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HomeMy WebLinkAbout040-1186-50-100Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may he used for secondary purposes [Privacy Law, s.15.04 (1)(m)] Oevering Homes TANK INFORMATION Q 1hff:? ,, TYPE MANUFACTURE 1v - , 1 APACITY "1 Septic , ` U Dosing 1 LL' TANK SETBACK INFORMATION r,hrl'I.1«1 Laj M�Mm® .•" mmm=-= .. ���.� I l�1a r . PUMP/SIPHON INFORMATION _ V , Manufacturer V Demand I 10 GPM Model Number iJ OT .4 �G) TDH LijLj' Friction Loss System Head 2 1�1Forcemain TDHI� �I Ft l�r Lengt tooI Dia.'Z H Dist. to Well I 1 SOIL ABSORPTION SYSTEM BED=NCH Width I Lena1 DIMENSIONS( TOWN OF TROY DATA STATION BS HI FS ELEV. Benchmark ' . /�+ �J f O 3 . Alt. BM Bldg. Sewer 0.9 3 . 2. St/ Inlet 12. �f .-!J pS- RG S Ht Outlet Dt Inlet Dt Bottom Header! •S 3.3 ist. Pipe Bet. System Final Grade St Goyer � � I S a 0 2.g U2. INFORMATION Tyge Of System: t . f ` /� CHAM M R OR Model N er: 1310 DISTRIBUTION SYSTEM 6' L-) t;1' +e nP.iakjil& Wit II -hh Yam, k.fvrr HeaderlManifold Distribution x Hale Siz x Hole Spacing Vent to Air Intake ( I Pipe(s) 'bb �' 3 II I % , Length Dia Length r+�+ Dia Spacing (V Li SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only T]OL 'nl L)A&WPO Depth Over \j Depth Over I I xx Depth of xx Seeded/Sodded xx Mulched Bed/trench Center (' / l� Bed(rrench Edges g / Z Tc oil ' � �' 2 \)# Yes A Na Yes � No MR COMMENTS: (Include code discrepancies, persons present, etc.) Inspection S1ly12 w#1: 0 Inspection #2: Location: 86 W WOODRI,D1G-E, DRR`�lwliril �jCsel 1i YLCW 1twCr'�%�..' 1.) Alt BM Description I tiG Will IV Q4% V4' ( 6-L*4 `,,,b 03) 2.) Bldg sewer length = O ] -amount of cover= I N� weal nod- ins+ul c1 b\4 ►rvgeuto )`T'If Mum At Plan revision Required? ■ Yes '10 No F I Use other side for additional inI'1�I) formation. 1 I SBD-6710 (R.3197) Date 41--pdksSlign.4r. Can. No. SANIIaQ(; - 0) - , o Safety Buildings Division �mmry and 201 W.. Wasttington Ave., P.O. Box 7162 shy permit N,onber (m be filled in by Co.) p- - MAR 05 2020 Madison, cal 53707, 7162 Ile � rn- as -S- jt� • Appllcatio Sur Transacum Number Coro In accordance 3932112), Wis. Ada Code, submission of thief to �ropnsm goverum Pro)ect Address (if dill cut than mailing address) is required prior to obtaining a sanitary permit Note: Application forms for stare -own suln umed an the DcparlmeR of Safety and Professional Sarin Personal mfomsBion you provide may be use M purposes in accordance, with the rs. Law, a. 15.Bt(1 m). Sta 6 , ) ac f 1 Application Information— Plane Print All Information Prepare) Owner's NNinonQ_ �1 f f)e% 1IaV�r - ✓o'' O"Ii Property Owner's Mining Property Location . , co OWL LAX b y1 y, Section City. State Zip Code Phone Nmnber i 6 T L 1 � N, R or EL Type of Building (check all that apply) u I.ot d Subdivision Name or 2 Family Dwelling -Number of Bedrooms Hlook G D ❑ PubliclC.ommaeial - Describe Use 5 �— 0 Ciry of ❑ State Owned- Datnbe Use CSM ❑ V'Bi age of Number own of IML T Permit (Check only one box on line A. Complete line B ifapplicable) A. sr ❑ Replacement System 0 Treacawnt Holding -rank BRlacmem only❑ OtherModificarioa to Existing System(explain) B. ❑ Permit Renewal ❑ Permit Revision 0 13ange of Plumbs ❑ Permit Ira aft m New Up Previous Perm t Number and Date Issued Befce Expiretiun Owner M TvDe ofPOWTSS stem/Cousoneut/Device: Check jad that apply) ❑ Nun-Prmnn'atd Io-Ground 0 Prpsmved In -Ground dirade 0 Mound > 29 a of suitable soil 0 Mound <IA io. of suitable soil ❑ Holding Took ❑ Otbc Dispersal Compmmt (explain) Pretr t Deilim (explain) V. Diu rmavrm ent Ara Information: Dail Flow (ppd) Dear Soil AppBcatioa Rate(gpdst) Dispersal An- Requited (at) Dispersal Area Proposed (sQ System Elevation VLTanklnfo Capacity in Gallons Total Gallons not Un¢s ti�stM�}}: ++ 1salQ 3 3 u Ncw Lab Fig Tavla A 52 vHi O Septic or Holding Taolc Dnmg Cbemba ? 3d VIL Responsibility Statement- L the mad me responsibility for insmOatim of the POWTS shore an the attached plans PI 's Name (Riot) 's Si WAVRS Number Busiors I'booe N ZZ 's Address (SUM Cuy. Zip - Va Countv/De eat Use VapProled ❑ Disapproved Permit Fee Date ing S' Gi 0owmervenRea�onCorlkoial S �71 ill �020 C DL Conditions of A prayal/Rea900E for Disapproval 4t2 gN, SYSTEMOCVNER: 3 t�MaQg �BaIS,�/ t°`gyt�y�Q 1. Septic tank, effluent filter and ,. I'K 1 t %4 QelMi dispersal cell must be serviced ! maintained a 0� r 5 /� �Q Y 1/ rO.W,!� S 5 as per management plan provided by plumber. AAA-0-1 nfs rat Or as per per nor for than a W } 11 loan ion sae -tl:gt� .� ,,�° �C S..e SSD-6398 (A 11/11 o2Qet r�rlamow. �rct�e a.✓2- Ma.F (02- tires a i �ZZ.C`7l� . System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 114 NW 1/4S 36 /T 28 N/R 19 W TOWN Troy COUNTY ST,CROIX SYSTEM ELEVATION 102.8' 2/20/20 BEDROOM 3 DATE CONVENTIONAL AT -GRADE %00( CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 IIOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 BENCHMARK V.R.P. Top of 34' pipe ❑ BOREHOLE O WELL •H.R.P. same as benchmark Area 15' below Grading is to be done to divert run-off system is to remain away from the system undisturbed Property Line ,0`( .46 Acre Lot V 2 1 03' 102.8' Scale = 1/4'= 10' B-1 101' # of chambers none ASSUME ELEVATION 100' Filter Lifetime Filter 0' 40' 80' -3 99' 1 8% SI e Well is to meet all WDNR setbacks Bedroom Huffcutt Combo Tank ease note: this site is to be surveyed and staked. This system does meet the setbacks 86 W. WoodRidge Drive but is extremely tight spacing. Caution will be used in installing this sytem inorder to make sure it Is in the proper place. OPI 4 DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 543045211 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Tony Evers - Governor Dawn Crim - Secretary March 4, 2020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2022-03-04 Plan Review: PWTS-032000280-C SHAUN R BIRD 1432 120th St New Richmond W154017 SITE: Oeverillg Homes 86 W. Woodridge Dr. Town of Troy Saint Croix County Total Amount: $250.00 FOR: At -Grade Component Manual - Ver. 2.0, SBD-10854 (N.03/07, R. 1/12) Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01/01, R 10/12) Description: 450 GPD (3 Bedrooms — New Construction Maintenance Required The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 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, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property fine(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger Lill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(I). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, 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. 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 Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Thanks, r%Ar �%sert'uo�eeef POWTS Plan Reviewer— Wastewater Specialist Department of Safety & Professional Services 1 Division of Industry Services email: tim.vanderleest(a.wisconsin.eov Cell: 608-516-6134 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:2/20/20 Owner:Oevering Homes Location:SW 1/4 NW1/4 S36 T28 N,R19 W 86 W. Woodridge Drive Troy Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7. Filter Specifications 8.4 Maintance and Contingencyrn Attachments: Soil Test Shaun Bird Si License number Page 1 of 9 PROJECT Oeyerina Homes SW 1/4 NW 1/4S 36 System PLOT PLAN ADDRESS 1433 Cemohous Ave Suite A New Richmond Wi 54017 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 102.8' DATE2/20/20 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 hk BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION too' Filter Lifetime Filter [:]BOREHOLE O WELL *H.R.P. same as benchmark Area 15' below Grading is to be done to divert run-off system is to remain away from the system undisturbed Property line 01 .46 Acre Lot B-2 ❑ 103' 102.8' Scale = 1/4"= 10' B-1 101' ❑ 0' 40' 80' B.M." B-3 99' 8% Slope Well is to meet all WDNR setbacks Pro 3 Bedroom House Huffcutt Combo Tank 86 W. WoodRidge Drive Please note: this site is to be surveyed and staked. This system does meet the setbacks but is extremely tight spacing. Caution will be used in installing this sytem inorder to make sure it is in the proper place. ��l At -grade System Sloping Site Cross Section and Plan View --------------------- ------------ E i� � —1 = Plowed r} f} = Clean aggregate 1 basal area ?�Cti V = 4 in. sch. 40 pvc L — , /Z to 2 /= in. dia. observation pipe Geotextile Fabric Lateral with 2" aggregate over pipe IC Ft Lateral Invert r:r:r:r:r• i.r•r• r 'r•{ a:Ghh r Ft Contour %fL{L. jrL:L:L �4r: rrr:r ivr c1iy_1.ti,L:L �— Slope Direction Plowed C 1 u � 0® 0� 0� 0�1 ©�r slope Observation Pipe With Cap � r/)Topsoil Cap GENERAL INSTALLATION: The at -grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a''/. inch soil wire when a sample is rolled between the palms of the hands. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After -the topsail cap is placed, the entire at -grade is seeded and mulched to promote vegetative groom, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/051gj Page of- Pressure Lateral Layout One Lateral — End Manifold Force Main X --} L 41�. , ..L n 2, Distribution Network Specifications Lateral Diameter Z In. Orifice Diameter 3 In. X Orifice Spacing) 2 In. L Lateral Len th Ft. Force Main Diameter Z In. Force Main Len Ft. Lateral Turn -up —0 �- Threaded Cleanout Plug Long Sweep 90 Bend Pressure System Construction Laterals are constructed of Schedule 40 PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral tum-ups terminate with a threaded ceanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. ••••• Grade •••••• 6-8 Inch Lawn Sprinkler Valve Box 03/05 lgi Page A of- Septic -Dose 'Tank Cross Section And Pump Performance Specifications • : R OME Filter Manufacturer Filter Model Number Minimum Pump Performance Required 3 OPM Ft TDH Outlet Manhole Min. 4" Above Grade With Looking Device. Inlet Manhole < 6" Below Orade Sealed watertittht � — — — -1 — Finished Gradc Outlet Filter Inlet I *--- 5wet Baffle Switch S and Reserve Capacity Tank Volume = S GPI Dimension. Inches Volume Gal. (maeerve) k (alarm) B 2 (dose) C : (dead) D. Total wil Total Dynamic Head (TDH) - Feet Elevation Head / U Distal Pressure Network Lose Force Main Loss Total /. v 3 Manhole Min. 4" Above Grade ather Mounted With Locking We Weather-proof 1 Junction Box -i I t Vent Min. 12" Disconnect Above Grade Means With Vent Cap A 4 o B He Off Elevation C �3 3 Ft Bottom D Elevation Ft GENERAL INSTALLATION: The septic./dow tank is bedded and book filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as spec W by the manufacturer may not be exceeded without prior tpproval. Manhole covers exposed to grade have an effective kicking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation "the sioeve is sealed watertight. Electrical aervi mplies with NEC 300 and Comm 16.28. 02/05 LI Page S of 280=SERIES 112 hp Submersible Effluent/Sump Pumps The Uberty 280-Serm provides a cost effective "mid- range" pump for on -site waste water systems, liquid waste transfer and commercial heavy-duty sump pump applications that require higher head or more flow. Designed around Liberty's unique'Unl-Body" casting, the 280Serles will provide years of reliable performance. All Models Feature: Q e Vortex Style impeller permitting passage of solids up to %' • 416 stainless steel rotor shaft e Pemlanentty lubricated upper and lower ball bearing e Epoxy powder coat finish • All fasteners -corrosion -resistant stainless steel e 1 h" Discharge e Stainless steel bottom screen - easily removable • Maximum fluid temperature: 140' F. 280-Serf" Cord Lengths Model 1W 26'(-2) 35'(-1) 500(-M 280 8tendard Optional O tlond Optional 281 9tarWard Optional Options, options, 283 8larndatd Opdonai opbormi WA 287 8mndard optionall WA WA 10' cad knpth standard on all models. Foopsonal lerperq add'-2, 4 or S" suffixto modal number. Fxenpla for nxdal 200 with 36' cord. order 78P3 Motor Specifricatlons % hp 60 Hz 3450 RPM Oil filled, themlaly protected (PSC) Permanent Split Capacitor 8.0 amps (115V) 4.0 amps (208/23OV) Performance Curve: 280-Serles 0 6 10 15 20 25 30 39 40 46 50 56 60 65 70 U.S. Gallons Per MhMs 38 78 114 156 192 228 770 Liters Per Minute Dimensional Data: Weight: 29 lbs. Height: 13' Major Width: 10' (model 287) Minimum Sump Diameters: Model 281, 283... 14' Model 287 VMF... 10" Factory switch Model 281, 283 Model 287 settings VMF Turn on level 13" 9.5' Turn off level 7- 4.0' The Model 2a3 features a fully adjustable wice-angle float D"Mmyasl adlurtre to can be awe easily by bothering the Moat to the dis- charge pipe or other mounting Wnt Verfkal float nfodal 267Is not adjustable. ModG1280 Model 281 Manual, no switch float switch with quick- with series _ I t�;IIll_lI�I �l plug�..aw 1n4 C12-us Certified Vertical mag- rwdc float for smaller pits - will operate in a 10" diameter sump Lgwrty Purnpe • 7000 Apple Tnee Avenue • Bergen, New York 14416 a Plrone 806643-25W Fax (WS) 404-189Y www.libertypumPs•oam Copy Vaolbrrty Punp4h ZM7 Aar Aghxsrwerw LLrraxppne6?i7 (.' ov / 20140048A 9.8161 9,3759 9A U .01 Gap be"en Cos, antl SepentM ++•81' A 10 SECTION A -A E Pegs _ of _, START UP AND OPERATION For now construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thrp may impede the tresbnant process and/or damage the 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 power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal call(s) in one large dose, overloading the oell(s) and may result 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 POWT$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat: foundation dram (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; Painting produdls; pedcldea; sanitary napkins; tampons; end water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to Insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property 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 Chad with sell, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls end 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 requllled setbacks from existing and proposed structure, lot lines and wefts. 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. Baring advances in POWTS technology a holding tank may be installed as a lest resort to replace the failed POWTS. lie -The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and Site evalua*W 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. 51�1!vlound and at -grade soil absorption systems may be reconstructed in place following removal of the biomet 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 POWr$ INSTALLER POWTS MAINTAINER Name s Name Phone ?)- Phone 'j/�—'�j SEPTAGE 8ERVICING OPERATOR P JMPER�_ LOCAL REGULATORY AUTHORITY Name �y Name Phone .�S�ti-Sl�f3� Phone This document was drafted in compliance with chapter SPS 3b3.22(2xb)(1)(d)d,(f) and 393.54(1), (2) s (3), Wlaoonsin Administrative Code. 7g9 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete We plan on paper not less than B 12 z 11 incMa in size. Plan must include. but not tir Aed to. vertical and horizontal reference point (SM), direction and Dement slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. P<r.a.r� You Ww my W wa corn sewn g15.01(1)(m)l t -- Canty Parcel I.D. Reviewed by Date Property Owner O 4n Property Loca on 77 Gkrvt. Lot (,( /i/ V4 S T L N R E( W Property GwrWs Mailing L!^ n ! S l Lot N Block N _ StDd. or ` l( City tate - Number City ❑ V page Town Nearest Road Nee' Consaumon Us Residential / Ntarlber of bedroans Cade denved4WW now rate -� KPn ❑ Replacement Public a commercial - Describe: Preto material Yi/ Flood Plain elevation it applicable �� R Grlral aorlxnerds and recommendations: System Typo /CL/ System Elevation�a f' ✓ __ ❑ Boring Boltg N QA Pit Groundourfaceelev/03, ZR. Depth to knifing tailor ` n. Soil Application Role Flordton Depth in. Dominant Color Murnel Redox Derr-pticn ou. Sz Cart. Color Text" Structure Gr. Sz Sh. Consistence Boundary Roots GPDff -Efptt I 'EfiN2 0 3 S 0 .7 ® acting N ❑ Bonng >/ [/ Pit Ground surface ebv 2 3- Z—R. Depth b inlitrq factor 0, sa Application Rate Hurt= Depth In Dommant Color Munsee Room Desonpaon Ou. Sz. Cont. Color Texture Structure Gr, Sz, Sh Ca stance Boundary Roots I GPD/T 'E1fN1 I 'Erta2 - 2 J — m ' ENMira 01 • 800, > 30 < 220 mg11L and TSS >30 < 150 ' Effluent N2 - BOO. < 30 mg/L and TSS < 30 mgrL CST Name (Please Print) S CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Teleplcne Number 1432 120th St, New Richmond, WI 54017 —a- o 715-246-4516 l� Property Owner _ ❑ BOrkV# Parcel ID # ❑ Boring .Pit Ground aurface elev/<' �ft. Depth to limiarq factor Y�n. Page —of WOM Mk 1EWINNY-Ai1A W, ® 1-1Bonng # ° Boring ❑ pit Ground surfacer elev. ft. Depth to lim*N factor In. Sotl �� Rate Hortron Depth in. Dordnard Color Munsell Redox Descnpdon Ou. Sz. Cont. Color Textur. Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM 'E1f#1 'Eff#2 ' EMl t #1 • BOD, > 30 < 220 mgrL and TSS >30 < 150 mgh ' Effluent 02 = BOD, 130 nVk and TSS < 30 MWL 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 department at 608-266-3151 or TTY 608-264-8777. Soil Test Plot Project Name Oevering Homes Address 1433 Cernohouse Ave Suite A New Richmond Wi 54017 >TM #226900 Lot 41 Subdivision Oak Ridge Acres Di% 2/20/20 S W 114 N W 1/4S 36 T 28 N/R19 W Township Troy Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation 102.8' "HRPSame as Benchmark E10 86 W. WoodRidge Drive .46 Acre Lot Scale = 1/4`= 10' 01' 0. 40' 80' 99' 1 1 1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _of_ FILE INFORMATION Owner Permit # / 1 -- DESIGN PARAMETERS Number of Bedrooms 3 O NA Number of Public Facility Units) NA Estimated flow (average) 3 U'gal/day i Design flow (peek), (Estimated x 1.5) yj'ZJgal/day Soil Application Rate al/da /ftz Standard Influent(Eff cent Quality Monthly average• Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODe) 5220 mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODs) 530 mg/L Total Suspended Solids OW) �/� 53o mg/L _�10 Fecal CoBform (geometric mean) 5104 cfu/100ml ,Maximum Effluent Particle Size )6 in dia. ❑ NA Other. 'Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity Z al ❑ NA Septic Tank Manufacturer ❑ NA Effluent Fitter Manufacturer ❑ NA Effluent Filter Model ❑ NA Pump Tank Capacity qaj, 0 NA Pump Tank Manufacturer ❑ NA Pump Manufacturer :1 NA Pump Model :3 NA Pretreatment Unit ❑ Sand/Gravel Fitter ❑ Mechanical Aeration ❑ Disinfection ❑ Peat Filter ❑ Wetland ❑ Other. ALNA Dispersal Cell(s) O In -Ground (gravity) X-at—Grade ❑ Drip -Line ❑ NA ❑ In -Ground (pressurized) ❑ Mound ❑ Other: Other. ❑ NA Other: ❑ NA Other. ❑ NA Service Event Service Frequency Inspect condition of tank(s) At leaat once every: ea s s) (Maximum 3 years) ❑ NA (Pump out contents of tank(&) When combined sludge and scum equals one-third (A) of tank volume ❑ NA 'Inspect dispersal cell(s) At least once every: 0 m a s(s) (Maximum 3 years) ❑ NA ceffluent lean euent filter At least once every: mont �l s(s) earlInspect O NA pump, pump controls & slarm At least once every: .,r month(s) as s 0 NA -lush lateralsCl-month(&) ls and pressure test At least once every: ears) ❑ NA IDther: At least once every: 0 month(s) yeat ❑ NA IRher: 0 NA MAINTENANCE INSTRUCTIONS iInspections 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 Melntalner; Septage Servicing Operator. 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 ezmbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal call(s) shall be visually Inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. 'fie ponding of effluent an the ground surface may indicate a falling condition and requires the Immediate notification of the local I-egulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (%) or more of the tank volume, the entire contents of I:he 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 POWiS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNEI S IIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address (Verification City/State LEGAL DESCRIPTION Property Locations C/'/_ t/ Subdivision 6 ✓ Parcel Identification Number G 9 0 —U4 hV V4, 3h 7``�� 9 e Sec% T Z O N R// w, Town of L p � Lot # Certified Survey Map # Volume Page # Warranty Deed # O Z o S Volume Page # — Spec house/5 no iut lines identifiab ye no SYSTEM MAINUNANCE AND OWNER CERTIFICATION ImrPr'oper 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 an,, 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 Phrrining & Zonuig Depat�tent a certification forth, signed by the owner and by a wear plumber, journeyman Plumber, restricted plumber or a licensed pamper 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. I/we. 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 Deparnuem ofNatmw Resources, Seale of Wisconsin, Certification stating that your septic system has been maintained must be completed and retuned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statemt:ats on this form are true to the best of my/ow knowledge. Iiwe am/are the owuer(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms R- •� - t / — ;`y 1 .. 3 lz/-d--o DATE **`Any information that is misrepresented may result in the sanitary permit being revoked by the Planning &'Zoning Deparhmemi ** * lnchide 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. 09/05) ,.. --- -- ----- - -- ---- m .I iv . 1 N i i�ai I � _ , r k i I i raw t 1 , 1 w 1„ II I I _Y , -- -- i --------- i I,IY Ii i I I I ------------- 1 I I I 8 D j�T, � • o..0 roe ,�. µ'i/715)2IB30f0 - - - - - - - - I 3 i t ----------� --------- y I�NoI�R -` El iw•�ve�.. r100'`wn'°'m.x"xormo.n I I , i _ I � . y e , I t-* I ----------- ------------ F _j BfV10ED WALL LINE tom{ PANEL DETN 1388 MAN LEVEL +ib M M MALN IEWiI _ µtl I I 1 1 �• j , , i VQ, x IIIIi{ 0 i , g ' R uommw � � � i i I I I I I I I I 1 .. $ g ,1966 the above named J.Francis 81 Richard Fox, May Beth 9 Elwood CO g 24 rsons who executed the foregoing instrument and acknowledged the same. P9 B9 3 O .. Unplotted land °1 4 25 1 .. N89053396,00' "00 40.96.00 100.00 100.00 - 100.00 9 a 200. 0' a o' eti ' a°e 100.00 100.00 , g.99 O \1 W O O .a• o 31 30 29 28 y 0 27 26 �� ,� \ V 0 N 0 0 BII : _ P 0 0 - - y a Z _ P I I 0 o > i V( m. die :y, •o• 90 96.Od 100.00 100.00 z i 100.00A0 ° 100.00 100.od •° A 6 0 05E Hillside 893fi. 6 59 00' Drive 0 10 �• elzO 6� _ _ � K89°534 _ 644.52' N la � \\g 0 / O A�\ 6 °6 z y6 0 a b op 99.00' 99.00, 99.00, 99.00" 99.00" 99.5; 0 BIO P10 . 0 0 ' 64 65 66 67 68 69 O ° MREPORT SOIL Wisconsin Department fCommgee `i EV!N � Page of Division of Safety and Buildings 1 t Jn b a cat. mm 85, Ws. Adm. Code pyre, n B 112 11 inches in Plan Ccuny c Attach complete site pl on�p,?Ftftr' s-1 5Fn x size. must include. but not limited to�i=oa nd horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. awed by Q ^ Date 312 Personal information you pravM may t,e usod for se=Mary purpwes (Prwacy Law, s. 15.04 (1) (m)). ✓}�(ci.�eJ/V„��"ti 20 Property Owner a�� Property Location Govt. Lot 1/ 114 S_3 T G N R E (o W (,{% W Property(OOwners MailingAc dre Loy" I Picric # 3 Subd. or CST ` L _ City " tale e Ph a Number AY Village Town Nearest Road ✓1 i a New Construction Us Residential ! Number of bedrooms Code dedved sign flow rate SI 1 V PO ❑ Replacement Public or commerdal - Describe: Parent material PI Plain eleva�p/onvf aaj�1lcable mte_ ft. General cornts�pr¢_ /l /--� �e� 4el and recommendations: !1 / ` /� �} �{ s ✓ System Type // All, System Elevation Boring # ❑ Boring Z ®, Pit Ground surface elev/i�!, ft. Depth to fretting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munse! Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDHF -Eff#1 •Eff#2 0- v r� t"J-- 3 --- s v 3 - D 5 U ® BM g # ❑ Boring / Pit Ground surface elevL'0T Zft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Cu, Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD1fF 'Eff#1 I •Eff#2 /1 7 / Effluent #1 = BOO. > 30 < 220 mglL and TSS >30 < 150 ' Effluent #2 = BOD, < 30 nxyL and TSS < 30 rngrL CST Name (Please Print) S' CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address - Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 —,3 ol 715-246-4516 Property Owner Parcel ID # Page of ❑ Boring # ElBoring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD#F •Eff#1 I 'Eff#2 Boring # ❑ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Bale Horizon '7epth in. Dominant Color Munsell Redox Description. Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDMF 'Eff#1 'Eff#2 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODr < 30 mg/L and TSS < 30 nVL 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 department at 608-266.3151 or TTY 608-264-8777. SeP93M nkE ) Soil Test Plot Project Name Oevering Homes Address 1433 Cernohouse Ave Suite A New Richmond Wi 54017 IC 1 3TM #226900 Lot 41 Subdivision Oak Ridge Acres Di% 2/20/20 S W 1/4 N W 1/4S 36 T 28 N/R19 W Township Troy Boring Q Well PL Property Line County ST. CROIX �M or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation 102.8' *HRPSame as Benchmark Prnnprly I inp. 01' .46 Acre Lot Scale = 1/4"= 10' 0' 40' 80' 86 W. WoodRidge Drive CST-aoJx— oia Wisconsin Depertrnent of Conen94eG �� `'- SOIL E REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not toss than B 112 x 11 inches in size. Plan must include, but rot limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print aN information. e Personal irdorrnatien you provide may a used for secondary purposes (Privacy law, s. 15.ee (1) (m)). � Govt. Lot Village Page of _ c S 5hT 1,?SN R/ % E New Construction Us'#�Residential / Number of bedrooms �_ Code derived(64sign Ilow rate Y I—C) tPD ❑ Replacement /��1/J$'j; Public or commercial - Describe: Parent material Y / FI9t6 Plain elevaG f a cable ft General commends C �..,¢_ AM` and recormrendations: r n 7L System Type /�/CLl System Elevation F BONN # Er�ll1t Bori"g Qf. Pit Horizon 1 Depth Dominant I in. Munsell m Bering # ° Boring Pit Horzon I Depth I Dominant I in. Munsell nq Ground surface elev/O';� Z— it, Redox Description Qu. Sz. Cont. Color -Z GroundsufaceelevG4)3 Z—ft. :olor Redox Description Cu. Sz. Cont. Cdor Depth to limiting factor in. Texture I StructureConsistenceBoundaryRoots Gr. Sz. Sh. Depth to limiting factor Texture Structure Coma Gr. Sz. Sh. 'EH#1 I 'Eft#2 e ►% w =111 - I®®M�M MMMIRAWNIM MMMWIMM SM, FAI MM Effluent #1 = BOO. > 30 < 220 ffxA and TSS >30 1150 ' Effluent #2 = BOD. < 30 mg& and TSS < 30 mg4 CST Name (Please Print) S' CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 j_-�:i n -19� U) 715-246-4516 Property Owner Parcel ID Of Page _ of Boring # El Boring 1;U'Pit Ground surface ele,/4c ft. Depth to limiting factor ®®� • • ®®®®M�I ❑ BoringBonn1:1g # Ground surface elev. ft. Depth to limiting factor in. ❑ pit Soil Application Rate Effluent p1 = BOD, > 30 < 220 mg/L and TSS >30 1150 mg& ' Effluent #2 = BOD, 130 mglL and TSS < 30 mg4 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 department at 608-266-3151 or TfY 608-264-8777. seuuw ta.smt Soil Test Plot Project Name Oevering Homes Address 1433 Cernohouse Ave Suite A New Richmond Wi 54017 Bird >TM #226900 Lot 41 Subdivision Oak Ridge Acres D We 2/20/20 S W 1/4 N W 1/4S 36 T 28 N/R19 W Township Troy Boring Q Well PL Property Line County ST. CROIX (�M or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation 102.8' *HRPSame as Benchmark B- Property Line 01' M .46 Acre Lot Scale = 1/4"= 10' 0' 40' E- 86 W. WoodRidge Drive