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HomeMy WebLinkAbout030-2113-00-000WI aeeaparn orvanemm"`� PRIVATE SEWAGE SYSTEM ruin $L Croix INSPECTION REPORTTorwy pi No GENERAL INFORMATION (ATTACH TO PERMIT) A?IAAn n[Pm (inI ,TOVVN�OF so No Mitchell & Karen Jorgeneen LIVlnq TrM " n SAINT JO SEPH 030.2113-00-000 aM E.. inw�e.. ereven nnDw..w�poaro TV Oi)IIA Is fillitir. 30.30 19 82] TANK INFORMATON ELEVATION DATA TYPE T101 M1HNVFACNRERM 1 LPPRLnYKSM 15`a S 2 $S D o IT (B F$ ELEV 00 o0 °®' b i 95e 3 S 1, TANK SETBACK INFORMATION Wfkgj4 TNIF TO RBI L4ELL BLCG VIM npleads ROAD mOMAN De,InB TPSo' 26' La NW9 GN p BM BYMwn Ids z. oi.eYs ioll. ✓J PUMPMIPMOM INFORMATION sV 4 f r 141 nest u wnM.mro� PM(0 .� H IN W aM s 'S�knee, TnH .8leader:°Y.8 b" S Ti .03FI or "r so= Verb,ULDITMENCH L BB•IOf Lq.1 DRATINS 0, a OTAIEM TO PrL N BLW WELL vi Inawo n c�L $�1 ti(CIA UNIT a, ��o�, �a "�F.e1>i58o x�132 le : w.�e 83A aw10.Ak. ,.role a.�nv SOIL COVER .o...i v....... n.. ..Wei "....._.-.-_ ..-. _x.., oe M porno voroln ei _.. •-_.__... vsxewBm eae v w um ZI' o �. Eee•=�� ""�12'� oN onaap•meealaaeR•naaa Nor.... Prevent •M.1 Laaaon 1303 WARE EAGLE WAY OR 334 1)Alt BM Gesell Y'aw4' 31 BIo9 eew'r length .emnnnn m•vL1Y' Plan urevisionRequired?[]Yea NO o er Mn Ibnal lnlmmefio SM06MO RYea1 In"P ll"al 1 floretIe(IS(2o lea Y3 an• .•a -w BN -iiy VU6 uw to I6 iA] I_;" �� I o 3 s MNapnnun- Gdw 1;,Ad ���II 1 a c _ I a:;W-vao - 1-74 .•.�"�` ei r (o248g0 ....r.r.wmnSa twypft 1. w..rre..er •wnr..a.r�.rn.ri Neawl.tsrr�. rnrrrrrvrr.w.� bloom tirr.�.......rrrrarrc -UTdooI Sol Zi3y Wh i4e Er It Peu -.IG(1EEh:6EN 7;;"- bv�Ari T✓osi 0,70 -2 11 -S-00- 600 rr. tiq! L N 2 l �{> €trio M nl D r � lK]�r1.r 30 *fix . 1�°' ff: j) R2, 61H.rYllil�.ti�r. AS pu 5amoAkd 0 rreorn-v.r.u. ViOtTe .p tE Oayr Ovo..r SE�l7— Oror-�ru a .weiK� i •r�ry yr Orp�� 0>�rrre»ur.saa �arri�Ir.re.�•r S a.A o.e..� o�...�r ❑mooed.. oe..r..,.r. �_� ,� zyzI71s713v5g .ri ' IoSU °• '1 29 6f ecd�SOSrtaw �"� 3 yJ(ll }p py,} NLBIL sefbecis in rmaT$. e,m°^T^x n>�nv.odee '4) Cbnd:hdAl 1A Sf.k ; wool,... l,M . ,..,. 01 -ih,s y.,...41 1911 ®ewaevu) r wZr.��El� j0L I'1 t✓ �y 46fr�II Te wi!<IJHI 1 t7 IL wltlR! f AL.1.�/ ,1•j�f r ,;c4� c� L`- 3 ns fend f �JI M ---�-1bxE � 96 BFNci ,_ 7dP of oKMJ6f t't F� e�= po o hLr FwArNlAg Iveor- `%LLOW t'iPE a= bt s' ❑ SDIL DMA-5 5c" 1 ON = 40' newpai July 22, 2020 CONI1mDNALAPPROVAL PLAN APPROVAL EXPIRES 2022-07 27 Plan RMewPWTi 072001598-C left Fox PO Box 565 Dresser, wI 54009 SITE: hil ll Jorg on White Eagle Way Parcel 342113-0100(1 Town of suosepn St Croix County Say T30N—R19W FOR: Oesctlptlon' Mound Component Manual —Ver 20, Sli S Bedroom Mauntl-150 GPD—NEW —17' 111691-PIN 01/01, R 10/12) to limiting factor —Effluent Filter- Pressure Dlstdbution Component Manual —Ver Malntenana re ulretl 2.0, SBD-10906-P N.O1/01,R 10/12) The submlidl described above has been renewed for conformance with applicable Wlscomin Administrative Codes and Wisconsin Statutes The submittal has been CONDITIONALLY APPROVED Th¢ system Is to be constructed and Iwoted in accordance with the enclosed approved plans and with antl component manually) referenced above The owner, as defined In chapter 101.01110), Wisconsin Statutes, Is responsible for compliance with all code requirements. No person may engage in or walk at plumbing In Me state pule a licensed to do so It"he Department per s.145 06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use Reminders The site shall be property Prepared prior to plowing. Any grasses longer than Are shall be M short and removed. To avold ma m& any leaves or loose organic miner shall be raked up and removed. Cut Nees and shrvbs flush to Me ground and leave stumps. Avoid operating equipment an the Mound she. N necessary, use only tracked equipment, duNrlg dry<oMiuens, wMr minimal passes, to avoid companion. I Companen4 and soil removed from the existing dram field shall he properly disposed of so that Mere is no dsk to puNl<w arMrmmemal real A mn0ary Permit must be obtained from the county where this protect is looted In accordance with the requirements of Sec. M.19, WIs.Stats. Inspection of the private sewage system installation is required Arrangements for Inspection shall be made with the designated county official in accordance with the provisions of Sec 145.201 Wis. Static • Astate approved effluent filter is required Maintenance Information must be given to the owner of the tank explaining that periodic cleaning of the fihens required. A copy of the approved plans specifications and the letter shall be on -sate ifilne construction and en to inspection by authorized representatives of the Department which may Include local inspectors Owner Respanslbllkles • The current owner, and each subsequentowner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manuals) and he comparable for ensuring that POWl51s operated and maintained in accordance with this chapter and the approved management plan under s SPS 383.Sq(37. 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. • The owner responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the componerath) utilized In the POWl In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for rode compliance As per state starts 101 12(2), nothing in this review shall relieve the designer of the responsibility for designing We building, structure, or component I counties concerning this correspondence may he 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 P(l management plan to the owner and any others who are responsible for the Installation, operation or maintenance of the POWs Sincerely, jodl2ua Rovl&y Joshua Rowley POWIS Plan Reviewer, orvision of Industry Servrces (715)813-9111 Joshua -DP a ,@wisconsin Pov MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN a Appl,aeon INDEX AND TITLE PAGE Pmae Name DPmera Nana Dw rs Address Legal Description Toensumm country SuMiviPon Nana Lot Number - Farrel I D. Nur ber Plan TraneaNOn No MilMell hrpenNn 4910 LmEan Tr N LW Elmo MN SSc 30 T30WR1911t, 10 SIX* Number ca,mrt,otellF FIV YGV DEPT, OF SAFETY AND PROPIUMal 6L Peet Irbea eM L01e SERVICES Pe9e2 Delp Starr DIVISION OF INDUSTRY SERVICES Page MVM Orewegs Page < Lateral aM Om a lank q Page Sysaem rnamlerarka spenlWeema n Page MermepemerN and conlnpNay plan Page] Pump uaYe xM yxlM1ulwm SEE CORRESPONDENCE Deaver Jell Fox Llcenae Number MPRS 223242 DNS 0T110l20 PMns Number 715i913155 Signewre CaNOrM Pursuant to 1M Mound (romw` en1 Manual for POINTS Vents 30 SR[uIWQU-P IN MIDI. R 11112) ✓d bent SSWMP Pudlullm RS Design d Pressure DzineNnn WMnnas for ST-SAS (01M1) ME Pressure Delneulkn Cemponerl Manual Ver P 0 SS010701rP IN 0Ib1 R I0112) VenI0n70(R 11112) Page Iof 7 Mound and Pressure Distribution Component Design Site Interva r la of c. ] Residential or Commonest Design on, "'na "!"h 500.00 Estemetea Wastewater Flow(gpa) wAerere.rm iu 1.50 Peekirg Factor(a g 1.5=1SYN ® rc ]5000 Design Poor(90) 10.00 Site Slope (%) 99.5o Contour Lire Fbvatron he 1T.00 Depth to Lmieng Factor (in) 0A0 Insw Soil Appl otim Rats, ardid°) debibutlOn Call Intervention 1_ T60P Onquessel Cell Lerglh Non Guests, (ft)= 1000 Cell Won(ft) 1.00 Dea l Cell resign Loading Role (gpdeP) 1 IMIueM Wastewater Duality or 2) Are he leKrals Me highest Ports in the drsOANwn V Postal daributlon Ihamretlon netwerki Enter Y or N K. or F 0 Cemerar Erbheanibld 333 Lateral$more hi) 3 Nurriaerof LMemis 0.168 Crew Diameter 0 ) 2.75 E511mated Orikce Sending (it)+ 2.00 ForremOrn el&Met (in) stop Forcemarn Length DD 90.00. Pump Tare Elweman di) 4 55 System Head (it) x 13 10M VMrceI LN(n) 252 Fnction Loss hC a. 1rNrne Filler Laos (ft) 1] 74 Toth Dynamic Heed hid Lmrel demWr Selection L.Lme mince o T5 tM 25 1 I 15o I is IX 33 x restaurant Tank lnlmmatlon 1W6 So Se crank Capecrty(ge) W1°rer .__..____MenNectmer Does Tank Inscapable MW Dose Tank Cerol(981) 25 S0 rose Tea Volume(geNin) Werax reanuMolurer If N above, show re elwelion (fly_ of the highest porn �f 926 n'lerdlro Does tire facemem drain back? Y Ener Y or 1060 Freeman Dmmbaak(gel 1012] 5x Void Volume dial 1118] Minurum Dose Volume (gal) 4362 System DemeM(gprn) Manifold Diameter SetMW in der o pno dwrde 125 150 1 x 200 300 _ GallomfbrJr CMPWator (opacn th Total Tank Capacity (gal) Total Warfare Liquid Depth (in) germ (enter result in call US) Effluent FlNer Metnrblgl lifetime _ Fifter Manufuourer r- 8 -—IFiller Model Number Priona Mlltlrell Jorgensen Page 2 of 7 Mound Plan and Crave Section Vtawa K .( A slowed Cmwoneat wwwwplorls ft It Aw06K 133b G 5a J 1 )5000(n) Dupanal con Ares w8550 (ft� Small Aid Available 1000 (ppdT) Liroar LaeElnp Role1 7 So (E)1110 E Oem. Flpe Flmva m Mound Crave Section View ApyeOem OlepMeal Mae Flniahea Grade 10I.EE (9) —+ — IIH F np� �y 1015E (n) Laurel ,p, ae (a)�I l�d Owparvai cae n Ekvalim O g:.. Y e a .. BB.W (n)Conbv FJrasm 10000%Smsbm Gpplppne FWnc Cover emaw^O Kay 8 Olaparad col sae hlamaneum Q1 TapemlI cap ya 1.5n Papas KKilunAer,Mm, © sudeoil Cap ig f s' T maspadng Watt s ® ASTM C335eM e! {j�Yt rr �.k4:' F Wnh vn wu•M TIIIeJ LBYer +� a n )SL~- 4�iF`i m[Wknm ml © p(payle <£•�• 4 •, - I wnlMlna inlM ---FFF aaNeupmncell(MEI End Connection Lateral Layout Diagram Place Lateral Diagram Here Number of Lsteeels 3 CnBm 01W in Drawn Diameter 1 50 In So Istfe Onlice Specuq (X) 2 83 k Lateral Dancing (P) 73.58 ft Center per Lateral 2] Lateral Sparked 333ft Once Density 928 Penalties Lateral Flnx Rate 14 519pm Manifold Lergtb 66] ft System Flaw Nate 4382 win Mamfoltl Diameter 150 in TMel Dymmic Head 1]]4ft Fcrcemem Velocity 445 fri Doss Tank Information Tank <nmymem k ✓Diem ✓Hied Markinuarturam C t 95000 Gallons VaNma 0500 edJ/LnMl/intJt es Irl 20 N 44] 1090 3000 MGaflons2083 eeeeendn dnmaa 2in Visproaci sonde" pwry ena.. 9091 Ix earn 3- Be00ing under tank 90 do Alum ManuMencomer RhivW a Note SweMres Neem Mpael Number W Plu99er oreamm0 no, wry _ may net be urea In Pump Manulecturim ZONIsr this system Pump Morel Number IBN153 py.. Pump Must Delver 43 fi29Pm at 1]]4 ft MIA Project Mecrall represented Pepealof 7 Dose Tank Cross Section And Pump Performance Specifications Tank nlmuficwrer Tack Modal Nmoba Tdal Tank Calamity Max. Bmy DrA PumP Mmufectmv Pump Mole] Number Almm Mavufecturvr AWm Modal Number Swhch Tya Minimum Pump Pammanae galnkad GPM PI mH TOW Dynamic Heed (TOR) - Pact Elevation Heed Dieal Pmeaure Ndwak Ptaane Laa PonceMaio Prtmue Lae Tend MmMa MAbove DeWa With Locking Dena Maana Wewfenfmof Aboo ve eGCaJwetloe Box W�NCep � - PiaiaM1edDMe 1 � DepthofCova Pt Diaw Switchs sand ltesma Canaefly Tank Volume= GPI Dimension fnchcs Volume Gal. (rewrve)A rn c;, s I e 4i slam B 2 IC dae C 9')1 (1) D Bamomdrmkaw. GENERAL MRTA TION: Dae don tank is bedded and beck tilled in ecenrdmoe with the manufeomar's product approval ryaifioatioos. Maximum depth of bury as apaiaed by Ne mmufil a may not be exceedd without prior approval. Manhole covm aWoaed to gale have an edativa locking device (padlock) ioamaed. Piping d the mlea and Bala is of approved meatiaL cumadwi be the tank with wererfight fftlg andleki on sable soil to pmamt saamga wabeoag. TheebCcoaraiuel miias erok:wmpeldiawiWith t aPcCh 3a00 and C comm oae d1g6e2tHheWess. v en. sane ie mIN Code. 03/05W Pege_of_ MoundMaingereencas andn Sissocificaticigns Semite Prmslder's Name _ _ Jeff Fox Plwne;_]1_5_-]_Si2061 PO'NFS Regulators Name SlCmixCwey Zon�__j Phone System Flow and Load Paramours Oongo Flmw-Peek ]50 gptl Maximum lMm pwde Sire iffi-71in Banned Flaw- Average SW lgpd Maximum SODS M mgll Septiart c Tank Coati i5B5 gal Mknum TSS 1W mglL Soil pbswoion Consomme Siae ]50 fl Mximal fOG 30 Pages. TgaedwasleMx Damandc Maximum Faso > OE< dW1WmL Septic and Pump Tank EfllraN Filler Pump and CaMmis Alarm Pressure System kOnurd Ins ardla reads, Once "no 3 wears snmue inspect am wean N IeaN ante theory a same Teat oncA ev 3 "are Should temal N n Laterals should be flushed and Wessure tested every 1 5 yeans Inspect for Winning and seBpge onear every 3 years M3celloneous Construction and MatedNs Standard 1 Observation popes are slatted and malmiels conform to Table SPS 3 W-1, have a waterlight cap, ad are secured In as shown In the mWnd mmporreril annual 2 Disposal call aggregate conforms to SPS 3 SO i6t(1), she Adn Codo 3 Ali peony and pressure prpsWGoal conform to the re0umements rn SPS 38( Wre Rtlm Colo Tillaaeot Na basal does is accomplismad will a mold board or roues plOx 5 The mwnd strumns WOVrNtli9luMed areas will W steedid aM mulcred to prevent list erwrcn and trelp reducsfmat p®nebatlan LMemh Turn -up Detail Finished ML ........ Grade vhDrmretm Lawn —Threaded Cle rased Sprider Va" BoxPlug a SMI VotreDiMrtodrah lateral_y\• rBBB Bonds SaSO(XTme Pmpd Micros Jorgensen moil Page Saf] Mound System Management Plan Pure arl In alre M].M, Ms. aJm, cab >�rr MedMiN0.apeYMFeIJIm, xM BPBM3N We Mm Cab,Imme mbeemp. Ingbwmeze W. Nam, nweeY IBWh10W1AMA1N1, X Itrya, SSLNi bMeYn p! 101211. etl Rene MWIbn Cvnpp.6 WUI Va.308BD O NO0 MOINI,X I mMeelbal mvm Name bepm m ybe"eY dmmco repvy 1 NoapdaM ern arM eeey4 orpwpYnR Yae Mpreaepw my0evwam Ml wWE Wue 080 SenI MPnv Ydi leitlpruneX Yel W F nmM1nu rM 9P9 )BI.M, MY LGm Gil'Mnn M1leie se no loigx ueetl ae POW59mnwFAb Ah M0.WN bmbeMpAu wY'b xelM wM00 Xe mrt0.getl[n deairW Np mp MmW Oimw]aleWRrWeNN^ wlmbbw mw XarePbaea BbaeeX.aee aeXP VWY, MaSMWbbmM Wel e. Wme.e FynenwYaNM EYba bpmem ec[Mxdl a umMw,YeX xO/ Mo a vnt v ampaaN. ertrSMY Theeg4Mbep pe meFYFeO Mn NMYI ai/beeNM eW W uW ea11AB. 8YY. 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Lake Elmo, MN 1y5p51L01 l a /��� Property Address P' ( W' 1�IJ o �6V (Ve[mcation rtaunnd true planning&Zomng bear A at m ) oly/smeHudson, WI ParselIdentification Number 030-2133-00- 00 LEGAL DESCRIPTION ProphifaeallonSE,/. sw 's See 30 T30 NR19 W,TnwnorSalntJoseph ,Subdivision Plal White Eagle ,Lot 10 Cerrmed Survey Map# _ .volume_ .Page _ Warranty Deedp _ _(before 2009)volume _ ,Page# spa to... ac'prn Letltea mentigame ants0no SYSI'EY1 MAINTENANCE. AND OW NI.R CERTIFICATION Improper TTse and Franchises of then nleb.num wart: result in its premature union to handle parka Pryµ+ consist,interference ofpumping out the topic Rain oerymkc years or sooncr.rt need W.bsnb«nsdpulper Whatyoa Pulann she ry9e rficarthe bur of she xpue fink fin age To thew Ie daPwnmaoleneoa u oxnl system Oer refponAmo, bow, m lacconedm trays rn] RI I I and Chapter 12-St Cost Cuuey Summey ONmwe I he Pmpary owner affect to whoa (11 SL (.mix County Photomg & /.oeen I) 1 arnheot a n¢vfirnuw to=, aged by the and by n master pumber.toumeyman Thurber. infrared plumbaor n Iiwoeod poopic venfymg that fay the oo-va noutcomper disposal sysem it To proper or..azug ""out" errer(2) afenrep r um ,,it pumping (if ucme t), the septic unit is less than [/I full of sags, I se ace encountered have Mad the:Mare Mryuaemenn and ago to mamurn me Pnvac uxaee disposal system "In the wyedr sn foM hamon as ur to The repamnun of ranks nM professional sae T.... M the l4wmmrns of eamml Raoumes Sure of Nl¢ nCoNGo mas young that,¢puc system hherd operates nmrof onto by, mmcu pld and houorG ro nd in, ('ar Confirm Planning& doctors DparmentxMm To days of the ohme year expiration Jake lose«nrfy that all sN U...on U...fan to one n ro un arc the ownery al of the property dacMMassetsassets,by citrus apartment, x'artacry dead rcmNed m Man star of Cads O 1 if cc Number of be�droo /m's 5 SIO AT OF APPLI('ANTf4) DATE "Any rnhimrction that: misrepresented nay man a' In' worry pemmr Ming mwksd by The Pla rang An (gang lKpamrcm holi with this Tran ,hmi ohri deed Loa The Register of That Om[e and a copy of the cerdlied worry map if reference a name an This wi may daa (REV (4na) omm;'mne�ws:Na� • eEm.. s 'taZ070 _ �,�a� TION RERE S+ RUIx mmd.x.u.gmmnw.�p, Was u.,e rn,„mmomxs Eire 1 namm 30- noime.ire,..:. namni,e tiw4wnmmem•,, Mei,.mo��.rve..m�.iow ..wa,emMno,...onn.no.,h"mno.meexw.®m...,r A.e nonh II -o -000 Z9 �,.nmm.mmol n roru e. u.m m,..mm me m n nywaer ,icv)SmT en S<ne P,�mviy Lemmn c d ws30 T,SO ❑ xx I E(10W O LMXT777q p WNLnIo Ec O ) Cg �e x �KF ELMO MN r IO Si N WP ®xExcoree�uwo u.®x.emu.ux�..mmo i,. ra.eox.eeaa.nQ.,w(�p mo ❑xad.. ❑ae .fl - �'uV�� v.,.mmx,d.i �r��I:nIT�IC� —rum ai...u..m�n.ppu.me '1 o+1 X GIN.rei mm.m.oe �mm.m.0 J - I C I Oeomex ®w"� amre.,ne®m, 4�A' o.mmimue,x Vim. � #7®0�■�GT� tiiEl7���7 ©r� Ptmff mp�cas�nv�raaarz�s�aw� �� �m .xwa .. x.� m ox �, E. � mun,., � , .EM r S c5n-zl RH,� Z G- Fear v e NST. •Enxmar-eoo>eo>sm •aN.mae-aox>x. aom .m Tw cb1 m.lnewv I 4 sere.. s 4 osceols wa a Ewai n ••�•�"°"° In, 0 V() '6026 �5 yof 3 ��m0�Lk7©0•©�i7SG17��Q�ia �amm�e��s��.rsr. 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