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HomeMy WebLinkAbout24-57S Olson-"V- 'yl'<l'V ]^~) "i!i:)l:5 MAV i -.!/'0-/;; l/fu^4 Department of Safety & Professional Services, Industry Services Division CountyBayfield Sanitary Permiy^umber (to be fill§4 in by Co.)^-^% Sanitary Permit Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. State Transaction Number I. Application Information - Please Print All Information Project Address (if different than mailing address) 9700 McCarry Lake Rd Property Owner's Name Blake D. Olson & Emily A. Collins Parcel^^'gOl 04-024-2-47-08-28-1 05-003-26000 Property Owner's Mailing Address N8254 11 Oth St Property Location Govt. Lot City, State Spring Valley, Wl Zip Code 54767 II. Type of Building (check all that apply) B 1 or 2 Family Dwelling - Number of Bedrooms D Public/CommerciaI - Describe Use D State Owned - Describe Use. Phone Number 763-355-7174 _'/4,',4, Section 28 Lot #T47__N R_08_Eoif^l Subdivision Name Block # D City of _ CSM Number D Village of 0To^ of Iron River TO. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if] applicable.) •;.;,'1":[:11'111:1 12, New System D Replacement System D Other Modification to Existing System (explain)D Additional Pretreatment Unit (explain) B.D Holding Tank M In-Ground (conventional) D At-Grade Mound D Individual Site Design D Other Type (explain) c.D Renewal Before Expiration D Revision D Change of Plumber D Transfer to New OwnerIList Previous Permit Number and Date Issued FV. Dispersal/Treatment Area and Tank Information: Design Flow (g(750^Design Soil Application Ra^(gpd/sf)lication Ra^(g 0.7 Dispersal Area Required (sl 1071.4 Dispersal Area Proposed^)1128 ^ System Elevation \/^ 94-92 Tank Information Capacity in Gallons^New Tanks Existing Tanks Total Gallons # of Units Manufacturer S S£, 0 u-gsw "K Ss£: 5 Ip< Septic or Holding Tank 1585 1585 1 Wieser x Dosing Chamber 950 950 | 1 Wieser x V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) C'^f \^;-00*^l Plumber's Si MP/MPRS Number (1W^I Business Phone Number •7^-^/7 '^co Plumber's Address (Street, City, State, Zip Code) W LJ. ^p^hr .Q-. !le.. H^f P^i^,^^ ij^O^ ^Vt.^C'Uuni^^at^iiteutUst! Only Approved S.^-3^\ D Disapproved D Owner Given Reason for Denial Issuing Agentjiignature^PZ'"^ A5'^y^/^? Conditions o(?Approval/Reasons for Disapproval4^&€(W^ ywxt a^ &-to^./ ^a-C^M ^'VW^p'UMAr plan w owiar. Attach to complete plans for the system and submit to the County only on paper not less than 81/2x11 inches in size SBD-6398 (R. 03/22) Private Sewage System Maintenance Agreement Owner(s) Name Blake D. Olson & Emily A. Collins Owner(s) Mailing Address N8254 110th St, Spring Valley Wl 54767 Site Address 9700 McCarry Lake Rd Tax ID #04-024-2-47-08-28-1 05-003-26000 As owner, I (we) do hereby certify the private sewage system will be installed in accordance with the certified soil tester's report and approved plans and specifications on file with Bayfield County Planning and Zoning Department. The system will be operated in such a manner as to meet the designed plans. I (we) agree to maintain said private system at the below listed location in accordance with rules established in the Wl Adm. Code. as from time to time amended. (COMPLETE Legal is required) __1/4 of_1/4 Section 28 Township _47_N. Range °8 W. PAR !N GOVT LOT 3 IN V 1142 P 82 568AAdditional Legal Description: IN DOC 2023R-601306 Tnwnnf iron River ,'Acrsage) 1 340 GoviLot 3 Lot _ Block_ Subdivision Lot_CSM#_Vol._Page_ CSMDoc#. DOCUMENT NUMBER2024R-60333 1 DANIEL J. HEF-FNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED 05/23/2024 AT 10:21 AM RECORDING FEE: $30.00 PAGES: 2 Recording Area Return To: Pruning and Zorung Dcpartmsnt^ MAyM ^ D In-ground gravity D Mound El In-ground dosed E] In-ground pressure distribution Sewage System: D At-grade Sewage System D Other Seotic Tank (system types A through E): The septic tank shall be pumped by a certified septage servicing operator within three (3) years of the date of installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to make such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum. Pump Chamber (system types B, C, D, and E) The pump chamber shall also be rinsed and pumped out when the Aeptic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Seotic Tank Effluent Filter (system types A through E; The septic tank eff'uent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specificafons. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visually inspected by a certified septage servicing operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three (3) years thereafter to determine whether wastewater or effluent from the system is ponding on the ground surface. Mounds. At-cirade, and In-qrounri Pressure System Laterals (system types C D and E): The laterals shall be flushed out and swabbed if needed when the wastev/ater distribution cell component is inspected as provided above. Owner(s) agree that failure to comply with this agreement will result in action being taken to pay all charges and casts incurred by Bayfield County for inspection, pumping, hauling, or othewise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any human health hazard caused by the system. Bayfield County shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll ar. a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future ow} Owner(s) Name(s) - Please PrintSnits/^llnS Blal^oi^o^ Notar;zeci^3y.'rier(s) - Signature(s) 'L^- Subscribed and sworn to before me on c^>\ \^, ^7L( property^MIE L BURUD NOTARY PUBLIC MINNESOTA My Commission Expfres Jan. 31 , 2027 Notary Public My CommissioN blic |^/YLC0 L.'^U-^^ issioW Expires:J^n. Z\) U-'z-? Drafted by: Ta^ ^-pi {A^i»r« <u<JU.\NLu<A\ \ ^MA^<^KU^\ o !-(-f^ i^»A».<^i!-r Date.5/i-^^Proofed by: u/forms/sanitary/septicmaintenceagreement Revised July 2020 ,/» I ' EXHIBIT A A parcel of land located in Government Lot 3, Section 28, T, 47 N., R. 8 W,, In the Town of Iron River, Bayfleld County, Wisconsin, described as follows; To locate the Point of Beginning, commence at a 2-1/2" iron pipe at the S % corner of said Section 28 and run, N 89"38'57" E, 1319,56 feet on the south line of said Section 28, Thence leaving said south line, N 00°29'57" E, 1321,92 feet to a %" capped rebar at the SE corner of said Government Lot 3. Thence on the south line of said Government Lot 3, S 89°48'04" W, 233,48 feet to a 1" iron pipe, which is the Point of Beginning, Thence from said Point of Beginning by metes and bounds: Continue on said south line, N 89°48'04" W, 186,52 feet to a 1-1/4" iron pipe. Thence leaving said south line, N 00°27'44" E, 250.00 feet to a 1" Iron pipe meander corner that is S00027'44" W, 38 feet, more or less, from the ordinary hlgh-water line (OHWL) of Lake Milticent, Thence on a meander line near said OHWL, N 74°15'19" E, 113.94 feet to a steel "T" post, Thence N 59°22'43" E, 90,03 feet to a %" iron pipe meander corner that Is S 00°27'44" W, 19 feet, more or less, from said OHWL, Thence leaving said meander line/ S 00°27'44" W, 327,43 feet, to the Point of Beginning, Said Parcel contains 58,460 square feet, more or less/ which Is 1,34 acres, more or less, Including that land tying between the meander line and the OHWL of Lake Mlllcent and the extension of the lot lines to said OHWL. Bayfield County Register of Deeds Document #2023R-601306 Page 5 of 6 HAY i 3 ;/1 POWTS OWNER'S MANUAL & FILE INFORMATION MANAGEMENT PLAN SYSTEM SPECIFICATIONS of Owner Permit # Blake D.Olson &Emily A.Collins DESIGN PARAMETERS Number of Bedrooms Number of Public Facility Units Estimated (average) flow Design (peak) flow = (Estimated x 1.5) In Situ Soil Application Rate Standard Influent/Effluent Quality Fats, Oil & Grease (FOG) Biochemical Oxygen Demand (BOD5) Total Suspended Solids (TSS) Pretreated Effluent Quality Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) Fecal Coliform (geometric mean) Maximum Effluent Particle Size Other: 5 DMA 0 NA 500 gal/day 750 gal/day 0.7 gal/day/ft2 Monthly average* $30 mg/L <220 mg/L D NA $150mg/L Monthly average ^30 mg/L <30 mg/L 0 NA <104cfu/100ml ^ in dia. D NA 0 NA Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Tank Manufacturer 0 Septic D Dose D Holding Tank Manufacturer n Septic 0 Dose D Holding Effluent Filter Manufacturer Effluent Filter Model Pump Manufacturer Pump Model Pretreatment Unit n Sand/Gravel Filter D Mechanical Aeration D Disinfection Manufacturer Dispersal Cell (s) E I n-G round (gravity) D At-Grade D Drip-Line Other: Other: vol. 1585 vol. 950 Polylok 525 Zoeller 98 D Peat Filter D Wetland D Other: D NA gal DNA gal D NA DMA 0 NA DNA D In-Ground (pressurized) D Mound D Other: 0 NA 0 NA Service Event Inspect condition of tank(s) Pump out contents of tank(s) Inspect dispersal cell(s) Clean effluent filter Inspect pump, pump controls & alarm Flush laterals and pressure test Other: Other: Service Frequency At least once every: ^ ^alr(s)s (Maximum 3 years) D NA 0 When combined sludge and scum equals one-third (14) of tank volume D When the high water alarm is activated At least once every: 3 § S"eTrt(s) (Maximum 3 years) D NA At least once every: 3 § I;e°anrt(hs()s) D NA At least once every: 3 g ^%s) D NA At least once every: g !neTrt(s) 0 NA At least once every: g f^f Q NA 0NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator (pumper). 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 sludge and scum and a check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluenton the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third (16) 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, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of ^12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (12/02) Page _ ofSTART UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presehbe of paihtirtg products, solvents or other chemicals that may impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the affluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: D A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. D A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate 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. D Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING»SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF APERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name S.J^ ^"-9'^^ {^^{^ ^uU.kl^l.J \A^'MU'^1 Phone -ttb^[1- ^W Name ^>Jt?ift.'» ^'.'Qti*--^ Phone -y;&, -0f-7-^oc/ SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name j^^.,,^ S~.L^|^ Phone 3^- 4^8.- ^<<<:ft'l NameBayfield County Zoning Phone 715-373-6138 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. BAYFIELD COUNTS SANITARY PERMIT (#04}-24r57S STATE SANITARY PERMIT OWNER: BLAKE D OLSON / ATTN: EMILY COLLINS GOVTLOT:3 LOT: BLK: 1/4 1/4 SEC: 28, T 47 N, R 8 W TOWNSHIP: Iron River SOIL TEST: 17-24 NEW SYSTEM SYSTEM T^PE: Non-Pressurized In-Ground PLUMBER: John Broberg MCKENZIE SLACK DATE: 5/30/2024 Authorized Issuing Officer CHAPTER 145.135(2) WISCONSIN STATUTES a. The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. b. The approval of the sanitary permit is based on regulations in force on the date of approval. c. The sanitary permit is valid and may be renewed for specified period. d. Changed regulations will not impair the validity of a sanitary permit. e. Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. f. The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. PREVIOUS PERMIT #: LICENSE: #988914 Condition: System to meet all setbacks. Management plan to owners. Properly maintain system per recorded agreement. THIS PERMIT EXPIRES 5/30/2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION Wisconsin Department of Safety & Professional Services Division of Industry Services ^}/2tf 1^ FEB 7QW Page_-of_ SOIL EVALUATION REPOgJ,^,, ^ .,__ ,^FvTiPfrf ;'"'"• /r'.n-;-Ts i'l^nt In accordance with SPS 385, Wis. Adm. Code Attach complete site plan on paper not less than 81/2x11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). ~V\7-24 County Bayfield Parcel I.D. /i 04-024-2-24-08-2E '05-003-26000 Reviewed by JV\i Date\d-^o^ Property Owner Blake D. Olson & Emily A. Collins Property Location Govt. Lot ,3 y< -DD" V, S 28 T 47 N R 08 E (or)® Property Owner's Mailing AddressN8254 11 Oth St Site Address or CSM and Lot #:9700 McCarry Lake Rd City, State, ZipSpring Valley, Wl 54767 Phone Number ( 763) 355-7174 D City D Village 0 Town Iron River Nearest Road McCarry Lake Rd Q New Construction Use: I^Residential/Numberofbedrooms D Replacement D Public or commercial - Describe: Parent material Outwash sands (Rubicon-Sayner complex) General comments and recommendations: Code derived designflow rate 75° GPD Flood Plan elevation if applicable — ft. Boring # South D BoringEZIPit Ground surface elev.96.7 ft.Depth to limiting factor y<3 in. / elev. 88.7 ft. Hon'zon 1 2 3 4 Depth In. 0-6 6-25 25-42 42-96 Dominant Color Munsell 10YR2/1 7.5YR 4/4 10YR5/4 10YR6/4 Redox Description Qu. Az. Cont. Color TOO Texture s s s s Structure Gr. Sz. Sh. Osg Osg Osg Osg Consistence ml ml ml ml Boundary cw gw gw Roots lco/1m/1f 2m 1f Soil Application Rate GPD/Ft2 *Ef»1 0.7 0.7 0.7 0.7 *Ef?2 1.6 1.6 1.6 1.6 Boring # North CJBoringBJPit Ground surface elev. 96.4 ft.Depth to limiting factor.96 in. / elev.88.4 Horizon 1 2 3 4 5 Depth In. 0-4 4-12 12-29 29-65 65-96 Dominant Color Munsell 10YR2/1 7.5YR 3/3 7.5YR 4/4 10YR5/6 10YR6/4VW Redox Descnption Qu. Az. Cont. Color cpo^ Texture s s s s s Structure Gr. Sz. Sh. Osg Osg Osg Osg Osg Consistence ml ml ml ml ml Boundary cw cw gw cw Roots 2f 1co/lm/1f 1m/1f 1f Soil Application Rate GPD/Ft2 *Efl»1 0.7 0.7 0.7 0.7 0.7 *Eff»2 1.6 1.6 1.6 1.6 1.6 CST Name (Please Print)Keith Wiley Address11623 E Larson Dr. Lake Nebagamon, Wl 54849 s"nu^ Date 2/13/2024 Fumber 654921 Telephone Number 218^51-2611 * Effluent #1 ° BOD > 30 & 220 mg/L and TSS > 30 s 150 mg/L • Effluent#2 = BOO, s 30 mg/L and TSS £ 30mg/L SBD-8330 (R03/22) Page..of. Boring #mid D BoringEZIPit Ip-, ll i; Ground surface elev. 94-3 ft. ||| f^Dtgtojli'Ateffififacior 96 in. / elev. 86-3 ft. Horizon 1 2 3 4 5 Depth In. 0-4 4-12 12-28 28-56 56-96 Dominant Color Munsell 10YR2/1 7.5YR 3/3 7.5YR4/4 10YR5/6 10YR6/4 vv\^ Redox Description Qu. Az. Cont. Color m^o Texture s s s s s Structure Gr. Sz. Sh. Osg Osg Osg Osg Osg •;!£ Consistence ml ml ml ml ml Boundary cw IW gw gw Roots 1f 1co/1nV1f 1m/1f 1f Soil Application Rate GPD/Ft2 *EfW1 0.7 0.7 0.7 0.7 0.7 *Efl»2 1.6 1.6 1.6 1.6 1.6 Boring #D BoringD Pit Ground surface elev._ft.Depth to limiting factor._in. / elev.__ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Eff#1 *Efl#2 Boring #D BoringD pit Ground surface elev._ft.Depth to limiting factor._in. / elev._ Honzon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Ef»1 *Effiff2 • Effluent #1 = BOD > 30 £ 220 mg/L and TSS > 30 S 150 mg/L * Effluent #2 = BOD, £ 30 mg/L and TSS & 30 mg/L Olson (5 bedroom) Soil Report Plot Plan lii; J±b :';:;:uzu L/ / Scale 1:40 <- / fl7 Blake D. Olson & Emily A. Collins 9700 McCarry Lake Rd PAR IN GOVT LOTS IN V.1142 P.82 568A IN DOC 2023R-601306 Sec28T47NR08W 04-024-2-47-08-28-105-003-26000 Town of Iron River 1.340 acres ^^?r^-^^-- Off^; 166.82'Property line X Bench Mark = Nail w/orange ribbon in power pole Elev = 100.0' NOTES: - Property lines not to scale -No well - Lake Millicent elev. " 79' CST#654921 Page 3 of 3 BAYFIELD COUNTY Blake D. Olson CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): B'CheckList !i' TO " ' j,/j L^' D Index Page / Title Sheet (Optional) c;s,..;- , ;. 0' Original Soil Evaluation Report (Submitted in Deed Holders Name - not prospective buyers) 52" Original Plot Plan D Cross Section Soil Profile Sheet (optional) D Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) E' Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used Q' Property Owner's Information (not prospective buyer's name) EJ Property Location (Accurate Legal Description with Sec/Twp/Range) ff Road Name (where driveway is/will be coming off of) E3'Floodplain Elevation, Flow Rate, Comments and Recommendations 5?'Complete Soil Boring / Pit Information E7 Date Soil Evaluation was conducted E/KCST Name, Signature, Number, Address and Phone Number ff *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) B/Bench Mark (Description, Elevation and Location) B'Contour Lines (Example = 98.0'/96.0' ,94.0') SrProperty Location (Sec/Twp/Range/, Accurate Legal Description) Q Borings (Locations and Elevations) sy Percent and Direction of Land Slope EJ Well Location (Including Neighboring Wells, if applicable) l\y Location of Wetland Areas, Floodplain and Navigable Waters 0'Buildings, Driveways, and Structures (Location and Descriptions) GyLocation of Property Lines 0'Existing System Location I\y Address Number and Road Name E7 Current Surface Elevation of Wetlands and Navigable Waters 0'CST, Owner and Property Information E/North Arrow Fee: 0'Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklisVchecklistforcsts In-Ground Dosed-Gravity Plan Index & Cover Sheet Component Manual Design References: In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) PAGE 1 OF 5 m 1 ^^?A Pg 1 of 5 Pg 2 of 5 Pg 3 of 5 Pg 4 of 5 Pg 5 of 5 Index & Cover Sheet Plot Plan Dispersal Area Cross-Section & Plan View Pump Tank Specifications Management Plan Attachments: Pump Curve tank cut sheet Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Olson In-Ground Dosed Phone: 763 -355 _7174 Zip: 54767 Owner Name(s): Blake D. Olson, Emily A. Collins Owner Address: N8254 110th St Spring Valley, Wl Project Address: 9700 McCarry Lake Rd Govt.Lot:3_ 1/4 of 1/4, Section 28 , T47 N-R08 E or wl/ Township: Iron River County: Bayfield Project Parcel ID #: 04-024-2-47-08-28-1 05-003-26000 Designer Information Designer Name: Keith Wiley _ phone: 218 .451 -2611 Designer Address: 11623 E. Larson Dr. Lake Nebagamon E-mail: s.shoreseptic@gmail.com Zip:. 54849 Tins space re.scrved for approval slamp. License Number: D2388PSS iin""'ini,,^jw^>,c;^"^s^ \ Date: -2- -/^ -^L^^^ Original signature required on each submitted copy. Olson (5 bedroom) In-Ground Dosed-Gravity System Plot Plan North ^ Wieser precast WLP1585-950 w/polylok 525 filter & Zoeller 98 pump Scale 1:40 <- Four rows of Infiltrtor Quick 4 Plus Standard 14 chambers rows 1 & 2 13 chambers rows 3 & 4 Blake D. Olson & Emily A. Collins 9700 McCarry Lake Rd PAR IN GOVT LOT 3 IN V.1142 P.82 568A IN DOC 2023R-601306 Sec 28 T47N R08W 04-024-2-47-08-28-105-003-26000 Town of Iron River 1.340 acres .c...^-- 166.82'Property line i^^:- NOTES: - Property lines n<j 98' --»• to scale X Bench Mark = Nail w/orange ribbon in power pole Elev = 100.0' -Lake Millicentelev. "79' - All vent, observation & conveyance pipes 4" ASTM D 1785 Page 2 of 5 Rows 1 & 2 IN-GROUND DOSED-GRAVIP^ DISPERSAL AREA Stepped Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down-sizing credit) _^ ,i_jL_i_jL\r SOIL COVER 12" mln. trench depth(typical) TYPICAL TRENCHCROSS SECTION VIEW (No Scale) --2. 1s': 34"—(typical) Highest Trench Lowest Trench (as applicable)Provide minimum 3 ft separation between trenches. System Elevations = 94 ft;. 94 ft;. 92 ft;. 92 ft;ft Quick4 Standard-W w/ End Cap (typical)(Show location of inlet / outlet pipe connection on plan view.) iiiB4Biiiii—-—i™n- - - - -V/- EUlgjgL5B^'IBgie^gS3i8-ll"SBgN ins Observation Pipe(typical) Install per manufacturer's instructions. INSTALL PER TRENCH: -^-------^-- B= _58_ ft (typical) TOPICAL TRENCH PLAN VIEW (No Scale) 14 Quick4 Std-W @ 20 ff EISA/chamber = 280 Pairs of end caps @ 6 ft2 EISA/pair = 12 ft2 ft2 -Quick4 Standard-W Chamber(typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. n>G)m00Q-n 01 = Proposed EISA per trench = 292 ft2 Required Infiltration Area = 1 °71 -4 ft2 trenches = Proposed Total EISA = 584 ft2 Distribution Method: branched manifold Rows 3 & 4 IN-GROUND DOSED-GRAVITY DISPERSAL AREA Stepped Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down-sizing credit) SOIL COVER 12" min. trench depth(typical) TYPICAL TRENCHCROSS SECTION VIEW (No Scale) (typical) Highest Trench Lowest Trench (as applicable)Provide minimum 3 ft separation between trenches. System Elevations = 94 ft;. 94 ft;. 92 ft;. 92 ft;ft Quick4 Standcj w/ End Cap (typical)(Show location of inlet / outlet pipe connection on plan view.)Observation Pipe install peSlcture. TYPICAL TRENCH instructions. PLAN VIEW [Lli3|g-3^3BffiSN:W5;fii|lNN2fi -V/- ------- -7^--- -iiiliiiiiniii.iiiiiiiiin-fnfennfimiH -^--------^-----v---- (No Scale) INSTALL PER TRENCH: Quick4 Std-W @ 20 ff EISA/chamber = 260 y Pairs of end caps @ 6 ft2 EISA/pair = 12 ft2 = Proposed EISA per trench = £-1 ^ ft2 •Quick4 Standard-W Chamber(typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's instructions. -u>G)mcoQ-n 01 Required Infiltration A^= 1071.4 ft. trenches = Proposed Total EISA = 544 Distribution Method: branched manifold PAGE 4 OF 5 :'w;GRAVITY-DOSED SEPTIC / PUMP TANK SPECIFICATIONS(No Scale) IMPORTANT: 4"0 Vent Pipe >10ft from Building 12" Min. or 2.0 ft above Established Flood Elevation(typical)ApprovedVent Cap Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) \1/ \^ Finished Grade Electrical must comply withSPS 316 and NEC 300 Weatherproof •Junction Box Extend manhole riser as necessary. Approved Locking Manholewith Warning Label Attached(typical) 4" Min. or 2.0 ft above Established Flood Elevation(typical)^ \1/ CAPACITIES 25 gal/in A B [C] D Depth (in) 20 2.0 6 10 Volume (gal) 500 50 150 250 38 in in Pump Tank Liquid Level = Force Main Diameter = 2 Force Main Length = 55 ft Force Main Void Volume = 8-9 gal 150 gal/dose 18"Min. (typical)1 Approved Joints with Approved Pipe 3 ft onto Solid Ground(typical) PUMP-OFF ELEVATION =88.58 ft INSIDE BOTTOMELEVATION = 8775 ft 3" Approved Bedding Material Beneath Tank [C] Total Dose Volume (TDV) = <0.2X(^ 0.2X design flow + force main void volume) 7.25 141.1 +8.9=150 Vertical Lift =ft PUMP TANK: Volume =950 gal Manufacturer:Wieser SEPTIC TANK(S): Total Volume = 1585 gal Manufacturers):Wieser Pump Manufacturer: Pump Model: Zoeller 98 (See attached pump curve.) Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Controls/Alarm Manufacturer: Controls/Alarm Model: SJE Rhombus EZ Plugger Filter Manufacturer: Filter Model: Polylok 525 Float switches containing mercyry arej3rohibited. TOTAL DYNAMIC HEAD FLOW PER MINUTE MAY .J/O^;. MODEL Feet 5 10 15 20 Meters 1.5 3.0 4.6 7.1 Shut-off Head: 98 Gal. 72 61 45 25 Liters 273 231 170 95 23 ft.(7.0m) QS 6.I0 QI 2-1 s 25 20 15 10 5- GALLONS LITERS PUMP PERFORMANCE CURVE MODEL 98 N 10 20 30 40 50 60 70 80 160 FLOW PER MINUTE 240 Model M98 N98 D98 E98 BN98 BE98 MODEL COMPARISON Seal Single Single Single Single Single Single Mode Auto Non Auto Non Auto Auto Volts 115 115 230 230 115 230 Ph 1 1 1 1 1 1 Amps 9.4 9.4 4.7 4.7 9.4 9.4 HP 1/2 1/2 1/2 1/2 1/2 1/2 Hz 60 60 60 60 60 60 Lbs 36 36 36 35 37 40 Kg 16 16 16 16 17 18 Simplex 1 2 or 3 1 2 or 3 Duplex 4 4 4 4 *BN and BE models include a 20' (6m) piggyback variable level pump switch. Additional cord lengths are available in 25' (8m) and 35' (11 m). 50' (15 m) cords are available for 230 V units only. SELECTION GUIDE 1. Integral float-operated mechanical switch, no external control required. 2. For automatic, use single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 3. See FM1228 for correct model of simplex control panel. 4. See FM0712 for correct model of duplex control panel or FM1663 for a residential alternator system. OPTIONAL PUMP STAND P/N 10-2421 Reduces potential clogging by debris Replaces rocks or bricks under the pump Made of durable, noncorrosive ABS Raises pump 2" (5 cm) off bottom of basin Provides the ability to raise intake by adding sections of V/z" or 2" (DN40 or DN50) PVC pipingAttaches securely to pump Accommodates sump, dewatering and effluent applications NOTE: Make sure float is free from obstruction. All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electrical Code (NEC) and the Occupational Safety and Health Act (OSHA). © Copyright 2020 Zoeller® Co. All rights reserved. 502-778-2731 | 800-928-7867 | 3649 Cane Run Road | Louisville, KY 40211-1961 zoellerpump.com TOP VIEX SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED AS7M C-1227 REQUIREMENTS WLP1585/950 TANK SPECIFICATIONS DIMENSIONS:WALL 3" BOTTOM: 5" COVER: 6" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 56" LENGTH: 15'-3 3/8" WIDTH: 8'-5 3/8" BELOW INLET: 45" LIQUID LEVEL 38"WEIGHT: BOTTOM 15,977 LBS.COVER S.300 LBS. INLET AND OUTLET:4" CAST-A-SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER:WISCONSIN. SEE DETAIL jj(10(OTHER STATES SEE CHART) LIQUID CAPACITf: 41.67 GAL/IN (SEPTIC) 25.00 GAL/IN (PUMP) LOADING DESIGN: 8'-0" UNSAWRATED SOIL TANK CAN BE USED AS: SEPTIC/SEP-nC, SEPT1C/PUMP,OR SEPT1C/SIPHON COVER: MIX DESIGN j^8 (NO FIBER)TANK: MIX DESIGN #3 (SMALL FIBER) CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETE KEY NOTES: 1 ) CONCRETE OR EZ-SNAP RISERS 2^ OPTIONAL 2" OUTLET 16" UP FROMBOTTOM OF TANK a:gCLILJK.-^ QL=J0a_1GO0_a. REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: ^ U31$smIL"^ 003: CO Qin01 10s <=) 0 CLLdw SHEET NO, 1 OF 1 Bayfield County, Wl LAKEMILLICENT PRPIO/Tax It) <* LAKE QssssffassssosssaQSlESSSSSI^f^fuSSSu^ 8368 ateSfiB? tiSBglSE@8S8N®aiaS8? lAKS W•o isste sesasssseeses'wss ssi iftaasaoarwK®^WBsssswssesi Ga2S2%oa50{EEE8ffiTOKBRU^p^l.ra <SS3Eff3338!>OSE'3mniKoi/wMasiaiin.CTnawi QSSSffSS/^OSEESQCBflGBGxSMSH) WI07iraiT'IOMl97.92lkTOByiEWSHi'IRON'J/M'ARCOVICH] Wssisssses f33SEffSSsSSX5333EQy lyiSSx^vBvwa esssssssffvtsssscyssss?(338SC32SB3 5/23/2024, 9:55:22 AM ::~;Mt":: Wetlands ; Approximate Parcel Boundary Rivers Road Type Building Footprint 2015 Building Lakes Town 1:957 0.01 0.02 0.04 mi 0.02 0.04 0.07 km Bayfield County Land Records Department Bayfield County Zoning Applicationhttps://maps.bayfie!dcounty.wj.gov/ZoningWAB/ 5/23/24, 9:54 AM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 5/23/2024 Property Status: Current Created On: 3/15/2006 1:15:34 PM Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN: Tax Districts 1 04 024 163297 001700 19801 Updated: 12/12/2023 04-024-2-47-08-28-1 05-003-26000 024107403000 (024) TOWN OF IRON RIVER S28 T47N R08W PAR IN GOVT LOT 3INV.1142 P.82 IN DOC 2023R-601306 1.340 1.441 0 No (R-l) Residential-1 118 'f, •'* Recorded Documents B LAND CONTRACT Date Recorded: 11/21/2023 B WARRANTY DEED Date Recorded: 5/8/2015 B CONVERSION Date Recorded: i Updated: 3/15/2006 STATE COUNTr' TOWN OF IRON RIVER SCHL-MAPLE TECHNICAL COLLEGE Updated: 3/15/2006 2023R-601306 2015R-558646 1142-82 258-171 Ownership BLAKE D OLSON EMILY A COLLINS Billing Address: BLAKE D OLSON ATTN: EMILY A COLLINS N8254 110TH ST SPRING VALLEY WI 54767 Updated: 11/28/2023 SPRING VALLEY WI SPRING VALLEY WI Mailing Address: BLAKE D OLSON ATTN: EMILY A COLLINS N8254 110TH ST SPRING VALLEY WI 54767 Site Address * indicates Private Road 9748 MCCARRY LAKE RD Property Assessment 2024 Assessment Detail Code Gl-RESIDENTIAL 2-Year Comparison Land: Improved: Total: Property History N/A IRON RIVER 54847 Updated: 8/2/2012 Acres Land Imp. 2.000 224,000 0 2023 2024 Change 224,000 224,000 0.0% 0 0 0.0% 224,000 224,000 0.0% https://novus.bayfieldcounty.wi.gov/access/master.asp?paprpid=19801 1/1 BAYFIELD COUNTSCHECKLIST FOR SANITARY APPLICATONS Blake D. Olson hAT ; J2024Submit the Following (Use Permanent Ink) (Title 15, Section 15-l-10(e)) 0 Check List 0 Original Sanitary Application (Submitted in Deed Holders Name - not prospective buyers) (383.21(1)1.) 0 Index Page / Title Sheet (Signed by Plumber) (383.22(2)69(c)) 0 Original Plot Plan (383.22(2)2. 3. & 4.a) 0 Cross Section, Over-Head Profile of the System and Schematic of Tank from Manufacturer 0 Pump Tank Diagram, Alarm and Pump Curve (when applicable) 0 Contingency Plan / Management Plan (383.22-3(2)(b)l.f.) Cf Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) D Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) D Holding Tank Service Contract (Original Signature of Pumper and Property Owner) (383.21(2)(c)5) D ATU Servicing Agreement (Recorded at Reg. of Deeds) 0 Fee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) 0 2 Complete Sets of Plans (383.22C2X2.) CNote: Sanitary Application and Maintenance Agreements are to be attached to all copies) 0 Soil and Site Evaluation Report (383.22-3(2)(b)l.e.) D State Plan Review (when applicable) D Copy of Warranty/Quit Claim Deed (Optional) Sanitary Application: (Include the following Information) 0 I Application Information must include: D 23 diait Parcel ID# - fdo not use 12 digits anymore-obsolete) 0 Project Address or Road Name where driveway is/will come off of) 0 (Owners Phone Number) 0 II Type of Building Ef III Type of Permit Ef IV Type of POWTS System 0 V Dispersal / Treatment Area Information 0 VI Tank Information 0 VII Responsibility Statement (Plumber's Information) S/ *Date Stamp* Plot Plan: (To Scale or To Dimension) 0 Signature and Plumber Information 0 Surface Elevation of Body of Water 0 Direction and Percent Land Slope 0 Tank and Filter Information and Location 0 Wetlands / Navigable Bodies of Water 0 Absorption Area (Proposed and Existing) 0 Bench Mark (Location, Elevation and Description) 0 Component Manual Version 0 0 Address Number and Road 0 North Arrow 0 Contour Lines (Zf Structures and Driveways 0 Boring Locations 0 Property Lines 0 Well Locations 0 Legal Descriptions ^ygncSlffi^'BtuiaiBg'se^i Turn Over > Cross-Section and Over-Head Profile of the System: MAY "! ^'W(A 0 Surface and System Elevation 0 Position of Observation and Vent Pipes Cf Dimensions and Depths 0 Make, Model & Number of Chamber Units in each Cell 1 Property Information Ef How many systems will there be on this parcel of land? Ef Has this property been split? no (Property Statement shows Property History) Fees: 0 Private Sewage System (Septic Tanks) $ 400.00 D Private Sewage System (Holding Tanks) $ 400.00 D Mounds or Systems requiring Pre-Treatment $ 500.00 D Sanitary Revisions D Private Sewage System Reconnection and Private Interceptor D Return Inspection 0 Maintenance Agreements ^ (checks made out to Reg of Deeds) $ $ $ $ 25.00 50.00 50.00 30.00 u/forms/checklists/checkllstforsanitaryapps(10/2009);(®7/2011);(®2/20l2)(®5/2/2012-dc) Proofed by: