HomeMy WebLinkAbout038-1239-25-000
,1:cows•rocra-Irr.crr.e•Cc ..,me'ce PRIVATE SEWAGE SYSTEM Gc"rcv St. Croix
Ss'e:'i and B.il, mg U v s'ier
INSPECTION REPORT San Wry Pe'ma No 606987
GENERAL INFORMATION (A I I ACH TO PERMIT) stale plan ID No
(.1!...'_
Per5ir31 i-fx--at Orr yeJ prw JC "'ly OC Use-U nor 3=(qnS ary Cdr'vpSe` IP'v3CV I a,, 3 15A4
pe'°.✓ticker, Na_e. Cty Vlaga loan>rip Farrel Tax Nv
Peter & Meghan Ament TOWN OF STAR PRAIRIE 038-1239-25-000
CST BM clcv lwv e`d Ftev BY Cescripton Sur_aona oswvitange'l.lap No.
Op 6 F t/c~ 17.31.18.1286
TANK INFORMATION ELEVATION DATA
TYPE- IVANUFACTURER CAPACITY SIATION BS FS ELEV.
Septic ~I L t 2. 5e~ BenchrnalM. /45 /604
R I-, j ak- `JZs Al Btl1a~ Cep 16. T5 /J6, AM
Aeration Bldg Sevier ` lil W. 13
Hold rg - SVHI Inlet (0 9 Z ll
•7
TANK SETBACK INFORMATION St:Ht Outlet & 77,'17 1-41 1 ANK TO C Pj~ _ ',N L~ BL:.1G. Vert c Air l •.a'.e ROAD Dt inlet \
0 641-4 - Septic G 5; I 4 t of Bottom
Dosing Header:tvlan r •O p~•
• 10 1
Aeration Uisl floe `.p
1 I 7,/• L 7
aoldl•g Hot System 7.9 X13 • LS csL
Final G!ade
PUMPISIPHON INFORMATION a
Manofaaurer IDemand St Cover •
o. /6158 x.18 p,
GPe+ F, I d.~ ~o
Model Nund>m ID Lft Friction Loss System He H Ft
Force LengRr U.a C St to Vvc I -
SOIL ABSORPTION SYSTEM
BED:TRENCH Jtiml• LcnyD' IN, CI I o~ PIT DIMENSIONS Ns;. Cl Pits hside C a l in"in Deph
DIMENSIONS 3 3 1 lei. \ \
SETBACK SYSII l IU P(L BLDG N.'ELL LAKE:S`rl LEACHING Ma•u'ac- it
INFORMATION T, e/'f 4r s'em CHAMBER OR Tin C
$eD pl UNIT
,AP a Y.n' er.~
lit 541
DISTRIBUTION SYSTEM met" U S F/rS~~ S
Fesaer'I'lari`c dI 7s:r oubcn x'010S7e HOIe Spacing Ven:toAr rWk.
Fipeiyn LL`
Lcnclr ~a~ Lcr•gth~ lira` Slarin-
SOIL COVER x Pressure Systems Only xx Mound Or At-Grado Systems Only
7.3 1h'1., er CcpR' O':0' F" 11 cl +Sclaeo A'r Mulched
Rt, T'er-cn Cu- t,( 4 % •1 Ben,Te"ch Ec jes -"'Y' No ~yIt
No
COMMENTS: gnclude cede dscieponcies persons present. etc l h•seeceion #1: //j7 I ? Inspection Ill
Location: 069 218TH AVE IZ. L
I ; Alt BM Descr plion = Fit CL4 t~ 15 ,l 1 _ _ 1- ` 8 r`
2 Hldg se•.ver length = Ve YYY"'~~~///^rt^ l~ C 1
-aroun: of cover= y~ 60 /Qg 4V 6%.JIACA L.J e% R1 `
Plan revision ReGu reds Yes o
5 2 g 'Q V ~$3 y
)51
Use other side for additional information. 5 , _ - - _ - -
Date Ir Cr' r9r ..re Cart No
SEDriT1D iH +w5)
+r fr~ _.i lade u+~cr: i,ca Ulv suer
6 ~ti - 11111 t 41a-.bn m \'r.
pp ~nnm Pc: 4 11, n `I lU i, 11 cd it. ny C.-..I
-1 ~¢i1~G11'N It pplicati Ac" ~tne l'r<nsxdion Nnnllx'
Li ldancc .ui -•tf ~~t I t h n 11 Li. i m t ti~.':pp1 n 1 xu cn1r rtal t n':[
u :i p:: 1 t Ln .1n u o N I lp 11 1 t, 1 _s i nt
'i I. Vrojc t AdJ: r_>s ail dla<ren: tltan mailing eJdrcs>)
n ll un 1 r I ♦ nU 'u I I : rv l , I 1 nt : ,r.. 1 ,-.wilc m_: Ile wed for 1 cnditry
1.111 `I. I I 1 ~.viihtl Ir . Lt I1a;]j1 a 5.I-. 1
1 Application Information Plrn<r1rutt111 Itifolmllior,F ~~6 _ •U 1-
I I I (ia/1 !.-mom v Yercc!+: -p
I I I~O~.:n)nM1 nr~,:\JJr P1l,mnylcc.rion 1'71 110,31 aB~
Gmi Lot J
r" 4;a (Zap Cod, ?h on. Numb<r 1 - -y
S:rti<.n I /
rVU - tz
rit,~JU
h1 rt (clrclc o:c)II Type Of iuldin;; (cb 111 th pl - I N; RE
Nu <>r(lR'i
I at :t Ih1 - C17- - - -
1 r ka::nl' Dc^.IGng \u b rntlie.b.,yrr,~ I - SuoJn "'on Naatc// /
r I I ic'Cmn a ,al Des .u`': Ls, -
ate/
U C [ nt
l dl 1 c ai
Na,l lhvn i U:>...1h1. Us,NUa:Mr
~ ~ od- ~,tl~ I✓/2ZYZZ G~np.,,>.~oer5 fS~inw„n°~.,~_ lip,'
III I cpe of 1 kl n< I('hcc6 nnl}' mnr 11.1%
t lI lulc 1 (omplek line It it applicable) T ~1 Nu e:.m rl 1.+-.rm n I L ttow- II h.i I' n::R 111 .u'cnl Only 1
OdIC1 \I Ll 1 ion to LXISLn S}51CT1 icxplainl
13 U :mu i n r,. I U I u an R. , .i 1•. C1, 1 ul I I »•,cr I❑ I un' 1 I ran.ier m Vcu' I hit 1 Pre inns Pen•rl Numb<r and Daze Icme1l
i'l 1rhtn I Uunr • ~
Il I qn of PO\R 1 S Spsum C mm onenr llunc. hcc6 all that apply)
\ 1 I :nr r hh law l U 1. slur r I I l "d U .t-G:. Iv U biouna --24 in. of ,y tlaoi,. soil ❑ M.w d 1 ur .d snrtaMc soil _ 1 _ _t1s
I.ld1r,„f:,i1 oit )11.u~.:~ Cu:n1.nen 1.,1.1.111 _ ❑ Pralwor.ent Device (erl Lrnj
\ Dnpcrnal lI'at m.RnaI formarion: fff _
11 1 n 'I: a• r 1', D,>icn Snil glSc;dion Rat.. ! i)isp<naL0.w Rryu r/cd (sl) D sp n.l Ar<a Pnlposcd iy{ Sr @m Ela•ation / 1
Y /
\'I. 1'anl: Info ~ f n a m n r T r.l 1r cl \11. i111:'urcr ~
Gdl rs I1I C i 1 ~ Untts c ~
N w'a Ik> V su~lg l.rs
II c c
a` nL v aJ a
1 1 Icha :.n6 ~ ` /
VII. Responaibibty Slalclor'nb 1, [Ile undersigned assume recpoosibila, for ill.itallmion ol'lhe Po44TS xbmsn.m the attached plates.
I I o I 1 , {aEc:h 11' ur ~ Iun:hcl +11 1,...6'/ . V I ':11 Ie, Au lx.: du a e~cP one t,u[t11::
III inL~~A+'~ .:1, 11 111. AliCs,/
4111 eun 1Itrincolet Usti Only
- -
~erln.tIcc D`IC 1,,ucd ")p J 11Rr
11p1 vl f 5 ~nts vm:rc
Coo
r~ Q
,rr G1 I (ID.n1:~ y~ ///I3U ~ O I
1\. ondn i~K7rl;NN.Kva+ons Ior Dlsauval
1. Step1tack. E 'h.iin; Iilte- +n•I C~
D }-fo
(alwe::.1 c,I r,t , ell be_.'r Ic's' 1 „ It el
!a per :ra men! mi; 1• -A Loot . -<W yl a c : 4 rte... a to12_. ~ 1 P.SIG ~f/rOr .
2. N eeRwck re robe euey!:;ntrs mast : d, , d e p'1 14
as per hppdwbit v)en I :Munro f. 5 ~ 4- m ~ - L4.j P - 06_'_- 0 -7 Z
\macil In I., pirt, plain la: thr xy..trn> vino o n +n Ihr C4oul~"n pvper "Cot Iris ill.. 8 1 1 11 ind", "Lilt /
ot
14
1
I
- ed . >F.✓ /icsC~ fF t is J°✓f - ~~F;
r !~mJ y J,~?5fi' - tc.f'.:= ~iiC • ~f'.o/~ - - .(`-.c J'c}"
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: -
Owners Name:
Owners Address: /
" 1`12
Legal Descnptior,: NF 7 d
Township:
County ! i
Subdivision Name f - /
Lot Number
Parcel ID Number
Page 1 Index and title
Page 2 Plot Plan
Page 3 Systfan Sing & CtossSedion
Page q FWet' Specs
Page 5 _ Maintenance Information
Page 6 Aftmoernerlt Plan
Page 7 SL Croix Cty Septic Tank ManEamanoe Form
Page 8 Warranty Deed
P-43e g CSM or Plat
Attachments- Sod Test s House Plans
Designer/Plumber License Number
Date: PhoreNumbet
Signature
Deswjnw pras4rte the In G,*Uad SoilAUserpilon Cviyonuf Manual for POWYS Version 20 SaD-107U&P rrMaj.
Parva 1
i
t~
2'r p
,8
, 1 9
,
A'dl
41
Soil AbmrnSon Sy bffl Cross Section
4' Sdw.drde 4o Final Grade
K'C Vend ppe
Vft Vent Cup
LeadAng
Chamber
System E%vation
$
ft
Soil Absorotlon SVStern Plan View
ft
it
I(
I Caching / ft Vera OrObservaSonPipe Chambers
L._^~~
crJ ,SJos
Illlllll>IID1>))111IIQII
4' Dia
Trench 2 Header
Leaching Gtramber soecifira6ons
ManufachuerAndModd_
E1SA Rating T- Sq ft Per chamber Sod AppUcation Rate gpdjft
Wd Design Flow Sod APP n Rate EISA =
2 rows of - chambers each.
Page of
o~ o Filters
s I
PL 525 EFFLUENT FILTER
Polylok, Inc is pleased to add its
new oornmercial filter to its existing
tine of quality effluent filters. The k
PL-525 is rated for over 10,000 GPD Alarm AafptsPVC
(gallons per day) making it one of a Arty ` extension handle
the largest commercial filters in its ,r r
Hass It has 525 linear feet of 1;16 i
filtration skits. Like the Polylok
PL-122, the new PoWk PL-525 has a
1V
an automatic shut off ball itstalled 525 6omr feet
with every filter. When the fitter is g of t1tC
d fltration slots Rated for over i
removed for cleaning, the ball will K to 00o cPD
float up and temporarily shut off t
the system so the effluent won't _ CEO S
leave the tank. No other fWer on -
tYte r»atimtcarr make that claim!
I ~ 4O Pfp ' k
1
PL 525 Mairftt=rtat:ct=: _
The PL-525 Effluent Fitter should 3 ~ -
operate efficiently for several years
under normal conditions before
requiring cleaning. It is recorr>- E
mended that the fitter be cleaned
every time the tank is pumped or I ` e
at least every three years. If the
installed fitter contains an optional
alarm, the owner will be notified
by an alarm when the filter needs Gas ddL-ekw
servicing Servicing should be _ Ems"
done by a certified septic tank Aukmwfit dad-off
ban viben taw
pumper or installer. '
is reaboved
i
1. Locate the outlet of the us Parent Nor gptS/M 4
septic tank.
t•~e
e
2.'Remove tank cover and pump
tank if necessary. PL-525 Installation: 1. Locate the outlet of the
3. Do not use plumbing when septic tank.
fitter is removed. Ideal for residential and com- 2. Remove the tank cover and
4. Pull PL-525 out of the housing. mercial waste flows up to pump tank if necessary.
5. Hose off fitter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the
or outlet pipe.
Make sure all solids fall ff tteer is If the
fi is not centered under the
back into septic tank. access opening use a Poylok
6. Insert the fitter cartridge back Extend & Lok or piece cf pipe
into the housing making sure to center filter.
the filter is property aligned and 4- Insert the PL-525 filter into
completely insert=d. its housing.
7- Replace septic tank cover. 5- Replace the septic tank cover.
POWTS OWNER'S MANUAL & MANAGEMENT PLAN" f_
FILE INFORMATION SYSTEM SPECIFICATIONS
I<fAanufn to or f' I NA
PCrmit 1e piir: O Dose p I clding` `yrolum - ga:)
DESIGN PARAMETERS I ant f:•lacufa:zurer. NA
NumherofBedroori.: ❑ NA ❑ Saplc Ll Dose I i Iloldirg Volume: ,gal
Numl,or of Pubic f acility llnr's: jq NA Vvrir31 Dis!acce Tank Eo ro.'tt(s) to Service Pad: Estimated (average) Flaw: 1 (aat+day) Hcrizontal Dislance Tank(s)
to Sevice. Pad: ruj
aL i unite 1 n ecnan s must ba ur Tided if vortcal i >15 fc t o:
Urwign (peak) Flor/= (estimated x 1b}: (cal Jay/ 11 r iz n al i 1 0 feel. Specific imlrur r Ifs to bu Proar led 'm back.
In Sit! Sol Anp.l..ntion Rate: I f,lnent Fii.et Marufacturor' I I NA
Sl::r.dard (Domestic:) In(IueaiEfCuent Morthiy average Ef1Llent Filler f:Icdel' " " -
Fa4.01&G. cise (FOG) i30Ing.: Purr D.Montiho-urrr:
N:whemlcal Oxygen De-:;mi (E3[)D,) .x20 mg+! iVP•. E] N.A
Total Suspended Scl:ds ITS',) S150 mg:L I';.~np PAcdel.
I :iph slren(:th InSurnUEftluert P;lonGrIy average Prctrcafmrrt ))colt
(FOG) >30 n'yiL (SJ3f:lltaCtnfCC
(,401),) >220 mgt) NIt ;4 NA
I .5 `i > I : . ech acical Aeration ❑ Peat filter
( " 1 150 r r.A
❑ Cis.nfrclion ❑ Welland
Ffd'-atcd Ef ucrt Monthly average I I sacd;G a:•e1=:Ite ❑ Othcr. _
(ROF,) 2n mg: Soil At, Tlio
:System
(TSS) _30 m"UL yv~ NA
f-ocal Ccli orm (geomeWc mean) s10e n Ground (gravit) InWound (pressure) , NA
1 •,C-ril qr.'y
"Dies;,^rr_rn Eftiucn Pa:;in'c5i7~, .11 . J' I I (found
t , diu ! ?l+^ I I Grip I'rc
❑ Other.
C:aec LJ NA OGrr_ ❑ NSA
MAINTENANCE SCI-IEDUI.E
Service Event Service Frequency
Nih^.n (:xr*b,,i(es sludg arrJ scum ~-qu_ds clr~ ti'.1!d f'fi Cf tnni vc tome
P::m i out ccntei is ; ~f t;;sk(<;i
1 ':Vhen tho hio.", s'atur alarm is aNivatnc.
r,o iaj
I,,spec co1d16c^ of TOMS) At Ieast Or= rtf (Maximum 3 years) I 1 NA
Insp` -l disper.al cex(s) - - _ I At least once eves; Ij-l mr°:'''s} (Maximum 3 years) G NA
J4 yea te)
❑ ~roi Il:f~t
Clcnn c-tluenf fidcr At Irast onto cvnry_- ors) ❑ N.:\
mcnth!s)
Inspect pump, puurp cony ots :alarm At leas( once ever,`: L) r yoa(si _ yJy
I lush latorals and pressure test At !east once every' ] " ' Ift6i ~I NA
At least orce eve, ❑ m0nlh~;"' I NA
❑ NA
MAINTENANCE INS1 RUC 'I IONS
ln;pecliors cf'a-ks and scoot eLsur,nticn systems Sir. 'I no made by an individual cauyinr.; one cif t:re 7,t111o':nnc ~i ucses II U_rK cstOns:
filast_:r F`.:r)ber, 7,".ester P:tl ri , Rss:fctcd Sow-_f, PiAWP: Insoentor, POI":?S "'Anirmincr or Septa.qe Serv, ring O,:orator (pu;nper)-
I:_nk irmpe:;lixs ni.t:a irc,udfe a visual irspe:Jion of the font;:;) to idunllfy any wzsiny ur broken hwomare, idnntif'y any cracks or !caks,
rleasure t::e •eu'~me ur combine-ci sludGe and scurc and a che~t fu1 x y ba:.;k LIP or p011(i of etrlunnt on the gruunti suracr,. I h- soil
absefp on system) shall Le visua:iy inspected 10 cheek C r --fluent leae.'s in Ine obser,a`on pipes and to cr:eck for any pending of er"Iuen(
on the grof:nd surtaro. Tte pocdirg o- c1runrt a :hc ground sarfare 'na'y incic rn a failing condition and reri0mr, the Immediate
nrr'tica6or of -,ho Inca rcgu'atory authority.
;i.en t.^e ccrnbined aCCUmulalon o` s:edge and scum in any healneit tank equals one-third (%a) or niore of the tank volume, the entire
Ccnten;s of tho tank s: )al be removed by a seplage Servicing Operator (pumper) and disposed o' in accordance with chapter NR 113.
t mcnsn Atiministn.,tivo Code
AI other services; :ncluclr:q but not hirniteJ `.o the, sevic.ng of -(f)eint fixers, clechanical of pressurlMl components, pretreatment units,
and any rmn.1nmq at irxcrvnls 0- 12 halt(a, shall be rn forn'rd by cc.titi^d PO'u"J i S hBainlainer.
m.dho. t" -,v.`hin 30 i y s cd s!rr li_..... e ly evenl-
Gte'V:`-005
START UP AND OPERATION
Fer ne•;: collstn;etlon, I) ci to use :;f 1i.6 PO'e'iTS cheer trees:::hen[ '.alt<. ej f:Ir the hrese-ee of p::int r'.g Pro:iu,-s, eolvents or other
chemicals Cr sediment -het may iripode :i c trentmen[ nrccv.ss anr,+or c imajc the soil absorption systom. If high concentrations are
detected have the contents of the tank(s) rerneved fly a Seplage Servicing Operaor (pt:mper) prier to use.
Pump tanks may 611 ab• fve no:nial highw,ater levels prior to slaCup or doe to O.atp fa::u:es. Stnrt up or rrsloaation of poser under those
ccndi%ns is not recommenced, as the excess wasted,Iater will be discharged to the soil abso-otlen system in ore largo dose, ezeusing an
u -load that may result in the backup or surace discharge Of effluent and damage to thr systeot To avoid this situat oil Lave the
con`ents n` the pomp tank rcmovrc ny a Septap Servicing Operator (pumper) prior to restc: f:::,:cr to the pump or contact a Plumber
or POV•!TS Maintainer to assist fn marua9y npcrating the pump controls until normal effluent levels ..ro restorccl the p'.mp tank.
Sysle•n stall up stall not cxur when sail conditions are frozen at the infiltrative surface.
Uo not drive cc park vehicles c,r tanks rr thn soil nhsorpfirn system, fro not drives ci park u t r, car cthcrvvise disturb or compact, the
:area within. 15 feet dovai slope of any mound or a grade soil absorption area.
Reduction or ellnunatioc of the -olfo-;ing from the wasteroater strcarn may improvo tnc p^rfcm;arce and prc'org the Vo of the front ment
tents and soil absorption system: adds, antic ids, baby .pet. cigarette butts, cnndcms, cotton s mbs, dogrenscrs, dental floss,
dine^r disinfects:rfs, fats, tourrdat.on drain (sump pump) discharge, fruit and v::gefab!o peelings, gasoline, greases. hrrb'cides, meat
srn?:;., moaic._ -ors: oil:;, pak±tir:g p ocucls, pesticidal, sanitary napkins: solvents, lampons, end -water softener Line cisu•`arce-
ABANDONMENf
%,'hn-r Ire PCP::' I S fails nnd';ors pe•manent:y taken cu' of servlre the follawing slel:s stall he taken to insure that tho system is properly
a d r;ufely abjlx2imed in uwllpliancr :with s. Comm 83.33,'::risconsin A.dm niatrative Code.
• Aa piping to tanks, pits and other soil absorption systems shall be disconnected and tee abandoned pipe openings scaled.
• Inn cements of all tanks 2nd pits sha:l be removed and properly dsoosed of by a Septago Servicing Operator (pumper).
• A`lei p.lrtping, all tasks and pits R^all no excavated and rcmrvad or their covers removed and the, void space filled with soil, -
grave' o- arotncr inert solid material.
CONTINGENCY PLAN
If the PO'l:YLS fails and cannot be rcpa`rod tho folloivirg measures :^ave. been, or must Le taken, to provide a. rondo c:omplianf
eplacement system
X A suitable replacement has beer evaluated 2nd may be cilized for the Ir..rion of a repla:;enent soil abse;p+fion system.
11,e. rpta:;ement ca smud be protected from distd.ILa•lce and con'.pad:on and shruld not be inf.irrged upon by required
setbacks from ecstL':c and proposed slruclure, lot liner; and vdrlls. Failure to protect the replacement area w 1l result in the need
for a rcvi sai. and site eva'aaiior, 4:7 establish a xwilable :epdacement area. Replacement systems must wmoly with the rules in
offec't at the -lime of thoi: permit issuance.
❑ A suitable iepfacerxnt area is not av..ilablc due to setback nether soil limitations. If the soil absorp on systcn F•vnot t:❑
rehabililated and barring advances in POW I S tecnrc.ogy, a holding -lark may be instal cd as a last resort.
I ne sale has I:et been evaluated to identity a saitahlo rrplammcnt area Upon failure of the POVUfS a soil and site evaluation
most be performed to locate a suitable replacement area. If no replac err.cu t area is available a holding tank may he installed as :a
last resort to rcplaco the failca7 POVV f S-
O f0aand Ar.d at-grade sat absorplir° :;whores may be mconstmcfad in plane °ollr•.ring removal o` the hiomat at the InfRrative
surace. ReconsU'uMinns ei sir:•:h syt; ems W.2'
.t :xmrply wif-, pie rile,; ill otfcrit -r flint 'lnro.
WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
ar~¢ RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INS"FRUC'I IONS:
POWTS INSTALLER POWTS MAINTAINER
N -mn fi Name
I'hune
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AU-1 HORITY
(banner - - - f i:nn
SL
. duct Ul cI I drsfled b !nc slaff., n, the r7 F' r e `teal I-I'l i-: V;c r.;i a .nrity rl-']L Elroy aywnn 4, c mm, liar':. , ui'f- .::I1 11
-mm n?, ii(?~ t i;!f,.&ti; r rr.'.:59(1: t (71.'8;1 r_1 i::cLu.1;1t:0!:11' .iAdu.
START UP AND OPERATION
F: r nmv c:xlstru:dion. ortor to csc of t-c. Pcy.aJ :;heck treatrnenf tarlk of te- if:- :r-s:;nre of F:aintirg pro:l;: ris solvents o' other
c°.e;rica!s or sediment feat may impede tnn treatment process ano!or daruage the soil absorption eystC,m G high concentrations are
cetectL'. have the contents of the tan-t(s) acmoveci by a Septage Servicing Ouera'.x (pumper) prior to use.
Pump ranks may tilt above norn a h1chdater levels prier to stariup Or due to punp failures. Start up or restoration of pcwr; under these
rondtions is no-. reccrrtmetided, as the excess wes neater will be d sshargsci to ire soil abscrolion system Ir one larye dose causing ar
overload that may result it-, t^e backup e: surface discharge o` effluent and damage to :ha system. To avoid lh's situation have the
contents r.` the pump tank r ennovec by a Sep;aar. Servicing Operator (pu nperi prior to reston:°c power to the pump or cc:ntact a Plumber
:r POVe I S 6Aaintiiner to issst in !nanualiy operator; the, pump commIS untf normal effluent levels are. 'esigred within the pump tank.
stem start up shall no: o;:cui when soil wndihons are frozen at the infiltrative sur,'ac c.
not drive or park vehiGes over tan:<s or the sot ahsorptiorl system. Do not dive c- park over. or ct^c°u:isc disturb or compact, the
ar::a within :.5 feet down slope or any mou::d or at -grade soil absr).-ntror area
lieduction or eliminator of the follon4ng rrc:n the vvasteawater strewn may improve the performance ar.d arc ong the life of thl treatment
;enks ar;d son! absorption system: x:fds. antib'clics, baby wipes c:vareae bulls. condoms, colon s cabs. eeprease:s, de: tal floss,
iiiaoers, disinfectants, fats, foundation grain (sump pump') discharge, fruit a.•ld Vegetable peelings. gasoline. greases, ;-crbicides, ;neat
,.craps. medications, oils, painting prc dads, nesticides, sanray rapkins, so;vcncs, tampons, and water softener brine disc-zge-
ABANDONMENT
b':9nec the PObNTS fails ancfor is psrmannnt,y taker. o_t of scrvi,^,a the followfng steps shall be taken to insure fiat the system is properly
a c safely abardonec in ccrnpl'ance wilt' s. Ccmrn to V.?, Wisconsin Administratve Code:
• All plying to tanks, pits and ofne• soi: absorpbon systems snial be dllsconreyted and the abandoned pipe openings sealed
• The contents of as tanks a::d pits shall be removrd and properly disposed of by a Septace Senaang Operator (pamperi,
• After pumping, all tanks anc pits shat! be excavated and removed or their :rovers removed and the timid sPaca- 511ed W.th soil.. -
gra•det or another :Wert solic mamma:.
CONTINGENCY PLAN
It t-ie PCYA/TS fails and cannot be repaired the folimving measures have been, c- must be taken, is provide a code compliant
replacement systen-
X A sui:ab'e reulaceme-t a-ea has been evakated and may ae utilized fo, the location of a replacement soil absorption syst~tT
T; P r replace-ne:x area should be protectec from disturbance and cenpacier anc should not be. infringed upon by (a;ui-_;,
re:backs Gon: existing and p-opesed 5vuctare, lo: lines and wells Fai:urc to p ctec: the replacement area will result is the nee
for a new soil and site e'•:aluaton to establish a suitabr repiacemen; area Replacement systems must comply with the rules
effret a. the fime of then: permit issuance.
I A suitable replacerne: area :s not availanlo due to setbaoe, and~or soil limitations If the set! absorption system cannot be
chabilitaled and barring advances in I?OW I S technology a holding tan: may be instalic.1 as a last resort.
Tine si-,c has no: beat, evaluated to id---try a suitable repboernen a•ea. Upon failure of the PO'v:TS a soi' and site evaluatic•l
nust be performed to looe:e a s.rilaale replacement area If no reptacemect area is avai'aUe a holdinG tank may be i.-.stalled as a
last rL---,orl to reo?ace the failed POVVTS.
I. 1 Mound and at-grade sei. absurptioru systems rcay " rror)n.=.tnr:-tea ;n purr: tnlio•vin, rerwnl cf t•~i: r:i,)rr - t-,e ir`Cr :f-;is
sjrfacz. Hc•❑ovtru^tio-^ of s:rh sate:r.l ,rust comely IN&I trio rules in effect a: that
WARNING TREATMENT TANKS, PUMP TANKS. AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
t RESULT. ESCAPE OR RESCUE FROM THE IN TFRIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER POWTS MAINTAINER
tame / .%l~✓J.SLd:: r~arnc
Pnorc
SEPTAGE SERVICING OPERATOR (PUMPERI LOCAL REGULATORY AUTHORITY
Nami: dar- -
P'lone
I t: is no^u^~_nt v:&s rrdlnd t.l,: _.tallr cf :'IE i_rt er _a i` .,cjet-c am tiaL,iefa Caunv ''~l1TE d-rv acecac_ IT mo sn_., hit ~%e'i5cs
C~.ai-S.<L2t Li'- 11 d;b;i)1¢ .."4fT, 1 vdis_, r= iv i,dmi,.tiri e`•I- - _
ST. CRO.IX COUN sty
SEPTIC TAME- LADrM-tZr C A.GU1^1VI NT
AN
O/V.?\TRSEAP CERTIKCATIONFORYL
M Address ,)c a 11' c
P_oPMTV Addrr , % f G
(vermcaaon rqunied i ram Platmmq & Zonng Dt pannicat for new ccrostrttcsioa)
City'State Parcel lderdfficatonNumber_F_.-,'~~
LEGAL DESCRI °T IOC
P=opery rxado , y L i V4, Sec. % T ?J R Town of
S,abdivision Plat C
Lot
Certified Survey Map R Volume Page
Warrautg Reed 4 7 (Wore 2W7)Volume Page Y
Spec 11oUSO O yes no Lot lin s idert6able 0 ycs 0 ao
SYSTEM MAINI&NAw;cF, A_»D OWNER GERTZFICA.TION
improper use and maintenance of your septic system could result in its premature ravtm: to bandla wastes. Proper
maintenance consists of pumping out he septic tank evav three years or sooner- if needed, by a licensed pumper. vrbat yon pat into
nc system can awe t funccon of nc~ s cNC izaS as a t atawt stale in the Haste disposal sywet! Owner ma enance
responsf6tTmes are spec5ed m §SPS. 38352()) and m aaprer l2 - S C orx County Sautraty Ord anrr-
71be property owner agrees to submit to St Croix County Plamhig- & Zoming Department a ctrtificauon form, signed by the
owwner and by a master plumber, journeyman _a.Su abet, restricted plumber or a licensed pumper veifyina that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) afmr inspection and pLmPng (ifnecessary), the septic tank is
.ass than U3 full of sludge.
Jwc,. the undo sz c3 have read the; above reauiresents and age : to ma~ain, tthe private sewage disposal sysien with the
sixndards set f ik huain as serby he Depa-rmmt of Safty And by e;sio a Scxv = and the
S~atc of w'-=c*~ t erUdcaxim strong that your septic systemm bas bem raaintameei D~~ p ! Resource`
must be comnieteri sod returned IItmed to the St Croix
Conroy Pta,r . n & Zenist g t NiQ~vi 3Q 3r„ ofihe,itoe9 zw~on one.
Uwe certify tbat all statements on this forw m Lie to the best of- my/our knowledge. I/we am/am the owner(s) of the
property descn-bed above, by vrtue of a warra0. deed recorded is F- ester of Deeds Office.
N ber of bedrooms
Xrl
Sre'_ _AT-G' ,E of APPLIC_tN i S)
"'Any information that is mistaprs nun may result m ;ate sanircaty permir be ng revoked by the Plannmg & Zoning Depathnent. x«x
L-iclade ivA this application a recorded wannmty deed from the Register of Deeds Office and a copy of the certified s'.Rvey map if
reference is mede in the umaanty dead--
(REV. 041n)
rTf- D LANDI: Nt Comer at iltS ur
North line: of 1•'+" NW-1/4 01
rthe NF-S/4 bre NP-1/4 1
984.9 -588:7G'OJ c 2.565.E0" ?
S8836'01 "F 1282.80
ii ~j G6.Q0'v - r C x a .r, rc 7N _~,e D95.55' d
1'La~.. \~S883G'DI E
1.98280"
vc Y ;l , \ 588'36'01" 322.82'
151.16' 171.68'
/c X111 i.
LOT 24 I r~
I
• l i , 3.54 acres t I•
Arco M O.N. W.M.: i` I41 ,
J LOT 25 J.15 cures '•t ti, ,11
kj % p W 746. FOR 5C.
ocres
66
A.
O o Area to OH. W. V-:
\h4 LOT26 n ZOS acres t ?r `r
107,06'2 sq. Ir.
2 46 acres
,
Arco to O.H.WM.: 0
2.25 noes , , f~
h i ~
96" F 944.4 ilk
v
LOT 27 LL AL
87, 651 sq,
%
.01 acres
s; Z;
7
Arz•r, (o O.HW,M:
0
1.81 acres t r °'J 1i i " H }
-r. GOO, LV n li
t' 11W. \ I 5 • • / l~. NN WW
JX -x
LOT 28 s a \ \ , r w
'4,7.70 sq. IL _ b, \ I r( ~o -7
2.3,j U'' A N~ \ I II VT
786 OCles' 2 ~~i .
If; to OltWk(-' AIL ( z I
?.71 acres ±
n
.B.O. ' 946.3 - - m Z
-944.1
:440. L~ ~ o~,., a z
N83 0 S5 1` 1 a o
7 2J" E '2' 0.00 X11 \ , :i ~iI I <r c
PS-5' •-108't ~ . ~ ~ I Y C Q Z
P ,j230-5., LOT 29 - -i Z w
98.60r ^q R. _ ~ . ~ 1 rz
2.26 Cc.'C$ I. I V. \ \ n IJ W i
c PAS{ Area to O.H.WM.: : c6 z f V it A~ v
N I aQ
1.72 cures 0)
~
' 'a Ordinary lligl >
1. B. 0..959.1'
Water Mork \
° aj~
945.7 V~.°
9. (OAW..M.)= \ I = .
t 529 6° i ac w ~z v' w
_rt ila _ 18(1.00' ~p 940-69 ' (os _
0' E 1 r
_,s9. Li ~ N83'14'01 •1. , +Szy t determined
1 > `n
by D.N.R.) ~ cv
r, n
S7 I / M \ rc~7(Y~
n-
LOT X
1,,5,264 sq. -~jI C t y
V) I Tt CL
2.60 cures
3 >
Arco to ` I''
z; s
2.19 acres f-- \ 7 ti '.6,q• o
1 r I I wKr
CD
Lf?.0. =959.;• I_
OZZ
954.1'
-D • •'-=--cc "P I it :~a~'ci
I s
:;.w:c~= 948.2 I ~-'V--;.!
pb 955.0'
kF
} LOT 3! (L W
-
eL a - o i
83,721 sq. It. Z w g
;1.04 cures r~ 1 4, uo r- i--
1 ti.. m
Area to OILWM.r r070,
i.,76 acres J' v v }
i_ j i ' N I O r
LOT 3? >,v,~
' \ 135.162 sq. It.: E 't M Cr~ ~.i
?.10 Ocres
y; Arco to 0.//
5@8'.SS -15 49.63' 7.18 ar:re: 3 -
ST. CROIX Community Development
_WSM"' 1'01 Cannot hael Road ! Hudson WI 5401b
Co _w oNTY Telephone: 713-386 4680 I ax: 71 S- 386 4686
www.sccwi.yov
1 l i %6i 70'8
Pc:rr R Meqhan Amont
1420 143"' Sucet
New R chmond, WI 5401/
Rr Conditional Approval: file:! LUP-2018 072
Prnjert I ocaCon. 1/.3l.'81?8G, I(,wn of S!m Pra ne
Project Aci&c,'s: 1369 "18"' A,,"
PPLPr & Meyhar
( m-rt~ln ty JCVC'uprn'nl ,taft rdv,: r(vivwed vie Land 1%. I'rnnrl application for tro ccrs:rurtion
c1 a srr'.gle farniy dwell'ny. awac^,ed garage, and (lriveway n the Shordand Overlay /onin- Cistm l
prnsuant to ch.rlrlrr I. 3i' ? a I he wotw%l has been condd c,nally a:.oroved based or, Uic
p:? ication s,rtnnissutn and the Iol owriq = ndings. Pleaw see the e•"dosed tte c an to n`Irn•n. r
tho goncral erosion c0•wo ,nd grading no:rs.
• I he low. sotbac< to the ordinary •uyh water mark has fxxr n ::1
I+r so'bacKS .o rrr pio1wrly r 'l,% have heen nrc:.
• 1o:al lard (I s u•banm is approkiNa:ciy IU,((X) uncxe fa-t
• Lloslon a',c: Sed:rr•c"lt Control I; w-s have been SLIw" tPd 1-.it "noor 'ail<ccr Sl•' t:epwl... m ll O'
N.,t.nal Rexrarces Iechnual Standarck ie•st Management 'IacCrcc.~ ,:nc slonrnvaler 'nanagertent
wT be incorporaioc:.
• The Imaerv ous S,wf,v F ;IS; caiculauon -.vas perlorrxxl and festal*,ed in 11.70k; mitigation wd nol he
nagt.rcd.
• I ho ( only sanitary permit for it nrw Pwate (ins IF Waste.vate rc u^ t S,slnnt c ,nrent v x!c
1(v cw
• No and CIISWIban( c to dopes q,cwel than '9 99`) s to oc cu,
Haled on these findings, approval of the land Use :'ermit is stab"o; I to Ihe'ellownq conditions
1 Pr or 10 Construct on. the G f0o- shereldn(1 selback rats, be fldggcd and rrosron control meaurc~,
su(h as silt `erciry rwst he irstailou lmwns ope the site )nor to land drsturnance
A pre-construction inspection is required :o vdlida!r wtbacKS and verity erosion and s(.rnnent
control has :,c(,n instated oownslupe of construrioo at tivties Please tail me at ;/IS) 386 4742 to
',("cdule th s .nsoectior.
3. St Croix C.-Wily rcu'rv(s IrP • qh: to mc:ure addrtio^,a w(iunw), a•)r: w:x no rnntrol mraSoiw, to
ha instated ` Lund necessary ens to site ;pew wncenr, tnd ,vill h.' non m, rc d r a it, :;(,Ill
site plan.
Nicole Hays
Ni(ole.Hays0)sc(wi qov
(715) 386 4742
1 AA lernporary croslen e o••nc mras.rres ,hall lrr left if place and ^:,u•ru: ncci if, III Int. Sift. nas
r t•act•cd a pOirrl of at least :0% prr rr,rr•E>n; vege:ato•t. l cnnwww vcov:aIwrl dial be establ:shed
r;nce final grade rs'Canccd of as soon 'u a:;pl:ilk r, par plan
S A post-construction inspection is required pno, tr is^toving the temporary sedtmen: anc crosio•,.
Control weamm-, ;,ease call me a! 386-1/42 :o a hedule'h s inspect on.
6 It is the applicant's tmpv-• r drly tu mx on, any otner requ rec local, stale or federal pennt(`;) and
acprovals; p, or:o land dislhrbar%e activity
I ;:durc to ; or-ply with :hc Iernr• or cond Lions above may rest It n :hc revocation of [firs perrnd by
rr,p 7onirg Adrnr'dslra:or purs..rant :o l.•rapter '17 .71 and dtaptr
Ti, s approval is suclect to 1-r ( ondrhons I s:ed above; it c;oes not allow for any and tionml
r on•anrrTion, structures. o, huildirgs oeyond Int. [nits of this reauesl. Your ir,4mnehon wl I Tema n
on file at Ow SI Croix County (cnnnwitty -)eveloprterl Depa•Imt.nt suited is your resporsicdity to
enu,rt. compliance .vil- w• y othe• lor.al• %!:rlc• or federal Ix rt ttinq or equlations, Irr lud ng
contactmg ihr lows cf Star P,amc and fliv Depaliment of Nattita kevmi as to :nrtu re if addrtro•ial
-ennismor•s we re aired. I k s po^ nt is valid lo• one year, .vdh the possibil ty Of up to two vr.
month extensions it the apol Cant submils ,ht. appropriate pe-Mil cxlcrsion lac and clo(umevlabcr•
:o We Lrnr mj Art'ni!mt'ator_ A (opy of -he -and 1.5e Pcr.nrl pia:,;r : houba N:' c.lrr, itcd 1, t
:ubvr+'% ocn Rlr I I d I n.^, ht pt ,U or uuon apply ng for lc•r:n c;u IdiI1 r(."hr ~n•(n.lr• l~,rr, Jrd rrn..!
No posted on nwdoh sae and viswIc hom DUL):C v evr.
Please 'reel hac to c onia: t we with any zmFe t ons or cone ern, ,rn t ;l .:IL; .;va I,& P Mc nnay =riday
hnm 8:00 a r•. 1CC ^t
r.~•:,I:w•~Uuily.
Nicole '-ays
aucl Use Technician II
c(: =ilc
NC 1own o4 :tar -,lair C
ortractol7Agerit
rut Per^nt Placard; Silt Plan
Nlcul(, Hays
Nirole.Hays@ScCwi.gov
;115)386 4742
y AI i`:O7iIK ._~•n'C A.I.L --S'=C; '•litl to YbtO. 1d1~
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1280
1,rsccnsmDepartment olCommerce SOIL EVALUATION REPORT Page I of 1
Dioslcn cf Safety and Buildings in accordance with Corwin 85. Ws. Adm. Code Tom Schmitt
1,dxh complete site plan on paper not less than 8%x 11 inches in sle. Plan musl County
St. Cro x
urclu:fe, but ro5 limned to vertical and hodeomal rclarence pninl iRMj, direcrcrr and - - - - - -
pcment slope, scale or dmemsanS with arrow, and location and distance to nearest road. Parcel I.D /r4 C,~ a S L G'
Please print all information. Reviewed BY - Date
rbr_:ona infonmun ~r ride narh 1 »n'daYW,s l~r~r')iml!. ~(.lv~-= Property Owner Property Location
Grand Properties, LP :;7,•. r. NW 1M NE V4 S 17 T 31 NR 18 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
712 Rivard SLreeet, Suite 300 25 Squaw Lake Estates
City State Zip Code Phone Number City Village ✓ Town Nearest Road
Somerset WI 54025 715-247-5900 Star Prairie 218Th Ave
✓ New Construction D`e ✓ Residential f Number of bedrounis Code derived design flow rate 450 (11PI)
Replacement Public or commercial - Descnbc.
Parent material _ Pitted glacial drift Flood lain elevation, if applicable na
General comments
and recommendations. Area is suitable for a conventional system with a 0 7 gpdtsq It rating. Possible system elevation for Area 1 is
high trench 93.30', low trench 91 40' Slope is 16%.
❑ Boring # Boring
✓ Pit Ground Surface elev. 98.10 If Depth to limiting factor 97+ in. 5cil _rohcaaon mole.
I' at _ forrnrran: Onlrr i Recex 7csrptien Texlma SI's'uw RYA, ' GPf''F
-Eff#1 'Elf#2
1 0 8 1Oyr3/4 none is lfsbk mvfr cs 2c,2m 7 1 6
2 8-45 ----T y none its Osg ml gvv 2m 2f 1 .5 1.0
3 45-97 1 1Oyr5/6 liI Im---- -
~ nonr. ~1I ms I Osg rill , ~ .7 16
.6
❑ Boring # Ronng
✓ Pit Ground Surface elev. 97.80 ft. Depth to bmibn factor 97+- in. r -
g jcJ 1,ooli.zhcn (fate
I4>r¢e° ]qah Dori -..-;-I CC, Hecht DC'orplicn Tmlure Snuclnte ;:o-sste^:e Iwnun.lary Ronts CPLrt°
'Eff#1 -Eff#2
1 0-8 1 Oy!3/3 none its lfsbk mvfr es 2c.2m 5 1.0
2 8-42 1Oyr6/4 1 none Ifs lfsbk mvfr gw 2c 2m 5 1.0
3 42-97 1Oyr5/6 none ms Osg ml 2m 7 1.6
'Effluent #1 - 800-1.> 30 < 220 mg/L and T SS >30 < 150 mgtL ' Effluent #2 = BOD, <.30 mglL and TSS < 30 mglL
CST Name (Please Pont) Signature CST Number
Thomas J Schmitt ~ 227429
Address Tan Schmitt Date Evaluation Conducted Telephone Number
159572nd St., New Richmond. WI 54017 8118/04 715247.2941