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Home My WebLink About020-639-06-2207-SAN-2024-068 `�pART�I{l� COUII�y � �--�, Department of Safety '�� & Professional Services, S°`"''' e� � �„�, � ��==1 �� a�a �j Sanita�y Permit Numbcr(to be tilled in by C `, � Industry Services Division ' ` t�S i �7(o I R' �>-, -c �� Statc'Cransaction Number � Sanitary Permit Application _ � In accordance with SPS 383.21(2),�Vis.Adm.Code,submission of this fonn to d�e appropriate governmental unit �'p is required prior to obLaining a sani4uy permiL Note:Application forms foi'stale-owned POWTS are submitted to Project Address(if differcnt than mailing add��e„) the Department of Safety and Professional Services.Personal infonnation you provide may be uscd for secondary puiposes in accordance with the Privacy Law,s. 15.04(I)(m),Stats. �y 9 ��(� �W G Ge1 G�l � I.Application Information-Please Print All Information ProperTy Owner's Name Parcel# .SGo�} + Ti ��a�� Kl�r� et- C�aO- (o39- O(�-�ZO'7' Property Ownet's Mailing Address Property Location 9SG 1�'7�''� Sk ��,��"k City,State 'Lip Code Phone Number �Gt m r►�o n e�, W T S`�O i S __�1.1�J �i<,_.N�1__'i�, seo��>„ C�� II.Type of Building(check all that apply) Lot# T N R O(o W �I or 2 Family Dwelling-Number ofBcdrooms_ _ _� _ � Subdivision Name �—� Block# ❑ Public/Commercial-Describe Use �� ❑City of ❑State Owned--Dcsa�ibe Usc CSn4 Number ❑Village of_ GS►-� t� �9 9 O ,1�(r<,�i,�,�,t D�;b�. — — -- v. ia ,a"75 IIL Type of POWTS Permit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Coinplete line C if a plicable.) A �New System 1 Y o ❑ Re�lacement S stem U Other Moditication to Existina System(explain) ❑ Additional Prelrea[men�Unit(explain) B. �Holding Tank ❑ In-Growid ❑ At-Grade ❑ Mound ❑ Individual Site Design ❑ Other Type(axplain) (conventional) ��• ❑ Renewal Before List Prc�ious Perntit Number and Date Issued ❑ Rcvision ❑ Changc ot�Plumber ❑ Transfer to New Owner I:xpiration N.Dispersal/Treatment Area and Tank Information: Dcsign I�low(gpd) Dcsign Soil Application Rate(gpd/st) Dispersal Arex Required(st� Di,persal Area Proposed(s� System Eleva�ion S� (DO /v (p, N I!k �v/q �V/A Capaciry in Tot�11 #of Manufacturer 'l�ank lnformation Glllons Gallons Units � � o "° � New Tanks Existine Tank. � � � � Y p � r a. U �n �, cn i t. C7 A- Sep�ic or Holdina Tank � - c�0 0 O ol Ooo � W� .�t r-�'ern t�t.!-�1 nG X Dosing Chambcr V.Responsibility Statetnent- 1,the undcrsigned,assume responsibitity fm-installation of the PO�Y7`S shown on tl�e attached plans. Plumbe�'s Name(Print) Plumbei's Signature MP/MPRS hwnber Bu,ines,Phone Numb�r T�av;s Q.,��c��'cicl G5� 8�9 �is-G3y-B�'7� Plumber's nddress(Sh�eet,Ciry,State,Zip Code) 1 y3 y 6 w rjkA�G Rb0.c� 77 �C�'yW Rrd� W= J��y3 VI.C unty/Department Use Only Pennit Fee Date Issued Issuing Agent Si�nature �A� o � ❑ Disappro�'ed � ��.� �I i �r� n n',^� �,� �-1 �.��y �r,i,�r��- ❑Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval ,..W.— .r.., ,T- - � . °� �nu;�'`j;��'{� � ,1� � � � � �:.3�t_r i� �� i �� . � , _ � �� ;��„ .;. ..- _ AF�R � 1 2024 €--�' �<*t . 3SIc _ _ _ � �51 N�� _ � SAWYER COUNTY � �C�� Q{�}pN4 ADMIN{STRATION Attach to complete plans(or the systero and suhmit to the County only on paper not Iess than 8 1/2 x I 1 inches in size NO REFUNDS AFTER SBD-6398(R.03/22) IS.SUE OF PEFiMIT ,�(7�J�'j j Sawyer County Zoning & Conservation Administration �� 11 10610 Main Street, Suite 49 � ER c p 1 � Hayward, Wisconsin 54843 ��'�i' ��Ci �� (715)634-8288 �Q `�� FAX (715)638-3277 � tq � ._, — _ _ � �( � www_sawycrcounlygov.�ir€ _ i i E-mail: sanitarian(a��sawycrcount��crv.cire �� ` '�y • � ��! Toll Frcc Courthouse/General Information 1-877-699-4110 I �2��, - ,_ � �?— �� i�\oN�� Holding Tank Approval Checklist I. Sanitary Cover Sheet: Date Stainp O `� / ( ( /� Parcel ID# c� � o _ � 3 9 - o � - � 2 0 7 II. Plot Plan: � Property Lines P(Benchmark BM ♦ � Site Address �North Arrow � Structure �Scale �Well �p < 25 ' to Service Road �Legal Description D�,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 Form ($30 to ROD) IV. Holding Tank Specifications: �1 Tank Cross-Section: Manufacturer: �`e�f Gallons: ��000 '>( Tank Anchor 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 Camponent Manual Reference: � Holding Tank Version 2. 1 (May 2022-2027) Owner: �-�;hy�T' Pluinber: �� g�,�; Application Review Date: �`( � lz I �`� POWTS Reviewer: � � , Name ��' �, (� Rev. 4/27/2023 Gcdential # CONCRETE HOLDING TANK DESIGN Single Tank Option INDEX AND TITLE SHEET Project Klinger-6982N Sweeney Ln Owner Scott&Tiffany Klinger Address 956 967th St Hammond,WI 54015 Legal Description NW 1/4,NW 1/4,Sea 06,T39N,R06W Township Ojibwa County Sawyer Subdivision Name CSM#2990 v.12,pg.275 Lot No. 2 Parcel ID Number 020-639-06 2207 Plan Transaction ID Number Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Designer Travis Butterfield Signature Phone No. 715-634-8176 License Num 652879 Date 03/27/24 Designed pursuant to: Holding Tank Component Manual For POWTS(Version 2.1) May 2022-2027 vers�on�.i(o�izz) Page 1 of 4 HOLDING TANK SPECIFICATIONS 1 Number of bedrooms Non-residential estimated flow(gpd) 2000.0 Minimum holding tank volume required (gal) 2000.0 Proposed holding tank capacity (gal) Wieser Concrete Inc Tank Manufacturer WLP2000-MR Tank model number Rhombus SJE Alarm manufacturer Tank Alert AB Alarm model number Tank Dimensions and Data Tank Anchor Calculations X for round tank 19430 Ibs Weight of tank and cover 36.0 Liquid depth below inlet invert (in) 1.10 Safety factor 8.0 Maximum depth of soil cover(ft) 13715 Ibs Weight of anchor required 53.0 Height (in) Outside 15.1 in Soil cover req. for anchor or 164.0 Length (in) Dimensions 3.4 yd' Concrete counter weight 96.0 Width (in) Only HOLDING TANK CROSS SECTION manhole cover with locking device and finished �vent cap junction � warning label grade box � I — �4"min y 12"min l`� �23 in. Manhole and vent locations T conduit � vent pipe �g^min. � tetherweight I — � ._._._`�._._._._. 12.0 in. building sewer � service � inlet bi�nd pi�g aiarm on Note: All tank joints, and ro seai joints between tank ouciec openings and piping are Electrical as per 24.0 in. sealed watertight. All NEC 300 pipe and vent materials and SPS 316 comply with SPS 384. 3 in. bedding under tank. Tank is anchored as necessary to negate buoyancy. Project: Klinger-6982N Sweeney Ln Transaction Number: Page 2 of 4 FiOLDli�C3 Ya4f��K SIY� P'LAN Project: Klinger - 6982N Sweeney Ln � �� ' Legal Description: NW 1/4, NW 1/4, Sec. 06, T39N, R06W i, Subdivision Name: CSM �2990 v. 12, pg. 275 Scale: 1" = 40 ft_� Parcel ID: 020-639-06 2207 Lot No.: 2 � - p le 40 � ��'1 x '�rJC� d cJ��. � c-e�e„1� Ccm C re�F�,c �-Fe� 1 c1 : neJ Tan1� Ch Dv�e lay W��e S¢ t' C.a•r� C i-e.a-e. �w C. , , (�. n ..,. '('a� p F (�/'vp G C L Y J��'0.K [ t � O t� , O C� F E !.�-�J . • �v 5�,��N E.� . � , . �� r �C�..� .11 � L`� r r ��„ Y �u&k `�µG �G� .� � �� J �t � � — r �� ~ �� -- \ 06G�� P`o�� \ ` � � . 7ro(��g `�� a�a`� � e8 ��ac� (��`�'9 �� \ ,��u �J�'e$a� \ cro Q�Q 6��c-� \ � �g4� a '�'�''� ' a 0 �/,�� P�?�� G�qj9 �\ . \ , �,� \ � . /r�`� \� M \ 6 , 1 � Transaction I.D.: Page 3 of 4 ' HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System(POWTS)has been designed,and is to be installed and maintained according to SPS 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 60 0 to 400.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance,induding 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 listetl in the current Service Contract must be called to empty the tank's contents and dispose of them in accordance with NR 193,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. S. 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 dlscontinued,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_....._.......___ .. Butterfield Inc Phone 715-634-8176 b.Service Provider........_..... ScotYs Septic Phone 715-634-7279 c.Co.Zoning or Health Dept. Sawyer County Zoning&Conservation Phone 715-634-8288 11. Project Klinger-6982N Sweeney Ln Transaction Number: Page 4 014 � D N53" AS 96" A REQD m 41�• _ ➢ Im z c w � ' D O � A m s\ � UP 40" 1 �� _� � 0 � 4" CAS � � � m � m I I � D A 3" 44" 6" � m m ➢ � � � r m � � o m � � 36" m � � � � � � � � o ? � m �' N I D N � A �P 38° � I m m n Q 4" CAS N c m A D m � � i z � � c . � � o n 39 r�- o m � n 1 c) D � 2 r r Z Z � —� � ZO Z Z O OD O r r ; -N1 T..� F D Z O � 1 1 Z Z n Z Srm r=�C) mfVl �N �� mZ Z ��c c� �c� � c� O�Z AZ RiQ��oz"—'>o o�a � `2 �o ox � m � =N yr�*tZ m y mOp Dp �Of� =�O� �r� � � �y Nm \ f*1 � D � � � � n ANC �� • mZ� .. • m� W � � D � c r � � _ .. z � vi-� I � ��rrn�cn�� .Svi N 3V1 zZ �ro >< z yo m cn �cn� �� A�Or�� `pA <� � � p � � U ZT. �� GJN f� Rl � C O' v NO� � ��m�� oOO CW � O � o m w c Q N �2 \ � m ' G) c mmr J.' O n m m � W � >� � � -Zi n� m Z y mjm o �� o � � D � o � a n s� Z �� C � O y r (�f-D O r p m � � � D m z m � m � � O W \ = Z � m n ti -< o A H y �t m � z � o° � Z Da o cn r D Q m .. m A � � A� O m VI Z � RI� O N '� GJ D .�i O�I A N -1 D Z T � � Z o � � � c�'i o v � C r D � Z � � ? � A r m o �J � O � Z Q �7 � O A � m v Z � Z � r m � \ � m WLP2000—MR WIESER COIICRETE DRAYM BY: SME SREV.� 4-� -0" PRE-POUR: � � SEPTIC MANUAL DATE: JANUARY 2010 OATE:. POST-POUR: W3716 US HWY 10 MAIDEN ROCK, W1 54750 � \ � REVISED JAN. 2010 800-325-8456 Fi�e xusaoo-uR HOI.DING TANK SERVICING CONTRACT Coi�tract Datc: p�{ / p� / aoa4 This contract is made between the Holding Tank O�vner and the Pumper. Holding Tanlc Owner's Name: Pumper's Name: sco}} �. T ► ��a�y I� l ; c,�e.r rjLo� � 'Pop�pe Parcel Identi�ication Number: (12 Digit Legacy ID) 0 0l� O - Co 3 �I - C� (o - � � U '�' 1. The ow�ier agrees to file a copy of Chis contract with the govermnental unit, Sawyer County, which has accepted and recorded with the Office of the Register of Deeds, the Maintenance Agreement for a Holding Tank rcquired under the Sawyer County Private Sewage System Ordinance for the issuance of a Sanitary Permit for thc installation of a holding tank(s). 2. The owner agrees to have the holding tank(s) serviced by the puinper and guarantees to permit the puinper to have access and to enter upon the property for the purpose of servicing the 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 equipinent. The owner further agrees to pay the pumper for charges incurred ii1 servicing the holding tank(s) as mutual ly agreed upon by Che owner and pwnper. 3. The pumper agrees to subinit to the Govermnental Unit, Sawyer County, a report for the servicing of the holding tank(s) as required tulder SPS 383.55, Wisconsin Administrative Code and the Sawyer County Private Sewage Systein Ordinance. The piunper 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 taiik; c. The site address of the holding tank; d. The date the holding tank was scrviced; e. The volumes in gallons of the contents pumped froin the holding tank for each servicing; £ The disposal sites to which the contents froin the holding tank were delivered. 4. This agrcement will remain in effect until the owner or pumper terminates this coiitract. I�i 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 new service contract with Sawycr County withiii ten (10) business days from the date of change to this service contract. Owner's Name: (Print) Owner's Signature: �onty one owner s,gnarure requirea� �Ca� 1��.t��(� i Pumper's Name: (Print) mper's Signature: 5 c� 1- + �o �p � S��- Pumper's Registration Number: 8 � � � 3 Rev. 03/26/13 4/12/24,9:04 AM Real Property Listing Page Real EStdt2 Sawyer County Property Listing PropertyStatus: Current Today's Date:4/12/2024 Created On:2/6/2007 7:5535 AM �Description Updated:2/7/2020 'r Ownership Updated:2/16/2024 Tax ID: �� 20999 SCOTT&TIFFANY KLINGER HAMMOND WI PIN: 57-020-2-39-06-06-2 02-000-OD0070 Legacy PIN: 020639062207 Billing Address: Mailing Address: Map ID: .6.7 SCOTT&TIFFANY KLINGER SCOTT&TIFFANY KLINGER Municipality: (020)TOWN OF OJIBWA 956 167TH ST 956 167TH ST STR: 506 T39N R06W HAMMOND WI 54015 HAMMOND WI 54015 Description: PRT NWNW LOT 2 CSM 12/275#2990 Remrded Acres: 0.730 �Site Address *indicates Private Road Calculated Acres: 0J69 6982N SWEENEY W COUDERAV 54828 Lottery Claims: 0 First Dollar: No -�Property Assessment Updated:8/20/2013 Waterbody: Chippewa Flowage 2024 Assessment Detail Zoning: (RR2)Residential/Recreational Two Code Acres Land Imp. ESN: G1-RESIDENTIAL 0.730 90,000 0 �Tax Districts Updated:2/6/2007 2-Year Comparisan 2023 2024 Change 1 State of Wismnsin Land: 90,000 90,000 0.0% 57 Sawyer County Improved: 0 0 0.0% 020 Town of Ojibwa Total: 90,000 90,000 0.0% 576615 Winter School Distrid 001700 Technical College (� tJ'Property History + Recorded Documentr Updated:2/16/2024 N/A WARRANTY DEED Date Recorded:1/5/2024 448011 QUIT CLAIM DEED Date Remrded:8/27/1993 237243 CERTIFIED SURVEY MAP Date Recorded:11/29/1988 211907 COVENANTS Date Recorded:8/29/1988 210661 https:lltassawyeroountygov.orglsystem/frames.asp?uname=Eric+Wellauer 1l1 � � � o � � N o y d � O W L � N � w `y � a F � U � U �w p � � W S Q � Q � �i m m O ¢ m `m_ N Z � V � � 1- = 2� } N � O d � � c c � >� � j w Z = x � E E � `m `m o o �" O K H O �n a � c c Q o. a 1- U U U a. � H � . ❑ ° r�• ;�a �� ^�`��"'`•,JI+1+�=��'�;!�v �'""'�'� `�`.�#��... •� ' # ?,}"�'��'�� * '�` � 4. �� „,�+-��',�t" � ..��.. . 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Return To:Sawyer County Zoning and Conservation Administration Recording Area-Leave Blank per s.59.43(2m) 10610 Main St.,Suite 49,Hayward,WI 54843 As an inducement to the County of Sawyer to issue a sanitary permit for a holding tank on the above-described property,the owner is responsible for the operation and maintenance of the holding tank, locking device, alarm and access, and agrees to conform to all applicable requirements of SPS 383,Wis.Adm. Code relating to holding tank management, including the following: 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) (ci), Stats., to have the holding tank properly serviced and to file a copy of the service contract with the governmental unit. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract,with the governmental unit within ten (10) business days from the date of change to the service contract. 2. The owner agrees to contract with a person licensed under Ch. NR 113,Wis.Adm. Code, who shall submit pumping reports to the governmental unit in accordance with SPS 383.55,Wis.Adm. Code, for the servicing of the holding tank. In the case of exemption under Section 281.48 (3) (d), Stats.,the owner shall submit the report to the governmental unit. The governmental unit may enter upon the property to investigate the condition of the holding tank when pumping reports may indicate the holding tank is not being properly maintained. 3. If the owner fails to have the holding tank properly serviced in response to orders issued by the governmental unit to prevent or abate a human health hazard as described in Section. 254.59, Stats.,the governmental unit may enter upon the property and service, or cause the tank to be serviced. Pursuant to Section 145.20(4)Wis. Stats., a governmental 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 agrees to pay all charges and cost incurred by the governmental unit for inspection, pumping, hauling,or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. 4. This agreement will remain in effect only until the governmental unit responsible for the regulation of private sewage systems certifies that either a soil absorption system that complies with SPS 383,Wis. Adm. Code, or a municipal sewer serves the property. In addition,this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property 5. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner.The owner shall subr�it 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 agreement to be determined by reference to the property where the holding tank is installed. -Onl ner si nature required- .ACKNOWLEDGEMENT Owner's S� State of:�,(�,(,��`1C.y) � County of: �,�y.c�C.� _ Owner's Name (Print): scribed and sworn to before me on this � �h ' � day of r , 20 a�� Date:/ ��F` _ � ne ^ � Not�r�r �xb Signature: Drafted by: ��o�$ bli Name: ' ' _ �or,.1�1 J4 T� � N`�i�ly com � n expires on: �;.� _ (� aC�?5_ O� SpqT��w�SV Personal information you provide may be used for secondary purposes[Priv' .04(I)(m)] Rev.09/29/23 Parcel 1:Lot 2 of Certified Survey Map No.2990 recorded in the office of the Register of Deeds for Sawyer County, Wisconsin,in Volume 12 of Certified Survey Maps,at Page 275,as Document No.211907,being part of the Northwest Quarter of the Northwest Quarter,Section 6,Township 39 North,Range 6 West,Town of Ojibwa,Sawyer County, W isconsin. Parcel 2: Together with and subject to a non-exclusive easement for ingress and egress over and across the presently existing driveways located in the Southeast Quarter of the Northwest Quarter of ihe Northwest Quarter, Section 6, Township 39 North,Range 6 West,Town of Ojibwa,Sawyer County,Wisconsin,for access to the town road as created by instrument recorcled in Volume 585,page 63,Document No.256303.