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Home My WebLink About008-1026-20-000Wisconsin 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)(m)) Randy Finstad 0 TANK INFORMATION TOWN OF EAU GALLE TYPE MANUFACTURER CAPACITY Septic 3 J Dosing Aeration 1 N Holding TANK SETBACK INFORMATION j_n�a,c t fltn;tfv5 TANK TO P/L WELL BLD(�,, ) nt to Air Intake ROAD Septic 7 ZG) J � )IL 1A Dosing 7 \V/ A [v /55' i 56 ' Aeration Holding PUMPISIPHON INFORMATION Mucv :M;,iaJ Manufacturer emand Model Number TDH Li_ Friction Loss Syste H! T 45t Forcemain Le t�l Dia. µ IDist MCI, SOIL ABSORPTION SYSTEM e ELEVATION DATA STATION BS HI I FS ELEV. Benchmark 3 1a3. o AIL BM Bldg Sewer SUHt Inlet St/Ht Outlet Dt Inlet Ot Bottom �. 8�7•456 Header/Man .�l 7 19 • �l S Dist. Pipe Bot System Final Grade Coverill�'CO•<,i Oct a l a qz �. �-� JN -11AS 1,6q.05 BEDITRENCH DIMENSIONS Width 1 J� Length 7 iJ r No O7 roles �, 2 PIT DIMENSIONS No Of Pits Inside Dia Liquid Depth SETBACK SYSTEM TO P/L BLDG IWELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR UNIT Typo Off Sy;t C H�-�' 1V.��. 7 I yQl Model Number DISTRIBUTION SYSTEM Header/Man fold Distribution b x Hole Size \ x Hole Spaong 'Vent to Air Intake Pipes) J �r Length Dia Length Dia Spacing l� SOIL COVER , \ x Pressure Systems Only xx Mound Or At -Grade Systems Only jjj ✓i7/,. rwLr y Depth r Depth Over xz Depth of xx Seeded/Sodded xx Mulched eetl ench enter % Bed/Trench Edges Topsoil es No� Yes[ l No COMMENTS: (Include code discrepencies, persons present, etc.) Location: 2377 45TH AVE 1.) Alt BM Description = l i�riiG��V 2.) Bldg sewer length = -amount of cover = DG" (ti��ts($"� Inspection #1: Inspection #2 YI ue 1>n ,V9UIl��UA st�x✓ �� .�.I-ktl� CID t I Plan revision Required? r� Yes *`0 1 P / ` V Use other side for additional information. _ I D Date nsepctoi's Signature Cen. No SBD-6710 (R 3/97). 1-M,;ltj Q r, it l- 2o21- M ( M 7 .,, .. -n �.--_Z�.__.—.__ lSafety and Buildings Division Count -- S{ �0I K is MAY 2 7 20 j 20� W Washington Ave , PO. Box 7162 P S I Madison, WI 53707-7162 Samtan Permit Number Ito be filled in b} Cc) 5t. Croix Coy y 3386 Z vel ment anRary Permit Application SaeTmnswtionNumber 'Ais 0- �Q 0-7— In accordance with SPS 3gt 2h21, Adm Code. submission of this furm to the eppmpnate gosemmemal unit is required prior to obtaining a sanuan permit Now Application forms for state-owned POW I S are submitted to Pm)ect the Department of Salty and Pro(essiowl Services. Personal information you provide may he used for aacimdary Address in'ditlerem than mailing address) u ties in acwrciame wth the Prisxv Laws 15 04(1 rim). Sags _� 2'3-7 !-� ST VC, 1. ApplicationInformation - Please Print All Information Pmperry Owner's Name RAkjq FiNsi-Ad Parccl a 008 - Z(o-a to -o00 Property Owners Sailing Addresc I 586 CtY G _ — --- -- Q Property Location tom• d ba• g• Gost L`l o4 /. �_I/4 Section C in. Stall �( nn �4MIir.Ot Wr !ip Code !� Phone Number s■■`/11 S-`�(� 11 -Z6D-lZC2 icircle one) T Z8 N; R �— West It. Type of Building (check all that apply) I.or a I or 2 Family Dwelling- Number of tdroom S pel I subdivision Public commercial Describe use State owned - Described use Na --- — CSMNumher (] Crp or_,_ XFodlagc of town of 111. Type of Permit: (Check only one box on line A. Complete line B irapplicable) A ,ew.sstem Replacement Sy aem 'rreatment'lioldmg Tani. Replxemvnt (illy ❑ (hher ModtScatinn to Evisung System (explain) B. ❑Permit Renewal permit Revision L C hinge of Number ❑ Permit 1 minister to Ncw List Prev tsus Permit Number and Date Issued Hefom Expuation 0"ner IV. Type of POWTS System/Component/Device: (Check all that apply) Non-Pncssur¢ed In Cround ❑ Pmssunecd lnl;ruund At-(iradc Mound _ 24 in of smiablc od Mound < 24 in of witable soil Holding-faM ❑ (Alien Ulspenel Component (expleml_ ❑ Pretreatment Ievwe lcxpleml __ __ V. DispersaVrreat ent.Area Information: -75 Z�cA-j — Design Flow (gpd) Design Soil Application Rate sD Dnpersal Amu Requi fs ria INspersai AProps st) Svskm Elevation y510 .6 Aso 0 92•s V1. Tank Info Capacity inIota] a of Nanulxmrer p: Gallom Gallons Onus e t Fl�tr 3 J s New tanks Esisnnx rant. c I � Septic Tank Lift Tank py p--- V II. Res onsibility Statement- 1. the unde d. suume ibilily in aaatlon of the POW I S shown on the attached pleas. Plumber's Name (Pnntl Plun S. Ignalum MPIMPRS Number Business Phone Number Lewis Bork 1253976 715-231-7375 Plumber's Address (Street City. State, Zip ('ode) E7818 County Road E MenomortilsWU4 V111. County/Department Use Only Approved ❑ Disapproved Permit tez Daft({ I ed Issuing Agent Signature SYS7 ,A 'ncr Green Reason for Daniel IX. CdadttbWt*,RO O60RIA*ns for Disapproval 3 (CSSo UC M h Lev dispersal cell mustbe serviced/maintained ,a�� as per management plan provided by plumber /} I) (.O1.ya�S 7 ✓7 7Z� ✓rT+ !z �0't� -1 1 7. All setbaca mcgev meril5 must be maintained �p 1 j //�� as pot applitabletode/ordinances. ,lyr fl/1 PVrTi.T �,•ryyfl5 - /A, Tt!'/aIr G) So1p ( L r e/ 1 c� C�I SGP •8 9g�R. ll; ]� 9• , Bh e f:+ A34V n a CHECK BOX AS AJIPL"�E. SOIL EVALUATION 40 1 40 .r go SITE MA PROJECT Ii♦ .. ., ►n 'tea CHECK BOX AS APPLICABLE. C SYSTEM PAGE2 F LOT PLAN�J� ` § DES:GN { FLOW SZ) GPO A!tach design flow calculations for oommerdal plans. PROJECT ADDRESS BM Sym¢G �r BM Elevation. ' � FT IV Pipe Malarial / ASTMS and (Tables 384.343 & 384.3Q-5) Sanitary ' � � Fww Main:_/ w r • BM M¢GAPIbn: -&W — SlapeGnWler¢(% p 1 $ Well Symtrd (II epplcaae), Q o/ Te¢ted Ana: InJknle ronh pr awin¢.n ono.. on Na ePVr¢PA�e Ina IMPORTANT: Show ground elevation contours at suitable intervals. 11c r OF04 04% N m4s a (s --pit 4txrz Asa 2539-t�i �` � � sus 9rar.�c 8� B5Q�0 TAM :�cpt s /Zg 100 S 9z-s amf- w��s 9U1, wt Flo 0596 zr ekv T54gb DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 546416462 Corded Through Relay httpJ/oaps,wi.go /Orpgremsfndi UY-Sem www.wm wn 9m N,. Tony Evero - G•V•Ir10I Dawn Cre, - Secretary May 21, 2021 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2023-5-21 Plan Review: PWTS- 052101074-C Lewis Bjork E7818 CTY RD E Menomonie, WI SITE: Randy Finstad County Rd BB Town of Eau Galle St Croix County SW Y4-SE 34-S9—T28N—R16W FOR: Description: At -Grade Component Manual — Ver. 2.0, SBD- 3 Bedroom At -Grade — 450 GPD —Depth to 10854 (N.03/07, R 1/12) limiting factor 36"- New — Effluent Filter - Pressure Distribution Component Manual — Ver. Maintenance required 2.0, SBD-10706-P (N.01/01, R. 10/12) 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 priorto occupancy or use: Reminders • The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed, To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the At -Grade site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. • Components and soil removed from an existing drainfield shall be properly disposed of so that there is no risk to public or environmental health. A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 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. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter isrequired. • 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. Owner Responsibilities The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POINTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS383.54(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. 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. 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 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POINTS. Sincerely, fir?&W� Joshua Rowley POWTS Plan Reviewer, Division of Industry Services (715)813-9111 Joshua.rcwley@wisconsin.gcv At -Grade Plan PAGE 1 OF 6 Index & Cover Sheet Component Manual Design References. Version 2.0, SBD-10854-P (N.03/07, R. 01112) & Version 2.0, SBD-10706-P (N.01101, R. 10/12) Pg 1 of 6 Index & Cover Sheet Pg 2 of 6 Plot Plan Pg 3 of 6 Dispersal Area Cross -Section & Plan View Pg 4 of 6 Distribution Network Specifications Pg 5 of 6 Pump Tank Specifications Pg 6 of 6 Management Plan Anacnments: tnciosures: Pump Curve — POWTS Application for Review Tank(s ) _ Soil Evaluation Report & Site Map Effluent filter Project Name I Description OwnerName(s): IC.!►hb FlIk)5 A 1 Phone:-1i;-7 - (ZOZ Owner Address: IS $i� Zip: St-{pt"'( Project Address: / Govt. Lot: 1/4 of SE 1/4, Section O9 , T ZIB WR I (o E ❑ or W❑ Township: F44 GA11C County: !E& • Cro; X Project Parcel ID #: oce— 2.0 -noo Designer Information Designer Name: Lewis Bjork Phone: Designer Address: E7818 County E Menomonie 715 _231 _7375 Zip: 54751 E-mail: lewisbjork@yahoo.com Conditionally 253976 APPROVED License Number: DEPT. OF SAFETY AND PROFESSIONAL Remarks: Signature: SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Date: C HF C% aC%F AS All 'L ILAe. E. 1 SOIL EVALUATION steals =ao ac SITE MAP ° �° 5° PROJECT NAME: to PROJECT ADDRESS BM Symod _7 BM Elevation (� A_-, FT I BM Descrlptlan. �� SIODe Gradleru (k) imi,,-t rorcn q of Testes Mes: Well S`imod ;.1 appll•"AMMI Q . th. aWWrlke Ike. CHECK 8C%AS A"PU:49iE PAGE L O G SYSTEM LOT PLAN D%h�, or SIONF1-0w 45D cco Attach design flow oalwlatlws for wrnmerdal plans. Pipe Material r ASTM S and (Tables 384 3013 & 384. 5) San,lery Sewer ,_ Face Main_ I .� bra 04% N sit s r 10 IMQR_TAN[. Show grwnd eievason contours at suitable intervals. BK � No W�IIa� �3 � Tn►M qt(. ,r - Is 4cef- 2/ts exco S 9z-s bW. Wv;�s vlu" Rht Wo 0595 Lsr ft v T554gt PAGE 3 OF 6 CROSS SECTION VIEW (No Scale) 0.5' TO 2.5' WASHED AGGREGATE (covered with approved synthetic fabric) UM MIN. 6.0' OF TOPSOIL COVER O &,"b Surface Contour SLOPING SITE Elevation = ft j AT -GRADE DISPERSAL AREA PLAN VIEW (NO Scale) (Show force main and flush valve locations on plan view.) L= W It i —.L / —/ P�ME.�R V _—__-- AGGR _.—._—__ l -� W= l� h(I 2 0 fl - AGGREGATE BED A- n _ _ — o0°8NH0O) _ _ _ J i Ij ` �ft�o (Nam) � 77 7 7 7 7 7 7 7 7=1, 1 1 Prohibit disturbance and vehicular traffic within 15 ft of downslope toe. Bend as necessary to follow contours. Reset Page DISTRIBUTION NETWORK SPECIFICATIONS FLUSH VALVE DETAIL (No Scale) Orifice in \ Valve Box Center of Threaded Cap (insulation optional) for Head Testing (optional) r \ I ) \ Ball Valve J \ (optional) \ Orifices edually spaced \ (ph9ck a) OR b) below) a) ItvY--�1rtr along bottom of lateral ` \ b) _L_L along top of lateral Flush Valve with every _ th hole Assembly facing down (typical - see detail (typical) LATERAL INVERT ELEVATION = 93 (typical) (No Scale) Laterals to be level Schdl 40 PVC Lateral 0 = (typical) � Shield odfices for gravelless applications OBSERVATION PIPE DETAIL (No scale) Screw Type or sup Cap (loose) W Finished Grade (mulched & seeded) 4'0 PVC Pipe Topsoil Cover Top of pipe to terminate (min. 1 foot) at or above finished grade (4) 114'-11 - X 6' Slots gb apart Anchoring Device Infiltration Surface W fire Spacing (X) = (typical) Orifice Diameter (types) I(0 in Fist Orifice (typical) C� '0 .� Schdl 40 PVC Force Main (riser Pipe / (slope to pump tank optional) for drain -back) Lateral Length (P) = 3-7 fl Number of Orifices per Lateral = 1 9 Orifice Dlscharge Rate = •&D gpm Number of Laterals = 2- Lateral Discharge Rate = IZ- ✓l gpm TOTAL DISCHARGE RATE = 2SP.GPM First Orifice (typical) I— X END MANIFOLD (typical) ❑ CONNECTION Check applicable box. First Orifice (riser pipe optional) D (typical) 0 ITI I--- XX/2 X/2 X A (typical) (typical) O Manifold jj`'j CENTER MANIFOLD -1 (riser pipe optional) 2n CONNECTION 0) PAGE 5 OF 6 SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4'0 Vent Pips > 10 fl from Building Elecin®I must comply YAh 12" W. or 2 0 ft above BPS 316 and NEC 300 Esisbeshed Flood Elevation weolM t Extend manhole roarer es necessary. (typr'el) Med ncJubon Box vent Cap Approved Locking Manhole IMPORTANT: wbh warming Label Atledyd I ln'dwi) Anchor tank(s) a1381=3(8)(g) pursuant to SPS —cons n 1' Min, or 2-0 fl ebose Established Flood Elevation (bWcdl �--Airtight Seel Fmished Grade CAPACITIES Q L. gaVin NO I M�� *T JA B IT Pump *Pump Tank Liquid Level =38 _in D Force Main Diameter = in 1 ` rce / 3" Approved Bedding Main Length = . =ft � 66.3 Force Main Void Volume = 4p_gal [C] Total Dose Volume (TDV) = as gal/dose , L(5X total lateral void volume <_ TDV <0.2X design flow) + (force main drainback volume) MIN. PUMP DISCHARGE RATE = a5• D5 gpm Quick Diseonned ,B•Mm 93 (lYPkbll Approved Joints Mtn S Weep Fide • Approved Pipe 3 n onto Sold Ground Pyp+ w) on PUMP -OFF Q on ELEVATION = (� f ' ft INSIDE BOTTOMQ� r �* ELEVATION = W'S It loll B,Qe,neam rank jVertical Head =(2 ft ' + M in. Supply Head = -Z.T�ft I� + FM Friction Loss = • 3S It + Fitting Loss` = It a(Min, wooly head x 0.3) = TOTAL DYNAMIC HEAD = � ft PUMP TANK: SEPTIC TANK(S): Volume = 410 gall Total Volume =ADAM— -gal Manufacturer. wkL'.J� ^� Manufacturer(s): (A,iit �J.,1 Pump Manufacturer. Zoeller Install approved effluent filter at the septic tank outlet Pump Model: N152 see enemeewmpwb t immediately upstream of the Durres tank inlet. Controls/Alarm Manufacturer: SJERombus Filter Manufacturer. Orenco Controls/Alarm Model: AB Filter Model: FT-0822-148 Float switches containing mercury are prohibited. Page 6 of 6 At -Grade Management Plan IMPORTANT: The owner of this at -grade system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all Inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = Ll SO gpd; Bi 5 220 mgL"; TSS 5 150 mgL"r; FOG 5 30 mgL" Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities (i.e,, pump re -cycling, float switch settings, etc.) o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tankisl shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stalls. when the volume of solids In the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent fliterfs) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. o Distribution laterals shall be flushed once every 3 years or when necessary. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wis. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Lewis Bjjo`rk Family Septic Service Phone: 7�115-231?-73/75 Local government unit: ,• C��y l.Ol.�! Phone: 1 tcJ" u$b— WYa Local government unit address: _ l Ad iM tw1 ZIP Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wis. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wis. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed at -grade dispersal component may be re- constructed within the originally approved area after removal of all failed components. System Abandonment If use of this POWTS is discontinued, it shall be abandoned In accordancewith SPS 383.33. Wis. Admin. Code io Series E luenl Pumps /.oeller Pump Compam https: 'www.zoellerpumps.cum en•na product sump-eliluent•pumps el.. 50 14 45 12 - 40 35 a = 10 U 30 Q z 0 8 25 J ta- g 2( 4 1( L PUMP PERFORMANCE CURVE MODEL 151/152/153 153 _ 152 151 i I 0 -1 10 20 30 40 50 60 70 80 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE 2 21 2018. 111,04 AM ul 5 Maintenance Instructions °a p, . Ry..r t-aaa'sasseas Biotubeo Effluent Fitter Now to Clean Your Effluent Filter To ensure your effluent filter is functioning properly, it should be inspected every year. Under normal conditions, your effluent filter will function for several years before cleaning is necessary. The filter should be cleaned when it becomes clogged enough to restrict normal flows out of the septic tank. At a minimum, the fitter should be cleaned whenever the tank is pumped. Most people prefer to have a septic tank service provider take care of filter maintenance and cleaning. You can find a septic tank service provider in the Yellow Pages, under'Septic Tanks & Systems.' Or you can contact your county health department for a list It you with to inspect and/or clean your effluent fitter yourself, be sure to dress properly. Wear full-length pants and shirt, shoes, gloves, and goggles or glasses. Then follow these instructions: I. Remove the access lid to your septic tank by unscrew- ing the stainless steel lid bobs with hex head wrench provided. If your lid is above ground, it will be easy to find. If R is buried below ground, find the marker that indicates its location. 2 Remove the fitter cartridge by grasping the tee handle and lifting it out of its housing (see photo f). 3. Spray the cartridge tubes with a hose to remove any material sticking to them (see photo 2), Ensure the three orifices in the optional flow modulation plate inside the filter are clear of any debris. Make sure the rinse water runs back into the tank but do not allow solids material to fall into the open filter housing. 4. Firmly place the cartridge back into the housing. 5. Some effluent fitters come with an alarm that activates when the filter needs cleaning. If you have an alarm, check to make sure it is working by lifting the float with a stick An audible horn should sound. The alarm panel Is normally mounted on the side of the house or in the garage. Now H your effluent filter doesn't have an alarm system and you would like one, call your local septic system installer. 6. Record the date that you inspected and/or cleaned your fitter on the torn that follows. If you checked the alarm or made any other observations about the tank or system, include that information under *Notes.` 7. Attach access lid by placing it on the riser, matching the openings in the lid with the bolt catches. Insert lid bolts into catches and tighten with hex head wrench provided. Photo 1. Remove the filter cartridge by liking it Our or as housing. Photo 2 Spray the carvidge tubes with a hose. alwrr-rr-r e«. u im Ape 3 v1 4 I 4" CAST —A —SEAL nff i i I{fi ii j24 \ iI FILTER OIi Ii I� I� I BAFFLE as II 4" CAST -A -SEAL 4' VENT TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS WLP1000/650-MR TANK SPECIFICATIONS DIMENSIONS: WALL- 3' BOTTOM: 3" COVER: S' MANHOLE: 24' I.D. PRECAST CONCRETE RISK HEIGHT: 54 1/2' O.O. LENGTH: 146' Q.D. VADTH: 84" O.D. BELOW INLET: 43' O.D. LIQUID LEVEL 38' WEIGHT: 14,W LOS. INLET AND OUTLET: 4' CAST -A -SEAL BOOT OR EQUAL GASKET, CAST -A -SEAL B0OT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: NASCONSIN, SEE DETAIL /10 (OTHER STATES SEE CHART() UOUIO CAPACITY: 1700 GAL/INGAL/IN (PUMP)SEPTIC) LOADING DES(GN: 8' 0' UNSATURATED SOIL TANK CAN BE USED AS SEPTIC/SEPTIC, SEPTIC/ PUMP OR SEPTIC/SIPHON COVER: MIX DESIGN 118 NO FIBER) TANK: MIX DESIGN 110 STRUCTURAL FIBER) CUSTOMIZED TANKS FOR CUSTOM TANKS CONTACT WIESER CONCRETE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: File #: ST CR0_QLJNTY SANITARY SYSTEM Office Use Only OWNERSHIP/ADDRESS FORM created212o2i Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. OWNER/BUYER INFORMATION Owner/Buyer Mailing Address.15 '6o r LC ).'fly (* City/State/Zip 1) 2t,J 'i�.c Phone Number (required) C S I - Email Address Parcel Identification Number (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location Ha 1/4 , \k)1/4 , Sec. _�, T -aN R� b W, Town of :FaJ 6 -CL U e Subdivision Plat: , Lot # — Certified Survey Map # Volume Page # Warranty Deed # lop/ /pp C6 (before 2006)Volume . Page # Number of bedrooms -3 Spec house Ct yes,0 no Lot lines identifiable 0 yes O no OFFICE USE ONLY New Property Address 2-3-7-7 y 5 T N A V 5i (Verification of new address required from Community Development Department for new construction.) s/i I/G /2( (Staff Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form 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. Community Development Department- Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cddtasccwi aov 1101 Carmichael Road, Hudson, WI 54016 wwwsccwi aov PERGOLA' — BURT-0d BENCH SEATING — GAS FIREPLACE DINING RM DECK LIVING R MASTER BORM '__-- KITCHEN 1 WiCl GREEN HOUS& _ _ _U BATH M J FOYER / M. BATH 2 0 GARAGE STUDY PORCH LEVEL 1 PLAN 3132- = T4)• Dram by Ben GI1H Finslart House DESIGN PLAN Not For Constregan Project AEtl s 011=21 AREAS LEVEL 012500 SF GARAGE 750 SF LIVING SPACE 1750 LEVEL 02: 1300 SF ATTIC 750 SF LIVING SPACE 550 SF QOPEN TO "I BELOW ', — ATTIC l LIly\ BEDROROOM IROO T� I� 2 LEVEL 2 PLAN alai• =1' 0" 0 zs sa 1001 zoo• A-105 CHECK BOX AS APPLICABLE. SOIL EVALUATION Scale: 1"=40 SITE MAP o ao eD Bc PROJECT E: ). PROJECT ADDRESS. (� N BM pe : BM Elmatlon' Fr acrl BM De��yR ,I•t�N•_i_is. IrNu , roM 4 Sloppe Gra&vt(M) $ Well Symbol (if sppll able): O tre«MB an rmu of Testee Ares: on itro appropres Yre. CHEC SOXASPPRICABIE. ,� fA SYSTEM PAGE'2 OF G SLOT PLAN DESIGN FLOW. 50 GPD Attach design flow calculations for C erClal Plans. Pipe Material / ASTM S lq and (Tables 384. $ 384.3¢5) Sanitary Sevor. rJ Force Mein: ^T—/ 4C IMPORTANT: Show ground elevadon contours at suitable intervals. p� _ R l t. Q!"k �-- �-tS}� A.►a. JUL 14 2021 _ I3K5 -}o _ 6t,P-j r.L 7)+JE — ST. CROIX COUNTY CDD Gaw 04'> m4s� ,le os.l( 2 39-161AMAY(i�EJyJt�b 3a S 1;5 Q Vs�S 14 1�-g .r Sleet 9 Z/ZS ioo V10 0595 sir ftu T-rb Nam+ TAB qY.s C $ �S 43b'S U 4 V 4 rry '"k ��rRia..3'i�: atd aa...a. a k. m =*' �.�r"=•�+ 77", - T "' .hx ��,� �2„^��ir .fr t a k�W+ric•w,.�'Ry. `.`„' ;..i ... .; �s 6� �+ �7W�^�+a`�'YL'w '.ibi'^M. WR't"•'�lf«°.r,--..,�+'�e laaitFk+!'vwMr .i � � a �rQ ... `Y 'AY 6�nyg�xyxS1/ x-r.3� gyp.. mON * T ry +Me.i yE yFi�1. yT M Y H -�.1��`,`•.- '�'. .�''f ?:+�^.e4f� '4`lh1i�F+'� C++1� '±a e4�i. ^. .�w.� a..n � ` � g - __ .,. � �� is t .+ IN ��,M�Mf�D I�e�1Se9 - 1MaconsinDeparMe or Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and ulldings u ❑ 1 s in21 •� - m BCCOfdanCe In comet oo, vns rani. wue Attach complete s' den on pagrl)Kkaa tMa B 1/ x 1 inches In size. Plan must Include, bud rwt IlmIt tov r g IttyrlietaYl point (BM), direction and percent sops, aced, arrow, and location and distance to nearest road. Please print all Information. Personal mlormation you provide may be used for secondary purposes (Privacy Lew, S. 15 Ge (1) (m)). County �•1�• + Reviewed by Dale / 7 H 8 tl •�I Property Owner Property Location CC a Govt. Lot SW 1 /4 % G 1 /4 S 09 T N R E (or) Property Owner's Mail ng Addr ss 1686 (, ;1fly Block # Subd. a IDS%" TO Z,, PRee.. / C tate Zip Code Prone Number zju • 0" VNlage Town Nearest Rold N I CTH ail EINew Construction V"E] Residential I Number of bedrooms _ _ Code derived design flow rate 4ff0 4M GPO Replacement Public or commercial - Describe. Parent material I o tJJ OV A-• y': �� Flood Plain elevation if applicable _ —III AA R General comments and—drrecommendations: — — 4IrA �0AAr, Oi J Z :96 q2.$-. 1 B-I Q4 Boring # Boring qo Pit Ground surface elev '�ft. Depth to limiting factor ✓ • in. $oil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Du. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDAf 'EB#1 I 'Ef(112 .� r VA w S' C- 2 r 6 •8 t o ej - KS '7•s`� � 5 s o — - -- Boring # El B_ °nn2__� 4o 12 p2. 2 It Ground surface elev. -1 �fl. Depth to limiting factor in. Sal Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPO/ft 'Et##1 -EMU p 3 •G a Z . wwl, i zr • 6 ` 2 VAjok iic2r=. 8 4 e 9 ' Effluent #1 - BOD > 30 1220 milli- and TSS >30 � 15u MWL uern ai = W1Jljt OPFTIWL mia I ow r9VL CST Name (Please Print) Sgnatu CST Number -,lamas Bork c`v 253976 Address Date ualloa onclVied Telephone Number E781 B County E Mcnomonic WI 54751 8-' - — 715-231-7375 Property Dvyner Fr N3rF►C� 12t( Parcel ID # 008— L0LJS" ZO-COO ❑B-3 Boring # Boring 'f0 %I p r;jit Ground surface elev. 7.5- A, Depth to limiting factor —349— in, Page _ of 3 Redox Description Ou. Sz. Cont. Color ■MM�®�� ❑ Bating # Boring Pit Ground surface elav ft. Depth to limiting factor In. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Do. Sz. Cord. Color Texture Stnucture Gr. Sz. Sh Consistence Boundary Roots GPDIff 'Ef#11 'Eff#2 ❑ Boring # H Boring roun PIl Gd surface elev ft. Depth to limiting Fedor In, Srnl AnNI� canon Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu, Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Gpofte 'Eff#1 'Eff#2 Effluent #1 - BODr > 30 < 220 mart and TSS >30 < 150 marl. ' Effluent #2 = 8O0. � 30 mgll and TSS < 30 mgrL T'he Department of Commerce is an equal opportunity service ryovider 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 608-264.9777 sqU 1307M(WM' CHECK BOX AS APPLICABLE 1 SOIL EVALUATION Scale; V 40' CMEC BOX AS APPLICABLE. C>r �p SYSTEM PAGE 2 OF G o BD D`j"G' SITE MAP LOT PLAN PROJECT NAME: DESIGN FLOW: 1� GPO 101 Attach design flow calwlelions for commercial plans. PROJECT ADDRESS: Pipe Material / ASTM S n and (Tables 98LL4.33��AA8(�3�84,32-5) Senitary Sower / .71,�A , /� f M BM Symbol 8.M1EylavNbnFT" Fo•ce Main //� BM Desolation; n: L�L�iri+�- Slope Gradient or Tested Area: Q well Symbol D y(n appu°eae): O Iw6astenonhor Palming an ea� IMPORTANT: Show ground elevation contours at suitable intervals. on lha ep .Pmo" 01. �. 6pi 1. "12aJ@ '^' Clao,L., 04' 5 :rw ' 4 64. 5 B� 85 pgvt, OS�S D . LUZ •S -/ o- SIoPc 8 crop 00 0595 Sr IRACV. TY51,tF� NeW 'rAW111 -ipi:e4,"re jol C W 0616� vi 1 d U .`4 v L' C 57`z()2/-13r 0 �— Wisconsin Department of Comma MAY 27 2OIL F�VALUATION REPORT page 1 of 3 Division of Safety and Buildings fmta�YfrHa WItM Comm 85, Wis Adm. Code Community Development County Attach complete site plan on pa less 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 Lew, s 15 04 (1) (m)). Property Owner 4A �' Property Location Q / i GovL Lot SW 1/4SEt/4 S 09 T� N R �b E❑(a Property Owner's Mailing-Addr4sis 1686 G Lot # Block # — Subd. Name or CSM# 1 6o acre .,t Q go A 4- 20 .o, C' fate Zip Code Phone Number d-7 ( ) -YLoZ []City ❑ Village Town Nearest Road N GA GT E] New Construction UseiE] Residential I Number of bedrooms _ Code derived design flow rate I -ISO GPO 11 Replacement ❑ Public or commercial - Describe: Parent material ' 0 t6 wi-,L- Flood Plain elevation If applicable p ft. General commentsfit A., and recommendations: �A,t - 1 f. 0 E oN 11 1 m 9 Z .s— (2e u r3w loci B-I Boring ® Boring YV NO+ uS4 V115 �1'�2. 2 Q Pit Ground surface elev. ft. Depth to hmmng factor J_ � I in, Soil Applicabort Rate Horizon Depth in Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIfF 'EB#1 'Eff#2 •.6 .� •s r . 6 i woq M1-- L - KS 7•s`t � Z 5 s o - -- . Z �� ❑ Boring # Boring °nn�O It Ground surface elev. ft. Depth to limiting facto 3 6 in. F-sooApplication Rate Horizon Depth In Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDKF -Eft#1 'Eft#2 P 3 .� 4a f .s 2f �n�dt vim. c 2-P • (o .$ 2 rhab�c wwln. �S • S c G t- S Effluent #1 = SOD > 30 < 220 mg/L and TSS >30 < 150 mg1L :SEjuent #2 = and TSS _< 30 mg/L CST Name (Please Print) Sgnatur CST Number Lewis Bork ew 253976 Address DatS.uatioitCond4ted Telephone Number E7818 County E Menomonie WI 54751 &� -46-71 — 715-231-7375 Property Owner Ft as}1AA t( Parcel ID# 008" 1024- w-WO Page 2 of 3 B-3 F-11it Boring # U Boring "1b 71 1• Ground surfaceelev, ft. Depth to limiting factor-36 in. $oil lication Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIN 'Eff#1 'Ef1#2 Q b .s�1.3 Lt ►tiw c.s 2F X.t• O ? • 54 tZ- as- S/ Z S 'sl IS s ❑ Boring # Boring • Pit Ground surface elev. ft. Depth to limiting factor in Soil lication Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 'Eff#2 ❑ Boring # Boring Ground surface elev. ft. Depth to limiting factor in. Pit Soil ADDllcatlon Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz, Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDffF •Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mgA- and TSS >30 < 150 rTKA ' Effluent #2 = BOD, < 30 mg(L and TSS < 30 mglL 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. Sao-e330Tni (a 07M) CHECK BOX AS AF'PUCABLE. . .. :. PROJECTSITE MAP 0 Ri\_.... firW CHECK SOX AS APPLICABLE. C> Jam" PISYSTEM PAGE 2 SOF G LOT yPLAN Dt Yl DESIGNFLOW': 1SD GPD Attach design flow calculations for commercial plans. PROJECT ADDRESS Pipe Material / ASTM S n aid (Tables 384.313 & 384.�3 -5) f� N SanitarySewer/ �1�- BMSymbol: B�MjEylev�at�ion�`y�y�� FT Force Malrc_/ SIw_ 4A NJ BM Descrption' wall Symbol(IIeppiloable): IMlrete noah by IMPORTANT: lope Gradient(%) $ STested Area p drawing an amom Show ground elevation contours at suitable intervals, Slept h 9 19 on the aWropme lm 11C 2539-76 � kS %6il •S co-op Low r w1FJ�► TAM C- 5' -prtillixPn 9Awtt VC T0"i J W0 a595 7r (+ccc �Sst 5 % C'rO;g COUNTY 3 P�drm.� NO. 633862 STATE SANITARY PERMIT m _ z377 1o150� Ave OWNER PLUMBER J eW%.$ ie TOWN OF SEC 9T Z8 N, R AND/OR LOT LICX 253f76 BLOCK SUBDIVISION 'ZoM E k CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. � W X7.r ED ISSUING OFFICER -DATE THIS PERMIT EXPIRESAU UNLESS RENEWED B OiE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI1/20)