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HomeMy WebLinkAbout026-1135-24-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division f INSPECTION REPORT Sanitary Permit No: 395285 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: P.C. Collova Builders, Inc. I Richmond Township 026- 1135 -24 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic N � / l � Benchmark Dosing I f - Alt. BM Aeration Bldg. Sewer Holding SttHt Inlet TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' �y Dt Bottom ' 3 Dosing T Header /Man. Aeration jDist. Pipe Holding Bot. System 4. IT PUMP /SIPHON INFORMATION Final Grade .) D Manufacturer Demand St Cover GPM I Model Number � TDH Lift Friction Loss System Head TDH Ft B t Forcemain Length � 1 � 41 Dist. to well I Dia. SOIL ABSORPTION SYSTE NCH Width Length f No. Wrenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM S .2 spar SETBACK SYSTEM TO P/L B G WELL LAKE/STREAM LEACHING Manuf r r: C INFORMATION CHAMBER OR 7� Type Of S sty � � � UNIT odel Number: DISTRIBUTION SYSTEM 7` Vent Header /Manifold Distribution x Hole Size x Hole Spacing to Air Intake Pipe(s) Length �-9ia Length 1) 1 acing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: It / of / 01 Inspection #2: Location: 1412 143rd Street New Richmond, , WI 54017 (SE 1/4 SW 1/4 24 T30N R1�t8�W) Evergreen ,[ Parcel No: 24.30.18.954 1.) Alt BM Description = 1 11 f-- .JJjJ��`"p 2.) Bldg sewer length = [� C�►P�v s f a,4 � 1� amount of cover - = j ; G - 3 ) 1 " tJL r -t00 r _ T1 I Plan revision Required? Yes [W No Use other side for additional rmation. �L Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) �_-, Who ly3" Safgty gad HW'Wirgs Dk.sicn comy AMML 201 W . W Ave �..� . r} P -0, Box 7162 , OEM - "t ciam PA* aCtt ary Per t Applic © 3 QsZ C P.S -- ra.w�aed N►�%oulmm w�, a.. oaa, porwew tl Cko t if bvwoo L Numbet RMUKU woe 3d Sy ; e _ G 5 r vapm Low" 4) Seth, `� 9 r r'� r , ' � tt °ItattbU) i nwvfwvw� at 6 C Addition to ar artg . k. jW � •a:; ��) p�tc � ... rwas8l�cwlougli► >awa > „` �: 0 Nts11 -bNNA*d bOioaed u© mom N Q &W NW sa ❑ Cnpef topd watlaad ` som Mndft Z P ow= i 77,/,.Z ✓ 1b�tgtlS>itaitiq►af8q Pt.y. '= t16��eoi1} .:,� �.,,�. . , y, atom at Tswa mw 1- 44 M imp r i WMAORIM4 . _ L1� a garatiA am A NT pow We i /S �T" �1��,�„ ; ,.. !l����a���l� �a�fi�triceg , cy� / .��� ,�wr��rr=a �/""� r-'. �•�` ��ar�. S`t�t <(� i�S;,f�4�' �' �,`l'� �IG�L�,J Gt.4tr1`�t��s.. ���d(t�'. �'�r#te � �k �kf �' - j lid{'• (�� l 0l : eoVe - ,' Lt slims * aim _.sf'�i�- iJiilYL� L`Y 5 T+b � T.wdi':'. ao v.re_ e. P .. n.i,,.n a .f r. _.., -.�.:. . ,a .. ,,. ' .. �.. r. .. .. ,.. r 4 y r .. , ; " ,�_,...,..�,., ,.. ire •�;. �•'' a,,2), . �"..e •,,i4 � .. ....:. - <..... . „, ,.,. ,... .. � ;: ..., .. __ ,...._....... .... ...... ... a ..- . -. � { ..- , ♦. , � .. :.. f. .s. >.... ..s4t. - h ..• T L'}Y t o x . s e1 .„may � h• }'.. , : yy . . v + � f , Y � a � a � 3 lb v � b .V v 9 4 � N o 0 1 ti .6 v bl, 0 V ' U Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page —L of Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and f percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please pri, Wll mation. Re ' by Date Personal information you provide may be used for seconds Ru�oSes (Privac)k w, s. 15.04 (1) Property Owne Properl)r Location 1 � Govt.L6t 1/4 C 1/4,S0 K T3C1 ,N,R E (or) Property Owners Mailing Address Lot #'- Block# Subd. Name or CSM# P"J! 2 E cm e Over City State Zip Code ,hone NG�t =FtCE Nearest Road ❑ "fifty ❑Village Town ( New Construction Use: [2rAesidential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 6 6d gpd Recommended design loading rate 1497 bed, gpd/11 trench, gpd/ft Absorption area required bed, ft 2 75` 6 trench, ft Maximum design loading rate bed, gpd/fL trench, gpd/ft Recommended infiltration surface elevation(s) Q L l • 7 ft (as referred to site plan benchmark) Additional design/site considerations � `1. 1? Parent material 0C-r "I 4 �j Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S [ U ❑ U S❑ U � S ❑ U ❑ S U ❑ S FP U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft2 hr W g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench SCI I F< 1 Z .3 Paz' Z • -7- 3 5r 1 2 rnabk m � t C — _ ' • ( Ground 3 Z Ib L 5 ZI-nS m� elev _ . 9 8.E ft. ` f Z 51 LS 2 Zm' r n-F, Depth to , limiting factor i n. Remarks: Boring # 615 11) Iz_ / r4r (V 3 z Q) C-5 Ground eiev. Depth to limiting factor ,JpL in. Remarks: CST Name (Please Print) Si ature Telephone No. cla 5 u er (7 15) Zq - �t Oog Address Date CST Number 21 S +. Sof e+ SSgLZS 9 -6 v 2533 09 SOIL DESCRIPTION REPORT -7 PROPERTY OWNER Page Z of PARCEL I.D.# X C, 7 1 Z 1 Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench lbvAz Ground 3 J� ��� Z (17� I C 7 elev. 5 L f 66 IQ 41 Ls N.e�1rz u Depth to limiting fa , l n'� in. Remarks: Boring # 14 - ► I(� 31 5� I (rnabk rrr c s I Z 3 1 16 vr 413 5 i Z rcb� rrA. c5 � 3 - Z )U vrq ILI L5 Zrr wv� c 5 1 8 Y Ground '7 LZ {� elev. . 9 I (p US Z L S g i 1�9_67 YA y" ; Depth to Q�' Z limiting factor _11 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # V� Z k r ?' 4 i y �> 5l Z C< S 3 - J L 5 C Ground 10 -]. 5 yr `J (D L S C S elev. `\ak 9 ft. z„ Depth to limiting S� ; f ct r in ' Remarks: Boring # Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R.9/98) PAGE�OF NAME LOT# c -, `, LEGAL DESCRIPTIONS E T-;v ,N,R(tS E (o0a) SCALE: F'= COD I BM I ELEVATION (OU • d BM I DESCRIPTION BM 2 ELEVATION 96 Z c� BM 2 DESCRIPTION p o� - Oc a P •e.- SYSTEM ELEVATION ! ALTERNATE ELEVATION L'' 9 7 ' x CONTOUR ELEVATION �/ Sa 13� SIGNATURE DATE L Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the department, agent, the parameters of Comm 83 and 84, and the conditions of approval Y or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies rivate Ons'tto Wastewater ater Code, and the Systems SBrpund S Absorption Component Manual for 10567 -P (R.6/99). Table 1: System Des i n Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak pd) Estimated Flow - Average (gpd) 3 v Septic Tank Capacity ( al) Soil Absorption Component Size (W) Domestic Type of Wastewater Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak ( pd) 1/8 Maximum Influent Particle Size (in) 220 Maximum BOD (m /L 150 Maximum TSS (mg /L) Table 3: Maintenance Schedule Septic Tank Inspect and /or se rviceonce ear and clean at least once every 3 years Outlet Filter Inspect once a y Soil Absorption Component i inspect once every 3 years Septi Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic ta fil ter a sh � be ed as necessary o e once every 3 years by inspection, The outlet proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the I& 2fj /20t)E7 14: i s 1 /1 J ,LJ000' Mound System Management Plan Page 2 of 7 Pursuant to Comm 83,34, WIS. Adm. Code The�p tl�nk shall be maintained by an individual certified to service sapttc tactics perat s. oondit• Sts:$. The contents n me sspdc tank shalt be disposed of in accordance with NR 113, Wis. Adrn. Cede. The apenang condition of the septic tank and oudet filter shad be assessed at least once every 3 years by inspection. The outlet Mier shah be ds ss necessary to the tank ftt ensure people operation. The fitter cartridge should not be removed Unless previsions are Made the flite r shWi b e n sarAesd If may slough off'the Agee when removed from its encioaure. If the Altar is s4vippsd with an alarm. the alarm Is sotivsted continuously. tnterrnittent filter alarms may indica 1 1 f3 the ourpe flows b1` an impsndiMg 3 thhe liquid alarm. The septic tank shall haw Its contents removed when the volume of sludge Ind scrum In the tank exceeds e l t�l hall advise the tertte tank. If the 40n Of the tail( are not remove n in d at the time Of a triennial ae>seaamsnt, maintsnanca parse the owner of when the next service needs to be performed to maintain less than r villmum scum and�sluddge nqu the tank. The addition of b1cioglc2l or ch'I i additives to enherrA septic tank performance g Y not How"W, it such products are used they shed be approved for septic tank use by the Depa"ant of Commerce. Safety and Buildings Dlvfsion. � er l ilan k if sha effluent flftardis at least Once installed within the tank it st- � I be I a sa*I ed assnec•sa tad to verify pro Mon and PrwM,uly 215tr ibutl2n 11111816011 o Vm or shrubs should be planted on the mound. Plantings may be made sround the monnfd from a a nr moun Shall be seeded and mulched as Meeeasary to prevent erosion and to provide Borne Proms penetration. (othe( than for vegetativa melntenenoe) on the mound is riot recommended *k. soil compeetlon may hinder aeration ct the infutrativs surface wit o the mound and snow conVaction in the winter will promos penetration. Cold weather frost Instaflstiens (omteapebruary) dkUte that the mound be heavily muichsd for frost protiman. influent quality into the mound system may not exceed 220 mglL S006 mg& TSS, and 30 mg/L FOG. Influent flow may not exc"d maximum design flow specified in the permit for this instatiatlon. 'nte pressure diatrlbugon system Is provided with a Rushing Dint at the and of each lateral, and R Is recom that each lateral be Rushed of accumulated slide at least once every 18 months. When a prosauro tat is performed it should be contFamd to the Initial test when the system was installed to detsmriria It od ae dogging has occurred and if orifice cleaning is required to makttakt equal diasrtbution wuhiti the 014041`941 Wi. an d any�e s eve 4 Inches i red as an imp ndlnq hydraulic failure nsgviring sdddtd l, A nton ffrrequ NtgnRwner, g Gentral coil system shah be Operated n accord a a local or 94% rv* pertaining to system maintenance and ma tIft � cafrtpanent manuel(360. 105 Z ( )1 reportin0. No one should evar enter a septic or pump tank shies dangerou gases mail be present that could cause death. 840c and pQuIm�� sbandonmsnt shag be in scaordsnce with Comm 83.33, Wis, AcInt Code when the tank$ are no longer used as POW TS 6orMPGOANA. Septic or pump tank manhole risers, access risers and covers should be inspected for watertightness and soundness. Access cpenir►gs used for sevio* and eeseseff"t shall be sesled wstisf4m upon the completion of 4eWiM Any Opening deemed be secured Dyrtective, o tfiec'M locking device to prevent eel don sad acc�� ee�ainto atta k or component. d iameter shell 2Qroad Plan if the septic tank or any of ib components become defective tits tank or componenl shall be repairod or replaced to keep the system in proper cpsimling condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be lmrnadiately repaired or replaced with a component Of the ssrae or equal performance. If the Mound oorWlont falls fo accept wastewater of begins to dlschsrge wastewater to the ground surface, it will be repaired or replaced in IW present bcatlon by IncreaskV "I aria If toe leakage occurs or by removing blologleady clogged � and dlspersal media, and related piping, and replacing sold components ss deemed necessary to bring the aye C penting CpndltbR. Questions or the operation or maintenance of this system 9 to d be directed to the County Zoning office at `tl5 - 4660 licensed plumber who installed the system. Management Pion for a Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shrubs directly over of within ten feet of the component should be avoided since root intrusion into the component m ay o bstruct wastewater flow. Contingency Plan In the event of system failure, a new system could be installed in an alternate area. With the installation of a diverter valve, the existing system could also be reused after a period of three to four years. It is the property owners responsibility to maintain the alternate area free from any planting of trees, shrubs, etc. In case of failure of the original system, the aitemate area will be needed. If any trees, shrubs, etc. have been planted on the alternate area, they will have to be removed at property owners expense. If attemate area is destroyed, there are other alternative systems that can be used, in which, could result in added expense to the property owner. Any tank abandonment shall be alone In accordance with Wise. Code 83.33. Any questions regarding this code, please contact your lo=1 Zoning Office or contaot the Installing plumber. t"( tp $ 0 n., t�1► v�K, b l w f FROM P C COLLOuR BLLRS, INC PHCJ IE N0. 715 549 59'_ i Feb. 01 2001 k rr : MW Pt ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FOILk1 Cwncr/Bu er o �. 1 Y %J< Mailing Address 0 0. �f a Property Address h ,ve rcq from Planning Department for new con „ruction) City/State )kC, noOC� wE Parcel 1de:,tfCcat:oa .lumber LEGAL DLSCrIPTION Propety Locadcn s"�_ ; %, Si.J i s ' _z 1,V, i ow„ of Subdivision Lot ;� CeOZIcd Survey *Asp It' V n_ Warranty Deed I (6Q Volume: 1 57 P3o� r �y Sae^. house ❑ yes ❑ eo rat a,-- id,--:tif3aolc ;•w ! no SYSTEM :rMALNTEZNANCL Improper and malnien.Lacc of your sci,uc ; cauid rexult is its grit =e fai rc to i azaic - nastc :. i ;o¢er it tcaa c cansists of pumping out the septic tank every tkr= year or seener, if accded by a licensed put=,tr. W'nat you put irto the syst. -^i can a$od the fuuetion of the septic tack as a : stage its the waste disposal ry The property owner aytt:cs to submi to St. Croix Zcaing Dep artm=t a a.- rtiLicatioa form, signed by tar owner and by a MaMrph=bcr jeumerm=phsmber. =tr.'cted plumber or a iitetssed sus er ; a- ifyiag tL:t (i) the on -sila wastcwate, dissesal systems is in prcper cgemdag condition i.^„dlor (2) alter iasgection sad 7=p iag (if aeczrz ry), the septic tack is iesz than 1/3 full cf sludge. I/w'e, the nadcrsigaad have read the above requirements and agr-_c to maintain flee private sewage dirposai system with the standards set forth. herein, as set by tine Department of Commerce and the Deputmcnt of Nat=i Resoure:s, State of Wisccnsin_ Certification rtstng that your septic rystem bas been maintaincd =ust be cempletc3 and rerirned to the- Si. Croix County Zon ng Office witlti.: 30 days o ;Lhe, c car expitstion 5. 77 Ljr SIGNATURE F APPLIC.�NT LATE OWNER CERTIFICATION I (we) certify that aU statements an an this form are true to the .best of ny (a',=) knowledge. I (we) ant (?a--) tiie ownet(t) of the perry zi d above ' virtue of a warranty dccd recorded in Rrgistcr of Deeds Office. p GNATUR& dF APPLICANT DATE "' Any information that s cis -moresented a m recruit in rile sanity x "'••' y rY gait being revokc3 by fete Zoning Lcpartmcrrt. ” Ineiude with this appliealten; a stamped warranty decd from the Register of Deeds omce a =py of the certified survey map if reference is made in the warranty dead PROM P C COLLOVA BURS, INC PHONE NO. : 715 549 5911 Jul. 21 2001 01:54PM P1 02,'MOO '1'UE 11:33 FAT lib 3 4687 REGISTER OF DEEDS gape 2 .7. PAW o PAW tiJ�k OF WLttaNtb)ppstrt j.. IM �' Qaormwt WASULArmDIU tS164f l�1Ytea 9�1Y10..2. Qlf k r jA jV ka � Orasear. and P Caibv� fiu))Oerf, t,�m.. m Ntlntteaota CarDOmutrm a no, fey a n)erble Cantu. , ..s 6111, coawye W coast tha T01fON�11Ad +G1lt)�id�ldtsi�lellSLC •.r,..,,.., Slue of 1Yiieoae h1(if mere spree k tleat!ad,,piww !Reek atltle,tdatek Raeerf.at akt Tko Iwtkma Qusnmr of dw 90 rb wgw Qu=u (SE 'e at SW C:) *f Sw as n ++tw lA aaatiAur4m%q( WN%ofUaft27,1yi WorlinlY of 14M Avau 40 �ouv.�i� 41 ALL is fir♦ MK Upp 11 ass, St. C iabt Cat,my, Wimprkt a ( a fire V'f Pact adN k ofS*46=ZS dwer+tied to PallawN Coamawins isN 9`3 SA aamw Draw &alit! 1s; *am Nuras a4 deZr.ae at M iG& em Wtnt at W44 of aw 6+1`8.3 2A. 0 Gat, thea4ca Stwh a 1 &IM 23 sammua Walt ins 044 thatot 961* 9p Io w" ad okomff Lit Im two dMau 16-107140" 416.19 W-CCO Nm * I dww 27 mioutof E )!6! aae to bm;4 N*th leer, Adana Nash S! hrod iaw ma" Naudtr (HN} &Sn w D6 nkrma Went co rid N Us 6:7 fait to 1Gco or tjMemhW St TV jr egg ltetttmvd . Cr�a t aunty. WltsrnsR� %I m ban lacaptlenr i0 xtYraatla 9m meW. rc;Wc&Ta and e!Q1wwAway of nnaC it >rsl. Vaud tho UY or MY—, mtr AUTRlNTICATION LCXM8WLZDCUm..mT stinawatq srri.. Y. Uoretett STATE QF VISCON914 ) u . gmthet es"m f X gift of kuy_ . sac faybs.ttr +mm.e bsfcra me t>tla _ day of au above nas+cd r xrtx4tmOtlutd _.....w MU, )AMA R STATE SAR. Olt MICC NSM — (trU4 w tee kea" to bathe p onfa(s) wooeaeswW nc� toMMUItyltorcya;N „+wods. s a 47416.06. W IL S WA -) tascrmaM end 44160++W04 Yw sst� '{f q t 4'MU>, Wr W *4 rILAYrIJU ny " Awe r Amm Owls i fc RSY tGDI C State of W rootuta a of Wit W14 My r.;o ---a an 4 pwm*mv. at mat, acme enkat2aG dam piSaaam mw 'o* atdmat jw at tstmetrdhd• 941h ate tlel 00mm.) ) •huosrow1clritdNLSmro matr betel dMilidDAMM. iw+r:w►w...� t wAAAANiY ut Qa 4rjA � 0jF 6W ,4tN 335.94' i 314.31' 1 LOT 20 N LOT 1942.25' -_ s� 44796 SQ. FT. N 9 0� 1.03 ACRES 3 44719 SQ. F7. ° 1.03 ACRES clq �s M N LOT 21 �`��•, N 45942 SQ. FT. h� 5 1.05 ACRES / / ? LOT 1 \ 18004 SQ ` 1.10 ACF I , I N87*48'55"W 4 516' I N85'S9 48'W 24 24 — 22 / LOT 2� -- 44036 SQ. FT. \ I LO/T 17 1.01 ACRES \ Q , 21 44266 SQ. FT. `° 1 �.01 ACRES i d r IZ S89'40'38 "E 292.Qp' ~ coo w co I ID I W W S 9'40'38 "E 291.E 44195 SQ N N to � � LOT 23 o �' o I,- N "2 . FT. I b W) b I LOT 16 Z o in 1.01 ACRES 11 00 Z z �� 1 4 SQ. FT. I� � O I 00' 1 1.04 ACRES Ld 0) 33' 33' S8T20'05"W 292. 6' 2 18 N - � I I -- OT 24 I 1 \ CN M 47 FT. \ \\ LOT 15 w 1.09 ACRES 50166 SQ. o i \\ \\` \ \ 17 1.15 ACR J N88'31 * 00 'W 359.26 JOINT 19 m w � LOT 25 ^ 'L� 00 ��, Or,► 127514 SQ. FT. � 2.93 ACRES �b16 C14 / �9 N66'1 9'36 'W _ �•N 63.38' .� A IV77 *5 . # - y 35 �ti *• 20o ss -� H W E= 987.0 M50'07'37'W� �c; i 156.55' DRAINAGE EASEMENT �/ 12 `� w • 12 5 y 10 v S) .9