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Home My WebLink About032-438-07-2306-SAN-2023-292 ,:��'""--="`�,>` Department of Safety �O1°�' �' � ��'�; �`=; &Professional Services, r«�t x�« �s�oa m c ` ,� �_`: 1�; Indnstry Services Division s�"'�`r br ;�; � � ��'� �----1 +.� _S � l0 8' � '�•`.��*� w � stace T�6oa xumber Sanitary Permit Application __ � !n accordence with SPS 383.21(2),Wis.Adm.Code,snbmission of this focm to the appropriate govetnmental wnt is coquircd ptior ro obtaming a sanitacy pe�it.Note:Application fomn for smteowaed POWTS aie sub�ued m Pcoject Addrass(if diRermt tlmn ma�aw..�� tha Dep�mcnc of safety aad rmr�a�sl s«v;«s.Pda�a,m�ama�n you p�aarr ix uua for u�dacy ��l��'1 3--N in acco�danae with the Priv�y Law.s 15.04(1 m),Stats. I. qltlon Infa�'m�ttion-Please�Pcint Afl WotmNian - �(,�E?;" Propetty Owner'a Name Parcd# e�- ��. �.�� -� -c� 1- c�Co Property Owoer's Ma9liag Address Property Loe�ti� S [�c./cc:� I�� -- c�cy.scax r.�coa� rt�e x,� �j l<.J , ,' �� L L /�. �� Y+. SCCttOn / �� k� �.� s r�7 �i� -�s - S��T II.�of��,��, a �# T 3� N R � E �„ �1 or 2 Family Dwellmg-Numbec of Bedmoa� ��N� Block# 0 Public/Corrnneneiat-I3escnbeUse ❑Cityof ❑S'tateOwned-DescdbeUse C3MNvmber ❑Villageof 5/n � �' �/��C.S �Trnm of (�C�)t 11�.e✓� _ III.Type of POW1'S P�{Chedc ei�er°`Naw"or�a�nt"asd oWer appl�6le os Bne:A, Checic one�ox oa line B,Compl�e tine C a l[csble. A. '�New SysOem ❑Replacement System ❑Other ModiScetion to Exis6ng System(explain) ❑Additioiml P�Unit(acPlaiu) � �xota�T� ❑to-cro�a ❑nc-c� ❑�a 0 rna�sa� n� ❑oa�Tre�(��) tco�ventio� c. ��se� ❑x�� ❑a�ofr�� ❑T�nsfertoNewOwoer Pcev�ausPam►tN�►berandDme?�ned �;�Q �..s N.D1 ssaVPreatment Area sad Tsak IsformaNen: Desigs F1ow(gpd) Desi�Soil Application Rate(&Pd�s� Di�r�i Area RaNiced(s� DiSPersal A�e+Pm�(s� System Elevatian a� � -- ��m r� �� e�x v��n«� c�uo� c,�u� cm►u � � o� � �f New Tanb E�ling Tadcs '" c V " m � �,. 3 «� � �� U v� � � w C7 w SepticorHoldtngTank l��V �l? I 1"7' Dasing C,hembet -?SC� � - ' V.ReSpansibiWy ShtemEat-I,the as�,aaeme respomo'6�Hy for imAa�f[oa�t6e P(3W15 ahawaba the athehed p�. Plumbd's Name(Prmt) Pl Si�ture MP/ivlPRS Namba Bosmess Pha�Number r ` l �I- ��v Q" v 71 - �l� - L /1 � � %' �r� � Plnmber's A (Sh+ce�City, mte,Zip Code) ��s� � � .��er �c.�.� S,� ��1� vi.c� mew�an�t u�oetq J� � 0 Disa�oved P�em�it Fee Dau Issaed Lgsaing Agenc 3ignadae �� ,O Oaner Given Reaso�fur Deoial a L uLJ.� � �l� I� �j ''" 1�L�J�a,�C�,E'z f�-�-2�� Condidons of ApprovaUReasons for DisapPa+�val r---- � � ,.- r.-- � � � f �-. �!� � ,;��n��l 1 y,.;J R'�' � e� �'�)�v'�,�'�� "//�_�'% �:`W �r� � � W� ...._l t�l�� 3 ��..� � � -� � NOV 0 1 2023 - (,�r��. _a._�...,_._....v - �'�T �'3� I ' \ .s c�,: ; sa��;�°YFv� c��_��v-. . , ;;n wmce co«.n�r�+�me�..aa,�umn�n�ca.�b�s�wr�eott�mm s v�:i��e.s m�e 33a� 7 SBD-6398(R 03/Z2) �c ��::r-�a��=�r��i l�S�.1�U�=f�t"t�'1�� v�u�\ Sawyer County Zoning & Conservation Administration ��, 10610 Main Street, Suite 49 � �R c0 �� Hayward, Wisconsin 54843 �'�;`—-\Ci �� (715)634-828R �Q� �� FAX(715)638-3277 ��__ '- � �_� �� www.sawvercount �ov.�i� i E-mail:sanitarian�dsawyercountygov.org �I,°� �-� �~j�� Toll Frcc Courthousc/General Information 1-877-699-4110 ��I.� '�_,`"-� `�_ ��';`�N:� Holding Tank Approval Checklist I. Sanitary Cover Sheet: Date Stamp �� / �1 /� Parcel ID# � 3 � - `� 3 g - o� - 23 0 �o II. Plot Plan: �Property Lines �Benchmark BM ♦ � Site Address �North Arrow pC Structure �Scale �Well �25' to Service Road �Legal Description �Nearest Road Intersection �Setbacks to: Property Line, Well, Structure, Water bodies, Roads III. Required Plans: �Index Page with Original Signature Management Plan/Contingency Plan Servicing Contract �Holding Tank Agreement Fonn ($30 to ROD) IV. Holding Tank Specifications: `� Tank Cross-Section: Manufacturer: �ik1'►z�� Gallons: 12�� Tank Anchar Calculations [SPS 383.43 (8) (g)] �Locking device, chains/locks �Alarm, 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: W`�� .��— Plumber: C �� Application Review Date: [� ( °l��3 POWTS Reviewer: 6/fi�-�%� Name (�`�'�?o((o Rev. 4/27/2023 Credential# CONCRETE HOLDING TANK DESIGN Sing/e Comba Tank Option INDEX AND TITLE SHEET Project Bill Kingston Owner Winter Camp LLC Address 1585 Sundew Rd Sobieski, Wi 54171 Legal Description PRT. SWNW S-7 T-38-N R-4-W Township Winter County Sawyer Subdivision Name Lot No. Parcel ID Number 032 438 07 2306 Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Designer Crai hom son Signature cc,� G` - Phone No. 715-266-2842 License Number 220810 Date 10/13/23 Designed pursuant to: Holding Tank Component Manual For POWTS (Vers� 2.0) � I SBD-10855-P(N.03/07,R.01/12) ` y�� -�-� Version 8.0(10113) P2 e 1 Of 4 HOLDING TANK SPECIFICATIONS 2 Number of bedrooms Non-residential estimated flow(gpd) �OC� 0 Minimum holding tank volume required (gal) Side A Side B Total 750.0 1250A 2000.0 Proposed tank capacity(gal) _ ._�._ Huffcutt Concrete Tank manufacturer 1250/750 Tank model number SJE Rhombus Alarm manufacturer Tank Alert 1 (101-01 H) 120 VAC Alarm model number Tank Dimensions and Data Tank Anchor Calculations X for round tank 16100 Ibs Weight of tank and cover 54.0 Liquid depth below inlet invert(in) 1.50 Safety factor 8.0 Maximum depth of soil cover(ft) 20725 Ibs Weight of anchor required 67.0 Height(in) Outside 35.3 in Soil cover req. for anchor or 146.0 Length (in) Dimensions 5.1 yd� Concrete counter weight 69.5 Width (in) Only HOLDING TANK CROSS SECTION Electrical complies with NEC 300 and SPS 316 vent pipe manhole cover with y locking device and � warning label f grade junction box � — 4"min. �23 in. 6"max. COndUit —� sealed water 1R"min tight thether - �weight Note: All tank joints, and joints - � between tank openings and building sewer blind plug alarm on piping are seated watertight. All inlet to seai pipe and vent materials comply out�et with SPS 384. Manholes with 90% Full 39.6 in locking device are typical for each manhole opening . 750.0 gal 1250.0 gal 3 in.bedding under tank. Tank is anchored as necessary to negate buoyancy. Project: Bill Kingston Page 2 of 4 HOLDING TANK SITE PLAN Project: Bill Kingston N Legal Description: PRT. SWNW S-7 T-38-N R-4-W Subdivision Name: Scale: 1"=40 ft Parcel ID: 032 438 07 2306 Lot No.: b4� s�l�. �� ` cjo �� L ,�,.�,'� � O � �� .� �,, � �� ) � Page 3 of 4 ��'I' �4e > 't �11 �Jc'�L'E Jl�(.� o� !d„ / �� ^!(.��7 HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and maintained according to SP 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P N. 03/07, R. 01/12), and the Sawyer County Sanitary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 40 to 400.0 gpd. 2. The owner of this POWTS is responsible 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 will activate), 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 timely 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 tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes 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). Con- nection 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 may be contacted: a. Installer.............................Don Thompson &Sons Exc. lLC Phone: 715-266-2842 b. Service Provider.................. NorthWest Sanitary Phone: 715-943-2650 c. Co. Zoning or Health Dept. Savryer County Zoning Phone: 715-634-8288 11. ►f this building is used as a year-round dwelling a mound system will be installed. Project: Bill Kingston Page 4 of 4 HOLDING TANK SERVICING CONTRACT Contract Date: �/ / U� This contract is made bctween the Holding Tank Owner and the Pumper. Holding Tank Owner's Name: Pumper's Naine: �1'' l� 1i`��S.-�c�,� Northwest Sanitary, Inc. �� `t� PO BOX 155 � �(\,{�/' �C,�y►�, Z�.� Radisson,W154867 Parcel ldentification Number: (12 Digit Le�acy ID) � 3 oZ - � ��- U �- a ,3 (`� (� L The owner agrees to file a copy of this contract witl� thc governmental unit, Sawyer County, which has accepted and recorded with the Orfice of the Register of Deeds,the Maintenance Agreement for a Holding Tank required under the Sawyer Co�mty Private Sewage System Ordinance for the issuancc of a Sanitary Permit for the installation of a holding tank(s). 2. The owner agrees to have the holding tank(s)serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing tbe holding tank(s). The owner agrees to maintain the all-weather access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. Thc owner further a�-ees to pay the p�unper for a charges incurred in servicing the liolding tank(s)as mutually a�reed upon by the owner and pumper. 3. The pumper agrees to submit to the Governmental Unit, Sawyer County, a report for the servicing of the holding tank(s) as required undcr SPS 383.55, Wisconsin Administrative Code and thc Sawyer County Privatc Scwage System Ordinancc. The pumper further agrees to include the following in the report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The site address of the holding tank; d. The date the holding tank was serviced; c. Thc volumcs in gallons of thc contents pumpcd from thc holding tank for cach scrvicing; f. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract,the owner agrees to file a copy of any changes to this service contract or a copy of a ncw scrvice contract with Sawyer County within ten (10) business days from the date of change to this service contract. �WriGT'S N1TIlE: �pPlrit� �Wri�T'S Sl fe: (Onl,y one owner signature required) �'il F��„{�-,�" Pumper's Name: (Print) Pumper's Signature: Ronald L Vieceti, owner Northwest Sanitary,lnc I/�� j ��E-(�i` � c_.. Pumper's Registration Number: #2389 Rev.03/26/I 3 10/23/23,2:18 PM Real Property Listing Page Real Estate Sawyer County Property �isting Property Status: Current Today's Date: 10/23/2023 Created On: 2/6/2007 7:55:55 AM —t �'Description Updated: 9/18/2023 '� Ownership Updated: 2/3/2022 __ . __ _ _ _ _ _ _ �_ ____. _..._..___ ____-- ----------._ _ _ Tax ID: 33267 WINTER CAMP LLC SOBIESKI WI PIN: 57-032-2-38-04-07-2 03-000-000060 Legacy PIN: 032438072306 Billing Address: Mailing Address: Map ID: .7.6 WINTER CAMP LLC WINTER CAMP LLC Municipality: (032)TOWN OF WINTER 1585 SUNDEW RD 1585 SUNDEW RD STR: 507 T38N R04W SOBIESKI WI 54171 SOBIESKI WI 54171 Description: PRT SWNW LOT 4 CSM 8/97#1625 �1 Recorded Acres: 4.496 �` Site Address * indicates Private Road __ Calculated Acres: 0.000 4342N TOWER RD WINTER 54896 Lottery Claims: 0 First Dollar: No � Property Assessment Updated: 10/10/2016 Waterbody: Dry Creek _._ __ _ _ 2023 Assessment Detail Zoning: (RRl) Residential/Recreational One Code Acres Land Imp. ESN: G6-PRODUCTIVE FOREST 4.450 10,100 0 � Tax Districts Updated: 2/6/2007 2-Year Comparison 2022 2023 Change ___ __ _ �__ _ - __ _ _ __ __ ___ -- 1 State of Wisconsin Land: 10,100 10,100 0.0% 57 Sawyer Counry Improved: 0 0 0.0% 032 Town of Winter Total: 10,100 10,100 0.0% 576615 Winter School District 001700 Technical College �Property History .. __ _ _ . Recorded Documents Updated: 9/18/2023 N/A ___._ _ _ _ ___------_ ____- WARRANTY DEED Date Recorded: 1/14/2022 437114 MAP OF SURVEY Date Recorded: 9/12/2023 7384-6 WARRANTY DEED Date Recorded: 2/21/2006 337081 CERTIFIED SURVEY MAP Date Recorded: 3/11/1981 177361 cs`� 23- �I� https:/Itas.sawyercountygov.orglsystem/frames.asp?uname=Eric+Wellauer 1/1 _ i��iiiif��i��i��i�� i � -USE BLACK INK ONLY iii �i ��;��:��?7G4'r;� POWTS MAINTENANCE AGREEMENT ?h:404�4 i 0 For Hoiding Tanks 447I5f3 PAULA CHiSS�R OwnersName(s)asshownondeed: �t��iSTER�F DEE�S �AVtfYER COUiVTY, WI ` �) /+ 11/O1/Z023 Q2:27 PM ' l w•l.� RECORDING F�E 3�.0� Parcei identifica ion Number. r� �� --7 (12 Difl�Legacy tQ) ,�J�—_.L�L�'Q.L"�� PAGES: Z Legal Description of ProPerty_ -SEE ATTACHED SHEET- We acknowledge that appl'ication is being made for the installation of a holdir�g tank(s)on the praperry described on the attached sheet Retum To:Sawyer County Zoning and Cans�vation Administratlon 10610 Main 3t Suite 49,Hayvvarcl.WI 54843 As an inducemsnt to the Coun#y of Sawyer#o issue a sanitary peRnit for a holding tank on the above-described properiy,the owner is responsible for the operation and mainbenancs of the holding tank,tocking device,a�rm and access,and agrees to conform fa ail appticabte requirements of SPS 383,Wis.Adm.Code relating to holding fank management,induding the foilowing: 1_ The owner agrees to contract with a person who is licensed under Ch.NR 113,Wis.Adm.Code,except as provided by Section 281.48(3)(d),Stats.,to have the holding tank properiy serviced and to file a copy of the service cantract with the govemmental unit The owner further agress 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(90)business days from the date of change to the service contract. 2. The owner agrees to contract witl�a person licensed under Ch.NR 113,Wis.Adm.Code,who shall submit pumping reports to tfie govemmental unit in acxordance wiEh SPS 383.55,Wis.Adm.Code,fior the servicing of the holding tank In the case of exempfion under Section 281.48(3)(dj,Stats.,the owner 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 report5 may indicate the hotding tank is nat being properiy maintained. _ 3. If the owner fails to have the holding tank property serviced in response to orders issued by the govemmental unit to prevent or abate a human heaith hazard as described in Section.254.59,Stats.,the govemmental unit may enter upon the property and service,or cause the tank to be serviced. Pursua�t to Section 145.20(4)Wis.Stats.,a govemmental unit may assess the owner of a private sewags 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 agrees to pay alt charges and cosf incurred by the govemmental unit for inspection,pumping,hauling,or otherwise servicing and maintaining the holding tank in such a manner as to preverrt or abate any human health hazard caused by the holding tank. 4. This agreement wiA remain in effect only until the govemmental unit responsibte for the regutation of private sewage systems certifies that either a soil absorption system that compties with SPS 383,Wis.Adm.Code,or a municipa!sewer serves the properly_In addition,this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which wi(f permit the existence of the certfication to be determined by reference to the praperty. 5. This agreement shall be binding upon the owner,the heirs of ihe owner,and assignees of the owner.The owner shall submit the agreement to the register of deeds,and the agreetnent shall be recorded by the register of deeds in a manner which will permit the existence af the agreement to be determined by reference to#he property where the holding tank is installed. -onl one owner si re u�red- ACKNOWLEDGMENi" Owner's Signature: State of: (/��,��Yl County of: ��`f�(1 Owner's Name(P nt): Subscribed and swom to before me on this �// �. s�� r��.�n3�1�' �lp day of fX��.Ir , 20� Date: By(Owner's Name): � �r i 4 2a�- Notary Public Signature: Drafted by: � Public Notary Name(Print): �_ . �` i� fZ�r l/"� My / �c LIZ LEPOW Notary Public Personal infortnation you provide may be used for secondary purposes(Privacy Law,§ 5.04(I)(�te of Wisconsin Rev.03/26/13 Thaf pgrt af#�e Southwest Qu�rter of the Nor�hw�st Quar#er {SUi�'/NV�'f}, Section Seve� {7}, 7ow�s�ip '�"hlrty-efght �38) Nort�, Range Faur t4} West� lacafied �n tt�e Tawn of 1�Iinter� Sawyer County, V�is�vnsin, rnarA par�fcularly described as L�� Faur �4} as recorded tn V�iume �fght (8) of C��tlfi�d S�rrey Maps� pag� 87-98, Survey Nn. 1$25 as Docucnent No, �I 7�36`!.