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HomeMy WebLinkAbout26-5SRDepartment of Safety County Bayfield & Professional Services, Sanitary Permit Number (m be filled in by Co.) Indust Services Division SS-oo696R R�JIsiorl (,—S&1Z 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 maybe used for secondary urposes in accordance with the Privacy Law, s. 15,04(1 xm), Stats. 66172 North Point Dr Property Owner's Name Parcel # CLAUDEEN E MC AULIFFE REV TRUST RESTATED 8/3/2023 04-024-2-47-08-21-400-327-40000 Property Owner's Mailing Address Property I.ocatm N3220 Hale Rd Govt. Lot 21 City, State Zip Code Phone Number Neosho, WI 53059 �. Section Lot# T47 ?41t°8 E 01 or2FamilyDwelling—NumberofBedrooms 1 4 Subdivision Name Block # Allison's Acres o Public/Commercial — Describe Use ❑ City of ❑ State Owned — Describe Use CSM Number 0 Village of O Town of Iron River A.Rm sWn ❑ Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit(explain) B' ❑ Holding Tank gIn-Ground ❑ At -Grade O Mound ❑ Individual Site Design ❑ Other Type (explain) (conventional) ,�/ C. O Renewal Before O7 Revision ❑ Change of Plumber Expiration ❑ Transfer to Ncw Owner ist Previous Permit Number and Date Issued aG - Ss 11 2'?-/ ao 2'd Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) Dispersal Area Proposed (at) System Elevation 150 0.7 214.3 225.2 Capacity in Total # of Manufacturer Tank Information Gallons New Tanks Existing Tetrka Gallons Units m a �+ 4 U n y ,z13 Septic or Holding Tank 840 840 1 Wieser Dosing Clmnber 500 - 500 1 Wieser Plumber's Name (Print) Plum r' Si MP/MPRS Number wines Phone Number Gtr p, 9fl7 is 2d9oJ b I rawc Plumbe Address (Street, City, State, Zip Code) /360 - srRt1'etWes. sgPi7 c Approved 0 Disapproved Permit Fee Date IssuedM„ Issum Agent Sip�napyyr� / P,vs/ t Q' Cj I// II T�l el'7 I 1 ❑ Owner Given Reason for Denial €2 5 l� I I �1 ll, V tom. Conditions of Approval/Reasons for Disapproval atfia 1eOCOI RECEIVED JUN 082026 Attach to complete plu. for the system and submit to the County only on paper not less titan g to a 11 ivelies In sue DoYnelo LO. Planning and Zord ig Agency SBD-6398 (R. 03/22) 0 -R-0og3�OIL TEST # SI-2fo nt of Safe and flrofessional Services Page 1 of 2 Wisconsin Department ty RECEIVED : Division of Industry Services SOIL EVALUATION REPORT 4PN 112026 In accordance with SPS 385, Wis. Adm. Code Cou Bayfield Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, Cld C. but not limited to: vertical and horizontal reference point (BM), direction and percent slope, P hbQend Zoning Agency scale or dimensions, north arrow, and location and distance to nearest road. 19631 Please print all information. Re 'ewed by S 1 Daatte!/ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m))/Tk1q(II'c(kc1'(�( Property Owner Property Location [=10 Claudeen McAuliffe Govt. Lot r Y. S 21 T 47 08 E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: PO Box 36 66172 North Point Dr City 1 State I Zip Code I Phone Number ❑ City ❑ Village 0 Town Nearest Road Iron River I WI 154847 I ( Iron River North Point Dr ■❑ New Construction Use: [] Residential/ Numberof bedrooms 1 Code derived designflow rate 150 GPD Replacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft. Parent material Glacial Till l�- General comments and recommendations: Conventional system Boring # ❑Boring MPit 101 >115 Ground surface elev. ft. Depth to limiting factor in. / elev. ft. I Snil Annliratinn Rat I 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 A 0-9 7.5YR 2.5/1 SL 2-sbk-m mvfs gw 3f -2m 0.6 1.0 B 9-25 5YR 4/4 LS 0-vf-sg ml gw If -1 m 0.7 1.6 C 25-115 7.5YR 4/6 S 0-vf-sg ml - - 0.7 1.6 Boring # ❑Boring 107.2 >108 ©Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Annticatian 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 A 0-10 7.5YR 2.5/1 SL 2-sbk-m mvfs gw 2f -lm 0.6 1.0 B 10-23 5YR 4/4 LS 0-vf-sg ml gw if -1m 0.7 1.6 C 23-108 7.5YR 4/6 S 0-vf-sg ml - - 0.7 1.6 CST Name (Please Print) ! =_.J Signature CST Number Tim Dykstra Y 1213855 Address I Date Evaluation Conducted I Telephone Number 10620 Eagle Lake Rd Iron River WI 7/28/2023 1715-209-5748 * Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 S 150 mg/L * Effluent #2 = BOD, s 30 mg/L and TSS 5 30 mglL SBD-8330 (R04/21) Page 2 of 2 Boring # ❑ Boring 96.1 1 Pit Ground surface elev. ft. >105. Depth to limiting factor in. / elev. ft. I 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 A 0-10 7.5YR 2.5/1 SL 2-sbk-m mvfs gw 3f -2m 0.6 1.0 B 10-24 5YR 4/4 LS 0-vf-sg ml gw If -1 m 0.7 1.6 C 24-105 7.5 YR 4/6 S 0-vf-sg ml - - 0.7 1.6 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. JUN 1 12821§ Depth to limiting factor i . / elev. ft. Bayfield Co. Planning and Zcnyirtg Aden' 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 *Effn ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. I 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= BOO, 5 30 mg/L and TSS 530 mg/L r PL Gt a,.'lae.Me-Av Ii !2t 661 7NSA ,3,f Or ►;rir wY cgfy7 iZ QJ 63 96.E RECEIVED JUN 1 12026 BaYfi&d Co. Planning and Zoning Agency 1' -?D L � 0 �o 1? }, I¢► So%� LISA ,j l06X e;" L i Ibn A: U1il `�Yg`� cST * tat38s' Page 1 of 7 icy Page 2 of 7 REVISED McAuliffe (1 bedroom) Lift to Gravity In -Ground Plot Plan North � 1 98.5' bedroom dwelling Wieser W840/500 -MR w/ polylok 525 filter & Goulds WE03L pump Scale 1:60 4 S Bench Mark = Nail in tree Elev = 100.0' S 2" forcemain ASTM D1785 fir] 103' J1N Q 8 2026 104.5' 1'f / geY field 6"g A9enc1 P�nnln9 end Zon I One row of 11 Infiltrator Quick4 Plus Standard chambers I CLAUDEEN E MC AULIFFE REV TRUST RESTATED 813/2023 66172 North Point Dr ALLISON'S ACRES LOT 4 IN DOC 2025R-608454 TOG W EASE S21 T47N R08 W Town of Iron River 04-024-2-47-08-21-4 00-327-40000 4.170 acres NOTES: - All vent, observation & conveyance pipes 4" ASTM D1785 or code equivalent Page 3 of 7 Cross Section of an In Ground Component Cell Using Leaching Chambers Observation/Vent Pipes V Finished Original Top of Ch System Eli 3rade[ . 10240.__.I......._.. Slope 20%, 3rade 10240 amber 101.00 Treatment and Dispersal Zone Limiting Factor Observation/Vent pipes to be constructed and capped with approved materials for the particular use. 47 feet - ! Vent Pipes to be located at the ends of the distribution cells. n RECEIVED JUN 082026 Bayfield Co. Planning and Zoning Agency Page 4 of 7 4' Sch. 40 Vent > or — to 12' Above Final Grade Inlet O— Baffle 15 55 2 1.39 0.76 15.76 Approved Manhole Coven With Wo'TMg Lobes and Locking Device / 4- Min. Above Final Grade \ Weothec Proof Junction Box Electric per NECN300 & COMM. 16.28 WAC R ' IAlternate W/Approved outlet LSleotlon eve _�-1II W/Approved 4' Sleeve 2 inch forcemain Polylok PL -525 A Hole or Anti Siphon Device C Weser 640/500 D Vertical Difference Between Pump Off and Inlet to Chamber Length of Forcemain(ft.) Inches Gallons Forcemain Diameter (in.) Friction Factor per 100ft. Friction Loss Total Dynamic Head A 23.7 280.2 B 4 47.3 C 3.3 39.0 D 12.0 141.8 Number of Doses per Day Gallons per Dose (Not to exceed 20% of Daily Design Flow) Volume of Forcemain Backflow Total Dose Volume Tank Capacity (Gallons) Tank Volume (Gallons / Inch) Level (in) Type Alert 1 43.0 508.3 RECEIVED JUN 0 8 2026 Bayfield Co. pbnning and Zoning Agency Page 5 of 7 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page sot? FILE INFORMATION Owner CLAUDEEN E MC AULIFFE REV TRUST RESTATED 8/312023 Permit # DEVGN OARAMPTERS Number of Bedrooms 1 0 NA Number of Public Facility Units 0 NA Estimated (average) flow 100gaL/day Design (peak) flow = (Estimated x 1.5) 150 gal/day In Situ Soil Application Rate 0.7 ayda lft2 Standard InfluentlEffluent Quality Monthly average` Fats, Oil & Grease (FOG) CO mg/L Biochemical Oxygen Demand (BODs) ≤220 mg/L O NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODs) CO mg/L Total Suspended Solids (TSS) CO mg/L 0 NA Fecal Coliform (geometric mean) ≤l o4dW100ml Maximum Effluent Particle Size k in dia. 0 NA Other: 0 NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: o 3 0 m� s) s) (Maximum 3 years) 0 NA Pump out contents of tank(s) 0 When combined sludge and scum equals one-third ('h) of tank volume O NA O When the high water alarm is activated Inspect dispersal cell(s) At least once every: 3 year(s) ❑ month(s) (Mmdmtmr 3 years) 0 0 NA Clean effluent filter At least once every: 3 O month(s) 0 year(s) O NA Inspect pump, pump controls & alarm At least once every: 3 O month(s) 0 years) O NA Flush laterals and pressure test At least once every: ❑ month(s) ❑ year(s) 0 NA Other: At least once every: ❑ month(s) ❑ year(s) 0 NA Other: 0 NA MAINTENANCE INSTRUCTIONS Ke V C IV C IJ Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septagej> gvi®r4j for (pumper). Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of efflaylydduuthe ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipe anditardh�ahrfai e1 cponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third ('G) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. SYSTEM Tank Manufacturer Wieser ❑ NA 0 Septic 0 Dose 0 Holding vol. 840 gal Tank Manufacturer Wieser ® NA ❑ Septic 0 Dose O Holding vol. 500 gal Effluent Filter Manufacturer Polylok O NA Effluent Filter Model 525 Pump Manufacturer Goulds O NA Pump Model WE03L Pretreatment Unit O NA ❑ Sand/Gravel Filter O Peat Filter ❑ Mechanical Aeration 0 Wetland ❑ Disinfection O Other: Manufacturer Dispersal Cell(s) O NA 0 In -Ground (gravity) O In -Ground (pressurized) Cl At -Grade 0 Mound ❑ Drip -Line O Other: Other: 0 NA Other: 0 NA A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (12/02) Page 7 of 7 START UP AND OPERATION .For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals that may impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT RtCt�VE6 When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure ti Uhg�sxsto2is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: JUN UU b • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. Sayfield Co. Planning and Zoning Agency • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. lt The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name �NameBayfield County Zoning Phone hone715-373-6138 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(b)(1)(d)Sff) and 83.54(l), (2) & (3), Wisconsin Administrative code. MFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: CLAUDEEN E MCAULIFFE REV TRUST RESTATED 8/3/2023 PO BOX 32 IRON RIVER, WI 54847 Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00439 Transaction Number: SR-00439-47AC5 Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 37468 Paid by: Dykstra Construction, Inc., PO Box 125, Iron River WI 54847 Payment Type: Check Transaction Date: 6/12/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. P --* YFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: CLAUDEEN E MCAULIFFE REV TRUST RESTATED 8/3/2023 N3220 Hale Rd NEOSHO, WI 53059 Description Sanitary Revisions Submission Number: SS -00696R Transaction Number: SS-00696R-47ACD Amount $25.00 Total: $25.00 Payment Amount: $25.00 Reference: 37471 Paid by: Dykstra Construction, Inc., PO Box 125, Iron River WI 54847 Payment Type: Check Transaction Date: 6/12/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. BAYFIELD COUNTY SANITARY PERMIT (#04)-26-5SR STATE SANITARY PERMIT OWNER: CLAUDEEN E MC AULIFFE REV TRUST G OV'T LOT: LOT: 4 B LK: SUBDIVISION: Allison 1/4 1/4 SEC: 21, T 47 N, R 8 W TOWNSHIP: Iron River SOIL TEST: 51-26 REPLACEMENT SYSTEM SYSTEM TYPE: Non -Pressurized In -Ground PLUMBER: GREG BROWN EMILY MACGILLIVRAY DATE: 6/12/2026 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 #: 26-5S LICENSE: # MP699374 Condition: Properly Maintain System Per Recorded Agreement. Old System needs to be properly abandoned per SPS 383. THIS PERMIT EXPIRES 6/12/2028 POST IN PLAIN VIEW MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION