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HomeMy WebLinkAbout006-440-17-5301-SAN-2023-297 Department of Safety c°""ty � � & Professional5ervices, ` r � =P Sanitary Pertnit N ber(to be fillcd in by � _ , Industry Services Division � ....., . �5� ���' R� w Sanitary Permit Application State Transaction Number � ln accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental 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: � the Department of Safety and Professional Services.Personal information you provide may be used for secondary purposes in accordance with the Privacy I.aw,s. I 5.04(I)(m),Stats. L Application Informatio�-Pkase Print Atl Information Property Owner's Name Parcel# _ oc .� � d Property Owner's Mailing Address Property Location Govt.Lot�___ City,State 7.ip Codc Phone Number ,1 "� D�t "-� � Section 1� IL Type of Buildi g(check sll that spply) Lot# T N R E or� t�1 or 2 Family Dwell ing-Number of Bedrooms +L �� Subdivision Name Block# ❑Public/Commercial-DescribeUse �� .-� ❑City of _ ❑State Owned-Describe Use N� CSM Number ❑Village of _ � �Town of ,��T��' I[I.Type of POWTS Permit:(Check either"New"or KReplacemeot"and other applicable on Gne A. Check one box on tine B.Complete line C i a licable.) A. ❑ New Sysicm ❑ Rcplacement System �Other Modification to Existing System(cxplain) ❑ Additional Prctrcatmcnt Unit(explain) B' ❑ Holding Tank �In-Ground ❑At-Grade gi yp ( p ) ❑ Mound ❑ Individual Site Desi ❑Other T e ex lain (conventional) C• ❑ Renewal Before ❑ Revision ❑Change of Plu[nber ❑Transfer to New Owner �st Previous Permit Number and Date Issued Expiration �.(y�� � . IV.DispersaUTreatment Area and Tank Information: Design Flow(gpd) Design 3oi1 Application Rate(gpols� Dispersal Area Required(s� Dispersal Area Proposed(s� Systcm Elevation 3�9p O.� (�O p t,���( ? c� c Capacity in Total #of Manufacturer Tank Information Gallons Gallons Units � � U ',�, � New Tank.e Existing Tank.e y o � � y � � � r�, U in �, v� w O a Septic or Holding Tank Cj�C Q��� ' q O Dosing Chnmbcr V.Responsibility Statement-I,the undersigned,assume responsibility for iostallation of the POWTS shown on the attached plans. Plumbcr's Namc(Print) Plumbcr's Signaturc MP/MPRS Numbcr Busincss Phonc Number p ,2oZ / 2. Plumber's Address(Street,Ciry,State,Zip Code) Ol �� E C L VI.Couuty/Department Use Only �� Permit Fee Date Issued Issuing Agent Signature �A ve ❑Disapproved _ $ [�� � �� �� (�3 �.�.�t�t }�.���. ❑Owner Given Reason for Denial ' Conditions of Approval/Reasons for Disapproval !r"� � �� ,� _ �t � l���-3.... � d��t� � uwv �`t_3? .�_ � C 5� �� I�,j 3 c�s�a , � ��i-�r;�i`•�;�'`�`,-;�f'1 ���. .I� i�,;;, � ;I i ' - ��` -- — - Attach to complete plaos tor the�ystem and submit to t6e Couoty osly on paper not less than S 1ri a 1 cp in size i; t� fl�T � 2 2023 _ RC f��F�llV���t=TER �---- ____.__...._. SBD-6398(R.03/22) �,�v,��QF�P;���+ `•n�;+�i���;:':? �". ��: ZO�VI+�G Ai:sJi;,�+;v�r�,. . - ; 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) Page 1 Index Sheet Page 2 Site Plan Page 3 Tank Cross Section Page 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Wolf - TANK REPLACEMENT ONLY Owner Name(s): Gerald and Cheryl Wolf Phone: - - Owner Address; 4486W Saecks Road, Loretta WI Z�P: 54896 Project Address: SAME - Govt. Lot: 3 1 l4 of 1/4, Section �� , T 4� N-R 4 E�or W 0✓ Township: Draper County: Sawyer Project Parcel ID#: 72�4 4�ccy �t'7 'S�1 Designer Information Designer Name: Kurt Brown Phone: �15 _943 _2390 Designer Address: 233N State Road 40, Exeland WI Z�P: 54835 E-mail: ��'��[h� � ��Ce-r�n_xe�` ,�� �. � ._� � �� � . License Number: 224281 Remarks: Signature: Date: 9�29�23 p igi I signature required on each submitted copy. SITE PLAN Pro ert Line Proposed 800 gallon Huffcutt tank with Polylok filter M cabin 2 bed � B 1 dwelling o 96.4' vent pipe eck Existing system 94.2 system elevation t � J A� � �. Q �j.,� (D �� r �y � •� (D '�,% s� �s �� �� s 4486W � = Benchmark 100' Top of slab at bottom step Vertical and horizontal reference Gerald and Cheryl Wolf 4486W Saecks Road + = Well Gov't Lot 3 - S17-T40N-R4W Town of Winter � = Soil pits with backhoe Tax ID 7274 ,jJG� ���� r��� NORTH 1" = 40' �'40' 0"� Page 2 of 4 �ayag� Anaerobic Treatment Tank Cross Section and Plan View With Outlet Filter Plan View > > > > > > > , > > > > > , > > > > > > > > > , > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > { { { { { { S t i L { { < ; { t { i { { { { { { { { { { { { { { { S { { { { { { { { { { { { { { { { { { { { { { { S } } { ; { } } { { L T } { { { } } { { S } � }< Typical Manhole <}< }{ 24" I.D. Opening {}i Inlet >{ Manhole � {>` ;{ � Opening {;{ < < < > > < < < > > < < < > > S { { } ? ` ` ` Outlet > > >{ Outlet {>{ ;< Inlet B affl e Filter `>` < < < > > < < < f > < < < > > < < < Y Y { { { } } } } } } } } } } } } } } } } > } } > } } } � } } } } > } } } } } } y } } } } ? } > ? } } > > } } } } } } y } } �{ { { { { S { { { { S { { { { { S i t { t { { t { { { { { i i { S S { { t { { { { { < i { { L { i { { { { { { { i { Cross-Section 1 , - - 0 � � " � � '� '— � Finished Grade — — — ' � � � — o � � 4" Dia. Vent � Max. 6" Below 12" Above —� , Grade With Min. 4' Grade & Sealed Above Watertight Vent Cap Grade > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > � > > > > > > > > > < < { < S S { { { { { { { L { { S { S 2 2 { { { { { { { i t { { S t S t i { { { { i } } y { i } } Tank Manuafcturer: HUFFCUTT >{ < > > < Inlet ' ' �.�'`� >{ }`} Tank Capacity: 800 Gallons ,� >{ < > > Outlet < > > > < > < t >{> Tank Maximum Depth of Bury: Ft ;< > > < { > > > 67„ 96„ 57„ >{ ;{; Tank Outside Dim.: Width Ft, Length Ft, Height Ft }< > , < ` POLYLOK ' > > S { J > > ut et Filter Manufacturer: < ` '< > > < > > > t 525 ' ;<; Outlet Filter Model Number: >i < , > > t � , > > { < , } } } } } } } } } } ? } } } y ? } � } y } } } } } } } } y } } } } } } } ) y } } } } } } } } y } } } } } } ) } } } )t { S { { { { { S { { { { { i i { i { { { { { { { { { { S { { S { { { i S < { { { { S { S { { { i i { { � { { L { { { GENERAL INSTALLATION: The tank is bedded and back tilled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the �nanufacttit•er may not be exceeded witllout prior ap��rovaL Manhole covers exposed to grade have an effective loeking device (padlock) installed. Manhole covers below grade are sealed watertight. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to pre��ent settling or sagging. Page 3 of 4 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 = 300 gpd; BODS<_220 mgL''; TSS<_ 150 mgL-'; FOG <_30 rr�gL-' Insaection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (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 capaci6es, 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, contro�s, timers, alarms, etc.) o distribution lateral 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 seroicing 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 12 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 com an C� �� Phone: ?�s-`jY �" �-3�O P Y' Locaf government unit: SAWYE COUNTY ZONING Phone: 715-634-8288 _ 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 shall be replaced pursuant to a plan submitted to the approp�iate 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. ��,,;1� ' A � �o��yly3 ys�v� � „�r� Office of C►�O � � 7 � :.� '�►''� Sawyer County Zoning Administration �� � � ]0610 Main Street Suite 49 � `' Wisconsin 54843 � ���.���� Hayward, � ��,.t� °.-;;;��►� (715)634-R2RR � ��t� Z I� FAX(7l5)638-3277 � � '`� u�`•�4, w�v_�t yaw�crcountv u��.�r�� � r� � - L,� ,.�1 I O � r ' '� �:� GmaiL zqningce<<ir,aH�c,r�ountv�o�_ore �, ���� , � Toli Free Courthouse/General Information t-877�99-4110 �O��,w ��0� C f� I 'i r ,'� / •��y /� '� ��c���`�'; ��q Fq �01� � i��"��. O,I���Cp� c SAWYER COUNTY SANITATIQN DEPARTMENT SrR'�o ti TEMPORARY EMERGENCY TANK INSTALI.ATION APPROVAL PROPERTY OWNERS NAME: (Tes^r� ( ctvlcl (' ItF ry ( Wt�t�F TOWN OF: ��ct D e�' ADDRESS: �I�{8�1A! Sa e��CS �� LeY�e'�"'f"� .W►__�yfl_`�fi ; I, �(ur-}� ��'pH(1� , a Wisconsin Licensed Plumber, authorized by the owner, do hereby acknowledge that I am receiving temporary approval to instalt a septic tank/holding tank without a soil and site evaluation, or existing system evaluation, and private sewage system plan review due to inclement ; weather and/on c�alth andlor safety emergency. I Further, I acknowledge that a soil and site evaluation,or existing system evaluation, and private sewage system plan review will be conducted by the deadline stipulated by the permit issuing agent, or as soon as wcathcr conditions or circumstances permit. If the private sewage system is found to be failing as defined in s. DSPS 381.01 (92), Wisc. Adm. Code,corrective measures wiil be taken as such that the�rivate sewage system camplies with all applicable requirements of chapter DSPS. 383, Wis. Adm. Code, within 90 days of this agreement. I further acknowledge that failure to comply by obtaining all necessary permits after the deadline date may result in the issuing of a citation,under Section 1 I 3 (?)Sanitary Pcrmrts], of thc Sawycr County Citation Ordinancc. DEADLINE Fn�2 THIS AGREEMENT SHALL BE: I I �02 Signed: _ zCL�' _------ _ _- . Date: tc��Jw 12.3 0 `� .�a� Accepted by: � ----- Date ofi temporary emergency approval: l o�R�Z-�.__ Rev. b3/26/13 10/9/23,9:54 AM Real Property Listing Page Reai� EState Sawyer County Property Listing Property Status: Current Today's Date: 10/9/2023 Created On: 2/6/2007 7:55:13 AM _ti �'Description Updated: 6/3/2020 '� Ownership Updated: 6/3/2020 --_ _ _. ___ _--- Tax ID: 7274 GERALD E&CHERYL A WOLF 7R LORETTA WI PIN: 57-006-2-40-04-17-5 05-003-000010 Legacy PIN: 006440175301 Billing Address: Mailing Address: Map ID: :3.1 GERALD E&CHERYL A WOLF GERALD E&CHERYL A WOLF Municipality: (006)TOWN OF DRAPER �R JR STR: S17 T40N R04W 4486W SAECKS RD 4486W SAECKS RD LORETTA WI54896 LORETTA WI54896 Description: GOVT LOT 3 Recorded Acres: 48.750 �p Calculated Acres: 0.000 r Site Address * indicates Private Road ___ ----_---- ----__ Lottery Claims: 1 4486W SAECKS RD WINTER 54896 First Dollar: Yes Waterbody: Blaisdell Lake .--�� Property Assessment Updated: 8/22/2016 Zoning: (RR1) Residential/Recreational One 2023 Assessment Detail ESN: 422 Code Acres Land Imp. G2-COMMERCIAL 6.000 85,000 70,100 � Tax Districts Updated: 2/6/2007 G5-UNDEVELOPED 18.000 3,800 0 1 State of Wisconsin G6-PRODUCTIVE FOREST 24.750 34,700 0 57 Sawyer Counry 006 Town of Draper Z-Year Comparison 2022 2023 Change 576615 Winter School District Land: 123,500 123,500 0.0% 001700 Technical College Improved: 70,100 70,100 0.0% Total: 193,600 193,600 0.0% .� Recorded Documents Updated: 10/20J2021 QUIT CLAIM DEED Date Recorded: 3/13/2002 Z9g7p2 �Property History _-- — QUIT CLAIM DEED N/A Date Recorded: 5/3/1993 234786 1l1 https:lltas.sawyercountygov.orglsystemlframes.asp?uname=Eric+Wellauer '`�.,�y' �' -i � ' r,d�i'� _,��`*�, ,v„ r � - -,�'�����y.Y �'��" �t'�'0� � .= f�_., .."� ,."�1`�-,Y; �y., �_ �rt'�,,i'�� � i ��'„t r'�� J}. y's'"w � �++1�' ' i�pX .rw"'� "`4, �. � 1 If �'. 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Z N`�P�\OSNRp,S\�N SITE PLAN — Ae_�u�l+ lo(IZ�� Property Line ����,� Proposed 800 gallon Huffcutt tank with Polylok filter cabin M 2 bed � B1 dwelling o 96.4' � ��^ay�., �vent pipe a' " � — Huil��nS : 5•0�' eck Existing system _ S n, = 5.04' 94.2 system elevation � Ov.� z 5.yt� 0,.. ���0iyd —�� r4smr `��c�ach a� locE. y v*� ou�� e„d!. .� ��i �Sr �eo�ra+r ��,h<P. p� � �k� o�d�c '" �i�'�`Y =�I'c�.�-l�l'�2 Es�'Co '�s a 4486W � =Benchmark 100' Top of slab at bottom step Vertical and horizontai reference Gerald and Chery 4486W Saecks R� 1 _We�i Gov't Lot 3-S17- T Town of Winter � =Soil pits with backhoe T8x ID 7274 NORTH 1"=40' �40'-0"� Page 2 of 4