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Home My WebLink About028-742-31-3412-SAN-2022-337 � -:�'.`-'��"'�;: Industry Services Division Counry � 4822 Madison Yards Way S8Wy2f - . � j�=1��..�Sp �� i� Madison,WI 5370J Sanitary Pcrmit Ninnber(to bc filled in by � a ` P.O. Box 73o2 � � �\k:�:_.`_;:��, \�- Madison,WI 53707 �C1V�yL��`( � ��..t„��.,,-: , � Sanita� PeY,l,l,ilt A ppllCatlOn State Transaction Number � L� 1 � In accordance with SPS 38321(2),Wis.Adm.Code,submission of this fonn to the appropriate govemmental unit � ` is required prior to obtaining a sanitary permit.Note:Application fonns for state-owned POWTS are submitted to Project Address(if different than mailing; � the Department of Safety and Professional Scrvices.Personal information you provide ma��be uscd for secondar}� �� purposes in accordance��ith the Privac}°I.a��,s.15.Od(1)(m),Stats. I.Application]nformation-Please Print All Informatioo Property O�cner's Name Parocl# CASSIDY SCHEER 028-742-31-3401 Property Owner's Mailing Address Propertv Location PO BOX 221 ae`� City.State 7ip Code Phone Number HAYWARD, WI 54843 �� s- i��; -�� S ��. Sv'' '/<, Section 31 II.Type of Building(checic all that apply) Lot# T 42 N R �� E or W �l or2l�amilti�D��ellin�-Numberof[3edrooms 2 _ � Subdi�°isionName Block# �Public/Commercial-DescribeUse _� �City of _ ❑State O��ned-Describe Use_____ __ ____ CSM Ninnber �Village of _ CSM 26/294 #6960 0��r spider�ake _ III.Type of PO�VTS Permit: (Check either":�e�+�"or"ReplacemenY'and other applicable on line A. Check one box on line B.Completc linc C if a licable.) `�� New S stem �Re l�cemcnt S stem �Other Moditication to Existin S stem e� lain �Additional Pretreatment Unit ex 1 lin ✓ Y' P� Y g�Y'� ( P ) ( P� ) B' �IioldingTank �In-Ground �At-Grade �Mound �IndividualSiteDesign OtherType(explain) (conventional) C• ❑Renewal Before �Revision �Change of Plumbcr �Transfer to Ne�v O��ner��ist Previous Permit Number and Date Issued Expiration IV.Dispersal/Treatment Area and Tank Information: Design Flow(gpd) Dcsign Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(st) System Elevation 300 0.7 429 452 94.00 Capacity in Total #of Manufacturer � Gallons Gallons Units � o � � Tank Information � U � New Tanks E�isti�g'I�anks � c c� � � � � � 0 � U v, U v: u. C7 a. SepticorHoldingTank 750 1 1 WIESERCONCRETE ✓ � Uosing Chamber � � � V.Responsibility Statement- I,the undersigned,assume responsibilify for installation of the NOWTS shown on the attached plans. Plumbers Name(Print) bsr's Si�naturc MP/MPRS Numbcr Business Phone Number Travis Butterfield 652879 715-634-8176 Plumbers Address(StreeL Ciry,State,7,ip Code) 14346W St. Rd. 77, Hayward, WI 54843 Vl.County/Department Use Only Pennit Fee Date Issued Issuing Agent Sienature � � ❑Disapprovcd C/ � � ., ❑O«ner Given Rcason for Denial $ /�� f �- ��;, ��'t -�� ;�� Conditions of ApprovaVReasons for Disapproval � � � _►�-.i� �-� � � � ��?� (� � ��GI �F �W a«�i �: �� ._�k# ;. 1 or �c� �'''�� DEC 0 1 2022 '• CT — ��i c� �= __�'-.---__�__ _ -�� S �-� �� , [�e--^,An/ {-� -- , � �� 7/AY1� 1.".r_'!_1 (w..�.,. .,.`..r: Attach to complete plans for the system and submit to the Counh�onk on paper not less than S I/z x 11 inches i � �i1 Jia!f�ly��j(y ��Q�.t✓l�-- 3 ��1 � sB�-639s�R.o2i22� NO R�FJt�DS A�TER ISSUE OF PEFNiIT c�•�d�`�`�� 3� rv��c\�-- PAGE 1 OF 4 In-Ground Gravity Plan Index & Cover Sheet Component Manual Design References: In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross-Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Scheer Owner Name(s): Cassidy Scheer Phone: - - Owner Address: PO BOX 221 Z�p: 54848 Project Address: PRT SESW LOT 1 CSM 26/294 #6960 Govt. Lot: 1/4 of 1/4, Section , T N-R E Q or W ❑ Township: Spider Lake County: Sawyer Project Parcel ID #: 028-742-31-3401 Designer Information Designer Name: TI"avlS Butterfield Phone: 715 _634 _8176 Designer Address: 14346W St. Rd 77, Hayward, WI Zip: 54843 E-mall: OffIC2@bll�t2tfl@�C�C�f 1��111g.00111 This space reserved tor ap�roval stamp. License Number: 652879 Remarks: Signature: — Date: I Z � Zz riginal signature required on each submitted copy. CHECK 60X�5 APPLICABLE CHECK�OXAS APPLICABLE. � SOIL EVALUATION o s`a1e 4'0 40 so 8D �'SYSTEM PAGE 2 OF�� SITE MAP PLOT PLAN PROJECT NAME: oesisN F�ow: 3� GPD /� ,t / 10' ( S 5 i IX y 5��!eP� Attach design flow calculations for commercial plans. PROJECTADDRESS; �i 7ei� /'Z,� ^' Pipe Material/ASTM Standard(Tables 384.30-3&384.30-5) BM Sym6ol:� BM Elevatlon: ��a� `� FT 'V Sanitery Sewer SG�`yb / sm oes�dptioo: aY" D��bLe os4lc � Fo,�Ma�": � slope Gradient(%) indi�aie nonn by IMPORTANT: of TestedArea�, H1ell Sym6ol(iiapplicahle): � drawing ana�row ShoW gfound clevation Confoufs at suitable inteNals. on the approyrite line. D;�r� R� � C�ss��Q� S�C,�er- /��„ —�oo ,� � �.G. �ox aa-� qwi� ,l� av"a�o��a c�r!{� i /-�y,,.�dl,wr sys�i3 � �� 9�,s— S��Sw S�� 3� 7�Ya N R�� a� q>,o � T�,,. o� SO�� 3� 9�, � i � �a�� '�a313 y�� I I I � L��onW�Ptv/Y�n� '13n� �d. Qut�k y 1��4s c��r � I �s� �� p ��.T) � � "' sybleM r� 9Y° � �.k� -- _ aa ° ,�b � obS io� - � Nc��----- -- -- �,,,5 � w-1-{�i�'e(� �,,�Q j{��(,�a�I'7 9 �� --� � ��e/� �� Y�awO Septic Tank(s) Manufacturer: IN-GROUND GRAVITY DISPERSAL AREA wieser Concrete Uniform Elevation Trenches with Quick4 Standard-W Chambers SepticTank(s) Volume(s): 3-ft Trench (down-sizing credit) 750 gal gal gal gal Effluent Filter Manufacturer: B@St I E�Ue�t F�iter Modei #� Gf 10-8 min. 12" SOIL COVER (tyPical) 12" min. trench dePtn � TYPICAL TRENCH (typlcal) •'. • ' -- • - -' �� °��a� •. CROSS SECTION VIEW �Yp��a��.. .a� ��. .. . . (No Scale) n � • ' a . • ° Provide minimum 3 ft System Elevation = 94.00 ft separation between trenches. (rypical) Quick4 Standard-W w/ End Cap Observation Pipe TyPICAL TRENCH (typical) (Show location of inlet / outlet pipe connection on plan view.) (rypical) Install per manufacturers PLAN VIEW instructions. �NO SCB�@� � - - - - - - - - - - �j�- - - - - - - - �� - - - - - - - - - - � � ' ; , ; . I �A = 3.Oft ��YPical) � � - - - - - - - - - - - �� - - - - - - - �� - - - - - - - - - -� D g - 44 ft — I G� rn (rypical) Quick4 Standard-W Chamber W INSTALL PER TRENCH: (typical) � (mfd by Infiltrator Systems, Inc.) � Install pursuant to manufacturer's instructions. 11 Quick4 Std-W @ 20 ft� EISA/chamber = 220 ftz � + � Pairs of end caps @ 6 ft� EISA/pair = 6 ft2 = Proposed EISA per trench = 226 ftZ Required Infiltration Area = 429 ftZ Distribution Method: x 2 trenches = Proposed Total EISA = 452 ft2 branched manifold � PAGE40F4 In-ground Gravity Management Plan IMPORTANT: The owner of this in-ground gravity system 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 system 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 performed by a registered POWTS Maintainer in accordance with SPS 383.52(3),Wisc.Admin.Code. Maximum Dispersal Area Operatinq Limits: Design Flow= 300 gpd; BODS_<220 mgL-'; TSS<_150 mgL-'; FOG<_30 mgL-' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o 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,etc.) o solids volume in anaerobic treatment tank(s)and any distribution appurtenance(s)(i.e.,distribution/drop boxes) o neglect or improper use(i.e.,exceeding design capacities,prohibited activities,etc.) o extent of ponding in distribution cell priorto dosing o dosing irregularities-if applicable(i.e.,pump re-cycling,float switch settings,etc.) o electrical components-if applicable(i.e.,wiring,connections,switches,controls,timers,alarms,etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure—compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS(or when necessary) o Septic and dose tank(s)shall be pumped by a certified septage servicing operator licensed under s.281.48 Wis. Stats.when the volume of solids in the tank(s)exceeds one-third(1/3)the liquid volume of the tank(s)or as required by local ordinance. Disposal of contents shali be pursuant to NR 113,Wisc Admin.Code. o Effluent filter(s)shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc.Admin.Code. Report any component failure or malfunction to: Name of individual or company: BUtt2lfl@ICI, If1C. Phone: 715-634-H�76 _ �ocal government unit: SaWy21'COUIIt)/ZOC11Clg Phone: 7�5-634-82$$ �ooa�go�e��me�t U�it address: 10610 Main St. Sulte 49, Hayward, V Z1P: 54843 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 treatment component of this POWTS cannot be repaired,it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils. SYstem Abandonment If use of this POWTS is discontinued,it shall be abandoned in accordance with SPS 383.33,Wisc.Admin.Code. -��``="'-"��i; PRIVATE ONSITE WASTE TREATMENT county :;`';�oSPS , !, SYSTEMS J � ( POWTS) Sawyer `�� _�:;;� �„"�� INSPECTION REPORT sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �� ^ �3� Persona]infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(l)(m)] Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#: C�55�� 5�-1�r- 5 � (� Insp BM Elev: BM Description: Parcel Tax No: l c�.�` �Y'' d,o,,, �, a�.l i� ✓�a� l� o�-��(2-31 - 3Y�( TANK INFORMATION ELEVATION DATA (1�r, TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic ,,�;`�r �� Benchmark l�,v� Dosing Aeration Bldg. Sewer qQ,�, � Holding St/Ht Inlet Q$`T ` TANK SETBACK INFORMATION St/Ht Outlet S�.7 ' TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet AIR INTAKE Septic .�-Sv � ��D� ,��' NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. 9��D � Holding Dist. Pipe PUMP 151PHON INFORMATION Infiltrative �3 �, Surface Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFO MATION DIMENSIONS W ,3` L �► [fY #of Cells o2 Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate �� INFORMATION P/L Bidg Well Waters � GP � Chamber Model Number: ❑ EZFIow CELL TO � ��,� � �. _��_ ❑ Mound o Other �� - — - - -- - - -----_ _._— DISTRIBUTION SYSTEM x Pressure Systems Only - - � ----— �' Header/Manifold Distribution Pipe(s) �X Hole Size X Hole Observation Pipes Length Dia �Length Dia Spac_ � �� Spacing ❑Yes ❑No � SOIL COVER _ - - — Depth Over �epth Over Depth of � Seeded I Sodded � Mulched Cell Center Cell Edges � Topsoil ❑Yes ❑ No ❑Yes ❑ `�o COMMENTS: (Include code discrepancies, persons present, etc.) �� 6/1��3 �� , � Plan revision required?❑Yes � No ;p �; �} �� ' �, �� c�� I I � � I-- ��`—'- Use other side for additional information Date POWTS Inspector's Signatu Certification Number SBD-6710(R.3/01) AOOITIONAL COMMENTS ANO SKETCH SANITAAY PERMIT NUMBER: �,2-332_ �. �P��`�� ►� ��' � �S� �� _ w . — � `�� \ � ( ��, ,� � �,. _ - -� �\ \� �.�`�`� I �� I �' �� \ � � -��'s3"f � a l��-. \\�� I ;+'�1' . J �° �(°i� � \ � � I �-- - i �` —� � n`�-`^- L.� � � �7� F J „�(t.T, / IL �,tPl.��, ��'s� �P , � �� -�t— S c�—