HomeMy WebLinkAbout030-2024-20-000
'scon;~r fre,anment of :lommerre PRIVATE SEWAGE SYSTEM Cu Ily St. Croix
Serer/ in) H,.dn ng Urd s.on
INSPECTION REPORT sir tarYPe-lNo 605114
GENERAL INFORMATION ;A T TAGH 10 PI-RT st:ne wan ID N.r
Perscnal I,"cnmal oI, ycc mcmce ,nay to ~suc IoI secc•rdary Proposes IPUVacy Las, s."a C4 119;nq)
PeirrI -Iold, f ; Name Gtp Village ICvrGnlp PawlTa^N9
Kenneth Youngdahl TOWN OF SAINT JOSEPH 030-2024-20-000
CST BM P e: 1•-sn BtA Elev. Btvl Descr pt,cr: Sen ion'Tnwm Ral Map No.
/DO o eC ~c~k_ 12.29.20.4348
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURFB S CAPACI rY STATION BS HI FS ELEV.
Sep: c T.~. benchmark
/Q9.3 /00
Alt BM
Frl P l k 525 F'i Co 5.5 9¢.Sne
Ae,arcn Bldg Sevier
Holding SVHt Inlet
/b, z
TANK SETBACK INFORMATION StIHt Outlet
Vev A, fl-take ROAD Dt Inlet
TANK TO X1`4 VdFl t jIILD!I
Septic .7 c` 72 U: 6ot:om Doscty Ilea::cUP.1an. 4' g p, 5 L`
Aeration Dist Pipe G
• ~i
Hold.no eot. System
,l
PUMPISIPHON INFORMATION Final Grade o. Cd 010 .
Manufac.Lael Demand StCever I ~~.Q
GPPA G o-j V- d
Model N.tmA)
rz, a g ~ . 5 q/ 6,E.
TDIi Lit: _ 1caol-oss__ S • c Tl Ft i ,3• QL .4~
Forcemain Length Dia+ f)e.: 'r,:':en
SOIL ABSORPTION SYSTEM
BEDiTHENCH V, 7th / Lcrvq / Nn Ot T•erines PIT DIMENSIONS Ne Cf PiC: Ins de D Lqud Depir
DIMENSIONS 1 167- y --17e.^cL%l
SETBACK SYSaTEEIA TO Pa Bt OG WELL LAKE+ST RFArd LEACHING %1anjfao
G q CHAMBER OR -i- ' t 0. /
INFORMATION Type Of S•;stem UNIT
Mf(/' ~ ! S UNIT '.,pttcl Number
7 Jil Srii
o Je ~g
DISTRIBUTION SYSTEM 14 x.4 d-1.5 r Zlo 75
U 51r OutOn x Hpv Svr x SIC:c Svaa'q Vc"l l~ i.u rtak
HeaDer'fvianilplJ it
l enoM ~Da ~J Lcngtb_ Iao shz?ins
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Uepfi I'Pr xx Dc Lt., Seeced+soded x. Vul- u
tic):' •er;.n Cp. rler 3 .y 6c7"'c •I G:uc3 Trp=nil ~1 Yes Nr. ~•-Y. N.,
COMMENTS: iInclude code discrepencies persons present, etc i Inspection #1 Inspecle)n #2
Location: 1Ofig O-D HA'Y Yrl 61) 5Vy/-4ri ~ /2.---. Cq>q-,
' Alt BM Description = Lpr / !A '
2.i Bldg sewer length - O !I
- amount of cover - ` qZ 111000
J
Plan revision Requil ! Yes )(No
Use other side for aodnional mrormation. I/ [
Dac- - I-sco;;tp g `Aroa re Cen No
S-'.D-C'101R. ~'9i
t amcy
y' A-- Safety and Buildings Div sion 2[)1 W. Washington on Ave AveBox 7162 bcfiUmdiW Co)
hAadison, WI $37(177--7 7162
L w05 l
Sanitary Permit Application " Sumr~,Jn Nu ,ate
In aceradmax with SPS 30,21M, Wis. Ad.
Code, submission of this form to the ap me m, submitted rnwl wit
y t s
is rey¢ired pdor b abl y a cod a s-r i,jlSc Note: Application forms, for sWr.Krwnexf d po YOWTS nm snbmitlad to
Address; (ifdrAaent Ilran mailing aridrrss)
the ogp ion of Sale y Pmfrasim.i Berries Peon nd iDfOrmmim You pmynk may be used for secondary
,j~_iroses l in accordance wily the Pn.ocy Iaw, s. 15.04(1 )(m)_S>a[t. ^qp
L_ Application Information-Please Print AU Informatlo /f! 35
Pmpary er's tvanx
Patcel3 G~ b-d0d~{ -o 6o
Ropejry ossmer'x Mad' Address
~ Property Incatitn
C~~`, ll L P~ coat Lot
I ry" Zip Code/` I Phone Nuutber
N v-,-WE Y, Section
} I V cue me)
rn Type of Building (check all that apply) T a N; R E or w
otSubdivision BbPubliJCommeaeiel-Describe ilse_ ` r✓
❑ City of
LM tkmcd -D.scrihe Use _ CSM Number D VI aee of
S SJS(
Z~ G 5 QTuwo Of..
. Type of Pnrmit- (Ch 'ne A. Complete line $ iFapplicable)
n New System amuem Systrm Treatmcn1/Holding Tank -
Replacement Only ❑ Otbd modification to Existing System (explain)
Pct mil Itarcw-li 1 Pt7mit Revisiw Chzoe or plumber ❑ Permit Transfer to New ~ P Permit Number wd Dwe lssoed
Bc(ore Expiration
owttej r,
I iV- a of POk^ig emlCompoamUDevicc (C tack all that apply)
Y.w-Pressunzed In-C:mund Q Pressurbrd ln-Groand I7 At-(xade ❑ Mutmd> 24 in. ofmit bre mil ❑ Motmd, 24 iu ofmiWdcsoil
I} _1o mg I.,k dra Dispv.:d (.nmiMrlQ,t (rj planl)_,.,_. ❑ Pretrratmcat [kv~ (expiam)
! V. Dispersallf cnt Area lnfotaaatioa
Dr.
r}'rgn FW Desi,Boil pltestion Rate(gp
Dis
Cob I per.:al Area Requircl (sf) Disp
Area Propos System L[eeation
Wo M' 'i. 'to L 4±b.
VI. Sank Info Capactry in
T Taal of Mar,utwxumj -
Gailtats Crn0nrts limits r:
lJ~ r iml¢ Fi,-istiup, Tacks T~ E v u °
_ Y OL ~~S ° is 8 3 s n
1I~Sasr' +c w Roidine Tmk } n. U w r. r7_ ii. O E f
~
[losing tlr b 5_s
VIL Rrsponsibility Stateineot- 1, the undersigned, a+ at
PlumCzme {Prig) respousihilitp for iawlladon of the POW15 s4lnwa M the aUaehed plaes-
ign MP/MI'RS Number ➢usaness Ptrone Num[ur
Nwnbm's Ad s (Shat, City. Sh._ a. Zip (ido)
v
V Coun~/IDty~ep-ar~renrUse my
Appm.Ka I - Prjntit f~-(ee Q Q Sigum. 50 _nvrn on for Dw.W Y ~t/~• p 7 p
IX. Conti tmas for Aisappr"a!
` 1. ' ~rtark, tt111xn:,iltn-tvt•1 OU
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ss per Tar ayement plan pre ide•I by !u nue.. f~A (gyp ~ !
2. AN a AwA fecuw..-en:s mud to r. a rt_i t ;
up4ttypil Iox;•sl:fdlaalcll.
_ --_i19~>a°^rN~Vlvafor De s)aem asO Slbmab Ne C.wroty ob a. ruPe'mrle: Wanarr:ll "orDnmva
SDL) 6398 (R. I [III)
Map
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CC7M/'WTIC),-N,IAI• COMPONIFNT DFC!GN
ResidenlW Apnlic~-if or
Project Name: - Va iv 1 vt - - c
G4-G(phI
- -
Owner'sNamp: (I
Owners Addj~,~:
Leg,nl pesrrip-,inn
Township J L
County
-SAdwisinn Nary,e tt n
Lot Number. N ~ ~ - -
Parcel 11) Nur"Lr:
Page t - nde ,nd tiffL
Page z
Page 3 _ 5yst=mr< r^
Page e - F., ecs I
Pia 5 _ klaintenahce !n~ormatrag,•t
Pane 6 I
Mtarar_men; r an
Page 7 Si Croix Cty Seu;ic Tank` Main M~
Page & t'nafti FOnh
_ _ NarrsnC Dees
'age 9 CSM a., P!at_
Axpichrnw ts: Sea Test & Hrnase Plans
! )eS he, r
3 7Plumter: a ~l~]ti
1~ r hcr~n Number
S+rlnefure
-n Q
I
X110 ALP
16P9 CN un 35 4m'
ji
T
. w91~
Gfrmucw)
roy of rk~K ~Ifv, Ivb.o
i
I?Sbyn{l i' 1y~
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s k A) g sty; Tr>Nk
i~~ ~aywells to
PWµp-Pd pbpWaoN-)
~1c (VO
a chbmhr~tl PrK ~rirtic~
~F BB.uo
Self- ~s'r
#-IW Sys#em___ rocs 9 0ll
Pdtdc 40
PVC Vent Pipe rural Grn(1!--
014th Vn~t cap
LegHrIg
ChaMber
A3G,~-
_ _ St Gam'' ilOYi
§011 .4_usarptfrl S°4~3eC'"YIi; §fia
r
reach 4-
CI Luribfu-,
{
ttliir'L Ulm .
I Trench 2J aN Bier
Vert; Or Ohse;IratiUn Pipe Header
I
7
"anufPclu er And NfodFt
Per chamber
' S'aif i\Ppi7ra;ion Rate
C~ U U 9Pd Design Rov, ft
j Soi7.1Pn(ica4ionRate I S6{7 1
EISA = { - Chambers
chambers each. -
n"P` of
Technical Specifications
PL-525 EFFLUENT FILTER (COMMERCIAL)
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Nt<ihils;
(Verificatum required from Planning b Zoning DepanmceN. ti)r new constn,_:inn.)
n Parcel Identification Number 14 3~ D'a y
LEGAL DE.SCRiPTFO:N
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1 : on~.t y T.oc.;uionly 'T Z ( NR
A X1r. Town of
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t:bdMsion Plat: - NP - Lot rt
['rllirlM ';Hrve} Map k - Volume Page n
Warranty Pont t - (beto;e 2007)Volume Page
Sne_ i,ct:sc es I-), i nt tines identif a`•ic'7 "
CS i i nfI~1'ti'i"EA1_i1fATNTENANCE AND OWNER CERTMCAT16N
Icnprincr asc anA mainterancr n'-your septic system et»uia rrsuh in its prematwe r"aihvc to hmtdle xxactes- Pr:,per
.ntcnancc consists of pi:rrping out tbr septic tans: every three years or sooner, if needed, by a licensed pumper. What yo:: put into
li.rem can affect the fuuctim of 'te scprir rank as n treaunent crage in dre. waste dispnsai sv.crcri. O:x^tc- mairtenanny
i ,~:ibilitirs a°e succui <1 in §Comm. 53.52(1 j and in Chzptrr t? - it. Croix ('onnty Saniaty Ordinance.
The property Omer ac.-ees to suhmii ro St. Croix County Planning & Zoning Department a cerification ?oral, signed by the
-iMcr a'ld by a master plumber. journeyman plumber, ;cgf.-irted plumber or a licensed puvmrr verifying that (1) the on-site
Nvas.imvatcr disposal sysem s in prop: r o?era'ing too;lition ardor ( j after inspection and pntnoing (if necessa, y he s ,,-ic lank is
less than 1!3 hill of sludgy.
Vw'e, the. 'sdersimNI ItaVe read the above requirrmews and agreT in maintain the private sewage d'tsix)sal system with fie.
standards set R -th. herein, as se! by the ncpanment of Comma cr and the De uncn* of Natural
C<:-ti5cation sUCtn that f'a Resources. Srae of R'iscoasin.
g you: s:. I rys'rm has be^ maintained must he r.,-nnplcird and^ rrtumed to the Rt. r"rnix County Piannino R
Zoninc ;Depar,ment wi0iin 30.J?.vs of Qw ihree y r expiration date.
lAve cr*tttp that alt stmemcn . o his a-m ai „o m i t,. t st n`myiour H'N l d .
prune'a?v desenh~. :.boy . _ 4r Uwv am a-c N:e n ar r.ei r'r the
Vtr1'1-JI ..-r R' `rjP i' _
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Nu er of I .ms i -
Sf(;N~ T ITF? O A.PTI_IC.4ItiTi,Sj - ~ ~i ~
DATE
""Any infor~;iat n f tat is rtit5rc-resz%t3t may regili in thr sanitar ve-mit brim; rcvokul by t , .
he Planning & Zoning Depa-rm rat.
fie
ryfurenrr ma nrl c ,1-,L r, -h rt -•'mo
(TIIVV W) h-1
a i;consin Dupartmenl W Safety and Professional Services i
I7 . v'nn OflndJ5t7•$eNIC05 ~ ly{` 1 L,
SOIL EVAtUATfOFI REPOR I r
In aex:ordance with SPS 365. Wis Adm Code County j
irltach eomplOte SrfE plan cr pope, not less than 6 1r2 x I 1 inches m site. Plan must include. St Croix
-
bur not limiteo to vpnipat and ronzcntal reference noint IBM). direct on and percent slope, Parcel 1.0
.
"::ale or-dmep5ronS4~enA 2--hi '.arW 16cation and distance to nearest road. 030-7024-20-000 F. ' 42I i
Please print all information. Ri by ~Q
rsonal nNUUnation you provide may be used for sec'4ntlary puroosos rPnvacy 1 aw, 5 1511)(m);.
f rtrperty Owner Properly I. oration
K,-ineth Ynungcfalu Gov[ Lot NE 'G NF Y, S 12 'f 2.9 N 19 E (,o r
r'clperty Owners Mailing Address Lot # Blom # I Si Name or CSPA#
I .Nil., Old Hwy 35 _ Na Na Na
C'ty State Zip Code Pnone Number
❑ City F] Village X Town Nearest P;o _,d
If.:::xon WI 54016 I:651)SW-1050_ Sl. Joseph IIlwy :i
New Construction Use: Res.dentiali Nu.mberofbedrooms 4 Cone derived design flow rate 600 GPD
[ ] Replacement ❑ Public o• commeroal - Describe.
Parent material Glaciallout{ash - Flood Plan elevation P applicable no It
General comments and recommendations. Site suitable for in ground POWTS'w IF. 0 4 gpu:sq. If loading rate. Recommended system infiltwn:•c rlai
elevations to be 88.0', 87.0' & 86 Or
i Honng # ❑ Boring
Pu Ground surface elev. 93 20 fl. Depth to limping tacro• 112" in.
_ So,! Ap 7 on Ra:<
Hommi Depm Demrnant Color Redox Descriprec I Texture Structure Consistence Boundary Roots (P_n:Ft
In Munsell Ou. Az. Cont Color Gr. Sz Sh l Eff#1 ff F IIC.
1 0-35 1(1 none IVsl fit. Na - mvfr M 2vf,fm .0 I : 0
2 35.41 10yr4M none sl 21 mfr i rw 24f n 1.0
3 41-82 1(1 none strat. gr Osg ml ON tI'm C.5 I 1 0
Islfs.*s
82 85 7byi,114 none sl Ini mfr aw - 0.4 _ 0 7
S 85-112 t0yr4:8 none stmt. gr Osg mi 0.5
' strats
- 1l
_ Boring # Bor g
J X Pit Grourd 5urfaco oleo. 90 g' fl Depth to limiting'actn; _1Q9 In
Sol Applieaua (are
Horizon Depth Domina•... color Redox Desorption lni u•e Structure i Consistence Boundary Roots t hD1F1
In. Munsell Ou. At Cent Co or Gir S7 81
1 0-20 `1 (1 ! none - Is:slhll Na mvfr c•N - 2fri CD 00
2 20-31 1 Oyr3:2 none I I 2fsbk mvfr cw 2fm 06 - - - - 03
3 :St-48 10yr474 none gr Is Osg ml cw 1vf 0.1 1 R
4 48-109 10yi none stmt qr I°s+ls+s osg ml 05 10
'
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FNluent 01 - BOD, 30 < 220 mi and TSS > 30 15 1 it EttlOenf #2 - BOD. 30 _
220 mg/L and TSS > 30 160-m
g.!I_
CST Name tPlease Prinli s_gnare CST Number
James K Thompson _ - 30021
Afldwss ate Evaluatior. Conducted ~ Telephone Number
340 PautaOn Lake Lane. Osceola, WI 540205413 July 02 70'8 1715) 2484767
'i Donna N ❑ Bonny
❑n Pit Grounc surface a ev. 93 17 ft Depth to uric r^, actci
Horizon Depth Dominant Color Redox Description texture Slruct.ve Cons~sten;x Boundary Roots
In Munsell Ou. Az. Cont. Color Gr. Se. Sh. .6IIk I
1 026 1 0y44 none Isis fill Na NA cw 2vfI fm 00,
2 26-59 t0y3:2 none sl Imsbk mvfr qw 1vf.f 04 Ali
13 59-70 10y3M nnne sl 1msbk rnvfr qw 1vf.f 04
4 70-85 10y3t6 nnne sl 1msbk mvfr gw 1vf-f 04
5 85-102 10 6 nore I
y•4: gr lI's Osg - ~ ml gw 05
6 102-118 10yr4:6 - more Is 0sg ml 0
I Boring9 ❑Boring
L1 11~ Pit Gfounk7Zace elev. ft. Depth Iu i~rr,.Il r'l
Horizon Depth Dominant Color Redox Description Texture Structwe Consistence Boundary Roots
In Munsell Ou. Az. Cont. Color Gr. Sz. Sh
I-.
i
Boring
Boring n
U pt G,ou: id surface elev _ H Depth to limding taf r
Hrn: ::n Uv::I1' T)om rant Color Redox Description Texture Structure Consistence Boundary Roots GFI_D_ l-
In. Munsell Ou Ar Cent Color Gr. Sz. Sh 'C"Nt •Cf,02
' Effluent #1 - BOD 1.30< 2220 rigiL and TSS > 30 _ 150 f-igia ' h"'cent N'l = ROU 5 220 rnyiL and TSS 30 15G nrl!1
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