Loading...
HomeMy WebLinkAbout040-1256-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 584779 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: V k 0V Sarah Haugen Mar MewS e TOWN OF TROY 040-1256-20-000 CST BM Elev: In BM Elev: BM Description: Section/Town/Range/Map No: `6116 M . &-bT 24.28.20.1356 TANK INFORMATION 19 ELEVATION DATA TYPE MANUFACTURE ^S CAPACITY STATION BS HI FS ELEV. Septic y^ Z Benchmark &54A., Dosing i 24 Alt. BM Bldg. Sewer Holding M"r► ~ . '3 ~~i ~ St/Ht Inlet 41 TANK SETBACK INFORMATION St/Ht outlet TANK TO P/L WELL BLDG. ent Air Intake ROAD Dt Inlet 4 Dt Bottom 1L 41 Septic J 4 1760# 1 Dosing w Header/Man. -7• 3 14, ZS Aeration Dist. Pipe -7 3 Holding Bot. System 73 95_z5 may,,, PUMP/SIPHON INFORMATION 7160 146 A AfUtcliot 100 Final Grade f- L Manufacturer Demand St Cover / GPM (r C~ 4.` Orj 116 Z Model Numb TDH Li Friction Loss System TD Ft Force main Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Li iclud Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING ManufaLl~er://~~ INFORMATION CHAMBER OR Type Of System: e6 AjeJli- O Jb 1 93 l A f / - B UNIT Model Numbe DISTRIBUTION SYSTEM C•'~I / 1 IT 4-1 [H,ngth eader/Mauifpld Distribtion x Hole Size Spacing Vent t5 Air In ke 1 Pipe(s) ~ Y 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 xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes F] No Yes E] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 250 ST ANNES P Y 1.) Alt BM Description = ~ 2.) Bldg sewer length = C? 47 - amount of cover = 41 Plan revision Required? ❑ Yes No J Q 1' I r / 4Z Use other side for additional informati n. ~O Imo/ V J Cert. N o. SBD-6710 (R.3/97) Date Inse4.t.re Z,~SL S`t 1~,NNS~i~iC'Ay lv vv S ~1y S Z`I i 2 ice' 2 ZZ~, vv ~i I IZC>'y lQv 01UL L l LLB 1L I y . r~1Vo~~12~' ! T~f OF Svv` (Kc~r~~ ELCv ,ICI glE- LA S~A ~ I y Jac) ~ % f / rJ(C~~ ~`t . / Jam` Opp,, I~ ~ . q (Y FIVE Jim , u~ T Safety and Buildings Division , JI C it0` X _ 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) SP° MAY 2 5 201 Madison, WI 53707 ~'t62 u ST. CROIX COUNTY ` - kog Tanitary'N'Pfff Application U tateTransactionNum er in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmen t is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POR'T'S are submitted t Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1 (m), Slats. 9 I. Application Information - Please Print All Information Property Owners Name i Parcel # ~-$RRNN AV GE I"I!,` M4, t p40-r256-Z© d30 Property Owner's Mailing Address Property Location Li a i3 Sr 2~ O ST ~1 iJ (J EJ VfxR K W A\/ Govt. Lot Z City, State Zip Code Phone Number 1 h, Section _ J v05Q(i `,t' r ~yor6 circle one vV ( T N; R Z~ Eor&) R. Type of Building (check all that apply) Lot # L/1't or 2 Family Dwelling - Number of Bedrooms S , -1 Subdivision Name 1 Block # ! 4 V 1 ; 1 1 t ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use l CSM Number 7 ❑ Village of D i' W /V I75 K town of TROY III. Type of Permit: (Check only one box on ii a A. Complete line B if applicable) Z-0 MAL4 A. N~Sy~iexn ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) 11 Permit Renewal ❑ Permit Revision El Change of Plumber 11 Permit Transfer to New List Previous Permit Number and Date Issued B- Before-Expiration Owner IV. Type of POWTS System/Component/Devi e: Check all that apply) XNowd=4-It-6round ❑ 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/Tr tment Area Information: 1 C Am Design Flow, ( ) Design Soil Applic n Rate(gpdsf) Dispersal Area R ed (sf) Dispersal Area Proposed (sf) System Elevation Aso i7 ia'7/ 10A01/ VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o z New Tanks Existing Tanks PI) /®k 5Zs III Septic or Holding Tank 155 /J6 C / lot SSE Dosing Chamber a/ VII. Responsibility Statement- I, the undersigned, assume responsibility for' stallation of the PORTS shown on the attached plans. Plumber's Name (Print) Plumber's S ature NffVJZRS b,., Business Phone Number _ZZ F -P FED K ~t I/ I 11~Ae_ O-Qyd ya -715. W.1 -3~'Du Plur er_s Address (Street, City, State, Zip Code) W1 :5LIOI'~'q VIII. Coun epartment Use Only ❑ Approved ❑ Disapproved Permit Fee Date Issued Issuing Agent Signature ❑ Owner Given Reason for Denial IX. CoogyMrvyal/Reasons for Disapproval „ir~I) ,f a Mee N ~,$12 ~-~{L. 1. Septic tank, effiuert r" ' it V dispersal cell rnus, qla as per management piL.~) prcs e id, m,:intainedr 2. All setback requirements tun ~1SMm~ ( Ce l an l~~l .q In ~ as,PPr a I°o icable codelordina nc;ra. Attach to complete plans for the system and submit to a County only on paper not less than 812 a 11 inches in gize C r u s SBD-6398 (R. 11/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: _LFIV 4 '5~2FA f(AU6;Et-J Owner's Name: S~ P, Wk G Owner's Address: J 0 S° r 1 35 -pp, R K V,/ft y ~L»I ~ Legal Description: _ Vj is r-- s Township: T-acd County: 1~T f? Vii;, 11- Subdivision Name. `r Rt j V I L(I\&, C-- Lot Number: 9 Parcel ID Number. `f - i 256 _cr) Page 1 index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 5 Management Plan Page 7 St Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: ~'FF fQ_ License Number. ►1~~5 2:~3z `1Z Date: Phone Number 115 LICI Signature Designed pursuant to the fn-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 l1k ,~~U 5 z'i 2-,~ f-J ►z Zt-~ ,y y TCNF CF- ~ VI/ Lc-f t" CLTV iz-6 r F,i~~ H n1~Z T~ L i l t i nc~►~ i pLE~ I i 7 `s 1 I I 1 I ~ I /00 it We VWA cop ft UM*ft -i► ~i-- ohm*w fts :aft ' Tre~a,1 Chwftm c• COL T 2 H"dw VMS or omwvwan P" Tomah 8 MwtuUtm And Model / 1`l F f LIRA-Ta i2. C U t C i( Et8/4 R aQ ft chamber 8d Ap*dM Mb 7 mom ft j 5 bpd tin Fbw a; -7 "Appbrs Raft 4. -0 C0 SM = ~'/ChWd O S n~ ~~~eads, PeQo , of„~,r,~ Y INSTALLATION INSTRUCTIONS PL- FILTER r Rl7~mrlP~3le r MCI ,F 12 • a FeaWres & Bone fts: a Rated for 10,000 GPO e Pt -525 = 525 Linear Feet of 911W Fftaffon PL-625 = 625 Linear Feet of 9/32° Filtration PL-525 PL-625 * ACCepts 4" and 6= SOM. 40 pipe PL-52&M Ofluent FifW should operate effida* 9 Built in Gas Deflector several years under normal condiilons before a Automatic Shutt Bali when Fier is Removed ;ring cleaning- tt is recommended that the filter be -led every time the tank is pumped or at least every a Alarm Accessibility yearn. tf The installed filter contains an optional n, the oter wilt be notified by an alarm when the 9ACCOM PVC Extension Handle needs servicing. Servicing should be done by a Fred septic tank pumper or Installer. AM7..J' urm PRODUCTS 17..~,. Potytok PVC fiber 4 3 - a.f-' v Randle T, 6 M-974 wr -Gun aid FilkwAlenn P" Mrs Miser covers Extend & f ok"O Mser Safew Sc s SM2MRt ~ t~nirt~i Poyak Extend Qt: LokTu Potytok safety nd Ong Your IS a Si{ 01% easy to use s eitos to ora4irrby d ildreri s POV& JOW 2f2 En panBlS $-C lard( cover wdi to grade. and sotu~orr first can extend l a vimuai AchIg yOur tamer WSW the wet or o pipe scut mid t~ ~g iota open acid his n Dn Of i am sag by enrol- moue fE w wWw baf ie sepue tal* rOM MVenNng iw and tank hg agging t D W tarn itrstanation a sump. sOMArv- r - Fits 37 and a pipe.. Fora full list of ftl YM products pie visit our web site at www43*44* k0c6m POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner UKT ~ GaU Septic Tank Cai)acity gal 5 5 ❑ NA Permit # tic Tank Manufacturer VIJ OR ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer tR"fi rG ❑ NA Number of Bedrooms 100 d/bedroom ❑ NA Effluent Filter Model i ❑ NA Number of Commercial Units NA Pump Tank Capacity al II(NA Estimated flow (average)* Way Pump Tank Manufacturer NA Design flow (peak), estimated x 1.5* al/da Pump Manufacturer 2f NA Soil Application Rate l1da Pump Model NA Pretreatment Unit ~ NA IntluentlEffluent Quality (NAp} Monthly Average*# El Sand/Gravel Filter E3 Peat Filter Fats. Oil & Grease (FOG) < 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD5) E3 Disinfection ❑ Oder. Total Suspended Solids (TSS) 220 mg/I' < 250 mg/L Manufacturer: Model: Pretreated Effluent Quality [3 Monthly Average*** Dispersal Cell(s) g(6ground (gravity) ❑ In-ground (pressurized) Biochemical Oxygen Demand (BODO < 30 mg/L ❑ At grade ❑ Mound Total Suspended Solids (TSS) Fecal Coliform (geometric mean) < 30 mom' ❑ line ❑ Other. :510 cfu/ 100ml ❑ Leacb{n Chamber Manufacturer - F T P Maximum Effluent Particle Size 1/8 inch diameter Model C x6 Laying LengthlChamberJ *Wastewater Flow Verification and Calculations: Soil Application Rate , gpd/ft Area Req. left (Other than bedroom based) Infiltrative Surface/Chamber-ESIA Rating C~ ft Minimum Number of Chambers ❑ Aggregate Design Flow Rate= $ min Values typical for domestic (non-commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ***Values typical for retreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At-grade Soil Absorption System, Siting, Design & Construction Manual"(Converse et.al. 1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds". R.J. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 62511-80-012 October 1980 ❑ SBD -1057" (R-6199) "At Grade Component Manual Using Pressure Distribution" ❑ SBD -10567-P (R.6/99) "In Ground Absorption Component Manual' ,SBD - 10705-P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD - 10628P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD - 10656-P (N.6199) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572-P (86/99) "Mound Component Manual" ❑ SBD - 10691--P (N.01101) "Mound Component Manual" Version 2.0 ❑ SBD - 10595-P (8.6/99) "Single Pass Sand Filter Componem Mannar" ❑ SBD - 10657-P (8.6/99) "Drip-line Effluent Disposal Component Manual" ❑ SBD - 10573-P (R 6199) "Pressure Distribution Component Manual" p SBD -10706P (N.01/01) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units 13 MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Fr uen Inspect condition of uwk(s) At least once eve ❑ months ears (Maximum 3 PUMP out contents of s) When combined sludge and scum equals one-third 1/3 of tank volume Inspect 4jTersal cells At least once eve El months s 3 Clean effluent filter At least once eve ❑ months year(s) Inspect pM!9p, pump controls & alarm At least once every ❑ months 0 s ❑ NA Flush laterals and pressure test At least once eve ❑ months ❑ Year(s)., ❑ NA At tPAct nnrP i-verv n months ❑ Year(s) ❑ NA Systeip start up shall not occur when soil conditions are frozen at the infiltrative surface. OPEMTION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetablelfruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ❑ Valves Valves shall be operated in the following manner: M Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. INPECUONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). ❑ Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, treasure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. p Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs shall be promptly taken care of. p in-Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75%,of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Paige of V ❑ Mound, At-Grade, In-Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failwe necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. PORT Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is property and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ,6-A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system The replacement area should be protected from disturbance and compaction and should not be infi inged upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK. MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name C- t- - 1- Name Phone -7 5 y4r -3 `ts Phone SEPTAGE SERVICING OPERATOR (Pumper) LOCAL GULATORY AUTHORITY. Name Agency V 0 Phone Phone { - ST. CROIX COUNTY SEPTIC TANK MAINTAINASNCE AGREEMENT AND OWNERSHIP CERTIFICATE FORM Owner/Buyer Ibiling Address 3 ~ti9 P (ti-T{- ~r T W Property Addres 1'4C.s a gyp! So n UJ:t ~{ot 6 m ficalimregairectfromPiamingDepmtmartfornew dim) City/State Au~G15lb-, 1A Parcel IdentificationNumber_Gy(~ ZS6 " -aOp LEGAL DESCR~III'TION , p Property Location ~ %1, jL'/a Sea l/ T Gb N R U W, Town of %4 Subdivision 6 16t Lot# p Certified Survey Map, , Volume Page Warranty Deed# , Volume Page Spec house yes _41no Lot lines identifiable yes no SYSTEM MAINTENANCE Improper use and maintenance of your.septic system could result 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.yomput.into, the-system-can affed the function of the septic tank as a treatment stage in the waste disposal system The property owner. agrees to-submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on site wastewater dispoW systemisda proper.operating condition and/or (2) after inspection and pumping (ifnecessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned'..reread-the above requiremmts and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by th Department of Commerce and use the Department of Natural Resources, State of Wisconsin.Certificatinnstating that.your.septic system lias been maintained must be completed and returned to the St. Croix County Zoning Office within 10 days of the three year expiration date J6 SIGNATURE OF APPLICANP _ DA #of proposed bedrooms ? OWNER CERTIFICATION I (we) certify that, all 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, by virtue of a warranty deed recorded in Register of Deeds Office: SIGNATURE OF APPLICAtqT D Any information that is mwepresaated may result in the spry permit being revoked by the Zoning Depxbncd Include with this application a wed warranty dad from the Regiaw of Deeds office a oopy of the omffiai survey map if'referm- is made lathe wa xwty dead. ST. CROIX COUNTY f~ WISCONSIN PLANNING & ZONING OFFICE 1NNpMI1NN■ _ r~rrr COUNTY GOVERNMENT CENTER 1101 Carmichael Road ' • ' = - ' Hudson, WI 54016-7710 (715) 386-4680 FAX (715) 386-4686 May 9, 2005 Keith D. Olson 1121 Lecuyer Court Stillwater, MN 55082 RE: Construction of house on designated POWTS Area Lot 98, Troy Village 3`d Addition Subdivision Parcel # 040-1256-40-000 (24.28.20.1358), Town of Troy Dear Mr. Olson: During inspection of tank installation for the Private On-site Wastewater Treatment System (POWTS) on 4/26/05, it became apparent that the house has encroached on the original area designated for the mound septic system. The soils in the mound area have been damaged and cannot be used to install the POWTS proposed on the approved sanitary permit (#463128, issued 10/19/04). The soil report for this lot, completed by CST Tom Nelson on 12/18/98, specifically delineates the soil-tested area. According to state code, the POWTS cannot be installed until a new soil evaluation report and revised sanitary permit application had been submitted, reviewed and approved by the both Dept. of Commerce and St. Croix County [per Comm 83.22(4)(a)4b-e Revisions]. A new soil report is being developed, however, during test pit excavation the CST encountered fill material overlying the original topsoil in the southeast portion of the lot (the only remaining area where construction hasn't damaged the surface of ground). This required an on-site soil evaluation by Leroy Jansky, Dept. of Commerce Regional Wastewater Specialist, to determine if an individual site design car ' considered for a mound constructed on other than original soils. The site conditions are `he proximity to both south and east property lines, which require a 5-foot setback from the 'ently is reviewing the soils data and other site constraints before making a decisi ' 1 installation. The builder allowed house construction to encroa( a and the developer allowed fill material to be placed across the south portion of to -iay be worthwhile to explore an option of providing lot 98 with a sanitary easemk nto the outlot immediately south of the possible moun -his-wn~ltd expan, 1 -A of a mound with either a long, narron(4' x 10(1' or 1ougel_Qr_whose b, V pit on the southeast corner of 98. ddition, updated soil evaluation reports will be required for lots 97, 96 and 95 to document if those lots 11 also require on-site soil evaluations by the state and individual site designs for their POWTS. These reports st be submitted before the county will issue any sanitary permits. e master plumber will need to submit the revised application for a state-a ound design with the associate - II Keith Olson - Page Two The county provides a copy of the approved permit, site plan, and POWTS maintenance information to be given to the property owner. If you did not receive a copy of this information, you may request a copy from your plumber or from the county permit file. If you have any questions feel free to call me at 715-386-4680. Sincerely, St. Croix Con ning Pamela Quin Zoning Specialist - P WTS Inspector Cc: Todd Featherstone, Master Plumber Bruce Lenzen Homes Troy Development Corp. Leroy Jansky, DCOMM Regional Wastewater Specialist David Steel, CST Permit # 463128 file sl-, Depari~ierdof Coriirnercz SOIL AND SIT E EVALUATION Page 1 of 3 of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Coded 57~ti1ES Environmental By Design Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent stone; scale. or dimensions, north arrow, and location and distance to nearest road- Parcel I.U.# - - APPLICANT INFORMATION - Please print all information. 0,16 - J.? Sb- 2 U- ~S 0 RPVie? Ely Da Pbi'SUllai inrw'lre`u~l You Niuvi'e i7ley be used rOf 3BC6nuai y Niu srs {~iivdCy Law, s. 115,04 t'7 j (m)). e Property Owner Property Location Continental _De_velopment Govt. Lot` NW 1/4, SE 1/4 S 24 T 28 N,R 20 W Property Owner's Mailing Address t 13kiek#! `$ubd. Name orCSM# _ R 12301 Central Avenue NE, Suite 230 _ '1'roY Burne Village City State Zip Code PhoneNumber ❑ City ❑ Village ❑Town Nearest Road rc.e~ a o m_ l ivlilu►ea- olis \%1N 61122-757-7568 1oy j Ln~dsayRoad 7-7 1 New Construction Residential / Number of bedrooms 4 Addition to existing building Use. ~ ❑ Replacement Public or commercial describe Code Derived daily flow 600 [:2j gpd Recommended design loading rate bed, gpd „'vtrench, gpd/ft2 Absorption area required 1200 bed, ft= 1000 trench, ft' Maximum design loading rate .o j bed, gpd/ t2 _.&_& trench, gpd/Ftz Recommended infiltration surface elevation(s) 95.5` tt (as referred to site plan benchmar Additional design / site considerations Primary area borings 2, 3, & 4 al, -q~ Parent material Loess Over Glacial OutWash FI d lain elevation, if applicable NA ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade Sv_ stem in Fill Holding Tank U=Unsuitable for system Li S❑ U ( E So U El S 1- u S n U Li S a ❑ s u SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ftz Boring# Horizon I in. A 4t~ un_ell n,. Sz. Cont Color Texture r X Cz ~Consistenc~ Boundary Roots , j Gt!. L)VU Trench 1 0-11 10yr3/2 - sil 2msbk mfr cw 2f 5 6 2 11-39 10yr5/6 sil 2msbk mfr cw If .5~ .6 Grou elev rid 3 39-49 10yr5/6 f1 f10r5/8* sil _ l msbk mfi cw .2 .3 4 49-96 7.5yr5/6 - S~ Osg ( ml - ( 7 .8 Depth to i ~ ~ limiting factor ---39 Remarks: * Note this :Teets the criteria of 8309(4yf; one feet exc„ytie 2 i 0-14 l0yr3/2 - ~❑~sit ❑ 2msbkk I mfr cw 2f 5 6 2 14-29 10vr516 sil 2msbk mfr cw I f 5 .6 Ground 3 29-96 7.5yr5/ s osg m1 - - .7 .8 elev 99.46 It Depth to limiting fac or X95„ ~ - Remarks: - - - - - CST Name (Please Print) Signature: Telephone No. Thomas C. Nelson 715-246-2454 Address Environmental By Design Date G51 Number Ref # 1432 120th Street, New Richmond, WI 54017 12/18/98 227387 83 i OMEM Continenta Deve_i_opmeni °jM DESC WT [ON 'R'CPORT 83 Rage 2 of 3 Environmental B Design Depth uu'iiiinantColor NIVWes Structure Gui L2 Horizon in. Munsell Qu. Sz. Cont. Color i Texture I Gr. Sz. Sh. Consistence Boundary I Roots I Bed Trench I. 3 1 0-12 10yr3/2 - sit 2msbk mfr cw t_2f .5 .6 - - 4 + - 2 12-31 IOyr5/6 - stl 2msbk mfr cw if 5 6 Ground ± efev 3 ( 31-98 7.5yr5/6 0 s ( Osg mt - .7 .8 1(v?.27 ft } Depth to iitniiing _ 111 factor >98 Remarks: 4 i U- 2U IOyr3/2 - sit 2msbk mfr cw 21 1 5 .6 2 ?I x{1_49 1 10,vrSl - - o - ~ msbk I mfr .5 .6 Ground elev 3 49-112 7.5yr5/6 - s Os ml - - 7 8 99.89 ft 4 112-114 1Oyr8/3 ~ BEDRX Depth to limiting fa- >1 14" 1 I I i I I ! I i Remarks: 1 0-12 10yr3/2 - sit 2msbk mfr cw 2f 5 6 2 12-52 1Oyr5/6 - sit 2msbk I mfr cw if + .5 .6 Ground - elev 3 52-75 7.5yr5/e - is Usg ml - - .7 .8 100.13 ft4 75-96 1 7 ',,-,r5!6 + s ()Sg MI i _ 7 R Depth to l~m~ti factor >96 Remarks: I ~ ~ I I Ground - elev - I I I I I I - Depth to limiting factor I ~ Remarks: NVI ONMENTfit BY DE51GN 1432 1201h STREET, NEW RICHMOND, WISCONSIN 715-246-2454 TROY BURNE VILLAGE PAG 3 NWY SE SECTION 24 T 28 N, R 20 W TOWNSHIP TROY COUNTY St. Croix, Wisconsin _ 16 ST CR&IX COUNTY ZONINGC -FICF: I,U acre ~ oM a o 7 r ~ r~ a r ct L3 d ys B~12 (3~1 166,3 'unary 6ocinrs 2~3~y SCALE 1" =40 Tom Nelson BM 1. SW LOT CORNER Top of iron pipe ELEV. 100' 227387 BM 2. SE LOT CORNER TOP OF IRON PIPE ELEV. 99.93' Aggregate SAS SYSTEM ELEVATION AND SIZING CALCULATIONS Below Grade Aggregate Soil Absorption Systems Lot 96 Permit Number 4/22/99 Date X X. Gravity Distribution oniy 1 Pressure Distribution 3 ft Suitable Soil 1 8 in Aggregate Depth 2 4 in Nominal Pipe Diameter 600 gpd Estimated Daily Peak Flow 0.60 gpd/ft2 Wastewater Infiltration Rate 1000.0 ft2 Minimum SAS Size 95.80 ft Proposed SAS Elevation Soil Surface Acceptable Finished Grade EL 3 (ft) Boring Grade Limitation SAS Elevation (ft) System Minimum Maximum Number Elevation (ft) Depth (in) Lowest Highest Elevation? 98.47 100.30 1 97.97 96 92.97 96.30 Yes Fill required 2 99.46 96 94.46 97.79 Yes 3 100.27 98 95.10 98.60 Yes 4 99.89 112 93.56 98.22 Yes 5 100.13 96 95.13 98.46 Yes 1. Depth of suitable soil required below the infiltrative surface for treatment. 2. Depth of aggregate below distribution pipe. 3. Based on chosen system elevation, and aggregate depth. The addition of fill for cover or the reduction of finished grade may be required to meet minimum or maximum code standards. Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)i. SBD-10553-E (R.05/98) FROM TOM0and0STACEY0NELS0N PHONE N0. 00000000000000000 JAN. 11 1999 04:42PM PS 1EJWl;0AA3EA~FflL BY D 1432 120"STREET, NEW RICHMOND, WISCONSIN 715-246-24S4 TROY BURNE VILLAGE Nay SE SECTION 24 T PAG 3 2~L_N, R20 w TOWNSH[P TROY COUNTY Cro Wisconsin },U c.ere. > 5 0 9,r\ re) tAr"4 v ~ ' b y5 I BcYt 2. (3r~1 LI~b,.3 SCALE V =40 Tom Nelson PM 1. SW LOT CORNFR Tnp of irrin pira FI.FV. lOn' 227387 L BM 2. SE LOT CORNER TOP OF IRON PIPE ELEV. 99.93' dT f 1Ao Ui I tJ co -:Fl t7 0G.L0 N x, , do 'x ~ 'Z6 r' vs Cn " ''o m v U p ZA ®ym " bo ® S tat3 LIN r~ C) 00 t ca N ®70 200, t5~~~'Q~ -TI 000 CJ yy) 0 > -Vol CIO m r cn >0 0• 4 /'00- C? to J JX 00 co $ w,Q a~ I ->C:) -P, cc ~lj LYI U) m C), r*a - n t r Lo 05 Q ia1n's Drawmo Room., LL 201 G $T I I r _ - - - - -------I I ~ i~l I I III is k_ c'E^I I I a I.. ~t In £p mIta - I - m _ f '11 { n 'u ~ ~x ?8'' 1 g Its O _ n Z i11n ~ ~ ~ E v z O ~ m a ox 1 M'. tlu n II I. an I QI i ~ I I M - I o 1'° i Wr=--- I _ pml i I I~ ~I I~ iL==:: 1 it 1 I 1 M~~ w =~selA~.. zl Lm r z 7' 0 Ci 7' ~:3: 7 71 Ci Oc Z ~ 2 z ~V F ~S O1~ fifJIWIL'Ok ,'2 .p, ~n iain's Drawinc Room. u: IS a KURT &ZARAN to HAUGEA WIWI[ 1. 250faint Anne's Parkway, Hudson, WI 54016 I g alc ©lalrs Grawls~ F~oom, LLC 21, I G~ I I i e ro c _ I;°~o= rs I~ 13IPa I gel„= I - osa~~ re era I I - I I I N _ Q - w -8 o I i. =I Ic I\ io 3s ~I~! iE~ C n mi In ~ fln ~S .III Go _ I ~ I one ~zl ~w :p" I _I - I - I - II, I I 'r'te- N I~ - I L - I - I~ I G kii Y I IN I I Q i =t z~ ICI t ~~as ^s~~ I ' oF° c 4 I l I w~ oP w x,xoo.F I. ' II F - iu I ~ X SI~I ~ I z 7 J 7~ c z c - z U O s Z U g~'~' R.JIDf/t:t roc Pik pl t `a I~~~a ~ la7n'sDravin Room.. KURT &YARAH HAUGE/i HARTMAN mpgll"; 250fainiAnne`sParkway, kudwn,'a/154015 ©lain's Drawing Room., LLC 20 i 6 Sw.E AE :ortrmr. i. Y III > I _ of °I r - im _ Vl I IP I I - I - I ~S- ~ I ~ Inc ° ,1~-~ U ~ I [Ev - IS I - < A i ~ ITS N, ~ N - i 0 ~ rv I s ,I I I i~l I I I I I ,I II i I ' I - - - - - - - - - - - - ----I - -II z o z O O C ~ ~ z i?hslz rcnorn:-ron:g'.~ol~ " loin's Grawino. Room KURT&,/'ARAH HAUGL,/ ~glmax ~~I 250falnt Anne's Parkway, Huason, WI 54076 - w