HomeMy WebLinkAbout042-1004-70-095 (2)
vssconsin Department of Comrn,:rcc PRIVATE SEWAGE SYSTEM •"•ou'9 St. Croix
Sofet'i and Bvlil ng Di:. an
INSPECTION REPORT Sanitary Permit No
(ATTACH TO PERNIIT) 606941
GENERAL INFORMATION State P:an ID Nu
Persona n'rma'ien ynu pm'eme mar hr ,sec hrt se'c... pu•peses:Pncuci La's, $.15 C4 i lyim)] 3163854
Permit r-r. Je" N.a Te City Village TC•nnsnip Pa,: l Tax No
Roscon Properties LLC TOWN OF WARREN 042-1004-70-095
"1 B`d Llev hsp. 31.' Les I ilk, Cescriol on t Ce, l%ntl G,%nlRange+`dar. Nr.
03.29.18.38A-18
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI I-S FLFV
Se::lic Benchma•k
Dosing Alt BM
Aeration Bldg. Sewer
Holding SUlit inlet
SUHt Outlet
TANK SETBACK INFORMATION
TANK TO P:L VdELL BLDG. Vent to Au hCBv: ROAD DI Inlet
Stroud Dt Bottom
Dosing Heade, Man.
aeration Dist. Pipe
Ho oing Bo: System
Fina Grade
PUMP/SIPHON INFORMATION
Mar!VaCtu•er Demand St Cover
GPA4
A40dol Nurlbef
TDH Lft Friction Loss System Head I D-1 ~t
Forcemain Length U a D st t> sbe
SOIL ABSORPTION SYSTEM
BEUTHENCH Ndth Le.-97h No O'Tre-ches PITDIMENSIONS No O'P~ts Ir151UL, Dta Iiruic Depth
DIMENSIONS
SETBACK SYSTEIvt TO PrL BLDG :WELL LAKE.STRFAM LEACHING I.la. u'aau'e(
INFORMATION CHAMBER OR
Type Of System UNIT Mucci N'.-'be'.
DISTRIBUTION SYSTEM
e
henU,t 1,10•n'u d Jis:cuuten x Hoe Soe x HCIC spac,)j; Vent to Air
^i in:
pcisj
Lengr Jia _enylh D a spauog
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Dcot'I Ovc.r Depth Over xK Dept of xx Seee_U+53ddec xx VUu -.ec
Bed+Trencf. Cen:c. Bec'Trancr. Edyus IupsoI - Ye8 Na Yes -1 No
COMMENTS: Ilincluce Code dis-roponc os, persons present. etc i Inspection #1: Inspection #2:
Location: No Acdress Available
1.) Alt BM Description =
2.) Bldg sewer length =
- amoun: of cover =
Plan revision Reguired7 Yes No
Use other side for add tional information. ! _ _ - f
Dale Insepctors S gnalure Cert. No.
SBD-6710 :R.9:97:
r ),9 ~O~S aa'elyand BuiloirsDIVISIor, r
x < pS ~j, 2G! 's.•. Vtashinglor. Ave P O_ Box p2
~1 j SI aml iR ?:t:nrt humhc fur be ULIW in br (;o.;
1 "dadlson. VO 537,7-7152
T~
Sanlt3 Sac T-r.:rvon li~mhs
r! Permit ~pplic~tilalti ~ <5 j
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apaitm¢t o S:cIY anJ Prof-ssioraj le: rs n..: J of miS.,m , u Lmeiac. ¢aY to wcil inr se,. c.a} OT~
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4Apihcatiun Information- Please Print :Ul lnformatiun _
igaty Oxrer s\amc
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-.n S'~
I 3 I
r. p C~~ien l Yhun: y;mrbc ~
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Il. ype of Building (chink all that npplyl r,N k-- T Z V.
~ ~A f
°I-a.rr' Dwell...;: Vumbcrr,f
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wri u:
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ermit: !Cilmk oniv une boa on line A. Cumplere line B if aphuhle)
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cP'u ,',nn ~.keU L•caliOC L- I:xI51N$ Snl..-o itx•.ta:n)
R. r r:= ken'.3l I . i'atar: k"Isioi. _ 1- P-enn :am-ier N,,, I _ia "re. wr i Permi: Rumbr cad Llbr L sur2 y
1 ir'angc n'
fx rV¢bu
I, I- . l .Ttlr UNTr
R'e of f UK fJ System Com~mrcuL Ue. ice: IC bec .II th.ll ap~lv`-----
'on P: resv.-u d l.. i,ra~n I lhv i r.c - h.:r,vd - de [ A!nuorl - --4w u;-- -
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L iN~t KTaak ;)ci (•r.__.il (.orrpc i:fxpi<u i'r= ,.lrc;.um n.=+r.::c iexp mi '
t• DtepersaLT rear ent Area luformauon - /j~- --il
')esop Elcu , pr'ITe:v L il Vi 3n nYa ii It ~iapas ' c k 7uirU )nprzal Avea VYnpos d c I -~auon j.p, `
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S1'fauk Into 7 I I cf Ssufa'a.„ T T-~
GaJ ns L'mG
Scp'i EIoLvV 74w '
_e I el yj _
L7 VII- Respousibdtty Statrmr t- 1. for undernp.Arl s rur rmpons_,i dny 1'or iu.,Whlioa of me PO Tl ihi.wn on the atUrheil plan. i
' P vin' is Vin rti '1 - i. 1i:^„ncrC - -r Af SIPnS V;ua!'Ca firz u+
~ a ~ u1cs...em- N n)hr
Pnivycr"sAJ.hrs Strcn,':: alc.Zipi C
A'111. County Department I_Jce llnly - -
~j~ ppnrv<d I 1 sapF1• ` d _ 1' rmi. Pec r)ah' L+'suoi s'u \ t Squ:uVr-
rven, ont< Ry~SI¢r0~
1V Condrt)ons of Approvi fnr Dmappiov al - _ p _ - - _
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E•,lii.:irneW li I.u -,p t s 1, jr, ~~1 11 ~,'.I L~'l~.CJC~IV•-l( ~S r-XVIA
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Ii.:F. ; r1e¢tb,nf groD~Id 1kU ~"~Se s~nua ~aDmi: v. iM f•wory onl. oa Vair+nne less due x )r r ti ixhn in vrr
ASa
SBD-6399i& 11:11)
ST_ CROI A ( 'O1 f N'1' Y
SEPTIC TANK NIAIN ITNANCE. kGkIiE.>vIFNI'l
ANA)
(3t~iNERS)HP ('rRT1TiC':4 fit- N F'UR',bl
C)wner!Buyt;r-~-12SL~Y~L. <o ✓
N1atIing Address T' - - - - -
Property Address
(l'criocation re(pum! from Pl•mninit Zunirig Daps:onenl fm uew conxhdctiou.j
City"State Paxel 1(1cr.;aicatiou Nut lher
LEGAL DESCRIPTION - - - - - -
Properly I .ocatiou Sec
Subdivision
Lof
Cerlilied Survey blap
Voklim. I- Page g
Warranty Decd k . \ oltunr
- - - _ - --,Page P
Spec. house •cs nn l.o( lme> ulrnnfiab.- yes ❑n
SYSTEM MAINITNAiNC'.k AND OWNER CERTIFICATION
Improper use and nrain[enance ol*vour septic sys[cm nwl(! ce:.ult wits prernanue fyiiiuv to handle wastes. Proper
manitcafauec consists of pumpurv out the septic rack every rhrce ye;us or soon-r, it needed, be a hr:anse:l pumper. Wha
the system can affect the funcoou of the septic tank a., it tredina It s6u.c in the aasie disposal s}~sreui. Owner maintenance
rosponsibihnus are spoturcd u t you put :nlo
: y(:o net 81 i'r(1) and in Chapter 12 - St Croix C., mty Saml.ue t)Idinancc
The property owner agrees to solunft to St. Cn>tx i .,miry Plaurung Az Zc.. D
.ng eparucnr a ccnif cation tirn)_ srgated by the
-)Wife]* and h}' it nwslcr pl umber, jomarynfaa ph ether, rest iced plumher or a liter ;cd pumper vet dyinf. [hat (1) the on site
Wastewater disposal system is in proper operatmV, ecueGuon au
icss titan li3 hill of sludge d~rn C) after hrspraion and P01110119 (if necessary), the Septic tank is
.
Love, the underarkrr«i irn" rca 1 tho above regwref _rnls aocf ranee to :nan. tail, the prig to .:ewatc di pouf system with the
standards set tiulh, herein. as sct by life Ucparto t it us C;ouvnr. ce and the Depa: ~rn_nl o:-Kam:al Kesourctz.. Stair of wise on,in
<:cGiBradon stating that sours" tic sy,tY,nhas been u:anraned must he complelo i and retumvil to the St. Croix ('ouno; Plan.nut" t~
Zoalcig Department wt!lun 30 davs of the lbree year expuauon fatc_ -
Uwe eert$y that all sialenicncs on th,a forni arc uuc rn he hest of my.oily k uoadeclge. I: -.vv am aie the owocr(s; of the
property described above, he vief tiw of a warranty deed recorded fit Itvrlsler of Deep fs Ullice.
Number bedroo
S iNATURF.OF VP1JCk\Tf.(S)
DA F
«**Any information that is !tusrefumcutcd stay :'asult in (tic saxtar: per nut bang n-voked by life Planning & ZonmP DepuYment.
Include with this application a ici;orded warranty decd front die Rct;isfur o` Deeds ~Ficc zmd a copy of the certified sinvev neap if
tefcrem r is rttade fn the warranty deed.
(RFV. 08/05)
DIVISION OF INDUSTRY SERVICFS
_ r.
-,•y 3824 CRLLKSIUC LN
_ HOI MFN Yv'l 54636 9466
S. _ Contact Thiouyh Relay
htl` CS S'/:i rv )uYra1ns4ndust Sewes
\NN/i '•VIfi::Cl1FiT1 GLV
Scott Walker, Governor
Laura Gutierrez. Secretary
October 14.'_018
COST ID So. 226900 17-TV: POd`7S Inspe( ror
RIIA(IV R IitR1) ZONINGOI hICI-.
BIRD MAT SI OR %(.i1. SI C'ROI \ (*Of I\T)' SPIA
1.1 I N I II SI 1101 C\R\11('1 I:Vd. RD
VLAV RICHMOND WI 54017-6409 HUDSOA A41 <4(116-7708
CONDITIONAL APPROVAL
PLA\ APPROVAL EXPIRES: 10!14;2020 Idcntilicrlwn \und,ers
I ransaction ID No. 3163854
Sll'E: / Site ID No. 854268
Rus/I `Properties Please refer to both identification numbers,
Lo'_ I S I St abo\~e. in all correspondence with the
'I own of \k arren agency.
St Croix ColtnR
N W i!4. N\\'U4. S3. INN, RIM
FOR:
Ohlcct Type: POW IS C'Ontpunen Mutual Regulated Object 11) Ao.: 1199018
Maintenance required; 450 GPD Ilo\v rate; System(s): At-grade Component Manual, Version 2.0. SBD-10854-P
(\.0.;0', R. 1: 12). pressure Distribution Component Manual - Ver. 2.0, SBD-10706-1)(\.0101. R. 11) 12); Effluent
Filter
I he subminal des, rihcd above has been rcvic%%cd tor corth nano \vith applicable \L iseonsin Administr ii%e
Codes and \\'isconsin Statutes. 1-he suhmittal has been CONDITIONALLY APPRO\'ED. This system is to he
constructed and hated in accordance with the enclosed approved plans and \vith any component Imunial(s(
referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance
with all code requirements.
\o person may engage in or work at plumbing in the state unless licensed it, do so by the Department per s. 145,06,
slats.
I he following conditions shall I)c met during construction or installation and prior to o ccupancy or use:
• This zystem is to be constructed and installed in accordance with the approved plans and wish publication
SB1)-10854-1)(\. 0;!071.
• the pressure nchvork is to Ix constructed in accord:utcc \vith publication SBD-10706-P I\ 0I01. R. 10: 12)
entitled "Pressure Distribution Component Manual f'or Private Onsile Sewage N\,tems" and based on pipe
sizing methods contained in Small Scale Waste Management project publication 9.6 entitled "Design o
Pressure Distribution Neteorks for Septic Tank - Soil Absorblion System.."
.A copy of the approved plans, speeifcations and this letter shall Lie on-site during construction and open to
inspection by authorized rcpreaentatiees oflhe Department which may include 1\xal inspceturs. All permits
required by the state or the local municipality shall he obtained prior to commencement of
construction: installation: operation.
In granting this approval the Division of Industry Set'viccs reserves the right to require changes or additions should
conditions arise making loin necessary tier exit compliance. As per state stars 101. 12(2), nothing in this review
shall relieve the daicncr uflhc responsibility li,r designing a Bali Injilding, structure. or component.
. ~I IAI!N R BIRD h,".' I:I II -ICIS
Inquiries concerning this correspondence nmy he made to me at the telephone number limed below. or at the
address on this letterhead.
The atawe left addressee shall provide a cop} of this letter and the I'M TS management plan to the owner and any
others who arc responsible Idr the installation. operation or maintenance ofthe PO\v TS.
Sincerely, Fcc Required 's 250.00
This Amount ill Be Imoiced.
\\'hen You Receive That Invoice,
Mauhe" Allen lanichJ " Please Include a (bpy With Your
\\'astewater Specialist . Division of Industry Ser\ices Pa\menl Submittal.
(715)3-10-0407 . WiSNIAR I' code: 7633
nlallhc+v.,jan ten'~r w i. _ov
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017 APPROVED
-,,EDT OF SAFETY
715-246-4516 ;,FESSIONAL,SMVI! '
? ZSION oF-1NOU~T6 SEI,`
Date:9/20/18 -
Owner:Roscon Properties
Location:NW 1 /4 NW1/4 S3 T29 N,R18 W lot 11 121st. St. Warren
Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07)
Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12)
Page#
1. Cover Page
2. At-Grade Plot Plan
3. At-Grade Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7-8. Maintance and Contigency plan
9. Filter Specific tions
Attachments: S i Test
Shaun Bird
Signature -
License nu or 226900
24
NI WI') NO SER /J DES Page 1 of 9
System PLOT ITAN
PROJECT Roscon ProoP.rtIP.S ADDRu:ss 1253 Av:atukee Trail Hudson Wi 54016
NW 114 NW I/4s 3 rf 29 Nnt 18 w TOWN Warren COLNfY ST. CROIX
SYSTEM ELEVATION 101.0' 9121±18 BEDROOM 3
Da"IE
CONVENTIONAL AT-GRADE, XXX CONVENTIONAL LIFT HOLDING 'T'ANK
1000 Gallons LIFT TANK SIZE DOSE TANK sl%I•; 630
Mrn ND st•:rTlc rANK sv.h
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 If of chambers none,
BENCHMARK Y.R.P. Base of wood lot line stake ASSUME ELE VA1ION 1011' Filter Lifetime Filter
❑ BOREHOLE, O 1VI•:LL "H. R. P. same as benchmark
Scale = 1/4" = 10'
455' Property Line
Huffcutt Combo Tank
1 00'
B.M.'
B-2 ❑
Grading is to be done to
divert run-off away from
250' system
2% Slope B
Pro 3 Bedroom House
B-1
101' 102'
Area 15' below system is to
remain undisturbed
Well is to meet all WDNR setbacks
121st St.
L C J