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HomeMy WebLinkAbout24-64S HirschJDL Department] ^f Sa^(&P^fess3?SeiW£52024 Industry Services Riyision C^ty BAYFIELD Sanitary Permit I^umber (to be filled in by Co.)',r3^^4S 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-ovrned 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. Slate Transaction Number^'W^Dllff}- & Project Address (if different than mailing address) Property Owner's Name HIRSCH FAMILY TRUST Parcel # 541 Property Owner's Mailing Address 28335 CHERRYVILLE ROAD Property Location Govt. Lot City, State ASHLAND, Wl Zip Code 54806 M 1 or 2 Family Dwelling - Number ofBedrooms 3 D Public/Commercial - Describe Use D State Owned - Describe Use. Phone Number 715-413-0937 Lot # JME_'/4,_SW_./4, Section 34 T 48 N R 5 Eofw Subdivision Name Block# a City of_ CSM Number D Village of MTown of BARKSDALE A.New System /stem D Other Modification to Existing System (explain)D Additional Pretreatment Unit (explain) B.D Holding Tank D 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 Owner AST Previous Permit Number and Date Issued BiHi5 Design FIow^gpd)450 v^Design Soil AppliC&tion Rate(gpd/sf);sign Soil AppliC&ti. 0.6 Dispersal Area Requa^d (sf) 750 Dispersal Area Propped (sf) 1058 System Elevation 103.30 Tank Information Capacity in Gallons New Tanks Exisriu^Tauks Total Gallons # of Units Manufacturer ts0 ussm 'ES S J§E U Scptic or Holding Tank 1000 1000 1 WIESER CONCRETE x Dosing Chamber 750 Plumber's Name (Print) QUINN GRANGER Plumber's Signature <^5. 750 | 1 | WIESER CONCRETE | X MP/MPRS Number 987826 Business Phone Number 715-685-4330 Plumber's Address (Street, City, State, Zip Code) 39860 JENSEN RD, MARENGO, Wl 54855 Approved jfrttHm D Disapproved D Owner Given Reason for Denial Permit Fee |./~ /] Date Issued _ / | Issuing Agent Signamre'^b^pWUA^T./,e!o>'7^/^ L'onditions IjifApproval/Reasons for Disapproval )W\ W <Wtf (^11 ?au^. '5zj2 Car^ f) MW^YW 0^ fc) oiuy^. ?.)oi^ ^\a w ^ owaff^ ^ s PS ^^ Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 03/22) •S3:gfc-wmIilitl^illli;;llIllI'll tt^sa.Si: £'5'<Q» s..::\\\:\\:\^\ IB.;"B:::;:;:::%;:^;;;T'^ •d;§'3 <s&M^':::*> i:::.'::fe .'•••l- '.'.^.:'t*<I: IS:1:ft 5': :1•^'•»f: :s 'sa g.1IA8t :iil s'i :::;:-1: ws ;£»; r W Ms. M^1; m ll^iii ^£:l':is.0 0 ffi <flF m WM;-^3;.:::llVi^i -B § a. .w .1: a>.1: i 3" I' af8. IOTIS;[>%iB 0.:V- t/>:"?:79^£•'. DN30tfl•<wWtoc Sh.' ^..: s^,^ N;::! Q. Tlw</<.••'i::! 1-: ^ sn w <?' *&•:: ;;;!©iiIll® w- ffl 8.' E rS sss- :1. tyM U)-t» 3- s:<s:® :cr t ;••, 0 a.. lc> &>IE» .!':......_|^.fc...^JjrSSi:3£EJT:1 ^"u! .iM:•y^^-fi:^§11feisfr:::llPf::r*v3:w ££J<.^^"";:?'T^;« ^Jc^svf^ —j- "^•1"""—"l?~ CONOmONALLV Dgpy. OFS SAFETY Ali& P^^'gSSIONAL SS^VKgSKSVESEON OF S?iO^STR¥ SSRVGgS L?//^^€V.-(5d^ ei^xs^w. SSt2m3Z4SEE eORHSSPONOENCE Project Name: Owner's Name: Owner's Address: GSF Wl MOUND DESIGN PROGRAM INDEX AND TITLE PAGE GSF MOUND SYSTEM II iMd U i 1 n h7074 HIRSCH FAMILY TRUST 28335 CHERRYVILLE ROAD ASHLAND, Wl 54806 715-413-0937 Legal Description: Township: County: Subdivision Name: Lot Number: NE1/4 SW1/4 S34 T48N R5W BARKSDALE BAYFIELD Block Number: Parcel I.D. Number: 541 Plan Transaction No.: Page 1 index and tffle Page 2 Data entry Page 3 GSF mound drawings Page 4 Laterai and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve-and specifications Page 9 Plot Plan Soil Test Copy Wieser Concrete Tank SpeaficaSons Designer: Quinn Granger Date: 5/13/2024 License Number: Phone Number: 987826 715-685-4330 Signature: ,/5%-^> » Designed Pursuant to the GSF Mound Component Manual (N. 08/16), and SSWMP Publication 9.6 Design Pressure Distribution Networks for STSAS (01/81) GSF Mound Version 2.3 Page 1 of 9 GSF Wl MOUND DESIGN PROGRAM INDEX AND TITLE PAGE JUN 052024 Project Name: Owner's Name: Owner's Address: Legal Description: Township: County: Subdivision Name: Lot Number: Parcel I.D. Number: Plan Transaction No.: GSF MOUND SYSTEM HIRSCH FAMILY TRUST 28335 CHERRYVILLE ROAD ASHLAND,Wl54806 715-413-0937 NE1/4 SW1/4 S34 T48N R5W BARKSDALE BAYFIELD 541 Page 1 Page 2 Page 3 Page 4 PageS Page 6 Page? Page 8 Page 9 Designer: Quinn Granger Date: 5/13/2024 Signature: /%^»»^ Block Number: Index and title Data entry GSF mound drawings Lateral and dose tank Distribution media System maintenance specifications Management and contingency plan Pump curve and specifications Plot Plan Soil Test Copy Wieser Concrete Tank Specifications License Number: 987826 Phone Number: 715-685-4330 Designed Pursuant to the GSF Mound Component Manual (N. 08/16), and SSWMP Publication 9.6 Design Pressure Distribution Networks for STSAS (01/81) GSF Mound Version 2.3 Page 1 of 9 Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, Wl 53707 JUNO 52024 II; Phone: 608-266-2112 If Web: hltDsZZdSES^id-g&Y -•';' Email: c!sES(t|ind£coiKiu^goy Tony Even, Governor Dan Hereth, Secretary May 28,2024 CUST ID NO.: 987826 QUINN S GRANGER 39860 JENSEN RD MARENGO, Wl 54855 CONDITIONAL APPROVAL Identification Numbars Plan Review No.: PWTS-052401101-C Application No.: DIS-052422722 Site ID No.: SIT-130864 Please refer to all identification numbers in each con-espondence with the Department PLAN APPROVAL EXPIRES: 05/28/2026 MCNICIPAUrtY:TOWN OF BAEKSDALE BAYF1ELD COUNTY SITE: HIRSCH FAMILY TRUST GSF MOUND 28335 CHERRYVILLE ROAD ASHLAND. WI 54806 NE1/4 SW1/4 S34 T48N R5W FOR: Design Wastewater Flow Value: 450 Bedrooms; 3 Limiting Factor(s): 18 Inches Maintenance Required: EfHuent Filter CONCmONAt.LY OEPT. OF SiltFETY &NB S6RV!CESOF INOUSTW SERVICES ®kl®hxmg«, <sS!2Sf2QZ4see CORRESPOKDENCE Eljen GSF Mound Component Manual - September 2019 Edition Mound Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A fall size copy of the approved plans, specifications, and this letter shall be on-site during constmction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following CTnditians shall be met during construction cr instaHation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the puny in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction pr<%iucts shall not be discharged into the drains discharging to the private oasite wastewater treatment system (POWTS). Waste generated shall be properly disposed ofon-site or off site. ® Any tail grasses, leaves and shrubs shaU be cut short and removed prior to tilling the surface for iastallatioa to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. ® Divert surface water from all POWTS Areas. • Prior to constructiua of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. » All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 ® Insuiate buUding sewer beyond 30 feet per SPS 382.30 (1l)(c) • Weii setbacks to meet chs.NR 811 & 812 !,', I! 11 ® Tank Installation to follow all manufacture's recommendations. ilil JUI^UD^U^.'i '••••' • Verify property iine(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatmeni. If no other siie is available, in the basal area of the mound must. be cii< off at ground level. A larger 11 il area is necessary when any of the above conditions are encountered. So provide sufficient infiltrative area. OWNER RESPONSIBILITIES ® The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper u se and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual aud/or owner's manual for tfae POWTS described m this approval and Wis. Admin. Code § SPS 383.5<H. a In tfae event this soil absorption system or any of its component parts maliunctions so as to create a health hazard, tfae property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for confonnance with applicable Wisconsm Admimstrative Codes and Wisconsin Statutes. The submittai has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component mamial(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 the Department per s.145.06, stats. All peimits required by the state or the ]ocal municipality shall 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 103.12(2), nofting in tiiis review shall relieve the designer of the responsibiiily for designing a safe building, stouctare, or componoit. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely,Fee Required: S250.00 Fee Received: S250.00 ( Balance Due: $0.00 /! _ | Refund Expected: $0.00if // -^f]wHeidi Eide Division of Industry Services Phone: Email: heidi.eide@,wisconsm,eov CHECK BOX AS APPLICABLE. SOIL EVALUATIONSITE MAP PROJECT NAME: CHECK BOX AS APPLICABLE. Scale: 1"= 40' 40 60 80 y////////7>Y////^ HIRSCH FAMILY TRUST POWTS PROJECT ADDRESS: 28335 CHERRYVILLE RD, ASHLAND, Wl 54806 BM Symbol: ^- BM Description: Slope Gradlent (%)of Tested Area; BM Elevation:100 FT TOP OF GENERATOR PAD Well Symbol (If applicable): Q 7ZAEZ3 10-^ S SYSTEM PAGE 2 OF PLOT PLAN DESIGN FLOW:450 GPD Attach design flow calculations for commercial plans. Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5)^^r 4-PVC / D3034 Force Main:.2" PVC ASTM1784 indicate north by drawing an arrowon the approprlte line. IMPORTANT: Show ground elevation contours at suitable intervals. .v^y^ift. C7'ra-tA-A&<~ ^<\ i<^1 -L|w] _^1^1 6-f^e.i ^r^f'AJ iWO ^>M^ /1./> D^k ^Hp ^AT"..y ..«.^'^'.-ra^7^ ^ '...!;,^^^ %£"^^T PJ^K S7-S ^IhN- JUN 0 52024 JUN 0 5!Qi GSF Wl MOUND DESIGN PROGRAM DATA ENTRY R 450 Site Information [Residential or Commercial Design [Design Flow (gpd) I Site Slope (%) I Installation Contour Line Elevation (ft) [Depth to Limiting Factor (in) 4.0% 101.8018 0.6 3 [Number of Bedrooms (optional) 120.00 | Contour Length Available (ft) In-Situ Soil Application Rate (gpd/ft") EFF #2 B43 Distribution Cell Information I Unit Used I Cell Width (ft) 3, 4, 5, 6, 8, 9 or 10 [Dispersal Cell Design Loading Rate (gpd/ft2) [Influent Wastewater Quality 2.0 Pressure Distribution Information I 61 |= Dispersal Cell Length (ft) Are the laterals the highest point in the distribution | Y | network?Enter Y or N N 1 None 13590 Center, End, No Manifold (Pump to Gravity), or Gravity (No Pump) None 12.88 5.54 0 18.42 I Lateral Spacing INumberofLaterals |0rifice Diameter (in) (e.g. 0.25) I Estimated Orifice Spacing (ft) = |Forcemain Diameter (in) Forcemain Length (ft) Inside Pump Tank Elevation (ft) System Head (ft) x 1.3 Vertical Lift (ft) Friction Loss (ft) Add'l Fitting Friction Loss (ft) Total Dynamic Head (ft) Lateral Diameter Selection in. diam. 0.75 1.00 1.25 1.5CT 2.00 3.00 options choice Septic Tank Information 1000|Septic Tank Capacity (gal) Wieser Concrete 1 Manufacturer Dose Tank Information750 20.28 Dose Tank Capacity (gal) Dose Tank Volume (gal/in) Wieser Concrete (Manufacturer If N above, enter the elevation (ft) of the highest point. Jn2/orifice Does the forcemain drain back? | Y | 22.02 0.00 67.02 Forcemain Drainback (gal) 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) Manifold Diameter Selection in. dia. 1.25 1.50 2.00 3.00 options choice 750 Gallons/lnch Calculator j Total Tank Capacity (gal) [Total Working Liquid Depth (in) Igal/in 37 20.27027 Effluent Filter Information I Filter Manufacturer ] Filter Model Number Polylok PL-525 Project: GSF MOUND SYSTEM Page 2 of 9 GSF Wl MOUND DESIGN PROGRAM GSF MOUND DRAWINGS JUN 0 AB D 4.00 61.00 18.001 244.00 7.38| ftft in EF G Mound Component DimensionsHI19.92 7.00 0.50 in in ft 1.00 9.35 6.92 Mound Plan View J A K l5( |3| 31 K wI/ KLw 9.4979.98 20.27 ft (ft) Dispersal Cell Area (gpd/ft) Linear Loading Rate 814.49 6.10 (ft ) Basal Area Available (ft) 1/10 B Obs. Pipe Placement Finished Grade 104.88 103.30 (ft) Dispersal Cell Elevation 101.80 (ft) Contour Elevation Shading Key Topsoil Cap Subsoil Cap ASTM C33 Sand Tilled Layer GSF Media & Cell Header /Footer SF 4% Site Slope 1 2 34 5 ?% s;;;^; 22 ^.1- C 0.Jo c01 0 GO CO:5 &a)•cl •t 0 •< 2ft| 0.5ft! Typical Dispersal Cell See Page 5 Geotextile Fabrict >^v 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: GSF MOUND SYSTEM Page 3 of 9 J UN 0 GSF Wl MOUND DESIGN PROGRAM LATERAL AND DOSE TANK End Connection laterai Layout Diagram Place Appropriate Latera! Diagram From Right Below 4" NON-PERFORATEDVELocnry REDUCTION PIPE^-SWEEP "T'FimNG 1.5" LOW PRESSURE RPE DISTRIBUTION BOX p o o -WATERLEVEL SPEED LEVELER GSF MODULE Numbers of Laterals Lateral Diameter Lateral Length (P) Lateral End (Z) Latera! Spacing (S) Laterai Flow Rate System Flow Rate 0.00 0.00Ift N/A 0.00 0.00 0.00 gpm gpm Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Veiodty Pump Off Height None N/A 12 m ft ft2/orifice ft in ft/sec m Dose Tank Information Alderon narrow angle float to be used Ssdrics! asperNEC 3CO_.ari©am'1SAVliK todanai:a<a'.wBiWn*»a. <as!edwsteEei<SR~^ 41n.-mn. -MtanvSsctslei'.OGscm 1&*w»i|m»tjs)x(paiywte(lz: '•MesisrCaSKKte. Capacity1: .Voiume CUneBsSa * ".6: € ••& Total 75Q' 3B3S- ftii^s is.gs iZ.OG '3M '32i.BES6M Manujiaau safesns gal/inctt ;(H116ns 339S6 .WS6SM 2A3.36 7SQ.W ^ ^^Jttgi.Wsa-snS-aphontfe'rfse »ifc a* Be&Blfl unto tafc Alarm Manufacturer Alarm Model Number Pump Manufacturer Pump Model Number Pump Must Delivery Project: GSF MOUND SYSTEM SJE Rhombus PS PATROL 1022728 Goulds EPO 511 AC Jepm at J,8.42]ft TDH Page 4 of 8 GSF Wl MOUND DESIGN PROGRAM DISTRIBUTION MEDIA GSF Distribution Cell Media Layout 4| Cell Width (ft)2|SidewalltoLateral (ft) Distribution Cell Cross-section Arrangements Drag appropriate drawing to space below. 4ft Wide a^B43^ JUN 0 5202^! Component Legend D ASTM C33 Sand/Mound Sand A42 or B43 Module Lateral Turn-up (contained in Turn-up Enclosure) Distribution Cell Plan View Layout - Typical 4| Cell Width-A (ft)61.001 Cell Length-B (ft) 15 B43 15 B43 Modules Required per Row Total Modules Required Pump to Gravity Diagram Drag appropriate drawing from left to space below. 4FTWDEPUMP TOGRA^-TY FORCE MAIN ^u——_—_—__—__—__—_^—- ^SS^^?S^MfS!S'S:MSS^sS^SsS-s:S3sSMi^SSSS^a Project: GSF MOUND SYSTEM Page 5 of 9 ^SS^9s^asKSRt!a^^¥:::^^^%^¥^^^SMs^issiMs^sslii^^^^^s-^^S!SS:SS!St^^?^^ FEET 10 9 iUM—5?n:74 u I§ ^a 10 20 30 40 50 GPM 6 8 CAPAOTY 10 12 m3/h Onler Number EP0411F EP0411AC EP0412 EP0412F EP0511F EP0512F HP .4 .5 yohs 115 230 115 230 tanps 12 6 13 6.5 Minimum Circuit Breaker 20 10 20 10 Phase 1 Host Switch Style Plug/Mo Switch Pi99ybacl< / Wide-Angle Plug/No Switch Plug/No Switch Plug/ No Switch Pi99yback/ Wide-Angle Plug/No Switch CartLssgth 20- 10' 20' Discharge Connection 1%" Minimum On Level Manual 12" Manua! Manual Manual 12" Manual MinimumOff Level Manual 6" Manual Manual Manual 6" Manua! Minimum Basin Diameter 15" Maximum Solids Size w Shipping! WeightIbsAg 20/9.1 21/9.5 20/9.1 20/9.1 22/10 23/10.4 22/10 PAGES ^:.. --4" CAST-A-SEAL 4" CAST-A-SEAL TOP VIEW PUMP PAD SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS WLP750-MR TANK SPECIFICATIONS DIMENSIONS: WALL: 2 1/2" BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISERHEIGHT: 54" OUTSIDE DIAMETER: 7'-0" BELOW INL£T: 42" LIQUID LEVEL: 37"WEIGHT: BOTTOM 3.740 LBS.COVER 2,410 LBS. INLET AND OUTLET: 4" CAST-A-SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL #10(OTHER STATES SEE CHART) LIQUID CAPACITT': 20.28 GAL/IN HOLDING TANK:OUTLET HOLE PLUGGEDACTUAL CAPACITC: 790 GALLONS LOADING DESIGN: 8'-0" UNSATURATED SOIL TANK CAN BE USED AS:SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER)TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTEDFOR APPROVAL APPROVED BY; APPROVAL DATE: PRODUCTS NEEDED BY: ^ (Di^lz°?luIsl2^10 >- 0|s o|I 03 I a: 0mr- <=3 < 0 Q-1-1-1en SHEET NO. 1 OF 1 Bayfield County, Wl 6/10/2024, 8:53:44 AM :.--W-. Wetlands I—...I Approximate Parcel Boundary Rivers Road Type "~**~ Town Building Footprint 2015 Building 0 0.05 0.1 0,2km BayHeld County Land Records Department Bayfield County Zoning Applicationhttps://maps.bayfie!dcounty.wi.gov/2oningWAB/ 6/10/24, 8:53 AM Novus-Wisconsin Access rev. 12.0206 Real Estate Bayfield County Property Listing Today's Date: 6/10/2024 Description Tax ID: PIN: Legacy PIN: Map ID; Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: Zoning: ESN: ^Tax Districts Updated: 6/17/2022 541 04-002-2-48-05-34-3 01-000-40000 002104910465 (002) TOWN OF BARKSDALE S34 T48N R05W ' E 300' OF W 624' OF NE SW IN IN 2022R-594833 (HIRSCH FAMILY TRUST DTD 05/26/2022) 9.090 9.627 1 Yes (AG-1) Agricultural-1 103 Updated: 3/15/2006 1 04 002 046027 001700 rSE>:*' Recorded Documents STATE COUNTi' TOWN OF BARKSDALE SCHL-WASHBURN TECHNICAL COLLEGE Updated: 1/8/2013 B QUIT CLAIM DEED Date Recorded: 5/31/2022 2022R-594833 Ei TERMINATION OF DECEDENT'S INTEREST Date Recorded: 6/13/2012 2012R-544293 1084-472 g3 CONVERSION Date Recorded: 3/15/2006 658-209 g3 WARRANTS DEED Date Recorded: 12/18/1995 423785 658-209 Ownership HIRSCH FAMILY TRUST Billing Address: HIRSCH FAMILY TRUST 28335 CHERRWILLE RD ASH LAN D WI 54806 Property Status: Current Created On: 3/15/2006 1:14:42 PM Updated: 6/17/2022 ASHIAND WI Mailing Address: HIRSCH FAMILY TRUST 28335 CHERRWILLE RDASHLAND WI 54806 Site Address * indicates Private Road 28335 CHERRWILLE RD Property Assessment ASHIAND 54806 Updated: 6/24/2021 2024 Assessment Detail Code Acres Land Imp. Gl-RESIDENHAL 2.000 16,500 152,900 G4-AGRICULTURAL 7.090 1,200 0 2-Year Comparison 2023 2024 Change Land: 17,700 17,700 0.0% Improved: 152,900 152,900 0.0% Total: 170,600 170,600 0.0% Property History N/A i?nanrnirl=' 1/1 Private Sewage System Maintenance Agreement Owner(s) NameH i rscV^ (^o^ < ^Tn^ /A(^ ^ '^Ji r^ Owner(s) Mailing Address ' . f^.^3^ (Lh-err^J'^e W ft^H^ lOT Site Address "-> ff/SOCft SClYw€- Tax ID #^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_5W_l/4 Section 3Ll Township M^ N. Range C>5 W. Additional Legal Description: €^ 300' £)*f W ^c^/ 0't is/£'<$W^ Town of Lot _ Block_ Lot_CSM#. (Acreage)Gov'tLot. Subdivision Vol. _ Page CSM Doc # 50^R -<^W^ DOCUMENT NUMBER2024R-60347S DANIEL J. HEF-F-NEF; REGISTER OF DEEDS BAYFIELD COUNTY. Wl RECORDED OS/05/2024. AT 9:25 AM RECORD'NG FEE: $30.00 PAGES: 1 Recording Area Return To: Planning and Zoning Department D In-ground gravity Mound In-ground dosed D At-grade Sewage System D In-ground pressure distribution Sewage System: Other Septic 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 septic tank is serviced as provided above. The switches and pump controls shall also be inspected and maintained to ensure operability of said components. Septic Tank Effluent Filter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance with manufacturer's specifications. 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-arade. and In-around Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbed if needed when the wastewater 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 costs incurred by Bayfield County for inspection, pumping, hauling, or otherwise 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 as 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 owners of such property. Owner(s) Name(s) - Please Print -H i rc> c i- h^n^ ^| / f ^°T ^>\6^^ L. -ft-ir-s:^ -fru^f Notarized,0wnerfs) - Sic €.<£- Subscribed and sworn to before me on this date: MA\I JC\V, ^J.*^3ub\ MICHAEL K.SCHNEEBSRGERNOTARY PUBLICSTATE OF WISCONBINNotarizest,0wner(s) - Signa(%re(s)•(&i^ftK^U Notary Public <m^Lj ]L .^l..A My Commission Expires: <-j ^J ia'^-o,^^ ^- Drafted by: l)'ia.v\ct L. ^--r-s-^A Date: 5/' )Qf12-^7—r Proofed by: u/forms/sanitary/septicmaintenceagreementRevised July 2020 GSF Wl MOUND DESIGN PROGRAM SYSTEM MAINTENANCE SPECIFICATIONS Mound System Maintenance and Operation Specifications Service Provider's Name POWTS Regulator's Name QS PLUMBING & MECHANICAL LLC BAYFIELD COUNTY ZONING Phone Phone 715-685-4330 715-373-6138 System Flow and Load Parameters Design Flow-Peak Estimated Flow - Average Septic Tank Capacity Soil Absorption Component Size 450 300 1000 244 gpd gpd gal Maximum Influent Particle Size Maximum BOD5 Maximum TSS Maximum FOG Maximum Fecal Coliform 1/8 30 30 10 10E4 in |mg/L ;mg/L mg/L cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test monthly Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years 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 mound component manual. 2. Dispersal cell media conforms to EIJen products approved for use with the Eljen Mound Component Manual approved August 2016. 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 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 Turn-up Detail FINISHED GRADE- LATERAL ENDS AT LASTORIFICE WHERE VARIABLELENGTH CLEANOUT BEGINS 4" PERFORATED PIPE 6 - 8" DIAMETERLAWN SPRINKLER 4" ENDCAP DISTRIBUTION LATERAL LATERAL CLEANOLTT THREADEDCLEANOUT PLUG LONG SWEEP 90 ORTWO 45 DEGREE BENDSSAME DIAMETERAS LATERAL Project: GSF MOUND SYSTEM Page 6 of 9 GSF Wl MOUND DESIGN PROGRAM MANAGEMENT AND CONTINGENCY PLAN Mound 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 Mound Component manual August 2016 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 lightness 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 outlet filter shall be assessed at least once 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 alarm, 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 sludge 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 be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical 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 shall 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 Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound 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 mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound 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 equal 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. Contingency 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 components) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if 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 for the name and telephone number of your local POWTS regulator and service provider. Project: GSF MOUND SYSTEM Page 7 of 9 BAYFIELD COUNTS SANITARY PERMIT (#04)-2A^4S STATE SANITARY PERMIT OWNER: HIRSCH FAMILY TRUST GOV'TLOT: LOT: BLK: NE 1/4 SW 1/4 SEC: 34, T 48 N. R 5 TOWNSHIP: Barksdale SOIL TEST: 41-24 REPLACEMENT SYSTEM SYSTEM T^PE: Mound > 24 in. of suitable soil PLUMBER: Quinn Granger MCKENZIE SUKCK DATE: 6/11 ,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 #: 425180 / 49-04 ST LICENSE: # 987826 Condition: System to meet all setbacks. Management plan to owner. Properly maintain system per recorded agreement. Old field to be abandoned per SPS 383. THIS PERMIT EXPIRES 6/11 ,2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION