HomeMy WebLinkAbout24-79S Baldwin'w^^^';
Department of Safety
& Professional Services,
Industry Services Division
County Bayfield
Sanitary Permit Number (to be filled in by Co.)2lh7cfi
'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 tbrois for slate-owned POWTS are submitted to
Ihc 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)
63745 Evergreen Ln. Iron River, Wl
Property Owner's Name
Jason & Amy Baldwin
Parcel#
13392
Property Owner's Mailing Address
4017MantiRd.
City. Slate
Farragut, IA
Zip Code
51639
II. Type of Building (check all that apply)
B 1 or 2 Family Dwelling-Number of Bedrooms
D Public/Cominercial - Describe Use
D State Owned - Describe Use
Property Location
Govt. Lot
Phone Number
712-215-0123
Lot #
SW ,/, NE ,/, section _4_
_N R 8 Eor^l46
Subdivision Name
Block #
CSM Number
D City of.
D Village of
BS Town of Delta
III. Type of POWTS Permit: (Check either "New" or -Replacement" and other applicable on Hue A. Check one box on line B. Complete line C if
applicable.)
A.New System D Replacement System Other Modification to Existing System (explain)D Additional Pretreatment Unit (explain)
B.D Holding Tank 8 In-Ground
(conventional)
D At-Grade D Mound D Individual Site Design D Other Type (explain)
c.D Renewal Before
Expiration
D Revision D Change of Plumber Transfer to New OwnerIList Previous Permit Number and Date Issued
IV. Dispersal/Treatment Area and Tank Information:
Design Flow <gpd)
150
Design Soil Application Rate(gpd/sF)
.7
Dispersal Area Required (sf)
214
Dispersal Area Proposed (sf)
246
System Elevation
95.5'
Tank Inf'urmation
Capacity in
Gallons
New Tanks Existing Tanks
Total
Gallons
# of
Units
Manufacturer
II&. uI 0ssen %
ssu: 0
Scplic or Holding Tank 750 Wieser Concrete
Dosing Chamber
V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
Edward B. Redinger
Plumber's Signature
^-<-A3:TZ^1*^.
MP/MPRS Number
221939
Business Phone Number
715-292-6670
Plumber's Address (Street City, State. Zip Code)
1015 11th Ave. E. Ashland, Wl 54806
VI. County/Department Use Only ^.Approved D Disapproved
a Owner Given Reason for Denial
Permit Fee 11KZH /^??^5 6/i'//A
Conditions of Approval/Reasons for Disapproval <^0t. c^a^c^a^ pe^roA <-A.V<A
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)
"7 <-w!J •:• ••' I
•sow^^o=2^Lc,yWisconsin Department of Safety and Professional Services
Division of industry Servicas
. — ., SOIL EVALUATION REPORT
\
^i%?.^' ; :,;; ;^:^,, \ In accordance with SPS 385, Wis. Adm. Code
Attach complete site plan^i^^rii^t less than 81/2x11 inches in size. Plan must include,
but not limited to: vertical andJiQdzdntal 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)).
Page.-L.,3
Property OwnerJason & Amy Baldwin Property Location
Govt.LotSW Y< NE '/< s4
Property Owner's Mailing Address4017 Manti Rd /)/A Site Address or CSM and Lot #:63745 Evergreen Ln. Iron River, Wl
CityFarragut
StateIA Zip Code51639 Phone Number?15-Q123 D CityDelta a Villaiigs Town Nearest Road
Evergreen Ln
•] New Construction Use:® Residential/Numberofbedrooms. 1
I Public or commercial - Describe:
parent material Sandv Glaclofluvial Deposits
Code derived designflow rate 150 GPD
Flood Plan elevation if applicable_ft.
General comments and recommendations: Conventional System elevation 95.5'
Boring #IPit 99.7
Ground surface elev. ft.Depth to limiting factor84 92.7
in. / elev. ft,
Horizon
1
2
3
Depth
In.
0-6
6-24
24-72
Dominant Color
Munsell
5yr4/2
5yr4/4
5yr 5/3
Redox Description
Qu. Az. Cont. Color
Texture
Is
Is
s
Structure
Gr. Sz. Sh.
0
0
Osg
Consistence
ml
ml
ml
Boundary
cw
gw
Roots
2co
3m
1 co
Soil Application Rate
GPD/Ft2
*Eff#1
.7
.7
.7
*Eff#2
1.6
1.6
1.6
Boring #QBoring 97.52
gPit Ground surface elev._ft.65 92.1^Depth to limiting factor ~ ~ in. / elev._ft.
Horizon
1
2
3
Depth
In.
0-7
7-20
20-65
Dominant Color
Munsell
5yr4/2
5yr4/4
5yr 5/3
Redox Description
Qu. Az. Cont. Color
Texture
sl
sl
s
Struchjre
Gr.Sz. Sh.
0
0
Osg
Consistencs
ml
ml
ml
Boundary
cw
gw
Roots
3f
1vf
Soil Application Rate
GPD/Ft2
*Eff»1
.7
.7
.7
*Eff»2
1.6
1.6
1,6
CST Name (Please Print)
Edward B. Redinger
Address
1015 11 th Ave. E. Ashland. Wl 54806
Signatura
Date Evaluation Conducted6/5/24
CST Number221939
Telephone Number
715-292-6670
* Effluent #1 = BOD > 30 S 220 mg/L and TSS > 30 & 150 mg/L ' Effluent #2 = BOD, S 30 mg/L and TSS & 30 mg/LPGOA ISO -^(^^D-8330(R04/21)
Boring #
C] Boringn pit 99.62.Ground surface elev. ft.Depth to limiting factor 60 Page 2 .3of
.94.6,in. / elev. ft.
Horizon
1
2
3
Depth
In.
0-6
6-20
20-60
Dominant Color
Munsell
5yr4/2
5yr4/4
5yr 5/3
Redox Description
Qu. Az. Cont. Color
Texture
sl
sl
s
Structure
Gr. Sz. Sh.
0
0
Osg
Consistence
ml
ml
ml
Boundary
cw
gw
Roots
3f
1vf
Soil Application Rate
GPD/Ft2
*Eff#1
.7
.7
.7
*EfW2
1.6
1.6
1.6
Boring ff Q Boringa 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 *Efi»2
Boring #D BoringD Pit Ground surface elev._ft.Depth to limiting factor.in. / elev.
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 *Efft»2
* Effluent #1 = BOD > 30 S 220 mg/L and TSS > 30 & 150 mg/L * Effluent #2 = BOD, s 30 mg/L and TSS & 30 mg/L
SUPERIOR
PLUMBING MECHANICAL
(715)278-3456^.^y^.Tz^-,6/<r/?y ' f
Customer Name: Jason & Amy Baldwin
Adress: 40r7 Manti Rd-
Farraeut. IA 51639
SITE: 63745 Evergreen Ln. Iron River Wl
Phone #: 712-215-0123
Email: jasonabaldwin@hotmail.com
CSTff 221939
Scale:!" =40'
PIN:13392
3.19 Acres
SWNES4T45NR8W
Town of Delta
Bayfield Co.
^ ^rc,^-^ ^.'-^ C^1
;-\
.^
^v<
PAGE 1 OF 4
In-Ground Gravity Plan
Index & Cover Sheet
Component Manual Design References:
In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027)
Pg1 of 4
Pg2of4
Pg3of4
Pg4of4
Index & Cover Sheet
Plot Plan
Dispersal Area Cross-Section & Plan View
Management Plan
Attachments:Enclosures:
POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
New 1 Bed gravity @.7 loading
Owner Name(s): Jason & Amy Baldwin
Owner Address: 4017 Manti Rd. Farragut, IA
Project Address: 63745 Evergreen LN. Iron River, Wl
Phone: 712 -215 -0123
Zip:. 51639
Govt. Lot:
Township: Delta
sw |-|1/4 of NE 31/4, Section 4_ , T45 N-R8E or W •
County: Bayfield
Project Parcel ID #: 13392
Designer Information
Designer Name: Edward B. Redinger _ Phone: 715 .292 -6670
Designer Address: 1015 11 th Ave. E. Ashland, Wl _ Zip: 54806
E-mail: ed@superiorpmw.com This space resev^frs^prov^ stamp.
License Number: 221939
Remarks:
Signature: /^-^-y< \3 ^
5.0,l;:t^\;o^tio^l;L-i^Sn\J^
Date: ^-/3--^
Original signature required on each siAmitted copy.
SUPERIOR
PLUMBING MECHANICAt
(715)278-3456
Customer Name: Jason & Amy Baldwin
Adress: 4017MantiRd.
FarraeuUA 51639
SITE: 63745 Evergreen Ln. Iron Rjver Wl
Phone #; 712-215-0123
Email; /ason3b3/div»n@hotmafLcom
/A/
CSTO221939
Scale: 1" = 40'
PIN:13392
3,19 Acres
SW NE S4 T45N R8W
Town of Delta
Bayfield Co.
^y^f^r^ ^7^«/< 9575''
^.'cfcV.\4.'/^^^
eyr ^/y ^A. ^r/^
^?k
^1^1 «?
\?^^r^ ^—<
A/<^ fc)S'6 ^1 LJ^-S<r'\—fc
IN-GROUND DOSED-GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard-W Chambers
3-ft Trench (down-sizing credit)
t—LJLJL 3^^
\\
SOIL COVER
I— min. 12"(typical)
12"
min. trench
depth(typical)
Quick4 Standard-W
w/ End Cap
(typical)
System Elevation = YO^
(typical)
(Show location of inlet / outlet pipe connection on plan view.)
TYPICAL TRENCH
CROSS SECTION VIEW
(No Scale)
Provide minimum 3 ft
separation between trenches.
Observation Pipe(typical)
Install per manufacturer's
instructions.
--^--------^-----
B= 48_ ft
INSTALL PER TRENCH:
(typical)
TYPICAL TRENCH
PLAN VIEW
(No Scale)
A =3.0 ft
(typical)
12
+ 1
Quick4 Std-W @ 20 ff EISA/chamber = 24°
Pairs of end caps @ 6 ft2 EISA/pair = ^.
ft2
ft2
-Quick4 Standard-W Chamber
(typical)
(mfd by Infiltrator Systems, Inc.)
Install pursuant to manufacturer's instructions.
~u>0m
C*3
Q-n
en
= Proposed E ISA per trench =
xl
ft2 Required Infiltration Area =
trenches = Proposed Total EISA = 246
ft2
ft2
Distribution Method:
branched manifold
PAGE 4 OF 4
In-ground Gravity Management Plan
IMPORTANT:
The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. Admin. Code, this system shall
be considered a human health hazard if not maintained in accordance with this approved management plan.
Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wise. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow = 150 gpd: BODs $220 mgL-1; TSS S 150 mgL-1; FOG < 30 mgL-
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors (/'.e. odors, user complaints, etc.)
o mechanical malfunction (/.e., pumps, valves, switches, floats, etc.)
o material fatigue (/'.e., leaks, breaks, corrosion, etc.)
o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes)
o neglect or improper use (/.e., exceeding design capacities, prohibited activities, etc.)
o extent of ponding in distribution cell prior to dosing
o dosing irregularities - if applicable (/'.e., pump re-cycling, float switch settings, etc.]
o electrical components - if applicable (/'.e., wiring, connections, switches, controls, timers, alarms, etc.}
o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification)
o surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o 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 contents shall be pursuant to NR 113, Wise. Admin. Code.
o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing 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 Wise. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: Superior Plumbing & Mech. he. p^ 715-292-6670
Local government unit: Bayfield CQ. Zoning _ phone: 715-372-6138
Local government unit address: 117 5th St. E. Washbum, Wl _ ^,54891
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wise. Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wise. Admin. Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan 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 component in a pre-determined area of suitable soils.
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wise. Admin. Code.
4" CAST-A-SEAL
TOP VIEW
OPTIONAL FLAT COVERIS AVAILABLE FOR EXCHANGEFOR DOME COVER.
WLP750-MRTANK SPECIFICATIONS
DIMENSIONS:WALL 2 1/2"BOTTOM: 3"COVER: 4"MANHOLE: 24" I.D. PRECAST CONCRETE RISERHEIGHT: DOME COVER 61" O.D.FLAT COVER 53 1/4" O.D.
OUTSIDE DIAMETER: 84" O.D.BELOW INLET: 42" O.D.UQUID LEVEL 37"
WEIGHT: 6.150 LBS.
INLET AND OUTLET:4" CAST-A-SEAL BOOT OR EQUALGASKET, CAST-A-SEAL BOOT OR EQUAL
INLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL j(HO(OTOER STATES SEE CHART)
LIQUID CAPACITf: 20.28 GAL/IN
HOLDING TANK:ACTUAL CAPAOn: 790 GALLONSOUTLET HOLE PLUGGED
LOADING DESIGN: 8' 0" UNSATURATED SOIL
MN TANKS:WILL HAVE ONE VENT OVER OUTLET
AND WLL HAVE -TWO VENTS IN COVER OVER INLET
TANK CAN BE USED AS:
SEPTIC/ HOLDING/ PUMP OR SIPHON
COVER: MIX DESIGN #6 (NO HBER)TANK: MIX DESIGN flO (STRUCTURAL FIBER)
CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETE
PUMP PAD
SIDE VIEW
TANKS ARE MANUFACWRED TO MEET OR EXCEED AS7M C-1227 REQUIREMENTS
JOB INFORMATION;
CUSTOMER:
308 NAME:
DATE NEEDED;
APPROVED BY;
APPROVAL DATE:
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SHEET NO.
1 .OF 1
Private Sewage System Maintenance Agreement
Owner(s) Name
^a^e>f\ ^-/^i/ 15z^'^
Owner(s) Mailing Address''^H A,//^. ^rr^utjft- S-^
Site Address^ 3 ?%r ^^'-<^ /^ ^ ^ ~^^r
_TaxlD#/i:m
As owner, I (we) do hereby certify the private sewage system will be installed inaccordance 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)
^J 1/4 of AJ^? 1/4 Section ^/ Township -V^ N. Range 'J W.
Additional Legal Description: ^<s^
Town of F) €- /"h^ _ (Acreage) ^i/cf Gov'tLot.
Lot _ Block_ Subdivision
Lot_CSM#_Vol._Page_ CSMDoc#.
DOCUMENT NUMBER2024R-603694
DANIEL J. HEFFNER
REGISTER OF DEEDS
BAYFIELD COUNTY, Wl
RECORDED
06/20/2024 AT 1 1:55 AM
RECORDING FEE: $30.00
PAGES: 2
Recording Area
Return To:
Planning and Zoning Department
0 In-ground gravity
D Mound
D In-ground dosed D In-ground pressure distribution Sewage System:
D At-grade Sewage System D 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 certifiedseptage 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 affluent 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.
Ownerfs) 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
/lm^ p^U^J'/t]
1^1 <0V\ '-^^l^(A; i"^
Subscribed and sworn to before me on this date: y - 2 2 - 2.(
•.•;TTi1;^3'i:r! ,!1
-^ r - i-
~'">.
.!' ^-.,^
NotarizecT(;) - Signature(s)Notary Public
Drafted by: ^t^/v'^.lsL^ Da{e<_^^2-^)j/-
My Commission Expires: '
?. •Zf7-^7
Proofed by:
u/forms/sanitary/septicmaintenceagreement
Revised July 2020
GOWEY Abstract & Title Company, Inc.
(800) 673-8710 • www.goweytitle.com
File Number:240075
ADDENDUM/EXHIBIT A
A parcel of land located in the South One-half of the Northeast Quarter (S1/2-NE1/4), Section Four (4),
Township Forty-six (46) North, Range Eight (8) West, Town of Delta, Bayfield County, Wisconsin, described as
follows:
Commencing at the Northeast corner of the SW1/4-NE1/4, Section 4, Township 46 North, Range 8 West;
thence West a distance of 216 feet to an iron pipe on the East lake shore of Muskellunge Lake; thence South
along the East lake shore a distance of 301.5 feet, which is the Place of Beginning; thence East along the
South line of Parcel 20 a distance of 947.7 feet to the Southeast corner of said Parcel 20; thence North along
the East line of said Parcel 20 a distance of 150.75 feet; thence West on a line parallel with the South line of
said Parcel 20 to the East shore line of said Muskellunge Lake; thence South along said East shore line to the
Place of Beginning. Intending to describe herein the South 150.75 feet of Parcel 20 of an unrecorded Plat of
the area, called Map of Section 4-46-8 West; EXCEPT a parcel described as follows: To locate the Point of
Beginning, commence at the Northeast one-sixteenth corner of said Section 4, and run South 83°11'31" East,
660.04 feet to a 1 1/4 rebar; thence South 09°21'23" West, 124.04 feet; thence North 84°24'10" West, 715.97
feet to a 1 inch iron pipe, which is the Point of Beginning; thence from said Point of Beginning by metes and
bounds; continue Ndrth 84°24'10" West, 144.00 feet to a 1 inch iron pipe; thence Sduth 05°35'50" East, 8.00
feet to a 1 inch iron pipe; thence South 76°53'06" East, 145.25 feet to a 1 inch iron pipe; thence North
05°35'50" West, 27.00 feet to a 1 inch iron pipe.
Bayfield County Register of Deeds Document #2023R-601652 Page 2 of 2
BAYFIELD COUNTY SANITARY PERMIT # 24-79S
STATE SANITARY PERMIT
D TRANSFER/RENEWAL PREVIOUS NO.
OWNER: Jason & Amy Baldwin
PROPERTY LOCATION:
Town of Delta
SW V4 NE V4
SEC 4, T46N, R8W
PLUMBER: Edward B. Redinger LIC. #:221939
Tracv Pooler _ 7/1/2024
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 a
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.
AUTHORIZED ISSUING OFFICER DATE
Condition: Management plan to owner. Properly maintain per recorded agreement. System to meet all setbacks.
THIS PERMIT EXPIRES 7/1/2026 UNLESS RENEWED BEFORE THAT DATE
POST IN PLAIN VIEW
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (R. 06/23)