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HomeMy WebLinkAbout010-1007-95-100-115 - Vq- or7il Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal Information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] Permit Holders Name City Village Township DuWayne & Deanna Richert TOWN OF EMERALD CST BM Elev Insp./ Elev BM Description AM 7 15 TANK INFORMATION Owl A. I l ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic (~J ;P-tsr- 100 0 Dosing (050 Awatilow I SZ-S Holding TANK SETBACK INFORMATION TANK TO A/L1 / WELL BLDG. Vent to Air Intake ROAD Septic �ZTS % f, ` "- t ._- —_ Dosing 7 Z51 J Aeration Holding PUMP/SIPHON INFORMATION tM ,4. Zy. 7 Manufacturer Demand GPM a a„ s Model Number 19F51 5 8 TDH Lit Fric(I•on L System He�d5 TQS t ,3 / 7 Forcemai�nn Len th d Dia. Z ' Dist ttoPWell I AA SOIL ABSORPTION SYSTEM STATION BS HI FS ELEV. Benchmark All BM )• 3 loL1Z3 Bldg Se er JOO. 2I St/Ht Inlet .7 SUHt Outlet Dt Inlet Dt Bottom Header/Man. 7.7� IoZ.Bp Dist. Pipe Bot. System Z. t ZFinal GradeSt Cgoyer V73 A lal. J>a BEDFI RENCH DIMENSIONS Width Length 50 {{ 1 z la Arr-a, GS PIT DIMENSIOl Of Pits Inside Dia, Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE/S Ma ufact er INFORMATION C MBE R UN Type Of Systerrl: V 1'tf71 —J /d 7` f'" NkL JREEACHIN Mo umber DISTRIBUTION SYSTEM Header/Manifold 3 ' Length Dia Distribution Pipe(s) / 7 r Length Dial „ I �- Spacing x Hole Size I , I — x Hole Spacing --7 20 L ` Vent to Air Intake '( YIA SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only a J v /` Depth Over xx Depth of xx Seeded7Sodded xx u ched e ren ter 7) a f1 (A �j Bed/Trench Edges Topsoil Z r r rj u y O l/ 6 LJ �F} Ves No Jt Yes No COMMENTS: (Include code dlscrepencies, persons present, etc) Inspection #1: I Location: 1750 250TH ST ff p lnay 1 ( 11. C4l4 c t, 1.) Alt BM Description =fur (Ovcr- }Io O 1 2.) Bldg sewer length - � (n - amount of cover = #2. 1vfiivm) el Plan revision Required? [Yes Fyn. No O Z I Z Use other side for additional informatidn' I I/::y:_ ✓M N SBD-6710 (R.3197) Date Insepctors Ignature Can No fli (�) 31l / "will i-2n 5 I — 4_ n SY 1.' 2. iiY ( Safety and Buildings Division Coun y S{ . eYGi.x Sanitary Permit Number (to be filled in by Co.) ' 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707-7162 63�i3�f ermit Application U State Transaction Number e In accords CAM' is Adm. Code, submission of this form to the appropriate mental unit O $ 2 (D ZO%2-C Project Address (if different than mailing address) is required nor to obtaining a sanitary permit. Note Apphcation forms for state-owned POWTS are s tied to the Department of Safety and Professional Servics Personal information you provide may be used for secondary ,I `7^ purposes inaccordance with the PrivacyLaw, s, 15.04 1)(m), Stats. I _l.J� C'O 'C C-t-- -TT,e.JU J I. Application Information - Please Print All Information Property Owner's Name Parcel q uw � L�r K1E- Olc�%a7-QS-/60 Property 0wri Mailing Address Property location / 75 o 250' Z s Govt Lot SC- Y., 5C— A, Section -� City, State Zip Code Phone Number LU ( 54013 7f7�-'� -Q ls.�% T_10 N. R�IE one 11. Type of Building (check all that apply) Subdivision Name — �-I or 2 Family Dwelling- Number of Be¢rooms� Cp,S ff11AA++A�/++�K-- B1ockH of ❑PubbeJCommercial- Describe Use ❑ State Owned - Describe Use CSM Ifni❑City y' village of ,J C-4"# Number V zt� P 5'-r ,.S Y�*' /{Ea own of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A Ncw Sys[em ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued I❑ Before Expiration Owner ff IV. Type of POWTS S stem/Com onent/Device: Check all that a t �1plr' " ❑ Non -Pressurized In -Ground ❑ Pressunzed In -Ground ❑ Al -Grade P"Mound > 24 in of suitable sod ❑ Mound < 24 m of suitable soil ❑ Holding Tank ❑ Other Dispersal Component xpl n) 01 etreamtent Device (explam) V. Dispersal/Treatment Area Information• eel Design Flow (gpd) I Design Sod Application R fist) Dispersal Area Required (sf) Dispersal Area Pro d is System Elevation j0U & 5t5o {z soo 30 VI. Tank Info Capacity in Gallons Total Gallons d of Units Manufacturer 8 Vj/t10 r • �" o +-' 2 tin tin M g V New Tanks Existing Tanks a U U tin rna Sepmc or Holding Tank &Cap Dosing Chamber 61, 5-V VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum s Name (Print) Plu 's Sign re MP/MPRS Number Business Phone Number Plumber's Address (Street, City, Slate, Zip Code) V1II. Coun fDe artment Use Onl Approved ❑ D ov Permit Fee S Date Issued 9 gsu AAK�it Signature ❑ iv on for Denial 6� 30 I IX. Conditions Appr IRteasrnsfm--Hisapproval 3 ��resSa tS �0 -, rLi.I TEM OWNER -,/ /I ,T •jam ��,yk tOL B'� O�IJp S pile tank, effluent filter and f0E1'ff��✓/ S1 �'"� 'iVT d spersal cell must be serviced / maintained , a per management plan provided by plumber.' -S DS� � A setback req uw rements must be maintained .�YT4 O'rt• t'tn' as per applicable codemrnlnxifa06to compkle plans for the system and *sub to Couary on on paper sot less roan a is z i i es+a vac f." D SBD-6398 (R- 1 V 11) f'�� Psi cQ.2 t9+►MRr CHECK BOX AS PPPLICAB!-E. CHECK BOX AS APPLICABLE.❑ SOIL EVALUATION scale: 10 ❑✓ SYSTEM PAGE 2 OF 6 SITE MAP I 4 60 so PLOT PLAN PROJECT NAME: 10' DESIGN FLOW: 300 GPO (10117b) DuWayne Richert / Attach design low calculot ons for commerdal plans. PROJECT ADDRESS: 1750 250th St, Emerald, WI Pipe Material / ASTM Standard (Tables 384.303 & 384.30-5) N Sanllay Sewer. PVC I ASTM D3034 BM Symbol: -$n SM Elevamn: 100.0 FT Force Main: PVC i ASTM D2665 BM oewdpbm grade 0 fenoepost with birdhouse Nelmle nano q' IMPORTANT: Slope Gradient(%) 5 Well Symbol (n applicable): Q dmNno an rrwi Show ground elevation contours at suitable intervals. of Tested Ana: on tM swoons irr PiL, X \\ t�l.st` �— YY.YI ` N�,— 1-3.-11, � ia5.15� 2� ---- r IL- �<�•%RI �SPS August 25, 2021 .d�]:1rlY1Gl:T_TWi .1lZ�S7_T PLAN APPROVAL EXPIRES: 2023-08-26 Plan Review: PWTS-082102072-C MICHAEL J MYERS 2943 130th Ave Glenwood City WI 54013 SITE: DuWayne Richert 1750 250th St Town of Emerald St. Croix County SE, SE, S3, T30N, R16W Total Amount: $250.00 DIVISION OF INDUSTRY SERVICES 2850 MIDWEST DR STE 104 ONALASKA WI 54650 Contact Through Relay http://dsps.wi.gov/programWDefauft.aspx www.wisconsin.gov Conditionally APPROVED DEPT OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Tony Evers - Governor Dawn Crim - Secretary FOR: Description: Two Bedroom Mound System \ Sloping site Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01/01, R 10/12), Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01/01, R 10/12), 300 GPD, 44" depth to limiting factor, Maintenance required, Effluent filter, New construction 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: Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Slats. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. 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. • 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 is required. 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 POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. 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. • 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. 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. 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 POWTS. Sincerely, Gerard M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892 — voice 1(608)785-9330 — fax ferry swim(aDwigov PAGE 1 OF 6 Remarks: Mound Plan Index & Cover Sheet Component Manual Design References: Version 2.0, SBD-10691-P (N.01/01, R. 10/12) & Version 2.0, SBD-10706-P (N.01/01, R. 10112) Pg 1 of 6 Index & Cover Page Pg 2 of 6 Plot Plan Pg 3 of 6 Mound Cross -Section & Plan View Pg 4 of 6 Distribution Network Specifications Pg 5 of 6 Pump Tank Specifications Pg 6 of 6 Management Plan Pump Curve POWTS Application for Review Soil Evaluation Report & Site MaD Project Name / Description DuWayne Richert Owner Name(s): DuWayne Richert Owner Address: 1750 250th St, Emerald, WI Phone: 715 _338 _0637 Zip: 54013 Project Address: Same Govt. Lot: SE 1/4 of SE 1 /4, Section 3 T 30 N-R 16 E ❑ or W ✓❑ Township: Emerald County: St. Croix Project Parcel ID #: Designer Information Designer Name: Michael Myers Designer Address: 2943 130th Ave, Glenwood City, WI Phone: 715 -265 -4115 E-mail: mcmyers@centurytel.net License Number: 267985 Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Zip: 54013 SEE CORRESPONDENCE Signature: 12� f �t x� w Date: Original signature re iced on each submitted copy. CHECK BOX 4PFJCAb'_E, CHECK SOX AS APPJCQLE. ❑ SOIL EVALUATION Scale: 1°=40' 80 ❑✓ SYSTEM PAGE 2 OF 6 SITE MAP ° a° 50 PLOT PLAN PROJECT NAME: DeslGn FLaN 300 ,' C It grid, 10' GPD DuWayne Richert / Attach design flow calculations for commercial plans. ?RO.IECTADDRESS 1750250th St, Emerald, WI Pipe Material; ASTM Standard (Tables 384,30-36 384.30-5) 00.0 N Sandary Sewer PVC ASTMD3034 am Sym9o1' +� aM Elevation' FT aM Deecnptwo grade fencepost with birdhouse Fmce Maus PVC ASTM 02665 Sloe Gradient (°,FI �rG!ca•e rc^,� rt IMPORTANT: of Tested Area, 5 Well Symcd ;d appllcaolel O -a.o-; a- Show ground elevation contours at suitable intervals, a Pe aopopme IM Y �r� a hI � dr � • ' td•.sa �d.r< `v ..y1P k J- - C /L- - W = 20.2 it r r r p fabric)over distribution pipe. and covered with approved synthetic ASTM C-33 SAND FILL Plowed Surface SINGLE -CELL MOUND DISPERSAL AREA MEMIN. 6.0" OF TOPSOIL COVER min. 1.0 It r--O 1-- O Surface Contour Elevation = 101.14 it (Show forre main, manifold and flush valve locations on plan view ) 5 % Slone �D= 10 it E = 13.6 it System Elevation = 101.97 it Lateral Invert Elevation = 102.65 it CROSS SECTION VIEW (No Scale) PLAN VIEW (No Scale) 1 112 " 0 Schdl 40 f 1� PVC I ateral = 5.6 it 8.33 ft (typical) 1 I ! (types) Observat" C I L_--- — — — — — —------------ — ---J I a = 50 it I I� 1= 8.6 it K= 8.4 it Ovpicag) Bend as necessary to fellow contour DOWNSLOPE TOE L = 66.8 it Prohibit disturbance and vehicular teak within 15 feet of downslope toe. Reset Page DISTRIBUTION NETWORK SPECIFICATIONS FLUSH VALVE DETAIL (No Scale) Orifice in — — Valve Box Center of Threaded Cap (insulation optional) for Head Testing (optional) \ I I \ Ball Valve ) \ (optional) \ Orifices equally spaced (check a) OR b) below) a) 0 along bottom of lateral b) n along top of lateral with every ___ th hole facing down (No Scale) Lateral Spacing S= 3 Shield orifices for graveness applications _� = - ( cacerar Lengm lrl = 4y n Flush Valve Assembly (typical - see detail) LATERAL INVERT ELEVATION = 102.65 (typical) - %= y- Last Orifice (riser pipes optional) 2 'O Slh'dl 40 PVC Manifold 2 -O Schd140 PVC Force Main (slope to pump tank r for drain -back) Laterals to be level First Orifice (typical) -'�--Schdl40 PVC Lateral 11/2 in (typical) Number of Orifices per Lateral = 30 Orifices equally spaced along bottom of lateral (typical) Orifice Spacing (x) = 20.28 in (typical) OBSERVATION PIPE DETAIL (No Scale) Screw -Type or ,�-�, y Finished Grade Slip Cap (hose) +• (mulched $ seeded) 4.0 PVC Pipe — Top of pipe to teminate at or above finished grade (4) 114 '112- x 6- Slots @ A apart Anchoring Device -�— Topsoil Cover (min. 1 foot) Infiltration �._ Surface Orifice Discharge Rate = .412 gpm Number of Laterals = 2 Lateral Discharge Rate = 6.18 gpm TOTAL DISCHARGE RATE _ 12.36 GPM Orifice Diameter= •125 In (typical) First Orifice (typical) I— x END MANIFOLD Check (typical) Wj CONNECTION applicable box. Manifold First Orifice (riser pipe optional) D (typical) - -�-xn- xn- x-�----� m (tylNcail) (tyvical) Manifold CENTER MANIFOLD n (riser pipeoptlonal) CONNECTION 0) PAGE 5OF6 SEPTIC / PUMP TANK SPECIFICATIONS 4'9 Vent (No Scale) Papa >10't 'mm BuJding Ek Mcam musl mm*win 12' MI^ a 2 0 fl aooae SPS 316 and NEC 300 EmOshed Flood Ebvalwr .n Weatnerproo' Eend anear as nas necessary. (ryptsp Juncwr Box Vporo�ed Approved Locking Manhole IMPORTANT: u+th Warning Lahsl Attamad Anchor tank(s) as necessary ` (rypoal) pursuant to SPS 383.43 —Caotlotl P 8{)(g) a• nun. o• ao n above Esuonsned Fkwd Elevatwn I T/ ;rydcap Finlsned Grace CAPACITIES @ 17 gaUn Depth (in) FVolume (gal) L A 1 20.9 354.7 B 2.0 34 A [C] 5.4 91.3 D 10 170 e I iC) *Pump Tank Liquid Level = 38.2 in ' Pump rp Force Main Diameter = 2 in Force Main Length = 80 ft Force Main Void Volume = 13.9 gal Avugrl Seal Quick Dmm'nect f 1 Er Mn. (typical) 1 weep \ `Approved Joints with Mole Approved Rpe 3 n orto Sole Ground (rywrary Alarm 3' Approved Bedding Maledal Bonsai- Tons [C] Total Dose Volume (TDV) = 65.7 gal/dose (5X total lateral void volume <_ TDV < 0.2X design flow) + (force main drainback volume) MIN. PUMP DISCHARGE RATE = 24.7 gpm PUMP -OFF ELEVATION = 91.8 ft INSIDE BOTTOM ELEVATION = 91 ft Vertical Head = 10.97 ft + Min. Supply Head =� 5 ft + FM Friction Loss = 1.08 ft + Fitting Loss" = 1.95 ft '(min. supply head x 0.3) = TOTAL DYNAMIC HEAD = 20.5 ft PUMP TANK: SEPTIC TANK(S): Volume = 650 gal Total Volume = 1000 gal ManufactureWieser Conctrete Manufacturer(s): Wieser Concrete Pump Manufacturer: Goulds Pump Model: iP( Q�lseeaaad Install approved effluent filter at the septic tank outlet ed WTp�Ne l immediately upstream of the pump tank inlet. Filter Manufacturer: Polylok Controls/Alarm Manufacturer: SJE Rhombus Controls/Alarm Model: PSP120V6H150P17A Filter Model: 525 Float switches containing mercury are prohibited PAGE 6OF6 Mound Management Plan IMPORTANT: The owner of this mound 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 Maintalner in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = rill gpd; BODs <_ 220 mgL''; TSS 5150 rrI FOG <_ 30 mgL` Inspection Checklist INSPECT EVERY 3 YEARS o type of use c age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e.. pumps, valves, switches, floats, etc.) c material fatigue (i.e_ leaks, breaks, corrosion, etc.) c solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution i drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) c extent of ponding in distribution cell prior to dosing o dosing irregularities (i.e., pump recycling, float switch settings, etc.) c electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) I 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 tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Slats, 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 filter(s) 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 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Northland Plumbing Inc Phone: 715-265-4115 Local government unit: St. Croix County Zoning Phone: 715-386-4660 Local government unit address: 1101 Carmichael Rd, Hudson, WI Zip. 54016 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, Wisc. 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, Wisc. 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 mound 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 accordance with SPS 383.33, Wisc, Admin. Code 'OULDS PUMPS APPLICATIONS Scec a y des gned for;He 'o ow,ng uses: • Vound Systems • Effluent/Dosing Systems • Low Pressure Pipe Systems "� • ?ase•nentDraining • Heavy Duty Sumo/ De:vate^ng ,'E'E Is -EET 40 PE5` 35� OL !--- 30 `PE < 25 z 20 r SPECIFICATIONS Pump -General: • D'scha,ge: 1 A P P' • 'emperature: 1C40F (40°C) maximum, continuous when fu4y submerged. • Solids handling: '/1" maximum sphere • Automatic mode's include a `cat sw'ch. • Vanual ^odels avar.ab'e. • P;.mc'ng •ange: see oer`ormance chart or curve PE31 Pump: • Maximum capacty: 53 G°V • Maximum head: 25: TDI PE41 Pump: • Maximum capacity: 61 GPV • Vax;mum head 29' TDH PE51 Pump: • Maximum capa, ry. 70 G P V • Maximum head. 37' TDH 5 c� 0 Z 2004 ',7' Whin TKhnatogry,'mc E•'Mve June 2C-04 BPE31'4' Submersible Effluent Pump PE MOTOR General: • 4^g e erase • EC Here • 1' S a-c 230 vo°.s • Eu: •:r ther^ai overtoac oro- tec:cn vr:^ automa'i< reset • C ass 3 ,"s- 2'. o^ •:•fileccesgr • - g^ 5:•e-gt- ca'co^ stee S^ZH. PE31 Motor • 33 ' P 3000 RPV 15:c:s • Snadec c^O e ces gr PE41 Motor: • .40 HP. 3400 RPr: • 115 a^d 230 volts • PSC desgn PE51 Motor: 5C -° 34C_. pp", ' � a' U. vc :s • csC cesgr 33 4C FEATURES ■ C0•'c5'c" res'S•Z" cclsruct c-, ■ Cas' 'o- cocv ■'-e• oc asuc moe' e• a^c cove,. ■ unoe• s'eeve and lo'we' heavy d :y oa' oear rig cols: X..'o ' o'cr s pe' 2ne'•-y .;b^ca'ed �o• exte^ded sev.ce'i`e. ■ powe•eo �0' cc^truous cDe'atior. ■ AI' raDres are W vc'K ngJ rn;' G. t,e mG:o' ■ cK c scor^en cover cord, 20' standard'ength, `,eavy duty 16,13 Si Tlv with "S o' 230 vo'c c•ourc no ■ Crro e:e s bear eo^zc'e a^c xTeacr ■ Vec"rmcal sea is aruc- ce•arr-c, 3"AA and s:a:r!ess stee:. ■ sta n'ess steel 425:ene's AGENCY LISTINGS e's Tested to UL 778 and CSA 22.2 108 Standards ay Cariedbn Standards Qssooatior. F4 #L438549 Gou ds Pv'^pf is ISO 90V Registered. Goulds Pumps CAPQCIry ITT Industries V-1/ VJs -)eo: or Swet)' anc Orcressionai Seti:zes SOI_ =VALUA T ION RRPOR T - ana .�i10.5iG, of Sa%e;v dnG Bll,ld'nDs _ -- ur, accordacc- vn:r S?S 395 /Vis Aom Code count' �7< A!;a_n „dmp:ete site aar on paper not less than E 1'2 x t' i,^.cries in size. Plan must L nc!aGe but no: ilm.tec tc ve'Ida! anc nonzontai rer=_rer::e can; +E;W a.rect:on a•r cant s;DDe scale r dlmersi_ls ''e^.r a -•ow ar-,c lxatio- arc dista^ce ;o ^ea,es' 'cac a l0 't Oc'7- 95-lop Please print all information. ReV1eVeo Dy Date `ormanor you orowoe may ce uaea tv seconca� ou•.^ses ;Pr, a:.. _as s 1_ r4 .1 i +,ml+ P'Dpwly Owner rrooery Loat;on _ . Sb vaSE,+a s 3 '30 IN = l(e =io- ^. a"c_-9-v Own • s tdailm- Address ` Blo-! # $tlCC /75-u 254 t 3/- r/o S:a e by Code Pro^.e NumDer pry ❑Vd;age Tow Nearest Roac J�asire(p/ k I SY/ur3 ! 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Grouna suiace elev. /a/• /Y t O/O 16,0 y'`r/eu Dept to lunitmc `actor ?age Z or J� SoiAnpliaatio^ Rate Horizon. ; Deptr i Dominant Dolor! Redox Descriohon ir.. Munser Oc. Sz Con;. Corr I Texture I Structure Gr. Sz. Sri -ons:Slen z 3cundary . i Rio s GPJ'h ' >' 2ms6k if 2 ''(/-2/ (oY,¢•s/Y ' ! s,/ 2.rr6.� �s c s /�' ; , � ! ,� ..5- ' S y ;3/-6 -7 (o m-4'/y l lnri%, CS I 1 i ' I i 8orir ! i Bcncg p.36 a Ground su�ace °:_v. AP f Dept^ to lim:Sng :actor 2� - Soil AooDcaaon Rate n.r zor. Depth !Janiran'. Co:or; Redcz Descripbc= M. P.lunsalCu. Sz Con: Cola: -exUra_ S:-uc:u,e Gr, Sz. �onsis;ence ounaa-� !Roes I Lf ?✓ I/a-2u/dy,2siy i s// �2/xs6� I ds es sr./ 2ms,6/� 'tnVq Cl ! 14 It 0/9 I 3 �' OSy j -h �'/ c jr - 15, b : 5 _ l� Yy-52/49%e. cs -7 4-7 7y /aY/L �/g I7 SY� 8� sG 1Fr6k : lh��y ! c S - E7.0 z) u 5oring # (✓' Bonn@ __ J � Pit ;;round sur'ace stet'. y� '?. 'aatr ?c iirc:nn3 factor 5 � ir. — Sc::.Aooka;ic^ Ratn ;ior¢on Deaf.^. m JominantCoiori RedorDescnpt1or Munsel! i 0,. Sz cnt Coro' 'ax�re Sr..ct,.re Sz. Sir Corns?ends !3ourcwr j I Rocs GPJ,:' 'c!`K+ '�'f42 / ID -13 d! Z 1/3-24 (de 2S/Y s,l 2ms6K ds e s ;(�r 3 b z3 `l��/e r� /� j s o s �n v�,, �. 5. / F 5S� y� s� m r����, s cisf •� / s - - ? j�5-Y,���f1dsP s+ 5e i"'Af6K i AW—ol I C5 _� a � lar? I EM,eni r.' = BOO I > 30 = 220 M:91; and "SS >30 11 5C mg!_ ' Esluent F2 = 3GD < 3' mg'L and TSS <30 r,.g''L 'f ne Dent. of Safen and Professional Services 9s an equa' opportunity service provider and empioger. 1 y ou need assistance to access services er need rnatcriai in ac alternate forma: eu,tcuc; t c department a. 608-266-- 1_ ! or Tl Y th.ousF. Rolm CHECK ROX AS A-RJCASLS CHECK BOX AS APPUCA6_E. F✓ SOIL EVALUATION Scale: " 40' SYSTEM PAGE 2 OF SITE MAP PLOT PLAN PROJECT NAME: DESIGN FLOW GPD ('G If grid; ' tpr DuWayne Richert Attach design flow, calculations for commerdal plans. PROJECT ADDRESS: 1750 250th St, Emerald, WI Pioe Material.; ASTM Standard (Taoles 384.30-3 & 384.30-5) MIA.$yTEd: $. amElevahm' 100.o N R Saneary Sewwer: FV ce Matt / But Deccnplwn: grade @fencepost with birdhouse ' Shoe Gradient (hi 5% w«w Syrnba (iraPPicabie): p 1^ewe row oy da,.tn an arrow IMPORTANT: Show ground elevation contours at suitable intervals. ul Tested Area: �. RA. e�rapra aY. I''� 82 1o5./S` ` (cc 3a' Y3 C�i yr/x L �> SF%y SE% S3 -r?vti/ Iz 16 %wWlaL[ra" AJKr1� -------------- v u T� - -- i ST. CR . UNTY SANITARY SYSTEM Filece Office Use Only OWNERSHIP/ADDRESS FORM Cre tcd 212021 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. If you would like to view your issued sanitary permit online, you can do so by using the property Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer Mailing Address / 7So City/State/Zip E~,,w//f u1/ -ya/3 Phone Number (required) 7IF 338- 64,?7 Email Address Parcel Identification Number /do7— y§ — (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location SEY4 ,SE 1/4 , Sec. .3T 30N R16W, Town of F_irurycl0/ Subdivision Plat: Certified Survey Map #. Warranty Deed # Number of bedrooms Lot # 6. Volume 2 c( , Page # SZD q 06 (before 2006)Volume Page # 2 Spec house 0 yesAfno Lot lines identifiableAryes O no OFFICE USE ONLY New Property Address 2 So S+• (C 60 (Verification of new address required from Community Deve opment Departme 44- 2Q (St ff Initials) I (Date) for new construction.) 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 cddCc1)sccwl gov 1101 Carmichael Road, Hudson, WI 54016 sccwi aov ti I,D^�IL CST-aoa i— 31y� W-s Dept of Safety and Profc sional SerweA SOIL EvAtOPage t of� Division of Safety and Buildin f J C I in accordance with SPS 385, Ws. Adm. Code • r County Attach complete site plan o papgfiil@�CIdrLS..tjb@Iiir�k:hh in has in size. Plan must include but not limited to: v omit (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow. and location and distance to nearest road d /0 - 6 S- /OO Please print al! information. Reviewed by Date cantonal information you crovioe may be uses to, secondary purposes (Pnvacy Law. S. 15.04 (1) (m)) V30 Property Owner Property Location i \ - lJ"W R,c �,- f GovL Lot S I M S E 114 S S T ,�� N R E (or Property Owrlars Mailing Address Lot//# Block # Subd. Name o / -7 2 5J'`A d it,,- (O ANIIIIIINW? City State Zip Code Prone Number ❑ City ❑ Village I[PTown Nearest Road New Construction Use. Residential f Number of bedrooms 2- Code derived design flow rate 3a0 GPD Replacement ❑ Public or commercial - Describe Parent material 9/ C!m/ -/7 // Flood Plain elevation if applicable ft General comments and recommendations nBoring / I Boring # Pit Ground surface elev /03 15 ft Depth to limiting factor in. Soil Application Rate Horizon Depth in, Dommant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. onststence oundary Roots GPD/fl t ff#1 ff#2 / o-9 /0Y41/7- siI 2nt 6 all ES / t& -'8 2 q-/r3 Io7� 5�Y S. 2Ars6.� ds -t S /r� 6e S 3 /8.4'/ /o7K�/8 4Ds5 U5 /AVIP, 6.7 / 5"4 , 5 y yl-Y /eYX(-/g M l S — 7 / 4 5 yy lot' /iy,2 S/S 1 7641KCf'8 :P/d3i d j sC / ASsA /net,' � S — (51,0 0.0 ,>60I40 <9v Boring # Boring I ® pit Ground surface elev /�/ �/ ft. Depth to limiting factor Solt Aonl�t7 Horizon Depth m, Dominant Color Munsell Redox Descnphon Qu. Sz Cont Color Texture Structure Gr. Sz Sh onsistence oundary Roots ' GPDfft ' ff#1 ff#2 D-/i /dYlL3�Y 2M56/T d 0, /I-Z`f ID K5/ Sit 2.r5:6K 015 d 3 t 2y'y/ /eYR ('/g S6 Os m��i rS /F' „s , 56 'Y/-Y7 /orR/-s s a mot" cs — 7 /.G S 'I 52 /n 711. 579 7.5ye 1- ;7,ff SG m f 6 A O. 42 G7 /ore �/p so /fs�/5 ryu<� c S — ar o, o ' Effluent #1 . BOD � > 30 < 220 mg1L and TSS >30 < 150 mg/L ' Effluent #2 = BOU , < 3C mdrL and t ss < 30 marl - CST Numbe C5T Nam�^jPlease ' �'7 pn//I Jyfe �� Z !a 7/��'rs. Address -/ Date Evaluation Conducted Telephone Number 7 10- 2o- '7i5--2�5 Y// 5 ► 'ram NO, 633934 STATE SANIT XRY PERMIT UqPR.4V9FE�RfR�MEAL PRC\90ryS V0. 1_ Rimrip'l:4 PLUMBER TOWN OFF SEC ,T 11 N, R 0 EXPIRES LIC.# 14JBDIVISION CHAPTER 145.135 RiWISCONSIN 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. (it) 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. ISSUING OFFICER — DATE RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI1/20)