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Home My WebLink About014-942-33-1114-SAN-2023-213 � .`�"""'"'`� Departrnent of Safety c°°"ty (/J _�\� � = & Professional Services, sa�-► e r � . ,, _ - Sanitary Permit Number(to be filled in by C � �,,� '�, �= Industry Services Division :,�_` (nSllol � � ��;:r,..:=< State Transaction Number �� Sanitary Permit Application s In accordance with SPS 38321(2),Wis.Adm.Code,submission ofthis fonn to the appropriate govemmental unit �— � is required prior to obtaining a sanitary permit.Note:Application forms for state-0wned POWTS are submitted to F'roject Address(if different than mailing adc � the Department of Safeh and Professional Services.Personal information you provide may be used for secondary W purposes in accordance with the Privacy l.aw,s. l�_04(1)(m),Stats. f$Cfy�(,v FOur.�!4.50`n5 � I.Application [nformation-Please Print All[nformation Property Owners Name Parcel# �r;c +- Y�c��-C W�; hn.9�sc C��y- 9va• 33 Jlly Property Owners Mailing Address Property Location aa�s c.A�c� c:� ��+ City,State 7_ip Code Phone Number �/S C.+n c+:a� P�N s53$(e NE Ya, NE '/<, Section 3 3 IL Type of Building(check all that apply) ►-'�— �I' Wa N R 9 �or ',�I or 2 Family Dwelling-Number of'Bedrooms_ 3 Subdivision Name �_ ��_ ❑Public/Commercial-Describe Use ❑City of _ ❑State Owned-Describe Use ❑Village of �Town of LGn r�4_� ______ [II.Type of POWTS Permit:(Check either"New"or"ReplacemenY'and other applicable on line A. Check one box on line B.Complete line C i a licable. A. ❑ New System Replacement System ❑ Other Moditication to Existing System(cxplain) ❑Additional Pretreatment Unit(explain) B' ❑ Holding Tank �In-Ground (xa..q�' ❑ At-Grade ❑ Mound ❑ (ndividual Site Design ❑Other Type(explain) (conventional) C• ❑ Renewal Befon: ❑ Revision ❑Change of Plumber .ist Previous Permit Number and Date[ssued ❑ Transfer to New Owner Expiration Q� - �3� ,{,��D � IV.DispersaUl'reatment Area and Tank Information: $,�S h $,�E <<�� 80�rf �o�►al' 960 llesign Flow(gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required(sfl Dispersal Area Proposed(s� System Elevalion � y50 a.o / �. o a�s /ysv �� /tic. a � 8q . 6� Capaciry in Total #of Manufacturer � Gallons Ga(lons Unils � v 'y � Tank Information � � New Tanks Existing Tanks y o y 2 « 9 m � n. U in �, v� iz.. C7 0, SepticorHoldingTank 10` v -" l�[�O � ln�: I�ha� S�S X Dosing Chamber V.Responsibility Statement- l,the undersigned,assume responsibility for installati of the POWTS shown on the attached plana Plumber's Name(Print) Plumber'- g ature MP/MPRS Number Business Phone Number R V� sock ,3oa3G 7is-G3y-IG79 Plumber's Address(Street�City,State,Zip Code) I � a�1 s +.+w � 3 l�.y...o.�d, w z .s`�8 Y3 VL C u ty/Department Use Only �Ap r �ed ❑Disapproved Permit Fec Date Issued Issuing Agent Sign�Wre Y �� ❑Owner Given Reason for Denial $ `�'� � I� �3 �S�G��L.e.�-C./ I�J- Conditions of Ap�roval/Reasons for Disapproval � G � �� ? � �3,. � �_ �5 ,J � � � ._ �.��. . _ ;.� � � � . �� nk#_ �o�� _ , AU� 3 0 2023 —_-- -- ,,�i ___w_. CS-r �3 —��-i a �c�tr'. a--�i o_tv_..____�___�.� ,� , . __ saw�rE� cc�rvn ZO1d�1JG ADMINlSTRATION Attsch to complete plans for the system and submit to the County only on paper not less t6an S Irz x I1 inches in size NQ REFJN��AFTER �5 S G�� S B D-6 3 9 8(R.0 3/2 2) IS�UE OF PERMlT ��f�,/�, �-��- GeoMat IN GROUND AND DOSING DISTRIBUTION COMPONENT DESIGN . t�af Aoplicaflon INDEX AND TITLE PAGE �,i ner n o . _ , Project Name: Huibregtse-Four Seasons Road Owner's Name: Eric&Yvette Huibre�tse Owner's Address: 225 Lake Cir Victoria,MN 55386 Property info . Property Address: 15942W Four Seasons Road Legal Description: NE NE S 33 T 42 N R 9 W Township lenroot _ County: Sawyer____ Subdivision Name: Tax ID:18569 Lot Number: Block Numbec CSM#: Parcel I.D.Number: 014-942-33 1114 Plan Transaction No.: n ex ages Page 1 Index and title _ Page 2 Data entry Page 3 GeoMat dist.cell drawings&calculations Page 4 Lateral and cell cross section Page 5 Management&contingency Page 6 Maintenance&specifications Page 7 Distribution media Page 8 Plot plan Ray Visocky License Number: 230236 Date: 08/29/23 Phone Number: 715-634-1679 Signature: �, �/� Designer Stamp: State of Wisconsin Approval Stamp: Designed Pursuant to the GeoMat In Ground Component Manual April 2019 Version Page 1 of 8 in Ground and Dosing Distribution Component Design Site infortnation R Residential or Commercfal Design N ISD Required? 300.00 Estimated Wastewater Row(gpd) 1.50 Peaking Factor(e.g. 1.5= 150°/a) 450.00 Design Flow(gpd) � 25.00 Site Slope(%) 89.00 Prop. Systertl ElOvetiOn(ft) Santl 8 Native wil Contour , 86.00 Depth to Limiting Factor(in) 1.00 In-situ Soil Application Rate(gpd/ft2) � 93.00 Lowest Original Grede Ele. In System Area(ft) 94.42 Highest Original Grade Ele. In System Area(ft) 86.00 Limiting Factor Elevation(ft) 3.92 Depth Below Grade s u ion e n rmation _ 325 Cell Width(ft) � Number of Cells �� 2.00 Dispersal Cell Design Loading Rate(gpd/ft�) 2 Influent Wastewater Quality(1 or 2) �stribution Mfortn on' C Center or End Manifold, Dist Box or Drop Box � Number of Laterals System dosed L_ N . _� 0 00 Lateral Spacing(ft) System not doseC a . Treatment Tank Infortnation Effluent Filter Information �� 1060.00 Septic Tank Capacity(gal) Lifetime Filter LLC Filter Manutadurer '�,InfiltratorSystems �Manufadurer LT1/8 . _ .��FilterModelNumber Project: Huibregtse-Four Seasons Road Page 2 of 8 In Ground Plan View Il � ��IlIl c��]�I�� 00000000000a000000000000000000000000000� 0000000 : 000000a00000000000a000000000000000000000000000 :• 00000000000000000a000000000000000000000 0000000 . - . o0000000000000000000000 0000000000 o0000000000000000000000 0000�0000a � .. o0000000000000000000�oo�ooa�00000000000000�000 �j, Q 000000000 00�0�0�0� :• .' o°o°o°o�o�o�o�o�o c°o°o°o°o°o°o 00000000�00000 ��d`➢/1L'6�. o000 0000 0000op0000 , �' NOTt '• � .�J � � 4C�G�'.�:c�•^0.� C.) �d 4� o � ASTM 33 Sa•,d +-n �e ac� crcc� �o upstopc 5 �at U� Cel1 � 'f�oTw l W �OTH = '7 . a5 �� J T�.;5 �1oes noA r.. trc�.sehwsc\ c.rcw a C ations _ I ft A 325 ft Basal Area Required 450 ft� K 1 ft B 80 ft Basal Area Pro osed 460 ft2 S 0.00 ft L 82 ft W 5.75 ft� 7.�5�� Basal Area Calculation GeoMat Dis ersal Cell Basal Area Calculation GPD Loadin Rate GPD Loadin Rate 450 1 gaVsq fUday 450 2.00 gaVsq tUday Total 450 ftZ Total 225 ft2 Proposed 260 ft2 Number of Cells 1 GeoMat Width 325 ft Cell Length I ft lineal Feet of GeoMat Required 692 Min. Cell Len th 69.2 ft Lineal Feet of GeoMat Pro osed 80 Cell S acin 0.00 ft NOTE:Min S dimension= 1' S stem Elevation 89 ft Limitin Factor 86 ft Se aration 3 ft 2'Min Directions Play with cell length to get desired cell spacing, length and width Remember system SHOULD be longer than it is wide It must also Satisf basal loadin rate and GeoMat cell loadin rete. Project: Huibregtse-Four Seasons Road Page 3 of 8 Cenbor Connaetion latenl Layout Diagnm , , :�,...,:,, ,.�.� -;s, O . ..,.. .. ... _ . _� ... ..---._..P ._...._.. .. _ �,...�i.,i� O Hole spacing is every 12", 7!2"hole at 4 8 8 O'clock,slarting 4 O'clock 6"from ena antl 8 O'clock Holes al 12"from end. 4"Pertoraled pipe may 6e used. Lalerel Spacing ODO ft Pipe Diameter 4" in ..O11� Ofl. . . ._.. . ... .... .. . . .... . .. . .. . . ... _ . F�n�cMA C:nAr �Y � `� ` W V �3s fk �� . : ` °,�mo� �R "— I co.Q�mmmmdea 12„�z nec.�o �.� Lm.�Itvel � '�: T� 4"in �► pipepu� � '��zu F1Cfilfnfik . ._� r;a i�.. Top of geomat to be at or ��. _ _ _ - � �_GEOMAT beloworiginal grade i I I ��33 cy� I � I , I � I � I Camp� I I 1 . I � �qq��g� - ==_NATIVE.SOII��===� `� I_ _____________��_y� �.,s� 86in y � o pes ..,.�+�o.� � Fultl6W � O•MYOs 72"Min. �. i ' \ I 42"M�. i` I sm r.,ae n� � / I .—a.H.,. T3ist. _ �agE m,n. +�� mm� i �T -- r 9o.SU I�� C33 .� ''' ��; �;»- �.>- S�.,d u�`�s� 89 ' Project: Huibreg[se-Fou�Seasons RoaO Page 4 of e Notes/ Maintenance Requirements MANAGEMENT P�AN This private onsite wastewater(POWTS)has been desfgned,and is to be installed and maintained in accordance with SPS 383,Wia Admia Code,the io-Ground Soil Absorption Component Manual for Private Onsfte Wastewater Treatment Systems Version 2.0 SPS-10705-P (N.01/01). GeoMat in ground Component manual April 2019 Version. 1.This POWTS has been designed to accommodate a maximum daily Flow of 45QtgAons of wastewater per day. The quality of influent discharge into the POWTS treatment or dispersal component shall be equal to or less than all of the following. A monthly average of 30 mg/L fats,oil and grease A monthly average of 220 mg/L BOD5 A monthly average of 150 mg/L TSS Wastewater shall not discharge to the POWTS in quantities or qualities that exceed these limits or that result in exceeding the enforcement standards and preventative action limits specified in ch.NR 140Tables 1 &2 at a pofnt of standards application,except as provided in DSPS 383.03(4),Wis Admia Code. 2.The owner of this POWTS is responsible for system operatfon antl maintenance. 3.Defects or malfunctions identified during maintenance descnbed above shall be repaired in conformance with SPS383 Wis-Admin.Code, and the pertaining county Private Sewage Systems Ordinance. The user's manual,provided to the owner of the POWTS includes the names and telephone numbers of the propedy licensed individuals to contact for such repairs. 5.No product for chemical or physical restoration or chemical or physiral procedures for POWTS may be used unless approved by the Dept. of Commerce in accordance wlth SPS.384,Wis.Admia Code. 6.If the POWTS is replaced,or its use discontinued,ft shall be abandoned in accordance with SPS 383.33,Wis.Admin.Code. NOTES Two Effluent Filters to be installed where possible 1 to be fnstalled in ST,and or 1 in pump tank in order to insure particle size less than or equal to 1/8". Filters should be cleaned once in spring,and once in fall. Also,strainers in sinks in the bufiding shall be maintained,so that solids and fats are minimized to flow into system. A minimum of 2 observation pipes per cell shall be installed. These pipes shall be located approximately at the end of each cell. The piumber,or county shall see to ft that a copy of these plans induding this page, maintenance folder,and maintenance agreement is given to the homeowner. This system may contain a dose chamber. If a pump,float,electncal wtage causes the dose tank to fll,the homeowner should see to it that the effluent level in the tank is brought down gradualty and not all dosed to the system at once. One large dose coulA cause damage. Contact a pumper or your installer if this problem occurs. The homeowner is responsible for fortnulating a water conservation plan that will ensure the system is rarely overloaded. LE.spread laundry out over time,not 6 loads in 2 hours,while everybody showers,and uses the toilet, ETC. CONTINGENCY PLAN FOR COMPONENT FAILURE A. Septic Tank.Any structural faiNre resWting in cracks or leaks in the tank must be corrected by replacement of the sep6c tank component. Leaks in the joints belween manhole risers or covers shall be repaired by replacing fauky seals with approved materials to make joints water- tight. B.Outlet Filter_The outlet filter shall be replaced or repalred when it is either no longer capable of preventfng the discharge of particles larger than i!8 inch or when it has become pertnanently degraded by dogging so as to interfere with the design flow out of the septic tank. C.Dosing chamber and pump.The dosing chamber shall be replaced if any structural failure is found-l.eaks in joints belween manhole risers or covers shail be repaired by replacing faulty seals wdh appmved materials to make joints water-tight The pump and conUols shall be replaced when they are no longer capable of functioning according to the design plan. D. Pressure DisUibution Pfping.Partial clogging of the distribution network may resWt in unduly long dosing cydes The ends of the distribution laterals may be exposed and the threaded end caps removed.The piping can be disconnected on the outlet end of the pump. The distribution piping may then be back flushed to cleanse any accumulated matter from the piping-It is recommended that the dosing chamber then be pumped by a licensed plumber. E.Soil Absorptfon Cell.The discharge of sewage or wastewater to the ground surface is strictly prohibited due to the human health hazard created by the effluen[All failures created 6y surface discharge shall immediately be reported to the appropriate county.The pump shall then be immediatety disconnected to prevent further discharge to the gmund surface via the sofl absorption celL The existing septic tank and dosing chamber shall be used as a temporary holding tank until the necessary repairs to the soil absorption cell can be achieved.The replacement shall be initiated only after any necessary plan approvals have been obtained from the appropriate plan review authority and the required sanitary permR is obtafned from the county. Project: Huibregtse - Four Seasons Road Page 5 of 8 in Ground System Mainte�ance and Operation Specifications Service Provider's Name Ray Visocky Phone (715) 634-1679 POWTS Regulator's Name Sawyer County SPIA-Zoning Administration Phone (715) 634-8288 Svstem Flow and Load Paremeters Design Flow-Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 300 gpd Maximum BODS 30 mg/L Septic Tank Capacity 1060 gal Maximum TSS 30 mg/L Soil Absorption Component Size 260 ft2 Maximum FOG 10 mg/L Type of Wastewater pomestic Mazimum Fecal Col'rform 10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Inspect and clean as necessa at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test periodicall Pressure System Laterals should be flushed and pressure tested eve 3 ears In Ground Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the GeoMat In Ground Component Manual Ver.April 2019. 2. Dispersal cell media conforms to GeoMat produds approved for use with the GeoMat In Ground Component Manual Ver April 2019. Media is covered wRh an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384,Wis.Adm. Code. 4. Scarification of basal area is accomplished with a rake or other tool. 5. All disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail 6-8"Diameter Finished Threaded Cleanout Lawn Sprinkler Grade � �;`'�� Plug or Ball Valve Box Vent if i � ot Dosed �. Wteral Ends at Las[Orifice Where � :.:tii.�. Long Sweep 90 or Two �45 Degree Bends Same Diameter as Lateral �:i.'�.� . :'�_ _ . �Distribution Lateral � Lateral Cleanout i 89 Feet Project: Huibregtse-Four Seasons Road Page 6 of 8 tieoMat Distrlbutlon Celi AAedia Layout 325 Cell Width(R) 2.63 Si0ewa11 to Lateral(ft) Distribution Cell Cross-section Arrangements . . . . . . . ._ . . . �1.� . 0 DiStribulion Pipe GeoMat is wvered with approvetl geotexlile tabric as per ihe their product approval. Distribution Cell Plan View Layout-Typical 325 Cell Witlth-A�ft) BODO Cell Length-B(ft) Cente�Connecna�__:'�.�- ._,�o�t'Diagram _-__—_._-_-_____-�-___-_._ . ._. _ _ _ . . �� . �.. _ ._ . . .. _ .. .. .. .. _ _. .. .. . . .. ._ .. .. . .. . .. . . . .. ._ . . . . . . . Ca ..{iB 0 . . . . . . _ . . ., . �iniched Crndc �`�` ��Y V`1�V' DiMbudm �Co.a�eoammmeeA:�. 12 ai�'.` B"�ra ��. I�tvdl.ev'! � _�: ��,f ` � �� (u y \ � Ffnfitutbva A Pipe I�_ u „ _ _ _ _ cEo� 1 �sa�y.i 33 > �� ' i � i i � z•AS`IM33£m I � � , � , � � � �°�°°� � _ —— — ——— —_— ——— _ _ In5ltaave Surtace �y —=-IVA'TIVESOIL==_= � I �_ - - �= ---��-- --f — L°^-'7'eFamr See Celails on page 1 for number,siie,aM spaci�g o!lalerals. Project: Huibregtse-Four Seasons Roatl Page 7 of e P�oT � �.r� N SCALt - 1 : Y � 159y�W FOu0.5ERSONS RO N E�/y � N��J�! I�e.1Scn Kt �.�— SEc. 33 , r �,�N , R9w ..._..^„ '�%.�-�+. TUW�16F I.GNRoOT "�%„_�. '�—� S0�4fY6R Go�1WTY �. P�,1 . o14-9v,^ 33 � � � �1 L3N= f�o,�l wlr�bbon �n ��i" Maplc T�et �� pq 9a.ad E L G V/t T! O N S B' So.na Ar+ ►o a . o o :� b - - - ---'----- - 9Y.ae� fl) A3 . o o P� 8!'1 II, '__"9�.00' �� .g.�n• Ba 4 G. o U �� 43 9 3 . a o �� o,,.a„��y \ S� � LnKE ± 99 .o O F� � s �40 u e y,�N°�`�,� sr.�o�oq�• ��ds��c s�+►�a+c,w�c �l�r mi.1Cb7 �nF�1�.�.lorSi.d�'►�-5 - AA: c�ba«pkco-. rare. c�..s;s�"7 b4 a 7.J5�' 8�'eri� co..�oM:+� �,� �'°�^-9'' 804+eC 6cw«...,+ 3400 • 6x;�...� srs r�.+ :s�. bo p^,�"'•�r fab ond.+tie.c! �. C�. k1 . FOUR .S� /�TSQW.3 RQ�D t�a9e $oF$, � , "`''; pRIVATE ONSITE WASTE TREATMENT county ��, :��os SYSTEMS p ( POWTS) Sawyer ',�,� s ._ \k� ` . �t��,�, ' "'� INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �3 � p� `3 Personal infonnation you provide rnay be used for secondary pucposes[Privacy Law,s. 15.04(1)(m)J Permit Holder's Name: ❑City ❑ Village I�Town of: State Plan Transaction ID#: C!'�G �- �� u�wt � �►'�lbv Insp BM Elev: BM Description: Parcel Tax No: (o o •�� ►«; I �-�,��b,� �� 1�f `' � IszT�_ 01�-(--9�� -33- (I r Y TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic (/` � ,,�y I�� Benchmark �oo.o � Dosing Aeration Bldg. Sewer ��,5' Holding St/Ht Inlet lo�,2� TANK SETBACK INFORMATION St/Ht Outlet ��o,� ` TANK TO P/L WELL BLDG vENrTo ROAD Dt Inlet AIR INTAKE Septic ' ,�-� � �-�D` .� a� NA Ot Bottom Dosing NA Installation Contour Aeration NA Header/Man. Holding Dist. Pipe �t� 9 ' PUMP 151PHON INFORMATION Infiltrative , Surface �`�•c"� Manufacturer Demand Final Grade Model Number GPM c_3 40 �f r TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist. To Well DISPERSAL CELL INFORMATION DIMENSIONS W -�' L � #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate ��4"� INFORMATION P/L Bldg Well Waters o GP ❑ Chamber Model Number: o EZFIow CELL TO �1-�a .�-�o �Sa �-�' ❑ Mound t� Other — — - __ — __--- - —_ _—_ _ ----- -- - —-- __ DISTRIBUTION SYSTEM X Pressure Systems Only Header/Manifold Distribution Pipe(s) li X Hole Size X Hole Observation Pipes i Length Dia _ Length Dia__ _ Spac _ , Spacing ❑ Yes ❑ No � _ ---- ---� SOIL COVER _-- — Depth Over T Clepth Over Depth of— Seeded/Sodded � Mulched � Cell Center � Cell Edges Topsoil �Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present,etc.) ��,,�rc�.�, ��i 3_�Y �.z.3 � H T� --� �,�,�.,��• G�.o�M�- Plan revision required?�Yes ❑ �Jo �p 3; �$ � � , � � � �� III i Use other sitle for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AOOITI�NAL COMMENTS AN� SKETCH SANITAAY PERMIT N�JMBER_o��__.�1�___ r'"� �f 2�s o�.,. ��/,..� 1, � � 7 - .Q� _ � ��- 7��ga � '��-3�� .`br �P� � L �� • e+ , �� *3° � � \ �•�� r , , � �A� � � o , �o � � 4 � � w�P� - - - -- -� � �z � „T.� � y°.n`�e— �� . P �' A �' \�,�1v� � --�� °"��