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HomeMy WebLinkAbout030-2000-95-000 1 O ~c o I ~ I C~ o j' I O i r ~ N y II I Q I I I II v z° I c _ m LL c B Q Cl) z rn Z E O Z 0 a m Cl) r) H Z o o Z d U O - CY) 7 O O y Q y O I • N U) C O O Q Z co z Z N I~ z d c I y E CV L m d L a ~ o O W d L O n G G a E C N N Z = f' I- F- a N ~i m 0 0 O d Z O •N r` a a a N I a m o N _ o m m N ;M; _rn ~ L7 Q 0 0 m o `tv m m Z m l C o cn ~ U) a 4j °0 3 06 w e o E O Ca O W O m U O Cs O V n O H N c 0) U n- 0) O V L CD C6 M a N y E r N O c ~ c w r C N o o N Z c a°i n CY) S • a, m ri r to w o E ,m o co fn U o Z to V R a _ m at a ` a (D C E ' c J A U a o N U abor n Department Industry, PRIVATE SEWAGE SYSTEM ,~County: Labor and Human Relations INSPECTION REPORT \ St, Croix 'Safety Ad Buildings Division 4ATTACH TO PERMIT) Lots 1&2 Sanitary Permit No.: GENERAL INFORMATIONNW',,NW4, ec.33,T30-R19,Arrowood Rd 149111 Permit Holder's Name: ❑ City ❑ Village N Town of: State Plan ID No.: Gary & Susan Christian St. Joseph CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 30 - 2 00 - 9 5 30-2001-10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark (v~ - , ~~r. vv 8 ~jG, Dosi n Aeration Bldg. Sewer 2 D GS/ , Holding St/ d inlet ff) TANK SETBACK INFORMATION St/ W Outlet p TANKTO P/L WELL BLDG. Ventto ROAD Air Intake Septic 2_0' NA Dosin NA Header/Man. ( B,OZ~ Aeration NA Dist. Pipe 1? 00 'M' q b,8 Holding Bot. System G 11 D, 3 9 PUMP/ SIPHON INFORMATION Final Grade - pa,da rer Demand Model Number GPM TDH Lift Loss S stem TDH Ft Forcemain Length Dia. Dist. SOIL ABSORPTION SYSTEM BED/TRENCH Wi!~L Length , No. Of Trenches o. Of Pits Inside Dia. Liquid Depth DIMENSIONS _ _ DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE STREAM LEACH Manufacturer: SETBACK CHAMBER Num er: INFORMATION Type O System:~"l/; OR UNIT DISTRIBUTION SYSTEM Header / Manifold „ Distribution Pipe(s) , x Hole Size x Hole Spacing Vent To Air Intake Length /2/ Dia. Length -V-L Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Z' ~r Depth Over 2 xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center 3 2' Bed /Trench Edges 2Z ` Topsoil El Yes E] No ❑ Yes El No COMMENTS: (Include co a discrepancies, persons present, etc.) _ e~12 Yrt~ G~~ Plan revision required? ❑ Yes ~vo Use other side for additional information. 1A. 2Z SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. DI~HR SANITARY PERMIT APPLICATION d In accord with ILHR 83.05, Wis. Adm. Code Cou % l STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than / 8% x 11 inches in size. ❑ Check if revislon to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPE OWNER 1 PROPERTY LOCATION 4- C f R) '/4 /Vw'/4,S33 TN,R ~9 W PROPERTY OW R'S MAILING ADDRESS LOT # BLOCK # N a CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER a Z 11. TYPE OF BUILDING: (Check one) ❑ State Owned N EST ROAD JOSe ❑ Public M 1 or 2 Fam. Dwelling-#of bedrooms PARCEL TAX NUMBER(S) 111. BUILDING USE: (If building type is public, check all that apply) 3p moo - 1 ❑ Apt/Condo + 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 in line A. Check line Bit applicable) A) 1. 9 New 2. ❑ Replacement 3.E1 Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 nSeepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. 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./inch) ELEVATION •y ~ r e Y 9e '/l . Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New F-xistin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank 161v-, We, , Its El I El M Lift Pump Tank/Si hon Chamber Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. 4eq Signature: No Stamps) MPFAbPPAWNo.: Business Phone Number: Plumber's Name (Print): Plum l~ C S e n e C - ~ 7 90 71- y~ 52-941 Plu tier's Address (Street, City, State, Zlp Code): - .e ever falls WE 4_ W6dr J4, IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater a e Issued Issuing Agen ps) Surcharge Fee) Approved ❑ Owner Given Initial ~J Adverse Determination [J X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber • APPLICATION FOR SANITARY PYRHIT • 9TC-100 This application form is to be cornplntad In full and signed by the ovnet(s) of the property being developed, My lnadoquaclea will only result in delays of the pt IrnIt Issuance. -Should thia development be Intended for reials by owner/contraetor,(spac houoe), then a second form should be tetalned and caYAP letad when ilia property is sold and submitted to thia office with the appropriate deed recordlnq. Ovn:r of property . lTarv M. CMA Susan kA. Chl`i2-6ay) Location of property . N L J-1/4 U J 1/1, 9aCt10n T. 30 _r•R Tovnshlp oTnseph Killing address _ A,. _ l T_((o Nue~ker• Veil H U A owl W► 64m • Ad drtss of alts _ R I Arc•dtssOOd TCQr~ ly~. 54010 subdivision Me" • Lot number Prevlous ovntr of property Ma('inf CRId Nerlwo4 Total size of parcel _ a nrres Date parcel wen c r e a t e d I L I /'7a At$ all corners and lot llner Identifiable? -._..~_yen No . Is this pro petty being developed for resale (spec house)?-- No volnr.. and•Page Humber _43 as recorded wlth the Register of Deeds. • iNCLUD9 VITN TNI© APPLICATION TIIY FOLLOwINCI A VAAAANTY D¢ID which Includes a DOCUMICHT },"OCR, VOLUxe: AND PAOt )4VXIIR, and the 8IKL Of TIM RE019TRR OF DRRDII. In addition, a certified survey, It available, would be helpful so as to avold delays of the reviewing process. If the deed description references to a CtttlLlad Survey Nap, the Certified turvey Nap shall also be required, -------------------7------------- PROPERTY OVIIER CERTIrICATION 1(ve) certlty that all statements an this form are true to the best of ■y (our) knovIld9t } that I (we) am (ere) Lila owner(s) of the property deecrlbed In this Infotmatlon form, by virtue of it warranty deed recorded In the office of the County Aeglatet of Deeds as Document }(o. ►f µ ~ --I and that I (ve) presently own the proposed alto for the newage disposal syater, (or I (Wt) have obtalned an easement, to run with the above deecrlbed property, for the construction of sold nystem, and the same has been duly recorded in the Office of the County Reglater of Deeds, as Document No. i~ / al atv[ of Owner -2 11AA t') LAt~ fllgnature oL Co-Owner (tt Applicable) Date of elgnature Date of Aignatuca r~l~.r-~.rrr r lure .~vrr_ ir4'0%J . uIV151JN LABO TF$l AN,D P.O. BOX 7969 1 N \yl5) MADISON, WI 5.$707 ML 1AAlJIV1N'FiELA.TIONS PERCOLATION TESTS (1 (1-163.090) & Chapter 145;045) L I SECTION: : TOWIP/M TY: LOT 0.: BLK. NO, SUB IVI O NAME: 1~ /T 1 N/R V(-,A 9,419: A 06U N T Y: 7N,,R2/ E 'S NAME: IMAILINFG A . 7 USE DATES OBSERVATIONS MADE ATION TESTS'. tr~~T~ NO. BEDRMS : COMMERCI R TON: r-~1 DESCRIPTIONS: PERCOL [4New ORapiace Mflesidence 7, RA ING: S= Sits•sultable for system U- Sits unsuitable for system V (N I NA MOUNcD: IN-GROUND- ESSURE: S ILL HOLDIcNG TANK: RECOMMENDED SYST .M:loptional) ES E]U • ®J E1U 91 d 0U S' [IJ If Percolation Tests are NOT requir DESIGN RATE: It any portion of the tested area is in the under s.H63.09(5) (b), indicate: ^ Floodplain, indicate Floodplain elevation_ PROFILE DESCRIPTIONS W ER ING DEPTH T GROUNDWATER-INCHES CHARACTER O SOIL WI H THICKNESS, COLOR, TEX UR , AND DEPTH ER Dt{iN, ELEVATION BS RV D EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) r l B~',sI F 'f V -2Z 1 ? _ ! Ai`, / ( all yt~t+,' }+J Z-Z I? 7 / IIY' , ,A,@_ (f All JV1 V' PERCOLATION TESTS. T ATER N HOL EST TIME DROP IN WATER N RA PE R 100,3 P I, OYA I ER A AFTER SWELLING I T RVAL-MIN: PERIOD 1. 1 ZA 10 &a A/Z 10 9 X, / rf{ V' ':'PLQJ PLAN: Show Vocations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are,thli hOrl ~gnpI and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and.perc$nt f I0 d slope: S1:STEM ELEVATION i X t vSa~4` /sJ w"/. i I ! i j 1 ini, fit.. i.. o. -74 i _ 1 _ _ t.. I L I I I I I M r.. I , i I i ~CQt , lithe undersigned, hereby certify that the soil tatsts reported on thii form were made by me In a the procedures and methods specified in the WiseOnsin Administrative Code, and that the data recorded sod the location of the tests are correct to' the best nowledge and belief. NAME pri TESTS WERE COMPLETIFO ON: A CERTIFICA7 ON NUMBER: PHONE NUMSfR: a~tigtjel ' I NATU h DISTRIBUTION: Oririinat and one copy to l ocalrAuthorltY, Property. Owner and Soil Tester. DlLflfi 31]ID-6395 IH.02,'!!21 -OVEli - i r.- " i .r...e......f,..r.+....s...~. • - its . s•as,ascixsl.. ppr .~,jc:atit8.... ...................................................._w. 1:. •Nf.~.. . ".w......... r ~ TY~ E1 t 11LitlM ra i w iMll.ls•Mei1M eggs* in . Via nt a Rate of wrisnowa: Tr PV ftim t Of the NW of NW of -Section 33, Township 30 North, w of St. Joseph, St. Croix County". Wisconsin descrired 00 NY corner of sad section 33; thence 1100'a35►**19.3 feet; 'aw-7`4"ce SU'UIE 114.5 feet; thence due t' t1W PIMI to be c South dkM f+ert onveyad herein; thence diner Eaat ~ t 25D.9. feet; thence doe West 178.7 feet; themm 1q9 7• to t1w point of 6egiirattp mano . r "70 au;s§$Ment for travel over the South 24 feet thereof for Scow the t'== to the East. r iifTti a non-exclusive easement for travel over a strip of land 24. deetribed in a Quit Claim Deed from Sables to Snyders dated Berl October 14, 1974 in Vol. "S16", Pa578, : ge Doc No. 324310, in the` ,Water of Deeds for St. Croix County, Wisconsin. mss; MIT1f a non-exclusive 66 foot wide road easement rwning from tilb UM e" Of the 24 foot easement described above, Sly to County Irw~ic #M Irf+ ta$@MW* i s the Sly Porti on of the easement descri bed i n a Warr410ty i "e a Warts to Sables recorded in Vol. "487% Page 543, Doc. No. 311747, In -off*:e of said Register of Deeds. This 'is..= - hoseetead property. a M (is net) 'r , to wacrsstiss: FEE Easements and restrictions of record. 1MM tee. ju I day of --...F:ebruary . . (SEAL) • . Robert Anderson . (SEAL) ~r4 6 P....1.is..0~ _SchOedei. aosants>rT=oAsiox AasitowLmseNtmUT tN STATE OF WASHINGTON di1Mo . M tWs - ef..-..__.. .SPORABiE.--...-se. a - 22 February case before on _ t F. •Aaderto►-dadyllis•..t F?i: 1[!1[BiB STATIC SA= Eft,,- N ty f '►asie. Rii.V >114 +4 - known to be the person s NlTa11MENT W" hW instrument and aekao~wledt@ tbg eras ~ THIS i1r William J R 1 adosevich, Attorne a 502 Second St., Hudson, W1 54016 tunn Notary Public pokane . M oe ads nowledM. Both MY Coa~s~ssios is paeraneat (it amt, e1NeC~jeti lY date: January T9 leR11e1 elyeMa i seer wed dwY be as xl►riaw MGn M.tr sjamj urea i SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ll"ur v . Si! s art Chi' 5 an I a 8 i ADDRESS: I a ?I a r cowood Ti-a► I FIRE NO: LOCATION: 1bj 1/4, N [J 1/4, SEC 1C W, TOWN OF: ST. CROIX COUNTY SUBDIVISION: LOT NO. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal systemi St. Croix County residents may be eligible to receive a grant to help with the cost of the replacement of a failing system, which was in operation prior to July 1, 1978. St Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to the St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification from will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system,in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification form must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 ~ara~e (7/~~er tax o2Gb ' to ~a~ N ~oase O 1ooOc~a~ Sufic~Onk s Scah ~ "-~o' B3 SloPe 8z II I r I ►f ~ t ~I ay o'Z . ! 1 ors T~ M ~,f e v /00,0, 31y O D Zr. P,y Lul /w-.m F?rn ce Po s r • PAG E OF CROSS SECTION OF A BED SYSTEM Fre6h Air Inlets And Ob6orvation Pipe J^~ Approved vent cop Minimum 12" Above Final Grade 20- 42" Above Pipe _4" Cost Iron To Final Grade Vent Pipe Marsh Hay Or Synthetic Covering min 2" Aggregate Over Pipe Distribution -.Too Pipe 0 0 0 0 0 b" Aggregate 0 Pertoroled Pipe Below Bensoin Pipe -Cuupiing Terminaling At bollum 01 System 601L FILL 2"OF AGGREGATE DISTRIBUTION PIPC--7 APPROVED SYNTHETIC COVCiC MATERIAL OR 4" OF STRAW OR MARSH W1 . 0 1 M • p N b OP/2-21/2 AGGREGATE ELEV. OF •y•n FEET.. JQ„ DISTRIBUTION PIPE TO 6E AT LEAST IWCHES BELOW ORIGIWAI. GRADE AND AT LEASTLO IWCHES BUT NO MORC THAW 42 INCHES OELOW FINAL GRADE r d N MAXIMUM DEFT11 OF LXCAVATIOU FROM ORIGIWAL GRADE WILL BE J O IWCHES MINIMUM DEPTH OF EXCAVATION FROM OKIGIWAL GRADE WILL. BE INCHES - - - I I WE(-vEFZEFZ E3 CJ I L TEST I tVC-i AND I3ES I CGRt SEFZV I CE • P.0. BOX 74 421 N. MAIN ST. RIVER FALLS. VI 54022 715-425-0165 June 27,1991 Gary and Susan Christian 516 Hunter Hill Road #1 Hudson, WI 54016 Dear Mr. & Mrs; Christian; I have reviewed your proposed building site with Mark Larson and feel a new perc test is not necessary. The site tested by Calvin Powers for Coldwell Banker, report dated 5-27-88 can be used with the following condition. The system should be sized in accordance with a class 2 design rate rather than a class 1 as shown on Calvin Powers's report. I recommend this because of the "layered" sand noted in borings 3 and 5 of the Powers report. Layers or bands of slightly different material could restrict water movement to some extent. I feel a class 2 system would overcome this limitation. A class 1 system would be 12' wide by 52' long with a class 2 system being 18' wide by 53' long. The proposed system elevation of 96.8 should remain the same. I have discussed this with Jim Thompson, Assistant County Zoning Administrator, and he concurs. (see sketch below) . a0gyz" I Arthur L. Wegerer C.S.T. No. 000576 cc: St.Croix County Zoning Office Mark Larson B.s s.z I ►~i 1`f'1 Fj L ~ I ~ PTO r i r'1 LD 8.5 I of 7 Zo% I 20~ 6 lir- M wtw, t E s.y s.~ iL Il L.O T 1_10.1 L 8~ - (ffLeo Lo0,0 0' ON 1/,/ "0-D. IRAN S~1PE ~psT- 01)--79 FFFFFFFF A X X F A A X X F A A X X F A A XX FFFF A AAA A XX F A A X X F A A X X F A A X % ST. CROIX COUNTY COURTHOUSE 911 Fours#h S-tneet Hudson,Wl 54016 DATE: 991 TO: FAX NUMBER: -/,q NAME: FROM: FAX NUMBER: (715)386-4628 NAME: NUMBER OF PAGES INCLUDING COVER SHEET: IF COMPLETE AND LEGIBLE INFORMATION IS NOT RECEIVED, PLEASE CONTACT: NAME: U- - TELEPHONE NUMBER: go Q O .-ll;~ l./ Q~