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Home My WebLink About010-841-32-2111-SAN-2023-033 � _ . r xia%;,-.. County , ` Department of Safety � �� ' � �� = ,-i S b�t i 1� �� i� ;� & Professional Services, � ,, = Sanitary Perrnit Number(to be ftlled in by C \ �'; � Industry Services Division .�} �,x ,. ;� �, 3� 3 5 3 ' �, �_p,W�,S � _ .__ .�allltaly PeY'1Tllt AppllCat10I1 StateTransactionNumber , ` Q ln accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmentat unit � is required prior to obtaining a sanitary permit Note:Application fonns for state-owned POWTS are submitted to Project Address(if different than mgiling ac �+' the Department of Safety and ProCessional Services.Personal inforrnation you provide may be used for secondary purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. �� (��p�N L Applic�tion Information—Please Print All Inform�tion Property Owner's Name (��+\�� v-t Parcel# L �2e,� �i�- �,�-�,2 ; ��, �� ,.-� �•a � I � Property Owner's Mailing Address Property Location � � �� v,�o �q l�rG �� (,7� Go�t.�ot City,State Zip Code Phone Number • , � ` �� " �� S'�-!�`� 3 �" � ��< � � �� a, .SeChOR II.Type of$uilding(check aII that apply} Lot# � T Z � N R E or� f�t or 2 Family Dwelling-Numher of Bedrooms_� Subdivision Name Block# � ❑Public/Commercial-Describe Use .--- ❑City of _ ❑State Owned-Describe Use CSM Number ❑Village of _ a5/B7 ��`� I 9�r�,�,�r___—��.,/J�_2 V _ III.Type of POWTS Nermit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Comptete line C if a licable.) `�' �New System i� Keplacement System U Other Modification Co Existing System(explain) U Additional Pretreatment Unit(explain) B. � Holding Tank �-4n-Ground ❑ At-Grade ❑ Mound ❑ Individual Site Design ❑ Other Type(explain) (conventional) ist Previous Permit Number and Date lssued C• U Renewal E3efore ❑ Recision ❑ Change of Plumber ❑ Transfer to New Owner Expiration N.DispersalPCreatment Area and Tank IqformaHo�: Design Flow(gpd) Design Soil Applica,tl�n Rate(gpd s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Fle�'ation p^� � � r / �j 7 .� � '�.�� ^ K•� Capacity in Total #of Manufacturer Tank Information Gallons Gallons Units p � � ;? � New Tanks Exisiing Tanks y o d � y � � � ri v �in y v� i�: c7 a Septic or Holding Tank �� •�� V� Dosing Chambcr V.Responsibility Statement- I,the undersigned,assuroe respo bitity for' alt on at the POWTS s n on the attached pians. Plumber's Name(Print) Plumber's Si�ma e M PRS Number Business Phone Number �J��✓ n.�.�. ��- � � ►__3�� ,�s-yi� ,��,� Plumber's Address(Street,City,State,Zip Code �v'j y�2 � , � �` �� ,/��- �,✓ S��/ �`'� 1 VL County/Department Use Only �A ��d'3 ❑ Disappro�'ed Pennit Fee Date Issued Issuing,4gent Signature �✓ O Owner Given Reason for Uenial � l��'�� I�� I` � ��'��i '" `'"'� Conditions of Approval/Reasons for Disapproval � ..��_ � 3 _ . o � �� ` � '`�� . _. ►� � . ... , .,��;��. � � � � -' .�::�::�; �. ; r �i �r�i chk# ou��c�a_...�_�, _ -- APR 1 1 2023 ��.� C ST D`�— `��l 3 RC�,-� �_�� . � ---- , c ''�J� SAWYER CC;� .�•� Atlach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size , I �� SBD-6398(R.03/22) NO REFJNDS AFTER ISSI�E OF PEFS�VfI"f ��1/�\� ��jC � PAGE 1 OF 4 In-Ground Gravity Plan Index & Cover Sheet Component Manua/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 Owner Name(s): ��L E n/ /� f L k'�i'a1�2 Phone: - - OwnerAddress: 10 1� l� 1✓) � �� +- 1'�JZip: 5�C�l� � Project Address £L 5E✓1._ �ta La-� � Govt.Lot: /b 1/4 of/�/�l✓ 1/4,Section 3� ,T�N-R � E❑or W� Township: �`��4'C�✓h��0 County: Sk��G►'L Project Parcel ID#: � � ��j `I � 3 �� I � ' Designer Information Designer Name: Dan BurCh Phone: �15 _416 _1642 DesignerAddress: N5921 Cty Hwy K Spooner WI Z�p; 54801 E-ma1l: burchplumbinginc@gmaiLcom , �,,,�,t , .,��,;. „ ,,,;�, License Number: 253808 Remarks: Signature: .�' � Date: y— j �� Original s� nature required on each submitted copy. . ' SCALE - t • �10 �� . le1 4 � GbM f� 4691 , vol. a6 , �a. S'7 ae�/y, aw�/y , Sec. 3, , TY�nr� R8W ToW^� oF HAYww40, SAWY�R Go�NTY � '� ' $►1a Nw�� ui OpAN6E Rl$({O+� �N 17° OA1t N � : � D , O • � � w�'n � 4y` 95' �� ' a� 3 ;`��, cl� �I � gM/, �,�.�u s N �opeSed Id � o�:�d;�g � s:k m c3 e�..,� -� �:,�� P� b, 1•�� .�t � � G � �5�� Pro�et�y Owr�er: ��y �L�L�'J� E L E 11 A T 1 O N S 13M 1 O C . 00 � p1 95 . 50 � aa 45 . oo ' 63 9y . oo� IN-GR4UND DOSED-GRAVITY DISPERSAL AREA � Uniform Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (dawn-sizing credit) � min. 12�� TYPICAL TRENCH SOIL COVER «P��I� CROSS SECTION VIEW ,2" min. trench (No Scale} depth � • �lYPIC31) •�. a . .a' � � • ,. • . d a i�--- -- - 34„ .a' . . ' (typical) ;', ^ :� a a � � Provide minimum 3 ft • ° �� '_ � 3 separation between trenches. System Elevation = ft (typical) Quick4 Standard-W w/ End Cep Observation Pipe (typical) (Show location of inlet / outlet pipe connection on plan view.) <<yp�� TYPICAL TRENCH Install per manufacturer's — — instructions. P�N V�EW — — — — — — — — — �- — — — — — — — � — — — — (No Scale) i-- �,�.�,,� �e w,� ," . -� /� ,��"� ��' ��+��'�� I '� � x �, Xi y� F y ;4 '�,� `� � Y v � .`�r �r a y� � , ��I �A = 3.Oca� „ � �r�,�.;�n��.��', — — — — — — — �� — — — — — — — -��- — — — :�� A� = ��r,,��,��r w.�� riP� � � �-- B = � �� ft �i � (typical) Quick4 Standard-W Chamber (� INSTALL PER TRENCH: �typ�� W (mfd by Infiltrator Systems, Inc.) O > Install pursuant to manufacturer's instructions. .�� Quick4 Std-W @ 20 f� EISA/chamber = `� � ft2 �1 + � Pairs of end caps @ 6 ft2 EISA/pair = � ft2 � = Proposed EISA per trench = � ftz Required Infiltration Area = � � ftz Distribution Method: x c, _ trenches = Proposed Total EISA = �5 �- ftz ��E�� I �7 �w�i:y"'rt� PAGE40F4 In-ground Gravity Management Pian IMPORTANT: The owner of this in-ground gravity system shall be responsible for fts perpetual operation and maintenance pursuarrt to requirements of SPS 382384,Wisc.Admin.Code. Pursuant to SPS 383.52(2),Wisc.Admin.Code,this system shall be considered a human health hazard'rf not maintained in accordance with this approved management plan. Furthermore,all inspection and maintenance activfties shall be pertormed by a reglstered POVYT3 Maintalner in accordance with SPS 383.52(3),Wisc.Admin.Code. Ma�cimum Disaersal Area Oaeratlna Limits: Design Flow= �s� gpd; BODS 5 220 mgL''; TSS 5150 mgL''; FOG 5 30 mgL'' Insoection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors(i.e.odors,user complaints,etc.} o mechanical maifunction(i.e.,pumps,vaives,switches,floffis,etc.) o material fatigue(i.e.,leaks,breaks,corrosion,etc.) o solids volume in anaerobic treatmerrt tank(s)ar�d any distribution appurtenance(s)(i.e.,distribution/drop boxesy o negiect or improper use(i.e.,exceeding design capacitles,prohibited activiGes,etc.) o e�erd of ponding in disiribution cell prior to dosing o dosing irregularities-if applicable(i.e.,pump re-cyding,float switch settings,etc.) o eledricai components-'rf applicable(i.e.,wiring,connections,switches,controls,timers,alarms,etc.) o distribution lateral or lateraf orifice plugging (measure lateral distal pressure-compare to design specfication) o surface diacharge of etfluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS(or when necessary) o Seotic 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 Ilquid volume of the tank(s)or as required by local ordinance. Disposal of�ntents shall be pursuant to NR 113,Wisc.Admin.Code. o Effiuent fliteNsl shall be inspected every 3 years and shall be deaned when necessary to remova any accumulated solids according to manufacturer's specifications. A serviang period will always be greater than 12 months. 3yatem maintenance reports shali be submitted to the proper local govemment unit in accordance with SPS 383.55 Wlsc.Admin.Code. Report any component failure or malfunction to: Name of individuaf or company: D8f1 BUPCII Pho�: 715.416.1642 �oc.�i yo�e��me�t un�: Sawyer County Zoning Pnone: 715.634.8288 �ocal govemmem unit address: 10610 Mair1 St. #49 Z�p; 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 diemical or physical restoratlon of the POWTS may be us�unless approved by the department in accordance with SPS 384,Wisc.Admin.Code. ConUnaencv Plan In the event that any failed treatment component of this POWTS cannot be repaired,it shall be rep�aced pursuant to a pian submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be abandoned and replaced by a code-complying dispersai component in a pre-determined area of suitable soils. Svstem Abandonment If use of this POWTS is discontinued,it shall be abandoned in accordance with SPS 383.33,Wisc.Admin.Code. WLP1000— MR TANK SPECIFICATIONS ? o o a 8�-8�• � � DIMENSIONS: � o WALL: 2 1/2" a � 4" CAST-A-SEAL 4" CAST-A-SEAL BOTTOM: 3" COVER: 5" --�=______;� MANHOLE: 24" I.D. PRECAST CONCRETE RISER Q �� \\ HEIGHT: 53 1/4" � ��% �� LENGTH: 8'-8" � ii �� WIDTH: 7'-2" w ii `7.°` �� BELOW INLET: 42" � i �' �� iQ ' ��'�`�� \ LIQUID LEVEL• 36" - 0 N I � � WEIGHT: 6,790 LBS. � a o � � �� -'� �� -' �� WLET AND OUTLET: _� 3 0 0 �� // 4" CAST-A-SEAL BOOT OR EQUAL GASKET � m o a �� FILTER OR // o _ �� BAFFLE �� 3 w 3 �� , INLET AND OUTLET BAFFLE AND FILTER: Q Q � w � `�;, _ ,;�' WISCONSIN, SEE DETAIL #10 � o o � - ----�� (OTHER STATES SEE CHART) W � � LIQUID CAPACiTY: 27.83 GAL/IN W � TOP VIEW � HOLDING TANK: � ACTUAL A ACITYGGE085 GALLONS 0 � � z w LOADING DESIGN: 8'-0" UNSATURATED SOIL Q �n � N � TANK CAN BE USED AS: � o � N � SEP11C / HOLDING / PUMP OR SIPHON W } o a = �S � o � = o� � COVER: MIX DESIGN #8 (NO FIBER) �i � � TANK: MIX DESIGN #10 (STRUCTURAL FIBER) � � --- ---- _� CUSTOMIZED TANKS: � 3 ---- ` --- FOR CUSTOM TANKS CONTACT WIESER CONCRETE INLET - OUTLET M �U ' — � - - — I - "�*Q - � cn � � I �n � �U - J <F � d' � NJ � � n- c M � � � �t Z Q � � -- -------�-�_`"=� O � 2 ' `_ REVIEWED BY � c� ;� PUMP PAD REVIEW DATE � a w DRAWINGS SUBMITTED � SIDE VIEW FOR APPROVAL APPROVED BY: SHEET N0. APPROVAL DATE: � � OF PRODUCTS NEEDED BY: / � TANKS ARE MANUFACTURED TO MEE7 OR EXCEED ASTM C-1227 REQUIREMENTS Soil Profile Sheet Owner, kilv,,�� SoilTeSte�: I�S S� . 1 System Ele�at�on: °�2�� Load Rate: �-� System Rangd9l.S�ro q a.2S , _ � � -- � ��n ........... ...... ..... .......... � :........... .... ..... �� ........... �� ... :: ::: : _:: ..... .........-- ...... ..... , ...._...... ........ q.., ...._...... ..... .... ...... ......... �� ..._........ ..- .--- ........... ::::::...... , .... ...... ............ i .....-9S; ,........:. �S ..........:... � .---....._. :........... ........ � .... _atS�� --� ............ ..--� �--�• o.co ............ � • ............ , ............ , � ... ... -�y.�r� — ... ... ...... ...... �Y :...---�--.. y _ n ............ ............ I _aY�a� n.� �3 � :::: ::: _G3,a5� � ::: :.. .:: :.: —93.5�� . ............ ...... ........... 0_ ..........: o�7 .......... ............ � ........... ............ ........... � � ........... o� ............ , 1 � ............ ............_� ,s ............ ............ V ..._....... � �( �'� i ........... ........... _9f,c� �- ............ .........: � ........... � n,.-Q- , y�.�S �- ........... ........... _ ----:_... . ,�,� ��i ............ .._........ � k3' .--....... ............ ........... � k3� ..._....... ........... ............ ............ , i ............ / ............ � .._........ � ............ �-3 ............ �, ............ _�.� ............ � � ........ ......:..... � ..... ...... � .._ ..... ...... _�8.og ::: :::: � ............ ............ ............ �� -B7.r, ........---. ........ , � ..... ...... ..... ........_... � .......- .. - -... ...... ......_:. �� ..._. ..... ...... 4117/23, 12:15 PM Real Properiy Listing Page RCdI EStdte Sawyer County Property Listing Property5tatus: Current Today's Date: 4/17/2023 Created On: 2/6/2007 7:55:20 AM �Description Updated: 6/20/2022 '� Ownership Updated: 3/17/2023 7ax ID: � 11642 LOREN G&LOURDES KILMER HAYWARD WI PIN: 57-010-2-41-08-32-2 01-000-000110 Legacy PIN: 010841322111 Billing Address: Mailing Address: Map ID: .5.11 LOREN G&LOURDES KILMER LOREN G&LOURDES KILMER Municipality: (O10)TOWN OF HAYVJARD 10299N ROUND LAKE SCHOOI RD 10299N ROUND LAKE SCHOOL RD STR: 532 T41N ROBW HAYWARD WI 54843 HAYVJARD WI 54843 Destription: PRT NENW LOT 4 CSM 25/87 #6691 m Recorded Acres: 1.020 r Site Address * indicates Private Road Calculated Acres: 1.020 � � � - � -�� Lottery Claims: 0 First Dollar. No l.J Property Assessment Upda[ed: ll/9/2015 Zoning: (RRl) Residential/Recreational One Z023 Assessment Detail � ESN: Code Acres Land Imp. i GI-RESIDENTIAL 1.020 19,000 0 �7 Tax Districts Updated: 2/6/2007 1 � � State of Wismnsin 2-Year Comparison 2022 2023 Change 57 Sawyer Counry Land: 19,000 19,000 0.0% O10 Town of Hayward Improved: 0 0 0.0% 572478 Hayward Community School District Total: 19,000 19,000 0.0% O01100 Technical College • Recorded Documents Updated: 3/17/2023 �L'�proper[y History WARRANTY DEED N�q Date Recorded: 3/14/2023 443702 WARRANTY DEED Date Recorded: 6/13/2022 439639 WARRANTY DEED Date Recorded: 10/18/2004 325926 CERTIFIED SURVEY MAP Date Recorded: 11/13/2003 317181 https:Utas.sawyercountygov.orgOsystemlframes.asp?uname=Eric+�ryellauer �� __..ia i .i -�r'. �/��s . ,� � :_ �,, ' �..� . 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