HomeMy WebLinkAbout032-1030-50-150
Department of Safety
& Professional Services,
Industry Services Division
County St. Croix
Sanitary Permit Number (to be filled in by Co.)
Sanitary Permit Application
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats.
State Transaction Number Na
Project Address (if different than mailing address)
I. Application Information – Please Print All Information
Property Owner’s Name
Jerry & Shirley Audorff
Parcel #
032-1030-50-150
Property Owner’s Mailing Address
271 72nd St. North
Property Location
Govt. Lot
SW ¼, NE ¼, Section 11
T 31 N R 19 W
City, State
Mahtomedi, MN
Zip Code
55115
Phone Number
(612) 360-0018
II. Type of Building (check all that apply) Lot #
04 1 or 2 Family Dwelling – Number of Bedrooms Na – Accessory bldg..
☐ Public/Commercial – Describe Use
☐ State Owned – Describe Use
Subdivision Name
CSM Vol. 16, Pg. 4320 Block # Na ☐ City of
☐ Village of
Town of Somerset
CSM Number 682642
III. Type of POWTS Permit: (Check either “New” or “Replacement” and other applicable on line A. Check one box on line B. Complete line C if
applicable.)
A. New System Replacement System Other Modification to Existing System (explain) Additional Pretreatment Unit (explain)
B. Holding Tank In-Ground
(conventional)
At-Grade Mound Individual Site Design Other Type (explain)
C. Renewal Before
Expiration
Revision Change of Plumber Transfer to New Owner List Previous Permit Number and Date Issued 633311 issued 4/16/2021
IV. Dispersal/Treatment Area and Tank Information: 11 Infiltrator Quick 4 Standard Plus chambers & 1 pair end caps, PolyLok PL-525 effluent filter
Design Flow (gpd) 150.00 gpd.
Design Soil Application Rate(gpd/sf) 0.7 gpd./sq. ft.
Dispersal Area Required (sf) 214.29 sq. ft.
Dispersal Area Proposed (sf) 230.60 sq. ft.
System Elevation 95.25’
Tank Information
Capacity in
Gallons
Total
Gallons
# of
Units
Manufacturer
Pr
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New Tanks Existing Tanks
Septic or Holding Tank 320 Na 3
20
1 Wieser Concrete X
Dosing Chamber
V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber’s Name (Print)
James K. Thompson
Plumber’s Signature MP/MPRS Number
MPRS 30021
Business Phone Number
(715) 248-7767
Plumber’s Address (Street, City, State, Zip Code)
340 Paulsen Lake Lane, Osceola, WI 54020
VI. County/Department Use Only
Approved ☐ Disapproved
☐ Owner Given Reason for Denial
Permit Fee
$
Date Issued Issuing Agent Signature
Conditions of Approval/Reasons for Disapproval
Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size
SBD-6398 (R. 03/22)
Project Name:Audorff Accessory Building Conventional POWTS
Owners Name:Jerry & Shirley Audorff
Owner's address:271 72nd St. N, Mahtomedi, MN 55115
Site address:657 Lakseside Ln., Somerset, WI 54025
Project Location:
Subdivision:Lot 04, CSM #682642, Vol. 16, Pg, 4320, Doc. #1118623
Legal Description:SW1/4 NE1/4, Sec. 11, T.31N., R. 19W., Tn. of Somerset, St. Croix Co., WI.
Parcel ID #:032-1030-50-150
Page 1 Index and Title Sheet
Page 2 Site Plan
Page 3 Dispersal Cell Sizing Calculations
Page 4 Dispersal Cell Cross Section
Page 5 Septic Tank Cross Section
Attached: Pole Building Plans
Mater Plumber Restricted Service:James K. Thompson, DSPS Credential #30021
Signature:Date: April 11, 2023
Conventional POWTS Index & Title Sheet
Page 1 0f 5
Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01)
Audorff Residential Accessory Building Dispersal Cell Sizing Calculations
1. (100 gallons estimated flow)(1.5 design factor) = 150.00 Gpd design flow
2. Infiltrative capacity of native soil = 0.7 gpd/sq. ft.
3. Absorption area required: 214.29 sq. ft.
4. Absorption area as proposed: 225.30 sq. ft. (11 chambers + 1 pair end caps)
Infiltrator “Quick 4” = 20.00 sq.ft. EISA per chamber, Infiltrator “Quick 4” end caps = 5.30 sq.ft, EISA/pair
214.29 sq. ft. – (1 pair endcaps)(5.30) = 208.99 sq. ft.
208.99 sq. ft./20.00 = 10.45 chambers required
Number of trenches: 1 @ 11 chambers per trench (20 chambers total)
Trench width: 2.83’
Trench length: 47.00’
Trench spacing: Na .
Total system area w/ 6’ trench spacing: 2.83’x 47.00’
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