HomeMy WebLinkAbout008-273-00-0200-SAN-2023-159 ��'""' Department of Safety �°'��'Wyer �
� ,i�� � `� & Professional Services �
�s �� � � Sani[ary Pennil Number(to be filled in
�v� ! �" � Industry Services Division �
'�'����j` (�s I O�Cp
Sanitary Permit Application 5[ate Transaction Number �
In accordxnce with SPS 383.21(2),Wis.Adm.Cude,submission uf this form to the appropriate governmental unit �
is required pnor to obtaining a sani[ary permil.Nute�Application fonns for state-owned POWTS are submitted to Project Address(if�ditTerent than mailir �
thc Dcpartmcnt of Safcty and Profcssional Scrviccs.Pcrsonal inti�rniation yo�provide may bc uscd for sccondary �
puq�oscs in accordance with thc Privacy Law,s.IS.Od(I)(m),Sta�s.
l.AppCieAilo�taCormadon-Plcase Priut All[nformation —9
�Property Owncr's Namc Parccl#
John& Karen Schroeder 57-008-38-09-27516-688-000100
o -� --o -b1o0
Property Owner's Mailing Address Property Location
29257 230 th ave �o��Lo,
City,Statc Zip Codc Phone Numbcr
Holcombe Wi 54745 715-577-8460 y,_ ',<, s���;o� 2�
II.1'ype of Buitdi��check all thst sPpIY) Lo�u 1 38NN R 9 E or W
unit 2
�'I or 2 Family Dwelling -Numbcr ofBedrooms 2 Subdivision Name
Rio�k a Ridge view Co�.lo
❑Public/Commercial-Describe Use
❑City of
❑State Owned-Descnbe Use CSM Number ❑Village of
�T����,�. edgewater
iTi.Type of POW'f5 Permit.(Check eiiher`�New"or"Replacem�ent"and other�pplicable on Iine A. Ch�ck one box on line R.Co�nptete line C i
a kicable.)
:� '
_ Ncw Sy,tcm i ��' Rcpluccmrnt tiystcm � 'Oihcr Mnditication Cn[�sisting Syucm Icsplain) � .-Addi[ional Prc[rcatinent l'nit(cxpluin)
B' ❑Holding Tank �In-Ground ❑AI-Cirade ❑Muund ❑Individual Si[e Design ❑Other Type(explain)
(comcntional)
C. L Renewul Befure �Revision ���Change uf Plumber ❑Trensfer to New Owner `�' ,��(7
List Previous Petm t Vumber and Date lssued
F:xpiration �-'G w ��"��CJ
�'t'„ rsallTreatment rirea and Ta�k Tnfurm�tinm
Dcsign Flow(gpd) Dcs�gn Soil Applfcation Ratc(gpd/s11 Uispersal:1rca Rcquircd(st) i)ispcnal ilrca Proposcd lstl Systcm Elcvation ��
300 0.7 429 440 95.60'or highe q'�0�
Capacfty in Total #of Manufactarer
Tank Infurmation Gallons Gallons Uni[s � ,�°, `_'
a :.' U , ,.,
�
Ncw Tanks Existing Tanks � � ?? � � p? �
a`V in �, rn i.�.C7 a
Sep[ic ur Hulding Tank 2 $ aW
Dusing Chambcr
V.Resporsi6ftity Statement-1,t6e uadenigned,assume respansibiliry for last�Hatloa nf the PQWTS shuw�on the attac6ed ptaos.
Plumber's Name(Prin[) Plumber's Signamre MP/MPRS Number Business Phone Number
David C. Laird 221253 715-239-6194
Plumber's Address(Sheet City.State.Zip Code)
20165 Co. Hwy. "Z" Cornell WI 54732
YI.C aa ID artment I)se Only" ___
���rmi[Pee Dntc Issued �Issuiug Agent Signeture
�A r ❑Ditinppruved � �. (� -y 1 _
❑Owner Given Reason tiir Denial (��� !'�-� r�3 ����-��-t j ji:l/i.,').t�
Conditions of Approval/Rcasons for Disapproval
�� � �;�►` GS� �-2- �b3�
A[[ach m complete plans(ar the s�stem and submil to the County only on paper not Iess Ihan R v2 x I I inches in size
SBD-6398(R.03/22) �
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NO R�Ft1N� �a�e.�-,_.�.�x,��,�_�.,F... i.5 �-=`. . - ` ; � ;
5 AFTER �� ,��;� ! 5 2�323 �__:�
ISSUE OF PERM�T -::hk# � ��'`�y a
RCpt# a3 51 �.. �:����v°-�;_:;��::�r:?r.��:�ff,
z�►v�r►�ac;�njt�:s�►�ai��:�^.
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Private Onsite Wastewater Treatment System
Title and Index Page
Project Name: Ridge view resort (unit 2 )
Owner's Name: 1on & Karen Schroeder
Owner's Address: 29257 230 th ave
Holcombe WI 54745
715-577-8460
Legal Description: 2�-38N-OW
Municipality: 0 Town, ❑ Village, ❑ City of Edgewater
County: Sawyer
Subdivision Name: Ridge view
Lot Number: 2 Block Number:
Parcel LD. Number: 57-008-38-09-27516-688-000100
Page 1 Title and Index Page
Page 2 Soil Data (A) &(B)
Page 3 boring locations
Page 4 p�ot plan
Page 5 septic tank profile
Page 6 infiltrator profile
Page 7 design criteria
Page 8 contingency plan
Page 9
Name of Designer: David C. Laird Telephone Number: � 15-239-6194
License Number: 221253 Date: g-22-2023
Designed Pursuant To The Following POWTS Component Manuals And Comm 81 -85
In-Ground Soil Absorption Component Manual (Version 2� ) SBD- 10705-P (N.01 /O 1 �
N/A r v 1 aa � a�� �
— � �
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Using Leaching Chambers �
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� POWTS OWNER'S MANiJAi.AND MANAGEMENT PLAN �
L+II.B II�03CNATiODi SYSTEM SPECIFICATIONS
�WON JoNiKRPE/Y 5<NRor.G�R tiGTank a� lC+G� ❑j.�-.
PO�it� T�k M� SK�I�.J ❑NA
PABAMET�BS E�ent Filta M� L i "tr r c ❑NA
N�bar a[Be3�oams 1 " a Effiumt F�ter Mo�l i v ❑NA
Idtnb�a[�1 Unib T� i NA
�eirled 8oa( ) 2a v Ta�M�u6�cnac ■NA
Soar(DWF),al�Bed z 1S 30 o M� �NA
Sai[ Ba1e o.� Mo� NA
Pr�Uatt(�NA)
Q�Y�G NA) �Y A� ❑S�dlt3isvel F�fa ❑Peat F�i
�.on��(Roc�) s so�/1- o M��t.a� ❑w�a
�°�'�en n�°°a�s°n� <azo�t, ❑n;�t� ❑oa,�:.
ratd�m�d So�c� <Iso Ma� M�odd:
Soil A�Co�a� (p NA)
P�ao�dB�uaotQu�Y(O NA) MO0�3'A��` ❑�$�e ��> ❑Mo�d ��� j
B��YB��BOd�Ds) 5 30mg/L
Tolal9uspmded Solids(TSS) S 30 mg/L ❑ ' l'me O Othr: i
�����) �Ocfn/100m1 ���—� ia�k�+�rrckro,ti° -�
M�B�e�PattirAe Sia 1!8 mch diameta ❑A88re��(s) Model r3� s j
Caledatla�
saal Div�xaa► Eud Cap (lTispasai una Elsa)�
gg�+ =Aron�g '�med-II,SA - fl'�ch Widthl =#Un�or Tom1I��h of T�mc6lsl
,300 0,7 N�3 - �,ao - ,�on' = IJ�k rRucl/ tuT oF a:a-
DH�I C�IIYitiA
a"ne.pt�P�es�e n�n rraw�lc.,ra�sq,ao r�lc-so�1 nb�ptio�n sy�sn roelicaz�a s.6<sswt�� -I
Q'Y�7C pJpwEech Mamd Con�ent MmnaP'Veasiam 12
p'EaFbwl6o�dCm�poomtM�ma�Ves�on 1?J152017
O�-I0854-P�L12)"AY-Crrade Ca�o�mt Maoaal Usmg Preasme Di�m"Veaion 20
,�38D-10705-P(NAl/Ol)`7a Ca�d Srnl Ahsosptiam Campon�t ManuaP'Ve�nn 20
p�-10691-P(NAU01)`Momd Campoomt Ms�P Vasiam 2.0 �
O�D-10659-�(R.G1�99)`�rip�tioe F.�D�pOsal Comp�t M�'�aP'
O�D-10�06-P(N.01/Oi)"P�e D��Msnnal"Va�on 2.0
Om�- _�J
MAII�IANC�MOPIITOBIIVG SC�DULE-MAII�T&NANCE AND MANAGEMENT ,
Sasviee Evwt Savice -?
s ' s clem flt� At least amce e _ ❑13 tmw�s 3 plhc�-
g �p]s,�, imrt AL 1eaSt�e e . ❑ � O 3 � NA
F�eh�d �mt 3�1s At lwst once e maatLs 3 ■NA �
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:For mw c�.Priac bo uae of the POW'tS c�t�etm�t rmic(s)for the Rex�ce of
P�P�ar adMr�ilnt maY�p�e the h��uncess and/ar d�age dee die�al cedl(s�Ifhigh oa�muaGans
aro delec6ed 3sPe Le�otthe 1a�Cs)�bY a��mS�P�m�-
Sys@�s�t�aLrII mt ot�a wfim sa1 cam�s me Lro�at the m5luaave sur�ce.
"me pmpalq�ow�r is rapam�bb ffu the opaati��d marotmauce of the POW15�d�ofx�¢�iepats TLe 9�Y
aod qa�tjr oFme�vapewata sQe�w�a�nar tho paLo�ce�d lo�gevay of yots POWTS.1Le�of wata-saveog
�p�oet md S�s at�mQ w�Poomptr�es of�redaas the cvastewater whmme.Abo t�6rme a�vasroe fnam waoer
w�ams.h�ml�oval mi4.odea cie�veaha ir�t devias�d Sw�chams sLoald be di�rged to d►e gmmd s�sface
wLmever po�Natx this doa not mc3ade lamdty wa�e,showeis,dishw�er,�c.
'ILit syMem is deci�ad to hmdle d��was6cwata,Lowev�dee disposal of fnod hased�s aod oHS,ve�6leJfiu2
peds ad aseti�.baoas.aod Sood adids sorh aa 8aaee P�ro�Ced b3'a�ba�di.+P�sbonld be mm�To�let tiaeoe s thc cnly
prye�dut aLoald be di�du�d'm6o tl�sYs�m-Ofhea mn-binde�adable itms sn�h aa bebY wipe�mtr�pa�s,�Y nt�s
omdomti cigatitfe 6�Is,dm�al8oae,md rntNn swabs shouW mt m6a the sysre�.A�icals�ch as P�'D�P�'$P�.
�ZorTJ
........�.�..�y Yq,.o.,...,�,a.............,,o......,.y......,�u.,.....„v.w�•.• a�uuu�uc aysic�u as rony can senou8ry aeIDe88 YOIff PO W1S
aod u�tami�6e yrnu drmldng water supply.
Mei�m a regalar smedy flow by s�u+oad'mg laimdry washing duoughout the week.Avoid vahiclo haffic ove�a11 syytam oo�,
C�of aoow ove ibe diepersal lmit may cause rt to fieaze up.
:Inspection s6all be mado by an individual cazrying aoe of tho following liceases or
oettiBcaHoro:Mttoer Pl�ber,Mas6�Phrmber Resh�icted Sawar,POW'I'S Maintxm�a�Sep�o Savicm8 Opecamr(I���ed
�Sahedule). Taok inspac4ona must mchide a visunl'mapoction of the t�k to id�tify auy missing�bmlo�bmziw�e,
�'aaY cisolcs�leaka,meas�ae tbe volume of combmad sludgo and xum and chack faa any backup or pondrog of affiuent w tho
gro�d�6ce md tat ell electical oquipmmi such as p�ps aud alarms.Any defecm ehall be pr�tly corra7ed.Faq�oeed°penm�
gmoec thm 8 hrLes in diamet�el�ell be sec�ad wkh effe�xive loddng devicas w prev�t accidemml or imem�oriaed e�y the mulca.
Whm tho�of shdge and swm m mry rnnk oxceeds omo-third(1/3)or mom of tha tauk vol�e,tha eotue c�tmts of the
ttmk eheR be removed by a Septege Seevicmg Op�abor and disposed of m accordsnce whh C6aprter N1LI13,w��namin�u�
coae.
'Ihe outlot fllta(s)sLall bo mapeix�ed end cleanad to re,nwve any accumuleted solids accoid'mg to menu�c0a�'s
waslrod Svm the filAe shall ba rqained in the tank.Filtar cl �i6catiaa�s.Solids
eanmg may be necessary at more frequ�t i�ervala than so�md in the
meroDwmt,e echediile to kcep Uie system operetmg.
Al�s ahouW be tosted�a m�ul�baeia by tLe home owaer.If an alarm so�mds,contact an mdivi�al liceneod to savix POWT$,
TTr+e is nomaity a I day mscrve w�rogular a�peratmg conditions,however wat�should be cons�ved tmu7 aqy pmblema witb the
eyshut mo caaaebod to prevmt bar3o-up of eewago mto the dwollmg or s�vfacmg.
�:W}te¢the POWTS fails and/or is parmenefltly tsken out of servica tha following steps shall bo tekan to e�e�ue
thM tbn ey�Eemt is peopeaty and safely abandaaned in compliauce wkh Ch.SPS 383.33,Wiscon�n Administ�ative Code.
- All P�PmB to t�ks md pits shall ba dieconnaxed and the abandnned pipe opanings xaled.
- - 1Le cootmts of all tanl��d pits eLall ba mmovad�d properly disposod of by a Septage Sorvicrog Opecayor. . .
- A&r�all imlm amd pits shali bo mccavatad and removod or thoir covas ronwved�d the wid eppce SI(ed with
ern7,gcm'el or ad�lnezt aolid m�lal.
:If tLo POWTS�ils�d cannot be rapairod the fotlowing�meea�uas have bam,ar muet be takav,bo p�ovida
. 8 COdE OOrt1p11m[iYpIECe�II[sys[em:
■' A wihbb roplac�area has been ovaluazod and may be util'v.ed for the location of a roplaoammt soil ab�tion system.
'lbe tepl�c�t aroa should be protacted fmm diat�bence and couipacaan and should�t be mfrmBed upon bY requo+ed
eet6arYs 8+om arietlug and propoaed atrwcha4lat lims and wells.Failwe to pro6act the mplece�t area xe�der it tmusabla
Rep�sys[ema must aoc�lY wuh the niles ID e$oct at the tima of raplacement
❑ A e�able replac�aros is not availebla dua to setback andlor soil limitadons.B�rmg advaocas m PO�V1'S Lxlmology a
holdiog tmk mny+be installod as a last rosort W replaca the failed POWTS.
❑ TLe ei0e Les aot l�eea evaluated to idmtify a wiitabk raplacemmt aroe.Upon faili¢e of the POW'I'S a wil�si6e evaluation
m�t ye ptafamed to locaos a suitabla roplaeement azee,If no replaceme�area is available a holding tanlc may be mstal(ed
aa s lmt resart to replace tha fa�led POWTS.
O Mwmd�d at-grade soil ebsorptioa systems may be ceconstructed'm place following m�oval of the biomat at the inSYastive
s�¢fioe.Recome4vctiom of such systema muat comply with the rulos in effecx at thet t�o.
<NVARNII�I�>
S&PTIC.,PUMP AND OTHER TAEA1'hi�1VT TANKS MAY CON17APi LETHAL GASSES AND/OR IN3UFFiCIENT
OZYGEN DO NOT ENTER A SEP1'IC,PUMP OR OTHS�TREA'I'MENT TANK UNDER ANY CIRCUMSfANCES.
D&ATH bIAY HESULT.ABSCUE OF A YERSON FAOM THE INTERIOR OF A TANK MAY B$DIFF[CUI.T OR
II1�I.&
ADDITiONAL COMMEIVTS
POR'TS IlVBTALLER POW15 MAINTAINER
N� DHVE L � r IQ P Name E�°oB ZcJciFvc_}�aFE�p
PLme 7/s'_ 517- 0187o Phone 775'- ��9- 3l�O - -�-�
SBM'AGS S$ItVICING OPERATOR m er L,OCAL REGUI.ATORY A ORITY
N� AgencySA�vE� coJNrr 20N / 1�([ �
� �r���e ��r- 'I�3 H- 8 a 8 &
Page p of �
7126/23, 12�37 PM Real Property Listing Page
Real Estate Sawyer County Property Listing Property Status: Current
Today's Date: 7/26/2023 Created On: 2/6/2007 7:55:15 AM
��Description Updated: 11/14/2019 � Ownership Updated: 2/3/2022
. _ _. __------ —.._. . _.._. _---- —__. . ____ ____._. __.._.__—._---
Tax ID: 7997 ]ON D&KAREN E SCHROEDER HOLCOMBE WI
PIN: 57-008-2-38-09-27-5 16-686-000200
Legacy PIN: 006273000200 Billing Address: Mailing Address:
Map ID: -23.2 ]ON D&KAREN E lON D&KAREN E
Municipality: (008)TOWN OF EDGEWATER SCHROEDER SCHROEDER
STR: 527 T38N R09W 29257 230TH AVE 29257 230TH AVE
HOLCOMBE WI54745 HOLCOMBE WI54745
Description: RIDGEVIEW CONDO DECL 848/400 UNIT
2& 1/9 INT IN COMMON ELEMENTS
Remrded Acres: 0.530 � Site Address * indicates Private Road
_ _. - __ ..___--- -------------- ---
Calculated Acres: 0.014 N/A
Lottery Claims: 0
First Dollar. Yes L.j Property Assessment Updated: 5/20/2022
ater o y: C etac Lake 2023 Assessment Detail
. _._- ------ ------—-- -----
0 Zoning: (RRl) Residential/Recreational One Code Acres Land Imp.
ESN: 430 G2-COMMERCIAL 0.530 21,100 18,800
�� Tax District5 Updated: 2/6/2007 2-Year Comparison 2022 2023 Change
1 State of Wisconsin Land: 21,100 21,100 0.0°/a
57 Sawyer County Improved: 18,800 16,800 0.0%
008 Town of Edgewater Total: 39,900 39,900 0.0%
650441 Birchwood School District
001700 Technical College
�Property History
�a� Recorded Documents Updated: 5/20/2022 N/A � �
--_.._ .. . .. _ .._._ ____. . _ .
TRUSTEES DEED
Date Recorded: 1/18/2022 437169
CORRECTIONINSTRUMENT
Date Recorded: L/17/2017 404969
CONVEYANCE RECORDED NOT USED
Date Recorded: 10/17/2016 403471
CONDOMINIUM DECLARATION
Date Recorded: 4/22/2003 310487
QUIT CLAIM DEED
Date Recorded: 7/31/2001 292643
QUIT CLAIM DEED
Date Recorded: 5/7/2001 290697
WARRANTY DEED
Date Recorded: l/6/1997 258613
ORDER VACATE PLATTED STREET
Date Recorded: ll/30/1995 251650
WARRANTY DEED
Date Recorded: l2/16/1994 245721
https://tas.sawyercountygov.org/systemlframes.asp?uname=Eric+�/Vellauer ���
�;'"'"`-""""'.� PRIVATE ONSITE WASTE TREATMENT �ounty
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;�;��o$ \���`; SYSTEMS Sawyer
����� �s// �' ( POWTS)
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�-'S"'-"-' ' INSPECTION REPORT Sanitary Permit No:
Safety and Buiidings Division (ATTACH TO PERMIT)
GENERAL INFORMATION a ?j — I���
Personal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)J
Permit Holder's Name: ❑City ❑ Village [.�Town of: State Plan Transaction ID#:
>ol���l,�.ae,� Sc,l,,,r�e� Eo� ,�,r�'
Insp BM Elev: BM Description: Parcel Tax No:
/
l��� $b��-,o� s,�i� d�bl, � �g -a-73—aa-o�o
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic S�V�/ 700 3oD Benchmark �<so,o'
Dosing
Aeration Bldg. Sewer �,� �
Holding St/Ht Inlet qg,� �
TANK SETBACK INFORMATION St I Ht Outlet ��,3 r
TANK TO P/L WELL BLDG vENTTo ROAD Dt Inlet
AIRINTAKE
Septic o' ,�.��� `7 ,f.. � NA Dt Bottom
Dosing NA Installation
Contour
r
Aeration NA Header/Man. 9'7,g
Holding Dist. Pipe
PUMP 151PHON INFORMATION Infiltrative �,a �
Surface
Manufacturer Demand Final Grade
Model Number GPM
TDH Lift Friction Loss Sys Head TDH Ft
Forcemain L Dia Dist.To Well
DISPERSAL CELL INFO ATION
DIMENSIONS W 3 L L�c� #of Cells Type of System Distribution Media Manufacturer:
r— �
SETBACK OHWM of Nav � Conv ❑ Aggregate `�
INFORMATION P�L Bidg Well Waters � IGP � Chamber
❑ AG � EZFIow Model Number:
CELL TO -f�D fn fip�� � ❑ Mound o Other �c-�
--_---- — — -- �L-- ------------ ------ -----�Y� ---
DISTRIBUTION SYSTEM _ x Pressure Systems Only
Header/Manifold Distribution Pipe(s) � X Hole Size X Hole Observation Pipes
--
.
-- —
Length Dia Length Dia Spac _� _ Spacing �Yes ❑ No �
SOIL COVER
—__— — __---
-- -- __ _-----
Depth Over Depth Over Depth of Seeded/Sodded Mulched
_ _ _
Cell Center Cell Edges � Topsoil _ _ �p Yes ❑ No � ❑Yes ❑ No �
COMMENTS: (Include code discrepancies, persons present, etc.)
���I� �(3�( �3
Plan revision required?� Yes ❑ No
� ���-� ���_�, _ -_-- �����
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
AODITIONAL COMMENTS ANO SKETCH
SANITAAY PEAMIT NUMBEA:____ �3 _I'S�___
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