Loading...
HomeMy WebLinkAbout24-14S"' INBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY °" TIME RECEIVED REMOTE CSID DURATION PAGES STATUS June 14, 2024 at 12:11:02 PM CDT 7157983470 36 1 Received JUN/14/2024/FRI 10:55 AM Andry Rasmussen & So FAX No. 7157983470 P. 001/001 Request for Sanitary Inspection (Fax this form to Zoning Dept when you want an inspection — 373.0114) Plumber: Home Owner: Sanitary Permit #: Date: Time: Address # & Road Name: or Directions To Site: Comments: Time Change Discrepancy Other Phone Number Fax Number 7is 798-3y70 ace l yc Plumber's Choice LIn4 lumber's Choice Zoning Dept OK 9:30 am —12:30 pm -rues. (Tracy) 9:30 am —12:30 pm Thurs, (Tracy) ling Dept lmmadiate Phone Number so Zoning OK Dept can call you right back (If needed) I ICao Sc iC ArI4 ( Reminder: YOU must confirm any changa(s) that have been made prior to this inspection will not be scheduled and a memo will be sent vo•'Jing the inspection. o — — — -- _.— — — — -- — Thank You! rx Pl(Inir),i•must verify any Cfl�lne v J ( ) /w fa;, n,e no ir,;y rtio17 will be sc/l�duled << �,r�arer y'�la $s, �. Private Onsite Wastewater Treatment Systems ( POWTS) Inspection Report �� p °•a„,r.�� (Attach to Permit) Industry Services Division General Information u.ronnst in£nrmatinn you provide may be used for secondary purposes [Privacy Law, s. 15.04 1 noses Privac Law s. 15.04 1 m City Village Town of: TIMOTHY P & PRUDENCE M MOTT 11020 SCENIC DRIVE BM Description: IRON RIVER WI 54847 Tank In mation TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road Septic £ N/A Dosing N/A Aeration N/A Holding — setback to: County Sanitary e It No.s State Plan Transaction ID#: Parcel Tax No: Pump I Siphon Information Pump Manufacturer Pump Model Demand GPM Filter Manufacturer Filter Model TDH Lift Friction Loss Head Total Forcemain Length Dia Dist. To Well Dispersal Cell Information DIMENSIONS Width Length # of Cells SETBACK FROM Prop, Line Building Well OHWM Type of Cell LU, Manufacturer: Model Number: Pretreatment Unit Manufacturer: Model Number: )istribution System Header / Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length Dia _ Length Dia Spec Spacing ❑ Yes 0 No Elevation Data STATION BS HI FS ELEV Benchmark Bldg. Sewer Tank Inlet fc, Z7 Tank Outlet cg p 7 Dose Tank Inlet Dose Tank Bottom Inst. Contour Header/ Manifold Distribution Pipe Infiltrative Surface p 7 Final Grade X Pressure Systems Only Soil cover Depth Over Depth Over Depth of Seeded / Sodded Mulched Cell Center Cell Edges Topsoil ❑ Yes 0 No ❑ Yes 0 No COMMENTS: (includes code discrepancies, persons present, etc.)) 1 7 I/ �/ r J f .i P;a ; ti t O4 ! 19 rr i( , yl 4d `t rwe 4 f rr�1LL k - wr / CU. I i A iii Di / ¢ l¢ /Sk1-1,f;tn� 7y( «v// Plan revision required? Yes 0 No Use other side for addition Information. Date FRnS.79n rR m/911 POWTS Inspector's Signature License Number Property Owner Information As you know BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT Telephone: (715) 373-61$8 Bayfield County Courthouse Fax: (715) 373-0114 Post Office Box 58 e-mail: zoning(aTbavfleldcounty.org 117 East Fifth Street Web Site: www.bavfieldcountV.org/147 Washburn, WI 54891 TIMOTHY P & PRUDENCE M MOTT 11020 SCENIC DRIVE IRON RIVER WI 54847 was contracted by you to install a private onsite wastewater treatment system on your property (Tax ID# above). To know when your system will be due for servicing please go to www.septiesearch.com Notes: Abandonment of Old System to meet all applicable code requirements: • Tank was pumped by: :• Tank was crushed! removed and pipes disconnected by: on at AM / PM On at (AM/PM) the above -mentioned plumber contacted our office to conduct a pre -cover inspection as required under DSPS 383. One of the following applies: ❑ System was inspected and appears to meet all applicable code requirements. ❑ System was inspected and appears to meet all applicable code requirements; however, a plan revision is necessary because the installation was substantially different than the original approval. ❑ System could not be inspected because plumber covered prior to scheduled time of inspection. System could not be inspected because plumber was not ready at scheduled time of inspection. County was unable to return to complete inspection. System could not be inspected because plumber was not ready at scheduled time of inspection. A re -inspection and $50 fee are required. ❑ System could not be inspected because County could not respond to plumber's time constraints. Comments: Ulformstsanitarypropetlyowner-input April 2019 r,,C-nn�RQ(k l5 iA • U Industry Services Division '#r£f, County 4822 Madison Yards Way C�, tE afield JUN 1 17 74 Madison, WI 53705 j1 Sanitary Permit Number (to be tilled in by Co.) ppvtield ,,. Madison, WI 53707 Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) 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 Same purposes in accordance with the Privacy Law, s. 15.04(1 )(m). Slats. I. Application Information — Please Print All Information Property Owner's Name Parcel # Tim Mott 13240 Property Owner's Mailing Address Property Location 11020 Scenic Drive Govt. Lot City, State Zip Code Phone Number Iron River, WI 54847 715-292-1940 SW / SW ¼, Section 2 T46 N R 08 E or W II. Type of Building (check all that apply) Lot if J71i or 2 Family Dwelling— Number ofBedrooms 2 Subdivision Name ❑Public/Commercial — Describe Use Block # ❑City of State Owned — Describe Use ❑Village of CSM Number j71Tmvn of Delta ill. Type of POW'rS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if applicable.) A. ❑New System Replacement System Other Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B' ❑Holding Tank I1In-Ground ❑At -Grade Mound Individual Site Design Other Type(explain) (conventional) C. ❑ Renewal Before ✓ Revision ❑ ]Change of Plumber �fmnsfer to New Oyer List umber and Date Issue - 4S Revision due to grade cut IV. Dispersal/freatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required (sf) Dispersal Area r 300 0.7 428 452 96.0 Capacity in Total if of Manufacturer Tank Information Gallons Gallons Units New Tanks Existing Tanks v L c, U o0 u, ti ii O a Septic or Holding Tank 750 750 1 W' f�ir,. ✓ Dosing Chamber jJ O V. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Jason Kuettel 675751 715-798-3355 Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 VI. County/Department Use Only D Approved ❑ Disapproved Permit Fee Date Issued Issuing Agent Signature ❑ Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not less than S t2 s II inches in size SBD-6398 (R. 02/22) PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet I U Component Manual Design References: lu JUN 11 7074 LJ In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) d6efd t tl;lY}('i UFE;I Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: I Enclosures: POWTS Applic Soil Evaluation Project Name / Description Mott 2 Bed Owner Name(s): Tim Mott Owner Address: 11020 Scenic Drive. Iron River, WI Project Address: Same Govt. Lot: SW 1/4 of SW Township: Iron River Project Parcel ID #: 13240 Designer Name: Jason Kuettel for Review & Site Ma Phone: 715 -292 -1940 Zip: 54847 1/4, Section2 ,T46 N -R08 E❑orww County: Bayfield Designer Information Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 Remarks: Phone: 715 -798 -3355 Zip: 54821 .i�ace reserved for approval stamp. Signature: Date: ! t,/T.L�/ Original si nature regwred on each submitted copy. • -__ _.__ CH_CKBO%a5.+"_IG3Lc'. 0 SOIL EVALUATION Scale: l"=40' SYSTE PAGE 2 OF SITE MAP 40 60 80 PLOT PIN PROJECT NAME:DESIG (10 M1 grid) 10x design FLOc o- GPO p M Tr 7 'T6� Attach design flow calo� bons for commercial plans. PROJECTADDRESS: /10 LO Sc c Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) % O 0 • 0 N Sanitary Sewer / 8M Symbol: BM Elevation:FT Force Main: / BMDescnption: fi'rns Slbl"vG NW 6M/t46C Cc4At2 Slope Gradient(%) r. Indicate north by IMPORTANT: of Tested Area: well Symbol (if applicable): 0 drawing an arrow Show ground elevation contours at suitable intervals. on the approprile line. II C"L IF Clwr Ca_IV` /j2l�N, v &- N- ._ _.. (:. S 6 Z 71b7-d1bz I20FL) l N, ! LZT/IG/G€c I I 'H - jS✓ 4Th /OO.d 103,16 tT U3 T /o3. zz Dc — /OO.1 l35 _ 95r1 ftJ rC1 el 90 5 LJ P1= f0 id0 r - W F' er -- O Well I - - IRt a�ti I lU'iL=TIC C -- - --- _ G 3, lou.o )3oirVA- . CJn'(Lr-'KiE C 7 vn� - r\ti5' Rn V 1- 2 n n_n ,- a :V p1 IN-GROUND GRAVITY DISPERSAL AREA i U-nifom Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) � a T CD SOIL COVER min, 12" (typical) Septic Tank(s) Manufacturer. Wieser Septic Tank(s) Volume(s): 750 gal gal gal gal Effluent Filter Manufacturer: Orenco Effluent Filter Model u: FT -0822 12" min. trench depth (typical) TYPICAL TRENCH '•a ;•: CROSS SECTION VIEW i 3a" '.. . (typical) .'�, .• .... �. .. (No Scale) b Provide minimum 3 ft System Elevation ='7�o t) ft separation between trenches. (typical) Quick4 Standard -W w(yp calap (Show location of inlet / outlet pipe connection on plan view.) t i ) B= 46 ft (typical) INSTALL PER TRENCH: 11 Quick4 Std -W @ 20 ft2 EISNchamber = 220 ft2 + 1 Pairs of end caps @ 6 ft EISNpair = 6 ft2 = Proposed EISA per trench = 226 ft2 Observation Pipe (typical) Install per manufacturers / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) IA = 3.0 ft (typical) '-Quick4 Standard -W Chamber (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturers instructions. Required Infiltration Area = 428 ft2 x 2 trenches = Proposed Total EISA = 452 ft2 ''PRESETJ distribution Method: branched manifold (7 m co O m i mu SEPTIC ?a}I cos s:• -non •rrJ S= 1�J [UT4 G(:4,40 PVC IPISP. cro 5 �� Bayfield Co. Zoning Dept. b (uihen knle+ fnc e �o�Ps urrfea /� GRADE (O�T.� � FINISHED GLADE r 18" HIP7. I I'ILET << APPROVED PIPE 3' ONTO SOLID SOIL APPS D SA -F( E- 0 FILTER MEG. OV,eanco model I 10922. 3" APPRO'JED EEDDING UMDER TANK SPECIFICATION5 SEPTIC TANK MANUFACTURER: WIES&L C.aNc1k:7� TANK sizes: SE3TTC %So GAL. Lys NOTES: APPROVED H.4iIHOLE WI Lc,}. W�R�iiu� LABEL 4" KIN. OUTLET PAGE4OF4 In -ground Gravity Management Plani' I' U IMPORTANT: � JUN 'i 'I CUL4 L/ The owner of this in -ground gravity system shall be responsible for its perpetual operation and rn&i$Ste.pLrsagrikot. requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. 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), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 300 gpd; BODS ≤ 220 mgL'; TSS ≤ 150 mgL''; FOG ≤ 30 mgL-1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.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, Wisc. 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 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Andry Rasmussen & Sons Phone: 715-798-3355 Local government unit: Bayfield Co. Zoning Phone: 715-373-6138 Local government unit address: 117 E 5th St. Washburn, WI ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. 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, Wisc. 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, Wisc. Admin. Code. Wisconsin Department of Safety& Professional Services •�.: \ Division of Industry Services liii JUN 1 'i (. UL`I ft9Page_/ of " �$PS SOIL EVALUATION REPORT ! Co. Zoning Dept. �.i In accordance with SPS 385, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, LYF/ Lam) but not limited to vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. / 3 Z•iO Please print all Information. Reviewed by Personal information you provide may be used for secondary purposes (Privacy Law s 1504(1 Vm\ Date Property Owner Property Location ❑ W --rj .0m'% Ntu T-i Govt. Lot SW % 51.) / S oZ T 5fG N R O$ E(or) W Property Owner's Mailing Address Site Address or CSM and Lot #: //OZO SCENiL 'b?.Jt SAM t= City, State, Zip Phone Number ❑ City ❑ Village Town Nearest Road /rt0/ p)uc'.C, W-]= SUB'%7 (7)5 ) ZSZ -/9ye EL. 5ca,;C DR1uc ,?] New Construction Use: 0 Residential/Numberofbedrooms g Code derived designflow rate, 34V _GPD ❑ Replacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft. Parent material on)Jrtrlr `xtd.t-1,- (lures I _7 General comments and recommendations: ��3fGN TV d'7 coca a.'c.r 9w-( Di Boring# Boring Pit Pit Ground surface elev. /03 _ %t. Depth to limiting factor lror in. / elev.94'.7'( ft. Horizon Depth In, Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots rr•- GPD/Ft2 •Eff#1 •Eff#2 O 9 7.S<, -3/r ' L -S osC ) h. ot7 /•4 7- 9-70 7s;.�f/7 ' 5 oS6 I Gtr Ill✓f o,7 /.te 3 3o -of 7.-5--a, — S o.fG - 1-4 ofl IC. Boring # ❑Boring ®Pit Ground surface elev/03,L`I ftDepth to limiting factor )IJ in. / elev.g lift. Horizon Depth In. Dominant Color Munsell Redox Description Qu, Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDN-Eff#2 •E##1 o -`l • ,S Y / - LS OS& V )kJO,7 z 9 3 7.5 r� t/> — S arG P3 2 - .s 7ec.y'{0.7 CST Name (Please Print) T^^ LL-4ltSC— I Sinn=,',•= cc I CST Number 19 0oo'z8 Address e orc 6 -3t&,/jr a Evaluation Conducted 4 /ut to I Telephone Number ` Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L • Effluent #2 = SOD, 5 30 mg/L and TSS 5 30 mg/L SBD-8330 (R03/22) I' JUN 1 1 2U[4 U Page Z of? Boring �IJ�•6ft. Boring # Pit Ground surface elev. 0' 5,Uft. 4eQt�t t4limitlng factor m. / elev._ Zoning uept. SallAod Horizon Depth In. Dominant Color Mansell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eff#1 Eff#2 / ®-6 Y pi GS 036 .4'1 61A 4)v a-7 /•L 4-79 ,.t rc sc S 056 nal 6W 1 o7 hi - 3 Z8 -SS ).Su — 5 oJG r'i — orl /-G 17 Boring irK t 35 ❑Boring �_.lf SPit Ground surface elev. 00.1 it. Depth to limiting factorM S in. / elev.51_tSft. O.v n__n__n__ a_._ Horizon Depth In. Dominant Color Munseli Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 'Eff#1 Eff#2 I o-% T rt/' — S od 6 M — o•? Boring # ❑ Boring Pit Ground surface elev.72.7 ft. Depth to limiting radar _In. / elev.ft. Horizon Depth In. Dominant Color Mansell Redox Description Du. Az Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots cull Nppuuauurl Rate GPD/Ftr •Eff#1 Eff#2 o Ssr STti"a — f o96 ,t.1 — — , E.G * Effluent #1 = BOD >3O5 220 mg/I. and TSS > 30 s 150 mg/I. • Effluent #2 = BOD, s 30 mg/L end TSS £ 30 mg/I. CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. SOIL EVALUATION Scale: ao 40' 60 80 ❑ SYSTEM 0 AGE 2 OF, SITE MAP PROJECT NAME: M OT_. 7 PLOT PLAN' DESIGN FLOW: ?-©'C' JUN'' GPOSU/4 Attach design flow calculations for commercial plans PROJECT ADDRESS: / 10 F 0 S(&. I c Ibtt\./ t Pipe Material / ASTM Standard (Tables 384.30-3& 384.30-5) t. NSanitary Sewer: / BM Symbol: BM Elevation: % o D . 0 FT Force Maln: / BM Description: ftb T73M St -1.G NW GA24&C CcQNt2 Slope Gradient (°h) v Indicate north by IMPORTANT: of Tested Area: j0 �� Well Symbol (If applicable): 0 drawing an arrow Show ground elevation contours at suitable intervals. on the approprite line. SC In L �2c 'C /2N / N OFiW '7QWP': i ITX t /_zoo _r' F0 7 _to Li /ao 61 ( /c.o 91 - /o3,/G 6-z 1�3.zy I c L_ I 1 s�,nG d p2N -fii c' ---t°< coif Proi ,_ JUN 12024 7i M-oTT Bay(ield Co. Zoning Dept. isi r.L Sitf,?lij'Co 9fj,O_ 1 05 �z �$ T 103 or, a ,o, e i4 95 cr2 cij NtW S'tr c1 .c( Sb,o '5S ,9 a aFCEIVED 2 3 2024 Industry Services Division 4822 Madison Yards Way County .. PjY/I�ItC.� ":' �• JAN Madison, WI 53705 P.O. Box 7302 Sanitary Permit N her ( o be filled in by Co.) Bayneld Co. Zoning Age Madison, WI 53707 / in and Sanitary Permit Application 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 POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary Same purposes in accordance with the Privacy Law, s. 15.04(1 )(m), Sats. 1. Application Information — Please Print All Information Property Owner's Name Parcel # Tim Mott 13240 Property Owner's Mailing Address Property Location 11020 Scenic Drive Govt. Lo[ City, State Zip Code Phone Number Iron River, WI 54847 715-292-1940 SW ', ½ Section 2 T 4 N R 08 ,E or II. Type of Building (check all that apply) ` Lot # ❑✓ I or 2 Family Dwelling —Number ofBedrooms 2 ivision Name f ❑Public/Commercial — Describe Use Block# yy ❑City of l ❑State Owned — Describe Use ❑Village of _ CSM Number Town of Delta 111. Type of POWTS Permit: (Check either "New" or "Replacement" andI r applicable on line A. Check one box on line B. Complete line C if a licable. A. C JNew System Replacement System Other Modification m fisting stem (explain) Additional Pretreatment Unit (explain) ❑Holding Tank ZIn-Ground E] t -Grade Individual Site Design Other Type(explain) (conventional) C. ❑ Renewal Before fl Revision hange Plumber _ElMound Transfer to New O er List Previous Permit Number and Date Issued Expiration NA IV. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/s VDispersal Area Required (st) I Dispersal Area Pm sad (sf) I System Elevation 300 0.7/428 452 99.5 Capacity in Total # of I Manufacturer Tank Information Gallons Gallons Units o $ 1.v E w d a New Tanks Ezisd Tanks a in rn ii (7 a SepticorHolding Tank 750 750 1 Wieser ✓ Dosing Chamber O 0 IE V. Responsibility Statement- I, the un ersigned, assume responsib' i for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumbers Si MP/MPRS Number Business Phone umber Jason Kuettel 675751 715-798-33 Plumber's Address (Street, City, State, ip Code) PO Box 66 Cable, WI 54821 VI. County/Department Use On'y Approved ❑ Disapproved Permt Fee ate IIsssuu dd Issuing Ag Sign re ❑ Owner Given Reason for Denial Y�r/ 7 Condition of Approval/Reasons for Disapproval Mit_a�l!/ tiClh Q3f7744i\ m.....prow plans sar me stem son saomit to me Louniy only on paper not lass than a l a xtt inches in size -/ SBD-6398 (R. 02/22) RECEIVED r (ti s4� kj Wisconsin Department of Safety & Professional Services Divisiotltldfl s SOIL EVALUATION REPORT Bayfield Co. Planning and Zoning Agengn accordance with SPS 385, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 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. County Parcel I.D. /3Z�j0 Page/ of Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). J > 1j'..7/..C Property Owner Property Location o71 1 tto'7—r Govt Lot Si-) % Sr.J 'AS 0Z �/�, N R 06 E(or) W Propert' Owner's Mailing Address Site Address or CSM and Lot t //OZ.O S(,t A%iL 'bZ.vt Sr4ME City, State, Zip Phone Number ❑ City ❑ Village Town Nearest Road /Ro.. p)uc.L, sus !7 (715 ) 242 -/946 a ec 7 &eN /C t,a n ,® New Construction Use: ❑ Residential/Numberofbedrooms ,— Code derived designflow rate_IW _GPD ❑ Replacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable ft. Parent material ov'rwa fir General comments and recommendations: I�PcJIbN To C? .7 Boring# RBoring ipit Pit Ground surface elev./ O3. Xit. Depth to limiting factor '"° i in. / eiev.9N 7q ft. Snil Annliratinn Rafe Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 'Eff#1 Eff#2 l 0-9 7.S -A -'/r r- IS cr( ) /A. Or) /4 Z 9-7° 7s r.c-h — S oit MI Ga jwc or 1.G .1 3 0- /0l 7. S y.c-'1 N -- S o( G I-i— or) /• 0 7 Boring # ❑Boring ®Pit Ground surface elevlo3.L'I ft. Depth to limiting factor >/,v in. / elev.9y q ft. Rnn Annlirafinn Rnfc Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' *Eff#1 'Eff#2 / O .S Y 3/ — (S OSG M 6w )AJ o;'7 %. Z 4 - 9 '7.5v45/ - S btG U l -F 0.7 /. G 3 Z -/°° .s 7.Jy/r — S ofG l — 1-(-- or) /4. CST Name (Please Print) Signature CST Number 19 00028 Address ate Evaluation Conducted Telephone Number PoxYQKG4 ;U ,-c- /o 6 2-7 >u —,5'1c -:33s5 ' Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L • Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 mg/L SBO-8330 (R03/22) Page L of ❑'Boring DBoring # Pit Ground surface elev. 03,uft. Depth to limiting factor >8 in. / elev�7�.c6ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 'i-' Y `i .� - 1.S ____ 656 o,.f 6 ✓%1 60 j.-' 4)vf- j.f- a.'7 b) /G b1 _____ (,-z9 ?.'r% 3 Z - 5s 7• S y -- S oS ______ �" — 0) i.6 Boring # ❑ Boring O Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L CHECK BOX ASAPPuCAa,.,.-.rV }y CHECK BOX AS APPLICABLE. 40 ❑ SYSTEM PAGE 2 OF ® SOIL EVALUAT' 1 Scale: 1"=40 60 80 SITE MAP JAN 23 2 PLOT PLAN PROJECT NAME: Bayfielti Co. (to ft grid) 102 DESIGN FLOW: I°p GPO An DS - 7 Planning and Zoning Agenq Attach design flow calculations for commercial plans. PROJECTADDRESS: I Io ZD SCLA IC... b-\- Pipe Material /ASTM Standard (Tables 384.30-3& 384.30-5) h 0 D . 0 N sanitary sewer: / BM Symbol: BM Elevation: / FT For Main: / Y BM Descdption: aoTTdM SI o IN G NW GA2ff Gt rCA radiate north by IMPORTANT: Slope Gradient(%) , I / Well Symbol (if applicable): O drawing an arrow Show ground elevation contours at suitable intervals. of Tested Area: on the approprite line. 7i inn-ci :. /> o?ff Sce&.rc e't*'C „ Ot' S1' &L, }, fly" Sy jjW V'lo3c Pt'^7 Oil... i/to.' F -68W '77/W N of L' M3 'TI.) 4t4e P, --- Sr�l!v� �Rnrii/3GE C q c Vic= Qz 1�3.zy h'-fl—� o - R - Hit i I � JAN 232024 -)oil P r O Ci l e Sheet aY5•`id Co. Planning and Zoningpg ;� System =terlion?S Load Re: 0.7 Syswm R./o!•/y to 9g.ns RCCiVED PAGE 1 OF 4 JAN 232024 In -Ground Gravity Plan Bayfleid Co. Index & Cover Sheet Planning and Zoning Agency Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 4 Pg 2 of 4 Pg 3 of 4 Pg 4 of 4 Attachments: Owner Name(s): Tim Mott Index & Cover Sheet Plot Plan Dispersal Area Cross -Section & Plan View Management Plan POWTS Application for Review Soil Evaluation Report & Site Map Project Name / Description Mott 2 Bed Owner Address: 11020 Scenic Drive. Iron River, WI Project Address: Same Govt. Lot: SW 1/4 of SW Township: Iron River Project Parcel ID #: 13240 Phone:715 -292 Zip: 54847 1/4, Section 2 , T46 N -R 08 E County: Bayfield Designer Information Designer Name: Jason Kuettel Designer Address: PO Box 66 Cable, WI E-mail: tim@andryras.com License Number: 675751 Remarks: -1940 or W❑✓ Phone: 715 -798 -3355 Zip: 54821 lus space reserre- "I-:. Condltiona;iycSOV s COUNZY CA; IELD 77 v S" Signature: Date: Original si§nattre required on each submitted copy. 1/1, /vu/ =QrCEiVED CHECK BOX AS APPLICABLE. . -„� 4 CHECK BOX AS APPLICABLE. JA ❑ SOIL EVALUATION O L ZL0 ;Scale' ao 40 60 80 ❑ SYSTEM PAGE 2 OF SITE MAP Pianniny en6 PLOT PLAN PROJECT NAME: , DESIGN FLOW: �00 (10 ft grid) 1p GPD nn OTr 2 , E Th Attach design flow Calculations for commercial plans. PROJECT ADDRESS: /1010 S CLti I Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) BM Symbol: 4. BM Elevation: /00.0 FT N Sanitary Sewer: cct-l-4a PC' / Force Main: / BMDescdption: J7°TTn' SlllNG NW (,424&c c de'&t Indicate no" by IMPORTANT: Slope Gradient (%) of Tested Area: Well Symbol (ii applicable): drawing an arms Show ground elevation contours at suitable intervals. on the approprite line. // G24 5ce rc //2i✓ i'2ry Ll�L N'� -...' i -, l,v sj tw V s Q u 5 I S 6 Z 'J b,v —20FW )�N cF �CZ7 `�/ r9L4CS I- 11 1T1IIIIIII__I c t+-rs.1.-4��tS sue, ro FHThH — -� I t.S H o L Z I:rI ti EEl o. b�M Jo l�u'7roA.. :jii �,NG � I�1 /03/6 —� j I � —i-- -i �e -- C�Rt Gt 0 i -. wai` 'L� Ic3.zy —�- -q3 4±± _S71zCik1 mil. —I I Lb _vn^,C� --L------ -mil. I ( /1 IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard -W Chambers 3 -ft Trench (down -sizing credit) SOIL COVER 2" min. trench depth (typical) min. 12' (typical) LII 34' •y' . (typical) System Elevation = 99.5 (typical) Septic Tank(s) Manufacturer. Wieser Septic Tank(s) Volume(s): 750 gal gal gal gal Effluent Filter Manufacturer: Orenco Effluent Filter Model #: FT -0822 TYPICAL TRENCH CROSS SECTION VIEW d d z (No Scale) s0) Provide minimum 3 ft m o 0 ft separation between trenches. m 2 Quick4 Standard -W w/ End Cap (Show location of inlet / outlet pipe connection on plan view.) (typical) r----------��-------��---- L----------- 7--------7�--- I (typical) INSTALL PER TRENCH: 11 Quick4 Std -W @ 20 ff EISA/chamber = 220 ft2 + 1 Pairs of end caps @6 ft' EISA/pair = 6 ft2 = Proposed EISA per trench = 226 ft2 Observation Pipe (typical) Install per manufacturers / Instructions. TYPICAL TRENCH PLAN VIEW (No Scale) IA = 3.0 ft (typical) `Quick4 Standard -W Chamber (typical) (mid by Infiltrator Systems, Inc.) Install pursuant to manufacturers instructions. Required Infiltration Area = 428 ft2 x 2 trenches = Proposed Total EISA = 452 ft2 Istribution Method: branched manifold D C) m W O -n -P i3 ru Pt C SEPTIC TAN 9. CENEU JAN 23 2DK C.'.055 SECTION ANTj SPECIr ICAO ScFL40P'IC INSP. PTor 6 " Miff. A.3OVE (when snle+ rr' dole 4c �ourfed FTPI7SHED GRADE Ie" NIN. IplLE� A P P R D A-FP.fzE - hLJ 0 FILTER APPROVED I MFG. Ohea,)cO PIPE 3' II ONTO SOLID1 I model R Tp___ SOIL II 3" APPRgJE-D BEDDING UNDEP, TMNh SPECIFICATIONS SEPTIC TANK, MANUFACTURER: %Ala& iL CoNcllr TANK SEES. SE'TIC %S0 GAL. UP NOTES: APPROVED f4MHOLE WI Lccg4. W812ti9N� LAO& 4" MIH. OUTLET r Industry Services Division County Ilt 23 2024 ^ 4822 Madison Yards Way Madison, WI 53705 8 P ,JAN Sanitary P Bayfield Co. Zoning AgOrY P.O. Box 7302 Madison, WI 53707 pthnning and Sanitary Permit Application State Tran 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 Project Ad the Department of Safety and Professional Services. Personal information you provide may be used for secondary Same purposes in accordance with the Privacy Law, s. 15.04(I)(m), Stats. I. Annlicatinn Infnrmation — Please Print All lnfnrmntinn IItTh1Y1 l Property Owner's Mailing Address 11020 Scenic Drive City, State Zip Code Phone Number Iron River, WI 54847 715-292-1940 II. Type of Building (check all that apply) Lot # ❑� I or2 Family Dwelling— Number of Bedrooms 2 Block # ❑Public/Commercial — Describe Use UCityof iSUte Owned - Describe Use 13240 Govt.t - SW %, sW ¼, Section 2 T46 , n O8 ,,,.m CSM Number Villageof Town of Delta III. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i licable. A1New System ®Replacement System IllOther Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B. ❑Holding Tank IZ1In-Ground fAt-Grade IflMound J Individual Site Design g OtherType (explain) (conventional) C. ❑ Renewal Before ❑Revision Change of Plumber UTransfer to New Owner List Previous Permit Number and Date Issued Expiration NA IV. DispersaVrreatment Area and Tank Information: Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required (sI) I Dispersal Area Proposed (st) I System Elevation 300 0.7 1428 1452 99.5 Capacity in I Total I # of I Manufacturer Tank Information Gallons Gallons Units . E o` New Tanks Existing Tanks W u 2 y eaI 0.0 in o ia,QIp. Septic or Holding Tank 750 750 1 WieserII m m V. Responsibility Statement— I, the undersigned, assume res' i for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber Si MP/MPRS Number Business Phone Number ponsib Jason Kuettel 675751 715-798-3355 Plumber's Address (Street, City, State, Zip Code) PO Box 66 Cable, WI 54821 ❑ Disapproved $ ❑ Owner Given Reason for Denial sew �uvtA— SBD-6398 (R. 02/22) s I/ T system an sub Ito the County only on paper not less than j9K II inches in size � , had RECEIVED PAGE4OF4 JAN 232024 In -ground Gravity Management Plan IMPORTANBayeeld C• - Planning and Z­In5 Aga Th The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. 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), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 300 gpd; BOD5 5 220 mgL-1; TSS ≤ 150 mgL-'; FOG ≤ 30 mgL-' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.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 (113) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. 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 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Andry Rasmussen & Sons Phone: 715-798-3355 Local government unit: Bayfield Co. Zoning Phone: 715-373-6138 Local government unit address: 117 E 5th St. Washburn, WI ZIP: 54891 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. 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, Wisc. 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, Wisc. Admin. Code. Private Sewage System Maintenance Agreement wner(s) Name wner(s) Mailing Address /o ZU SGC)C l71 ,ivC ,'n -N J'�Iy L/C ti /7Zya es owner, I twe) do nereoy cemry me 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 WI Adm. Code, as from time to time amended. (COMPLETE Legal is required) Su 114 of 5W 114 Section O •d- Township (6 N. Range 08 W Additional Legal Description: St t A-n-Acy-tj\ Town of Lot_ Block Subdivision (Acreage) Y. / Gov't Lot Lot _ CSM g Vol. Page _ CSM Doc tt flw . tN 3 i 2u24 DOCUMENT NUMBER d Co. Zoning D*P24R-602055 DANIEL J. HEFFNER REGISTER OF DEEDS BAYFIELD COUNTY. WI RECORDED O1/3O/2O24 AT 1:42 PM RECORDING FEE: $30.00 PAGES: 2 Return To: Planning and Zoning Department Area ® In -ground gravity 0 In -ground dosed ❑ In -ground pressure distribution Sewage System: 0 Mound ❑ At -grade Sewage System 0 Other Septic Tank (system types A through E): The septic lank 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 (V3) 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, Wls. Admin. Code. Private Sewage System Dispersal Cell (system types A through E): The private sewage system distribution cell shall be visualty 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 -grade, and In.eround 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 co atJUig 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 d tttaa.��I The terms and conditions of the agreement shall be binding upon and inure to the benefit of all current and future owners of such Owner(s) Name(s) — Please Print 77i.OT7tY MV-7- itarized Owner(s) — Signature(s) II�Ij/zy 7 sworn to before me on 5is 2c sly Z%2 QY. ,,-- Notary Pc'Y': I, Yu r? e 7 prole.tb'l ...'77A.CL.4'ts'— '. I• AILS I,• ', • .. •.. t. - , • ' . •. . '.' • ' •` , , •; . • . • • • ' •f• ..•' • . SHEET A Parcel 1: A parcel of land located in the Southwest Quarter of the • Southwest �uarter (SW% SW%) of Section Two (2), Township • Forty-six (46) North, Range Eight (8) West, in the Town ' of Delta, Bayfield County,. Wisconsin, described as follows: To locate the Point of Beginning; commence at the Southwest • (SW) corner of said Section 2 and run N. 00° 07' 31" W., 1120.47 feet,. along the West line of said Section 2. to the North right-of-way line of Scenic Drive, which is the • Point of Beginning. • Thence from said Point of Beginning by metes and bounds:- ` `Continue N. 00° 07' 31" W., 223.86 feet to a 114" iron _ pipe at the S 1/16th corner on'the West line of said Section 2;• ' Tb•ence along • the South 1/16th line of said Section 2, S. 85° 15' 11" E., 405.39 feet; Thence leaving said South 1/16th line, S. 00°'07' 31" E. 660.46'feet, parallel with the: West line of said Section 2 to the Northerly • right-of-way•line of Scenic Drive; • Thence along said right-of-way line, N. 40° 44' 22" W., 620.51 feet to the Point of Beginning. •TAX I.D. NO..• 016-1075-08-990 (Continued) t: .•t . �. V63 5P22o BAYFIELD COUNTY SANITARY PERMIT (#04)-2414S STATE SANITARY PERMIT OWNER: TIMOTHY P & PRUDENCE M MOTT GOVT LOT: LOT: BLK: SW1I4 /4 SW1I4 /4 SEC: 2, T 46 N, R 8 W TOWNSHIP: Delta SOIL TEST: 13-24 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: JASON KUETTEL TRACY POOLER DATE: 2/26/2024 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: # MP 675751 Condition: System to meet all setbacks. Management plan to owner. Properly maintain system per recorded agreement. Properly abandon old system per SPS 383. THIS PERMIT EXPIRES 2/26/2026 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION