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HomeMy WebLinkAbout026-839-07-5211-SAN-2023-061 , � - '' Department of Safety c°°"ty s a w t�- � • = & Professional Services, y � a Sanitary Permit Number(to be filled in by �= Industry Services Division � � 3� �� � � ,,.. c.,� Sanitary Permit Application State Transaction Number � (n accordance with SYS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit � is required prior to obtaining a sanitac} permit.Note:Application forms Yor state-owned POWTS are submittcd to Project Address(if different than mailing: � the Department of Safety and Professional Services.Personal infonnation you provide may be used for secondary — purposes in accordance wi[h the Privacy Law,s. 15.04(I)(m),Stats. ) t,i 3�O W 'j'�D,rp��,qk�d�G,�..�1 1.Application Information-Please Print All Information � Property O�vner's Name Parcel# S�-cvet, + J���e pyl� O��^ 839� 07 5�t1 Property Owners Mailing Address Prope�Location ) :7011$ rcl:r"�Gn1CS Tf-� /V� Gbvi.Lot al City,State Zip Code Phone Number p�+:�e- (�{�G� M N Ss3'7 a _�a�_,' 4. Section �� � II.Type of Building(check all that apply) Lot# � T 3 9 N R C�$ Eer �I or 2 Family Dwelling-Number ofBedrooms 3 Subdivision Name �— [31ock# ❑Public/Commercial-Describe Use .— ❑City of ❑Slate Owned-Describe Use CSM Number ❑Village of G5 M i$Cv 8 SS �•own of J�o..rG� LaKG--- �.. ��• P.7G [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 if a licable. '� �New S stem y ❑ Replacement System ❑Other Modifica[ion to Existing System(explain) Additional Pretreatment Unit(explain) B' ❑ Holding Tank (�[n-Ground ❑ At-Grade � YP ( P ) ❑ Mound ❑ [ndividual Site Desi Other T e ex lain (conventional) ist Previous Permit Number and Date fssued C. ❑ Renewal Before ❑ Revision ❑Change of'Plumber ❑ Transfer ro Ncw Owner �_ Expiration IV.DispersaUTreatment Area and Tank Information: � $ Qu�CK �l Pluy Cha.+.b«5 w/ �SstS o F s nd Design Flow(gpd) Design Soil Application Ra[e(gpd/st) Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation c�� ?J� �,+Sp o. c� 7So '�- � ��. �FE Capacity in Total #of Manufacturer� � Tank Informarion Gallons Gallons Units � ,n � o v � New Tanks Existing Tanks � � � � Y � � � n. U vi � v, w C7 G. Septic or Holding Tank I Ou ^ O � ��,L S�,j-C��,K� x Dosing Chamber V.Responsibility Statement- t,the undersigned,assume responsibility tor installaGon of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber s Signature MP/MPRS Number Business Phone Number a ,��,�,15 �� �� aac.�sa ��s--sss-Gy7a Vlumber's Address(Stre C,City,State,Zip Code) �aoSN S�'�++e, Ro a� a� �-�a ��.�a, w z sy a y3 Vl.County/Department Use Only �App v � ❑Disapproved $ermi[Fee Date Issued Issuing Agent Signature 0 Owner Giveo Reason for Denial Y�•�a �I �� �a� �Z � Conditions of ApprovaUReasons for Disapproval W 55 D � ���?��f�{' r� aIS�D S �s�.,_.��.__._ ._. V ��� :, , � � ►� �� — s � ���' �� s�# a�s� .. _ MAY 2 4 2023 � .�:,,µ;�t�_�53�'- ----- SAWYER COUhl7Y C��� oz " l�� VVI� ZONING ADMINISTi��T(QN Attach to complete plans for the system and submit to the County onty on paper not less than 8 In x 11 inches in size NO R�FJIVDS AFTER SBD-6398(R.03/22) ISSUE��PEFSi1�IT PAGE 1 OF 4 In-Ground Gravity Pian 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 Pyle-Thoroughfare Ln Owner Name(s): Steven&Julie Pyle Phone: ' - - Owner Address: 15218 Fairbanks Trl NE; Prior Lake, MN Zip; 55372 Project Address: 14370W Thoroughfare Ln Govt.Lot: 2 1/4 of 1/4,Section �� ,T 39 N-R 08 E❑or W❑✓ Township: Sand Lake County: Sawyer Project Parcel ID#: 026-839-07 5211 Designer Information Designer Name: Ronald A Spreckels Jr Phone: �15 _558 _6472 Designer Address: 9205N State Road 27;Hayward,WI Zip; 54843 E-mail: ronspreckels@yahoo.com _ _; .: : License Number: 226688 Remarks: Signature: �i�",� �� Date: vs/a3/d3 —�riginal signature r uir on each submitted copy. � Pa�a. ��F y_ r �� s r i �Y � 6"'� .� PLo-r P � r� N a , P� /� � � r� SGALE = i : y0 � r��� � :—F 4 i � 1 � �� /� � O 10 iS y� � 80 IV O / �4 370 W THOROuGH FARE L/J � P/o 6ou+ Le� ] � Lea 1 GS►9 M 46SS v.�4 p.'� (� / Sce. oh, T39N , Reaw Tvwn .af (3ase LaKc �� Sa...,yer Cv �nay �roQ�4^ � 3�,`:'� p��. �a�- sa9- o� s� „ o �,o QN= NA\(, Wf (L18SON IN D J�S�*• 1a" On�c �y��frFg11 . � � E' IEVA'rlon�5 � 6M = I �o .00F� �31 - qt, .4U FE Cia _ 9` . 3o F� .E--.,�n t33 = 9s. 9v f� 0�� 5 i= 1600r�at. � rc.�ab co++cre�c st�;� c �uAk �de by W�eSer GenGK�-e ln[, I,af! L:�c�+rnc Fi/�itr LLC Lf-�/8 Fl l�ht� /.�p � (�bSerP}-.'on PKl cw+s%SF��f o� �u CeUs, SPcced �34k nperl, Len►a�e;^3 Q �er-arot 3pQ��ci� YPtis ctid.�.bcs ■ 63 d� qv > e 3 W � � G �-p'fMpwe�6HaaqE L�I 'T'c� T1i L�+6i Septic Tank(s) Manufacturec � IN-GROUND GRAVITY DISPERSAL AREA wieser Concrete Inc Uniform Elevation Trenches with Quick4 Standard-W Chambers SepticTank(s)Volume(s) 3-ft Trench (down-sizing credit) �oo0 9a, gal gal 9a� Effluent Filter Manufacturer: � Lifetime Filter LLC � Etn�e��Fu�e�nnodei»: LT-1/8 min.12' (rypicaq SOIL COVER 12" min.trench depM �am�u • TYPICAL TRENCH a CROSS SECTION VIEW �«,p,� • (No Scale) \ � ' Provide minimum 3 fl System Elevation = 9 � ft G' � � ( separation between trenches. (typical) � Quick4 Standard-W w/End Cap Observatbn Plpe TyPICAL TRENCH t ical (Show location of inlet/ outlet pipe connection on plan view.) (tiai�q �yp � Inslallpermanufacturefs PLAN VIEW Instructlons. �NO .SCB�@� f j��asese��w���'- - - - �� - - - - - - - �� - - - -ns�wri s�rR�.alner4*eFl, � � � �I I� A= 3.O ft � �� filW.�il�i�Y"� — — — — ��' — — — — — — — �� — — — t�a..�YaYr��Wlur[a�y J (hPical) Y _ B _ 79 n � —� m (typical) �uick4 Standard-W Chamber W (�YPical) O INSTALL PER TRENCH: (mtd ey��mt�arorsystems,mc.) � 19 Install pursuant lo manufacNrefs instructions. � Quick4 Std-W @ 20 ft� EISA/chamber= 380 {�� + � Pairs of end caps @ 6 ft EISAlpair= 6 ft� = Proposed EISA per trench = 386 ft' Required Infiltration Area = 750 ft' Distribution Method: x 2 trenches = Proposed Total EISA = 772 ft� 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 Operating Limits: Design Flow = 450 ypd; BODS<_ 220 mgL"'; TSS <_ 150 mgL"'; FOG <_30 mgL-' Insaection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance fadors (i.e. odors, user complaints, etc.) o mechanical maifunction (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 negiect 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 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 shall be pursuant to NR 113,Wisc. Admin. Code. o Effiuent filter(s)shall be inspected every 3 years and shall be Geaned 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: ROIl81d A SP�eCkelS Jf phone: 715-555-6472 �o�ai 9o�e��me�t „�;t: Sawyer County Zoning & Conservation phone: 715-634-8288 _ Local government unit address: �OO'I O M81f1 St, Su'ite#9; 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 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 wmponent 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. Soil Profile Sheet Owner. 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SI25123,7:38 AM Real Property Listing Page Redl EStdt2 Sawyer County Property Listing PropertyStatus: Current Today's Date: 5/25/2023 Created On: 2/6/2007 7:55:46 AM �Description Updated: 12/20/2022 ''�'� Ownership Updated: 12/20/2022 Tax ID:�� 27395 STEVEN G &JULIE M PYLE PRIOR LAKE MN PIN: 57-026-2-39-08-07-5 OS-002-000110 Legacy PIN: 026839075211 Biiling Address: Mailing Address: Map ID: :2.11 STEVEN G&IULIE M PYLE S7EVEN G&IULIE M PYLE Municipality: (026)TOWN OF SAND LAKE 15218 FAIRBANKS TRL NE 15218 FAIRBANKS TRL NE STR: 507 T39N ROBW PRIOR LAKE MN 55372 PRIOR LAKE MN 55372 Description: PRT GOVf LOT 2 lOT 1 CSM 26/76 w #6855 r Site Address * indicates Private Road Recorded Acres: 1.440 14370W THOROUGHFARE LN * STONE LAKE 54876 Calculated Acres: 1370 Lottery Claims: 0 l.� property Assessment Updated: 9/28/2017 First Dollar: Yes -- � Waterbody: Lac Courte Oreilles 2023 Assessment Detail Zoning: (RRS)Residential/Recreational One Code Acres Land Imp. ESN: 448 G1-RESIDENTIAL 1.940 217,000 3,500 2-YearComparison 2022 2023 Change �� Tax Districts Updated: 2/6/2007 Land: 217,000 217,000 0.0% 1 State of Wisconsin Improved: 3,500 3,500 0.0% 57 Sawyer County Total: 220,500 220,500 0.0% OZ6 Town of Sand �ake 572478 Hayward Community School District 001700 Technical College � property History N/A a� Recorded Documentr Updated: 3/7/2022 WARRANTY DEED � � Date Recorded: 3/4/2022 437956 LAND CONTRACT Date Recorded: 8/25/2015 397347 CERTIFIED SURVEY MAP Date Recorded: 9/16/2004 325075 WARRANTY DEED Date Recorded: 10/1/2001 294482 https:/Itassawyeroountygov.orglsystem/frames.asp?uname=Enc+Wellauer ��� . � �/' � - .�.\� \ � , •�J / � . i� � r�` �r�/ �� ., . �'.f�1 � �i /: �r f! !l� � t - ,-�4 ,P'�{�v�� A �F-.r ,�p� a- �,� � �. t `�4 }�. � �,�� � t+l � i" � �Kf ,y 4i i�+ .r°u4,_�'Y,fr„ `y. .� µ ' ` ��, '�e � � � �% ���ri���yr��; � ��R,��'� ` .� � �. ` C � f.)y �r ��{f.s. 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J �i � "'-"E` :, PRIVATE ONSITE WASTE TREATMENT county ,,,� � � ="� oS = SYSTEMS p r ( POWTS) Sawyer "�\1 s. ,.�, �k �--�% "' "'� INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION 23 _�� Personal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(I)(m)] Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#: ,S�-e�.�► �-J��,� �Py�� s� �+I,� -- Insp BM Elev: BM Description: Parcei Tax No: Coo.� �,w�D,.,.� (�.,►-�► ,yr►J� .e.`R�., ba�O_ �39 ��-�•Z► 1 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic �,; �� Benchmark l�.� � Dosing Aeration Bldg. Sewer �- 9w $ � Holding St I Ht Inlet � � TANK SETBACK INFORMATION St I Ht Outlet ��{, z TANK TO P/L WELL BLDG vENrTo ROAD Dt Inlet AIRINTAKE Septic �t�S' �Sb' (� .�.. ' NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. ^. �(7•O' Holding Dist. Pipe PUMP 151PHON INFORMATION Infiltrative , Surface ��•� Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS w 3 L � S"� #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate �`� INFORMATION P/L Bidg Well Waters � IGP � Chamber — ❑ AG ❑ EZFIow Model Number: CELL TO -�-,2� td.S �Y �-(o� ❑ Mound o Other Qt�� - -- -- __ _ -- -------- - --- - -- ___- DISTRIBUTION SYSTEM �� X Pressure Systems Only - - -- __ ----_ ---- _ �-- -- Header/Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length Dia Length Dia Spac , , Spacing 0 Yes ❑ No � -- ---- - - --- ------- SOIL COVER _ - -- — — — -- - Depth Over Depth Over � Depth of Seeded/Sodded Mulched Cell Center Cell Edges j Topsoil _� ❑Yes ❑ No � ❑Yes ❑ N� COMMENTS: (Include code tliscrepancies, persons present,etc.) �►s�//� -��-�/�-o�. � _ __ _- � Plan revision required?❑Yes❑ No �v , 3 ' `-� �.2`� ( � � � G� �(� i-_--- _ _� Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3(01) AOOITIONAL COMMENTS AN� SKETCH SANITARY PERMIT NUMBER __ z3 - O�_ �- L�� 1.�, �--. .- / , � 6� 3 _ _ _ ��a ', C.�o \ `�D� �,.�� �.s� . �� ,�,;� �� `r`jP�.r � ���� �°�c_.. 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