The URL can be used to link to this page

Home My WebLink About012-640-17-4306-SAN-2023-233 /;��^ar"_'('�,,� Industry Services Division County � �;� ` 4822 Madison Yards Way Sawyer ,;;, e `='� � �,� ,` S �:' Madison,WI 5370J Sanitary Permit Number(to be filled in by� ',,,�l, �, Ra ;�' P.O.Box 7162 � '`�R� � � Madison,WI 53 707-7 1 62 � 5 � `:. ;�S �;.;�u� ``�� vJ Sanitary Permit Application State Transaction Number � In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit � is required prior to obtaining a sanitary permit.Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailina a� the Department of Safct��and Professional Ser��ices. Personal information y�ou provide ma��be used for secondary 9066 W Moore's Bay Trail,Hay�vard,WI ��4843 purposes in accordance with thc Privacy Law,s. 1�.04(I)(m),Stats. I.Application Information—Please Print Ali Information Property Owner's Name Parcel# Kelley Ann Bohmann 012640174306 14430 W State Rd 77 Property Location (.ka�� Crevt-6e�---• City,State "Lip Code Phone Number Hayward 54843 715-558-I501 .Sw y, S� y,, Section 17 _ Il.Type of Building(check all that apply) I.ot# � T 40 N R 06 __F,or W X 1 or 2 I�amily Dwellins—Number of E3edrooms 4 Subdivision Name Block# � ❑Public/Commeroial—Describe Use ❑City of ❑State Owned—Describe Use CSM Number ❑Villa�e oY 7/65#1361 X Town of Hunter IIL Type of POWTS Permit: (Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C if a licable.) _ �. ❑ New System ❑ Replacement System �Other Modification to Existing System(explain) ❑ Additional Pretreatment Unit(explain) Adding 2 more bedrooms �3. ❑ Holding Tank "In-Ground ❑ At-Grade ❑ Mound ❑ Individual Site Design ❑ Other Type(esplain) (conventional) ��• ❑ Renewal Before ❑ Revision ❑ Change oCPlumber List Previous Permit Number and Date[ssued ❑ Transfer[o Ne�v Owner��_235 //�� Expiration � �O��I �C7 J ( IV.Dispersal/Treatment Area and Tank Information: Desi�n Flo�c(opd) Desian Soil Application Kate(_pd/s� Dispersal Arca Requircd(sfl Dispersal Area Proposed(s� System Elevation 600 7 8�8 92� 93.6 Capacity in Total #of Manufacturer �I'ank Information Gallons Gallons Units � � U „ � New Tanks Existing Tanks � c n� � � s � � o _ n. U �n � cn �.i :7 � Septic or I lolding Tank 750 800 Wiesei-Skaw X Dosinc Chamber V.Responsibility Statement- I,the undersigned,assu esponsibility fo i tallation of the Y0�4'TS shown on the attached plans. Nlumber's Name(Print) Plumb � Sianah�rc MP,MPRS I�'umber E�usincss Phone Numbcr �Cravis Buttertield 652879 715-634-8176 Plumber's Address(Street,City,State,Zip Code) 14346 W State Rd 77,Hayward W[54843 VI.Coun /Department Use Only ? 9 Pemiit Fee Date Issued Issuine Aeent Sianature �Ap �� ❑Disapproved ` ` �,,� � $ Y�� I�� J�3 r�1��,�lt�� t-4�z p Owner Given Reason for Denial , Conditions of Approval/Reason�s for Disapproval � � � �� ,�� "� � � I � a ��.�.__�,-� �_i � �� - � � ��Gt � _ �__ r- �� !� :�,k# �-q��..._.w.__..._,.:.. �rt ,.. SEP 15 2U23 C S � l l � I � � `''�"�t*` .5 ��_S.� __. SAW"(ER COUNIY Zp�K3 ADkqPJ�STRATION Attach to complete plans for the system and submit to the County only on paper not less[han 8 1/2 x 11 inches in size � N'�� i`d�FLFJND��'TER ss�-639g�u.o3i2i� lSSU�dF t��tidtiT 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 Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description owner tvame(s): Kelley Ann Bohmann Phone: �15 _558 _1501 Owner Address: 14430 W State Rd 77 Z�p: 54848 Project Address: 9066 W Moore's Bay Trail, Hayward, WI 54843 Govt. Lot: 1/4 of 1/4, Section � 7 , T40 N-R 06 E ❑or W � Township: Hunter County: Sawyer Project Parcel ID #: 012640174306 Designer Information Designer Name: Travis Butterfield Phone: 715 _634 _8176 Designer Address: 14346 W State Rd 77, Hayward, WI Zip: 54843 E-mai�: drillerbiker@gmail.com ��„�s�,��,-��z-u«�f�„�a��,��,�rr,;�r�,��. License Number: 652879 Remarks: Signature: Date: 09/15/23 Original signature required on each submitted copy. CHECK BOX AS APPLICABLE CHECK BOX AS APPLICABLE. � SOIL EVALUATION o Scale: 4�0 40 so so ,� SYSTEM PAGE 2 OF y SITE MAP PLOT PLAN PROJECT NAME: �oz �Esicry F�ow: � �� cP� ��C� ��.,,,�n,.� Attach design flow calculations for commercial plans. PRo�ECT ADDREss: 9(��011� �✓ �ov K' ��o•r (�a�� Pipe Material/ASTM Standard(Tables 384.30-3�384.30-5) �� N � Sanitary Sewer. �__�/ BM Symbol: � BM Elevation: FT Force Main: / BM Description: ��I� ��e slo e Gradient /o Indicate north by IMPORTANT: P (° ) Well Symbol(if appllcabie): p draw�r,g ar,arrow Show ground elevation contours at suitable intervals. of Tested Area: on the approprite line. C�;Q�e c�- � ��-�— � ��y �30��w� �� 3� w s �-� � � � � y / w� SY8Y3 L c�� 1 a� `�o �� `-l�° h fi c,/o✓l/ JQ o l� w �e�� S l� �.�1�'' vw�t o� �r9C�P �S c� W:eW�nK �I � �� S �� T(Ow N��o , /r�5� �/�� - �3 � S�S�,� ��-. NP� � �Sv I ' I � � �� c� � /�� 1`�'f �-T'�� ( �avi5 -��6 w �► �>,� s � �sag� 9 f'�'}°o/`�S' �°„� `-7-�°u I � IN-GROUND GRAVITY DISPERSAL AREA �� S.��pt�Tank(s) M��s��: �`ef� Uniform Elevation Trenches with EZ1203HP Bundles SepticTank(s)Volume(s) 3-ft Trench (down-sizing credit) � �� gal gal gal gal n Effl ent Filter Manufacturer: . /��S � I GF io-s min.12" Effluent Filter Model#: Geotextile I (typical) Cover SOILCOVER TYPICAL TRENCH 12�� CROSS SECTION VIEW min.trench � � � depth (typical) L — — —.. .-��.��:::� (No Scale) OBSERVATION PIPE DETAIL • �' '• : (No Scale) 3 /,, • n..� � �!/ y,• �. Screw-Type or System E�evation = � ft. . � . � Provide minimum 3 ft Slip Cap(loose) W WW•W� (mulch d&seeded) (typical) • separation between trenches. 4"0 PVC Pipe J' ` Topsoil Cover Top of pipe to terminate "� (min.1 foot) at or above finished grade . ' (4)1/4"-1/2"X 6"Slots TYP I CAL TRENCH (Show location of inlet/outlet pipe connection on plan view.) @ so apart . ,� PLAN VI EW Anchonng Device Infiltration 4n � Observation pipe shall be installed Surface (No Scale) atjunctionbetweentwounits. ft Perforated Lateral Observation Pipe (typical) (typical) (typical) �- - - - - - - - - - - - - - - �� - - - - - - - - - - - - - - - - - - - � � ______ _______ _-___ __ ___ _______ =_______ � A= 3.0 ft � _ t ical m - - - - - - - - - - - - - - - �� - - - - - - - - - �Yp ) — — — — — — — — — � ;-- B = � ft - I (typical) INSTALL PER TRENCH: EZ12�typ Bj ndle � � 10-ft bundles @ 50 f� EISA/unit= a� ft2 (mfd by Infiltrator Systems, Inc.) � Install pursuant to manufacturers instructions. + � 5-ft bundles @ 25 fi� EISA/unit= as ftZ = Proposed EISA per trench = �7� ftZ Required Infiltration Area = �s � ftz Distribution Method: x � trenches = Pro�oSe�i T�lal EISA = ga� ftz ��''-�� `�°'�� S � � �� /Ow --a i�i�.�s �� ;�S_" 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 382-384,Wisc.Admin.Code. Pursuant to SPS 383.52(2),Wisc.Admin.Code,this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore,all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52(3),Wisc.Admin.Code. Maximum Dispersal Area Operatinq Limits: Design Flow= 600 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 factors(i.e.odors,user complaints,etc.) o mechanlcal 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 distribution appurtenance(s)(i.e.,distnbution/drop boxe:,) o neglect or improper use(i.e.,exceeding design capacities,prohibited activities,etc.) o extent of ponding in distribution 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 laterel or lateral orifice plugging (measure lateral distal pressure—compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS(or when necessary) o Septic and dose tank(s)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 shall be pursuant to NR 113,Wisc.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 1? 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: BUtteffl2lCl, II1C. Phone: 715-634-$�76 _ local government unit: SaWy21"COUCIt�/Z011lllg Phone: 7�5-634-828$ �oca�9o�e��me�t��it add�es5: 10610 Mairl St. Suite 49, Hayward, V Z,P: 54843 Any defective part of this system shall be repaired,replaced,or removed pursuant to SPS 383.51(1),Wisc.Admin. Code.Repair or replacement 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. ContingencY 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 approvai. 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 shall be abandoned in accordance with SPS 383.33,Wisc.Admin.Code. 9/19/23, 8:58 AM Real Property Listing Page R2aI EState Sawyer County Property Listing Property Status: Current Today's Date: 9/19/2023 Created On: 2/6/2007 7:55:24 AM � Description Updated: 4/30/2015 '� Ownership Updated: 4/30/2015 --..__ _____ _ __ __.__ _ _.._---_.___-- Tax ID: 14104 KELLEY ANN BOHMANN HAYWARD WI PIN: 57-012-2-40-06-17-4 03-000-000060 Legacy PIN: 012640174306 Billing Address: Mailing Address: Map ID: .15.6 KELLEY ANN BOHMANN KELLEY ANN BOHMANN Municipality: (012) TOWN OF HUNTER 14430W STATE RD 77 14430W STATE RD 77 STR: S17 T40N R06W HAYWARD WI 54843 HAYWARD WI 54843 Description: PRT SWSE LOT 2 CSM 7/65 #1361 Recorded Acres: 0.580 � Site Address * indicates Private Road __ __ Calculated Acres: 0.659 9066W MOORES BAY TRL * HAYWARD 54843 Lottery Claims: 0 First Dollar: Yes � Property Assessment Updated: 4J26/2023 Waterbody: Chippewa Flowage 2023 Assessment Detaif 0 Zoning: (RR2) Residential/Recreational Two Code Acres Land Imp. ESN: 414 G1-RESIDENTIAL 0.580 158,800 28,700 � Tax Districts Updated: 2/6/2007 2-Year Comparison 2022 2023 Change 1 State of Wisconsin Land: 158,800 158,800 0.0% 57 Sawyer County Improved: 20,700 28,700 38.6% 012 Town of Hunter Total: 179,500 187,500 4.5% 572478 Hayward Community School District 001700 Technical College � Property History ., _ _ __ __ _ _ .___ ---.._..._ . Recorded Documents Updated: 4/30/2015 N/A WARRANTY DEED _ _ _. _ __ _ Date Recorded: 4/15/2015 395151 QUIT CLAIM DEED Date Recorded: 321472 459/252 QCD#321472 https://tas.sawyercountygov.org/system/frames.asp?uname=Eric+Wellauer 1/1 � """`"'� PRIVATE ONSITE WASTE TREATMENT county > ,,, , . � '�°�sp �.�� SYSTEMS SaWyer ,,� s �� ( POWTS) `� �v� �— �%� ' ""� INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �3 ' �33 Personal infonnation you provide may be used for seco�dary purposes[Privacy Law,s. I 5.04(1)(m)] Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#: ��-�I,- 1�v► �3��►�Q�,v� H��.�- _ Insp BM Elev: BM Description: Parcel Tax No: t�-�� Y1ai 1 i,.� ,j6�� C.�.1T��.�.,�►� � Ola. .. �j�(0 -1� - �3p�o TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic � � s��,�j $Od ew w:�f` �� Benchmark C.,� wv� ? Dosing e#�-�m,� �(�3� Aeration Bldg. Sewer Holding St/Ht Inlet ,$s ` TANK SETBACK INFORMATION St I Ht Outlet a.(s` TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet AIR INTAKE Septic ,}5` �6a �ko ��o NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. Holding Dist. Pipe PUMP 1�IPHON INFORMATION Infiltrative , Surface �I I.� 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 � L ` � � #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate INFORMATION P/L Bldg Well �/aters � �GP ❑ Chamber Model Number: ❑ AG p� EZFIow CELL TO ¢-�_ ,r-�- '�'�� ,f�� ❑ Mound o Other -- - - ---� - - _.. --___ -- --- DISTRIBUTION SYSTEM X Pressure Systems Only -- — -_____ ---- -- -- ---— — Header/Manifold Distribution Pipe(s) � X Hole Size XT Hole Observation Pipes Length Dia Length Dia Spac _ ', Spacing ❑Yes ❑ No � - --- -- _— - ----- SOIL COVER --- — — -- _--- - —- Depth Over Depth Over Depth of Seeded/Soddetl Mulched � Cell Center Cell Edges , Topsoil � ❑Yes ❑ No l ❑Yes ❑ Na COMMENTS: (Include code discrepancies, persons present, etc.) ��,s}�((r�Q �'�a�(2� � � �', � �(�k.C��r„� �_� - - � Plan revision required?❑Yes❑ N�� p3 �q a Y� �____��- � ��t � t Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AOOITIONAL C�MMENTS ANO SKETCH SANITARY PERMI? �JUMBER �3 '-p��3 ni ------- -----�i G�/u� �(��.a, � ��WM Ne..' �� Io� , `� a� _ • ' 3 � � �1nn'J /I'�,I�nS�' • O � � n ��{o� �° �� = .30'_ al i' ;�� le ��,, �� i� , .- -r�L^ 3; —a�� 5'_'��(-. ?� ' 4 lo� to` T � ..>1�-' — —i `�_ 3� —�� (,_ ta' (a' Ti . QM �,�• �� 3� q��i� ��-�4.,� ' Ce-�S x� � k� S� � �� X� �� _ d°�' � -�. �� 4