HomeMy WebLinkAbout032-538-09-1111-SAN-2023-183 _;:;.�TUF� Counry C/�
:;�;.--�f., Department of Safety o . � �
S �w c �_
�:,�, �S �';=; & Professional Services, �itary Peimit Number(to be Slkd in by� �
`5` � Pg ��� Industry Services Division
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Sanitary Permit Application State Tiansaction N►unber '�
In accordance with SPS 383.21(2),Wis.Adm Code,sabmission of this focm to tbe appropriate govemmeatal unit �0
is rcquircd prior m obtaining a sanitary permit Note:Appliw6on fonas for stataowned POW1'S ere submitUed ro Projed Add�ss(if differrnt than mailirtg a �J�
the Departmeot of Safety and Professional Secvices.Personal information you pmvide may be used for seoondary
Pucposes in�cocdance with the Pcivacy Law,s.15.04{lxm),Stats. ) �I
I.Ap lia�tion Information-Please Piint AD Informalion ��L6�o��l'f �f� '��l� �1�
Property Owner's Name Parcel#
"^ c,�cX �- c� 7 r-� � d:3�•S, , •p •
Property Owner's Maiiing Addres Property Location PRT
�S��� �-T�; C SZ� , 1tl� N�E
City,State Zip Code Phone Number '�
�,n ,-, ,� ?1 S- L�j� -3:�o s�� N W �,., l`�t v., s�;o��_
II.Type of Build'mg(check a1t that apply) � �t# � T � N R E�
�1 or 2 Family Dwelling-Number of Balrooms Subdivision Na�
Block#
a Public/Comme�ial-DesciibeUse
❑City of
❑State Owned-Descnb�Us� CSM Number ❑Village of
8 33l �l 7�t� �Town of LV!��!'
III.Type of POW1'S Permit:(Check either KNew"or KReplscement"and other applicable on 6ne A. Check one boz on line B.Complebe line C
a licable.
A' �New System ❑Replacetnent System ❑Other Modification to Existing System(eacplain) ❑Addirional Pmreatment Unit(expiain)
B' ❑Holding Tank �In-Gmuad ❑At-Grade ❑M�nd ❑Individual Site Design ❑Otha Type(explain)
(convenrioaal)
C. ❑Renewal Before ❑Revision ❑Change of Plumber ❑Transfer ro New Owner ist Previous Permit Number and Daoe Issued
Expitarion —'
IV.Dis rsalft�ealment Area snd Tank Tnformation: / �� ' S �.���, �,� �� CC
Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� DispcRsal Aiea Proposed(s� System Etevation Tu p . C-3�j
s l�� ��1.� ��� 7 s �r�s.a
Capaciry in Total #of Manufactu�er �
Tank Information Gellonc Gallons Units ,o �i �u ^
New Tsaks E�cisting Tanks � o g � $ ,�a �
a U �n �, v� w C7 O.
Septic or Holding Tank j 1 S�[�,;�' ;` ��C
4
Dosing Cham6er
V.ResponsibUlty Shtement-I,tLe undersigued,asaeme responstldliry tor installatba of t6e POW1S shown oa the attached pl�m.
Plumber's Name(Prmt) Plum 's Signatiue MP/MPRS Number Business Phone Number
Gc�4:� ��m sv� ` .�' - a�a��o �i��a��-_��'�1
Plvmber's Ad (S1net,City,State,Zip Code)
�c� f;y� l� %��� Svn �iX � i l�-�e�; �� ��� �'�2 U
VI.Conn /Deparhaeat Use Only
�AppcBo� ❑Disappnoved P�t Fee Date Issued lssaing Agent Signature
O Qwn�r Given Reason for Denial a I Wc� �/I`� I �3 �Lt��1 1""""``'`-
Conditions of A.pprovaUReasons for Disapproval �--�_
D ������'.� .
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C�-�-1 ao - ($�-> ,,^�.,��. a s��..--- _._
�CJN1lVG qpM;NI��TR 1J41fJIV
Aqaeh to eamplKe plam tor the system aad sobmit ta/6e Coeoty onty on paper aot leis ihan 8 t2 z ll inches in size ?3���
SBD-6398(R 03/22) f�p RrFUNDS AFTER
I�SlJE OF P'�R�,l!!1'
PAGE 1 OF 4
In-Ground Gravity Plan
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
At#achments: Enclosures:
POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
Owner Name(s): __�ocQcQ-� �D�1�l /w^c:c}��'_ Phone: 7I5 -�1�1d - ��5�
Owner Address: (vS�a` � �`���C'_ SZ�- (�c.�L+���' C�'-i Zip: ����`l�
Project Address: �y�5-N ��r���K��ly �n, (,������� f.�
�� ��� 1�Cc�1/4 of �I L� 1/4, Section � , T 3� N-R � E Q or W �
Township: �.,t� i�`l'�e-�'� , County: �rt+�:�'��;r-
Project Parcel ID#: � 3 a •�3`; v� llll
Designer Information
Designer Name: �l`4-� � � �'+Jrn ��I"� Phone:��/S _��� _ ;,Z��J�
Designer Address: ��(� 1o�,Ps�n 1 l�f� l%U�� ��i'1 Zip: ���z'�
E-mail: ����1'1� ���.Sr�t � �c)i,1�e�' �t,J� _ _ , w 1-�, ��_�.�x4� ��� r���; .. :���;�,n
License Number: �oZC� �C�
Remarks:
h
Signature: � �� Date: �-7,'�3
Original sig2a e required on each sub itted copy.
CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE.
❑ SOIL EVALUATION o s`�1e: a�o 40 so 80 � SYSTEM PAGE 2 OF
SITE MAP PLOT PLAN
PROJECT NAME: , DESIGN FLOW: ��� GPD
(10 ft grid) �p
�����-���e �����.�,� ����` Attach design flow calculations for commercial plans.
PROJECT ADDRESS: __"!�S�Z��) {✓.''�: ^�� �f� Pipe Material/ASTM Standard(Tables 384.30.3 8 384.30-5)
N Sanitary Sewer y�� / �U�
BM Symbol: � BM Elevation: �D 7-S�c FT
BM Dascription:
���F� i f� c7cC7�� �v�i�.<'' �i �1� Force Main: /
Slo e Gradient % ` Indicate north by IMPORTANT:
P � � �3,3� Well Symbol(if applicable): � drawing an arrow Show ground elevation contours at suitable intervals.
Of T2Sted Aree: on the approprite line.
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Table 2
SIZE AND ORIENTATION i
<10 feet=Number of produd rows x product
width.Product width is shown in Table 2b;two
rows of A42s can achieve a 6 foot width. Units
may also use up 18 inches of sand on each side of
Distribution cell width(A)a the product to achieve a 6 foot width. For
instance,843 units used with 18 inches of
specified sand can achieve a 6 foot width;refer
to Table 2c for configuretions. A 843 unit with 12
inches of specified sand on each side can be
placed in two rows to achieve a 10 ft wide celi.
>_Design wastewater flow rate=design loading
rate of the fill material=square footage of
Required#of Products product(shown in Table 2b),round up to nearest
whole number;Min 5 843 units per bedroom or
6 A42 units per bedroom in residential
applications
Distribution cell length(B)a Multiple#of GSF units x 4 ft+1 ft
Orientation Longest dimension parallel to surface grade
contours on sloping sites.
Deflection of distribution cell on concave <10%
slopes -
Design wastewater flow=soil applicatio�rate for
the in situ soil at the infiltrative surface or a
Basal area lower horizon if the lower horizon adversely .
affects the dispersal of wastewater in accordance
with s.SPS 383.44(4)(a)and(c),Wis.Adm.Code
The designer may use Effluent�t2 in accordance
Soil Application Rate with s.SPS Table 383.44-1 and 383.44-2,Wis.
Adm.Code
Table 26
APPROVED PRODUCT MODEI NUMBERS AND DIMENSIONS
Product Square Footage Produd Width Product Length Produd Height
A42 12 square feet per unit 36" 48" 7"
843 16 square feet per unit 48" 48" 7"
Table 2c
APPROVED PRODUCT INSTALLATIONS AND SQUARE FOOTAGE
Product Square Footage Installation Width Installation Length Install Height
12 square feet per unit 36" 48" 19"
A42 16 square feet per unit 48" 48" 19"
20 square feet per unit 60" 48" 19"
16 square feet per unit 48" 48" 19"
843 20 square feet per unit 60" 48" 19"
24 square feet per unit 72" 48" 19"
Eljen Corporetion �� U�;-f 5 x ay'�a = a88�
P�,�� 3
SEED AND LOAM TO PROTECT FROM ER0.SION
�� GEOiDCfiLEFABRIC �
MIN 12'OF
CLEAN FlLL
T �
� ..... .. .:.:� . :. - . -: . ..... ��. 15,
�r SPECIFIEDSAND � �.. �
6" 36" 6"
48"
843 WITH 6"OF SAND TO SIDES
SEED AND LOAM TO PROTECT FROM ER0.SION
�� � �r�l[.
MIN 17'OF �����FABRIC
CIEAN FILL
T ': �
�":.. �. -_� : .. ...:. . . . :.. 19"
1z� SPECIFIEDSAND ��- �� �
�r 3s- �r
�
eas v�nni�r oF sfw�To sioEs
SEFD AND LOAM TO PROTECT FROM ER0.SION
r—� GEOTDCfiLE FABRIC �
MIN 12"�
C�EAN FILL �
� �'Y
� ; _ ag.�6�
.' .. : ,s�
�r - - sa�ciFlEosiwo �
= 9�.2(,i
. 18' 36" 18"
72"
B43 VNTH 18'OF SAND TO SIDES
Figure 2. 643 Single Lateral In-Ground Cross Sections
Eljen Corporation
�a5e 3 �(�-�
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 382384,Wisc. Admin. Code. Pursuant to SPS 383.52 (2),Wisc. Admin. Code, this system shali
be considered a human heaith hazard if not maintained in accordance with this approved management plan.
Furthermore, ail 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 Operatinq Limits:
Design Flow= �!�� gpd; 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 fac[ors (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 distributlon appurtenance(s) (i.e., distribution /drop boxesj
o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
o extent of ponding in distribudon 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 spec'rfication)
o surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Seotic and dose tank(sl 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 shail be pursuant to NR 113,W isc. Admin. Code.
o Effluent filter(s)shall be inspected every 3 years and shall be cleaned 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: Q�l1 ��p�l'1 d' Sd�5 �Y L l�L Phone: ��5 ���� ��yoZ _
Localgovernmentunit: J441�P/� C,c�f���1 �nJl%�``1 Phone: �715���3��— ���� _
Localgovernmentunitaddress: �Cj�olC �4�n sZ�� S�c�'fC' 11 ( �k��ci�ZIP: s�(�"�3
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1),Wisc.Admin.
Code. Repair or repiacement 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 component in a pre-determined area of suitable soils.
Svstem Abandonment
If use of this POWTS is discontinued, it shai� be abandoned in accordance with SPS 383.33,Wisc. Admin. Code.
� 8/6/23,3t14PM Nnvus-WisconsinAccessrev. 13.1108
Real Estate Sawyer County Property Listing Property Status:Current
Today's Date:8/6/2023 Creabed On: 2/6/2007 7:55:57 AM
��Description Updated: 1/20/2020 34 Ownership Updated: 11/5/2020
Tax ID: 33944 TODD]&HOLLY M TURCOTTE WINTER WI
PIN: 57-032-2-38-OS-09-1 01-000-000110
Legacy PIN: 032538091111 Billing Address: Mailing Address:
Map ID: .1.11 TODD]&HOLLY M 7URCO77E TODD]&HOLLY M
MuniCipality: (032)TOWN OF WINTER 6522W GROVE ST TURCOTTE
STR: 509 T38N ROSW WINTER WI54896 6522W GROVE ST
Description: FRT NENE&NWNE LOT 7 CSM 8/331 WINTER WI 54696
#1756
Recorded Acres: 3.250 � Site Address * indicates Prnate Road
Lottery Claims: 0 4452N DRAGONFLY LN * WINTER 54896
First Dollar. No
Waterbody: Winter Wke � U dated: 10/SO/2016
Zoning: (C-1)Commercial One ��-- Property Assessment P
ESN: 428 2023 Assessment Detail
Code Acres Land Imp.
� Tax Districts Updated: 2/6/2007 G1-RESIDENTIAL 3.250 9,000 0
1 State of Wisconsin Z_year Compariwn 2022 2023 Change
57 Sawyer County �nd: 9,000 9,000 0.0%
032 Town of Win[er Improved: 0 0 0.0%
576615 Winter School District T��; 9,000 9,000 0.0%
001700 Technical College
� Recorded Documents Updated: 8/16/2011 �Property History
� WARRANTY DEED N/A
Date Recorded: 10/30/2020 427645_
O ROAD EASEMENT
Date Recorded: 10/30/2020 - -
O PERSONAL REPRESENTATIVES DEED
Date Recorded: 1/SO/2020 .'-,':G'�_
O WARRANTY DEED
Date Remrded: 11/26/1994 .____1.J_ 544/174
O CERTiFIED SURVEY MAP
Date Recorded: SO/14/1981 .___�'=a9
https:ll[assawyercountygov.org/IAccesslmasterasp?pnprpid=33944 ���