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HomeMy WebLinkAbout032-2100-40-000 i ST. CROIX COUNTY ZONING DEPART' AS BUILT SANITARY REPORT r... , Owner '� - �-• �, Property Address �-! City /State "�'�u Oi =F10E Legal Description: Lot zz Block - Subdivision/CSM # Aa '/4 S1,) t /4, Sec., T_JLN -RAW, Town of PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer - Size ST/PC /16�D Setback from: Housg4 Well/ -, �s P/L — Pump manufacturer Model Alarm location ` ' (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width _�_ Length g� Number of Trenches Setback from: House Well / //e P/L ,� Vent to fresh air intake 75 ELEVATIONS Description of benchmark Elevation 1,6n� ey Description of alternate benchmark �_• /� ¢/ �°.r Elevation /�� Building Sewer SaS�D ST/HT Inlet s- ST Outlet aLLf PC Inlet �Z PC Bottom W—,2'?— Header/Manifold lso, 7,�2 Top of ST/PC Manhole Cover _ ; 79 Distribution Lines( ) () ( ) Bottom of System ( ) , a Final Grade () ,1a.2. 4 () ( ) Date of installation 2,�2C *' Pe it number State plan number z 2 �2Z 4 /9 Plumber's signature License number ,�-?" Date Inspector ,1�,r/ Complete plot plan � NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW I ? A �o _ ye 5 INDICATE NORTH ARROW T , 1 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No -: ST. CRO Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 338957 Permit Holder's Name: ❑ City ❑ Village pq Town of: State Plan ID No.: MEYERS, TOM SOMERSET CST BM Elev.; Insp. BM Elev.: BM Description: Parcel Tax No.: / ,00 d o 1 -1 f /n LL 032- 2100 -40 -000 TANK INFORMATION - Z -q ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S /Z 420 Benchmark Dosing ` DDU -9m 3. 03 -PZ Bldg. Sewer Z & �U F ol S' / Ht Inlet �Z TANK SETBACK INFORMATION a/ Ht Outlet 3, �Y z TANK TO P/ L WELL BLDG. Air I to ntake ROAD Dt Inlet �,r ir Septic > 66 y 9'U r Z L� k7- NA Dt Bottom Dosing >I(0 f o r y5f f y NA Header /Man. �{• 9 (d Z A Dist. Pipe 4. 160 - ?- L Holdi Bot. System , 1. /6 0. 0 z PUMP/ SIPHON INFORMATION (,` Final Grade � ,,L anufacturer 66C,tj5 1p N Desnand 4 i n o y C Model Number �j S PM TDH Lift ��s Friction System Z l TDHi� 2 t Forcemain Length r Dia. H Z /% Dist To well 7 (ou' SOIL ABSORPTION SYSTEM ell EtV4RENCH width r Len No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth EN 1 N t Z �i DIMEN I N SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEA u acturer: INFORMATION Type Of � Q f 7i� C UNIT DISTRIBUTION de Num er: System: DISTRIBUTION SYSTEM Header/Ma Z Distribution Pipe(s) /� i x Hole Size x Hole Spacing Vent To Air Intake Length :3 Dia Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only — 7 Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: SOMERSET 26.31.19.959,NE,SW 1952 62ND ST — PINECLIFF LOT 14 d) &Njouv f &Z y9 Plan revision required? ❑ Yes [� No f Use other side for additional informa {ion. z SBD -6710 (R.3/97) Dat Inspector's gnature Cert No. Safety and Buildings Division Vi PERMIT APPLICATION 2 01 W. Washington Avenue n In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. r • See reverse side for instructions for completing this application State Sanitary Per it N umber 3 3 875`7 Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property wner Name Property L I SGi/ 1/4, S T . , N, R/ FforoV Propert Owner's iling Ads Lot Number Block Numbe City We Zip Code Phone Number Subdivision Na r CSM N II. TYPE OF BUILDING: (check one) ❑ State Owned 0o Vill It age Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms Town O �> III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) cjsg 1 E] Apartment/ Condo ®� /�- -Av 1 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1 ONew 2 ❑ Replacement 3 ❑ Replacement of 4_ E] Reconnection of S. [].Repair of an ------ System --- ----- System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 I Mound 30 ❑ Specify Type 41 []Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. 'nch) Elevation Feet _ Feet Cap acit y VII. TANK in Ca gallons Total # Of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Cl Septic Tank or ng Tank _ ® ❑ ❑ ❑ ❑ ❑ Lift Pu nk /Si on Chamber/ 00 1 Am ® ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, theAindersigned, assume responsibility for in allation of the onsite sewage system shown on the attached plans. Plum r' Name: Print 1� 7 Plumb r' g : ( amps) MP /MPRSW No.: Business Phone Number: P umber's Ad ress (Strp.Mt, City, State, Zip ode): IX. COUNTY / DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit Fee (includes Groundwater ate Issued ISSUIn Agent (No Stamps) Approved [:]Owner Given Initial 3 ��t'O Surcharge Fee) G Adverse Determination J /� V e— X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: I SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber I Safety and Buildings 15837 USH 63 HAYWARD WI 54843 -8107 TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 25, 1999 CUST ID No.224263 ATTIC• POWTS INSPECTOR ZONING OFFICE KIM A O'CONNELL ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 0.5/25/2001 Identification Numbers Transaction ID No. 226649 Site ID No. 172761 SITE• Please refer to both identification numbers, Site ID: 172761 above, in all correspondence with the agenc ST CROIX County, Town of SOMERSET; 62ND AVE, SOMERSET 54025 NE1 /4, SW1 /4, S26, T3 IN, R19W Facility: TOM MEYERS 62ND AVE, SOMERSET 54025 FOR: MOUND SYSTEM, 600 GPD Object Type: POWT System Regulated Object ID No.: 469298 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: c o 1. This plan action is subject to designer comments on the plan. ' t 2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular to the direction of maximum slope. ,r. PS 3. The area 25' below the downslope edge of the mound must remain undisturbed. visu0'A Qr -.,r 4. Insulate building sewer per COMM 82.30(11)(c). S F- E C, G'RF A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, FEE REQUIRED $ 360.00 Make checks payable to �— COMMERCE. PATR4 &IA L SHANDO , POW TS PLAN REVIEWER WiSMART code: 7633 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE. WI.US RESIDENTIAL MOUND DESIGN INDEX AND TITLE SHEET Project TOM MEYERS Owner TOM MEYERS Address 62ND AVE. SOMERSET WI 54025 Legal Description NE -SW SEC26 -T31 R19W T. - �nal�Y Township SOMERSET County ST. CROIX Subdivision Name PINECLIF Lot No. 14 GO MMERCE YY 1.01NGS Parcel ID Number Plan ID Number ESPON�E INDEX SHEET PAGE ONE MOUND CALCULATIONS PAGE TWO MOUND DRAWINGS PAGE THREE PRES. DIST. CALCS. & LATERALS PAGE FOUR PUMP TANK DRAWINGS PAGE FIVE PUMP CURVE PAGE SIX PLOT PLAN PAGE SEVEN Designer KIM A QCONNELL License Number L � - 7 Signature Phone No. 715 -755 -3145 Date 4 -19-99 Notice: Tarnpering rmh this fife Jay unauthorized persons is prohibited. Deliberate modification Alf result in disciplinary action under s, 145.10, Ms. Stats. SBD- 10462 -E (R.04W) Page 1 of 7 RESIDENTIAL MOUND DESIGN Eight Bedroom Maximum Complete information in red framed boxes as necessary. (y or n) n Is the s fstem over creviced bedrock? Slope 2 % Number of bedrooms 4 Wastewater flow rate ffiin gpd 2271 Lpd Depth to limiting factor 96.5 1 cm In situ sal infiltration rate (code) 1 0.4 gpd/ft 16.3 Um Contour line below the upslope edge of absorption cell 99.1 ft 30.21 m Use standard fill depths? I_x OR Designer spec'd depth I in L -1 cm Place X In box to use standard depths (I Z 24, A+4 Inclusive) OR specify design fill depth. Center or end manifold I a 1(core) Estimated hole space 4 ft Not a final calculation. Lateral spacing 1 3 Ift Minimum dose >= 10 times void volume Use a o lateral spacing for trenches. Pump tank elevation 88.7 ft Outside bottom of tank. Number of laterals Force main diameter 2 in Force main length 80 Force main actual dia. 1 2.067 lin SYSTEM SOLUTIONS Inch- pounds Metric Cell media "x" one only. Estimated daily flow ®gpd 2271 Lpd x Aggregate and pipe Chamber and pipe Absorption cell Design load rate & area 1.2 gpdM 500.0 ft 46.45 m Linear load rate 7.1 gpd/ft 88.0 Lpd/m Design width (A) 1.83 m Cell length (B) 25.60 m Depth of cell (F) 10.4 in 26.4 cm Sand filter Upslope fill depth (D) 12, n 30.5 cm Downslope fill depth (E) n 34.0 cm Basal area required (gpdfinfiltration rate) 1500 ft 139.35 m Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.4 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 10.3 ft 3.14 m Upslope toe length (J) 8.1 ft 2.47 m Downslope toe length (1) 11.9 ft 3.63 m Includes basal adjustment Total mound length (L) 104.6 ft 31.88 m Total mound width (W) 26.0 ft 7.92 m Project: TOM MEYERS Plan I. D. Page 2 of 7 MOUND PLAN VIEW observation pipes (typical) vv 26 ft A A= 6.0 ft 1.83 m 7.92 m -- B = 84 ft 25.6 m B K J= 8.1 ft 2.47 m = 11.9 ft 3.63 m K = 10.3 ft 3.14 m = 104.6 ft 31.9 m typ. obs. pipe A X B refers to absorption cell width and length (anchored securely) J = upslope width I = downslope width V K = end slope dimension e" (150 mm) MOUND CROSS SECTION subsoil cap D = 12.0 in 30.5 cm lateral topsoil G H E = 13.4 in 34.0 cm invert 100.6 ft ,- F = 1074 in 26.4 cm elev. m see note F G = 12.0 in 30.4 cm „D E ASTM C33 H = 18.0 in 45.6 cm ,!. Sys. 100.1 ft sand Fill elev. 30.51 m 99.1 'ft contour 2% 30.21 m slope Note: Absorption cell media vu111 D = upslope fill depth plowed layer consist of aggregate and pipe E = downslope fill depth or leaching chambers and pipe F = absorption cell depth as specified FilChamber Aggregate G = subsoil + topsoil depth at cell wall m right. H = subsoil + topsoil depth at cell center Designer notes: If aggregate is used, it is covered with code compliant material. Project: TOM MEYERS Plan I. D. Page 3 of 7 Curves- Pump °{ METLRS FEET 25 11 J Y:Z5 - - — 3 i." Solids WE15H 70 WEIGH' 60 O wE07H- — r 15 50 - - - - -�— 10 30 we03rK - �_ • WEOJL 10 -- -- 0 10 20 00 40 50 w 70 60 w 1 W 110 1 GPM p l0 CAPAG ,•v; 0UL0 PUt,1PS. INC. METER$ FEET 120 �N10DEL 3885 SIZE 3 /4 " Sol 1 10 W E 1 S 100 � -- r 25 80 - j- -� —1 -- — i 20 7G 60 -- WE05 H T- 10 - 30 r — _ - ..- T — I - 20 _ -- oL 0 0 10 20 90 w 50 w 70 110 1i0 GPM 0 CAPACIY Y • W6 Owlo4 Pympa, Inc. k�Kav� h.q. ira� C)1A• 1 r y< % w 44 17' Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page of bivisirn of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and �� ✓ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 4 APPLICANT INFORMATION - Please print all information Reviewed by Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location or � r, Govt. Lot 1/4 ( Property Owner's Mailing Address Lot # Block# Subd. Na SM# CR zON/NN1Y Ci Stated Zip Code Phone Number Nearest ❑ C Village .2 To New Construction Use: Residential / Number of bedrooms _ Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow �Q� gpd Recommended design loading rate _bed, gpdh? _ trench, gpd/ft Absorption area required .S'E� bed, ft 2 _ ( trench, ft Maximum design loading rate _ bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) ,/Q/7 , / ft (as referred to site plan benchmark) Additional design /site c h%a considerations Parent material !2/EL2 4 emu) /o p �R� Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system EIS ®U COS ❑ U ❑ S U ❑ S � U ❑ S Uq U ❑ S ® U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench � ral P-Y —,ZhLI 4� Ground elev Al? AIX a1ft. r Depth to limiting factor Remarks: Boring # vl J Ground / "- elev. _ 2 X [e ft• r Depth to limiting factor ,tin. Remarks: CST Name (Please Pint ` Signature Telephone No. S "I_IL�ill - - Address � ` ate CST Number f PROPERTY OWNER SOIL DESCRIPTION REPORT Pageof.. PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench ILL-2 - Ground ' elev. �tt• 3 e 8 Depth to limiting factor Remarks: Boring # Ground elev. tt. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; Ground elev. tt. Depth to limiting factor in. Remarks: Boring # i Ground elev. Depth to limiting factor — in. Remarks: SBDW -8330 (R. 08/95) I j o : j 04/13/99 TUE 10:58 FAX 6516283800 COUNTRY INN & SUITES IM ` 007— Al -109 1402 rM 9961SLE ExCAVATtNG TiaxaT=ttie• r►.Os air atoix coUPM SEPTIC TANK MAINThBNANCB AOUBMBNT AND OWNERSHIP CERTIFICATION FORM owner/Buyer T A M X38' Mail{ts= Addretea � a>re's Dom_ 6iQV ©�Pietf Peeperty Adduces �4 (Verification required from piansisg DepwWwat for new oornruetion) arylState Parcel Identitleation Nurnba - S �?S IMAL RU�SIPTi41Y Property Location r/., iV... Sea (_, T —jLN -R d_W, Town of Subdiviaioa 2 h-e- Lot d , n Volume Pere .g Warranty Dad a , Volume ., � page Al _._..�.� Spec~ bouse D M)s _no Lot tutee identiftobte t ee D no bops" a use andtrsaitxct: attceatyoursepticsyebtstcouldtieHltin (IJU retohandlesra etas,ptogWM@iottmasee vertsists orp n*q out flea septic tank every thyme bead or sowwr, it needed by a 11MM4 pumper. W"t y" ptu in" lbs sy" can aftitet 1111 NISCOoa of the septic taeh of a tresarkeat Stage in tAr: waste d ieposal system. 7U prop rey Owner Weals to submit to SL Croitt Zoaiog Depe"meW 1 ao floc m form, Aped by do epee asd bx s msaterpltwtber, jowsry+etOpImmber, testrictedpiumbsror a licesuedPwV01 raifyiag %M(11) tU c"ire wratewatwdiepowds"Wo • is if Bees t!e SO P" Oak is less 6" t/3 lit of ddis. y is proper apnttag ooiditiott sad.a (2) char isapeedOn and punp re ( sary), P Uwe, dw tasdersipted have toad IM9 above requi►emtom and agree to maintsia the private sewar disposs) system will► the seetdards set A%tb. baebk a1 sat by ttse DOpae mal of Com wtee sad do Depameat of M&MMl Atmwe", Stan of W Wee With ka e &7VU eptic system has been Mliltiained worst be t ompiewd and returned to the St. Ctelx CooAN Zatttnp per expiration date. ad a gtfl O NT DAIS tttt� O WNER to state s on this borer art trite to rite best of my (our) knowledge. f (we) am (a14) die ow"I(s) of (we) gRily drat the depa above, by virtue of r W a!ransy deed recorded in ttRlisRer of D cede Office. 41- g t}NA�'tJ1tLr OP k0ft ANT DATE tani A v ttsa Lswiro DWW4Mawt "" ...... Any iwfartstNion that is istia•espre�+ may tsanh ix am u e:tnit beft� re by '• Include with this appliestiew; a stapttped w4vnoty dad from the Re`i#wr of Dads efftee • copy 0 ilic cenWedntrvey mop if ni TMA is nude in tits, rntranty deed Vnt.1427PAGE 43 WARRANTY DEED 6'26'7 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI Document Number RECEIVED FOR RECORD 05-17 -1999 10:00 AN WARRANTY N DEED Return Address CERT COPY FEE: Bank Of Somerset COPY FEE: TRANSFER 1-40 P.O. Box 220/115 Parent St. RECORDING F FEE: 1000 Somerset, WI 54025 PAGES: 1 Parcel I.D. Number: 032 - 2100 -40 Pinecliff Partnership, consisting of Michael J Hartman and Wendell V Viebrock conveys and warrants to Thomas W. Meyers and Marilyn S. Meyers, husband and wife, as survivorship marital property, the following described real estate in St. Croix County, State of Wisconsin: Lot 14, Pine Cliff in Town of Somerset, St. Croix County, Wisconsin. This is not homestead property. Exception to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 6 74 day of May, 1999. Pinecliff Partnership ./`' // 1 By � r / / / Michael J. Hartman ACKNOWLEDGEMM Personally came before me this 6/4 wohMiRRIPMbil XXXXXXXXX6 1999 KKK day of May, 1999 the above named Michael J. Hartman as partner of Pinecliff Partnership to me known to be the person who executed the fore- going instrument and acknowledged the same. KEITH H. W , Notary Public-State tate of of W;:; Keith H. Vardon THIS INSTRUMENT WAS DRAFTED BY: , Notary Public, St. Croix County, WIS. Attorney Kristina Ogland My commission expires March 19, 2000. Hudson, WI 54016 r 1000 - \ • - 4 \ c ti 1 1 X9 •, A 1 I g n U) O m N CO m cn LTI QJ e O N ; .A . W .� m v .p A 1 ,pti _ O 1 � 1 00 may m 6Z'1£6 M„SZ,BZ,zos , ` .ti 1 Q 0 .�1 w . Ul o CD cA b c "Q A =1 \\ rn D a \ c0 11 A coz ou PO I � °i o h2s`0�. 00, 234 "'? A� D 38 0 0 1 v ' C�