HomeMy WebLinkAbout038-1116-30-000 (2)
Vascp~snDeoaa°en:c'Co-^•orcC PRIVATE SEWAGE SYSTEM c,~unty. St. Croix
Sa'e:y and Bditcin5 D visi0r
INSPECTION REPORT sar ropy Pemrt No
(ATTACH TO PER1~11.1) SAN-2018-266
GENERAL INFORMATION State Plan UND
Pe'sonaI trfonral on y0., prod de -ai, oe used for se✓JOCary ojrpuses [P'vauV Law. s 15.04 (1 V(^:
Perm 1 Holder's Name. C r~ V Nape Towns-,p Parcel Tax No
Robin Asums TOWN OF STAR PRAIRIE 038-1116-30-000
CST 110 F ev Insp RM1,I Ele'✓ RM De5✓ip:i0n SecncnT wr Range Map No.
29.31.18.488E
TANK INFORMATION ELEVATION DATA
TYPE NLWUFAC'URER CAPACITY STATION BS Hi FS ELLV.
Sep: c Benchrri
Dos rc Alt. BM
Aeration Bldg. Server
Holding SVH! Inlet
St H! Out et
TANK SETBACK INFORMATION
TANK TO P;L V-,E'- L BLDG Vent to Ar Inra,:e ROAD Dt Irldt
Septic Of Bottom
Dosing Header.-Man
Aeration Dist. Pipe
tied. rg Bot. System
Final Grade
PUMP/SIPHON INFORMATION
Manjlac!uicr Demand St Cover
GPM
Model N.rreb
TDH Lit Fnc4on Loss System Hea- TDH Ft
Forcerrai'i Length Da . ~i si to Veei
SOIL ABSORPTION SYSTEM
BEOITRENCH frh Nn O' Lre•.ches PIT DIMENSIONS Nr. O` P is ns ce pia Lqu J UW-
DIMENSIONS
SETBACK rSYSTEr,,l TO P:L BLDG WILL IAKEtSf RELEACHING INFORMATION CHAMBER OR
O' SYste° UNIT Mcdel Nunn^,
DISTRIBUTION SYSTEM
Heave- Man folc r*trr bpi r. hale Sve X I-u'ie Sparing Vert :c Air Intake
Pita:,
le'a'h__Cia Lc,,g:l :Act Spar.r-g
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
U=1;;P Dv, LU."t . Omr xx repP• el xr SeededlSDdcec xx Mulcred
bed ^c-ch Ccnler Red+Tre. nnh Edges -opse I Yes No Yes No
COMMENTS: :,Include cece d:screper•ies, persons p'esent etc) Inspection #1: Inspection #2'.
Location: 199C 93RD ST
) AL BM Descr pf or =
2 ) Bldg sewer length =
- aToun: of cover =
Plar revision Reauned> Yes No L -
Use other side for additioral information. L l - l
Gate InSCpCC"s Sigr.a;u•e C¢rt No
SBOVOkRi
County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN
In accord with Chape112 St. :mix County Sanitary ordinance PLANNING & ZONING DEPARTMENT
Psrs:irol Information yei, provide may be used for &econday purposes ST. CROIX COUNTY GDVERNMEN7 CENTER
(Priia_y Law'. 3 15.04/140yj ? 1 M Carmichael Road
FsSLIJ--~/_~N I FIVd9on, Ail 5401f-7710
1715 864686 Fax Q15,3864586
Attacr coir0lab tans to- the e` Stem on as- or, &te.
ICvumy Sanita.Y Permit ❑ Chaa 4 rev'sion to provlout appfca50n
I
I. Application Intormatton - Please Print all Informs - Location:
ProoertyO -nar Name - - -
1,4 114 Si,l,
pPropecty, Ovmers Mailing Aodmss Lot Numer Block Number
Clty, Srle Zip Code Phone Numer v division Name or CSIA Number
1' Type of Bullding: (check one) ❑rtty ❑ Village AiTove Y
: a 2 Family Dwelong - No. ei °_dmort. 3 M r~
❑ PublidCommertaal (describe use).
❑ State-owned Nearest Road n~ S~
f
It. Type of PennR: (Chat only one box or, lint A. Chad box on Bre S rf apol wWe)
Pane,' Tax, nber(s)
AI ' . Repair , Reconat-tion Nor.-plvmbim . QR_iuvaw4;ur O4 Q _ I I (Q _ ~j0 X000
Sanltalivn J O . 31. I8. y
BI Pern'f. Numbe- ~Dale Issued
G State Santa'), pernlt was prev,ousiv issued
IV. Type of PDU7 S Check all that apply;
Non-pressur¢eo In-ground ❑ Mounc ` 24 In, suitable soil ❑ Mound 24 i-~. sultedle soil C Mound A,C
an ❑ Constructed Wetland ❑ Peat roller ❑ On- Lme
❑ Pressuraad Ir-grounc ❑ Moiding Tank ❑ Sinple Pass ❑ Otner
1 Ai-o-ade ❑ Aeroblc Treatment Unr. ❑ RBGIfGVlatinE
V. Dispersat'Treabnent Area Information:
Uesipr Fioiv (ged) 2. Daporsn' Area 5. Diseemai Area 4. Seil Application Rase 5 Par:alaii0n Rate E. Ststem E evatlon 7. Fine' Grade
16 O Rzquimd$;5~4 proposed Ga sldey'ss P j Mnlncn) E evaton
I. lank Information Capai• ty in Gallons 'cal 001 Ma"Ndctumr Pre%b Site Con-1 Stes Fiber- Plastic
Nevi Existmp Gallons Tanks Concrete stricted glass
'ants states
1 t^ C? ❑ ❑ C ❑
- - ❑ ❑ ❑ ❑ ❑
VL. Responsibility Statement
I, the underJgned assume reseensibdey to- repaATrECOnnencT•oyrejuvena6on/lnsta~atior of non-olumbm3 for tte pDN,^S shovr, on tie attached plans. A
license is not required for tenallft Mow or the mstababor of non-climbing sanitation systar.
Plumbers NaTe (print) PwmbersSgn 'ne scamps;' MpaiPRS No. rfIausiness Phone Number
ou - Zi Code)
~U',. County Use Only
Di^ rove; iSarha•y Pam: Fee Darer Issued Issuin enl Srgrabre tam
App•oved Jvm neSco VeT3 v1~ i OO 1/31
LX. Conditions of ApprovaUReasons foyplsapproval: l 1
S 20(t 11 ~.tJZ- O/~ F i 40 - G i t!~
S t ~►e~ r ~ alo o~
Ra~^ 6/C5
rS BUILT SANI7:1r.T S°STE_° REPORT
ADDRESS CROI S. (:OIUITY, WSCUMS_t,
i
SUBDIVISION 1.0'1' U:T f?°.D:
i
PLAN 1':E'V.
I::ua notes and dimensions to meet reSniremsn:a .'.}FF. to
i;lUl. HI; F'1 t!. N1 'd 1'tti=[: I{Ili M'P:I!'r Ul :f. S?E'.
v
i I
I
i. _
V O~ I
:Mlut:rl NORTH ARROW
CENGEiK4P.}:: L-...n ci~t ic: cn sots Pour usa2 %'r
t::.•rnt_or of ~er:iti :ef erence ncint: !/r- Prnm~."•c L:nc n: ai;e:
T
SE_o_ T.S17,: !fanvEacn¢ _ ' J7::[i' gv ' ;:a n+ri ;r: i,`.'
Fcuer of ^ngc: used: - "anl: mvtl:cle Ceeer cl _.'ation:
.s:: Y. lr.ie: E'.cw'1rr.:_• ank Out:e[ E'evatinc•
..umber :f feet Ln:m nrnr. s, 3! ac: Rear,
-ror. ceatest property li-.c Frout 10 S idiRea; O
Nrmihur of Re.t fr....
d,dc th;:= in`erms;ion c[ tbv a'novc Piot planj( .e-sots timors.ionr. to s:-nt i,.
SEE rl'VECSE F'L:1C
Fora - S T C - 104
AS BUILT SANl'IARI' SYSTEM. RET'ORT'
OWNER TOWNSHIP 21,' SEC. I _Y N-RAW
ADDRESS ST. CROIS COIMTT, WISCONSIN
SUBDIVISION
','.i /rte. ; sy,( LOT LOT S[ZF.
PLAN VIEW
Df:aanres and dimenninna to meet requirements of ILHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
T ~
i
i7
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used b'j.
Elevation of vertical reference point: Proposed slope at site:
SEPTIC TANK: Manufacturer: 1 did Capacity;
Number of rings used: Tank manhole cover elevation: t
Tank Iola[ Elevation:
_4 _ Took Outlat Elevatfon:
Number of feet it= nearest Road: Frnot O Side Rear, 0- _ ,f.• _ f~ec.
From nearest property line Front,O Side,~Rear,O icct
Number of feet from: well building: CJ
(Include this information of t_h`e abovvee plot plan)( Z reference dimensions to septic tank)
SEE REVERSE SIDE
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address) 1990 93RD STREET located
at: NE 1/4 NW %4, Section 29 , Town 31 N, Range 18 W,
Town of STAR PRAiRE St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25. and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service
Did flow back occur from absorption system? Yes Nox
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
Tank Capacity: 1000
Construction: Prefab Concrete X Steel Other
Manufacturer (if known): POWERC
Age of "fink (if known): 35
Permit number (if known) YES
PAUL R KOEHLER
(Licensed Plumber Signature) (Print Name)
MASTER PLUMBER MP225410
(Title) (License Number) MP/MPRS
AUG 22 2018
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06. Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page? of 2
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner ROBIN ASUMS Septic Tank Capacity 1000 al C NA
Permit A Septic Tank Manufacturer POWERS 0 NA
DESIGN PARAMETERS Effluent Filter Manufacturer Q(NA
Number of Bedrooms 3 C NA Effluent Filter Model Q(NA i-
Number of Public Facility Units [)(NA Pump Tank Capacity al LXNA
Estimated flow leverage) 300 gal/day Pump Tank Manufacturer Q NA
Design flow (peak). (Estimated x 1.5) 450 allda Pump Manufacturer 13c NA
Soil Application Rate .7 gaUda !ft' Pump Model C44A
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit 0 NA
Fats, Oil & Grease (FOGI 530 mg.1 C Sand/Gravel Filter 0 Peat Filter
Biochemical Oxygen Demand (BODs) 5220 mg/L C NA C Mechanical Aeration 0 Wetland
Total Suspendec Solids (TSS) 5150 m91L 0 Disinfection C Other:
Pretreated Effluent Quality Monthly average Dispersal Cellls) 0 NA
Biochemical Oxygen Demand (BODE) ! 53C mg,L 13 In-Ground (gravity) C In-Ground (pressurized/
Total Susuended Solids (TSS) 530 mg)L C NA 0 At-Grade O Mound
Fecal Coliform Igeometric mean) 510` cfu!100m1 0 Drip-Line LADther:
Maximum Effluent Particle Size Yt in dia. 0 NA Other: EXSISTING BED 13 NA
Other. 0 NA Other: 0 NA
' Values typical for oomesb; wastewater and sepric taffk effluent. C"e ' C NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: 0 monthls)
3 EXyear(s) (Maximum 3 years) 0 NA
Pump out contents 0f tanklsl i When combined sludge and scum equals one-third of tank volume Q NA
Inspect dispersal cell(sl At least once every: 3 0 month(s)
Qkyear(s) (Maximum 3 years) ❑ N
Clean effluent filter At least once every: ayearearls)
A
_ y(s)
inspect pump, pump controls & alarm At least once every: C monthls) ❑ NA
_ 3 ~year(s)
Rush laterals and pressure test 1 At least once every: 0 month(s) 13 yoarls) 9CNA
Other: At least once every: ❑ yeaea C r(sl rs) O,NA
Otha° - -
NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Piumbor; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visua. 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 pending of effluent on the ground surface.
The dispersal ce!1W shall be visually inspected to check the effluent levels in the observatior pipes and to check for any ponding
of effluent on the ground surface. The pending of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one third or more o' the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of ir. accordance with chapter NR 113.
Wisconsin Administrative Code.
All other services, including but not limited 10 the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POINTS Maintainer.
A service report shall be provided to the local regulatory authority within 1C days of completior. of any service event.
Page ? of Z
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 and/or damage the dispersal Collis). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are f,czan at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
dischargec to the dispersal cellls) in one large duce, overloading the cell(s) and may result if. the backup or surface discharge of
effluent. To avoid this situation nave 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 ai-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 {sump pump) water; fruit and vegetable poelincs; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails andlor is permanently taken out of service the following steps shall be taken to insure that the system is
properly 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 scaled.
• 'he contents of all tanks and pits shall be removed and proporly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or 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
replacement system:
C A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. Tne replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot fines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available die to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
abla ' me - s ni mg (ank Die rSp v be i- e ate ~1?D}{(8 r`-DP-kj6V-i rb"S'TRUC-no
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infihrative surface. Reconstructions of such systems must comply with the noes in effect a: that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name COUNTRYSIDE PLUMBING Name PAUL R KOEHLER
Pnone ! 715-246-2660 p" ono 715-246-2660
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name BERENDS _ Name `jT. 1 (9V 1.1' 2bAj irj
Phone 715-2654623 Phone -7(,
Ims document was draftee it cumplranee wflh chapter Comm 83.22,2)(1bl(1)Idl&u; and 83.54111. (2i F ;31. Wtsconsir. Aaminiatahve Cuoe.
~ x
M [p m
i ~ I 1311 w
c
Q~
g
I
' J 6V0167A3H
If~'iU YJ N W .0
,q '7 ~x x: T
I
Cs4r
o i
a
M-1 Z
rn
R N ~ ~ C ~ I
Q
e
z
i
i
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
O\vnevBuvcr-ROBIN ASUMS
Mailing Address 1990 93RD STREET
Propetty Address SAM E
(Verification required from Planning & Zoning Department for new construction.)
City State SOMESET Parcel Identification Number
LEGAL. DESCRIPTION p
Property Location NE NW , Sec. 29 , T 31 N R 1 U W, Town of STAR PRAI RE
Subdivision Plat: Lot tt
Certified Survey Map # Volume Page 4
Warranty Deed # _ (before 2007)Volume Page
Spec house Oyes 0lo Lot lines identifiable Byes❑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 lank as a treatment stage to the waste disposal system. Owner maintenance
responsibilities are specified to ASPS. 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 lbrm, signed by the
owner and by a master plumber. journeyman plumber, restricted plumber or a licensed pumper verifying that ( I I the on-site
wastewater disposal system is in proper operating condition an&or (2) after inspection and pumping (if necessary), the septic tank is
less than 1!3 full of sludge.
Iwe, 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 Salcty And Professional Services and the Department of Natural Resources,
Slate of Wisconsin. Certification staling that your septic system has been maintained must he completed and returned to the St. Croix
County Planning & Zoning Department w' tin 30 days of the three year expiration dale.
Uwe certify that all statements n This form are true to the best of m}"our knowledge_ I+we am,are the owner(s) of the
property described above, by virtue of warranty deed recorded in Register of Decds Office.
NUmI r of bedrooms 3
V ,
7- 8 22 203
il SIGr ATURE OF APPLICANT(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 decd from the Register of Deeds Office and it copy of the certified survey map if
reference is made in the warranty deed.
(REV. 04/12)
ST. C ROIX Community Development
Government Center
CCU-iJ NTY 1101 Carmichael Road I Hudson WI 54016
1 , ~ Telephone: 715 386 4680 1 Fax: 715-386-4686
w'M'V.sccwi.gov
MEMO
To: File
From: Sarah Borrell, Land Use & Conservation Specialist
Date: August 2, 2018
RE: Replacement of a Nonconforming Principal Structure located in
Sec. 29 T3 IN R18W (.488E) Town of Star Prairie
Wisconsin Act 55 2015 & Wisconsin Act 67 2017
On June 22, 2018, Community Development Department staff met with Robin Asmus, owner of
the property address as 1990 93 Street, located in the Town of Star Prairie. In April of 2018,
Robin experienced a fire and his home burned down. He has inquired what approvals/permits
are necessary to reconstruct his home within the same footprint. Robin's home is
nonconforming to the road setback, Ordinary High Water Mark (OHWM) setback and may
possibly encroach over property lines; enclosed is the 2017 county aerial photo with the
property in question highlighted. There is a Sanitary Permit for this property for the
replacement of a 3 bedroom home (14' x 60') that was installed in 1985; the site plan for the
permit is enclosed.
Due to changes of state law in 2015, commonly referred to as '2015 Act 55', the county can no
longer enforce the Shoreland zoning ordinance section which regulates the maintenance, repair,
replacement, restoration, rebuilding or remodeling of a nonconforming structure if the activity
does not expand the existing footprint (Wis. Stat. 59.692 (1k)2.2m.) No approval, fee or
mitigation is required. A structure is defined per Wis. Stat. 59.692(1)(e) and means a principal
structure or any accessory structure. A nonconforming structure is a structure that does not
comply with the required setback from the OHWM identified in NR 115.05(1)(b).
In addition, due to changes of state law in 2017, commonly referred to as '2017 Act 67', the
county can no longer prohibit, require a variance or limit based on cost, repair, maintenance,
renovation, or remodeling of a nonconforming structure or any part of a nonconforming
structure under general zoning authority.
This request has been determined to meet the referenced changes in Wisconsin Statues above;
therefore, a Permit or Variance will not be required. It is highly recommended to have the
property boundaries flagged by a Wisconsin Professional Land Surveyor, to avoid property line
encroachment. All boundary disputes must be resolved between neighbors.
Reconstruction of this structure, in the existing footprint, will require a County Sanitary Permit
for reconnection of the septic system to the new principal structure. This permit must be
applied for by a Wisconsin Licensed Plumber and meet the requirements of the St. Croix County
Sanitary Ordinance, Chapter 12.
Enclosure: 2017 county aerial photo
Wisconsin Act 55 2015
Wisconsin Act 67 2017
CC: File
EC: Robin Asmus,robasmus2 a gmail.com
Town of Star Prairie Clerk, townstarprairie(a)frontiernet.net
I