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HomeMy WebLinkAbout032-2045-30-006 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 597368 GENERAL INFORMATION State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Parcel Tax No: •►Z iV~f _ Stetson & Laura Baker TOWN OF SOMERSET CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: /b0 13 rn G 5T- 12.30.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER . _ IL CAPACITY STATION BS HI FS ELEV. Septic eye Benchmark 0 bb A 2-/06 Dosing .441 5 4- G Alt. BM I oP, Z •7°1 q3 3 AWL S Bldg. Sewer ' •~J 9• Holding St/Ht Inlet p[7 ~r 40 TANK SETBACK INFORMATION St/Ht outlet Sq•9 TANK TO M(/L WELL BLDG. nt Air It ntake ROAD Dt Inlet Septic 7 Dt Bottom Dosing Header/Man. 7,75 911'Ikiii, Aeration Dist. Pipe ~O O .O .d Holding Bot. System 9.0 6 '-oy -47.9 Final Grade PUMP/SIPHON INFORMATION .~r• G Manufacturer Demand St over (1 Z. -n qt3. 3 GPM W~- 2- Model Number ?YI~f7 r J D^. 4.75 h 3 TDH Lift Friction Loss System Head TDH Ft 1 Z4 r• - 1 r Forcemain Length Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ,WZ SETBACK SYSTEM TO O P/L BLDG WELL LAKE/STREAM LEACHING Manufa tur r: INFORMATION CHAMBER OR ;Y` - ~~70vrQL Typ Of System: Z6 7~ j1 UNIT Model umber:/ 4P ` ,fin DISTRIBUTION SYSTEM Z64_Z4 Z6Z__60~ lus Header/Manifold Distribution Ix Hole Size Ix Hole Spacing Vent to Air ntake Pipe(s) LLength Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Q t/~ 5~- Depth Over Depth Over xx Depth f 1XX Seeded/Sodded xx Mulched Bed/Trench Center 3 V Bed/Trench Edges Topsoil `yes n No Yes F-] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Ins ection 2: Location: No Address Avai ble / VFW • ti5 5 Call 1.) Alt BM Description = I = r 2.) Bldg sewer length Al 5 - amount of cover 71V x.13 , Asp la,f Plan revision Required? [ ] Yes No L/0 Use other side for additional informs on. SBD-6710 (R.3/97) Date Insepctor's r atu re Cert. No. t .9" M1rr l , County Safety and Buildings Division St. Croix " i IV.CEIVE 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 53707-7162 ocl 5,,,~,,,°`{~ It Application State Transaction Number .111.111 -1 In accordance wifjt~~►~3. Z , Wis. Adm. Code, submission of th 7 r HEPNg -it Na is required prior to obtaining a sanitary permit. Note: Application fort.._ G ~ the Department of Safety and Professional Services. Personal information you provide may uo~~~~ Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(1)(m), Slats. 833 165 h Ave. 1. A lication Information - Plea int All Information Property Owner's Name ~ o2 Parcel # 7 J Pew, 63n Stetson & Laura Baker F 02' " 9 ~ Property Owner's Mailing Address Property Location 721 26 „Ave. Govt. Lot City, State Zip Code Phone Number NE /a, SE /a, Section 12 (circle one) Cumberland, WI 54829 (715) 651-9210 '1 30 N, R 19 W If. Type of Building (check all that apply) Lot # ❑ I or 2 Family Dwelling- Number of Bedrooms 4 Subdivision Name ~k Block # Na ❑ Public/Commercial - Describe Use . - Na ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of Zb Na WXfown of Somerset III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 4. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal Permit Revision ❑ Change of Plumber El PermitTransfer to New List Previous Permit Number and Date Issued Before Expiration Owner 597368 issued 6/12/17 IV. Type of POWTS 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 (e, %nfil Pretreatment Device (explain)_ V. Dispersal/Treat ent Area Information: for Quick 4 Standard Plus ch hers & 3 pair end caps. Poly A PL-525 effluent filter Design Flow (gpd) Design Soil Application Ra dsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System , eva ion 600.0 Gpd 0.7 Gpd/Sq. Ft. 857.15 sq. ft. 1,215.60 sq. ft. 87.0', 86.5' & 86.0' VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks Existing Tanks ~Ok a U vi 7~ n C7 a. septic or Holding Tank 1,340 1,340 1 Wi ser Concrete X Dosing Chamber VI 1. Responsibility Statement- 1, the it dersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signatu MP/MPRS Number Business Phone Number f James K. Thom son MPRS 30021 (715) 248-7767 Plumber's Address (Street, City, State, Zip Code) 340 Paulson Lake Lane, Osceola, WI 54020 Vlli. Count /De artment Use Onl Approved ❑ Disa roved Permit Fee Date I tied Issuing nt Signature $ . o>b /6 Zi5 17 Ow iven Reason for Denial IX. Condi&YGTE~ (Reasons for Disapproval 1. Sept tank, trfltb tilts- <<n i 3~ ~Obl.bl 44 a~ ~ l°r{yN.. (Jst_ler. „ cell riust III be slrvic is ! , o, ILr 9s per ; oar:3gerrien. plan n c iclerf by plumber. 2. "AO sett~ck reetJl en;s tntnit ot~ i-,rrt; irE as per ipFllcttbla c,txii ! v.rd;na tru. 'f A46 pJ- $ lib L Attach to complete plans for the system and . ubmit to the Coun only on pager no less th 8 1/2 x I f inches in size SBD-6398 (R. 1 I/I1) CQ~- 5) g u.a , a. 6S~~dc. 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Q I 0 - U c U 0 a < U I 7 Q a) cn Q c M a I I p U) _0 o 0 00 I I' v v $ ~ I I p N r a I CD N LO LO L E- a I I ° r~ ~2 I „ 11 I` ~ X LO a) U z O 3 m Q C O o co U) 0 O I I U w o c I i cn LLJ I I = I @ w U a) I I W ' 0- cn Z N " o -C CU 0- CD M _ ti ~ C ICU I I ~ I Y f Cn c (n cn Q o w I Un > N Csrt'~~i? - 13 1 Wisconsin Department of Safety and Professional Services P Page 1 of 3 Division of Industry Services Aftso~l/HEPN65X►'CEVE In accordai7 i r,om. Code County t ! St. Croix Attach complete site o~ ~~e'rrlot less than 8 1/2 x 11 incnes in size. Plan must include, but not limited to: ve~~i~al and hao~{ eference point (BM), direction and percent slope, Parcel I.D. scale or dimensions. ~ end distance to nearest road. From 032-20 0-005 Ref #2490 x. p lease print all information. Reviewed 1AIJW ;e--, D.act 1W17 Personal inforrt'iaatiion ou rovide ma be used for seconds ur oses PrivaLaw, s. 15.04 1 m . 1V Property Owner Property Location ❑ Stetson & Laura Baker Govt. Lot NE '/e SE % S 12 T 30 N R 19 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 721 26 3/4 Ave. 04 na CSM Vol. 28, P g. 6335 City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road Cumberland WI 54829 (715) 651-9210 Somerset 883 165" Ave. ® New Construction Use: ® Residential/ Numberof bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Glacial Outwash Flood Plan elevation if applicable na ft. General comments and recommendations: Site suitable for In-ground POWTS with 0.7 gpd/sq. ft. loading rate. Recommended infiltrative surface elev. to be 87.0', 86.5' & 86.0' 1❑ Boring # ❑ Boring ® Pit Ground surface elev. 90.11 ft. Depth to limiting factor >102" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-9 1Oyr3/3 none sil 2fgr mvfr cw 2vf,1m 0.6 0.8 2 9-14 1Oyr3/6 none sil 2msbk mvfr cw 2vf,f 0.6 0.8 3 14-20 7.5yr4/4 none Ifs Osg ml cw 1 vf,f 0.5 1.0 4 20-30 7.5yr4/4 none Is Osg ml cw 1vf 0.7 1.6 5 30-102 1Oyr5/6 none grrOs%) Osg dl - 0.7 1.61 (3 A 11 1,- .9 1 It ❑ Boring ❑ Boring # ® Pit Ground surface elev. 90.03 ft. Depth to limiting factor >100" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-10 1Oyr3/2 none sil 2fgr mvfr cs 2vf,f 0.6 0.8 2 10-20 1Oyr4/4 none sil 2fsbk mvfr cw 2vf,f 0.6 0.8 3 20-29 1 Oyr4/4 none sil 2msbk dh cw 1 vf,f 0.6 0.8 4 29-36 7.5yr4/6 none Is Osg dl cw 1vf,f 0.7 1.6 5 36-100 1Oyr5/6 none (COs%) Osg ml - 9 1.6 1 * Eff luent #1 = BOD, > 30 220 m /L and TSS > 30:5 150 m /L ' Efflu 2 = BOO, > 30:- 220 m /L and TSS > 30 L 611, %W CST Name (Please Print) Signature CST Number James K. Thompson 30021 _ Address ,15ate Evaluation Con cted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020-5413 October 9, 2017 (715) 248-7767 SBD-8330 (R04/15) 3❑ Boring # ❑ Boring ® Pit Ground surface elev. 92.38 ft. Depth to limiting factor > 104" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/2 none sil 2fgr mvfr cs 2vf,f 0.6 0.8 2 9-21 10yr4/4 none sil 2fsbk mvfr cw 2vf,f 0.6 0.8 3 21-31 10yr4/4 none sil 2msbk dh cw 1vf,f 0.6 0.8 4 31-35 7.5yr4/6 none Is Osg dl cw 1vf,f 0.7 1.6 5 35-104 10yr5/6 none s Osg dl - 0.7 1.6 11 i' ❑ Boring # ❑ Boring AOF Vj ❑ 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/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # ❑ 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/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30:5 220 mg/L and TSS > 30:5 150 mg/L * Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30:5 150 mg/L 3?8.m' a. 6~S~ffdc. ~.So%s✓a/ua~aos~~"Sj'"T~orn~sir, /d/o9~/7. 3 Ex~~add :ZC/o/a/~ Ster<sa+~ f LQG~,I~.r-~,~o ~n wl~l~ /a of~o:/ue. fluk~ad 88.3 /mss-`q~Fdc. ZWjerS" .C.od ~f, csM ✓•l..?~/~. G33S o /IE~~.S~Jf'ySe~ T. ~o~,(, /9cJ., i3•rf~..' T.a,~~srvsL;Sb.Crpix~'e;K?: r'~opOSudGck// , ~ 3`tt~~"''oFS.d:`y P~ A'o-U-loslS-3o-ties- loch-{~'cn r E/avj= 96.,,47dd r r ' •ysso \ \ 83 62. g ` :a4~G Esa.,xn` ro• 33~•~ / P 2 lie ~f.' County ECE'V Safety and Buildings Division St. Croix 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) ~uN Z017 z~disfO , W377~--7162 ROD( COUNTY -OMOUNITY ermat Appllcatioil State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Na is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary ~~II,, purposes in accordance with the Privacy Law, s. 15.04(1)(m), Slats. T'1 M 1. Application Information - Please Print All Information l~~/~ Property Owner's Name Parcel # Stetson & Laura Baker p~~fi • Qom,-~_ ~Property Owner's Mailing Address Property L-atiou 721 26 r Ave. Govt. Lot City, State Zip Code Phone Number NE /4, SE Section 12 (circle one) Cumberland, WI 54829 (715) 651-9210 T 30 N; R 19 W 11. Tjyrpe of Building (check all that apply) Lot# ~/Ior2FamilyDwelling-NumberofBedrooms 4 -Wii 4 Subdivision Name ~ # ❑ Public/Commercial - Describe Use O~U/ 4 of l(S ()bIHI, Block Na -N&- CSC [I City of _ ❑ State Owned- Describe Use Dv I s` l CS er ~/L , ZFf ❑ Villa e of ID2l s t2Q f ~n mown of Somerset 111. Type of Permit: (Check only one ox on line A. Complete line B if appli le) A' ew System ❑ Replacement System ❑ Treatment/Holding T fcement Only [I Other Modification to Existing System (explain) A 6 B List Previous Permit Number and Date Issued [I Permit Renewal [I Permit Revision Ch ge of P~r❑ Permit Transfer to New Before Expiration Owner IV. Type of PO m/Component/Device: (Ch II apply) Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ rade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitabgoil U' ~ L ❑ Holding Tank Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat ent Area Information: 4 Infiltrator Quick 4 Standard Plus chambers & 3 pair end caps, PolyLok PL-525 effluent filter Design Plow (gpd) Design Soil Application Rat pdsf) Dispersal Area Required (s0 Dispersal Area Proposed (sf) ystem Elevation 600.0 Gp 0.7 Gpd/Sq.. 857.15 sq. ft. 1,215.60 sq. ft. 95.0', 94.0' & 93.0 V1. Tank Info Cap ity in Total # of Manufacturer Gallons Gallons Units o New Tanks Existing Tanks ~ ~ ~ ~~k 2[w J °J o P a U % n w v G Septic or Holding Tank 1,340 1,340 1 Wieser Concrete X Dosing Chamber VII. Responsibility Statement- 1, the un rsigned, assyime responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number James K. Thompson MPRS 30021 (715) 248-7767 Plumber's Address (Street, City, State, Zip Cody- 340 Paulson Lake Lane, Osceola, WI 54020 VIII. County/ )ear ent use Only ed Disapproved Permit Fee Date Issued Issuing Agent Sig ature en Reason for Denta $ IV Q~ D/] IX. Conditions of Approval/Reasons for Disapproval L //fJ SYSTEM OWNPH; ; fAlis 1/ ilalld VSf 14ffM 41 1, Septic tank, of%@nt fllttrf and dispersal cell must be S YLORd L maintained w/ ap~~val,/ as per management plan provided by plumber. 2. All setback requirements must be maintained per app ica e @ Winoftatins for the system and submit to the County only on paper not less than 8 1/2X 11 inches in size SBD-6398 (R. 11/I l) ILL Conventional POWTS Index & Title Sheet Project Name: Baker 4 bedroom Repl Conventional Dispersal Cell Owners Name: Stetson & Laura Baker Owner's address: 721 263% Ave., Cumberland, WI 54829 Site address: RiA165th Ave. Project Location: Subdivision: Na Legal Description: NEIA SW/a, Sec. 12, T.30N., R. 19W., Tn. Of Somerset, St. Croix Co., Wl. Parcel ID 032-2045-03-005 Page 1 Index and Title Sheet Page 2 Site Plan Page 3 Dispersal Cell Sizing Calculations Page 4 Dispersal Cell Cross Section Page 5 Infiltrator "Q-4" Chamber Specifications Page 6 Wieser Septic Tank Cross Section Page 7 PolyLok PL-525 Effluent Filter Cross Section Page 8 System Management Plan Page 9 Septic Tank Maintenance Agreement Page 10 Warranty Deed ~I CSC Attachments: Soil Evaluation Report Mater PLumber Restricted Service: James K. Thompson, DSPS Credential 430021 t Signature: Date: CLG~/~ Page I Of 10 Design pursuant to In-Ground Soil Absorption Component Manual tier POW' I'S_ version 2.0 SBD-10705-P (N.01/01) Xi S EaY~ g ~a a/C G/Cd i i S~ctS~ ~~"cvG ~v xxx /(o5`! Aee . q~/gs~vey SeC, /Z T3011, O PCI, fr o~1--w5~S 03-coS- d 3 o (~raPoscd w,~s~r Ca-,cr'c.~ VC,9sTit-[~/79SP,Vie, neCut,0 7 % in a,(! S/G4' o P~opos<."dw~ V o, ` C - v H / ~ tud f cOr+-, ~ ~ 83 ~ ~ ~ 98.0 y¢s!`elta-rtbvs~~•e"~,~, ~i{•/bo.~i'✓P \ ~ csz. Co,,~,~. .5cc~~ct ~lt~!s 14~6e 93.0; 9~/.D~'9,j0~aZ . ~ q7.o• ol! 30 S/Z '6,e /`u~ adC 0 9G S. 0 Baker 4 Bedroom Dispersal Cell Siziny, Calculations 1. (4 bedrooms)(100 gallons estimated flow)(1.5 design factor) = 600.00 Gpd design flow 2. Infiltrative capacity of native soil = 0.7 gpd/sq. ft. 3. Absorption area required: 857.15 sq. ft. 5.2 4. Absorption area as proposed: 1,215.60 sq. ft. (based on 0.5 gpd/sq. ft. = 60 chambers + 3pair end caps) pr s pos.c el ' Infiltrator "Quick 4" = 20.00 sq.ft. EISA per chamber, Infiltrator "Quick 4" end caps = 5.20 sq.ft, EISA/pair 857.15 sq. ft. - (3 pair endcaps)(5.20) = 841.55 sq. ft. 220.00 = 42.08 chambers required Number of trenches: 3 ~ 20 chambers per trench (60 chambers total) Trench width: 2.83' Trench length: 83.00' 'French spacing: 9.0' on center Total system area w/ 6' trench spacing: l 8'x 83' Pg. 3 of 10 + N ~ C) I CD cZn I m a D (D v r p o r o u a m a cn CD Q _0 CD _0 CD Z o v m a w Nm CD O n Q G) m m m = I m o f n i0 ~ D D n CD O ii- O m C < w y v o cD mm - CD v m ~ o mi x i n 11 I I v ~ n CD CD l< D --I N C) -2. 0 cD CD N o (D m D ti N N ~ o C o n N G) O r2 cD ~o _ CD ~ p ''ll C o Qi 0 (n (D o O o CQ ~ I :3 Q o 0 o u . Cn r-r v " " 3 CD J O. I N m R'1 D v v cn II II ~ ~ i ~ ~ c N n O _ Q cn v C) w v ~D ~CD~z Zen 5 ID X3-09 0 MD ~ m c O ~ ci p Z ~3vC) D mom 3 _D Z zy w N m Z 07 o < C7 CD - = m a CD U) Q Cl m v o D D 9 z CD CD :3 < --1 o CD <m m C w Z s o n m Q = cn P~. 0(10 The is 3~~lus Standard Chamer i 5 The Quick4 Plus Standard Chamber offers maximum strength through its two center structural columns. , This chamber can be installed in iNS01 y a 36-inch-wide trench. Like the original line of Quick4 chambers, it offers advanced contouring capability with its Contour Swivel Connection- which permits turns up to 15-degrees, right or left. It is also available in four-foot lengths to I provide optimal installation flexibility. The Quick4 Plus All-in-One 12 Quick4 Plus Standard Chamber Benefits: Endcap, and the Quick4 Periscope • Two center structural columns offer increased stability and superior strength are available with this chamber, • Advanced contouring connections providing increased flexibility in • Latching mechanism allows for quick installation system configurations. • Four-foot chamber lengths are easy to handle and install i • Supports wheel loads of 16,000 lbs/axle with 12" of cover i Maximum Strength size Quick4 Plus All-in-One 12 Encap Quick4 Plus Ali-in-One Periscope 34"W x 53"L x 12"H Benefits: Benefits: I (864 mm x 1346 mm x 305 mm) F • May be used at the end of chamber • Allows for raised invert installations Effective Length row for an inlet/outlet or can be I . 180° directional inletting 48" (1219 mm) installed mid-trench • 12" raised invert is ideal for serial • Mid-trench connection feature allows applications Louver Height construction of chamber rows with 8" (203 mm) center feed, as an alternative to inletting at the ends of chamber rows Storage Capacity • Center-feed connection allows for 47 gal (178 L) easy installation of serial distribution systems Invert Height Certified by the International 0.6" (15 mm), 5.3" (135 mm), ° Pipe connection options include ( Association of Plumbing X8.0" (203 mm), 12.7" (323 mm) sides, ends or top and Mechanical Officials (IAPMO) APPROVED in . 5So1clo D z N D m 59~" AS 93" z REQD C D 48" 2 r C m m rw p -I O m m 3" 515" \ -Ti x I-- o I m 43" 0 I m;u D pD I I a I_ Lo < O m C m Z ~ O N D 46" z v, o m n D N D I N m D r n >O > r r p m u') Z~ O p m rZri m 0 -1 Z D O~ f7 Z grW~r2~nCD`LCn Z C tp~pZm➢<0-0-110 C 3 O (n D G7 C) O~z C>' >z rz L Om xx -0 Z p D np [nn0 cm) o Ov a: -irZ p 00 c p u) n 00 m D mOO mDO ~o0 o m n ;1 z LO r- r N Ln -4 Ln Oz cN ~ N z NNE I mZC"~O iX Zz \-u m D Dye ~~-iOG+ fN~ N fTl D ak (O M m co V N o p W\ : O X O OD 2 ~ N m I D W Opp' ^i i O i. , OD ➢ Lo N 0 z z m N mmmrm- I r (n 0'O O n C n n O -0 Z O O m -1 m V) co o v n c z Z7 O ➢ D D m0 p o' x D N r c o z D z n Fo C7 D _ z D O p D D< -n D C M '_1 C Z Z Dip co O N O H C x pm 0;u O ^ o ° ~7 Z D K: D r O Z C m m 0 _Tl _v D l l1 p o° z CO >7 v A D n Vl x O m r m c rm ~7 C n m O R7 zz ;u < 3 A cn D H m m r u \ n W840/500-MR HHERER CADCAETE DRAWN BY: WCP SCALE: 1/4"=J'-O" PRE-POUR: 2 m REV. (D m SEPTIC MANUAL W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: 00 00/00 DATE: POST-POUR: 0 800-325-8456 RILE: waoo/600-uR pi 4, of L-525 n t Fitt ° ~ rwpi ©n5 "~.Ec~'9[, u sd 7E i7bni,. +u uSa. rnw:'r,Per ~ arzasPS A sicn of Po(ylok inc. PL-525 Falter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 'i25 linear feet of 1/ 16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and teniporarily shut off the system so the effluent won't leave the tank. Ieaturs=s: 111.6" Filtration Slots L A1~3 r7n ~J~~1tCt1 • Rated for 10,000 GPD (gallons per day)_ 10 (optional) ~'p~ B, • 525 linear feet of 1/ 16" filtration. r000 A ( k Acce1~ts4" and 6" SO 11) 40 pipe. 3C~- c pts 1 ` 1) V Extension Iiandlc • Built in gas deflector. • Automatic shut-off ball when filter is removed. Alarm accessibility. Rated for 10.000 Accepts PVC extension handle. PL-525 Installation: Ideal for residential and commercial waste flows up to 325 Linear Ft. of I/ 10,000 gallons per day > GPD . 1o ~ p ( ~ - 1 filtration Slots 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. Accepts 4" & 6 3. Glue the filter housing to the 4" or 6" outlet pipe. If SCI 11) 40 pipet the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. P„ 4. Insert the PL-525 filter into its housing. Certified to 5. Replace and secure the septic: tank cover. s?1360 Standard 46 PL-525 Mxaintenance- ~ M, e„ F he PL-525 Effluent Filters will operate efficiently for several. years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned ;every time the tank is pumped, or at least every three Years. tf the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter hole, toi needs servicing. Servicing should be done by a certified septic tank pumper or installer. vntun,atic Sinrt-Oh h,fll I . Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL. 525 cartridge out of the housing. A~ 5. Llose off filter over the septic tank. Make sure all ' 6 , solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making t3+rtdtxnSrrtartttttei- A(aran hatc.nat & Lo E. sure the filter is properly aligned and completely inserted. nlvk,l , label rest filters accept I:asi1v insrius 7. Replace and secure septic tank cover, tic sinm tGiilcr ) s~tiitrh an t alarm, into evisring Lloks. Polylok. Inc. 3 Fairfield Blvd. LVallingforcl, CTT 06402 Toll F`rec: 877.765.9565 I ax: 203.284.8514 wtivw.polylok.cona P~ ra{/0 Conventional Septic Syste7Ma ementPlan Pursuant to SPS 383.54, . Code General The conventional septic system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10705-P (N.01/01). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Questions on the operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715) 248-7767 or the St. Croix County Zoning Department at (715) 386-4680. Septic Tank Septic tank servicing mechanics comply with SPS 383.54(1)(e). Septic tank to be located within 150' of service pad, with bottom of tank to be 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents ofthe septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 28 1.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shal l advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. 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. Septic tank manholes 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 the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce. Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October-March) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220rng/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate 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. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. P,-,. 8 of 10 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Stetson & Laura Baker Mailing Address 721 26 3/4 Ave Cumberland WI 54829 Property Addre, 8Sj , 65th Ave. A (Verification required from Planning & Zoning Department for new construction.) City/State Somerset WI Parcel Identification Number 032-2645-03-665 LEGAL DESCRIPTION Property Location NE '/4 , SW '/4 , Sec. 12 T 30 N R 19 W, Town of Somerset Subdivision Plat. Lot # N d Certified Survey Map # Na Volume Na Page # Na Warranty Deed # 043973 (before 2007)Volume Na Page # Na Spec house ❑yesElno Lot lines identifiable Dyes❑no SYSTEM MAINTENANCE AND OWNER 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 §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, 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 Safety And Professional Services and the Department of Natural Resources, Sat,; cf W...co nsin,. Certification stating that ` .11.. septic system has been maintained must he completed and returned to the St C-oiy County Planning & Zoning Department within 30 days of the three year expiration date I/we certify that all statements on thi orm 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 ranty deed recorded in Register of Deeds Office. Number of bedrooms 4 05 12/17 A~7~A- WivinaAakw, S[GNAT RE OF APPLICA T(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) ~5, OI</D :k~ o o Qo 3° m W oe o.~ os ov J Q a LL 1 I I w ae I d I- Iu I ~m I w9 O O wn I I o E~ e~ >y o~ I ,y e I I - - - - I w II I - ® o ~,9 s 0 ©e _ L o oa _ 0 g^ 3 I aaiv vn a I I I I I - I I I I I I v.~ 3rvi~ i~vv.o3~troe I 7~ I I rc3 a3 B ~e~ o o gQO _ ¢y ~ J 00 U ogre _ co o w ,~r'' l(j ZO w 3 w N N Z ~a«°~d aaS `d ~a ao ,.a ~aza~b _ n s ero zi .s~ J ~ F ~ I Q Ww w Q ~ i 2l J i a - rvn 3nme ~ ~ ~s OE) alx ,e. >RB s, I El> _ Loo z4 Fj- - es c .s r riio u n ~ ~ [i svna~eon~i.x~ III .t m _ ..-----T---- - IS W i v3irnvn I o3_invn _ - - _o - _ - - - - - - - - - - - - - - - - - - - - - - - - - - - r r~s 3rvii nvm a3~vae I -03 i =o B ~9 ~e mum- N _ 1- ~ Q o _ _ C In ~ Q sw y N Z I, n Oin Paul Y A~ YS ~ O -9-4° .s i n > W Z N J J J F i O w I 43a Q d I F I i - . y III ~ il' o oz-_ I ~o LLa °o< 0o II I 'S li I 0 0 : s~ sssrvn, yooz.. I I z eR a e n I ® ~ t~~ Ij I I I IT ..I I I a - II I I I I I - II I - I - rt L_~ I cl I _ I III I f4rr I I In Ili I O I III I- I" I ~I I III II ~ I e II ~ ~ I e I ~ fJ I _ - ----1 I I 'I Y~i 3rvlt nvM a3~we / J ~R m zQ B oe R IV "f f. v Wis.`Dept. of Safety and Professional Servic9s SOIL EVALUATION REPORT- _ Page 1 of 2 Division of Safety and Buildings in acco~cewith SPS 385, Wis. Adm. Code County St. Croix Attach complete site plan or LNfWf1Hi%_f12`k*4i;i;hes in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 032-2045-30-001 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Q Please print all information. Revie by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z 2 J Property Owner Property Location BRENT MASON Govt. Lot NE 114 114 S T 30N R 19E (or) W© Property Owner's Mailing Address Lot # Block # Subd. Name or M# 2334 KINGSTON AVE NA NA NA City State Zip Code Phone Number ity village ■ own Nearest Road MAPLEWOOD MN 55109 ( 65)1-307-5082 Somerset 165th ave 1 New Construction UseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD 0 Replacement E ]Public or commercial - Describe: Parent material Outwash Flood Plain elevation if applicable NA ft. General comments GOOD FORCONVENTIONAL SYSTOM WILL NEED TO SIZED AND LAYED WITH THE CONTURES OF and recommendations: 2PE. ] Boring # D Boring ❑ Pit Ground surface elev. 100 ft. Depth to limiting factor 89 + in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2 1 0-10 10 YR3/2 SIL 2msbk mvfr cW 3m .6 .8 2 10-24 7.5YR4/4 L 2msbk mfr ci 2m .6 .8 3 24-89 10YR5/6 S -m- ml .7 1.6 a Boring # F ]Boring 97 94+ ` pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 01 ff#2 1 0-12 10YR3/2 SIL 2msbk mvfr cw 3m .6 .8 2 12-27 7.5YR4/4 L 2msbk mfr Ci 2m .6 .8 3 27-94 10YR5/6 S -m- ml .7 1.6 t * Effluent #1 = BOD > 3C < 22 g/L and TSS >30 < 150 mg/L * Efflu nt #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature - CST Number PETER ERICKSON 1293207 Address Date Evaluation Conducted Telephone Number 1291 170TH STREET ST. CROIX FALLS WI 2/25/2017 952-261-1100 SBD-8330 (RI 1/11) BRENT MASON 032-2045-30-001 2 2 Property Owner Parcel ID # Page of Boring # Boring 93.5 88+ 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/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 ff#2 1 0-18 10YR3/2 SIL 2msbk tnvfr cw 3m .6 8 2 18-34 7.5YR4/3 L 2msbk mfr ci 2m .6 .8 3 34-88 10YR 5/6 S -m- ml .7 1.6 P-1 Boring # 11 Boring 97.5 101+ Q 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/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 ff#2 1 0-12 10YR3/2 SIL 2msbk mvfr cw 3m .6 .8 2 12-28 7.5YR4/4 L 2msbk mfr ci 2m .6 .8 3 28-101 10YR5/6 S -m- ml ci .7 1.6 ❑ Boring # 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/ft l in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2 * Effluent #1 = BOD s > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access set-vices or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-8330Tw (RI 1/11) 9 t k. Ao- SMA ~q R,i irY,6 y~d Y k yr~ 3 tl ~ 1 i e: ~e i 1 ~J 1 1 IE d„j a 5 4 j ✓ 7 J$ _f q d to, iC too tV3~ 93.E 9 Ly E l' r,. /7r -KZ U EN p m o a r o V c`o~ m y O h N d N N t rn C L U o c a 3 m a m m m z'~- - 2 Cm - lO •O o m o w - t J > rA 'o p w m o 'm 'o N 3 o N L Cl LL v> w in o _ in U of C~ G~ U) ~ N +r gs~ O U ~ U (nom p Q U v ° y ~ , /ate qe.f ~q. A LD q Y`• LO u ti J ,v y k ' LO -Ir ,r • tfi w , ~I LO - ~ t v r : r 3 ~X 4 1~aQ Ait ~ x c 5 ON, 14 6, p It &A, r - r 4 ~ ryry i Ly, F xf ~ lb' 71 w .L Land Use ST. C R O I COUNTY Planning & Land Information Resource Management Community Development Department 6/13/2017 Stetson and Laura Baker 721 26 3/4 Ave Cumberland WI 54829 RE: Conditional Approval: Land Use Permit, File# LUP-2017-016 Project Location: NE 1/4 SW 1/4 Sec. 12 T30N R19W Town of Somerset Project Address: 833 165th Ave Dear Stetson and Laura Baker, Community Development staff have reviewed the Land Use Permit application for the construction of a new Single Family Dwelling and to fill and grade greater than 10,000 square feet within the Shoreland Overlay District, Chapter 17.30. The request has been conditionally approved based on the application submission and the following findings. • The proposed project meets all applicable setbacks and the proposed principal structure will not exceed the 35-foot height maximum. • The amount of new and existing Impervious Surface (IS) is less than 15%, therefore compliant with Shoreland IS standards. • Vegetation will not be disturbed within 35-feet inland from the navigable water body. • Erosion and Sediment Control plans have been submitted that meet Wisconsin Department of Natural Resources Technical standards. • A 40-foot Drainage Easement is mapped on CSM document number 1046208 describing this property. There can be no filling, grading, construction or excavation or any alteration of the existing flow of surface water within this area. • The property received the Sanitary Permit #597368 and coverage is valid for two years. Based on these findings, approval of the Land Use Permit is subject to the following conditions: 1. The mapped drainage easement, Private Onsite Wastewater Treatment System (POWTS) drainfield component and the 75-foot setback to the pond shall be flagged. 2. A pre-construction inspection is required to verify the flagged areas in #1 above and that erosion and sediment control has been installed prior to any land disturbance activity. 3. St. Croix County reserves the right to require additional sediment and erosion control measures to be installed if found necessary due to site-specific concerns. 4. Permanent vegetation shall be established once final grade is reached. A temporary cover crop such as oats, winter wheat or rye shall be applied on all disturbed areas if seeding cannot occur prior to September 15th or freeze up. Phone 715.386.4680 Government Center, 1101 Carmichael Road, Hudson, WI 54016 Fax 715.386.4686 www.sccwi.us/cdd www.facebook.com/stcroixcountywi cdd@co.saint-croix.wi.us Land Use S T. C R O IX C. U N T Y Planning & Land Information Resource Management r Community Development Department 5. Phosphorus fertilizer shall not be used to establish and/or maintain vegetation unless a soil test confirms phosphorus is needed. 6. Sediment and erosion control shall not be removed before the project site reaches a point of at least 70% perennial vegetative cover. 7. It is the applicant's responsibility to secure any other required local, state or federal permit(s) and approval(s) prior to land disturbance activity. 8. Failure to comply with the terms or conditions above may result in the revocation of this permit by the Zoning Administrator according to Chapter 17.30(13). This approval is subject to the conditions listed above; it does not allow for any additional construction, structures, grading, paving, filling or clearing of vegetation beyond the limits of this request. Your information will remain on file at the St. Croix County Community Development Department suite. It is your responsibility to ensure compliance with any other local, state, or federal permitting or regulations, including contacting the Town of Somerset and the Wisconsin Department of Natural Resources to inquire if additional permissions are required. This permit is valid for one year, with the possibility of up to two (2) six-month extensions if the applicant submits the appropriate permit extension fee and documentation to the Zoning Administrator. A copy of the Land Use Permit placard should be submitted to the local Building Inspector for the town upon application for the building permit. The orange placard must be posted on the job-site and visible from public view. Please feel free to contact me with any questions or concerns. I am typically available Monday- Friday from 8:00 a.m. - 5:00 p.m. If you would like to schedule an inspection, please call the main office so your call can be directed to the next available staff member to accommodate your request as soon as possible at 715-386-4680. Respe ully, Sarah Droher Land Use Technician II cc: File ec: townsom(cbsomtel.net office@allcroix.com s1baker9416(bgmai1.corn jim bhm-inc.net enclosure: Site plan Phone 715.386.4680 Government Center, 1101 Carmichael Road, Hudson, WI 54016 Fax 715.386.4686 www.sccwi.us/cdd www.facebook.com/stcroixcountywi cdd@co.saint-croix.wi.us r 1 vc r~ Vr Y1 _ ' 1 r ~e 116 ~f vEti s ~ c1 i