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HomeMy WebLinkAbout182-1026-40-125VOsconsm Depanmem of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and 8m0d.ng D'v—n INSPECTION REPORT Sar,%ry Perms No GENERAL INFORMATION (ATTACH TO PERMIT) 645489 Femoral ntormstion you provide troy be used br sitoOndary Purposes [Primacy Law. e.1 S.04 (1)(m)I Slam Plan ID No. Parma Holds a Name Donald J 8 Lori J Stephens City Village Toenallip Parcel Tax No: VILLAGE OF STAR PRAIRIE 182-1026-40-125 CST SM Ela, Into. SM Elar BM Daacnptbn: Sechon1Tov nrRangefMsp No. kT FE0 09 5- -% TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic ei5¢-,f o o '� Dosing y' on riv.�s (om TANK SETBACK INFORMATION ®E=��1AA 0 Iva F/IIMAWMWE= MMM��r = PUMPISIPHON INFORMATION 2 a ' I Manufacturer �RdLE? mand GP�S,y I'a ( Model Number �j ,n )S) TDH 1-iN55 Friction Loss System Head TDH FI 2s3 g.o3 Foroemain Length Dig. Dial to Vyap s 10 Z 10 ) mro i� bVIL AtSbUKV IIVR bYbTEM STATION BS HI FS ELEV. Benchmark 914 QG. s Alt. BM Bldg. Sewer �.I3 9D `i2 SUHI Inlet ID.4s �i.2s StIH1 Outlet of Inlet of Bottom i3o g(o� Header/Man. Sys 92.zs Dist. Pipe Bat. System �1 L r y b Final Grade 9 VF St Cover 31 9' 4. znleJ SED"RENCH DIMENSIONS V*fth ( Larger (Db No. Of Trenches 'l (*)to.1 PIT IONS No. Of Pits Inside IN.. Liquid De SETBACK IN SYSTEM TO PIL BLDG WELL LAKE/STREAM LEACHIqO. CHAMBE anufacturer I �nIi111dto•/ Type Of System: �sndhiioval )25 ) J� I OD UNIT odal Number U10 1 KIGU I IVP/ OTO I CM HeaderlMene P, x HaN SQ.: Hab S1lecap Vmt b Air mtaAa LM D' Lanpm Die Spacing SOIL COVER x Pressure Systems Only It Mound Or At -Grade Systems Only Depth Over I Bsrfrtrerlch Cares" 2.s C." Over Be nrA xs Deptlr of sos Ssadedr5odded xa Mu '� Ysa 1 Yes No COMMENTS: (Include Code discrepancies. persons present. etc.) Inspection 01: Inspection e2: Location: 456 HILL AVE 1.) Alt SM Description = 2.) Bldg sewer length = 7(0'1 • amount of cover • 4- Plan revision Required? ❑ Yea ❑n. No � Lu 1 it -a 1 -+ Use other side side for additional nlamadon. �`�� � 5 plq 5-1 J SBD-6710(R.3/97) Dab pcbh Signsrs Can No D $S QI s aoa11- � M'x • 3020224822 Ldway SWion DivW= jNaWIS370Sw� emery S�fayilisiWw6r(bM1®ednbyCo) 1�1i1�1t�: N0� �'�►\�— Co�ntV t Modiaoq WI St. Croy m {p c° Permit Application smrT b.tmedoree web SPS 3t3.21(21 wit Adm. Co. wioinion dbie brm to to •Paaw+ wtmmnwrat on Rojat AM— (if diRmmmt Nn meld{ ed&—) is �� P� w.bm�6 • »ey prek Nae: Appbow- form far.roe•oweed POWIS use■&eared Is the DWw%q t ofSo" wW Ptol.iotol s—imx Po®e1 memoom yew powWemay Ise used br>mordry pumaoss .,ocorree wib de ' lawtiS.op1 m $lobo / ySb Itllu. Av� rdrrY.-Pborer.dtwA. Prapmty qwe .'s Nome NAuD S tLOKA 3 - 7sTE ENS Proel / Pgz- IGz6-90-1Z5 �. ► E C, b 3 Z8 C oon$ Add— � taer;m NF. I/NK/,� s— rz T 3 R city. Sow R �Zi Al%E WI Try Code 59 C) Pb.. 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A0�"� m tle eN va i. ro.'ae/4 .yelelwa4la� Singl kce Filter Case ' _ I Neaw��•wner�s�+mr��inuwe y��'� '! �a.eq Orb�aeWlaayeoYr,ame�smMe ne.e.Pa�lw✓w.o+N�ie�r�.�� OIM V E'M� aYf.l�aa/�ma �M�wbP.�e� ��7101f4{b1r Y���r61MYr9NR 6.aD w�r�r�M4 ►iolded-in Support Hubs ierin] W.ar«e,�rrvear.wn41, ✓rY0gbltba.a/ldlrueaRr�en.lYe/Ir flr8 TbwrenaW Save Money Now o .e.msaub.w M,e.aeea►�ar.e ea+.eararitir r�u� YW �HixYe,de�y w� �Bm rt�a POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I m 2 FILE INFORMATION Owner Uoal L(ig,\ S Permit t DESIGN PARAMETERS Number of Bedrooms 3 13NA Number of Public Facility Units ,Is NA Estimated flow leverage) 3 al/de Design flow (peak), (Estimated x 1.5) Lt�gal/day, Soil Application Rate --1 galldeytW Standard Influent/Effluent Quality Monthly average• Fats, Oil & Grease IFOG) SW mg/L Biochemical Oxygen Demand fBODs) 5220 mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODr) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ❑ NA Fecal Collform Igeometric mean) 510' cfu1lOOml Maximum Effluent Particle Size Y. it dia. ❑ NA Other: ❑ NA •Values typical for domestic wastewater and septic tank etfimM. SPECIFICATIONS Septic Tank Capacity y ❑ NA Septic Tank Manufacturer tAfJJZ O NA Effluent Filter Manufacturer `, / �./� C ❑ NA Effluent Filter Model 1 8 ❑ NA Pump Tank Capacity 660al O NA Pump Tank Manufacturer W165 6 K ❑ NA Pump Manufacturer ZOeLLEi2 O NA Pump Model 5 O NA Pretreatment Unit ❑ Sand/Gravel Filter ❑ Mechanical Aeration ❑ Disinfection ❑ Pest Filter ❑ Wetland ❑ Other: jo ,Diis'persal Cellls) WIn-Ground (gravity) ❑ At -Grade ❑ Drip -Line ❑ NA ❑ In -Ground (pressurized) ❑ Mound ❑ Other: ❑ NA Other: ❑ NA Other: ❑ NA ` Service Event Service Frequency Inspect condition of tankls) At least once every: monthlsl (Maximum 3 years) earls) ❑ NA Pump out contents of to nk(s) When combined sludge and scum equals one-third p51 of tank volume ❑ NA Inspect dispersal celllsl At least once every: ❑ monthlsl (Mulmum 3 years) !� serial ❑ NA Clean effluent filter At bast once every: ❑ monthlsl serial ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ aerial ❑ month(s) NA Rush laterals and pressure test At least once every: ❑ mon 11 - ❑ ea(sl NA Other: At least once every: ❑ month(s) ❑ ear(s) NA Other: ❑ MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal calls shell be mad+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 include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal celllsl shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding 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 IYs) or more of the tank volume, the entire contents of the 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 filers, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. 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ABOVE GRADE t MGM PROOF 2 26' PROM DOOR, MINDOY OR .UMMON SOX APPROVED FRESH AIR INTAKE WITH CONWIT MANHOLE FINISHED GRADE Y' CI RISER W/ PAOLO 6" MIN. WARNNING _ ABOVE G ADC s►" MI I$" 1fI11. 6" MAX. •� INLET ,`WATER TIGHT SEALS T GAs- ; TIGHT-' Y" BAFFLE A SEAL • APPROVED Ci Pi PE —�— NA JOINTS W, 3' ONTO B N PIPE 3' i SOLID T- SOLID So: C SOIL PUMP OFF ELEV. FT. RISER O PERMITrM IF TANX MANUFACTL 3" APPROVED BEDDING UNDER TANK HAS APPRN CONCRETE PAD SPECIFICATIONS gcPTIC 1 DOSE TANK MAMUTACTURERs WIE 5£iZ NUMBER DOSES PER DAY: r TANK SIiCS: SEPTIC iCoO GAL. DOSE VOLUME INCLUDING QA DOSE GAL. FLOWBACK: GAL. ALARM MANIFACTUNER: M �S CAPACITIES: A : MODEL NL_ INCHES UMBER: SWITCH TYPE: B : 2 .INCHES'` i PUMP MANUFACTURER: 20C L(G 0 -7G AI- C = RICHES MODEL NUM817t : byu us I � G` � n,r � SWITCH TYPE: D n INCHES = I�7.-71 REQUIRED DISCHARGE RATE 3L GPM PUMP G ALARM WIRING AS PER ILHRz16.23 VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . . 'FEET MINZtQlfl NETWORK SUPPLY PRESSURE . . . . FELT )_. FEET FORCEMAIN X FTlioo FT. FRICTION FACTOR . 2. FEET TOTAL DYNAMIC HEAD � FELT INTERNAL DIMENSIONS OF PUMP TANK: LENGTH IZ� : YIOTH 15 DIAMETER LIQUID DEPTH - :IGNED: LICENSE NUMBER: PULL POiFi0R11111iCE CLIME � mme F+ WMNN m wiw ST. CR NTY SANITARY SYSTEM Flefk " 1- OWNERSHIP/ADDRESS FORM oan 21 oaty rr.oted2/zoat 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 PropeM Files Scanned weblink. OWNBVBUYER INFORMATION Owner/Buyer Donald J & Lori J Stephens Mailing Address 456 Hill Avenue (P.O. Box 280) City/State/Zip Star Prairie, WI 54026 Phone Number (required) 612.961.6492 Email Address (required) don.stephens@gaderandhighstrom.00m Parcel Identification Number 182-1026-40-125 (found on the property tax bill) NEW SYSTENk LEGAL DESCRIPTION Property Location NE ,�, NW Yi Sec 12 T 31 N R 18 W, Town of Village of Star Prairie Subdivision Plat: Lot # Certified Survey Map # tO I Z 5 0 . Volume L 3 Page # 3�53 Warranty Deed # 0 3 �tqx (before 2006)Volume . Page # Number of bedrooms 3 Spec house O yes ■ no Lot lines identifiable ■ yes O no OFwc[ USE ONLY New Property ddress Nerifi ion of new address required from Community Development Departmen for new construction.) I� ( aH nitiah) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. Now 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 cdd0sccwi.aov 1101 Carmichael Road, Hudson, WI 54016 www.sccwt aov Kevin Grabau From: Doug Avoles Sent: Tuesday, December 6, 2022 5:40 PM To: clerk@villageofstarprairie.com Cc: Kevin Grabau; Linda Geraghty Subject: Address question Attachments: 456 and 474 Hill Ave - Village of Star Prairie.pdf Follow Up Flag: Follow up Flag Status: Flagged Amanda, Per our phone conversation today, I have moved address 456 Hill Ave to parcel 182-1026-40-125 (the lot the Stephens are going to be building on) and assigned 474 Hill Ave to parcel 182-1026-40-135 (the lot with the existing cabin). Attached is a pdf map showing the new address points in our GIS data. Kevin, you can use 456 Hill Ave for that permit the Stephens have an application in for. Let me know if you need any other info from me. Doug Amanda, We recently received a Sanitary System Permit application from Donald J & Lori J Stephens for their property on Hill Ave. They have 2 lots of a Certified Survey Map. They are planning on building on Lot 1 which is the eastern lot of the two. On Lot 2 they have a smaller home/cabin, not sure if they reside their or if it is just used as a vacation place. They also have indicated on the application form that 456 Hill Ave and PO Box 280 is their current mailing address. PO Box 280 is what is listed in our records for the tax bill mailing address. And we have 456 Hill Ave listed on both of their parcel records (182-1026-40-125/1-ot 1 and 182-1026-40-135/Lot 2) for the property address in our property assessment system. In our GIS map data we have an address point for 475 Hill Ave that appears it may have been assigned in 2015. It is located on 182-1026-40-125/1-ot 1, but is not an existing property address listed in the property assessment system. We do not have an address point in our GIS data and 911 Dispatch system for 456. Therefore, I am working to reconcile all of these discrepancies in our information and I am hoping you will be able to help shed some light on these issues Do you know if 4S6 is actually being used? Has the Village assigned an address for 182-1026-40-125/Lot 1 that the Stephen's are planning to build on? If 475 was assigned for Lot 1 back in 2015, and the home/cabin is 456, then these would be out of sequence. If that is the case we should look at either flipping 456 and 475 so that 475 is for the existing home/cabin and 456 is for the new home they plan to construct. Or even assign new numbers. I also see that the Village has all even number addresses on the north side of the road, so I am a little more confused on background of the 457 address point we have in our GIS data. Thank you for looking into this. Doug Avoles I Community Development - GIS Analyst II 1101 Carmichael Rd Hudson WI 54016 T:715-381-4934 I F:715-381-4400 DouaAvolesgOsccwi.aov ST. CR VNTY srna.ru Doug Avoles I Community Development - GIS Analyst II ST. CR NTY m �I-� �' ��' �� � �� ��' � , � � �� �� ;�-� � � ; u� r �ii� �� f B ;� ®�A �'I .<I it I RP �II�f���l��s►� F O C-3 C7 O N 0 N N ----------------------------- --� I I I I I I I I I I 1 f lr ___-__ ______J .fry _�Y... ...............'. _____________ I I 1 I 1 I I I I I I „ I 1 YY 1 1 1 1 I I I 1 1 1 � lv rl lv .yi O C 7 I O O O v C i 1 2 IV A N O O r...a lever. ooanrs rx 1 sv rlrr.rwconln slosh I 0 000000 '�' 1 000000 �� L Wisconsin Department {safety and A '' Page I of vrq(e�„slgrrM'6ervice N� RR L EVALU �0 • DN'rsbn of Industry 'j V C�16` 4' —�7 cc op St'u�,a D op ante with SPS 385, Wis. Adm. Code County St C'ro 1 X Attach complete site plan on p s than 8 112 x 11 inches in sae. Plan must Include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. u 052 -1 - 1 z6 C scale or dimensions, north arrow, and location and distance to nearest road. I Z Pease print all Information. R 'awed by 1l�atR �Z 27/7z. Personal infcanadon u provide may be used for seconds u sea Prive Law 1 s. 15.04 m Properly Owner Property Location NE ''/ '/. S 1 2 T 3 N R ❑ E (or) W n V\ e S GovL Lot tQUJ Prope'fS,vn 's fling Address Lot # ( Block # Subd. Name or CSM# Cs 3753 a 2 uo I City State ZI Code Phona Number eares ❑ ray Village ❑ Town Nt Road St7+R Pr �v e LA,sTwr Rq;r,e I R CT New Construction Use: GM Residential/Numberof bedrooms _ Code derived design flow rat _ GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plan elevation if applicable _ ft. General comments and recommendations: c re r ElBoring �. Pit Ground surface elev�Z- Fil Boring # ft. � epth to limiting factor _ in. AQ leh!zit- c..a e.,. Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' 'Eff41 'Eff#2 f 0-7 7, R — SI zmqr rn I CS Zf 2 -zli 7,5yayjq- IS o IMt Ck 2q-15 7-3vek 946 m M — ORI S -0 c, RAV Boring # ❑ Boring �5. 2 7 103 Pit Ground surface elev. —ft. Depth to limiting factor _ in. Soil A lication Rate Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eff#1 'Ef#t2 0-7 r,5v, Zb ICS 2rw �D 7- O .5. S OMSq 01 7 /. ZV'3 7.5. - n'I qs .(- 1 Is 0ms tr I -- - 7 . G ZS AV6(L ' Effluent #1 = BOD, > 30 5 220 /L and TSS > 30 5 150 m /L ' Effluent #2 = BOD, > 30 s 220 m /L and TSS > 30 s 150 m CST a (Please Pri a Q Signature CST Number ^ /!� L 7 Address T �P s rtir Date Evalu Cond ed /( Zz Telephone Number a - s/yo -5VC& Q i.� Boring # ❑ Boring 1 3 • 1 7 7 V Pit Ground surface elev. ft. Depth to limiting factor _ in. Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont Color Texture Structure G, Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eft#1 'Eff#2 q r rn 115 sq ml q • lu ✓ns 1 — V!32- ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. -ft. Depth to limiting factor _ In. Boring # ❑ Boring ❑ Pit Ground surface elev. -R. Depth to limiting factor _ In. Soil Application Rat. Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont Color Texture Structure Gr. S.Sh. Consistence Boundary Roots GPD/FP 'Eff#1 'Eff#2 Effluent #1 = BOD, > 30 5 220 mg/L and TSS > 30 s 150 mg/L ' Effluent #2 = BOD, > 30 s 220 mgfL and TSS > 30 s 150 mg/L P52�{� Boring El Boring 1 J.q 7 721/ E Pit Ground surface elev. —ft. Depth to limiting factor_ in. Soil Applicatlon Rate h. ���1'C!r•3L ���i-111L1�-����� ❑ Boring # ❑ Boring ❑ Ph Ground surface elev. —ft. Depth to limiting factor _ In. Soil Application Rate Horizon Depth .. .. In: Dominant Collor Munsell Redox Description Ou: A.F. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •EfF#1 'Eff#2 7 Boring # ❑ Boring ❑ PR Ground surface elev. _ R Depth to limiting factor _ in. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont color Texture Structure Gr. Sz. Sh. consistence boundary Roots GPD/Ft' •Eff#1 'Eff#2 • Effluent #1 = BOO, > 30 S 220 mg/L and TSS > 30 5 150 mg4 ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 s 150 mg/L r y � � J� Ig2-foZto— k0 —125 .I` �12z \ C57 # \ i. 2 ZZ3 Lf S \ \ �a3 s l _ (JRI L (N TRG6 MASKED \ ^ W 61 iTN ANGC R 88vN/ u ( � ORANr-E. c.p,,?\ CD iM = I oc) O- -�- �iZ.' y E ILOw l� I h� L O- TOP dF P� PE = (0.5 G=NrAIZoNrAL_ (3M y�''= I b' �53o�`i I / / / / / / p9 yo�H el/ / / PREOLnIM�Nw RY 14, / / / Q / J MAIM / \' / / `Aamow.urr HOOD Q % / fD.eAuuwDAxr Q � / // �/ IIOfOSED MOMf C )SJIOAWNAAY faosnMG / \ ` / IYLMWATER •� . /'MMIfL1MQ H'CIAVFIIT � L4W1' `-f1f6,WD Y/IK TAx. 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