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Home My WebLink About014-942-27-2407-SAN-2024-083 �`"�i"'�� Departmen"t of Safety c�°°°�' � � , /�,. Sa� �r- � �� r ��/S� };�� c� pYOfeSS1011a� Sel'V1CeS� Sanitary Pcrmit Numbcr(to be tilled in by C� � , s :i Industry Services Division �S i �� ' ` `\ State Transaction Numhcr -� Sanitary Permit Application � �-- I�i accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropiiate governmental unit � is required prior to ob[aining a sanitary permit Note:Application fi�rms for state-owned POWTS are submitted to Project Address(if diffcrent than mailing add � the Dcpartmen�of Safety and Professional Scrvices.Per,onal information you provide may be used for seconda�y /� � puiposes in accordance with thc Privacy Law,s. 15.04(I)(m),Stats. ��'/ �'�� /�i n C �►o r� L�_ I.Application information—Please I'rint All Information �� Property O�vner',Name Parcel# r 0�4-9ya - a� ay�� Propeity Ownei', Mailing Address Prope�ty Location � / � ( (p ��K�',$O�'1 C� Govt.Lot City,Slatc Zip Code Phone Number 5�. y� J�.."''%, Section _�- LaKev; J 1�, M t�l SSb�1 y --- II.Type of Building(check all that apply) Lot# � T �f� N R� W �I or 2 Pamily Dwelling—Number ofBedrooms__ _ _� Subdivision Natne Rlock# ❑Publfc/Commercial—Deseribe Use r--- ❑Cityof _ ___ __ ❑State Owned—Describe Use CS'�4 Numbcr ❑Village of C5t1 # 8`l0� �5ow�,�,r_ Ler,roo�' ___.__ vo�. 3G __— ID.Type of POWTS Permit: (Check either"New"or"Replacement"and other applicable oo line A. Check one box on line B.Complete line C if applicable.) '4 �New S stem y, U Replacement System ❑ Othcr Modification to Existing System(explain) ❑ Additional Preh'eatment Unit(explain) B. �Holding Tank ❑ In-Ground ❑ At-Grade ❑ Mound ❑ Individual Site Design ❑ Other Type(explain) (conventional) C• ❑ Renewal[3efore List Pre�•iou,Pcrmit Number and Uatc Issued ❑ Re��i,ion ❑ Change of Plumber ❑ �I�ranster to New Owner Expiration N.Dispersal/Treatment Area and Tank Information: Design[low(gpd) Design Soil Application Rate(gpd'sf1 Dispersal Area Required(st) Dispersal Area Proposed(s� System Elevation 3 0 — — — '— Capacity in Total #of Manufacturer :? Gallons Gallons Units � o '° � Tank Information � � U �, ,., New l�anks Existina Tanks � G a� .�^, � p � c`�-„" — U V� v� ci� [i Ci 0.. Septic or Holding l�ank �� _ ��Q� � •��Q� /'� X l. Dosing Chamber V.Respottsibility Statement-I,the undersigned,assu 'esponsibility f •inst Ilation of the POWTS shown on the attached plans. _ Plumbei's Name(Print) Plumb Signature � MP/MPRS Number Business Phone Number �.�:s o��+��„� �� saB�9 ��s-�3y-8�7� Plumbe�'s Address(Street,City,State,Zip Code) ��3y� � J��G �C�4G� 7� �7C� t,tl4rd Ws' rJL/8 y3 VI.Coun y/Department Use Only Pennit Fce Date Issued I;;uing Agent Signaturc �A � e� ❑ Disapproved �� E� � � � � , � �'� / c w 1� �[t�u,`�'.Q-Z.��ZR/1�-�- /��v ❑Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval N S��'( ('� , � �"�K._J�J � � � � 1 �',� !p� � � � L �i � a� _ . _ � �) w ��' ��,��,; APR 17 2024 " � .hk¥� 35I . G S� Nd� �� I I"1,� . _.._ SAIM�ER COUNTY ZONING ADMINISTRATION Atlach lo comple[e plans 1'm•the system and submiL lo lhe Counly only on paper not less lhan 8 I/2 x 11 inches in size NO R�FUND6 AFfER SBD-6398(R.03/22) ISS�E OF PERtVtiT � s��:� Sawyer County Zoning & Conservation Administration 10610 Main Street, Suite 49 `��11 �R �� IIayward,Wisconsin 54843 '�� Ci I (715)634-8288 �� FAX(7l5)638-3277 �y� ,` —_ _Y �,�� wwwsawyercountyeov.org � o o � E-mail:sanitaiian(�sawvercountv�ov.org I =�� " Toll Free Court6ouse/General Information 1-877-699-4ll0 �l�Z�\_�r�`�_ ��`ON`�'� Holding Tank Approval Checklist I. Sanitary Cover Sheet: Date Stamp �`� / (� / �� Parcel ID# c� 1 `( - �T Y �-�-'� - 2`1 �? II. Plot Plan: pC Property Lines D( Benchmark BM ♦ 1C Site Address �North Arrow v�Structure �i Scale �Well �<25' to Service Road �C Legal Description DCNearest Road Intersection � Setbacks to: Property Line, Well, Structure, Water bodies, Roads III. Required Plans: D� Index Page witll Original Signature �Manageinent Plan/Contingency Plan �D Servicing Contract D�Holding Tank Agreement Form ($30 to ROD) IV. Holding Tank Specifications: KTank Cross-Section: Manufacturer: wirt�- Gallons: � �h Tank Anchor Calculations [SPS 383.43 (8) (g)] �( Locking device, chains/locks �Alann, electrical per SPS 383.43 (8) (e) �3" Bedding Material < 1/2 " V. POWTS Component Manual Reference: , �Holding Tank Version 2.1 (May 2022-2027) Owner: �� Plumber: `�: .��. Application Review Date: dY 'I 9��a�'� POWTS Reviewer: �-'�r-� Name 6� �l� Rev. 4/27/2023 a�ea�„��i a CONCRETE HOLDING TANK DESIGN Single Tank Option INDEX AND TITLE SHEET Project Bertrang-Anchor Ln Owner Stacy R Bertrang Address 17176 Jefferson Ct Lakeville,MN 55044 Legal Description SE1/4,NW1/4,Sec 27,T42N,R09W Township Lenroot County Sawyer Subdivision Name CSM#8400 vo1.36 pg.95 Lot No. 1 Parcel ID Number 014-942-27 2407 Plan Transaction ID Number Index and title sheet Page� Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Designer Travis Butt Id Signature Phone No. 715-634-8176 License Number 652879 Date 04/16/24 Designed pursuant to�. Holding Tank Component Manual For POWTS(Version 2.1) May 2022-2027 Verslon 7.1(07/22) Page 1 of 4 HOLDING TANK SPECIFICATIONS 3 Number of bedrooms Non-residential estimated flow (gpd) 2000.0 Minimum holding tank volume required (gal) 3000.0 Proposed holding tank capacity (gal) Wieser Concrete Inc Tank Manufacturer WLP-3000MR Tank model number Rhombus SJE Alarm manufacturer Tank Alert 101-01H Alarm model number Tank Dimensions and Data Tank Anchor Calculations X for round tank 22313 Ibs Weight of tank and cover 43.0 Liquid depth below inlet invert (in) 1.10 Safety factor 8.0 Maximum depth of soil cover (ft) 22977 Ibs Weight of anchor required 60.8 Height(in) Outside 21.2 in Soil cover req. for anchor or 184.0 Length (in) Dimensions 5.7 yd' Concrete counter weight 102.0 Width (in) Only HOLDING TANK CROSS SECTION manhole cover with locking device and finished ��ent cap junction � warning label grade box —� � — 4"min. 17'min. �� 23 in. Manhole and vent locations T conduit —� vent pipe �g^min. � tetherweight I -- � � building sewer � service „ 12.0 in. inlet biind pwg aiarm on Note: All tank joints, and co seai joints between tank ounet openings and piping are Electrical as per 31.0 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: Bertrang -Anchor Ln Transaction Number: Page 2 of 4 HOLDING TANK SITE PLAN Project: Bertrang - Jolly Fisherman Rd �IS�� N Legal Description SE1/4, NW1/4, Sec 27, T42N, R09W Subdivision Name: CSM#8400 vo1.36 pg.95 Scale: 1" =40 ft ] Parcel ID: 014-942-27 2407 Lot No.: 1 O 10 �T Yo �D � G� Q L 0 b � e` .�•+ P�oy. A� 3 Ao f J ``'e�� .,� �y � o �.F1T �� ap�pac sa Ka \ pSthsEtt \ \ \� HT < 3000ya�. Qc�-kb c�.•�,<+c \ �.�otd'.•�• �w,.K MaB e bY \ witS6r Gc+r+e'ek �n C . NE�So\\ L A� \\ \\ 0�1 � T6P o4 pre,par)y 5}aKf Transaction I.D.: �\ _ �oo.00 EF e��• 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 600.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed in the current Service Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code. 5. All 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. 8. 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 discontinued, components no longer in use it shall be abandoned in accordance with SPS 383.33 Wis. Adm. Code. 10. If there is a problem with, or question about this installation, the 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: Bertrang -Anchor Ln Transaction Number: Page 4 oi4 WLP30nn ,a4�� TANK SPECIFICATIONS � � � o o � a � DIMENSIONS: w v�i WALL: 3" � a , ,. , . . . . . . , BOTTOM: 3" HEAVY - 5" � COVER: 6" � MANHOLE: 24" I.D. PRECAST CONCRETE RISER ,° 4" CAST-A-SEAL 4" CAST-A-SEAL HEIGHT: 60-3/4" O.D. � LENGTH: 184" O.D. � � � � WIDTH: 102" O.D. � > k N �2q." � BELOW INLET: 48" O.D. ca., � o o LIQUID LEVEL:y 43" `� TYP � ` WEIGHT: TANK - 3 BOTTOM 13,013 LBS. o TANK - 5" BOTTOM 15,980 LBS. N \ J FILTER OR J WEIGHT: COVER 9,300 LBS. � } BAFFLE INLET AND OUTLET: �' a 4" CAST-A-SEAL BOOT OR EQUAL m Q � � � INLET AND OUTLET BAFFLE AND FILTER: � Q � � ; • . . - , WISCONSIN, SEE DETAIL #10 � o "- (OTHER STATES SEE CHART) 4, o � � LIQUID CAPACITY: 69.77 GAL/IN W � TOP VIEW HOLDING TANK: � � OUTLET HOLE PLUGGED � Y �p ACTUAL CAPACITY: 3,140 GALLONS C � � LOADING DESIGN: 8' 0" UNSATURATED SOIL � z o0 � o I TANK CAN BE USED AS: � N SEPTIC/ HOLDING/ PUMP OR SIPHON � r� W � i COVER: MIX DESIGN #8 (NO FIBER) y � � o � TANK: MIX DESIGN #9 (SMALL FIBER) W N a0 ¢ � CUSTOMIZED TANKS: — � — , 4 _ . , ,r , — FOR CUSTOM TANKS CONTACT WIESER CONCRETE � M INLET OUTLET 3 O � - � — _ — 1 - N Jo p � Q r�r _ if') Q Q N cD ' - � 3� � � �r� � a � � CD o Z � � � _ � � o Q a � � � ' . . . : JOB INFORMATION : � � o CUSTOMER: w j - � w ''� JOB NAME: � SIDE VIEW DATE NEEDED: SHEET N0. APPROVED BY: � / APPROVAL DATE: OF ' TANKS ARE MANUFACTURED TO MEET OR EXCEED AS7M C-1227 REQUIREMENTS � � HOLDING TANK SERVICING CONTRACT Contract Datc: ��l / 1 3 / aoa This contract is made between tbe Holding Tank Owner and the Pumper. Holding Tank Owncr's Namc: Pumper's Namc: S�Gc.y � 3er �ran4 SGo}� �aPpe J Parcel Identification Number: �Iz ��t Lega�y 1�� o r �- 9 � a -� '7 -�. y o '7 1. The owner agrees to file a copy of this contract with the governmental unit, Sawyer County, which has accepted and recorded with the Office of the Register of Deeds, the Maintenance Agreement for a Holding Tank required under the Sawyer County Private Sewage System Ordinancc for the issuance of a Sanitary Permit for the installation of a holding tank(s). 2. The owner agrees to have the holding tank(s) serviced by thc pumper and guarantees to permit the purnper 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 equipment. The owner further agrees to pay the puinper for charges incurred in servicing the holding tank(s) as inutually agreed upon by thc owner and pumper. 3. The pumper agrees to submit to the Governmental Unit, Sawyer County, a report for the servicing of the holding tank(s) as required under SPS 383.55,Wisconsin Administrativc Code and the Sawyer County Private Sewage System Ordinance. Thc pumper further agrees to include the following in the report: a. The name and address of the person responsible far scrvicing the holding tank; b. The n�me of thc owner of the holding tank; c. The site address of the holding tank; d. The date the holding tank was serviced; e. The v��lumes in gallons of the contents pumped from the holding tank for each scrvicing; f. The disposal sites to which the contents froin the holding tank were delivered. 4. This agreeinent will reinain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owncr agrees to file a copy of airy changes to this service contract or a copy of a new scrvice contract with Sawyer County within ten (10) business days from the date of change to this service contract. �WrieY'S N3117e: �PT'lrit� �WriCC'S /� 3tUT'e: (Only one o�vner signature required) � � sk-0.�Y R i3«�.�g � Pumper's Nasne: (Print) Pu er s Signa . 5�� p�P�e ��?� ��° Pumper's Registration Number: 8 � 813 Rev.03/26/13 4/19/24,9:42 AM Real Property Listing Page R2dI EStat2 Sawyer County Property Listing Property5tatus: Current Today's Date:4/19/2024 Created On:10/ll/2019 3:06:02 PM �Descrip[ion Updated:11/12/2019 �Ownership Updated:4/11/2022 Tax ID: 43662 STACY R BERTRANG LAKEVII.LE MN PIN: 57-014-2-42-09-27-2 04-000-000070 Legacy PIN: 014942272407 Billing Address: Mailing Address: Map ID: STACY R BERTRANG STACY R BERTRANG Municipality: (014)TOWN OF LENROOT 17176 JEFFERSON CT 17ll6 JEFFERSON Ci STR: 527 T42N R09W LAKEVILLE MN 55044 LAKEVILLE MN 55094 Description: PRT SENW LOT 1 CSM 36/95#8400 I�I Recorded Acres: 0.870 r Site Address *indicates Private Road Calculated Acres: 0.000 15602W]OLLY FISHERMAN RD HAYWARD 54843 Lottery Claims: 0 First Dollar: Yes J property Assessment Updated:5/13/2020 Waterbody: Nelson Lake 2024 Assessment Detail Zoning (RRl)Residential/Recreational One �ode Acres Land Imp. ESN: 400 Gl-RESIDENTIAL 0.870 98,300 8,400 �Tax Districts Updated:10/17/2019 2-Year Comparison 2023 2024 Change 1 State of Wisconsin Land: 98,300 98,300 0.0% 57 Sawyer County Improved: 8,400 8,400 0.0% 014 Town of Lenroot Total: 106,700 106,700 0.0% 572478 Hayward Community School DistriR 001700 Technical College '��Property History • Recorded Documents Updated:9/20/2022 parent Properties Tax ID CORRECTION INSTRUMENT 57-014-2-42-09-27-2 04-000-000060 40789 Date Remrded:9/12/2022 441275 TRUSTEES DEED Date Remrded:3/29/2022 438344 QUIT CLAIM DEED Date Recorded:10/19/2021 435357 EASEMENT DEED Date Remrded:10/7/2019 420325 CERTIFIED SURVEY MAP Date Recorded:8/30/2019 419661 CERTIFIED SURVEY MAP Date Recorded:8/26/2008 355592 WARRANTY DEED Date Recorded:6/25/2001 291925 AGREEMENT Date Recorded:8/7/2000 285658 WARRANTY DEED Date Recorded:6/24/1964 118907 Child History Recard Count.3_-.- ____.. . __._ ._. _. ______. - - ___ _--.._----` HISTORY 0 Expand All History White=Current Parcels Pink=Retired Parcels �Tax ID:18411 Pin:57-014-2-42-09-27-2 04-000-000010 Leg.Pin:014942272401 Map ID:,8.1 0 Tax ID:40082 Pin:57-014-2-42-09-27-2 04-000-000050 Leg.Pin:014942272405 Map ID:.8.5 O 7ax ID:40789 Pin:57-014-2-42-09-27-2 04-000-000060 Leg.Pin:014942272406 Map ID:.8.6 43662 This Parcel Parentr Children https:Utassawyercountygov.orglsystem/frames.asp?uname=Eric+Wellauer �� " "'.tiA"�_. -Y` ,�, . '�,. .. -�� ..�+ .. .. �. '«''T+e" ,:.. �� °*�..�+r. �` . --R` "�i� �' � '�'. 'G.��'� -•�j�. ie�v ;�. i'� j .c� � • AddreSses � . . - ��y �� ~.,y�� . ��y s3A..� _ ' �' }y ` .� � � . +��..�,�_ „ - _ +�y � � 'F' - �. i .s,��; —� _�.• 1� . .S ...,`: '. � 7.- "+�.�.,,p + . i� . . . '�,.y�*'_��i3-' � + . � '�yd�'..r � ti. � :,,. ��u�F� �� ,. '•a. �y� y' y�J Parcels � § . 1 �!• yl�f Y��' � .�r'4�.}��'�+ �r �� . . ,. . M: I ,P � YH *^Y �s a �r'� . } .. _ l a�,J�_ i �� L�• � .�r, 'h au ,,,�v�_•� +�.Sr/ , . � ��',,rr` _ � r .. ,�. . _� ' � �r;('��.�� `d#�'C,� � M PefC0lNumbe�5 �� ..� .� _,�,�.-_ , � .�..^. �.- r :..,, •,�-..�` � � �,,. -.� �'�� t �,/r'. F � a .� .`;.4: _ . �►;�.r u� - �"� � � l�'"�•�''t �t" � �" �( ..n-�� ~ ��k',�� w� tf �a . -'�,�,^"• ` . . � ,_ry�'.+..� .: Towns , _ • n _ � .{' _ J. r, -�+r ey�[ 4 ' , - -f < '. . ❑ . .. �. ' . . � �, � __. .-+.,.;,e � . Nw:+r�' ,�'r,r,,� ' � _ ,. " -.#� n�.,,'.� 1'� v �_„�,�--�'i. 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