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Home My WebLink About006-146-03-0900-SAN-2023-186 ��`'""`'`�' Department of Safety c°"°�' � ___,,;.. _�`�/• & Professional Services, `� � �jr � , •,, a ' �< Sanitary Permit Number(to be filled in by Z �: :_ Industry Services Division ' w= (� SI �; � �1 k� / Sanitary Permit Application StateT�tionNumber `�' In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this fonn to the appropriate govemmental unit is required prior to obtaiaing a sanitary permit.Note:Application fortns for shate-owned POWTS are submitted to Project Address(if differcnt than mailing � the Departrnent of Safety and Professional Services.Personal information you provide may be used for secondary putposes in accordance with the Privacy Law,s.15.04(1)(m),Stats. C� I.Application Informatioa-Please Print All InformAtion (�c ( 7Q ' �l � !�(� �� Property Owner's Name Parcel# ��:1u, N� ��n�- Y71 S� �" 5 �� ,�� ! /L Q�� Property Owner's Mailing Address Property Location I�SSe��-E.e��1 �c�tlk 13C� /�c�`�/� 5Z` � Govt.Lot .�.. City,State Zip Code Phone Number � ��'.✓t'�15 �� W�- s� Y., _' '/., Section R.Type of Building(check all thst apply) � �t# T N R E o W �l or 2 Family Dwelling-Number of Bedrooms �-� � Subdivision Name Block# �' �t'ub�i�,commerc�al-vescr;be use � �City of ❑State Owned-Descnbe Use CSM Number l�.Village of L O��'�"L�( �,Town of �Q�,(� III.Type of POWTS Permft:(Check either"New"or"Replacement"and other applicable on�tne A. Check one box oa line B.Complete line C i a licable. A' ❑New S stem R lacement S stem y � ep y ❑Other Modification to Existing System(explain) ❑Additional Pretreatment Unit(explain) B' �Holding Tank ❑ In-Ground ❑At-Grade ❑Mound ❑ Individual Site Design ❑Other Type(eacplain) (conventional) C• ❑Renewal Before ❑ Revision ❑Change of Plumber ❑Transfer to New Owner �st Previous Permit Number and Date issued EXp�tion �, k. ? N IV.DispersallTreatmeut Area and Tank Information: Design Flow(gpd) Design Soif Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevallon C.J� '_— Capacity in Total #of Manufacturer � Tank Information Gallons Gallons Units � � o v o New Tanks F�cisting Taoks � p d � y � A `�Y$ a V �n �, �n is. C7 w Sepric or Holding Tank � �� 1 5�4 uJ �'� ��L Dosing Chamber V.Responsibility Statement-T,the andeisigned,assume respon�bility for installation of t6e POWTS shown on the amched plans. Plurr�e�'s Name(Print) Plumber's � ature MP/MPRS Number Business Phone Number C I�G.. � �� rC�`� � � �� 7 .�-02�0� �� Plumber's Addtess(Street,City,State,Zip Code) S c� `�` - �.�� n �cS� �r,��'l��e� (,c� �� l�O VI.Coun /Department Use Only �A � ❑Disapproved Permit Fee Datg Issued ]ssuing Agent Signature ❑Owner Given Reason for Denial a ��"� ?f'� I�3 "� (�� Conditions of ApprovaUReasons for Disapproval .,� � �, : r_� _ � �� ,�_�.__ ° � �� G� �W� � ��ty L �.hk# AUG 14 �2023 ' C � N�- ��. {�f�� .�n s __ ; _ . � . _ _ _ __ ------- --� ��,,-�- zo�w��i��r�� AUach m complete plam for the system and sobmit to the Coaoty only on paper oot Icss thru 8 trz:l l inches in siu S'l J � _� SBD-6398(R 03/22) N��G�viVaS AIF1��R 153UE O�PER�1T Sawyer County Zoning & Conservation Administration ``""`1 ]0610 Main Street, Suite 49 � �R c� 1� Hayward, Wisconsin 54843 �'1 — —��Ci I (715)634-82R8 �Q� �'�� FAX(715)638-3277 �� _� - �% www.s�w�rcountyt�civ.ote � ol o � E-mail:sanita�'iano�saw�countyt�crv_�� I� \� '� l'i � Toll Frce Courthouse/General Information 1-877-699-4110 I�v�,_"'�'�� :�'.- �1�SCONS� ��\\�� Holding Tank Approval Checklist I. Sanitary Cover Sheet: Date Stamp �g / ��( / .��- Parcel ID# o D�- 1 �{ (Q- o� _ ��d O II. Plot Plan: �Property Lines �Bench�nark BM ♦ )CSite Address pC North Arrow �Structure /Scale �(Well �<25' to Service Road D(Legal Description �Nearest Road Intersection �Setbacks to: Property Line, Well, Structure, Water bodies, Roads III. Required Plans: �Index Page with Original Signature X Manageinent Plan/Contingency Plan �Servicing Contract �Holding Tank Agreement Fonn ($30 to ROD) IV. Holding Tank Specifications: x Tank Cross-Section: Manufacturer: s��`'" Gallons: .3�°� �Tank Anchor Calculations [SPS 383.43 (8) (g)] �Locking device, chains/locks �Alann, electrical per SPS 383.43 (8) (e) �3" Bedding Material < 1/2 " V. POWTS Component Manual Reference: �Holding Tank Version 2.1 (May 2022-2027) Owner: �. � ��_�, Plumber: C,T� Application Review Date: b��(�(�� POWTS Reviewer: � �� Name �5�,1� Rev. 4/27/2023 Credential# Co�Grc�e HOLDING TANK DESIGN , INDEX AND TITLE SHEET Project Draper Nolding Tank Owner Federai National Mortgage Assoc. Address Associated Bank 1305 Main St Stevens Point Wi 54481 Legal Description S-3 T-39-N R�-W Township Draper County Wi Subdivision Name Village of Loretta Block 3 Lot No. 9&10 Parcel ID Number 006 146 03 0900 Plan Transaction ID Number Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Designer Crai Thom son Signature �� /� Phone No. 715-266-2842 License Number 220810 Date 06/27/23 Designed pursuant to: Holding Tank Component Manual For POWTS(Version 3�i') SBD-10855-P(N.03/07,R.01/12) C�,�'�7) Version7.0(it/�2) Pagel Of 4 HOLDING TANK SPECIFICATIONS 2 Number of bedrooms Non-residential estimated flow(gpd) uMinimum hofding tank volume required (gal) 3000.0 Proposed holding tank capacity (gal) Skaw Pre Cast Tank manufacturer 3000 Tank model number Tank Alert Alarm manufacturer 101 Alarm model number Tank Dimensions and Data Tank Anchor Calculations 56.0 Liquid depth below inlet invert(in) 17930 Ibs Weight of tank 8.0 Maximum depth of soil cover(ft) 1.10 Safety factor 180.0 Length (in) 14510 Ibs Weight of anchor required 76.0 i,l;�Q}� (in)}��'"��ie Din�e 18.3 in Soil cover req. for anchor, or 3.6 yd3 Concrete counter weight HOLDING TANK CROSS SECTION manhole cover with locking device and vent finished junction �N'arning label � grade box —� � cap 4" min. 12" min. � . .., ,. F 23 " min. � �� vent pipe conduit —� tether weight------ 18" min. blind Note: Alltankjoints, � � plug and joints between to seal tank openings and 12 in� buifding piping are sealed SeN1� sewer inlet outlet Water tight. Pipe and vent materials comply with SPS 3&4. qq,0 in. Manhole and vent locations Electrical is as may be reversed. per NEC 300 and SPS 316. 3 in,bedding under tank. Tank is anchored as necessary to negate buoyancy. Because of this tank's rounded surface,soil cover alone may not be adequate to prevent flotation. Project: Draper Holding Tank Transaction Number: Page 2 of 4 HOLDING TANK SITE PLAN Project: Draper Holding Tank N Legal Description: S-3 T39-N R�-W '�r�� Subdivision Name: Village of Loretta Block 3 Scale: 1" = 30 ft Parcel ID: 006 146 03 0900 Lot No.: 9&10 I a+� _ �� k � o� �s u ,� d � � .�''�� a�` ,� _� � � o _, �-- -� I �t7C N Transaction I.D.: � Page 3 of 4 �3m: T� �$ i.v��l �3m = J . HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and maintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P N. 03/07, R. 01/12), and the Wi County Sanitary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 40.0 to 600.0 gpd. 2. The owner of this POWTS is responsibte for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90%of the tank(s)capacity or a level of 12" below the inlet (at which time the alarm activates), the pumper listed in the current Servicing Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timeiy manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code. 5. All service events or inspections of this POWTS shall be reported to the county within 30 days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes from this hold- ing tank to the ground surface, including intentional discharges and discharges caused by neglect, consti- tutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replaCement). Connection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with SPS 383.33 Wis. Adm. Code. 10. If there is a problem with, or question about this installation, the following persons should be contacted: a. Installer.............___............ Don Thompson & Sons Exc LLC Phone: 715-266-2842 b. Service Provider..................... NorthWest Sanitary Phone: 715-943-2650 c. County Zoning or Health Dept. Sawyer County Zoning Phone: 715 634-8288 11. Project: Draper Holding Tank Transaction Number: Page 4 of 4 Real Estate Sawyer County Property Property Status: Current Listing Today's Date: 4/18/2023 Created On: 2/6/2007 7:55: 11 AM Description Updated: 2/24/2020 Ownership Updated: 2/24/2020 _ _ Tax ID: 5743 FEDERAL DALLAS TX P�N: 57-006-2-39-04-03-515- NATIONAL 167-030900 MORTGAGE ASSOC _ Legacy PIN: 006146030900 Map ID: -2.3.9 & .3 .10 Billing Address: Mailing Address: Municipality: (006) TOWN OF DRAPER ASSOCIATED ASSOCIATED STR: 503 T39N R04W BANK BANK Description: VILLAGE OF LORETT'A LOTS 1305 MAIN ST 1305 MAIN ST 9 & 10 BLK 3 STEVENS POINT WI STEVENS POINT WI 54481 54481 Recorded 1.003 Acres: Site Address * indicates Private Road Lottery � 6970N SECOND ST WINTER 54896 Ctaims: First Dollar: Yes Zoning: (R-1) Residential One Property Updated: 8/22/2016 Assessment ESN : 2023 Assessment Detail Tax Districts Updated: 2/6/2007 Code Acres Land Imp. 1 State of Wisconsin RESIDENTIAL 1 .003 4,500 34,200 57 Sawyer County 006 Town of Draper Z_Year 576615 Winter School District Comparison 2022 2023 Change 001700 Technical College Land: 4,500 4,500 0.0% Improved: 34,200 34,200 0.0% Recorded Total: 38,700 38,700 0.0% Documents Updated: 9/14/2011 SHERIFFS DEED Date 422663 Property History Recorded: 2/21/2020 N�A . - - WARRANTY DEED Date 334680 Recorded: 11/1/2005 7 5n � n �, �-� �.Q�t+r� � S��,�"'"e9`" r �� lv►,� � �`"� �� e� � � 5 ��` �t� Y � �Q:tiS-� � �"� -lj-�� , S w J��c,�cc. � l5^— �`�� — 01�.c"� �� ,-..� ,� _, r .��, h� - :.v._ ;. - .� � - ,�: ` ,g �. � ; � , . � :� �.� � p .4' .�„ � ?-.` y. 1.�„�. , . �� .�� ,r��' ,�, .; ,�, �� ' + �,`q� �i��`�^' �`.. . , �'�-'., "^. 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' ��A. , .$' :r ; 'Y#' t� _^,,c�„y- � a, ,- . A. -� , a:� � r� • � � .. r.' � � ` , , _ . •�. aIP i � �:e4�if� • V�n �"��' �y � , . s.'. _°�;�` i *:a- �� k.. ��J,.�f` r• ..'. � ,.�. .f -; a Y��. ..a �+ -�� :1 i s„, � `-r� x � : .s ; . . t°: - �sr ^"` A, s • � m ' : .� t, �� ,�► q[�` a '_ �e�:: ` �-: � � ; _ X .+� .. . � , . • C . . r . .y.� ` Y � 'z'�' �.. �'a7.,x a'21 ,f,. '�34.�t��`�+��9F_i._ � ��f., _F DocuSign Envelope ID:69474086-F65F462F-68D2-E22B2FSCF249 HOLDING TANK SERVICING CONTRACT � Contract Date: 07/ 20 / 2023 This contrec[is made behveen the Holding Tank Owner and the Pumper. Holding Tank Owner's Name: �Pumper's Name: FdfI0l2 Md2 i NorthwOst Sanitary,Inc. PO BOX 155 . Radisson,WI 54867 Parcel Identification Number: (12 Digit Legacy ID) _006_-_146 _- 03_- 0900 __ l. The owner agrees to file a copy of this contract with the govemmcotal unit,Sawyer Counry, which has accepted and recorded with[he Office of the Register of Decds,the Maintenance Agreement for a Holding Tank required under the Sawyer County Pnvate Sewage System Ordinance for the issuance of a Sanitary Pennit for the installation of a holding tank(s). 2. The owner agrees to have[he holding tank(s)serviced by Ihe pumper and guarantees to permit the pumper[o have access and to enter upon the property for the purpose of servicing Ihe holding tank(s). The owner agrecs to tnaintain the all-weather access road or drive so that the pumper can service the holding tank(s)with the pumping equipmenc The owner further agrees to pay the pumper for a charges incurred in servicing the holding tank(s)as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the Govemmental Unit,Sawyer County,a report for the servicing of the holding tank(s)as required under SPS 383.55,W isconsin Administrativc Codc and thc Sawycr County Privatc Scwagc Systcm Ordinance. The pumper furthcr - agrecs to include the following in the rcport: a. The name and address of the person responsible for servicing[he holding tank; b. The name of the owner of the holding tank; a The si[e address of the holding tank; d. The date the holding tank was serviced; c. Thc volumes in gallons of thc contents pwnped from thc holding tank for each scrvicing; f. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement wil]remain in effect until the owner or pumper tenninates this conVacL In the event of a change in this co�tract,the owner agrees to file a copy of a�y chauges to this service contract or a copy of a new service contract with Sawyer County within ten(10) busincss days from thc date of change to this service contract. Owner's Nama(Print) Owner's Signature:(on�yonenwnersisnacurerequired) Fannie Mae / steve swoboda agent r cr �'✓it fA"nfMM1:11��C Pumper's Name:(Prin[) Pmnper's Signature: Ronald L Vieceli,owner Northwest Sanitary,lnc � f /��,�� l��.� Pumper's Registration Number: #2389 Rev.03/26/13 11 II�1�1�: 111�1111 I�/il I 1 II �II DocuSign Envelope ID: 694740B6-F65F-4B2F-B8D2-E22B2F5CF249 II I�!II! II I!! II !II�I� I fl II� i _ n__?-_; _nn�n-i:in� - USE BLACK INK ONLY � �-'•��!U :O�`? L;�� T'.. . :fi A•^-l�ltT ix. :4v4orvv POWTS MAINTENANCE AGREEMENT �4584� For Holding Tanks PauLA cr�IssER r��l�re^Tr� 1'fr r�rrr�c rtGusJ i cn asr vLiv� �wne�s Name(s)as shown�deed: SAWYER CQUIYTY. VMfI Federal National Mortgage association OSI11/2623 OS:11 AM REC�RDING FEE 3flA0 Parcel Identificatian Number. (12DigitLagacylD) _006_ - 146 _- 03_- 0900 _ i��E�: � Legsl Descri�ion of Property: - SEE Al"TACHED SHEET - We adcnowledge that appiica6on is being msde for the instaliation of a holding tank(s)on the property described on the attached sheet Retum To: Sawyar County Zoning and Conservation AdminisKation 10810 Main St Suibe 49.ItaY+Kard WI 54843 As an inducement to the County of Sawyer to issue a sanitary permit for a hoiding tank on the above-described property, the owner is rasponsibte for the operation and maintenance of the holding tank, locking device, aiarm and access, and agrees to conform to all appiicable requirements of SPS 383, Wis. Adm. Code relating to holding tank management, induding the following: 1. The owner agrees to conhact with a person who is ticensed under Ch. NR 113, �s. Adm. Code, except as provided by Sectwn 281.48 (3) {d), Stats., to have the hoiding tank properly serviced and to file a copy of the senrice contract with the govemmentat unit The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the govemmental unit within ten (10) business days from the date of change to the service contract. 2, The owner agrees to contract with a person licensed under Ch. IVR 113,Wis. Adm. Code, who shali submit pumping reports ta the govemme�al unit in accordance w�th SPS 383.55, Wis. Adm. Code, for the servicing of the holding tank in the case of exemption undec Section 281.48 (3) (d), Stafs., the ovmer shall submit the report to the govemmental unit The govemmental unit may enter upon the property to investigate the condi�on of the holding tank when pumping reports may indicate the holding tank is not being properiy maintained. , 3. If the awner fails to have the holding tank properly senriced in response to orders issued by the govemmental unit to prevent or abate a human heafth hazard as described in 5ection. 254.59, Stats., the govemmental unit may enter upon the property and service, or cause the tank to be serviced. Pursuant to Sedion 145.20(4)Wis. Stats., a govemmental unit may assess the owner of a private sewage system for costs related to the pumping of a septic or holding tank. The charges will be assessed as prescribed by Section 66.0703, stats. The owner agress to pay all charges and cost incurred by the govemmental unit for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent ar abate any human healtl� hazarti caused by the holding tank. 4. This agreement wi�l remain in effect only until the govemmental unit responsibte for the regulation of private sewage systems ce�tifies that either a soit absorption system that complies with SPS 383, Wis. Adm. Code, or a municipa! sewer serves the property. In addiGon, this agreement may be c�ncelled by executing and recording said certification with reference to this agreement in such manner which wilt permft the existerice of the certfica6on to be detertnined by reference to the property. 5. This agreeme�t shall be binding upon the ovmer, the heirs of the ovmer, and assignees of the ovmer.The owner shall submii the agreement to the register of deeds, and the agreement shail be tecorded by the register of deeds in a manner which will permit the ex(stence of the agreement to be determined by reference to the property where the holding iank is installed. -Onl one owner s nature uired - ACKNOWLEDGMENT Owner's Signatur � State af: �+r''s�S �� 5 .�'` � Gounfy of �5 c�w`i�- r Owner's Name (Print): Subscribed and swom to before me on this steve swoboda agent for Fanni e Mae �� day of �� ^ ti�+S �` , 20 � Date: ' l v l �/� � '' �IQ r's Name): 5 �� S �. �S� � � � ��n�.� Mh� � � �" z ��Idofa u 'c Signature: � , i' Drafted by: I � / ^. OTI�ii�Klpta Name (Print): -�_. K.aZlow5l,c . ``�c� � l�t_c�Z�,�,jI,�C� �-comrni expires on: �/ I�6�� ,�� , '°�I81-�' Personal infortnation you provide may be used for second�r purpos }(m)j Rev. 03/26/13 Lots Nine (9) and Ten (10), Block Three (3), Village of Loretta O[Tce vf Sawycr Cou�ity 7o»i�ag Ad�uiiai�t��-<<tioi� , 1'O 13o�c G7G +:.:1`� ,'=';' � � S,�\a 4 ;�� 1-layward, W[ 5�1843 -= '--_- -- , TeL(715)G31-828R '''�� r�r:��is>��3�-3z�7 �-��'�`� AUG 3 1 202�. UIu,:Lllp:llsawvercouu_ lvi;oti�.oi� �___,_ L'mail: zoiui�sec@sawvercouql_ygov or�; SA'JWY�� C;t7�fi�i�"Y . 7011 I�rce:CourUiousc/Generll lnforn�alion ZONING ADMINiSTRATI�N 1-877-G99-�1 I 0 S�wyet' County Zoning �►�tl S�nil�lioii "As - t3uill" l+o��i� Property Owner's Name �4,� ;�u ��,, q�L �SsOC, Pire Number atid Roacl Nnme �7p— [y anc�_�,-�'�+___._____ Plwnber's Name �V,��ll,� S�� 11 Date o(Installation �� a��o? J Counly Saiulary Pern�il Number � l �� 12 Digil Parcel NwnUer ��_` 1� �� —� G�' � Descri��lion:md Cleva(ivtt of L3enchmark ��p a��E�l �� [L 'Tank M�nnfa�l�ir�.r s�irf f'anari�y 5E.4l,�,1 �f� l.it 5� �;�� Selback-Ta1�k lo Nearesl Lvt Line SL �� — � Selback-Tank lo Nelresl Well �(� Setback-'Tank lo Duilding 1 3 , _ _______ Cell Widtli '�^ . CeII LengW _ ��— -_----- N�mber of Cells Setback-Cell to Nearest Lot Li��e -- Setback-Cell lo Nearesl Well SetUack-Cell to Builcling _ Setback-Cell to Navigable Waler _ Make a��d Model of Dispers�l Unit Make and Moclel of Pilter ' Make a��d Model of Puii�� _ _ - �'Ie�se coi»�i�cle oll►cr side- � a�� s-�, � d wc� H � z � S- � . � � n' � 3 �' �" � o- � � � n (�' y � � � W r � �) � ;s .�a.� $ � a F � � � u � � � � � a? � ----��G � � J� � �� ` �� v� �, � � x � �� _)r� SZ�.