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HomeMy WebLinkAbout020-1491-13-000 (2)Cram h i I �Coy- 13 oav'iLiRi— 13—No - - 13,act- R. 31yy — Safety =w ambdmp mvidam Cmmty m) W. poa Aye.. P.O. Bma n� y.ir,. w.R N�bm ro be foil h la, Cb.) b//5�A Af,�eo.. rn s3�oT - ns1 atfi De artment of Commerce (6M 2663151 "L Sanitary Permit Application Pq�p �"` "m `° tb� / % In tmd wdm Caws a3.21. vra. Adm Code. permY �a.rla 3m mq be mod for awamduI Prpm'+ Pdv-7 law, s15.BN11(m) Proptl Addma ltfdiBmaM lra oii.dd•m) L APPSCOOM Wwamalfa - PMme Prim AB Ilamstim i i Popmr-Owe'. Ne s Puri / In / Block / S- — Ptapwry owads ttiWR Ad/rn ! Papeny tamtlom Cky. Sete Zip Code Pba qpG cdrecp�) am_ N; R/ E —L a�i' r2 DI. Type dBmTSBB (eieek A Om ap*) CSY Subdiritem Nm2 N�bw ❑ 1 r 2 P WLY OwelBq -Nadtw of flbb w YAwxam umw-Dm to Use EJ6p_❑vmw l❑'fowmdo of ❑ See Owed - VMMW Un L S � '�� HL Type of Iles d4 (Cbrk a* wm bw m HBe A. Campkie Hoe B it wppicid" A. Q'New Symr ❑ Replae®e SMm ❑ TtmmedrHotlmg Tat Raphoca ml Orly ❑ odw Yoiiuddm a Btm6tR SyMm B. ❑Pry Rew.wl ❑ Rail Reruim ❑ amp of❑ Pwm t hm mitr m New Iie Rwioa PmmY Narber and Dee lamd Home Bginim Pkmbw Owew S IV. Tnm of Fowls ((.lad. an a" ) �Na-Ptam�d h.Otmd ❑ Yard > 2f i.(adobe ttoi Mead < 24 a deitmble.ai AlAi de ❑ Simile rmr Smd Pmw ❑ Cammm.ed Wdlmd ❑ hasmamied YQomd ❑ Hrl I- Tmk ❑ Ft d IYtw ❑ Amobc IYmu>m Udt ❑ ❑ R=kcft B SPrlwde Mmdk PRv DL=cbhgChmbw OlDrIpLim ❑ (AmIcH AW ❑ Ob V. Am Idwmd m - DemipP—(iRPd)d) Dmwksai Applmdm RmWdoO I Ddpead Am D:wm+Anm P.9q�z i R. C-s 3't�Mi VI. Tank Info C¢i1. TOW NtNumber.) P✓seUb Whom Gbs of Ua6 C Caamomd Glr G TabOD T�— abet wdl.IR.a3L Dalftcwbe YII. stmra.ml- 4 d.ewdmiOd. amwmme n fr budamadma or the T0vm ahewe m the etta.bod plum 'a"lo8erTy0M&bing .s.,Pwe— idrVIAMHwhw Brides meNiaba #221180 Z-tzLvp FWmbWWMbW%WjdCWN0me, Zip Cade) Spooner, WI 54801 CesC. 45'1-Y4i-,2Ao*1 Vm. Ilae km A�� ❑ Da&PPF� Pl sldlw) Pwai Fee C�tdm Ommd.mw nme lamed Stp+mt st .mps) ❑ ovrr Gram Ream rr DcmW IX. Comatiaam of App Vraimasmm for DNappwral QtJ-hB�: �Yt4µ` / ty�'t"�� wMdl{ r/.).�10t-dAAA+t.Cnl//j�NDtw'IAR�dB' � _-- ii 7 i I' v11»anye�rrderx a cem.rr�e Sefelt'Md &lldrw Dirisui GENERAL INFORMATION Pmewial idmnelion w omvide.reYd,,.d I i I 1 I I /00.l10 � TANK INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) Iliiverr Lew, n 16.d (1)(m)f. o.oy' Len PvC P:ps ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic WI;S .L✓ ZSGG Dusvg Awallm TANK SETBACK INFORMATION ®®®®® r r vimmmm©m "mmm�m' PUMP/SIPHON INFORMATION Manufaduw Model Number z Puy - nF C 'It 9.46 Ffirbon i. Z System Head fDli R Forcerrra n Length 3' Dian„ Dw. b wen SOIL ABSORPTION SYSTEM A L It STATION BS HI FS ELEV. Benchmark tt1no Poe 99. /o<+- AIL BM Bldg. Sewer M1t Inet1 I 3 -y 95 -L S" Owet cw k- 1 1 A 3. ti Qs-Dt S Inlet 6 . otWturn " I�°diMti tloi-Fes`_•• 57 93.3 {`P ` sir- //-- Ee4+ I ( 79 92 2 Final Grade de_- n fc.4 G.I.00 OSC �. ate, :..i✓. ?. .( ///. / y- l S 1art i /oy. 01—t 1. 4 fog - I-olp Vr:< _Of Trarlra�s PITONENSIONS .Of Pft lrn Dla OePar OIMENSgNS 31 1-3 2cu r / —f SETBACK SYSTEM TO - r� Pf BLDG L LAKEISTREAM LEACHING nRanrremxa INFORMATION CHAMBER OR SnC: lir��Qf -SEA Of SyeMie V, 7f00 �l(p0 1Z00 BNR MlydBf 0, NV. DISTRIBUTION SYSTEM lla4n' �a (<mrpn Oia xSOIL COVER SrsMa N g x Of At -Grade Svabma ONr wrvnm.p.t;ems eea in capes 1. epea� arm .mow I err ww COMMENTS: (Indroe code discrepancies, perxpns p(esent, etc.) Inspection #1:0 9 If& / 4" Inspection Locedon: 966 Alexander Road Hudnon, VA �p54016 (HE 114 HE 11413 T29H R19W) NA Lot Parch No: 13. A9. 1.) All BM Desaiplim = %r It.S- T. # ? Cw r.,n.l� `S V. 2.) Bldg sewer length = E' � Y. 7- • amount of corer = 3) G•re•sn'n+. :n A4 tpac�e�P w/�" Sf.�.o�oR/� Off! 2- 3.4 qS Plan revLvPon ftegied? a' Yes No ! 4 e r I 1 Use other stile for aedltional lnlorrrra ' I3 a i ' _-._ --_. I i!` •pr'J� Site Plan For. St Croix Va q Girl Scouts NEIXNEl/4 Sec. 13 T29N-Rl9W Hudson Tnsp. - St. Croix sww.�pd o ab w 1i�1 1 LaY � p K 97. PrWm i AoJ117 � c BM[*-' Top of 2" PVC Pipe Flagged �E HRP - same ASSUMED ELEV. - 100 �.. AioU: Mmkii11h9M1wwibwsuMrbpwca 83.45my IhYrI0lavhusl/.UlPK> IM Pgrs9 ¢19 - ere rap Ql4'Fvcp4,m r. . BM 99.30, BM F 1 propordl" FdL Nlsssr Cwrrw 7300 yar. AmW CAowbw \\ I en. 3034 &s Poo a,; > JWI Prcpa l ram7.67GkkQW w. dsas 303i4- md cb=md aoaA,w.. � 3Aorw l990 fki GYw1GNuyV ii. PropessdDwwWy M/17wAw w✓7aMrd-l09FVe� NWAULDWF Visconsin Department of Commerce JM 25, 2003 CUST ID NoIM59 KErM E STONER 23220 WOOD CREEK RD SIREN WI 54872 ATM• POW73Inspector ZONING OFFICE ST CRODC COUNTY SPIA 1101 CARM CHAEL RD HUDSON WI 54016 Safety snot Bu8dngs 10541 N RANCH ROAD HAYWARDM 54843 TDD it. (608) 264-8777 www.agrnen ,Mlemmushb www.wwowsine.gov Jim Doyle, Governor Cary 1. Mottles, Saaatry CONDITIONAL APPROVAL _ Ideotifnationi Numbers - - PLAN APPROVAL FXMM: 0QM005 Tramaetlan ID No. 877208 SITE: Site ID No.173033 St. Croix Valley Girt Seoul Camp Please refer m both ideoli8 q duels,-' Alexander Rd & IOM Ave above, in all ctenspoodenea Willi ibeagency-. Town of Hudson, 54016 St Croix County NEI14, NE114, S13, T29N, R19W Subdivision: Cem Vol 565, Pg 45 #344842 Facility: St Croix Valley Girt Scout Camp - Dorm & Cooling Faalitiesi, Hudson 54016 FOR: Description: Noupressurized In -Ground 2400 MW. Object Type: POWT System Regulated Object ID No.: 907933 The submittal described above has been reviewed for confomance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter I01.0l(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be exautructcd and located in accordance with the enclosed approved plans and with the "Component Manual, SBD-10705-P ( N. 01N1)". • Comm 84.10, AB materials used in this installation shall conform to die provisions of this chapter. A copy of the approved plans, spec f cations and this letter shall be oo4te during construction and open to V. inspection by authorized representatives of the Department, which may include local inspectors. All permits C(11 required by the state or the local municipality shall be obtained prior to corrnneucement of constnrctioultr stallationloperstion. 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 t review shall relieve the designer -of the responsibility for deigning a safe building, structure, or component yy Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address yc on this letterhead. KF3TH E STONER Pap 2 6075,01 The above left addresses 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. S Fee Required S 275.00 R Fee Received $ 200 / Balance Due S 0.00.00 Thomas E Devereaux Plumbing / POWTS Reviewer B , Integrated Services WONUXORM - (715)634-3026 , 7:15 am - 4:00 pm Mon. - Fri sdevermix@commerce.state.wi.na ec: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Donald J Adair Scout Gal Scout Council of St Croix Valley Fogerty Plumbing & Perk Testing, loc. Index and Title Sheet Project Name: St Croix Valley Girls Scout Camp Properly Owner: Same Address: 400 South Roberts St St Paul MN 55107 Legal Description: Doc.# 344842 Vol. 565 Pg. 45 NEl/4-NEl/4 Sec. 13 T29N-R19W Township: Hudson County: St Croix Subdivision Name: NA Lot: NA Comp.#/Parcel ID: 020-1016-60 CONTENTS Page: 1 Index and Title Sheet Page: 2 Sizing Calculations Page: 3 Plot Plan I Page:4 Plan View lID1ta y Page: 5 Cross Section of Cell # 1 and #2® 1L °F C ° LONGS Page: 6 Cross Section of Cell #3 and #4 zv Page: 7 Pump Chamber Cross Section _Oh06N C�5 COFF� g772 Page: 8 Pump Curve Data I Page: 9 Cross Sections of Septic, Grease interceptor and Pump Chamber (a b,c,) Page: 10 Management and Contingency Plans In -Ground Soil Absorption Component Manual Used = SBD-10705-P (N.OI101) Designer: Keith E. ner License # 1575-007 Signature Phone # (715) 653-2324 Date: 5/31/03 * • • •`* s STONER = ° Fogerty Plumbing u221180 28288 McKenzie Rd. OG Spooner, WI 54801 ` (715) 635.9609 J 2of10 Sizing Caleubtion for the St. Croce Valley Girl Scout Camp Dormitory with Cooking Facilities Camp Day/Night 60 People 25 gal. = 1500 g8l- 4 Floor drains x 25 gal- = 100 gal. Total estimated daily flow = 1600 gal. 1600 gal. x 1.5 = 2400 gal. Design Wastewater Flow Note: Effluent quality to fall within domestic effluent guidelines. Propose a 1000 gal. Wieser Concrete Grease Interceptor Model W I000-P or W-1250-MR Grease Interceptor Siring Per Comm 82.34(Sx2)b C= M xGxH 2xP C=180 x3 x 9 C= 4860 = 810 Gallons 2x3 Site Plan For: St. Croix Valley Girl Scouts Pqm 3 of 10 NEl/4-NE1/4 Sec.13 T29N-R19W Hudson Tnsp. - St. Croix Sopw rva o eo «� BM o, of!'PYCPmm3W. p3 ABM mil AL BM[t Top of 2" PVC Pipe Flagged * HRP -same ASSUMED ELEV. - 100 Nob.• Mabamb MmU and Maft4bw mfba bjw Cm 83.43(8)Q Now !O Ao Parod/AA P2>100' Pr*wmd 3' P.M Wkl Cary, 3306 ad. PUR Ckmnbw !'Amm 30 43~Pgb appm: 300' Amain 30.i4 I' P/Pm \ Pmpawd Rkm Cammmb loos Pot GI a aummrpu. r/7aW A-3WIP rank and Pxpwad Ckmmma J Lmabmwm and A~ Waft Prcpaamd Da.d►vr DMA" 240099 DWF Plan View For: St. Croix Valley Girl Scouts Page 4 of 10 NE 1/4-NE 1/4 SEC. 13 T29N-R19W Hudson Tnsp. - St. Croix Co. '� Proposed 4 Distribution Cells composed of Standard 12"Infiltrator leaching chambers. Cell # 1 -29 Chambers Cell # 2- 29 Chambers Cell # 3 - 29 Chambers Cell # 4 - 25 chambers Serial Distribution Leaching chambers EISA rating 31.1 Sq. ft. (112 total) 4"Astm 3034 Pipe—� 2"Sch. 40 Force Main Vent Pipe Material to be Schedule 40 and Terminate 12"above Grade. Proposed Rgeser Observation Pipe Material to be Astm Concrete Pump 3034 and Terminate at grade. Chamber 2500 Vent/Observation Pipes to be located 115 tol/10 gallons the length of the distribution cell measeured from the end of the cell. Pg. S of 10 Cross Section of a Two Cell Inground Component Using Leaching Chambers Obeaev�iodveat Pipes Cell # 1 Located overt Coat= % 25' / � Cell # 2 Located over Contour 93.89 Finished Or&& 96 2S' J — _--. _ Finished Grade - 93_80' iT slope % . 11-16% Original Grado z 96 2S y' �"0.."' � ; % Orisinal Grade = 93,80' 50 Top of Chamber m 94.08' TV Of Chamber = 91.80 Y System Elev. •93.08' rs, • ' . • L system Elev. - 90.80' �___:. __...y_�S �S. 7 Y ^ �' a _iL_L•' s ] _ Limiting Factor Observation/Vent pipes to be conducted and capped with approved materials for the particular use. Pg. 6 of 10 Cross Section of a Two Cell Inground Component Using Leaching Chambers Observation/Vent Pipes Call # 3 Located over Contour 91.40' Cell # 4 Located over Contour 89.001 Finished (bade — 91.401 Finished Grade = 89-00' Slope % 11-16% a I Lt. %AUA S % Original Grade gl.--4;0' Original Grade = 89.00' Top of Chamber 87.401 Top of Chamber = 85-W System Elev. 86.40' System Elev. = 84.00 Limiting Factor Observation/Ventpipas to be cmstuated arid capped with approved materials for the particular use. v-v *@X8kVEN7 lMi 3PM&O4albau6manaawWUjoq=v (S)gY£S vag0o gad*IRL wH H[0'i0i PPDNUMW L9LOSZ IS dnoZ owam •rs DIY _ OY PHd'J Y11 -�H�!Q Z46[G 9 a "d$ FMdmd £8'6 D IPPOI) AM dmod L£86 �0 z H Ma v Q6Y A3.L�d WRM4 gwuwo . 1 °O�Lq•LOSLZwmdrJ iwZ dmd W__.__...__..._._�....___...._.._.._.. UMMOA Owa 1WO,L 18D 9S£ - ""'_. 3� �A ro ost-mmapuAmawiso "a=+d S =".mwaw zqmnm OZ'OI=..............__PoH*mmm4amoi -_--I"LP4�d =*=& Of£z�aand3o JA pZ _w VN - amfud 44&8 PaunboH VV6= AJ PM.&O &Wd KPH =02=Va PEA ,to 'AQM 4Mi asoa a 'no0osz 'M31m1 3 apxxmo is to 'AM_UO dMOd H= JMWA es vpa amodnowPon V a96►�pP@R*m&Ud mom �!ma its wv PM Wf8.t PAY/M mqoDviwmowgwv aPoDINMA OAI9Y .ZI W-A< OVMM \ �A04'goS.4 7�D V OOE �'dN� �W�H mH �f 3�+dA�M �DPMAaAm K.l,/m"aft.qwlpw gQWTvtq(wMCO QFKFM PTV uonws 33O10 luouOdLUO7. 3FOiLo3OQ 0130 L'sd Visconsin Department of Commerce June 25, 2003 CUST ID No.224059 KEITH E STONER 23220 WOOD CREEK RD SIREN WI 54872 AT M• Phumbing Inspector MUNICIPAL CLERK TOWN OF HUDSON 429 STAGELINE RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06f25/2885 Transaction ID Ni SITE: a St. Croix Valley Girl Scout Camp Alexander Rd & 100TH Ave -- Town of Hudson, 54016Ot-`e''� - St Croix Canty NEl/4, NEl/4, S13, T29N, R19W , Subdivision: Cam Vol 565, Pg 45 #344942 Facility: St Croix Valley Gal Scout Camp - Doan & Cooking Faeili6esi, Hudson 54016 FOR: Descripti xterior Grease Interceptor 100 06jec ype: Sanitary Drain & Vent System Re Iated Object 1D No.: 907941 1 trreep Safety and auadar0a 10541 N RANCH ROAD HAYWARD M 54843 TDD #: (608) 26"M WWW ,new.wiamrssia.gov Jim Doyle, Gweroor Cory L NwIll", Secretary The submithi described above has been reviewed for conformance with applicable Wisconsin Admvushative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(lo), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: e Comm 84.10 Materials used in the installation shall be in accord with this chapter. 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 Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stets 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component Inquiries concerning rrespondence may be made to ice at the telephone number listed below, or at the address oW SFee Required S 70.00 Fee Received $ 70.00 Thomas E Devereaux Balance Due $ 0.00 Plumbing / POWTS Reviewer H , integrated Services (71*34-3026,7:15am-4:00pm Mon. -Fri. idevereaux@cnmmeme.shrte.wius - - - cc: Donald J Adsit Scout Girl Scout Council of St Croix Valley Donald D Hough, Plumbing Consultant H, (715) 6344804 Fogerty Plumbing & Perk Testing, Inc. Cl Index and Title Sheet Project Name: St Croix Valley Girls Scout Camp Property Owner: Same Address: 40o South Roberts St St Paul MN 55107 Legal Description: Doc.# 344842 Vol. 565 Pg. 45 NEl/4-NEl/4 Sec. 13 T29N-R19W Tovmship: Hudson County: St Croix Subdivision Name: NA Lot: NA Comp.#/Parcel ID: 020-1016-60 CONTENTS Page: i Index and Title Sheet Page: 2 Sizing Calculations Page: 3 Plot Plan Page: 4 Cross Section of Grease Interceptor and Manhole Cover and Lock Detail In-Grormd Soil Absorption Component Manual Used = SSD-10705-P (N.01/01) Designer. Keith E. Stoo Signature: STONER 8 O. 1575 - IYIa License # 1575-007 Phone # (715) 653-2324 Date: 5/31 /03 did0"all D RcE iF A�aO EILMO "• .Of ESPOND E CO 7Z2(' Fogerty Plumbing #221180 28288 McKenzie Rd. Spooner, WI 54801 (715) 635-9609 A 2 of 4 Sizing Calculation for the St. Croix Valley Girl Scout Camp Dormitory with Cooking Facilities Camp Day/Night: 60 People 25 gal. = 1500 gal. 4 Floor drains x 25 gal. = 100 gal. Total estimated daily flow = 1600 gat. 1600 gal. x 1.5 = 2400 gal. Design Wastewater Flow Note: Effluent quality to fall within domestic effluent guidelines. Propose a 1000 gal. Wieser Concrete Grease Interceptor Model W 1000-P or W-1250-MR Grease Interceptor Sizing: Per Comm 82.34(5)(2)b C=MxGxH 2xP C-- 190 0 x 9 C= 48W = 810 Gallons 2x3 Site Pian For: St. Croix Valley Girl Scouts NE 1/4-NE 1/4 SEC. 13 T29N-R19W Hudson Tnsp. - St. Croix Co. Page 3 of 4 To 2500 gat \ Wieser Concrete Lift approx. 3600 Astor 3034 4" \ Note: Grease Interceptor to include Pipe locking cover with warning labels. Manhole cover to be above grade for servicing. Finished grade around tank to be crowned to divert surface water. t Proposed Wieser eser Concrete 1000 Gal. Grease Interceptor w/Zabel A-300 Filter Proposed 5044.32 gal. Wieser Concrete Septic Tank w/Zabel A-100 Filter Bathroom and Shower wastewater Kitchen Waste Proposed Dormitory W/Kitchen 2400 gal. DWF Note: Building Sewer Pipe to be of approved exterior materials.