HomeMy WebLinkAbout014-941-09-4202-SAN-2022-331 ; � � ' � �n;i��c�n,�LNr�rjL'Pc i�Iiylci{)R I l�(rilii[V �
� � 4822 Madison Yards Way ' SAW'YER
_ �s - Madison,V1%1 53705 Sanitary Pertnit Number(to be fiiled in by �
�� I P.O.Box 7162 �
� Madison,W153707-7162 �y �`"i 3 � iu �
State Ttansadion Number �
Sanitary Permit Application __ �
In accordance wifh SPS 38321(2),Wis.Adm.Code,submission ofthis form to the appropriate govemtnental unit ---.
is required prior to obtaming a sar�itary pecmit Note:Appliption forms for state-0wned POWTS are submitted to Project Address(if different ihan mailing a,.....,.,��
the Departrnent of Safety and Professional Services.Personal information you provide may be used for secondary 11453N Staie rd 77tZ7
purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats.
I.Application Informatioe-Plesse Print All Information
Property Owner's Name Parcel#
Larson family property trust 014941094201
Property Owners Mailing Address Property Location
4931 Bonita Bay Blvd suite 1802
Govt.Loi
City,State Zip Code Phone Number
Bonita Springs,FL 34134 NW y,,SE '/,, Section 9
II.Type of Building(check all that apply) Lot# T 41 N R 9 E o
�1 or 2 Family Dwelling-Number ofBedrooms 2 Subdivision Name
❑PublidCommercial-Describe Use Block#
❑City of
❑State Owned-Dese;ribe Use
CSM Number �Village of
PSj Town of Lenroot
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 i
s licnble.
'�� �New System ❑Replacemert[System ❑Other Modifica[ion to Existing System(explain) ❑ Additional Pretreatment Unit(explain)
B' ❑ Holding Tank �In-Ground ❑ At-Grade ❑ Mound ❑ Individual Site Design ❑Other Type(explain)
(conventional)
C• ❑ Renewal Before ❑ Revision ❑Change of Plumber ❑Transfer to New Owner ist Previous Permit Number and Date Issued
Expiration
IV.DisperssU'I'reatment Area and Tank Information:
Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(sfl Dispersal Area Proposed(s� System Elevation
300 .7 428.6 450.2 92.50
Capacity in Total #of Manufacturer
Tank[nformation Gallons Gallons Units � � v � N ^
New Tanks Existing Tanlcs � p y; � � � i� c`�
a` U v� ti v� is. c7 a
Septic w Holding Taok 50 50 1 teset
Dosing C6amber
V.Responsibility Statement- I,the undersigned,assume respoosibility for installafion of t6e POWTS shown on the attached plans.
Plumber's Name(Print) Plumber's S� e MP/MPRS Number Business Phone Number
Gerald Froemel Q 950111 715-558-1138
Plumber's Address(Street,City,State,Zip Code)
13502W Froemel Rd Hayward,Wi 54843
VI.C un /Department Use Only
�Ap d ❑Disapproved Permit Fee Date ssued. Issuing Agent Signatu�e
s �Qip,� � � �i' 1��� �'✓��.�.�.����--��
❑Owner Given Reason for Denial
Conditions of Approval/Reasons for Disapproval
�� �ate i � ------._... � � �� �'/_�:�
�� ' ��
�e# t`�►� s OCT i 2 2022 ,
�; q�/ _ u�/ .� !�1Q.�,� �p,�f 1cl ��\�� v,,;.���'��I� i�, .. � _J
l b � l I ��,, - , , :,,.-
ZOIVItif'..-,A:�t�s:;;�s;�'�i!1i+;��iV
ptbc6 tu co�plete as for the syste�aed s�bsit to the Coaety only oa paper not kss t6ae 8►/t:il ioche4 ie size
C S� �� ,��� f�4 REFUNDS�,FTER
SBD-6398( 03/21) ISSU�OF PE}i:�AIT
Larson fami prope trust Property Owners Name
h 77/27 Property Address
014941094201 Tax Parcel Number
Sawyer County
��2 i
NW/SE Gov Lot or Qtr-Qtr/Qtr
S9 Section
T41N Town
R9W Range
Page Index
1 Property Information
2 Data Entry
3 Plot Plan
4 Drainfield Cross-Section
5 Dose Tank
6 Maintenance Plan
7 Contingency Plan
County Parcel Listing
Gerald Froemel Plumber's Name
� Plumber's Signature
950111 Plumber's License Number
715-558-1138 Plumber's Phone Number
10/12/22 Date
Not an endorseme�,written or implied for the following companies and products;DelZotto Concrete,Wieser Concrete Products
Inc..Skaw PreCast Co.,Huffcutt Concrete Inc.,Zabel Environmental Technology,ITT Industries(Goukis),The Pentair Pump
Group(Myers),Infiltrator Systems,ADS Products,Polylok Inc.,Orenco Systems Inc.,Simlfech Fitter Inc.,Sta-Rite Industries,
Page 1 of 7
-��
In{',rwxd Sal Absorp�on 5B0.10705-P(N.07/01)Version 2,I Component Manual Used
. . . __......'.__._....._•.• _�
2 �Number of Bedrooms
Percent Slope(%)
102 Depth to Soil Limiting Factor(in.)
0.7 'In Situ soil application rate
200 Estimated Wastewater Flow(gpd)
300 Design Wastewater Flow(gpd)
1 Number of System Elevations
92.5 � ��Proposed System Elevation#1
��:Proposed System Elevation#2
;Proposed System Elevation#3
'Original Grade#1
96 ;Finished Grade#1
TSOriginal Grade#2
Finished Grade#2
�Original Grade#3
���� �Finished Grade#3
Infiltrator Quick 4 Standard Chamber Type
15 Height of Chamber(in.)�� 20 sq.ft.per chamber
2 Rows of Chambers 5.1 sq.ft.per pair of end caps
3 �� 'Distance Between Celis(ft.)
22 Proposed Number of Chambers Used
428.6 Minimum Distribution Cell Area Required(sq.ft.)
450.2 Distribution Cell Area Proposed(sq.ft.)
Wieser 750 Septic Tank ose an (i�appiicabie)'; f;
Lifetime Effluent Filter ••seled only rf NOT using combo tank
Soil Boring SurFace Depth to Lowest Highest System
Number Grade Limiting Elevation Elevation Elevation
ElevaSon(fk) Factor(in.) Acceptable
1 96.50 102 91.00 95.25 TRUE
2 95.28 96 9028 94.03 TRUE
3 96.45 102 90.95 95.20 TRUE
4
5
Page 2 of 7
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C�css Secti�r� of Q �wa Ce?� In Ground Ccmper�e�� :.
Using Leachinq Chomb�r�:
O�se�vatio^/Ve-it Pip�s
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9fs.d0 Finished Grade _ � , _ — Finist►ea �rade -- ��
�lope C�i�Seperation � �
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Original Grasie % 7��,-y + . �`.}; ', ..�rigin� Grade
93.75 Top of chamber �-' '� . Y�" ;,-'�Top of cnarrber 93.75
---- - ` �' -- -•--�-•
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g2.50 System Elevation �',. . . .: ___ ''Y System Elevation 92.50
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Dia rams Not To Scale
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bservation /Vent Pipes to be located 1/5 to 1/10 the length of the distnition cell measured from the end of the cells
Page 4 of 7
Larson famil rope trust
h 77/27
1.49E+10
Number o Bedrooms 2 Septic Tank Wieser 750
Estimated Flow(avera9e)ganons/day 200 Effluent Filter Lifetime
Design Flow(peak),(Estimated x 7.5)gaVday 300 Pump Tank #N/A
Soil Application Rate gal/day/ftz 0.7 Pump Type
Influent/Effluent Qual' Month Average
Fats,Oil&Grease(FOG) 30 mg/L
Biochemical Ouygen Demand(BODs) 220 mg/L
otal Suspended Solids(TSS) 150 mg/L
i„�;-,;.-F;, Servicing frequency of 12 months or less requires the
Maintenance Schedule Management Plan be recorded with the Register of Deeds.
Service Event Service Frequency
Inspect condition of tank(s) At least once every 3 Year
Pum out contents of fank(s When combined slud e and scum=1/3 of tank volume
Inspect dispersal cell(s) At least once every 3 Year
Clean effluent fiRer At least once every 3 Year
Inspect pump,pump wntrols&alarm At least once every ,
Maintenance Instructions
Inspections of tanks and dispersal cells shall be made by an individual cartying one of the following
licenses or certifications:Master Plumber,Master Plumber ResVicted Sewer,POWTS Maintainer,Septage
Servicing Operator. Tank inspection must include a visual inspection of the tank(s)to identify any missing
or broken hardware,identify any cracks or leaks,measure the volume of combi�ed sludge and scum and
to check for any backup or ponding of effluent on the ground surtace. The dispersal celi(s)shall be visually
inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on
the ground surtace. The ponding of effluent on the ground surface may indicate a failing condition and
requires the immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals 1/3 or more of the tank
volume,the entire contents of the tank shali be removed by a Septage Servicing Operator and
disposed of in accordance with ch.NR 113,Wisconsin Administrative Code.
A service report shall be provided to the County Zoning Department within 30 days of any service
event.
Start-Up and Oceration
For new construction,prior to use of the POWTS check treatment tank(s)for the presence of
painting products or other chemicals that may impede the treatment process and/or damage the
dispersal cell(s). If high concentrations are detected have the contents of the tank removed by a
licensed Sepfage Service Operator.
System start-up shall not occur whe�soil conditions are frozen at the infittrative surtace.
Page 6 of 7
Do not drive or park vehicles over tanks and dispersal cells.
Reduction or elimination of the following from the wastewater stream may improve the pertortnance and
prolong the life of the POVYTS: antibiodcs, baby wipes, cigarette buUs, condoms, cotton swabs,
degreasers, dental floss, diapers, disinfectants, fat, foundation drain (sump pump)water, gasoline,
grease, oil, painting produc[s, pesticides, sanitary napkins, tampons, and water softener brine.
Abandonment
When the POWTS fails and/or is permanentty taken out of service the following steps shall be taken to
insure that the system is properly and safely abandoned in compliance with Wisconsin Administrative
Code SPS 383.33;
-All piping to fanks and pits shall be disconnected and the abandoned pipe openings sealed.
-The contents of all tanks and pits shall be removed and properiy disposed of by a SepTage Servicing
Operator.
-After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void
space filled with soil, gravel or another inert solid material.
Contingencv Plan
If the POWTS fails and cannot be repaired the following measurers have been, or must be taken to
provide a code compliant replacement system: (Check One)
" The site has not been evaluated to identify a suitable replacement area. Upon failure ot the POWTS a
soil and site evaluation shall be performed to locate a suitable replacement area. If no replacement area
is available a holding tank may be installed to replace the failed POWTS.
A suitable replacement area has been evaluated and may be utilized for the location of a replacement
soil absorption system. The replacement area should be protected from disturbance and compaction and
should not be infringed upon by required setbacks from existing and proposed structures, lot lines and
welis. Failure to protect the replacements area will result in the need for a new soil and site evaluation to
establish a suitable replacement area. Replacement systems must compty with the rules in effect at that
time.
A suitable replacement area is not available due to setback and/or soil limitations. A holding tank may
be installed to replace the failed POWTS.
��WAi2Nit.r..:�.
Septic, pump and other Veatment tanks may contain lethal gasses and/or insufficient oxygen. Do not
enter a septic, pump or other treatment tank under any circumsfances. Death may result. Rescue of a
person from the interior of a tank may be difficult or impossible.
POWTS Installer Septic Pumper
Name Gerald Frcemel Name Scott Poppe
Phone# 715-558-1138 Phone# �(715)634-1450 ��'��._�R v�
POVYTS Maintainer Local Regulatory Authority
Name �Jays Septic �� � Agency Sawyer County Zoning
Phone# 715-558-1138 Phone# 715-&34-8288
Page 7 of 7