Loading...
HomeMy WebLinkAbout002-1091-60-050RECEIVED lwustry 5 owww I — SA ry ac /6 - lfl 1400E Wa on Ave NOV Z it ', P.O. BOX 1 Smeary Perout Number( to be fdledia by Co.) Mado-n WI 53 16 ! <A 7z I'% - ST. CROIX COUNTY �/ / !J / / ermit Application Tramta�m ''� Inaccordance with SPS 3ffi'.21(2i. Wis Adm Co&a smbous4m off]= form to &a appromate gov is regmimdpci m obran8 a =mtsypc=n Now Applicaftm fomu fer state-ownedPOW TS ace sobmmw- Oa Adders Ctf 3ffamt than mpg ad�m) *e Depstmma cf Safety aid 2rc swQoA Servies Pemocal mformaam you provide maybe used for secanday I ' is act acdamrsw lhAe PAvacy Laws 15. m . Stam. �/ /j/1 L :vtmrtim-P%eawF it �ma (Q�ti`D Property Oame shame ! I parcel # 1 003 _1011_bo-� So TA501t1 lAR2s0 Poop" Owaves lbaing Ad&r Prapeof Locchoa b , d q . ► • Sa .� 7 7 e o f/ c,) Gowt Lee Lt Ya Y4 �m �— city. Stabt Zip Code Phone Number e 4- r- / 5�1 8 /.S a8 - r q 7 ct a ma T o79 N; $lEoW iLT]pe�iBdi�(tLeekaBtWt�iS� Lotf 1a2FamilyDweBmg- of Bedrooms 3 tzi Name 6k as Bl aty �, Pmb icC4mmercW -Desmbe IIse 0e 4L Sate Owmed-Deaembe Use AjMl*bcr V image cf k Townaf- TtL Type stPdslC (Qdedc oml�r 04 Da a A. Cf ) A. DTew Syse�� Rspis®eat Sys TreameudSdding Tank kWy Other Modfica:into Axis" Spskat(ezplaos) B. PemSSraeval PemafEevisim a ofPtumber � 'i Tram:frrto Near Li4Prewoas Permit Number amdDamIs mW t BvFem Espir>dm i er IV. dfPOW18 C9eetk cal hen 7a13rovad Px=--i adim-Gra d Atl-ade Md d> 24 in. c€smimbie soil Monud < 24 m of mCable sml r act T D"pe mai Component (=Oxn Preseatmeat Device (explain) ArmLftnmxdam Devgp Aow(gpd) Deism Sail Apph=a6M ilea (sfl Disposal Ar Prop- fl ' Esc o.s 900 900 9 • l0 VLTakW# Capacity im Towi #of bfamnfamtcer GA Gallons Units V ffi Nav Tanks Easatg7 A oriiotdmgTaviXX e0 HuF f1clu L&e sigaei, a s==e*msibtliipfw msra9aimm of duPOW2 s tLe anw L picas Plmmbefs Name(ptimt) Phomber's Sigemsmm � Number Baseness Phone Ibmber c 1-gIR. c- 3 7f5a3?-Z,i9y 's Address (Strut, C W -p Code) Z VEL Permit FCC Dare rismeng S>g0atmiC - 1 I`T i7 for Denial 73Lrw Cstr s uisFrr.:aiap�adllM( } I rice! riA nkneeC / 3� 7 PH Pt'g'ridlrt by NlUmber. y �erki c OA ,a.dau:E� •• dL loe f I� Za'/ LJ ewgklpbMimr Stesysteveand ahmitu the I as w xnkcbMMv, ! J SED-SM (RM1.3) 0 � r 6LA) i �;r.�.I IF ,� (ar.Svh Ida 370 �a�,r<<.I_�on I of 1 12/11/2013 4.20 PM 001 n ' dc� ' CV - iI-76 0 O �M F/L ariler o� S1k�/� Qh l oe ¢ q� C{1 h6 ! d7 --6 iE e -si4 �c�1r5 )rn 7-7IF(YyoJ I� ��c-�/tom 3'��lG'niC�' �vIC'�4'�b�$ •,Nl .�hf�� -gam(, -SQL x)o-d 7'.LS '0J $r a hS 'A Qoo CJ ..(yo,y41-:)o•-1 (vp5vvl (vo5yr ;�r3rvCh© i r f vate Onsite Wastewater ` teatm-ent System 7 ide amd Index Wage P� dame: 0-77y co, Kwy GJOOD Yt LLL (.(J�• JryOolg 97 Leg* Desa*gtiog Ste- S�J_ .3 6 - a 9R% 14 c.) 2 Tom, i_s vi age; 1-1 CiTV Of P a LO cJ i ,y Counv: ST, C_ 2 o i X Su'b&visi(n Nwia: Lot Number Block NfLnanber Parcel L3. Nzm*er Page 1 Time and i ad= Page Page So(L- 0A7t-4 4) 68 ) Page 3o R ✓tJ G Lo C 7 o /� S Page 4 �Lo T A) Page s 7-jg- AJk- ` Re)F (L J::'- Page3 /NFILT2l�� �Rc�rLt= ?age? N CRtizRr,� Page8 ConJrrN�cn/cy Page 9 ff'- f est `_fi'-. /III —�- M,/i 1. ffi•fw , I v- Dempedf A f.:: To f'Foilowing POWTS Comf- >dManuaLs And }flit i Page i F r 9AFFL� r 9AfF[t vxNr FRoNr ' I $EAR 3" QEnn,.J� �104✓ JK /1)itN. Jfyf�urr ,.✓c. 512 E5 , I ;eo v 00 fill. REAR . 3 0 o GAL. �v�a (cOr7 Gti`. of,*t A s QdJ R 5 oN 019AJ lk� cJ r�c�r,r.rc + I ,�OELCE R N IS" �ump sir-c . AL FRlcr10a 10-0 13. �LecJBACk 9.d GAL• 6 DOS r S 90. - 94, d 64L iPrQ D. GAL. Q6a INCH 13, 9:s 7, I I,UCNGs OF '(R-RJEL FOR r--tear S tJ l 7' C.I•F Cross Section of a Two Cell Inground Component Using Leaching Chambers 7 Finished Grade Slope % = l Observation/Vent Pipes f Cell- Finished Grade = loos' ie Ori ' 1 Grade = /Qo r � � %� .'� ; 'Original Grade =9P 9 7 0 i 0 Top of Chamber = - ` �' '.'' . �' ;�' Top of Chamber = �,' systemElev. s i �• ..: „ ; �, ' V� System Elev. • - �l '�� �f w . " • 1 iwnv4`nM 1'J, l.DpelDal�i.�. ♦ .. w • '. �* .. Limiting Factor observation/Vent pipes to be constucted and capped with approved materials for the particular use. t M POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION 0%yner Perutit # nscrrx PARAMF:TFAS Number of Bedrooms i oom 3 0 NA Number of Commercial Units NA Estimated flow (average)* 3o ogal/day Design flow (peak), estimated x 1.5* (s6 gal/day Soil Application Rate p, 5gal/dayfe— InfluaWM* Quality (MAD) Mouthty Average** i ' Fats. Oil & Grease (FOG) < 30 mg/L BiochemicafOxygen Demand (BOD5) < 220 mg/L Total Suspended Solids (rSS) s 250 mpiL Pretreated Effluent Quality ❑ Mossthly Average*** Biochemical Oxygen Demand (ilOW < 30 m911, Total Suspended Soltds (rSS) s 30 mg/L Feca! Coliform (geometric means) <10 cfu/IOOtId Maximum Effluent Particle Size 1 /8 inch diameter *Wastewater Flow Verification and Calculations: (Other than bedroom based) ** Values typical for domestic (non-commercial wastewater and septic tank effluent. ***Values typical for pretreated wastewater. QVQTC11d QVIPCIRICATION.4q Septic Tank Capacity _ st C NA Septic Tank Manufacturer ( d F;4t✓TT iNG 7 NA Efflucid Filter Manufacturer 57 .,__---0 NA Effluent Filter Model —�"" i C NA Pump Tank C city---_.l�oo Pump Tank Manufacturer WVEfCurr D NA Putup, Manufacturer 1,z 0 c«_—O NA Pump Model 15!---__—❑ NA Pretreatment Unit ❑ NA ❑ Sand/Gravel Filter 13 feat Filler ❑ Mechanical Aeration G WCtland ❑ Disinfection ❑ Other: Manufacturer: Model: Dispersal Cell(s) M in -ground (gravity) ❑ la -ground (pressurized) ❑ AI -grade Ct Mound p Di 0 Ccitzi: _ __— IM Lraclung Charnber Manudaclwexi�jRATOIZ---- Model to, q5 1.-tyingLeugllt/Chanslxs_q z Soil Application Rate o,S gpoli -' Area Req.. qoo i) Infiltrative Surface/Chasuber-ESIA Raling___ 30 _ ft2 Miniuium Number of Cltarmixis c3 Aggregate Design Flow/Loading Rate= fig nun Materials: all materials must CORIPly wiih Wl Adm. Code COMM83 and be iststalled per rusuufactwers specifications and approvalletters. -Wicwasin At -grade Soil Absorption System, Siting Design & Construction Manual" (Converse el - I'd ! 990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J C. and E.1. Tyler. Publication 15.22 p "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Public:atioa.s 9.6 p "Design of Conventional Soil Absorption Trenches and Beds". R.J. Otis - ASAE Publications 5-77 wld "Ihsig;s tytent l -- Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ❑ SBD - 10570-P (R-6/99) "Ai-Cuacle Component Manual Using Pressure Distribution" ❑ SBD - 10567-P (R.6/99) "In Ground Absorption Component Manual" lg( SBD - 10705-P (N.01/01) "In Ground Soil Absorption Component lvlanual" Version 2.0 ❑ SBD - 10628-P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD - 10656-P (N-6/99) "Split Bed Recirculating Sand Filter System Cornpouetu N- o SBD - 10572-P (P-6/99) "Mound Component Manual" SBD - 10691-P (N.01/01) "Mound Componeia Manual" Version 2.0 1] SBD - 10595-P (R.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657-P (R.6/99) "Drip -line Effluent Disposal Component Manual" ❑ SBD - 10573-P (R 6/99) "Pressure DisUibution Component Manual' p SBD - 10706-P (N.01101) "Pressure Distribution Component Manual" Version 2.0 El I)np-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treala"I Units AYA MAINTENANCE MONITORING SCHEDULE Service Event Service Fre uencv _ 1 Inspect condition of tank(s) At least once every 3 ❑ tang CR al(s) (M:rxiiumn 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (1/3) of tank .ouu.sa Inspect dispersal cell(s) At least once eve 3 ❑ mouths W xcaris) _(Nlamai.mi 3 yrs.)—� Clean effluent f1her At least once every 3 El usotulss ®y:'as Inspect PUMA pump controls & alann Al least once eve 3 ❑ ntotdhs NJ ywr(s) 0 'HA - - Flush laterals and pressure test At least once every ❑ iuonths D year(s) NA Valves At least once e e D mouths ❑ year(s) O At least once every ❑ nsonths ❑ year(s) — 14A. ---- 7o r 3 0 Mounit -4la-Chound Pressue 'I�te � slra#1 �dnde recording the levels of goading, i€ airy is the obser.•atiau inix:s arid. a vises='� Scs any zadenm Of surface seepage or &=bargr- Any discharge to the ground surf trust be P-romplty rqx%IcdW the - egulatory auftdly. Paneling grater ilm 75% of the he& of the mmPosexAmay it Le a ytd nnpiux�-g hydra rite fail are necessiWing more hi The przssurc &SUARdIon system is ployXiect with an opening at the cud of each Aaexx to be, xte.e log III asnj.& rac iatwais Idumki be thutuxi at le-ast once every three (3) years_ Presmce- dwcks of sysents w& muftiple ]Mews Simi be done to cus= that equal dLsLnlwuQa of cfao= is occuvimg to pmmmc The umigevuy of L4c systm RLPORn Rq)0rtSFzrIP§kMWaM= 'W'hMrite P6WTS -fails andforispen-u=eugly taken ow affsemi ce PEOPedY aud 4aft abawbwd In cOMPL-mce with QL CMW 83-33, Wiscomm Adminuvative, Code. AM pipsrg to twks and pits shall be cimcounectca and the pipe openings seal it,. TM-cWtnnxsofaLItanks aadpits shall be removed aadproperly clispose AJkcrPumpia& ailank-,z and pits shall be cxcawwed and removed or dieir cover r=ovcdia:r, dI=void cp* Wed -sod, gravei or other mat soled matezial- CO"INGENCY MaX if ibc Fovr.rs fails and be MpaiTed the following imeasureviiave been, or maig he takui, to pravx!� a =4d;- replamment syst� A 9u:-able replaccaumL area has bee4 evaluated and may be ualized for the iocatwn of a repiacen"i s.- ii ELL Tbc repbccuk-ot area Should be protected Prow diaurbance and compaction and shouid not be mlruigcd UP01--- by, --txr-tized setbacks from =aging and propt�sranictrue lot lines and wells- Failure to protect the rqpfa�, I arc: m lyi-re—sa-I in 2—he L—=d sIr a WW sod Ikow existing aiki proposed anic:zurc, lot lines and wells- Fadure to promci We- K-phi%=ujc.A -., rz:-i :call result M the wed for 3 new soil and site evaluaWa to establish a suitable zcpAac==.tI area Re--ju-1-c-alcia syst,--m.c inns, cDmp,y with the niks m cl*ct at that, erne 0 A si-w-abla- = i=ee >f azea is "rh srrzitaale duc to SeLb&* audio: --,Oil !Lmiiatzous. Fk, 1-ug aua-zmW:; t;.-, 2cj 41 -S .,zcizL so; Qgy a holdiz tank maybe installed a"sILLq rcsWIQ replace the failed POWT& M The sue b2s =E been evaluated to identify a �NL3ble replacement. Area Upon faxicizect' zhicPi, Nvia a soil aaasn�. cVA-"41VU must be performed to locate a cautable mac ement area if no r--placement area is avail ible z liouL.-as jaak inq bu wA;IdeL as a last resort to rq)JaW the Failed POWIS. 0 Mound and at-gia& sod absoqawn s35Vd--= naa5 surface- Rcoonsftuctions of such systems ca" comply with the rales m effect 41 thzt ii -<--WARNING>> SFJYM PUMP AN 0 OTHER TRKAT-Pd EN T TAN KS &LA Y CON TIA N LETRA L GA -S'S ES -AA WG X IN S L M 4C. 1 E ii T OXYGE& DO NOT EINTER A SEPTIC, PUMP OR OTHER TREATMENT TAXK UNDER ANY CIRCUMSMA144CIes. D FATH MAY RES FJLT. RESCUE OF A PEWA-W Mt)ji4 THE INTFI-tw R 0 F A TANK *LAY BE DIFFIc.VU;.r G R IMPOSSIBLE. A NAL COMMENTS POWTS DWALLER POVMMAhNTAINER Pbose 3100 SFPTAGRSERVICING OPFAtATOR (Pz=pc-x) LOCAL RECUIATORY pit T110RITY A Ageacj sr. 4z; Ro I A C- a. -Z- Ok) J fj cr Phone I Phone 7/6- 4e - tir&VIA) C-A,,k,9A0 of ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM � Owner/Buyer36sc, is dr(r Mailing Address ?n —Lon( I Property Addres* 2& Z i0 G b i (Verification required from Planning & Zoning City/State Parcel Identification Number On 3 - 1011 - G O - 05'0 LEGAL DESCRIPTION % Property Location iE '/4 , SW '/4 , Sec. �, T �N R / 6 W, Town of �4-Zc1l Y� Subdivision Plat: , Lot # Z Certified Survey Map # C� --�y icoy , Volume , Page # lv` Warranty Deed # I c 3 99 31 (before 2007)Volume dZs Page' Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St Croix County Planning & Zoning Department within 3 days of the three year expiration date. I/we certify that all statements on this orm are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a w ty deed recorded in Register of Deeds Office. Number o bedrooms NATURE OF APPLICANT(S) i/ NS lA. DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * * * Include with this application 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. (REV. 04/12) �RIOHT NOTICE- 'PRELIMINARY DRAWINGS ONLY - NOT FOR CONSTRUCTION USE`*' Trw dxl'g=a Ur FAPArW er PMGullb. SCALE IS 1l2 AS SHOWN IF PRINTED ON 11X17 PAPER NOTE. LWaN OTNERWSE NOTED Y12, 5112,& d12• N' ON AT EAVES i 1Ny ror MrApOdKM.rtleenmura Iw cenwcllen pvier°uHV urrlw p�nlrlen D 7/I2 L W2 PITCH• IE' ON AT EAVES MIx.1W2.1v121L12-1r OHATFAVEB 2 E1 rrM PIOGu�b pRr f�Al CepJ�yrL Lw. UwUWrIYG UY Iuy r..,eeoylyEA 4I,9^HAMi _ _ _ - 1TOH TYYIGL AT W1 T TRUBBIMMF TOADNET HEEL XDfiXl9 E Y ! ACCORDMOLYIOAL10N iAtCNB 5f([ L E 33Ij illii��Sll lilt. �iI W N O REAR ELEVATION SCALE: 1W = P-0" j O J O m � O �-0 10y U O Of N a.e O W � a� aE LEFT ELEVATION RIGHT ELEVATION SCALE: 114" = V-7 SCALE:1W = V-V w U a .CONSTRUCTION SCALE IS 1/2 AS SHOWN IF PRINTED ONNOTED �I I■ial = = ICI ��I _ L■�I hi B _il 11 � � lil lii ■ ill li�� � p C FRONT• 14 14 - I-TRIGHT NOTICE- ***PRELIMINARY DRAWINGS ONLY - NOT FOR CONSTRUCTION USE*** MUTE of PraBUI1C. T.SCALE IS 112 AS SHOWN IF PRINTED ON 11X17 PAPER UNNOUOTHERWiBBNOTED {I fly{ iwlg. RF u1s prcgFny W1E, W1, BW1E. W ON AT EAVES TNy ny rol B. npratluutl,nWFun,aueb 7112 n W12 PITON. IB• OH AT EAVES rR Ip ee 11—pu — m'. u.I.Pvnlrlp WI], IM2,1111I, IW2- 1W OH AT EAVES rwn P.aGulla ps Fie.. 1 D owt LY.. IS• OH TYPICALATGABIES IWublitl ur .rj null In eepylBrl lMlg.w.R MUM TO UAT HEEL HEIGHTS I t y„eg... ACCCRDINWYTOALIGNFASCUB Will Ao.rim°ifw,.w. ggil IL N@G N m ADDRICN BEARINGUAY BE REQUIRED J ol O m � O CI 3 03 p m Inhg 9 C O N 1 � �b4b4c MAIN FLOOR PLAN - SCALE: 114'= 1*-W FINISH S.F. = 13" w Z Q d ' I 4�70, I� .I Tl I ra n ^ RIGHT„otK `PRELIMINARY DRAWINGS ONLY - NOT FOR CONSTRUCTION USE` «wprq"aweme SCALE IS 112 AS SHOWN IF PRINTED ON 11X17 PAPER i E noIAret 1t tail T1" »/ ro, w r•preWc•C, IH•rn a. ww TI121M2 MW-IF OM�TEAW8 Ft fw CTNK4IMPWr •1Y1Oul iNw pIMY�M fYIY.IMt.1ll1R.1]/1], tCC11 AT FAVE$ Itil�xt!! Iron Pro0.lb P•I F .rn LWY'9^ ur. tYOIWZI I W ,1 •r •, Yw•�NPitM ub M/Nrult In repylglH lMrlyNnl TRVKIMMIF.TO4MEI(iNlt i�•�i}F{ ewers,. tOOOROINOLY TOftRLWION F ,UCW •1 fj 'd 'd ]Y-0' �l1111{11r RIF{iF rll 14J a] 111 ------ I eunoBz ------- �s � X � -------------------------------------------------- I ,~ ------ - 4 eanamml I §" to �F � _.:.. �.� e �. �• b S "4 N x J OPEN TO BEi OW �y 7 d L lm 'm 1.1 p 0V Z ----------------------------------- 464 nark �n i C b C T T f ••••••' 1Od T 'CE� L' t .'W&Pd s dYd 2ND FLOOR PLAN SCALE: lie -1'-0• — FINISH S.F- - 1410 BONUS BY = 602 (f a IQ