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HomeMy WebLinkAbout018-2019-48-000Wisconsin 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)]. C&J Builders Inc TOWN OF HAMMOND TANK INFORMATION TYPE MANUFACTURER CAPACITY eptic Dosi Aeration Holdir� TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD septic t j0 Dos' ration L-c 1. L Holding-- PUMP/SIPHON INFORMATION Head n SOIL ABSORPTION SYSTEM ELEVATION DATA STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer �.30 ln�o.3`f SUHt Inlet Z O o 9. LI SUHt Outlet g•4o . z Dt Inlet Dt Bottom Header/Man. Dist. Pipe i Bot. System Final Grade l St Cover I 1 i 8 w. 12 ob(p.D4 �Mn-r.-Gutse/ (o�$Jo BED/TRENCH DIMENSIONS Width Length No. Of Trenches _ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer Type Of System: Model Number: 1 10 I r V 0 V 1 1 V 1\ a I a I a 1Y1 - HeadedManifold IDistribution x Hole Size x Hole Spacing Vent to Air Intake --- iPipe(s) Length--� Dia en------Uia-----�paeing---__... ---_--_—__. JVIL V V V Cr[ v PrGCC11ra Rvefcme riniv .. ru.. -A n. A• c—A- c.,.......... ^—h, Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Sed/Trench Edges Topsoil L7 Yes No 6L'IENTS_-:(Include code discrepencies, persons present, etc.) Inspection #1: /ZL/Zp� Inspection #2: 01AtCon: 744 61 ST 1.) Alt BM Description 1 2.) Bldg sewer length = 3p - amount of cover = $ f f Plan revision Required? [Yes X No Use other side for additional information. SBD-6710 (R.3197) �-{- Date Insepaor's Signature Cent. No. I ��n) SAadat U Safety and Buildings Division County St. Croix Sanitary Permit Number (to be filled in by Co.) c 't02� • S=� .r:� 2 1 W. Washington Ave., P.O. Box 7162 OCj Madison, WI 53707-7162 .Q nt C0 ego me^t // C� Q (D33 / -7u Ctotx • .t ermit Applicatio State Transaction Number In accordance with SPS 38 . ), Wis. Adm. Code, submission of this form to the tal unit os1so14ss is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are s d to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may he used for secondary purposesin accordance with the Nvacy Law, s. 15.04(I)(m , Stars. 744 161 st St. I. Application Information — Please Print All Information Property Owner's Name Parcel # C & J Builders Inc. kAJ 018-2019-48-000 Property Location Property Owner's Mailing Address 316 Kamloops Place Govi. Lot y,, SW y., Section 29 City, State Zip Code Phone Number River Falls, Wi. 715-222-9731 (circle o T 29 N; R 17 EorWb H. Type of Building (check all that apply) Lot # X I or 2 Family Dwelling - Number of Bedroolas 4 48 Subdivision Name aS ie Rolling Hills Farm Block ❑ Pub)ic/Commercial - Describe Use ❑ City of ❑State Owned - DescnbeUse ❑ Village of CSM Number l Town of Hammond ID. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑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 Previ a it and Date Issued Before Expiration Owner 61546 Ld% �`' 9/3/19 W. Type of POWTS S stem/Com nent/Device: Check all that apply) ❑ Non -Pressurized la -Ground ❑ Pressurized In Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) X1 Pretreatment Device (explain) Hoot 600 / Wieser ATU V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation Existing VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units 'Jew Tanks Existing Tanks y a. a. U in rn Y V Septic or Bolding Tad` 400/921 1 Hoot 600 / Wieser ATU x Dosing Chamber VII. Responsibility Statement- I, the undersigned, ssuW respo ibility i tallation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum ignat ._ MP/MPRS Number Business Phone Number Keith Knudtson 1648443 651-470-1737 Plumber's Address (Street, City, State, Zip Codev 927 150th St. Roberts,Wi. 54023 VHI. CountyMepartment Use Only ,Approved ❑ Di Permit Fee Date Issued Iss ing ent Signature 1 ❑ i Reason for Denial ! Z / L0941 M Conditions OJA pprosapproval 3 YSTEM OWNE1. Septic tank, effluent filter and 4SI6.1 dispersal cell must be serviced / maintained 1 �_ as per management plan provided by plumber. T`�^�` _ All setback requirements must be maintained T aS pei aNNut;attic wuelVlttlkaPtYdibpkte plans for the system and su\b-nu4Lto�the Coup tyonly od�per not IM ti 8 ill inc�cchY is size"�.W N_`k..ari3P� `.'•+' tyre SBD-6398 (R. 11/11) / d-(z /wp 111CA M s� ce I-e- q .5- 7' c COPY I CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: C&J lot 48 Owners Name: C & J Builders Owners Address: 316 Kamloops Place River Falls ,Wi. Legal Description: NW 1 /4 SW 1 /4 S 29 T29 R 17 Township: Hammond County: St. Croix Subdivision Name: Roling Hills Farm Lot Number. 48 Parcel ID Number. 018-2019-48-000 Designer/Plumber. Date: Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross -Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Keith Knudtson 09/27/2021 License Number: 648443 Phone Number (651) 470-1737 Signature Designed pursuant to the In -Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01101). Page 1 0 pz6t f."-An z W 749 �/Q /7i rtao n�ml c7c,v a t�°°� boo �O.k C. B VA or Private On -Site Waste Treatment System (POWTS) Inspection Agreement The correct operation of the equipment noted below significantly influences the life of the wastewater system. Periodic inspections will help extend the life of the system and prevent the need for costly repairs. The agreement authorizes access to your POYVTS equipment by a trained and authorized technician, during daylight hours, to provide regular inspections and routine maintenance to help assure the equipment is working properly. It is hereby agreed by and between Purchaser and Knudtson Plumbing and Contracting that in consideration of the payments provided for herein, Knudtson Plumbing and Contracting will provide the services of a factory -trained representative to perform periodic inspections of the equipment described below. Knudtson Plumbing and Contracting will prepare a written report after each inspection and provide a copy of the report to the Purchaser. This report will contain recommendations for any operation and maintenance deemed appropriate by the inspector. This agreement does not assume any responsibilities for obligations that are normally the responsibilities of Purchaser and does not extend to cover any costs that may be associate with any recommendations made under this agreement. In no event shall Knudtson Plumbing and Contracting be responsible for any special or consequential damages, including but not limited to loss of time, injury to person or property or incidental economic loss due to equipment failure or for any other reason whatsoever. Knudtson Plumbing and Contracting may supply additional services, parts or labor only after authorization by Purchaser. This agreement shall remain in force for a period of _3_ years, beginning _May 2020_ and will automatically renew each year thereafter for one year unless canceled by either party with at least 30 days written notice. This agreement may be canceled by the Purchaser only If replaced by a service agreement with an authorized service provider for the equipment listed below. Knudtson Plumbing and Contracting may delay or cancel future inspections if payment becomes at least 15 days past due. Periodic Inspections: Association agrees to pay Knudtson Plumbing and Contracting $_200.00_ _,_-_ per each house's annual inspection. Any additional testing or services required will be billed on time and material amounts. Equipment Covered Under This Agreement ! Description Model No. Serial No. ; Install Date Location if different i —_- — from system owner ATU'S Hoot or Micro -fast Al Knudtson Plumbing and Contracting Signed•� ./,f%/, ., �_ --. Date: /9 1 9271501" St., Roberts, WI 54023 - 651-470-1737 System Owner Signature: l.RlrS�e�Date:— ----- .---- --- Rolling Hills o6rsociation Inc. Print_ Names- 2 - Street- $--- Pho -- --- - CO3 State ' �1---1/��7 Fax: it1�_Z-1 -- ` I�� S fvL Z� Email: �e �vl.S e (gig ►16 A 17 C� v� A co 4" CAS TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM 0-12227 r1 �p SO OPD ORAVrZoll CHARGE SYSTEM -600 A TANKS CATIONS 4" CAS DIMENSIONS:. WALL. 3 BOTTOM: 3" COVER} 4" MANHOLE: 12" & 24" I.D. PLASTIC RISER HEIGHT: 70" O.D. POLYLOK 12" ACCESS LID (TYP) LENGTH 109" O.D. WIDTH; 74 1/2" O.D. BELOW INLET: 57" 0,0, LIQUID LEVEL; 51" WEIGHT: 11035 LES. rZ SET RISER (TTr) Is INLET AND OUTLET: 4" CAST -A -SEAL (CAS) BOOT OR EQUAL TANK i MIX DESIONN (SMALL FIBER) CUSTOMIZED TANKS FOR CUSTOMI%TANKS CONTACT WIESER CONCRETE . DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY; 1 U'J✓ au H-Series Gravity Treatment System High performance, low cost, energy efficient treatment system C�{fdm K1F/AMB� Green Choice Applications: Single and Multi -Family Dwellings, light commercial, Churches, and other similar Residential strength uses. Performance: 98% Reduction CBODs 99% Reduction TSS 99% Conversion of Ammonia (NH3) C�-gl ,t nnnlT/C diSinfeai�n Range of Sizes: 500, 600, 750 & 1000 GPD The H-Series Gravity Treatment System provides high performance at a price comparable to most entry level ATU`s. Producing effluent of less than 3 mg/L on CBODs and 2 mg/L on TSS, it far exceeds the secondary standards of 25 mg/L on CBODs and 30 mg/L on TSS. With these results, many locations allow reductions in disposal areas between 25 and 40%. Because the H-Series completely transforms ammonia into nitrate, it is best suited for applications with rich organic soil content, surface plant growth and depth to groundwater to prevent nitrogen pollution of the water table. Simple installation, reliable performance, low cost of ownership This level of performance is enhanced by its simple installation, energy efficient performance and low cost long term maintenance and ownership. The systems components are assembled at controlled manufacturing facilities, rather than in the field, to ensure reliable performance with local support Energy efficient, environmental protection Made of locally available and manufactured concrete, the H-Series features an energy efficient linear compressor that uses less power than an average light bulb. Its polyethylene clarifier hopper is made of recycled milk jugs. Choose Hoot, and you make a sensible, decision to protect the environment as you protect our most precious resource, our water Drainfield and Vertical Separation Reductions With gravity flow discharge, the H-Series allows you to choose your disposal application from conventional lateral lines, leeching chambers, other alternative drainfield materials. In some areas direct discharge is an option as well. Reductions of vertical separations to groundwater and impermeable layers such as rock range from 1 to 2 feet. Make the green choice for wastewater treatment Your wastewater system is the most expensive and important appliance you will ever purchase. Don't settle for just any system. Protect your family and the environment with a Hoot H-Series System. Wieser Concrete Products Inc. 1-800-325-8456 www.wiesercortcrete.com Homeowner Guidelines for homes equipped with Aerobic Treatment Uni* The septic system for your home depends on the proper functioning of the Aerobic Treatment Unit (ATU), which is designed to treat and degrade solids prior to discharge into the shared septic system. To avoid breakdowns and costly repairs, please observe the following guidelines: • Avoid allowing any inert materials such as plastic, rubber, scouring pads, dental floss, cigarette filters, bandages, hair, mop strings, lint, rags, cloth and towels to enter the system These materials can build up in the tank, resulting in system malfimction, clogging and premature pump failure. • Do not flush or drain chemicals and toxins into the system, as they kill the microbes necessary for treatment. These include paint and paint thinners, solvents, drain cleaners, automotive fluids, fuels, pesticides, herbicides, fertilizers, metals, disinfectants and sanitizers. • Paper products including disposable diapers, paper towels, baby wipes, facial tissues and moist toilet paper are not designed to dissolve in your on -site treatment systems. Neither will excessive amounts of toilet tissue decompose. • Limit garbage disposal use to food waste that cannot be scooped and thrown in the trash. Do not put animal fats and bones, grease, coffee grounds, citrus and melon rinds, corn cobs, egg shells, etc. down the sink. Also avoid putting spoiled dairy products and yeasts from baking into the system. • Do not put medicinal materials, automatic disinfection tablets and similar items into the system. Also, septic tank additives generally do more harm than good. • If possible, spread laundry practices out over several days, rather than one `wash day," so the ATU can more efficiently process the water as it enters the system. Liquid detergents are recommended over powder, fabric softener sheets are preferred over liquid softeners. Use bleach sparingly, at half the recommended rate_ • Clear water waste from dehumidifiers, HVAC units, gutters, whole house treatment systems and sump pumps can increase the flow to both your on -site system and the shared system, leading to shorter life. Both clear water and backwash from water softener regeneration should be discharged to an alternate outlet. Talk to your contractor. Do not disconnect power from the unit! Your ATU is equipped with an alarm that will notify you of a malfimction. If the alarm does sound, for diagnostics, service and repair call: Knudtson Plumbing and Contracting 651-470-1737 1.6 2020 2 eft Wm%d fire tfo_ 2DIS AIL �• T#2@� sal � tEti�d 1t rt�eyess �t� �s �. �o .2��dt�. Tide ttl t � d �si#te t� tip s ix�it � ��' bid id bfl liadi�l ' s li'il av a'sEtn aSps 3, i%Uaetmmwmnen&disbeti# tndir bONam tts bin tithe tMk aid the . • VWUM "aft9 d bWft shad to pmop& 1% b B b.6 sa4* iwm tip, ki tbo�. a 4 hchw n dUrater in the WWA dam. 77i�i�iFtt�stray�nri��tggp�t �- �itl� _ ��€�t FEW. f � 1- IlIV,01V,1 SJr� \�.PAN VAE IA 7M7 FbME �>iTti almmbdmr MOOT SYM T. ll� ITT nkmi i ask H450 O" FjFr= [4m 201 *Mwd old i-rue SPS $82 mod, t', ad MooWulft a©d - . SMXGV�EUA tt1• This appravaf %fuedt" two 124 ' Tffs appmyt ie� iit � � • ff„ ...;E, ST. St2*111020SANITARY SYSTEMOffice Use Only r NTYOWNERSHIP/ADDRESS FORM c--w2aiii, J 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 S7c (I �ny �� C, Mailing Address [� �. •ti �pp� P&r 0 City/State/Zip tom/ •� Z Z _ Phone Number (regwred) Email Address (required) Parcel Identification Number (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location 1/4 , 14 Sec. _T _ N R L/ W, Town of /" �i� .-� - `lNt--- . Subdivision Plat 1 nil- _ _ Lot # _ Certified Survey Map# Volume_ Page #__ Warranty Deed # 1�(before 2006)Volume _ Page #____ Number of bedrooms Spec housellQyes O no Lot lines identifiable Dyes O no New Property Ad ress _ (stalf ton Is) OFFICE U ONLY !ol_U'Sr (Vonfigr'a/unn of ne address reNured from Communxy �O[ (betel I Uepartmene for new. `ors[nrcfion) I This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form. a recorded worranry deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in Hm warranty dyed. Community Development Department - Land Use Division 715-386-4680 St Croix County Government Center 715-245-4250 Fax cdd0sccwi.ag 1101 Carmichael Road, Hudson, WI 54016 wwwsccwioov �s3 fcqr Jd3l 3�V?�t+9 I4i �i a i ;� t � tt qt 0 is b 8 3 ' it is is is it it I ' ' . a B B it '! 0 ai i� O m �+ O01,0 ii is it El ii is is F-i ii ii �t V it is is a QMAffvw nww ............................. ................ ------------- ........ .. .. ................................ . ....................... ------------ ------------------ ...................... .................. - ------------- ----- 11 .... .......................... -- ------ ------------ -------------------------------- -- ------- .. .................. ........... ......................... LU -------- ------- .................... .... ................................... ................................... --------------------------- - -- — --------------------------- -------- -- ------- - ----------------------- ------------------ ..... .. (DE" ,lonPlan A2 1. 4 3 f ' �•...�wraww •' W Itmw e ie Ps S y v : 9 '---- Ag. ... h .. ... . T •••vwin i" a wmq � __ __ Ell 1.41 Q i 0 ,.b. ________- u b :, •.b. ,b. ,b, X yp rµ S 'm j W Q Q •'c' va vo• ye. �.� e —® nMaI Floor Plan •BA4. ram. - �°°»•»-° w -� 043 Document Number Document Title Tx :4721892 1141147 St. Croix County BETH PABST AEROBIC TREATMENT UNIT (ATU) REGISTER OF DEEDS ST. CROIX CO., WI SERVICING AGREEMENT RECEIVED FOR RECORD 10/14/2021 09:29 AM State Permit Number - EXEMPT 3t: C 8c d Builders, Inc. REC FEE 30.00 PAGES: 1 Name — (Owner) Typed or printed He/she is the legal owner of the following parcel of land located in St.'Croix County, Wisconsin, with their deed or document of ownership interest recorded as Document Number 1139983 St. Croix Register of Deeds Office. This Property is described as follows (include lot no. and subdivision/CSM or detailed legal description):. Lot 48, Plat of Rolling Hills Farts in the Town of Hammond, St. Croix County, Wisconsin I Rocordln area (--f 7 17w,1 a" -7 •-r 3��rtv. ychnbao9 L�- � a VG� FA ❑ See attached deed copy for legal descriptions w Z' S - { as I,,,, � �p� �7 018-2019-48-000 Agreement Date: ©� 6, `�— �" Parcel Identification Number (P" As an inducement to the county to issue a sanitary permit for a POWTS equipped with an Aerobic Treatment Unit on the above -described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of SPS 383, Wis. Adm. Code relating to Aerobic Treatment Units (ATU) and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater Treatment System) technology. If the owner fails to have the POWTS and ATU properly serviced in response to orders issued by the governmental unit or the Department of Safety and Professional Services (DSPS) to prevent or abate a human health hazard as described in s. 254.59, Stats., the governmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stars. 2. The owner agrees to maintain a contract with a licensed POWTS maintainer for the life of the system. The POWTS maintainer will perform periodic inspections and maintenance as required by the manufacturer and the Department, including, but not limited to: the blower, electrical controls, and treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. The owner agrees to contact the POWTS maintainer immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described in s. 254.59, Slats. 4. The owner recognizes that the county, DSPS, or POWTS maintainer may make periodic inspections of the components to complete performance monitoring of the unit. 5. The owner or the owner's agent agrees to report to the department or designated agent at the completion of each inspection, maintenance or servicing event in a manner specified by the department or designated agent within 10 business days from the date of inspection, maintenance or servicing. 6. This agreement will remain in effect only until the county office responsible for the regulation of POWTS certifies that the aerobic treatment unit no longer serves the property. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the Register of Deeds, and the agreement shall be recorded in a manner that will permit the existence of the agreement to be determined by reference to the property where the Aerobic Treatment Unit is installed. Owner(s) Name(s) - Please P;i t 9 b� .Frey0 Subscribed and sworn to before me on this date: Notprized Owner's Sign u e(s) Notary P 'c ^ � YIIiSC Governmental Unit Official Name, Title - Please Print Community Development Department My Commission Expires per- oco• aoZS �•tiQ� A ,9y . r * iWIE N141 Govemm tal Unit Official Si ure Drafted by:01 9Y1 Personal information you provide may be used for secondary purposes 1Privacy Law S. 15.U4(l (M)1 Contractor Guidelines for ATU Septic Homes The septic system for this home will depend on the proper functioning of the Aerobic Treatment Unit (ATU), which is designed to treat and degrade solids prior to discharge into the shared septic system. As contractor/builder, please observe the following construction guidelines: • As part of design and construction, arrange for water from sump pumps to go to an external discharge. Backwash from water softeners should also be discbarged externally, as doing so will extend the life of the septic system. Note: Regulations prohibit furnace condensate from being discharged externally. • Garbage disposals are not recommended. • Avoid allowing any inert construction materials such as plastic, rubber, cigarette filters, bandages, rags, cloth and towels to enter the system. Likewise, prevent construction chemicals and toxins such as paint and paint thinners, solvents, etc., from entering the system. • Contact Knudtson Plumbing and Contracting prior to siting house grade in order to confirm that adequate fall will exist to allow gravity flow between the house, the ATU and the shared septic line (which may be as shallow as 42 inches). Incorrect siting may require an additional pumping station and incur significantly higher costs. • The ATU manufacturer does not recommend tank installation in frozen ground, and it will be done only at the contractor/builder's request and risk. Installation under these conditions will likely also incur added costs related to requirements such as snow removal, frost ripping, etc. • Ere= warning: Water from furnace condensate lines or other sources including sinks and toilets, entering the system during winter construction can cause the tank and components to ftrxxe and fail as Were is no bacterial action at this stage to_gemcrate heal Use a salt sump to treat this water prior to entering drain lines. Contact Knudtson Plumbing and Contracting for a description. Budders failing to observe this precaution may be liable for system repair and/or replacement due to tieezing. Whenever possible, keep interior water lines turned off during winter until the time of occupancy. • Tanks must be pumped prior to homeowner occupancy For questions regarding these construction guidelines, call: Knudtson Plumbing and Contracting 651470-1737 I have Feviewed and and d We above guidelines: Con�tr Mr Ilnlc: Rolling Hills Lot # W I a Sanitary Site Plan 41� i k FOr;: ' Tyme Pe'bpert6es;LG' r' � �-'�;� .. li�llmg 12�,flts x'arm C�ji"lot Z �; �� • dts 464tPart ajithe Wl%�I I; n r til ` $g4`,29 T29N-R17W g 'a vn of?, �tmmQ St. Cra'!z County t, z 3 034 N75o58g0,Eg32.67' BMELEV, 1075.88 • WELL � F = 600 gpd Hoot H-000 N Blo/septic 1 (, wad �, FNN 4 LOT 48 c UT-% N 21,781 SQ, FT, 4" Sch. 40 PVC f � g78'34,02�n� 239•T • WELL DWF = 600 gpd 161 t St. FN8742 LOT 47 21,781 SQ. FT. • WELL 740 DWF = 800 gpd � LOT 46 21,781 SQ. FT. D15 C35 I R 39' 19" W 243.69' LOT 45 1 rS 'SS,, N87°089143"E 160.52'r� Z OPage 2 of p°S6 yeA9 S� p�D ilk? ' Sr .p0 ared e =•1073.84' Top of pipe - 1087.84' ' q� J 72 80' Tq, �WW 1072.48 Hoot H-800 Bio/septic N N f 4" Sch. 40 PVC 07 r Hoot H-800 Blo/Beptlo J 4" Sch. 40 PVC 1064.3_ Proposed Wieser Concrete J� WLP1250-MR w/ Duplex Pumx w/ Simtech STF-100 Filters Top of 82 TW Top of Wood Hub Elev. - 1061,69' NZ o ao eo �n• .b 0 ore GJ OUTLOT 2 42,71 ACRES 1,1380,359 SQ. Ff. DWF of 1800 gals. /1.80 = 1126 sq. ft. /Bft. = 141 ft\ LOIB 48-48 Typical of each lot will be 4" Sch. 40 PVC Bldg. Sewer 44"" Sch, 40 PVC or Astm D-3034 PVC Conveyance Plpe. g Proposed Duplex 2" Sch. 40 PVC F.M.'s PTO 2084 ~ PTO 2083 Top or Wood Hub Top of Wood Hub A BM Mov.-1068.33' B2-L46 Elay.-1068.28, B1-1-46 01007.28' 1044 18' B3-1.4 I0n1 !8' 1066.34' Ins! !r 0A aM Ma le NII „lu•II NII,111: N'rN I601% "mill Irves. Pre"A A Ir s 141 M11"u1 nl"lxirsal Cell lallN01if1"1Ilfit IrInt,it ,,nhourwife NY410t11 Mo NI 1111m I I' S- N a9,t� 2 Wisconsin Department or 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.a< (1)(m)I Permit Holders Name: City Village Township Rollinq Hills Farm Owners Associatiorb TOWN OF HAMMOND CST BM Elev. Insp, BM Elev. BM Description I Ofoi8 - 7- TANK INFORMATION TYPE MANUFACTURE n CAPACITY Septic Dosing ++ LL [ Aeration liefdrrfy Z S M -fC L.L TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Z—] -t Li Uot A)a Aeration Holding PUMPISIPHON INFORMATION P, Al h", 25,4Z Manufacturer / �k V Ov' % Demand GPM t L.ly Model Number ��� , 1 TDH Ltt� Friction Loss System ygadL L J T H . SFt Forcemain f�wlaz r. Dist to well 1.`iU I ttI_�:rcral:7 J 1 Nl: !.y I,y l ct d� ELEVATION DATA county: St. Croix Sanitary Permit No: 615461 IT101PRIVA 018-2019-46-000 29.29.17.1246 ELEV. !O Z STATION CBi 'OHHHI FS Benchmark �� li•T� (Lv2� .Z.� Alf BM Bldg. Sewer OP'Hver r- [ SUHI Inlet SUHI Outlet Dt Inlet Dt Bottom Jo6a . t Header/Man. Z .7 Dist. Pipe Q� �T Bct. System 3. Final Grade st ca L� d `f S It,.y + �iouC 4J �{%o �b`i• 281 «�ii� BED/TRENCH DIMENSIONS Width v 613 Len L') No.-0fi+mChes Q ir%% �„rf PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKEISTR Ma a rer.INFORMATION VLEACNG ROR Type Of System. 1 1 AA I Nu r: 91611:1I= ism 11010*.Vk--vIAJ' I Header/Manifold r. iii Distribution � . ` V t x Hole Size r• x Hole Spacing , Vent to Air Intake L Length D�a Length lfJv Dia Spacing 2 I SOIL COVER r Praaaura Svatama nnly rr Mnund Or At.rrarfw Svatama Only ! e%- f-t �] A.#Ak t- n ' BedPM1ffiR.'RCenter J � Depth Over Bed/Trench Edges 7) �+ � Depth of Topsoil 71 v xx Seeded/Sodded AYes � No xx Mulched irYes No I Q 7 COMMENTS: (includecodediscrGepencies, persons present, etc-) Location: 740 161ST ST `�• OL�I J 1 � C ,x6.v,5 1.) Alt SM;Description = fial j 4 i d } 2.) Bldg sewer length = C oiyNP'I 'MJ`/ S C t,J4 f + 1 t TKO - amount of cover = C O �K i / r_'1 ! hSDLt�rt (l `1 Plan revision Required? [ I Yes No i Use other side for additional informatio KJ F+ f llD=ItIOIR 31 1) Date °i �671 1 Inspection #1: i /4/iZ D 2* Ir Inspection #2: („ R lo3t s Inaeoctor', igne U e Cent NO. OWNERCkS PLUMBE TOWN AND/OR Iwo�.CRouEouNnr NO. 633978 STAE SANITARX PERMIT loot r�n q GOP ISTS PREVIq� NO,L1SYI, L C SUBDIVISION 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. (i) 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. OFFICER —DATE 1XI pw4rw/ ESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI 1/20)