HomeMy WebLinkAbout004-839-24-5403-SAN-2023-035 Department of Safety �°°"ry D
_: � s c�w �' �
� & Professional Services,
s - Sanitary Permit Number(to be filled in by
�= Industry Services Division
>„, C�' 3`� �355 �
State Transaction Number W
Sanitary Permit Application �
In accordance with SPS 383.21(2),Wis.Adm.Code,submission ofthis form to the appropriate govemmental unit �
is required pnor to obtaining a sanitary permit.Note:Application forms for state-owned POWTS are submitted to Projec[Address(if difterent than mailing; V
the Department of Satety and Protessional Services.Personal information you provide may be used for secondary �1
purposes in accordance with the Privacy Law,s. 15.04(I)(m),Sta[s. S ���N �pv��r �aWY G�
I.Application Information-Please Print All Information � �
Property Owners Name Parcel# �Sc�b�
James � T� I� e Zb� n�ew� c-z (�ON-- 839 -ay-�
Property Owners Mailing Address Property Location
a �9 a �„�ti,; �,� a� ��p.L°`���
City,S[ate "Lip Code Phone Number
S v n 1�f`G�.� C'�e.. � W Z 5',3� p , a, ection el Y-
IL Type of Building(check all that apply) 3 Lot# � � � T .3 '�1 N R O$ 6-e
�1 or 2 Family Dwelling-Number ofBedrooms o Subdivision Name
E31ock#
❑Public/Commercial-Describe Use �
❑City of
❑State Owned-Describe Use CSM Number ❑Village of
I`1 I �3 I ���c� 4�"ro�of Co.��e c-ay
I IL Type of POWTS Permit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C i
a licable.
'4 ❑ Re lacement S stem g y p p
�New System p y ❑ Other Modification lo Existin S stem(ex lain) ❑ Addi[ional Pretreatment Unit(ex lain)
B' ❑ HoldingTank �In-Ground ❑ At-Grade
❑ Mound ❑ Individual Site Design ❑Other Type(explain)
(conventional)
C• ❑ Renewal Before ❑ Revision ❑Change of Plumber ❑Transfer to New Owner �st Previous Permi[Number and Date[ssued
F.xpiration `
IV.Dispersal/Treatment Area and Tank Information: � , v: K 4 P Ivt ha+» ers a SetS eE Gn�S
Design Flow(gpd) Design Soil Application Rate(gpcl/st) Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation �
ySv o .� �y3 � Gs , 4C.. 3 C�
Capacity in Total #of Manufacturer
� �
Tank Information Gallons Gallons Units � � o � � v_
New Tanks Existing Tanks "� o v � Y � iv �
�A�'14� a U in � v� u.. t'7 fi.
TANK
Septic or Holding Tank OO O I O�� � �
Dosing Chamber `�� — ��
V.Responsibility Statement- 1,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans.
Plumbers Name(Print) Plumber�s Signature MP/MPRS Number f3usiness Phone Number
��,�.�a � � r� �'� aa c.�ae �,s•.S 58 -(oy7 Z
Plumber's Address(St eet,City,State,Z.ip Code)
9aoSN .S�k Raad 37 Ha w-�o��d, �^'2' �"yay3
V1.Co n /Department Use Only
�Ap� �e ❑Disapproved $ertnit Fee � Date Issued Issuing Agen[Signature
❑Owner Given Reason for Denial Y��' �I`�'`{ I � � �'�'�%'�n-�"-'�"`�r�"v�'—
Conditions of Approval/Reasons for Disapproval -•. � �' ��` �� �,' ; ;�',
i ,�1� �� �: 1
� ��, � h u �-� a 3 �__ _ -- \`'� :�
:i ���' ��i � ��a le____��__.r_...�..�____.�.-m-- APR 18 2023
�-q►� ..
�.hk# ��'�� --�
C ��(�,—��� . SAWYER COUNTY
� / ,'�nY�--.I.��'�'(s _ ____ ��NG ADMINISTRATION
rY►
Attach to complete plans for the system and submit to t e County only on paper not less than 8 Irz x 11 inches in size S � ���
sBD-639s(x.o3i22) NO R�FJhDS AFTER
t5 sUE UF PEF�MIT
PAGE 1 OF 5
In-Ground Dosed-Gravity Plan
Index & Cover Sheet ��.
Component Manual Design References:
Version�, SBD-10705-P (N.01/01, R. 10/12) � , '
� 2 - 2�
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
Zbigniewicz - County Hwy "CC"
Owner Name(s): James & Julie Zbigniewicz Phone: - -
Owner Address: 2792 Twilight Dr ; Sun Prairie, WI Z�p; 53590
Project Address: County Hwy CC
Govt. Lot: 4 1/4 of 1/4, Section 24 , T 39 N-R 08 E ❑or W ✓❑
Township: Couderay County: Sawyer
Project Parcel ID #: 004-839-24-540�
Designer Information
Designer Name: Ronald A Spreckels Jr Phone: 715 _558 _6472
Designer Address: 9205N State Road 27; Hayward, WI Z�p; 54843
E-mail: ronspreckels@yahoo.com .,.,_ ,�� ���5��,������ �, ,�,r�, . ;,.::;���_
License Number: 226688
Remarks:
Signature: Date: �j' / I 8133
Original si natu required on each submitted copy.
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rouN oF Gu.,oEany, SAWyER ��UNr`T
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-SYo3
GT = I0001400 Sa1. CornDlna�lon se���c/
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� bY W�eS�r Gvne�l.e. w/ �r�e.lrnrL7-�/b
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AP- Absa�pt�� RRc co�+s:s�rnq nF fwo
cella, S�ca<2 � 3fF a�.r}, <ev+>-a4a:.�
4�'O�F4� OF 3] Q�:GK4 PlvS Cl�a�+Eat�'S
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1�rapesed �� �
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� (if1:. To�oG P�ape��y SkaKC
(�!a"��" Iro�6..r)
f��, Fn�ct Mat n
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e� �, ELEvhT I o N s
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a �c�KE ' ss.o o PE
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$'1� — — '_
�Q9�? e F s
IN-GROUND DOSED-GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard-W Chambers
3-ft Trench (down-sizing credit)
�
""" 12 TYPICAL TRENCH
SOIL COVER (Np1ca1J
CROSS SECTION VIEW
,z
min.tre�cn (No Scale)
depm
(NPlca�� . . '
.'. '
a ,
r 34„ �'� � . .
�rypicap , , Provide minimum 3 ft
• � ' separation between trenches.
System Elevation = 96.30 ft
(typical)
Quick4 Standard-W
w! End Cap observanon wpe
(typical) (Show location of inlet / outlet pipe connection on plan view.) <<YP���� TYPICAL TRENCH
Ins[all per manufacturefs
��s«�����s. PLAN VIEW
- - - - - - - - - - - - - — �_ (NoScale)
�ppp���!I ;At�[MIe[�(�14 �� �� — — — —e•sns revtPrl�esrmr 1 T
I� � , 4 ^ � d �i� I A = 3.0ft
0
��i�JIYI rY�li � ' �Wrai�ia�wYa����au _j � (ryPical)
- - - - - - - - -�'�' - - - - - - - -�j`- - - - - - - - - �
� B = 67 ft � — { �
(typical) Quick4 Standard-W Chamber m
INSTALL PER TRENCH: (tyP���� �''�
(mfd by InfiltratorSystems, IncJ O
Install pursuant to manufacturefs instructions.
� 6 Quick4 Std-W @ 20 fl� EISA/chamber = 320 ft' �7
+ � Pairs of end caps @ 6 ft' EISAlpair = 6 ft' �
= Proposed EISA per trench = 326 ft� Required Infiltration Area = 643 ft� Distribution Method:
x 2 trenches = Proposed Total EISA = 652 ft� branched manifold
�
PAGE 4 OF 5
GRAVITY-DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4"0 Ven1 Pipe
>10 ft from
Building Electnral must comply wilh
12"Min-or2Aftabove SPS316andNEC300
Eslablished Flood Elevation Wealheryroof E�end manhole nser as necessary.
(ryP��l) Approved �unclion Box
Vent Ca APP��ed Locking Manhote
IMPORTANT: � P ��m wam�n9�aeei ni�acned
Anchor tank(s)as necessary «YP��I�
pursuant[o SPS 383.43(8)(g) �cond�a
4"Min.or 20 f[above
Eslablished Flood Eievalion
(NPiral)
�Airtighl Seal
Finished Grade �
Quick DisconneG
1 B"Min.
CAPACITIES @ � 1•$2 galfin y _ .- �ryP'��>
Depth (in) Volume (gal) • o �
A 31.0 366.42 — *� w�v �—Avv���ee�o���s�m
Hole Appmved Pipe 3 it onto
B 2.0 23.64 q Solid Ground
� nYw��>
[C] 6.0 70.92
_Alarm
D 12.0 141.84 �B ��0-0�
� [C] PUMP-0FF
*Pump Ta�k Liquid Level = 51 in
� P°mP �_orr ELEVATION = 92�0 ft
° INSIDE BOTTOM
Force Main Diameter = 2 in c°""e`e
�� Bi°°k ELEVATION = 91•� ft
Force Main Length = 68 ft 3"Approved Bedding Matenal8eneath Tank
Force Main Void Volume = 11.08 gai
[C] Total Dose Volume TDV = 70.92 gal/dose
��
(<0.2X design flow+force main void volume)
Vertical Lift = 5�3 ft
PUMP TANK: SEPTIC TANK(S):
Volume = 602.82 gal Total Volume = 1000 gal
Manufacture ser Concrete Inc Manufacturer(s Concrete Inc
Pump Manufacturer: Liberty
Install approved effluent filter at the septic tank outlet
Pump Model: 253 (Seeattarhedpumpcurve.) immediately upstream ofthe pumptankinlet.
Controls/Alarm Manufacturer: SJE Rhombus Filter Manufacturer: Lifetime FilterLLC
Controls/Alarm Modei: PS Patrol
Filter Model: LT-1/8
Float switches containing mercury are prohibited.
PAGE SOF�%
in-ground Dosed-Gravity Management Plan
IMPORTANT:
The owner of this in-ground dosed-gravity system shall be responsible for its perpetua� 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 heaith hazard if not maintained in accordance with this approved management
plan. Furthermore, all inspection and maintenance activities shall be pertormed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operatinct Limits:
Design Flow = 450 ypd; 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 prior to 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 W is.
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. Disposai of contents shall be pursuant to NR 113,Wisc. Admin. Code.
o Effluent filter(s1 shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servici�g period wiil always be greater than 12
months.
System maintenance reports shall be submitted to the proper local govemment unit in accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or maifunction to:
Name of individual or company: ROC181d A SpfeCkelS J� Phone: 715-558-6472
�o�i 9ovemme�t ���c: Sawyer County Zoning & Conservation Pno�e: 715-634-8288
�oca� government unit address: 10610 Main St, Suite 49 ; Hayward, WI 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 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 repiaced 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.
Svstem Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33,Wisc. Admin. Code.
W1000/600-MR
,,,�•� TANK SPECIFICATIONS �
� �
DIMENSIONS: a ai
WALL: 2 1/2" w �
BOTTOM: 3" a a
COVER: 5"
MANHOLE: 24" I.D. PRECAST CONCRETE RISER �
� � HEIGHT: 69 1/2" O.D. �
/ \ LENGTH� 114 7/8" O.D. `a
WIDTH: 93" O.D.
BELOW INLET: 57" O.D. w �
LIQUID LEVEL: 51" �a, � o
h
mz4" � � WEIGHT: 12,380 LBS. N
O1 TY� � � INLET AND OUTLET: o
4" CAST-A-SEAL B00T OR EQUAL �
FILTER OR GASKET, CAST-A-SEAL BOOT OR EOUAL � a g
\ BAFFLE / INLET AND OUTLET BAFFLE AND FILTER: ' � ��
WISCONSIN, SEE DETAIL �10 m � �
� _ � (OTHER STATES SEE CHART)
K Q
J
LIOUID CAPACITY: 19.61 GAL/IN (SEPTIC) � � �`
11.82 GAL/IN (PUMP) W �
a
TOP V�EW LOADING DESIGN; 8' 0" UNSATURATED SOIL �y �
� �
MN TANKS: � x �p
WILL HAVE ONE VENT OVER OUTLET C o �n
AND WIIL HAVE TWO VENTS IN COVER OVER W�ET p �
` z �
N a 4" VENT TANK CAN BE USED AS: a �
a � SEPTIC/SEPTIC, SEPTIC/PUMP � � N
�
�n OR SEPTIC/SIPHON `V � I
O
COVER: MIX DESIGN �8 (NO FIBER) W � �
WLET — TANK: MIX DESIGN p10 (STRUCTURAL FIBER) �
OUTLET �
CUSTOMIZED TANKS: � M
FOR CUSTOM TANKS CONTACT WIESER CONCRETE 3
�
c�0 ' � U � � U �
"' Zl,� � `v � � � y. N � j O
2
O a Z
� � �
JOB INFORMATION : � � o
0
o F w
� PUMP PAD CUSTOMER: 3 N j
]OB NAME: �
SIDE VIEW DATE NEEDED:
SHEET N0.
APPROVED BY:
APPROVAL DATE: 1 OF/
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS � �
4I20/23,9:36 AM Real Property Listing Page
Redl EStdte Sawyer County Property Listing Property Status: Current
Today's Date: 4/20/2023 Created On: 2/6/2007 7:55:10 AM
�Description Updated: 1/3/2020 '� Ownership Updated: 10/21/2021
Tax ID: 5500 ]AMES A&]ULIE A ZBIGNIEWICZ SUN PRAIRIE WI
PIN: 57-004-2-39-08-24-5 OS-004-000030
Legacy PIN: 004839245403 Billing Address: Mailing Address:
Map ID: :4.3 7AMES A&)ULIE A lAMES A&]ULIE A
Municipality: (004)TOWN OF COUDERAY ZBIGNIEWICZ ZBIGNIEWICZ
STR: 524 T39N R08W Z792 NJILIGHT DR 2792 TWILIGHT DR
SUN PRAIRIE W153590 SUN PRAIRIE WI53590
Description: PRT GOVT LOT 4 LOT 1 CSM 19/131
#5629 m
Recorded Acres: 1.050 r Site Address * indicates Private Road
Calculated A�res: 1.033 5783N COUNN HN/Y CC � � COUDERAY 54828
Lottery Claims: 0
First Dollar. No J property Assessment Updated: 4/8/2022
Waterbody: Ashegon Lake 2023 Assessment Detail
Zoning: (RRZ) Residential/Recreational Two Code Acres Land Imp.
ESN:
G1-RESIDENTIAL 1.050 60,200 0
�+� Tax Districts Updated: 2/6/2007 Z-year Comparison 2022 2023 Change
1 State of Wisconsin Land: 60,200 60,200 0.0%
57 Sawyer County Improved: 0 0 0.0%
004 Town of Couderay Total: 60,200 60,200 0.0%
576615 Winter School Distric[
001700 Technical College �
�i'Property History
• Recorded Documentr Updated: 10/21/2021 N�q ���
WARRANTY DEED
Date Remrded: 10/20/2021 435377
WARRANTY DEED
Date Recorded: 9/30/1997 263433
CERTIFIED SURVEY MAP
Date Recorded: 8/13/1997 262507
https://�assawyercountygov.orglsystem/frames.asp?uname=Eric+�n/ellauer ���
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