HomeMy WebLinkAbout020-1491-11-000oao-I'�3;aR.19." e
Safety and endings DNlslon
A"an SANITARY PER SIC zol Box Avenue
In accord with lL vas. �j
P 1 Bat 7302
Department of Can•erce � � pC � \� Madison. WI 53707-7302
ILL �
• Attach complete plans (to the county copy only) fort tem, on papery�y� ass
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umy
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than 8 in x 11 inches in size. SF_P 2 _'
C
ate SarutaryPermit eZmbar G7
• See reverse side for instructions for completing this a tcptitin $t�X ///
Ous
Personal information yprovide may be used for seWndary, purposes �� �. POWW"
a rerem b prwvu
State Plan A.D. Number
lPrrvacy Law, s. 1544(1)(m))
1APPLICATION INFORMATIONPRINTALLI
ZY 217
Property Owner Name
LO C OP �/
Property Location
a tw,S TN.R E(or
Property Owners Mailing Address
Lot Number
Block Number
—�
r�
City, State Zip Code
I Phone Number
Subdivision Name or CSM Number 1
G 94
)
�.
DING:11 TYPE OF 81111 (check one) ❑ State Owned
rt) 124 y
Village
Nearert Road
Public t or 2 FamilyDwelling-No. of bedrooms
own of O
III- BUILDING USE: (if building type is public. check all that apply) arcel Tax Number(s) 19)Y'r lei
1 ❑ Apartment/Condo 3e 6 — l0 — d'1
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. Uf New 2- Replacement[]Replacementof 4. Reconnection of 5- Repair of an
❑5)rstem 3.Tak
-__SLrstem Only______ -_____❑Existing System___-_❑ExrstingSLtstem
B) ❑ A Sanitary Permit was previously issued. Permit Number — Date Issued --
V. TYPE OF SYSTEM: (Check only one) pf7=OL
Non -Pressurized Distribution Pr2leed Distribution Experimental Other
11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 ❑ In -Ground Pressure 42 ❑ Pit Privy
d
13 ❑ Seepage Pit 1— 43 ❑ Vault Privy
14 ❑ System -In -Fill L 41-
VI. ABSORPTION W&TEMI INFORMATION:
t. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6 yrstem EI 7. Final Grade
uired(sq.ft.) Pfsposed (sq. ft.) ( alslday/sq. ft.) (Minlinch) •11T/ q).d✓ Elev i r�
7Teet
Sir.477 /0 Feet (felt
VII NFORMATION
capacity
In 9
Total Gallons
Tanks of
Manufacturer's Name cores ate�st�TedS'eel
Plastic
x App.
New
ExisUn
yl
.2 X/Ajuc
Tanks
T n
Septic Tank car Holding Tank Z
E
❑
❑ ❑
❑
❑
Lin PumpTank r
❑
❑ ❑
IQ]❑
ar VIII. RESPONSIBILITY STATEMENT W/ —Z10%%;C
1, the undersigned, assume responsibility for installation oft onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber's SignM NO SUm
MMMPRSWNo.:
Business Phone Number:
0
— 6s6
umbersAddmst(Strern. City. State. ZjCode):
IX. COUNTY/ UPARTM ENT USE ONLY
❑Disapproved I Sandacy PermdFee
Date Issued
Rsui Agem Sgnature(No Stamps)
Approved
pp
S.%, rut
[]Owner Given Initial �
s
II
RAN
Adverse Determination Z
OF APPROVAL/ REASONS FOR DISAPPROVAL:
'N(iS tb'sskt� Lod S rtGr[f � •u+< 1 � L✓a S � CC I Ca4Se � eui 'o�
SBfl d]!B'(IC7't157J•��- oisu•unaa:a,y:Wte cw�n. a. wr;e: s.N.rawxdmy,ls an.owr.. rxv.a.r
m
Satatl' and &*Vnw
PO BOX 7152
MADISON WI �Ilk
53707-7162
Visconsin 'IMI T17
www.cortrronce.afaLe.rri-ens
Department of Commerce Tarnow G.Thotnp.on,00vemor
Brands J. Blanchard, SavaWy
September 16, 1999
CUST ID No.259518 A77N: POW7S INSPECTOR
ZONING OFFICE
ULBRICHT & ASSOCIATES ST CROIX COUNTY SPIA
655 O'NEIL RD 1101 CART UCHAEL RD
HUDSON WI 54016 HUDSON WI 54016
RE: CONDITTONALAPPROVAL—
APPROVAL EXPIRES: 09/162001 Tmeusectloa ID No, 245429
Site ID No. 167594
SITE: A SP" MIL aim
allow
ST CROIX County, Town of HUDSON - - - -aspocidenceWithPoa
NEIA, NEIA, S13, T29N, R19W
Facility: GIRL SCOT CAMP / AMERICA 965 ALEXANDER RD, HUDSON 54016
FOR:
Description: NON -PRESSURIZED IN -GROUND SYSTEM / REVISION TO TIN 212826
Object Type: POWT System Regulated Object ID No.: 452294
The submittal described above has been rt:viewed for conformance with applicable Wisrnnsi i AdmmnVxtive Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as ejefitted n
Wisconsin Statttes, is responsible for cog )ali x u ' aR4aly.r
a.�1
A copy of the approved plans, specifications and this letter shall be o sitc 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 heal municipality shall be obtained prior to commencement of
construction/' st lla_rkmroperation.
Inquiries conceming Otis correspondence may be made to me at the telephone mmnber listed below, or at the address
on this letterhead
Sincere ,
PAG REVIEWER H
Integrated Services
(608)266-2889 , M , 0745 - 1630 HRS
PEPAGELQCOMMERCE.STATE. WLUS
cc: SCOUT GIRL SCOUT COUNCIL OF ST CROIX VALLEY
FEE REQUIRED $ 60.00
FEE RECEIVED S 60.00
BALANCE DUE S 0.00
ORIGINAL
e.
ULMICHT & ASSOCIATES CO. RECEIVED
655 O'Neil road • Hudson, WI 54016 SEP neslu.esdF.pawer►gsyA`
715 386 8165 2 ��"S"�`C° qwm*.
A REVISION TO PROJECT INDEX
DILHR PLAN ID ! 212826 (2-24-1999) DATE Aug. 31, 1999.
OWNER Girl Scout Council/St. Croix Valley PHONE 7
ADDRESS 965 Alexander Rd. Hudson,Wis. 54016
LEGAL DESCRIPTION
PIN 020-1016-60. NE1/4,NE1/4, Sec.13, T29N,R19.
cSM 344842, Vo1.565,Pg.45.
TOWN OF Hudson
CSTM David Fogerty #2211
COUNTY St. Croix
LOCAL AUTHORITY/ SUPERVISION St. Croix County Zoning nr+pi•_
PROJECT DESCRIPTION: New construction. For proposed 2 small
seperate office buildings (summer
seasonal occupancy only). Day camper offices, with up to 6
employees each building, and 3 floor drains. Daily estimated
wasteflow per building: 270 gals. Total for both buildings,
connected to a single common treatment system is 540 gals/day.
Soils are very permiable (.7/.8 GPD/ft2) suitable for a
conventional inground system. Proposed: 2 trenches on a
12% slope, using INFILTRATOR high capacity trenches ("Side-
winder" models), each 6-2' section with an approved capacity
of 31.8 sq.ft. The minimum required sq.ft. for trenches is
675. Proposed: oversize the trenches, using 16 sections per
trench, i.e. each trench shall be 31x100' or 508 sq.ft.
Total proposed trench capacity shall be 1016 sq.ft.
Each small office shall be provided with 2 1000 gal.
precast septic tanks in series (Wieser Concrete Co.). The
second or final septic tank for each building will be provided
with a Zabel filter, and with an approved above ground locking
manhole cover for servicing convenience.
Effluent lines -tying into a common lift pump tank shall
each have a frost proof cleanout (c/0) ahead of the junction
to the pump chamber inlet.
Pg.l PLOT PLAN VIEWS
Pg.2 SYSTEM CROSS SECTIONS 6 SYSTEM PLAN VIE. / co se"
Pg.3 PUMP CHAMBER SPECS S CROSS SECTION. !
Pg.4 PUMP CURVE S SPECS. 3 k INARIQR I
y „ ,RJV
Ibis design rot installation Is based entirely on measurements, elevations.
la11d"cAPP. "31M.lI11011s (a1.opP_P etc.) and soil sultability provided by CSTM 221180.
The amvary nI 1A....,. -----L-.. _.._.. __ . ..
ULBRICHT & ASSOCIATES CO.
655 O'Neil Road • Hudson, WI 54016 "WC'D Flog oeaVy dEN—Iq$yaf
715-386-6185 B Z 2 Pmale sewmie c�aan&
PROJECT INDEXS AI!
DILHR PLAN ID # DATE
OWNER Girl Scout Council/St. Croix Valley PHONE 71s-�86-si�a -
ADDRESS 965 Alexander Rd. Hudson,Wis. 54016
LEGAL DESCRIPTION
PIN 020-1016-60. NE1/4,NE1/4, Sec.13, T29N,R19W
CSM 344842, Vo1.565,Pg.45.
TOWN OF Hudson
CSTM David Fogerty *221180
COUNTY St. Croix
LOCAL AUTHORITY/ SUPERVISION St Croix County Zoning Deny_
PROJECT DESCRIPTION:
New construction. For proposed 2 small
separate office buildings (summer seasonal occupancy only). Day
camper offices, with up to 6 e mployees each building, and 2 floor
drains. Daily wasteflow per building: 220 gals. Total for both
buildings;connected to a single treatment system is 440 gals/day.
Soils are very permiable (.7/.8 GPD/ft2), suitable for a
conventional inground system. Proposed: 2 trenches on a 12%
slope, using INFILTATOR high capacity trenches (•Sidewinder"
model), each section measuring 612n long, with approved capacity
of 31.8 sq.ft. A total of 20 sections shall be used, for a
total of 636 sq.£t. of trenches. The minimum required sq.ft.
is 550.
Each small office shall be provided with a separate 1000
gal. precast septic tank (Wieser Concrete Co.), each septic
tank provided with a Zabel filter, and an approved above
ground locking manhole cover for servicing convenience.
Effluent lines tying into a common lift pump dosing
chamber shall each have a frost proof clean out (c/o) ahead
of the junction to the pump chamber inlet.
Pg.1 PLOT PLAN VIEWS
Pg.2 SYSTEM CROSS SE
Pg.3 PUMP CHAMBER S1
P9.4 PUMP CURVE 6 A
PLAN VIEW S
rMW
f \1
K111111M
040 OEM V yiQ�_- �1 1
This design for installation is based entirely on measurements, elevations,
ianA..,e .v..Airi,,..c 1.i,...ee ea.. i �-A e,.i. � r 221180
_h -:o/ .Od
Oh
0
17 �swi
01
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cox,f ,��ytoL,S
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TA000ndn0spasm4"(°rc � SOIL AND SITE EVALUATION
Di"SondsmisCyand a+idige pawot .i
a.eou of tree~ Serneoss in 9 A W
. ILNR 83.09, ws. Adm. Code
6 ,
AMcnnete seaper s plan m pnot lase eaen 8 W in/ Y
trraeds, but ed &Old a .wean utl hl U.M pwnbqyA aarrd
perosn slaps, scsN or dkrrnelpr, roM snow. nrgari-O�tl. Proel l.o.
r
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APPLICANT INFORMATION - Pli .a Vo Ditirl.Log9 I �i 1 G �— Dib
Prsarl seormeem Yoe pwrede mrya ued for 16Dr (r( r..— �—
pvlPeM Owner '�>�ZOMNGOFROE Laoaem _
_ 1N E 1F1.5 T N.R E(�
Perry Dwrten+gAddressF ( . ewca sna or csMe� Z�3 vSz
o T — z
Cay Slide zip Code (irate Nurnber ❑ coy ❑ Wage 0 Town 'Pon Rood
L II1r ( 1 I - F_lZ k 6
0 Naw Canhrcem UM: ❑ Rstldw" / Nuriber a bsaomr AdAeon te strop Wilding
❑ ReplaoenwK 14 PnEea or omrmwalr - Desats:
Code derMd dolly low gpd RemrmnstlW deep ktedrp rats --Zysd. 9�ppW—Y—at -arh. WdV
v AbPecn S M required bK it VeMt, a Y ma).knrn design - , - - rats moped, gpolle�_wer cN gpd,10
Reconownfed eieagm sedsce revaem( / O►R-Qri Siz OK -___R (as mhned so YY plan badannk)
Ae AdorW deelpdape amaWarMarsigt Ne 0q'Lrw.c-VA7E yj 7Nrr cx7F s56 wgE7 Ater A!)"Lwx�0&-
1. Food pleln sesvweon. if sppecabte e
S - suilWe for system �C,7`nsotel yLioub A System h H Hd Ing Teak
U lAWAW* ter syaee n 0 s LJ U /O S❑ U YJ s❑ U S� ❑ S L 1� ❑ S JZ U
Bork19 f
CI
Ground
awv.
la -Ad
Dapdn b
W nith9
isdlor
>1/i%L
SOIL DESCRIPTION REPORT
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Remarks:
Boring A
13
Ground
OW.
/Wall
Depri te
1103010
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loolor
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A/H Ste. , ''v iNSpECT/D,rJ p/
-' 4d Pvc
^Z. F/N/SA`ED
'-t—odc
5 y6 rEM
C,Po SS SECTiox) of T/PEs
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Af
WS/�u 6- /N�iG7/P/4 To e,5
Yio e4idW/'ry 'f 14 oPs---j. .. 3,)( & 'a " Govlr
wOIL 3/• 9' 5Q, FI' TV 7-,} C dej, see rio.v
%vrz�XnTo�E' N
at rti. rar�.a[a�
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DNS/EcPOW fO Ae
'z F/iN/SEED
ME
n
PUMP CHAMBER CROSS SECTIOU AMD SPECIFICATIOUS
VEUT CAP
4'C.I. VENT PIPE WEATHER. PROOF APPROVED LOCKIAIG
JUNCTION BOX MANHOLE COVER
25' FROM DOOR, W14VA01,06-IIA'l ,
WINDOW OR FRESH I
AIR INTAKE 1
41RADI ElE4AT-lON 9� GRADE
I 4' MIU.
h `--
CONDUIT _ __ _
ElEven oN
93•Q PROVIDE I -----
INLET AIRTIGHT SEAL I III
I I v
APPROVED JOINT/ A 51/AEK I III APPROVED JOINTS
IJl C.I. PIPE INl .N({p1A 1 I III W/C.I. PIPE
CXTEUOIWG 3• ,O,O` I II ONTO, SOLID ALARM EXTENpIN(' 3•
V 10 SOIL
• ONTO SOLID SOIL � 31 � i � I
�
0/ A 3
G� I I ON
GJ 7i I
ELCV.�D, FT. i I PUMPS __1 OFF usE 3"�
ID .qa
00
K $Eev/p 6- SihvD
6LocK
�-a�—
RISCR EXIT PERMIIFED OULy IF TAUK MALIUFACTURCR HAS SUCH APPROVAL
SEPYIC E SPEGIFIC`A`TIOAIS
DOSE TANKS MAUUFACTURER:����� ��E~rs� IJUM6E OFODOSES: Z PER W1
TANK SIZE: ��/ `"" GALLOUS DOSE VOLUME 15 235
ALARM ANUFACTR: �-Avt�ddL /!4,wAl INCLUDING 6ACKFLOW:
MUERGALLONS
MODEL UUM6E R_: ' n' U L CAPACITIES: A= !� G IUCHE5 OR ql1o_L GALLONS
SWITCH TYPE: F�7"T Witc1� e=� T�' INCMESOR 542 GALLOWS
PUMP MAUUFACTU0.ER: A(A 1 , C=11ULHES OR� GALLONS
MODEL UUM6ER: ` �tf '�`S v D- INCHES OR �75 GALLOUE
SWITCH TYPE: _ NOTE: PUMP AND ALARM ARE TO eE
MIN^fin MINIMUM DISCHARGE RATE GPM INSTALLED OU SEPARATE CHtCUITS
VERTICAL DIFFEREUCE 6ETWEEU PUMP OFF AND 013TRIBUTIOU PIPE.. 7.3 FEET -rAOV SPECS '
�T y/
} MIUIMUM NETWORK SU PPL'! P0.E UKE✓,/... . . ... . . /)d- FEET cAc(,- I OS- .Y {'PIN.
} 7S FEET OF FORCE MAIM X /'IfilooFtFRICTIOU FACTOR.. /• � FEET £-/�VA'S 25 YAis
TOTAL D9UAMIC .HEAD = ��• FEET Y
A N
IUTERUAL DIMEUSIOUS of TAUK: LENGTH /V ;WIDTH S& ILIQUIO OEPTH 7�
Uwp vol 0Ar- foR 75 I o f P vt�