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HomeMy WebLinkAbout261-7000-11-012 11 12 n 14 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ' INSPECTION REPORT Sanitary Permit No: 487956 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide m y be us for secondary rposes [Privacy Law, s.15.04 (1)(m)]. x4 _- TM; • Permit Holder's Name: X City Village Township Nrcel Tax No: Jacobson, Mark City of New Richmond 261- 7000 -11 -012 CST BM Elev: ! Insp. BM El : BM Description: Section/Town /Range/Map No: . 0 . O' I CST xcr. $ = 4.0 �2 l 24.31.18. TANK INFORMATION 'ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. sr,;A la.*' a Septic Benchmark FFC.�T'C 12- /7c0 q r w Isa.X Q. ►g 1�° �� .1 Dosing 0 It. BM r a" 01 3.61 1 }•42- Aeration BIT0. Sewed 9, cto r Holding St/Ht Inlet 9.23 172 t St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic P/A ' r Dt Bottom 1 Dosing Header /Man. I Aeration Dist. Pipe SeA olding Bot. System >fla l2 Final Grade � 1 PUMP /SIPHON INFORMATION .O 97. Manufacturer Demand St Cover a 64C Model Number 4.0 TDH Lift F ti ss System Head TDH t t+rX Forcemain lLene6 Dia. IS. SOIL ABSORPTION SYSTEM g I�•`ecb �, BEDITRENCH Width 1 Length I No. Of Trenchgs PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS W 2Q • 3 11 1 SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Man acture,,[[: INFORMATION CHAMBER OR �cdL� Type Of System: 1 UNIT - �/� 32 ,,[ Model Number. --?.% DISTRIBUTION SYSTEM 4o S• 8 yV�O�Q� Header /Manifold u Distribution xx Vent to Air Intake !.� Pi e(s) "> I Length Dia \ Len Dia Spacing SOIL COVER 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 .,o• 51 Yes No tad Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /Ydy• � t - 200 Inspection #2: ` 1 -- i Location: 11- 12/11 -14 W Hanger Road New Richmond, WI 54017 (SW 1/4 W 1 Ne mo I 1.) Alt BM Description = Fla' S" ` 6&4* , � 2.) Bldg sewer length= 11,0 u . 7-e / = q�'SD 10'80 - - amount of cover = > �Z�1 fZ, ar to. ft `(. 7y 1 /o .iv . qo •T'f 3) ( Sc l SI ' io •ac _ ?I'.3(f 1 0.80 • Pla revis egtir'bd7rYes No /lieu, Use other side for additional information. ( � �,,� a e " � L S Insepctors Signature e . No. j CS T^ ( R 3 /97) �.�- B t r,Q - aal � „" � � 0.1g = i.� � �+� -P'•P r ,. ��`� Y � ""_.� Coon �I c yy 3fety and Buildings Division t- (201 W. Washington Av ., . �� �� "' t� l Mr lvladison, 3 07—' anitary P it Number (to be filled in by Co.} ISCOt�SIn 08) - s1 `j S(, 7 Department of Commerce , plan, D. Number , Sanitary Permit AP 10 r In accord with Comm 83.21, Wis. Adm. Code, p oral orm you ovide C CV (if different than mailing may be used for secondary purposes w, sl (I)(m) ST. W ect Add ess n nt ) ZONING OF a^- I. Application Information - Please Print All Information Parcel # Lot # Block # property Owner's Name � / / � , / /- - /� / r o4 C j Z k � Property Location jj f2 : Mailing Address ' /., Section Zip Code Phone Number 11 trc one N or W II. Type of B uilding (check all that apply) Subdivision Na kQt�pof SM Number / 1 ❑ 1 or 2 Family Dwelling — Number of B edrooms Ile, t biiclCommercial — Describe Use7� � ; ty ❑Villa ❑ State Owned — Describe Use ' III. Type of Permit: (Check only one box on tine A. Complete line B if applicable) A. w System ❑ Replacement System ❑ Treatment/Holding HReplac-ement Only ❑ Other Modification to Existing System `-- List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of fer to New Before Expiration Plumber IV. Type of POWTS System: Check all that apply) on — Pressurized In Ground El Mound > 24 in. of suitable soil ❑Mound < 24 in. of suitable soil ❑ At - Grade ❑Single Pass Sand Filter Constructed We anti d El Pressurized In Ground ❑ Holding Tank ❑ Peat Filter El Aerobic Treatment Unit 11 Recirculating Sand Filter El ❑ Drip Line El Gravel -less Pipe El Other (explain) � / Recirculating Synthetic Media Filter El Leaching Chamber p V. Dis ersaVrreatment Area Information: El lion Design Flow (gpd) Design SoilA plication ate(gp Rdsf) Dispersal Area Required Dispersal Area Proposed (sf) Sy v� Prefab Site S 1 Fiber Plastic VI. Tank Info Capacity in Total Nu mber Manufacturer Concrete Constructed Glass Gallons Gallons of Units New E)dsting 2, Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement 1, the undersig sume responsibility for installation of the POWTS shown on the attached plans. MP/MPRS Number Business Phone Number Plumber' Plumb afore / s Name (Print) 1/ , r Plumber's Address (Street, City, S tp Code) J �% VIII oun / - e artment Use Onl Sanitary Permit Fee (includes Groundwater Date Is Issuing t Sign e o S PS) Approved ❑ �erqGiRmo Surcharge Fee} 1 D Z7 S ❑ niai IX. Conditions of ApprovaMasons for Disapproval t 3) 6,D 11 MTW OWNER: I 1, '8eplic fink, etflllsnt Nlter and I � dispersal cell must all be services / maintL as per management plan provided by plumber. 2. AN setback requirements must be maintained as per applicable code / ordinances. Attach complete plans (to the County only) for the system on paper not less than 812 x 11 inches in size SBD -6398 (R. 01/03) i a A��WtJ M�lT81►L� h »6 we! +n�uPwa ,anal �itq t 6 r ,,Z }• , vtlZRh T94 26 PLOT,PLAN Jacobsen Hangar and New Richmond Aviation LLC 21 b7 ( SW 1/4 SW 1/4s 24 /T 31 N/R 18 W City New Richmon COUNTY ST. CROIX J SYSTEM ELEVATION 94.1/94.0/93.9 GPD 1028 CONVENTIONAL )XX AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 2026 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 1492 # of chambers 48 Ilk BENCHMARK V.R.P. Top of Power Box ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark A Exterior DNR approved holding tank is to be installed Scale = 1/4 = 1 for the floor drains mention in the previous plan. Both hangars are to be served by this holding tank! Please note: This system Jacobsen Hangar is design for domestic waste only!Absolutely no 15 employees X 13 catch basins are to be gpd /employee =195 gpd plumbed into this system! 2 floor drains X 25 Cal s: gpd /drain= 50 gpd Tank Size = 1028 gpd X 2.088 = 2147 gallons ,,�or 3 years, the proposed tank isn't large enough, going to have a 2.8 year interval! using a 2026 gallon tank r Total GPD 245, X 1.5 for Chamber Calcs: 1028 gpd /.7 ftA2 /gpd = 1492 ftA2 J� peak flow = 368 gpd 1492 ftA2/31.1 ftA2 /chamber =4 Please n te: Owners of each angar lt' have bo h signed maintainance / fcutt 2026 ST agreeme t and have joint responsi lity of maintaining system 4 0% slope FBO Hangar B-1 (NewRichmond. Aviation LLC (Jay Griggs) (� 30 employees X 13 gpd To Have /employee =390 gpd >42" of 2 floor drains X 25 Cover gpd /floor drain= 50 gpd B -3 Total GPD = 440 X 1.5 for peak flow = 660 gpd B.M. * /Alt.B.M. is top Well is to meet all of Telephone Box @ B-2 setbacks found in Comm. 83 City of New Richmond owns entireAirport Road /Taxi Way parcel, the hangar space is leased, thus no lot line issues apply Safety and Buildings 4003 N KINNEY COULEE RD commerce.Wi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 I tlepartment sco n s i n www.commerce.wi.gov /sb/ www.wisconsin.gov of Commerce . Jim Doyle, Governor Mary P. Burke, Secretary September 26, 2005 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 Identification Numbers PLAN APPROVAL EXPIRES: 09/26/2007 Transaction ID No. 1189488 Site ID No. 703719 SITE: Mark Jacobsen/New Richmond Aviation LLC Please refer to both identification numbers, above, in all correspond I ence with the agency Lot 11 -12/ 11 -14, Airport Rd City of New Richmond St Croix County SWIA, SWIA, S24, T3 IN, R8W Lot: 11 -14, 11 -12, Subdivision: North Hangars FOR: Description: Commercial (2 Aviation Hangars) Non - pressurized In- ground System Object Type: POWTS Component Manual Regulated Object ID No.: 1036685 Maintenance required; 1,028 GPD Flow rate; 120 in Soil minimum depth to limiting factor from original grade; System: In- ground POWTS Component Manual, SBD- 10705 -P (N.01 101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed' to - do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the "In- ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10705 -P (N.01 101). Co"ditt • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan APPR( approval and Comm 83, Wis. Adm. Code 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 EP TMENT OF precedence. OF WIEY • The plumbing for this project discharges to a private sewage system. The approval covers only SEE C ORRES domestic /sanitary wastes directed into this system. The Department of Natural Resources must be contacted regarding the treatment and disposal of all industrial wastes. • State and federal regulations prohibit the discharge of hazardous wastes to a private sewage system. Accidental discharge of any hazardous substance to a private sewage system must be reported to the Department of Natural Resources or the Wisconsin Division of Emergency Government. • The well must be a minimum of 25 feet from any POWTS tank. chs. NR 811 & 812c SHAUN R BIRD ' Page 2 9/26/2005 • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the . POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A col2y of the approved plans specifications and this letter shall be on -site during construction and o ep n to inspection by authorized representatives of the Department which may include local inspectors Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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, operation or maintenance of the POWTS. Sincerely, Fee Required $ 225.00 Fee Received $ 225.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II, Integrated Services WiSMART code: 7633 (608)789-7893, 7:45 am - 4:30 pm Monday - Friday cbratz@conitnerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 I ,' .� ,. . Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 8/18/05 Owner: Mark Jacobsen/New Richmond Aviation LLC Location: SW1 /4 SW1 /4 S24 T31 N,R18W Hangars 11- 12/11 -14 NR Airport System type: In- ground absorbtion system(conventional) Manuals Used: In- ground absorbtion system (version 2.0) Page# 1. Cover Page 2. System Plot Plan 3.Chamber Cross Section i 5 -7. maintance and contigen an 8 -10. Soil Test '� Signature License number 226 00 RECEIVED wl1 y AUG 2 3.2005 SAFETY & BUILDINGS Lo�� GS 0 NQErvcE . PLOT PLAN Jacobsen Hangar and New Richmond Aviation LLC 22 (?7 t7 SW 1/4 SW 1/4S 24 /T 31 N/R 18 W City New Richmon COUNTY ST. CROIX 1 SYSTEM ELEVATION 94.1/94.0/93.9 GPD 1028 CONVENTIONAL XXX AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 2026 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 1492 # of chambers 48 BENCHMARK V.R.P. Top of Power Box ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark A Exterior DNR approved holding tank is to be installed Scale = 1/4" = 10' for the floor drains mention in the previous plan. Both hangars are to be served by this holding tank! Please note: This system Jacobsen Hangar is design for domestic waste only!Absolutely no 15 employees x 13 gpd /employee =195 gpd catch basins are to be 2 floor drains X 25 Cal s: plumbed into this system! gpd /drain= 50 gpd Tank Size = 1028 gpd X 2.088 = 2147 gallons ,,for 3 years, the proposed tank isn't large enough, going to have a 2.8 year interval! using a 2026 gallon tank Total GPD 245, X 1.5 for Chamber Calcs: 1028 gpd /.7 ftA2 /gpd = 1492 ftA2 peak flow = 368 gpd 1492 ftA2/31.1 ftA2 /chamber =48 chambers Please note: Owners of each hangar have both signed maintainance Huffcutt 2026 ST agreement and have joint responsiblity of maintaining s tem 0% slope FBO Hangar B-1 (NewRichmond Aviation LLC (Jay Griggs) 30 employees X 13 gpd To Have /employee =390 gpd >42" of 2 floor drains X 25 Cover gpd /floor drain= 50 gpd B-3 Total GPD = 440 X 1.5 for peak flow = 660 gpd B.M. * /Alt.B.M. is top Well is to meet all of Telephone Box @ N B-2 setbacks found in Comm. 83 City of New Richmond owns entireAirport Road /Taxi Way parcel, the hangar space is leased, thus no lot line issues apply Cross Section of Standard Biodiffuser Leaching Chamber Typical cross section for 2 of 3 cells Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area To be >1' above grade Finish grade elevation Typical Installation 99.3' Vent Grade Vent 4 4 4 X30/34 Septic Tank 6' Long 1 99 5' 6' Long 1 34 Grade at System Elevation 3499 Grade at System Elevation Spacing 5' 3 -3' X 100' Cells Same on other end Observation tubeNent 2 ' A B System elevations: C A__94.1 B94.0 C___93.9 16 chambers per cell Page of _ E11T PLAN N�R,S MANUAL & MANA gpE iF[CA�oAlS DNA Q O SYSTEM at Septic Tank Capacity D NA r C,PvC -rank Manuf r Q NA O-e MOOR �p-YlOK GD p,Kner Q Effluent Ff1f Manri'rer p NA Permit - Effluent F;fler Model 1,NA )ESI�N PA� p -Tank capa NA Q NA M u f a �rer g�'� Of Units alCda Pump Tank ��. Numt►er aUd .Pump man' Esflma { d x 1.5? Pump Mode► ' Demon flow j. (( �tirnaoe ` allda lfc� PfebvAtment, Unit - t3 Peat Fitter Rate mo nth average' sarwo ravel F ter n O wetland soDAPP °n O m9 p Mechanical Aera� p Other 6rW Mu Q �; uality a (FOG) 0 p i Manuf Brodiwm vv� 'S pS) �0 m era e D Pern Cell(s ravilY) E3 in.ground (pressw� Total Sus Pen NA Monthly s g _ i ground fo p Mound Pry went QuaW BOOS �0 mg/L L73 e 0 Other. on D ( 530 mg/- ❑ Dri ine � y a swwaoW and siioch�ical O'qV ed So (T$S) i OOmI rd for d (ion oomn'e Total Sus0nd m etric mean) S i 0' va W fiuen Fecal �rtform (9eO Y . in ch diameter iar� Se ptic tank +a naesrea wastews particle See - ..� Yaluu tyP� for p Maximum roue uencY Service F,* s) (M - n'u`n 3 yrs.) NWNTEllANCE SC }'Fj FV E p month rrd (K) of tank volume Service Event At least once every a and scum eQuais no-th 3 m•) mbined siudg r(s) (Maximum Y Inspect condition of tank(s) when co p month of tanks) At )east once every r(s) � contents / [3 month Pump - cell(s) At least once every the p year(s) O NA Insped dlsPe ❑ months Clean effluent fitter p months D Yews) DNA pt least once every fnsped P� reps Pump controIs &alarm A t least once every t3 m onths t7 year(s) 01+IA t ts and pressure test At least once every t7 mo nths 0 }isms) ❑ NA Flush At least once every 066 ing notr or o tt_r of the foitawMa ti�ses e CE lNSTRUG tts S halt be m ade by an indivtd TS j spec t i � r � m 9 or broken u PON and t Restr Sewer of tan' s) rden6fY an bade P :heck InsPOO&M Master ber Mi mus it n dude a vrsuat i Spect►on thtank( nd scum and ch� the efflr� W � r. Tank inspecD s ure the volume of co mbin ed U be visually Ir+sPa d to nding of effluer't on the Sem*V id�enfY any crate or leaks. Tt�e dispe round surface• a utfiorrtY hardware• round surface- nding Of effl On ttte g ro u nd of the lords � � volume, the or -� O f etf►uent on the ground W any Pc wires the immediat in the obw"W Or and to eondIVOn and requires equals one - iii ( or more �niance With uh. NR of ground SU�e may indicate a in any tank e4 mula#i+on of sludge and scu a Sen�ng Operator and disP°Sed When the combined a� shall be removed by a Septag - t cornPonent5, and any entire contents of the tan onents. pretreat S Maintains e ' m ed by a r POVYT in Admifi�'� � P01tY[ - S co P ed 113, anicai or pressurized event e setvicin9 e �9ueni fi►ters. m i te"Is Of V MO11PS Or less sham Q d2 c�mplevon °f any sen►i� Th nitonng autiloritY with OthermaIntenance or mo laa regulatory produc or other r shaifbe pn� ent tank s) of pa to the A service for the presence intirx3 �WnS are 0 OPERATION treatm ceil(s). if high concer' START UP AN use o f the PODS check. a e the dispersal kph, poor m s and/or dam 9 rator prior to use - For i teW GO - e �e treatment PA'S b a septage servicing cps checri�m mat may imod of the tanks} removed Y - dete(xed ham tits contents • � - t Page of conditions are frozen at the inflt trative su rface_ System start up ll not occur when socl n is reSfoCed the elcCess snag des pump me: fray flit above normal a L ievets. fe P ceff(5) and may result in the D ig tanks dispersal cell (s) in one large dose. avertOadn9 urn tank removed by a a w wgW wW be d � of etttuent- To avoid t� situation have the contents of the lug or POVYTS Malatainer to t or surface power to the effluent pump or contwt e Sung OPe�OC pn� ttJ restore normal levels within the pump in manuaffy tank - oP� '� ft Pip d�alrb or canpact. y o,rer' � and dlspelsat r�lis. Do not dtnrs or park over. or o0eN6se Do not d W or panic mound or at -grade so lll absorption area - the area with n 15 Meet dawn slope- of arty r f and prolong the fde or. of Wa the from the vvasteywater stream may imprrnre the as denial floss: draPers; Reduction dg butts; ,condoms; cottorl sus: deg : of the POWTS_ antibiotics; baby vsripes: arette �np} >firater, fruit and vegetable peertngs: gasofine; gmwl' herbiades; meat d- rsinfr�W- fat fO� d[dlrt P. pesf=des: sanitary napkins; = Sod water softener brine. sc iaaps medications: ASANDONWEN taken out of service the following su=ps shalt lee taken to Insure Mat the When the POWTS falls andlot iS permanently Prance with rh_ Comm 83.33, 1A/isconsin Adminlsbmfive Code„ and, safely abandons in camp system is properly be d< pe ri and the abandoned Pipe ongs sealed' Alt piping to tanks and p disposed of by a Septage Servicing O perator. The Contend an tanks and pits shall be removed and properly an the void space pEtmping. a ll flanks and pis Shall be excavated and removed or th covers rcnwved filled with soil, gravel or another inert solid material_ CONTINGENCY P the following measures have been, or must be taken, to provide a code if the POWTS facts and cannot be repay ent soil m t replacement system suitable re placement area has been evaluated and may be utilized for the location c om pa c tion a and shoul6 not from absorption item_ The rep cement area should be protected sed structure, lot lines and ll -- Failure to be infringed upon try trued setbacks fr existing and propa eva luat i on to establish a Suitable prated the replacement area Wt71 mutt in the need r that lime_ site t with the n effect at )� Lsu — vology lcement area- Replacement systems must comply advances in POWTS able replacement area is no as a last resort to replace the failed POWTS- Barrin a holding tank may n failure of the POWTS a soil-and not been erraluatr.d to identify a suitable replacement area- Upon t�crtent area is available a, CI The sRe has to locate a suitable replacement area.- If no reply site evaluation must be Performed Iast resort to replace the railed POWTS holding tank may be installed as removal of p Mound and atViade $o a the biamat at iil absorption system S may be reconstructed in place fetl 5 me infiltrative sucfiace. Reconstructions of such systems must comply with the rules in effect at that <<WARNING>> TANKS MAY CONTAIN LETHAL GASSES AND'OR K UNDER AI�IY (NSUFFIC(ENT OXYGt.I�. SEPTIC, PUMP AND OTHER TRF- f�TMENT CIRCUMSTANCES, DEATH MAY DO NOT ENTER A Sl!] MC, PUMP OR OTHER TREATMENT TAN RESULT. ,RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADornONAL COMMENTS pOW - S MA[NTAITiER POWTS INSTALLER Name Name �c Phone 7l�'' ` Phone LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING OPERATOR PUMP• I'll =AgencYT /�9�� Name .•n- /� Phone 7/ �J" 7 6 Phone Thisdoaccrientmee� rrds aocument was diatted by the staffs of the (been Lake, AftMiietre and Waushara County Zoning and Sara C--d document does not the minimum Mquirements of ctL Comm 83- 22C11(6xY}CQ1�{� and S3_Sa(1). (I) & (3). Wisconsin � GFJW (O guarantee the Iierforniance of the POY4TS. • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND FORM OWNERSHIP CERTIFICATION own er/Buyer Au Mailing Address 2 properly Address d (Verification required from Planning Department for new constriction) Parcel Identification Number City/State LEGAL DESCRIPTION 3l N -R W, of Property Location — /., !7 Lot # "'r r-_ Subdivision Certified Survey Map # Volume , -- _Page # — -- Warranty Deed # Volume , Page # Spec house ❑ y Lot lines identifiable es ❑ no licensed p NANCE nance SYSTEM What you put into the system use and maintenance of your septic syste ro r m could r if needed b as tamper. dle wastes. Proper mainte three years consists or sooner, if n Y of Pumping out the septic tank every system can affect the function of the septic tank as a treatment stage in the waste disposal b the owner and by a t a certification form, signed Y sal system a . Ihe property green on - s it e wastewater Apo owner a to submit to St. Croix Zoning Department of sludge• ruasterplumber, journeymanplumber, restrictedplumber or a licensed Pumper verifying that (1) the on -s the tic tank is less than 1/3 full is in proper operating condition and/ (2) after inspection and pumping (d necessary), septic the standards ents and agree to maintain the private sewage disposal system Certification Vwc, die .undersigned have read the above requirements Department of al Resources, State of z onin g O ffice Departm of Commerce and the Dep Natur � to the St. Croix County Zo�g O within 30 set forth, herein, as set by the Depa b ee must be completed and return stating that your septic system has been maintained LGTUR e three year expiratio date. / lVl 17 DATE OF APPLIC pW N A I l 1 _ F5 - 0 few '�" ✓ ( are) the owner(s) of OWNER CERTIFICATION our k I ( am I (we) certify that all statements on this form are true to the best oism= of Deeds Office descr above, by virtue of a warranty deed recorded in Reg the property k / — 0y DATE IGNATIJRE OF APP L pr F )3 o en J c� J f - C 0 �4'G� rmit being revoked by the Zoning Department. « «s « «« Any information that is mis- represented ma result in the sanitary Pe tamped warranty deed from the Register of Deeds office «« Include with this application: a copy of the certified survey map if reference is made in the warranty deed 7 A RE_C1E,1VED 'E7 3 20 &IL VALUATION REPORT Page of 2 Wisconsin Department of Comm ce Division of safety and Buildings STur(;li3lm iJ 85, Wis. Adm. Code County r , n r ZONING IC C Attach complete site plan on p in size. Plan must 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. Reviewe by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). W Property Owner Property Location - k ' r t j ovt. LOL 1/4 -5,J14 S /, � / T 3/ N F E( ) Property Owner's Mailing AddresVf Lo # I Block # Subd. Na or CSM# City State Zip Code Phone Number 4 ❑Village Town Nearest Road New Construction Use: ❑residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement r commercial -Describe: Parent material �Z z2.c� ,� Flood Plain elevation if applicable, ��1 ft. General comments and recommendations: ' Y $'0_ el��aJ� ✓ ��! l �y d �3, l3e1, ID Boring # Boring ) Pit Ground surface elev. , 5 Depth to limiting factor l 0 in. Soii 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 •Eff#2 0 Ell 3 J` Eil Boring # ❑ Boring �it Ground surface all ft. Depth to limiting factor 1 2-0 in• [ El lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD(fE= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 - Eff #2 o -L �— �� ► 1o,3t>: Z.- 2 ��VL / U , 3 1 7- - -- /z 6 s s Tj / ,tyl li • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 • Effluent #2 = BOD < 30 mg/L and TSS < 30 nVL CST Name (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5401 0 ^ 1_ ,�— 715- 246 -4516 Property Owner _ Parcel ID # Page of Ong # BoringQ� Pit Ground surface elev. JJ ' ft. Depth to limiting factor Z _ L) 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 7'Eff#2 T 3 O qq a 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 'Eff42 I F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appl ication 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 'Eff#2 I I Effluent #1 = BOD > 30 5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 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. SBD -8330 (8.6/00) J Soil 'hest Plot Plan Project Name Mark Jacobsen/ New Richmond Aviation Sha Address 266 Red Pine Trail Hudson Wi 54016 M #226900 Lot 11- 12/11 -14 Subdivision Richmond Airport Date 8/1/05 SW 1/4 S W 1/4S 2 4 T 31 N/R W City New Richmond ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Power Box System Elevation 94.1/94.0/93.9/93.8 *HRpSameasBenchmark Scale = 1/4" = 10' City of New Richmond owns Jacobsen Hangar entire parcel, the hangar space 15 employees X 13 is leased, thus no lot line issues gpd /employee =195 gpd apply 7 floor drains X 25 gpd /drain= 175 gpd Total GPD 370, X 1.5 for peak flow = 555 gpd 0% slope FBO Hangar ❑ B-1 (NewRichmond Aviation LLC (Jay Griggs) 30 employees X 13 gpd /employee =390 gpd 8 floor drains X 25 gpd /floor drain= 200 gpd B -3 Total GPD = 590 X 1.5 for peak flow = 885 gpd B -2 B.M. * /Alt.B.M. is top of Telephone Box @ Airport Road /Taxi Way 100.1' ST. CROIX COUNTY SEPTIC TANK. MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ile" Owner/Buyer /�� 1411 ii9-eoG,SG'v✓ C !� �l� Mailing Address- R4� 't-QJ T� el'���' Prop Address �^ ,07 1 1 - 12 '�� i r Prop y (Verification re aired from Planning & Zoning Department for new construction.) City /State Parcel Identification Number LEGAL DESCRIPTI Locatiorr /+-� 1 /4 ,Sec P w P o Property " � A �^ Subdivision a%� �Tct90 ��S'� , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house yes no Lot lines identifiable es 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 tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The ro ert owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the P P Y owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. Uwe, 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 Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. we certify that all statements on s form are true to the best of my /our knowledge. I/we am/are the owner(s) of the prope describ above, by virtue of anty deed recorded in Register of Deeds Office. SIG OF APPLICANTS) 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 deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) HANGAR AREA LEA THIS AGREEMENT, made and entered in�o he date indicated below by and between the City of New Richmond, State of Wisconsin, a municipal corporation, hereinafter called the Lessor, and Mark and Marjorie Jacobson hereinafter called the Lessee. WITNESSETH: WHEREAS, the Lessor owns and operates an airport known as the New Richmond Regional Airport and said Lessee is desirous of leasing from the Lessor a certain parcel of land on the said airport, hereinafter more fully described, for the purpose of: aircraft storage WHEREAS, the Lessee will use the below described property for the purpose of storing aircraft and shall conduct only such aircraft maintenance on its own aircraft as performed by the Lessee or by regular employees of the Lessee. NOW, THEREFORE, for 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 Lessee the following premised, rights, and easements on and to the airport upon the following terms and conditions: 1. Propegy Description Lot 14, Row 11 of the Airport Layout Plan - New Richmond Regional Airport. Leased Property equals 20,400 square feet (120' x 170') 2. Hangar Construction The Lessee shall have the right to erect, maintain and alter buildings or structures upon said premises providing such buildings or structures conform 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 buildings or structures shall be reviewed and approved in writing by the Lessor prior to construction. 3. Terms The term of this lease shall be for a maximum of thirty (30) years commencing on July 1, 2000 and ending on June 30, 2030. 1 4. Rent 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 $2040.00, 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. 5. Non - Exclusive 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 to the approval of the Lessor in the interests of safety and convenience of all concerned, all equipment necessary r the safe han arin of the e Lessee s air g g craft, 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 Regulations The Lessee agrees to observe and obey during the term of this lease all laws, ordinances, rules and regulations promulgated and enforced b the Lessor, and by other . Y authori having proper jurisdiction authority over the g J conduct of operations at the airport. 7. Hold 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 i omissions. 8. Insurance The 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 premises 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. Rip to Inspect 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. 2 I . Taxes The Lessee shall pay all taxes or assessments that may be levied against the personal property of the Lessee or the buildings which he may erect on lands leased exclusively to him. 12. Signs: The Lessee agrees that no signs or advertising matter be erected without the consent of the Lessor. 13. Default The Lessee shall be deemed in default upon: a. Failure to pay rent within 30 days after due date; b. The filing of a petition under Federal Bankruptcy Act or any amendment thereto including a petition for reorganization or an arrangement; c. The commencement of a proceeding for dissolution or for the appointment of a receiver; d. The making of an assignment for the benefit of creditors without the prior written consent of the Lessor; e. Violation of any restrictions in this lease, or failure to keep any of its covenants after written notice to cease such violation and failure to correct such violation within thirty days. Default by the Lessee shall authorize the Lessor, at its option and without legal proceedings, to declare this lease void, cancel the same, and re -enter and take possession of the premises. 14. Title Title to the buildings erected by the Lessee shall remain with the Lessee and shall be transferable. Upon termination of this lease, the Lessee may, at the option of the Lessor, remove the buildings, all equipment and property therein and restore the leased property to its original condition. 15. Snow Removal The Lessor agrees to provide NO snow removal services to the Lessee's leased premises in the hangar area. 16. Lease Transfer The Lessee may not, at any time during the time of this lease, assign, hypothecate or transfer this agreement or any interest therein, without the consent of the Lessor. 3 17. Airport Development The Lessor reserves the right to further develop or improve the landing area of the airport as it sees fit, regardless of the desires or view of the Lessee, and without interference or hindrance. If the development of the airport requires the relocation of the Lessee, the Lessor agrees to provide a compatible location and agrees to relocate all buildings or provide similar facilities for the Lessee at no cost to the Lessee. 18. Subordination Clause This lease shall be subordinate to the provisions of any existing or fixture agreement between the Lessor and the United States or the State of Wisconsin relative to the operation or maintenance of the airport, the execution of which has been or may be required as a condition precedent to the expenditure of federal or stated funds for the development of the airport. Furthermore, this lease may be amended to include provisions required by these agreements with the United States or the Stated of Wisconsin. 19. Arbitration Any controversy or claim arising out of or relating to this lease or any alleged breach thereof, which cannot be settled between the parties, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the dispute rendered by the arbitrator(s) shall be final and binding on the parties. 20. Floor Height The Lessee agrees to erect a building on the leased remises p with a minimum finished floor height at least six (6) inches above the finished grade of the taxilane nearest the front of the building. 21. Taxiway Access The Lessee is prohibited from operating automobiles on runways or main taxiways. 22. Parking Automobile parking must be on the leased premises or on designated areas of the airport. 4 IN WITNESS WHEREOF, the parties have hereunto set their hands and seals this day of , in the City of New Richmond, St. Croix County, Wisconsin. LESSOR: Airport Manager, Mike Demulling LESSEE: Mark Jacobson Marjorie Jacobson I I i i 5 t L ✓� HANGAR AREA LE _g' THIS AGREEMENT, made and entered into a date indicated below by and between the City of New Richmond, State of Wisconsin, a municipal corporation, hereinafter called the Lessor, and New Richmond Executive Aviation LLC, hereinafter called the Lessee. WITNESSETH: WHEREAS, the Lessor owns and operates an airport known as the New Richmond Regional Airport and said Lessee is desirous of leasing from the Lessor a certain arcel of land on the said airp hereinafter more full p rp y described; and WHEREAS, the Lessee will use the below described property for the purposes of: Fixed Base Operator services pursuant to Minimum Standards and Procedures for New Richmond Regional Airport, sections 10 -6 -6, 10 -6 -8 through 10 -6 -12, 10 -6 -14 through 10 -6 -17. NOW, THEREFORE, for 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 Lessee the following premised, rights, and easements on and to the airport upon the following terms and conditions: 1. Property Description Lot 12, Row 11 of the Airport Layout Plan, New Richmond Regional Airport. Leased property is 170' x 120' equaling 20,400 square feet. 2. Hangar Construction The Lessee shall have the right to erect, maintain and alter buildings or structures upon said premises providing such buildings or structures conform 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 buildings or structures shall be reviewed and approved in writing by the Lessor prior to construction. 3. Terms The term of this lease shall be for a maximum of thirty (30) years commencing on July 1, 2000 and ending on June 30, 2030. 1 4. Rent The Lessee agrees to pay to the Lessor for the use of the premises, rights, and easements herein described, a yearly rental of five ($.05) cents per square foot for the land leased, for a total annual charge of $1020.00 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. 5. Non - Exclusive 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 to the approval of the Lessor in the interests of safety and convenience of all concerned, all 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 Regulations 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. Hold 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 The 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 premises 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 Inspect 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. 2 11. Taxes The Lessee shall pay all taxes or assessments that may be levied against the personal property of the Lessee or the buildings which he may erect on lands leased exclusively to him. 12. S_ ions The Lessee agrees that no signs or advertising matter be erected without the consent of the Lessor. 13. Default The Lessee shall be deemed in default upon: a. Failure to pay rent within 30 days after due date; b. The filing of a petition under Federal Bankruptcy Act or any amendment thereto including a petition for reorganization or an arrangement; c. The commencement of a proceeding for dissolution or for the appointment of a receiver; d. The making of an assignment for the benefit of creditors without the prior written consent of the Lessor; e. Violation of any restrictions in this lease, or failure to keep any of its covenants after written notice to cease such violation and failure to correct such violation within thirty days. Default by the Lessee shall authorize the Lessor, at its option and without legal proceedings, to declare this lease void, cancel the same, and re -enter and take possession of the premises. 14. Title Title to the buildings erected by the Lessee shall remain with the Lessee and shall be transferable. Upon termination of this lease, the Lessee may, at the option of the Lessor, remove the buildings, all equipment and property therein and restore the leased property to its original condition. 15. Snow Removal The Lessor agrees to provide NO snow removal services to the Lessee's leased premises in the hangar area. 16. Lease Transfer The Lessee may not, at any time during the time of this lease, assign, hypothecate or transfer this agreement or any interest therein, without the consent of the Lessor. 3 ' I 17. Airport Development The Lessor reserves the right to further develop or improve the landing area of the airport as it sees fit, regardless of the desires or view of the Lessee, and without interference or hindrance. If the development of the airport requires the relocation of the Lessee, the Lessor agrees to provide a compatible location and agrees to relocate all buildings or provide similar facilities for the Lessee at no cost to the Lessee. 18. Subordination Clause This lease shall be subordinate to the provisions of any existing or future agreement between the Lessor and the United States or the State of Wisconsin relative to the operation or maintenance of the airport, the execution of which has been or may be required as a condition precedent to the expenditure of federal or stated funds for the development of the airport. Furthermore, this lease may be amended to include provisions required by these agreements with the United States or the Stated of Wisconsin. 19. Arbitration Any controversy or claim arising out of or relating to this lease or any alleged breach thereof, which cannot be settled between the parties, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the dispute rendered by the arbitrator(s) shall be final and binding on the parties. 20. Parking Automobile parking must be on the leased premises or on designated areas of the airport. 4 IN WITNESS WHEREOF, the parties have hereunto set their hands and seals this A; day of 4 , in the City of New Richmond, St. Croix County, W' consin. IN THE PRESENCE OF: LESSOR: BY: Airport Manager LESSEE: /Vol --- /I r- I ZIJA i 5 l� Q�`� �� � ��