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010-277-00-3000-SAN-2023-287
_ _ , � ,, r� , � ����� ��, � � � 1\��' � �� � �� � ,� � ��5° � � � �� �� � .R`"`� Industry Services Division Counry l/� % i �i; 4822 Madison Yards Way Sawyer � i�r� , $ Madison,WI 53705 Sanitary Permit Number(to be filled in by ` �s P.O.Box 7302 , y� - Madison,WI 53707 (.p_<, I (.p �](� � 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 mailing a< _ , the Department of Safery<3nd Professiunal Sercices.Per�onal information yuu provide may be used for secondmy ������ ��.a�) � pwposes in accordance with the Privacy Law,s. 15.04(I)(mj,Stats. I.Applicarian Iniormation-Piease Prtnt All Information Property Owner's Name Parcel# Gregory and Rose Anderson 010277003000 Property Owner's Mailing Address Property I_ocation 10730 Cty Rd BB �i City,State Zip Code Phone Number Marshfield WI 54449 — � � �i. Sect+on 19 II.Type of Building(check all t6at apply) �oc# T41 N R 8 E or w �I or 2 Family Dwelling-Numher ofBedroums 4__ ,30 Subdivision Name B,o�k# Hatchery Creek 5�b�. �PPublic/Commercial-llescribe Use_ _ __._ _ �City of _ ❑State Owned-Describe Use CSM Number iilage of _ ���»m�r Hayward---------- --- IIT.Type of POWTS Permit:(Check either"New"or"ReplacemenY'and other applicable on line A. Check one box on line B.Complete line C if a licable.) � A. �ew System �Iteplacement System �Other Modification to Existing System(explain) �Additional Pretreatment Unit(explain) l_1 B' ❑Flolding Tank �In-Ground �At-Grade �Mound Individual Site Design Other Type(explain) (conventional j C� ❑Renewal Before �Revision 'hange of Plumher �i'ransfer to Ne�v Owner List Previous Permit Number and Date Issued Expiratiun IV.Dis ersallTreatment Area and Tunk Infarmatian: Design Flow(gpd) Design Soil Application Rare(gpdis� Dispersal Area Required(sfj Dispersal Area Proposed(sfj System I:levation 600 .5 1200 1212 91.5-94 �'�P Capacity in fotal #of Man�facturer Tank(uformation Gallons Gallons Units A � o '� o New Tanks Existing Tanks � o � � y � � � 0. U cn h v; k. C7 p.� Septic or Holding Tank 1250 1250 1 Wieser ✓ Uosing Chambcr O � V.Responsibility Statement- I,the undersfgned,assume responai ty for stal tion of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's Signatu V1P%MPRS Number Business Phone Number Dan BurCh 253808 715.416.1642 Plumber's Address(Street,City,State,Zip Code) N5921 County Hwy K Spooner WI 54801 Vt.C a ty/Qepestment Use Only �A� � ,d Issuing Agent Signature p rove ❑Disapproved $ �n 1 p Permrt Fee Date Issuc v�� ❑Owner Given Reason for Denial ��.�� � � I � � "' ' r Y ,`�`"�''�-E'`/����- Conditions of ApprovaVReasons for Disapproval ,:.+v''�� �! "� !.�...�1e.��.3 ___.._ a �` �' ,�k, r s�i��1i� E��+�:v ;`s:# b!� a 1�-P _ � � J��S �t� �_"'1 � �� '---''r`� c��r- �3 - ► � �} ,� , , < << � ��,� �� r \J.- �! :_.--.- _. ` . 7 Attach to complete plans f the system aod submit to[he County only on paper not less tha � 11 i4q1►�.p s� o ��^� �� ��� i,—� u s [ � SBD-6398(R.02/22) {�C �};;f�;}���,�,,����1 '`---- ��tit;:.j,,��._, _ .. I�S�J�:Ur F��SrU�`!� ZG�J11G;':U��'ii"s.t�f r,;-+<...;��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 Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Owner Name(s): ` 1'v��S B 'J Phone: - - Owner Address: f J J ��' �` � .��r y � Zip: S Y y`/�f Project Address: 9,> ����N T� Govt. Lot: 1/4 of 1/4, Section��, T �� � N-R �E Q or W � Township: ►�/�Yl�+fi�/Z� County: Project Parcel ID #: � t � ,� � � ��7 � J � 7 Designer Information Designer Name: Dan Burch Phone: �15 _416 _1642 Designer Address: N5921 Cty Hwy K Spooner WI Z�p; 54801 E-mail: burchplumbinginc@gmail.com ;��,;,;�:,,��,����������;za «»�����t>r«��:�� ,t.,,,:�_, License Number: 253808 Remarks: � /v - ��- � � Signature: Date: Original signature required on each submitted copy. CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. Q✓ SOIL EVALUATION o s`��e: so 30 a5 60 �✓ SYSTEM PAGE 2 OF SITE MAP " PLOT PLAN PROJECT NAME: 7 5, DESIGN FLOW: 6OO GPD Greg Anderson Attach design flow calculations for commercial plans. PROJECT AODRESS: BIfIC@Il T�aII Pipe Material/ASTM Standard(Tables 384.303&384.30-5) N sanitary sewer. SCh 40 PVC � BM Symbol: -� BM Elevation: �00 FT Force Main / BM�S��,Pt;on: Nail in basswood Sio eGradient %) Indicaienorthby IMPORTANT: P � cJ Well Symbol(if applicable): 0 drawi�g an ertow Show ground elevation contours at suitable intervals. Of Tested Afea: on the approprite line. r� � ��. � � � q���a� � �, \ ������ I ��L � . � a- �` � �, \ � ` x \LS� s� Q \ �,z � � � os��' 2' Se �� �.�� �� �� � � � ���� b� � . � - �� � , �,, � �7f �1,�L�Y� a \� � � ; \� \� \� ` � \Q� � ` \ �� �� � � — , : �•� �I �G'` �� Septic Tank(s)Manufacturer. IN-GROUND GRAVITY DISPERSAL AREA ������" Uniform Elevation Trenches with Quick4 Standar -W Cham ers SepticTank(s)Volume(s): 3-ft Trench (down-sizing credit) �. I _ P � 'ZSV gal gal gal gal �t� � /� pCi`/��� Effluent Filter Manufacturer: ; �r I - �*7c Effluent Filter Model#: 7 t�J min.12" SOIL COVER «P���� �z~ min.trench depth � �ryP���� '� • � TYPICAL TRENCH --- �- �-:-- � •� �� � �°��a��-. CROSS SECTION VIEW F`- 34° �� , �: �� � � (No Scale) cryP���� �:�, . . ., • . � � ` Provide minimum 3 ft System E�evation =������ ft separation between trenches. (typical) Quick4 Standard-W w/End Cap Observation Pipe TYPICAL TRENCH ityp���� (Show location of inlet/outlet pipe connection on plan view.) tHp��O Install per manufacturer's PLAN VIEW instructlons. (No Scale) � �L��� ��,� ��,��� - - - ��- - - - - - - - �� - - - -� —,— — — i A= 3.Oft �� i �N Y��7� .��t IS 1 i }� 4 t � � '� � �tYPical) '� , , �- - � - - - - - - - - - -��- - - - - - - - ��- - - - - - - - = - --� D B = �� ft - -� G� m {rypical) Quick4 Standard-W Chamber W INSTALL PER TRENCH: �tyP���� � (mfd by Infiltrator Systems,Inc.) � �� , 1�U Install pursuant to manufacturers instructions. � Quick4 Std-W @ 20 ft� EISA/chamber= '"� ft2 + �- Pairs of end caps @ 6 ft2 EISAlpair= 6 ft2 = Proposed EISA per trench= y�� ftZ Required Infiltration Area= '�'�� ftz Distribution Method: x 3 trenches = Proposed Total EISA= �Z I� ft2 PAGE40F4 In-ground Gravity Management Pian IMPORTANT: The owner of this in-ground gravity system shall be responsible for its perpetual operation and matntenance pursuant to requirements of SPS 382-384,Wisc.Admin. Code. Pursuant to SPS 383.52(2),Wisc.Admin.Code,this system shali be cansidered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shafl be perFormed by a regfstered POWT3 Maintainer in accordance with SPS 383.52 {3),Wisc.Admin. Code. M�ximum Dispersal Area Oueratins� Llmlts: _ � Design Flow= � � gpd; BODg S 220 mgL''; TS3 S 150 mgL''; FOG 5 30 mgL'' Inspectlon Checkilst INSPECT EVERY 3 YEARS o ty�af use o age of system o nuisance factors (f.e. odors, user complaints, efc.) o mechanical malfunction(i.e., pumps,valves, switches,floats, etc.) o materfal fafigue(i.e.,leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatmerrt tank(s}and any distribution appurtenance(s)(i.e.,distribution 1 drop boxes) o negtect or improper use(i.e., exceeding dasign capadties, prohibited acdvities, etc.) o exterrt of ponding in distribution cell prior to dosing o dosing irregularities-if applicable(i.e.,pump re-cyding,float switch settings, etc.) o electricai components-if applicabie(i.e.,wiring,connections, switches, controls, timers,alarms, etc.) o distribu�on lateral or�ateral orifice piugging (measure lateral distal pressure—compare to design speciflcation) o su�face 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 senriang operator licensed under s. 281.48 Wis. Stats.when the volume of soltds in the tank(s)excseds one-third(1/3)the Ilquid volume of the tank(s)or as required by loca!ordinance. Disposal of co►iterits shall be pursuarrt to NR 113,Wisc.Admin.Code. o Effluent fliter(s)shall be inspected every 3 years and shali be deaned when necessary to remove any accumu{ated solids according to manufacturer's specifications. A senriang period will aiways be greater than 12 months. System maintenance reports shalt be submitted to the proper local govemment unit tn accordance wiri� SPS 383.55 Wisc.Admfn. Code. Report any component failure or malfunction to: Name aF individuai or company: Dafl BUCCII Phone: 715.416.1642 ��i 9a„�,me1�� Sawyer County Zoning Ph�.1e: 715.634.8288 Local gavemment unit address: �O6'I O Malt1 St. #49 Z�p: 54843 Any defective part of this system shali be repaired, replaced, or removed pursuant to SPS 383.51 (1),Wisc.Admin. Code.Repair or replacement of failed or maltunctioning companents shall compty with SPS 383,Wisc.Admin.Code. No product for chemical or physical restora�on of the POWTS may be used unless approved by the department in accordance with SPS 384,Wisc.Admin. Code. ConHns�encv 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 faiied in-ground dispersal component may be abandoned and replaced by a code-complying dispersaf component in a pre-determined area of suitable soils. Svst�m Abandonment If use of this POWTS is discon�nued, it shall be abandoned in acxordance with SPS 383.33,Wisc. Admin. Code. W1250—M R TANK SPECIFICATIONS � o s'-a" � � a i DIMENSIONS: � ~ � o WALL: 2 7�16" a n- 4" CAST-A-SEAL 4" CAST-A-SEAL BOTTOM: 3" COVER: 5" w MANHOLE: 24" I.D. PRECAST CONCRETE RISER Q ����_______���� HEIGHT: 64 1/2" o �i�� ���� LENGTH: 8'-8" > �� �� WIDTH: 7'-2" � ii��_ 'L� �� BELOW INLET: 53� � Q• � �-� ! � '� �y � �� � LIC�UID LEVEL: 47" o `i i � WEIGHT: 7,220 LBS. � a o � i � i n � � E ��� `--' �` �'�� INLET AND OUTLET: � o 0 �� // 4" CAST-A-SEAL BOOT OR EQUAL GASKET � m o ."'v �� FiLTER OR // o ��\\ BAFFLE ���� � 3 �;; 3 , INLET AND OUTLET BAFFLE AND FILTER: Q Q � w ��; �%' WISCONSIN, SEE DETAIL #10 v", o o i ------ � (OTHER STATES SEE CHART) W o � � LIQUID CAPACITY: 26.81 GAL/IN W N TOP VIEW � � HOLDING TANK: OUTLET HOIE PLUGGED � � � ACTUAL CAPACITY: 1,340 GALLONS � � � V W I � LOADING DESIGN: 8'-0" UNSATURATED SOIL Q N � � a� TANK CAN BE USED AS: o�j � SEP11C / HOLDING / PUMP OR SIPHON � 3 0 � = ao --- COVER: MIX DESIGN #8 (NO FIBER) W N -___ _� TANK: MIX DESIGN #10 (STRUCTURAL FlBER) � � INLET - OUTLET CUSTOMIZED TANKS: � 3 _ � i FOR CUSTOM TANKS CONTACT WIESER CONCRETE �n a i � _ cn � a � � =-�v � � U � - �= I - co b a �° ;.� d' � i� 'n I �� o � `� � a� � �n Q I I � � 1 If, l � Z 2 2 ` -------�—G_ _� p � REVIEWED BY N v ;� PUMP PAD REVIEW DATE 3 d w � DRAWINGS SUBMITTED SIDE VIEW FOR APPROVAL APPROVED BV: SHEET N0. 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"r-� t�.. µ�' - +�: .4 _ �P_.. ��yv;. i� .+'� Office of Sawyer County Zoning and � ��i� `'�� D c �'�:J Conservation Administration � 10610 Main Street, Suite 49 �����,o�� Hayward, WI 54843 � ` � Tel:(715)634-8288 ��, ��� � ������O� Fax: (715)638-3277 �.? �� ���g� URL:http://sawyercountygov.org r.����;pM Email: zoning.seC(c�sawyercountygov.org ���J\N Toll Free: Courthottse/General Information 1-877-699-4110 Sawyer County Zoning and Sanitation "As - Built" Form Property Owner's Name (�7'rLG t� ����,2 5 ��✓ Fire Number and Road Name �. �✓�/G/ 1�/� i L Plumbei's Name � �},� �..�5 �/�('�-C� �� Date of instailation / - E"/- � � 2 '1 County Sanitary Permit Number � � �- � � 7 12 Digit Parcel Number � � � a 7 � 00 � J � C� Description and Elevation of Benchmark �s<,,1 �-�, �I�� 5 y '^�°"� Tank Manufacturer and Capacity l,✓� t � -� � ���J�� �� � � Setback-Tank to Ncarest Lot Line � � Setback-Tank to Nearest Well /U�/� � Setback-Tank to Building � � � Cell Width >� � � Cell Length � ''� Number of Cells � � Setback-Cell to Nearest Lot Line �;� v Setback-Cell to Nearest Well /�� i Setback-Cell to Building �"l J� Setback-Cell to Navigable Water ��� Make and Model of Dispersal Unit � � � 1✓t l� � Make and Model of Filter ;^ � ���� � � J Make and Model of Pump ,j�� / � .Z -Please complete other side- "As-Built Plot Plan" Elevation Data Benchmark �°•�� Please include the followin�: Building Sewer 9.2.3' Tank In i U. °! � q�a''S� �Location of observation and vent pipes Tank Out �•�"— 8`��45� �Feet of risers used on tank(s) Dose Tank In Location of benchmark and North arrow Dose Tank Bottom i ti• 7 � .3' �Location of all co�nponents Header or Manifold -7., `i 3.`�� Length of pipe between components Distribution Pipe �Number of chamber units in each cell System Elevation �- S `� �S �Location of well,lot lines and road I�P ,.� S.a�✓�� ��, S q3-�� �� �k�� � P ��l��l�r 15 2 f;� Ze b sc� W �5�� k�H a s�J 0 0 ?l� r+u�s� �. �,a� R'k ���I��� CS`��'�� ND �yr MR�° ,� � 0 � ys' ��'� 6� 5 �C6�p� �� UbSery �oN � T V2r'�' �'7�� � ' 1 -Plcusc completc othcr sidc- "As-Iiuilt P1ot Plan" F��ttprl �illfl Bcnchm.u'k ��•�� (' e�►s4 ii�clud�he toliowin�;: Buildinb Se�ver � 3 � Tank In _J�`� ' `�d�''s ' I.ucutiun ul'ubscrvulion and vcnt pipcs Tank Out __r_�__� � _ S �'�S' • 1•'�ct c�f'ris�ru u�ccf cm tank(h) Du�C 1'R�lk In �� � Lacfttic�ti c�F bcnchmtirk t�nd Nnrth arruw Dose Tatik Buttom '4�,,,;_._�` ? .�$� 3' • Lcic��tic►n ��f f�ll cc�rnponcnls Head�r a ��innifi)ld �7� �"'��_.._.:1.cngth c�f r�i�c bc�wccn cc�mponcnts Distribution Yipc • Nu»ibcr c�f'eh�trnher units in each cc11 S�'stem Clc��atian ___,< � ����`Y���� 1..�>ctilic�n uf wcll. l��t lir7cs and road ��j�q N'i'> > � �� 9`�- S'� io v .r�,',�`��'`•.: �: � �, �:;;..;�.,. ."E, � =� �'��� �5, ti:.;%';--.• . � �ty, � , � i�, p-'` , ��=�� � �'��; `} �J � t? � �, /� �'�' P� �,�'�'-����' � f �b��` u r�P � ���c�`5,� o y 1�r 15� P ���, ��� 2°�t b Js0° ��\�G ���S er Q y � a� ��` �'v°S� ,�".."rY _ 00 k . �1 �; _ _ . t o �� r� _- - - - 6S �or�� N �N -_ a, , - �'�''v fl� y� �. � �-' � � � --��,�:�,�.. �; � �� � � '����'��--� �� .�, . � � � ' � ��� � � _ � _ , _ _ � - �1S� '^ - �.. ..� .�a�� ��� � � ' . 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