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HomeMy WebLinkAbout020-1106-90-200 (2)Wisconsm Department of Commerce Safety and Building Division GENERAL INFORMATION Personal information you provide may be used for PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) [Privacy Law, s 15 04 (1)(m)J City Village Towns I--- St. Croix I Urcnlns LLC ITOWN OF HUDSON 11 020-1106-90-200 CST BM Elev Insp BM Ell BM Description Sectionrrown/Range/Map No 35.29.19.423B TANK INFORMATION TYPE MANUFACTPRER e� S CAPACITY Septic Z•1G¢. �.SC lDoo Dosing I o P 3.5 W Min �vOo !/+ Holding TANK SETBACK INFORMATION L w k 5 TANK TO P/L WELL BLDG Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION ... %-Na>...., 2n Manufacturer Demand GPM Model Number L� TDH Lii Fri n Loss 1 Systepn'}le� TDY Ft Forcemai�n LengtUl Dia ty Disstt to W II SOIL ABSORPTION SYSTEM ELEVATION DATA 7, 3 10 STATION BS HI I FS ELEV /oZ .o Benchmark 9, Z la`!. I �o Alt_ h,4� 6,� r�3•e Bldg Sewer St/Ht Inlet 10,3 98.E SVHt Outlet Dt Inlet Dt Bottom Header/Man Dist Pipe • 5` 7 ✓ ✓ Bot. System Final Grade St Cover ioti�..� �y- �o �Oz•s BED/TRENCH DIMENSIONS Width v l %- Len 6% No. 9i Trenches" PIT DIMENSIONS No. Of Pits ri Liquid Depth SETBACK INFORMATION SYSTEM TO I P/L JBLDG IWELL LAK /STR M LE HING CH BER O NIT anufacturer Ty Of System rc t C 1 'J I Model Numbe - UIS 1 KIdU I IVN SYSTEM Header/Manifold IDistribution x Ho a $¢e x Hole Spacing Vent to Air Intake Lengt Pipes) 'q r Length U 0 Dia �� l _� Spacing JVIL liV VCR x Pressure Systems Only xx Mound Or At -Grade Systems Only D pth Over d/Trench Center ` vt Depth Over !Trent tlges xx Depth of Topsoil tx xx Seeded/SoddedAll xx Mulched O •� 7 I Yes O No Yes Nc COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 'ruy IG or'l l Inspection #2: Location: No Address Available 1.) Alt BM Description = f' Ll'r`E UVU f 2 ) Bldg sewer length = - amount of cover = >) 8 0 Plan revision Required? 0 Yes No Use other side for additional informs o SBD-6710 (R 3/97) t t/zt/Zl C� hS-M Co►, �a., r S%,{dc d u� S11aiQ d� �a PrDYi wt l %( � o �rw+cc�f Aaaii il Date Insepctor's Signature Cart No C0 51IN-acac)_3ay Cary II T. �T Safety and Buildings Division 201 Vtf"Washington Ave., P O Box 7162 sanitary' Permit Number (to be fined m by Co ) ,,, a r ouncy Madison, WI 707-7162 3T2- coix rent Develop .&W mmunitV Sanitary Permit Applicatio State ra p pnsacn°°N [ W-Ts - I I2a0 '�- in accmdanm with SPS 3&32l(2), R uda ACade, submission of this form to the appropriate ow Project Address (if differeat than railing addles) is required poor to obtaining a sanitary permit- Note .Application forms for stambwved POWTS are m the Department of Safety and Professional Servies. Personal information you provide may be used for secondary Purposes in aecotdanec with the Iaw, s. 15.04l1 m), Stator --/ ^ �� L lication Information- Please Print All Information Property Owner's Name 1 I�� zznfCy Parcel #' potf : 020- i196-et u f " Property Owner's Mailing Address _ wn Pr°Pem°° 17.S f Govt Lot �- �% ;4, i/y Section 3 N Stare Zup Code Phone Number (w S I (tale r N; w U/I}, Type of Building (check all that apply) 2 Lot # Subdivision Name atmly Dwelling -Number o/yg,�,�ooms J I ( �'i Block# / ([ iC 0 City of ❑ PubliclComaremial- Describe Use` 1 ❑State 0wved-Describe list CSMNumiber ❑Village of Of III. Type of Permit (Check only one box on line A. Complete line B if applicable) A System El Replacement System ❑ Treammart/Holdtng Tank Replacement Only ❑ Other Modificanon m Dusting System (eaplam) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber O Pemu Transfer to New List Prevmas Permit Number and Date Issued Before Expiration 0w cr fV. Type ofPOWTSS stem/Com nerruDevice: Chet all that e I ❑ Non-pomurosd ln.Groimd ❑ Prmsutved In -Ground At El Mound 124 m. of suitable soil El Mound <24 m of suitable sod ❑ Holding Tank 0 Other Dispersal Conk®em lam) ❑ Premeamieot Devrw (explain) V. D'Sven re'S eut Area Information: go flow (gpd) Design Soil Application dst) Dis Aria Required (sf) is Area Proposed (st) yAerm Elevation i VL Tank Info Capacity m Gallons Total ciallons # of Mmufactu er Uma v l 2 0 U 6-75 a _ Anew Sinks EuannH rsW¢ Septic or Holding Tank Dosing ah..ba Vil Pe pomdlyility Statement- LAc undersigned, me responsibility for installation of the POYM shown on the attached plans Plum 's Name (Print) PI s Signature MP/MPRS Number Business Phone N ber Sa � Phmtber s AQ; Street, rWp C/aa/ntLer-aartment Use Only ,mot Approvedssi�pp 0 Di Penn Fee S Date Issued Issum cut Sign ((� [I Owner Crtv`nial DL Conditions o ppro i ! TEM OWNER. �t.�.p� S t iRS erf epbc tank effluent filter and be. I maintained ispersal cell must serviced. per management plan provided by plumber. 2 p or f)x system�a ba�it /m Me Cowry ody a paper an Ins tbao g to s 11 es m s 1 t as per applicab'.o code 01 finances, 5 A41 C&-Ate ,�-R1 e-'-S t�n� S SBD-6398 m 11/11) '� 4te-d OA4_ (t\ UtwLptr' PROJECT Urchins LLC N 1/2 NE 114E 35 /T 29 System PLOT PLAN _ ADDRESS 1353 Awatukee Trail Hudson Wi 54016 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 101.5' 11/2120 BEDROOM 3 PATE CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC 'LANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of Chambersnone 1k BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime ❑ BO�REEHOLE O WELL .H,R,P, same as benchmark Scale = 1/4" = 10' � 313' Property Line a Pro 3 Bedroom House Grading is to be done to divert run-off away from system 1 5 0' 40' 80' WWII Is to meet all WDNR setbacks ©"" 0 6% Slope B-2� B- V 102' 101.5' 101' 1001, Benny Circle aQn`geE� ementT Ar 5' below stem is to remain undisturbed 452' Property Line �Ov DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay http lldsps wi.gov/programs/industry-services www.wisconsin.gov Tony Evers - Governor Dawn Crim - Secretary November 5, 2020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2022-11-05 Plan Review: PWTS-I 12002678-C SHAUN R BIRD 1432 120th St New Richmond Wl 54017 SITE: Urchins LLC 745 Benny Circle Town ofHUDSON St. Croix County Total Amount: $250.00 FOR: At -Grade Component Manual - Ver. 2.0, SBD-10854 (N.03/07, R. 1/12) Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N OLOI, R 10A2) Description: 450 GPD (3 Bedrooms —:Vero CoeUtructiom 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 material 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 wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it 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 with rock bacnicnts, tree roots. stumps and boulders reduce the amount of sod available for proper treatment. If no other site is available, trees in the basal area of the mound most be out off at ground level. A larger fill area is necessary when any of the above Conditions are encountered, to provide sufficient infiltrative 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. Owners 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 hazard, 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 construct i on/install ati on/operation. In granting this approval the Division of Industry Services 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 provide 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: tim.vanderleest(m'wisconsin.eov Cell: 608-516-6134 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:10/31 /20 Owner:Urchins LLC Location: N1/2 NE1/4 S35 T29 N,R19W 745 Benny Circle Hudson Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 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 8.4 Maintance and Conting¢4P' Attachments: Soil Test Shaun Bird Signature License number Page 1 of 9 PROJECT Urchins LLC N 1/2 NE 114S 35 /T 29 System PLOT PLAN _ ADDRESS 1353 Awatukee Trail Hudson Wi 54016 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 101.5' DATE 11/2/20 BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of Chambersnone BENCHMARK V.R.Y. Top of 3/4" pipe ASSUME ELEVATION too' Filter Lifetime BOREHOLE O WELL .H.R.P. sameasbenchmark Scale = 1/4" = 10' 313' Property Line 01 40' so, Pro 3 Bedroom House Well Is to meet all WDNR setbacks Huffcuff Combo Tank Grading is to be done to divert ` run-off away from system 6% Slope B-2 102' / 101 .5' 101' 1 50' 100, a�11r" Benny Circle Lain lge E �ernent A 5' below stem is to remain undisturbed 452' Property Line At -grade System Sloping Site Cross Section and Plan View _ _ _ _ _ - - 1 � t Plowed Clean aggregate 0 = 4 in. sch. 40 pvc basal area },'+y %s to 2 '/� in. dia observation pipe Lateral with 2" aggregate over pipe Geotextile Fabric Topsoil Cap Slope Direction U Observation Pipe With Cap --� Topsoil Cap 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 %a 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 suzface. After'the topsoil cap is placed, the entire at -grade is seeded and mulched to promote yegetativa 064h, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 in&es and secured in place. 03/051gj Page of� Fc Pressure Lateral Layout One Lateral — End Manifold � N r,`,(oa, DI /- LA VJ P. 0 Distribution Network Specifications Lateral Diameter I e,2, In. Orifice Diameter 3 in. X Orifice Spacing) In. L Lateral Len Ft. Force Main Diameter In. Force Main Length S Ft. 4 Threaded Cleanout Plug ong Neep 90 t3end 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. ••••• Grade •••••• ;ip._?..;_.;.; ••••••• 031051gj Page L of- ank Crosse Section And Pump Performance Specifications Filter Manufacturer Filter Model Number i Minimum Pump �erfotmance Required TDH outlet Manhole Min. C Above Grade With soaking Device. Inlet Manhole ✓✓/50 < 6" Below Grade Sealed Watgrtimht a® -� � — — 'i — Finished Grade outlet Filter Inlet �— - inlet Baffle Switch S and Reserve Capacity Tank Vohuna = Y -- ' GPI Dimension, I Inches Volume Gal. (reserve) A; s tS s (alarm) B 2 O (dose) C; ,S 97� (de4 D .--�— Total '630 treimberOuarumberc� Womd Kr G KTotalynamic Heed (TDH) - Feetdess Manhole Min. 4" Above Grade Securely Mounted With iAcicin6 Device Weather-proof 1 Junction Box Veer Min. 12" Disconnect Above Grade Means With Vent Cap A 04 _ Weep B nX. Hole Off Elevation C ;y a7 Ft Bottom D Elevafrton '4 .9 Ft GENERAL INSTALLATION- ne sopticldow tank is bedded and back filled in accordance with the manufacturer's product approval spoofflotions. Maximum depth of bury as VmiWd by the manufacturer may not be exceeded without prior approval. Manhole covers expo to grade have an effective loddag device (padlock) installed. Piping at the inlet and'ouflet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. no force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation acid the sleeve is sealed watertight. Electrical sml plies with NEC 300 and Comm 16.29. 02105 LI Page 5- o 2S0=SER►ES 1/2 hp Submersible Effluent/Sump Pumps The Liberty 280-Series provides a cost effective "mid- range" pump for on -site waste water systems, liquid waste transfer and commercial heavy-duty sump pump applications that require higher head or more flow. Designed around Liberty's unique "Uri -Body casting, the 260-Series will provide years of reliable performance. All Models Feature: • Vortex style impeller pemitting passage of solids upto%' • 416 stainless steel rotor shaft • Permanently lubricated upper and lower ball hearing • Epoxy powder coat finish • All fasteners -corrosion -resistant stainless steel • 1 X' Discharge • Stainless steel bottom screen - easily removable • Maximum fluid temperature: 140'F. OW -Series Cord Lengths � Motor Specifications A hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps (11 M 4.0 amps (20812WV) Performance Curve: 280-Series v B 2 aio.ttuo.ttt�uu.ttt�..o.00sac U.S. Gallons Per Minute as 78 114 156 192 228 270 1]ters Per Minute Dimensional Data: Weight 29 lbs. Height 13' Major Width.10' (model 287) Minimum Sump Diameters: Model 281, 283...14' Model 287 VMF... 10" Factory switch Model 281, 283 ModN 267 sate VMF Turn on level 13' 9.5' Turnoff level 7' 4.0' The Model 293 katurea a tt4 adlistab6a vade-erVIO coat DMennri.i aaUxbrt ft wn ba made •aasy bytvt whmg the Mat to the rk charge pipe or other rnotndng point vertical Mat modal 207 to not Aust". J J J J IIManual, Wide angle Wide angle no switch �' - I(plggy-baclQplug 1II1��1 C us Certified Model 257 VMF4krles Vertical mag- netic float for smaller OW - will operate ti a 10' dlarneter• sump lRerty Pumps • 70W Apple Tree Avenue • Bergen, New Yak 14416 • Phone 800-643-25M FAX MW 494-18" wwwJlbertypurnps.eom cor„ay,r o ubatr Pt•ro•. I==7 Atrly.biv.eva tur2000novm7 4' 0� 20140048A 045200 19.B000 IB-000D 1.1921 �A v K q 9J759 94 9.4356 6r-7 .01Cop beh+ Cme a Serpentine JA I• r } 10 --r2 - _ S' SECTION A -A POWTS OWNER'S MANUAL.& MANAGEMENT PLAN POP— ILE INFORMATION Owner &r7 1-C, I Permit by )ESIGN PARAMETERS Number of Bedrooms 3 ❑ NA i Number of Public Facility Units DNA Estimated flow (average) gal/day Design flow (peak), (Estimated x 1.5) yu1) Soil Application Rate - %3 aUda M? Standard InfluenUEflkient Quality Monthly average Fats, OfI & Grease (FOG) 530 mg1L Blochemical Oxygen Demand (BODs) 5220 mgA. ❑ NA Total Suspended Solids (TSS) 5150 mglL !Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODs) 530 mg& Total Suspended Solids (TSS) 11 530 mg/L >7 NA Fecal Cogforrn (geometric mean) 5104 cul00mi ,Maximum Effluent Particle Size i& India. ❑ NA Other. *Values typlcai for domeek; wastewater and septic tan k.effiuent MAINTENANCE SCHEDULE SYSTEM Septic Tank Capacity al ❑ NA Septic Tank Manufacturer ❑ NA Effluent Filter Manufacturer ❑ NA Effluent Filter Model f� ❑ NA Pump Tank Capacity t ❑ NA Pump Tank Manufacturer 0 NA Pump Manufacturer �� ❑ NA Pump Model ❑ NA Pretreatment Unit ❑ Sand/Gravel Fitter ❑ Mechanical Aeration ❑ Dielnfecuon ❑ Peat Filter ❑ Wetland ❑ Other. Dispersal Cells) ❑ In -Ground (gravity) At•Grade O D p-Llne ❑ NA O In -Ground (presaurizad) ❑ Mound El Other. Other. ❑ NA Other. ❑ NA Other. ❑ NA Service Event Service Frequency Inspect oondition of tank(s) ! At least once every: ea s s ,Max mun 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third ()3) of tank volume ❑ NA Inspect dispersal celt(s) At least once every: ❑ mordh(a) (Maximurn 3 years) ❑ NA Clean effluent fitter ' At karat once every: � ❑ °mtlh(s) ❑ NA Inspect pump, pump controls &alarm At least once every: ❑ th(a) 3 NA Flush laterals and pressure test At bast once every: ❑ monih(a) 3 wr(s NA er, At least once every: 13 =(Ls)NA r. NA MAINTENANCE INSTRUCTIONS llnspectons of tanks and dispersal cells shall be;madeby an individual carrying one of the following licanim or certifications: ter Plumber; Master Plumber Restricted Sewer, POWTS Inspector, POWTS Malntalner, Septage Servicing Operator. Tank hspecilon must Include a visual Inspection of the tank(s) to Identify any missing or broken hardware, Identify any cracks or leaks, measure the volume of =mbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shag 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 effiuem on the ground surface:may Indicate a falling 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 (%) or more of the tank volume, the entire contents of Ifro tank shall be removed by a Septage Servicing Operator and disposed of In accordance with chapter NR 113, Wlaconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment urib, and 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 arty service event ,::6D4 � Pape _ of _, START UP AND OPERATION For new construction, prior to use of the POWTS Check treatment tank(s) for the presenoe of painting products or other chemicals that may Impede the treatment process and/or damage the dispersal calks). 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 be discharged to the dispersal cell(s) in one large does, overloading the call(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 Sept"* Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Malntalner to assist In manually operating the pump controls to rest" normal levels within the pump tank. Do not drive or park veMces over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soili absorption area. Reduction or ennifnaton of the following from the wastewater stream may improve the performance and prolong the His of the POWW$: antiblotica; baby wipes; cigarette butte; condoms; cotton swabs; degreasers; dental floes; diapers; disinfectants: fat: foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting product's; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS falls and/or is permanently taken out of service the following steps shall be taken to Unsure that fie System is propeliy and safety abandoned in compliance with chapter Comm 83,33, Wisconsin Administrative Code:. • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another Inert solid material. CONTINGENCY PLAN If the POWTS falls 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 systekn. The replacement area should be protected from disturbance and compaction and should not be Infringed upon by requirled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the nefed for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule$ in effect at that time. ❑ A suitable replacement area Is not avallaWe due to setback and/or soil limitations. Barring advances In POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. must has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and alto evaluation must be performed to locate a suitable replacement area. If no replacement was is available a holding tank may be install.d as a last resort to replace the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in piece following removal of the blomat at the Infiltrative co. Reconstructions :tions of such systems must comply with the rules In effect at that time. <M/ARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER ASEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK; MAYBE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWT8INSTALLER Name 1 -9,-, _^ Phone J SEPTAGE SERVICING OPERATO PUMPER LOCAL REGULATORY AUTHORITY Name Name �i��xj4 _ /o Phone — — 41 1 Pine /IJ ' fI a D This domumit was drafted In mrpllanee with chapter SPS 393.22(2)(b)(1)(d)&M and 383."1), (2) i (3), WkcorkW Adminbaarive Cods. JUN 29 DMalon DepartmentofCom+wma J. EVALUATION REPORT Page of DlNsbnaf 8aley end Buldinge ' In 96dofftede '®auCbM 85, . Adm. Code pm u I Dev to men[ Gornto (g(. Attsdt Mrtiplets sMe pion on paper Plan must Irclo rw rotBMled to: vertical and halrortblrefemtapolM(BM), direction and Perosit.D.Qar1'•(t 01O'Ilb6-eIb-l0b Pw=nI slope, Irma er(1en.rtauta, north crow, and I=tion and dlelar"to nearest road. Please print ail Information. Re b Data Pw-nw IKoerw9enyw.w*vda may se uwd brsaomary OWDtws (iMscy,aw, a 13.04 im.)). I'MpenyDvmer Pmpenyl.oradon GovL Lot t 114 114$3 T N R E( W Propertyamwes Meting Address 3s Lot 0 !� BlockIt Subd. Name or CSWN Sc, / SUMS g1p4wee rJ UCMy ml xvt Nearest Road t Nee'Corrooucdon aidentWINumbsofb diacros Code dedvsd deagn crow rob Cj RedawmeN �/j/f) ❑ PvbH commerdel • Deembs __ Parard meledal•-t"f l�lG i1/ Eil'L ✓ Flom Plain swation If appurawa Z Gsrrsl mrmxdarjg4}rG S�a:a-i Bred raoorm endenona: System Type System ElevationIT OPD __ � l Zb I 1 e� e. �T+� ❑ Baring n BoNp 0 j9-pit Ground atafsa elev. I U L• 1L Depth to kAfti g factor _ {' L- in. SoX ADoliostIon Rate Holbert Depth In. Dommarecow I Murtse9 R.edox Description ou. SL Cont. Color Texhse I Struchua Gr. SL Sh. Consistence aoundsy Roots &MI 'E,f02 C J (/ n F:OW,i Boring a' Be" 0 )5-fit Ground arafaoe alev.lo 2,0M Depth bMilling tailor 7- In. soa ApplUostlon Rat. Hottmn Depths h Dominant Color I Murtwo Radpx Description Du. SL ConL Color Taxaae Struchue Gr. SL Sh. Consletanw Boundary Roots GPWR 'PA01 'EM 2 I t S ,- 4 — V v > •Efused N1 vWD.>30:1 myl and TSS>30a1 sd 02- BOD. 130 nVL and TSS 130 not CST Name (Please Print) gnalum Bird Plumbing, Inc. Shaun Bird CST Number 225900 Address 1432 120th St, New Richmond, WI 540 Eveawtfon Conducted 17 Telephone Number 715-246-4516 u Y•7 Property Owner_ Parcel 10 # ©"#ng F.'It Ground surface,elev. ✓ h. Depth to lUnhing recta -3-7- In. Page _of_ Sdt App-10 tl hate MON rm Mffln�� � I .Am, e . . /�! s' D4 0-1■L�J�J JLIWIM ■■�� ■■■■■■■ ■ a = a'fi m # ❑ 13anrw Cl Pit Ground aurtaa elev. R Depth to ln„laag hoar in. SoM�AaaBcebon' Rale1 Effluentill - BODr> 30 < 220 mg& and TSS>30 < 150 mgA ' EeRlaM #2 + BODr < 3p mgh and TSS < 30 mgti 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. aeouwotamt Soil Test Plot Pla Project Name Urchins LLC S n Bird Address 1353 Awatukee Trail Hudson Wi 54016 STM #226900 Lot 11 Subdlvlslon Summer Prairie 1st. Add Dat 6/24/20 N 112 NE 1/4S 35 T 29 N/R19 W Township Hudson Boring Q Well PL Property Line County ST. CROIX BMorVRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation TED •HRPSame as Benchmark Scale = 1/4" = 10' 313' Property Line 1 50, 6%Slope A / Benny Circle 100, B� B-3 10' .M.' 102' It Drainage Basement 101, �0 i&4 X +Uj, 100' S ty je, 8 ha.U` 6e- ingAa.U.cd 452' Property Line W ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer R 1- L ©• � t.tfi Mailing Address Property Address 3S % Y_ (Verification required 141-4A.S0K( L-�1SG Zoning Department for new City/State _V\-%Ake.0 h % kASl&C,• Parcel Identification Number LEGAL DESCRIPTION q Property Location �1 _ '/1� '/, , Sec. T � f N R/ W, Town f Subdivision Plat: It/ AA 2 ( �, Lot # . Certified Survey Map # Volume , Page # Warranty Deed # � p13 2gs-2— (before 2007)Volume Page # Spec house Dyes*o Lot lines identifiable)(yesOno SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you pm into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 fiill of sludge_ I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms_ SIGNATORE OF APPLICANTS) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department ••� Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. - (REV. W12) LEFT ELEVATION FRONT ELEVATION ,, v" . i C. BACK ELEVATION RECEIVED NOV 16 2020 ST. CROIX COUNTY CDD armI� i�_I�I it RICFIT ELEVATION z N O _ o � w 5 i b NMd NouyaNnoj GID a1y;100 xlo2io 1S OIOZ 9 1 AON NV'ld UAll NIVW .. S It I-V77 i p t r � �, 7-1 r nnp Alljn00 M(D2jo IS w� a 01019 1 AON — Nvid 12AT aN031s 'n 3 Y n do s no�unnooxioaolg N �o oaoa s AON 1 w _ 4 DECK LEDGER DETAILS ° E OVERALL SECTION RECi ... .-. ,, ._ NOV 16 2020 sr.CaOIXCOU: i c'D C ..... ,. �� 0) g'r .. ...„� .. _..... a,... ..m�,. se .. ... .. .ter. .. v..m... PULL WALL DETAIL AT 6A5EMENT 2 GARAGE PARTY WALL DETAIL 3 WALKOUT DETAIL 5 DECK POST DETAILS 5 ,. 5,.. ,- z 0 c, 0 311 cn cn rn 7o V SGsg�sr� 2.42 ACRES 105,479 SO. FT. L.B.O.=979.00' 15065, V% 3.00 ACRES 3B, 130,733 SO. FT. L.B.O.=980.50' L.8 —..� / 1BENCHMARK y —TOP REBAR ' HLEV. = 977.73' c\i , iso has `02 ` ROB 71g 69 C7 ` • Ge�iO / S4 3'03"E STORMWA TER EASEMENT HWL/E,O.F.-g77.00 N7g°78'31,w 45_8 -� LOTS 3.00 ACRES 130,702 SO. FT. L.B.O,=980.50, I� II HWLJE.O.F. = 978.30 STORMWATER I EASEMENT 23.15; r-39.70� X LI 2p, /Q,p9�G 2.0 1 G� 88.0 N�o L.B.0 e � 1"W REMAINING PART OF LOT 2 - CSM VOL. 29, PG. 6614, DOC. #1077822 ACCESS RESTRICTION CLAUSE 'ALL LOTS ARE HEREBY RESTRICTED SO THAT NO OWNER, POSSESSOR USER, LICENSEE OR OTHER PERSON MAY HAVE ANY RIGHT OF DIRECT VEHICULAR INGRESS FROM OR EGRESS TO ANY HIGHWAY LYING WITHIN THE RIGHT-OF-WAY OF INTERSTATE KQ& IT IC PYPDPQQI Y IAITCKInCn T ATTWC DCQTDIhTlllI rnr.icnn iry n hM�y C,,ST-2a2c) ILI Wisconsin Department ofCommerce SOIL EVALUATION REPORT Division of Safety and Buildings I j In acdordan¢e wxh Comm 85, Wis. Adm. Code (�j'� n county Attach complete site plan on paper riotless=s , Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel LD Qr r {-o i; 02D- 11 Percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed b`{% I Pmsanel infarma Ya Provide meY be used la secondary PuToses (Privacy Lew, a. 15,04 (1) (m)) y, A _/ Page _ of Date e't GovL Lot jl/ ' 1/4 1!4 S 5_S T N R E ( IN Property Owners Mailing Address Lot # Blook # $lid. Name or CSM# �nr�;t — S i City State Zip Code Phone Number ❑ city ❑ Villa wn Nearest Road New' Construction Uso� esidential / Number of bedrooms Code derived design flow rate %-U GPD ❑ Replacement �//�/1 ❑ Publi r commercial - Describe' Parent material L�ry/r,(r,,.� ['(-C(�dC,e/ '�� Flood Plain elevation if applicable /I✓i r1� `y n Q }L General oommenf ,s-,(A rC Sen Q2�, and r'ewnwriandations: '7-� System Type c r � System Elevation 1 ;ip FTBoring # Boring I n l jn-pit Ground surface elev. L ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture4Sh. Structure Boundary Roots GPDNF in. Munsell Qu. Sz Cont. Color •Etf#1 •EB#2 3 77��, v ; oi, �f , # Boring , n 4/ 7 it Ground surface elev. ` �� L • �1L Depth to limiting factor in. Sod Application Rate Horuon Depth in. Dominant Colo Munsell Redox Description Qu. Sz. Cont. Colo Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#2 1-4- ^ /— C aEff#1 � • ElAuem #1 = BOD- > 30 < 220 nxyL and TSS >30 < 1 Went ir2 = BOD, 30 ng/L and TSS < 30 rtxyL CST Name (Please Print) gnature CST Number Bird Plumbing, Inc. Shaun Bird l—� 226900 Address 4te Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 / J'-[7 715-246-4516 Parcel ID Page —of ,❑,�r� Boring �y yu_p,t Ground surface elev. iL°ft. Depth to KmMV lads _--1 in. Sod gpdicayce Rate ©AP�41�J.��1.1.1�L'�.Al_�'iJ�JI�'JL'!�r/�7 Boring # ❑ rg ❑ pit Ground surface elev ft. Depth to limiting factor in- Sol APdicafiw Ti�te Effluent #1 = BOD, > 30 1220 mWL and TSS >30 1150 mg1L - Effluent #2 = BODs < 30 mg& and TSS < 30 mWL 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. Soil Test Plot Project Name Urchins LLC Address 1353 Awatukee Trail Hudson Wi 54016 Bird -PSTM #226900 m Lot 11 Subdivision Sumer Prairie 1st. Add Dat 6/24/20 N 1/2 NE 1/4S 35 T 29 N/R19 W Township Hudson ❑ Boring Q Well PL Property Line County ST. CROIX L� BM or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation TBD *HRpSame as Benchmark kalna.q,� LGt � t Rtr (l 0 nl# CODIFY PLAT SUMMER PRAIRIE 7 ST ADDITION SURVEYOR OWNER LOCATED IN THE NWIX OF THE MEW AND IN THE NET 14 OF ME NW1,10F SECTION 35, AND IN SF11A D{ THE 6W1/A OF SECTION {I ALL IN T21N, R19W TOWN OF HUDSON. ST CROM WSURVEY NFM UN"WISCONSIN. INCLUDINO PART OF LOTS I AND I OF CERTIFIED S \ MAP RECORDED IN VOLUME 29 PACE AN A, DDMNUMBER 1071922 AND PART OF TDT A OF CERTMIEO SURVEY MAP ^Y ~x � v .w RECORDED IN VOLUME SO PACE I731. DOCUMENT NUMBER 1092902 5[Alf , FMl I- . r W of Fel✓Y T,z tsMJ 29"e6, o". .," rBv2rN MtW 3 MI I/ �¢ srn m: v s raz; - 1- r 5N[FT I OF 2 5NEETS