Loading...
HomeMy WebLinkAbout042-1070-60-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Saf and Buildings Division INSPECTION REPORT S Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar Permit No.: Personal information you pro-Ace may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 393986 Permit Holder's Name: ❑ City [] Village Town of: State Plan ID No.: Friedrich, Mark Warren Township CST BM Elev.; Insp. SM Elev.: BM Description: Parcel Tax No.: ov . L C9ij . i V? P VC = CS � � �-� 042 - 1070 -60 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 5 ; 7-1 1c 74 C70 o Dosing Alt. BM 2 v Aeration Bldg. Sewer Ho[ ' St /Ht Inlet 2O p[.oS" TANK SETBACK INFORMATION St/ Ht Outlet ( E=5� �tSIO.�S r TANKTO P/L WELL BLDG. Ailntake ROAD Dt Inlet �- Septic I(* / NA Dt Bottom a r i Dosing NA Header / Man. s ' (ale9• ( S (oe./S Aeration NA Dist. Pipe — ", cQ, Holding Bot. System (045- �� q? n PUMP / SIPHON INFORMATION Final Grade ---� Manu cturer Demand over � Model N ber GPM TDH L' Friction System TD DI H Ft cemain Length a. ti Dist.ToweII SOIL ABSORPTION SYSTEM d,,. f ' BED/TRENCH Width 3 I ertgSh gL No of Tenches PIT No. Pits Inside Dia. Liquid Depth D IMENSIONS y 3 DIME SION LEACHING Man urer � SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM -- t�Trk CHAMBER a Num er: INFORMATION Type O (� I Sir e--- - OR UNIT u System: CpytAl DISTRIBUTION SYSTEM Header / Mani old 4 Distribution Pipe(s) x Hole Size 1111111 x Hole Spacing vent To Air Intake Length i Dia. I f Dia. SOIL COVER x Pressure Systems Only Yx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center B#td /Trench Edges Topsoil w C] Yes ❑ No C] Yes ❑ No � c Ion c o / / C OMMENTS: (Include code discrepancies, persons present, etcT — Location: 1454 70th Avenue, Ro �rts, WI 54023 (SW 1/4 SE 1/4 25 T29N R18W) - 252918397A 1.) Alt BM Description = oP �.C �or.osz ) G .�-S s Y ss4*— f 2.) Bldg sewer length = . 7_o 6 6 ` &,, ' u - amount of cover - I 4- . wr ^`^ -� r5 3� �� cnvelL to l IZ � t aoer' Q,, t � aa &;t- to w eti n revision required? ❑ Yes I& No *her side for additional information. t 0710 (8.3/97) [�) I CO-1 tee n \ Inspector's Signature Cert No. .; .� •�,. z 1 �� zi r---- �S ----3 � n/ £� t' o� vU 73 5ait Ly cc Dui1Wr1sS 41Y1J1Vs+ 201 W. Washington Ave. Sanitary Permit ApplieatiOD PO Box 7302 ��ao►ns�l►n In accord with Comm 83.21, Wis ode Madison, Wl 53707.7302 Depert of Commerce Personal information you provide may be 4ed for s ary rposes ; (Submit completed farm to oaunty if not [Privacy L AW, s" 15.040)(W)j 1 state oomcd.) Attach etc lens m the cou o s on riot ; 8 -1/2 x I I inches in size. County State , Number P t ho& if MWW66 to pm%rious application State Plan 1. T], Number 1. keelson Information - Please Print all Information - operttio,ocation __- Nope%ty Owner Name A SGd 1 114, S Q S '1:.2 `)' .N,14'6 Block slumber property Owner's Mailing Address t ot Number Crty_ State "lap Code Phone Number Subdivisicln Name or t'SM Number of Bnimin • (tcheck one) © city * Type 8• ' "' `' � � °i '� v illage D I or 2 Family Dwelling -No. of Bedrooms: 3 SLR own of O Public/Commercial (describe use): D State -owned �� re Ill Type of Permit: (Check only one box on line A. Check box on line B if applicable) t`� R0� 7e 7 - A,) LA E3 )"New System 2. 0 Replacement 3. ❑ Replacement of 4. D Addition to Parcel T Numbe Svstem Tank Oil Existin System © 41 rs) — l 0 6 6 — B) )artist Number Date Issued Sanitan Permit was viousl issu / �i Type of PO'1WT System: (Check all that apply) - ►� -1 tm oti- pressunaed In ground ❑ Mound © Sand Filter E3 Constructed Wetland ressuhzed In- ground CI Holding Tank: ❑ Single Pass ❑ Drip Line A At -grade ✓ Q Aerobic Treatment Unit C? Recirculating ❑ Outer: 38 _ V D nallTrestment Area Information: 1. Design blow Wd) 2. Diamrsathrea 3. Dapessal Area 4. Soil Application S. Percolation state 6. System Blevarion 7. Pirust Grade Required Proposed Rate (Gals. /day /sq. n.) (Min Itnoh) f $c '? O Elevation sd VI Tank Capacily in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con - glass New Existing shod 'T'anks Tanks ❑ ❑ ❑ 0 0 r103 ❑ ❑ VII Responsibility Statement the undersimwA assurne bilit for installation of the POWTS she a the attached ens. plumhoes Name (print) Plta ber's Signature ( stamps): S No. Business Phone Numbrx r Pltanber's Asddzeas (3trevK. City. State. Zap Curio) 5 c c ' VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued twaWns Agent Sipftattre (No stamps) $(,Approved 0 Owner Given Initial Adverse s ge ��S OD ( 0 i ntinativn IX. Condition' 9 App Val Measons for Dime royal: i:VZ c6 i aj is + i -k Ale ear.+ 1 ` So Cast- 1 a-4 M�` C 3 tr _p_ S -Fb ee Will. b� wR �e �2 -4o w � �., t kt lZ '�f g� S "k ttY k e- N �3 � o 6 S� q b i � a a 4 • b .0 k e- SO , cam' 3 a 4 �. - -�-G- '00" ,e- Wiseortsin DepaMMrnt of Commrerce SOIL EVALUATION REPORT Page t of 5 Division of SafetvQnd Buildings - accordance with Comm 85, Wft Actin Code n County pan Attach complete site not less than 8112 x 11 inches in sire. Plan must Per include, but not limited to: vertical and hOfbv a l reference Point .ols nc e 10 n and P I D. percent slope, sole or dimensions. north arrow,,. and iocatior arui .distarree to nearest n�ad. by Date 'r Pieose Print ailanfonM on. 2e0 .It paraonal k*OMOUM yaa pro nW be for secondary tP�v�Y LaV�r s.1b.04 (7) (m) ?. ` Property Owner t .' } party 1_ocation ` Lot W 1/4 114 S T 0 q N R I E (or) M sub& Name or CSW Property Owner's Mailing Addmss t Fti X # BMdc # / / blew Zip Code', ❑ City ❑ Village ® Town Nearest Road City 1�bC�T p re• ® New construction t)se: (51 Residential / Number_ Code derived design flaw rate �d O O GPD ❑ Replacement ❑ Public or commercial - Describe: Rood Plain elevation if applicable — Parent material, -/; // General comments SyS - lc sn e- l ` v. '�° P 98 7O L w +' _ 9 Sv and recommendations: .4 41, �� V • 04'P /OO - 0 9I ❑ tag F I Pit Ground surface elev. ICS/ �C� k Depth to in. d Rate ® Horizon Depth Dominant Coto Redwc Description Texture Structure co nsistence Boundary t [*EW1 GPDHI? in. MurnseH Qu. Sz. Cont Color Gr. Sz 'Eff#2 c. 5 8 O 1 k C 3 SL 2 m k M -J' r 5 .9 4 5 5 -- S1 i o # ® Pit Ground surface slev. — 106S-0 ft. Depth to GrrHfing factor in. S A Rats Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *M *01#2 0 -14 1 — 2nicJ k fi C5 `j . $ ty- 27 (byr 5 .9 27 - 76 10 31 SL 2 m Sbk i ' i . A- -ICS • 0 wag• ' Elfluent #1 = BOD > 30 710 mg& and TSS >30 < 150 mglL ' Eilluent #2 = BOD < 30 mall and TSS _< 30 mg& Nam (Please P CST rint) Signature CST Number 9 Address Date Evaluation Conducted Telephone Number 2 - "2 ��f0 _ S- — ,, 2y 7 - 4Q 0 � l F re r L Parcel ID Page 2 of pmperty Owner ❑ Boring a B orin g Pit Ground surface Sol lQG ya t Depth to iii factor �� p _ m ' Sol Rate Redaor Descrip5on Texture Structwe Coneiderm Boundary Roots GPDW Horizon Depth 'EfM1 in. Munsell Qu. Sz. Com Collor Gr Sz Sh. b-i3 )O zqL I mfr C- s 5 8 Z " 9 3 27 _� I S L 2 ❑ tom �� # ❑ Pit Ground sudW18 elev. R Depth to limiting factor in F—I Rate Horizon Depth Dorrnr�nt Redox Deso"m Texture Struchre Constance Boundary Roots GPDII� in. Munsell (h. Sz. Cont. Color Gr. Sz. Sh. 'Eif#1 'Efl#2 ❑ �9 a Boring # ❑pit Ground surface elev. ft. Depth to limiting factor in. Sad Rate Horizon Depth Dorrarmnt Color Red= Description Team Sftdwe C.amanae Bounday Roots GPDW in. munsell Qu. Sz. Cont Color• Gr. Sz. Sh. •EM •Efl#2 • Eamt #1 = BW > 30 220 rnglL and TSS >30 <_ 150 MWL • Blkmd #2 = BOD, < 3o m9IL and TSS :S 30 mg/- The Depammit 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 6o8- 266 -3151 or TTY 608- 264 -8777. SB"30 ra.mmo) PAGE <3 OF NAME Frc d r : c k LOT# LEGAL DESCRIPTIONSw '/SCwG,S 29,N R 18 E (orXk, SCALE: 1 "= yO ' M 1 LEVATION j/03 .O BM 1 DESCRIPTION {v p o 1' Luc Pepe M 2 LE VATION c j q•? d S ec. Z S BM 2 DESCRIPTION {op o-f- l z " P_D e I SYSTEM ELEVATION j6 ��pGo w --r' ?7 56 ALTERNATE ELEVATION cow 1 K OUR ELEVATION ' r1 Z al I f 160 S 0 Q� 0 0 A� 70 ,�vt SIGNATURE ��� DATE C Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 383 9 Number of Bedrooms Design Flow - Peak (gpd) SAD Estimated Flow - Average (gpd) LM Septic Tank Capacity (gal) t lao Ok ' Soil Absorption Component Size (W) 3 'Z - Type of Wastewater Donlestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Q� Design Flow - Peak (gpd) c�ts0 GT Z - a t S44ak& q Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the s and outlet filter shall be assessed at least once every 3 years by inspection. Th =oe occa� s hall be cleaned as nPr( to Pnci,r grop operation The filter cartridge removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three Y the levels of ondin ears. The inspection shall include recording p g, if any, , in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 npr 27 01 06:56a WILLIAM HRWKINS 1- 715- 796 -8859 p.l ST CROIXN�CB A,GnNT SEPTIC TANK MAII'� D DVTNSILSHW CERTIFICATION FORM wner/Buyer iailin g Address ✓ ropcuty Address oat for now caustrucuoa) (yeritication a quirod from Planning Dcpartm Parcel Identification Number 'ity /Statte ,EGdr, DESCRIP QS T pz g W, Town of /• >n r e S: I arty Location S Y�, — , Sec. .- I Lot # 3nbdivisian _ Volume Page # Certified SUrVeY Map # -e7 �3 Wsere�I3' Deed #� - Volume - . F ° page # Dose D yes A no Lot lines idearifiabie 0 yes � no Spec h fiTEM ANCK tetncould result is its premature failurato b2nc'lewmtes. Propermaint tessaaceof your sys psed r. What you put into the stem Improper use and atain thrx y or sooner, if needad by a hee p� condo of pu mpia8 out the septic tank every c in the waste disposal system. can affbct the function of the sopdo tank as a treatment stag by the Owner and by a to submit to St Croix Zoning DeP a certification form. signed stem 'l�u pro perty ow= agrees eted lumber or a liceasedpt� V0dfY uG that (1) the suk i j = Than at /3 full Of s}' st Vkw*Qr O0=YmaaPltsmber. nstri p ssary), the septic teak is less th$a 1J3 fuU of sWidgc• ma is in proper op�� O°nditioa aadlor (2) after iaspcctioa and pumping (If tteca c system with the s 1 is and agret to msi"�'a vale sewag dispose the psi catlact Vwc, the undersigned have read the above req dremen scut of Natural Resources, Stara of WiscoasOffi� thin 30 sot fotih, set by the Deportment of C and the Dap ed to the St. Croix County Zoning tic m has been maintained must be completed and serum s t�m g that y our � � e days of the three y expi ation data �1 d DATE SIC3NATU[tB OF APPLICANT RTIF ;CATION our knowledge. 1 (we) am (axe) the or(s) of v-� I (w I (we) cc ay that e, b s tatement s f a w ty deed corms the best 'Of in Register of Deeds Office- prope d above, b n DATE SIONATURL' OF APPLICANT a Zoning Doputwent « « « « «« •. « +«r A information that is mis- representod may result in flu sanitary Pe ntrit being rev o ked by th licstion• a stamped warranty deed from the Register of Deeds off"ioo «« Include rvitlt this app • a copy of the cerdmf d survey map if referenee is made w the wattaatY deed V : 1589PAGE 393 Ci STATE BAR OF WISCONSIN FORM 2 .1998 Es 37902 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST- CROIX CO., WI This Deed, made between Dorwes Farms, Inc., a Wiscon RECEIVED X RECORD Corpor �_ — -- 02-02 -2001 10:40 AN WARRANTY DEED Grantor, and Mark C. Friedrich and Angela J. Friedrich, husband and EXEMPT # wife CERT COPY FEE: COPY FEE: TRANSFER FEE: 234.00 RECORDING FEE: 10.00 Grantee. - PAGES: I Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Recording Area Name and Return Address The West 880 feet of the SE 1/4; the East 46.87 feet of the West 926.87 feet of Thomas A. McCormack S the South 254.96 feet of the Southwest Quarter of Southeast Quarter (S 1/4 of 1020 loth Ave. SE 1/4); and the West 880 feet of the Southwest Quarter of the Northeast Baldwin, WT 54002 ua (SW 1/4 of NE 1/4), All in Section Twenty-five (25), Township Twenty -nine North (T29N), Range Eighteen West (RI BW). 042- 1070.50; 042- 1070 - 60;042- 1068 -50 Parcel Identification Number (PIN) This is not homestead property. M (is not) Exceptions to warranties: all easements and restrictions of record. Dated this � � S day of TLl INo c C`y 2001 rwest Farms, c. David Cowles t AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ) ss. ST, CROIX County. ) y Personally came before me this . day of authenticated this _ day of_ yu AXI- 1 2001 the above named David Cowles TITLE: MEMBER STATE BAR OF WISCONSIN (Ifnot, to me known to be the person(s).wfi tr instrument an nowled the salt u �, authorized by ¢ 706.06, Wis. Stats.) _�� � � •1 ,•Ja .. THIS INSTRUMENT WAS DRAFTED BY 'i Thomas A. McCormack iN 4 Ba ldwin, WI 54002 Notary Public, State of Wisconsin s ' r c Z (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. not, state explrauon ate! necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 INFORMATION PROFESSIONALS COMPANY FOND DV LAC, WI 900- 655 -2021 ire ... ui .!C'ri JVA Wiu- L1••ci ru L. �- � ti A GRANBERG sUR vEyjNG tzzy �T�;..�•' ,,lets Richnw :iJ W) ti ;F�1 1 rcic 1,711) :3fi•7i2lj Fa,1 t7 i 5) 246.4 Jos NO scolt = 150' Mortgage Plot Uroa*ing for MARK & ANC1E T RIF -VIUCI l Date 01 /12101 OwneiriBuyer \4APK& ANGIE FRIEDRICH 410' NOTE, THIS PARCEL CONTAINS � � I DESCR�pTfrJ `; APPROXUATELY 11 1 ACRES The South i 179 oi'tile West 4 { W of the SW !/, of the SE ,a of Section 25, T'29N, Ft19W, Town of Warren, St. Croix County, 1 Wisconsin. This parcel contftins approximately 1 ! . l acres_ +t1 This map and description is int$nd4e� sea 0111y, No now lots ha O for woApS e P rpa pego TEST AREA + E been) created. Tris rasp represents that port.on of Ole as.Ibiect property in whioh the lender has ; 44 v interest. � 1 k I r a r ~ r . r { Scale V 160' 5 �1N� S• 93 J �� % pt ¢0` QSG U SI A CORNER. : SECTION 25 If r bt0` 7v TH AVENUE .� �. I 1 r 4 p V cb/_