HomeMy WebLinkAbout038-1000-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
514945 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: ► City Village X Township Parcel Tax No:
Luehmann, Richard & Laural nn I Star Prairie, Town of 038 - 1000 -30 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
/6t> I (SST 01.31.18.28
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
i
Septic ) Benchmark Z I JOa
L
Alt. BM
Aeration Bldg. Sewer (� 5 ��• 3
Holding St/Ht Inlet ► ` 94 �p
TANK SETBACK INFORMATION St/Ht Outlet ( 35 9 (o . 3
TANK TO P/L WELL BLDG. V nt to Air Intak ROAD Dt Inlet
Septic -7 20 1 45 5 3 Dt Bottom
Dosing Header /Man. - 7r35 `)s`
Aeration Dist. Pipe i
z .,
Holding Bot. System qy 3Z
Final Grade
PUMP /SIPHON INFORMATION 3 +5 `"
Manufacturer Demand St C oy
, e b W+ - 7
Model N er
TDH I 'ft Friction Loss Syst d H Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length No. Of Tre nches PIT DIMENSIONS No. Of Pits Inside Dia. Li uid Depth
DIMENSIONS
(PL/ Z ` , e - _ _ ^ S
�-
SETBACK SYSTEM TO P/L BLDG WELL G LAKE /STREAM LEACHING Manufacturerr�
INFORMATION Type Of System: CHA LINER OR Model Number: !'{�
j � /S S�j�' ��
DISTRIBUTION SYSTEM / +42 z 3
Header /Manifold Distribution x Hole Size x Hole Spacing Ve o Y Intake
Pipe(s) 4 3 Length Dia Length ` Dia Spacing_ \ Q, .3
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only �CAL
Depth Over Depth Over xx Depth T Seeded /Sod e T Mulched
Bed/Trench Center j Bed/Trench Edges \ Topsoil � [] No Yes E] No
- -
COMMENTS: (Include cod persons present, etc.) Inspection #1: / / Inspection #2: / /
Location: 2351 Cty. Rd. M Star Prairie, WI 54026 (SW 1/4 NW 1/4 1 T31 R1 8W) NA Lot 1 Parcel No: 01.31.18.28
1.) Alt BM Description = �' ��'�^— �b.��. � WCO _ �l
TA Cxts CJ
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? E] Yes � No
Use other side for additional information.
SBD -6710 (R.3/97) Date Insepctor Signatur Cert. No.
04/22/09 ZVS 09-.30 FAX 7 386 4686 RECEIVED
AUG 0 4 2008
car f I
M wbeft%vil S37011-9tO cw ngy 4
d�r�r„rnwei Soft 11�Y�fa�
Sanitary Perm# Application
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1 Septic tank, effluent filter and Cat l�
dispersal cell must all be serviced / maintained
as per management plan provided bX plumber
2• tre�l.. a.+ .w.ura.c�...a.�+�..w.w�r.�r.,.t us: a wa.b+.�
as per applicable code /ordinances.
SOD -6348 (R. 01107) VdW titer 01104
PLOT PLAN
PROJECT Richard Luehman ADDRESS 2351 Ctv Rd M Star Prairie Wi 54026
SW 1 /4 NW 1/4S 1 /T 31 /R 18 W TOWN Star Prairie COUNTY ST. CROIX
MPRS Shaun Bird 226900 8/3/0$ 3
DATE BEDROOM
CONVENTIONAL XXX IN -GR PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Bottom of Sidng ASSUME ELEVATION 100' Filter BEST Filter
❑ BOREHOLE O WELL * H. R. P. Same as Benchmark
Well is to meet all SYSTEM ELEVATION 94.6/94.5 4.5' below grad
setbacks required by Plans Designed Using
WDNR Conventional Powts
Manual Version 2.0
Property Line
Scale is 1" = 40'
unless otherwise 30'
noted ST B_ 1
35'
20'
25'
5' '�
B . 30'
10' B-
Existing 3
Bedroom 2 0
House
0'
Old system is a cistern in 2 -3' X 65' cells with >3' sTell 0% Slope
basement and a drainfield
of unkown location t 7 _ 107- V is B -2
Vent
> 6» Quick4 Standard -W
?4'Long r Leaching Chamber To cty rd M
with 20.0 ft2 of Area
12" 5.8ft ^2 /pair of end caps
.54" Grade at System Elevation
4-
rc C0 PV
Property Line
PLOT PLAN
PROJECT Richard Luehman ADDRESS 2351 Ctv Rd M Star Prairie Wi 54026
SW 1/4 NW ' 1 /4S 1 /T 31 /R 18 W TOWN Star Prairie COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 8/3/08 BEDROOM 3
CONVENTIONAL )OCX IN -GR PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Bottom of Sidng ASSUME ELEVATION 100° Filter BEST Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
Well is to meet all SYSTEM ELEVATION 94.6/94.5 4.5' below qrade
setbacks required by Plans Designed Using
WDNR Conventional Powts
Manual Version 2.0
Property Line
Scale is 1" = 40' 30'
unless otherwise
noted ST 35' B -1
20' A 25'
5'
B.M. 30'
10' B -3
Existing 3
Bedroom t20'10'
House
0 '
0% Slope
Old system is a cistern in 2 -3' X 65' cells with >3' spacing
basement and a drainfield "—'- -'
of unkown location Well 70 , Vents B -2
Vent
>6 » Quick4 Standard -W To ct rd M
of Cover Leaching Chamber y
with 20.0 ft2 of Area 0.
4'
12"
Long
5.8ft ^2 /pair of end caps
Lo
34" Grade at System Elevation
Property Line
i
RECEIVED
Wisconsin Department of Corn me A 0 20 0SOIL E UATION REPORT Page of
Division of Safety and Buildings
i�MTtN Com 8 is. A . Code
Attach complete site plan on p 'ONING OFFICE nc es 1 ize. mu County
include, but not limited to: vertical and horizontal reference point (BM), ' edion Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distan near ro . �/ 3 - U -
Plea print all information. Re ' wed by Date
Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04
Property Owner Property Location
P j a /!� n� Govt. Lot 1 /4 ��14 S T N R tE
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
. " .�
City We Zip Code Phone Number ❑ City Cl Village Nearest Road
Q New Construction Use: esidential / Number of bedrooms Code derived design flow rate - GPD
Replacement ❑ Public or mmer I - De cribe: __-
Parent material 4 , U Flood Plain ele ation lfapplicable ,2i]2� ft.
General comments c/
and recommendations: , I , L� `� -t,(J
-^
System Typ / c1� l'ysx. System Elevation �/r - J
Boring # Boring Q' ���
a pit Ground surface elev. �! } ft. Depth to limiting factor I"' in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/rf
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Ef1#2
ya -e ' c o, , % - 6
®Boring # ❑Boringg
Pit Ground surface elev. ( '' 2— ft. Depth to limiting factor -1 ��y ,�� in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2
Z z - �---
s - 7
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L Z Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signa CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 �� — �7 715- 246 -4516
i
Property Owner _ Parcel ID # Page of
Boring # ❑ Boring
Apit Ground surface elev. / ' t ft. -e Depth to limiting factor / in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description ' Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color ' Gr. Sz. Sh. 'Eff#1 'Eff#2
4'1 U 3lZ - �' - L
Z
7:2 oor
F-1 Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
❑ Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
pit Soil lication Rate
Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777.
580.8330 (8.6/00)
Project Name Richard Lueman Soil Test Plot Plan Shaun Bird
Address 2351 Cty Rd M
Star Prairie Wi 54026
CST 6 8900
Lot 1 Subdivision --- - - - -- Date 8/3/08
S W 1/4 N W 1/4S 1 T N /R W Township StarPrairie
Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Bottom of Siding
System Elevation 9- 4.6/94.5 *HRPSameasBenchmark
Property Line
Scale is F = 40'
unless otherwise 30'
noted B -1
Old system is a cistern in 25'
basement and a drainfield ,�
of unkown location B.M. 30'
10' B -3
Existing 3
0'
Bedroom 20'
House
0% Slope 0'
70
Well B -2
To cty rd M
Property Line
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
pVPNEIE,SHW CERTIFICATION FORM
r !" t- n a
o wner/B u y er
� � S � �� ✓'
Mailing Ad dress
Property Address
(Vacifie Wn required from Planning & Zoning Department for new construction) J�
City /State
�- Parcel Identification Number
LE M ;SCREMON / /
SG� t �I� /a Sec. �, T Z N R ! - W, Town of
Property Location /a ,
Lot
Subdivision
Certified Survey Map #
Volume Page'#
?� Volume Page
`Warranty Deed #
Spec house yes no Lot lines identifiable ;
SYSTEM 1MA1N'TENANGE AND OWNER CEgTICATION
tore failure to handle wastes. Zeper
Improper use if needed, and maintenance of your septic system could result in its p a licensed pumper ,he you put
so into
maintenance consists of pumping out the septic tank every three years or sooner,
if needed. b s Owner maintenance
the system can affect the function of the septic tank as a treatment stage in the waste disPoY
responsibilities are specified in §Comm. 8352(1) and in Chapter 12 - St. Croix County Sanitary Otdinal
to submit to St. Croix County Planning & Zoning Department a c n ti5cat(1) .f signed by the
The property owner agrees to restricted plumber or a licensed pumper vent that (1) th e on -siu
owner and by a master plumber, journeyman P n and p iseptic pumping (if necessary), the s tank is
wastewater disposal system is in proper operating condition andlor (2) after inspectio
less than 1/3 full of sludge.
ce to maintain the private sewage disposal system with the
I/we, the undersigned have read the above requirements and agr of Natural Resout+oos, state of Vraoonsiu
standards set ford', herein, as set by the Department of Commerce and the Departmen
Cm,ifWation stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
r/we certify that all Statements on this form are true to the best of my /our knowledge. 1/we am/are the owner(s) of the
roperty vt, by o a warranty deed recorded in Register Deeds Office......
SI OF AppLYCANT(S) DATE
# * Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * **
of the certified survey map if
Inc Wde with this application a recorded warranty deed from the Register of Deeds Office and a copy
reference is made in the warranty de PA
(REV. W05)
Maintenance and Contingency Plan for a Septic SysteM
Maintenance Plan
1. Septic Tank is to be pumped once every 3 years.
2. Effluent fitter is to be cleaned once a year. Please note: a larger filter is being installed in
order to extend the maintenance interval of the filter.
3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of
the cells.
4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system.
5. The owner agrees to save this plan.
6. Do not plant trees nor park nor drive over system.
7. Watershed is to be diverted away from system.
8. Discharge into system is not exceed those required as per Comm. 83
Contingency Plan
Option #1. if system-falls, determine cause of failure, use alternate area and Install new
ed replacement area.
Option #2. stall system at a lower elevation, by removing chambers, removing biomat,
_ install new system.
Opfion#3. No adequa area is suitable for replacement area, and system elevation
cannont be lowered. install holding tank as last resort.
3. Replace any other failing components as needed.
Plumber: Shaun Bird 715- 246 -4516
St. Croix County Zoning 715- 386 -4680
Pumper Tom Mondor 71 5- 246 -5148
Shaun Bird #226900
...�,
351259
CERTIFIED SURVEY MAP
11 �
� � 1
PILED
AUG 29 1978 N
CO AAAM O' �+ltl
APPROVAL Of Tyi15 MSNOR SUBDIVISION �t of W.* co
M -AN APP..CVAL FOR y1, cb
DOES NOT Wy-„� h ' ,
BUILO1Nv I_ 0 SEPTIC ; Y_TEM. 8
REfrtR TO N62,
APPROVED
AU G 2 3 1978
S 88 "E 242.23'
$T. CtOIX CC3l: -, v
15 5.00 723
ROM� :EKcVSIV ?• FKS FSAnr.WO
10.414G COMUWIM&
��
Arw 20.A
NORTH IS REF. TO THE
WEST LINE OF THE NWI /4 BARN O
NORTH SEC. I -31 -l8 AS
ASSUMED BEARING
N 0 36
un
SCALE 1 "= 100'
too 0 loo 200 a LOT Q
3 2.46 AC. INC. ROAD ,a
O I" X 24" IRON PIPE WEIGHING 1.13 LBS./ LINEAL FOOT co 2.29 AC_ EX. ROAD cc%j
• I" IRON PIPE FOUND p � o
O N
Z
lV
M 4 M
M
N 88 0 37'16'W 230,16
S Wr37'16 "E 760.24 i Py 3 aL �� M t
UD
38
i _SOUTH LINE OF T ----, - N 88 229 22 tO
NW 1/4 OF SEC. 1
CORNS CENTERLINE OF ADAN DON
S�1 9
SEC. 1. T31N, R 18 ���. �\ TOWN ROAD
Volume 3 Page 667
I, Artkur L. Wagerer,' registered land surveyor, kereby
certify: Tkat in full compliance witk tke provisionsaof
Ckapter 236.34 of tke Wisconsin Statutes and tke provisions
of tke St. Croix Count yy Subdivision Ordinance and under tke
direction of Edgar A. Luekman, owner of said land, I kave
surveyed, divided, and mapped said parcel of land, dkat suck
plat correctly represents all exterior boundaries and tke
subdivision of tke land surveyed: and tkat tkis land is located
in tke SW 1/4 of tke NW 1/4 of Section 1, T31N, R18W, Town of
Star Prairie, St. Croix County, Wisconsin, to -wit:
Commencing at tke West 1/4 corner of said Section 1; tkence
S88 ° 37.16 "E along tke Soutk line of tke NW 1/4 of said
Section 760.24• to tke point of beginning; tkence NO °30'58"W
455.14 tkence S88 °37 .16 "E 242.231; tkence S1 0 07 .22 "W
454.90•; tkence N88 °37'16 "W 229.22 to tke point of beginning.
Said parcel contains 2.46 acres and is subject to a roadway
easement over tke Soutkevly 331 tkereof.
Dated tkis 4tk day of August, 1978• Ulu
Artkur L. Wagerer
Wis. R.L.S. No. S - 963
Dtttloff Engineering Co.
River Falls, Wis. 54022
ARTHUR L •-
WEr,FRER
_ y S -9.53
+� ELLSWORTH
`C Wis.
— _ itCIIW +.C.ae��
ooct crrsa wa _ �,, 5TA EMkR or ,tttcotasa. - FOR" t �
a.
nalrirr o�
t� e : rs SPACE ft£sERV50 Fort RECCtRoffys i)ArA t
REGISTERS OFf
FM E. A. Luehmann and � ST. - crzoi i co.,. Wi °-
Ya y s tcemi `i a.-a r Rc'd for Reocxd t.'sfs B5:2t =
_ - - - - - - - -- -- raasar day of Hov. ,a D: 197
h9rd�A hpanalt �nc3�a -sr_a_ v?�R a at e ,d,A.
fivtehra3"+n b_ Ua2 33Ed-.._ a..d- _Wi.F.e— iu$— � »ts
�Er,.atar ro
crracrg3 tr, t�sac3 =ee nr. Eot ca pie eYr�t'razx ray,! �staa.s tc: 4 5�.__�!"t�1X —
3
Tax Key No. —
part o-F - 'the Soutthwesc Quarter of the Nr_rLhwest Quarter (SW'1-.- of NW;) .
Section One, Township Thit -ane (31-) Nor", nange Eighteen (18) West,
hose particulaily described as follows. Lot One (l) of Certified
su veyT Map riled in volume °3a, page 667, as document no_ 351259,
subject to roadway easements of record.
a
Y_
if
:r —_
'fltis..45.� asc>iL•_ b�- �i�a�m.! a���rtb.. {
a
T*ge: -0jer with alt ontg �ler, :hti EIi:LFllit T -titt4 a td appunenanees IhPraunto belonging:
Alt!
a: urr[tit4s tear,; :ltC tai R>; is reso4., ir. ear (tee sim101e rind frC•e aryl clear of cnctfmbraac_s except - ,
municipal zoning ord'i.nances, easements and restrictions of record.
and -A"i ! W4.'raaat .eft4 dfisr scut the snav3 !_
.._-._.—.N _ ._ -, 7
i�
p
fSEriLi K t �i LLB te , 0 ��t�le Alai
K Edq&r_ A. Luehmann
- (SEAL) - 14sS�, - ��- t SEAL)
Glad K. Luehmann
f
AUTHENTICATION ACKNOWLEDGMENT
1 -.aaurca authenticated hi. _ ..slay o` STATE OF WISCONSIN l f.
November -- -- $97 1 ti ss. t
Count S
OL L Personally came befsre me, this _day of" a
Hen dr i!c !fl Van Dvk - - -_ - -- t :.e above : ar ed
TITLE.: tlE.NIBER �i-O ATE. BAR OF WISCCINSIN — �e
Yo2GE{ .Y�S�G:3L.� %:{82is2s��= resiCZC' iCY€XjXX - - -- — ,)�+
E
G
ttzi7t5 t -[ a & Van Dyfc, to me known to be the person — who executed the fore -
At torneys at Law going instrument and acknowledged the same.
New Richmond,., Wisconsin 54017
__�- _ - .. ,a c<.r�_d r.zrr :•h =dyed. Both -- . --- - --
,. Notary Pub!ic.. — County, Wis.
%Iy Commission is permanent (If not, state expiration
prir.icd betoo: heir a➢gn2fc /e5. -
F P L -? - _. - f P, AR !;F «,: . . G.`: Sri f - OR.•A ;:-J 1— 197 7 - .._