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HomeMy WebLinkAbout032-2019-80-000 ' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420376 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. � q (7r_ Permit Holder's Name: City Village X Township Parcel Tax No: Ristow, James I Somerset Township 032- 2019 - 80-000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA V V TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 2. ` L M66 Benchmark 0 CU •0 Ly) Dosing Alt. BM Aeration Bldg. Sewer ,.�, L t Holding St/Ht Inlet -Z ' TANK SETBACK INFORMATION St/Ht outlet 77-63 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD 9EInfe4S t-z 7� , f3/ � WtJi' Septic � � ^' � � .,... -- et -atmem 2 $.04 � 3 �I Dosing ILt 1 Header /Man. Aeration C I • t 6 Holding Bot. System ID .-35- 4s.ao Final Grade PUMP /SIPHON INFORMATION M anufacturer Demand St Cover _-) „ `e .� GPM Model Num r TDH Lift iction Loss System Head 5H Ft i Forcem I aid Length D to Well SOIL ABSORPTION SYSTEM Q 0 Pa RENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. pth I 3 D b � SETBACK SYSTEM TO P/L D WELL LAKE /STREAM LEACHING ct y�? r � INFORMATION CHAMBER OR I ! Type Of System: UNIT Model Number DISTRIBUTION SYSTEM Header /Manifold . , Distribution � ,, Hole x Hole Spacing Vent to Air Intake �� — t�J �— Pip ) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over IDepth Over xx Depth of xx Seeded /Sodded xx Mulched BedlTrench Center Bed/Trench Edges Topsoil All Yes ® No [j Yes Og No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 12— / Der / OZ _ Inspection #2: ' Location: 427 Highway 35164 Somerset, WI 54025 (NE 114 SW 1/4 5 T30N R19W) NA Lot 1 , Parcel o: 05.30. 19="6� u.so- '5 *'2 a t*k-0r p c�°,er.,o :, 6,4 pl,p� w, C 3 vv 1.) A lt g s ewer length Description = n � M /I - 2.) Bldg s = '� � tt.0+�+� Cam. - amount of cover = ( k `b "Dk•So�+ ->u P ` (�- e"Iou ° � �,,, -- 2 " -- 1& �AP '� ®� � f ';�o�,� oa. ( - sT �Z. 3) N o AO aA- "e0,D, a c4_ ( � Use other side for additional information. I _ '�- Plan revision Required? Yes No O 6 formation. ,. Date nsepctor' Signature, d n ot It t _A Qelt. Flo. SBD -6710 (R.3197) o� �� ek�" bt�_VIp County ................. .._.. Safcry anJ liuildutgs ptnstun . Washington Ave., P,O. Uox 7162 Site h60r'ail T l �sconsin MaJlson, WI 53707 - 7162 � Department of Commerce SaNwyPettatit Sanitary Permit Application ��36 ut au,ord with Comet $3.2 1, Wis, Adm. Coda )xrwml info u° ❑ Chock if Revision au be used for second ses Privac l.,aw s 5. 1x SqW .PwD 1,D Mum t 1, AppUwuon Lif(IMUtloa - Please Print All inforntutlon g 228 �`cu+5• /D . p Mumbo r p� (��• p Props wsxr's Nuns 2 ?p Q $U �. �J ZD J property Locaoon Pro tzy Owner's & x& Add u N, R '� � /� t Number Block unapt r '�j! I , � Phunc Numlrcr City, State k Subdivision Now sue? r� ociry U. 1y{se of t1uilJutg (check all that w {r{rly) I or 2 Family 0wolltng - Nwn(xr of lkOrvvm> _.._...,_._... QVhia�e ..�.............�- ---- -- _ owru Pubitc)Conuncrctal - lkxntx Usc �..t£ :....?� O State Owtsed ) III, Type or Penult; (Check only one ox oo line A (uunsbcrUsg scheme for intcrual use), Compieto Woe, appucable) A' l New 2 O RcptaceaacnI System 3 O Rcplawicnt or 6 Q Additio For Couaq ua n to S � Tank ON taxis S stem Dow lssuod B, O Cboek if Saniwuy Pcrusit Previously issued Pcraut Numlxr IV, Type of Permits (Check all that apply)(nuwbering scheme is for Intcrnstl use) -f, 0 A- - �� �r 47 Q surd Filter 50 O Coaurucwd WoWnd 44,ta.Non - Pressvriu.4 !n•Grouad 21O Moursd 22 Q Pnsswized in -Oround 410 Holding Tank 43 O Siaglo Pass 510 Drip Lice 45 O At -Grads 0 O Aerobic Trwtmcnt Urea 44 O Rocireuladn 30 Coot V, p ersaJ/Treatment Ar Inf ormation: percolauon Raw ytwm $levation FUW Gndt Design flow (gpd) Dispersal Area Dispersal Area 'oil App icaavn F.Joradon Required Proposed Rate(G+tls• /Days /Sq,Ft,) (Min.Aneh) G �/_..0 , . 5 _ Prefab Site StKI Film( Nlu V1, funk lnfv Capacity ut Tvul N�unlxt Manulacwror Cos>oR� ��� Ql+ss Gallons Gallons of Tanks Ncw Eru Septic or Holdiq Tank Dosias Cumber D VII, Respousibility Statement- I, the uudcrrt ed, assume responAbILty for tastalladoo of the POVM shown 0o the ettsebed plaw. Plumber' Manse (I' ' ) Pltsmbe 's Si MP/MPRS Number PbAOi Nuafber AL Plumber's Address (Suet, City, StaW, Zip Codc) VIII, Count /Dc artmeat Use Onl Sanitary Permit Fee (includes Groundwater Daw lewd 16004 441111 30 NO Sum; Approved O Disapproved Surcharge Fee) Q Owner Givco initial Adverse Deter mination .,_.. - LX. Conditions of pp rov v /�� j D S P >r r►tBNMLO 2 3 , �' L P,� ��.,.. .,� f_�tM S Sk�t: c caoplot pLwu (to tat Coyatl ou))) ror tog gviva va popor w Wei Is/3 i Il IiHsw Is trip s tns M&4m aa P-t. SBD -6398 (R. 05/01) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County l Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner cation S J ,4 14 Gdvt. Lot 1/4 1/4 S T N R E (or Property Owner's Mailing Addre s Lot # Iloc # Subd. Name or CSM# City State Zip Code Phone qumber City Village ❑ Town Nearest Road l ON New Construction Use: ❑ Residential / Number of bedrooms Code derive design flow rate GPD F Replacement 0 Public or commercial - Describe: 0 - 4 Parent material Flood Plain elevation if applicable ft. General comments and r Boring # Boring C� ./ Pit Ground surface elev. ft. Depth to limiting factor > / Y in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 r J Boring # Boring ® pit Ground surface elev. , 9, (�2 ft. Depth to limiting factor j in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 -- * Efflue9t #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L uent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name le a Pri i Signature CST Number ZZ I Address 1 ate Evaluation Conducted Telephone Number SBD -8330 (R07 /00) Property Owner Parcel ID # Page L�2_ of Boring # 12 ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor f in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 / •/ Boring # ❑ Boring ® Pit Ground surface elev. ft. Depth to limiting factor f C in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 s ❑ Boring � �// Boring # Ground surface elev. ft. Depth to limiting factor in. ® Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 X/111 All i .2 9( L * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /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. SBD -8330 (R.07 /00) Property Owner Oct Parcel ID # Page -3 of Boring # ❑ Boring C Ground surface elev. '� � ft. Depth to limiting factor in. 1 Pit _9�` P 9 �— Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. C nt. Color Gr. Sz. Sh. *Eff#1 *Eff#2 r c am^ S'8.8 9 Y. � F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. El Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /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. SBD -8330 (R.07 /00) .Y . Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of . Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code * A. County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 1/4 1/4 S T N R E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village ❑ Town Nearest Road ❑ New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: F-1 Boring # Boring ❑ ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 I * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number Address Date Evaluation Conducted Telephone Number SBD -8330 (R07 /00) A4 19 0 / O PP 98 Li 4 SAFETY AND BUILDINGS DIVISION Field Operations Bureau � 13 East Spruce Street INSPECTION REPORT Chippewa erce to sa7 � � www.commerce.state.wi.us isconsin Scott McCallum, Governor Department of Commerce Philip Edw. Albert Secretary Date of Inspection: June 18, 2002 RECEI ame and Address: Project Name: Ristow Use: New Office Space Legal Description: SW, 5, 30, 19W �,� i r 0 1 20D2 Site Number: .f �� Subdivision: sT. t: Olx c;t1t0 einm oil Tester Name and Address: Municipality: Town of Somerset oriil`c O`( O'Connell, CST 224263 County: St. Croix 4 3rd Ave Osceola, WI 54020 Plan Transaction Number: Sanitary Permit Number: Owner Name and Address: James Ristow Wastewater Flow: 600± gpd 423 165" Ave Persons Present: K. O'Connell, K. Grabau Somerset, WI 54025 Onsite consultation and soils investigation at the request of the CST, Kim O'Connell. This lot has been filled and compacted. Past attempts to design a system to serve this lot have been unsuccessful in that only a holding tank system was available. Holding tanks for new building use in St. Croix County are prohibited by county ordinace. Therefore this lot is only developable using a septic tank — soil absorption system. Several soil pits were reviewed. The south half of the lot had been extensively filled with sand. However, the underlying materials will not readily accept wastewater and flow may move laterally and seep out at the property line. The southwest edge of the lot was not filled but is too small to install a dispersal system. Several soil pits were constructed at the northwest comer of the lot in an area previously used for vehicle parking /storage. The upper 10 -12 inches is compacted and exhibits redox features due to compaction. The subsoil consists of a well- drained, massive, sandy loam glacial till to more than 72 inches. Soil application rates for such material are 0.3 gpd/ft ^2. The completed soil and site evaluation report shows various depths of compacted fill at the surface. In addition the natural soil below the fill may also be compacted. Redox features observed in the fill and compacted soil are not naturally occurring and do not have to be considered in the design of a below grade system. Finer textured massive soils with a 0.0 gpd/ft ^2 soil application also exist in areas to a depth of about 38 inches. These conditions must be avoided. It appears from the results of the soils report by CST O'Connell and my observations that a system could be installed below grade and meet the requirements of Comm 83. However, this is still a marginal site and the design of the system should be conservative. Recommendations include: 1. Install the system at an elevation of 95.0 ft. This is 0.4 feet deeper than proposed on the test. 2. Use a 0.3 gpd / "ft soil application rate or less whether or not pretreated wastewater is used. 3. The final infiltrative system elevation of the dispersal cell should be left rough and uncompacted even by foot traffic. A backhoe bucket with teeth must be used for the excavation of the cells to break up the massive soil at the system elevation. 4. Use of highly pretreated wastewater into the system instead of straight septic tank effluent, This will add to the cost of the system due to the treatment unit and pressure distribution requirements, but will enhance system performance and greatly increase system longevity. Note that use of highly pretreated wastewater is not mandatory only recommended. 5. Use of water conserving fixtures in the building. rr f June 18, 2002 Ristow Property Page 2 of 2 If there are any questions regarding this report, please contact me as soon as possible. er y G.Pfnsky, Wa water Sp alist Ljansky ommerce.state.wi.us - ail 715/726 -2549 Fax 715/726 -2544 Voice cc: (§County ❑ Plumber CST ® Owner ❑ Other i i i w Wiscsin Department of Commerce SOIL EVALUATION REPORT Page / of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information Rev'ewed by Date Personal information you provide may be uso d for s vacy N, s. 15.04 (1) (m)).� p Property Owner Property Location Sad Govt. Lot t 1/4� 1/4 S T N R Z 0(or Property Owner's Mailing Address Lot # Block # Subd. Name or_CSi),4# S ST, CRZ to City Sta a Zip Codl PAOM"9 ICE ❑ City ❑ Village jj Town Neare t oad ( -) - p New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: I E L Boring # E] Boring Pit Ground surface elev. ,/Og6 ft. Depth to limiting factor � in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 *Eff#2 Boring # ❑ Boring ® Pit Ground surface elev. q i ft. Depth to limiting factor , in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 - 7 s / 3 �" — - 3 ZL N -3 = " Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L ` Effluent #2 = OD < 30 mg /L and TSS < 30 mg /L �p I Y — � � - �, – - 4UZE 1- - CST Name (Pie a Prin Signature CST Number - I C- Address D valuation Conducted Telephone Number SBD -8330 (R07 /00) K � , i Property Owner Parcel ID # Page of Boring # ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 < -- fs Boring # ❑ Boring ® Pit Ground surface elev. ft. Depth to limiting factor 14 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 a - 3 - o o r A -3 Boring # ❑Boring S ® Pit Ground surface elev. /�/. /S" ft. Depth to limiting factor �� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 i / 1 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /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. SBD -8330 (R.07 /00) q- Property Owner Parcel ID # Page 3 of _ Boring # ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F�] Boring # F1 Boring Pit Ground surface elev. //� ,' 4S ft. Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color ) Gr. Sz. Sh. *Eff#1 I *Eff#2 / P11.1 cam! g „c S ❑ Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. El Pit Soil Application B Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /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. SBD -8330 (R.07 /00) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of,� Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 1/4 114 S T N R E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village ❑ Town Nearest Road ❑ New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: F-1 Boring # [] Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number Address Date Evaluation Conducted Telephone Number SBD -8330 (R07 /00) U i w I V ev e� a,/ /1 p /,Ac L-2 e �. � ✓�, s 'k iz� /DG 7 it ,6 '.Z 1d 6 b s rS 7 �a • 35 77 5' tate N�ghwa� 3 �/ o 8 O'W. Lmc cf yli ►a� 3 f �9 OH OH OH r i v a t e g o a d ArAlel South l irle of Rrw4e Road Ea6exe rt ------------ o------------ - - - - -- - � � vs proposed I'arkin� ST' � � •\ �.t'p {,fir /J�c�O F,fer �r( w� � - (�IL.MJO ✓� µ1� /� ' 3 Puildl I AXIS) 1 0nC6Adar ,' anl - 1, 1 , Vf�1C�/ /7J� � � �/, e t .Sun'Jt� s'�g�1'�' • �;l /C�,D.p �._ //, >?� C l = •s/o scy�E ' Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Vi4consin www.commerc .wis ons Department of Commerce www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary August 22, 2002 CUST ID No.224263 ATTN: POWTS Inspector KIM A O'CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/22/2004 Identification Numbers Transaction ID No. 778228 SITE• Site ID No. 647531 Ristow Trucking Please refer to both identification numbers, Hwy 35/64 L above, in all correspondence with the agency, Town of Somerset, 54025 St Croix County NEIA, SW1 /4, S5, T30N, R19W FOR: Description: Commercial (Office) In- Ground Non - Pressurized System Object Type: POWT System Regulated Object ID No.: 867078 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: Condrthv • This system is to be constructed and located in accordance with the enclosed approved plans and with the "In- APPRC ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10705 -P (N.01 /01). DEPARTMENTOFI N • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the SEE CORRESP manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • The plumbing for this project discharges to a private sewage system. The approval covers only domestic /sanitary wastes directed into this system. The Department of Natural Resources must be contacted regarding the treatment and disposal of all industrial wastes. • State and federal regulations prohibit the discharge of hazardous wastes to a private sewage system. Accidental discharge of any hazardous substance to a private sewage system must be reported to the Department of Natural Resources or the Wisconsin Division of Emergency Government. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c . KIM A O'CONNELL Page 2 8/22/02 • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, 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. 145.20(2)(d), Wis. Stat • Comm 83.22(7) 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. • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. Changes to the approved plan must be submitted for review and approval. Failure to properly attach the approval and index page to plans that match the copy on file with the Department may result in enforcement action under s. 145. 10, Stars. " Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbmtz@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 % • oo� /4 / �E[ .�c_Sc MCP 1�i one NLt) 1 1 9 I'd � �� � T'S ow� ,��P ���,✓��• � � /yl�,�/�6�.�,�,r: >%✓ salty )VED : OMMERCE // - p 'N ILQINGS 1 x,J �%n'AG.JO ."o, l ff45pR (. vl�k� / / /�Uu� /.0 / 75 S.b',O — /D 7d .>'�" • 9� (it� , D� /I J � f�E�SipN v�d /- 30 ;x700 / 6f frf TB,cE ©�•�G't J",�,CsQ�,,J.�/ - �"%° %,r,cs � �A�� - -alJ A� /.Sg�d — 31�'G G.�c,�• �`O,Or�/ X X088 /���✓ �o l/sF •' 01-- ,[�?GG �,EE�S �.►� - �o�� � c��?CJ�f,N ... Gip 0�1 F . � , .� Q -�,�►' s ��Do (�,.a� " /iV �o //��'h1•�/ � �''��.17 t+� f 1 � 9., / J • o I ` 1 7f.'�a /i�L l �t�:fr', - „J - �,.�c 1 V/s , // // ,�M l ).0 � )o 4, 36-7,77 State wa� o a 3 64 i mout �, 6�, W 1-a►� � wow y► � - - -..\ � UH OF•i OH Gravel dd� private goad -- �5 � O F y South l ir►c of �n�dt� Road fsoemit _ _ _ _ _ _ — - - - - - - ; ----- --�6 -- - --- - -- - - -- - - - - - - 98 — � —� � proposed f'arkin� . SaPt�'c Auw5 Alt" I ° 5o x 100' e� r c. -,je.•/ <� pp -- I a poi / 46,e; j s J I I I • I' k01 z °e/ I c4,s /✓ SGt /.� 'OUSi+c'✓�e./ - JET✓! /�b • o,� 3'�cl�„»6,arr.�.ti �r �o 3' Z 3' + i J 3' .3 x ,x- ��s/�.v� L �.1 Prju•v1�;( .00fh ��+.r/eN.s / /Jt S71 - //-�D ��y/ �o/c•,'�Y C/i.!<i►�41'�Y �• ,S�sll�,... jf JS � �o %�i,¢.Jl- is 1:%iCi✓ - � G'IuJ,. +F.FS J rifw� sys/�.�N/ � �7�055 S GT T / DDS �9 ' No s� .s'�af+E �lSa�Cf/C,t ll,►�+rt ,�4.J�+.✓.iG',E .I + 4 JtM - o POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page. Ur� FILE INFORMATION SYSTEM SPECIFICATION Owner AJ Septic Tank Capacity al o NA Permit # Septic Tank Manufacturer - o NA Effluent Filter Manufacturer d a - o NA DESIGN PARAMETERS Effluent Filter Model o NA Number of bedrooms g(NA Pump Tank Capacity al 9 NA Number of Commercial Unit - NA Pump Tank Manufacturer ONA Estimated now (average) gal/day Pump Manufacturer it NA Design now (peak), E stimated x 1,5 ) j �2 gal/daZ Pump Model A Soil Application hate 3 gal/day/ft' Pretreated Unit Inllucnt /l:fflue rtt (,duality Muntltly Average* u SmId /Caravel Diller [a feat Kilter Fats, Oils & Grease (FOG) <30 mg /L ri Mechanical Aeration Lt Wetland Biochemical Oxygen Demand (BODs) 5220 mg /L in Disinfection o Other: Total Suspended Solids (TSS) : 5150 m L Manufacturer Pretreated Effluent Quality ❑ NA Monthly Average" Dispersal Cell(s) o In- ground (gravity) o In- ground (pressurized) Biochemical Oxygen Demand (BODs) <30 mg /L ❑ At - grade o Mound Total Suspended Solids (TSS) <30rng/L o Drip-line o Other: Fecal Coliform (geometric mean <10 4 cfu /100mL Maximum Effluent Particle Size '/6 inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. *i Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequenc Ins ect condition of tank At least once ever in months fiY ears Maximum 3 rs ;)urnp out contents of tanks When combined sludge and scum equals one third '/� of tank volume :ns ect dispersal cell At least once every o months ears Maximum 3 rs _ 'lean effluent filter At least once ever ❑ months year(s ,.s peel pump, pullip controls & alarm At least once every a months ❑ year(s) 9 NA ush laterals and pressure t st At least once e ❑ months o ear(s) x NA )ther: 4Z IdA At least once ever ❑ months ears o NA )they: L - At least once every o months ❑ ears o NA MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator, rank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any , .racks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ,round surface, The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to heck for any pond ing of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a piling condition and requires the immediate notification of the local regulatory authority. `.t'hen the combined accumulation of sludge, 111d scum in tiny tank equals one -third ('A) or more of the tank volume, the entire untents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. Nft 113, �Visconsin Administrutive Code. 'he servicing of effluent filters, mechanical or pressurized POWTS components, pretreatment components, and any other Ittaintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer, 1 service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other :hemicals that my impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have he contents of the. tanks(s) removed by a septage servicing operator prior to use. Owner: —�A'aa Page '.or I System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal high water levels. When power is restored the excess wastewater will be discharged to the dispersal 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 Servicing Operator prior to restoring power 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 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 soft absorption are. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONEMENT 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 ch. 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 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 void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: X A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. o A suitable replacement area is not available 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. o The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. o Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at the time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLr>R , POWTS MAINTAINER Name Name , aL Z2 Phone Phone SEPTAGE SERVICING OPERATOR PUMPER) Name LOCAL REGULATORY AUTHORITY Phone Name Phone ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP C RTIFICATION FORM Owner/Buyer Mailing Address �- Property Address (Verification required from Planning Department for new construction) City /State .rte P x� 5 P arcel Identification Number LEGAL DESCRIPTION "J'e S td L Property Location &9Z_ Y4, _s, _ ' /4, Sec. _, T � O N -R_)_g_W, Town of Subdivision , Lot # Certified Survey Map # �S' /f1 �' , Volume , Page # _�____ . Warranty Deed # 7 y,3_7C2______._ , Volume ,C /S , Page # „l 7 Spec house ❑ yes f, no Lot lines identifiable ( yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof 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 put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix 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 1/3 full 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 Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained trust be completed and returned to the St. Croix County Zoning Office within 30 ;NATURE f the three year expiration date. OF APPLICANT DATE OWNER CERTIFICATION I (we) 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 p operty described above, by virtue of a warranty deed recorded in Register of Deeds Office. I NATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a co of the cer copy rt Pied a if reference is made in the warranty Y p rr my deed 53 0?? 7Q State Bai of Wi xonsin Forn! 2 1982 WARRANTY DEED .• - _ , DOCUMENT NO t ?� �1JcJFa�- 173 t ,'� 1 Joseph A. Iange _ D EC 1 1 ?995 . � 11:45 A. convevs and warrants to James H.- RistoW ­ Ar. E H.`i {H•.Fn FOH PFCOFWINN , RATA yA44E AND HE tuWi AL pH _5S _ -- - _ — - - -- James H. Ristow the following described real estate in _ ____St` CrQix, 423 '65th Aven� e Ccuntv. State ofWisconsin: Somerset, 'JI 54025 TR 1`lSFE - - x$ (Parcel Identification Numher) Fart of the NEl /4 of SW1 /4 and part of the NWl /4 of SWI /4 of Section 5, 'owrship 30 North, Range 19 Hest, St. Croix County, described as follows: Lot 1 of Certified Survey 'LAap filed August 31, 1989, in Vcl. "8 ", Page 2146, Doc. No. 451085. Together with and subject to private road easement for ingress and egress as shown on said Certified Survey , page Map and private road easement as shown on P Certified Survey Ma in Vol. '6" e 1589 , Doc. No. 406864. This deed is given in complete fulfillment of that certain land contract between the rties hereto dated October 6, 1995 and recorded October /� , 1995, Pa , P S ' in Vol. // , Page 4�76, as Doc. No. S - � /�, in the office=_ of the >Z_21._ter of Deeds for St. Croix unty; Wisconsin. f This not -__,__ homestead property. 1 S (is not) Exception to warranties. Easements, restrictions and rights -of -way of record, if any. Dated this — 5th day of Daeember 95 ij - -- (SEAL) _ ___ _ -_ — (SEAL) ' - — -- J —ems A. _ ge— - - -- -- (SEAL) - -- — (SEAL) I AUTHENTICATION ACKNOWLEDGMENT + � Signature(s) _— — - -_ __ STATE OF WISCONSIN St. Croix___ - County. j authenticated this - ,__ day of _ — __ — , 19____ Persoaully came before me this 5th _ day of ,i Decelaber 19_9 the above named -- -- . _Jose-&._ A. Lange - -- - TITLE: MEMBER STATE BAR OF WISCONSIN — r (If not. -- - -- - - -- — - - -- — — - -- authorized by §706.06, Wis. Stats.) to me knoan to be the person who executed the forego atarument a acknowledge the same. — — THIS INSTRUMENT WAS DRAFTED BY — __Krstina Oglr►c------ - - - - -_ P _Attorney_ at _ I.aw Notary > 3 T_ ___ —__�`• f,�— Wis. k; (Signatures may be authenticated or acknowledged. Both are not My comnil i its permanent. (1f not. state expiration date: necessary.) 1j SMIXISE F 'Names of persons signing in am capaca should be Typed or prime:! 19WRh4ir aw WARRANTY DFF.D STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc _ i� FORM No. Z — 1982 Milwaukee. W,s. - ti CD ��2 £ FILED a ?of 9- AUG 311989► JOB aCON aL 45108 �- '•r m c Z ' r �• d _ rt o M Z o N o o Y I a n a o o r• m to to r M a ►-r D to '+ to O m - N a - 3 7 t9 = f71 o ' S o to o_ o a Z . �p •� ,'a� C o to m z CD T ' 2 6Qa F•S 6 p �� 9 `0 mil. ' o 0 r —� 6 6`0' �``rvt `p' 'Per z o 'm a o z m . do o" It CD CD o W n to •- f '- m o r w d t t - v a to c ` O 0 a r r r r o n to o to rn ---a f r . f .. r• r• r 2c m m s tn s9 s�� a m A t�s t m c> a �_ / O Lti f 'P 0 > O s o a ao a c X �_ -t+ 0� `990pp1 l' O ' ��� d . f ro •n n n m W te rn e o '* / �Z g�` >� ` p�0 to H x r• N Z z 2 r S - ' n .G It, C) N O m avr w m m o m 0 0 0, 0 • 1,E a to r ' Z w w N N N �g0 `9Z 62L °' v Z O1tio�gc' p, to v s r w > a v u �' "o o :" = z rc i s � c v� C-2 w m � O c rti- I m L {� c m G) '` CD N a 0 .r .- or w N 1 a R .r o to w I rt z � cai m y to a taw cn to i m 'li 0 •• C/ o to 0 1 n. o o rt z I t o tc n v '° . s It 1 a rt r r• r. 7 O 1 N 4 tJt I N to , r p 1 I *- A t t0 O� fyS to w n eb to A to- t �O� v O -n m m o '� z q�` W 00 z l i s o e "` / N t 4 m A) c F c; N ` 00 0 09 cx f•• p. r 1... N DO N r• 1 > > o. rn w w 0 I m rn m m m �-. I. a o m to to n n l� w 01 rn CPS t4 0 o o � v'i o o+' . o 0 o to 14 to I G I o 0 I rt m O O CD -j i. W � :'� I r,• m V I o rt 0 ° /v v m I y CL to a N \ O CJ I of `', x a . I I V Z A ^ a C7 ci I :� G < r L� f; o a x r+ 0 In c (.11 v m Z o }F V• � fij s; (7'rw� il' (01 cn 1292.21' 536.89' I 3751.34' east Yline of the SW} N01 / N N `) .+- unplatted lands owned by others W n --- °---- -- ---- ---- °-- -- --- - -- .1- to r W . o m •� c n CUL —DE —SAC CURVE DATA w o u, R 6 L C CB TB TB `n total 80.00 234 06 326.94 142.46' N36 N80 14 S26 c") i •- a w tO lot 2 80.00' 115 161.52' 135.45' S84 lot 3 80.00' 118 165.42' 137.48' N21 u; rt n n AUG 2 3 1989 VOLUME 8 PAGE 21 19 ST. CRON COUNTY CD Y`WPr*HENSIVE PARKS PLANNING Ar'. "ON ?'":NING f''- 'WW9TTEE SURVEYOR'S CERTIFICATE I, Allen C. Nyhagen, registered Wisconsin Land Surveyor, do hereby certify that by the direction of Henry Lange I have surveyed, described and mapped the land parcel which is represented by this Certified Survey Map; that the exterior boundary of the land parcel surveyed and mapped is described as follows: A parcel of land located ih part of the NE4 of the SW4 and in part of the NW o• of the SW)- of .Section: 5, - T30N, R19W, Town of Somerset, St. Croix County,.Wisconsin, further described as follows: Commencing at the Sk Corner of said Section 5; thence NO1 "W 1292.21 feet along the east line of said SA to the point of beginning of this description; thence continuing N01 "W 536.89 feet; thence N80 11 W 1173.37 feet along the southerly line of Lot 1 of Certified Survey Map volume 3, page 688; thence S53 "W 559.79 feet along the centerline of S.T.H. 11 35" & "64 "; thence S34 "E 540.24 feet along the easterly line of Lot 1 of Certified Survey Map volume 6, page 1589; thence N88 "E 1319.17 feet along the south line of said A of the SA to the point of beginning. Together with a 66 foot wide Private Road Easement as shown on Certified Survey Map volume 6, page 1589 and subject to right -of- way for S.T.H. "35" & "64" as shown on this map and all other easements of record. I also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary surveyed and described; that I have fully complied with the current provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of the County of St. Croix in surveying and mapping same. � tF6S;�p� ALLEN NYH N /1 �• Q +r •f �,t�<q ti {t' *, til t NOTE: The roadway shown on this map is a Private Roadway. All maintenace costs of the Private Roadway, after its approval by the Zoning Administrator as a standard road, shall be shared pro -rata by the adjoining owners. If the Private Roadway is taken over by a municipality as a Public Road maintenance costs thereafter would be a public expense. VOLUME 8 PAGE 2146 AVG 2 3 40.0 ST CROIX CUuivey +e 6* PAWS PlqIft?C. AND KMMNC, raj;, throl7EE p l 1 rj A-Ofs iv� y C � A -Lf-