HomeMy WebLinkAbout010-841-27-5208-SAN-2023-137 Department of Safety c°°°�' SAWYER y
� = & Professional Services, �
� _' - Sanitary Permit Number(to be filled in by(
: Industry Services Division
(�� � V`'�� W
Sanitary Permit Application State Transaction N�mbAr �
ln accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit 1V t-� W
is required prior to obtaining a sanitary permit.Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing ac J
thc Department of Safety and Professional Services.Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law,s. 15.04(I)(m),Stats. 1�.-10358 N WHITF,BEAR AVENUE
l.Application Information-Please Print All Information {i�-
Property Owner's Name Parcel#
MARK E. & CATHERINE R. JONS O10 - 841 - 27 -5208
Property Owner's Mailing Address Property Location
10490 ABBOTT DRNE N Govt.Lot 2
City,State Zip Code Phone Number
BRD��,YN PA�I{, wI 55443 �4, ��4� Section 27
II.Type of Building(check all that appiy) Lot# T 418 N R 06 4*or W
C�or 2 Family Dweiling-Number ofl3edrooms � Z Subdivision Name
B��k# NA
❑Public/Commercial-Describe Usc NA
❑City of
❑State Owned-Describe Use CSM Number ❑Village of
#6992; V27, P9 ���f HAYWARD
Iil.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.)
A �New S stem
y ❑ Keplacement System ❑ Other Modification to Existing System(explain) ❑ Additional Pretreatment Unit(explain)
B' ❑ Holding Tank �In-Ground ❑ At-(irade ❑ Mound ❑ Individual Site Desigi ❑ Other Type(explain)
(conve►�tional)
C- ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner �st Previous Permit Number and Date[ssued
F;xpiration
IV.Dispersal/Treatment Area and Tank information:
Design�F15oO(gpd) Design SoilOApplication Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System F:levation � �
�� 642.86 652 9 FT. `�����
Capacity in Total #of Manufacturer
Tank lnformation Gallons Gallons Units � � V � � N �
ca u v �n in
New Tanks Existing Tanks � p � � � p _ �
a U in v �n i�. U a,
Septic or Nolding Tank 1 000 1 Q�� 1 WIESER A
Dosing Chambcr Ej�O 6�0
V.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumb�s Signature MP/MPRS Number Business Phone Number
� r(/�-�� 1�l �9(f��� ��`�-j !!��
Plumber'. Address(Street,Ciry,State,Zip Code) v
i�57 l4 �T ���-e�f�nG� -�C�'l�- I�� � �,c��2�� c�- `� ���l�
VI.Co ty/Department Use Only
�App ❑Disapproved Permit Fee � Date(ssued Issuing Agent Signature
��'✓� ❑Owner Given Reason for Denial $ ��� � � � ������ ���""""'--� '" " --
Conditions of Approval/Reasons for Disapproval
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W ���� ��i�ti ��hk# a-�,�,�..�� �
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r--- .�-�,��►__?-�-0�_.. _ .____._- . JUL 14 2023 �,„�.�, v\
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l � `I-. SAWY ER CG v�' .° ,��
l:�i i�E1!it)iV �
Attach to compkte pla for the system and submit to the County only on paper not less an 8 1¢a 11 inches in sue �,•��C
S� �' NO R�FUND�A�1'ER ,
SBD-63 R.03/22) ��_ � � � ISSUE OF F*ERM1T
MsN-
PAGE 1 OF 5
In-Ground Dosed-Gravity Plan
fndex 8� Cover Sheet
Component Manuaf Design References:
in-Ground Soil Absorption for POVYTS Ve�sion 2.1(May 2022-2027}
Pg 1 of 5 Index 8�Cover Sheet
pg 2 of 5 Plot Plan
Pg 3 of 5 Dispersal Area Cross-Section 8 Plan View
Pg 4 of 5 Pump Tank Specifications
Pg 5 of 5 Management Plan
Attachments: � Enc{osures: _ ____-_
_ - —-----
_-t---
Pump Curve POWTS Application for Review ______
- -- -
—
--- - -- - Soil Evaluation Report 8�Site Map_
Tax Statement _ —
TA/LR Sf't�e5__ _ _—
P�oject Mame!Description
awner Name(s): MARK E.& CATHERINE R. JONS phone: -
Ow11e�Addfe55: ���ABB07T DR1VE N.BROOKLYN PARK,MN L�: 55443
ProjectAddress: �0358 N WHITE BEAR AVENUE, HAYWARD
Govt.Lot: Z 1/4 of_ 1/4,Section Z� ,T 41 N-R 0� �a �
Township: HAYWARD County: SA_ WYER ___
Project Parcel ID�: 010-841 -27-5208
Designer Information
Designer Name: MARY JO HUPPERT phone• ��5 _ 426 _ 1775
Des+gner Address:_25720 FIREFLY LANE, WEBSTER, Wi Z�p: 54893
E-maii• hollisterdesign@outlook.com a`��v��;�r;;'r�;,t;%..
. �,
License Number: 1859-007 a •'' ��� '- �%
a* •C�A.'-i".NJ ,;.: -
Remarks: - N��.•;.:,T =
- D t:.::y
� ;R�VF�;7t:.L� -
'�%,.., ��;1R: Yt ..
� �,�'..;
/ �' I -,.� :..,�,�..,,�::;.,,
Signature: l��� J�L n �� Date: 07-09, 2023
o�� i��w�e����rea aon�,e�o�ned�y.
Plot Plan Pa� �,of y
PRO�ERTYOWNER: NI;}r:k E. ti :'�'�� tiL '�-�,r1c �' � _ I „
2 -= 40 FT.
(except where noted)
Legal Description: :�"T :', ;'_,4'1 �t �- ' '__ '.- �7� 1�-(, �- ��� �F --t��J�. L'J ==backhoe pit
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AGC• i' ba_{�6� � ���UI Ftf.EMArN._ _-t^_C�CNEW WIES"t(; I(L'��YCO �
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�ite location: ___-
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IN-GROUND DOSED-GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard-W Chambers
3-ft Trench (down-sizing credit)
�
""" 1z� TYPICAL TRENCH
SOIL COVER (ryp�cap
2„ CROSS SECTION VIEW
m;�.o-e��n� (No Scale)
tlepth
(bPicap .
. '
a '.
j� 34"
�ryPicaq , Provide minimum 3 ft
, .
• ' separation belween trenches.
System Elevation = 95.50 ft
(rypical)
Quick4 Standard-W
w/ End Cap Observatbn Plpe
� (typical)— - - - �Show location of inlet/ outlet pipe connection on plan view.)— (�yP���1 TYPICAL TRENCH
Inslall per manufaclurefs
� Instmctions. P�N U�EW
_ (No Scale)
��Y������r�rrYr����i�- �� �� ;�er�.r.�.�*.r�{Vkk'! � A= 3.Oft
o �����y{��
I��rvro��.�YYW�MYY.6�� iYYtlYIIiY�1MY6YY�I�M��I (ryPicep
_ - _ _ - _ �� _ _ - _ _ _ - �� _ _ _ - - - - - - T
I �� I V
r B = ft �� �
(typical) Quick4 Standard-W Chamber �Tl
450 GPD / 0.7 LR = 642.86 FT. 2 �typical) W
INSTALL PER TRENCH: 642.86 / 20 EISA/UNIT = 32.t4 uNIlmSrd by�oti�tretarsyscerns,��o.�
OR 32 X 4 FT. = 128 FT. / 2 = Install pursuant to manufacturer's inswctions. �
16 Quick4 Std-W @ 20 fP EISA/chamber= 32� ft' (2) 3 FT. X 64 FT. TRENCHES
T
6 (J7
+ � Pairs of end caps @ 6 ft'EISA/pair= ft'
= Proposed EISA per trench = 326 ft' Required Infiltration Area = 64z 86 ftz Distribution Method:
x z trenches = Proposed Total EISA = h5� ft' B��NCHEs
� MARK & CATHERINE JONS
PAGE40F4
In-ground Dosed-Gravity Management Plan
IMPORTANT:
The owner of this in-ground dosed-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 Disaersal Area Oaeratinq Limits:
Design Fiow= 450 gpd; BODS <_220 mgL"'; TSS <_ 750 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 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 surtace discharge of effiuent 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 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 Effluent filterlsl 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 ot indi�idua� or company: RYAN STRAND Phone: 715-558-1673
�ocal government unit: SAWYER COUNTY ZONING pnone: 715 - 634 - 8288
Local government unit address: 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.
Continpencv 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 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.
PAGE40F5
GRAVITY-DOSED �ONS, MARK
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4'0 Vent Pipe
>70 fl fmm
Building Electnfal must mmpty wi�h
7Y Min.or 20 fl above SPS 316 and NEC 300
Eslablishad Flood Elevalion W¢atherproof Extend manhole nser as necessary.
(ryP���) Junction Box
APP�� Approved Loticing Manhde
IMPORTANT: Ve"��P with Waming Label Allache0
Anchor tank(s)as necessary (ryP����
Conduit
pursuant to SPS 383.43(8)(g) 4'Min.or 2 0 fl above
Established Flood Elevalion
(NPicaq
�Airtlgh[Seal
Finished Grade
Quick Disconnerl
CAPACITIES 11.82 ,e•M��.
@ 9al/in � . crov��n
Depth (in) Vo I) , a I
A 31 366.42 — *� \
� Weep - `Approved Joinis wilh
Nole Apprpv¢d pip¢3 fl onlo
B 2.0 23.64 A �� sa�a c���,a
(HPira�)
[C] 6.0 70.92 � I i
D 12.00 141.84 ��—,— —Alarm
B —On
} [c� PUMP-0FF
*Pump Tank Liquid Level = 51 i� ± P""'P �_on ELEVATION = 79•00 ft
i
° INSIDE BOTTOM
Force Main Diameter = 2 in ei u�e ELEVATION = 78�00 ft
�
Fo�ce Main Length = 95 ft 3"Approved Bedding Malenal Benealh Tank
95 FT. X 1.39/100 = 1.32 FRICTION FACTOR
Force Main Void Volume = �5 �y gal 95 X .163 GAL/DOSE = 15.49 GALLONS FLOW BACK
70.92-75.49 GAILONS FLOW BACK=55.43 GALLONS/DOSE
[C] Totai Dose Volume TDV = 70.92 gal/dose 6.35 DOSES/DAY
�
(<0.2X design flow+force main void volume) 95.50 - SE
79.00 - PUMP OFF
Vertical Lift = 18 32 ft 16.50 FT. _ .504NVERT + 1.32 = 18.32 TDH
PUMP TANK: SEPTIC TANK(S):
Volume = 600 gal Total Volume = 1000 gal
Manufacturer: WIESER Manufacturer(s): WIESER
Pump Manufacturer: ZOELLER
Install approved effluent filter at the septic tank outlet
Pump ModeL 98 (S¢¢allached pump wrve.) immediately uastream of the pump tank iniet.
Controls/Alarm Manufacturer: SJE RHOMBUS Filter Manufacturer: CLEAR WATER
Controls/Alarm Model: AB TANK ALERT
Filter Model: 324
Float switches containinq mercury are qrohibited.
W1000/600-MR
TANK SPECiFICATIONS °� �
_ ._. _ _ ��' t;q' - a a
DIMENSIONS: a o
�, WALL 2 1/2" a
a" cnst- n--sEn� : a" cn > --n-srn�
BOTTOM: 3" �
_
-- — — COVER: 5"
'-=--
%�' I�iil ��' �\ MANHOLE: 24" I.D. PRECAST CONCRETE PoSER o
�� �iii � �� HEIGHT: 69 1/2' - -
I ��� �> �ii� � \�� I LENChI: 9�-6 7�8� W�
�i mti�Q- iiii'a � �i� WIDTH: 7�-9� ��
� ' S �'� �h � u BELOW INLET: 57"
i . \ / I .
L � LIQUID IEVEI: 51" �
� � � �� ii -� d WEIGHT: 72.380 LBS. - ,� �
� �` �-- -' ni _ , ri � �
� `�� �ni " IN�ET AND OUTLET: \i r 8
ii
�\ FI�_TCR OR- i�h �� 4" CAST-A-SEAL BOOT OR EQUAL GASKET • m g
���\ BAFFLE ���� ii� � �
i�i�i .:' INLET AND OUTLET BAFFLE AND FILTER: � � a
��_,:;�� WISCONSIN, SEE DETAIL x70 �+ a �
� -- �---- - --� (OTHER STATES SEE CHART) W o
1� ::
LIOUID CAPACITY: 19.61 GAL/IN (SEPTIC) y,� '"
TOP VIEW 11.82 GAL/IN (PUMP) Qj. #
e' Y C
LOADINC DESIGN: 8'-0" UNSATURATED SOIL C� � `.
z �
� TANK CAN BE USED A5: C'J E�
��°-� SEPTIC/SEPTIC, SEPTIC/PUMP, 3 c
a o -4" VEN! OR SEPTIC/SIPHON � ,;�
w
a
1__ - _- _ .�_ _— .__ ;n - .., __ . , COVER: MIX DESIGN �8 (NO FIBER) y � �
��- - �-�-� " I TANK: MIX DESIGN M70 (STRUCTURAL FIBER) �r �
_ __ �_ �_ � _.. . { � �n
_ � _
CUSTOMI2ED TANKS:
MLE i _ - - - OU fLE 7 FOR CUSTOM TANKS CONTACT NAESER C04CRE'E �
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:-, ���",%MF' i'^�� REVIEW DATE o a
3 c�i
DRAWINGS SUBMITTED
SIDE VIEW FOR APPROVAL
aPPROVED BY: _ . __ .__ SNEEt No.
..._. ___. ... ._
APPROVAI DATE � �
..__._.____'_. _ _ _.'_ OF
VRODURS NEEDED BY: ;/ �
reuuv naF unNUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS � � �� ��� �