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HomeMy WebLinkAbout020-1106-11-400Wsconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law s 15 04 (1)(m)] Permit Holder's Name City Village Township Oevering Homes/Urchins LLC I TOWN OF HUDSON CST BM Elev linso. BM Elev IBM Descnntinn TANK INFORMATION �-& ns TYPE MANUFACTURER -it 4 CAPACITY Septic r� V Dosing Aeration Holding TANK SETBACK INFORMATION i n,I✓ir s ( IAn',.A TANK TO P/L WELL BLDG. ent t6 Ar nt ke OAD Septic I C) L Dosing N Aeration Holding PUMP/SIPHON INFORMATION nn — r. �ol ...1 11 Manufacturer berrand GPM y Model Number TDH Li` � � Fnctio Loss J System lad TDH Tt Forcemain Len t Dia,�r t. Dist'jto Well SOIL ABSORPTION SYSTEM ELEVATION DATA STATION BS HI FS ELEV Benchmark Alt B Bldg. Sewer 133 gg.3 SUHt Inlet o SI/Ht Outlet Of Inlet Dt Bottom o L4 Z 0 Header/Man Dist Pipe i q -7 I Bot. System Final Grade 81 Cover f .a BEDfTRENCH DIMENSIONS Width Length No OfIsencFas i,. v.1 \ �T T DIMENSIONS No ns Inside Dia Depth SETBACK INFORMATION SYSTEM TO PIL BLDG WELL LA /STREAM LEACHING CHAMBER OR UNIT anufacture Tye 0f S stem 1 n I'L\ Model Number Ulb I KItdU I ION SYSTEM Header7Menifold IDistribution x Hole Sze x HoleSpacingVent to Air Intake Length _ Dia Pipe($) Length !� 611 Dia Spacing BOIL GOVLR ■ PrA%gilre Svstame rinly yr Mnnnd nr At-f:rndn svetame nniv .I _. 1.. _ Depth Over Bed/Trench Center f I 'I a ti J Depth Over Bed/Trench Etlges xx Depth of Topsoil �j t xx Seeded/Sodded A 1, Mulched l ® Ye Yes No COMMENTS: (Include code discrepancies, persons present, etc) Location: OLLIE CIR 1 ) Alt BM Description =<0- (.OJT ✓(nr;.�a�l� 2.) Bldg sewer length - amount of cover Inspection #1 Inspection #2 Na u�ei��wi 41QIA — �6Y� 5lt�n�t,rt ICI }u d Plan revision Required? '_] Yes ] No for ad Use other side for additional information. JI li rYI JI f� SBD-6710 (R 3197) Date nsepctor's Signature Cart No 9X-'Qax_7�C;Z' S 1 o� '>a O2 2OZO C Safety and Buildings Division 201 N@Washington Ave., P.O. Box 7162 Cou"I y�( Smrmry PC[mrt Number (m be filled in by Co) Madison, Wl 53707-7162 Sanitary Permit Application4474,1 State Transaction Numbs In accordance widen SPS 38321(2), wens. Aden Code, subtsissimi of this form to the approprtae govnri=S p is requited poor to obtaining a sanitary pert. Note Application forms for state-owned PORTS are submitted m ro)ect Address (d different dim mailing address) the Department: of Safety and Pmfessioual Serviet. Persona( mformmon you p: ide may be used saondary purposes in accord== with the PrivacyIsw, s. 15.0af1 m , Stars, & ,mQO t� l� 1 L licatiou Information - Please Print All Information Property Owner's Name 7 rr Parcel # 0 aU—�1o6 r +/tic f l Property Ownrr-s MailingAd4!!0- /dy' 3 3/City, 'y' Season 3- t Store Zip Code Phone Nrber SleD.Type N; R E W of Baildtag (check all that apply) ?,ot # 2 FmodY Dwelling -Numbs of (f, (�j Sulxirvismon Name Brock ri per�� ❑ PublicACoamsercial - Describe Use Crq of ❑ Stare Owned -Describe Use ❑ Ydlage of CSM Nmanba/p.30 I (pee.: 1 1 Dl (o3 wT of Ulf. Type f Permit: (Check only one boa on line A. Complete line B if applicable) A. m C Replacement S W Ystcm ❑ Treauent/Holdiog Tank Replacaomt Only ❑ Dm4 ModiLcatioo m Fri �e System (erzplain) B. ❑ Permit Reoewal ❑ Permit Revision ❑ Chmge of Plumber ❑ Permit Trmsfa m New Litt Previom Permit Nmuba and Dale Lssned Before Expiration Owner IV. Type of POWTS System/Component/Deo,ice: (Checy all that apply) J *don-Pressmimd In -Ground C Prmsutired In-Caound 54�,iIiCr.^ye� C Mound > 24 um. of suitable soil O Mound <24 in. of suitable soil ❑ Holding Tack ❑ Orbs Dtspersal Comproeat ( lam) ❑ wt Drnu (orplam) V.DrsaUfreatment Area Information: u cv D5;W Flow (gpd) Design Sod Application Rare(gpdst) Dispersal Ama Required (st) Dispersal Area Proposed (si) System Elevation/ , VL Tank Info Capacity in Gallons Total Gallons # of Units Manufacturer New Tasks F.:� Tads = Y p 1 = S p y. L 0 ! V W m N � C✓ Septic or Hordtag Task �1 - Dosng Chamber J'ZVI Id VII. Responsibility Statement- T, the undersigned, —possibility for immURtiou of the PORTS shows on the attached pleas. s ?same (Print) PI ignmae MP/A7PRS Number Business Phue N bar < ' Zz� 7/� - .. o�� " Plumber's Address (Street. C!byI Zip 2-5r/ X-%u/ 2 ? I Countv/Detuartmeart Use On Approved ❑ Di Permn Fa Date Issu/eel 3 65D-- f uing ant Smgomoe 1-IX ❑ ep Rcasm Denial �h / Conditions o ppr auees{er-Bisappcewl 3) l 7l$ce- ,t.a-uea.0 �- ..t�- STFM OWNER: Septic tank, effluent filter and rKi`(yb+t dispersal cell must be serviced I maintained by t �_t"`�i/, as per manngernent plan provided plumber R rryUaTlx'sa -lU ✓lRW pf 6f1/"S I - SBD-6398 (R 11/11) .smea m msprete perm for rmu ystem saes sysmn m me �ouotr ow. oa p.per nest teas rnada rn: a toae�m sa i J System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond WI 54017 NW 1/4 NE 1/4S 35 /T 29 N/R 19 W TOWN Hudson COUNTY ST.CROIX SYSTEM ELEVATION 94.5' 9/14/20 4 DATE BEDROOM CONVENTIONAL AT -GRADE %00( CONVENTIONAL LIFT HOLDING TANK 1255 gallons SEPTIC TANK LIFT TANK SIZE DOSE TANK SIZE 765 MOUND SIZE HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none IL BENCHMARK V.R.P. Top of surrey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL "H.R.P. same as benchmark Property Line B-2 B-3 4 Acre Lot Scale = 1 /4" = 10' 0' 40' 80' Area 15' below system is to remain undisturbed 3% Slope Grading is to be done to divert run-off away from system Well Is to meet all WDNR setbacks 93' Huffcutt B-1 94.5' 95' To 011ie Circle Pro 4 Bedroom House Tank Property Line _ J � c7 C) October I, 2020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2022-10-01 Plan Review: PWTS- I 02002297-C SHAUN R BIRD 1432 120th St New Richmond WI 54017 SITE: Oevering Homes Lot 4 011ie Circle Town ofHUDSON St. Croix County Total Amount: $250.00 FOR: DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay http Odsps wi gov/programslindustry-services www wasconsin gov Tony Evers - Governor Dawn Crim - Secretary At -Grade Component Manual - Ver. 2 0, SBD-10854 (N.03r07, R. 1/12) Pressure Distribution Component Manual — Ver. 2 0, SBD-10706-P (N.01/01, R 10/12) Description: 600 GPD (d 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 drams 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 matenal 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 well soil will result in reducing the infiltration capauty of the sort Proper soil moisture content can be detennined by rolling a soil sample between the hands. I f it rolls into a 1 /4- inch wire, the site is too wet to prepare. [fit 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 line(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 ri ith rock fragment., tree root, stump; and boulders reduce the amount of soil available for proper treatment It oo othei site n .n actable, ties, in the ba.al area of the mound must be cut oft Lit ground level A larger till ❑rru i, necessm-N %�lwn an} of the aN,ne condmoni are encountered, to pro�idc sufficient inliluallce 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. Ow ners 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(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health liazard, 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/insta l l atioti/operation. In granting this approval the Division of Industry Senaces reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state slats 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 proN ide 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, POWTS Plan Reviewer— Wastewater Specialist Department of Safety & Professional Services I Division of Industry Services email tiro vanderleest'a wiscomm uo� Cell: 608-516-6134 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:9/14/20 Owner:Oevering Homes Location: NW1/4 NE1/4 S35 T29 N,R19W Lot 4 011ie Circle Hudson Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 IN. 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: 9. Maintance and Contingency Plan Attachments: Soil Test Shaun Bird License Page 1 of 9 System PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cemohous Ave Suite A New Richmond Wi 54017 NW 114 NE 1/4S 35 /T 29 N/R 19 W TOWN Hudson COUNTY ST.CROIX SYSTEM ELEVATION 94.5' DATE9/14/20 BEDROOM 4 CONVENTIONAL. AT -GRADE %00( CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE. TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 $ of chambers none IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑BOREHOLE SWELL *H.R.P. sameasbenchmark Property Line B-2 B-3 4 Acre Lot Scale = 1/4" = 10' 0' 40' 80' 1 1 1 Area 15' below system is to remain undisturbed 3% Slope Grading is to be done to divert run-off away From system Well is to meet all WDNR setbacks To 011ie Circle Pro 4 Bedroom House 9 3' 94' Huffcutt Combo Tank B - 1 94.5' 95' 220' Property Line At -grade System Sloping Site Cross Section and Plan View ------------- I Tr,' �. t — 1 = Plowed r�r� = Clean aggregate L•L basal area } ,t % to 2 '/2 in. dia. Lateral with 2" Topsoil Cap aggregate over pipe Geotextile Fabric Q = 4 in. sch. 40 pvc observation pipe Ft Lateral Invert Dimension Feet A L B /aU 116 B (o C D 2.0 E 5.0 F 0.5 G 1.0 L W Z. Observation Pipe With CaT) JUMMOrL Topsoil Cap Surface 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 Y4 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, groCvA, limit erosion and protect from freezing. The observation pipes are perforated in the lower b incthes and secured in place. 03/05 Igi Page 0f Pressure Lateral Layout One Lateral — End Manifold Force Main .50 o t De, Distribution Net4kvork Sp ecifications Lateral Diameter In. Orifice Diameter X Orifice Spacing) In. L Lateral Len Ft. Force Main Diameter Z In. Force Main Len Ft. 03/05 lgj ..... Grade ... 6-8 Inch Lawn Sprinkler Valve Box f— Threaded Cleanout Lateral Tum-up -► 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 turn -ups terminate with a threaded cleanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. Page I of Septic -Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Tank Model Number � O Total Tank Capacity , 5 '7 Max. Bury Depth Filter Manufacturer Filter Model Number Inlet Minimum Pump Ferformance,Regmred GPM1 @ j /So FtTDH Outlet Manhole Nv in. 4" Above Grade With Locking Device. Inlet Manhole < 6" Below Grode Sealed Watertight -- — -j Finished Grade Outlet Filter �y (*__---- Wet Baffle switch sett}ngs and Reserve Capacity Tank Volume — / 7 GPI Dimension, Inches Volume Gal. (reserve) A; j 0 (alarm) B 2 y' (dose) C ; %, S / 7 (dead) D T01W 7 6 ManufacturerModel Number ,2 0 Manufacun� N if Model Number 7 Switch Type /71E Total Dynamic Head (TDH) - Feet Elevation Head Distal Pressure 3 Network Loss 1 Force Main Loss Total S, Manhole Min. 4" Above Grade Securel y Mounted With Locking Device Weati Weather-proof it`/\j Junction Box • Vent Min. 12" Disconnect Above Grade Means With dart Cap AWeep Hole B Off Elevation C ` 53 42 aj. Bottom D Elevation F1 GENERAL. INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the: manufacturers Product approval specifications. Maximum depth of bury as speci6ad by the manufacturer may not be exceeded without Prior approval. Manhole covers exposed to grade have an effective k4ung 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 and the sleeve is sealed watertight. El ice C�{IlpI. with NEC 300 and Comm 1629. 02/05 LI Pageof 280=SER/ES 112 hp Submersible EffluentJSump Pumps The Liberty 280.Senes provides a cost effective "mid- range" pump foron-site waste water systems, liquid waste transfer and commercial heavy-duty sump pump application/ that require higher head or more flow. Desigi-eed around Liberty's unique "UN -Body" casting, the 280-.Series will provide years of reliable performance. Ali Models Feature: • Vortax style impeller penrkting passage of solids up to %' • 416 stainless steel rotor shaft • Permanently lubricated upper and lower ball bearing • Epoxy powder coat finish • All fasteners -corrosion -resistant stainless steel • 1 V Discharge • Stainless steal bottom screen - easily removable • Maxkrnin fluid temperature. 140• F. : r;; r . .. Motor Specifications Y. hp 00 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps 01510) 4.0 amps (208/23oV) '� rrrrrrrrrrrrrrrrrrrrrrrrer a am Nunn rrr/.�rrrru rrrrrrrrrrrrrrr■ rrrrr\aamrrrti Rosmrrrrrrrrrrr onuuc.uawuorronu rrrrrrrrrr.!irrrrrrrrrrrrrrrr. nrrernno+c%rar/r0000 rnom__urrncmmnum . 20- "Zzz .z.uu-,Urrrrrrrrr rrrrr////r�'1/\i■11\�rrrrrrrrr 1s rrrrrrrrrrrrrrrrf/rrcirrrrrrr rrrrrrtrrrrfirrrrl�rrr�:rrrrrr rrrrrrrrrrrrrrrr nrrrr►�rrrr rrrrrrrrrra rrrr urrrrrr+. rrr @Mason rnr:aruooc�r ,rrrrrrrrrrrrrrrrlurrrrrrrr��, 1015 20 25 30 35 40 55 eo ss 70 U.S. Gallops Per Minute 38 78 114 150 192 228 270 Liters Per MtrxRe Dimensional Data: Weight 29 lbs. Height 13' Major WkML 10- (model287) Minimum Sump Diameters: Model 281, 283... 14' Model287 VMF... 10" S� G Factory awihOlm Mode1281. 283 Model 287 settings VMF Ttrn on level 13" 9.5' 1 Turn off level 7' 4.0' The MOC16 293 %ahaae a Rally a tustable wWe--* 9 Dff%MVIW er$rnawnW can b, mega eeeey by NOwtpthe fIDW W "ds• Chang• pipe Or 06W MMXNnp point VWUCW Yost model207 In rot adtustabie. :rKo odel 280 Model 281 Model 283 Model 287 anual, Wdeangle WIdewVle VMF411edee switch float switch float switch Vertical tlW with quick- with series � _ disconnect (piggy -back) smalierwill operate In PIuO a 10' & rneter sump 0 f-us Certified a wdbat•w.,ei.ab CvV•.luf rM LPoerpr Pumps • 7000 Apple Tree Avenue • 8er8er4 Mew Vorlr 14418 • Phorw 800-•543-2550 Far (SW *P0-1839 www.ddbertyprmmp&oorn ccvrsy OLA rrra•raa i Zr!: 0-( 20140048A SECTION A -A POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Oeze Septic Tank Capacity Permit # *Values typical for domestic wastewater and sepuc tank euent MAINTENANCE SCHEDULE DNA Service Event Service Frequency Ilnspect condition of tank(s) At least once every: morn a) (Maximum 3 years) (3 NA' ea a Pump out contents of tank(s) When combined sludge and scum equals one-third ()6) of tank volume ❑ NA knspect diaper" cell(s) At least once every: 0 month(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: 6 EI enths(s) ❑ NA Inspect pump, pump controls & alarm At least once every:0 month(s) S. earls Flush laterals and pressure test At least once every: 0 onth(s) rs that; At least once every: D month(s) D e s)EE tEl ether: MIAINTENANCE INSTRUCTIONS f iInspections of tanks and dispersal calla shall be madeby an Individual carrying one of the following licensee or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer, 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 leeks, measure the volume of combined 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, 'The ponding of effluent on the ground surface may Indicate a failing condition and requires the Immediate notification of the local (regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (34) 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, 13nd any servicing at Intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shag be provided to the local regulatory authority within 10 days of completion of any service event. C�a9 Page _ of START UP AND OPERATION For new construction, prior to use of the POW, S check treatment tank(s) for the presence of painting products or other chemicals thelt may Impede the treatment 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 by discharged to the dispersal call(s) in one large dose, overloading the cell(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 Servldng Operator prior to restoring paver 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 caps. Do not drive or park over, or otherwise disturb or cornpect, 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 We of the POINT$: antiblotios; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers: disinfectants; tat; foundation drain (sump pump) water, fruit and vegetable peelings; gasdne; grease; herbicides; meat scraps; medk;aflons; oil; painting Products; pastiddes; sanitary napkins; tampons; and 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: • Ail piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the volt space filled with anvil, gravel or another Inert solid material. CONTINGENCY PLAN If the POINTS fails and 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 eystem. ,he replacement area should be protected from disturbance and compaction and should not be infringed upon by requi4d setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the neled for a new soil and site evaluatlon to establish a suitable replacement area. Replacement systems must comply w(th the nrleri In effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Bening advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. jhe site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evalua$on must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be Installedl as a last resort to replace the failed POINTS. oum nd and at -grade soll absorption systems may be reconstructed In place following removal of the bioat at the Infltrative 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 O� A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS POWTS INSTALLER Name r j�,'' " Phone 1 is-- POWTS MAINTAINER Name Phone<r SEPTAGE SERVICING OPERATOR 'UWMR _�( LOCAL REGULATORY AUTHORITY Name%(/r ��_ L I/1� Ie f / i I Phone I /J-- d2 _ 6 S/y Phone b�.� 8 ThisdoaaneM was droned In conphorice with chapter SPS 383.22(2)(b)(1)(d)&(fi and 383.54(1), (2) & (3), Wisconsin AdmInistrali a Cade. G3[C�G�d�D ��e�ppY 22 2019 S Nlacerhefn Department C'n.,, k'` S )l EV T h Page _ of. Divlabnof Sefatyand Bul ings 1 Se. n1i`i Dee Veto MOD, rrra neon. wux Attach complete ells pia ^i-,^_ an B 1/2 x I I Is In aka. Plan must Include. but not limitedto: vertical and horizontal reference point(SM), direction and Percent slope, sole or dimensions, north avow, and location and distance to nearest road. Please print all Information. Penantl MAomulbn you ryeHda may to one ra eemnesry ahuPnan lPd+ecY Lew, a, te.t/ Itl (m11 L ry ) Parcel I.D. }aft ' R b Date I Property Oxner cL r Propertylooetion Govt. Lot 114 114 9 3TT79N R E Pmpeny0wnet8Maling Address , Lott I Blocks S Nsme late p a umber 5 p 0 CRy Ville a N e t Road 1n ere CM*Uc ton Useesldental / Number of bedrooms Code derived design Row rate GPD 0 Replacement ❑ Pu or —} d /yDre�c Ibe: ___ Paint material �,( I l y/ Flood Plain elwation llapptceble R. GerreN comments ssdiw %nee ) and reoonnrendstionns:/,.. System Type l! 7 �q�e,d,�— System Elevation Bodma acting_ L}�� L"/� �� R Plt Ground surface slay. 1 1 h ft. Depth to Wn...1. L in Nation Depth in. DaNnant Color Mawll Redox Deaalption Ou, Sz. Cont. Color Textse Structure Or. Sz. Sh. Cone Roots 'Etet '01112 �r6 147 777- N/Lj 2 6ofiu0 1t �7f Baring L� 7 safactor Pit Ground surfaceelev.7 1, 1�] factorft. Depth to limiting factorJ[In. Application Rate Horizon Depth in. Dominant Cobh Munsetl Redox Deeaipibn Ou. St. Cont. Cola Texture Structure Or. Sz SM Consist"" Boundary Roots GPDM 'ERet 'ERIY2 0'I Z 'Eladerltal�tlW,>W�"L'N myLeM lt>J >:fa�1W - cmuem et. M OVWS 2.>w F,py� w,u 1.—Z CST Name (Please Print) ore CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Dala E luetlon Conducted Telephone Number 1432 120th St New Richmond WI 54017 715-246.4516 Property Ovmer Parcet ID M L/ Page _ of __ ■m�m�©��r�e��rr�r� �■�r�©ra�r��r�ea�+�r�c� � ,,,rr,�rn2r�war�■e►�'rc�►r��rr�►��� ■ Cl ° Depth o ■■■■■■■■■■■■■■■ EMuentp1-BOD,> 30�S220 mg4end TSS 1301 160mg4 'EMuem M2-8OD,_<30mgLand TSS!30mgL 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 T7Y 608.264-8777. Soil Test Plot Project Name Dick Stout n Bird Address 1353 Awatukee Trail Hudson Wi 54016 / CSTM #226900 Lot 4 Subdivision to 5/19119 NW 1/4 NE 1/4S 35 T 29 N/R19 W Township Hudson Boring ()Well PL Property Line County ST. CROIX BM or VRP Assume Elevation too ft. Top of survey iron System Elevation TBD "HRPSame as Benchmark _ ST. CROIX COUNTY SENIC TANK MAIWENANCE r 1GRJi1NI N'f A?dU OWNERSHIP C) RTlFJCAT1(..N FORM Owner/Buyer Mailing Address! Propr:rty Address _�, ,r (Verification rcquved ftoni planning & Zoning11cpuitneat fur ueh+'cis(lalction.) �- - - CJty/State.--------__-- — i-- PareelldeutiCicationNur�hct bZp—/(O�— ��—L%� LEGAL DESCRIPTION Property [ocation�/}{�;,,fr� '/<,tiCC. �s 9 \'R19 W,'fownoI' Subdivision Lot # _ Certified Sart e} Map # --- ___-- �1�63 �O `]I V( huue .-�. Pig fl i� Warranty Deed # _ _. _..-_-�pQt"Z _-.....—__ _.. _ , Volume —� _.., Page JI ---- Spee house yCs no 1 tit lioe irlenb8ahle no SYSTEM MAINTENANCE AND OWNER CERTIFICATION V Improper use and vhatnrenauce of your septic system Could result Ili its pr =atore failure to handle wastes. proper inainimtanee consists of punlpurg out the septic tank every three years or sooner, if needed, by a heensed puuhper. What you put into the system can atleet the, function of the septic tank as a treatment stage jn the tvasfe, (hsposal system. Ownri maintenance responsibilities are specified in §Conran. 83.52(1) and or Oruple, 12 St. (',nix (:ounty Sanitary Ordinance The property owner aeleos to submit to St. (a nix Couo(y I'luvning & Zon.g INtpairmcot a certification folk, signed by the owner and by a roaster plumber, jom-neynwn plumber, restricted plumber or a licensed pamper vei itymg that (1) the oil -site wastewater disposal systean is in proper operating condition and/ot (2) after inspm:ioll and pumpulg (if necessary), the septic tank is less than 1/3 full of sludge. f1w'e. We undcrsit tied have read fill, nbeve, ,Cliff iremcols and agiee to matn(ain the pnvatu sewage disposal syscol with tho stailaw(IN Not fel th, holciq as Sol by the Deparinrem of Coinmorce and the Departir.cnt of Natrval Rcaotitccs, State of Wisconsin. Certification stating that your septic systehn has been vlaintauhed unst he completed and returned to the tit. Croix County Plannule & Z,oull Dopaunwut within 30 days of the three yeal explIaliou dafc. )awe certify that all statements or, thus form are no,: to the best of ruyiour knowledge. I/we anJutc [ho nwaler(5) Uflhe property described above, by virtu�o of a warranty deed Iecouled in Register of Dec. Is Office Number of bedrooms SIGNA'I'URT? OF , iP1.1C/iN'J (S} - DAT}? *"Any infirnnation that is inisrepiescuted may n-sidt in the salli(ai y permit being n:voked by the Plauuuhg & Zoning Departmout. "'t' include wn6 tins apphcation a recorded wan auty died lion the Register nClrceds �dfice and a copy of ihr, certified survey mxp d reterence is made in the wariauty deed. (REV. 08/05) e 12 - .l,.l. ft/JI MIORIMMM mffi ®HER Rffffi EEJ ® -- IIIIIIIIII Wll1ID ®�f EM Ilflll`9 Mm FMMTID EM- -t'. Q ➢ Wll llll `�'-I:,_' ffm = ME]] IIIIIIID .",<,-- FRONT ELEVATION�,zw r, ' -- - - cos MrounwnoN. $MELT INFG AT M 5HEET PFpI[(Tp 16I7 - - LEFT ELEVATION BACK ELEVATION RIGHT ELEVATION scut. ws snwm I OF 5 _ .— ELEVATIONS MAIN LEVEL PLAN SECOND LEVEL PLAN y x .uuvu r � n —i P�• i+ I ems_ FOUNDATION PLAN FCO!meg� uyWisconsin DepartmentE2 2 Z0I9 S K- EVA=T Division of Safety and Built L➢i.L1�Y-- LST-docl -063 Page _ of T1 UI11LV Deg. C. Attach complete site plaip_Q��pecno 1 an B 1f2 x 11 mches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Personal lnfo wtM you pny We may be used for secondary purposes tPrwacy law a. 15 os (1) (m)) vw n) J Parcel I.D. , ;f t+f: Reviewed by Date Property owner ,or, Property Location GOA. Lot 1/4 1/4 S% —T N R E (or PmpertyOwners Mailing Address .� lFi1 Lot # Block # Subd. Name or CSM# State Zp Code Phone Number D ( ) ❑City ❑ Ylla a Wown Near t Road ! n ,�,,I �J Construction Use kResideneal / Number of bedrooms Code derived design flow rate y i`X2 V GPD ❑ Replacement ❑ Pugl c o ccgq/ nn-}m-erea/�/y Desaibe: A _ Parent material f9U 6? 7 1 / / � Flood Plain elevation If applicable /:% _IR7 _j. I __ ft. General COfm18mt5 fj,.,4iw Yn z j � 1"� (r. , and remrr1mefdaations: System Type � cee System Elevation _ I Boring # Boring �� ❑ mil- Pit Ground surface elev. (-1, y" ft. Depth to limiting factor �� in. Soil Application Rate Honzon Depth in. Dominant Color Mursel RedoxDescription Ou. Sz Cont. Color Texture Stricture Gr. Sz Sh. Consistence Boundary Roots I GPON •Eft#1 I •EB#2 I - L) C -7 , 6 J/` A1iW aBoring # 0 BMW n y� Pit Ground surface elev. ' a ft. Depth to limiting facto 7 in. Shc AlpPlicaticin Rate Horizon Depth in. Dominant Color Muset Redox Description Ou. Sz. Cont Color Texture Structure Gr. Sz Sh. Consistence Boundary Roots GPDM 'Eft#1 f 'Eff#2 3 - s- v ' Effluent #1 = BOO. > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ure CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date E luation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 C—�—1 T 715-246-4516 Parcel ID # Page —of © • "'ss ./ WRIems ®� FA'� �c0rffl=r9►24WIAU 0 M rfriAw3 ■° ME I Effluent #1 = BOD, - 30 1220 mg1L and TSS >30 1150 ng(L ' Etiluem #2 = SODS c 30 rnglL and TSS 130 nV(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 department at 608-266-3151 or TTY 608-264-8777. seo (s ) Soil Test Plot Project Name Dick Stout - Address 1353 Awatukee Trail I-Indsnn Wi s4niF; Bird VSTM #226900 Lot 4 Subdivision --------- /mate 5/19/19 NW 1/4 NE 1/4S 35 T 29 N/R19 W Township Hudson ❑ Boring Q Well PL Property Line County ST. CROIX ' BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation TBD *HRpSame as Benchmark OWNER URCHINS, LLC 1363 AWATUKEE TRAIL HUDSON, W164016 SURVEYOR EDWIN C FLANUM NORTHLAND SURVEYING, INC P.0 BOX 152 AMERY. WI 64W1 'deg N �i pl CL fezUJI') � Y V �I ti I F 6 U S i a cn Im L`L W25� r W Y a cc � Q SCALE IN FEET 1' = 280' W o � ®��� z V 0 200 4IXl e'$9e• INSTRUMENT DRAFTED BY EDWIN FIANUM o DRAFTED 3/07/19 FIIELD. 3/07/19 REVISED 6/12119 (z F` 51 BEARINGS ARE REFERENCED TO THE NORTH 4) 3 S LINE OF THE NELM BEARING SB 41'14W ST CROIX COUNTY COORDINATE SYSTEM p NE CORNER SECTION 36 NIA CORNER SSO-41'14W SECTION 3fi t° - - — 76306 y see°41'14W 187703 NORTH LINE OF THE NE1/4 E,IptN WTERSTATE "94• je/ Fs SEE SHEET 2 FOR DETAIL OF i DRNEWAY LOCATION AND DRAINAGE EASEMENT DATA] / LOT2_ CSM VOL 29, PG 6614, DOC MIO77B22 It A') BORINGS j 2 38"11-27"E 328.68' �� 888'16'27•E 597.70 _ DEDICATED TO THE PUBLIC C2 d,'}�y,, i' p•-7 ��l i_ 1�7.F '''yppp ----7264 33J33� N88'16'27'W - 7 / J SBB'16'27'E 27424' I 1B512 C3 ;� E O F -sen s LOT 1 7eslk, x+�`j HWE-N48 _��tl 201ACRES it es _ ; e7,563 SG FT �`' pf LEGEND �� 'c`l LYE `989ai Leo-993B •�" _ ST CROIX COUNTY SECTION CORNER POSITIONED LOT 4 $ +� 1� 81 FROM COUNTY COORDINATES POSITION VERIFIED 4 84 ACRES eaI N76'2025 - 16, / WITH MONUMENT AS NOTED OR TIES OF RECORD i 202,070 SO FT 1 by 347 _ LBO-986B ---- ` 1 - IU I / • 1.0D IRON PIPE FOUND • 4�9 v_ _ LOT 2. I n 3/4' X 18' IRON REBAR SET WEIGHING CC.3p+4J 66 � v'" 200 ACRES 1 50 LES PER LINEAR FOOT LOT S 87,285 SO FT 2 W AORES L B 0 -993 6 IS 3/4' IRON REBAR FOUND a7,182 SO W LBO- 98a B L B O a993 a \� \� g -' - - UTIUTY AND DRAINAGE EASEMENT \ \ (SEE SHEET 2 FOR INFORMATION) 19612' 471,33' 19583' L1_ _ _ S89°41'11'W 863.28' LBO- LOW BUILDING OPENING ELEVATION SOUTH LINE OF THE NWI/4-NEI/4 e�a' HWE HIGH WATER ELEVATION