HomeMy WebLinkAbout024-272-00-1300-SAN-2022-338 �v�e�"�"'Ftir Industry Services Division Coimry �
;`'i `�1y 4822 Madison Yards Way 5370� Sawyer �
; `Ds S � PO f3ox 7162 Sanitary Permit Number(to be filled in b} �
1 P Madison,WI 53705-7162
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nR��<stiiu�,�t 5�.���,
Sanitary Permit Application State Plan Review Number �
,
In accordance with SPS 38321(2),Wis.�dm.Code,submission of this form to the appropriate governmental unit PWTS- �- �
is required prior to obtaining a sanitary permit.Note:Application forms for state-o�imed POW'I�S are submitted to
the Department of Safety and Professional Services.Personal inforn�ation you provide may bc used for secondary Project Address(if different than mailing a�.,��
purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. Timber Trail Condo unit# 13
I. A lication Information-Please Print All Information
Property O�vner's Name Parcel#
AI&Mary Reinemann 024-272-00-1300
Property Owner's Mailing Address Property Location
12150W Cotmty Hwy B
�� r � �
City,State Zip Code Phone Number _��- /�,, S30;T41N;R07�V
Hayward,WI 54843 ��` \
II.Type of Building(check all that apply) Lot#
� 1 Subdivision Name
� 1 or 2 Famil} D�vclling-Number of Bedrooms 3 �h�
�
Block# T�t�. $.f� r ` o a
❑Publie/Commercial-Describe Use ---
❑ City of
❑State Owned-Describe Use
CSM Number ❑ Village of
_ �To«n of Round Lake
III.Type of Permit: (Check only one box on line A. Complete line B if applicable)
A' ❑ Ne��°System �Keplacement ❑ TreatmenUHoldina Tank Replacement Only ❑ Other Modification to Existine System(explain)
System
B. ❑Permit Renewal �Permit Revision ❑ Change of ❑ Nermit Transfer to Ne��� List Previous Pennit Number and Date[ssued
Before Expiration Plumber Owner 21-3 Q']�9�21�2]
IV.T e of POWTS S stem/Com onent/Device: Check all that a 1
�Non-Yressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil
� Holding Tank �Other Dispersal Component(explain) ❑ Pretreatment Device(explain)
V.Dis ersal/Treatment Area lnformation:
Design Plo�v(gpd) Design Soil npplication Rate(gpds� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation
450 0.7 643 664 95.5
VI.Tank Info Capacity in Total #of Manufacturer
Gallons Gallons Units � o '" �
� U � �
t3 U
New Tanks Eaisting Tanks � o �? a � p �s �
a. U ci� � cn :i. '.7 CL
Septic or Holding Tank ���� 1000 1 w1eS0I' COI1Cr0te �
Dosing Chamber � ��� �� �
VI1.Responsibility Statement- 1,thc undersigned,assume sponsibilih m�i ta ation of the PO��'TS shown on the attached plans.
Plumber's Name(Print) Plumber's 'gnature MP/MPRS Number Business Phone Number
"Cravis Butterfield 652879 715-634-R176
Plumber's Address(Street,City,State,Zip Code)
14346W St.Rd 77,Ha ward,WI 54843
Vlll. o nt /De artment Use Onl
�A�p ❑ Disapproved Pennit Fee Date]ssued Issuing Agent Signaturc
❑ O�vner Given Reason for Denial $ �7 " •� ( a I���� '"I� ��t'i''"�
�
IX.Conditions of ApprovaUReasons for Disapproval �_��$Q � � �[o ��a Lj ��
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� ,�� '� � � � DEC 0 5 2022
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� NTY
Attach to complete plans for the system and submit to the County only on paper not less than 8 ll2 x mches in size �A�1N�STRASj
ZON u�';� t 3
�S� � � �- 2�f�
NO R�FJI�DS AFTER
s��-639s�x.oaii9�... ISS�1�pF PERiv11T
PAGE 1 OF 5
In-Ground Dosed-Gravity Plan
Index & Cover Sheet
Component Manual Design References:
In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027)
Pg 1 of 5 Index & Cover Sheet
Pg 2 of 5 Plot Plan
Pg 3 of 5 Dispersal Area Cross-Section & Plan View
Pg 4 of 5 Pump Tank Specifications
Pg 5 of 5 Management Plan
Attachments: Enclosures:
Pump Curve POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
owner Name(s): Alan & Mary R Reinemann Phone: - -
Owner Address: 12150W COunty Hwy B, Hayward, WI Zip: 54843
Project Address: Timber Trail Lodge Condo Unit # 13
Govt. Lot: _1/4 of .1/4, Section 30 , T 41 N-R07 E ❑or W❑✓
Township: Round Lake County: Sawyer
Project Parcel ID #: 024-272-00-1300
Designer Information
Designer Name: Travis Butterfield Phone: 715 _634 _8176
Designer Address: 14346W St. Rd. 77, Hayward, WI Zip: 54843
E-mall: OffIC@@bUtt@1�1@�C�C�I"I��It�1g.G011"1 '['his space resezved for apprf�val;ta�Tl}�.
License Number: 652879
Remarks:
Signature: ,�.� Date: � �'� - S � `���
Original signature required on each submitted copy.
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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) �oo0 9al gal gal gal
Effluent Filter Manufacturer:
B@St
I
Effiuer,t F�ite�Modei�: GF10-8
min.12"
SOIL COVER (typicaq
12"
min.trench
aePtn �� TYPICAL TRENCH
(typical) •'. .
- `- - �. . --' �� �� ��°��a��•. CROSS SECTION VIEW
� 34�� �� _ a� �� � � (No Scale)
(typical) •;', • .
., ° ..
. • •° Provide minimum 3 ft
System Elevation —95•5 ft separation between trenches.
(typical)
Quick4 Standard-W
w/End Cap Observation Pipe NP ICAL TRENCH
(typical) (Show location of inlet/outlet pipe connection on plan view.) (typical)
Install per manufacturer's PLAN VIEW
instructions. ��JO SCB�@�
� — �� - - - -,- - - - -�� - - - - - - - �� - - - - - - - - - — �
��s� � �� � �. ���. A= 3.0ft
,
! ��� � I (bPicaq �
� - - - - - - - - - - - �� - - - - - - - �� - - - - - - - - - � D
� B = 32 ft _ I G�
' rn
(rypical) Quick4 Standard-W Chamber W
INSTALL PER TRENCH: (typical) O
(mfd by Infiltrator Systems,Inc.) �
Install pursuant to manufacturers instructions.
8 Quick4 Std-W @ 20 f� EISA/chamber= 160 ftZ �
+ � Pairs of end caps @ 6 ft�EISA/pair= 6 ft2
= Proposed EISA per trench = 166 ftz Required Infiltration Area = 643 ftz Distribution Method:
x 4 trenches = Proposed Total EISA = 664 ft� branched manifold �
. ..�.�,�.T
PAGE40F5
GRAVITY-DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4"PJ Venl Pipe
>10 ft fmm
Building Elec[ncal must comply with
12"Min.or 20 ft above SPS 316 and NEC 300
Established Flood Elevation Exlend manhole riser as necessary.
(typical) Weatherproof
Approved Junction 8ox
Vent Cap Approved Locking Manhole
IMPORTANT: with Warning Label Attached
(typical)
Anchor tank(s)as necessary
—�—Conduit
pursuant to SPS 383.43(8)(g) a��M�n.o�2o rc abo�e
Established Flood Elevalion
(typical)
�Airtight Seal
Finished Grade �
Quick Disconnect
e 18"Min.
CAPACITIES @ 10.7 gal/in �%� � . a ..�� � � � • �`yP'�'>
� a . � . �
Depth(in) Volume(gal)
q 28.6 306.84 * � I �/�/eep ��Approved Joints with
Hole Approved Pipe 3 ft onlo
8 2.� 21.4 q Solid Ground
(ryplcal)
[C] 8.7 93.26
� _Alarm
D 5 )(53.5 g I��—o�
� ��� PUMP-OFF
*Pump Tank Liquid Level = 44 in � PumP —off a ELEVATION = �� ft
.�
° INSIDE BOTTOM
Force Main Diameter = 2 in c°�°�e`e
� B�°°k ELEVATION = 10.33 ft
. . . .d. - n . -
Force Main Length = 20 ft 3"Approved Bedding Material Beneath Tank
�
Force Main Void Volume = 3.26 gal
�
[C] Total Dose Volume TDV = 93.26 gal/dose
(<0.2X design flow+force main void volume)
Vertical Lift = � ft
PUMP TANK: SEPTIC TANK(S):
Volume = 500 gal Total Volume = 1000 ga�
Manufacturer: Infiltrator Manufacturer(s): Wieser Concrete
Pump Manufacturer: Champion
Install approved effluent filter at the septic tank outlet
Pump Model: CPS3 immediatel u stream of the um tank inlet.
(See altached pump curve.) Y p � �
Controls/Alarm Manufacturer: SJ Electro Filter Manufacturer: Best
Controls/Alarm Model: Ez set
Filter Model: Gf10-8
Float switches containinq mercury are prohibited.
PAGE'�OF �
In-ground Gr vity Management Plan
IMPORTANT: ����
The owner of this in-graund 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 Operating Limits: �
Design Flow= 450 gpd; BODS <_ 220 mgL-'; TSS <_ �i 50 mgL`'; FOG <30 mgL"'
inspection Checklist INSPECT EVERY 3 YEARS
e type of use
c age of system
c nuisance factors(i.e..odors, user complaints, etc.)
„ mechanical malfunction (i.e., pumps, vafves, switches,floats, efc.)
c maferial fatigue (i.e., Ieaks, breaks, corrosion, etc.)
e solids volume in anaerobic treatment tank(s)and any distribution appurfenance(s)(i.e., distnbution /drop boxes)
e negiect or improper use (i,e., exceeding design capacities, prohibited activities, etc.)
o exfent of ponding in distribution cell priar to dosing
^ dosing irregularities-if applicable(i.e., pump re-cycling, float savitch settings, efc.)
c electrical components�if app�icable (i.e.,wiring, connections, switches, controls, timers, alarms, efc.}
„ disfribution lateral or lateral onfice plugging (measure lateraf diskal pressure—compar-e to design specification)
o surfiace discharge of effluent or sewage back-up into structure served
Maintenance Check(ist MAINTAfN EVERY 3 YEARS (or when necessary}
o Septic and dose tank(s� shali be pumped by a certified septage serviciny operator licensed under s. 281.48 Wis.
Stats.when the vatume ofi solids in the tank(s)exceeds one-third (113) the liquid volume af the tank(s}or
as required by local ordinance. Disposal o(contents shall be pursuant to NR 113,Wisc. Admin. Code.
o Effluenf filfer(s)shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumufated solids according to rnanufacturer's specifications. A servicing period will always be yreater than 12
months.
System maintenance repo�s 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: TI"aViS BUft�l�fl2ld Phone: 715-634-8�176
�o�ai go„eCnme„t�n�t: Sawyer County Zoning & Conservatian Phon�: 715-634-8288
Local government unit address: ����O Maln St, Suite 49, Hayward, WI z�P: 54843
Any defective part of this system shall be repaired, replaced, or ren�oved pursuant to SPS 383.51 (1),U�Jisc. Admin.
Code. Repair or replacement of failed or malfunctioning componenis shali comply with SPS 383,Wisc. Admin.Code.
No product for chemical or physical restoration of the POWTS ma�be used unless approved by the department in
accordance with SPS 384,Wisc.Admin. Code.
Continqency 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 repiaced by a code-eon�plying dispersal component in a pre-determined area of suitable soils.
�
�stem Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 353.33,Wisc. Admin. Code.
,��' "`'` PRIVATE ONSITE WASTE TREATMENT county
� ^��`'`r�
%='� o �`K' SYSTEMS
�-i�SPs ��,1 Sawyer
\���--i�% ( POWTS)
�r'S'—"�'"' INSPECTION REPORT Sanitary Permit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION �a -33�
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#:
�� d-IMaC �Q��ra.w��►�^✓1 ,,�� � �—
Insp BM Elev: BM Description: Parcel Tax No:
Io�•� ` � �� �^ o��-a��- 00- �300
TANK INF RMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic �,,,;��- � � Benchmark D,�S' (Oa.1S� l�•a �
Dosing � �p
Aeration Bldg. Sewer �.'�S� �`(•S�
Holding St/Ht Inlet o1 � � r
TANK SETBACK INFORMATION St/Ht Outlet 33 ' �
TANK TO P/L WELL BLDG AIR INTA�KE ROAD �Inlet �-r- (,.3$'' �3 �
,
Septic oe -��po� ly � �f Y` NA �Bottom P'T' 1�•3 3 � $ 9�`
Installation
Dosing �� �pp � �' .�� NA Contour
Aeration NA Header/Man. , S� �(� i
Holding Dist. Pipe
PUMP 1 SIPHON INFORMATION Surf cte e j � �
�(,75" c�S S-
Manufacturer C� � Demand Final Grade
Model Number 3� GPM }�{; .t'�1-• 3 �7S� �(,,,� �
TDH'] Lift Friction Loss Sys Head TDH Ft
Forcemain L �t Dia � Dist.To Well
DISPERSAL CELL INFORMATIO
DIMENSIONS N1 L #of Cells Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav � Conv ❑ Aggregate �,.��� .
INFORMATION P I L Bldg Weli Waters � GP @� Chamber Model Number:
❑ EZFIow
CELL TO ` ' �- ' X(pd� ❑ Mound o Other
- --��__—
DISTRIBUTION SYSTEM X Pressure Systems Only
-- -- —
Header I Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes
Length Dia Length Dia Spac Spacing ❑Yes ❑ No �
- --
_ _- ---- -
SOIL COVER
---- - --- ------ — - —
Depth Over Depth Over Depth of Seeded/Sodded Mulched
Cell Center ( Cell Edges � Topsoil � ❑Yes ❑ No �Yes ❑ No�
COMMENTS: (Include code discrepancies, persons present,etc.)
��„S�,,l(� o$�,���-�
S-� a�s a � ► -,�a�
Plan revision required?�Yes ❑ No �a o g �.� �� � � 6����
.. . . �
Use other side for atlditional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
A���TIONAL COMMENTS ANO SKETCH
SANITAAY PERMIT Nl1M8EA: ��- 33�
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