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Home My WebLink About004-838-10-2105-SAN-2023-298 �c"""t� Department of Safety �°'�' `� .=:°��4:. Sq� �r � �rj�� i `�=� &Professional Services, , . S : , ; s�;�yr�cx��wt�s� a mby co: � �;� �a ?' Indnshy Services Division 5 t �,-� � ,,: �---:/'� l� l�� ,,�`N\n��* W Sanitary Permit Application s�'`T�`'_�„` � !n accordance with SPS 383.21(2),Wis.Adm.Code,sabmission of this form to the appropciate govemmenml umt "9 is rcquirod prior to obtsming a sani�y pe�it Not�Applica6on forms for smte�ow�d POWTS ace submitted m Pmjea Addrcss(if ditTiera�t thaa ma7ng add� � the Depe�ent of Safiery aad Pivfessional Savias.P�!infoimation You provide maY be used for sxondary m axo�e with the Pcivacy Law,s I5.04(ixu�,St�s. �. ��8��-��t��wn �313�- 4� �T �w� �� a Prop�ty Own�•a N�e P�d� Co�.c.��,��, l�u��,c1�-�ee:� ��re � �, �v�C, D��j�83�-�D -�lo,,� Property Owner's Mai ng Add►�ess Pmperty Locati� l� �.� 1,J ��S I� C��e�� cQ c�,.,� C�ry,stace ziP Coae Phoue x�ber jy��!`I k� ^ Sc � �J lU C � �'� (,�..�— S�l��`S i., v.. sea;o� II.Type of Buil�ag( ail thatspp�y') _ Lot# T 3� N R � B r• CJ 1 or2FamilyDw�eliing—N�berofBetlrooms � ��OIIN� �PnbliclCo�ia1—DeacnbeUse ��rC �}c��' Block# � ❑City of ❑State Oamed—DescnbeUse (S�1 Number ❑Villageof_ � :�F �Town of l'�UG �.�� C�m 3� 3� �.��,�� _. III.Type of.POW1'S Pe�mi�(Check ei�er"New"or�t"asd oth�appliea6le os Bne A. Chedc one�o:on Ii�S Compl�e Nne C a llcsble. A. ew System ❑Replacement Sysoem ❑Othec Modifieetion to ExuGaB SY�(�Plain) ❑Addi6onal PretreatmaR Unit(acPlam) B' �HoWmg Tadc ❑In-Gmund ❑At-Gcade ❑Mound ❑Individual Site Design ❑Other TYP�(�P�) (conveutio� c. ❑�s�� ❑x�oa �o�ofr�� ❑TransfereoNewOwnu P�enausPamrtN�berandD�e?asued E�cpaatioa N.D1 rsaVl�ealmeat Area and Taak Iaformation: Design FFow(gpd) Desi�Soil Applicatian Rate(Spd/s� Dispersal Area RaNired(s� Dispe�al A�ea Ploposcd(sQ Sysbem IIevati� 1<oC"� ---- �� c��y� romt #of M��.,,� Tank tnfotmarion Gauo� Gal�a umts � �i c 3 � l,v/�t,�x.� NewTada F�gTa�s ''�' o U � � `a� m g 8 `� c�U vi m � t:.C7 f3. Sepric or Holdmg TanY ��1�[�� l�(J �� x at Dosing C6amber ` J�C./ �l~ •� �C: V.Responsib3�ty Shb�ent 1,t6e aedera�eed,aswme reapo�y for imh�Noa ot me POW15 s4awn bx tLrato�ehed pl�s. Plumber's Nsme(Priat) Plumba's ' ) MP/h�RS Nmiber Bosme�Phone Namber C�G �G / /Ci,�I —�C� 'i-�:`- � /� ��C��l(.� �lJ^ �6 X�L �- Pimnber's A (Sd+cet,City, Zip Code} S G� �� - �%�� 71t � ��i�� (,� .�� VI.Cou /Departm�t use Only - �i �D�� Petmit Fee I�te Issued Issaing Aga�t SiBnsnae ao�c;�x��rn� sY00�� t� �� Z3 ��'u1L�`f��- Condidonc of AppmvaUReasons for Disappmval , -�1?` `� .;�� j`�, i 3 ,,^�r� �i �I j , � �*+� �`/� � 01 �.� � 3_.,�___._ ....__._ , ;,�r -- __ �;�, � � R � � � ��I� ��-� .4 ..t:; i��3 � '"-; f��`� 0 2 '�23 ��.. �hti�: ; -. C� � /� ��"— �p„ ' ��i%s� ,_,�.. . . ..:;-:,,....�. , �E(jr � V � � ��i . .,-\: � wmee to c.mpie�pba.for n�e sysum ana aa6mit to ue couty oa�y os pa�eot iw tM�a vs:n mdus ia�e SBD-6398(R.03R2) �� =��"��4� IS�JE QF E��l�i Sawyer County Zoning & Conservation Administration �� 10610 Main Street, Suite 49 � �R Cp �� Hayward,Wisconsin 54843 ��'��' �Ci�� (715)634-8288 �� FAX(715)638-3277 �� —_ �,�� www.sawyercountygov�i� I � E-mail:sanitarian(n sawvcrcounlY'o�v c>rg I o\ -_�-�~ �o I� �� _�;;�y �� Toll Free Courthouse/General lnformation 1-877-699-4110 I�L`., _ ��j�`oN�� Holding Tank Approval Checklist I. Sanitary Cover Sheet: Date Stamp �� / O 2 / ,20�3 Parcel ID# � o �- g 3 }�_ � v _ � ( o s II. Plot Plan: �Property Lines �Benchinark BM ♦ �Site Address �CNorth Arrow �Structure �Scale �Well X< 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 Agreeinent Form ($30 to ROD) IV. Holding Tank Specifications: D( Tank Cross-Section: Manufacturer: �, Gallons: ��'�/�� 7� Tank Anchor Calculations [SPS 383.43 (8) (g)] `?� Locking device, chains/locks �Alann, 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: C V F�� i,�c , Plumber: C�. Application Review Date: ��D�"��'2 3 POWTS Reviewer: �- w•l<�'�. Name � (0`3�(10 Rev. 4/27/2023 Credential# CONCRETE HOLDING TANK DESIGN Single Combo Tank Option INDEX AND TITLE SHEET Project Couderay Owner Couderay Volunteer Fire Dept Inc Address 12353 W Jos R Chafer Rd Couderay Wi 54828 Legat Description PRT. NENW&SESW S-10 T-38-N R-8-W Township Couderay County Sawyer Subdivision Name Lot No. Parcel ID Number 004 838 10 2105 Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Designer Crai om son Signature � � Phone No. 715-266-2842 License Number 220810 Date 10/10/23 Designed pursuant to: ^ I Holding Tank Component Manual For POWTS (Versio .0 � oS , SBD-10855-P(N.03/07,R.01/12) �uY �� d—� versioh 8.0(10/�3) Page 1 of 4 HOLDING TANK SPECIFICATIONS Number of bedrooms 160.0 Non-residential estimated flow(gpd) 20,;�0 0 Minimum holding tank volume required (gal) Side A Side B Total 750.0 1250.0 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) Onfy HOLDING TANK CROSS SECTION Electrical complies with NEC 300 and SPS 316 vent pipe manhole cover with �j bcking device and � warning label finished junction grade box —� r—� — 4"min. �23 in. 6"max. conduit sealed water �R"min tight thether -- �weight Note: All tank joints, and joints - � between tank openings and building sewer alarm on p�ping are sealed watertight. All inlet blind plug pipe and vent materials comply to seal outiet 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: Couderay Page 2 of 4 HOLDING TANK SITE PLAN Project: Couderay N Legal Description: PRT. NENW&SESW S-10 T-38-N R-8-W � 4i"`" Subdivision Name: Scale: 1" = 30 ft Parcel ID: 004 838 10 2105 Lot No.: ��. H�� a�/�a 13i37-�,� \ � � s 3 ��. � � Y .% ? (R ��2�0 �I'`'��i� �'�re �1� o� �s'� �, C�o .� �„',� O �,GctJ �`' �o+�br � r Page 3 of 4 Q�r : C;�r�c'��'fi� UaSc� a� 1,a 5m�, s;v�l �;ae Q�'l= /cU.�) Nov 06 23 01:41 a Don Thompson&Sons Excva 715-266-2143 p.1 �� !� ( �1 , �cz er e , 1a � � � = 1s� � � � -� 1 � �2� �vf�Q; C'�� = �c� �s , l� rn �� 1�' � � � u 11�� . las� �s� � ' � � �- �- I , /J C'�n'1 ��n�Z��r�/1 f c��?t� �� l b� 1 �s��l��r� �.��s � � o � N� ��a� � � � � � � ��.� � � � ��.��-�� tiov \�� o sq o� � �v,�,�� pZ� � ��-`�i��f�N sT�� HOL.DING 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 32 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 senrice 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 (ocation (a new sanitary permit is required for such a replacement). Con- nec#ion to municipat 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 folfowing 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. Sawyer County Zoning Phone: 715-634-8288 11. If this building is used as a year-round dwelling a mound system will be installed. Project: Couderay Page 4 of 4 HOLDING TANK SERVICING CONTRACT Contract Date: /U / / This contract is made between the Holding Tank Owner and the Pumper. Holding Tank Owner's Name: Pumper's Name: Cu�t'►�I�� "�/�n1�),��,.e ��e� Northwest Sanitary, Inc. �x, v t -C PO BOX 155 ��, Radisson,WI 54867 Parcel Identi�cation Number: (12 Digit Legacy ID) O Q�-� � � -�Q- :� (�.j 1. The owner agrees to file a copy of this contract with the governmental unit, Sawyer County, which has accepted and recordcd with the Office of the Register of Deeds, the Maintenance Agreement for a Holding Tank required under thc Sawyer County Private Sewage System Ordinance for the issuance 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 pump�r to have access and to enter upon the property far the purpose of servicing the holding tank(s). The owner agrees to maintain thc all-weathcr access road or drive so that the pumper can service the holding tank(s)with the pumping equipment. The owner further agrees to pay the pumper for a charges incurred in servicing the holding tank(s)as inutually agreed 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 under SPS 383.55, Wisconsin Administrative Code and thc Sawyer County Private Scwage Systcm Ordinancc. The pumper furthcr agrees to include the following in the report: a. The name and address of the person responsiblc 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. The vofumes in gallons of the contents pumped from thc holding tank for each servicing; 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,thc owner a��ees to file a copy of any changes to this service contract or a copy of a new service contract with Sawyer County within ten (10) business days from the date of change to this service contract. �wriel''S�ISrile: (pClrit� �wriCP'S S1�ri8111C0: (Only one owner signature required) �� /� � � ��" �1.��" -/� � Pumper's ame: (Print) Pumper's ignature: Ronald L Vieceli,owner Northwest Sanitary,lnc /�� l�r,� C. �, Pumper's Registration Number: #2389 Rev.03/26/13 _ �! �� -USE BLACK INK ONLY ��I�� :30755�2 POWTS MAINTENANCE AGREEMENT Tx:4048433 For Holding Tanks �47�7s PAULA CHISSER OvmersName(s)asshownondeed: �ZEGISTER OF QEEDS SAWYER COUNTY, WI CO�ci�.�'f�•:,� �C��1.t/l '! � ('e i,l -L Yll� li/02/2023 12:01 PM Paroei ident'rfication umber. RECORQING FEE 3Q.00 (12 Digit Legacy tD) � c�1-��-L�,-�� PAGFS: 2 Legal Description of Pin�Ay_ -SEE ATTACHED SHEET- We acknowledge that eppl'ication is being made for the instailation of a holding tank(s)on the P��Y described on the attach�sheet Retum To:Sawyer County Zoning and Consmvafion Administratlon t0610 Main Sk Suite 49,Hayward,W!54843 As an inducement to the County of Sawyer to issue a sanitary permit for a hotding tank on the above-described property,the owner is responsible for the operation and maintenance of the holding tank,locking device,alartn and access,and agrees to conform to aii applicabte requirements of SPS 383,Wis.Adm.Code relating to holding tank management,induding the foilowing: 1_ The owner agrees to contract with a person who is ticensed under Ch.NR 113,Wis.Adm.Code,except as provided by Section 281.48(3)(d),Stats.,to have the holding tank properly senriced and to fi(e a copy of the service contract with the govemmental unit The owner further agr�ees 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(10}business days from the date of change to the service contract. 2. The owner agrees to contract with a person 6censed under Ch.NR 113,Wis.Adm.Code,who shall submit pumping reports to the govemmental unit in accordance witli SPS 383.55,Wis.Adm.Code,for the servicing of the holding tank In the case of exemption under Sectlon 281.48(3)(d),Stats.,the owner shall submit the report to the govemmental un�. The govemmental unit may enter upon the property to investigate the conditi�on of the holding tenfc when pumping r�orts may indicate the holding tank is not being properly maintained. . 3. If the owner fails to have the holding tank properly senriced in response to orders issued by the govemmental unit to prevent or abate a human heatth hazard as described in SecUon.254.59,Stats.,the govemmental unit may errter upon the property and service,or cause the tank to be serviced. Pursuant to Section 145.20(4)Wis.Stats.,a govemmental unit may assess the owner of a private sewage 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 agrses to pay aU charges and cost incurred by the govemmental unit for inspection,pumping,hauiing,or otherrnnse servicing and maintaining the hatding tank in such a manner as to preverrt or abate any human health hazard caused by the hofding tank. 4. This agreement wifl remain in effect only unfil the govemmental unit responsible for the negulation of pmrate sewage systems certifies that either a soil absorption system thaf complies with SPS 383,Wis.Adm.Code,or a municipal sewer serves the property_fn addition,this agreement may be cancelled by executing and recording said cefification with refere�ce to this agreement in such manner which wil!permit the existence of the certifica6on to be determined by reference to the property. 5. This agreement sha0 be binding upon the owner,the heirs of the owner,and assignees of the owmer.The ovmer shall submit the agreement to the register of deeds,and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreeme�t ta be determined by reference to#he property where the holding tank is installed. �,,;��,;,;,� -onl one si nature utred- ,�� '�,, ACKN01fItLEDGMENT Own �Signature- :� � ' ��%State of: � ( � ��n j r, � � ��l County of: - � -�� Owne Na e(Print): �Ma,� = s nbed and swom to efore me on this �� ✓ _ !�s ;� �day of �' � .20� Date: ��i� /�`;L�G ..�z.�y(Owner's Name): � � � l �.� � 9 . � % � G'��Notary Public Signature: Drafted by � �'��,, I��S`\� �`�� public Notary Name(Print): �'Y); �1 �!'w{/ _r�� My commission expires on: � S'�L�o? Personal i�ation you provide mey be used for secondary purposes(Privacy Law,§15.04(I)(m)] Rev.03/26/13 �� `G�� C�� C�� 7��►� ��E��S� ��c�� 3�, ��r�e� ��. �5� �� . �2�6�, �€��e� �r� t�� '��rn �� au��ta�, 5�� e��an�, ��nS�r�s �e��t� c-� part t'��S��la��/4 �f ��C#�l"1 �; �'r1@ ��'1��1i��a, N�=1��'`�� o�r ��r�n '��, a��i in ��e�shi� 3� �t�r�, ��r�g� � ��ss�. �'�� +d��rf�t�e�� a�� sb�ag�e� ��8� ��a�� a� �� C�m�n��e�a� �o. �#�3��'��. 11/2/23, 11:30 AM Real Property Listing Page Real Estate Sawyer County Property �isting Property Status: Current Today's Date: 11/2/2023 Created On: 5/24/2021 3:47:10 PM L�'Description Updated: 5/24/2021 � Ownership Updated: 5/24/2021 __. _ ---___ ___. Tax ID: 44182 COUDERAY VOLUNTEER FIRE DEPT INC COUDERAY WI PIN: 57-004-2-38-08-10-2 01-000-000050 Legacy PIN: 004838102105 Billing Address: Mailing Address: Map ID: COUDERAY VOLUNTEER FIRE COUDERAY VOLUNTEER FIRE Municipality: (004)TOWN OF COUDERAY DEPT INC DEPT INC STR: S10 T38N R08W 12353 W]OS R CHAFER RD 12353 W JOS R CHAFER RD COUDERAY WI 54828 COUDERAY WI 54828 Description: PRT NENW&NWNE, PRT SESW 3-3$;8 LOT 1 CSM 37/38 #8522 Recorded Acres: 8.270 � Site Address * indicates Private Road _. .--_ Calculated Acres: 0.000 13137W STATE HWY 27/70 COUDERAY 54828 Lottery Claims: 0 First Dollar: No :.J Property Assessment Updated: 4/8/2022 Waterbody: Couderay River 2023 Assessment Detail 0 Zoning: (A-1)Agricultural One Code Acres Land Imp. ESN: 454 X4-EXEMPT OTHER 8.270 0 0 � Tax Districts Updated: 5/24/2021 2-Year Comparison 2022 2023 Change - _ 1 State of Wisconsin Land: 0 0 0.0% 57 Sawyer County Improved: 0 0 0.0% 004 Town of Couderay Total: 0 0 0.0% 576615 Winter School District 001700 Technical College �Property History •� Recorded Documents Updated: 5/26/2021 Parent Properties Tax ID . . _ CORRECTION INSTRUMENT 57-004-2-38-08-10-1 02-000-000010 4664 Date Recorded: 5/20/2021 432022 57-004-2-38-08-10-2 01-000-000010 4669 WARRANTY DEED 57-004-2-38-OS-03-3 04-000-000040 41945 Date Recorded: 3/z9/2021 430819 CONVEYANCE RECORDED NOT USED Date Recorded: 3/29/2021 430818 CERTIFIED SURVEY MAP Date Recorded: 1/28/2021 429634 CORRECTION INSTRUMENT Date Recorded: 8/14/2019 419308 CONVEYANCE RECORDED NOT USED Date Recorded: 5/22/2019 417869 LAND CONTRACT Date Recorded: l2/30/�013 388863 TERMINATION OFDECEDENTSINTEREST Date Recorded: 9/27/2013 387489 WARRANTY DEED Date Recorded: 11/5/2012 381655 TERMINATION OF DECEDENTS INTEREST Date Recorded: ll/5/2012 381654 QUIT CLAIM DEED Date Recorded: 7/Z6/2006 340458 ("hilri HiStON RPmrr1 C'niint' S- HISTORY�Expand All History White=Current Parcels Pink=Retired Parcels 0 Tax ID:4669 Pin: 57-004-2-38-08-10-2 01-000-000010 Leg. Pin: 004838102101 Map ID: .5.1 0 Tax ID: 4664 Pin: 57-004-2-38-08-10-1 02-000-000010 Leg.Pin: 004838101201 Map ID: .2.1 O Tax ID: 4529 Pin: 57-004-Z-38-08-03-4 03-000-000010 Leg. Pin: 004838034301 Map ID: .15.1 O Tax ID:4523 Pin: 57-004-2-38-08-03-3 04-000-000010 Leg. Pin: 004838033401 Map ID: .12.1 O Tax ID:41945 Pin: 57-004-2-38-08-03-3 04-000-000040 Leg.Pin: 004838033404 44182 This Parcel Parents Children https:l/tas.sawyercountygov.org/system/frames.asp?uname=Eric+Wellauer 1/1 0 0 11111I II1I if iI I I IIII Il I!I I NI 8 0 4 0 9 7 0 Tx:4026621 429634 Sawyer Count� PAULA CHISSER REGISTER OF DEEDS SAWYER COUNTY, WI Certified Survey Map O1/28/2021 08:37 AM RECORDING FEE 30.00 Part of the SE1/4 of the SW1l4 of Section 3; PAGES: 3 the NE1/4 of the NW1/4 of Section 1Q, VOL: 37 PAGE: 38 CSM MAP #: 8522 and the NW1/4 of the NE1/4 of Section 10, all in Township 38 North, Range 8 West, Town �f Couderay, Sawyer County, Wisconsin See olso Highway Project S-1415/8783-1-27 NW CORNER, SEC. 10: (R.O.W WID7N YARI£5) Fd. 2"Brass Cop 1.P. Deed Ooc.� 147644 (Vol.257 Pg232) COUMY HIGHWAY C" ,g ------ - rE-----_ _ ��RD�QD �. y L15 � � UB �A �i.,e L7s L17 0 0� .. ... . .. ...............o --1'. ._....... ........ . 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