HomeMy WebLinkAbout026-1158-00-069
;a,:cnsro uap::nmert of Cotrr,,Q= PRIVATE SEWAGE SYSTEM County. SL Croix
Hrdetp anc Bu' m^9 D,WSr00 Sanitary PMnuI NO
INSPECTION REPORT 605105
GENERAL INFORMATION (At I ACH TO PI I I nr Plan ID No
Per=--anal irY2m JI'On Bien CvCtvloe may he -See for seen^.'Mfv p„'POS-' ^riVanj W'/. . e nG '11' 3127499
PeI-. t doll-is Nmne Cty 'r tllayc IU,,$-d r. Faroe! Tax No
Luke Miller TOWN OF RICHMOND 026-1158-00-069
CST Brvl Elea. Insp BM Ele: RM Deicr phc* Sec'ie,T.rvin Rand, % p No
25.30.18.1204
TANK INFORMATION ELEVATION DATA
TYPE 1111ANUl-ACTURER "r CAPACITY STAIION BS HI FS ELEV.
/Z-A 5
S
Sep: 2..S Benchmark
Doslrg Ir ; r All. BM 'S
_ Ci0 5
V,r,6 S .3 /ao 5
peret+on - Ring Sevier ♦ t/16% S` IFZ
r-.. Pa LA4 116 12- S
Holding SVI II Inlet • ♦7 B b 3
SNHt OI.tlcl
TANK SETBACK INFORMATION
TANK TO PA vIELL BLDG. :i~nl e. a Imatt ROAD DI Inlet
p 1
oel'th 3,3 63 zU r r- Dl Bottom I ~l.x p'
Z-~ 1J
Dosing -hl I / Hoader70an /QZ . y 5
,
Awatlon Dist. Pipe
/oz-4S
T
Hrldmq But. System
Z. yz /6(
ICI z' ~7
Final Grade /69 7J
PUMPISIPHON INFORMATION 6,-7 \ Danand St Cover Manotac~u,er ~,l~ J' d7. lz d 92 !5
O GPPAO J
A1odcl Number 5 'jig c; I
to 3 a do. 3
!DH Df)„- Friction Loss System eZ TDH Ft _
6Q 7
rercemaln Leroth Dia r 11M 1a11 . 4e' r
~i5 z ~3
SOIL ABSORPTION SYSTEM S r
BED,TRENCH idth 4 engl'r INC, Of nd'r PIT DIMENSIONS t, O'P I ]"side DIA I Cold DsPth
DIMENSIONS V 5`, ~j
SETBACK SYSTEM TO FIL BLDG I V:'ELI y LAKF!STREANI LEACHING Mam.fartuc,.
INFORMATION / CHAMBER OR
O, r f !Q J qS I I~ UNIT ~AOdcl Numter
p ' 3 ] 1 J ,l/
DISTRIBUTION SYSTEM
ake
heedcd6dn7J . fA9trieutic •r x Hole 5 tc x Hole SPdC/n9 o Ali
Lrn4p, ua ~-encrh p ~ Da 'r 5 SPAT ~g T /
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
DeP1h Ovc. CeF'1h O:e, UV`1, c,r xx Seeded'sonded xx M~atched v-'
Bid:Tre-_h Center f, RedTre'eh EC:n`; Tops:nl ~..yFy NP No
F
COMMENTS: :Include co::e dlscrepencies, persons present. eta i Inspection #1 Inspection ill
Location: 1362 144TLl ST
1 : Alt BNI Descnplion = r r W.~ C~ L-J
2.i Bldg sewer length
- amount of cover - 1 G~Q•;,^~ C..ff. S S
L ' / /`7II~S
P an revision Required? I YesL A!\ ~JiJ
?
Use other sine for additional information. r
1 - - - - Ccrl No
Date :nsepd Sgnalu
- 5fiiti -),o ► - as a
County _
Safety and Buildings Division S / •
0S ? t 201 W. Washington Ave., P.O. Box 7162 Snninvy permit'Number(lob,-. filled in by Cm)
Py j t • Madison, WI 53707-7162
5
Jtatc 665105
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Sanitary Permit Applicatior*
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~3 I~icenitlicn aal '1'emnt Region TISadr„e:n,, Y.nait'Number and Date lsn:d j
to Sue i
1\'. Type of I't)\\TS $ystem/C.ompootnNDccice: (Check all that apply)
. ' \mt-1r 'v t tIv V r u:d 2' in ofmitbte sod , 7n-rsd<?.?in al vit:.b;e xtil
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l 11 Responsebdtly Slalenteol- t, lbe aademxneA, nu~t a mgrotnWthn• far installation oYlhe 1.Ot\TS 560»n .,he lachrd plnn> - _I
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of • ~fl t+~ • /7\~_
is par ,narayemety Hi._n ~ c.ioe•1 by yiu,nix:. WL
2. AY atRWk (ect•it9r^en,s must l:u r, a,rt: If /
L` » Per nork4W5 c.),!!:nf,amel.
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DIVISION OF INDUSTRY SERVICES
1054' N RANCII RU
I IAYWARIl V.I 54843.6462
` D S` 7 Conlar t 1 h. ougn Relay
`'1 P 5 http. rldsps.'n'i.ga: cro4+arns'ind rst 1-services
Cov
lop;
Scott Walker, Governor
Laura Gutierrez, Secretary
Juh 19.2018
C.1!ST It) No. 220357 A'17:V: POU IN Inspector
IiR;%DY J U'EGARD ZONING 01 FICF
L I6ARD PLCMBI\G & I ILAI'I\G ST CROIX COUNTY SPIA
PO BOX -0 13 1 101 C'ARMICIIALL RU
1A~Il RY IVI 54001 HUDSON kki 54016-7705
CONDITIONAL. APPROVAL
PLAN APPROVAL EXPIRES: 0?:19:20211 Identification Nutnhcra
Transaction ID No. 312-499
SITE: Site II) No. 851319
1 uke' Miller Plcasc rclcr to both idcnlilicalion numbers,
1362 144TH Si abovc. in all correspondence with the agency.
l'oa'n ol'Richmond
St Croix County
SP.1!4, NV1'I+-1, C0;.130N, RI8W
1'OR:
(bjeel Tvpe: POWTS Component Manual Regulated Object ID No.: 1755592
Maintcmmcc required; 450 GPI) Flaw rate: System(s): Mound Component Manual - Ver. 2.0. SBD -10691-P (N.0101.
R. 10`12): Lfllucnt fiber
Cox
1 he ubn I.tal dos rlticd abovc has been rcvu wed fur eonlbrmar ce with applicable kk isconsm Adhninistrative Codes A
and 1V uconsin S n ute The _uhinitial has been CONDI I IONAI LY APPROVED. This s% is to be ` `P9`F
ant. located in accordance with the enclosed approved plans and with any wmpouem mtuwal(s) relcregced above. AN
The owner, as defined in chapter 101.01(10), W'isamsin Statute,, is responsible' for compliurree with at] code DIVISION of
requirements.
A copy ul the approved plan, spvei iceuons and this letter shall he on-site during conm uction and open to ~C
in,pcUron by allhm ved rcp(c unativc, of the Dep ar0uent, which may include local m-pcctor.. All permits
required by the state or the local municipality shall he obtained prior to commencement of
constnaclioWinslal lat ion`operal ioo.
ct SJ'
In rran[inc this uppn»al the Divizion of Industry Scrviccs re,ervcs the ri_eht to raluirc changes or ad9itions sl:, ;dd
conditions arise making Them necessary lur code compliance. As per stale slats 101.12(1). nothing in this review
,hall relieve the designer of the responsibility lix desienim, a sale building, structure, or component.
Ingniries concerting this correspondence m;q, be made to lac at the telephone number listed below, or at the addre,s
on this letterhead.
I he above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and arp
o,hcrs who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely, j Pee Required $ 250.00
Fcc Received S 250.00
Balance flue $ 0.00
Z L
Ltlwin A lay. ?r
Wastcwalcr Spccial1s i
t , of haduslry Services W'iSR1ART code: 7G±;
(715)6;4-1.15.1 , Mon-fri. :00 a.m. -4:30P.111.
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MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
INDEX AND TITLE PAGE ~~C~wED
X114 ~
Project Name: MILLER 1NpUS~ftY St ~~~LCS
Owner's Name: LUKE MILLER
Owners Address: 1541 160TH. AVE. NEW RICHMOND WI. 54017
1362 144TH. ST.
NEW RICHMOND WI. 54017
Legal Description: SE/ NW/ S25/ T30NI R18W
Township: RICHMOND
County: ST. CROIX
Subdivision Name: RED PINE CORNER SECOND ADDITION
Lot Number: 69 Block Number.
Parcel I.D. Number: 26115800069
IOX4LLY
Plan Transaction No.: PROVED
PROFESSIONAL SERVICE
Page 1 Index and title INDUSTRY SERVICES
Page 2 Data entry Page 3 Mound drawings
Page 4 Lateral and dose tank
Page 5 System maintenance specifications
\
Page 6 Management and contingency plan 1
Page 7 Pump curve and specifications
Page 8 PLOT PLAN ~SPO ENCE
Page 9 SOIL EVALUATION
Designer: BRADY UTGARD License Number: 220357
Date: 07/02/1 Phone Number. 715-760-0946
Signature:
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01101), and
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)
Version 3.11 (R. 06/01) Page 1 of 9
Mound and Pressure Distribution Component Design
Site Information
R Residential or Commercial Design Note Sand fill (O) calculations assume a
300.00 Estimated Wastewater Flow (gpd) Tabie 83-44-3 in-situ soil treatment for fecal
1.50 Peaking Factor (e.g. 1.5 = 150%) col form of 36 inches.
450.00 Design Flow (gpd)
3.50 Site Slope
100.00 Contour Line Elevation (ft)
19.00 Depth to Limiting Factor (in)
0.50 In-situ Soil Application Rate (gpd/ft)
Distribution Cell Information
56.25 Dispersal Cell Length Along Contour (ft) = 8.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft')
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution Y
Pressure Disrbution Information network?
E Center or End Manifold
4.00 Lateral Spacing (ft) If N above, enter the elevation (ft)
2 Number of Laterals of the highest point.
0.188 Orifice Diameter (in) (e.g. 0.25)
2.50 Orifice Spacing (ft) = 10.23 ft'/orifice
2.00 Forcemain Diameter (in)
/ 125.00 Forcemain Length (ft) Does the forcemain drain back? Y
85.00 Pump Tank Elevation (ft)
A21.75 System Head (ft) x 1.3 20.39 Forcemain Drainback (gal)
Vertical Lift (ft) 50.29 5x Void Volume (gal)
Friction Loss (ft) 70.68 Minimum Dose Volume (gal)
Total Dynamic Head (ft) 28.84 System Demand (gpm)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. o tons choice in. dia. options choice
0.75 1.25 x
1.00 1.50 x x
1.25 2.00
1.50 x x 3.00
2.00 x
3.00 x
Gallons/Inch Calculator
Treatment Tank Information Total Tank Capacity (gal)
1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in)
weiser Manufacturer gaVin (enter result in cell B49)
Dose Tank Information Effluent Filter Information
600.00 Dose Tank Capacity (gal) POLYLOK Filter Manufacturer
11.82 Dose Tank Volume (gal/in) PL525 Filter Model Number
weiser Manufacturer
Project. MILLER Page 2 of 9
Mound Plan View
.:''Obserahon'Pipe 3" . J
. . -T
- K.
O ❑Q A
W t.....'.'.'.'.'. 4 I
- B
.'.'3 '
. . . . . . I
.'.Q.
♦ . - L
Mound Component Dimensions
A 8.00 ft E F12 .36 in H 1.00 It K 10.05 ft
B 56.25 ft F 9.50 in t 10.02 ft L 76.34 ft
D 17.00 in G 0.50 ft J 7.35 ft W 25.37 It
450.00 (ft) Dispersal Cell Area 1013.44 (fe) Basal Area Available
8.00 (gpd/ft) Linear Loading Rate 5.63 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 103,21 (ft) ►_1 G
.,iiiJ-i::,.. H
F Dispersal cell 101.92 (ft) Lateral
101.42 (ft) -10- - Invert
Dispersal Cell 3 =c c c t
Elevation E D 3
❑
1 1=
F41 4
100.00 (ft) Contour Elevation
3.5 % Site Slope
Geotextile Fabric Cover
Shading Key o c Dispersal Cell See lateral details on
Q-~ Topsoil Cap c c 1.5 ft Page 4 for number, size,
Subsoil Cap o ° _ ❑5 0 and spacing of laterals.
F311:7:7: ASTM C33 Sand v / F Laterals are equally
[9] Tilled Layer 0.15 It Typical Lateral spaced from the
0 v l [5] distribution cell's
0 Aggregate o H - - t centerline in the
4 A distribution cell (AxB).
Project: MILLER Page 3 of 9
End Connection Lateral Layout Diagram
LMeralscentereJ over Me Ati dmenSion
P * - Turn-up HAbell valve or claenout plug
< -
All laterals are identical IF X~I Flores *,1,,d on the bottom of the lateral
equ.09 spaced s
Force mam ecMnectron uta tee or cross to manifold at any pant. Lateuls a lord. manor PVC sch so
(per COMM T.rbl. iN.JO-51
Number of Laterals 2 Onfice Diameter 0188 in
Lateral Diameter 1.50 in Orifice Spacing (X) 2.61 It
Lateral Length (P) 54.81 It Orifices per Lateral 22
Lateral Spacing (S) 4.00 ft Orifice Density 1013 ftZ/orifice
Lateral Flow Rate 14.42 gpm Manifold Length 4.00 It
System Flow Rate 28.84 gpm Manifold Diameter 1.50 in
Total Dynamic Head 21.75 ft Forcemain Velocity 2.94 fUsec
Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and
Comm 16.28 WAC Drsconn 4 is min.
eG
Tank component is properly vented E ARemate outlet
location
Forcemain diameter
Weiser Manufacturer 2 in.
Capacity] 600.00 Gallons rt-
Volume 11.82 gal/inch A
Weep hole or anti-
Dimension Inches Gallons _ B siphon device
A 34 78 411.12
B 2.00 23.64 C
of Pump off elevation (it)
C 5.98 70.68 85.67
D 8.00 94.56 D
Total 50.76 600.00
Dose tank elevation
F---85--001
ng un er tank. .Alarm Manuafacturer LEVEL
Alarm Model Number DLV
Pump Manufacturer GOULDS
Pump Model Number PE 51
Pump Must Deliver 28.84 gpm at 21.75 It TDH
Project: MILLER Page 4 of 9
Mound System Maintenance and Operation Specifications
Service Providers Name UTGARD Phone 715-760-0946
POWTS Regulator's Name ST. CROIX Phone 715-386-4680
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 450 ft2 Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Col'rform >10E4 cf i/100 mL
Service Frequency
Septic and Pump Tank Inspect and/or service once eve 3 ears
Effluent Filter Should 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 years
INSPECT FILTER ONCE A YEAR
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code.
3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Lateral Tum-up Detail
Finished
Grade
6-8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Lateral
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: MILLER Page 5 of 9
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
this system shall be operated in accordance with Comm 82-84 Wis. Adm. Code. and shall maintained in accordance with its'
component manuals (SBD-10691-P (N.01101) and SSWMP Publication 9.6 (01/81)) and local or stale 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 Comm 83 33. Wis. Adm. Code when the tanks are no longer used as
POINTS 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 sub)ect 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, Slats 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 fitter shall be
assessed at least once every 3 years by inspection
The outlet fitter 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 fitter 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 113 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 fitter is installed within the tank t shall be inspected and serviced as necessary
.
Mound and Pressure Distribution System
No trees or shnrbs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be
seeded and mulched as necessaryto prevent erosion and to provide some prolection from frost penetration. Traffic (other than for
vegetative maintenance) on the mound 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. Coif weather installations (October-February) dictate that the
mound be heavily mulched as protection from freezing.
Influent quality into the mound system may not exceed 220 mg/L BOD5. 150 mg/1. 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 t should be compared to the initial test
when the system was installed to determine if orifice Dogging 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 pending. Pending levels shall be reported to the owner, and any
levels above 6 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 con
. porxent 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 mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it unit be repaired or
replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically dogged absorption and dispersal
media, and related piping, and replacing said 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 POINTS regulator and service provider.
Project: MILLER Page 6 of 9
ITT GOULDS PUMPS
Residential Water Systems
APPLICAATXWS MOTOR
Specially designed for the folmving uses: General:
• Mound Systems • Single phase
• Effluent(Dosing Systems • 60 Hertz
• Low Pressure Pipe Systems • 115 and 230 voles
• Basement Draining • Built-in thermal overload protection with automatic reset
• Heavy Duty Sump/ • Class B insulation.
Dewatering • Oil-filled design.
• High strength carbon steel shaft.
SPECIFICATIONS PE31 Motor:
Pump - General: • .33 HP 3000 RPM
• Discharge: 1'/:" NPT • 115 volts
• Temperature: 104OF (4080 maximum, continuous when • Shaded pole design
fully submerged. PE41 Motor.
• Solids handling: 'h" maximum sphere. • .40 HP, 3400 RPM
• Automatic models include a float switch. • 115 and 230 volts
• Manual models available. • PSC design
• Pumping range: see performance char or curve. PE51 Motor.
PE31 Pump: • .50 HP 3400 RPM
• Maximum capacity: 53 GPM • 115 and 230 volts
• Maximum head: 25' TDH • PSC design
PE41 Pump:
• Maximum capacity: 61 GPM AGENCY LISTINGS
• Maximum head: 25 TDH
K51 Pump:
• Maximum capacity: 70 GPM S _
• Maximum head: 37 TDH ' J Q k-
; ` Tested to UL 778 and
CSA 22.2108 Standards
By Canadian standards Association
METE 81 FEET Ime *L,549
PESt +•su K3%KAI. asp
+Y lf. 4l, `O
to 2 coon Goulds FNnnps is ISO 9001 Registered.
30 -PEAT - - ~ 1 R
4"
25 W PE31 i
~ r
s
i 20 ~ -
0
0 15
10
s -
0 00 in 20 40 so 60 70 GPM 80
0 5 10 15 mI;h
CAPACITY
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGR-LUNIENT
AND
OWNERSIRP CERTIFICATION FORM
Owner,Buver ` A //e7l~
Mailing Address,_ //`~'7 / _ /~71 te/
Property Addrefi' y y2 r~ 7 1
(Verification required from Planning & Zoning Department for new construction.)
City/State & 1 G ll/(J/2 Parcel Identification Number Qzrp Q(09
LEGAL DESCRIPTION
Property Location , ice' 4 , Sec. S , T >L: N R (C W, Town of
J Nf)~ c
Subdivision Plat:_ Cc-ti>-~~ 'Lot # = r
Certified Survey Map # Volume Page # .
Warranty Deed # O 6, ] .5 J -(before 2007)Volume Page #
Spec house J yes Kilo Lot lines identifiable 9yes J no
SYSTF,M MAINTENAINCE 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. 38352(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 toaster plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal systern 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
U'we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards .set fordi, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources,
State of Wisconsin. Certification stating that your septic system has been maintained must be completed and retuned to the St. Croix
County Planning & Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on is form are true to the best of my/our knowledge. Uwe am'are the owner(s) of the
prope..ry described above, by virtue of a w ranty deed recorded in Register of Deeds Office.
Nu er of bedr ms J J
,
~ - - 7 Rol
SICiNATLTOF APPLICANT(S) DATI
""`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. 04112)
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1016
scoisrn Ueparmert of Commerce SOIL EVALUATION REPORT Page I of 3
DI soon of Sa'oty and Buildings in accordance with Comm 85. Wis. Adm Code Steel Soil Service
County r,.!s::h rznnplete site dam. un paper 'rot less Ina" RS4 z 11 °.cbes m s¢c Vlan n st Sl. Croix
!udu, Cut not I:Wlt?d IC V(,- -!1G"! W%! huri~on!al reference p:anl fHF"1 d redo- and
cold slope. sca'a ut dr enrauw uudh annw, and ir..anen and di%lar .e to nearest mad Parcel I D 2 _j
Please print all information. !
et1 By n Date
n;:rul r`:nre~irr w~pvn.cmu7 b.u»ilc.eec:Ndry puxse%I°nvw:Yldws lC. }t 11 m;l
Property Owner Property Location
Oakwood Land Development _ Gn. it Ior SE 1A NW1A S ' 1 u NR Is W
Property O•.vncrs Mailing Atldress //E, l /fwy +r//v ll/, K • Lot # Block # Subd Name or CSM#
Spnng Lake Park 69 na Red Pine Corner Second Addition
City State Zip Code Phone Number (Ay Village ✓ l nwn Nearest Road
MN 55432 ij 780 4996 Richmond 136Th Ave
✓ Nev Construction Use. ✓ Residential! Number of bedrooms 4 Code derived design flow rate (y OG' GPD
Replaremenl Public orcommercial - Dmta i!x. pp~ 1,
Parent material Pitted Glacial Drift Flood plain elevation d appllc`AbXC UII' E r ~~tF~A
General comments
1
and rec:vnmenualunrs Mound Design, system elevation 101 OOft based on contour line 100A0f1 JUN 1 1 ZQQZ
AH: Uoon r.I
During # 9 L I, if Pit Ground Surface elev 100.50 t! Depth to limiting factor 2 - in Scd Applicator ate .
Ilor¢en Depth Eprn.-~,; Calv'r Radx¢Ue,ropiian Iex'.ule Imp slsiF ee rr',m"aIy R.6 GPDRt'
'Fff#1 •EtHt2 _
1 0-9 10yr3/3 none sil 2msbk mfr cs 2t b 8
2 9 14 10yr414 none sicl 2msbk mtr gw 1t 4 6 r.1~•
3 1424 1.5yr3/4 none act 2msbk mIr gw na 4 6 I
4 2436 75yr3/4 c2d75yr5/8 sl lesbk nlvfr gw na 4 6
5 36-96 7.Syr4!6 limestone residuum na na na na na np np
Ronny # Boring
Fil ✓ Pit Ground Swtaxx eiev 100.5 it Depth to limiting factor 24 in Suit Apphca;iml Fate
Hmrun Depth I:rrtrinant (:nlnr 'iedin 7esn;iwn L•ctwe 'l-.atwe rm;istencn ..rddy R>.A, GPCih'
-Ett#1 'EfNl2
1 0-9 1Oyr36 none sit 2msbk mfr cs 2f .5 .8 '
2 9.15 10yr4/4 none slcl 2msbk mfr gw 1t 4 6
4J
3 15-24 7.5yr3/4 none srl ?msbk mfr gw na 4 Ei
4 2438 7.5yr3Y4 c2d7 5yr5Y8 sl om mfl gw na 3 b
5 38-96 7.5yr4?6 limestone residuum na na na na na np np
Effluent #1. = DOD 30 < 220 mgrL and TS -30 , 150 mgrL ' FHluent 42 = ROD, <1.30 mg.i- end 133 130 my!L
CSI Narne(Please.Print) Signature CST Number
David J Steel 248956
C R. _~.~J
Address Steel sod service `J Date Evaluation Conducted telephone Number
1564 CR GG. New Richmond WI 54017 61512002 175-246-5085
property Owner Oakwood Land Development Parcel ID# Pending ? Rage 2 of
a Borng# Boring f- 3:v -
✓ pit Ground Sudace etev 98.4 11 Depth to limiting factor in. Soil Applv:duuu Ra,-]
110tuen Depth Ccminant crler Redox Des-,^rwn T, Aurc S7°..cture -.Mslstenre l!omxlaiv Rents U1,0 t,
'Eff#1 'C1f#2
1 0-9 10yr313 none sit 2msbk mfr CS 2f 5 8 v
2 9-19 10yr4l4 none Sid 2msbk mfr gw if 4 6
3 19-30 7.5yr314 none sl 1csbk mfr cs na 4 6
4 30-96 7.5yr4/6 limestone residumm na na na na na np np
Boring # Raring
P4 Ground Surface elev. h. Depth to linuuny factor in
c",i ~,-°licatnn. Ratc
rb:.'h J i L'a e: 1 I]( 11,11[l C- IC%'mC LlmCUrc C'-,nsstume Boundary Rnols (1P!111t'
'Flf#1 'Flf#2
❑ Boring # Boring
Pit Ground Surface e!e'+ fl Depth to Gmding factor in. f Soil P.pp!~=nnn Rxe
Prnxan 6epl:•: Llom1nan1 Cnlm Relix L`escnpton Irxb.re S7mct,.^e Oonsas'en: e Roundarj Roots 6 fIP
'Ffl#1 'FI1K'l
Fffluen! #1 - eO7 93 2n t1r;1 and TSS -31 . 150 nigiL ' Uflucnt 4 2 = BCE, 30 rig!L and TflS - 30 nig!L
!1•.I`;.i..n;:nt.-(:.o::or.:i:. an cGual-~n?; rtan:D: n.i: t•;nvid ra:.J aqd;I. rcu r.:..'.., .ct:w.. t., .n..:.. ,r: u:::cnr
Page 3 of 3
_ 7 SOIL SURVICE
David J. Steel - - - - - - - - -1564 &y Rd GG
CST-POWTSM New Richmond. WI 54017
Lic. #248956 (715) 246-6200
CWCt1 ~u aG~ f~e.✓ca(715) 246-5085
/t 2~'P ~!f(C. !'OrIZ L'r SGc..Cri~V ~TdU i~i C~~
Y7 ~
- = 133 ; ~t
r24 n C
(~:~r Qm__f/e✓..,~.'a~ ~_/off'
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Dori yr 5 f/e J
82 ~ SD/