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HomeMy WebLinkAbout25-11SSS-OOS01 Department of Safety & Professional Services, Industry Services D[h^sijMi[] t | C'ountvBayfield Sifni^ary Pemiil Nunibur (to be tlllud in by Co );?ni}aiy 112S-US Sanitary Permit Application MAR 1] 'WC Stah; Tronsaciion Number In awwAincc uilh SI'.S 383.21(2). Wjs. Adin Codi;. suhniission ot'lhis Ibnn lu thi; appropriati; lioyernmcntal unit Is rcc]uin:d prior lo obtainina; a Mnilun' pennil Note Application forms tbr siaie-invncd SQV^SU the llcpartmenl ol' Salely anil I'nitessional Sun'ices, I'crsonal intbrmnlion you pnniiic may be used tbr secondiin' purposes in accordance ivitli Ihc I'rivucy l.uw. s, 15.(M( 1 )(m). Stats, Wjirct Address (il'dinereni than^iling'addrtfss) I. Application Information - Please Print All Information Propcny Owner'-, Name Henry S Meschievitz Jr LE ET AL Parcel H38687 I'ropurty Owner's Mailing Address 44305 Trail Inn Rd City. SlalC Cable, Wl Zip Code 54821 II. Type of Building (chtck all that apply) 0 I or2 Family Dwclling-Numbcrol'Btfdnioms^. 0 I'liUic/Comnicrcial - Dcscnhu Use D Stale Owned ~ Describe Usw I'hone Number 970-227-7327 I'rnpcny Locatinn (i"VI 1,01 6&10, _..-..'/<.-.__'/ii. 'Sculiun 08 l.oi H T_43_N R 07 ,liwW SuMivision Name Block » a c'iiy of. CSM Number 2197 a Village ol" Blown of Cable III. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other applicable un line A. Check one box on line B. Complete line C if| applicable.) D New .S\ stem I Rcplaccmcm System D Other Mudifiwliun io Kxistinji Syslum (expliiin)a Aildiu'onal I'rclrvalmcm Unii (explain) B.a HnUingTank In-Grouml (uonvcnlinnal) a Al-Ciradu D Mound D Individual Silu Design D OHicr Type (explain) t'. I D Rtinewat Before Expiratitin D Revismn a Change of Plumber a Translcr to New Owner ll.ist 1'rcvwus Pcnnit Number ami Dale Is.suci) IV. Dispcrsal/'i reatment Area and Tank Information: Design t-low (iipti I 450 Design Soil Applicalinn Raicfgptt/sO 0.7 Dispersal Area Kcquired (st1 642.9 Uispur!.,!! Area Propowd (sl'»650 System Rk'valiun / . ... ..j^r ^Z/^ Tunk Intbrmalitin I'apaeity in (iallons Sw TUI&&K?iii.tttir^ T;ml^ Total Gallons » of Unns Manufacturer -o eIIL) 11.S 5W V. 5 S-6 -a Scphc tir Itofdinu Tunt>1000 1000 Wieser Concrete DOTJH^ Chnmhdr 600 600 V. Rcsponsibitit)' Statement- 1, the undcndgncd, n!/uirip rrip^nsibility rnr inataHntiun uf the POWTS shown on the attached plan*. Plumber's Name (Print) Douglas E. Manthey I'lun^icr's pigiiydirc 1/j//^/^.^MP/MI'RS Number MP 230722 Businciis I'lionc Number 715-739-6868 I'lumiw's Addrc-as (Street. C'ily. Slate. Zip ante)^7 PO Box 196 Drummond, Wl 54832 VI. Ceunly/Department Use Only Appruvctl D Disappritvcd Q Owner (iivcn Reason l<»r Ucnial Permit l:tfc3L^'^^?Dale Issued ::}. Issuiny Agent Signgiun;•'ftgcnt Signgiun;M^< •c.-. ConilHionsurApproval/Rcti.sons for Disapproval rCTAO; ~l ">""^-^ ' "6/" , , , /,' , ,^^/^Z^"<?^^SUI ^!'^^ ^':v'1 ^^ 1^^^ - ^^^^ -f^ abw^ w^ ^^ — tofi^ w^ ^^ ^ '^ ^^'}^ufM ^ con Atladt in cnmptne plans fur the system and tubmiuuUic Cuunty nnly un pa|wr nnl tm» than 8 1/i » H inchM in -<ar SBI1.6398 (R. 03/22) S5~<]QS07 ,/-5S"!^~;... <-x'' -~''-y,\ i:8^ •%••<. <n :'i'' ^ r« /' ''•w>. I * /y':i%,^^/ Department of Safety & Professional Services, Industry Servu^es Division i CountyBayfield Sanitary Permit Number (to be filled in by Co.) Sanitary Permit Application MAR •?n7i-,i.'".^State Transaction Number 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 IPQWTS 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(1 )(m). Stats. Project Address (if different than mailing address) I. Application Information - Please Print All Information Property Owner's Name Henry S Meschievitz Jr LE ET AL Parcel #38687 Property Owner's Mailing Address 44305 Trail Inn Rd Property Location Govt.Lot6&10 City, State ;able, Wl Zip Code 54821 U. Type of Building (check all that apply) 0 1 or 2 Family Dwelling — Number of Bedrooms D Public/Commercial - Describe Use D State Owned - Describe Use. Phone Number 970-227-7327 %. Section 08 Lot #T 43 N R 07 _EorW 1 Subdivision Name Block # a City of. CSM Number 2197 a Village of 0 Town of Cable ffl. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if| applicable.) D New System Replacement System D Other Modification to Existing System (explain) D Additional Pretreatment Unit (explain) B.D Holding Tank 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 D Transfer to New OwnerList Previous Permit Number and Date Issued IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) 450 Design Soil Application Rate(gpd/sf) 0.7 Dispersal Area Required (sf) 642.9 Dispersal Area Proposed (sf) 650 System Elevation 94.0 Tank Information Capacity in Gallons New Tanks Existing Tanks Total Gallons # of Units Manufacturer s.o ii §s s& 0 31 -s _sE S Septic or Holding Tank 1000 1000 Wieser Concrete x Dosing Chamber 600 600 V. Responsibility Statement- I, the undersigned, a^unip responsibility for installation of the POWTS shown on the attached plans, Plumber's Name (Print) Douglas E. Manthey MP/MPRS Number MP 230722 Business Phone Number 715-739-6868 Plumber's Address (Street, City, State, Zip Code) POBox196Drummond,WI 54832 VI. County/Department Use Only Approved D Disapproved D Owner Given Reason for Denial Permit Fee$Date Issued Issuing Agent Signature Conditions ofApproval/Reasons for Disapproval 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) SCKW12.-^=; <^2--0>o2.HORIGINAL WsconsinDepartmentofSafety&ProfesstonalSen/lcssDMslon of Industty Services SOIL EVALUATION REPORT Psge_^___of. In accordance with SPS 385, Wls. Adm. Code Attach complete site plan on paper not less than 81/2x11 inches In size. Plan muet 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)). County ^Y^J Parcell.D.r<^ -&-/- -t^38>62^ "T^.--Dete ^/Z-^/^i -a- E(or)W Property Owner^^ $^se.^}&^ 3'^ C^^Tflj. Property Location Gavfc Lot %y^of» T H3 NR^T> Property Owner's Mailing Addrass^3as- r^//j-^, ^J I Site Address or CSM and Lot fc ^</So 5- Tf^ I X^ ^. '-•Tl d^ ff^tff /n Awr ^Ts&i /o /»»^<c- 2»z.ne-F^fStia- City, State, Zip^Ait^ WS S-W\ Phone Number { ) D City Damage {&- B'Town Nearest Road Tyi^il Z/i^i ^W a NewConstructlon Use: B^esidentlal/Numberofbedrooms ^ Q'Replacement D Public or commerolal -Describe:. Parent material /ifa^e.t /0&7~&/-f<& Code derived deslgnflow rate. Flood Plan elevation If applicable. LGPD -ft.^f2 ?^ General comments and recommendations: ^ Treytff'l-€ i<^/ fi-f^u^ ^.f ^ .$^1^*-- ^-, €>4 ^fr^ /Bonog iSt ] Boring} Pit Ground surface alBv?^'^ ft.Depth to limiting la '€^&. Horizonizon z^~JLTr- ^_Borin Depth In.~^T ?--&? ?£-^ tt6-S'i ?-A>S 1# Dominant ColorMunsefl 7. y ^ JA tf/y H ^-y " %^^/ Redox Description Qu.Az.Cont. Color C.S.d S-ft^ Texture A_^_ -$/-^Sff/.^- cos Structure Gr.Sz.Sh. -?^ ^ ^.s^ ^^_ <a-5 Cr ^-S 6- QBaring ,ggplt Ground suriacs eIev.JStiIl.ft, Conslstence /3f.^^^ t^VW~^7T ^^. ^^-... Boundary 6^i^ 6f^ £rj^ 4^-L Roots /e^/n ^<cv^^ Soil AppteaUon Rate . GPD/FP *SiSM -3- _£-~^s- .y -2- Depth to limiting faotor^Ljn. / elevf^ 'EfBffi -A^-J^-^ 1.6. ^(S it.. Horizon / -LT t^ s~ Depth In. 0-^^^<-?8r 3^-io ^-,^8 Dominant ColorMunsell •?,s- y^3/l ¥/3 y/y~StL^F Redox Description Qu. Az. Cant. Color <w4 s-ys. s^ CST Name (Please Print)/f/C/^v^ A?ALL^( Address//.?^ ^Sffn^is.Se^ 'sir' ^--a ki* u>3. s-vrs.\ __ Texture zz. ^L .&L Ao^.J' i.»s Structure Or. Sz. Sh. f^.^^ s6A- OHlt ^-^6- ^-J&- Consistence _fwf^ i^^^rJJL ^i. rt.^._ l8,"*"^^^ Dste Evaluatton Conducted//^-^y Boundary 6-^*, £ft^ ($-<6/ ^-^ Roots <fee>^*/ 1^^ ^- Soil Application Rate GPD/FP •EffiM .?^ .^ _s- _2- *Effiffi _^L /.o -^-^^^- CST Numberj'A(y/-2/^<3%%?7 Telephone Number7,^- ^{-/l^ei • Effluantfrl = BOD > 30 & 220 mg/L and TSS > 30 s8160 mofl- • EffluBnt#2 s BOO. s; 30 mgn. and TSS s 30 mg/L SBD-8330(R03/22) %^ ^So.oo ^llS(2oZS «flA SR-00^ Department of Safety & Professional Services Industry Services ^ " ^ ^.1^,^ I MAR 1.0 2025 In accordance with SPS 385, Wis. Adm. Code SOIL EVALUATION REPORT%sSJ^^i^/" Attach complete site plan on paper not less than 81/2x11 inchBS 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. Persona] information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). couniga^idpp^oiyng 0@pl Parcel I.D.T^^ U. -tt-38>62n Reviewed by Date Property Owner /^?/^ S ^l^s^i&^-f-? 3-/e ^ &T ^i. Property Location Govt. Lot % Dr" % S Of> T YJ N R<? 7 E (or) W Property Owner's Mailing Address yy^;r r^//jr^ ^j I Site Address or CSM and Lot #; ^/Ja 5~ Tr^ I 1^ ^ ^€>J . t-oTt d^ *<-2/ft' /», ^o^^- ^"?^- <?/ /0 ^ zlo^ 2o2.l^ -S-^/S'•12. City, State, Zip _^^?//^. /t/2- ^f^ < Phone Number ( ) D City D Village B. TownCQ^/^i Nearest Road 7^4 // Z/n ^<^ Code derived deslgnflow rate $/^Z?GPD Flood Plan elevation if applicable_ft. D New Construction Use: B'Residential/Numberof bedrooms ? D Public or commercial - Describe: Parent material ^-/a^/'&f /!?A7~&/<r A. General comments and recommendations; ^ Tre^t^-I-S it^/ S'L-^^ouJ ^-^ ^ <, 'y^T'e^^. ^r'^-. 0-ft ?'^ c' Boring #D Boring12 Pit •^f ft.Depth to limiting factoi ,./elev^M Horizon -/- _^_~L ~J_ r- Depth In. ^-^ ?--?-? ?^^0 V6-S-6. ^-^>« Dominant Color Munsell 7.yy^ -^^^. ^/y " y/^ - -9^ / Redox Description Qu. Az. Cont. Color c.s.d s-rc ^ s^or$ Texture ±J- s/^ SL. ^/,,-s' ^PJ- Structure Gr. Sz. Sh. -z^i ^ ^*i s^y <!> ^i <S-.$ 6- ^?-S 6- Consistence ^.l^ft^ ^t^/~^ <q H ^?^ ^t. Boundary 6-to ^sr-t^l 6rl^^ Roots /e.o^p:, '{^F<s- I l^jt: Soil Application Rate GPD/Ft2 *Eff»1 .7^ -2. .73: *EffB2 /^ l-c?^^A^ ^Boring #QBoringjgPit Ground surface elev7^' ^ ft.Depth to limiting factor /<:>18> in. / etevf^^ft. Horizon _/__ _^_1 A.^~ Depth In. 0-^? ^-/f, ^3<S H-^o ^>-/^g Dominant Color Munsell 7,S-y^^/l^V/~w"^ Redox Description Qu. Az. Cant. Color ^^' s-ye. ^ if^-s Texture / J' ^L r^_ 4L'>Lt c»s Structure Gr. Sz. Sh. ^6.^^ ^A- 0-A ^-.5~6r Q-.Sl^ Consistence fwft/?. ^^/•< ./// ^t- ^ H.£- Boundary ^-t^J <^^ ^r-l^ <y-£^ Roots /t.0^t:, ^A& /^ Soil Application Rate GPD/R2 *Efl#1^7 •^ .^ _2_ ^_ *Eff»2^ /.^ -<r~u ^'c i CST Name (Please Print) ? /f/*^/^^ /€^M^ j Address ^3^^ ^O^tji^fi^ c^r ^t,lf U>S. S-V^\ ^Signature Date Evaluation Conducted/A^?-^?y CST Number J'/9' OU I (300^ I Telephone Number/%^ ^(-ll<!o * Effluent #1 = BOD > 30 £ 220 mg/L and TSS > 30 & 150 mg/L * Effluent #2 = BOD, e. 30 mg/L and TSS S 30 mg/L 3BD-8330 (R03/22) BoringS Q Boring0PK Ground surface elsv.'nn.ft. Page _^_ of. Depth to ffmlfing factor1^8' In. / elev??^^t. Horizon /2:z2 Depth tn. ^n 7-^?^^ y-ryw Dominant ColorMunsell 2.s~/< y^.7~^ *. V¥ '*_ sye/-f Redox Description Qu. Az. Cent. Color <^2ef S-W ^ Texture LS SlL. su. C.&S Structure 6r. Sz. Sh. •?^t 6-^ ^^.^^- Q ^! ^3-r<?- Conslstsnca ftly/s^ •/*ty f/j d H-^ Boundary ^^ 6r£^ ^{^ Roots ^Vt ^/v fy^ Sol] AppllcaUonRate GPD/Ft? *Bf»l L '7 »^ . <? -^ •EfB2 ^&_ /.^? ~s_ 1^_ Boring*DB°'Na "t Ground surface elev..-ft.Oepth to amib'ng factor.jn./etev,-ft. Hortzon Depth In. Dominant ColorMunseft Redox DescriptionQU. Az. Cont. Color Texture Structure Or.Sz.Sh. Conslstsnce Boundary Roots Soil Application Rats GPD/FP •EW1 •EWK Boring #Boring . 0 Pit Ground surface etev..Depth to llmlUng factor- In. / etev... , ft. Hcaizon Depth in. OominantCotorMunscll Rectox Description Qu. Az. Oont. Color Texture Structure Gr. Sz. 9h. ConsfstencB Boundary Roots _SoilAppltcattonRate GPD/Ft2 •ewi "EWS • EfflusnW = BOD > 30 a 220 mg/L and TSS > 30 i 150 mg/L * effluent US.» BOD. s 30 mg?L and TSS ^ 30mg/L c-^r^ s/3-owfff>wi 7./^--^^i- n^ coro t\ 3Ull- H i | i H I .^ •< 3 »s ce »w Ca ^H ^ t l t ir ? i B ^ *t ( » - 4 ^ ' -^^^ ^t t4 ^ ^ ^ 1 1 ^ l i ^ > c > S - X " Si i j ^ ^ v € J-s .» ^^l^^ na%r i " f c S . »- ' % - r- ^ . ' CT ; LA ) ^>•s VO BAYFIELD COUNTYCHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): | ^ ^^ !W "s !'! ;•'? ip i~.'\'ffj ^ K (5, li r i in]^ "" ' ; ' "" III! U YQ'tc^ ^ D Check List '^:!BQ ua 70n!PS ^ D Index Page / Title Sheet (Optional) D Original Soil Evaluation Report (Submitted in Deed Holders Name - nfit prospective buyers) a Original Plot Plan D Cross Section Soil Profile Sheet (optional) a Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) BTarcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used C3^roperty Owner's Information (not prospective buyer's name) Location (Accurate Legal Description with Sec/Twp/Range) Br^oad Name (where driveway is/will be coming off of) O^Ioodplain Elevation/ Flow Rate, Comments and Recommendations B^Complete Soil Boring / Pit Information ETbate Soil Evaluation was conducted 'CST Name, Signature, Number, Address and Phone Number H *Date Stamp* Plot Plan; (Include the following information drawn to dimension or to scale) EfBench Mark (Description, Elevation and Location) B^ontour Lines (Example = 98.0796.0794.0') B^roperty Location (Sec/Twp/Range// Accurate Legal Description) C3^6orings (Locations and Elevations) B^Percent and Direction of Land Slope EfWeli Location (Including Neighboring Wells, if applicable) Ea^.ocation of Wetland Areas, Floodptain and Navigable Waters Q^Buildings, Driveways, and Structures (Location and Descriptions) B^ocation of Property Lines Location "Address Number and Road Name B^Current Surface Elevation of Wetlands and Navigable Waters 'CST, Owner and Property Information Arrow Fee: [^Certified Soil Tests-Review & Filing Fee $ 50.00 U/forms/sanltary/checklist/checklistforcsts PAGE 1 OF 5 In-Ground Dosed-Gravity Plan ^ b ? Index & Cover Sheet 11 ^R i o 2025 ^ Component Manual Design References: In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2D^);k Co, Zoiiin;j uW. Pg1of5 Pg 2 of 5 Pg 3 of 5 Pg4of5 Pg 5 of 5 Index & Cover Sheet Plot Plan Dispersal Area Cross-Section & Plan View Pump Tank Specifications Management Plan Attachments: Pump Curve MANUFACTURER TANK SPECS Enclosures: POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Meschievitz Conventional w/Lift Owner Name(s): Henry S Meschievitz Jr LE ET AL Owner Address: 44305 Trail Inn Rd Cable, Wl Phone: 970 -227 .7327 Zip:. 54821 Project Address: 44305 Trail Inn Rd Govt.Lot 6&10 1/4 of Township: Cable 1/4, Section_08_, T43N-R 07 E County: Bayfield or Wl Project Parcel ID #: 38687 Designer Information Designer Name: Doug Manthey _ Phone: 715 .739 .6868 Designer Address: PO Box 196 Drummond, Wl E-mail: norpines@cheqnet.net Zip: 54832 Th;?, spiii.c I'cservdi jur ;q^'>;'<'>'.'<'l sla:n)t. License Number: MP230722 Remarks: Signature:Date: 02/07/25 Orj^nal signature reycSfe^ on each submitted copy. l^ ? 5 : ^ ^ ^' ? ( ' : £ . K D ^ ° ? ^ ' °? ^ ^ '• ^ ^ ^ : 1 ^ p sf ^ ? l ^ 3 - 1 . 5 ^^ ] ( ^ M | > ^ ® ^ | P ^ i \ ^ < L te ^ ^ y^ << - ^ t\ « - , M ^ a , ^ ^ ®3 s & t ^ ? "^li R ? ~^ > ( ' - < s < IN-GROUND DOSED-GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down-sizing credit) SOIL COVER TYPICAL TRENCHPLAN VIEW (No Scale) TYPICAL TRENCHCROSS SECTION VIEW (No Scale)OBSERVATION PIPE DETAIL(No Scato) Scraw-Type wSBp Cap (loose)Fini&ned Grade(muicri&d & sei?;t<K!) System Elevations 92.25' ft. (typical)Provide minimum 3 ft separation between trenches. (Show location of Intel I outlet pipe connection on plan view.) 4*0 PVC Piira Top a f ptpe to iBCTiftatuat or above finished gnjco (4)1/r-t,g-X6" Slots©^b spar) Anciiorina Owtafi (nfifcatfanSuftSCB E 3CZ 4"0 Perforated Lateral (typical) -<- Observslion ftipo shsfl be !ns(3)tod at;unrfion balwaen two units. Observation Pipe(typical)(typical) .-^_ B= 65 ^^-.==-.-.=-.-.=^^3 ji ;==[^=;:=:^| |-A=3.0ft_, J__ _ _ J -L (typical) .^ (iypcal) INSTALL PER TRENCH: 6_ 10-ft bundles @ 50 ff EISA/unit = 300 + J_ 5-ft bundles ® 25 ff EISA/unit = 25 EZ1203H Bundle(typical) (mfd by Inflltralor Systems. Inc.) install pursuant to manufacture<s fnstructtons. f--lc>r<?c-n •- Proposed EISA per trench ft2 Required Infiltration Area = 642.9 fti trenches = Proposed Total EISA = 65° ft' 1-5'., ^-^ Distribution Method; branched manifold -0>0mODQ-n 01 PAGE 4 OF 5 GRAVITY-DOSED „SEPTJC / PUMP TANK SPECIFICATION^(No Scale) i'MAR 2025 .L IMPORTANT: 4"0 Vent Pips>10 ft from Building 12" Min. or 2.0 ft aboveEslabllshod Flood Bevation(typical)ApprovedVonlCap Anchor tanl<(s) as necessary pursuant to SPS 383.43(8)(g) \1/ ^/ Finished Grade Electrical must comply wilhSPS3t6andNEC300 Wealherproof•Junction Box Extend manhole riser as necessary. Approved Locking Manholewith Warning Label Altached(typical) 4" Mln.or2.0n aboveEstablished Flood Elevalion(typical) \1/ CAPACITIES @ 16.76 gal/in A B [C] D Depth (in) 18 2.0 6 10 Volume (gat) 301.7 33.5 100.6 167.6 Pump Tank Liquid Level = Force Main Diameter = 2 36 •IB-Min. (typical) Approved Joints with Approved Pipe 3 ft ontoSolid Ground (lypical) PUMP-OFF ELEVATION = 81.33 ft INSIDE BOTTOM ELEVATION = 80.5 Force Main Length =140 ft 3' Approved Bedding Material Beneath Tank Force Main Void Volume = 22.8 ga] [C] Total Dose Volume (TDV) = 100.6 gal/dose (< 0.2X design flow + force main void volume) Pump 35GPM TDH=15.2 11.5 + 3.7 friction loss = 15.2 ft Vertical Lift =11.5 PUMP TANK: Volume =600 gal Manufacturer:Wieser Concrete SEPTIC TANK(S): Total Volume = 1000 gal Manufacturers):Wieser Concrete Pump Manufacturer Pump Model: EP0411 Goulds (See atlaehed pump curve.) Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Controls/Alarm Manufacturer SJ Rhombus Controls/Alarm Model: SJE1025830 Filter Manufacturer: Filter Model: Orenco 14B Float switches containing mercury are prohibited. iH) iPAGB^dF^ In-ground Dosed-Gravity Management P\an[ ^ , ^ ^5 !! IMPORTANT: , The owner of this in-ground dosed-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 = 45° apd: BODs £ 220 mgL-1; TSS £ 150 mgL-1; FOGS 30 mgL-1 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 {i.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, ete.) 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 laterat 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 tankfs) 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 filteris) 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: HK SeptJC _ phone: 715-798-3494 Local government unit: Bayfield County Zoning _ phone: 715-373-6138 Local government unit address: PO BOX 58 Washbum, Wl _ Z,p.. 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. SdgjGOULDS PUMPS Submersible Effluent Pump MODEL 3871 EP04 r"£:':..: ii;iH MAR ,uZUZ5 M bs/teki Ca /'cn;iiCi !^.;i;L APPUCATIONS Specifically designed for the following uses: - Effluent systems • Homes a Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 3/4" maximum. • Capacities: up to 60 6PM. •Total heads: up to 31 feet, •Discharge size: 1',2° NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. •Temperature:104°F(40°C) continuous 140<T(60CC) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP,115 or 230V, 60 Hz, 1550 RPM, built in overload w'rth automatic reset. •EP05 Single phase: 0.5 HP,H5Vor230V,60Hz.1550 RPM, built in overload with automatic reset. •Power cord: 10 footstandard length, 16/3 SJTOW with three prong grounding plug. Optional 20foot length,! 6/3 SJTW with three prong grounding plug (standard on EP05). © 2002 Goulds Pumps Effective September, 2002B3871 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES • EP04 Impeller: Thermoplas- tie Semi-open design with pump out vanes for mechanical seal protection. construction. AGENCY LISTING • EP05 Impeller: Thermoplas- • Bearings: Upper and iower tie enclosed design for heavy duty ball bearing improved performance. • Casing and Base: Rugged thennoplastic design provides superior strength and corrosion resistance. • Motor Housing: Cast iron for effident heat transfer, strength, and durability. • Motor Cover: Themnoplastic cover with integral handle and float switch attachment points. • Power Cable: Severe duty rated oil and water resistant. [ Canadian Standards Assodafion Goulds Pumps is ISO 9001 Registered. METERS 10 Q<Ulxu? sj FEET 3t 25 20 1S 1C 5 0 T-1- •"! •1 I I ,L ..I -.............. I 1 "T- _L «*—50f-M -2,5 FT 10 20 30 EPO' ! -.1- ^ 40 50 GPM 10 12 mVh CAPACITV Goulds Pumps ITT Industries 4" CAST-A-5EAL- -•i2'-6" 4" CAST-A-SEAL TOP VIEW 4" VENT PUMP PAD plDE VIEW •ANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS WLP1000/600-MR TANK SPECIFICATIONS DIMENSIONS:WALL 3" BOTTOM: 3" COVER: 5"MANHOLE: 24- 1.0. PRECAST CONCRETE RISER HBGHT: 51" LENGTH: 12'-6"WIDTH: 7-0"BELOW INLET; 42" LIQUID LEVEL: 36"WEIGHT: BOTTOM 9,500 LBS.COVER 5.470 LB5. INLET AND OUTLET: 4' CAST-A-SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER:WISCONSIN. SEE DETAIL fW(OTHER STATES SEE CHART) LIQUID CAPACITY: 27.88 GAL/IN (SEPTIC)16.76 GAL/IN (PUMP) LOADING DESIGN; 8'-0" UNSATURATED SOIL TANK CAN BE USED AS:SEPTIC/SEPTIC, SEPTIC/PUMP.OR SEPT1C/SIPHON COVER: MIX DESIGN fS (NO FIBER)TANK: MIX DESIGN #W (STRUCTURAL FIBER) CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTEDFOR APPROVAL APPTOVED BY: APPROVAL BATE: PRODUCTS NEEDEO BY: 1*1' ISliIHSl'*-00m^.sl0 I0|;S"1I CO] uf=0.UJV) SHEET NO.T" / BAYFIELD COUNTS ^CHECKLIST FOR SANITARY APPLICATONS i ij Submit the Mlowina (Use Permanent Ink) Qttle 15, Section 15-l-10(e)) 111' MAR t U 2025 Im -mecK Us;: . .... ., , ..<WieMi.;,''.^OHi;;:.ii.!.?<.Sanitary Application (Submitted in Deed Holders Name - not prospective buyers) (383.21(1)1.) 'Index Page / TiUe Sheet (Signed by Plumber) (383.22(2)69(c)) ia^Original Plot Plan (383.22(2)2. 3. & 4.a) j-oss Section, Over-Head Profile of the System and Schematic of Tank from Manufacturer 'ump Tank Diagram, Alarm and Pump Curve (when applicable) Plan / Management Plan (383.22-3(2)(b)l.f.) a Maintenance Agreement (Owner's Original Signature) (383.21(2)(c)(5),(6) (Recorded at Reg. of Deeds) 0{^V\€f^~ a Holding Tank Agreement (383.21(2)(c)(5) (Recorded at Reg. of Deeds) ^>-^4 ^ 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) EfFee (Make Check Payable to Bayfield County Zoning) (383.21(2)(c)7) CoQiRteK Set& of Plans (383.22(2)(2.) (Note; Saniteiy Appiicat.ion aiid Majntenance Aqi-esrii@nts ere tu be aEtaci'ieo to_alj_coi;}jys} 'Soil and Site Evaluation Report (383.22-3(2)(b)l.e.) a State Plan Review (when applicable) a Copy ofWarranty/Quit Claim Deed (Optional) Sanitary Application; (Include the following Information) Ert""^ Application Information must include: D 23 diait Parcel ID# - (do not use 12 digits anymore-obsolete) El-Project Address or Road Name where driveway is/will come off of) B-(0wners Phone Number) efif Type of Building Q^II Type of Permit Q^\f Type of POWTS System B^ Dispersal / Treatment Area Information Q"\/I Tank Information Responsibility Statement (Plumber's Information) D *Date Stamp* Plot Plan: (To Scale or To Dimension) and Plumber Information -0 Address Number and Road 'Surface Elevation of Body of Water P^lorth Arrow D-Ofrection and Percent Land Slope /tfContour Lines EHank and Filter Information and Location J3-l3tructures and Driveways Blfttetlands / Navigable Bodies of Water J>fi&ring Locations Q^bsorption Area (Proposed and Existing) 0/Property Unes "Bench Mark (Location, Elevation and Description) B^iVell Locations Manual Version P-tegal Descriptions DJ?iph^g^%ns!:lR?Gm<^'on^cQnv9y3nee^sn%^yRa'f> Turn Over > Cross-Section and Over-Head Profile of the System: In] ^ f[11 ir- B'Surface and System Elevation 'ill MAR i u 2025 ^. of Observation and Vent Pipes ;,,.,,,,,.,,, ., .^!'/neicK;u. 2onnit; Dso^ )imensions and Depths C^ake, Model & Number of Chamber Units in each Cell Property Information D How many systems will there be on this parcel of land? f D Has this property been split? _ (Property Statement shows Property History) Fees: 'rivate Sewage System (Septic Tanks) $ 400.00 D Private Sewage System (Holding Tanks) $ 400.00 a Mounds or Systems requiring Pre-Treatment $ 500.00 a Sanitary Revisions $ 25.00 D Private Sewage System Reconnection $ 50.00 and Private Interceptor D Return Inspection $ 50.00 D Maintenance Agreements + S 30.00 (checks made out to Reg of Deeds) u/forms/checklists/checkllstforsanitaryapps (10/2009);(®7/20U);(®2/2012)(®5/2/2012-dc) Proofed by: Private Sewage System Maintenance Agreement Owner(s) Name Casey D Meschievitz Owner(s) Mailing Address 44305 Trail Inn Rd Cable, Wl 54821 Site Address 44305 Trail Inn Rd ~M# 38687 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 uu Township 'Tv^ N. Range ul W. Additions! Lega! Description: Town of cable _ (Acreage) _ Gov'tLot. Lot Block Subdivision Lot J_ CSM # 2197 Vol. 12 Page 424 CSM Doc # DOCUMENT NUMBER2025R-606556 OANIELJ. HEFFIMER REGISTER OF DEEDS BAYFIELD COUNTY, WI RECORDED 02,13/2025 AT 1 2:35 PM RECORDING FEE: $30.00 PAGES: 2 Recording Area Return To: _ _ ,_; ,. ;,.; ,..: r— Planning and ^d/iin^Deparfenent '' ^ | ;-T'. ' - i: 0/3 ^ "iywiu '-..•u ^,ur;it:g ^ypL In-ground gravity D Mound 0 In-ground dosed At-grade Sewage System In-ground pressure distribution 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 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 Casey D Meschievitz Subscribed and sworn to before me on this date: ^/ 10,^ Notarized Owner(s) - Signature(s) r-^. Drafted by: DOU9 Manthey ;%^ ' <$^y ^o ^ ^^^; ;pires:(pires:pw^':/^ •< .. • :—T-%"/^/^Rvr'\ • '^^•-" _ :vO .;PU®^ ,-'^/^^Proofed by: u/forms/sanitary/septicmaintenceagreementRevised July 2020 2/13/25, 12:00 PM Novus-Wisconsin Access rev. 12.0206 R.eal Estate Bayfield County Property Listing Today's Date: 2/13/2025 Property Status: Current Created On: 11/10/2021 11:35:15 AM Description Tax ID: PIN: Legacy PIN: Map ID: Municipality: STR: Description: Recorded Acres: Calculated Acres: Lottery Claims: First Dollar: ESN: r'sW Tax Districts 1 04 012 041491 001700 Recorded Documents S3 QUIT CLAIM DEED Date Recorded: 11/3/2021 3 CERTIFIED SURVEY MAP Date Recorded: 9/17/2021 63 QUIT CLAIM DEED Date Recorded: 2/6/2019 63 QUIT CLAIM DEED Date Recorded: 5/18/2016 S3 QUIT CLAIM DEED Date Recorded: 3/30/2016 £3 WARRANTY DEED Date Recorded: 1/31/2014 Q CERTIFIED SURVEY MAP Date Recorded: 1/2/2014 Updated: 11/1/2024 38687 04-012-2-43-07-08-4 05-006-13000 (012) TOWN OF CABLE 508 T43N R07W LOT 1 CSM #2197 IN V. 12 P.424(LOCATED IN GOVT LOTS 6 & 10) IN DOC 2021R-591842 17.510 17.510 1 Yes 108 Updated: 11/10/2021 STATE COUNTr' TOWN OF CABLE SCHL-DRUMMOND TECHNICAL COLLEGE Updated: 3/18/2014 2021R-591842 2021R-590981 12-424 2019R-576323 2016R-563618 1160-659 2016R-562764 1157-997 2014R-553232 1121-199 2014R-552951 11-84 Ownership HENRY S MESCHIEVITZ JR LE 3ESSIE L MESCHIEVITZ LE CASEY D MESCHIEVITZ Billing Address: HENRY S MESCHIEVITZ 3R LE ETAL 44305 TRAIL INN RD CABLE WI 54821 Updated: 11/1/2024 CABLE WI CABLE WI CABLE WI Mailing Address: HENRY S MESCHIEVITZ 3R LE ETAL 44305 TRAIL INN RD CABLE WI54821 Site Address * indicates Private Road 44305 TRAIL INN RD Property Assessment 2025 Assessment Detail Code Gl-RESIDENTIAL G6-PRODUCTIVE FOREST 2-Year Comparison Land: Improved: Total: Property History CABLE 54821 Updated: 3/14/2022 Acres 1.000 16.510 2024 157,500 83,700 241,200 Land 122,800 34,700 2025 157,500 83,700 241,200 Imp, 83,700 0 Change 0.0% 0.0% 0.0% Parent Properties 04-012-2-43-07-08-4 05-006-30000 04-012-2-43-07-08-4 05-006-11000 FLb Tax ID 8539 36861 •? ^ »GSi»i-,S ^ 'OP!. HISTORY S3 Expand All History White=Current Parcels Pink=Retired Parcels S3 Tax ID: 8539 Pin: 04-012-2-43-07-08-4 05-006-30000 Led. Pin: 012102307000 63 Tax ID: 8547 Pin: 04-012-2-43-07-08-4 05-010-10000 Lea. Pin: 012102405000 £3 Tax ID; 8541 Pin; 04-012-2-43-07-08-4 05-006-20000 Leg. Pin: 012102309000 £3 Tax ID: 8540 Pin: 04-012-2-43-07-08-4 05-006-10000 Leg. Pin: 012102308000 S3 Tax ID: 36861 Pin: 04-012-2-43-07-08-4 05-006-11000 38687 This Parcel ^Parents ^Children https://novus.bayfieldcounty.wi.gov/access/master.asp 1/1 4/15/25, 4:52 PM BAYFIELD COUNTS Carmody™ SANITARY PERMIT rt04)-25-11S STATE SANITARY PERMIT OWNER: HENRY S MESCHIEVITZ JR LE ET AL GOVTLOT: LOT: 1 BLK: CSM: 2197 1/4 1/4 SEC:8,T43N,R7W TOWNSHIP: Cable SOIL TEST: 12-25 REPLACEMENT SYSTEM SYSTEM TYPE: Non-Pressurized In-Ground PLUMBER: Douglas E Manthey CECERUDNICKI DATE: 4^2025 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: # 230722 Condition: SYSTEM ELEVATION SHALL BE > OR = T BELOW TENSION SATURATED HORIZON - SYSTEM ELEVATION = 92.25'. PROPERLY ABANDON EXISTING SYSTEM PER SPS 383. CORRECTED SOIL TEST SHOWS SIL IN TENSION SATURATED HORIZON. PROPERLY MAINTAIN SYSTEM PER RECORDED AGREEMENT. THIS PERMIT EXPIRES 4/15/2027 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION h+tn<s-//www p.Firmnrlvinr1 p.nm/PprinitAnn/Pprmit Rinn a<sny?Print=1^,nftrmit?inniri==74c;n 1/9