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HomeMy WebLinkAbout026-1286-09-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 479493 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: Oevering Homes I Richmond, Town of CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: �lfb l GS ( 34.30.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic y C4- / 600 Benchmark 5 J c� Q; Dosing / I Alt. BM c� ,'b �bJ • 1 Aeratien Bldg. Sewer eta Z�S -�eQ� 10� �f -t-l� ✓01 �5 Holding St/Ht Inlet 7 �\ TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 30, , �, Dt Bottom �I S cl Q Dosing / N / 3 �, Header /Man. 3 1 6 1 Aeration Dist. Pipe Holding Bot. System w v Final Grade I, PUMP /SIPHON INFORMATION - J A W, Manufacturer � e 1 GP a St Cover \\ � ' qV 16. (A z cZ� /63--7 Model Number j 2, 4. 3 G oJ. �o J r ' D � I O f'o l' TDH Li f Friction Lo System H d TDH Ft 3L �• 2• � b- � � S.b /oo •� Forcemain Lengt '\ Dia Dist. to Well /IJ4- SOIL ABSORPTION SYSTEM BEDITRENCH Width / Length No. Of gench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /6 O e ---- I- -- SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type f n 1 +r ' / ' IV „ t A UNIT Model Number. HT l�l DISTRIBUTION SYSTEM Header /Manifold 1 Distribution f 1 / x Hole Size 11 i x Hole Spacing Vent to Air Intake Pipe(s) � Length D Dia \ Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At Systems Only Depth Over / Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil I r�l -- . \yes No yes No G. • G.. jam COMMENTS: (Include code discrepancies, persons present, etc.) Inspection ##1: Inspection #2: Location: 1232 121st Street New Richmond, WI 54017 (W 1/2 SW 1/4 34 T30 R18W) Sunset Ridge Lot 9 f � `7Vf Parcel No: /n34.30.18. I 1 1.) Alt BM Description= �i C.p J G�a , S �- L o 0 2.) Bldg sewer length - amount of cover Plan revision Required? Use other side for additional in Yes o� k ^ — - - J / [✓ vc} -- formation. Date Insep or 's Signa Cert. No. SBD -6710 (R.3/97) I County 5��, d gs Division J �- I� Y, 201 W Was o ve -> P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) 53 7 7 — 162 1 c ousin (60 -3151 1 D Sanitary �(� 3 Department of Commerce ate P Permit c 'onRECEIVE® �� I o' Address (if different than mail3rtg a S C In accord with Comm 83.21, Wis. Adm. purposes Privacy Lawsl 04(lx u provide / 12 I Z } S may be used for secondary purpo � :) j, A c ationlnformation — Pleas e P rintAlllnformation T. CROIX UQ Lo Block# NG OFFICE} # property Owner's Name Prop e Location ) property Owner's Mailing Address ,/� / C ✓ y Section Zip Code Phone Number L— aro one) City State 1 �� U N:E r W S CSM Number II. T pe of Building (check all that apply) Y`' IG C Subdivision Name aM s 1 or 2 Family Dwelling- Number of Bedrooms Cn o ❑ publiclCommercial - Describe Use ❑City ❑villas p of ❑ State owned- Describe Use ap 1II. T Permit: Y (Check only one b ox on line A. Complete line B i T Replacement only [I Other Modification to Existing System A. stem C1 Replacement System ❑ Treatment/Holding List previ permit Number and Date Issued ous ❑ Change of ❑ Permit Transfer to New B. ❑ permit Renewal ❑ Permit Revision plumber owner $efore Expiration (] M d < 24 in. of suitable soil t- de ❑ Single Pass Sand Filter ❑ ❑ IV. T e 0f P0 S stem: Check all that a l > 24 in. of suitable Sol Sand Filter ❑ Non - Pressurized In- Ground ❑Mound _ n Tank ❑Peat Filter ❑Aerobic Treatment Unit ❑ ReclrculannS Constructed Wetland C] Pressurized In- Ground [] Holdi g 0 Gravel -less Pipe ❑ Other (explain) Chamber ❑ Drip Line Recirculating Synthetic Media Filter ❑ Leaching Dispersal Area Proposed (sf) System Elevation ( �7 S f V. Dis ersal/Treatment Area Info ticanon Rate(BPdsfl Dispersal Area Required Sf) [s/ Design Flow (gpd} Design Soil App 170 Prefab Site Steel Fiber Plastic C app in Manufacnrrer Constructed Glass / Cacity Total Number Concrete VI. Tank Info Gallons Gallons of Units W j-��.Q /4— /1M New 5 s ting Tanks Tanks septic or Holding Tank Aerobic Treatment Unit Dosin.- Chamber the attached Plan responsibility for installation of the POW TS shown °n s Business Phone Number VII, jjegpons statement I, the undersigned, a MpA Number 7� �� Plum Name (PrintZ plumber's Si S C� Plumber's Address ( / Cr/t}Y> State Issuing Agent Signs des Di (Pic Stamps) Sanitary permit Fee (inc Groundwater Date Issued VIII. Cozen /Dep artment Use On 2� XApproved ❑ ved �% Surcharge Fee) ZZ ZGY� 11 R for Denial IX. Conditions o prov SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be servicedIlumberd as per management plan provided by p 2. All setback requirements must be maintained as per applicable code /ordinances. a ernotlessthan8l /lxllinchesinsize Attach complete Plans to the Couniy only) for the system on P P SB D -6398 (R. 01/03) i LV 1 1 LAl V Sunset Ridae LLC ADDRESS 838 Summer Pines Circle Hudson Wi 54016 112 SW 1/4S 34 /T 30 ' N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 101.5' BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none ,BENCHMARK V.R.P. Top of Survey Iron /Nail ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL *H.R.P. SameasBenchmark 4 � To 120th St. Scale = 1/4 = 1 1 404' Property Line Pro 3 Bedroom House Tank is to be properly Huffcutt Combo Tank bedded and provided with lockdown covers with approved warning labels 102' B -3 101.5' 452' Property Line 101' 100' B -2 Grading is to done to B-1 divert run -off away 6% Slope from system Area 15' below system is to remain undisturbed Well is to meet all setbacks found in Comm. 83 B.M. Property Line a Safety and Buildings commerce.wi. OY 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i scons in w ww.coe.wi.gov/sbi sin.gov www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary September 20, 2005 CUST ID No. 226900 A777V.• POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/20/2007 Identification Numbers LLLL Transaction ID No. 1194981 SITE• Ow 9'r no �"`-•� L-L- Site ED No. 704768 S seti dge i✓LCI Please refer to both identification numbers, 120TH Street L above, in all correspondence with the agenc Town of Richmond St Croix County W1 /2, SW1 /4, S34, T30N, R18W Lot: 9, Subdivision: Sunset Ridge FOR: Description: Three Bedroom At -Grade System Object Type: POWTS Component Manual Regulated Object ID No.: 1040624 Maintenance required; 450 GPD Flow rate; 44 in Soil minimum depth to limiting factor from original grade; System: At -grade Component Manual, SBD- 10570 -P (R.6/99); Biofilter The submittal described.above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, co stats. A ' I The following conditions shall be met during construction or installation and prior to occupancy or use: DEP RTM9 Reminders l� SEE CORP • This system is to be constructed and located in accordance with the approved plans, and with publication SBD - 10570 -P (R. 6/99) "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems ". • The pressure network is to be constructed in accordance with publications SBD - 10573 -P(R. 6/99) 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ". • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. SHAUN R BIRD Page 2 9120/2005 • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved Mans specifications and this letter shall be on -site during construction_ and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 S SF,o 1 C FO Cover Page 9 FF, y ¢c c�B Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 9/13/05 Owner : S uraset-Rkge --PL Location:W1 /2 SW1 /4 S34 T30 N,R18W Lot 9 Sunset Ridge Richmond System type: At -Grade Manuals Used: At -Grade Component Manual version 1.0 SBD 10570 -P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Page# 1. Cover Page 2. At -Grade Plot Plan v 3. At -Grade Cross Section°- 4. Pipe Cross Section /Pipe Layout p�Y 5. Pump Chamber Cross Section 6. Pump Curve C Er:3c Z 7-8. Maintance and ntigency plan 9 -11. Soil test Shaun Bird Signature License num r 226900 PLOT PLAN PROJECT Sunset Ridae LLC ADDRESS 838 Summer Pines Circle Hudson Wi 54016 W 112 SW 1 /4S 34 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 101.5' 3 BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.R.P. Top of Survey Iron /Nail ASSUME ELEVATION 100° Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark To 120th St. Scale — 1 /4" _ 1 404' Property Line Pro 3 Bedroom House �- Tank is to be properly Huffcutt Combo Tank bedded and provided with lockdown covers with approved warning labels 102' B -3 101.5' 452' Property Line 101' 100' B -2 B -1 Grading is to done to divert run -off away 6% Slope from system Area 15' below system is to remain undisturbed Well is to meet all setbacks found in Comm. 83 B.M. * Property Line 2: B > 5 pyc FOP.LE M >51 Zt r`-Tupw —UPS" W srAgtii �E� ot �tRTt�ert vtec� � O v___,_ - = t 5 l/f B id2B 8 = D L. = 1 719 1$. CELL OF fi Z/Z AarmaF-c-&# Val Z- Z— ft. hippa.bvEa symTs nc— Fabric Distribution Lateral 'MBtiLMr -b Observation------,, '; „ ti " Soil Cover S ate l 1 ` ` 12 . 6V11�C� L A`lE2 2:5 A =fi —5 plan View and Cross Section of pisconsiti At-8rade Unit with a Single Absorption Area on a Sloping Site �.tC�nlSE�= S1tae�3t� KE. Page Of Distribution Pipe Detail For Lateral ldetwork AC c e st' TURK-UP (CLERT40 . - PVC Force Main PVC Distribution Pipe P * Last Hole Should Be Next To TuRr3• �P P t. F Mole Diameter Inch _ x °� inches Lateral Diameter Inch(es) Y c3- Inches Force Main Diameter Inches r # of Holes /Pipe Invert Elevation Of Lateral A � Ft. Signed: License Number: Date: r CROSS SECTION AND SP£CIr ACA IONS SEPTIC TANK CHAMSER wEATHEftPR00F APPROVED ._ SIN. ABOVE GRADE jUNC ION BOX MM14CLE COVER 4 __ �, V ENT PIPE WI NDOW NDOW OR WITH CONDUIT I`ItOM DOOR, W1 PADLOCK FREat' AIR INTAKE NARKING LABEL E MIN. rRAD a. t8u Mtas- INLET t ` GAS s a SKATER TIGHT SEALS T IGHT IGHT l { JOINTS WITH Lm APPRDYED PIPE s S SO ICSOIL APPRVED PIPE 3 C — a OFF g Otter SOLID. / o ff• t;7FT . ' SOIL pump OFF ELEY - D 30 APPROVED BEDDING UNDER TA3+I1C CONCRETE PAD S PYr I E ICP"TI ONS DOSS PER DAY: SEPTIC ! DOSE CI�JDY�� GAL - TANK T4ANUFAC•Ts".ER : 1>05r, V {} MME � gA CK: __ ,-"—, � AA GAL . d� TA3iK SIZES: SEPTICL. �! ` I N CH ES DOSE CAPACITI'� : A r" GAL - • 2 INC SES _ ALA MANUFACTURE ' GAL. MODEL AJ14SER : _ � 7 INC fIES / SW ITCH TYP£ : /�" a m C = AC'RER = .G! t��� INCHES GAL PUMP �i�i€JF TU i 15.x WN 14()DEL H U tI ' lfP ALARM WIRING AS PER ILRR FEET DIFFERENCE ZI�'E'ION pIP£ _� �� FEET R .QLIRE3 pUPEP OFF AND DISTK - T — r--"" FEET VERTICAL VERTIDIFFERENCE BNE£3K - '£- ;C'TIDN 'FACTOR - - ----- fir` "x'4`311 NETWD3tK SuFFLY XRES� R FTlI€� £ 3`I L 7Yt -IC lir l s- - --- p�£T FEnvi l � DIAMETER .i ~- - WIDTH_____ -_— IN'£ERt4RL DLtIENSIflN5 /pv F PII! f? `FAiKiC : Lr.? - z /� r' -DATE* LICENS SIGNED _ ;188 TOTAL DYNAMIC HEAD /CAPACITY • PER MINUTE ' HEAD CAPACITY CURVE EFFLUENT AND DEWATERING MODEL 152/153 MODEL 152 153 ~ Feet i Meters Goi. Liters Gal. Liters 50 5 1.5 69 261 77 291 153 1 p 3,1 I 61 231 70 1 265 t2 40 152 15 I 4.S S3 201 S1 231 a i o 61 I 44 i67 52 197 �25 7.6 34 129 42 30 159 30 9.1 z 87 33 i 125 - I a B 10.7 -- 22 85 a 20 40 I 12 -2 -- -- 11 I 42 Lock r t 1 Z F 4 Ft. 1 .,•4R1 ' o � 4 ..0 .,8.0 11.6m) { ) 4 Gt4M 10 i 0 20 4 6 0 80 100 GALLONS LITERS 0 80 160 240 320 - 3 27/32 4 579 --1 1 FLOW PER MINUTE 3 27/32 1 • I f 1 CONSUL T FACTO RY FOR SPECIAL APPLICATIONS _j a + - � ® � 3 27132 panels available. �' I Timed dosing p are available and supplied with • Electrical alternators, for duplex systems, �---- ! an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable I 1 level long and short cycle co ntrols. . 1420. '�" • l • Sealed Qwik-Box available for outdoor installations, See FM I • over 130 °F. (54 °C.) special quotation required. I 1521153 Series 1 I 7�, 1 ! B 152653 MODELS Control Selection t/n Am s Sim lex lox Model ! v t ode Du 1 2 or 3 j N152 115 1 Non 8.5 W064 am 6 _ 115 8.5 Included 2 or 3 t 1 l 115 1 4.3 t 2 or 3 E152 1 Non 4.3 Included 2or3 8Et52 230 t Auto 2 at 3 N153 tt5 t 10 1 SELECTION GUIDE 10.5 Included 2 or 3 BN153 n5 t Auto !045 i z or 3 1. Single piggyback variable level float switch or double piggyback variable level float E153 230 1 Non 5 -3 BE153 230 1 Auw 5.3 Included 2 or 3 switch. Refer to FM0477. 2 See FM0712 for correct mode! of Electrical Alternator E-Pak. n caunor! du plex 3 protection devices and wiring should be done by a qualified 3. Variable level control switch 10 -0225 used as a control activates S pediy p { Au installation of controls, p or (4) float system. recent National El ectricCodee(( E) andtheOccccupationalSafety landHealthAct(OSHA).ost RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P_0. Box 16347 Louisville, KY 40256 -0347 Manufachrrerso(• SHIP To: 3649 Cane Run Road w �r e Louisville, KY 40211 -1 961 Pirlws J / NCE f9�� � p;//f yww.zo e11 er. coo PUMP l4. (502) 778-2731 02) (80 -362 PUMP ©Copyright 2000 Zoeller Co. All rights reserved. - UAL & MAi'IAGEMENT PLAN Page of _ POWTS OWt+IER'S SAN SYSTEM SPgGiFiGA7lONS Capacity I� al DNA (; Septc Tank Q NA FU- V- rntt=ot pox optic Tank mantttai r NA O1ener �: f1 NA t F Effluent M cturer _ NA Pettrnt � [7 Effluent Flier Model �� . DESIGN P� C3 NA �� d at 0 NA Putnp-Tank Capacity Number of t3�rooms Units Pump Tank Manufacturer t NA Number of Cc .l � �� altd - .Pu Ntanis�r,�urer NA W ( avd Estittt�d (estimated x P UM P Model n flow (Peak+ � aild �� Pre�'�nent Unit - D Peat Filter Son r vpaaawn Rage Monthly average' t7 Sand/GMYel Filter p Wetland QUAY 1L nical Aeon ❑Other_ Fats, O ue R s ag ling p Mecha tnttuenflEffl G) - rrtical OxYge1' Demand (B s) 12210 rYtg/L ❑ Disinfed►on Biodte ��,� Sonds SS) S l so m 1L Manufacturer Monthly average" Dispel Cetl(s) [3 ln (pressurized) Effluent QuaCtY NA E�grrad o und (gravflY) ❑ Mound Pry SOD$) 00 mg1L e D Other_ g - errtic�t Oxyg dDed S s � ) 3D mg1!- ne 4 00mt �rnerr�"" Total Sus rrn metric mean) 51 (1 cful values Wical for dariestic Fecal 00252 m (9ed y, inchdiamete a muem s epw w+sLEWStef- Maximum Effluent Particle Size values tyalcal. ror arrested 5er+rice Fro uency SCHEDULE r ( s ) (Niaicirnum 3 yrs.) � MNNTFt,ipfdCE S ce Event ❑ month Servi ird of tank volume At least Once every m equals one-th (>S) vVhen combined sludge and scu ears) (max 3 yrs _) Ins opndttion of tank(s) p months Pump out contents of tank(s) At least once every ar(s) lnsped dlspe� cell(s) At least once every [3 months . year(s) ❑ N A 0 months Gin effluent filter At least once every s ) Cl NA controls 8. alarm � D months Inspect PUMP- Pump At least once every 0 y8sr(s) 0 NA s an d pressure test 0 mon ths Flush laberei At least once every p months II years) 0 NA otlW_ At least Once every UP oet licenses or MMNT0,,ANM iijSTRUCTIONS an individual carrying one of the following tainer, Singe it be made by cbo P01M`5 MaII7 or broken Its sha WTS 1ttsPe of tanks and dispersal oe Sewer, PO identify any c h ec k back tnspe •Master PtuMW. Master Plumb Restricted on of the tank(s) th for any ba relic •. ns must include a vfsuat I sludge an d m um d to check the effluent � Servfdn9 perator- T ank inspec o ure the volume of �rnbined �SUatly IruP nd g of effluent on Vie hardware. klenfify 9 packs or leaks. rheas The dispersal cell(s) shall be authority round surface riding of effluent on the ground surface The Po ulatarY or ponding of effluent on the g for any Po fication of the local � tank Yot the in the obsenmflon PIPW and to chv* n and requires the Immediate nod or more may indicate a failing co nd'r6o eq uals one-third with ch. NR ground surf a and scum in any tank eq of in accordance cumulation of sludge a Septage Servicing Operator and disposes � When the combined and any entire contents of the tank shall be removed by nt ponents; Waconsin Adminlstraf ode rued POWTS components Pm a awt POWTS Mainta;ner. 113, niechaniCdi or p reSS U , by The serViang of effluent filters. o f �mPlegon of any seMCC event at intervals of 14 months or less shall b ofiiermatntenanoe or mon'ltorng local regulatory authority witfiin 1Q sia� A sew report shalt be provi to the or other �� are START UP AND OPERATION use of the POW'rS check.treatment tank(S) > i ice of painting ii if high conWn For new =Zuc�on, Pf or to s and/or damage #1 nor to use - cAemicals that may impede the treatment Pte$ a septage servicing operator P dewed have the contents of the WKS) ren'oved by _ - Page of so i l are frozen at the in9trat ve surface - Syshem start u p shaFt not occur vmen is restored the excess M,V tV above normal highwatet le'veis. When P° s and may result in the tanks overloading the cell } During p�'O1�es Pump do To avoid c ell(s) in one large dose. urnp tank removed by a p rva be drschad to the t id units situation have the contents of the p ate backup 9 � perOtm �� poYYer to the effluent pump or contact a pl or POWTS Maintainer m SepFag 'contrt?ls to restore normal levels whin the pump tank asst in rnartFratlY oPrr pip over t MI and dispersal . Do not drive or park over] or of#netxrise dtsturfr or compact, DO not drive or park mound or at -grade soil absbrption aFiea_ �d pra[on the fife the area within 15 feet down slope of arty improve the perforrrwxe g of the folbwMg from the wastewater ; may P s; deyreas�; dental floss; �peM Reduction tte butts; condo or- elimination Cigare cotton swab , 1ease; herbiddes; meat of the POW TS: antltltot-t'S; baby water, fruit and vegetable peermgsf - 9 distnfe tat fotrda tirjon drain (sump PUMP) soimar brine. scxaps; merit: �; parrWn8 Products, pesticides; sanitary napkins. tampons; and water ABANooNWENT out of service the following steps sha11 tEe taken to insure that the When the POVgS ftils andfOf is pomlartently taken e: an d safely abandoned in compliance with ch. Comm 83.33. W system is properly a and the abandoned plPe �n g WW All piping to tanks and pi stfatl •be disco properly disposed of by a $ servicing Operator. The contents of an tanks and pits shall be removed and After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soli, gmYel or another inert solid material_ CONTINGENCY PLAN the foltorving measures have been, or must be taken, to Provide a code if the p0VVTS fads and cannot be rePai� compliant replacement system: evaluated and may be utilized for the location of a replacement should not ❑ A suitable MpL ement-area has been absorption �- The r plaaernen setbacks fro t area should be pro tected proposed szuciure. lo Finns and wells- Failure to be infringed upon by required existing and propo w-H riasult in the need for a new soil and site evaluation to establish a suitable p the replacernenL area the rules in effect at that time_ replacement area- Replacement systems must comply suitable replacement area is not ava the ilable due to setback ar�dlor so iE limitations- Bamn9 advances !n POVYTS 13 A red as a last resort to replace failed POWTS- ology a holding tank may be instal failure of the POVVTS a sod and has not been evaFuated to identify a. suitable replacement area Upo t area is available a s eva l ua tion must evac be per�� to }ocate a suitable replacement area_ If no replacem� o!ding tank may be installed as a last resort to replace the failed POWTS_ removal of the biomat at nd at..grade sor7 absorption systems may be reconstructed i } pl w the U gn effect at that time. the infiltrative surface- Rec0nstnrdions of such systems must comply TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND T A INSUFFICIENT DEATH OXYGEN <<WARNING>> . SEPTIC, PUMP AND OTHER TREA CIRCUMSTANCES. DEATH MAY DO HOT ENYERA SEPTIC, PUMP QR OTHER TREATMENT TANK F)NDF_R ANY RESULT. "RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADOFTIONAL COMMENTS POVYTS MAINTAINER POWTS INSTALLER Name r/ > 'x 1� Na �^ _ l am � c�-u Phone 7) , - - 7 , ) / 6— �t�� l Phone) LOCAL REGULATORY AUTHORITY n SEPTAGE SERVICING OPERATOR P MP Ag r � `t Name i'N Phone 1 Phone _ / ' � 1I and Santlation ager>des; This doarr ' tt�e st�lFs of the Ctaea t alre. Marquette and Wa ushard County Zia 4 Cedes Use of this die °t does not This document wasdralted br f XQ)�Cfl and 83-54(l).(2) & (3). Wisconsin Admrrttsirad'�e C ch r FVOt} th e mkimwn mquimnents of . Comm 83 -22MO guarantee ft performer m of the POVMr Wisconsin Department of Commerce � � SO _ REPORT Page of Division of Safety and Buildings WOVE in accorda h r i t i my Attach complete site plan on paper not less than 8 112 x 1 1 size. Plan must include, but not limited to: vertical and horizontal reference t A9Wi ddnnr reel I.D. percent slope, scale or dimensions, north arrow, and location .- tance to a re Ffsad ST. CROIX COUNTY by Date Please print all information ZONIN .2Z Personal information you provide may be used for secondary purpos 7 Property Owner Property Location g ( / ` IA 'd.c A S __)y T� ®N R AE (o W �-•� �= Govt. Lot 1! Property Owner's Mailing Address I Block # Name or CSM# ,.�tz a ✓" "dam City State Zip Code Phone Number ® City ® village own N est Road New Construction Use: esidential I Number of bedrooms ` -_ _---*-_ Code derived design flow rate ❑ Replacement ® Public or commercial -Describe: _ -_ - - -- - -- - - -- Parent material J __ _ __� Flood Plain elevation if applicable l A ft General comments and recommendations: n 1_71 Boring # El Boring it Ground surface elev. _ f. Depth to limiting factor in. Soi Application Rate Horizon Depth Dominant Color Redox Description — (cxture Structure Consistence Boundary Roots •Eff#1 Etf#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boring �n /� El Bori # it G round surface elev. ? 4 Depth to limiting Aco:nsitece i^ Z / O K P Soil Application Rate Horizon Depth Dominant Color Redox Description f exture Structure ndary R oots GPD/ff 'Eff#1 'Eti#2 in. Munsell Qu. Sz. Cont. Color _ Gr. Sz. Sh. 4 - i O 1 Z P /a he; 60 Z ) rs /� 1j n ' Effluent #1 = BOD > 30 < 220 mglL and TSS >30 - 5: ' Effluent #2 = BOO _< 30 mg/L and TSS < 30 mg/L CST re CST Number Name (Please Print) Bird Plumbing, Inc. Shaun Bird 226900 Date Evaluation Conducted Telephone Number Address - 1008 192nd Ave, New Richmond, WI 017 _- 715- 246 -4516 J Property Owner _ Parcel ID # _ _— Page of 13 Boring # ❑ Boring Pit Ground surface elev. 0Z.t ft. Der,"t.'c , - Nting factor _� in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture c;ture " Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz_ Cont. Color __. 3h. 'Eff#1 'Eff#2 I n W4 % -_m �_Oc F-1 Boring # ❑Boring ❑ Pit Ground surface elev. ft. Dep i .o limiting factor in- Soil lication Rate Horizon Depth Dominant Color Redox Description Texture : >tr icture Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Colo f_ 3z. Sh. `Eff#1 `Eff#2 - -- F-1 G Boring # ❑ Bari _ _ round surface elev. ft. Dept .o li miting factor in. Cl Pit Soil Application Rate Horizon Depth Dominant Color Redox Description- Texture 't<uctire Consistence Boundary Roots GPDfff in. Munsell Qu. Sz. Cont. Color :;r. Sz. Sh. `Eff#1 'Eff#2 EEI Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mc_UL ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the derar.ment at 608- 266 -3151 or TTY 608 -264 -8777. 560.8330 (RAW) Soil Test Plot Plan Project Name Sunset Ridge LLC Shaun Address 838 Summer Pines Circle Hudson Wi 54016 CST #226900 Lot 9 Subdivision Sunset Ridge Date 4/15/05 W 1/2 S W 1/4S 34 T 30 N /14 W Township Richmond F] Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Nail /Iron System Elevation 101.5' *HRpSame as Benchmark Scale is 1" = 40' 404' Property Line unless otherwise noted 452' Property Line B -3 70' 90' ' B -2 B 6% Slope 150' B.M. 274' Property Line ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND C OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address (Verification required from Planning Zoning Department for new construction.) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location ' /a , Sec. T -� ; c /9 N Rl W, Town of Subdivision Lot # �. CY Certified Survey Map # ,Volume , Page # Warranty Deed # �� _ , Volume 2S70 , Page # Spec hou ye no Lot lines identifiab yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and /or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. �] ' S OF APPLICANT(S) c — DATE * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) FROM :OEVER1NG HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10:14PM P1l AN 8' a� 1 a�w iwm of a -- - - -- - -- f -. • 11 a� Q :.M S,! ® Y Y QQII • I • • � YYYY� f f I ti - FROM :OEVERING HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10:14PM P12 LW Im i - - - -- ---- - - - - -- - -- r o p N d i •- U, 2 8 9 0 P 4 7 5 016712118 State Bar of Wisconsin Form 2 -2003 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI Document Number Document Name RECEIVED FOR RECORD 09/19/2005 09:30AK WARRANTY DEED THIS DEED, made between Sunset Ridge, LLC EXEMPT # REC FEE: 11.00 ( "Grantor," whether one or more), TRANS FEE: 140.10 and Oevering Homes, LLC COPY FEE: CC FEE: PAGES: 1 ( "Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is ' e7u7t , please attach addendum): Plat of Suns Ridge i n the Town of Richmond, St. Croix County, Wisconsin. RVAT 2684191 026 -1098- 20-000 & 026 - 1098 - 30-100 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated September 16, 2005 (SEAL) 9 6 G (SEAL) " ' nset Ridge, L C (SEAL) (SEAL) s : AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF Wisconsin ) ) ss. St. Croix COUNTY ) TITLE: MEMBER STATE BAR OF WISCi�IN Personally came before me on September 16, 2005 , (If not, ���� t q ", the above -named Sunset Ridge, LLC authorized by Wis. Stat. § 7 ; ... �� • • .� Aq O .y''� to me ow to be the person(s) who executed th foregoing THIS INSTRUMENT DRAFTED: �O y •• * : ins ent d acknowledged the same. Attorney Kristina O land :'* V ' ? Z E n) u'v Hudson WI 54016 • • Connie M. Gul ixso 1� OF 0 0,0 `�� My Commissi n (s permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 0 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. 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