HomeMy WebLinkAbout032-540-14-1401-SAN-2024-073 '� ' Industry Serviccs Division County (/1
� , 4822 Madison Yards Way Sa�/�/er _ �
- _ S - MadisOn.W[53705 Sanitar}'Pcnnit?�umbcrlto br tillyd in by C'u_I �
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Madison.WI 53707 '�0 5+ ��� �
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titatc Ti�in,acliun�umher
Sanitary Permit Application �,/ �/� �
In accordance with SPS 3R3.21(2),Wis.Adm.Code,submission ofthis torm to the appropriate govemmenWl unit ����/I��W���"� �
is rcquired prior to obtaining a sani[ary permiL Note:Application forms for stx[e-owned POWTS are submit[cd to ('ruj��ct A�Idre,��if dif fcrcnt than mailin�nddress� .-..�
thc Department of Safcty and Prolessional Seivices.Personal infbnnation you provide may be uscd for secondary 5360 W Lo Lod e Rd U'
purposes in accordance with the Privacy Law,s. 1�.04(I)(m),Stats. � �
I.Application Informarion—Piease Print All Information
Prope�ty O���ner's Namc Parcel#
James Smiley 032540141401
Proper[y Owncr's Mailing Address PropertY Location
W8663 Koshkonong Manor Dr ►°4ffi
City.Statc 7ip Codc Phone T�umbcr
Ft. Atkinson WI 53538 SE �,, NE �;q, Se��;�,,, 14
II.Type of Building(check all that apply) ���� T 4'0 1�1 rt 5 l,or w
�I or 2 Family Dwelling-Numhcr ufBcdrooms�__ 2 Suhdivision Namc
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Slock t1
�'ublic/Commercial-Describe Use
"�— �City of
❑State Owned-Describe Use CS:N Number illagc of
24/53 #6502 pT�µ��f Winter __
IIT.Type of POWTS Permit:(Check either"New"or"ReplacemenY'and other applicable on line A. Check one box on line B.Complete line C if
a licable.)
n.
�New Systetn nlZeplacement System ther Moditication to Gxisting System(erplain) �Additional Prencatment L'nit�explain)
L_I
R' �llolding Tank �In-Ground �t-Grade �Mound X Indi��idual Si[e Design Other Type(explain)
I conventional�
C• �Kenewat Be�brc �Re�ision 'hange of Plumber �I r�n;irr to Nc���(hvner
I,ist Previous Pemiit Number and Date Issued
Lxpiration —'—
N.DispersaUT'reatment Area and Tank Information:
Design FioH�(gpd) Design Soil Application Rate(gpd/st) Dispersal.4rea Requircd(sf� Di,persal Arca Proposed(sl) Svstem Elevation
450 1 450 450 100.23
Capacity in Total tt of Manufacturer
Tank Information Gallons Gallons Units L � c ? �
�cw�Tanks Existing Tanks '+`� c c� f
` ` � � :� �
cL U cn � v; i� t7 F.,
SepticorlioldingTank � /1(1(1 � (1/1(1 1 �/
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V.Responsibility Statement- I,the undersigned,assume responsibili or installado the POWTS shown on the attached plans.
Plwnber's Nxme(Print) Plumber's Signature �lI'!MPRS Number Business Phune Number
Dan Burch 253808 715.416.1642
Plumber's Address lStrcct,City,Statc.Lip Codc)
N5921 County Hwy K Spooner WI 54801
VI.C un /Department Use Only
�A(5 � ❑Disapprovcd 1'ermit Fee Date Issued Issuing Agent Signa[ure
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❑O���ucr Gi��cn Rcason for Dcnial $ ��' � ��%+'��tz-f�C4�-�tt/!/1,tp--�
Conditions of.4pproval/Reasons for Disapproval �-���':'� , ��� �.�
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Attach tu eomplete plans for the scs[em and submit[u the Counn�unk on paper not Iess th•an R�2 s 11 incheti in size
�"-�"� NO R�FiJNDS AFTER
sB�-�39s�R.o2i2z� ISSUE OF PERMIT
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Wisconsin Department of Safety and Professional Services �;� T'�� Phone:608-?.66-21 12
Division of Industry Services � � �% Web:htlp://dsps.N�i.�;ov
4822 Madison Yards Way ^ � 0� � Email:dsos(d:wisconsi�
PO Box 7302 ' � p '
Madison,WI 53707 % �a ^/ Tony Evers,Governor
0
�R„�. ���� Dan Hereth,Secretary
�.s.s,<��.�-
April 16,2024
CUST iD NO.: 1469067 Tdentification Numbers
DALE A SCHLIEVE Plan Review�No.: PWTS-042400h64-C
312 CONRO ST Application No.: DiS-042415185
RHiNELANDER, Wi 54501 Site iD No.: SiT-129072
Please refer to all identification numbers in each
correspondence with the Department.
CONDITIONAL APPROVAL
Condrfionally
PLAN APPROVAL EXPiRES: 04/16/2026 APPROVED
DEPT.OF SAFETY AND PROFESSIONAL
SERVICES
MUNiCiPALiTY: o�visior,oF�N STRY SERVICES
TOWN OF WTNTER
SAWYER COUNTY
SEECORRESPOND CE
SiTE: �„,6���<
SMILEY HOLLTNGER
5360 W LOG LODGE RD
WINTER,WI 54896
SEl/4 NEI/4 S14 T40NRSE
FOR: REViSiON—Distribution media
Design Wastewater Flow Value: 450 Mound Component Manual -Version 2.1 (May 2022-2027)
Bedrooms: 3 Pressure Distribution Component Manual -Version 2.1
Limiting Factor(s): 26 Tnches (May 2022-2027)
Maintenance Required: Effluent Filter
SITE REQUIREMENTS
• A full size copy of tl�e approved plans, specifications, and tl�is letter shall be on-site duriug constiuction and open to inspection
by authorized representatives of the Department,which may include local inspectors. A Department electronic stamp and
signature shall be on the plans which are used at the job site for construction.
• The approved changes will become an addendum to the plans approved on 06/27/2022 under PWTS-062201345-C.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• A sanitary permit inust be obtained froin the county wllere this project is located in accordance with the requirements of Sec.
145.19,Wis.Stats.
• Prior to the constniction of the dispersal area, check the inoisture contcnt of the soil to a depth of 8 inches. Proper soil
moisture content can be determined by rolling a soil sample between the hands. If it rolls into a '/4-inch wire,the site is too
wet to prepare. If it crumbles,site preparation can proceed. [f the site is too wet to prepare,do not proceed until it dries.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the
designated county official in accordance�vith the provisions of Sec. 145.20(2)(d),Wis. Stats.
• A state-approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that
periodic cleaning of the filter is reyuired.
• All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5
• Insulate building sewer beyond 30 feet per SPS 38230 (11)(c)
• Well setbacks to meet chs.NR 81 1 &812
• Tank Installation to follow all manufacturer's recommendations.
• Verify property line(s)prior to installation.
i
OWNER RESPONSIBILITIES
• The current owner,and each subsequent owner, shall receive a copy of this letter including instiuctions relating to proper use
and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or
owner's manual for the POWTS describcd in this approval and Wis. Admin. Code � SPS 383.54(1).
• Tn the event this soil absotption system or any of its component parts malfunctions so as to create a health hazard,the property
owner must follow the contingency plan as described in the approved plans.
The submittal described above has been reviewed for conformance with applicable Wisconsin Adminish-ative Codes and Wisconsin
Statutes. The submittal has been CONDiTiONALLY APPROVED. This system is to be constructed and located in accordance with
the enclosed approved plans and with any component mai�ual(s)referenced above. The owner,as detined in chapter 101.01(10),
Wisconsin Statutes, is responsible for compliance with all code reqttirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,stats.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
Tn granting this approval,the Division of Tndustry Services reserves the right to require changes or additions, should conditions arise
making them necessary for code compliance. As per state stats 101.12(2),nothing in this review shall relieve the designer of the
responsibility for designing a safe building,sh-ucture,or component. The Di��ision does not take responsibility for the design or
construction of the reviewed items.
Tnquiries concerning this correspondence may be made to me at the contact information listed below,or at the address on this
letterhead.
Sincerely, Fee Required: $85.00
Fee Received: $85.00
���� ����/J Balancc Due: $0.00
G Refund Ex ected: $0.00
Katie Petzel
Division of industiy Services
Phone: 608-574-1 189
Email: katie.petzel(u;wisconsin.gov
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN
(� —. . il r� ��'� �� • Page � of �
FILE INFORMATION (? � ��� � C� �
�____ SYSTEM SPECIFICATIONS
j Owner: � � ����1 Septic Tank Capacity � (��O gal NA
� t
Permi{k Septic 7ank Manufacturer �'�/� ('�,�� NA
DEStGN PARRMETERS ; Effluent Filter Manufacturer L � � NA
! Nur mber of Bedrooms ❑ NA Effiuent Filter Model � (� .. ❑ NA
' Number of�ublic Facility Units �NA Pump Tank Capacity (�� ❑ NA
Estimated flow (average) C C� gal/da Pump Tank Manufacturer ^ � � ❑ NA
� Design flow (peak), ( Estimated x 1.5) — ga�/day Pump Manufacturer "�,.,�� -� ❑ NA
� Soil Application Rate , �
gal/day/ft= Pump Model 1 '�"�� ^ ❑ NA
I Standard Influent/Effluent Qua{ity Monthiy average• Pretreatment Unit �NA
; Fats, Oil &Grease(POG) <_30 mg/L ❑SandJGravel fifter ❑ Peat fiiter
i Biochemical Oxygen Demand(BODs) <_220 MG/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
� Total Suspended Solids(T55) <_150 mg/L ❑ Disinfection ❑Other:
i Pretreated Effluent Quality Monthly average Dispersal Cetl(s) ❑ NA
Biochemical Oxygen Demand (BODs) >30 mg/L ❑ In-Gro�nd (gravity) ❑ In-Ground (Pressure)
I
� Totai Suspended Solids (TSS) <_30 mg/� �NA ❑At-Grade ,�'Mound
; Feca�Coliform (geometric mean) � 510°mg/L ❑ Drip-Line ❑ Other:
iMaximum EfFluent Particle Size NAn dia � Other: A
�
! Other: �NA Other. �NA
� --
"Value typical fnr domestic wastewater and septic tank effluent. � Oth2f: �NA
MAtNTENANCE SCHEDULE
� Service Event Seroice Frequency
I Ins ect canditions of tank s At least once eve month(s) (Maximum 3 ears
P ( ) ry' � ❑year(s) Y ) ❑ NA
� Pump out contents oftank{s) When combined sludge and scum equafs one-third(1/3� of tank volume
Ins ect dis ersai cell s At least once eve month (s)
P p ( � ry: 3 � (Maximum 3 years) ❑ NA
�__ year(s)
I Clean effluent filter At least once every: 9 ,�month (s) � NA
___. _ 1 year(s�
inspect pump, pump controts&alarm At least once every: ( 3 �month (s) � NA
year(s)
1 Flush laterals and pressure test At least once every: t� month(s) � NA
year(s)
i Other: ❑month (s)
i At least once every: �y ( � NA
ear s
MAINTENANCE �NSTRUCTlONS
Inspections of tanks and dispersal cells shall be made by an individuai carrying on of the following licenses or certifications: Master
Plumber; Master Plumber ReStricted Sewer: POWTS Inspector, POWTS Maintainer, Septage Servicing Oparator. Tank inspections must
include a visual inspection of the tank(s) to identify any missing or broken hardware, Identify any cracks or leaks, measure the volume of
combined siudge and sum and a check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shali be visuaiiy
inspected to check the effiuent levels in the observation pipes and to clieck for any ponding of effluent on the ground surtace. The ponding
of effluent on the ground surface may indicate a falling condition and requires the immediate notification of the local regulatory auihority.
When the combined accumulation of siudge and scum in any treatment tank equals one-third (1!3) or more of the tank volume, the entire
Contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
Administrative Code.
All other services, induding but not Iimited to the servicing of effluent filters, mechanical or pressurized components, pretraatment units,
a�d any servicing at intervals of= 12 months, shall be performed by a certfied POWTS Maintainer.
A service report shall be provided to the locai regulatory authorfry wfth 30 days of completion of any service event.
L/�
START UP AND OPER4TION
For new construction,prior to use of the POWTS check Ueatment tank(s)for the presence of painting products or other chemicals that
may impede the treatment process and/or damage the soil dispersal cell(s).If high conceM2tlons are detected have the contents of the
tank(5)removed by a septage senncing operator pnor to use.
System start up shall not occur when soii conditions are frozen at ihe infiltrative surface.
Dunny entended power outages pump tanks may fill above normal hlghwater levels.When power is restored Ne excess wastewater will
be dischargetl to the dispersal cetl(s)in one iarge dose,overloading tha cell(s)end may resWt in fhe backup or surface discharge of
effluent.To avoid this sRuation have the contents of ihe pump rank removed by a Septage Seroicing Operator prior to restoring power
to ihe effluent pump or contact a Plumber or POWTS Maintainer to assist in manuaily operating the pump controls to restore normal
levels wi[hin the pump tank:
Do not drive or park vehides over tanks and dispersal celis.Do not drive or park over,or othervvise tlisturt or compact the area within
15 feet down slope of any mountl or atyrade soil absorp6on area.
Reduction or eliminatlon of the foliowing from tha wastawater stream may improve tha peRormance and prolong ihe life uf Ihe POWTS:
anti6iotics;bay wipes cigaratte butts;contloms;cotton swabs;degreasers;tlental floss;tllapers;dlslnfectaMs;Fat;fountla[ion tlraln
(sump pump)discharge;fruit and vegetable peelings;gasollne;grease,herDidtles;meat scraps;metlica[ions;oll;palning protlucts;
pesticides;sanitery napkins;tampons;antl water softener btlne.
ABANDONEMEN7
When the POWTS Yails and/or is pertnanantly taken oul of service fhe following steps shall be taken�o insure that M system is propeAy
antl safely abantloned in compliance wiN chapter SPS 383.33,Wisconsin Atlministra6ve Cotle:
. All piping to tanks and pits shall be diswnnectetl and the abandonetl pipe openings seaied.
• The contents of all tanks and pits shall be removed and properly disposed of by a Sepfa9e Servicing Operelor.
• After pumping.all tenks and pits shall be exwvatad and rcmoved or their covers removad and the void space filled with soil,
graval or another Inert solid matarials.
CONTINGENCV PLAN
if the POWTS fails and cannot be repaired Ihe tollowing measures have been,a must be taken,to provide the code compliant
replacemen[system:
❑ A suitable replacement area has been evaluated antl may be utilized for the location ot a rep�acement soil abso�ptlon system.
The replacement area should 6e pmtected fiom disNrbance and compadion and should not be infinged upon by requiretl
selbacks from exs[ing and pmposed structure,lot Ilnes and wells.Failure to protect the replacement area will result in the
neetl for a new soil and sRe evaluation to establish ihe suitable replacement area.Replacement systems must comply wiTh the
rules in effect at the fime.
❑ A 5uitabie 2placement area is not available due to setback anNor soil limttations.Bamng advances in POWTS tachnology,a
holding tank may 6e installed as a last resort to replace the Failed POWTS.
❑ The site has not been evaluatetl to identify a suitaCle replacement area.Upon failure of the POWTS a soil antl site evaWation
must be performetl to loqte a suitable replacement area.If no replacement area is available a holding tank may be installed
as a last resort to replace the failed POWTS.
�Mound antl atyraae soil absorption systems may Oe reconstructetl in place following removal of the biomat at the infiltrative
surtace.Reconsiruc➢ons of such systems must comply vnth the rules in effed at that tlme.
«WAftNING» t ���
SEPi1C,PUMP AND OTNER TREATMENT T!t �AW��AIN LETHAL GASSES ANDlOR INSUFFICENT OXVGEN.DO NOT
ENTER A SEPTIC,PUMP OR OTNER TREA�E��T1fN1�I�ADG�bt ANV CIRCUMSTANCE.DEATH MAV RESUIT,RESCUE OF A
PERSON FROM THE INTERIOR OF A TAt¢(�S:VF$���IG�ICIit�OR IMPOSSIBLE.
ADDITIONALCOMMENTS: � ! SCHLIEV =
� E =
POWTSINSTALLER � POWTSMAINTAINEN
Name `` Name --- �
{�if1!-}
�rho�e --7 ,5_e�!�-�b�[-? —� on��—
SEPTA�_E SERVICING OPERATOR(PUMPER) IOCAL REGUUITOR IIGENCY
'I....... .,..... —�
F _—_-. .-_. _ _�_- UI"GI(.{Z. f.��
i Phone � . _ .'� � ... . � ohone����6?/1' '��O
� �]`T z�
This da�vment was daketl in rompllance w2h[haple�SPS 383.22�2)@)Ill(d�&(�a�W 383.59�1�,�])&�3f,Wiuonsin Adminisint've Code.Revisetl 3/29/13
TOTAL DYNAMIC HEAD "
FLOW PER MINUTE �ILL PUMP PERFORMANCE CURVE
MODEL 151 f 152/153
w
MODEL 151 152 153 „ 45 ��
Feet �leters Gal. L'rters Gal. Liters �aL L@ers
5 1.5 50 189 fi9 201 77 291 1z 40 - -
10 3.0 45 170 67 237 70 265
15 /.6 38 144 53 207 51 23/ Q �-'` 152
20 6.1 29 11Q 44 16' 52 191 = �a
:5 7.6 76 67 34 i29 42 755 i 30
30 9.1 — — 23 87 33 125 � � � 151
;i5 10.7 — — — — 7Z 85
a
40 12.2 — — — — 11 42 o S p —
ShutoffHead: 30tt(8.tm) 38R(11.6m) 44ft.(13.4mJ
15
4
t0
5
0
10 20 30 40 50 60 TO 80 90 70D
G/1LLON5
lf7ERS p �10 80 t.� 160 2[10 240 280 320 3E0
PLOW PER MINUTE masm
MODEL COMPARISON
Model
Seaf MOde VOFtS Ph Amps FIP Hz 1-b�s KQ Simplex Duplex
N151 Single Non 115 7 6.0 1J3 60 32 i5 1 2or3
E757 Single Non 230 1 3.2 7/3 60 32 15 1 2 or 3
BN757 Sinple Auto 175 7 6.0 tA 60 33 75 • 2or3
BE757 Singie Auto 230 t 92 1� 80 33 16 " 2 or 3
Ni52 Single Non 175 1 &5 M70 60 37 77 1 2or3
E752 Single Non 230 7 4.3 4/70 8Q 37 17 1 20r3
BNt52 Singla Auto 115 1 8.5 MiU 60 39 SB ' 2or3
BE152 Single Nan 230 1 A3 4l70 60 39 18 ' 2 or3
N753 Single Norr f75 1 10.5 72 � 37 17
BN753 Single Auto 175 1 10.5 1@ 60 39 18 • 2or3
E753 Single Non 230 t &3 1/2 80 37 17 1 2or3
BEi53 Single Non 230 .. 7 5.3 trz 60 39 � t8 . . . ' 2or3
*BN a�d BE mode�indude a 20'(6 m)piggybadc variabie level pump svritrh. Addrtia�a�cad laz�hs are avaitable 4u�25'(8+n1 and S'(ti mi.5U'it5 ml cords are
available ior 230 V utNts only.
NOIE�Mode1151 has a P�es�c base.�752&753 heve a cast Ga+bsse.
SELECT/ON GU(DE
1. For automatic use single piggyback vanable �evei tioat swrccn or aoubie ptggybsc�c variaeie ievei noac swncn.
Refer to FM04Tl.
2. See FM7228 far correct modei of simpiex conirol panel.
3. See FM0772 for corr�t mode! of duplex coatrol panel.
�CAUTIOh �� 'natallation of controls,protection devicec and wiring shouid ba done 6y a aualified licensad elec[rician. All elec[rical and safaty codas should 6e
foliowad includine me most receni National Eteetrieel Code WEC)end ths accupationai Safery and HaaRh AcI 10SHA).
�CapyrigM 2014 Zoellerm Co.Ai)�ghts reserved.
502-778-2731 ( 806-92&7867 � 3699 Cane Run Rond � Lpu�ville, KY 40211-9 9 61 � wWw-zoeHer.com
4/16124,3:46 PM Real Property Lisling Page
R2dl EStdte Sawyer County Property Listing Property Status: Current
Today's Date:4/16/2024 Created On:2/6/2007 7:56:00 AM
�'Description Updated:9/7/2011 �Ownership Updated:6/6/2019
Tax ID: 35689 ]AMES L SMILEY FT ATKINSON WI
PIN: 57-032-2-40-OS-14-1 04-000-000010 TAMIKA T HOLLINGER Ff ATKINSON WI
Legacy PIN: 032540141401
Map ID: .4.1 Billing Address: Mailing Address:
Municipality: (032)TOWN OF WINTER JAMES L SMILEY ]AMES L SMILEY
STR: 514 T40N ROSW W8663 KOSHKONONG MANOR RD W8663 KOSHKONONG MANOR RD
Description: PRT SENE LOT 2 CSM 24/53#6502 FT ATKINSON WI 53538 FT ATKINSON WI 53538
Remrded Acres: 14.680
Calculated Acres: 14.685 �Site Address *indicates Private Road
Lottery Claims: 0 5360W LOG LODGE RD WINTER 54896
First Dollar: No
Waterbody: Fishtrap Lake .J property Assessment Updated:10/SO/2016
Zoning: (R-1)Residential One 2024 Assessment Detail
ESN: 421 Code Acres Land Imp.
G1-RESIDENTIAL 14.680 89,000 0
�Tax Districts Updated:2/6/2007
1 State of Wisconsin Z-Year Comparison 2023 2024 Change
57 Sawyer Counry Land: 89,000 89,000 D.0%
032 Town of Winter Improved: 0 0 0.0%
576615 Winter School Distrid Total: 89,000 89,000 0.0%
001700 Te�hnical College
• Recorded Documents Updated:6/6/2019 ���property History
SPECIAL WARRANTY DEED N/A . .... ............. ............. .
Date Recorded:5/31/2019 418000
LETTERS
Date Remrded:5/31/2019 417999
CERTIFIED SURVEY MAP
Date Recorded:11/6/2002 305051
WARRANTY DEED
Date Recorded:5/20/1999 276552 672/496
https://tas.sawyercountygov.org/system/frames.asp7uname=Eric+yi/ellauar 1/1