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HomeMy WebLinkAbout020-1487-12-000Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes (Privacy Law, s 15 04 (1)(m )) Oevering Homes/Andrew Kurkowski CST BM Elev:g111pil 0 Insp BM Elev IBM De TANK INFORMATION �sPER _ him TANK SETBACK INFORMATION M®mm -••a ®MzA*AVjM_�- a. -= � ®_`=_--3 ®m-_--1 PUMP/SIPHON INFORMATION SOILABMRPTION SYSTFM /7 TOWN OF HUDSON ELEVATION DATA IWId 1021. "I'll in. amwe :. =Mrfai El DI s dth f 3 Length IF DZ No f Trenches 3 PIT DIMENSIONS No. Of Pits Inside Dia Ugmd Deptn SETBACK INFORMATION SYSTEM TO JPIL BLDG JWE4 LAKE/STREAM LEACHING CHAMBER OR UNIT Manufac urer ' Tye Of Systa r n I� /- A I / Modal Nyrq iCk .+wr Mrovrw11 a Valli HeaderfManifdd Distribution x Hda Size x Hole Spacing Venl to Air Intake Length Die Pipes) Length Dia Spacing V V.L V V e Vn Y praws,i G Cuafama nniu .r- ^- A. 0 • P I - Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Sad/Trench Center Bed/Trench Edges Topsoil ', -' - Yes No vas No 6A wMIVJENTS' VA ude c ' discrepe 60 Locat o Sgg AVIN SS Iff N r,•r�lk,/ 1.) Alt BM Description 2.) Bldg sewer length = ,C I l+� C.t'+sw1r7( C�\J 93 amount of cover = 7 , t ��kiFlS \ 1 ` 4fo Q3, IO t Plan revision Required? Use other side for additional t a SBD-6710 (R 3i97) ^ `_I �c re /; /� art S: ry - .36 dr"""w, Industry Services Division County Q 4822 Madison Yards Way Madison, WI 53705 Sanitary Permit Number (to be filled in by Co.) $ p rI 2oi2 P.O. Box 7162 Madison 537 71 �r a it Applicati S eTrensaclionNumMr In accords with SP3 6}t . Adm. Code, submission of this form to note govem ental unit Project Address (if di(fe-ent than mailing address) is required br p, a sanitary permit. Note: Application forms for state-owned OWTS are submitted to the Depa f rty and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy law, a. 15.04(I m), Stars. I. Application Information Please Print All Information - Property Owner's Name Parcel N Property Owner's Mailin Tess Property Location i ` Govt. Lot C _ S� City, State Zip Code Phone Number A % Section C T� N R E W II. of Buildho (check that ) Lot N pe all app � Subdivision Namc 2 Family Dwelling -Number ofBedrooms -� Block N ublidCommeroial -Describe Use try of ❑State Owned - Describe Use illage of CSM Number of 111. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on One A. Check one box on line B. Complete hue C If applicable.) A. ew S to Ys a lacement System P Y (''�.,ther Modification to ExistingSystem (explain) 1�' Y ( P ) ❑ Additional Pretreatment Unit(explain) It' ❑Holding Tank -Ground ❑a,t-0rede ❑Mound 1:1Individual Site l?esigoTT' r Type (explain) C. ❑ Renewal Before Expiration ❑ Revision nge of Plumber ❑transfer to New Owner List Previous Permit Nun ber and Date Issued 5 IV. Dispersalrrreatment Area and Tank Information: 0 Design Flow (gpd) Design Soil Application Rate(gpols0 bispeg6illArea Required (af) Dispersal Area Proposed (sf) Systt[ T-T El it n Tank Information Capacity in Gallons Total Gallons N of Units Manufbctdrcr 1` ,' _ I D "° to 8 ��i .� New Tanks Existing Tanks l YNC ,tl [1'G( g .2 ia V N w N li. t) tL Septic or Holding Tank Dosing Clamber V. Responsibility StatemelA I, the uadersigne ma responsibility for Installation of the POWTS shown on the attached platuls PI u ber's Name (Print) ,s P ber's Signature MP/MPR umber Business Phone Nur z Z csv Plumber's Address (Street, City, Sta ip C04 L Vt. County/Department Use Only Approved O Disappmv Permit Fee Date asued �� Issui Agent kignaturc rven n for Denial / Zoo Conditions 9CApprov 3)b SYSTEM OWNER: d e tAa t� -} rend r4G� 1. Septic tank, effluent filter and dispersal cell must be serviced / maintained as per / At(vw4-4,� management plan provided by plumber. M�->�a�`rte —� 2. All setback requirements must be maintained i as per appueaole n"ta ootYrte OMfor the.yatem nd sa mil to the only only on paper nor I a than 8 In s t l Inches size A P p"mIr; s �I0mcf SBD-6398(R.0321) �G_ ` _-W- 64 %Zr. l Si/stem PLOT PLAN PROJECT Oeverina Homes I ADDRESS 1433 Cemohous Ave Suite A New Richmond Wi 54017 1/4 SE 1/43 23 1T_j N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 6below wade 12/28/22 5 BEDROOM DATE CONVENTIONAL )00( CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC T SIZE 1000/600 LHt[ TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1519 # of chambers 75 BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filtet BOREHOLE O WELL •H.R.P. sane as benChmark L 66' AB.M.' 629' Property Line B- 30' 13% Vents )' 20' 45' B-3 B-2I 15' 98' 100' Gavin Pass Vent >6" of Cover 30' 4' Long 12" _g 4 y Pro 5 Bedroom 51 ' House Scale is 1" = 40' unless otherwise noted Quick4 Standard Leaching Chamber with 20.0 ft2 of Area `6.6ft^2/pair of end caps .-Grade at System Elevation RECEIVED DEC 2 8 2022 Ar CROIXCOUNTY CDC) System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 1/4 SE 1/4s 23 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 98.0/97.0/96.0 5' below grade DATE 10/25/22 BEDROOM 5 CONVENTIONAL XXX ('0NVF1YT1nNA1. 1.IFT ITOUDING TANK MOUND SEPTIC TANK SIZE 1000/600 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1519 # of chambers 75 IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL .H,R,P, same as benchmark B-1 30' 13% .. , B-21 98' Vents P 629' Property Line Vent >6„ of Cover 45' ' 'W� 30, L4, B-3 100' 1 Scale is 1" = 40' unless otherwise Gavin Pass 4 12" Pro 5 Bedroom House 5,50 Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 6.6ft^2/pair of end caps .LGrade at System Elevation C PY Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 10/28/22 Owner:Oevering Homes Location SE1/4 S 14 T29 N,R 19W 899 Gavin Pass Hudson Used: In -ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintance and C ency Plan 7. Filter Cross Secti Signature License nu System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 1 /4 SE 1/4S 23 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 98.0/97.0/96.0 5' below grade 10/25/22 BEDROOM 5 DATE CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000/600 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1519 # of chambers 75 BENCHMARK V.R.P. Top of survey iron ❑ BOREHOLE O WELL *H.R.P. same as benchmark n B-I 30' 66' B.M.* Vents 45' =111111i B-21 98' 100' 102' Scale is 1" = 40' unless otherwise noted Gavin Pass ASSUME ELEVATION 100' Filter Lifetime Filter 629' Property Line nVent >6" of Cover Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 6.6ft^2/pair of end caps _Grade at System Elevation C.A �' -� - Cross Section of Quick 4 Standard Leaching Chamber Typical cross section for 2 of 3 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 6.6f A2 pair of end plates Typical Installation Vent Grade 4" 4 A;,0�30/34 Septic Tank 4LonRyl " _ 5' Grade at System Elevation Spacing 5' 4' To be >1' above grade Finish grade elevation 103.0 ,Vent 1 " at System Elevation Observation tubeNent Same on other end To be located on end of Cells 25 chambers per cell %A B System elevations: C A 98.0' B 97.0' POWTS OWNER'S MANUAL. & MANAGEMENT PLAN Page _,of — FILE INFORMATION Owner�e Permit III -+ 13ESIGN PARAMETERS Number of Bedrooms J ❑ NA i Number of Public Facility Units 7CNA j Estimated flow (average) �auday i Design flow (peak), (Estimated x 1.5) aka Soil Application Rate aUda e i Standard Influent/Effluent Quality Monthly average' Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODE) 5220 mg/L 5 NA Total Suspended Solids (TSS) 5150 mg/L !Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) 530 mg/L <_30 mg/L Fecal Coliform (geometric mean) 5104 cfultooml !Maximum Effluent Particle Size 36 in dia. ❑ NA Other. NA "Values typical for domestic wastewater and septic tank effluent MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity 19 al ❑ NA Septic Tank Manufacturer /'e - f ❑ NA Effluent Filter Manufacturer ❑ NA Effluent Filter Model O NA Pump Tank Capacity al NA Pump Tank Manufacturer Pump Manufacturer Pump Model rNA Pretreatment Unit ❑ ❑ Sand/Gravel Filter ❑ Peat Filter ❑ Mechanical Aeration ❑ Wetland ❑ Disinfection ❑ Other. Dispersal Cell(s) ❑ NA n-Ground (gravity) ❑ In -Ground (pressurized) ❑ At -Grade ❑ Mound ❑ Drip -Line ❑ Other: Other. ❑ NA Other: ❑ NA Other. ❑ NA Service Event Service Frequency Ilnspect condition of ti nk(s) At least once every: 2 month(3) (Maximum 3 years) year(s) ❑ NA !Pump out contents of tank(s) When combined sludge and scum equals one-third (33) of tank volume ❑ NA trspect dispersal call(s) —_ _ (s) At lt every: least once ❑ month(s) (Maximum 3 years) � earls ❑ NA Clean effluent filter _ _ At least once every: ear sonth(s) _ ❑ NA ! nspect pump, pump controls & alarm _ At least once every: mon ❑ year h(s) ❑ NA 1=lush laterals and pressure test At least once every: ❑ month(s) ❑ year a) ❑ NA I I7ther. At least once every: ❑ month(s) ❑ year(s) ❑ NA f tither: i---- D Dba. MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master (Plumber•, Master Plumber Restricted Sewer; POWTS Inspector: POWTS Maintainer; Septage Servicing Operator. Tank inspections must linciude a visual Inspection of the tank(s) to identify any missing or broken hardware, Identity any cracks or leaks, measure the volurne of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shah be visually Inspected to check the effluent levels In the observation pipes rmd to check for any ponding of effluent on the ground surface. 'The ponding of effluent on the ground surface may indicate a failing a3ndltio•r and requires the Immediate notification of the local I-eguiatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Ya) or more of the tank volume, the entire contents of the tank shalk 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 filtera, mechanical or pressurized components, pretreatment units, land any servicing at Intervals of 512 months, shall be performed by a certified POV•rrS Maintainer. A service report shall be provided to the local regulatory authority -within 10 days of completion of any service event. Page of _—, START UP AND OPERATION products or other chemicals theft If high concentrations are detected have the contents of thb For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting may impede the treatment prrcces and/or operator damage ther to udisspersal cell(s). tank(s) removed by a septag 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 be r prior a restoring power to the discharged to the dispersal cell(s) In o one large dose, overloading the cells) and tea e+ Se�ciRe backup pel P surface r storing a of r to to . To avoid this situation have the contents of the pump tank removed by a Sap 9 ist In manually operating the Pump controls to restore normal levels effluent pump or contact a Plumber or POWTS Maintainer to ass within the pump tank. compact,diersal the area within D5o feet dawn slope of any mound otaatks and solPabsorptills. Do not drive or perk over, or otherwise on area henvise disturb or Reduction or elimination of the following from wastewater stream may improve the performance and prolong the life of the POWTG. antibiotics; baby wipes; cigarette butts' condoms; cotton swabs; degreasers; dental floss; drapers; medications; disinfectants; fat: foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medicatlons; oil, painting produclls, pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to Insure that the system is propel y and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings 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 Suil, gravel or another inert solid material. CONTINGENCY PLAN easures have been, or must be taken, to provide a code compli nt If the POWTS falls and cannot be repaired the following m� replacement system: replacement soil absorption systefm. A wlteble replacement area has been evaluated and may be utilized for the location of a replacement area should be protected from disturbance and compact bn and should not be infringed upon by he ncied / setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area Wit result in the nged for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rulert in effect at that time. C3 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a WTS. holding tank may be installed as a last resort to replace the failed PO ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTs a soil and site evaluatior must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) ae a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in p� foI time.rem oval of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the «WARNING» SEPTIC, PUMP GEN. DO NOI ENTER A SEPTIC, PUMP OR OTHER TREATMENT D OTHER TREATMENT TANKS ANK UNDER ANY Y CONTAIN LETHAL RCUMSTANCES. DEATH MAY RESULT RESCUE O� I PERSON FROM THE INTERIOR OF A TANK MAY BE DI FICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS nnaLE3 POVPTS MAINTAINName Phone SEPTAGE SERVICING OPERATOR MPER LOCAL REGULATORY A Name Name a a ,,� D n Phone �)j � Phone S 6 This doorrnemt was drafted In corrplbnea *1h d*Ptsr SPS 3a3.22(2)(bx1)(d)d(8 and 3&3.54(1), (2) 6 (3). WIsO agn AdministiOn Cads. 1 4 0 0 4 8 A SAl SECTION A -A 1921 JHIt.�CUYEDD owisoorson ?sv�g r 2018 SOIL MUATION REPORT ape of% of Set and in awtv Wnce with Cam 85, wa. Adm. Code u x i-untr Wally 1 Allach �elt'P�erelal Itin t12 s 11 inches in size. Plan must ' inckde. tlut erance Dad (BM). direction and Paid 11. arrant skpe. scale or dunensiord. north arrow, and location and distance k nearest road. Please print all information. Reviewed by ! Dos o'peonN wrawe0m pW ppde Try Oe ueed ra neawiMry VOV=" (Prwwy Law. • 13 tit (r) (m)1 / �' Pmwty ownw Property Location �� J( Govt La 114 tH S T Z w N R E( PMpatyowrlsrs Lot fr Block N Subd. rii- ^" r i3al 1. zip t3 cityO Town �r ���!/A �.odw wrssucvm �11 Number of bedroomaj14t_ Cods derived design lbw rate r/J2%6 6 ❑GPD RepWmnant 0 Pubic crnmWow- teadrlbe: _—_----------- - - - Pawnt matsdsl Chi . "-4 _ Flood Plain elevation if appGcabbAef LR. General wnsrrnb -5 %X�IG�C.�S+ trzt and woamrrtdatiar: / System Type ---- - System Elevation j Bw" a � Pit Grand fufaoe elev. tL Depth 10 imbK facia -- f-)= In- Sol ApOicalion Rate Hai km D$* DCM 62 W-ColorRedox Oaa"M Te>mse StruLaae Corostence Boundary Rods in. Murrell Ou. Sz Cat color Gr. Sz Sh. •Elw1 'Elfin Fin 77 J I _ l i 1 is cro.ard uff%m elev/ ft. Depth to tirtritirp lector 1/ 1in. I QM A.,. 6�e R OFAMIM © MIA FBW14 IFFAIM ® __M_ �________ CST Name (Phase Print) aturp e _ CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address / Dak Evelustion Conducted Tebphone Number 1 1432 120th St, New Richmond, WI 54017 O _ ,3o --/g 715 246 a516 PropertyOwner Parcel ID N eair+p N O RLPII Cirotrrtd atnc�e stev.�ll. Dsplh to WnftV UK*& // - in. Paps d Sol AppkWAon Fiats ours P.M., ©►r�s�,rr� �F�r��r�rr�r��Rt�®���� u'1�171LA�1'/L/ ��ii�f»©��Idol �---� Boring .. uu� u��uuuu uu� u��uuuu uu� u��uu u Eftwo Nt . BOO, > 30 1220 rrprL and TSS >30 < 150 ffV& ' Eflk)wa N2 • BODe � 30 mg& and TSS 130 mpL 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 60&266-3151 or TTY 609-264-9777. sanuwA 60) Soil Test Plot 7Pan Project Name Oevering Homes h_aun Bird Address 1433 Cernohous Ave S 't A Lot 12 1/4 SE CSTM #226900 6/15/18 Township Hudson Boring Q Well PL Property Line County ST. CROW BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation TBD "HRPSame as Benchmark we New Richmond Wi 54017 Subdivision Hunter Hills Estates 1/4S 23 T 29 N/1319 W ST. Ctz NTY SANITARY SYSTEM File#: OWNERSHIP/ADDRESS FORM Created Use Only ceoreA aizoat 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 Mailing Addres City/State/Zi p ,j Phone Number Email Address ( Parcel Identification Number O (found on the property tax bill) OWNER/BUYER INFORMATION 21e - nzv/ NEW SYSTEM: LEGAL DESCRIPTION Property Location 1A , �G 1/4 , Sec T &N Rj Vq, Town of T ! r Subdivision Plat: �1CD Lot # Ld`.- Certified Survey Map # c"'—'� Volume . Page # �1 Warranty Deed # 11436 D (before 2006)Volume . Page # Number of bedrooms Spec house es O no Lot lines identifiable3(yes O no OFFICE USE ONLY New Property Address �7 j�tJW%lam / YC' / aA'gr CS) (Verific ion of new address required from Community Developmen Department for new construction.) I I 20 Z (Staff Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POINTS) 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.gov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.00v LEFT ELEVATION ' a��a�gs�■ IIIIIIIII ■aa�aaa���aaw IIIIIIII IIIIIIII IIIIIIII IIIIIIII 11111111 IIIIIIIII IIIIIIII IIIII��I III: � ICI` � I'I 1 IIIIIIIII IIIIIIIIII; IIIIIIIII IIIIIIIII IIIIIIIII IIIIIIIII IIIIIIII IIIIIIII IIIIIIII IIIIIIII �� FRONT ELEVATION BACK ELEVATION 114.Ot..N.w V . fl®,a...m1p.1 mB R 1.0�..1� .00I IOY _d TMO6Nw M1.0114 Joe INFOOM"i iwu,.a, �or.ow. W� 4�Y1pR 414b ]IQf arowA ow 5HEET I OF 5 ELEVATION5 MMJCCfh 1610 19C: ,5y,a" Oi Ma 5ECOND LEVEL PLAN ��PwrM M�Yu[ `� 4Y• tl♦w �R�Si���t�YION���I O 116 �R 1 V � M i1 � R�! IYIII lOO\ YORP Iipw O!'wIMR110P�1F QYO�OR�OIYK�O�L JOB wrolmmnm IYIM� �JOM. Y�YYY �apOR. �sYl�r �oifl. O4 {iM�OI�. �Y IYR. 1P1 4lKpI�. �MM 5n9Ti INFOI WTIOW sileeT 4 OF 5 2ND FLOOR FQDJWT 0. 1617 scmeL AS Src" �_� MqupW emt � aim! rw N g •YOAs.1Y i I II rl I i I I "rem, rwa I rr » m l { i �•:.� \ems.•. i » �»tilt I I I I .e •� aa. ••� � �4=.' 11 Wiwi • i . I FOUNDATION PLAN YI.l�MIiMY[ w" im r.�rrw. lllJV�• p•, 0MlfiR.O2 ��m.6�W i4,i�00 YL 110111.N r•�P illidR IWIVA �m P ltlp!!OM �i•L\. i V Pl11i m.Y.Oib�tlOYC loe wuRwnd� Ary. ,W a1� LEFT ELEVATION f .W. ro FRONT ELEVATION REAR ELEVATION 1 LEFT ELEVATION ado i. w imw4r• r�r�w.on •is�um; 11L TOt AN nl Cl.l.lm Iq.F.m11y\ F\C1� IAilf ii0mirslGl! Im V i 1� � M ®� wIOO rY6 Mlb ®IPLLYif10OYL ar�aarrcu.arfc n. 1 . Wn loofa n 5hM INIOR/MTION SHEET I OF 5 ELVATION5 nmxrr �: I o-x !kC%: „5PO" n E-SE E-NE M I 0 O I I SPECIAL WELL CONSTRUCTION AREA BOUNDARY 33' tD rn rn 00 3a� I (A o ai 00 00 � I � N N zn Z zn ►n � O I ao Q o z ool V' NI I N I L.B.O.=972.0 N89058'30"E 207.78' LOT 11 128,607 SQ. FT. (2.952 AC.) rn N89048'39"E 629.71' LOT 1 132,878 SQ. FT. (3.050 AC.) SE CORNEF SEC. 14 NE CORNE SEC.23 N N89048'39"E 627.16' N 50' SETBACK FROM 00 NON -NAVIGABLE WETLAND:' N C LOT 13 "' 126,759 SQ. FT. '- -o �N (2.910 AC.) L _ LnLn 'L S00o 16t 46n W / O m 40.17 �' �F 10 k.0 / L.B.O.=981.0 ` �,y� :In N rIq '22"W 42d:26`------- --Ln S89 42 z, Ln ( n� I 0 RECI OMC D CST-N'Zott �c� d�2018 SOIL EV UATION REPORT Page_Lof h with Cam85. ohs. Adm. cods , St. Croix County Caurxy Atteelt Mnp Ulan 1/2 x 11 Wow in stye. Plan must 1 hdude. but Point (BM), direction and Pared 1.1 O a c - i tl � Parent Map, oral. or dimensions, north arrow, and location and diatr,a to nearest road. 14 Please pint all in/onnatlon. Reviewed by _ L Lfs /'� ry l 7 /� Pam Yhlanreon Vim proridm mey the used � d for secandwy oow farY Low. s.13.or (1)(m)) C i� 1 ;1�ih_ 1/ r x Govt. Lot 114 <,C 1/4 S 19 T 29 N R // E 9 Number of bedlii�_ Coda derived design flow rate %Grz C 1D ❑ Reptawrtert ❑ P&W commercial - Describe: _ 14 Parent a_4 Flood Plain elevation it appbeade --- -- - ft cerwai w.v.w,a 5 �3elu c✓� �- aid noonener,d.tar: System 7w)e ^^.• __ System Elevation / I� li �L • � I I 1 1 60 eod❑� no it Pit Ground straos « ft. Depth b krv& p actor f E= -in. G.i A�iiv. Rom. I I 1 1 60 eod❑� no it Pit Ground straos « ft. Depth b krv& p actor f E= -in. G.i A�iiv. Rom. S'L%fAM®M ©/ rMWAW AMrd= EMUffit /1 w K)D. > 3D < Z0 nWL and TSS 3-30 < 150 ' Eskw t 022 = SOD.' 30 mWL arM T55 < 30 mWL CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird ature 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 e/ ' ,30 — f 9 715-246-4516 �Z Property Owner - © BortrV 4 Parcel ID p R. Pit Ground surface elev. L� --71L Depth to to &V factor 4 / ? in. Pegs - of Sol AnoRration Rate ©® I■MFIAWM MrIP WAMWUMFWU ■i��r ■�R. MMMM 7m=� ■ : T•, Effluent 01 - BOOS > 30 1220 mgrL and TSS >30 1150 mgA. ' Ellluert Art = BOO, 130 mgrL and TSS < 30 mg1L 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. Soil Test Plot Project Name Oevering Homes Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 f Lot 12 Subdivision Hunter Hills Estates 1/4 SE 1/4S 23 T 29 N/R19 W Boring 0 Well PL Property Line BM or VR_p Assume Elevation 100 ft. �haun Bud �N�,� , CSTM #226900 6/15/18 Township Hudson County ST. CROIX Top of survey iron System Elevation I bU *HRPSame as benchmark Ulr-oUj4-007 I Ji.A 11(NI SNF I{:11 II!NTER I IIUS l 5'I'A•I'LS AUG os � 18 I IA A I}H IN PART OF THE NW 1/4 OF 11W NE 1/4 AND PAR I III I I1h NE 1/4 OF THE NE 1/4, OF SECTION 23 AND PART OF Ili E SW 1/4 OF TIIE SE 1/4 AND PARTOh I OF >F .1 OP I IIE SE 1/4 OF SECTION 14, AEI. IN T29N, R19W, TOWN OF HIIDSON, a I 1 8ul \ I , II �f, I Y, WISCONSIN. -- IE9O• ' it I l29N. R19WIts v'" sOsro ... .. • r"u�..a.w �, Nlf f'a 107I u1u.[I yp6a� • I . � _ I 4Jrin1, y +0 ly ' LOT LOT ....,.. L flygr ~Y ' LOT 9 IOTt un, r�j I • wrnrr N)ll 1 a _ ua.cl M.VWII RrVW11 WTI \uwa11 I umul uaal • ... �. y Yr uann • I Y � brw Y ur.cl ! Y w jt • • • / / • LOT 10 LOT 5 r � wai..w•rr n -�. I : usrinc� • � � 1 ..1.. 4 jAck 0^reE nfn. _ • LOTH 410� 1®.0 ir LOT 12 LOT at • If ecr ne• �Y(1. 19f: \Ii\•.I li a\..Y\ i LT IIOY't LOT is W .r ( wwr�r al 4AK1 Ii I\e.wr Y ----- sasl as ��` I 4 Y I rcu �11 IY �I I rlreel;W V r- • `r �...... / RI I 1s r n n \` Ti]ar IItlllnnn /� LOT_ a Q T¢ ' 1rY!'• ma � � _ Y\MAt1 � � •\••�I• - _ tl RQIRI�MIfRf MR!_ a f i rw % � toy 17 ..:m`re�..'... I 70•jl•W 1j. a�r_,ow ice. u�,Ml I • LOT StlY7II'W t I y I a • y S/N .. i • 7 LOT 14 lie ram 1 4 YDLIIFR&E lo�rffrM y1 SEE MEET 2 .9EE I YDL II lAOtl9! ,�r.e.r. Imp_ � .92 I L .00/X couNrY NO. 645469 STATE SANITIRY PERMIT GM.Nkss 47TRAfi9PEib'REMG�HAL PREVIONO. OWNE PLUMBER TOWN OF SEC_lt_,T /OR LOT WSW l� zMaR - =-*0 N, R_1_7 E/W _BLOCK SUBDIVISION CHAPTER 145.135 (7) WISCONSIN STATUTES (a) 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 maybe renewed for a specified period (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit wW be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) 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. D ISSUING OFFICER - DATE 202L now 4 PE T EXPIRES LESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI 1/20)