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HomeMy WebLinkAbout042-1090-20-665 rascroslr repamme-I-rt;omrner-e PRIVATE SEWAGE SYSTEM `O0 1j St. Croix Safety anc Eu :1~.:, ILVx,l~yn INSPECTION REPORT Sunsti,vPernmNn (ATTACH TO PERNII I) 605108 GENERAL INFORMATION stmu war lu Nc Persona ntu-,,,0v gnu p'wUc m,/ by a ,d T, n 'ary P'.uP IPr °v i IS a: ( rdm,) Penny hp de'S N1-1. V~ age Toansh p Pain. I Tax No Jose Franco Trujillo and Leticia Franco TOWN OF WARREN 042-1090-20-665 CST 8!.1 Fie, 1 hisp. 8I.1 Llcv EI`.1 Ll@s;.nl;'d4n t Section'Tov r."RaI1014an No /rte 3VIA GS 32.29.18.497B TANK INFORMATION ELEVATION DATA TYPE PAJtNUFACTUKEH CAPACITY STATION BS HI rS ELEV. S eSeeppttiitc- w n Z` f i L5d Herchrnark a /a F• I f o ~o ~G ZS J AI Hna~1 C 7.~(, ~61r Acrahcr Bldg. Sewer io4t) ,$5 Bolding - SUH: Inlet 1r ~7 1-g TANK SETBACK INFORMATION s,+Ilt outlet • $ 06 Ado , TANK 10 '"ELL BLDG. :Pr tc A.re•'hfP ROAD Dt Inlet Dt Bollorn Septic 5 Dosing HeadeNFAan Aeration D st. Pipe JL`- tlnld,ng Hot Syslern Feral Grade • 9 PUMPfSIPHON INFORMATION is• L Manufacturer IDemand St cover l G 7• g4 ~d 5.3 IPM Model N imbof. - ` f / [I • I C! r 1 (r V I `P TOP Lift , Fiction Loss Systen ad I IDB R r rCr,l 9z-d o F orrRntairl Lc l" 1c.LVell - u i l3. Z 95 SOIL ABSORPTION SYSTEM BEDITRENCH 010-11 1 r 9'h No Of T er<: -rs PIT DIMENSIONS Nc. Of 'C:: Ins ]u Div. Llgma Dep:h DIMENSIONS V A + Pc,, SETBACK SYSTEM TO Ptl. BLDG WELL LAKEiSi RFAIA LEACHING D,1an ~r Wryy. r INFORMATION „r _ CHAMBER OR UNIT DAOdc fLymCer L-d A e.rV~ 0 7 7 (~J.. s c.~ DISTRIBUTION SYSTEM Sad 1-7 fl(~) 17 -:-~51 Ika7c^'dnr talc it (3151"I13i.I XT x he e Sicc x H. e Spacmu -eeto A'r Iflike I•IC.~!sa . \ I eagth_ Gla _ Lc^pN_ f? id ?:psrinc_ A SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only DcJP' O ar ' r Gcetr J'v - De ata o' x. SeedeNBSdcec xx Mulched C Jh.. .h !:enter ! Bcd Tx-h Ep~C' I;.>J ` ti.~4i:: Nn Z\ta N COMMENTS: ;Include code d screpencies. persons present etc.) Inspection ffi1' /S )23 /I Inspection #2: Location: 6991OOTH ST G~~"hi 3---4 rS.~ F 1 (,ooe.~ 1.) Alt Bh9 Uesaipt or. - / 2.) Bldg sewer length = f f - amount of cover = > r C n// Plan revision Requ'red? Yes XNo Z6 9, G p ~ J Use other side for additicral Information. Datc - - hsecotcr's S , a.re. Cer. Nn. SBD.@9to )ii IC; J n~ri~ I - ' I Sr9w-ao, 8 - aa3 AAft Safety and Buildings Division St. Croix tint R! 1 I t \ucilwr m, he h11"Im III Co.) .rIR I"-1 11 3 20}a 201 W Washington Ave P.0 . Box 7162 nm Madison. WI 53707-7162 og N S R) vterl'.tn,.tctt vn,.lh<I Es~ltar Permit Application In 1-c'xdun¢ with Slh X. `ItI I Pk Aim (11a. subnic toa of thu Ilan to tl1 t1.Im I u, nmcnl]l µunl i. !ry ,ncd 111 rv t - -hia....1l a 'uu!erV pcnnrl. \mc, kpphcaGmt IunuS 1W itaw owned IN Ak I S arc 'U1111 I to ~ 'ngcct r\ddress 111 d rh,rnt jinn mmllnp addtCUl n 1 f.u Hutt If ~,m, and 1 I I t m:J Prnun: I inh,r munn you provide ttla} he lI fin srt:unrian I ~.Ll IIIIVII~A ~ 1 11 F111111 11111 t-11 lrt 1. Application lnl'u_rintiIPlease Pnnt AHInformation. _ /V^/\_x` /vr\--ll `•l frolxth!h. f, i'-'-V _ _ - I'ntcclA Jose F. Franco Trujillo and Leticia Franco 042-1090-20-665 Proluns(huw' I M'st'np AdJ0.sv _ _ I'ropcnl l.C:IltiNl 3a,~,`I. t)S•`I 4t 1035 70th Ave. i„<t I 'A Ow Slate Ajl(-Me Phone Number NW , NW 32 ii Roberts W, 54023 I 29 R 18tr'r`I` rmW H. Ty-pc of Ruildini; (check all that cI I L _ I or' I amd+ Ihscllln{, Mtmh•r of Wh"Ilrm CA{ (f~'r^ 10 tiuhJrv uiun N:tmc N~ Iur~k a ItPuhlic'C"i "Vi" I Ih'I 'IlcI I, J Cc, ul' ❑State<)wl ncscrlhcI sc ^7 CS'l Ni'lk~r t:U]Village nl SMIMS 3 _D'.bX C2QaS w/ I ~-I t _ i S lawn ul Warren - 111. Type of Permit: (('heck unh one x on line A. ( olnplete line Rif applicable) r - :f. I ~Krs _A stc. L Kcplaicmcm \..q<m ❑ 1 ,n....I l t .I. l1:nk Rcplaccmcnt (W) ` ❑ Oll,cr 61.~ddi-at n.n to I skl+ng.m' "I lcxpll I 1 ' It. I ❑ Permit R ncwal ❑ Pint t Ro, C1 C hange of P111I C1 I'crmd T,mn2r t Nca I i.11 r •nuu++Pcnnn Numhor un l Ua< I..ucd ndDrc F!>_poauon Owner F,J ;P_t1 rE ` _l „ IN'. T)'pe of PUN"I'S SS'sleniA onlpunentiUecice: (Check all that apply) L{ ~TSUM) SY ,p N. n I r. ..d In G n 1 I 1 1'r:. ,u: <c ! I t UtomW Q AM1G.,.Jc ❑ \Ioun7 ] 74 m ul'.mr,hl ❑ \L.un,i '4 -r. ua:.blc ~Ihddr•.rle.nk ~<,Ihcr Un:fin::L (l+a p.•ncnt 0.apluup ❑Prclrcatmen!Ue. ice Poxplatn) V. Dispenali I reatment Area Information: - - - tfn I h'I ('j 'j I I Uc.m, \"J Applre't v, R.uc(plsl4l Ih,par.nl Arc.. Itapnrcd W) - D sFxrsal Arm, I r.p.•xcJ l Sv iii 1],1, r7\ 600 .6 1000 1020 3. 93.5 94 fee V'1. 1ank Info Calcuthm I-tai ti of Manufaamcr C:dh.n+ G Ihnt-. Urals FOt LOk 525 ° u - t- V _ N. larlic, s.PUe.s FtdI,,g I 1 1200 1200 Wieser X 11. Responsibility Statement- I, the unaerdReed, uaeunle rIlir) If utstallµtioa the 1N)V, I ti rh I oo the •n.,h,d print, I h mfs, Nan 11 n i Plum 'r 1." . - AIPRd I'RS Nund~r B,utness I'honc M,mlwr Keith Knudtson 648443 651-470-1737 own? 1_.. I lunthis Addn..t5tn:cl.t i ~ tic. APt1..4i 927 150th Street Roberts Wi, 54023 Il~l (0unh 9)c larlmW 1 sa Only [1 f,. I - Ii c nt, ngc r tii tmc n:tr(ai rnk.::Iknkd IS iC 4if R* nrsal/Reasons for Disapproval SYSTEM WNI NI R' 7. J\ b'Ltt4C!' Septic tank o l.lent hltel and dispersal cell mrist t>e serviced.: ntainlaines. as per management plan provideC Cv p''~Jmrur F,11 selback requirements mus! hu rralnlarred s pe.r applicable ror$sVfrtlmarlr[etN• Idu~t. s., ut~ -.,Lin .,tn wMmt to the ('ratty only oe p ,e and 1.v Ilan a la It 11 iochm iu w< ~IVlt n_ ~:(R II III ~o:X,~c ~ 3-6se F. f;,q "oTJ ; Lem 01- L e f . a, l Pe .eea /vimI fl iox/ J-J;z KNUDTSON PU U. CONTRACTING,, LL , 927150TH ST. 648447MPFS ROBERTS, WI 54023.8526 CELL 651410'1737 n6u5,e- Bd r U Si , P~cy r C4 \ C y~ 1/~f;lfra7`o~ CCam~6>~5 ~3 cs yy, / 1oo'z ~oo,z -3 9G CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name Franco Sewer Owner's Name. Jose F' Franco Trujillo Owner's Address: 1035 70th Ave Roberts W i. Legal Description: NWU4,NW114.S32.'129N,RI8W Township. Warren County SL Croix Subdivision Name: I of Number 4 i Parcel ID Number: 042-1090-20-065 Page 1 Index and title Page 2 Plot Plan Page 3 System Sizinnc & Cross Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 --Management Plan Page 7 St. Croix Cry Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: Keith Knudtson License Number: 648443 Date: 07123 2018 Phone Number (651).,170-1737 Signature r' Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBIJ-I a/O5-P KO1101), Page 1 Still Absorption Svsbwn Cross Section 97.00 ft 4- 96.00 ft 4' Stfredule 40 Find Grade PVC Vent Pipe y,t Vft Vent Cap ft Leaching 93.00 ft Chamber System Elevation 3.00 it 4.00 ft ft Soil Absorption &atem Plan View ft 3.00 ft i a 4.00 ft Leaching Trench 1 Chambers 4' Dia. Trench 2 Header Vent Or Observation Pipe Trench 3 Leaching Chamber SoecfflcaWrrs Manufacturer And Model _ EISA Rating ?.0.00 sq ft per chamber Sal Application Rate 0.60 gpd/sq ft 600.1b gpd Design Flow 4,0.60 - Soil Application Rater 20.00 EISA = 50.00 Chambers 3 rows of 17.o0 chambers each. Page of POWTS OWNER'S MANUAL & MANAGEMENT PLAN Faye ~1, 2 FILE INFORMATION SYSTEM SPECIFICATIONS Ov ner - YCr P Septic Tank Capacity al O NA Permit X Septic 'tank Manufacturer Q/" O NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ( ❑ NA Effluent Fitter Model J' Z ❑ NA Number of Public Facility UnitsA Pump Tank Capacity gal NA Estimated flow laverage) gallda Pump Tank Manufacturer j~NA Design flow (peak), (Estimated x 1.51 gaud Pump ManufacturerA Soil Application Rate al/da tftt Pump Model Standard Influent/Effluent Quality _ Monthly average' Pretreatment Unit A Fars, Oil & Greaso (FOG) :~30 mg/L ❑ Sand/Gravel Fitter O Peat Filter Biochemical Oxygen Demand (BODs1 420 mg/L NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids ITSSI 5150 mg/L O Disinfection O Other: Pretreated Effluent Quality Monthly average Dis rsal Cell(s) ❑ NA Biochemical Oxygen Demand IBODr,I 530 mg/L In-Ground (gravity) 0 In-Ground (pressurized) Total Suspended Solids (TSS) QO m9A O NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 510' etu/1 OOml ❑ Drip-Line ❑ Other. Maxirnum Effluent Particle Size Yb in die J ❑ NA ❑ NA Other: O NA Other. Ll NA *Values typical for domestic wastewater and septic tank elfluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Serviu: Frequency nthlsl Inspect condition of tank(s) At least once every: 3 O (Maximum 3 years) ❑ NA rls ) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA yeanth(sl) r (s (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: 3 O~ }d Clean effluent fitter At least once every: / n nth(s) ❑ NA i Year(s) Inspect pump, pump controls & alarm At least once every: El month(s) jZ;A ❑ year(s) Hush laterals and pressure test At least once every: - ❑ month(s) NA ❑ year(s) thee.- - At (east o t once ❑ month (s) ❑ NA every: ❑ year(s) other - - - O NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber: Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a tailing condition and requires the immediate notificatior of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) 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 NR 113, Wisconsin Administrative Code. All other services, including but not 1'rmrted to the servicing of effluent fitters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of !512 months, shall be performed by a certified POWTS Maintainer. A sorvice report shall be provided to the local regulatory authority within 10 days of completion of any service even;. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process andior damage the dispersal collls). If high concentrations are detected have the contents of the tank(s) refnoved by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result to the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain Isump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is property and safely abandoned in compliance with chapter 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 property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or then covors removed and the void space filled with soil, gravel or another 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 replan e. em system: ❑ 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 infringed upon by inquired 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 and site evaluation to establish a suitable replacement area. Replacement systems must comply with [tie rules ir. effect at that time. ❑ A suitable replacement area is not available due to setback andior soil limitations. Barring advances m POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. T aluat nI mg `ark be Je al S. 'PRD1415 TEM~ ~b27J&J Cot 157RtJC7tpnl ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiftrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN 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 INSTALLF3t POWTS MAINTAINER Name Keith Knudtson _ Name Phone 651 470-1737 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Powers Liquidwaste _ Name ST. I Phone 715-246-5738 Phone This oocumem. was dratted in compliance with chapter Comm 83.22(2)1b)f .)(dl&(fl ane 83.5417), (2) & (3). Wisrnn in Administrative Code. Filters F` PL-525 EFFLUENT FILTER 025 Filter is rated for aue- "3.000 GPD (gallons per day) 1116" Filtration Slots aRzc -c it one of the largest filters rs AWM err t V class. It has 525 linear feet aik 4 e t cf' -e" filtration slots. Like the o[c PL-122, the Polylok =20 has an automatic shut „ all installed with every filter. rY-e'1 the filter is removed for =ring, the ball will float up and ' x-oorarily shut off the system so '-e effluent won't leave the tank. Un+ ~ eofXW ~.c other filter on the market can -ara that claim.- 1D.OODGPO i 523 R. SCND. GO Ppe -e Effluent Filter should :,perate ate efficiently for several years cinder normal conditions before requiring cleaning. It is recom- e Tended that the filter be cleaned every time the tank is pumped or a: least every three years. If the r -stalled filter contains an optional i alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be j done by a certified septic tank ca ono, cumper or installer. 1. Locate the outlet of the U.S. Patent No# 6,016,468: srw« ri septic tank. 5,871,640 2. Remove tank cover and pump tank if necessary. - 3. Glue the filter housing to 3. Do not use plumbing when the 4" or 6" outlet pipe. If filter is removed. Ideal for residential and com- the filter is not centered 4. Pull PL-525 out of the housing. mercial waste flows up to under the access opening 10,000 Gallons Per Day (GPD). use a Polylok Extend & 5. Hose of( filter over the septic Lok or piece of pipe to tank. Make sure all solids fall 1. Locate the outlet of the center filter. See page back into septic tank. septic tank. 19-21 for Extend & Lok 6. Insert the filter cartridge back 2. Remove the tank cover and information. into the housing making sure pump tank if necessary. 4. Insert the PL-525 filter the filter is properly aligned into its (lousing. and completely inserted. 5. Replace and secure the 7. Replace septic tank cover. septic tank cover. Cs -ad~~ °(7 wuooranDepartment of Commerce SOIL EVALUATION jZ 7RT Page _.~or_ Dratuan of Safety and Butdirlgs 50.1 in eccadarlce' With Cann Wr- Corn1Y Attach complete site plan on paper not less'then 8 Y2 x 11 rr✓ inetude, but not Imfled to. vertical andhmmnlilefew AM -,AOn and Parcel I.D. percent slope. scale or dimensions,-nol$i arrow, and QS 1 .ante to nearest road, Please print all inform. a. Roviewed by Date Yenonel irsorrnor,a. ywr Vrev'e^ may M Wre for rr~a7 purposes (Arv~aY l~v., s 15.ar (r) (mil. Property Owner Property Location _ Govt. Lot S _ I i" i N R I E ( W Property Owrw_es MAN Address r Lol # Block # Srbd Nine or CSM# Lip Code Phone Nuttier ❑ City ❑ Village DTOwn Nearest Road City ! (f Shoe 77 O~Ww _ Construction UseMResdential I Number of bedroom . Code derived design flow rate --GPO ❑Replacement ❑ Public or tarvnercial - Describe: Pare" material Flood Plan elevation if applicable r. General comments and remrtvnendatiorw: System Type ,_.'1i-,._ System Elevation f~ ❑ Boring is Boring 11T j- / - I Pit Ground surface elev. _ 11. Depth to 4rrNi,'lg factor J L n. Sal icatlon Rate Horizon Depth Dorman Color Redox Description Twd fs Stuck" Cauislance Bourdary Roots GPDAP In. Munsee Qu. Sz. Cont. Color Gr. Sz. Sh. r*Eff#21 'E##2 k- # 0 Boring Aorkq ®pit Grand surface elev./,,' / n. _ Depth to limrtng raaor ~ in Sal Application Rate Horizon Depth Dlxriinant Color Redox Description Texture Structure Consistence Boundary Roots GPDlK in. Munsef Cie. Sz. Cant. Color Gr Sz- Sh. •Enll1 •EM'#12 r: I ' Effluent #1 = BOD, ' 30 < 220 nxyL MA TSS >30 150 mqAl) ' Effluent #2 = BOD. < 30 n4l. and TSS < 30 ffwA CST Name (Please Print) Sig t e CST Number Bird Plumbing, Inc. Shaun Bird / 226900 nJAreRS Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond. WI 54017 j 715-246-4516 Property Owner _ Parcel lD p - Page -Of- Bori , ^ 4. Being ~Y ng Pit Ground surface elev. 2. j ft. ~ ^~ft. Depth to Yrniarq fade 2 in. SW Applicabon Rate Ifodzori Depth Ddrmar t Coto, Redox Description Texture Strudtre Consistence Boundary Rods GPDM n- Muns_ell Ou. Sz. Cod. Color Gr Sz. Sh. 'Emll 'Eaa2 _ P n 0-1Z n IL yr ( _ ( ~,V - c ~ /7 ~.J I Boring a ❑ Bating I I ❑ Pit Ground surface elev r fl. Depth to Imiting tariff in. SON Application Rate Figiaon Depth Dominant Color jR9d= Description Texturo Strudtre Consistence Boundary Roots GPU7P o YMunR sea ent C olor Gr. Sz. Sh. 'Effat 'Erta2 in. b~i~ jA yo 3 7' r I -qo _ 0.7 07, ❑ Boring Boring * Ground surface, elev. ❑ Pit n. Depth to bniln8 11 citor m. Soil Icalson Rate Florizrxr •lepth Dominant Color Redox Description. Texture Stnrcare Consistence Boundary Rods GPDRf in. Munsell tau. 8z. Cod, color Gr. Sz. Sh. 'Etfat 'Erta2 tf8uent a1 = BOO, > 30 < 220 mg4 and TSS >30 = 150 nlgL ' Effluent 92 = BODr 130 nVA. and TSS f 30 n-41- 'I he Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. 511f•F\1C ~A 6~M1 Soil Test Plot Plan Project Name Roscon Properties Shin Bird Address 1353 Awatukee Trail Hudson Wi 54016 ;STM #226900 Lot 10 Subdivision Date 2/10/18 N W 1/4 N W 1/4S 32 T 29 N/R18 W Township Warren M Boring Q Well Pl. Properly Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation TBD *HRPSame as Benchmark 7tnh Ave 100' Area of poorer suds B-2 5' 98' 96' 20' b 50' C 0' B 30 12% Slope I00th St. B-1 13. V1. * 98' 25' 5' 412' Property line Page I of I LNDRY/ PANTRYt--- oo end MS BATH 2 cwE NVl KITCHEN r - ~ C.LL•r 1, Y,p.• a as van r!m~ CO BATH, O W.I.C. GxYfl l CIf. C54 HALL - aco•r uafr f! LIVING l R r. ~l J- a c.+u.rfn:n: M BE R M BED 'tl (%!H CAVi!1 t Clq Q 6 nn Qv COVERED PORCH 1 ' V'CO'KILLIt LAY •y_ t7 http://inleral ic.cotri/wp-content/uploads!2017/04/tuwuse-pl ans-bedroom-bath-designs-floor-... 7/16/2018 ST. CROIX COUNTY SEPTIC TANK MA INTENANCF. AGREEMEN 1 AND (M \LRSI III' CI R I IPICA"I ION FORM Owner'BMcr Jose F. Franco Trujillo (vlaifing Addres 1035 70th Ave Propert, Addres I Vcnti::n I,.r rcgwnd In I I I Planning Zonin!; I)cpart rent for new core ltrmUm I i CitwS,,,tc Roberts Wi. 54023 Parcel ldentilication Nutnbcr 042-1090-20-665 LEGAL DI'_SCRIPTION Property Location NW . NW,, ,tics. 32 29 R 18 \\'.'Lo.+n of Warren Subdivision Plat: Lot ^ 4 Certified Survey Map # VOItlme . Page 4 Warranty Deed # _ (before 2007)Volume . Page 4 Spec house 0\csdto I rn lines identifiable 0)es❑no SYSTEM NIAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic s) stem could result in its premature failure to handle wastes. Proper maintenance consists ofputnping oul the septic tank cv ery three years or sooner, if needed. by it licensed pumper. what you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal svstein. Owner maintenance responsibilities are specified in §SPS. it; i.52( I ) and in Chapter 1' - St. Croix County Si milar% Ordinance. -I he property owner agrees to submit to St. Croix County planning & Zoning Department a certification form. signed by the owner and by a master pluntber,.lourneyntan plumber, restricted plumber or a licensed pumper verifying that ( I ) the on-site wastewater disposal system is in proper operating condition and or C2) after inspection and pumping (if necessaryl, the septic tank is less than I.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 bN the Department of Safely \nd Professional Services and the Department of Natural Resources. State of Wisconsin. Certification slating that your septic system has been maintained must he completed and returned to the St. Croix County Planning & Zonin Department within in days ofthe three year expiration date. I!we certify that all statements tin this firm are true to the best of mv/our knowledge. I/we am arc the owner(s) of the property described above. by virtue of it warranty deed recorded in Register of Deeds Office. N tuber of bedruonts 4 ~yam ; Z - SIGNA I ( SRI: OF APPLICANT(S) DA 11. 'r':\ny information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warramy deed front the Register of Deeds Office and a copy of the:er ified survey map it' reference is made in the warramx deed. (REV. 04/12) Wisconsin Department of C: rnence SOIL EVALUATION T'7RT Page_ _o!_ Division of Safety and BuildingsL ` w - - in aocerdance',w.th Comm 85, w" 1•~ -.1 `'e' ('rxmty < I1 Attach compete site pan on Paper not less then 8 112 x 11 in" 0,`• . „us; - - include. but not limited to: verl cal and hortrontal rdferw . 10 .aeon an:f Parcel I.D. ,j 9 ~t percent slope. scale or dimensions. north arrow, and CIS I ..ance to nearest roar d Q ~ L6 Please print all inform. O. Revi ed by Date Panoaal rnfnrmatson you provide maybe used Ior sawndary purposes (Prmacy Law. S. 15 04 (11 (Pill ✓ / Property Owner Property Location) _ Govt Lot 114 )J4 S r T r- N R E (or W Property Owner's Mailing Address Lot It Block 11 Subd. Narr or W t City / Slate_ ~tD Code Ph e Number ❑ city ❑ Village 5?own Nearest Road --LL IL C.«x5trVG9«I Use Residential I Number of bedrooms Code derived design flow rate -11~ GPO ❑ Replacement ❑ Public o commercial - Describe: Parent material Flood Plain elevation if applicable General oomments / and remmlerdaoms: System, Type L.'7 System Flevauon LG # Basing 7zq F Boning Pit Ground surface elev//. V,.. Depth to limbig factor rr. din. Soil icabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMF in. Mtmsell Ou. Sz. Cont. Colo Gr. Sz. Sh. 'EHP1 'Efftt2 l- lJ 1 acting M Q Boring © Pit Ground surface elseC--41L- Depth to limiting facto r_-_y~a1.~ Soil lication Rate Horizon Depth Dominant Color Redox Descrlpborl Texture Structure Consistence Boundary Roots GPD.Kf in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'EfW2 • Effluent p1 = BOO, > 30 < 220 nx and TSS x30 < 150 ' Effluent N2 = BOD. < 30 my and TSS 130 mG'L._. CST Name (Please Print) Sig t e CST Number Bird Plumbing. Inc. Shaun Bird 226900 nddrass / Date Evaluation Conductor Teleptlone, Number 1432 120th St, New Richmond, WI 54017 = 715-246-4516 1. r Pro{xMy Ovnor_ Parcel lD# / Pace Of-- _ ^ J Bonrig a L7 Bcnng pit. Ground surface elev. 2 I ~ft. Depth to limiting facto in. Sal APPI'CatiOn Rate Horizon Depth Lkxninant Cdor Redox Description Texture Stnxdue Consistence Boundary Roots GPD1W in. Munsell Ou. Sz. Cont. Colon Gr. Sz. Sh. 'Eff41 'EIf#2 G-1L -1 Z ; Boring # ❑ Boring ❑ pit Ground surface elev. ft Depth to limiting facto m. Sal Application Ratc f kxuon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPUM' in. Munsell Qu. Sz. Cons Color Gr. Sz. Sh. 'Eff#! •Efi#2 ❑ Boring P Boring - Pit Ground surface elev. h. Depth to limiting fads m. Suit. ication Rate Horizon 'lepth Dominant Color Redox Derscriptiot. Texture Structure Consistence Boundary Rohs GPDfff m. Munself Qu. Sz. Cont. Color Gr. Sz. SR 'Ef#tt 'Eff#2 V-- i ' Effluent #1 = BODE > 30 < 220 mry'L and TSS >30 < 150 mgt ' Effluent #2 = BOD, < 30 mgt.- and TSS < 30 mgt. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need mntenr.l in a7 a!. erne'.. fl=it., please conla,! the department at 60A ;hh-3: St. nr 1-1 Y 608264-F?77 Wrfr1101R AT( Soil Test Plot P1 Project Name Roscon Properties St~t~inB i r d li Address 1353 Awatukee Trail ; Hudson Wi 54016 ' f'fi1'M #226900 Lot 10 Subdivision Date 2/10/18 NW 1/4 NW 1/4S 32 T 29 N/R18 W Township Marren M Boring 0 %Vell PL Property Line County ST. CROIX B11 or VRI• Assume Elevation 100 ft. Top of survey iron System Elevation TBD 'HRPSame as Benchmark ?0th Ave 1. 00' Area of poorer soils B 2 5' 98' 96' ?0' 50' B-3 311 12` Slope 100th St. B-1 1.4 98' .42 412' Properly Line