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Home My WebLink About030-737-07-4404-SAN-2023-027 .%:*�'^Y'-",�4;. Indusfry Services Division Counry _\. . • " 4822 Madison Yards Way �q� /' � ,-`�,�=p , ' Madison,VVI 53705 Sanitary Pcrmit Numbcr(to be filled in b�� ` s P.O.Box 7162 � , � '``�"„_?:_:_;�;'� Madison,WI 53707-7162 �0 3 � 3 � � _ � Sanitary Permit Application StateTransactionNumber ` (n accordance w�th SPS 3R321(2),Wis.Adm.Code,submission oftl�is fo[m to the nppropriate governmental unit � � is requirecl prior to ob�aining a sanitary permit.Notc:Application fnrms for state-owned POWTS are submitted to Pmject Address(if difTerent than m.�iling a � ti�c Dcpartmcut of Safcty aud Professional Sen�ices.Pcrsonal information you provide may be uscd for secondary .J pucposes in accordance with tLe Pnvacy Law,s_ 15.04(1)(�n),Stats. I.Application Information-Please Print All Information /7 y p / Property Owner's tiame Pazccl# .T e.� ,v! ; o 07 7o7V -- Property Owner's Mailing Address Property Loca[ion . 0.(3o Gev'."r-L� City.State Zip Code Phone Number wr f,y �'/,,,£�;:, Section -�-- II.Type of Building(check all thatapplg) Lo�� T 7 N R 7 �or QI or 2 Pam�ly D�sclling-1lwnber off3edrooms �( _ ' Subdivision Name Block� �ublic/Ccnnmercial-Describe Use _ ❑City of _ ❑State Owned- Describe Use_ CSI�4 Numbcr illage of __ — �Town of_W�1�1.�L— _ -_--` -- 0 IQ.Type of POWTS Permit:(Check either"Neiv"or"Re�lacemenY'and other'apphcable online A Checkone bos ori:Iine`B.Gomplete line C if a licablc_) ----- A �lew System �[tep►acement System ❑Other Maiification lu Existing System(explain) aAdditioaal Pretreatment Unit(espiain) u �' �Holding Tank ❑In-Ground �At-Gcade �Mound Individual Site Desi�n Other Type(expiain) (conventional) C• ❑Rcne.val 13efi,rc �Rcvisior� ge of Plumber �I'ransfer to New Owner List I'rcvious Pemtit NumUer and Datc Issucd T:xpiration IV.DispersaVl'rcatment Arca and Tank Information: =� `� �,,: ��,t�_:� . }'-` � Design Flo�t�(��d) � Design Suil Application Rate(gpcL'sf} Dispersal Area Required(s� Dispetsal Area Proposed(s� System Elevation � ,� ...r ` ...�- Capacity in Total #of Manufacturer Tank Information Gallons Galtons Units D ? o �„ � heu�Tanl:s Existing Taoks � U U " � � `" ^ � o M � � a� � m m a. V cn �n n ij. C7 A. � Scptic o loldin Tank �, � ��00 000 / Qk/ Dosing Chambcr � � � V.Responsibility Statemc�t-I,the undersigned,assume•,'� "'st'�'i5ity for installahon'o�tSe.POW'I'S shown on the attached plaas. Plumber's Name(Print) Plumber's Signature �4 ��fPRS Number Sus[ness Phone Number uk ✓,' .d � .7•10 yy� I 7rs-�yl-�3rr.z_ Plumbcr's Address(Strect,Cih�.State,Zip Code) v� .� o - �f.v , ws. y VI.County/Department Use Only �A� O Disapprovecl Permit Fee Datc Issued Issuing Agent Siguature { ❑Owner Given Reason for Denial � yoo.�D 313► I�-3 n�,G�.�,�-�.N��,� Conditions of Approval/Reasons for Disapproval ,.� T;:�L-;� r""��L,� �+ ►� � �' ��`!�r',;`;' ��Ge ��,� ;} �� 3,��3 _ _- ,� � � ..1�.4...�..... -�\5j� -:hk#i o�<,� NlAR 2 9 20�3 �- CS� N�'� �� `1 �s . .. ��.+�^�V�'�r ��:�:;p�V+"`t� �fGl« .� ZONWG AU�+iIN't5 i�R.:iw�JIV .4tt�ch to complete plms(or the systtm and sabmi[to the County only on papec not iess ihaa 81R a 11 inches io siu ..�` � 7� � SBD-6398(R.03/21) NO REFURDS AFTER 15SUE O�PER+'V�1'f Sawyer County Zoning & Conservation Administration ``""`1 10610 Main Street, Suite 49 � �R Cp �� Hayward,Wisconsin 54843 ��1�%�� I (715)634-8238 �Q� �.��j FAX(715)638-3277 � �H i �' � !,�j www.sawvercounry�o��.org / �, � _� i o� E-mail:zonin .�cclu.sawvercuuntyeov.ore � :% " Toll Free Courthouse/General(nTormation 1-877-699-4110 i�� 1``O{``` Holding Tank Approval Checklist L Sanitary Cover Sheet Date Stamp�/�_/ 23 Parcel ID# O 3 0 - `7 .3 7 -p�7 - `� `� o� II. Plot Plan �Property Lines �Benchmark BM ♦ xSite Address �North Arrow ➢C, Structure � Scale �D Well �(< 25' to Service Road �Legal Description �Nearest Road Intersection �Setbacks to: Property 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 D( Cross-section —Manufacture, Gallons: s`�"w �� Tank Anchor Calculations [SPS 383.43 8) g)] �Locking device, cl�ains/locks �j 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 2 SBD-10855-P (R.3/07) (2�"a-�> � Owner: �/�� Plumber: � � c2•, Application Review Date: e3�3� (�'� POWTS Reviewer: (�.�� Name /�� 6 License# Revised 4/l l/2013 CONCRETE HOLDING TANK DESIGN Single Tank Option INDEX AND TITLE SHEET Project Metton Holding Tank Owner Jason 8 Mariah Melton Address PO Box 33 Exeland,WI.54835 Legal Description PRT SE-SE-S.7-T.37N-R.7W Township Weirgor County Sawyer Subdivision Name Lot No. Parcel ID Number 30737074404 Plan Transaction ID Number Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Tank Drawing Page 5 Designer Bruce Vitcenda Signature �� Phone No. 715-943-2382 License Number M.P.220498 Date 03/29/23 Designed pursuant to: Holding Tank Component Manual For POVYTS(Version 2.1) May 2022-2027 vers�on z��o�rzz� Page 1 of 5 HOLDING TANK SPECIFICATIONS �Number of bedrooms Non-residential estimated flow(gpd) 2000.0 Minimum holding tank volume required (gal) 2000.0 Proposed holding tank capacity(gal) Skaw Tank Manufacturer 2000 HT Tank model number Rhombus SJE Alarm manufacturer Tank Alert 101-01H Alarm model number Tank Dimensions and Data Tank Anchor Calculations X for round tank 20000 Ibs Weight of tank and cover 49.0 Liquid depth below inlet invert(in) 1.50 Safety factor 8.0 Maximum de th of soil cover(ft) 17254 Ibs Weight of anchor required 58.0 Height(in) Outside 25.1 in Soil cover req. tor anchor or 154A Length (in) Dimensions 4.3 yd' Concrete counter weight 77.0 Width (in) Only HOLDING TANK CROSS SECTION manhole cover with locking device and fnished ��ent cap junction � warning label grade box � � — 4"min. 12"min. �23 in. Manhole and vent locations conduit vent pipe 18"min. � tether weight - � ._.—._._. ._._.—._._._._._._._._�._._._._._ ' � service � 12.0 In. buildinlesewer blind plug � aiarm on Note: All tank joints, and to seai joints between tank ounet openings and piping are Electrical as per 37.0 in. sealed watertight. All NEC 300 pipe and vent materials and SPS 316 comply with SPS 384. 3 in.bedding under tank Tank is anchored as necessary to negate buoyanq. Project: Melton Holding Tank Transaction Number: Page 2 of 5 a w�c� /iumi�� a�«�;t«N J.soN e mu�aA nult•.� I`f7vNrrH,�Y yo P.o. //ox 7J E x tl n nrli w�JYP75 �x�/r.ud,w;SYy;S . ��f"943'.t7Y� MPdA0y1F � o'�' �N 6� t o� . h a � Scalca ttc, stia � : '`� �.o 1 N o �'7 $!N'� (�!T Sf-f� f•7 l.37e/ R• 7 v Wa� 7ew.~�3��j�a7 vyoy W ur� � �k4lo✓o.o•7e�n4,��lr/ R000%el[;a 4n we�yb erAA t 16'T•re R✓v v/µt;u�a� P�Pe I.r 3ly-lo-7 '�'eli Ya,tl[pYfeTb�� I[ �7y6�✓ i I sc4�t �"= vo' / P�MPi�AkR� HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be insfalled and maintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P N. 03/07, R. 01/12), and the Sawyer County Sandary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 40.0 to 400.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed in the current Service Contract must be called to empty the 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 inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with 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 county within 30 days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one shouid enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. in the event that this POWTS faiis and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Con- nection to municipal services would also be considered at this time if they are deemed available to the praperty. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with SPS 383.33 Wis. Adm. Code. 10. If there is a problem with, or q�estion about this installation, the following persons may be contacted: a. Installer......................... A-1 Plumbing Phone: 715-943-2352 b. Service Provider............... Northwest Sanitary Phone: 715-943-2650 c. Co. Zoning or Health Dept. Sawyer County Zoning Phone: 715-634-8288 11. Project: Melton Holding Tank Transaction Number: Page 4 ot 5 INLET 67.00 71.00 77.00 i//' ``\�� WARNINGOEATHMAYOCCURIFTANKISENTERED � Q � WITHOUT PROPER EOUIPMEN7 154.G0 I 1 � I � � ��\ � NOTE:SEE INNER WALL PHOTO ON THE"EXCLUSNELY AT SKAWS"PAGE. 14B.00 � � 744,00 TOP VIEW OF MANHOLE COVER NOTE WHEN THE OUTLET IS PLUGGED THE LIQUIO DEPTH IS INCREASED TO 49 INCHES. 4 00 � � 4"PVC SCHEDULE 40 COUPLING(VENT) � n � s.00 � I — i ; � TOP VIEW OF TANK (TAPERED) � �i6.Q�—� ,.�� J.y��2.00 INL� � � � i 5icnwsaao j I I I— 6A50 4 WCH PRESS i � SEAL GASKET I I i i INSTALLED WHEN POURED I I j i 49.00 � � i i � � � i i i � � i i i � � i i i i i � i i L_________________________J s.00 SECTION VIEW OF TANK AND COVER s oo OUTLET END VIEW OF TANK Model Number: ZOOO HOLD/NG SKAW PRE-CAST � ) Approved for:HOLDING Phone: 715 967-2277 Weight n e im. Outlet Dim. �4 eP Gal./In. ax. ap. 26255 105th Street, New Auburn Toll Free: 1-800-924-8625 Wisconsin 54757 Fax: (715) 967-2707 16,1001bs. 52�, N/Fl 49„ 44.19 2�65ga1. W�skawprecasGcom HOLDING TANK SERVICINC CONTRACT Contract Date: � / � / �� This contract is made betwcen the Holding Tank Owner and the Pumper. Holding Tank Owner's Name: Pumper's Name: Northwest Sanitary, Inc. PO BOX 155 M � Radisson, WI 54867 Parcel ldentification Number: � i2 ��g�t Lega�y 1�� a � o - � � � - � Z - y � o � L The owner agrces to file a copy of this contract with the governmental unit, Sawyer County, which has acccpted and recorded with the Officc of thc Registcr of Decds, the Maintenance A�neement for a Holding Tank required under the Sawyer County Private Sewage System Ordinance for the issuance of a Sanitary Pennit 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 access road or drive so that thc pumper can service the holding tank(s) with thc pumping equipment. The owner further agrees to pay the pumper for a charges incurred in servicing the holding 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 tanlc(s) as required undcr SPS 383.55, Wisconsin Administrative Code and the Sawyer County Privatc Sewagc System Ordinancc. The pumpee 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 volumes in gallons of thc contents pumpcd from thc holding tank f'or each 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 agrees to file a copy of any changes to this service contract or a copy of a new servicc contract with Sawyer County within ten ( 10) business days from the date of change to this service contract. Owner'S Name: (PCint� Owri�i'S S1�TIlat : Only one owner signature required) �'�, � 5 , �c t��,J Pumper's Name: (Print) u��per's Signature: Ronald L Vieceli, owner Northwest Sanitary,lnc i�Tj�'2Z^2� G , /� (�l Pumper's Registration Number: #2389 Rev. 03/26/I 3 : .�., , � . lil liI ' � I �illl I I� ��il I) I�� ' -USE:BLACK INK ONLY- �nr�d;�r^��6'�� POWTS MAINTENANCE AGREEMENT ix:4i��4105 443'�CtO For Holding Tanks �'r�tlLA CF-IISSER 12E�ISTER�F DEEDS Owner's Name(s)as shown on deed° , SAWYER CClLlNTY, WI 03j31J202� 10:52AM J4.SOn! � /►1�/'iq/� /M(lte.✓ �ECQRt]ING FEE 3fl.00 Parcel Identification Number: (12 Digi[Legacy ID) 0 3 �-��Z- 0 �-�.�0.� PAG�S: � Legal Description of Property: -SEE ATTACHED SHEET - We acknowledge that application is being made for the installation of a hoiding tank(s)on the property described on the attached sheet. Retum To:Sawyer CountyZoning and Conservation Administration 10610 Main St.Suite 49,Hayward,W154843 As an inducement to the County of Sawyer to issue a sanitary permit for a hoiding 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 SPS 383,Wis.Adm. Code relating to holding tank management, including the following: 1. The owner agrees to contract with a person who is t�censed 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 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 serv�ce contract,with the govemmentat unit within ten(1Q)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 shali submit pumping reports to the governmental unit in accordance with SPS 383.55,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 governmental unit may enter upon the property to mvestigate 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 atrate a human heafth hazard as descRbed�n Section. 254.65, Stats.,the govemrrrerrtat unit rnay enter upon the property and service, or cause the tank to be serviced. Pursuant to Section 14520(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 66.0703,stats. The owner agrees to pay all charges and cost incurred by the governmental unit for inspection, pumpfng, haut�rtg,or otherwfse servrc�Rg and rrTaintaining ttre hafdiRg tank in such a rrranner as to preverrt or abate - any human health hazard 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 certifres that either a sa�f absorpt�on system that corrrplies with SPS 383,Wis.Rdm. Code,ar a rrrunicipaf 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 properry. 5. This agreement shati be b�nding uport the owner, the heirs of the owRer, and assignees of the owner.Tne owner shatl 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 ttre existence ofi ttre agreemerrt ta tre deterrrTirred by reference ta the praperty wher�e the Frotding tank is instaffed. .._f: �,, :� -Onl one wne ' nature r uired- I t ACKNOWLEDGM'ENT � ', Owner's Sigrratu : i State of: �J \-�w n ��^ ` '�� = Cou�ty of: S c�� '�e� - � _ Own s Name (Print): Subscribed and sworn to befor� m� on Chis � � ' _ �Hs:�n1 � �%Y��-7�� __ �'�day of m G r��,�., 20:�� Date: � By(��uner's Name): c�-- ��'�'�� ;_�,��'' �� , � J �v� "r�t�,a(3 _i Notary Public Signature: � ' """!� �— ------ � Drafted by: � Public Notary Name (Print): VY�� `� �(�'`� � lj�{�ccv.'t�.veA j My commission expires on: ' I "� S � �-(�_� �_ Personal informatian you pravide may be used for secondary purposes[Privacy Law,§15.04(t}(m}} — Rev.03l26/13 � The Southeast Quarter of the Southeast Quarter, Section 7, Township 37 North, Range 7 West, located in the Town of Weirgor, Sawyer County, Wisconsin, lying North and East of the Soo Line Railroad right of way. . Real Estate Sawyer County Property Property Status� Current Listing ' Today's Date: 3/22/2023 Created On: 2/6/2007 7:55:53 AM Description Updated: 6/29/2022 Ownership Updated: ll/2/2020 _ __ _ __ __ ___ __ _.___ _ _ _.._ _ ._ . _. . Tax ID: 31674 JASON 5 & MARIAH EXELAND WI P�N: 57-030-2-37-07-07-4 04- N MELTON 000-000040 Legacy PIN: 030737074404 Billing Address: Mailing, Address: Map ID: .16.4 JASON 5 & JASON 5 & Municipality: (030) TOWN OF WEIRGOR MARIAH N MARIAH N STR: 507 T37N R07W MELTON MELTON PO BOX 33 PO BOX 33 Description: PRT SESE EXELAND WI 54835 EXELAND WI 54835 Recorded 4.990 Acres: Site Address * indicates Private Road Lottery 1 1746N R APPLEBEE RD EXELAND 54835 Claims: First Dollar: Yes Zoning: (F-1) Forestry One Property Updated: 3/9/2021 Assessment ESN: 432 . _ __ .. . _ 2023 Assessment Detail Tax Districts Updated: 2/6/2007 Code Acres Land Imp. _ _ 1 State of Wisconsin RESIDENTIAL 5.060 9,900 4,300 57 Sawyer County 030 Town of Weirgor 2_Year 540735 Bruce School District Comparison 2022 2023 Change 001700 Technical College �and• 9,900 9,900 0.0% Improved: 4,300 4,300 0.0% Doc ments Updated: 10/15/2014 Total: 14,200 14,200 0.0% ____ ___ _ _ _ _ ___ _ WARRANTY DEED Date 427554 Property History Recorded: 10/28/2020 _ _ ___ _ _ _ _ _ _ . 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