HomeMy WebLinkAbout002-940-14-2411-SAN-2024-076 _ ''' ' Department of Safety �°""ty SAWYER �
�� � & Professional Services, �
- � �� - Sanitary Permit Number(to be filled in by G
,,, _ , Industry Services Division
(r S � "1 (p Cv �
State Transaction'�lumber �
Sanitary Permit Application o,
[n accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit pW'I'S-0424006t14-C �
is required prior to obiaining a sanitary permit.Note:Application fortns for state-0wned POWTS are submitted to Project Address(iPdilFerent ihan mailin�adc �
the Dcpartment of Safety and Ptufessional Services.Personal information you provide may be used for secondary SAM E
purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. � �
I.Application Information-Please Print All Information
Property Owner's Name
Parccl t#
BOLITHO TRUST 002 940 14 241 1
Property Owner's Mailing Address
8766N WOOD TRAIL Govt.Lot NA
City,Slate Zip Code Phone Number
HAYWARD,WI 54843 �� NW '/,, Section 14_
II.Type of Building(check all that apply) �1 Lot# T 4� N R 09 �`or W
�or 2 Family Dwelling-Number ofBedrooms_ L 2 Subdivision Name
B�ock# NA
❑Public/Commercial-Desc;ribe Use NA
❑City of
❑State Owned-Describe Use CSM Number �Villagc of
�, BASS LAKE
V37 P180
III.Type of POW"CS Permit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C if
a licable.)
A- �w System X Replacement System Othcr Modification to Existing System ( p )
❑ Additional Nretreatment Unit ex lain
(e�lain) ADD FILTER IN PUMP TANK
B.
❑ Holding Tank (n-Ground ❑ At-Grade ❑ Individual Site Design ❑Other Type(explai�)
(conventional)
C- ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner List Previous Permit Nutnber and Date Issued
Expiration
210049/ 11-12,1993
iV.DispersaUTreatment Area and Tank Informallon:
Design3OO(gpd) Design Soil�pplication Rate(�dis� Dispersal Area Required(s� Dispersal Area Proposed(sfl System Elevation
� 150 195 98.00 FT.
Capacity in Total #of Manufacturer
Tank Information Gallons Gallons Units 9 � o ,b, _
New Tanks Ezisting Tanks w � � � y v � v
� o � � ac � �a
a U �n �; in ii C7 a.,
SepticorHolding7'ank �� o00 1 WIESER
Dosing Chamber 500 500
V.Responsibility Statement- 1,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name(Print) PI r's Signatu MP/MPRS Number Business Phone Number
RYAN TRAND 798301 715-558-1673
Plumber's Address(Street,City,State,Zip Code)
10571N TOWN INDUSTRIAL PARK ROAD, HAYWARD, WI 54843
VI. ounty/Department Use Oaly
i[1,fY pro d ❑Disapproved Permit Fee llate Issued Issuing Agent Signature
/�� O
Y"`� ❑Owner Given Reason for Denial $ ��' � �' � � '�� frL,�f-�� - "�'�
Conditions of Approval/Reasons for Disapproval r� `,�;,^,; �� . � -
'','"f M � �� �._�...�.-�,.� p � ._... �
��w �� �,�',,. _ --- Q�F� � 5 ��� ` �/
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.5,��� _. ._._... __='
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Attach to complete plans for the system and submit to the County oNy on paper not less than 8 i/2 x I1 inches in size
N�REFUND6 AFTER
SBD-6398(R.03/22) ISSUE OF PERMIT y� 3�-j�
\`;p�Hl\I/;�
Wisconsin Department of Safety and Professional Services �� ��� Phone:608-266-2112
Division of Industry Services �%\ SP_�-._—:�--
� � ` Web:hu /ds �wi ov
4822 Madison Yards Way r ��� � ������ Email:�1:��s'«��_i.rui�in.,��c
PO Box 7302
Madison,WI 53707 �J J � a %;%� Tony Evers,Governor
, �_j.i
k,, _ �r� Dan Hereth,Secretary
��ssiu�.��/
April 8,2024
CUST ID NO.: 224832 tdentification Numbers
MARY JO HUPPERT Plan Review No.: PWTS-042400604-C
25720 FIREFLY LANE Application No.:D[S-032413421
WEBSTER,WT 54893 Site ID No.: SIT-128539
Please refer to all identification numbers in each
correspondence with the Department.
CONDITIONAL APPROVAL
co�arr;o�,a�ry
PLAN APPROVAL EXPIRES: 04/08/2026 APPROVED
DEPT.OF SAFETY AND PROFESSIONAL
MUNICIPALITY: SERVICES
TOWN OF BASS LAKE DIVISION OF INDUSTRY SERVICES
SAWYER COUNTY
STI'E: � �F'"'C�%?rL�.-��
BOLITHO TRUST
8766N WOOD TRAIL SEE CORRESPONDENCE
HAYWARD,WI 54843
SE 1/4 OF THE NW 1/4,S14,T40N,R09VV
FOR:
Design Wastewater Flow Value: 300 Geomat Mound Component Manual- 5/18/22
Bedrooms• 2 Pressure Distribution Component Manual -Version 2.1
Limiting Factor(s): 24 inches (May 2022-2027)
Maintenance Required: Effluent Filter
SITE REQUIREMENTS
• A full size copy of the approved plans,specifications,and this letter shall be on-site during construction and open to inspection
by authorized representatives of the Deparhnent,which may include local inspectors. A Deparhnent electronic stamp and
signature shall be on the plans which are used at tbe job site for construction.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• This system is to be constructed and located in accordance with the approved plans,and the"Geomat Mound Component Manual
for POWTS(5/18/2022)".
• The pressure network is to be constructed in accordance with publications`Pressure Distribution Component Manual for POWTS
(Version 2.1);(May 2022-2027)"and/or the sizing methods of publication"SSWMP Publication 9.6 Design of Pressure
Distribution Networks for ST-SAS(O1/81)".
• A sanitary permit must be obtained from the county where this project is located in accordance with the requuements of Sec.
145.19,Wis.Stats.
• Prior to the construcrion of the dispersal area,check the moisture content 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.
lf it crumbles,site preparation can proceed.If the site is too wet to prepare,do not proceed until it dries.
• lnspection of the private sewage system installation is required.Arrangements for inspection shall be made with the designated
county official in accardanee with the provisions of Sec. 145.20(2)(d),Wis. Stats.
• _� tit;il�°-:1� t';��>>�'�� i�liu�'�II !I�i�T 1� 1����l!11�<<�. �-j.11C�1(eI]illl�e' Ifl���l'f?11111U1i 1111IS) hC !�1A��(11l)thl(��1�ill'!-if( 'ili i�i'lh :A����1l171t1_' lh£1T
�,cri���ii�� �l�..inin,_t�i�t,v� i�ilter i� rr��uar-�tl.
• All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5
• Insulate building sewer beyond 30 feet per SPS 382.30(1 l)(c)
• Well setbacks to meet chs.NR 811 &812
• Tank Instaliation to follow all manufactwer's requirements.
• Verify property line(s)prior to installation.
• Pump Floats to be set and verified per the approved plan.
• Preserve dispersal area prior and during construction to avoid disturbance,compaction and use of the site.
• Any tall grasses,leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting
under the dispersal area. All loose organic material to be removed from POWTS Dispersat Area.
Recore
• The following must be completed in addition to any comments made from the County inspector:
a. Remove excess/overgrown vegetation from mound,mow and remove clippings.
b. Pump out any standing wastewater through observation pipes.
c. Permit dispersal area to dry out.
d. Pump out septic and dose tanks.
e. Remove and stockpile topsoil from the mound system.
f. Remove cap soil and stockpile.
g. Remove aggregate from absorption area(s)and dispose of in approved manner. It cannot be re-used.
h. Remove distribution pipes and observation pipes. Dispose of properly.
i. Remove end cap markers if present and dispose of properly.
j. Remove clogged sand plus an additional 3 inches of clean sand and dispose of properly. This sand cannot be re-iised.
k. Sample remaining sand at severai locations to assure it meets ASTM Specification C-33 for fine aggregate. If thc
sand does not meet ASTM Specification C-33 for fine aggregate,it must be removed down to the natural soil.
Install replacement mound system using procedure outlined in the approved Geomat mound system component manual,5/18/22.
• Jar test should be performed to ensure ASTM C-33 sand was used under prior installed mound. If not the
entire mound sand component must be replaced per Geomat requirements.
• Ensure the existing septic tank is watertight, structurally sound and baffles are in place.Any changes made to the tank must be
approved by the manufacturer. The Sawyer County Zoning Dept.may require an evaluation of the existing tank be completed
prior to issuance of the sanitary permit.
OWNER RESPONSIBILITIES
• The cunent owner,and each subseyuent owner,shall receive a copy of this letter including instructions 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 described in this approval and Wis.Admin.Code � SPS 383.54(1).
• ln the event this soil absorption 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 Administrarive Codes and Wisconsin
Statutes. The submittal has Ueen CONDIT10I�1ALLY APPROVED. This system is to be constructed and located in accordance with
the enclosed approved plans and with any component manual(s)referenced above. The owner,as defined in chapter 101.01(10),
Wisconsin Statutes,is responsible for compliance with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by tl�e Department per s.145.06,stats.
All permits required by the state or ttie local municipality sball be obtained prior to commencement of
construction/installation/operation.
in granting this approval,the Division of Industry 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,structure,or component. The Division does not take responsibility for the design or
construction of the reviewed items.
Inquiries conceming this correspondence may be made to me at the contact information listed below,or at the address on this
letterhead.
Sincerely, Fee Required: $250.00
Fce Received: $250.00
Balance Due: $0.00
�;-'`� ' Refund Ex ected: $0.00
��{��
Timothy Zoromski
Division of Industry Services
Phone:
Email: timothy.zoromski@wisconsin.gov
GeoMat NOUND AND PRESSURE DISTRIBUTION COII�ONENT�SIGN
INDEX AND TITLE PAGE
�M111@��flf0
Project Name BOLITHO TRUST .
Owners Name: (SAME)
Owner's Address: 8766N WOOD TRAIL
HAYWARD.WI 54843 __- -----
Property l�o
Property Address: 8766N WOOD TRAIL
Legal Description: SE NW S 14 T 40 N R 9 W
Township Bass Lake Counry: Sawyer
Subdivision Name: NA
Lot Numbec 2 Block Number NA CSM# 37/180
Parcel I.D.Number 002 940 14 2411
Pfan Transaction No.
Index Pages
Page 1 Index and title Page 9 Tank cross sections
Page 2 Data entry Page 10 Site Diagram
Page 3 GeoMat mound drawings Page 11 Soil test
Page 4 Lateral and dose tank Page 12 Soil test
Page 5 Distribution media Page 13 Soil test ���L: rp��
Page 6 System maintenance specifications Page 14 Soil test �8
Page 7 Management and contingency plan Page 15 Soil test
Page 8 Pump curve and specifications P�1�� � ��_2 ,�,
MARY JO HUPPERT License Number: 1859-007
Date- ., 03/25/24 Phone Number. 715-426-�775
...,�... ��_
.�:�,ignature` "v k�
=� Ue�igner Stamp State of Wisconsin Approval Stamp:
a� ' , �
'3 =
� • _
"s , �
� t]espneA Purcuanl tn Ihe
�GeoMat 6Aound Component Manual SH8Q2
�BSWMP Pvb4�i�9.6 Deeign of Pressure Distribulion Networks for ST-SAS(01/81)and
Pressure Disfibutwn Component Manual Ver.2.1(May 2022-2027)
Condiconally
APPROVED
DEP7.OF SAFETY AND PROFESSIONAL Page 1 of 16
SERVICES
DIVISION OF INDUSTRY SERVICES
Mound and Pressure Distribution Component Design
-._-,�_�n Worksher,
Site Information
- R Residential or Commercial Design N ISD Required?
- 200.00 Estimated Wastewater Plow(gpd)
1.50 Peaking Factor(e.g. 1.5= 150%)
300.00 Design Flow(gpd)
8.00 Site Slope(%)
98.00 Installation Contour Line Elevafion(fl)
24.00 Depth to Limiting Factor(in)
'� 0.60 In-�situ Soil Application Ra[e(gpd/ftZ)
80.00 Contour Length Available(ft)
Distribution Cell Information
3.25 Cell Width(ft)3,25_ 6-5 or 9.?.`_J_�J�, 60.00 Designer Input Cell Length (ft)
2.00 Dispersal Cell Design Loading Rate(gpd/k�) 46.15 Dispersal Cell Length Required(fQ
2 InFluent Waslewater Quality(1 or 2)
Pressure Distrib �od rtnation
E Center or End Manifold Are the laterals the highest point
1 Number of Lalerals in[he distri6ution Y I
0.00 Laferal Spacing(ft) network?
22.84 Forcemain Drainback(gal) If N above,enter the elevation ft
0.50 Forcemain Filter Loss(ft) of the highest point.
2.00 Forcemain Diameter(in)
j 140.00 Forcemain Length(ft) Dces the forcemain drain back?� Y �
� 86.50 Inside Pump Tank Elevation(ft)
� 0.156 Orifice Diameter(in)(e.g.025)
� 1.50 ��.- ����_�ated Onfce Spacing(ft)= 4.88 ftZ/orifice
4.55 System Head (R)x 1.3
11.75 Vertical Lift(k)
1.47 Friction Loss(ft)
1827 Total Dynamic Head(ft)
47.71 Sx Void Volume(gal)
70.55 Minimum Dose Volume(gal)
21.54 System Demand(gpm)
biameter election
Lateral Diameter Selection Manifold Diameter Seledion
in.dia. options choice in.dia. o tions choice
0.75 � � 125 '�
1.00 � -� --- - , 1.50
1.25 _--� 2.00
1.50 3.00
2.00 x X
3.00 x
Manufacturerinform on
Treatment Tank Information EfFluent Filter Infortnation
1000.00I Septic Tank Capaciy_(q,al) Isee pump tank � Filter Manufacturer
-� . -- ------..
-
Wieser Concrete Products, Inc. _ ���Manufacturer �e pump tank '��Filter Model Number
Dose Tank Information Gallonsflnch Calculator�optional)
500.00 Dose Tank Capacity(gal) �� Total Tank Capacity(gal)
�� 9.43 Dose Tank Volume(gaf/in) ' Total Working Liquid Depth(in)
'Wieser Concrete Products. Inc. .JManufacturer �� gaUin(enter result in cell DoseTankVWume)
Project: BOLITHO TRUST Page 2 ot 16
Mound Plan View
— —?
❑ J
.- ��T.10 * ObservahonPipe �•� 3 - _ I
l •
K —i- � I
s A
w I I �
B —
. . _❑3 �.:: - ��: . . . .�� : . �.. . .�.
I
� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �
L
Mound ComponeM imensions
A 3.25ft E 3.12in H 1.00ft K 7.14ft
B 60.00 ft F 15.00 in I 7.93 ft L 74.28 ft
D 0.00 in G 0.50 ft J 4.23 ft W 15.42 ft
195.00 (ftZ) Dispersal Cell Area 671.05 (ftz) Basal Area Available
5.00 (gpd/ft) Linear Loading Rate 6" End of B Obs. Pipe Placement
ound Cross Section vew
GeoMat Dispersal Area
Observation Pipe
12"AS7M C 33 sand as GeoMat
required for Geo Mat Distribution Cell
component � GeoMat+12" ASTM C-33 sand
' H.: G
100.25 Finish Grade Cover Material
99.08 Lateral Invert Elevation �
98.00 DispersalCell ., E:�,:. :;,���ll Slope 8.0
Elevation
ContourElevation 98.00
,4�' Tilled Area
Forcemain
In situ soil �
In situ soil
Shading Key
� � Topsoil Cap
Z C� Subsoil Cap
3 � ASTM C 33 sand (F)
:{ Q ASTM C 33 sand (D)
5 L� Tilled Layer
6 Q Geo Mat
See details on page 4 for number, size, and spacing of laterals.
Project: BOLITHO TRUST Page 3 of 16
End Connection Lateral Layout Diagram
•=Turn-up w/ball valve or cleanout
All orifices pant down
x lst wifice located at Z
H
P
�
Laterals&force main of PVC Sch 40 cer SPS Ta61e �
Number o(Laterals 1 Orifce Diameter 0.156 in
Lateral Diameter 2.00 in Orifice Spacing(X) 1.50 ft
Lateral Length(P) 5925 ft Orifces per Lateral 40
Lateral End(Z) 075 ft Orifce Density 4.88 ft�/orifice
Lateral Spacing(S) 0.00 ft Manifold Length 0.00 ft
Lateral Flow Rate 21.54 gpm Manifold Diameter 2.00 in
System Flow Rate 21.54 gpm Forcemain Velocity 220 ft/sec
Dose an nfortnation
�,,.�����,,,.�.„���,,.�����„��:,�,��.
lockingi Jc�i.a and e atcr�icM u.tl _
� .I"Von�edCoacr Ti
I-lcao-ical M�c
ns per NGC:(HI
a J Sl�ti:IG2R VA'\�'�
n. l�� Iini.h.Jf,rd� _.:i-: ki� .�i-.�� �l �'�
llisrouucU�
J"ClmnumPipc � Upiimiallroll�phe
�.I.I ioconlrole�nYJaf
W'ircsPrmnl3kctricsourcc / I'�. �.plucmbcinsAux�J
. \opa�mal ouii�� Forcemaln diameter
r�mi.�i rvtia.. . "� _ 21n.
��.�n.. _ .;;i
� �� � � �
13�¢smp ��� � � � � ,�.��� nqrrni,��
J��a�cr � ._�i 1 n
A� �iphlenzAct .. � V��'"��r"����`I Punco
. ,��o�.ru.a.�,�:��n ,
Clearflow ` �„","°e„`°
N55CFF324 illighw�atcralam��rl =.
rn
BI PumpOnl9oat��'..I '., s,�
j'�, �-- Pump oRelevatron(ft)
; Pmnp 01519oa�'I I._:,.Pu p `; 87.33
0 _ := t
i i�i,�� I �_Dose lank ekvation(ft)
g} .. -_:j}tr 86.50
Yi� a ;',Rcddin�undcr lankF . � }�. . .,.�.. „ji13� .
Dimension Inches Gallons WieserConcreteProducts, lnc.
A 33.54 31629 Ca aci 500.00
B 2.00 18.86 Volume 9.43 gal/inch
C 7.48 70.55
D -10.00�� 94.30
Total -53.02 500.00
FilterManufacturer 'Clearflow �- �
Filter Model Number NSSCFF324
Alarm Manufacturer SJE Rhombus ��J
Alarm Model Number AB Tank Alert T—
Pump Manufacturer Zoeller Company _______f.
_.____._ _.
Pump Model Number: 98
Pump Must Deliver 21.54 gpm at 1827 ft TDH
Note�. Switches containing mercury may not be used in this system-
Project: BOLITHO TRUST Page 4 of 16
GeoMat Distribution Cell Media Layout
325 Cell Width(ft) 1.63 Sidewall to Lateral(ft)
Distribution Celi Cross-section Arrengements
� _ - -
Component Legend
� Distribution Pipe With Pressure La[eral L.J Onfice Shield
• Tumup Enclosure —— — — — Pressure Lateral
GeoMat is covered with approved geotextile fabric as per the Iheir product appmval.
Distribution Cell Plan View Layout-Typical
325 Cell wdth-A(ft) 60.00 Cell Length•B(ft�
End Conncr.hon Lateral Layout Diagram
� - - - -- - - = - - - -- - = - J
yp cal ispersal e I
Distribution Laterai
Sand Fil�Rewmmendetl
. � � Orifi<e Shield
Pipe Dia ApOroved Infiltrative Fabric
�'L-.y�n .. a�x�, wr....�.r ��
I ��,�,.�33� ' GeoMat
� . _ _ ' ' ".. ' � ' ' - Component
Q -� /. ndd�tlxtlATACJJ(wEl' ' _
Infltrative Surface/Plow Layer
fu=�tir�y ir.�v
Observation Pipes Shad ng ey
�wace�nenc
� � 0 Topsoil Cap
raieaFia�ee f ^"m�^ ti � Z �—� SubsOil CBp
I �� Rey�, 3 � ASTM C 33 sand (F)
�^« 1 0 ASTM C 33 sand (D)
i'nnm �I ����a��a��i Mm S � Tilled L.ayC�
.j nd/Geo
;�� 6 � Geo Mat
t.
-� : . 'J�2`itu�_d:.kot3rl
..,��'ATER CI.O.."Ef�SLUA . .
�' � yYA„"RACd]md�deCmmC�. . '. .
See tletails on page 4 for number,size,and spacing of laterals.
Project: BOLITHO TRUST Page 5 of 16
Mound System Maintenance and Operation Specifications
Service Providers Name RED'S SEPTIC SERVICE Phone 715-934-9412 '
POWTS Regulator's Name Sa er County SPIA-Zoning Administration Phone (715)634-8288��.
Svstem Flow and Load Parameters
Design Flow- Peak 300 gpd Maximum InFluent Particle Size 1/8 in
Estimated Flow-Average 200 gpd Maximum BODS 30 mg/L
Septic Tank Capacity 1000 gal Maximum TSS 30 mg/L
Soii Absorption Component Size 195 ft2 Maximum FOG 10 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform 10E4 cfu/100 mL
Service Frequencv
Septic and Pump Tank Inspect and/or service once every 3 years
Effluent Filter Ins ed and ctean as necessa at leas[once eve 3 ears
Pump and Controls Test once eve 3 ears
Alartn Should test periodicall
Pressure System Laterals should be flushed and ressure tested eve 3 ears
Mound Ins ect for ponding and.se�age once every 3 years
-- _
Other . __._ _
Miscellaneous Construdion and Materials SWndards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as
shown in the Synergy Systems GeoMat Mound Component Manual Version 1,2017.
2. Dispersal cell media conforms to GeoMat products approved for use with the Synergy Systems GeoMat Mound Component
Manual Version 1, 2017. Media is covered with an approved geotextile fabric.
3. All gravity and pressure piping materials conform to the requirements in SPS 384,Wis.Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost
penetration.
Lateral Tum-up Detail
6-8"Diameter Finished Threaded Cleanout
Lawn Sprinkler Grade � Plug or Ball Valve
Box
Lateral Ends at Last Orifice W here
Long Sweep 90 or Two
�45 Degree Bends Same
Diameter as Lateral
�Distribution Lateral � Lateral Cleanout �
2 Feet
Project: BOLITHO TRUST Page 6 of 16
Mound System Management Plan
Pursuant to SPS 383.54,�s.Adm. Code
Generel
This system shall be operated in accordance with SPS 382-&4 Wis.Adm.Code,and shall maintained in accordance with its'component
manuals[Synergy Systems LL.C.,Geomat Mound Component Manual version 1,2017, Pressure Dislribution Component Manual Ver.2.0
SBD-10706-P(N.01/01)and SSW MP Publication 9.6(01/81)]and local or state rules pertaining lo system mainte�ance and maintenance
reporting.
Septic and pump tank abandonment shall be in accordance with SPS 383.33,Wis.Adm.Code when the tanks are no longer
used as POWTS components.
Septic or pump tank manhole nsers,access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,defecfive,or
subjecl to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking
device to prevent accidental or unauthorized entry into a tank or component.
Seotic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48,Stafs. The conlents of[he septic
tank shall be disposed of in accordance with NR 113,W is.Adm.Code. The operating condition of the septic tank and outlet f Iter shall be
assessed at least once every 3 years by inspection.
The outlet filter shall be deaned as necessary to ensure proper operation. The filter cartridge should not be removed uNess provisions
are made to retain solids in the lank that may slough off the filter when removed from its enclosure. It the filter is equipped with an alartn.the
filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge Flows or an impending continuous
alartn.
The septic tank shall have its contenis removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume oi the
tank. If the contents of the tank are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner as to
when the next service needs to be perfortned to maintain less lhan maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance seplic tank perfortnance is generally not required. However, it such products
are used they shall be approved for septic tank use by the W isconsin Department of Commerce.
Pumo Tank
The dosing(pump)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper
operation. It an effluent flter is installed within the tank it shalt be inspected and serviced as necessary. If the force main has a weep hole,it
should be noted if it is tunctional dunng pump operation,and if not,it should be cleaned.
""'No one should ever enter a septic or dose tank since dangerous gases may be present that cou/d cause death.""'
Mound and Pressure Distribution Svstem
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's penmeter,and the mound shall be
seeded and mWched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic(other than for
vegetative maintenance)on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the
mound and snow compaction in the winter vnll promote fmst penetration. Cold weather installations(October-February)dictate that the
mound be heavily mulched as protection from freezing.
Influent quality into the mound system may not ezceed 220 mg/L BODs, 150 mg/L TSS,and 30 mg/L FOG tor sep6c tank effluent or 30
mg/L BODS.30 mglL TSS,10 mg/L FOG,and 10°cfu/100 mL for highty treated effluenL Influent flow may not exceed mawmum design Flow
specified in Ihe pertnit tor this installation.
The pressure disMbution system is provided with a flushing point a[the end of each lateral,and it is recommended that each lateral be
flushed of accumulated solids at least once every 3 years. W hen a pressure test is peAormed it should be compared to the initial test when
the system was installed ro determine it onfice clogging has occurred and if orifice deaning is required to maintain equal distribution within
the dispersal cell.
Observation pipes vrithin the dispersal cell shall be checked for effluen�ponding. Ponding levels shall be reported to the owner,and any
levels above 4 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring.
Continnencv Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in
proper operating condition.
If the dosing tank,pump,pump controls,alarm or related winng becomes defective the defective component(s)shall be immediately
repaired or replaced with a component of ihe same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surtace,i[will be repaired or
replaced in its'present location by increasing basal area'rf toe leakage occurs or by removing biologically clogged absorption and dispersal
media,and related piping,and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 6 of this plan Tor the name and telephone number of your local POWTS regulator and service provider.
Project: BOLITHO TRUST Page 7 of 16
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COPJSIiLT �.-.0 i GRY FGr`2 SPEGIAL �+P�P�-IC."nTIC�^"`
. Elecfrical al�emalds. far duP�x SY�• are avaUab�e and • variabie level float switdies are available tar contralfr�9 sin9�
and Mfee Phese sys�rt�''
���wM�aFann. • ����p�Ieve1 Ibat switd�es are availaWe
. ��.�r dup{ex syslert�s,HR eVeileWe fOf Vaftabie{BVe�brKJ�Y���UDIS.
wim a witl�out alarm switches�
dEL"cCl�ON GUIDE
1. MMeQd RoA Wa"�Z���swiltll no e+dama canYd n�Pw�1�
Standard all models -Wei aht 39 !bs. - '/, H.P. 2 S:�ys dYDf�k����°'d�.'�'"M��°����'����°�°��
w s.+e c°'n'°� s'r`a°" a ��+cr�o.i�oaon o.xwoTs.
yppN V Wb�N wa � � �. Ses FM0772.br mrr�U nn0e�d Electri�al AMr�.
M� 175 1 hb Q� t a 1 a 7 — ]. GOf1►'u�lwNf1�70-0�5 uwG M e oo�id�oY�iabr.qdY AuO�r l3)�la)
NgE 115 1 Non 9.1 2a268 3w485 ppy�y��,
ppB zio t Au�o s.7 t a t i t — a rw H)rwr.Fvak.fvew^�ror.aw�y+�+�'�'«••�•o-:�
Fy9 DO t Nan �7 2a7d6 3a185 7. Two9(2 IaIeJ�Pak.(orwWNWMo'n��^orspMca_
i�iio:'
�b�O��v�r��y� i�ll inslall,tio.^:i aenuols. p:u�--ociuc cro^kn_,tnJ�::iring�houltl be Jane Sy a O�IiheG
��pnmaOEiur7s�rV�� �R��: Gu�u�delectridar...�lielectricalandsaleigcodes5houlebefa0oriedineludhiY�mvst
YD1T7.Bedo�Ms�br•�D�:��'�'���� recentNationalEieclricCotlelNEC�anet�eOccWala�ISalelyam111eaNUAc1�O5HA1.
iyePlonS�i�A�«RIUY6:AYn�91�.��.
, .. .s. .'5��:. 4'l�'�.��t':�m.r �.1 �.�.:. _ ..
For�x�sua�conditions a reserve safety fac�r is erigineared ir�to the desi9n of every Zoeller pump.
—_- ---
__ _ _
----
-- ---
_._...__—__ - —'____ yV_70'P.OBO7[iSM7
`O. �� ld�iLl(Ytl73Gs7�7 'W��ad_ '
Slf iR 3QA LY�HwliaO
Lauiwi�r.KY ID711-/96/ rr Pd�w,F/.�.�
PUMP !O_ "°a �'nu� ___. —___ -
^�O;h.."'°'"-`°" —
' . � �4�.1� � � ' i!;. .1 .� ���n
Paqe � Of ' � � i
S�?�IC TP.VK E ?UM? CHAM?�3 CROSS SECT?ON P.t.D SP�CI?iCP.'I':UI•1S �
4" CI V:hT F1.�L 12 " MiN . aaov� >RADE E WEATHERPROOF
? 25 ' FROM DOOR , 47INDOW OR JUNCTIOIJ B0:{ AYPROVED
FRESH AIR I1dTAKE WITH CONDUIT MANHOLE COVER
W/ PADLOCK 6
FZNISHED GRADE •r WARNING LAAEL
4" CI RISER �—
y / lr_y " MIN .
18" IN . b�� r�AX . a,•�
.-� —� <<:,;. '��
L
:.ET / , , ', I�
� � �
� � �
� � -- GAS- � �
4fAT"'L.� "FG'r.T S� , � \ /
, . � T TIGH'P � , ' VAPPROVED
�� K��� .j' .A SEAL � �, JOINTS WITH
ROVED �E`` ^��� � . ��� -''' �— ; ; AL"; APPROVED PIPE
/ 3 � 3 ONTO
E 3' � :. ;l,,; , � ori
! " �— ' SOLID SOIL
0 SOL I D �5�' , ' �
i
�
L t.�,.•� Or: :r EV . =c_ . —�--- 0?:� � :::: �i :,iR _i:_:'
J..•
� I ?EH:'•1ITTED C`dL'.
� -- =AtiK
:p.:iJF'AC':'U�i:3
.i�.5 �:??RGVn:.
� " A??30�'�7 3=��_::S .i'.<:.�� _..ivK
'�n�...'."_
' "' ' .,:' '
'�lC � ..Q'_
?:K ?•tANUPnC_`.::=3 . tieisers ' ..,,..c_R DCSES ?_ :,nY ; ��
•"1 C '7LC : �:?1_ � ......_.. _ _... . �� �''i
. 00O -.� __ v .�_"" ' \�. :.vL_ �\v
= _ �OSE —�— G�� . :'LOW3ACb.• SAL.
_�RM MANUFr.C:JRER: 5 . .7 . Elec�ro CA?nCITI�S : A = `'� Ii � S = �� � ' ' GAL•
MODEL tiJMBER : '. •�'�•
S4lITC:i TY?�: ?1e y ��� B = Z I CN:, = 19 GAL.
"1P MANUFACit1RER : F.vd o tic 7���E� C = � � ?��C'r.ES = 10? . '. 3 Gr+i. .
N�ODEL 1JUMBER : Sri Rg
SWITCH TYPE: � e � D = A INCHES = 1 0 GAi. .
:QUIRED DISCH.4RGE RATE Z5 . 57 GPf! PUMP E ALARM RING AS PFR ILHR 16. 3 WAC
RTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . . FEET
N:INZMUM NETYIORK SUPPLY PRESSURE . . . . . . . . . . . . . . 2 . 5 FEET
140 FLL1 FORCEMAIN X FT/100 FT. FRZCTION FACTOR . . • • � � FEET
TOTAL DYNAMIC !1�qD = • •��'� FEE'1'
TERNAL �IMcNS=O�S OP PUMP TA\i:: ..�NGTH � � �" ; WIDTti �3 ; �?r".M�TER �` • '� •
LiQUID v?'rsI'F� .-, ",_p��mE�imbcr -
:e�•en i'riends�uh •
>: ? of C .S.>?. = 360� , SE , �P;, ' : , .:� , 9ti
,.:n o` 3ass Lake, Sa�;}�er Co�.;nt � �C'� 6� �! _
;Y r, • -
.. . �..���f � _ . !' I/_
\ � uy� � �� .
� \ �
\� � , �jOLI"fN0 � RUST
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` ' ' ,��O (������ n �,�u
'-i
. ;�,-��� � �� �:.
. �
Steven Friendshuh
Lot 2 of C . S .M. #3602
SE,NW, 14 , 40 , 9�J n ,�
Town of IIass Lake � �. •
Sawyer County � �
J nor,�ri�
L P L
`�
0
O
3 *No well at Lhis Limc .
� Owner shall assure eliat
new well is p1��ced .� min .
of 25 ' to tanl: and ;0 �.. to
mound area . �W
D
RI� ',)U')/500 tveisers '
Eh, � Comuu T�nk
AY 1e�\/ .,g�'�G� SCALC is 1 " = 00 '
lome� oQ �f 4�l l
� ��
/ r
'� b
\ ` .
.-
o � ��
� Furcemain
� R�
n
£3^.; m ',L� 'x ,^a*RE F u Ll.Y �E R.A�-'� R�6�i R�.J
--'� - - --� M�'fE9lw1..S.
�fi�1p. � i A nr F r�?ER tnl Pr�-+�t� T�^�� *
J
' `N �
N s FQx�"NO'I'E : NO vehicular traffic
� � � �F,�� permi ted within 25 ' frum
, ! �o���own lope toe of mound . 2y
3 . 5"'� .
�'.
; —= �� ' �o �� ,�,�=-pd� �`M�
, i�.<Z-M�u•.�- -
-- Pro�4Sed �asomcai-t-6ifre- - n �• I/1 A�' llD
;co��s��oeparorientot�ndusvy. SOIL AND SITE EVALUATION REPORT Page /_ot,3 _
�cr a�..Human Relauons
isbn ol Satery 8 Buldirgs in 8ccord with ILHR 83A5,Wis. Adm. Code
GOUN?Y
ach complete site plan on paper not less than 8 1/2 x 11 inches in size. P�an must include,but SAW 4r 2
t limited to vertical and horizontal reterence point (BM),direction and%of slope,scale or PARCEL ID.X
nensioned, north arrow, and location and distance to nearest road.
>PLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWEDBY DATE
lo -i4 - g3 t�,w nQa,�
�ROPERTY OWNER: PROPERTY LOCATION
STC=Vr / iYA�KUN GOVT.LOT $�va �I kJ va,s f y T 4 D ,N R E�W
'R PER�Y OWNER':S MAILING ADDRESS • U OX LOT a BLOCK x 9tlB8-kAkIE6RCSM� �j71�
�b�6 80fiN CUU�1� � �
'ITY STATE ZIP CODE PHONE NUMB R OqTY a�ILLAGE �OWN NEAREST ROAD
>�VAC� MN S.�3 �Giti �Oly.' B ss ���� cv�c.���rns i?D
a New ConstruCtion Use �yQ Residential I Number of bedrooms �. � J Addition to existing building __
j Replacement ( � PuMic or commerpal desaibe --
;ode derned dtity tbw 3�9Pd Recommended design bading rate '�i �bed,gpoltt2�_Vench,gpolfl2
�bsorplion area iequired NR bed,ft2�A Vench,ft2 Mazimum design badirg rate�_bed.gpolft2�uench,gPd/ft2
iecommended infiipation surface elevation(s) �1 q fl (as referted to site plan benchmark)
�ddi6onal design I site considerations ST20N bl. �2tZ 0I�11'11 txJO � O�/Nv SVSTt-�'►'� —
'arent material �rl�C���- ��I C Flood plain elevation,if applicable h
i=SUil2b12f015}'SICrtI CONVEM�ONAL � MOUND IN�GROUNDPRESSURE AT�GRAC� SYSTEM IN FILL HOLDING TAKK
J=Unsuitable for s stem ❑s �u � s ❑u �s ❑u ❑s �du ❑s �u ❑s fs�u
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure �nsistence BanrJary Roots GPDJft
ing # Horizon in. Munsell Qu.Sz.Cont Cola Gr. Sz. Sh. i Bed •.T�
�"� I o-3 sv2 r — sr� 1UF58� � s - - 1 ''� •3
__.:_. 2 3-,�y SY�' (o — S L I V�SBK (I W .? -d� � `1 �I � Jr
und 4-(ck ..5 r 2,S42y F�IF CL C�M -- — �P •.7P
,
�/rt. ,S 5 2
�th to
6ng
��� --
�N - THi2G'Ub 'u-T '�(li2V - CTS
RemarEcs: ►13 ' 21.'F P� iti SpQT � �J 39'� exTntine2y ��mpfrc,�z=r; K�✓'i<c= f�tsarA,vcc>��"_�•
'ing # r� �1
b � 0-d 5 2.'3 I — S1 L � �SB.� F7�t � S - I•` ' ,-�
� 2 - s a �--- � , �Fsa,� w F . y : ,s
.5yR3 ,5�iQ L SC�. DM — - NP ,�1P
�und
v. � �.-i''/Q5 �2
;2n.
,th to
6N1�g
'2�'F
a r /!A L�K �d. �!L/2ll 073
Remarks: 3` (-� CZ CfAY� �)' / = CG ''-� ` C�Vtf/1.4Tnk! -
ST Nuno�—Plo�so Print . � � Phone� �� ��� 3��(i
Cv;��/Ir� !I �y2r rn A�Cf _ - - _ 7 �------
--- —
ddress f?fL2 ec�1C _I-� STU,t/c' LRKtr u�� S`�r g7h
°ROFERTYOWNERS%E�`VC_LR���S�`1 __ SOIL DESCRIFTtOfi REPORT Pageg�.,of .3_
�AH:.ELI.D.1 __ _
Depth DominantColor �� Texture Structure ���� ��, Roots GPO/ft
Boring # Horizon �n. Munselt �u.Sz.ContCotor ; Gr. Sz. Sh. Bed Tierdi
kr.�
� 0-4 srr� I — S1L i�•<seK eui � _ ..2 .
, Z ti-2�� S'iR y - s� i v�sBK � dw .� m . Y :5
croua G-39 �'s y2.s�y ' - s � i vrs/.3/� d� -ro .3 . `1
�n 4 . -L3 �?SY�3 _ s�� i<s6'ic — �� . Y : •S
�m ro
fimi6ng
fac�iq
cj
� �
Remarks: H3' CO/n�'R[TE� (D/19� f1RC� � a�'iy 3�"O< SCL� ,�i✓iL� �/Ern�o,(/(v�y-�
Boring#
q-. � / -.3 S�YR � — src. ,� s rn s - ,2 : :
����
� Z 3-25 SY�y -- s � cv - � �s'
�.�.
.S 4R3 .5 2 SC� ' — ,2P
cround
elev. 3 7 S Z
��ft.
�m ro
Gmi6rg
facta�� — '
,'�,�—_ L„ � iM� 77�t u2tb - S �. F E- �"TIL ?iC�vl!
� •� � ;�
Remarks: � � ' —
Boring # � _ _ L tv fS� (�,� �2 : :�
::�: cS l
S '` � -.?5 S -- � / �,SB,�' �, d � ` ,5
°�� 3 - 5 � �,sy/� C�' . C�i. !l� ' -� - � : .2P
c�o�e
�+. �, 5 .
�r�. ,
���
e��y
facror
� B � v .-r�c • �S 1 �' :
Remark5:���i� 7?tJA} (��15 �'C-� ' � � � - 3 j' —
Boring#
",a»`�',,g�u
�,Q' ;�s
��i
Grourd
@ICY. �
ft.
Depth ro
Gmfing
lactor - _ I
• J ✓/.i
�> tqy,��) ✓
�/(:' F 12 i t+'�D S H L!H � C �1 NIC / �
rt�l.?, s�Yv , �wYy, m ��ra�,�-4)qL�iy6y�k� i0f' �
�4, T'+�u, �4 �� �� � y-� cv�.ti'> BRs� t�.vE= �2 .r3nR.,vc� cvC�n����
� � yv
7i. l,d� LO1- G>il/C� l�'Jf4hKG D (.l� iTH
� i�r \ 82 oiNIC T7T/�E�
Y �d.a'�
I IYJ'
� a
�Q7.8�� �7� SIOPr
B�
B� �
Co��'�
r
pCopusc-y „'�] �co' ,�
Du.��-u.,NG- - ;
I.00�nGN NAi� iu BAle
(Sr�7Kc�) o F 3'�"��A �
pcP�Rn
/VDT Th SC.A��
�,c��z�- �c�c a-n t�,v n!o r
yc-r D�c�ONv
,4r�► n�' /�v���,ve�s �,an��c.�
PUOG,4�-� N�R!1(UTjp�
Scr��c� n�-c�u �n��s�n��vrs
,¢2� m�T
(,!�'�(,�iOrh)
Ll�K(s'
LC%iLuilYH-1 I: I� H/bHG/A!C-' �.D �Q. �
/YI�LbS
��un'�.'[/""""� `S ' �✓/��" i "--�'?7 CO. ON-S�Te �O- LZ ' �}3
�K2 pQ1C. �- C}' qo w.e.,.� da� �D Meus�.re
S�=�/G �.�lcC-% CU/ .�� )-f� CO""Y¢cEccl 3Q,-4o� w.d be�u�J
`7r � �'hS"- �.�Dy lo-L5 - ti3
n ,- -.-.�.,„ � n n� ft . ,r- n n . u G � Kw E1a-1,.
W�sconsm Department of Sately 8 Professimal Services Pa9e � °��
, DrvsanoflndustryServices
_�= SOIL EVALUATION REPORT
In accordance wrth SPS 385.Wis. Atlm Code Canty ���
Attach camplete srte Plan on paper rat less than 8 112 x 11 inches m s¢e. Plan must inUWe.
but rot I�mMed lo vertical antl honzontal reterence pant IBM).directan and percent slope. Parcel I D
swle a dm+ensans.north artow. and locabon a�tl d5tance to nearest road. OD �
Phas�print all inTormation. Re`ne�'etl by I Date
Personal uNormatron You Pra^de may be used fw secoMary Purposes IPrrvacY Vw.s. 15 041�I(ml�. �{
Property Owner Property LocaOon � Y' ��.
I OL�T 7R� I GaW-Mt � '�:�,J ., S � T yQ N R �q =,�, W i
Property Owner s Mading ACtlress SRe Address or CSM and Lo �� �
��o�a nl oor� � , �or 3� r ro
Clty.State.Zip Phone Number ❑ Crty ❑Vdlage Town '� Nearest Roaa j
�}� � ,j � i SS LAKF OOD T 1�-
_ pI . _ ��v, _
� NewCmSWct�on Use:p' Residen0a�/Numberofbedrooms Z- CodeAemeddes�+�owrrete��GPD
�R2plaCement ❑ PuNK w cor^meraal-Desttibe Flood Plan elevation if applicable�_ft
Parent matena� �,AND�F �:t� �L
f R
General comments and recanmerMatrons f1Ny SAND '(N+4T �5 `-�������.�` &W ��
�� •F C33,qSftit S,ln1D - R6R�ACE •V.1� -�O�r� N�c�
CI p eonng
8°"�# �prt Grountl surtace elev � fl Depth ro limrong lacta 3� in �ekv=ft
$wl Applicalron Rate
� Honzon Deptn Dominant Cdor �.. Reaox Descnptan � Texture �; Stnicture Consistence Bouidary �I Rools GPDIFt
In. I Mv�sell I Du.Ai. Cm[Color I '', Gr.Sz.Sh ' .E11n1 'ERJt2
G-5 )5� z. s i — I ?.F56K rh r � - 0' 0. 0•8
a , 530 ' tj ' s( ' ��s ' 0 0.7
3 � 30- 7-S 3 5 9 . s/ OA� i - - I 0,2 0.(0
, i � �
S I i � ,
I '
5
C ��# �Bonng
�Pn Ground surtace elev. tt. Depth to I�mmrq taGa_in. �elev_R
' Soil Apphwtan Rate
Hanzon pepth � DanmmantCola � RedoxDescrtptro� I Texture � Structure � Consistence Boundary I Roots GPDrFt
In I MunsHl '�, Qu Az Conc Cobr � Gr Sz Sh �i, .EtNtt 'E1M2
I
i �
I
I �
'
� C5T Name 1Please Prntl S na e` �� , _f/ CST Number
MARV JO MUPPERT�Hd65ter's Sal TeaWg S De g��j/u L I 224832
Address Date Evalua C«+guctetl Teleplane Number
zs�zoF�ren Lane,Webster.WI 54E93 ���LS Z�`f
'Ertluent at =BOD� JO s 220 mgiL arW T55� 30 s 150 mg/L 'ERluent r2=BOD.s;0 mgiL aM TSS s 30 mgiL
SBD-8330(R03l22�
Plot Plan � �3
;— .
PROPERTY OWNER: ��� ��� 7K�' 1" — 40 FT.
(except where noted)
Legal Description: I.�'T L C5M Y 37 "�8'D Sb�/y OF?�'E Nw'�4 �= ly i Q =backhoe Pit
-r " Rcq y 7oWN OF iSRSS Lf►KE SAuVER CDuwStY W�SCoN 5 i� - 3.2�I�S
� �
00 9 ' 'D y Z i 4��� �1 WooC 'feni�
North
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Site location:
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i� � f.��, ;� 1�� ��(�� �_ �� �Y�' 1'� �1 .� �`�.•����a.. ,
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SANITARY PERMIT APPLICATION � . �°
���LHQ In exord witA ILHR 83.05.Wia.Adm.Cods Sa er � � y
CST 93-372 �' - �� ��z4 sr��awrt�nrva+►Mrr , .
Attach complete plans(W fhe county copy oMy)Ior the aystam,on peper noTf�i�r-�--- 210049
BY,x 11 Inches in size. G ��`M"'�0"°o°"1101°'°°�
See revarae slde for Insbudlons tor eompletinp thls applicatlon. G- ✓�� Bi�tE P�AN iA.Nu�A�R
APPLICANT INFORMATION-PIEASE P1111IT ALL INFONMATION. ;�-- l �a'�� ' -
�q PfiOPERTYLOCAiION � ' . �". � '�-ll%� �'/%: � ';�
teve Frieffishuh S.EY. N.M.74.S 1� T 40 .N.R
pppEpTY S w111JNo ADDRE88 t0T/ �A
°'"�o. sar<a32 �7G N�u,�ls 2
STA7E 7JP CODE PHpE NUMBBI M610N NAME OR C8M NUMBER
8aysge�, hIN. 55378 CSM Volume 1 a e 17
�ar ao�u
�. rne oF eu�nn�cs: ccn.a�oM� ❑su+�o�.a �= Ba,.-�xe William tm•
❑ Publlc 01 or 2 fam.Dwsilln��ol bedrooms Z
�. su�tx�u�: In��a��ah�wb�.d'°e��ia"t'��y� part of 002-940-14-2401
1 ❑ ApUCondo
2 ❑ Aasembly Hall 6 ❑ Medical Facility/Nuning Home 10 � Outdoor Reeroetb�al F�cllity
3 � Camppround 7 ❑ Merchendlse: 3ales/Repairo 71 ❑ ResfaurentlBsr/DInInO
4 ❑ Church/School 8 ❑ Moblls Home Park 12 0 �^�a���^��W�
5 � Hotel/Motel 9 ❑ OHicelFsetory 13 � Other. SpscHy
V. TYPE OF PERMR: (CAsck oniy ons In I�ne A. CMdc Iliro B Ir spplkabla)
1) 1.L8 New 2 0 Replacemenf 3. �RsplecsmeM o1 4.0 Recon�ectlon ot b.� ReDelr o1 an
3ystem System Tank Only Existlnp System Exlstlng SysMm
!) ❑ A Senitary Permlt wes rovlowl lasued. Permlt� Dats Issusd
l. TYPE OF 8Y8TEM: (Chsek only ons)
Non-PressuHzed Olstribution Preseurized Dhh�utlon Experlma�tel Other
tt ❑ Saspege 9ed 27 � Mound 30 O Specly Typs 41 ❑ Holdinp Tank
12 ❑ SosWQeTnnch 7! � In�irou� 42 ❑ PHPNvy
13 SespepsPlt Preesure 49 � VauftPrWy
11 � Syatem-In-FIII
�I. ABSONPT�ON SYSTEM INFORMATIOq:
.QALLONS PER DAY 2.AB&ORO.AREA 9.�BSORP.AREA 4. LOADINO MTE 6. �C.RATE 8.SVSTEM ELEV. 7.FlNAL ORADE
REQUIRED(sq.lt) PROPOSEDIWR) (��deY�Wn) (MMJIne�) EIEVATION
300 � � 4 � F..�
hL TANK ��d�oni Total Aot Prehb. Sits Fiber- F�cper.
IIiFORMATION Nsw Istl Oellais T�nW Menutaetwer'�Name Con- � ylw P� App.
�trueted
Tenks TaMm
T � T X� 1 1 Mieser
MPum T CMn�r OOmb.
mi. aEsroNs�eamsr��MEert
I,ths undenlpnsd,suums respo�slDlllry for Inpolatlon d tlis omite ehwaps�yalam ehown u�M��tlach�d Ww•
lum�r'�Wma(PrIMI� PI SlpnYurr.Rb MPMPRBW Mo.: Bu�in�Phen�NumDo�
larenoe Metoal� m+'!� 1498 5"63 077
umbx's Aderow(9trest. r. P Y•
RT.6 Box 6901 Hayward�, Wie.•5484�3
K. COUNTYfDEPARTMENT WE ONLY
ols��sd wY � p��a� e ��Y�M �
�ApprorW Ow��r(ilv��InitW O ' �
;, CONDITIONB OF APPROYAUREASOf18 FOR D�511PPROYAL:
i�n,„,,,,yr�ner�ca.��roe� DISTRi8VTI0N: 0ApIndbCouMY.Or»CopYTo:S�Nb68uIWNp�DIWNan.Ownsr.RumDsr
v�sco�s��oewnme��oemeus�ry. pRIVATESEWAGESYSTEM ounty:
aborandHumanAelations INSPECTIONREPORT �w �r J'
atety and Buddmas Q'vislon �K�ry Permit No.: `r�
(ATTACH TO PERMIT) 1,�ooy 9 9 3 - 3s y
GENERAL INfORMATION
pelmrt N ar t ama: Ry Vi aga own o : tate an I o.:
s{-c�e � �.�. sh� LnY-� 51 3 - ZI 333
CST BM E ev.� Intp.B .. BM Dei[npt�on: srce Tax No.:
tOo ock- oe�e. - q40 - �4 - 'iY0 i
/
TANK INFORMATION ELEVATION OATA '
TYPE MANUFACTURER CAPACITY STATION BS HI FS EIEV. ,
Septic Benchmark l O D�
V.1�eser cunc I�a
Dosing n " �a
Aeration Bldg.Sewer
Holding St/Ht Inlet 91•�9
TANKSETBACKINfORMATION St/Ht Outlet 97.L�
TANKTO P/L WEII BLDG. ventco ROAD Dt Inlet -
lurin[ske
sev��� +sa' +ls ��' �zr NA Dt Bottom
Dosing F SO �� ►b� tzS NA Header/Man.
Aeration NA Dist.Pipe
Holding Bot.System
PUMP/SIPHON INFORMATION Final Grade
Manufacturei Demand ~
Model Number GPM
TDM lift Friction S stem TDH Ft
Forcemain length Dia. o�s�.rowd�
SOIL ABSORPTION SYSTEM
BED!TRENCH w�dth tenqin No.01 Trenchn PIT NoA�v�ts inside Oia. LlQu�d Depth
� Manu aRurer:
SVSTEMTO P/L BLDG WEII LAKE/STREA LEACHING
1 FORMATION Yoe CHAMBER M e Num r '
Systam: OR UNIT
DISTRIBUTION SYSTEM
Hea er r am D�stn ut�on Ype s ■ H S�ze ■ Mo e Spsdng Vent To Aur IMa e
Length _ D�a _ le�y�h _ D�a Spatmq _
SOIL COVER x Pressure Systemz Only ■x Mound Or At-Grade Systems Only
DeO�hOver DeDthOver ax Dep�hOf �: Sceded/Sodded � Muk�ed
Bed/TrencACenter 8ed/TrenchEdqes Topwil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Includecodediscrepancies,personspresent,et<.)
S .T�P •T S..'� t1- �-3- 13
tho....d �e 4se i.,t�A�lcd SP�:wS /S..w�..e.. q4
Plan revision requiredi p Yes �) No �� Z3 9 3 �,,,t w p,t`�^ S 2 3
Use other side for additional iniormation.
SBD-67101R OSNt) D�te tns0eclor'sS�qnature Cart No.
4/17124,9:50 AM Real Property Lis[ing Page
R2dl EState Sawyer County Property Listing PropertyStatus: Current
7oday's Date: 4/17/2024 Created On: 1/3/2022 i1:20:35 AM
�Description Updated: 1/3/2022 '� Ownership Updated: 1/3/2022
TaxID: q4342 BOLITHO TRUST HAYWARD WI
PIN: 57-002-2-40-09-14-2 04-000-000110
Legacy PW: 002940192411 Biiling Address: Mailing Address:
Map ID: BOLITHO TRUST 80LITH0 TRUST
Municipality: (002)TOWN OF BA55 LAKE 8766N WOOD TRL 8766N WOOD TRL
STR: 514 T40N R09W HAYWARD W154843 HAYWARD W154843
Description: PRT SENW LOT 2 CSM 37/180#8580
Recorded Acres: 3.420 � Site Address * indicates Private Road
Calculated Acres: 0.000 8766N WOOD TRL * HAYWARD 54843
Lottery Claims: 1
First Dollar: Yes �..� property Assessment Updated: 5/31/2022
Zoning: (RRl) Residential/Recreational One Z024 Assessment Detail
ESN: 406
Code Acres Land Imp.
Gl-RESIDENTIAL 3.420 18,800 126,500
� Tax Districts Updated: 1/3/2022
1 State of Wismnsin 2-Year Comparison 2023 2024 Change
57 Sawyer County Land: 18,800 18,800 0.0%
002 Town of Bass Lake Improved: 126,500 126,SD0 0.0%
572478 Hayward Community School Distrid Total: 145,300 145,300 0.0%
001700 Technical College
• Recorded Documents Updated: 1/3R022 ��.�Property History
CORRECTION INSTRUMENT Parent Properties Tax ID
Date Remrded: 11/ll/2021 435980 57-002-2-40-09-14-2 04-000-000010 3209
QUIT CLAIM DEED 57-002-2-40-09-14-2 09-000-000040 3212
Date Remrded: 10/29/2021 435586 57-002-2-40-09-14-2 04-000-000050 3213
CONVEYANCE RECORDED NOT USED
Date Recorded: 9/29/2021 434980
CERTIFIED SURVEY MAP
Date Recorded: 8/25/2021 434246
WARRANTY DEED
Date Recorded: l2/27/1993 239578
CERTIFIED SURVEY MAP
Date Recorded: l0/18/1993 238299
Cttild tlist�BecQr.d S�unt:3.=— -----. ____-- --
HISTORY 0 Expand All History White=Current Parcels Pink=Retired Partels
O Tax ID: 3213 Pin: 57-002-2-40-09-14-2 04-000-000050 Leg. Pin: 002940142905 Map ID: .8.5
0 Tax ID: 3212 Pin: 57-002-2-40-09-14-2 04-000-000040 Leg. Pin: 002990142904 Map ID: .8.4
O Tax ID: 3209 Pin: 57-002-2-40-09-14-2 04-000-000010 Leg. Pin: 002990142401 Map ID: .8.1
44342 7his Parcel Parentr Children
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