The URL can be used to link to this page

Home My WebLink About032-2174-25-000A'sconsin Department or Commerce PRIVATE SEWAGE SYSTEM �OL.Mly St Croix Safely and Building Division INSPECTION REPORT Sawtary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State Plan D No 644750 Personal information you pr"ide may be used for secon.lary r urprses [Pnvac,, a.N s 15 04 � 1 rl ] Permit HoIders Name C Ilae I,.-, ),h p Par,el Ta� No Gary and Terri Edgar TOWN OF SOMERSET 032-2174-25-000 CST BM Elev Si,:�cr low. P,rje Map No 27.31.19.1480 TANK INFORMATION ELEVATION DATA TYPE MANIJFAC�F7 ; a CAPACITY Septic if\ Dosing kI *.rgFl on W I ii� 1-161ding TANK SETBACK INFORMATION L&U-i- 4 1 I'm �rl C- TANK TO PIL WELL BLDG �.,mt to Ar Intake ROAD Septic 71 --;7 k Dosing Aeration Holdlng PUMPISIPHON INFORMATION frivi Aoiii,./A I ?1� Manufacturer I - )emand GPM Model Number o -� A . 0 U TDH Li Fric n Loss Syste T D�4 I Ft Forcerri Len P Dia " [)is! to "K 1 14-1 n ? I I A - bUlLAbZ)UKP'IIUN bYbititirl STATION HI FS ELEV Benchmark All 'L. Bldg Sewer st'l4l Inlet Iris "1 *9 Oils St" It Outlet DI Inlet CA Bottom HeaderWan CP- `1 Dist Pipe Bol System Frial Grade Cover Melt tir, e7r BEDiTRENCH DIMENSIONS 'A�idtt Le III No No Df Pits lrs�de Dia Liquid Depth SETBACK YS r SYS EM TO jPiL 4� JBILLK3 l,%'IE L L 1-41KEISTREAY LEACHING Manufacture, INFORMATION CHAMBER OR UNIT 117 Model Nunbe, Lit 111111:51.1111 bY.5 I F-M Header Marnfold JD,stnbulion I I. x Hole Size Hole Spacfg �era to Air intake 11-fingth � Dia Pipe(s� � I %it 511 1 611' — I-enq!h D,a —Z-- Spacing bUIL LUVZ�K - x Prosquirp Svqtam% Oniv vir Minunrl ()rAf.p`rarIn-q.Qtam�0nJv�A., 'i.ImIlr7j, y Depth (D�� Th ve JZ Depth of wX Seeded Soddedl- I xx Mulched Bed ;e ch Center 11, �B T,.),chr Edge, % yes '40 I Yes No COMMENTS: (include code discrepencies persons present etc ) Inspcction #1 Inspection #2 Location: 1981 57TH ST -PI Nf auk 4W�� Iri I , 4 1 ) Alt BM Description (Orei &<�rc� Uj I - I it - i/ an�ov r ms lift 2 1 Bldg sewer length A V - amount of cover Plan revision Required? 'Yes 'K No Use other side for additional information q ?�- SBD-6710 (R 3 9-1 Date in ec, nature Cert No 2. Industry Services Division 4822 Madison Yards Way County kz. Number be filled in by Co W P Madison, 153705 P.O. Box 71 Sanitary Permit (to 7 Madison 537 4�q TS 0 uuv,. ft it Applicatilown State Transaction Number -2 Adult Code, subill propriatc gov ,R"r it accordance wit SP r-Ti. Code, subr!issiou of this form to Ili p"p"'t' go s required Prior to a sanitary permit. Note: Application forms for slate owned POWTS it 6A ried POWTS it u6nnued to —Project Address (if different than mailing address) tire Depariment of Safety and Professional SMICCS PCTS011al luforniation you provide may be used for scconda purposes inaccordance with the Privacy Law, s. 15 04(l)(m), Slats. A?s >y- 1. Application Information — Please Print All Information Property Owner's Na e mr,2, EAe-�,,e- Parcel # (�573,2--aZIZ -z%`7Z)_ ,1 f�"I)Wck PE2�crty Owner's Mailing Acidic Property Location GovtLo, Govt. Lot o,9--7 44-1� ction C ty'' state zip Ndc Phone Number ,E,bcrEI p2pz/ '? ;L --5 N R Z F, Lot it 11. Type of Building (ch&k all thit apply)�3 or 2 Family Dwelling - Number of dr oin c7� 5 Block H :]city of D'Liblic/Coruncrcial Describe Use — F]Stile Owned Describe Use �Jvlagc of CSM Number I of 111. Type of POWTS Permit: (Check &Iscr "New" or "IlVeplacement" and other applicable on Une A. Check one box on line B. Complete line C if applicablipo.) A. �R� -- ew Syste Replacement System )ther Modification to Existing System (explain) F1 D 1:1 Additional Pletreatinent Unit (explain) F liol(iiiigTank El In -Ground I G, dc �E]Mound�jlln Ividual site De plain) (conventional) C. Renewal Before [--]Revision Dchange of Plumber 1 1:11'ransfer to New Owner List Previous Permit Number and Date Issued H.xpuration I I 1- \ IV. Dispersa[U/TrcR ment Area and Tank Information:/ it) X Yo D Flow (gpd) Design Soil Application Ratc(gpdisf) \.Dispersal Area Required 1 Dispersal Area 11 posed (so System Ele allon r� �2zy) 970 V Capacity in Total 'V of Mantificturer N I ank Informaucin Gallons Gallons Ullits New Tanks Exisonit Tanks ; ct U Seplic or Holding Tank E 17-j F--J 17-11-1 Dosing Chauibcr " , L—J -- V. Responsibility Statemenvol)he undersigned, a sponsiblilly for Installation of the pow'I'S shown on the attached plans. Plulliber's Name (Print) Pi er's Signature MP/MPRS Number Business Phone Num I 7 IV — ['In nber's Address (Street, City, Slate, Zip Co -3 /Z "ffi)i ? Lq c (AA VI. County/Department LJ%c Only Ali proved El DisapproN - "d I Permit Fee S I'llitte Issued Issuing gent signature 19 0 Ow it for Demal �� A�nso 'z Conditions LA� 'STEM OWNER: 3),;4a E eptiC tank, effluent filer and i c isperral cell rmust be Ftrvicud maintained 2 5 per management plan provided ty plumber. I il setback requirements must be maintained s per applicable Ccdeicrdiriaices Atnich to cornpurle fil... [or tht, a 1 11 to in, �yr�ly 4oWpn di� I F � d SBD-6198 (R. 03/2 1) Pw� "r- Wr IMMISIS System PLOT PLAN PROJECT Gary Edoar ADDRESS 411 Walnut St. #13 Sicer Cove Sorinas rL 32043 NE 1/4 NE 114s 27 j'r 31 N/R 19 w 'rOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 101.3' DATE 6/25/22 BEDROOM 3 CONVENTIONAL AT -GRADE )00( CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of Chambersnone IL BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime DBOREHOL'F WELL - H. R. P. same as benchmark 6' Property Line 200th Ave 01 40' 80, ..... ........ Scale = 1/4" = 10' Well is to meet all WDNR setbacks � kor Pro 3 Bedroom House 1981 57th St. B - 3 Huffcut Combo Tank B.M.* B - 1 0% Slope B-2 co DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay Milo //dsps wi gov/programstindustry-services � wisconsin gov Tony Evers - Governor Dawn Crim - Secretary July 6, 2022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2024-07-06 Plan Review: PVVTS-072201438-C SHAUN R BIRD 1432 120th St New Richmond WI 54017 SITE: Gary Edgar 1981 57th st. Town of SOMERSET St. Croix County Total Amount: $250.00 FOR: Description: Three Bedroom At -Grade system k Level Site Pressure Distribution Component Manual — Ver. 2.0, SPD-10706-P (N.01/01, R.10/12), At -Grade Component Manual - Ver. 2.1 (May 2022-2027), 450 gpd, 36 inches to limiting factor from original grade, Maintenance required, effluent filter 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. Stats. • 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 ran 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(l). • 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 insi)ection by authorized representatives of the Department, which may include local insi)ectors. 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, <a4 -Pe�5d POWTS Plan Reviewer — Wastewater Specialist Department of Safety & Professional Services I Division of Industry Services email: Katie. PetzeiCcDwisconsin.gov Cell: 608-574-1189 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:6/25/22 Owner:Gary Edgar Location: N E 1 /4 N E 1 /4 S27 T31 N, R 1 9W 1981 57th St. Somerset Manuals Used: At -Grade Component Manual version 2.1 (May 2022-27) Pressure Distribution Manual version 2.1 (May 2022-27) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7. Filter Specifications 8.4 Maintance and Contingency Plan Attachments: Soil Test A Shaun Bird Signature — License number Page 1 of 9 Pizoji�-.cr GarvEdoar NE 1/4 NE 1/4s 27 /,1, 31 SYSTEM ELEVATION 101.3' DATE 6/25/22 BEDROOM 3 CONVLNTIONAL AT -GRADE. XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFTTANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of Charribersnone BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime BOREHOLE 0 WELL *11,R.p. sameasbenChmark 386' Property Line 2001h Ave 01 40' 80' I I I System PLo,r PLAN ADDRESS 411 Walnut St. 413 Sicer Cove Sorinas FL 32043 N/R 19 W TOWN Somerset COUNTY ST. CROIX Scale = 1/4" = 10' Well is to meet all WDNR setbacks � kato Pro 3 Bedroom House 1981 57th St. B.M.* B-1 B-3 11111 0% Slope Huffcut Combo Tank B-2 -X� loam NNN= 0.5'TO 2.5'WASHED AGGREGATE em(covered with approved syriffielic fabric) C-Trn-mrn 99 MIN. 6,0"OF TOPSOIL COVER PLAN VIEW (No SGale) PAGE 3 OF 6 CROSS SECTION VIEW (No Scale) NEARLY LEVEL SIFFE Surface Contour Elevation = Z?Z, 3 ft AT -GRADE DISPERSAL AREA (Show force main and flush valve locations on plan view.) L= //Oft -7-7-7-7 PLOWED PERIMETER AGGREGATE BED V, L? fftt I A=:/o ft (typqcw) Observabm P,Pe ft 0 (Typim) 7-7-7-7 Z— Z— Z— B- F�i�se Page �t R Pressure Lateral Layout One Lateral — End Manifold 9 C5- ') r" �, 0 L', IV r- �� 'J Distribution Nci;;Tk Specifications Lateral Diameter 'Z_ In. Orifice Diameter In.. X (Orifice Spacing) L (Lateral Length) 38Z 9� Ft. Force Main Diameter Z.., In. Force Main Length ao Ft. 03/05 lgj 'rhreaded Cleanout Plug long weep 90 Dend Pressure System Construction Laterals are constructed of Schedule 40 PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral turn -ups terminate with a threaded cleanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. 0 0 0 0 0 Grade 0 * * 0 0 0 6-8 Inch Lawn Sprinkler Valve Box Page A— of — Septic -Dose Tank Cross Section And Pump Performance Specifications 'u r anufa7 OA a �:u:m:b�" - — 7 uf cturor FTfank Manufact or pump Manufacturer b er 3 TiWiTWAK-d I —ber Purnp Model Number e3 M Total Tank Cap city Alum Manufacturer f 0 1 er c .J��. ury del Number Wa�-X—.jB D Alarm Mo Switch Type T i i i e- —rM an —ufa-c-t- I Total Dynamic Head (TDH) - Feet or ter ElFe on Read Ej e ati D1 ?ressure 9 Ll P Network Loss M ,eEali'n Ioss Force Main I,oss Minimum Pump Ferfbrmanc�Requir�d '9 CiPM: I @ 1 773_ _Ft_TDH Total j Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade LookingDevica. InletMarihole < 6" Below Grade Sealed Watertight Securely Mounted With Locki g Device Weather-proof Junction Box ....... 'hod Grade Finished Grade t Vent Min. 12" Disconnect Above Grade Means With Vent Cap 1: 4XX1 -X Outlet Filter �Inlet ------ Baffle Inlet I t a e X. 11 --r- - '�witch Settin#s and Reserve Capacity Tank Vol 0— /J— GPI Dimension, Inchis Volume Gal. (reserve) A: 36 (alarm) B* 2-3o (dose) C. ??, �- (dead) D 3 Total 12— i� 73 J E1111111111 Off Elevation C F" --1 Bottom Elevation D7�a jj:;. �'Z,(42 F, GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the manufacturor's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior eipproval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid oo stabiq soil to prevent settling or sagging, The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation si)ad the sleeve is scaled watertight. Electrical 8 V . I M lies with NEC 3 00 and Comm 16.28. 02/05 U Page 5 0 '_ 280=SERIES 112 hp Submersible Effluentill"Sump Pumps The Liberty 280-Series provides a cost effective "mid- range,, pump for on -site waste water systems, liquid waste transfer and commercial heavy-duty sump pump applications that require higher head or more f low. Designed around Liberty's unique "Uni-Body" casting, the 280-Series will provide years of reliable performance. All Models Feature; * Vortex style impeller permitting passage of solids up to 1/4" * 416 stainless steel rotor shaft * Permanently lubricated upper and lower ball bearing * Epoxy powder coat f Irish * All fasteners - corrosion -resistant stainless steel * 1 Y2" Discharge * Stainless steel bottom screen - easily removable * Maximum fluid temperature: 140* F. 280-Series Cord Lengths Model 101 25'(-2) 35'(-3) 50-(-5) 280 Standard Optional Optional Optional 281 Standard Optional Optional Optional 283 Standard Optional Optional N/A 287 Standard Optional N/A N/A 1 O'cord length standard on all models. For optional lengths, add "-2,-3 or-Y suffix to model number. lExample: for model 2BO with 35'cord, order 280-3 Motor Specifications Y; hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps (11 5V) 4.0 amps (208/23OV) Performance Curve: 280-Series 2 ILL. 2 12 11 9 . . . . . . . . . . . . . n 5 10 1.1, 90 25 410 35 40 45 10'55'60 65 7( U.S. Gallons Per Minute I I I i I i i I 0 38 78 114 156 192 228 270 Liters Per Minute Dimensional Data: Weight: 29 lbs. Height: 13" Major Width: 10" (model 287) Minimum Sump Diameters: Model 281, 283 ... 14" Model 287 VMF ... 10" Factory switch Model 281, 283 Mode1287 I settings VMF Turn on level 13" 9.51, Turn off level 7-1 1 4.0" The Model 283 features a fully adjustable wide-angle Wat. Differential adjustments can be made easily by tethering the float to the dIs- charge pipe or other mounting point. Vertical float model 287 Is not adjustable. N Model 280 Model 281 Model 283 =)C/ Model 287 M anual, Wide angle Wide angle 0E*a&"1h VMIF-Serles no switch float switch float switch Vertical mag- with quick- with series netic float for disconnect (piggy -back) smaller pits - plug will operate in a 10" diameter sump C us Certified S�Iftall� wo "94=t to c�nqe mthout nollco. Liberty Pumps # 7000 Apple Tree Avenue @ Bergen, New York 14416 a Phone 800-543-2550 Fax (585) 494-1839 www.libertypumps.com Copydght 0 Liberty Pumps, Inc. 2017 AlIrIghtsreserved. LLIT2000ROS/17 9 -�- 1 4 �-- 0 4 8 A )00 0 -, [GOP bel�en C�e ond Sepenfi� SECTION A -A %?921 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION Owner GV Permit # DESIGN PARAMETERS Number of Bedrooms 3 111 NA Number of Public Facility Units NA Estimated flow (average) gal/day I Design flow (peak), (Estimated x 1.5) gal/day Wl Application Rate aallclav)IR2 I— I Standard Influent/Effluent Quality Monthly average* Fats, Oil& Grease (FOG) :530 mg/L Biochemical Oxygen Demand (BODO) !�220 m91L [I NA Total Suspended Solids JSS) sl 60 mg/L -!Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODO 1530 Mg/L Total Suspended Solids (TSS) 1530 mg/L NA XI Fecal Coliform (geometric mean) !�j 04 CfUjj OOMI iMaximum Effluent Particle Size %i in dia, CI N -10ther: KA 'Values typical for dome3tIc wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity ZMf2 gal 0 NA Septic Tank Manufacturer C] NA Effluent Filter Manufacturer 11 NA Effluent Filter Model 0 NA Pump Tank Capacity gal 0 NA Pump Tank Manufacturer 0 NA Pump Manufacturer ZI NA Pump Model 0 NA Pretreatment Unit 5;jtNA 0 Sand/Gravel Filter 0 Peat Filter 11 Mechanical Aeration CJ Weiland ZI Disinfection 0 Other: Dispersal Cell(s) 0 NA 13 In -Ground (gravity) 0 In -Ground (pressurized) 0 Mound ,�At-Grade 0 ip-Line 13 Other: t er: EI NA Other: 0 NA Other: El NA Service Event _�lnspecl Service Frequency condition of tank(s) At least once every: month(s) year(s) (Maximum 3 years) 0 NA Pump out contents of lank(s) When combined sludge and scum equals)ne-thlrd (A) of tank volume 13 NA Inspect dispersal cell(s) At leasl once every: _4ye r 8) (Maximum 3 years) 0 NA Clean effluent filter At least once every: R;onis)(s) ear 0 NA Inspect pump, pump controls & alarm At least once every: D month(s) year(s) 0 NA I:Iush laterals and pressure test At least once every: nth(s) X0 2e0a r (8) NA -I)ther: At least once every; [J month(s) 0 year(s) NA INA _bther: MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal calls shall be made by an individual carrying one of the following licenses or cartlfications: Master Plumber: Master Plumber Restricted Sewer: POWTS Inspector ' POWTS MaIntainer; Septage Servicing Operator, Tank inspections must include, a visual Inspection of the tank(s) to Identify any missing or broken hardware, Identify any cracks or leeks, measure the volume of tombined sludge and scum and to check for any back up or pondIng of effluent on the ground surface. The dispersal cell(s) shall be ,visually inspected to check the effluent levels In the observatlon pipes and to check for any ponding of effluent on the ground surface. 'rhe pondlng of effluent on the ground surface may Indicate a failing condition and requires the Immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum In any tank equals one-third (�) or more of the tank volume, the entire contents of Ihe tank shall be removed by a Septage Servicing Operator and disposed of In accordance with chapter NR 113, Wisconsin Administrative Code. All other services, Including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units. lind any servicing at Intervals of 1512 months, shall be performed by a certified POWTS MaIntalner. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. �0 74�� Page — of — START UP AND OPERATION For new construction, prior to use of the POWTS Check treatment tank(s) for the presence of painting products or other chemicals thilt may Impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of tho tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the Infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will bIB discharged to the dispersal cell(s) In one large dose, overloading the cell(s) and may result In the backup or surface discharge of effluent, To avoid this situation have the contents of the pump tank removed by a Seplage Servicing Opnrator prior to restoring power to tho effluent pump or contact a Plumber or POWTS MaIntalner to assist In manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal calls. Do not drive or park over, or otherwise disturb or compact, the area within 16 feet down slope of any mound or at -grade &oh absorption area. Reduction or elimination of the following from the wastewater stream may Improve the performance and prolong the life of the POW7ri: antibiotics; baby wipes; cigarette butts; condoms; cotlon swabs: degreasers; dental floss; diapers; dioinfectents; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting producils; pesticides; sanitary napkins; tomponsl and water softener brine. ABANDONMENT When the POWTS falls andlor is permanently taken out of service the following steps shall be taken to insure that the system Is properly and safely abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code: All piping to tanks and pits shall be disconnected and the abandoned pipe opening$ sealed. The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soll. gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code complitlint replacement system: • A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm, The replacement area should be protected from disturbance and compaction and should not be infringed upon by requl(�ad setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result In the neled for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rvleil in effect at that time. • A suitable replacement area Is not available due to setback and/or soil limitations, Barring advances In POWTS technologV a holding tank may be installed as a last resort to replace the failed POWTS. \Y�lThfe site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evalual)on at be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be Installed as .4,al,est resort to replace the failed POW7S. o OL _ und and at -grade soil absorption systems may be reconstructed in place following removal of the biamat at the infiltralive s su u ace. Reconstructions of such systems must comply with the rules In affect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT, RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER N I � ("�d/ ame Phone /6 POWTS MAINTAINER /I I Name 1.511 17 4Z/�� /3;q[/ Phone 1 ;71.1-, �- V SEPTAGE SERVICING OPERATOR (PWMPER) LOCAL REGULATORY AUTHORITY 7 Name 59 Phone Phone 1 .00 ThIs document was drafted in compliance with chapter SPS 383.22(2)(b)(l)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. Wisconsin Department of C�ornmerce SOIL EVALUATION REPORT Page — of Division of Safety and Buildire?s kn 80oordanca with Conim 85,'Afts. Adm Code Affach oomploto she plan on paper not loci than 8 1/2 x ', I inches in &as Plan must include, but not limited to vertical and horizontal reference, point IBM), direction and Parcel Da3'� Percent slope, scale or dimensions, north arrow, and location and distance tenearest road. .21 ZZ— Please print all Informstion. Reviewed by Date PersOnal Vilonnalim yw pirovidt me) be ufto lix settimery purpcsev (Privacy La%, v 1.9.04 (1) (rn)�. Prop", Owrw Property Location ro 0 r- Z� i<- ty GoNt Lotx/,?, 1/4 14 S �? �T 31 N R E (04 Propsity Owner's Mallin 7 of �#Blo�as S or CSW City State zP Code Phone NLjFZW— city NAllage Town Nearest Rto -7 / 7, e PIT, - 71 -zj�. , -1.-S < A-�' construction Usep2ZIResidendaf I Number of bedroom3-� Code derl�,ed design flow rate GPD 0 Repifinament Perot material di 26L Public or nommercia: - Desrnbe. Flood Plain elevation If applicable ft. General oornments and recommandalixis: m Type "'d Syste 4z -z- C7 (- ez." &'.11 7 System Elevation EEIBoring aph Boring Ground surface $16,1A ft Depth to UmMN factor —.L� In 5;,711 �A,4k�flnn �Rala 0 F79 TTIM NP, 9 0 0 1 MT M P? MM �11- 0 9 4 1 "M �MWZMMMM 0 0 W-7.1 a �a MMMZM� I r2m FOOM � � IN M Mo M MMFAFM MF4%Pe2.fA Wja4aoarfAMW�A-M BMng 0 C] Soifng SL pit Ground surface oley/,O/�3 ft. Depth to IImftV factor-3-3—in. P11,ff=rff#A�MMWM ,Apt ,,Mr ,OR .4,4,7 ,MM I WAS �1024 MAwit PM M AM ARM -0 - crivulant ri - nuu, , --u 5 "u migri- anu i oo -ju j�pu'KVL cl"AAW11 *A - DWW. z " "%P' . — Z � -- W- CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation conducted Telephone Number 1432 120th St, New Richmond, WI 54017 .2x -.2 Z 715-246-4516 Property Owner Parcel 10 # BcMng# Boring Ground surface ft. Depth to (iml0i; (actor bn. I-N � Pit elev. 01-1-3 —34- Page —of FS—oI—IA,f)p—Itcatx—>n —Rat-a-I �Wm, �.�p ��Mreymm� M PIRM N W EVA, 7 Boring # Boring pit Ground surface alev. — ft. Depth to limiting factor — in. WI Application Rate ffiw�=Mff Boring 0 Boring pit Ground surface alev. — ft. Depth to limiting factor — In, I Sell Application FWte Boring 0 Boring pit Ground surface alev. — ft. Depth to limiting factor — In, I Sell Application FWte my- MWW"TRM ' Effluent #1 a 800, � 30 1220 rnglt. and TSS �30 1150 mot I Effluerd #2 - BOO, � 30 mipt and TSS 130 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 altemate format, please contact the department at 608-266-3151 or TTY 608-264-8777. "D 1330 (R &W) Soil Test Plot PI Project Name Gary Edgar Address 411 Walnut St. #3 Sicer Cove Springs FL 32043 Lot 25 Subdivision NE 1/4 NE 1/4S 27 T 31 I= )TM #226900 River Hawk Ridge DaM 6/25/22 N/R19 W Township Somerset E] Boring 0 Well PL Property Line County .*)I - (�Hu'A k BM or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation 101.3' * H R pSame as Benchmark -A PATIO SOMEN PMCH B-8 U-4 icadmillal cow MD M F11-4 T RD RM 601 DNW Sol Sol 11-4 13-0 I U-0 11-4 x 13-0 fireplace d cl U�d skylights MAT RM 15-9 x U-0 drop Obox Vey op 20" C~ "aa we bath bath w d * I UTILITY . 6-0 x 8-2 barn 6 FOYSt (r-3"c~ dow ot KITCKN 6-io x d mon" $10 . 14-0 x U-4 pah" 3-2 8-4 x 3-0 PORCH zi-u I ji-W L C 2021 DCNALD A. GARDNER Al: r:ghts iesetved x U-S master both 1.0 4;14— "Po� Plo lm-- t 67 "N -.1 z �I�i 1� -1 -le�4 T I -1 rx � irk -,Sri File #: ST. C LJNTY SANITARY SYSTEM Office Use Only OWNERSHIP/ADDRESS FORM Created 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 AddrE City/State/Zip Phone Numb( Email Address Parcel Identification eu nbe�'� 21 7��— (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property LocatioVj�r 1/4 4� 1/4 , Sec.:;�2, T N '542, R(-ZW, Town oL— �-yr'/' Subdivision Plat: Lot Certified Survey Map # Volume 117- , Page W� I Warranty Deed # (before 2006)Volume Page Number of bedrooms Spec house 13 ye/i-�o Lot lines identifialb.14yes 13 no New Property Address OFFICE USE ON (Verification of new address required from C�o e, zbol?,2- F-453—te) 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 cddPsccwi.go 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.ao LOT26 S77-20. 53�E IJI,974 sq. ft. 419 14, J. OJ acres 'IV -T '�o 9 0 LOT22 LOT24 1-10, 892 sq. lJ2,5.91 sq. ft. i J. 00 acre J. 04 acres u 35 'p 9 .rc5 "ll 6Or2�5 LOT 9 .1.001- acres TO OHWU 61 j LOT12 J. 001 acres rO 0. H. W At. Lor v J.01f acres TO 0,H.WM iju, /oe sq. rr. J. 00 acres P LOTA 131, 05J S4 J. 01 ocr 6ig. 09 .19, C18 WZ �*T Mamnwr Dg�- 4_'—�AL�jATICN REPORT rape D-,�tsior 1' Sate*% an� 6j(1:JIn--E ze wfl- v":s C*ae' ktzct mmpiete sne Pa- d- pa.)e- no� iesE �ar E In:nets 1, 5,ze Rj@- -.js� j tnciJOe bJ, no'. fl�ite- tz 16-tz�a a': �)37z3nza 'ewen::e::oi-r SW. di�ect'o- anc Pa_ DO'ce"! 5'Vt S:;a,E o- ziume-siolE no-t- a -ow a-,2 ocatj3- aqc! 31stance tc nea,es� roaz _e f/Mov F)ease Print a/! informatior, Rere"&- :'Mpe-r' A -ozatio- i G�,-, - 4,f,/ I �T3/ 1, R LZC�q /�' 1 E nl� A.�L 57-, 1 a, 0z �4' �;Dje =11one 1vj-LW �7' - 0hage o*7. -Z6Z Y�gl sonstjobo, NJM�Iel D :)e31oo--15 -=: -a3e oe-vez: oesig- fi-M �a:e L- a Des--qt'E Piai- eievabor � appii�aote --imi-net-ft anc rocomirranciaba-Is SVS:e- E�e'a-13- Z4 7- 131� C— I �'- 8"v j4m�Fl Z --) 171 *: � 610-Ing r-, � �, �4�, -i� Soil Application Rate Honzoin Depth IM Dornina-I! Coiar! R03ax 2�85--npbor� 7extre Struc%ute C-Insistence Sa �y 1 Roots Munsel i ou Sz- Com ooky Gr. SL Sh. GPO OEff*l I 'Eff#2 0 �7- 70 M' W 1 5,"kf z/s-" 4zz:�z I Boring # Boring ER Pit Ground stjr� e4evx—� ft Depth to WnftV %ctor I Sod Application Rate Hon;= Depth in. Dominant Coiorl Munsel Redox Desmpbon Qu. Sz. Cont Color Texln Sructura Gr. Sz Sh Consistence! Boundary Roots GPDA? -Efti -Eff#2 0-t �/'7- - "e 74) 1 'All L'� �0 — ff Eftwt 01 N BOO, > 30 5 220 MQ& and TSS >30:Ea� Efflue" #2 - BOD, < 30 mg& and TSS < 30 mg/L CST NaM8 (Please Print) ture CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluatior f�ondjctec Teiephone Number I 1432 120th St, New Richmond, W1 54017 er� -�- -.21 Z 715-246-4516 f�* Z*� Propwty Owner [] So Ej Boring # 4 Pit ring ParcelID # Xae�,5- 7 Ground surface eiev. ft. Depth to Urrirting factor Page _ of Redox Desonphon Qu Sz Cont. Color - 4 . : I flew Boring # Boring F-1 pit Ground surface e�ev - ft Depth to iinlifing factor - in, I Horizon Depth in Dominant Color Munseft Raclox Description Qu Sz. Cont Cdor Texture Shicture Gr. Sz. Sh Consistence Boundary Roots Gpoff *Eff#1 *EW Boring # Boring Ground surface eley. _ in. pit - ft. Depth to 10*bN factor 1-7. Effluent V = SOD, > 30 �� 220 nx gvT and TSS >30 < 150 mgl EMueM #2 - BOD,:� 30 nityl and TSS �n 30 rrigl 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. SSDSJ+�� jk+ ZIP Property Owner Ed Boring Parcel ID # Boring Pit Ground surface e4ev. IA211-3— ft. Depth to WnftffV factor Page —of I Sol ZM�wRata MMM_ WAIM M M P Up. fff� MUM M0, 6. 9,10 M "M w VIA M "_ F�Boring # 0 Boring 0 pit Ground surface elev. — ft. Depth to lirn11inl;; factor — in. Sol AWZ3�twRate Redox Description Qu. SL Cont. C;olor i JIL- FT�- * Effluent #1 - SOD, > 30 < 220 ffv/L mid TSS >30 c 150 mg& * Eftient 02 - SOD, 130 ff9t and TSS 130 mg& 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 forms% please contact the department at 608-266-3151 or TTY 608-264-8777. $0"30 (RAW) Soil Test Plot PI Project Name Gary Edgar Address 411 Walnut St. #3 Sicer Cove Springs FL 32043 S'FM #226900 Lot 25 Subdivision River Hawk Ridge Dafq 6/25/22 NE 1/4 NE 1/4S 27 T 31 N/R19 W Township Somerset F71ioring (DIVell P1, Property Line County ST. CROIX kL 13NIorVRp Assume Elevation 100 ft. Top of 3/4" pipe System Elevation 101.3' * H R pSame as Benchmark ( 3 ass, COUNTY OWNER (onAsVe NOe 644750 RY PERMIT re-9 PREVIOUS NO. PLUMBE LIC.# 22000 TOWN OF SEC ,T�jl Nq R_Jwl_�, A�41)10R L T BLOCK I i SUBDIVISION CHAPTER A5.135 (2) WISCONSIN STATUTES (it) 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. ko) 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. (0 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. % "19222 A" AI;X401YZED SWING OFFICER - DATE PERMIT EXPIRES W.z UNLESS RENEWED BEF6RE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI 1/20)