HomeMy WebLinkAbout261-7000-11-008 11-8 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
463206 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: X City Village Township Parcel Tax No:
Young, Carl City of New Richmond
CST BM Elev: Insp. BM Elev: BM Description C Section/Town /Range /Map No:
/e)o /db �5 u �` 24.31.18.
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic i e J V Benchmark 11 /dd
Dosing Alt. BM
Aeration Bldg. Sewer ,Yr to
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet S
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet q7
Septic _7 -3 / _� Dt Bottom
Dosing Header /Man.
Aeration Dist. Pipe ( '- t4 , /
Holding Bot. System TP
PUMP /SIPHON INFORMATION Final Grade
Manufacturer Demand St Cover S
GPM r 'E I �
Model
Z
TDH L Friction Loss Syst ad H Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liq ' Depth
DIMENSIONS `'� I —�-t\
SETBACK SYSTEM TO I P/L BLDG IWEL L v LAKE /STREAM LEACHING Manufacturer. `
INFORMATION Type Of System: CHAMBER OR
/ UNIT Model Number
C e�ti lJ r 0l1 I-T - A - a V �
DISTRIBUTION SYSTEM al ; a� t a 4
Header /Manifold i� Distribution x Hole Size x Hole Spacing Vent to Air take
Pipe(s) \
Length Dia Length Dia \ Spacin \ \ t c
SOIL COVER I x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges' Topsoil NI-1 No es C No
COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2:
Location: Lot 8, Row 11 New Richmond, WI 54017 (SW 1/4 SW 1/4 24 T31N R18W) New Richmond Airport,Lot 11 -8 Parcel No: 24.31.18.
1. Alt BM Description = S14%L ` G° J e_A,
2.) Bldg sewer length = j
- amount of cover = \ J G � (, (A (3�
Plan revision Required? Yes No
Use other side for additional information. Z
SBD -6710 (R.3/97) Date Insepctor ignatu Cert. No.
Safety and Builision County _ ++
AF W. Washington x 7162
isconsin Madison, WI ?!T � 3 Sa nitary Permit Number (to be filled in by Co.)
Dep artment of Commerce (608) 266 -315
Sanitary Permit Application fate Plan I.D // Number
In accord with Comm 83.2 1, Wis. Aden Code, personal infbm ation you d�
maybe used for secondary purposes Privacy Law, sl 04(IX 1 6 ?004 ftiect Address (if different than mailing, address)
I. Application Information - Please Print All Information ST. CRUX COJN ti
ZONING OFFICE
Property Owner's Name Parcel # p
�d� p r roW
Property Owners Mailing Address Property `
City, State Zip Code Phone Number 1$ llk Section
�j bj- Cj lo fi J
It W O
Type of Building (check all that apply) N; a
I or 2 Family Dwelling - Number of Bedmoms Subdivision Name CIM Number
P L
ublicWA m nercial - Describe Use d,� ,Q� F 19'0'1— Gr C--. , 1' • �/ ✓
✓✓ S ate Owned - be Use Ci Village o of
IM e of Permit: ( Check only one box on line A. Complete line B if applicable)
A yytem Rept —mesit System Treatment/Holding Tank Replacement Only Other Modification to Existing System
B • Permit Renewal Permit Revision Cha nge of Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV._Type of POWTS System: (Check all that appl
Non-Pressurized In- Ground Mound Z 24 in. of suitable soil Mound < 24 in. of suitable soil At -Grade Single Pass Sand Filter
Constructed Wetland Pressurized In- Ground Holding Tank Peat Filter Aerobic Treatment Unit Recirculating Sand Filter
Recirculating Synthetic Media Filter c Drip Line Gravel -less Pipe Other (explain)
V. DispersaVrreatment Area Informs on:
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal / Area jtgquirAd (sf) Dispersal Area Proposed (sf) System Elevation
VL Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units -/LV Concrete Constructed Glace
New Existing
Tanks Tanks
Septic or Holding Tank
Aerobic Treat ent Unit
Dosing Chamber
VII. Responsibility Sta t- 1, th nnderalgn assu rewrsilillity for installation of the POWTS shown on the attached platm
Plu s Nary t) Plumber's MP/MPRS Number Business Phone Number
Plumber's Address Steet, City, State, Zip Code)
q Cl
S nl
VIII. corm m artment Use Onl
Sanitar Permit Ise (i Groundwater D t ate Issued Signata o stamps)
tt p� Surcharge Fee)
Owner Given Reason for Denial 25V . �(0
IX. Conditions of Approval/Reasons for Disapproval
SYSTEM OWNER: 3) clp-�
1 Septic tank, effluent filter and 5 , IX
dispersal cell must all be serviced / maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained / as per applicable code/ordinances-
Attach complete plans (to the County only) for the system on paPdr not less than $1/2 x 11 inches in size
PLOT PLAN
o ADDRESS 1593 140th St. New Richmond Wi 54017
1 /4S 24 /T 31 N/R 18 w City New Richmond COUNTY ST. CROIX
un Bird 226900 DATE 10/25/04 GPD
TIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
s
ND SEPTIC TANK SIZE 261 LIFT TANK SIZE DOSE TANK SIZE
OLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 186 # of chambers 6
BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter Zabel A-
1800
❑ BOREHOLE WELL
H.R.P. Same as Benchmark
SYSTEM ELEVATION 93.7'6' below qrade
Scale = 1/4" = 10' Tank is to be properly bedded and
provided with
lockdown covers
Taxi way with approved
B. M. warning labels
Alt. B.M. Top of sla B -1 Absolutely no
Well ent catch basin waste
°
Pro Hangar 2 is to discharge
:B:- into system,
employees, 1
floor drain domestic waste
only!
77 d
gp
Floor not B-3 0% Slope
yet
lease line I Poured f r- 1
Well
.4 -- Lease line
Airport Rd
ji Sta Vent y Elevation nt G
ndard Biodiffuser
Leaching Chamber
with 31.1 ft2 of Area
1199 Well is to meet all Plans Designed Using
setbacks re uired b Conventional Powts
Grade at S stem Eleva i q y 34 WDNR Manual Version 2.0
l
Safety and Buildings
111111e1'Ce.Wl. ov 1 HAY RANCH ROAD
co
g HAYWARD WI 54843
TDD #: (608) 264 -8777
.
isconsin www.commerce.wi.gov /sb/
Department of Commerce www.wisconsin.gov
Jim Doyle, Governor
Cory L. Nettles, Secretary
November 11,2004
CUST ID No.980164 ATTN.• POWTS Inspector
CARL YOUNG ZONING OFFICE
WESTERN MOBILE SERVICES ST CROIX COUNTY SPIA
1593 140TH ST 1101 CARMICHAEL RD
NEW RICHMOND WI 54017 HUDSON WI 54016
CONDITIONAL APPROVAL
Identification
PLAN APPROVAL EXPIRES: Numbers
Transaction ID No. 1078425
SITE: Site ID No. 168375
New Richmond Airport Please refer to both identification numbers,
County Road CC North above, in all correspondence with the agency.
City of New Richmond, 54017
St Croix County
NW 1/4, SW 1/4, S24, T3 IN, R18W
FOR: PETITION FOR VARIANCE TO COMM 83.43(8)(i)
Your Petition for Variance of the code section(s) noted above has been reviewed.
Departmental Action: CONDITIONAL APPROVAL
The code section petitioned requires POWTS treatment, holding and dispersal components shall be located as to
provide the minimum horizontal setback distances as outlined in Table 83.43 -1 as safety factors for public health,
waters of the state and structures in the event of component failure. Table 83.43 -1 requires an exterior subsurface
treatment tank to be a minimum of 5' from any building. Table 83.43 -1 requires a POWTS treatment component
consisting in part of in situ soil or to be a minimum of 10' from any building.
The variance requested is to allow the construction of POWTS that will have a 3' setback from the septic tank and
a 6' setback from the distribution cell to the building, and the septic tank will have a 3' setback from the lot line and
the dispersal cell will have a 0' setback from the lot line.
The intent of the code section petitioned is to protect the structure in the event of component failure and
encroaching on neighboring property.
The petitioner submitted a notarized SB -9890 application form including additional page(s) of supporting
documents and/or plans.
Reviewer's Comments:
1. In reviewing the petition, it was noted that the request is similar to other petitions accepted by this department.
2. Based on the precedent established by the previous petitions, this petition for variance is being processed as
permitted by Wisconsin Statute s. 101.02(6)(g), and Comm 3.
3. This approval does not cover any part of the soil absorption system or system components.
All of the petitioner's statements included on the variance application form, any other documents submitted to the
Department, and all conditions of approval, if any, listed below shall be carried out. This variance is specific to the
subject petition and cannot be used for any additional modifications.
Conditions of Approval:
CARL YOUNG Page 2 11/11/2004
• The slab for the building shall be of reinforced concrete.
• The building sewer shall be installed between the footings.
• There is to be no construction on or damage to the neighboring parcel without the written permission of the
land owner.
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. If plan index sheets
were submitted in lieu of additional full plansets, a copy of this approval letter and index sheet shall be attached to
plans that correspond with the copy on file with the Department. All permits required by the state or the local
municipality shall be obtained prior to commencement of construction /installation/operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions
should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this
review shall relieve- the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincer Fee Required $ 225.00
Fee Received $ 225.00
Balance Due $ 0.00
Patricia orf
POWTS Plan Reviewer, Inte ated Srices WiSMART code: 7633
(715) 634 -7810, Fax: (715) 634- , 4:30 pm
pshandorf@commerce.state.wi.us
cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544
Shaun R Bird, Bird Plumbing, Inc
Safety and Buildings
10541 N RANCH ROAD
commerce HAYWARD WI 54843
TDD #: (608) 264 -8777
t s co n s i n
w ww.ce.wi.gov/sb/
D epartment of Commerce www.wisconsin.gov
Jim Doyle, Governor
Cory L. Nettles, Secretary
November 11, 2004
CUST ID No.226900 ATTN.• POWTS Inspector
SHAUN R BIRD ZONING OFFICE
BIRD PLUMBING, INC ST CROIX COUNTY SPIA
1008 192 ND AVE 1101 CARMICHAEL RD
NEW RICHMOND WI 54017 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 11 /11/2006 Identification Numbers
Transaction ID No. 1078428
SITE: Site ID No. 168375
New Richmond Airport Please refer to both identification numbers,
County Road CC North above, in all correspondence with the agency.
City of New Richmond, 54017
St Croix County
NW 1/4, SW 1/4, S24, T3 IN, RI 8W
FOR: Description: New commercial non pressurized in ground system, 2 employees & 1 floor drain
Facility: 644560 Carl Young / Western Mobile Services Hwy 65 N & Hwy Cc - N Lot 11 -8 New Richmond 54017
Object Type: POWTS Component Manual Regulated Object ID No.: 990767
Maintenance required; 77 GPD Flow rate; 136 in Soil minimum depth to limiting factor from original grade;
System(s): Conventional POWTS Component Manual, SBD- 10567 -P (R.6/99)
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes -T_S-
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in V.� ona
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. Coll t
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per 145.06, ?
stats. 01
, ,
The following conditions shall be met during construction or installation and prior to occupancy or use: AML F
General Approval Conditions:
• This system is to be constructed and located in accordance with the enclosed approved plans and wi th - ; F GO SPA
design manuals noted above.
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans. In addition,
the owner must insure that the operation, maintenance and monitoring duties as described in the "In- Ground
Soil Absorption Manual System" are complied with. A copy of this information must be given to the owner
upon completion of the project.
Key item(s)
• This approval is for a non pressurized in- ground system that serves a airplane hangar with 2 employees and 1 floor drain
that receives domestic wastes only.
• The plumbing for this project discharges to a private sewage system. The approval covers only
domestic /sanitary wastes directed into this system. The Department of Natural Resources (WDNR) must be
contacted regarding the treatment and disposal of all industrial wastes, including those combined with
domestic /sanitary wastes.
• This approval does not include plans for the general plumbing systems or sewer piping leading to the
septic/holding tank that may be required for this project. See section COMM 82.20, Wis. Adm. Code, to
determine if plan submittal and approval is required.
SHAUN R BIRD Page 2 11/11/2004 D-
• The gravelless system components must be installed in accordance with the manufacturer's printed instructions,
the plan approval, and COMM 83 system sizing criteria. If there is a conflict between the manufacturer's
instructions and the plan approval, the plan approval and code requirements will take precedence.
• The designer proposes to install an outlet filter to achieve the requirement of wastewater particle size.
Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic
tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations.
Reminder
• Materials shall conform to the requirements of COMM 84.
• Surface water drainage shall be diverted away from the system area.
• Maintain well and waterline set backs per COMM 83.43(8)(i).
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions
should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this
review shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operati intenance of the POWTS.
Sincerel Fee Required $ 175.00
Fee Received $ 175.00
i
Balance Due $ 0.00
Patricia L Shandorf
POWTS Plan Reviewer, Integrated Services WiSMART code: 7633
(715) 634 -7810, Fax: (715) 634-5150, M -f 7:45 am - 4:30 pm
pshandorf@commerce.sta'te.wi.us
cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544
f
Cover Page
Shaun Bird
Bird Plumbing Inc.
1008 192nd Ave
New Richmond Wi 54017
715- 246 -4516
Date: 10/25/04
Owner: Carl Young
Location: SW1 /4 SW1 /4 S24 T31 N,R18W New Richmond Airport Hangar 11 -8
System type: In- ground absorbtion system(conventional)
Manuals Used: In- ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Pettiion for Variance information
3. System plot plan
4 - 5. maintance and gency plan p
6 -8. Soil Test
Signature
� gU1 �9 G
License nuo4er 226900
)NE G�
v ,
Bird Plumbing Inc.
1008 192nd Ave
New Richmond Wi 54017
715- 246 -4516
Shaun Bird #226900
10/25/04
RE: Petition for Variance for Carl Young
To Whom it may concern:
The tested area does not meet the current setbacks found in table 83.43 -1 in Comm
83. Currently, the airplane hanger is built but no floor has been poured. The septic is to
have a 3' setback from the building and the leaching chambers are to have a 6' setback.
For safety, the proposed slab in the hanger is to have added rebar in order with stand
potential settling around the tank and possible caving in when the tank is being dug, The
tank is to dug as shallow as the code allows, and the tank is as shallow as the code allows
and the shallowest septic available (40" inlet). Also, the building sewer is to be installed
between the footings, in order to prevent caving in of soil.
The septic tank and leaching chambers will not make the setback for a property line.
The cell is to have a 0' setback from the lot line and the septic tank is to have a 3' setback
from the lot line. This problem is satisfied because all the parcels are leased from the City
of New Richmond. Thus, lot line issues can be avoided due to 1 owner.
Thankyou
Shaun Bird #226900
r
-' PLOT PLAN
PROJECT Carl Youna ADDRESS 1593 140th St. New Richmond Wi 54017
SW 1/4 SW 1 /4S 24 /T 31 N/R 18 W City New Richmond COUNTY ST. CROIX
10/25/04 GPD 77
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 261 LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 186 # of chambers 6
BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter Zabel A -1800
❑ BOREHOLE O WELL *H, R. P. Same as Benchmark
SYSTEM ELEVATION 93.7' 6' below qrade
Tank is to be
Scale = 1/4" = 10' properly bedded and
provided with
lockdown covers
Taxi way with approved
warning labels
B. M.
Alt. B.M. Top of sla B-1 Absolutely no
Well @ 100.0' Vent catch basin waste
o is to discharge
Pro Hangar 2 B-2 into system,
employees, 1 domestic waste
floor drain only!
77 gpd
Floor not B-3 0% Slope
yet
lease line Poured
o
Well ST Lease line
Airport Rd
Vent
>6 „ Standard Biodiffuser
of Cover Leaching Chamber
with 31.1 ft2 of Area
Well is to meet all Plans Designed Using
6' Long 11 setbacks required by Conventional Powts
Grade at System Elevation WDNR Manual Version 2.0
3 4"
r
MANUAL 'a8e of
• L & MANAGEMENT PLAN
POW TS OWNER S
• SYSTEM SpEtiFICATIONS o7 6/ --ai 13 NA
Septic Tank Capacity
F[t.E INFORMATIO � G Ma nu f a cturer ❑ NA
Ayer Septic Tank Ma —.�
❑ NA
Permit #. Effluent Fitter Manufacturer 4 /
DESIGN PARA Effluent Filter Model
13 NA
Pump
Number of Bedrooms
Tank Capaw gal NA
Number of Commercial. Units % altda pump Tank Manufacturer NA
Esdmated flow (average? a1/d Pump Manufacturer
Design flow (Estimated x 'i. 5) Model
< iYt2 Pump
pretreatment Uni
aVda t
Son APpsmwn Rate * ❑ Peat Fitter
Monthly p gandlGrave, Filter Wetland
Influent/Eftluent Qual �0 mg/L p M anic, Aeration [I Fats'. on & Grease (FOG) 42fl mg/L ❑ Other.
Demand (600 ❑ Disinfection
Biodhemlcal Oxyg nded Solids frSS) 51 so m �L P nufacturer
Tota Suspe Monthly average' persat Celts]
pretreated Effluent Qualty NA In (gra�Y) Q [n ground ;pressurizeed)
pretreated
530 mg/L t grade [1 Mound
B•tochemical Oxygen Demand (BOOS) 530 mg/L ❑ Other.
Total Suspended Solids (TSS) D Ori ire
(geometric mean) s10' cfu /100mi rya ,,, ",Q
Fecal Corfortn (g :: Y, inch diameter values typic for domestic no eomme n x p tank et[tvent.
Mmum uent Particle Size ..
Values typical for pretreated wastevrater.
Freq
Service Frequ
Mgi[dTENANCE SCHEDULE ea s Maxim 3 y rs.]
Service Event ❑ months Y '�)
At Least once every of tank volume
Inspect condition of tank(s) When combined sludge and scum equals one -third (Y)
[03 month ear(s) (Maximum 3 yrs.)
Pump out contents of tank(s) At least once every
s
Inspect dispersal cell(s) ❑months Years)
At [east once every ° A
Clean effluent filter At least once every ❑ months L3 year(s)
Insped Pump, Pump controls & alarm At least once every [3 months E3 year(s)
❑ year s) ❑ NA
At least once every
Flush laterals and pressure test C3 months
s ❑ NA
Other ❑months f3 year( ?
At least Once every
Other_
of tann one of the following licenses o�
NANCE INSTRUCTIONS _ _ � POWTS Maintainer, Septage
Inspectlons ks and dispersal cells shall be made by an individWTS inspe a missing or broken
cerullioat nix Master Plumber, Master s must Plumber de visual i specflon of the tank (s) to identify rtY
Servicng Operator. Tank inspedio asure the volume of combined sludge and scum check th i,eyels
hardware, klenlSfy any cracks or leaks, me The dispersal ce ll(s) shall be visually inspected
of effluent on the ground surface• of effluent an the ground surface• The ponding of effluent on the
or l�� for any ponding ulatorY authority.
in the observation► pipes and to check �nd'rtion and requires the Immedlate no tifi c ation of the Iocai reg
ground surface may indicate a failing equals one-third W or more of the tank volume, thN
When the combined accumulation of siudg
e and scum in any tank eq sect of In accordance with ch•
entire onntents of the tank shalt be removed by a Septage Servicing Operator and dispo and any
113, WlSconsin Administrative Code- co mp onents. pretreatfinent
The servicing
by a certified POwTS Maintainer.
of effluent filters, s of 12 � or
other sall be Pe rforme d
other m8fntenanCe or monitoring at o f completion of any service event
A serve report shall provided to the local regulatory auznority within 1Q days
START UP AND OPERATION for the p resence of painting products or other
f the PO check treatment th dispersal cel are
For new construction, prior to use o P rocess and/or damage the dispersal ( )• if high concen
chemicals that may impede the treatment by a septage servicing operator prior to use.
detected have the contents of the tank(s)
- Page / of
f nditl are frozen at the infiltrative surf, (lS res tored the excess
i not o=r wtig" s°'i o0
system s' +tart up steal above normal liigtnnrater levels. Wt►en powe
ta nks may oveRoading the cea(s) and maY resul� in the
Powe ou�� pump tan the dispersal
c all(s) in one large dose,
During r 611 be discharge
id thtion have the contents of the pump tank
d to is situa
removed by a
rnaae dlskrDe of efRuent. To avo to the affluent pump or contact a Plumber or POWTS �ilntainer to
-badwp O t�or prior -to rpstO n9 Pow
raga Serv�n9 ta n the pump to restore normal tene
Sep oper is within the pump tank.
ta in manually oper g peifs. Do not drive or park over, or otherwise disturb a, compact,
over tanks and dispersal
Do not drive or park vehicles mound or at gmde soil absorption area.
the area within 15 feet down slope of arty rove the performance and prolong the rde
from the wastewater stream may imp s;
Reduction or etiinination of the following from butts; condoms: cotton swabs; degreaser;: dental floss; diaper
of the POWTS' antibiotxs; baby PeS; urtl sanitary water; fruit and vegetable peel'in9s= gasoline; grease, rine .ades; meat
foundation dialn (sump Purr . napkins: tampons: and water softener brfine.
drsinfecMnffi Qns; 04 ain8ng products; pmWdes:
scraps: sa p ' .
-
'SAN00SMEN S fa[Is andlor is pemanentiy.taken out of service the following steps shad � taken to Insure that the
When the PO ed in compliance with ch. Comm 83.33, Wisconsin AdmtnIVtlV )ve Cod �:
system is property and., safety abandon openings sealed.
its shalt .tie i
disconnected and the abandoned Pipe ope � � e Servicing Jperator.
to taks and p disposed of by a P g
All piping its shall "be removed and property
The contents an tanks and ¢
. After pumping. . all tanks and Pits Shat[ be excavated and removed or their covers removed and the void space
tilled with soli, gravel or another inert solid material.
CONTINGENCY PLAN lfowtn measures have been, or must be taken, to provide a rode
if the POWTS fails and cannot be repaired
the fo g
compliant replacement system: coon arc should not
0 A suitable replacement-air" been evaluated and may be utilized for the location c a c om pa ct i on a ni s oil
h
a bsorp tio n system The replacement area should be protected from disturbance and com pa
r e q uired setbacks from existing and proposed structure, lot tines and wells. Far
to
be infringed upo try eQ the need for a new sol and si
protect the replacement area will re5 must comply with the n at that time�b�h a suitable
replacement area- Replacement systems
A suitable replacement area is not available as a last resort to replace 1
the failed POWTS-
ng advances t 1 PO
xechnology a holding tank may be in
e site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS :i soil and
/ evaluation must be performed to ate a suitable replacement area_ if no reptacerne area is available a
holding tank may be Installed as a last resort to replace the failed POWTS_
Mound and at -grade soil absorption systems may be reconstructed in place following removal of the b omat at
the infiltrative surface. Reoonstsuctions of such systems must comply with the rules in effect at that time.
«WARNI TANKS MAY CONTAIN LETHAL GASSES ANDiOR INSUFFICIENT OXYGEN.
SEPTIC, PUMP AND OTHER' TREATMENT
ANY DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATME T A T MAY BED CIR CU M STANCES. CUT OR MPOSSIEt H MAY
RESULT., RESCUE OF A PERSON FROM THE INTERIOR
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
F Na Name Lf/i/' Phone
SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY
Name %v,� Agency �r I X-
Phone
This aoarmettt was diafted try the staffs of the Green Lske, Artarquetfe and Waushara County Zoning and Santt fm agendas. This document meets
the minimum mquirements of rat Comm 83.22(2)(b)(i)(d) &(t1 ad 83.54(1). (2) & (3), V4Wisa�nsin Admtnlstrative Cote_ Use of this Qottrment does no [2101)
guarantee the performance of the POW *S_
�ECEI V
OCT
2 5 200
Wisconsin Departme of C rce LUATION REPORT Page of
Division of Safety and uildi��ROIX
ON1N� OOP' dan with Com Wis. Adm. Code
County S� l' V
Attach complete site plan on paper not less an 8 112 x 11 inches in size. Plan must l.'
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. evie ed by Date
Personal information you provide may be used for secon ry purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner L , i , Property Location
O 4111 Govt. Lot �� 1/ (�/�14 S� T N R� E (or) W
Property Owner's Mailing Ad ss Lot # I Block # I Subd. Name or CS NW
City to Zip Code Phone Number City ❑ Vi / llage ❑ T�vn Nearest Road
Uff New Construction Use: ❑ Residential/ Number of bedrooms � —� Code derived esign flow rate n GPD
El Replacement - Public / or mmercial - Describe: G
Parent material FloocrPlain elevation if applicable
General comments � �
and recommendations: 5 /� ,
e "A
B of i ng # Bonng /
pit Ground surface elev. ' ft. Depth to limiting factor 6 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
4' 30 L --�` -- —
a7f 93• �" °
�2 /log
® Boring # 0�it ring
Ground surface elev. c ' ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN
in. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
0 �8 D
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Sig CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Con u ted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 xe ���S�r� 715- 246 -4516
Property Owner _ Parcel ID # Page of
Boring # ❑ Boring
it Ground surface elev. ft. Depth to limiting factor /_ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
�
❑ Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2
Boring # [] Boring
Ground surface elev. ft. Depth to limiting factor in.
❑ Pit
Soil Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Efi#2
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS 5 30 mg/L
The 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.
SOD -8330 (8.6/00)
a
Soil Test Plot Plan
Project Name Carl Young Shaun ird
Address 1593 140th St.
New Richmond Wi 54017
, Ofi 4 #226900
Lot 11-8 Subdivision N.R. Airport Date 10/25/04
SW 1/4 S W 1/4S 24T 31 N /11 W City New Richmond
❑ Boring Q Well PL Property Line County ST. CROIX
IL BM or VRP Assume Elevation(1 ft.::= Bottom of Siding : 5w4
System Elevation 93.7 *HRPSame as Benchmark
Scale = 1/4" = 10'
Taxi way o B.M.
Alt. B.M. Top of sla B -1 no W e I I waste arge Pro Hangar 2 g _ 2 m, employees, 1 aste floor drain 77 gpd
Floor not B - 3 p%
yet
lease line poured
No O
well � Lease line
Airport Rd
COUN'T'Y
ST CRO ENiCfi AGREEMENT
SEPTIC •T
F ORM
O
MP CERTIFICATION
LAJ ► `
1
Owner/Buyer
Mailing Address f -
Address pig Department for new construction)
Property (V required
p Identification Numb or
City /S.tate
DES RIPTION a fw'
LEGAj -... T N- R
1 /, 2 i /,, Sec. � t #
Location, =sac— --- 0
property
Subdivision Page #
Volume — ,�-
Cerdfied Survey gap page #
Volume
W Deed # - ntifiable YeS C3 no
W Lot lines tds
Spec house C1 Yes o e wages. P Maintenance
�, s it re mature failure to �VPhat you put into the system
SY y � septic system could result in d b a licensed Pump er use and maim °f your three Yew or sooner, if nee' o � system.
�°p ing the septic tame every out . tenant stage in the waste
disposal the owner and by a
of umP as Signed by
is P teak sign
coasis tic 'on form, cm
can affe ct the function of the septic ar iment a certificat► e �terdisposal syst
to St. Croix Zoning Dop verifying that (1) the ou -site w� 1/3 of sludge.
The property owner agree s to sn,,'e or a licensedpumFer the septic tank is less than
ourneY�'Plumber, restrictedp r nmnping (ifnecessary),
masterpl operating c ondition and/or (2) after and punVing sal system with the standards
is prop maintain the pvate sewage dispo Certification
eats
above and agree to main ri ResourCeS, State of Wisconsin- 30
d have reS the f orce and tb,e Department of Natural Zoning Uwe, the undersigned the d tlu tmennlfnC t be complied and. returned to the
St Croix County Zoning
set fortk. herein, as set by been
tsied n
stating that Your septic system has l �119
days of the three year CXP'mt'on date -
/1 DATE
Si(}Tif:1VRE OF APPLIC�x?
OvVNER ICATI form gfe true to the best of my (our) knowledge
. I (we) am (are) the owner(s) of
is on th inter of Deeds Office.
I (we) certify that all statemen i
of a warranty deed zecorded in Reg //—
the pro perty described above, by 'fie
DATE
ppPLI
e rsvokedby the Zoning D "' "``*
SIGNATURE p er mit b in g
ration that is Luis- represented may result in the sanitary P
Any R eg ister of Deeds office
d warranty
do if referenc
d from the Reg de in the warranty deed
lieatiOn: a staniPe e is tna
ss Include with this iPP a copy of the certified surveY maP
FROM :WMS FAX NO. :7152467027 Nov. 15 2004 09:46AM P1
HANGAR AREA LEASE
THIS AGREEMENT, made and entered into on the date indicated below by and
between the City of New Richmond,Statise sin, a municipal corporation,
hereinafter called the Lessor, Carl & Sue Young, ercinafter called the Lessee.
WITNRSSETH:
WHEREAS, the Lessor owns and operates an airport known as the New
Richmond Municipal Airport and said Lessoc is desirous of leasing from the Lessor a
certain parcel of land on the said airport, hereinafter more fully described, for the purpose
cif.: aircraft storage
WHEREAS, the Lessee will use the below described property for the purpose of
st0r4 aircraft and shall conduct only such aircraft maintenance on its own tdreratl as
performed by the Lessee or by regular employees of the Lessee.
NOW, TII:REPORE, and in consideration of the rental charges, covenants,
and agreements herein contained, the Lessee does hereby hire, take and lease from the
Lessor and the Lessor does hereby grant, demise, and lease unto the Lessec the following
premised, rights, and easements on and to the airport upon the following terms and
conditions:
1. P roperty De %ri tiui : Lot 8, Row i l f the Airport Layout Plan - New
Richmond Municipal AI or eased Property equals 5920 square feet
2. Hangar Con tru lion: The Lessee shall have the right to erect, maintain and
alter buildings or structures upon said premises providing such buildings or structures
confbrm to the applicable requirements of the Wisconsin Department of Industry, Labor
& Human Relations and pertinent provisions of any local ordinances in effect. All plans
for such Moldings or structures shall be reviewed and approved in writing by the Lessor
prior to construction.
3. Te : The tern of this
�� ,lease shall be for a maximum often (10) year.
commencing on July 1, 2001 and ending on June 30, 2010.
Post -It* Fax Note 7671 DO lij 14 ►
7b '. From
COJDept. Co.
Nnona # rtwo « 061
"29 ago
I
FROM :WMS FAX NO. :7152467027 Nov. 15 2004 09:47AM P2
4. nt: The Lessee agrees to Pay to the Lessor for the use of the premises,
rights, and easements herein described, a yearly rental of ten (10) cents per square foot for
the land leased, for a total annual charge of $592.00, payable on July 1 annually. It is
understood and agreed that the rental rate herein specified shall be subject to re-
examination and readjustment at the end of each three year period of this lease, provided
that any readjustment of said present rates, or as same may be amended hereafter, shall be
reasonable.
3. N -Exc n aive Use The Lessee shall have the right to the non - exclusive use,
in common with others, of the airport parking areas, appurtenances and improvements
thereon; the right to install, operate, maintain and store subject P , s , t to the approval o1'the
Lessor in the interests of safety and convenience of all concerned, al l equipment
necessary for the safe hangaring of the Lessee's aircraft, the right of ingress to and egress
from the demised premises, which right shall extend to the Lessee's employees, guests,
and patrons; the right, in common with others authorized to do so, to use common areas
of the airport, including runways, taxiways, aprons, roadways, and other conveniences for
the take -off, flying and landing of aircraft.
6. Laws and Re ul ions The Lessee agrees to observe and obey during the term
of this lease all laws, ordinances, rules and regulations promulgated and enforced by the
Lessor, and by other proper authority having jurisdiction over the conduct of operations at
the airport.
7. I gild ..Harmless The Lessee agrees to hold the Lessor free and harmless .from
loss from each and every claim and demand of whatever nature made upon the behalf of
or by any person or persons for any wrongful act or omission on the part of the Lessee,
his agents or employees, and from all loss or damages by reason of such acts or
omissions.
8. Insurance 'fhe Lessee agrees that he will deposit with the Lessor a policy of
comprehensive liability insurance upon 90 days written notice from the Lessor.
9. Maintenance of Premises The Lessee shall maintain the structures occupied
by him and the surrounding land premiscs in good order and make repairs as necessary.
No outside storage shall be permitted except with the written approval of the Airport
Commission. In the event of fire or any other casualty to structures owned by the Lessee,
the Lessee shall either repair or replace the leased area to its original condition; such
action must be accomplished within 120 days of the date the damage occurred. Upon
petition by the Lessee, the Lessor may grant an extension of time if it appears such
extension is warranted.
10. Right to Insist The Lessor reserves the right to enter upon the premises at
any reasonable time for the purpose of making any inspection it may deem expedient to
the proper enforcement of any of the covenants or conditions of this agreement.
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