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HomeMy WebLinkAbout008-273-00-0100-SAN-2023-160 Department of Safety �°'��' �/' 5� wyer � �11 '�� & Professional Services, „ _ ?;�� Sanitary PemutNumber Ito be filled in by Co.) �� �'�g ,_ Industry Services Division ��� �3a �-�S� �,��...: � Sanitary Permit Application Sta[e Transaction N���rti�� � [n acconlance with SPS 38321(2),Wis.Adm.Code,submission uf this torm w the appropriate govemmental unit � is required prior to oblaining a saniliiry penniL No[e:Application forms for statc-owned POWTS are submitted[n Projcet Address(if ditiercn[[han mading address) —� the Dcpartmcnt of Satcty and Profcssiunal Scn�iccs.Pcr5unal mfbnnatinn vou pro��idc may bc uscd fiir sccondary � puq7otics in accordancc with the Pri���cy[aw,5.15.04(I)Im),SWts. ����� /� �1� � � �.Applicarioa Tnformakian-Pleasa Print All Information �'"� �� Property Owncr's Namc Parccl# John& Karen Schroeder 57-008-38-09-27516-688-000100 - a� -oo -o Property Owner's Mailing Address Property Loca[ion 29257 230 th ave �o�� �o� Cily,Statc 7ip Codc Phonc Numbcr Holcombe Wi 54745 715-577-8 '�, y, s��i�o� 2� B.�:Type of BIl�1d3IIg(ChCCk��-;fhIIt 3PP�Y�� �'���� Lot� Ufllt �. T 38� R 9 E or W 2 Subdivision Name �I or2FamilyDwclling -NumbcrofBcdrooms ___ _____ Ri��k Ridge view ❑I'ublidCommercial-DescribeUse ❑City of ❑State Owned-Describe Use CS M Number ❑V i I lagc of' �T���t. edgewater iII.Type of PUWTS Permit:(Check either"New"or"ReplacemenN'and other applica6tc oa linc A. Check one box on line$.Complete Iine C if a licable. � �c«S��icn, '� Rcpl,tccmcnt S��tcm _ O�hcr Moditicahon I�f.�isun:�ti��;tcm IcYpluinl I �addi�innul Prctrc.rimcn�Cnit(cspl,iinl B' g ❑Other Type(explain) ❑Holding Tank �In-Ground ❑A[-(irade ❑Mound ❑Individual Si[e Desi n (convcntional) C. ❑Renewal Befure �Revision �y�Qy� �Change of Plumbcr _'Trunsfcrto New Ownrr Q List Previous Permit Number and Da[e Issued Expira[ion �'Q���� �� - ��G� IY.�ts rsailTrestmeut Area and Taatc Iefnrmaktnn: _ _- ---� � Dcsign Flow(gpd) Dcsign Soil Application Ratc(gpd/s� Dispersal Arca Rcquircd(st) Dispersal Aroa Proposed(sfl Systcm Elcvation 300 0.7 429 440 95.60'or higher q6� Capacity in Total #uf Manufacturer °`{ Tank Infurtnation Gallons Gallons Units � � V� n � NewTanks ExistingTanks ` � ai � � �_ �y a V �v� � in t�.C7 G. Sep[ic or Hulding Tank S 8W Dosing Chambcr Y.Itespe►�sibfllty Statel�ent-i;the uadereigned,assume recponsibitifg for losta��tNaa ef the�VYTS�how�on the attached gtans. Plumber's Name(Print) Plumber's Signu[urc MP/MPRS Number Business Phone Vamber David C. Laird 221253 715-239-6194 Plumber's Address(Strce[,C�ity,State,Zip('ode) 20165 Co. Hwy. "Z" Cornell WI 54732 v�.c m� tt�Anb��u�oo�y �A ❑Disxpproved ennit Pee Date csued Issuing Agent Signature , $ �j� ❑Owner Gi�en Reason for Denial J�/.� <3� �� � 2�'���-� Conditions of ApprovaURcasons for Disapprov • -- __ . -, �'� �3 µ _��.,.,..�_ � � � �►a�.e '��� SY_.._._...---�--�.. ._ �S� �-�—(63 � ��GI � � .�-- ���, .�. ,�3Sa Attach�o complete plans fnr�he system and submit�o the Cnunry nnly on paper no�Iess than A ii2 x 11 inches in size —�rl�'I Lv SBD-G398(R.03/22) !-1 ,!r, '��, [i ��S�j r,'_'�l�-� �t! ��.�U{Vt7.7l�1FTGI'9 ,-'t:`:;;:� � . � ,/j !r_I;.`'��,�� -' \..��.'_��.�i il �'� ( ��,'�'._. — �?;' , 1�6UE OF PERMtT _j' ,��� � � 2��3 .�sJ` �::'•��r=t-s' �O�.�iJT1' ZO��(NU�L�MlNIS7RATiON Private Onsite Wastewater Treatment System Title and Index Page Project Name: Ridge view resort (units } Owner's Name: Jon & Karen Schroeder Owner's Address: 29257 230 th ave Holcombe WI 54745 715-577-8460 Legal Description: 2�'38N-OW Municipality: � Town, ❑ Village, ❑ City of Edgewater County: Sawyer Subdivision Name: Ridge view Lot Number: ��;r i Block Number: Parcel I.D. Number: 57-008-38-09-27516-688-000100 Page 1 Title and Index Page Page 2 Soil Data (A} &(B) Page 3 �oring locations Page 4 F1ot plan _ Page 5 septic tank profile Page 6 infiltrator profile Page 7 design criteria page S contingency plan Page 9 Name of Designer: David G Laird Telephone Number: � 15-239-6194 License Number: 221253 Date: �-22-2Q23 Designed Pursuant To The Followin� POWTS Component Manuals And Comm 81 -85 In-Ground Soil Absorption Component Manual (Version 2:! ) SBD- 10705-P (N.0 ( /O 1 � N/A �aY �� ���� � � Page 1 of g o�K��� JONt KR��� s�t�Ra�.D�"R � g �`7 a3o '� ��� �p[Co/A��� Gj� �47 5�5 7is���T- s�6° `�� vt���,�R �:;, �,�z s` �� �D c'RT10�('- � �� � �-�" CO: 5r9 u) �c�'' ��... [ . ��cv-� �'. ��6� 1,�ArER �, Q �� �- �a. �.,/�.�y �z. sa�-3�x-9� -o�N��� � . 5 y�3�� �,,- :r 3 9— �lq� /i! 3OC7� CO3 NcJ�'.F �-�" S /''VQ�. .58"Q`�n�/_ SIW_ �W_ DOOIOO v�v�r t �---� �� p� ��` �d � � �- y ___1 �CRL.E I"`='fo� % ��� ._ , /� NKE ��� /� � � � � , _._. 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Sy��t��Y�H aot aoaQ wLin��od4lao�o ho�x��u��he��� 7ti.y.o�pa�s.r k n�pm�i+k far tYe apaatim m m�mmo4 oime Poa�'cs.oa.�6mrrion odieyuiod+rPaa'1LS 9�roory �d 4r��(�wi���ls�es wm adion6i P��b°�O1a3'of yqQ POWIS.'1De iorMB�aE wra`�n'i� �yr�SoM����D�'�P�l�pk dladu nduces mp wwe��'vabma AYo t!e 6eios ar w�Soo��tla rWg ilot�owl�iY.a`r aMsw�ttalmmt dsvbes o¢Lo�md�tio���Lodd be di�d b��omd�a8cs w�wrPordw li°I��do�s mt Ldod�i�y��0.�ow�s.dyhwatrr•°ec` '11it�yMr lt dr�l�dlo l��e boiortic��.howevar�he�of Eood b�ed 4cwsr ad a�.v�b�Wfrua � �oold b��To�ctir�l�A��Ty p�ls a�d wd4 b��.�Lod�oNBr a�ah�r bo�s peodiwd bg s d�D� p*rft rMdd b�dYi�i��iolo td ry�a�� �emr aaah�b�by'Wip,M.�Pm.�Y� u��.��bWlr,d�l�l nor.md aalon n�hs�Yauid sat aPOor tLe syaaoi.C�mi�1��T°ti�P�a�Pn�.P�. �Z ot� .aaa.r.ti:n:ro�a�hi�.nmt+upp{y. - • - -�- ----��-.. trf�ihiinac�ls�Oe�dY 8ow'bY�r�dm�L�mdtY wu6m��u�ho�tlm xroelc.Avold va6icb tr�ffic ovQ�II syaem°°mP��. Cm�pwtkn aloow ova t6e dirpac�l imit mry wwe k to fi+eem up. •lu�peotian i6ell be made by m individuel catybo�me of the bolb�Lr�IYr�o�es a o�lleerla�liwr PYab�r,llMr Plumbs�rtdcosd Sew�r,POWT'S Mdnu�a SrPdP�i�(D��+�oh.d 1/�iYo�o�83�drb� 1Ldc mip�don mmt mande a vitud'm�peclim of the Ldc to idmti$'�'uwdui a'6tdom hrdwae, ideefi��4'aa�ia a kYo,me�nnr the v�oh�e of oombioed�L�dye imd ea�m aad aheak 5or dq bsolmp ar paa�of ef�mt ro the �oad��od twt all eLotrio�l aqu�meot nrh ro p�mps md aLrmr..�ay dsbop�Il be proaq�tly aamord B�poNd uPeohp �Wr 4�i i�c��iu dl�orler ihdt b�ecu�ed w�ttt e�odw lodcloa dwica t�provmt�ooid�ohl a�a9sd�a1ry tY�t�ta Wman the 000bi�tlm a��hd�e md ewm m aqy uol�aorcoods aoethtr�d(1/3)a mare of d�o 4mk w1�o.the aatae caaOeoO of the u.t rti.n b.iaa�.a br•9�p0�e SRvloaot Opa�oor.oa di.po.ea of�.coora�ooe wN!►(7rp0�r rTRI ls.vrr000dn Adomim�ave C.ada 13s aWIR�)�11 be ioq+ec0od�d alamed m rmove ury aocumul�ced aolide sooaedio�to m�ouScaux's�d6c�aos,So1We wurea humr mlar.h�n be,enioea in Neo tadc.ruMr ciaoo�msy be uecac�y u m«e aequmt i�erv.r mm mlea m are m�r000e�abduk oo ImeP the sy�oem opea�. ALms�hooW br tM6rd m a x�ulr brit by tLe homo owmr.If m ai�m somda.000nct m bdividiul llcm�d bo rrvios POW7'S„ TLs�.i.o�uy a 1 aiy d.:w maer m�ula�couditiaw.howevar w�0ar.honla bs om.«vea�n a�pioWm wlm me �y�bm a om�A�d to pnv�otlydc-up at'�srva�s mto d�s dvvellioy x wv�. �WhQ�POWT'S biL od/or u patmweoNy tdom out of aawiw the b�llow�eteq�h�ll be ooloou to mnaa 1L�tA�y�l�popt�od n8e�dnodaoed�ao�oe w�th Ch.SPS 38333,Wirwadn A�atlw Cods. - AII p�1D t�lta�d pfu�4ell bs diwmmo0ed od the eb�udoad p�o apmfio�aaled. - - T1�oomoe�d�11 mlu ad pda�Ldt t»r�mov�d md Proparb'd+�P��'vY���'�'�A��'. .. - wesyn.p+.t..n dob�a pdb.h.0 ne�oa.�aa.m ramm�ea or m.tr oov.o�owa�e m.wie.p.o.mw.vlm �11.�vd or amv�oatt alld memirW. Ht6e POVV4'8 S�iL�od c�a be,ep�'ved We followin��mer�a.s h.v+hast or�rt be nlom.Ou piovid� a ao6�CCopM�t npYcemmt Mrom= ■' A wY�Yi�nPYo�ma�t nea Ln bem ev�Fu�ed�od may be udlimd Snr the bcNon of a+ePLamot��baPum�Y�tam '[3r p�Lpmmt atia�6wild b p[ooeoEed Sam dbhabooe�nd oo�tfm md thauld not be ioRbwd upaa by nqoind .M6��b taum�odMfo��od wopaMd xn�aa4la lioe.aod wau..F.14ae to pooeot e�.:epl.oem�oc...�k mowbh ����Y����Y wLh We ruMs�e�a u 1Le tlme of mpLoamamt. . O A wY�Ub n�Pl�o�met�ees is mt tvdLbb dae ro�Mb�alc�nd/ar wIl I��dm�.H�m��dv�oca iu POW'FS tecLoolo�y a hoL�o�tr�lc m�y bs Imo�Ded u a lrt rosat a rapLae the faled POWCs- O I1r rY lr aotb�sv�d m�oei�a a�bk r�p4omot�raa Upm Silms oPthe YOWTS a soil md siee evayrtiap ot M p�m�d b loca0s s addhle ropLameot aea If no repLcamem aea u adLbN a Lo1dY�tmlc mq b��qlled �t Irt nw't ro mpYiae�e 8dlad POW7'S. ❑ lto�a wa.a�.e..�.b.apekn.ywrm.m.y be r.cmavcaa m plao.rouowms imoval or,L.htoms at m.b8laatln wrAAo�.B�oao�uotloos of nkh sy�om►s mmt oomply wqh the mla+in effieot�t W�t tima aciYAAi� Y�l1X'e�11�OTSLR T�iATMiNT TANYS MAY COl�TIAN LETHAL GAA6�8 ANDr�A II�OF�IT OZYfiilf.DO IrOrP I1�ITZA A 8ZlTiC,FUMP 01t 01'Ef�R'l7tEATMENT'fANY UNDiA ANY CDOCUIISfANC�B. �A��(AY�LOLT.1t�8COE OF A PZF90N FAOM T�II�T6RIOR OF A TANY MAY HB DIlFlCULT Ok �S ADiD111'LOlYAL 00�!lKP1r18 pp�y�(g POw'1'S MAIIVTAII'IB:R � DHVE L'A �R p Nsme G�Fs� o F6ip P�am 7is_ s7�^- a s�o P6oae 7�s- a - 3 i o 0 �i0i SiRVi4^1N<i OPiRA1'OA(Pvomr) LOC.�L R&(iULA?OItY AI7TSOk►TY N� � ��yLy�R coJNtr oA�C�—�l pAoe� P4one 9!S'^ '%r 3�1- 8 a a &__ -1 ��'af� %'�`''=T"'��"�� PRIVATE ONSITE WASTE TREATMENT county i'��% ,.� � SYSTEMS ��; ��:�, '�4���5�$� ����` ( POWTS) Sa.WyeT ����;--/ �-'--' INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �3 — ��p O Personal infonnation you provide may be used for secondary purposes[Pdvacy Law,s. 15.04(1)(m)] Permit Holder's Name: �City ❑ Village Town of: State Plan Transaction ID#: Ta����C.�e.n S��rae�s' ���ewa�er ,� Insp BM Elev: BM Description: Parcel Tax No: r (oo.� 8� 6� si�� c�og-.273--a2� -oloz� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Benchmark �� o� Dosing Aeration Bldg. Sewer 4$•eZ ' Holding St/Ht Inlet `�'� 9 ' TANK SETBACK INFORMATION St I Ht Outlet Q7,6 � TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet AIR INTAKE Septic ��o� �oe' 9 t�� NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. �i'�, Y � Holding Dist. Pipe PUMP/SIPHON INFORMATION Infitrative � Surface �•Y 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 c�Y #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate ��� P I L Bldg Well ❑ IGP � Chamber INFORMATION Waters Model Number: ❑ AG ❑ EZFiow CELL TO ' � �-� � s� ❑ Mound o Other �„�„ .—_ — --lQ-- � ___ -------- ----- --- --- DISTRIBUTION SYST M X Pressure Systems only - --- -- ------ Header I Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipe� _Length Dia _�Length Dia Spac �_ __ Spacing ❑Yes ❑ No � -- --- -- SOIL COVER --- — __— — De th Over De th Over �De th of Seeded/Sodded Mulched Cell Center I Cel�l Edges � Topsoil __ _ � ❑Yes ❑ No � ❑Yes ❑ N� COMMENTS: (Include code discrepancies, persons present, etc.) ��l���J ��s� (z3 — --� -- Plan revision required?�Yes 0 No � � �°�-�6�- �� J 6� �� (� Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) A�DITiONAL COMMENTS ANO SKETCH SANITARY PEAMIT NUMBEA: �b� ��---- ��G v �� , - , __ ._. _ _ .,._ , . ; _ . '. . ..._.. .y_ . ... . _.,_ : .. � . . -�. .._ . . . ... _._ :. _. . . . . �/�) ! . _ ; : _ ��(�� ' . . _ : __ : , . . _ ; . . �� N� � � ` � �° � u„��-- � � � � , Yo s� �� � � �' � . 6� � � �. � y� Y' �' �� 8, �����Pl��. ���. �.,�. ��1��, � I )� �foa' �— s =