HomeMy WebLinkAbout020-1481-09-200Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM I
County St. Croix
Safety and Building Division
INSPECTION REPORT sanitary Permit No,
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No
633957
Personal information you provde may be used for secondary purposes lPrivacy Law, s 15 04 (1)(m)I
Permit Holders Name: City Village Township Parcel Tax No
Sharkey Design Build TOWN OF H DSON 020-1481-09-200
CST BM Elev. Insp. BM Elev BM Description y `n W (q/I Section/Town/Range/Map No
T lmovL�Gestip. Imo` 07.29.19.3067E
TANK INFORMATION Z!J �! n -, I, Y'.`)J.
TYPE
MANUFACTURER
CAPACITY
Septic
tJ
1 Z6
L
Aeration
Holding
TANK SETBACK INFORMATION it el %GhriY1
TO I
1 k
I W��((E��LL
I BLDG
Vent to Air Intake
l ROAD
eptic 1
?Z15 i
! r��
1LANK
Dosing
PUMP/SIPHON INFORMATION
Manufact Lif
er
Demand
GP
Model Nu ber
TDH
Li
Friction Los
S em Head
TDH Ft
Forcem
Length
D
Dist to Well
SOIL ABSORPTION SYSTEM
DA
STATION
BS
HI
FS
ELEV.
Benchmark
/ r
Alt. BM `COW.
6.-7
49, �j /
Bldg. Sewer
-1 13
C
SNHt Inlet
£UHt Outlet
/Dt
`� J
Inlet
Dt Bottom
Hea r/Man.Pipe
I
1b.�'
.
Bot. System
-1-
Final Grade
7
. )
St Cover, r
6.7
p
�! .
STD -70--.;�In /An "4 -.rt
BED/TRENCH
DIMENSIONS
Width I
Lengt�Z 1
/1/1
No Of Trenches
G—
PIT DIMENSIONS
No Of Pits
Inside Oia
Liquid Depth
SETBACK
INFORMATION
SYSTEM TO
P!
BLDG
IWELL
LAKE/STREAM
I LEACHING
CHAMBER OR
UNIT
Manufacturer, t 1
Type Of System
f I
oywcn C)Kd
13 '
J
lb
%Ua
—_
Model Number
;c,
DISTRIBUTION SYSTEM
HeaderWan fold „
-11/
Length Dia
Distribution
Pipets)
Length Dia Spaang
z Hole Sze
z Hole Spaang
VenttIntaake
Q *r'VY
A z'Lt 4f
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over
Bedrrrench Center
�l�
I)
N f
Depth Over
BedrFrench
Edges ! �, r�
xx Depth of
Topsoil
Im Seeded/Sodded
as No
Ixx Mulched
E] Yes
[J Na
W
COMMENTS: (Include code discrepenaes, persons present etc. Inspection #1 Inspection #2: 1
Location: 1084 AUTUMN OAK LN *Se f� Q �� 5��. Ara
ccd. QN� ae/'i t33 en ifs Dry dfi..
1 Alt BM Description =r/ llrCOv�'J- j//�//
2.) Bldg sewer length -G' jt$/")�Ir 2P" �11w � �f
-amount of cover = ��8" ��i 63 Gli�Yas�-'Oh �-- w191 use On ny-W S.
Plan revisioniredv Yes ❑ No
Use other sides for for additional information.
r' Date / Inselacto Zgppi Carl No
SBD-6710 (R 3/97) — Na � // t7 N ••�_L �j I (V y4 � r 110�/ �(�'� {'[07- � O
V�tn ( o,, 1V2�57�-e✓t� eltGee� Br7 at,� COvct-�
ServicesDivision
M�rJison Yards Way
County�jC822
d r - `�-t1jO
2UL1 icon, WI 53705
C�13
Sanitary Permit Number(to be filled m by Co.)
0. Box 7162
Madison, WI 53707-7162
4, �?s3 F6'7
l -Sanitary Pen -nit Application
Slate Transaction Number
In accordance with SP_
S 383.21(2), Wis, Adm. Code, submission of this form to the appropriate governmental unit
is required pnor to obtaining a sanitary per -ma. Note Application forms for stale -owned POWTS are submitted to
Project Address (if different than mailing address)
the Depamment of Safety and Professional Services. Personal Information you provide may be used for secondary
purposes in accordance with the Pnvacy Law, s. 15.04(1)(m), Slats
I. Application Information Print All Information
-Please
J
Property Owner's Name
S/�,. �
Parcel #
(�1�- ►'--('8 I —�— Zan
-.'�
Property Owner's Mailing Address
Property Location
6
Govt. Lot
✓� Section
5 City, Snit �� �//�
/ 1
Zip Code/
Phone Number
c"a , 1
D
�JC
TL N R E W
I--177,Type of Building (check all that apply) �
It--;;
Lot # �
T7F -2 Family Dwelling- Number of Bedrooms _
YY--''
D
Subdivision Name
Dublic/Commercial -Describe Use
Block#
11CIty of
Dicta Owned - Describe Use
CSM Number
Jlage of
Zo L n- Al,
Town of
III. Type of POWTS Permit: (Check either "New'"`oorr"Replacement" and other applicable on line A. Check one box on line B. Complete line C if
a licabl
A.
System
❑Replacement System
DOlher Modificalion to Existing System (explain)
Additional Pretreatment Unit (explain)
B'
❑Holding Tank
In. Ground
Dt-Grade
JE]Mound
Individual Site Design
Other Type (explain)
co enlional)
C.
Before
F.x iration
Expiration
Revision
❑Change of Plumber
�1'ransfer to New Owner
List Previous Permit Number and Dat Issued
i
�_�
IV. Dispersal/Treatment Area and Tank Information: Z
Desig Flow (gpd)
boo
Design Soil Application Rate(gpd/sf)
D. -S
ispersal Area Required (sf)
Dispersal Area Propose (sf)
System Ievahon
l zoo
r u
k 9y• s3
Tank Information
Capacity in
Gallons
Total
Gallons
#of
Units
Manufacturer
New Tanks
Existing Tanks
Septic or Iloldmg Tank
Dosing Chninber
0
V. Responsibility Statement- I, the undersigned, a expansibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
PI r s Signature
MP/MPRS Number
ness Phone NWober
!'u
C/
PI ber's Address (Street, City, StZip Ca e) �f , / i /y//ter//
�2i IP ��V �C
i /l/��//^ C C' /
VI. County/Department Use Only
Approved
❑ Disappmved
Permit Fee
��.v0
E-21I
Issuing Agent Signature
:
❑ Owner Given Reason for Denial
Conditions of Approval/Reasons for Disapproval "? �. / (''evis fo-. p r,(- , h%
SYSTEM OWNER.
,SO t% �esl-- 0ry Sl Yter / Se tj / � fir$ o�
1. Septic tank, effluent filter
.
and J
dispersal cell must be eery cad lcil b plumbs tag I tl v� /4CG N� n� �. (,v t 1 . sti �C�y V/
nyndai %� l Tom' p`
as per management pion prost 1
2. All
the
must be maiMaiMQ a K� vS� /_ /J�r� J
setback applicable
BS per applicable ttltla/OrdlnarlCla, 'j )G�-/1 R(L l'lt CJe pv i!I
Anaea I. compieie in Ior In system aad submmi( to the County only on paper n/ot less than 8 Irz x 11 Inches In size 1�,
SBD-6398 (R. 03/21) 5� 0N�y LO�� 83 'fj"pyt�, pr^t�t nyr SOtr/ /'=./
�nt�ds. izcskb 4- 63 q r ov,, e 1� � w )k� LN
I
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 9/23/21
Owner: Sharkey Design Build
Location: NE1/4 SW 1/4 S7 T29 N,R19W 1084 Autumn Oak Lane Hudson
System type: In -ground absorbtion system(conventional)
Manuals Used: In -ground absorbtion system (version 2.0)
Pressure Distribution Manual (version 2.0)
Page#
1, Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specifications Sheet
8. Dose Tank Cross Section
9. Pump Curve
Signature_ Y47:��
License numlYer #226900
Soil test System PLOT PLAN
PROJECT Sharkev Design Build ADDRESS 610 Main St. N Stillwater Mn 55082
NE 114 SW 1/4S 7 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX
SYSTEM ELEVATION
94.8' 5' below grade
9/23/21
BEDROOM 4
DATE
CONVENTIONAL
CONVENTIONAL LIFT XXX HOLDING TANK
1255 gallons
LIFT TANK SIZE
DOSE 'TANK SIZE
MOUND SEPTIC
TANK SIZE
HOLDING TANK SIZE
LOAD RATE .5
ABSORPTION AREA 1219
# of chambers 60
BENCIIMARK V.R.P.
Top of foundation
ASSUME ELEVATION
100' Filter Lifetime Filter
❑ BOREHOLE O WELL *11.R.p. same as benchmark
B-3 60'
Cut Bank 5'
Replacement area needs to be a lift station, B-5
otherwise further testing would need to be
done.
30 ' Vents
438' Property Line
Scale is 1" = 40'
unless otherwise
noted
Vent
>6"
of Cover
4' Lone112
20'
DEC 30202,
Pro 4 6' 20� -
Bedroom B-2
99
House
System was oversized to a .5
loading rate due to the pressence
of VFS and massive SL in the
middle 6 chambers of the northern
cell.
Quick-4 Standard
Leaching Chamber
with 20.0 ft2 of Area
\6.W2/pair of end caps
.LGrade at System Elevation
of poor
Autumn Oak Lane
Cross Section of Quick 4 Standard Leaching Chamber
it
4'
Spacin
Typical cross section for 2 of 3 cells
Quick 4 Standard
Leaching Chamber with
20.0 ft2 of Area per
Chamber 6.6ft^2 pair of end plates To be >1' above grade
Finish grade elevation
Typical Installation 102.0'
Vent Grade Lnt
' sJ
A/30/3:1: �` 's��
t „ 4 LonGrade at System Elevation
1"Grade at System Elevation 34
Observation tube/Vent
Same on other end To be located on end of Cells
'Wchambers per cell\�
\ A
System elevations:
A 96.0'
B 95.2'
C 94.4'