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026-1160-14-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT UN/ f Sanitary Permit No: (ATTACH TO PERMIT) 584751 GENERAL INFORMATION A State Plan ID No: 2699287 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] Permit Holder's Name: City Village Township Parcel Tax No: Steve Dalton TOWN OF RICHMOND 026-1160-14-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: /oo,&0 Losr QC''-CSTf}B & aK/RWIA14S oetb,v 23.30.18.1220 TANK INFORMATION ELEVATION DATA "5r TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 5001 L(SS► Dosing Alt. BM VF-4r pf O /14 (aU0 N H dQ Nod s to 1.3 Aeration W/~~r/~~ N F(G~ Bldg. Sewer s D / Iva. l , l Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ? 30, >7~4 ~ Dt Bottom lv~•~ 13•!s 8'~• 9 Dosing ~k Header/Man. 3. J 6• 35~ 9 .7s Aeration Dist. Pipe lo O l 4"55, . ZS Holding Bot. System ZZ-0) STALL c0A1 lou,(z la1•~ S,l ~'(D•Z PUMP/SIPHON INFORMATION Final Grade 10.1 } ~(.7 > 78 y Manufacturer Demand St Cover on Uu zz hD~CLAS GPM 2•Y A)0.4S Model Number P2_& ~P ~o2/,JGtt 1 to .3 96.y TDH Lift b• V Friction Loss 1Systern,,.Head TDH Ft s~ /z•~ Forcemain Length I Dia. Dist. to Well , RS Z y 7~ ;v3 SOIL ABSORPTION SYSTEM l•~ BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS OI SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: - fTT } l_ I >1U0 fap 'V1 UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution u x Hole Size Ix Hole Spacing t Vent to Air Intake Q Length Dia iLength~+ ' Dia S Spacing 6,1576 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over c~ xx Depth of « Seeded/S dded xx Mulched Bed/T ench Ce ter Bed/T ench Edg s / ITopsoik, / rD Q3~( Yes No Yes ~I No 711 V lC/ a oW~IE/L i+ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~Zz _ 16 Inspection #2:6 -22 ~~(0 Location: 1306 146TH AVE A OR B - PLp"i 0 [C.4 R1 eXP- 7b0 14 t.cS6-1) 10 U•06 VL PLO 1.) Alt BM Description = - G~~ ~N.~~ F/NlsAG'~l Qty ~L~~"• 2.) Bldg sewer length = - amount of cover = a S ' Ott R4D Arno' ~/DES G497_1N!T /T Plan revision Required? Yes No G S Use other side for additional information. (p ZZ 147 SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. x,~erArxryT Count Industry Services Division ~i~c JC Q $ d 1400 E Washington Ave P P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) S 1 LSJON-, a ` Madis on, Vt C--EWER 45,g 14 1 E• 6 Sanitary Permit Application MAY 10 2016 State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the a ro~p?ria,,t,e,gve ll1~ unit 2 -7 is required prior to obtaining a sanitary permit. Note: Application forms for state-oz d %WT~S tthd the Department of Safety and Professional Services. Personal information yoSQgM~d W, a to Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(1)(nt), Stats. ~ 1. Application Information - Please Print All Informati •(•+~"~p~. Property Owner's Name i Parcel # Property Owner's Mailing Address Property Location Zd 93 (~il-- liar- ,(-)A • Govt. Lot Ci State t , Zip Code Phone Number rL' N 14, Section 2- 3 (circle op;) ~'1'►'/ ~'2 S f 7 L T :'C N R E o II Type of Building (check all that apply) Lot # 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name ❑ Public/Commercial -Describe Use O t`' Block # Ac, C~C ~N .7 ~o J i ' ❑ City of ❑ State Owned - Describe Use 2 d CSM Number El village of K Town of J S k9* r C~rrn vA- III. T e of Permit: (Check only one box on line A. Com lete line B if applicable) 2nd A-c- A. New System ❑ Replacement System ❑ Treatment/I folding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List P evious Permit Number and Date Issued Before Expiration Plumber Owner IV. Type ofPOWTS System/Component/Device: (Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) V. Dis ersal/Treat nt Area Information: Design Flow (gpd) Design Soil Application Dispersal Area Required (sf) Dispersal Area Pro ed (sfj System Elevation Q~j 1/ j 0 Rate(gpdsf) a6 V/~ I ;O Y / 1✓ 1 VI. TTank Info Capacity in Gallons GaTotal 4 of llons Unit manufacturer / 4 c w s Nett Tanks Existing Tanks err J Septic o Holding Tank d'rJ cs ( ~k / [9 El ❑ E-1 Q using Chan er 600 0 ❑ ❑ N'11. _Responsibility Statement- I. the undersigned, assume responsibility for installation of the PONI TS shown on the attached plans. PI m is Name (Print) Plumber's Signature MP/ 1PRS "umber Business Phone Number C. ~t f vv ~ ti S ~z ter- Qv. Z Z 2- 7 Z 7/J J 3 Plum er's A dress (Street, City, State, Zip Code) 0, t:pl- ta I ,t v Q VIII. County/De artment Use Only ppruved Permit Fee Date sued Issuin- ent Signature r Given Reason r Denial S IX. Conditions of Approval/Reasons for Disapproval SYSTEM O NER 1. septle"rk, effluent filter and dis : r,i cell roust all be seti_~Jces !ma nta'ref as pW rraragement plan provided by plumber. / l A, 2. -AN isa!ttitiok re(}ttirements must I:ie•mairtt6 id as per aWlicable code 1 ordinanaea. Attach to complete plans for the system and submit to the County only on paper not less than S 1/2 x 1I inches s /I 5 3) 0-64 Coj 11,, 5d-t-t.. (back, ~i•G~~.~..~- ~t~ t a~ w! AN eer,,^F4-! tee-- 3 ~ I w S ~ TIP Q 2 \ O I~ cs- T 3 l M S J lv _ i !'aR7sr DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54843-6462 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov \~ssioN~ Scott Walker, Governor Dave Ross, Secretary May 04, 2016 CUST ID No. 222872 ATTN: POWTS Inspector JACQUE M HAWKINS ZONING OFFICE HAWKINS SOIL TESTING & SEPTIC SYSTEMS ST CROIX COUNTY SPIA PO BOX 2 1101 CARMICHAEL RD LUCK WI 54853-0002 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/04/2018 Identification Numbers Transaction ID No. 2699287 SITE: Site ID No. 823347 Steve Dalton Duplex Unit a Please refer to both identification numbers, 146TH Ave above, in all correspondence with the agency. Town of Richmond St Croix County S1/2, NWIA, S23, T30N, R18W Lot: 14, FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 159797<< Maintenance required; 450 GPD Flow rate; 56 in Soil minimum depth to limitinu kicl or Cron, ~11_i2in di L" a"W~ ~ "'C11 i s At-grade Component Manual, Version 2.0, SBD-10854-P (N.03107, R. I%I?), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed 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. 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: This approval is for the .A duplex portion only. This is a three bedroom designed at-grade. Reminders • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. 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 Industry Services 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. 1ACQUE M HAWKINS Page 2 5/4/2016 The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 J This Amount Will Be Invoiced. When You Receive That Invoice, Carl J Lippert Please Include a Copy With Your Wastewater Specialist , Division of Industry Services Payment Submittal. (715)634-5035, M-f 7AM - 12PM WiSMART code: 7633 carl.lippert@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm JACQUE M HAWKINS Paee 2 5!4%2016 The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely. Fee Required S 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Carl J Lippert Please Include a Copy With Your Wastewater Specialist, Division of Industry Services Payment Submittal. (715)634-5035, M-f 7AM - 12PM WiSMART code: 7633 carl.lippert@wisconsm.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 Monday - Friday 8:00 am To 430 pm RESIDENTIAL AT-GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET Project Steve Dalton At-Grade Mound "Duplex A" Owner Steve Dalton Address 930 Brave Drive Somerset WI 54024 Legal Description Part of the S1/2-NW1/4 Sec. 23 T30N-R18W Township Richmond County St. Croix Subdivision Name Whitetail Meadows Lot No. 14 Parcel ID Number 026-1160-14-000 - Plan Transaction Number OF SAFETY AND ,ONAL SERVICES Index sheet Page 1 Calculations Page 2 At-grade drawings Page 3 Laterals and dose tank Page 4 / Specifications Page ' Management & contingency plan agg L CUi",p i=ce 4 Y; L= Pump curve & specifications Page 7 Plot Plan Page 8 lj01 ~5 c~c 7Ei Designer Jacque Hawkins License Number MPRS# 222872 Signature i ri.~t-~• Phone Number l 7 Date /13/16 Designed pursuant to: At-grade Component Manual Ver. 2.0 for POWTS SBD-10854-P (N. 03/07), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (03112) Page 1 of 8 PRESSURIZED AT-GRADE DESIGN At-grade Design Worksheet Sloping Site Flows and Site Data Entry. (r or ~r Residential or commercial? 300.0 Estimated wastewater flow (gpd) 450.0 Design wastewater flow (gpd) 3.00 % Site slope 95.90 Contour elev. below lateral (ft) 6.6.00 Depth to limiting factor (in) In-situ soil application rate (gpd/ft^2) Distribution Cell Information (1 or 2) _ 1 Influent wastewater quality 8.00 Linear loading rate gpd/ft 8A0 Effective absorption width (ft) 10.00 Max. effective width permitted (ft) 94.00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) s~ c Center or end lateral connection 2 Number of laterals 0.156 Orifice diameter (in) e.g. 0.25 _ 2 00 Estimated orifice spacing (ft) calculation 2.00 Forcemain diameter (in) 2.63 Forcemain flow velocity (ft/sec) _ 40.00 Forcemain length (ft) y or n Does forcemain drain back? 88.00 Pump tank elevation (ft) y or n/ Are laterals at highest point? 4.55 System head (ft) x 1.3 NA 7.57 Vertical lift (ft) 6.5 Forcemain drainback (gal) 0.59 Friction loss (ft) 42.0 5x Lateral void volume (gp: 0.00 In-line Filter Loss (ft) 48.5 Minimum dose volume (gai) 12.71 Total dynamic head (ft) 25.8 System demand (gpm) Lateral Diameter Selection Gallo_nsllnch Calculator (optional) Pipe diameter Design options Design choice Total Tank Capacity (gal) i:resigner 1 in Total Working Liquid Depth (in) must select, 1.25 in X Gal/in (enter result in cell G46) one lateral 1.5 in X X #ianieter 2 in x Treatment Tank Information 3 in x - 1000~Septic tank capacity (gal) Skaw VConcrete Manufacturer Effluent Filter Information Dose Tank Information {Lifetime Filters LLG Filter manufacturer i 642.3 Dose tank capacity (gal) LT 1/8 Filter model number j 16.5 Dose tank volume (gal/in) ;Skaw Concrete a ]Manufacturer Project: Steve Dalton At-Grade Mound "Duplex A" Transaction Number: Page 2 of 8 AT-GRADE PLAN VIEW B A 8.00 ft D 1/6 B Observation pipes (2 typic7al) 94.00 ft t- 1/6 B 15.67 ft C 10.00 ft W D 5. 00 ft E 2.00 ft L 104.00 ft D B W 20.00 ft A x B 750.00 ft^2 L T T r~ Cap rT = Total aggregate cell A x B Slone l obs. plow. Slotted in the lower 6", and i = Plowed area L x W anchored securely. 6" AT-GRADE CROSS SECTION Synthetic fabric cover 97.69 ft Finished grade Lateral elevation invert elev. 96.40 ft Observation pipe at aggregate toe E 3 % Slope Surface contour 95.90 ft C A and system elevation D F777= 12 in, topsoil and subsoil over aggregate and tapered to toes. Plowed layer below LxW = 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: Steve Dalton At-Grade Mound "Duplex A" Transaction Number: Page 3 of 8 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection I P 1 1~ xl2, I 0241 Laterals & force main of PVC Sch 40 Last hale drilled next to end cap per SPS Table 384.30-6 Hater drilled on t he bottom of the lateral. equarlyspaced • Tu rn-up wfball valve or al4anout plug i Lateral Specifications 0.156 Orifice diameter (in) Center Lateral connection point X 1.95 Orifice spacing (ft) 2 Number laterals 24 Orifices/lateral P 45.83 Lateral length (ft) 12.9 Lat. discharge rate (gpm) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) 25.8 Sys. discharge rate (gpm) 40.00 Forcemain Length (ft) 12.71 TDH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather-proof warning label and locking device junction box Final grade 4" disconnect Tank component is Alternate properly vented V-, outlet location 18" min. Electrical as per NEC 300 and I~ Approved SPS 316.300 WAC outlet Tank full joint c Inches Gallons JA Provide 1/4" .2 A 24.0 395.8 Alarm on weep hole or B 2.0 33.0 antisiphon _ C 2 9 48 5 Pump on B device. 6 D0.0 165.. 88.83 ft C Totals 38.9 642.3 11 Pump off D LL L 3" Bedding under tank ~ 88.00 ft ;Goulds Pump manufacturer ISJE Rhombus Alarm manufacturer 'EP04 ~Tm Pump model number 'Tank Alert 1 Alarm model number Project: Steve Dalton At-Grade Mound "Duplex A" Transaction Number: Page 4 of 8 At-grade System Maintenance and Operation Specifications Service Provider's Name Powers Sarntation Phone 715 246-5738 i 3 POWTS Regulator's Name St Croix County Zoning Phone [Z_15-386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 750.0 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 vears C ala1 ~r Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the at-grade component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 1 All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. 'The at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at-grade component manual SBD-10854-P (N. 03/07). Lateral Turn-up Detail Finished .••®•®w®••a•••• •e•••~•®•a•®••• Grade v1 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution ~ Long Sweep 90 or Two 96.40 ft 45 Degree Bends Same Diameter as Lateral Project: Steve Dalton At-Grade Mound "Duplex N' Transaction Number: Page 5 of 8 At-grade System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10854-P (N. 03107), SSWMP Pub. 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706 (N. 01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic, tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At-grade and Pressure Distribution System No trees or shrubs should be planted on the at-grade. Plantings may be made around the at-grade's perimeter, and the at-grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at-grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the at- grade be heavily mulched as protection from freezing. Influent quality into the at-grade system may not exceed 220 mg/L BOD5 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at-grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. I' Project: Steve Dalton At-Grade Mound "D Transaction Number: Page 6 of 8 Page ? of 8 rGOULDS' PUMPS Submersible Effluent Pump EP04 3871 EP05 APPLICATIONS • Fully submerged in high ■ EPOS Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for e lubrication and efficient improved performance. construction. following uses: heat transfer. • Effluent systems ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation, Auto- superior strength and corrosion resistance. Heavy duty sump matic models include • Water transfer Mechanical Float Switch N Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "C" or 7".) factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic GwIds Pt npsisISO90M Awpured FEATURES cover with integral handle and • Solids handling cal,abili,y: - float switch attachment points. 114" maximum. N EP04 Impeller: Thermoplas- ~ Power Cable: Severe duty • Capacities: up to 60 Cl'i.J. tic Semi-open design with rated oil and water resistant. • Total heads: up to 31 pump out vanes for mechanical • Discharge size: 1'l." NY, f. seal protection. • Mechanical seal: mrborn- rotarylceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40`1C) continuous 140°F (60`1C) intermittoii:. MrTEns rEer 10 • Fasteners: 300 sera ~s stainless steel. 9 30 s GPM, • Capable of running dry without lama gc to a 2s rr components. 25 Motor: v 6 • EP04 Single phase 0.4 i,P 20 115 or 230 V, 60 FIr, 15:;0 RPM, built in overload v, th o s 15 automatic reset. a ; • FP05 Single phase: 0_5 "P, o EPOS 115 V or 230V, 60 viz, 1.,50 3 10 RPM, built in overload v, ith EP04 ~ automatiC reset. 2 • Power cord: 10 foot s 1 i standard length, 16,13 S1TOW with three )pond grounding plug. Optionni 20 ° 00 10 zo 30 as _ so GPM foot length, 16/3 SiIVJ ~).ith three prong grouncinr) i~'ug 0 (standard on FP05). 2 4 6 a 10 12 m3/h CAPACITY Goulds Pumps 0 2001 Goulds PUMPS ITT Industries Effective May, 2001 83871 qt w ,u cn oo ' ~ a ~ y._. 0 'Q13 J L o OZ9'28'E- 1r99•la , I CV z d 1 SOO'29'29'E 57130 L~ -JR" Ju244.21' O 00'29'28"W- 199.58' L* - _ R b F`D I Job m S y -•40.18' 7.45'-~ 37.64 'Olt 0I ' 04 0 43 C'j E$ ray ! \ ~I Jy ° 01 O CL cn .1 -4 C4 C-41 0) co ~OI 0-'l v~ C) ` w I Itt ZYI CD 14V J r h^ n! J go N K f on A / .40 O> ~ N .N z Z, i p h. i d3M0ild .59. W'$ O1 ~!.oe .a ER I r.- - ` - - -SS300Y !03810 ON- - \A%O ti of -,arsztt- ~f -,ooslt o9sas- ^ ~a1•g~- -ob'`-L; - , - .o ,ZOr,Q~G>7S :,r`ft'LC QO'4CL^ - - 3.~£.Ff~WS _ 4 ,t1,po -,90'918- AN.R.AZOOOK 000 *11-#N OW Jo ~ .S'9..l t+' .l d'UI76f131 ~'1S ►a l'LS9L 99e MM 49e1r /,IL~OON i3/~ -.Y) ° vua aa~,. a..a..aa♦a. aa.. ii..i_. LUiJ aViWL~1L.1 AND OWNERSHIP CERTIFICATION FOR.wI OwnerBuyer _S f'f v FD) ~'b lU Mailing Address 5'J O BA., -,e Q,:, - JO1_P71r:-c.- 5 r fi ~iv. ~ o ~c y L 72 Property Address (Verificatior. required from Planning & Zoning Department for new construction.) Cim/State / w K , c yr d /L" Parcel Identification ?umber G 2_6 /G l LEGAL DESCRIPTION Property Location ~5 Z.x fy 1/a Sec. Z 3 . T 3o N R W. Town of C,4" " ,n,Cl Subdivision Plat: ICU), , er 4~ Lot = 1 41 . Certified Survey Map # Volume . Page= VG'arranty Deed # (before 2007)Volume Page # Spec house . yes~)no Lot lines identifiableAyes = no SYSTEM NLkI TEN A'SCE -A-ND QWNER CERTIFICATION 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in MS. 383.52(1) and in Chapter 12 - St. Croix Counts Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verif}ins that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary). the septic tank is less than 1'3 full of sludge. Iwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth. herein. as set by the Department of Safer, And Professional Services and the Department of Natural Resources. State of Wisconsin. Certification stating that your septic system has been maintain°d must be completed and returned to the S-. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I,we certifi that ali statements on this form are true to the best of my-our knowledge. I we am'are the owner(s) of the property described above, b- virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms ~ pk/4;- SIGNATURE OF APPLIC_A,NT(S) DATE ***Anv information that is misrepresented mai result in the sanitar} permit being revoked by the Planning & Zoning Depa-=: -nt. include with this application a recorded w-arrann deed from the Register of Deeds Office and a conN of the certified surve- mar if reference is made in the warrant\ deed. (REV'. 04,112) c she go~€ A% l 1111 IN In jij.-ilgl a TFg o~•~H` - Q Q =Z) II ~ I NLL~ - I I j 1 `f...• I I I ~1 1 I II ~ ~~J _ ~b I I I III 1 - ~ ; 11111 LEE] \ CCD I I ❑~~1 L:J , Cat-=J Cam. %0 ` e 1 p t,•n II I) a. .i; ~ I~t(.~l 41 r, ~~frll u„ I ~ I L~J ~~Illll 9 e aim 'a.a 4 t ST. C► - :JIX COUNTY • fr ti WISCONSIN - ZONING OFFICE T' ~~r..r..■--_ ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road w Hudson, WI 54016-7710 (715) 386-4680 • Fax (715) 386-4686 June 16, 2004 File Ref: 10-04 Dal Stock, Inc. 1748 112`" Street New Richmond, WI 54017 Re: Board of Adjustment Decision Dear Applicant: The St. Croix County Board of Adjustment has reviewed your request for a special exception permit for five two-family dwellings in the Ag/Residential District and has approved this application with conditions. The enclosed document is the formal decision regarding your application. Should you have any questions or concerns, please do not hesitate in contacting me. Sincerely, Rod Eslinger Interim Zoning Director dz Enclosure cc: Donna Ray, Clerk, Town of Richmond, w/enclosure Ty Dodge, JEO Consulting, w/enclosure Pete Kling, LWCD, w/enclosure i i FINDINGS, CONCLUSIONS, AND DECISION OF THE ZONING BOARD OF ADJUSTMENT ST. CROIX COUNTY, WISCONSIN Case: 10-04 Applicant: Dal Stock, Inc. Complete Application Received: March 15, 2004 Hearing Notice Publication: Weeks of April 5 and 12, 2004 Hearing Date: April 22, 2004 FTNDTNGS OF FACT AND CONCLUSIONS OF LAW Having heard all the testimony, considered the entire record herein, and conducted an on-site inspection, the Board finds the following facts: 1. The owner of the property is Dal Stock, Inc., 1748 112th St., New Richmond, WI 54022. 2. The property is located in the Whitetail Meadows Subdivision, 146th Avenue, New Richmond, Wl, in the SW 1/4 of the NW 1/4, Section 23, T30N-R18W, Town of Richmond, St.Croix County, Wisconsin. 3. An application was made for a special exception permit to construct one twinhome on each lot (lots 12-16) of Whitetail Meadows, for a total of five twinhomes. The Board of Adjustment finds that the requirements have been met to grant the special exception pursuant to Section 17.15(6)(a) of the St. Croix County Zoning Ordinance. 4. The Town of Richmond has recommended approval of the request. 5. There was no opposition to the request. 6. The plans for the project have been designed by a professional company and will be professionally installed. 7. The Land and Water Conservation Department has approved of the request with recommendations stated in the conditions. 8. The Board finds that the location chosen in the subdivision is an appropriate place for proposed twinhomes to be constructed. 9. The Board finds that the twinhomes will provide affordable housing to the residents of St. Croix County. 10. The Board finds that the request is not contrary to the public interest. 11. The Board finds that the spirit and intent of the ordinance would be met by granting this request. DFCTSTON On the basis of the above Findings of Fact, Conclusions of Law, and the record herein, the Board approved the request for a special exception pen-nit for a two family dwelling in the Ag/Residential District with the following conditions: 1. This permit allows the applicant to construct one twinhome (two family dwelling) on lots 12-16 of the Whitetail Meadows Subdivision. For any other use, the dwelling would have to fully comply with the provisions of the St. Croix County Land Use Regulations. 2. The applicant shall demonstrate to the Zoning Office that each lot has an area sufficient to accommodate for the Private Onsite Wastewater Treatment Systems (POWTS) serving i the structures before this permit is valid. 3. Applicant shall secure a sanitary permit for each structure from the Zoning Office and a building permit prior to commencing construction. 4. The best management practices (silt fence) must be installed before commencing grading activity (site preparation) for the project per recommendation from the Land and Water Conservation Department. 5. In an e-mail dated April 5, 2004 from Pete Kling, the LWCD has reviewed and approved the request with three comments. The applicant shall comply with the following recommendations made by the Land and Water Conservation Department: 1) Constructing the driveways all the way to the building pad would be ideal and provide an even better construction entrance for the twinhome construction; 2)Require twinhome construction to adhere to the Uniform Dwelling Code erosion control procedures identified in Comm.. 21.125; 3) Additional erosion control maintenance. In addition to the silt fence around the existing wetland, require twinhome builder to accept the responsibility of maintaining and repairing existing erosion control practices (erosion mat and temporary ditch checks) in the west road ditch from station 2+00 to 11+00. 6. Applicant to maintain at least 1 '/2 off street parking spaces for each family for which accommodations are provided in the building plus one more space per building per section 17.57 (2). 7. The property shall be kept in a neat and orderly manner. All outside storage of garbage containers shall be screened and protected from rodents. No junk, junk cars or garbage shall be allowed to accumulate on the property that may attract rodents or pose a threat to the health, safety and welfare of those citizens of St. Croix County. 8. All driving and parking areas must be provided with a dust free surface (asphalt/concrete/road millings, etc...). The applicant must submit a paving plan to the Zoning Office prior to commencing this project. 9. Any proposed lighting is to be directed away from neighboring properties. 10. The Zoning office is to be notified at the start and the finish of the project. 11. The applicant must allow free and unlimited access to the project site at any reasonable time to any Zoning Office employee to inspect the property for compliance with these conditions. 12. Any change (or addition) in use, or expansion of the project, including building, signage, shall require review and approval by the zoning administrator and in some circumstances through the Special Exception approval process, where applicable, as stated in the ordinance. 13. The applicant shall have one (1) year from the issuance of the special exception permit to commence the construction. Failure to do so shall result in revocation of the special exception permit. If the special exception permit expires before business commences, the applicant will be required to secure a new special exception permit before starting or completing the project. 14. These conditions may be amended or additional conditions may be added if unanticipated conditions arise that would affect the health and/or safety of citizens or degrade the natural resources of St. Croix County. Conditions will not be amended or added without 2 i I notice to the applicant and an opportunity for a hearing. 15. Accepting this decision means that the applicant has read, understands, and agrees to all conditions of this decision. i The following vote was taken to approve: Peterson, yes; Maraolf, yes; Krueger, yes; Golz, yes; Chairperson Speer, yes. Motion carried. APPEAL RICMTS Any person aggrieved by this decision may file an appeal in St. Croix County circuit court within 30 days after the filing date shown below, pursuant to sec. 59.694(10), Wisconsin Statutes. St. Croix County assumes no responsibility for action taken in reliance on this decision prior to the expiration of the appeal period. St. Croix County does not certify that the identity of all persons legally entitled to notice of the Board of Adjustment proceedings, which resulted in this decision, was provided to the County. If an appeal is taken of this decision, it is the responsibility of the appellant to submit at his/her expense a transcript of the Board of Adjustment proceedings to the circuit court, which is available from Northwestern Court Reporters, Hudson, Wisconsin. It is the responsibility of the Board of Adjustment to submit its record (file) of this matter to the circuit court. 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J(t - i ?lye .,t ?I9 Ia}!l. !1 d E ~ ~ :r ~t }iii 77 ! 1 4S I :d yl to I..i:•-yE ~ l i y4 pc" 1 a a g ~ € € ill! P1111 € ill Hill ~ V sg eo Dpgeg ~Y cO~ § o _ 1 z 90 ' r v M. 4 ~~Y & >e O - 4 S * tt 0 ~g~a$ $ Wisconsin Department of Safety and Professional Sees Division of Industry Services MAY01L lALUATION REPORT Page of in actor MUN @kjW Adm. Code in WpMI~' County 37t Attach complete site plan on paper not less than 8 112 x 11 inc es in ust include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Z It, -0e 0 Please print all information. Revie by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). (5 /c3 A0 Property Owner Property Location Govt. Lot 114 ~j ~dlA Z aJ T ~ N R /'8 E (or) Property Owner's Mailing Address Lot # Block # Subd. Name r CSM# 930 bl- /Y 1r dcviCity State Zip Code Phone Number City EjVillage Town Nearest Road LG _2'V '10'1)/y~ ih eve New Construction Use[] Residential / Number of bedrooms Code derived design flow rate GPD ri Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: Pv, t2 l K 6 F/I n Boring Boring # in. Q Pit Ground surface elev. • y ft. Depth to limiting factor 1> SILO Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 5-11 L / o y 2 j3 -3 I amr ~blc . , ~s / ' 31 Boring # Boring Fd-1 94 Pit Ground surface elev. . 4" ft. Depth to limiting factor > 601 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 27 r11-n fl-- 3 v 7 c 3 70l ? S`1 '/4~ SC' l rm c 6,Ce - - 3 ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD< < 30 mg/L and TSS < 30 mg/L CST a e (Please Print) Signature CST Number cxe4~kE' a~-S ZZZS,z- Addres f Date Evaluation Conducted Telephone Number cJ ~oz/-~7 SfJB SBD-8330 (R07/13) II(.U I Property Owner D Cc Parcel ID # - / Page a of F 7~ Boring # Boring gS j J/ 3 Pit Ground surface elev. ft. Depth to limiting factor J / 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 57/ VY~ 0,5 Ilan s1/)may yiy se's Z/n~s~,(yr v c s %vf" c~ El Boring # fl Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 ~Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 `Eff#2 ' Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L SBD-3330 (R07/13) w rA O\ ~ J s 74 C M w T 1°N ©v O, J 1~ ~ _ Q1 \ z' cs- 1 C ~J ® t v C2 nn o _ 7- r ca Z c~ - ~ h ra ~ ~ r h Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 584752 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2699289 Permit Holder's Name: City Village Township Parcel Tax No: Steve Dalton TOWN OF RICHMOND 026-1160-14-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 100.60 GoSr ES 1 IS//- I 6rJA44 A)45 6057' 23.30.18.1220 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 5FVq W` /0v0 Benchmarks Dosing - Alt. BM - Ldln RP " (000 P OfA4r111 H 106,E (a Aeration g. ewer v n/ t/FF ~n~ ~ ~i0r~'~ oz. I~ 97 Z Holding SUHt Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic loo` (,Co, Dt Bottom Dosing Header/Man. Doz. ~ y 97 Aeration Dist. Pipe 11.97 Holding Bot. System .%Nsr141L 401VT411 100.8 3 170 d PUMP/SIPHON INFORMATION Final Grad 102. (o 3.7 ~ n Manufacturer Demand St Cover ? pq V u GPM GVe✓ Z_-' 7• 7p/' (!O~ Model Number t / EPa 7 TDH L Friction LL1oss System Head TDH Ft co. g 7 yfo 1. I I O_ Forcemain Length , Dia. Dist. to Well t SOIL ABSORPTION SYSTEM Inside Dia. Liquid Depth BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of is DIMENSIONS 8 9y~ - - SETBACK SYSTEM TO 7 P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: , UNIT Model Number: AT_ 61ZA1)F ''-lol 'loo >laa •J/A DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size s x Hole Spacing Vent to Air Intake _ Pipe(s) 7 t Length - Dia Lengtht (P'I'NG Dia Spacing 3G• /CZ, SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over i Depth Over xx Depth of =_Seede~dloddecl xx Mulched Bed/Trh Center Bed rench dges Topsoi Yes No YesNo COMMENTS: (Include code diiscc~repencies, persons present, etc.) Inspection #1: (a Inspection #2: / - ZZ 140 306 146TH AVE A ORIB ! P(,Oc.J o 4 f tZ I e, Gi- I-,pen` 444 /Z1 6q1-Vt rl C>h~ W Location: 1 6T 1.) Alt BM Description = V - goo ~,4T) <c)/w F~,(J~7 P(~St I LAA), 70 2.) Bldg sewer length = 60` ' w A1f Eu-7UNf Qi ~~N/S(•(~ (n&7e 'n - amount of cover = >5' - /tIUT C R('~ 4-r Plan revision Required? I Yes ~k No Use other side for additional information. 7,~ SBD-6710 (R.3197) Date Insepctor•s Signature Cert. No. sftr+r~T County Industry Services Division D 1400 E W t Sanita Permit Number (to be filled in b Co.) SPS P.A VED ry Madison, WI 53707-71 2 A ~",Al 0 07 Sanitary Permit Applicatio State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this fore ~Mwsl µp, z 9 V / is required prior to obtaining a sanitary permit. Note: Application forms for t he Department of Safety and Professional Services. Personal information you provide may be used for secondary Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. ~ 13&0 ~ to ~fh 1. Application Information - Please Print Ai nformation Property Owner's Name Parcel # a_~fU Property Owner's Mailing Address Property Location 6 B /,_,t 1/ L" • Govt. Lot ' City, State Zip Code Phone Number A Section G 3 f t Ai ✓ Q j-- ?/j- 766 _2-flV 7 (circle o e) 17'0ZY, t14-5 J T A) N R 11. Type of Building (check all that apply) Lot # / ~ division Name [2'1 or 2 Family Dwelling -Number of Bedroom Sub ❑ Public/Commercial - Describe Use O Block ~r-~, ! ! f k dD:N S ❑ Ciq of ❑ State Owned - Describe Use to l %1 yy CSM Nu er ❑ Village of~ / J l •~]Town of U` : ~1mi ir~U L1. G E x -6 * 94 111. T e of Permit: (Check only one box on line A. Complete line B if applicable) A. (Jklew, System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System/Component/Device: (Check all that apply) AA-Med • ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground O-At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) V. Dispersal/Treat nt Area Information: Design Flow (gpd) Design Soil Application Dispersal Area Required (s Dispersal Area Pro seed((sf) System Elevation Rate(gpdsfl .7, 5 '~~c1-7 ✓ --~1`~t) ~G V1. Tank Info Capacity in Gallons Total # of z ° Gallons Units Manufacturer V V _2 V L Ne%~ Tanks Existing Tangs l r _ r - Septic Holding Tank de $0 SKu w ® ❑ ❑ ❑ ❑ fosingChamb K (nd[ti ❑ ❑ ❑ ❑ ❑ VI1. esponsibility Statement- 1, the undersigned, assume responsibility for installation of the POAN'TS shown on the attached plans. Ph tber's Nance (Print) Plumber s Signature \I SIP Number Business Phone Number L4 f 7 91 _15,390 Plu tber's ddress (Street. City. State, Zip Code) v VII . County/De artment Use Only Approved ❑Dis Permit Fee Date Is led Issuing g t Signature O~ rr &LM.0~_ n en Reason r Denial $ (511311 IX. Conditions of Approval/Reasons for Disapproval SYS • OW 1. to . ; effluent finer itnd i7isp m*1 cell must all be services / rn~inL ne_ as per management plan provided by plumber L/ P~nJ / ° 2. AY seStxCk regWmraents must,ta ~,ain kiid / as per applicable code / orrdinai . Attach to complete plans for the sst and submi to the Counh on n pa er no t ss than 8 1?2 x t i inches in size 3 &Q, e L ' ~ r Perm .