HomeMy WebLinkAbout002-940-26-5304-SAN-2024-086 County �
, ;' " ; Department of Safety � �
6 ,`�\`- & Professional Services, SO`�'' e�' �
$� �< Sanitary Permil Number(to be fillcd in by Cc
���'l� � Industry Services Division "
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State Transaction Number �
Sanitary Permit Application ' �
ln accordance witl�SPS 383.21(2),Wis.Adm.Code,submission ofthis furm to the appropriate governmental unit �
is required p�iur to obtaining a sanita�y pei7nit.Note:Application forms for state-owned POWTS are submittcd to Project Address(if different than mailing add �
the Department of Safety and Professional Seivices.Personal information you provide may be uscd for secondaiy
puiposes in accordance with the Privacy Law,s. I 5.04(I)(m),Stats. � ���� � ��x w+,�� �
1.Application Information—Please Print All lnformation
Propc�Yy Owncr's Namc Parccl�
3 � ; - c.�C od�- 9tia -�4�s3oy
Propetty Owuei's Mailmg Address Propert�Location
r
"1 o s fi c>►., �a�-t.Lo�__3_ _
Ciry,State Zip Code Phone Number `
NA l^T0.r O� W Z S''-i 8 y 3 —�`� - �� Section __d�
IL Type of'Building(check all that apply) Lot# T �U N R � L cn�__
�] a'2F�amilyDwdling-NumbcrofE3cdrooms � � SubdivisionName
IIlock#
❑Public/Commercial-Describe Use ��
❑City of
O Statc Owned-Dcscribe Use CSM Number ❑Village of_ _
CSt-� # b5 SS �7
�'Tow„af'_ �.7_as5 La.KC
- -- —
va�• 37 p.� �q
IIL Type of PO�VTS Permit:(Check eithcr"Ne���"or"Replacement"and other applicable on line A. Check o��e box on line B.Complete line C if
a licable.)
�' �New S stem
y U Replacement System ❑ Other Modification to Existing System(explain) U Additional Pretrcatment Unit(explain)
.. ShN,�- o
B' ❑ HoldingTank �In-Ground ��G'n ❑ At-Grade ❑ Mound ❑ Individual Site Desi n
g ❑ Other Type(expiain)
(conventional)
❑ Chan List Preaious Pcrmit Number and Date[ssued
C• ❑ Renewal Before ❑ Recision ge of Plumber ❑ Tl�ansfer to Ne�r Owner ?
Expiratiai �^1� a1�"''�J�/ 7/Z� (�O.'Z`
1..
IV.Dispersal/Treatment Area and Tank Information: �C' �o Gt�l t U�x 33' G a. w 1 v 1-c..� o E 3a d y e, E�'tn
Dcsi�n Flow(gpd) Design Soil npplication Ratc(gpd/st) Dispersal Arca Rcquired(st� Dispe�,al Arca Proposcd(st) System Elcvation e���t
q o o � . c� /a. o s�3 y so 6�'0 �ko '� �-
Capacity in Total �of Manufacturer
�
Gallons Gallons Units �? o 'D �
Tank Infoima[ion p � U �,
New Tanks Exis[ing Tanks � o a� � � � � �
n. U v"� � v� u. c.7 a
Septic or Holding Tank ���� �_ ��x� � w��,�j C j- ��C�,' }�
Dosine Chamber '
V.Respousibility Statement- I,the undersigned,assume responsibility for installation of the P0�4'TS shown on the attached plans.
Plumber's Name(Print) Plumber's Signature MP/MPRS Number Busincss Phone Number
� a ���.�s s� r �- aa�` �� >�s-ss8-���a
Plmnber's Address(Stree,City,Statc,Zip Code)
Sa os nr 5�-��►�c ,}?�,d a7 l-I� �r� , w r .5*-i 8 y3
VI.Count /Department Usc Only
�A � ❑Disapproved P�rmit Fcc Datc Issucd Issuing A�;cnt Signaturc
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❑Owner Givcn Rcason for Dcnial {��• � ��`2��"���� -f I�������������
`('� Conditions roval easons for Disapproval � , ��1;'i?,tt,� �'���
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SAVt1YER Cc�l;r�1T��
��-3� ZONING ADMiNlST(�.�;IQ?�l
Attach to complete plans for the system and submit to the County only on paper not less[han R�l2 s I1 inches in size
NO RCFUNDS AFTER
ss�-639s�R.o3izz� ISSUE OF PER�AI'r
``yl �1�x
GSF WI IN-GROUND DESIGN PROGRAM
INDEX AND TITLE PAGE
Project Name: Bl�c Crystal Visions LLC - Beckwith Rd
Owner's Name: (31ve Crystal Visions LLC
Owner's Address: 7678N Post Ave
Hayward, WI 54843
Project Address: 15195W Beckwith Rd
Legal Description: P/O Govt Lot 3, Sec. 26, T40N, R 9W
Township: Bass Lake
County: Sawyer
Subdivision Name: CSM # 8555 vo1.37, pg. 119
Lot Number: 1 Block Number:
Parcel I.D. Number: 002-940-26 5304
Plan Transaction No.:
Page 1 Index and Title Sheet
Page 2 GSF System Views
Page 3 Distribution Media
Page 4 System Maintenance Specifications
Page 5 Management and Contingency Plan
Page 6 Plot Plan
Designer: Ronald A Spreckels Jr License Number: 226688
Date: 02/16/24 Phone Number: 715-558-6472
Signature: / �
Designed Pursuant to the
GSF In-Ground Component Manual (N. 11/19)
GSF In-Ground Version 2.23 Page 1 of 6
GSF WI IN-GROUND DESIGN PROGRAM
GSF IN-GROUND DRAWINGS
Plan View
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Two cells, each 10ft x 33
In-Ground Component Dimensions
A 10.00 ft B 33.00 ft D 1.00 ft F 7.00 in
H 1.00 ft Excavation Depth 3.75 ft
From Grade
650.00 (ftZ) Basal Area Available Finished Grade 99.83
Lateral Invert Elevation 98.83
Dispersal Cell Elevation 98.25
Bottom of Excavation 97.25
Typical Cross Section Trench View
��. , , . , � --FlNISHED GRADE
MIN'12"OF GEOTIXTIIF
CLEAN FlLL(I-� FABRIC �qTERALINVERT
� 7"(� �3 �3 �—ELEVATION
OISPERSAL CELL
�—ELEVATION
(p) MOUND SAND MOUND SAND
BOTTOM OF
I I~—DCCAVATION �
10'
Typical Dispersal Cell
� Q See Page 5
�- , 2 ft Geotextile
o �
� o � Fabric —�
— �
c� � �
� F
a�
.� � �"
� o 0.5 ft l 1
A
See details on page 4 for number, size and spacing of laterals.
Laterals are located in the 4"gravity distribution pipes as shown on page 5.
Project: Crystal Visions LLC- Beckwith Rd Page 2 of 6
GSF WI IN-GROUND DESIGN PROGRAM
DISTRIBUTION MEDIA
GSF Distribution Cell Media Layout
10 Cell Width (ft) 2.5 Sidewall to Lateral (ft)
Distribution Cell Cross-section Arrangements II
Drag appropriate drawing to space below. I
10ftWide ���'= B43 � ` � - B43 ,�
,t�
Component Legend
�� ASTM C33 Sand/Mound Sand
�. .���:�. : A42 or B43 Module
��
[�---____� Laterai
� _-� Turn-up (contained in Turn-up Enclosure)
Distribution Cell Plan View Layout-Typical
10 Cell Width-A(ft) 33.00 Cell Length - B (ft)
8 B43 Modules Required per Row
16 B43 Total Modules Required
Pump to Gravity Diagram
Drag appropriate drawing from left to space below.
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wo Cells, 32 total units
Project: Crystal Visions LLC - Beckwith Rd Page 3 of 6
I
GSF WI IN-GROUND DESIGN PROGRAM
SYSTEM MAINTENANCE SPECIFICATIONS
System Maintenance and Operation Specifications I
Service Provider's Name �— Ronald A Spreckels Jr Phone 715-558-64/2
POWTS Regulator's Name Sawyer County Zoning and Conservation IPhone 715-634-8288
System Flow and Load Parameters
Design Flow-Peak 900 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow-Average 600 gpd Maximum BODS 30 mg/L
Septic Tank Capacity 0 gal Maximum TSS 30 mg/L
Soil Absorption Component Size 650 ftz Maximum FOG 10 mg/L
Maximum Fecal Coliform 10E4 cfu/100 mL
Service Frequency
Septic and Pump Tank Inspect and/or service once every 3 years
Effluent Filter Should inspect and dean at least once every 3 years
Pump and Controls Test once every 3 years
Ala�m Should test monthly
Pressure System Laterals should be flushed and pressure tested every 1.5 years
In-Ground System Inspect for ponding and seepage once every 3 years
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to the standards, have a watertight cap,and are secured in a as
shown in the Eljen In-Ground component manual.
2. Dispersal cell media conforms to Eljen products approved for use with the Eljen In-Ground Component Manual approved
November 2019. Eljen media is covered with the manufacturers geotextile fabric.
3. All gravity and pressure piping materials conform the requirements in the state code.
4. Tillage of the basal area is accompiished with a mold board or chisel plow.
5. The system structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost
penetration.
Lateral Turn up Detail
6-8"DIAMETER
LAWN SPRINKLER
FINISHED GRAD�—� — _ _ � —
THREADED
LATERAL ENDS AT LAST 4"PERFORATED PIPE CLEANOUT PLUG
ORIFICE WHERE VARIABLE- 4"END
LENGTH CLEANOUT BEGINS C� LONG SWEEP 90 OR
_.. _..........._ __ . ..._._.._ . ....._..._ _...._. NV045 DEGREE BENDS
_. _.._ __...
..__ _._
SAME DIAMETER
AS LATERAL
� DISTRIBUTION LATERAL IATERAL CLEANOUT
Project: Crystai Visions LLC-Beckwith Rd Page 4 of 6
GSF WI IN-GROUND DESIGN PROGRAM
MANAGEMENTAND CONTINGENCY PLAN
System Management Plan �,
General
This system shall be operated in accordance with SPS 82-84 Wis.Adm. Code, and shall maintained in accordance
with its'component manuals Eljen in-Ground Component manual November 2019 and SSWMP Publication 9.6
(01/81)]and local or state rules pertaining to system maintenance and maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic and pump tank abandonment shall be in accordance with SPS 83.33,Wis.Adm.Code when the tanks are no
longer used as POWTS components.
Septic or pump tank manhole risers,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, defective, or subject 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.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The
contents of the septic tank shall be disposed of in accordance with NR 113,Wis.Adm. Code. The operating condition
of the septic tank and outiet flter shall be assessed at least o�ce every 3 years by inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed
unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure.
If the filter is equipped with an alarrn, the filter shall be serviced if the alarm is activated continuously. Intermittent filter
alarms may indicate surge flows or an impending continuous alarm.
The septic tank shall have its contents removed when the volume of siudge and scum in the tank exceeds 1/3 the
liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment,
maintenance personnel shall advise the owner of when the next service needs to 6e performed to maintain less than
rnaximum scum and sludge accumulation in the tank.
The addition of biologicai or chemicai additives to enhance septic tank performance is generally not required.
However, if such products are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump(dosing)tank shail be inspected at least once every 3 years. All switches, alarms, and pumps shall be
tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as
In-Ground and Pressure Distribution Svstem
No trees or shrubs should be planted on the system. Plantings may be made around the system's perimeter, and the
system shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost
penetration. Traffic(other than for vegetative maintenance)on the system is not recommended since soil compaction
may hinder aeration of the infiltrative surface within the system and snow compaction in the winter will promote frost
penetration. Cold weather installations (October-February)dictate that the system be heavily mulched as protection
from freezing.
The pressure distribution system is provided with a flushing point at the end of each lateral,and it is recommended
that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed
it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred
and if orifice cleaning is required to maintain equaf distribution within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to
the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more
frequent monitoring.
Continqency 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 wiring becomes defective the defective component(s)shall
be immediately repaired or replaced with a component of the same or equal performance.
If the in-ground component fails to accept wastewater or begins to discharge wastewater to the ground surface, it v✓ill
be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing
biologically clogged absorpfion 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 for the name and telephone number of your local POWTS regulator and service provider.
Page 5 of 6
Project: Crystal Visions LLC-Beckwith Rd
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4/17l24, 1122 AM Real Property Listing Page
Redl EStdt2 Sawyer County Property Listing PropertyStatus: Current
Today's Date: 4/17/2024 Created On: 6/1/2021 12:25:29 PM
�'Description Updated: 10/29/2023 � Ownership Updated: 4/27/2023
Tax ID: 44192 BLUE CRYSTAL VISIONS LLC HAYWARD WI
PIN: 57-002-2-40-09-26-5 OS-003-000040
Legacy PIN: 002940265309 Billing Address: Mailing Address:
Map ID: BLUE CRYSTAL VISIONS LLC BLUE CRYSTAL VISIONS LLC
Municipality: (002)TOWN OF BASS �AKE 7678N POST AVE 7678N POST AVE
STR: 526 T40N R09W HAYWARD WI54843 HAYWARD WI54843
Description: PRT GOVT LOT 3 LOT 1 CSM 37/119
#8555 S A FRIENDSHUH REV TRUST- LC � Site Address * indicates Private Road
Recorded Acres: 1.920 15195W BECKWITH RD HAYVJARD 54843
Calculated Acres: 0.000
Lottery Claims: 0 J property Assessment Updated: 5/31/2022
First Dollar: No
Waterbody: Grindstone Lake 2024 Assessment Detail
Zoning: (RRl) Residential/Recreational One �ode Acres Land Imp.
ESN: 406 G1-RESIDENTIAL 1.920 234,200 0
2-Year Comparison 2023 2024 Change
� Tax Districts Updated: 6/1/2021 Land: 234,200 239,200 0.0%
1 State of Wisconsin Improved: 0 0 0.0%
57 Sawyer County Total: 234,200 234,200 0.0%
002 Town of Bass Lake
572478 Hayward Community School DistriR
001700 Techni�al College �
Property History
Parent Properties Tax ID
. Retorded Documents Updated: 3/5/2024 57-002-2-40-09-26-5 OS-003-000030 3714
CORRECTIONINSTRUMENT
Date Recorded: 2/14/2024 448581
WARRANTY DEED
Date Recorded: SO/23/2023 446997
LANDCONTRACT
Date Recorded: 6/21/2021 432777
CERTIFIED SURVEY MAP
Date Recorded: 5/27/2021 432208
EASEMENT
Date Recorded: 2/26/2021 430197
TRUSTEES DEED
Date Recorded: 5/3/2004 321177
Child_tiisLorX_Retord_Cour�t_1-_ __ __ ___ _ _ __ __.---
- -- ---- — --— _ _ _ _--
HISTORY O Expand All History White Current Parcels Pink=Re[ired Parcels
O Tax ID: 3714 Pin: 57-OD2-2-40-09-26-5 OS-003-000030 Leg.Pin: 002940265303 Map SD: :33
44192 This Parcel Parents Children
https:lltas.sawyercountygov.orglsystem/frames.asp?uname=Eric+Wellauer ���