The URL can be used to link to this page

Home My WebLink About024-741-19-5514-SAN-2023-262 � � Department of Safety c°°°�' � Sawyer � � & Professional Services, = Sanitary Permit Number(to be filled in by i �= Industry Services Division � �° (� S I lo S � c,� ,.. � Sanitary Permit Application State Transac�ion Number � In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this fonn to the appropriate govemmental unit � is reyuired prior to obtaining a sanitary permit.Note:AppGcation forms for state-owned POWTS are submitted to Project Address(ifdifferent than mailing auu�r,�i the Department of Safety and Professional Services.Personal infonnation you provide may be used for secondary 10670N MCCLAINE ROAD purposes in accordance with the Privacy Law,s_15.04(I)(m),Stats. I.Application Information-Please Print All Information Property Owner's Name Parcel# KAYJAY ENTERPRISES LLP 44110 ��Y_�YI�� 1 "SSI`� Property Owner's Mailing Address Prope�ty Location 961 245th Avenue P�`t' Govt.Lot 5 City,State 7ip Cc�de Phone Number Fairmont MN 56031 507-238-2476 �_ �_�'�, Se��n 1� ✓ II.Type of Building(c6eck all that apply) Lot# T 41 N R � E or w 0 1 or 2 Family Dwelling-Number ofBedrooms 3 �— Subdivision Name Block# �Public/Commercial-Describe Use �-- ❑City of ❑State Owned-Describe Use CSM Numbe`_ ❑Village of �Tow�of Round Lake III.Type of POWTS Permit:(C6eck either"New"or"Replacement"and other applicable on line A. Cheek one box on line B.Complete line C if a licablc. A' ❑New S stem y �Replacement System ❑Other Modification to Existing System(explain) �Additional Pretreatment Unit(explain) B. ❑Holding Tank ❑In-Ground ❑At-Grade ❑ Mound �Individual Site Design ❑ Other Type(explain) (conventional) C. ❑Renewal Before ❑Revision ❑Change of Plumber .�st Previous Permit Number and Date Issued ❑Transfer to New Owner Expiration �h k. � a IV.Dispersal/Treatment Area and Tank Information: Design Flow(gpd) Desi�m Soil Application Rate(�d/s� Dispersal Area Required(s� Dispersal Area Proposed(sf) System Elevation 450 .6 643 678 93' Capacity in Total #of Manufacturer � Tank Infortnation Gallons Gallons Units � �? v � N � Ncw Tanks Existing Ta�ks "` � � � y � � � a. U cn �, in w �7 a Septic or Holding Tank 1000 1000 1 Wieser Q✓ Q � � � Dosing Chambcr a � ❑ ❑ ❑ V.Responsibility Statement- 1,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plu 's Signature MP/MPRS Number Business Phone Number Ryan Strand c/ 798301 715-558-1673 Plumber's Address(Street,City,State,Zip Code 8959N State Road 27, Hayward WI 54 VI.C unty/Department Use Only �A �v'e ❑Disapproved P��t Fee Date Issued Issuing Agent Sigiature �ti� 0 Owner Given Reason for Deniaf $ ( �� L� lV I-�3 ��e-G�T��"ti`�'�''�" Conditions of Approval/Reasons for Disapproval � � ' �51�L1\��v 1�,��. Ir1� ii,. �G I �' __.___ _ � � ; - ��,�-.: �"� r." ��, �Y 11 ��-�►� � �� C � �ate.�..Lt� � � �. _ - - �� 0 3 2Q23 � CST� �.31 l t� �1 :.�,k# �a�� ---_-�.... sAvw�� ouNrr �� ;�;� �-3l J �ONIN��q�MINISTRAT101+� Attach to complete plans for the system and submit to the Count�only on paper not kss than 8 uz x 1 I inches in size ��'I � NO R�FJN��AF7'ER SBD-6398(R.03/22) ISSUE Or f�R�1 i C0.�� PAGE 1 OF 4 In-Ground Gravity Plan Index & �over 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 KAYJAY Enterprises Owner Name(s): Kayjay Enterprises LLP Phone: 507 _238 _2476 Owner Address: 961 245th Avenue Fairmont MN Z�p: 56031 Project Address: 10670N McClaine Road Govt.Lot: 5 1/4 of 1/4,Section i 9 ,T 41 N-R� E❑or W�✓ Township: Round Lake County: Sawyer Project Parcei ID#: 44110 Designer Information Designer Name: Ryan Strand Phone: ��5 _558 _1673 Designer Address: $959N State Road 27,Hayward WI Zip: 54843 E-maiL• strandsmidwest@gmaiLcom .. �.,t�a t�„�,cc��>��1��,,,p. License Number: 798301 Remarks: � SIgf17tU�@: D8t2: 9/29/2023 Origin �signature requi ed on each submitted copy. PLOT PLAN Placid Lake �g5� 4" PVC Approved Pipe ieser 1000 gallon Proposed addition 9 , ank with filter � 4" 034 PVC 3 bed a o 33 Quick 4 chambers dwelling 11 in each cell BM 7% Existing steel tank and drywell to be abandoned no setback issues on neighboring � property c J � � O a` � J � 3 � a � i 10670N 1" = 40' �40'-0"� Kayjay Enterprises LLP � = Benchmark 100' 10670N McClaine Road Bottom of siding on SE corner Gov't Lot 5 - S19-T41 N-R7W Vertical and horizontal reference Town of Round Lake +=Well Tax ID 44110 NORTH � - Soil pits with backhoe Page 2 of 4 IN-GROUND GRAVITY DISPERSAL AREA Wieser SepticTank(s)ManufacNrer Uniform Elevation Trenches with Quick4 Standard-W Chambers SepticTank(s)Volume(s) 3-ft Trench (down-sizing credit) i000 gal gal gal gal Effluent Filter Manufacturer: �� Polvlok � etn�e��F�icer rnodai#: PL525 min.12" SOIL COVER �yP�� 12" min.irench dep�h �ryP�� • TYPICAL TRENCH • ' a . CROSS SECTION VIEW ��vP��> (No Scale) , ... Provide minimum 3 fl System Elevation = 93 n separation between trenches. (rypical) �uick4 Standard-W w/End Cap (Show location of inlet/outlet pipe connection on plan view.) Obse(ya�t�nl)Ipe TYPICAL TRENCH � (lyPIC81� InstallpermanWaclurers PLAN VIEW � �°s"�"°°9. (No Scale) ��fR11�l�t}��t�'��.-- — — — �� — — — — — — — �� — — — —��#tllll�ft111f •R��t• � ( , � � ; �� TA= 3.Oft f O , � , ?.'. '. I ill1U�Ylaair�a��iiu1� - - �ri�y�r��i�ru��sy� 1 (haicaq D - - - - - �f- - - - - - - - �� — - - - - - I� g = 44 ft �-�; m (typical) Quick4 Standard-W Chamber W RYPical) O INSTALL PER TRENCH: �r�td ey�oti�t�etorsystems,�oo.� -n Install pursuant to manufacturefs instructions. 1 � Quick4 Std-W @ 20 ft� EISA/chamber= 220 ft' 'p + 1 Pairs of end caps @ 6 ft' EISA/pair= 6 ft' = Proposed EISA per trench = 226 ft' Required Infiltration Area = 643 ft� Distribution Method: x 3 trenches = Proposed Total EISA = 678 ft� branched manifold 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 periormed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Disuersal Area ODeratinq Limits: Design Flow = 450 9Pd; BODS 5 220 mgL"'; TSS 5150 mgL-'; FOG <_30 mgL"' Insaection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance fadors (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 distribution appurtenance(s) (i.e., distribution/drop boxes) 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 laterai or lateral orifice plugging (measure lateral distal pressure—compare to design specification) o surtace 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(s1 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 submitfed 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: REDS SEPTIC Phone: �15-934-9412 _ Local government unit: SAWYER COUNTY ZONING Phone: �15-634-8288 Local government unit address: HAYWARD WI 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. Continqencv Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shail 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 shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. ;<,, ' "`'"``� PRIVATE ONSITE WASTE TREATMENT County ;�j�$�S ; SYSTEMS Sawyer ( POWTS) h �`- P`v ' `' INSPECTION REPORT Sanitary Permit No: Safety and euildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �3 - �6 2 Personal infor�nation you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)] Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#: �� ^�• L� � �,,.� 1.��.�. � Insp BM Ele : BM Description: Parcel Tax No: ��•O� V 6 n,� 0��5 i u i v� D�, s� Cu�n-¢.r' 6`� d� , b�-`�"'1�f� - (9 -.J,l TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic w�� oeSc� Benchmark �Op.o� Dosing Aeration Bldg. Sewer q�'.� ' Holding St/Ht Inlet �i y�p ' TANK SETBACK INFORMATION St I Ht Outlet R3�? ' TANK TO P/L WELL BLDG vEr,rrc ROAD Dt Inlet AIR INTAKE Septic �-(� ��5� �Y� � NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. c�2,7` Holding Dist. Pipe PUMP I 51PHON INFORMATION Infiltrative i Su rface `t I•?3 Manufacturer Demand Final Grade Model Number GPM � �2 5S.'i3 TDH Lift Friction Loss Sys Head TDH Ft �g 3 �oo,g ' Forcemain L Dia Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS W 3 L Hy Y' tr4, r #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate ,��, INFORMATION P/L Bldg Well Waters °� GP d� Chamber Model Number: o EZFIow CELL TO �(o .}� �SD � ❑ Mound � Other �,,f,t. - — _- ------- S -- � --- --- - — ---- - DISTRIBUTION SYSTEM X Pressure Systems Only Header I Manifold Distribution Pipe(s) X Hole Size �X Hole Observation Pipes � Length Dia �Length Dia Spac , �' Spacing ❑Yes ❑ No � _- — ----- __ _ _ — - � SOIL COVER - - -- Depth Over Depth Over I Depth of Seeded/Sodded Mulched -- Cell Center Ceil Edges I Topsail �Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) ��f(,� ��larl �3 Plan revision required?❑Yes❑ No I��3 '�� '�� Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) \ AOOITI�NAL COMMENTS ANO SKETCH SANITARY PFAMIT NUMBEA ________�_3_�r�-6 0�__ � � � �1�� ` �I b�. �� t \`r� �..�� t----�a'f �=t�� , � a' -- � _ � � 1 ` W�p � Ba C� 3 6a�• / w��'b y� u, �� -' ��o.� ��. S'�`� � �' B f�a� o 5 `� ��3 �' �,�1 � �-�(��P`S � � � b'��'� �� nI l�� —}�---- �� C�� 5 =