HomeMy WebLinkAbout020-1419-50-000Wisconsin 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 tri
aniel L. and Cara M. Schwartz
Elev Ilnspi BM Elev. —TB—Mc
G
TANK INFORMATION
TYPE
MANUFACT RER R;ytS
CAPACITY
Septic
(
5
' — L a
7
Dosing
G�
r
r
�IYtiC.
Holding
TANK SETBACK INFORMATION blcj-,s 4-
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
Z'q I
110 ,
3 1 ,
Dosing
3 7 t
5 z x
Aeration
Holding
PUMP/SIPHON INFORMATION tkx t-• tJ.i %n Abvi
Manufacturer
Demand
G/1r�. GPM 9Z
Model Numberz5b
TDH
Lift
Friction Loss
System Head
TDgZ Q Ft
// •�
tO
Forcemain
Length L, t
Dia' a
Dist. to Well 50 ,
SOIL ABSORPTION SYSTEM
TOWN OF HUDSON
ELEVATION DATA
County. St. Croix
Sanitary Permit No:
630389
State Plan ID No.
Parcel Tax No
020-1419-50-000
SectionrTown/Range/Map No.
20.29.19.2663
STATION
BS
HI
FS
ELEV.
Benchmark '%
'J, C
_I J
'
(D�
t. BM
S ri t
Z . Oo
4�7, ?-
Bldg Sewer
p p '
D o
St/Ht Inlet
K. 8
s7.
St/Ht Outlet
Dt Inlet
Dt Bottom
17,
HeaderlMan.
Dist Pipe
, x
7
z-
5. /0
65.
95•
I
Bot. System
'T')
L
(o .
7, /
114.1
Final Grade
Z -5
fig,
St Cover /
, l
-Z .3 r.G ZI- -r2Z C%C.iii S
BED/TRENCH
DIMENSIONS
Width ,
3
Length t
!D
r
No Of Trenches
PIT DIMENSIONS
No Of Pits
Inside Dia
Liquid Depth
SETBACK
INFORMATION
SYSTEM TO
P/L i
BLDG
WELL
LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer. //
r r7i�`oY
Ty/pe Oi System
0l7 µ bH/t
7
2 '
GO .
�
Model Number' ^ Ji C
DISTRIBUTION SYSTEM
Header/Manifold 1`
Length , Dia
Distribution
Pipe(s)
Length Dia Spacing
x Hole Sze
x Hole S acing
Vent to Air Intake
,L
I IJ /*
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Svstems Only V-C i74-
Depth Over
N
Depth Over
xx Depth of
xx Seeded/Sodded
xx Mulched
Bed/Trench Center-3— -
Bed/Trench Edges Z r r
Tops
es _ o
— �Yas t� Na
COMMENTS: (Include code discrepencies, persons present, etc) Inspection #1: 1 Inspection #2
Location: 849 CHEBEK L2N I ^.IA
1.) Alt BM Description = V D�'�-wh 51�1 076V-t 1 r+� 7C�✓'E� ! o Px�4 v(O Q i -� µs �-•t �40'
2.) Bldg sewer length = 3 g p� 11 tt
-amount of cover =)v t.v Tsr Inr�IO.� +l./ya,
Plan revision Required? L— Yes No
rmS 3 2 IZZ /.1 2 J ��
Use other side for additional infoalidn. /��7 ` / �._ `II
SBD-6710 (R 3/97) Date Insepctors Signature Can No
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi54017
715-246-4516
Date: 11 /18/20
Owner:Cara Schwartz
Location: NW1/4 SE 1/4 S 20 T29 N,R 19W 849 Chebek Lane Hudson
Manuals Used: In -ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintance and Con4ency Plan
7. Filter Cross Section.
Signature
License number #226900
s0'aT'rtM.a
Safety and Buildings Division
Calmly
201 W:iNashington Ave., P O. Bex 7162
/ ' l
Samtary Petmrt Number (to be filled in by Co )
Madison, WI 53707a 62
p
u
Sanitary Permit Application
Sa<rraosacnooN®bQ
In accordance with SPS M321( ), WJs Adm. Code, subausstm of thus face ental �t
�e�ry
is required prior to otrimunga sm+latj permit Note .Application fortes for state-oowned POW 'iR%"WAUed to
.the DcPartmem Servies. Pers:mal information you provide may be used for secondary
ProJecr Address (tf different than mazling address)
,
puiposes in accordance with the Privacy Law, s. 15.04(1)(m), Stal s
/ /
.
L Application Information- Please Print All Information
Property Owner's Name /f / Pared #
ozo- 1'4N-50-000
Properly Diviner's Mailing Address property Location
j tt� lrl Z� C 3
7� , , •
IbI 0/\ l . Govt Lot
City, Store Code Phone Number
IT
'i1 Section J
II. T Building that 7N; R Eo
pe of (check all apply) Loi #
Family Dw<iling-Number ofBwroorns_� � Subdivrs Name
,
Block #
❑
Public/Commercial- Describe Use
City of
❑ State Owved - Describe Use CSM Number ❑ Village of
ZOA) F of
IIItType rmit (Check only one box on line A. Complete line B ifapplicable)
A1
❑ Replacement Sy, ❑ Treanuentrloldug Tank Replarvnent Only Other Modification to'c osting Sytem (explain)
B. Renewal Permit Revrsioe ❑ Change ofPlumber ❑ Perron Transfer m NewLmP•roviousPerronNumberandDauI=
puahon Owner / v .l l Q
/ C/ ?f / // L
iV. T of POWTS S stem/Com onent ome,e: Check all that a 1 i e Z
❑ Non-Precsuued In -Ground ❑ PressunzcdIn-Ground ❑ AI-C do O Mound 124 m. of suitable soil D Mowd <24 m. of suitable soil
❑ Holding Tank ❑ Otber Dispm-al Component ) Prei rmnetn Device (explam)
V. Dis r i/Tr meat Area Information'
Flow Design Soil Appbcan t) Dispersal Ara Requir (sf) ,JDisCi s7I•pawl Area Pr d (sf) System EI on
M
rok Info Capacity m Total # of Manufacturer
Gallons Gallons Units � I/ l� '�' P Jam-' New Taeks Eumng TaNs ` �1 1"C`f-v i'ih r �-Q - - I ti g;
_
a
ST. or Holding Tank _
lhswg CLambe j
ACV
V11 Responsibility Statement- L the undersigned, a me ponsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Pleb s azure WftAPRS Number Business Phone Nurgber
S ( n /
`--�� z
Address Cry
Plumber`s (Street, Stare, Zap Code
'//
z_ ,s
VM County/Department Use Only
Appmv<d ❑Disapproved
PermitFee
5
Date Psued,
Issuinatme ,
❑ Owner Given Reason for Denial
DL Conditions of ApprovaVReasons for Disapproval '3 ti ` N�
SYSvh`�Gv�t �s o. PJ
I
I
>TF
�YSTEMOWNER: 9Krti 35�(0 (pq
Septic tank effluent f1terand �ab� Oi SU1�aLl� Soil ,�ti`er]
VA
as per marvigewent t�`ii r anod sabmawtbe ComtyoolympaWnalasau.Sla.11,cS .. wl
AH setback reyuvements musl he maintained �5 F �� �y(t�e..�'f q�.-t q wws-� 6f(-der it
as per applcaN', code;crdlnances \ C / l
SBD-6398(R II/11) r' %t'l,lis//��� 'B(//GJfyS lGLI /T'1LZ'ini1.' /rQl4(�-
//K('Ur`Iry,al RCJY1 Ito /}o �p�'�% � [A'✓3' �'t(�'`
Avytem PL
PLAN
PROJECT Cara Schwartz
ADDRESS
4601 Park Commons Drive #224 St. Louis Park Mn 55416
NW 1/4 SE 1/4S
20 /,1' 29 N/R 19
W TOWN Hudson
COUNTY ST.CROIX
SYSTEM ELEVATION
92.5/92.0 4' below grade
2/5/21
BEDROOM 4
DATE
CONVENTIONAL
CONVENTIONAL LIFT
XXX HOLDING TANK
1255 gallons
LIFT TANK sIZE765
DOSE TANK SIZE
MOUND SEPTIC
TANK SIZE
HOLDING TANK SIZE.
LOAD RATE .7
ABSORPTION AREA
891 # of chambers 44
,", BENCHMARK V.R.P.
Top of 1" steel pipe
ASSUME ELEVATION loo, Filter Lifetime Filter
❑ BOREHOLE O WELL *II.R.P. same as benchmark
166' Property Line
25'
45' Vent
B-1
Vent
Scale 4 1 /4" = 10'
A
Quick4 Standard
Leaching Chamber
with 20.0 ft2 of Area
5.6ftA2/pair of end caps
2
Grade at System Elevation
34"
All piping shall be ASTM SDR 30/34 i in
10' of tank, piping shall be ASTM 91
To be >5' from �6
lot line
74'
v�
Huffcut
Combo
Pro 4 Bedroom 30, Tank
House
230' Property Line
r
6% Slope 41w 12
B-3 Yr
sf31 Z►gyf-
B-2
95.5'
■
2-3' x 90' cells with >3' spacing
.M. *
ne
5'
Cross Section of Infiltrator Quick 4
Typical cross section for 2 of 2 cells
Leaching Chamber
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber
5.6ft^2 pair of end plates
Vent Typical Installation
Grade
� 30/34 Septic Tank
5'
Spacing 5'
System elevations:
:61
at System Elevation
5'
To be >1' above grade
Finish grade elevation
,Vent
1"
at System Elevation
2-3' X 90' Cells
Same on other end Observation tubeNent
At end of cell
A
B
22 chambers per cell
% A4-1-c r-
I ti►k-eJ
�a PiVM41
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e l-cv.(4vKs
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