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HomeMy WebLinkAbout010-941-33-1327-SAN-2024-018 OrioJ. ��% Indus[ry Services Divs on i County � Y� , �B : 452�Madi�on Yards Wav ,SC�w�.e�/- � ..\SP ' � Madison,W'i5i705 :SanicaryPcrmicru berRoi�C � ;. , t �> I P.O.Box 7302 � �r���.,�%� �ladison.P'i 5707 I�S I '��t r Stare Transactiov Number � Sanitary Permit Application __ o In acrordantt wi,h SPS 3R3.21�2),Wis.Adm Code,submi:sion of�his fortn to the appropna¢govemmenlal unit �tJ is requircd pnor to obtaining a saniwry permit.Vocc:4pplication forms for stam-owncd POWTS are submittcd ro Project Address(if different than mailing adurcssl the Depamnen[ofSaCery and Profession�Services.Personal information you provide may be used for secondary purposes in accordaoce with[he Pmacy Law,s.I5.0411)(m),S[au. I.ApplicaHon Informafion-Please Print All lnformation �qti k � PropertyOw'ncr'sNamc �Q1;`���,�.� Parccl� $ Lan� �-�-C -at- � 3: ay o�o -��Ef-3�- �3z Pmperty Owne/r's�Msiling Address _I �7 Pmperty Location �S Z 7� "V. ��S .T a I 1`-� O L �Gnv�.Lo� City,Sta[e �Zip Code Phonc:Jumber �w wa..�l w I 5`-{e�-t3 y-DZ— 639/ i�..►JE �,se���a� 33 1-II.I Type of Building(check ail[ha[apply) � Loe.� T �� K R�� E �y�lor2FxmiiyDwelling-NumberufBedroons 3 SubdivisionName Y+' Bloc ' �ublic/Commercial-Descdbe Use �City of �StateOwned-DescribcUse CSMNumber iliageof_ 2l zz( �-6037 �To�mof ��w�� III.Type of POWTS Permit:(Check either•'\ew"or•'Replacement"and other applicable on line A.Check one box oo line B.Complete line C if a licable. I—L A� ��'ew Sys[em � pceplacement System ❑Other Modifieation to Fxis[ing System(explain) �Additional Prztrtahnent Unit(explain) LJ B' ❑FioldingTank �fn-Ground �+.i-Grade �Mound IndividualSiteDesign OtherType(cxplain) (co entional) �� ❑Rrnewal Before �Revision hange of Plum6er ❑Transfer ro New Ovmer 's�Previous Pecmit V�mber and Dam Lcsued � Ezpiration IV.DispersaVTreatment Area and Tank Informaaon: Desi�n Fiow(gpd) Design Soil Applicaeion Rate(�pd/sf) Dispersal Ama Reqd d(s� Dispersal Area Proposed Is� Sysrem Elevation �k50 �L 6 43 t� c�Z q�{ o� Capaciry in Tota! ;of Manufac[urcr � , I Tank Informa[ion Galions Gallons I L'nits � �� ,``o u _ NewTankx ExixtingTank.c � _ - W QISey-- a`u' vi y ' .:.�J i cp orHoldingTank 1oD � Dosing Chambcr � � � V.RespOnsibility Statemen[-I,the undersigned,assume rosponsibility for installafion of the POWTS shown on the attached plans. Plumber';Name(Prin[) PI ' Si�natu l MP/MPRSNumber BusinessPhon<Numbe- Rvb � h4rr — � z�z�a ��_��-093� Plumber's.4ddress(Street City.Stare.Zip Code) t'�5�� ,� s-�- w ��] w ,,,��rd w Sy��t3 VI.Conn /Department L'se Only �.App � � O Disapproved 7ermit Fee Daee issued i lssuing Agen�Signanue /�,' �'� �ry�CO j � Cj L �/���%/���9���/ .�_�� !/"'� �Owncr Givrn Rcuon for Dcnial � W � � "� ( � "'"�""µ'�"""'�1�"""''` Conditions of Approval;Reuons for Disapproval �---��/c ' � � ���GI����. ���t�_______ � � �_ ' '= � �.� co.��-1�___. � FEa o� zo?� CST �-�- �I � � S-�'i SAVJ`(EH CCUNTY � ZONHJG ADMINISTRATION Anach ta camplete plans for tAe system anA submit ro the Counh'onh�on peper not less than R la x I7 Inches in size SBD-6398(R.02/22) NO REFl1ND5 AFTER ISSUE OF PERMIT �� ;� �ti.� PAGE 1 C In-Ground Gravity Plan � l y Index & Cover Sheet Component Manual Design References: Version 2•I, SBD-10705-P (N.01/01, R. 10/12).. . 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►: A � L�r� � LLC Phone: boZ `-EOZ- 63 R/ OwnerAddress: �SZSS W ��-oSP,'{-�� R� I�-�ywqr� Zip: S`t8`t3 Project Address: oh �'���- R� Govt. Lot: 5(.c� 1/4 of tii � 1/4, Section�, T 4 l N-R �� E❑or W� Township: E}�� W�`^ � County: s�'c-w� cr- Project Parcel ID #: b I � , '�f�l _ 3 3 — l 3 Z"� Designer Information DesignerName: ��6 ��'i,rY'� Phone:-1t5 -b�r9 - 093�0 Designer Address: l �l S�Iq S'� FE-w� �Z �}c��d Zip; S`E 8�3 E-mail: ^ , License Number: 2.ZCv Z I� Remarks: �_� Signature: � � ��� Date: Z 3 ��`r � Original signature required on each submittetl copy. � zf � �� �� �� �-a,h c� LLC S�w�cr �o , �4.�c.v�v. � �`'`''� ( SZ �`� c,u �os��Te � � �l i� Old -- 4�[ , 33 _ �3z� �-�� �. �, � � s� gy 3 sc.�/w c � 3 3 �- � � N R o�c-� 6 o Z _ �{e Z. _ 6 34 � _ (�ofi 3 Cs �-t 2-�/'-�-! -� �03 7 S c�G : tb ►� ��t � � � z.oo N i . ,� � o� sc0.1e 1 a , � ,�- o �o �0 30 � W `o w � • Z �.�.�� s;-�� � �1 o Co�.-�,rg �' 3 � � � [��,e ���1 �+ a � �doo s:r � o • g�•- t� � �G,.k R� A�� ioo ��.� � � c� �6r�� 30" � � C S�'�.e l3�`S�r�c.� t3 l , q-t . ( ' z , ��.Za ' 3, a� .�-t ' ,�. sa � ls , s �s+ �l�v- a4� �Sk �L dc� S ei..�2�r- 9, �p � F� S''r t N °C s.S ` S2Wcr C�. � �i(,S� -- CI�FS � � �Jc s cbL P��e u Cl 6.�—l. vJ� l 2�` S�ti d.- L� ��- • SepticTank(s)Manufaclurer: • IN-GROUND GRAVITY DISPERSAL AREA ��is-e�- Stepped Elevation Trenches with Quick4 Standard-W Cham ers �� 3eptic Tank(s)Volume(s): 3-ft Trench (down-5izing credit) l y�, __ ��, �a� 9a' � �� ��r�I�ftluent f�ilter Manufacturer: _ � � .111L��- - � ``�_ � — ��- SOIL COVGR k. -�._� -m�n.�2" S - -- = (ryPlcap Effluenl f�lller Mcxlel IP�---------- E _ - i 12" � min.Irench T�YPICAL TRFNCH ����'h � � , (�YPlcel) CROSS �ECTION VIEW _ ___ ___ _., . P�ov� � __._.___.- , . ,. • .. n �; � ' 'rnmum dc m� _ ". • . . separation helween U�enches. (No Scale) :�a��=4- - --I � . F----��yp�cap e � . �. � I-lighest Trench - ____—-- -------_ �___-.a.--- t_owest Trench(as applicable) r' �. ft; .�___...�.-....._._. ft �� {t; .�_.__.._._.,�.-- ft; __.____ System Elevations=� ��i��„�, ft; cautck4 St�andarci-W ObsorvallonPlpo TYPICAL TRENCI-I lryplcaQ w! Fnd C�p (Show loc�tion of inlet I outlet pipe connection on plan view.) Install p�r manufaciurer's P�AN VIEW --- (lyplC�]1) InstrucUons. �NO �Cc`1�E,'� -- — _ _- - - _- i ; ��� - - --- - _ -_ __ _ + , - -- --- -- �= 3.0 t �f- -- -- - - �__ - -- _ , t�! ; . ° � � ;, � ��y��c�al) � , : : °�, �. � - - �' �{ , , � __ . --`-- . �_ . ___ - -- - --• - _._ .�. _- - -��- - -- --- - - - -- -�f-- -- - --- - m � - f t ---- - ------------------ ----------...-�`� -------- -------. _ ....�e, C,� �"'- -- - Cluick4 Standard-W Charnber (typic��l) ��yp�cal) � (mfd by Inilltratar Systems,Inc.) � �NS'�"/��.L PER T(�ENGH: Inslall pursuanl lo manufacturers instruciions. .p. ----- -- 3�k� rt' �_ Quick4 Std-W @ I�f���S�Ichamber= � 6 ft2 EISA/pair= _ b ftZ + _ �a;rs of end caps a� ______ ._ 6�3 ftl Distribution Method: = Proposed �ISA per trench= 34b ftZ Required Infiltration Area= x Z trenches = Proposed Total EIS� _ �jC(Z. {(Z C'4J,� � PAGE�OF � i�-��Q�,��:c� �ravity Managerrent Pla� lMPORTANT: Tne owner or ih:s ir,-^yround grviry sys:em snal!be responsible:`cr i:s perpe:ua''�operaiior,and main;enar.ce pursuant to recuiremenis o?SPS 3823°4,Wisc.Admin.Ccde. Pursuant to SPS 383.52(2).GVisc.Admir..Ccde.this system shali be consicered��nu-:>n�ezii^.h.az�re ir^��ot maintanee ir�.accordance with this aoproved^�aragement plzn. , p��,r,errr;ore,�i;inspection ard�^��.airten�nce ac:ivit,es shall be pe�errn=d�y�registered POiNTS Maintainer i^. accord�^ce v✓iih SPS 383.52(3),Wisc.Admir.Code. Maximum Disqersa!Area Operatina Limits: Design Fiow= 3'fS� gpd; BODS<_220 mgL"'; TSS<_150 mgL''; FOG<_30 mgL"' tnspection Checklist €NSPEC 9 EVERY 3 YEARS „ type cf use � c age of sys:em o� ru:ssnce?a�tors;Le.odors,�ser compiaints;etc.) o mec^2^icai maliunc�cn(r.e.,oumps:valves,switcres,loats,etc.? o metenall2iioue(i.e.,!e2ks,breaks,corrosion,etc.)� o soiids volume in anaero5ic:reatment tank(s)and any distribu:ion appurtenance(sj(i.e.,distribution/droo boxes) o r.eglec:cr improper use(i.e.,=xce=ding design capacities,prohibited activites,efc.) o extent o*oonding ir�.distnbuuon celi pnor tc dosing c dosir,g irregu!erities-if 2pF��cable�r.e.:pumo re-cycling,float switch settir.gs,etc.) o electriczi compenen:s-:?2eplicable(i.e.,wiring,connectiors,switches,controls,:imers,alarms,etc.) o distribu�icn lateral or!a�erai cr.fce pluggir.g (meesure latera:distal pressure—compare tc design specification) „ ;uriGce dischzrge o'eir��en!or sewzge b2ck-up inte structure served Maintenance Checkiist MAINTAIN EVERY 3 YEARS(or when necessary) o Sectic and d_ os�_tank(s)shG�!be pumped by a ce�i,ied sep:2ge sevicing ooeraior licensed u�der s.281 48 Wis. Stats.when the vol�me of soiids in the tank(s)exeeeds one-third('l/3)the liquid vokume of the tank(s)or as reauired by:cc2i ordir.z^ce. D'sposal ci cortents sha!1 be pursua^:tc NR':�3,Wisc.Admin.Code. � Effluent filter{sl sha!!be irspe�ted every 3 years and snal!be Geaned when necessary to remove any accumula:ed soiids accordirQ tc mznuTzCure�s soecifcators. A servicirg oenod will always be greater t�an'I2 mc.^.ths. System maintenance reports sFali be submitted te:he proper loca!govemmerrt unR in aecordance with SPS 383.55 Wisc.Admin.Code. Report any ccmncnert failure or matfunction to: Q�3 � n�� cc b^r�e. ��l�q Phene:-!I S-��t- Narneo'individua!orcorpzny � _63�{ gZgg � Phone: �s :pcaigovemmer.tunit Sc�l,u�tt`r 1..0 �O✓t,.�iG �ocal govemrner.t unit address: l D�J(C t✓�,2�.� S'�"� �-l�i !-�H wQ.r� Le.�iQ: S—'-E�`f-3 Any deTecTve part of this sys:em s'r:�li be repzired,rep!aced,or removed pursuar.t to SPS 383.51('),Wisc.Admin. Code.Repair er rep!aceme^:e`:r2ile�or m�isunctioring componenis sh211 compry wi?h SPS 383,Wisc.Admin.Code. Ne oreduct for chemica!or p^;ysicai restora*(o.^.o�:ha I'OWTS m2y be used unless approved by the departmer.t n accordance with SPS 38?,W!sc.Acm:n.Cece. Contina___.?n�V p�a� In:he eveni;nat any rziled treat^en:compo^e^:o��his?OWTS cannoi be repaired,it shail be reolaced oureuart to a plar.s:;bmi'ed:o*.ne approoriafe age^cy rer r=v;ew 2nd approva:. A fai!ed in-grourd dispersal component may be abzndened and reol2ced by a code-complying dispersai comooneri in a pre-detenrined area of suitable soils. Svstem Abandonment li use et`.nis FO�S is ci;cont;^ued,i:s!�a!be abandoned in acccrd2nce wi;F.SPS 383.33,Wisc.Admin.Code.