912878 ABRIOGMENT OF]UDGMENT Date Recorded:2/13/2018 411112 TRUSTEES DEED Date Recorded:2/8/2016 411015 QUIT CLAIM DEED Date Recorded:11/18/2016 404011 QUIT CLAIM DEED Date Recorded:10/10/2016 403363 CERTIFIED SURVEY MAP Date Recorded:6/29/2016 401778 WARRANTY DEED Date Recorded:12/28/2012 382676 WARRANTY DEED Date Recorded:12/28R012 382677 WARRANTY DEED Date Recorded:12/28/Z012 382676 WARRANTY DEED https:Nlas.sawyercountygov.orglsystem/fremes.asp?uname=Enc+yyellauer 1�2 ( 10/24122, 327 PM Real Property Listing Page Date Recorded: 12/28/2012 362675 WARRANTY DEED Date Recorded: 6/21/1988 209616 WARRANTY DEED Date Recorded: 6/8/1987 204931 CONVEYANCERECORDED NOT USED Date Recorded: Child History Remrd Count 5 - HISTORY O Expand All History White=Current Parcels Pink=Retired Parcels O Tax ID: 32911 Pin: 57-032-2-38-03-22-5 OS-002-000110 Leg. Pin: 032338225211 Map ID: :2.11 O Tax ID: 32907 Pin: 57-032-2-38-03-22-5 OS-002-000070 Leg. Pin: 032338225207 Map ID: :2.7 O Tax ID: 42610 Pin: 57-032-2-38-03-22-5 OS-002-000170 Leg. Pin: 032336225217 O Tax ID: 42612 Pin: 57-032-2-38-03-22-5 OS-002-000190 Leg. Pin: 032338225219 O Tax ID: 32913 Pin: 57-032-2-38-03-22-5 OS-002-000130 Leg. Pin: 032338225213 Map ID: :2.13 44157 This Parcel Parentr Children https:Otassawyercountygov.orglsystem/frames.asp?uname=Eric+yyellauer 2�z , 1�.��5} *� x+s��:� �'� .?c w+L i�Z. �y�.,�� .�'h�4: "`7 3 fYt'\ u ♦ : �.1C`l,., i3 S�.'h'�1i . � '�'�S* �"" .�.r Y ��`a.�� '�n., L '' ..i� i�`a�,i"c?n "'Fy ��c:F. 4`i..��i.ir :��c�c;, 1 i+� �y�{�"�.F:. - t� t t `t.. 3�� `I � i' -t E,� �y� � i � • 9 g ? S '�� SE7�t''"s",�',�, _ '��. '�z � �ae,.. y ti � �� y;�` v v,�� r,r,�,t r� E�,.�.�� . 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X .4U'��JL�J For Holding Tanks 441978 PAULA CHISSER O+nmer'sName(s) asshownondeed: R�C',I�TEFt OF DEEDS � �� SAWYER COUNTY, WI � � � 1aJ25I2022 0$:29 AM Parcel identification Num6er. RECORDING FEE 3D.OQ (12 Digit Legacy�D) 0 3 a - 3 3 8 - a a - s a � � PAGES: 2 Legal Descrip[ion oi Property: - SE� A�"�ACS�ED SEi�ET' - NJe acknowledge that appiication is being made for the instailation of a hoiding tank{s)on the property described on the attached sheet Retum To: Sawyer Count}t Zoning and Conservation Administration �0690 Main SL Su'rte 49, Hayward,W154843 As an inducement to the County of Sawyer to issue a sanifary permit for a holding tanic on ihe above-descrihed 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 SPS 383, Wis. Adm. Code retating to hoiding tank management, including the following: 1. The owner agrees to contract v�itl� a person who is licensed under Ch. NR 113, Wis. Adm. Code, except as provided by Section 281.48 (3) (d), Stats., to have the holding tank properly serviced and to file a cooy of the service contracf wi[h the governmental unit. The owner fiurther agrees to file a copy of any changes to the service contract, or a copy of a new servics 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 governmental unit in accordanee with SPS 383.55, Wis. Adm. Code, for the senricing of the holding tank. In the case of exemption under Section 281.48 (3) (d), Stats., the owner shall submit the report to the govemmental unit. The govemmental unit may enter upon the property to investigate the condition of the holding tank when pumping reports may ind'icate 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 governmental 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 Sec6on 145.20(4) Wis. Stats., a govemmental 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_Q703, stats. The owner agrees to pay all charges and cost incurred by Ehe govemmental unit for inspection, pumping, hauling, or othenr✓ise servicing and maintaining the holding tanl: in such a manner as to prevent or abate any human health hazard caused by the holding tank. ��uuuu�� . This agreement will remain in effect only until the governmental unit responsible for the regulation of private s��'a�e s�te�p�, �i,� certifies that either a soil absorption system that complies with SPS 383, Wis. Adm. Code, or a municipal se `�cerves me , tip '�,,y property. In addition, this agreement may be cancelled by executing and recording said certification with refe�ice�this J • J�� agreement in such manner which will permit the existence of the certification to be determined by referenG$y�tEie q�operty!� . � ^ — . Q � m _ 5. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The��n�r gFiafl s6bm�j ' � � • O � the agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a Fpa'T�,ner�G�I' h wi141 � permit the existence of the agreement to be determined by reference to the property where the holding tan(Gi�stall�. , �P��' •Qnly one owner signature required - ACKNOWLEDGflAEfUT f'''�O�►��'��``````` Ow er ignature: State of: '�' �� • � County of: pNrn Name (Print . `I Subscribed and swo to fore e on this `�r �day of C IUt� , 2� c� Oate: By (Owne�'s Name): � '� �L � .-�� Notary Public Signature:� � � �rafted by: � Public Notary Name (Print . D ► � ✓av� %;dl�°� �/� My commission expires on: '`f�02 S �d 3 Personal infonnation you provide may be used for secondary purposes [Privacy Law, § 15.04 (I) (m)� Rev. 0312fi1'13 L�GAL A��CRIPT�Ol� Lot 1 �ts recorded zz� Volume 37 of CertiCied Sut•vey M�ps, p�ge 92, Survey No. 8543 as Docuinent No, 431612, loc�.tcc� iiz the Towi1 of Winter, Sawyer County, Wisconsin, being a p�.rt oC Goverilznei�t Lot 2, Section 22, Township 38 Nor�h, R�z�ge 3 West. Grantoi•s t�heir sttccessors �i�d or �ssi�ns retain a iion-exclusive easenlenl Cor iiagress, e�ress �nd uCiliCy as shown on CertiLied Stirvey Map referred to lierein Cor the beiaefit oC Otttlot 1 as recorded in Valltrne 37 ot' Certified Sttrve� M�ps, p�ge 92, Survey No, 8543 as TJoclunent No. 431612 and Lot 3 �s recorded in Voluz�ae 10 of Certified Suz•vey M�ps, page 93-94, SL��•vcy No. 2132 as Document No, 191227, �till located in C11e Towu of Wi�lter, Sa�wyer Couz��y, Wisconsi��, being a part of Go�vet•�linent L,ot 2, Section 22, Tawnsl�ip 38 Nortl�, Range 3 West, /�=�'—"��"�":��;r; PRIVATE ONSITE WASTE TREATMENT county �� SYSTEMS ��;� osP ��; Saw er `��_ $,��' ( POWTS) Y i'Npfis�-y-�� INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) /, GENERAL INFORMATION �2 �- ��a Personai inYonnation you provide may be used for secondary purposes[Privacy Law,s. L 5.04(1)(m)] Permit Holder's Name: ❑City ❑ Village I� Town of: State Plan Transaction ID#: �P�orl�► t��a��s L(.�— I��,� � Insp BM Elev: BM Description: Parcel Tax No: lc�,c�' `�C— �� ,� 03�, '338 - a-2—5�a2 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Benchmark �� Dosing � � y� g� Aeration Bldg. Sewer O �6,� ' Holding �� w, �o�p G�', 3 c� k J /Ht Inlet �,� ' TANK SETBACK INFOR TION S�Ht Outiet TANKTO P/L WELL BLDG AR"Nr°KE ROAD G,� �, `��.� ' Septic NA A�-Be�snr'G,Z- p.�T q� �- � Dosing NA Installation Contour Aeration NA Header/Man. Holding � 3( � ,f/� ' �� Dist. Pipe PUMP/SIPHON 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 Celis Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav ° Conv ❑ Aggregate INFORMATION P 1 L Bldg Well Waters °� G ❑ Chamber Model Number: ❑ EZFIow CELL TO ❑ Mound o Other - --— -- _ - -- ---- - --_ ___ __ DISTRIBUTION SYSTEM X Pressure Systems Oniy Header/Manifold Distribution Pipe(s) i X Hole Size X Hole Observation PipE s Length Dia 1 Length Dia Spac � Spacing ❑Yes ❑ No -- -- --- -- --- --— SOIL COVER fDepth Over Depth Over i Depth of Seeded/Sodded Mulched Cell Center Tell Edges �I Topsoil � 0 Yes ❑ No � ❑Yes ❑ �Jo COMMENTS: (Include code discrepancies, persons present, etc.) �S�r1� �(a� 1�3 � G.� � H�� `� � — - Plan revision required?❑Yes❑ No �� p� �2Y � Ctiw� � (jGt � I� Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AOOITI�NAL COMMENTS ANO SKETCH SANITAAY PERMIT NUMBEA: �� ' ��Co �6 �pr�v�� l�� . . . _ _. . . _ _ _ . , . . .. _ ,. _. . , � : . _ . . _. i , _ . _ . , , � . . _ _ , . - � , , _ __: __ _ __ _ � � _ � -- __ .. 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