HomeMy WebLinkAbout040-1303-00-070
Saret:,n r;in C^partmen7 of Curnm[rr^ PRIVATE SEWAGE SYSTEM .,"`.°i'.
Safe;y ane Bcildine Dr.~ision .St. Croix
INSPECTION REPORT Sanitary Perm t No:
GENERAL INFORMATION {A7 FACH TO PERtvIIT 584743
State Plan ID tJo
Pc-soral information y❑u provide may be dS:rri for secondary p,rpuses ~Pr vacy -a v. s 15 o4 (11(m)j. 2701 765
Permit Holder's r.artle. City Villaqe Township Parce Tax No
Oevering Homes LLC TOWN OF TROY 040-1303-00-070
CST Bbl Elev nsp P,N c BM L'est:r of om,
1 SectonfTewn,'Range.Vap No
J I d:` 22.28.19.1805
TANK INFORMATION ELEVATION DATA
TYPE NIANUFA Tl1F 1 CAPACI-Y STATI'N BS HI FS FI FV
i,
Septic
j l , ~ t3enchmark „ ,
Dosiru~ r dd t I ~ L 1~ j Li,~ 1 _ _
1 Alt BM
l.:I) i,
Af".4 n , / r Blag. Sewer v
1lofding
i ~ St!Fit Ltiet
TANK SETBACK INFORMATION SUHt outlet
TANK TC P; WELL BLDG vent to Air Intake RpAp Dt Inlet
l
Septic ' i Dt Bottorr
~l.Z
Dosing r• ' HcaderiMan.
f /
Aeration
Dist. Pipe ~~r
HolCing
Bot. System ;
PUMPISIPHON INFORMATION Final Grade
Manufacturer
Demar}tj SI Coyer
Model Numce, x -
~S~ ~o f ~G'G.U S. o _
TDH Lift Friction Lass System Head,- TD
Forcemain Length Dla Dist. to bVell
SOIL ABSORPTION SYSTEM( i'
BEDrTRENCH YVid h Leng No. Cf Tmr-.rer. PIT DIMENSIONS `.o Gf P is Ins de D., Liquic Depth
DIMENSIONS `
i
SETBACK SYSTEM TO P(L B'_DG WELL LAKE/ST%EAM LEACHING Marutaclu'er
INFORMATION
Typz )(.Systc~rt ` CHAMBER OR
- I y~ ) " UNIT Model Nurnbe-.
i
DISTRIBUTION SYSTEM i, lit Ntp
HeaidecManrfold _ Distribulwn
= oe s _ l r x Hole Size r x -cle Soacing _1 I Dent to Air Irtake
Leny:h_ ' Dia Le~gW j
L - L•_ Spacing f ; y. L
SOIL COVER x Pressure Systerns Only xx Mound Or At-Grade Systems Only
Depin Dver i Depth Over xx G^--Pth of rx Serdec!Sodde'j lulcltecl
pedrTrench Center
' Bed! I enrh Edges 1 To soil
p / Ye Ll No
_ 'Yes No
COMMENTS: (nclude code disrrepencies, persons present etc) Inspection #1. Z g ection #2:
Location: 249 WAI NUT HILL WAY II } 1 ' l I
r ' d~ l-~J f 1! f_ j N
1 ) All BM Description = ) ~ Q ~CVQ,~
2 ) Bldg sewer lenqth = WWI ~1
- amount of ccvejrJ= w
/ u21t ~I I ~ L~
Plan revision Required? ❑ Yes LNo ~F ! I I 1 i f )p 1 !
Use other side for additional information. YfI'~ I Y
SBD-6710 ;R 191; Date htsepctor gnature Cert o
PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
'SE 1:4 SE 1/4S 22 iT 28 N/R 19 w TOWN Troy COUNTY ST. CROIX
SYSTEM ELEVA'T'ION 96.7' 1.2' Sand Lift 4/22/16 BEDROOM 3
DATE
CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE 'L'ANK SIZE 630
HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none
BENCHMARK V.N.P. NE lot corner stake ASSUME ELEVATION loo, Filter Lifetime Filter
❑ BOREHOLE a WELL * II. R. P. same as benchmark
All piping shall be ASTM SDR 30%34, within
IW of tank, piping shall be ASTM F891 Scale = 1/4' = 10'
Property Line
i'
Grading is to be done to Scale - 1 /4~1 _ 01
1 Acre Lot B-2 divert run-off away from
96.5'
\System
95.5'
B-1
9 4.5'
7% Slope
'El
B-3
Property Line
~Ilstern ea 1 5' be I ow
i3 to
emain
ndisturbed
~ Prr-t,„ Line,
Huffcutt Combo Tank
Pro 3
Bed roo m
House Tank is to be properly
bedded and provided with
lockdown covers with
approved warning labels
Well is to meet al I WDNR setbacks
Town Road
VE__ _ Count}'
!r>~ _ ~ ~ Safety and Buildings Divisio ~ ( <<' /x
i f 9 - ~ p 2C1 lN. Washington Ave., P.O. 8, 2
P f. S Permit Number (to be fiLtd ir. by Co.)
Madison,Wl 53707-7
\ OIX COUNTY
1Y BEVELCMENT 1S J
} Sanitary Permit Application oni;nnber in -cL"auce %i'h SPS 3832! (2), JL'i. Um Ccdc; submis•:ior: ut th:s form to the appropriate govetnmenTai omit - -7
7
is requiird prior to obtaiilT a Sanitary 'x"=. Note Applicaujori furms for state-ow-red POIWJs due submi=d to Yr ect.Address if diBerent thae trailing address)
the Dciia tment of Safety and Professiotia! Servies. Pc scmal infiyrm uton you provide may be u-.rd f.,r secondary
ptns : rrdance Information theon - - plPleaFse Print DS All,C4{'1 Nm
1. Application _ 24Q
lnforma ' l-- r
Pry xr r > n-ten's Name
°aar/rm1yir'
I Property Owner's Mailing :wdtrss I Property Location
ry, State Zip Code T phanc Ktnnt,er
!'y Sedum j
>n,e e
ii. ype of Building (check all that apply' t T N; R ,r u
1 or 2 Family Dweil'u- - Ntunber of Bedroo Subdivision Name
~~/7/ ~f
Q Pubhc)Commer~ial - Describe Use 011-- I I y y of
❑ City of
f State Ouved - r$ribe Use _ i_!s M Number _ illage of _
Town of i
r 5 4~
III. Tvpe of Permit: (Check only one box on line A. Complete line B if applicable)
A. rliew S stem J R
Y ep'.aceme ii System U TreatrttentHolding Tack Replacetncnt Only
I Other Modification to ExistirtF Syst.^m iexp,ain}
B. ❑ Permit Renewal Permit Rev siou Change r f 'lumber `Perm? Traasfrr to New List Previotu Permit Number and ]late ]ssuej
Befixe Expiration i
IV. T 1 i Qwnc d-
yM ofPOWTS Spstell-fCm; onentDDeyice. (Check xll that apple) - -
❑ 'Non-Pres;.ai r-d In-Ground- ❑ Fiess ira d In-Ground ^ AtyJrade ❑ Mound _ 24 ir.. of suitabie soil d < 24 in. of %imable soil
Holding Tank CJtbc Dispersal ( rxi pcttsent (explaini - LL Nctrcaamert rJeviic (explain)-
V'. Dis rsallrreat eat Area Information: -
7esi_sm Flow ;gpd) Design Soil :pplicapon 1 ~ Dispersal Area Recu fst fhs
pi-sal
Pro . s2 Jj5lein ^iet'a[iU i
;1;
V L Tank Info Capacity m Total #01 Nlanufacttser
Ga!lons Gnl;ons knits ( ° -
New larks -E--91 anl:
'septic a FFolc;n Ta A(~a I v I h t
I Nrag Qwnba ` _ I I
1
VIII. iRtsponsibifity Statement- a nndersigned, a_ responsibility for- installation of the PORTS shown on the attached plans.
Pitmiber~s Naine (Perri Plum s atur p
!v WW'RS .`dumber Business phone N/uumber /
Z- 7291
Piu:nb~'s Address (Serest, : m'. Sm C
t~ 1
3 z
V ounlv/De artment Use Only _
toyed )i:a v prrmi Fee Da su
P 1 Issuing : rnt S:gnani e
Ramon for Jeniat S Goa l /
-IX. Cooditijlrl~~` 0jVW~asons for Disappr<rval
I t. Ser tack, e-flucnt fine, vnd 3 i~tt~wD V >~O 1'~~+c(~
ci err:si cell must all Ds-a.'L 'j-' r-into rec_ .
a: , er Marapement plan prolrlded by plurnbei,
2. Ali seft&troqWorXM" Rlust, k a MWntE.IMti pp n I
-as per 40=bw cod. / ad=*". Alf U ~ ~CW ~ D ro J ~ 01 aLl•. /1eL
♦ tt Cb to compete pia= for the arstr and submit to the County only na paper oot less taau 8 : z 11 inches
DI`dIS10N : ~F INDJSTRY SERVI-; 6
92331 SAN LUIS PL STE 153,
-t GREEN BAY W1 54304-5211
S P Contact Through Relay
ht:p:!tdsps wi govrp-og,arnsiindustry-serrices
www.wisconsin cov
TO,
Scott Walker, Governor
Dave Ross, Secretary CON
AP
May 03, 2016 DEPT O
r tiJFES51
Cl.'STIDNo. 225900 ,RTT, POT•i`ISh;s;:eaor
SHAUN R BIRD ZONT-N6 OFFICE
BIRD PLIrtiLLIiNG INC ST CROIX COUNTY SPIA
14-1-2 1201"H ST
11.111 G1RN'1ICH.AE1 RD
NFIN'R1C'HMOND 111'1 5.1017-6409 HUDSON' %VI X4016-77~18
CONDITIONAL APPROVAL.
PLAN APPROVAL EXPIRES: 0,'03%2018 I:1entification Number
'T'ransaction ID No. 2701765
SITE: I Site ID No. 823602
OeN"cr:n Homes Pl.-use refer to both idenr, cat:or, numbers,
«'alnut Hill Farm Lot 70 alxrvc, in all corres o).a e Nith the a~!ercv.
Town of Trov
Sr Croix County
4, SE1l4, S22, T28N• R19
LnC. -0.
I OR:
Desc:ipti~~n: Nlound Sxstcm (Ne1N Construction)- Linear Loadinc, Rate= 7.9 Gallons+'Linear Ft
O'cyst Type: PUNTS Component Manual Re!-,•-ilated Object ID'No.: 1599286
Maintenance reuuired; 450 GPD Flow rate: 22 in Soil rnir.imum depth to limiting factor u'om ori_:1ial ~r~de;
System(s): Mound Component i xiual - Ver. 2.0, SBD -110691-P N.01'01, R. 10122).
i're~su-e D a: ihu:iuri C 1 p:,nest
Manual - Ver. 2.0, SBD-10706-P (N.01'01, R. I0r12); Effluent Filter
The submittal described above has been reviewed for conformance with applicable «iscor,;ri AJimm+U :i" c Cc ce
and Wisconsin Statutes. The submLttal has been CONDITIONALLY APPROVED. This system is to oe cunl~trJcted
and located in accordance with the e:tciosed approved plans and with any component manual(s) refererccd oc .
The owner, as dc.ined in chapter 101.01(10), `v'isa.:~~in S:;1tu1c:• resaor.~ibl~: for CL)ra-fiance .•,i-,h ~11 C:)~12
requirements.
No person may engage in or Neork at plumbing in the ;r.t " n' iic~ sca :o , DC,-1-T--,1-r-,-1 p r < 1 15.06•
seats. `
The followmo conditions sha'i be met during construction or installation and rr10r to cccl;-ranc% or use.
• Preserve dispersal area prior and during consm.ction to avoid disturbance, compaction and use of the site.
• With new construction; it is recommended not to activate the pump in the dose tank- until the tanks are rut rd
prix- to homeowncr occupancy",
• 'Wastewater generated from contractors cleaning of equipment and tools and'or left over cor-structior
products shall not be discharged into the drains discharging to the private onsite wastewater treatment s%.sI, r
(POWTS %Vaste generated stall be p-op,rly disposed of on-site or off site,
• Any tall brasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installaticn to
proven' mattin under the dispersal area-
• Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inch
Smear in, and compacting of wet soil will result in reduc ins the infiltration capacity of the soil. Proper soil
;T;oistu-e content can be-determined by rollim! a so:i sample between the hands. If it rolls into a 1'4- inch wire,
the site is too met to nrepare. If it crumbles, site preraratior can proceed. If the site is too .vet to prepa.- do nct
2rt,c::cd until it dries, -
• Di%ert surface water fr-rr P( 1'~ I i area.
• All piping shall conform to SPS Table 389.3+1-3 and SPS Table
• insulate build ina sewer beyond 30 feet per SPS 382.3'0 (11)(:
• Tank installation to follow all manufacturer
• Verify property line(s) prior to installatic n
• final elcNations of pump off and invert of distribution pipe; :Iced to vcrilied for roper punir s:zin
• areas that are occupied ',%izli rock fragments. tree roots, st'_nr_ps and boulders reduce the amount of soil
available for proper treatment. l;"no other site is availa~le, trees in the basal area of the mound must be cLit -t
at 2TOt:nd level. A lar_,e: f'II _rea is neccssar: hen an r`thc at~ove conditions are enc~-,intercd. to provi_e
s1:f,'_1cient hif t--:ative area.
OiN ner Responsibilities
• The c'.trrent cn ner, and e~cl~ sl.b:;:,yuent o~rncr. shall r c it e a coFe -I T`Iic lei:c- i7: lLdi-I~' 1n~,CtiOnS relatir~_'
to proper use and maintenance of the system. Otivmrs snall receive a copy of the appropriate operation a:id
maintenance manual and:'or owner's manual for the POVv TS described in this approval SPS 383.=4(1
■ In the event this soil abserption system or any of its component parts malfunctions so as to create a heal:h
hazdt"d, Ch: E^rJpZ1"'`,' i+',aller ]aUSC :Q.'p« the CVLtIn'_enC'.' p.dn 35 d~SC-iDC~ lll the app-o\'?~ plans.
A eopj of the approved places, specifications acd this letter sh-ill he on-site durur= constru:ti~-n c,nc rpen to
inspection by authorized representatives of the Department, which may include: local i'nspecto-,. .~ll pem-. is
regt:iTed by the state or the local municipality sha':l be obtained rrior to commencement
consm:ction'iastallation.`operation.
In granting this apps %al the Division of Industry Services reserves the right to require chan-es or additions should
conditions arise making. them necessary for code comp*'ance As per state stats 101.12(2). nothing in this re', icw
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Ilnquirics coccerning this correspondence may be made to me at the telephone r-irr.ber listed belx.v, cr at tie address
or this ',ettcrh~-.ad.
":ae above left addressee shall provide a copy of this ietter and the POIN I S mamvemc-it r.lan to the ovs 1er and acv
others who are responsible for the installation, operation or maintenance of the PCAVTS.
Sincerely, Fee R_-yui-ed S :50.00
I'h:s An,ou-it Will Be Invoiced.
v when You Receive That Invoice,
Tian Vander Lee,t Please Include a Copy With Your
Private Sewage Plan Rev;ewer , Division of Industry Services Pavrrent Suhmiual.
f 920;>492 2214 , Monday - Friday b am To 3:30 pm % iSMAR i code: ; 633
n andorleest'.a «isco-1sin._!o\
cc: Fd~i in A Ta-,lar. Wastc%. at--r Spec a.ist, 15 ~ 534-31' 84 , y1c'nd2y - Frida, S:00 art To --.30 poi
• Divert surface Fate- f Dr. ?C'\17 S A.7 H.
• All piping sha . _oafz)= :i SPS i ahie ..8 _ aa~ SPS Tan:.: i =
• Insulate bt:iidin2 SeKer bevon-`3G SPS 2K.5",
• Taal: Ii2SLallation :0 _ Lc-.;- 3' u.dII'=`3C LL 5 ' 0 ➢T 10'IL':1 1^S.
• Verify oropcrt~' liQe(s i ?-ior to is : lia:iou.
• Final elevations Of wjj:: c"an-' irve:7 of
G S' J IaOL l^e I]_ l 'r-, i07 r 1 1 7)'1IL S =IPr
• Areas Ltla: are occupied K:LL .'JCI, t s _ _ _
coy-. z:lc n :id ...::auc_ -fie a1lnur_ 01
If no o i-,e- cite ;r thz nas ?ra 1:O L1~ DC5: be .
C :h--
~:1dIt10rls are
O"-ner Responsibilities
• li: c=u-n-, FII °3C7 sU SeQU t ov-nc". S a! L_
e1 1 L L; IC
7'_' 'T):: $ 37-- . -
7,177,pe-L'S,a =-c: L; Tei'=u C i,i tl]e dSTe'W. 1'"ba`._ S:121:.- :YL a CD7, C:,Le a:1L
Li _IlSns T anr,._ and Or O HT ~..:ia=al f1)7 ::1:5 ax)7C1'a. STIS 3S3.54k 11.
• 1~ Ct- l tl is so~ a SO r .OL S`S:_. Q' a7_' > '
iS . Lem: ➢ s Ir~:.L :I R_ SO as T. ..r-Cale - hta:Th
1us:d:..,, .JC r0')ei" pv7e.- L712SI :U.10ti'.' the 0:1II"L^__eII-~ :3L as 1°sC:•1::..:I in z?T.1*,^,V°u t.iaLS.
. GJ➢_v L? L~'C 3D.,-0~ " _3IlS. SJeC 1Cd" UC c7j .LllS 1:. `2 _ .
t be CD-3.t° Qlli iL_ CQ2Su 1]C:1~~~L 3II^ C➢f!_ iC
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3C `I:10 s shoal'
Q➢ :`-IOns a-_s! m~-Jdzz- :ii= Ssc " for CDdt'! C--)! L,!i2: ;s. A3
r Sl:ic 5:2 :s ! _ . 1 ➢^T1~ in Tjis i °t i.°~
shall relieve the des;,-Le.- r i^1i des' _
'1 sa? bT.:Lt'i1:1~
~%:li'IeS COIlCe_ L ' L ss i:C-CS nn6°- . may 0t L3C= IC H: --Ic iCIcnh0ne HSteC J':C,. ai 11_ ad ~Ss
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This O'1Ili 'W] Be IzvoiCe;:
TL- \ ~.u : Plea : Intl d. a CO. -vN :L-
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Cover Page
ROV:.
Shaun Bird SAFE,
Bird Plumbing Inc. NAL ;
.DUSTK ~S
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 4/22/15
Owner:Oevering Homes
Location: SE1/4 SE1/4 S22 T28 N,R19 W Lot 70 Walnut Hill Farm Troy
Manuals Used: Mound Component Manual Version 2.0 (N.01 /01, R. 10/12)
Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12)
Page#
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7-8. Maintance and Contigency plan
9. Filter Specifications and cross section
Attachments: Soil Test
Shaun Bird
Signature
License nu r 226900
Page 1 of 9
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