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HomeMy WebLinkAbout036-1054-20-100 i consin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538788 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Vincent, Troy & Nicole Hand - Vincent Stanton, Town of 036- 1054 -20 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: J'V\ cS T 23.31.17.342B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Z Benchmark Dosing v� � Alt. +.`� Bldg. Sewer r�.•I �- F 9• 97• � .a� Holding St/Ht Inlet �, Z . � �•� � ' TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. V t to Air Intake ROAD Dt Inlet ` Septic . 166 53 9 9 Dt Bottom L b Z Dosing W66 1 53 9 99 / Header /Man. 3 a Cp U o Aeration Dist. Pipe 3• 7 a 7M. l Q O Holding Bot. System 6 A PUMP /SIPHON INFORMATION Final Grade 2 ci f. Zg Manufacturer Demand St Cover GPM �1 0 2.3`t `? . 83 Model Number Zt� • 3 TDH Lift 2 u Friction / Los System H d TDH� ��t /# Forcemain Length Dia. Z of Dist. to Well /�� SOIL ABSORPTION SYSTEM S BED /TRENCH Width / Length / No. Of rench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/ LDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type f ystem CC :/• r /� 3 /42 Z 13 A l UNIT Model Number \ DISTRIBUTION SYSTEM / V Header /Ma Distributions x Hole Size r/ x Hole Spacing 1 Vent to A; Intake Pipe(s) I Length ` Di > Length " v Dia Spacing 3L S -CC?VER x Pressure Systems Only xx Mound Or At - Grade Systems Only G �_ Depth Over ` Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center , Bed /Trench Edges Topsoil ' P_. Yes [71 No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: �p / 12 Inspection #2:___ Location: 1855 210th Avenue New Richmond, WI 54017 (NW 1/ NE 1/4 23 T31 N R17W) NA Lot 1 C�� P rcel No: 23.31 17 342E 1.) Alt BM Description 2.) Bldg sewer length - amount of cover Plan revision Required? Fall Yes No ZS Use other side for additional information. Date Insepctor's gnature Cert . No SBD -6710 (R.3/97) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538788 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Vincent, Troy & Nicole Hand - Vincent I Stanton, Town of 036- 1054 -20 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 23.31.17.342B TANK INFORMATION ELEVATION DATA oHoldipn MANUFACTURER CAPACITY STATION BS HI FS ELEV Benchmark Alt. BM Bldg. Sewer St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length ria. I Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM CHAMBER OR Manufacturer INFORMATION Type Of System: UNIT Model Number DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ❑ Njxx ]Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection Location: 1855 210th Avenue New Richmond, WI 54017 (NW 1/4 NE 1/4 23 T31 N R17W) NA Lot 1 Parcel No: 23 31.17 3428 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑ Yes ❑ No Use other side for additional information. -- - - Date Insepctor's Signature Cert. No SBD -6710 (R.3/97) REC P Via. E commeree.W1 4g 81 d uildings Division County 1 Oro 4' ST CROIX4�C}ly(NWeshin n Ave., P.O. Box 7162 4 �/. C ,____. scon s PLANN NG & ZONINCiIEdibli6, 1 53707 -7162 Sanitary Permit Number (to be fitted in by Co.) -- IMU ■wepeetment of COmnMroe 3 7 8 Sanitary Permit Application state Transaction Number in accordance with s. Comm. 83.21(2), Wia, Adm. Code, submission of this form to the appropriate governmental_er!J +.�! - -- unit is requited prior to obtaining a sanitary permit, Note: Application forms for state -owned POWTS are Project Address (if different th in mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary Av u o ies in accordance with the Privacy Law, s. 15.04(1)(m), Stats, — �� J Z / p`Ti�, I. A,1 1plication Information — Please Print All Information _ _ -- Prop arty Owner's Name Parcel # r""' r LAP Property Owner's Mailing Address Prope Location Govt, Lot City„ state Zip Code Phone Number �� y , ZE �, seal ion _, t role onf)� G��� - — V -- -N; R Lo(W ) II. '11 pe of Building (check all t at apply) -- Cot # _ — / -- - -- Subdivision Name i or 2 Family DWC lling - Number of Bedrooms __ 1 _ Block l -Qal�er� ❑Public /Commercial -- Describe Use _ -_ _ ❑ City of - -- ---- - - - - -- ------ - - - - -- _- -------------------- CSM Number Village of El 'Nate Owned -- Describe Use __.__.__ I wn of 17— X - - -- [II.. ype of Permit: (Check only one box on line A. Complete line B i f app A. ❑ New System replacement System ❑ TteatmentlHolding Tank Replacement Only ❑ Other Modification to Exist ng System (explain) List Previous Permit Number a td Date Issued B. ❑ Permit Renewal El Permit Revision ❑ Change o: Plumber ❑ Permit Transfer to New Before Expiration Owner IV.. Type of POWTS temlC omponent/Deviee: (Chec all that apply)__ - _._ _____________ ❑ Mon Pressurized In Ground ❑ Pressurized In - Group At - Grade ❑ Mound ?o 24 in. of suitable soil ❑ Mound < 24 in. of suitable soit ❑ }folding Tank ❑ Other Dispersal Component ❑ Pretreatment Device (explain)___ -- - V. 1 )ispersall Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpdaf) T Dis ersal Area Require sf) Dis eras) Area Propo sf) :System Elev itio, Vil. Tank Info Capacity in l Total # of Manufacturer Gall Gallons Units / g O y y New Tanks Existing Tanks Q / �" U iiz i 1 m w U' P, Sepdc or Holding Tank Dosing Chamber _ ^ V11. Responsibility Statement- I, the undersigned, assume onsibillty for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's a re MP/MPRS Number Business Phone Number PI umber's Address (Street, City, State, Zip ode) _�7_ II. ount /1)e ar tment Use ___ -- - -- -- ---- - -- -- - — Permit Fee Date I sued Issuing nt Signatu Approved [ I . &MA rove Ow tven a 13, Condit A"sons for Disapproval 3 \ /� J 4 S t C �,eD('aJaX 1..Siptic tank. effluent ffter and C dispersal cell must all by servb= I maintained �� t A. e � Gx JI • S r as per management plan provided by plumber, Z. AiN°eettbatsk requlrementa must be maintained Attach to complete plans for the system and submit to the Coanty only on paper not less then B 1121 it fuck" In size f113D -6398 (R. 01 /07) Valid thru 01109 PLOT PLAN PROJECT Trov Vincent ADDRESS 1855 210th Ave New Richmond Wi 54017 NW 1/4 NE 1/4s 23 /T 31 N/R 17 W TOWN Stanton COUNTY ST. CROIX SYSTEM ELEVATION 98.0' BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.R.P. top of walkout slab ASSUME ELEVATION 100° Filter BEST GF10 -8 ❑ BOREHOLE O WELL * H.R. P • Same as Benchmark i U '- (Z. C4" N \,\j C c: "A c+z- c 2 at Ave S cale = 1/4" = 10' � 4 Acre Parcel G� O W e l l Existing 3 Bedroom Ho use Jt- Tank is to be pr9perly )ld system is to be bedded and provided with pumped and buried lockdown covers with approved warning labels aredi ng is to be donje to Huffcutt 9ivert run -off away -ombo tank From system 0-2 8 -1 i"IE 97' 1j U 'o Slope �Oa' Sl 8- 4 rea 15' below 8-4 System is to remain Safety and Buildings t commerce.Wl.gov 10541N RANCH ROAD HAYWARD WI 54843 Contact Through Relay s co n s n www.commerce.wi.gov /sb/ , t i c epartm of Commerce www.wisconsin.gov Scott Walker, Governor Paul F. Jadin, Secretary June 07, 2011 CUST ID No. 226900 ATTIC• POWTSinspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON W1 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/07/2013 Identification Numbers Transaction ID No. 1948959 SITE: Site ID No. 768076 Troy Vincent Please refer to both identification numbers, 1855 210TH Ave above, in all correspondence with the agency. Town of Stanton St Croix County NWl /4, NE 1/4, 523, T3 IN, RI 7W FOR: Description: At grade, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1319035 Maintenance required; Replacement system; 450 GPD Flow rate; 40 in Soil minimum depth to limiting factor from P.0.1Al. original grade; System(s): At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), Pressure Distributio�r ►ondii Component Manual - Version 2.0, SBD- 10706 -P (N.01 101); Effluent Filter P P The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes DEPARTMENT 0 and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed l)M510N OF SAFL and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. SEE CORFii:S No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described the At Grade Component Manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 prohibits the installation of float switches or relays that contain mercury. Please specify an alternative product prior to applying for a sanitary permit ". • The designer proposes to install an effluent filter to achieve the requirement of wastewater particle size. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations. SHAUN R BIRD Page 2 6/7/2011. Reminder • The orientation of the at grade system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the at grade per At grade Component Manual. • Surface water drainage shall be diverted away from the system area. • Materials shall conform to the requirements of COMM 84. Comm 84.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. Comm 82 and 83 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are res i e or the installation, operation or maintenance of the POWTS. Sincerely, / Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Patricial.-S17a dorf POWTS Plan R� er, , Integrated Services WiSMART code: 7633 (715) 634 -7810, Fax: (715) 634 -5150 , M -fr 8:00 - 4:45 pat.shandorf@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 828-5902, Monday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www. commerce. wi. Qov/ SB/ SB- BuildingContractorProoram.html 1.• Cover Page a Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 5/25/11 Owner: Troy Vincent Location:NW1 /4 SE1 /4 S23 T31 N,R17W 1855 210th Ave Stanton System type: At -Grade Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706 -P(N. 01/01) Page# T.S. 1. Cover Page anatly 2. At -Grade Plot Plan gFRCE 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout ON _ CF 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Co ti enc Ian g Yp 9 -11. Soil test Shaun Bird Signature License number 2 70 PLOT PLAN PROJECT Trov Vincent ADDRESS 1855 210th Ave New Richmond Wi 54017 NW 1/4 NE 1 /4S 23 /T 31 N/R 17 W TOWN Stanton COUNTY ST. CROIX SYSTEM ELEVATION 98.0' 3 BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. top of walkout slab ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H.R.P. SameasBenchmark 210th Ave Scale = 14" _ 10' 4 Acre Parcel o 'dell Existing 3 l8edroom House .R- t�1 Tank is to be pr9perly{ old system is to be bedded and provided with bumped and buried lockdown covers with approved warning labels rad i ng is to be done to H uffc utt Divert run -off away/ vombo tank Fro system 8 -2 8 -1 Li Li X00' 3 Slope 8 -3 area 15' below 8-4 }stem is to remain At -grade System Sloping Site Cross Section and Plan ViOw E i� Dim Feet 4..... 4 4.4.4 4 4 4 L Ljg'�L + }L• ■ L■ � }�'. 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Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plc wed with a molcboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a' /4 inch soil wire when a sample is rolled between the palms of the hands. The A :( B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. 4fter'the topsoil cap is placed, the Entire at -grade is seeded and mulched to promote vegetative growth, limit erosion ,ind protect from freezing. The observation pipes are perforated in the lower 6 inches and Secured in � b", 03 /Q i lgj Page of Pressure Lateral Layout One Lateral — End Manifold i 4 -- Threaded .Q Cleanout Force Main !1' Lateral Turn -up ---► Plug i X --� L Long Sweep 90 Bend Pressure System Construction; Distribution Network Sp ecifications Lateral Diameter T In. Laterals are constructed of Schedule 4 J PVC Orifice Diameter S/ 3 2. In. pipe. Orifices are drilled perpendic Aar to X Orifice Spacing) C2 In, the pipe with a sharp drill bit and face down. L Lateral Len ,5 Ft, Lateral turn -ups terminate with a threaded Force Main Diameter In, cleatiout plug and are enclosed in a 6A inch Force Main Len th 6 Ft, diameter lawn sprinkler valve box acc -.ssible from finished grade. ••••• Grade ••••••• Q ••••••• 6 -8 Inch Lawn Sprinkler Valve Box 03 /051gj Page of Septic -]Jo se Tan k Cross Section And Pump Performance Specifications ^ ` P ump Manufacturer _ — Ta Man pu Model Number -- Tank D �Iodel r lumb G Alann Manufacturer Tota -r Ci %pacity Alarm Model Number e �Max.l D1 3pth Switch Type — Total Dynamic Hea (TD I) _ Feet - _ Filter lylanu£ �,cturer - ► • Filter Model Number reE E levation Head Distal Pressure - Network Loss Minim Pump performa Re quired Force Main Loss cr 3 GPM @ J"` Ft TDH Total Outlet Manhole Min. 4" Above Grade With Manhole Min. 4' Above Grade Locking Deice. Inlet Manhole Securely Mounted With Locking vice < 6" Below Grade Sealed Watertight Weather -proof 1 "'" - +► W Junction Box Finished Grade WM --s Vent Min. 12" Disconnect Above Grade Means With Vent Cap r Qutlet Filter --� - -� ,. alet __ __-- -- Znlet Baffle - A .w itch S nas and Reserve Capacity e GPI ; Weep _Tank Volume — r ` Hole :�.�. B di Inches Vo lume Gal _ .; ' ( reserve) A s J _ 3 <„ ;alarm) B 2 3 0 Off Elevation C . � ' a gg• Ft Bottom (dose) t{ (dead) D _ Elevation 3 D Total C.7 >; {/; . > I ►{ rr.:r: ��$ Ft ,, /,Y; ; ; 1 > a � >; >; s > ; ;;� ; t >; ;{ ; t > I / <: / ; t :•:; a: > l: i > ; a <'; •r'' +' t ' 1 GENEWLL INSTALLATION: The septic/dose tank is bedded and back tilled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufaci urer may not be exceed ad without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight finings,, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank exuavatio�i and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm IIi -2R. 02105 LJ Page of �— ent By: HP L4aserJ.jt 3100; 1 lib Ob2 15tH! Iw773y "D'vo g ` al . 9 EH SERIES SUMP/EFFLUENT PUMI. A a 11MIMtEN1r� >MMi Ir LML Bass r. O 300M 811 1 !3t ay "A11% 0B Mt um 1Mt.7k1 t81sas11 ! t* tae 14 �W 8.71 x11mmL � M 9p9g310 SAO► 4m 115 9N In tam 70 54 �i A 32 55 A 82 t3B �' 22 !!11 tUbt�Bet OWN Is 0148 4C0 AD at u 7000 70 64 41 82 138 20 ;7 8 i1 z 1eS1 � Bet ggd,OAM SD a Wadi 440 115 9% Ila 1000 70 Ie 55 � m fps. 76 in �1M a —.� ra�teso °N°°eiKduhra°IeM��Y�ra►MIMip FLOW L1TEfaS/t OM CiAlfi C�OM � d Cast Iron o saoo r'000 3000 m e w Mabaiat Po Qvborl W hnpe!!a 10 _. e Clowd Vht10 __ . 30 �7roluu AM - P O wer Cord 3JTW A zo Mechanical :shell Seat Nitrite witfi i�r{l011 and ceramic faces ° FastCttem SInum f A Shah as Beam Upper Stem and Leger FW1 & swings 'ITM TM T"11 o 20 w Go 1B8 ltav- WFGIt +sn+nucre PI P og JMP E p{tF'gtiMANGE CURyE � �t oic 115V am ro om llr/r • 11.1 �i 73117 1BYwes NfdM7JS7kl -Tm 4 OL22 M 1 lWWWJ lttl AH"tftmp.cmm Earn4gl14'.!d— brlo�s PLAN POVV rS p�EWS MMUAL & MAN _ p ft.F- WPOii �+i 8stsdc Tri+N[ COY - f 0 NA LJWW c `t triar►u� ? ©rvw - r — �'ttue»t r Martltl�otu�r ❑ NA Dl P ` CI N went F�rl�todet �.%, o - d' o as ,twat NA Putnp.TW* 0 40* �3 ? ga t (2 Number Uc> PturiA Ttistk MMa� .. DNA eamw low O ' tNisan[st � � C3 NA Down *1 W x 1A . Parr Mo C ,C e ` t7 Na APPOOfto arm. Nly sw+srage" �� o Pont t w► VVWand Fais,ON Dom a ilA� � a oth OWN s r t� �n ProhrMNrd g � M In- grewnd g C4�'a'VM © AMM (pnr"uft0d) Mound Tabd �,;rpdoc! 6eptidit } e 0 mgl1. ❑ Dd ne Fib tin rrseer� :O rr ,drs{1 Uomt " �, t�hdlarneber +' vatacwast� � cwia�en. +iw.na • mum Pardee wcadhrwsetr- t4�J11t+frF.NM 1 SsM►tarr Fmquoncy _. SWvft* �' �+ least antis ervwy mon ©ths S) [Nlaxln Kura 3 At Vi nes.) tnspeclt carne c omblbsd sludge and scorn �� ash CSI of tanf ;volume: When Frump out o at` tAUdc(sJ t3 rnorrtiei r(a) (04aidn iUM 3 r.�s_) AV S" once a very inspect dioperaoI ae1KS) s) At kWWt Otme levow ' 10 _,. �°e D rrtonehs �teart stlWerrt r-a a;} Q NA _,. $n"Ww t pump, > �' i aiorrn At lasses arsae ewiery < S s) p MA ts� At least 011010 +swtY' m 3 Q nyrintl+* Hash ta asd PrOOMM 0 morsths � �r{s} d NA At least ands ewary __.... _.. At C flrxSe aM9ry D nwr*W 13 rW (s) E3 NA MAWrltat MKM Wf!<'lfWCTOOM sir is rnod0 by on kXgVk trat tsttTi V Me of th e � 8 tptspe ic apeotbons °f ptrun p'k nber' R Bd Sswbr. POWrO h*Pwtwr' ' �• n trardeteis a vlwat htspeotto of the Umic(e) to kbnft an nt oo ft o r broi•n SWVMV pp = To* iropedbl" nor a� 1,s volume of combined stodge and eaum � edw� the girth � �+� up r tirdrrara�. VW Swund surfis*'L J 'i tea d aaUfsJ st�adttl be a ;sondbV C? aii� a rtt cn ,rte of 6-a kxW MVLdOWY far Pon" of 41MMS �rpurtd Mrslirce "my and ragednss the irnrnsd�s r°r' m, mots of irtts ttirtlC Vt �' OM it ie► who the 1701191Jmw twi do of ate �� � � � � Of M i0c s r r9h d^E NR 0*8 Nls of #0 tom" be MMOVad by SePWO 143, W A&MOVIVO Code, rr+elt 5 p mtaarnponentis; raMd stlrr �ff of ' trt9dw*1d W u PZ11NT5 oattto � s nt POWTS 16 datol1 w at 1nt�eltrsis &.12 nWn#IS COW shalt be � � � � s nat oi)Mt m en i7r n Qf t wIl 9f A 201*0 MPCA*WbO PvWdW to the kWW ttigtllNCOry:aludW* VA ft 'CD START UP ADO OPMAWN pfp�tns pmdu+c is ar otf�er Formr oonsiM an. ! to use crew POWTS dW*.t "d&n 9 tanks) ) fat` m`P► dxtca��rta I ; use crssnbdo Viet weer ds t MrWor digs am dispersw ( ). if W domed tm the OnwAs of slue twigs) remove d by a sop" serWdng try arr to UM Pam or Sysbrera start .1P shush not occurwheri sotTconditions are feazen at the infiltrative surface. OurDr si poefwtr des t P 181" w ay IM above nomiat highwater ferrets. When pa�sner• is fes0aed the aoar wa mRsai er re III be dlo heryed to the dispemW ceit(s) in one large dose, averloadng the ced(s) and nmy► result in the aau chas tx" qp or au dis charge of t. To avoid tl�s situation have the contents of file pump flour rem wed by a g Sels le Sour kbV Ops�ratlor pt6cx� Power to the effluent pump or carabasct a FWanber or POWT S Makjh* er to a o l ill rlwfi ;idy opet> the Fop cartes to amore normal levels within the pump yank. Do n :* ddw c K park v d*w ontel' mks aid lff erW tat1s.. Do not drive or park over, or afmbe dish rb Qr =mpact, the arena vvM a 15 fleet down GkVS oi`>ttrly ni XMd Or a t-mde soft absorpibn am t. Reducbm or. arouWation of The frafiow(mg from the wastewater stream may impttrve tine per Awmatrloe and orolottg Ow If e of tbl1.. poWI& Wwbk§W •btllbywlripa ,dQar butts; candomw, cotton swabs; degfflasew. dente ff diaper than i ec w ts; tat foul; dnele jeump pump} wader flint and v�egetabie petfgs; gene; Wow he fld Ma-, meat l e : atd of P��* phew' �ftrY napkins: tarnpans; - atnd water solUsdnor brit :e. ABANI:NMAUI?.NT Wheii ibe PO NTS faits and/or is perMarwritfyr.taken out of service the fbilao4ng steps shat( he faker( to fns um that fife+ systeno is pmt" and sfldary abandoned in co mpfrance with ch. Comm 83.33, Wisconsin Adtrti99buffm C uda� • AN pk to tanks and pHs shall be disconnected and the abandoned Pipe openhMs seakkL - The o xaEe nho of art tan ks and 1ft shag be removed and properly disposed of fay a Septage Servk* tg Operamw_ Alder I aunp ing, all tanks and pfts still be excavated and removed or their cawms ra mci ved mkd the w*W space lilted t tfltt poll, gntvel ora naMier Inert solid material. CONn'11 FAIGi r PLAN If the :l 'i:)WM fails and Cannot be repaired the f011owtng measures have been, or must be taken, to pro a code compliant rem mm m l: system: ❑ A suit; eke replec eff ent ace+a has been evaluated and maybe utilized for ft location of a n q*oeml rt sot? absoqdion sysbern. The repla — a mentaree should be protected from disturbance and corttpiactllon aid stwuw not be infr aged upon by required setbacks from eadsting and proposed structure, lot lines and wells. Fr;lfure to preotw : the n apAcement area will +riesult in the need for a new soil and site evaluation to establish a t uitabie replao invent area. Replaorsment systems must comply with the rules in efrect at that time- 0 A suits ble r eplac:>rtrraefnt a nm is not available due to setback and/or soil limitations. Barring advance!: tut POWTS technology a bolding tank may be instdlfed as a Last restart to replace the failed POWTS_ ' The she has not been evalueW W identify a suitable replacement area. Upon Faliure of the POWT,< � a soiil and site em iduation must be psrfori msed W locate a suitable replacement area - If no replacement area is available a ld;rx tank may be Installed as a last resort to replaces the failed PC»IYt'S_ 1Aound and at -grade solr absomildn systems may be reconstructed in place folk wAng rmnorai of the 5ioneat at the infil ttafte surface_, Reconstructions of such systems must comply wfth the rules in elliiarl at VW- t me. < - WARIviNG>> SEPT&:'. PUNIF a AND OTHER TREA7WENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFIC Mir OXYGEN. DO NOe'r EWE R A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER. ANY CIRCUIWSTANCES_ DE ATM MAY RESUL L , RESCUE -OF A PERSON FROM THE INTERIOR, OF A TANK MAY BE DIFFICULT OR JAIPOSSt 3L.E_ ADDIT1094AL. CC IWACENTS POWYS W STALI AR POWTS NArNTAIMER Name % Pharte 71, SEPTAGE N OPE RA7QR MPE R�� LOCAL REGULATORY Af MORffY N ame .' )),. [ 7T : �) hoe �' 2 nos aoc�men�t� t t brUxe smM s of VW [jinn Latta. MaMuette and W aushera CQUnty 7_onfnq .area Sark on age. This do= eA Ante is me nrifiGnwn itq�rrAq aMidr arch, Comm S3_Z (2XbX1Xd)& 1`1 and 83 5a(1}, (�) 4& (3). WfsaDmin ,Adm' 1hb*af m Cad- Use of Mak efae um I doses not guarA tee ttdc pelmn acce of ft pOWTS. ST. CROIX COUNTY SEPTIC TANK MAIlMNANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer r o I WvLk Mailing Address ` property Address (Verification required from Planning &Zoning Department for new construction.) City /State Parcel Identification Number 0 3 L EGAL DESCRUON 3 T .5 � N R�W, Town of Property I,ocation�� 1 14 , .1v.� V4 Sec. , Lot # Subdivision L� 7 f] Volume Page # _ - L / Certified Survey Map # 7 G IS C Cl 3 , Volume Page # Warranty Deed # Spec house yes (gr Lot lines identifiable _S YSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature fair to handle wastes. Proper maimbaoance needed, by a licensed pumper. What your put into consists of purq=g out the septic tank every three years or sooner, if the system can affect the function of the septic tank as a t stage in the waste disposal system Owner maintenance r esponsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by rho owner and by a mash plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and Pumping (if neceY), the septic tank is less than 1/3 full of sludge. have read the above requirements and agree to maintain the private sewage disposal system with the l/we, the undersigned of Natural Resources, State of Wisconsin. tgt standards set forth„ heroin, as set by the Depar of Comauarce and the Department our c has been maintained must be completed and returned to the St. Cro ix County Planning & Certification stating that y s eptic Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe atnlare tine owner(s) of the property described above, by virtue of a wgawly deed recorded in Register of Deeds Office. N bedroo SIGNA OF APPLICANT(S) DA� ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department: * ** Include with this application 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 (REV. 08105) ! 'U' � | ^ SmrFoxnor WISCONSIN FORM ,-.nnI / \VAM8xNTyDEED / DOCUMENT NO. |� �����N���� � .. ',~ . c ii . _ '/ ------'------ NOV 8 1996 | h "»»:ys and °:ir,m,m T roy L. Vincen and Nicole K ji NAME AND nvURN AF)MEOn 11 'ollowing described reil eswe in St. Croix County. av DOCUMENTS TO: -SU'ife of Wisconsin: 't'lPage Tide I'v Ile 214 Now's Part of the Northeast 1/4 of Section 23, Township 31 North, Range 17 I'lest describee, as Lot 1 of Certified Survey Map filed in Volume 7, paeg 197G, as Docunent No. 437980, all in Townsbip 31 North, Range 17 West. TRAN (KKX (is 1100 Fxreptiontowartantles: Easements, restrictions and rights-of-way cif record, if Pny. AUTHENTICATION ACKNOWLEDGMENT State of Wisconsin, St. Croix A. 43x980 CERTIFIED SURVEY MAP N0. Qua ps • 1P76 Located in part of the Northwest Quarter of the Northeast rter of N 1/4 CDR. I; ; f Section 23, Township 31 North, Range 17 West, Town of Stanton, St. Croix SEC.23-31-17 E „ County, Wisconsin. �133� j hIPLATTE,p - LANDS - — m --- N89 °34'35 "E _ _ 90 5.00 ' ^ -- - 2_IO Tit CENTERLINE OF -- - - - - TOWN RQ (_ x j! - -S69°34'35'_W 1783.85' 9' WALK THRU \ SHED 3 1 3C - 33.00' NB9 °34'35 "E 36 C i' - COlVC _CULVERT RIGHT-OF-WAY NORTHEAST Y DRIVEWAY GRANT IN M 33• NOR [2FSHED TH LINE x 456" PG.431 CORNER OF SEC.23. HSE - . 30� ' M CO. RECORDS. SEC.23 x OVERHEAD J w ROAD POWER LINE BARN SILO'S I 1 3 , RIGHT \ SCORN BIN l y m LEGEND O G a T L 0 T I SILO , �' s PUBLIC LAND CORNER, F x ;l 0 435,600 SQUARE % pal A SET I" IRON PIPE, 1 0 ~ x+___„ CORNERSHEET TO BE -if Z l� x x " x ° Q� FILED WITH COUNTY. a F E E T (10.00 AC.) o.r HED' S � ' bl INCLUDING RIGHT -WAY ) t1n� Or I" by 24" IRON PIPE SET, 1 3V Mh 390939 SQ. FT. (8.97AC.) EXCLUDING R/W f WEIGHING 1.13 LBS. PER LINEAL FOOT. I� JF- -I{ =FENCE LINE. `x'ss' --- S89 ° 34'35 "W 905.00' UNpLA77ED _LAN D$_ 1 I x SCALE= I "«200' X11 Ow ner: Gerald Kasten NORTH ° NoerH /sourH Rt. 3 Box 168 o so 10 00 300' S I/4 COR a\ I I/4 LINE. New Richmond, WI 54017 SEC.23 - 17 %+ Bearings are referenced to the North line of the NE4 of Section 23 -31 -17 which is SURVEYOR'S CERTIFICATE assumed as N89 °34 "E. I, Ronal F. Johnson, a Registered Wisconsin Land Surveyor, do hereby certify that I have surveyed and mapped a parcel of land located in the Northwest Quarter of the Northeast Quarter of Section 23, Township 31 North, Range 17 West, Town of Stanton St. Croix County, Wisconsin described as follows: , Beginning at the North Quarter Corner of said Section 23; thence, on an assumed bearing referenced to ° thenorth line of the Northeast Quarter of said Section 23, along said north line N89 34 r 35 E a distance of 905.00 feet; thence S01 °18 "E a distance of 481.38 feet; thence S89 °34 a distance of 905.00 feet to the west line of said Northeast Quarter; thence, along said west line, N01 0 18 1 05 1 W a distance of 481.38 feet to the point of beginning. Containing 435,600 square feet (10.00 acres) more or less. Subject to a Town Road (210th Ave.) along the north 33.00 feet of the above described parcel and subject to County Trunk Highway "T" along the west 33.00 feet of said parcel. The above described parcel is also subject to all easements,restrictions and covenants of record. The above described parcel is subject to a Right -of -way Grant to the Wisconsin Telephone Company in "456" page 431 of County Records. I further certify that I have complied with the provisions of Chapter 236.34 of the Wisconsin State Statutes and the subdivision regulations of the Town of Stanton and St. Croix County in surveying and mapping this parcel. Ua te - gala r. o on R.L. Ron Johnson Land Surveying 1 P. 0. Box 194 �► ` � • +'��1`� � [J Amery, WI 54001 , f � f F � t � b � • -- - UN ' ♦Aw�� 4 4 AV S01 Wisconsin Department of Commerce V U R ORT Page L _ of Division of Safety and Buildings t in accordance with C m. Code minty Attach complete site plan on paper not less than 8 1/2 x 11 ches in size. Plan must t� include, but not limited to: vertical and horizontal reference 'nt (BM), directiq� d�v� P I.D. / / O S . ZQ bd percent slope, scale or dimensions, north arrow, and location nd dis ton est \3 t� Date Please print all information. \ �tZO �NGO� /• by 1 Personal information you provide may be used for secondary purposes ( 'vacy tF1 m)) Property Owner Property Location a) f Govt. Lot 4/LC) 1 AA,� 1 A S Z T 3 N R E (o Property Owner's Ma 5 Address POC,4ty r Subd. Na a or CSM# v0 /� e city Sta te Zip Code Phone Number Village Town Nearest Road ! ( ) ❑ New Construction Use�esidential / Number of bedrooms LJ > Code derived design flow rate .5Z7 GPD eplacement Public or commercial - Describe: -- - - -- -- ' —' -" - -- - -- Flood Plain elevation if applicable �2 ft Parent material � � � / /J General comments L C7c�fC// n and recorruriendations: System Type ,� � System Elevation 7 � 2 1 FSo Boring # [] Bo I � Pit Ground surface elev. � ft• Depth to limiting factor � in• il Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 7. 7�7 L2 lad a r •-- c''� , � � l� � rl Boring 9Q ? Pit Ground surface elev. 6 0 ` ft. Depth to limitin Soil lication Rate a # � g factor in• Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 1 * `Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 Z1 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L • E nt = BOD < 30 mg/L and TSS 130 mg/L CST Name (Please Print) Si CST Number 226900 Bird Plumbing, Inc. Shaun Bird Telephone Number Date Evaluation Conducted p Address 715- 246 -4516 1008 192nd Ave, New Richmond, WI 54017 —1 Property Owner Parcel ID # Page of Boring # ❑ Boring K Pit Ground surface elev% ft. Depth to limiting factor in Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z �Z 5Z P J I Boring # Boring / (( r/ , I � pit Ground surface elev. Zj 7ft. Depth to limiting factor /y C7— in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ft' F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef1#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 150 mgA- ' Effluent #2 = BOD < 30 mglL and TSS < 30 mglL 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 - 2648777. SBD4330 (8.6/00) Soil Test Plot Plan Project Name Troy Vincent Sha d Address 1855 210th Ave New Richmond Wi 54017 C #226900 Lot 1 Subdivision - -- ------ Date 5 /11 N W 1/4 N E 1/4S 2 3 T 31 N /R W Township Stanton Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. top of walkout slab System Elevation TBd {.� *HRPSame as Benchmark Scale is 1" = 40' unless otherwise noted Well 20' 40' Existing 3 30' Bedroom M * House 40' 210th Ave 125' ST DW Old system not yet failed 60' S0' 35' B -1 B -2 98' 30' 3 %Slope 300' 97 B -3 50' B -4 County Road T