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HomeMy WebLinkAbout010-176-01-0100-SAN-2024-116 U����. � lndustryServce Dbfsion Counry � ��� _ � 4b2°�fadiaun Ya ds Way S4 w Y Y" � .. fP ' - '�(adison,Wi5i705 Sani�aryPcrtni�.umber(tobeflicdinby : � _ -�- P.O.Rox 7302 �!��;��"� i Madison.WI53707 (p,j I ��� � S+anitary Pernllt AppllCatl�n StareTrnnsactioeNumber � In accordance with SPS 3R311(2),Wis.Adm.Code,submi,sion of�his�oim ro che appmpnate govemmental unit �- 6� is requircd pno w obtaining a anitary pcnnic.Notc:.4pplica�iun Corms for stam-owncd POWTS are submittcd ro Project Address(if different chan mailiog addmss) ihe Departmencrof'Safety and Profrssion�Sen�itts.Personai infoma[ion you provide may be useA for secondary purposes in acrordance with the Pmacy Law,s.15.04(i)(m),SWts. .I J � I.Application Informalion-Please Print All Tnformatlon ��y Q3�/ S io✓�etJOo� Q- Property Ouncr's Namc Parccl z IRJ�II�.c.�, I�. Lqcie. M. ��a��eh c�l�- 17b- o(_ o�oo Property Oumer's Mailing Address Property Location I o 4 9 3 �1 .S�o hewoad � c�-rar--, Ciry,State Zip Code Phone Number �G. wav-� W� 54�`13 � �— l'��4,secdo� 2.CY II.Type of Building(check all that apply) Loi� T � n R � E W �Iar2FamilyDwelline-NumberofBedrooms_��_ 1 SubdivisionVame Blocki' s�p QI.�OU� wQS� V��l �ublidCommercial-Descnbe Use 1 ❑Ciry of ❑SrateOwned-DescribeUse CSMNumber i0ageof�/ I _ -- �Town of ITG y Wc�.Y'n _ iIL Type otPOWTS Permit:(Check either"Nen"or"ReplacemenY'and other applicable on line A. Check one box on line B.Complete line C i a licable. A� ew 5 stcm �'�,,e lacement S srem Other 1lodification to F.xisting � Y I xln P Y � System(explain) ��Additional Pre[reatment Unit(explain) LJ B� ❑F3oiding Tank �In-Ground ❑4�-Gmde �Mound Individual Si�e Design Other Type(csplain) (conventional) G �Rrnewai Bef'ore �Revision .han�e of Plumber ❑I'ransfer[o New Owner Lis[Previous Pyermit Number and Date L sued Expiration OZ���0 r/a3 �o„2 IV.DispersaUTreatment Area and Tank Informatlon: Design Flow(gpd) Desi�n Soil Applicaeion Ra[e(�pd/sf� � Dispersal Area Required(s� :Dispersal Aaa Proposed(s� System Eleya[ion S� �-7 (,SZ G�.5 Capaciry in Total @ of Manufacmrcr Tank information Gailons Gallons IInics `a Nev Tank.c Exixting Tanka y� - � r:U �n v .r.J L zpo orHoldingTank � 0.5 µ1�SSQ ng Chambcr � � � V.ResponsibiliTy Statemen[-I,thc undersigned asmme responaibility for installatlon af[he POWTS shown on the anac6ed plans. Plumy-b�er's Vame(Pnn[) Plumber'x Siymat '�iP/MPRS�umber Buciness Phon<Number V IQ G�J(�L �S�{o �2- 71S -SS�—$�tD 7 Plumber's Address(Street,Ciry.Stare.Zip Code) �O l(o W S-�O✓( L� S C-l1 S�t VI.Co ry e artment Use Only PermitFee �,Dat issued issuine Agen�Signanve �App v ❑Disapproved ��'� � I � p� �� I�,-_,_ ❑Owncr Givcn Rcuon for Dcnial ���� S '�I'�� �1Juti71�"°r Conditions of Approval�Reasons for Disapproval .__._, _ . c--,.,r--�.�.__ _ .. �y f ����I�tir'S�� ' -.-.1,.[:..5��.�a�1.__.,,.,.eP..., U ._-J''�'' J:�: '�-_ ' � hk#�aa� MAY i 5 2024 �5i � y - o-�� � ;,���u__�s�� __ ' SAWYER COUNTY Attvch to compleh plans for tM1e s7shm anA submit ro Me Counn oNy on paper not less than S 1/i x 11 inches in size � SBD-639S(R.02/22) NO REFUNDB AFTER ISSUE OF PERMIT Ic0g�1 PAGE 1 OF In -Ground Gravity Plan `f Index � Cover Sheet Component Manual Design References: In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross-Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Owner Name(s): (,�) � �« �;� �I a r, �� Phone: - - Owner Address: ( D�-t �,3 ►J ��n��-+��� �u�`^� Zip: S�fS`-f3 Project Address: sav�n�._ - Govt. Lot: 1 /4 of 1 /4, Section Z�I , T `-� 1 N-R ��1 E Q or W� Township: �4 ��-cx�� County: S � � � Project Parcel ID #: 0 � O l � C� _ D I -- D t b0 Designer Information Designer Name: ��� S�� � � 1 Z- Phone: 1c - SS£� - Sr� DesignerAddress:'io�(nW �0 �2 La��e � S'�h.� � � �1 Zip: S�7� .. . .... ...� ........ �l'L�t . _ , �1i7T(1�. .,. $t[:r!�:�r E-mail: License Number: � �' l(o( z �7 Remarks: - Date: `S'��' Z � Signature: - ginal signature required on each submitted copy. � _ ___._ _ _ _ _.----. � _..... __._.._^__ ..... .__ ----- ____.. _..__ ___ . ; � - s . p . � .. . - � . . . f � , t ° . .. � : # � _.._. � : �. ___. ..__'_ _.__.'_ _ . . , ..... ._..._.... i ..__.. _.._ ."___ . . ..... .. E . . .. .. .. ...... . � � '._ . C 3 _ �� �f• __ L�: ; _ ° . _ _ l _ : . . . � L4Gi� rt Q � Ct�C ` S4Lv �e1^- ca. �ct Wct�C ��� � �,.� �4�.. �.. ' .. �-----�-- _ _._.�.�.._._....._ _... ._ _......._ . .. .. __....�_._ __ ..._._.__ .� ,.....�.^_�.__.._.j,._._._ ; (c��fa3 N s#ane�ood. 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' ` _`-.' _` ' . . . . .r--.-._-.-_.'-.'__...__ � : � . . . � _ ._.---- e ..` . i .. . , ._.._._._._ _..._.._.- __. � -�-----'_-- . . . . . . . -- - '-- -- . �,. ! . . , , . IN-GROUND GRAVITY DISPERSAL AREA I SepticTank(s)Manufaclurer: ��cLS 't,,,.� � �.ct S Stepped Elevation Trenches with Quick4 Standard-W Chambers � 3-ft Trench (down-sizing credit) - SeP'��Tankcs��o�ume�s': �gal gal gal ga� f � �— �� Efftuent Ffiter Manutacturer: SOIL COVER min.12" (rypicaq Etfluent Fliter Model#: ,1�� 12" � min.Irench TYPICAL TRENCH deplh ' � CROSS SECTION VIEW �"P�ca�' �. � - ------ - __---- .<.. . � • -. •� � .4 a, Provide minimum 3 ft (No Scale) � -- 3'a° '`< � . ,; � •a• separation hetween trQnches. (�Yplcat) •:', ., . . n . e,. . e. a I-lighest Trench --- Lowest Trench(as applicable) System Elevations= �-J�,� __ ft; � �� S ft; ft; ft; ft Qufck4 5tandard-W W/Ef1d Cap ObservallonPlpe TYPICAL TRENCH t Ical (Show location of inlet/outlet pipe connection on plan view.) (typlcat) �YP ) Install per manutacwrer's PLAN VIEW ' Instructlons. ��f 0 SCa�B� �— - --- - - - - - -- - - �jL - - �— �-- --- -- - �'f-- - - -- - - - -- - .- -� � �, :� E . � �. � � A= 3A ft � _ ; ; ': , , ' " ` � (typfcal? � I� _. — ._— __. _. � �. - - - - �f- - - - � - - - 7�f-- - -- --- - - - - - - -= —� � ` B = (��, ft _� m (typlcal) Quick4 Standard-W Chamber W (typical) O INSTALL PER TRENCH: (mta by��tutratorsystarns,i��.� -n Install pursuant to manufaclurers instructfons. � Quick4 Std-W @ 20 f�EISAlchamber= 3�ftZ + __!___, Pairs of end caps @ 6 ftZ EISA/pair= � ft� =Proposed EISA per trench= -3� ftZ Required Infiltration Area= a�3 ft` Distribution Method: x �trenches = Proposed Total EtSA= S Z- ttZ ��4-v� �y PAG E`(O F `{ In-ground Gravity Management Plan IMPORTANT: The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuan:to requirements of SPS 382-384,W:sc.Admin.Code. Pursuant to SPS 383.52(2),Wisc.Admir.Code.this system shall be considered a human healthhazard if not maintained in accordance with this appreved management plan. Furthermore,all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52(3),Wisc.Admin Code. Maximum Dispersal Area Operatinq Limits: Design Flow= �-{�a gpd; BODS<_220 mgL"'; TSS<_150 mgL'; FOG<_30 mgL' Inspection Checklist INSPECT EVERY 3 YEARS c type of use o age of sys;em o nuisance factors(i.e.odors:user complaints,etc.) o mechanical malfunction(i.e.,pumps,valves,switches,floats,etc.) o material fatigue(i.e.,leaks,breaks,corrosion,etc.) o solids volume in anaerobic treatment tank(s)and any distribution appurtenance(s)(i.e.,distnbution!drop box>s) c neglect or improper use(i.e.,exceeding design capacities,prohibited activities,etc.) o extent of ponding in distnbution cell pnor to dosing _ o dosing irregularities-if applicable(i.e.,pump re-cycling,float switch settings,eta) o electncal components-if appllcable(i.e. wiring,connections,swltches,controls,timers,alarms,etc.) o distribution lateral or lateral onfice plugging (measure lateral distal pressure—compare to desigr.specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS(or when necessary) . Septic and dose tank(s)shall be pumped by a certified septage servicing operator licensed under s.281.48 Wis. Stats.when the volume of solids in the tank(s)exceeds one-third(1/3)the liquid volume of the tank(s)or as required by local ordinance. Disposal of cortents shall be pursuant tc NR 113,Wisc.Admin.Code. o Effluent fiiter(s)shall be ir.spected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicirg period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc.Admin.Code. Report any component faiiure or malfunction to: Nameofindividualorcompany: �A� ���c�w, � bf�e✓` Phone: Local governmeni unit 5�-er CO ��✓<<�C Phone: . �115—(�34—Q�2�� Local govemment unit address:�(��'� Ma;vt S'{��'-(� (�c,,y(�r�ZIP: S`{8�3 Any defective part of this system shal!be repaired.replaced.or removed pursuant to SPS 383.51 (1),Wisc.Admin. Code.Repair or replzcement of failed or mal:crctioning components shall comply with SPS 383,Wisc.Admin.Code. No product for chemical or physical restoraiior.of�he POWTS may be used unless approved by the department in accordance with SPS 384.Wisc.Admin.Code. Continqencv Pian In the event that ary failed treatment comporent of this POWTS cannot be repaired,it shall be replaced pursuant to a plar submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be abandoned and replaced by a code-complying dispersal componert in a pre-determined area of suitable soils. Svstem Abandonment If use of ihis POWTS is discontieued,it shall be abandoned in accordance with SPS 383.33,Wisc Admin.Code.