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Nisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
e ,
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
463156 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:
Jacobsen, Mike I City of New Richmond
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No:
/ - C, `� � /3.� ( ) CU , d 24.30.18.
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic ; Benchmark
Dosing Alt. BM
Aeration Bldg. Sewer
Holding St/Ht Inlet q Y> i L1,7 Z
TANK SETBACK INFORMATION SUHt Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic Lj ` �r� _ �� Dt Bottom
Dosing Header /Man.
Aeration Dist. Pipe -�•
Holding Bot. System _
f 3 — 1
PUMP /SIPHON INFORMATION Final Grade t.3 3 I c / C l
Manufacturer Demand St Cover
` GPM
Model Number,_ ...
TD Lift Friction Loss System Head TDH Ft
f
Forcemain Length I Dia. Dist. to Well
SOIL ABSORPTION SYSTEM,,
BEDITRENCH Width Length No. Of Trenc['es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 7
T.
SETBACK SYSTEM TO P/L JBLDG I IWELL LAKE /STREAM LEACHING Manufacturer.
INFORMATION CHAMBER OR , ,, i - -
Type Of System: !' + / UNIT Model Number:
C u/tuz n� 1�.n - 1
DISTRIBUTION SYSTEM �^ -f :5 )3+
L' `1Gt, r��YS rim 1 �
Header /Manifold Distribution x Hole Size x Hole Spacing V nt to Air Intake
N 1a — a Pipe(s) II
Length ' Dia Length Dia Spacing i— " L ! 1
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 x / Bed/Trench Edges Topsoil
Yes No 7 Yes E� No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: /1 8 / Inspection #2: 1 /
Mu-t
Location: 14 -7 & 15 -6 Airport Road New Richmond, WI 54017 (SW 1/4 SW 1/4 24 T30N R18W) New Richmond Airport Parcel No: 24.30.18.
1.) Alt BM Description =
2.) Bldg sewer length = 31
- amount of cover = 3 3 - 5� J
I
Plan revision Required? Yes No
Use other side for additional information.
SBD -6710 (R.3/97) Date Insepctoes Signature Cert. No.
• Safety and Buildings Division County /
201 W. Washington Ave., P.O. Box 7162 j�� )C_
VAI sc (608) 26 6 ons n Madi son, WI 53707 — 716 Sanitary Permit Number (to be filled in by Co.)
Dep arttment of Commerce V � *31 J
• State Plan I.D. N t c4dUd6 _•) 3
Sanitary Permit Appli tin 0�4
In accord with Comm 83.21, Wis. Adm. Code, personal info ation �ror�leJ b ="C 1*lS ) d. r�W 5
may be used for secondary purposes Privacy I.aw, s .04(1 � 0\0 Y ject Address (f different than mailing address) J
L Application Information — Please Print All Information g BONING pF
Property Owner's Narcu Parcel # t # Block #
/ , ` a /Y (-
Property Owner's Mailing Address LJ Pro perty y
City, State
Section
tip Codc Phone Number
IV/
of Build' check all that T yN•
II. Type � ( aPPb')
1 or 2 Family Dwelling - Number of Bedrooms
Subdivision Name CSM Number
Public(Commercial- Describe U
State Owned - Describe Use -e!— c Village Township,
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A System Replacement System TreatmendHolding Tank Replacement Only Other Modification to Existing System
Permit Renewal Permit Revision Change of Permit Transfer to New List Previous Permit Number and Date issued
Before Expiration Plumber Owner
IV. Dpe of POWTS S Check all that appl
on - Pressurized In -Ground Mound;_- 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 Recircukg Sand Filter
Recirculating Synthetic Media Filter Chambor Drip Line Gravel -less Pipe Oder (P lain) , J
V. D!giersaVfreatment Area I ormation: , 0 1
Design Plow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area equired (so Dispersal Area Proposed (so System Elevation
/S 3 / ? p'" ':Zq� S r
VI. Tank Info empty in Total Number Manufacturer Ptebab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
14M Existing
Tanks Tanks
Septic or Holding Talc
Aerobic Treatment Unit VCJ
Dosing Chamber
VII. Responsibility Statement- I, the a responsibility for installation of the PO% S shown on the attached pWm
P Name (Print) Plumber's MP/MPRS N mber Business Phone Number
Plumbees Address (Street, City, State, Tip )
tA -<- .
VUL Coon artment Use Onl
Appmv Sanitary Permit Fee (occludes Groundwater Date Issued Agent S' at (No Stamps)
Surcharge Fee)
ens Denial 2 � 0 Z�' ? c
EK. Conditions of Approval/Reasons for Disapproval
SYSTEM OWNER: 3J
1 Septic tank, effluent filter and \IC1 W , e-.4 t_e_, t' w (�-
dispersal cell must all be serviced j iron ntelned
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 paper not less than 91/2 x 11 inches in size
` PLOT PLAN
Jacobsen ADDRESS 1273 142nd St. New Richmond Wi 54017
J SW 1/4s 24 /T 31 N/R 18 W C i ty New Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 92.5' 6.5' below grade GPD 153
CONVENTIONAL XXX AT -GRADE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE
800 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 248 # of chambers 8
IL BENCHMARK V.R.P. Bottom Of Siding ASSUME ELEVATION 100' Filter Zabel A-100
❑ BOREHOLE O WELL * H,R.P. Same as Benchmark
Alt. BM Bottom of Siding C 100.0'
Entire Parcel is own and
leased from City of New
Richmond Property has no
S cale = � � lot line setbacks. The
hangars are on a 100 year
del I is to meet al I I ease, I of I i nes
need not
Tested area has 0 setbacks found in apply.
Slope and thus no Comm. 83
contours 0
Total = 153
I
Hangar Please note: Septic system is to
Originally this serve toilet and
2 employees hangor was to be floor drain waste
and 1 floor only! A catch basin
drain apart of this is not be installed
system, it is no and attached to
Currently built longer the case system
a B.M. * Alt. B.M.
S By 4
ST B -2 B -3
Vent
S Well is to meet all
setbacks found in Comm.
Hangar 83
2 employees
and 1 floor
drain
To be built
r
Safety and Buildings
10541 N RANCH ROAD
commercemi.gov HAYWARD WI 54843
0 TDD #: (608) 264 -8777
www.c s c o n s i n ommerce.wi.gov /sb/
www.wisconsin.gov
Department of Commerce
Jim Doyle, Governor
Cory L. Nettles, Secretary
October 15, 2004
CUST ID No.226900 ATTIC• 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: 10/15/2006 Identification Numbers
Transaction ID No. 1068305
SITE• Site ID No. 690748
Mike Jacobsen Airplane Hangars Please refer to both identification numbers,
Airport Rd above, in all correspondence with the agency.
City of New Richmond, 54017
St Croix County
SW1 /4, SW1 /4, S24, T3 IN, R18W
Lot: 14 -7 & 15 -6,
FOR: Description: Commercial non - pressurized in ground system for 2 airplane hangars totaling 154 GPD
Object Type: POWTS Component Manual Regulated Object ID No.: 985731
Maintenance requited; 154 GPD Flow rate; 136 in Soil minimum depth to limiting factor from original grade; P.Q.
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 L
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. p pR7MEt
F SF
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: SEE GOF
General Approval Conditions:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
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 2 airplane hangars each with 2 employees and 1
floor drain that serves the water heater.
• Comm 83.02. This approval covers only the domestic wastewater directed into the POWTS. The Department
of Natural Resources must be contacted regarding the treatment and disposal of non - domestic wastewater,
including those mixed with domestic wastewater. Please refer to the following website for more information:
http• / /www dnr state wi us /org /caer /cea/compliance /auto /wastewater.htm #septic
SHAUN R BIRD Page 2 10/15/2004
• 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.
• 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 stipulatioris.
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, ope ion or'maintenance of the POWTS.
Sin a Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Patricia L S11 ndorf
POWTS Plan Reviewer, -ITatedervices WiSMART coder 7633
(715) 634 -7810, Fax: (715) 634-5150, M -f 7:45 am - 4:30 pm
pshandorf @commerce. state.wi.us'
cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544
f
i
Cover Page
Shaun Bird
Bird Plumbing Inc.
1008 192nd Ave
New Richmond Wi 54017
715- 246 -4516
Date: 9/29/04
Owner: Mike Jacobsen
Location: SW1 /4 SW1 /4 S24 T31 N,R18W New Richmond Airport Hangors 14- 7,15 -6
System type: In- ground absorbtion system(conventional)
Manuals Used: In- ground absorbtion system (version 2.0)
Page#
1. Cover Page �nall�
2. Variance application information
3. System plot plan E s
4. Chamber Cross Section
5 -6. Maintanance and Co ngency Plan ESPnN��NC�
7 -9. Soil Test
Signature
License nu ber 226900
Bird Plumbing Inc.
1008 192nd Ave
New Richmond Wi 54017
715- 246 -4516
Shaun Bird #226900
9/29/04
RE: Petition for Variance
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 to built to the specs of this variance. The hangar to the
north is currently built and thus would not comply with the variance so the proposed system
is to have the variance for the south hangar. 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 the parcels are both being leased by
Mike Jacobsen and the City of New Richmond owns both parcels. Thus, lot line issues can
be avoided due to 1 owner.
Thankyou
Shaun Bird #226900
PLOT PLAN
PROJECT Mike Jacobsen ADDRESS 1273 142nd St. New Richmond Wi 54017
SW 1/4 SW 1/4S 24 /T 31 N/R 18 W City New Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 92.5' 6.5' below qrade GPD 153
CONVENTIONAL XXXX AT -GRADE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 800 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 248 # of chambers 8
BENCHMARK V.R.P Bottom of Siding ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL *H.R.P. SameasBenchmark
Alt. BM Bottom of Siding @ 100.0'
Entire Parcel is own and
leased from City of New
Richmond Property has no
I _ � �� _ � � lot I i ne setbacks. The
hangars are on a 100 year
We I I is to meet al I I ease, I of I i nes need not
Tested area has 0% setbacks found in apply.
Slope and thus no Comm. 83
contours
Total GPD = 153
Hangar Please note: Septic system is to
Originally this serve toilet and
2 employees hangor was to be floor drain waste
and 1 floor only! A catch basin
drain apart of this is not be installed
Currently built system, it is no and attached to
longer the case system
B.M. * Alt. B.M.
B -4 ST B -1 B -2 B -3
Vent
Well is to meet all
Hangar setbacks found in Comm.
83
2 employees
and 1 floor
drain
To be built
Page of
PLAtA ,S M ANUAL & MANAGEMENT TioNS
OWTS OW SPECIFI
_ P SYSTEM al ❑ NA
riic Capacity Septic to city HA
N Manufacture
r
FILE MiFORNIATtO f4 � ;0 Tank Man p O NA
pwner 3 Effluent Filter Manf r 1�
Permit;. ,,- O NA
Effluent Filter Model
DESIL�N PM Tank CapadtY al NA
of Bedrooms O 1dA Pump
Number � er
endal Units p Tank Manufac tut
Number of Comm j O. Z aUda '`
E.dmated 00W (WOM9e) J 3 aVd Pump Manufa
(e0msttied x 1.5) Pump Model
Design flow (PeaK aUda /ftz ent Un Fitter
trea
SOU APP�on Rabe Monthty average` pre Gravel Fitter t3 peat inc nd
Ara
e m9n O M anicai Aeration
InfluenVEffluent Quardy on
O Wetland
(FOG) 13 Other
Fats.- 00 b Grease B ODs) �p mg/L [3 Disinf6aon
Biochemical Oxygen Demand ( SS 5150 m /L Manufacturer
Total suspended Solids {T ) Fade al Cett(s) ❑ in -ground ( preSsurized
t
Monthly average" r�OA ound (gf$vtry)
Praetrea Epfluent Quality 5 30 M91L Mound
en Demand (GODS) [3 Other.
B• ,hernical oxy9 SS) S30 mg/L Dri ine .
Total Suspended Solids 51 04 cfu/1 Dom, ►car for darr+estic (nori corrmC'`�� was tewater and
Fecal Colifom1(9gOmetric mean) . v�ues
ke
Y. ttdiameter ,t uent ter.
Maximum Effluent Particle Size
values typical for prptrtiated
Service Frequency
MAINTENAJNCE SCHEDULE p months ear (Maximum 3 yt's•)
Service Event
At feast once every of tank volume
condition of tanks) m equals one -third ()
Inspect When combined sludge and scum ear(s) (Maximum 3 yrs.)
c3 months
Pump out contents of ta nk(s) At least once every ear(s)
months .
ins pad cell(s) At least once every
pact p months r(s) O NA
Clean e ffl uen t filter At least once every r(s) C3 NA
Pump controls 8, alarm �". ❑months
Inspect Pump pu At least once every [3 months
fl mar(s) ❑ NA
Flush laterals and pressure test
At least once every E3 Months ❑years) [3 NA
°t1°r At least Once every
otw. Pd licenses or
M pl OWfS fnspe 4ANCE INSTRUCTIONS an indiv one of the follow Ma
intaine
odor. WrS Mar, SaPtaken
of tantcs and dlsPer�l cells shall be made by idual carrying r tank(
s) s to ;dent back UP
;ty any rrirssing or
Inspections Plumber; Master PwmtKer Re
sited So . on of the ta) for any b
ins:. Master a and s cum and It check t levels
fir. Tank ingpectwns must include a visual i 000 to check t h e e ffluen t
Setvi ing op or leaks, measure the volume of combined elude ^ding of effluent on the
hardware, iden* any dispersal cell(s) shall be visually Insp
auth
or ority.
round surface- The dispe round surface. The po oory
hardware.
of Of fluent on the g for any nding of effluent on the g
in the obsen►ati° a failing co one-third (YQ or I pipes and to check pe
r any n and requires the immediate noti figtion of the local rag rat tank volume, the
indicate tank equals on more of th
surface �Y ance with ch. NR
ground
acc umulation of sludge and scum in any O eratOr an d disposed of in accord
o
When the combined accum a Septage Servicing p
entire contents of the tank shall be removed by rior to use.
retreat ^tent components, and any
113, Wisconsin Administrative Code' one
e fflue nt filters, mechanical or pressurized POWTS comp nts P �tmed by a certified POWI•S Maintainer.
The servicing of efflue o f �mpletion of any service event
maintenance or monitoring at infatuate of 12 months or less shall be pE
other local regulatoy authority within 10 days
to the r other
'clad
hall be provided ucts o
r
s rod
A serer r eport presence of painting p
S check treatment tank(., areal cell(s). if high ionWtmWns are
START UP AND OPERATION e of use the P01NT
For new consbudOn. Pn s and/or ge the dis a ope rator p
chemimis that may impede the treatm by a septage servicing ent a dam pe _..._
detected have the contents of the tanks?
Page oi
• conditions are frozen at the infiltr ative surface-
! shalt n ot occur when above normal t ighater levels- w men P� is restored the excess
:start fi(s) and may result in the
system start u o P ut a ges Pump tanks tnaY ovetloads o &M tank removed by a
real c ! this in one large dose.
pucing Po`�" -it be discharged to th dI'P or contact
r surface dtsPUMP a Piumber or P01NTS Maintainer to
wraste+�� . e of ettl , t To avoid this situation have the contents of the p
backup od�as�8 ��� fi p
g pvrter to the effluent
e SsrvLarig OpeMW th pump cants to re store normal wets within the pump tank. 1.
assist in manually P w over tanks and dispersal cells. Do o not drive or p
tic over, or otherwrtse dlsbulti or compact,
mound or a t soli absbrPtion area•
po not drive or pa slops of any pe r f orm ance and prolong the Be
the area within 15 feet down im rove the pe dentaos,
the wastewater stream may P s, deg l floss; diaper
Reduction or.erunlnation of the following �ammtte butts; condoms; cotton swab ; herbicides; meat
' fruit and vegetable peelings; gasoline; goease;
of the POWrS: antibiotics n d* (o pump) water; ns; and water softener brine.
dsinfeclattts: fat: fouthdaW ndng l (SUMP
p Pe es; santtary napkins; tampo
scraps. eons, Olt par
service the following steps shalt � taken to insure that the
ABANDON%M ENT taken out of s Wisconsin Admist
inMWB Code:
When the POWTS falls andlo�Per I piiance with ch. Comm 13 33. Wings seated•
system is property andfe� od P nnected and the abandoned Pipe ope a $ervicing Operator.
in to tanks and pits shall be disco di of by a SePta9
• All pip 9 its shall be removed and properly
The contents of all tanks S
all tanks S nd pits steal[ be excavated and removed or their covers removed and the void space
• After pumping• raven or anothe inert solid matena
filled with soli, 9
CONTINGENCY PLAN aired the following measures have been,
or must be taken, to provide a code
if the Knt VTS fails and cannot be neP
com repl aoernent system: area has been evaluated and may be utilized for the location of a r
each n a should not
suitable rePlacement should be protected disturbance and nd comps
Sys tem. The rep l ac ement area sect s tructure, tot Lines and wells_ Failure to
absorption sys aired setbacks
be infringed upon by from existing and proposed
t area w(It result in the need for a new the'rules Snteffect at that time es tablish a suita
protect the
,pt ems must comply
vv ith replacement area- Replacement cyst
re pl a cement area is not available s a last resort to replace the failed POWTS- advances I to se
A suitable nepl be installed as a n failure of the POWTS a soil and
technology a holding tank may a suitable replacement area .
i dentify f no replacement area is available a
Upo
b The site has not been evaluated to
m ust b performed to l oca t e a suitable rep
PO
site evaluation m led m a last.
to replace removal of the biomat at
Installed ed in face fo[lowing
M be r _ rec o ns tructed P t that time
tank aY recd effect a
to be elf r ption hold tams may 1 with t h e rules 1n
Q Mound and a absO true of such systems must comp Y
the Infiltrative
> KS MAY CONTAIN LETHAL GASSES UMSTANCESF DEATH OXYGEN.
«VIIARNING> TAN CIRC
SEPTIC, PUMP AND OTHER TRF.�►TM OTHER TREATMENT TANK UNDER � I1=FICULT OR IMPOSSIBLE
OR Y
130 NOT ENTER A SEPTIC,
PUMP TANK MA
RESULT.. RESCUE OF A PERSON FROM THE INTERIOR OF A
ADDITIONAL COMMENTS
CL.•
POWTS MAINTAINER
POWTS INSTALLER Name v�
......... /
t
�/
/ li
Na cLlt. J
Na � P hon e -
Phone
E
R
LOCAL REGULATORY AUTHORITY n
TOR PUMP /
yICING OPERA L
SEPTAGE SER Agency
Name m / Phone / ✓��
Phone / — Z Zontn and Sanitation agende .-
This dociment meets
Ow staffs of the Glean Lake. Marquette and Wausllara County 9 Cede_ Use of this dowment does not
Tnia coarment was drafted by 1 a and 83.54(1). (2) & (3), Wisconsin Aaministrai GM W (2/01)
the minimum Mui(eroents of c L Comm 83.22(2)(b)(
guarantee the performance of the POWTS_
Safety and Buildings
10541N RANCH ROAD
commerce.Wl.gov HAYWARD WI 54843
TDD #: (608) 264 -8777
isconsin www.w
www.commer isco govsb,
isconsin.gov
Department of Commerce
Jim Doyle, Governor
Cory L. Nettles, Secretary
October 15, 2004
CUST ID No.978021 ATTN.• POWTS Inspector
ZONING OFFICE
MIKE JACOBSEN ST CROIX COUNTY SPIA
1273 142ND ST 1101 CARMICHAEL RD
NEW RICHMOND WI 54017 HUDSON WI 54016
CONDITIONAL APPROVAL
Identification Numbers
PLAN APPROVAL EXPIRES:
Transaction ID No. 1068303
SITE• Site ID No. 690748
Mike Jacobsen Airplane Hangars Please refer to both identification numbers,
Airport Rd above, in all correspondence with the agency.
City of New Richmond, 54017
St Croix County
SWIA, SWU4, S24, T31N, R18W
Lot: 14 -7 & 15 -6,
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, roval, if any, listed below shall be carried out. This variance is specific to the
p
subject petition and cannot be used for any additional modifications.
MIKE JACOBSEN Page 2 10/15/2004
Conditions of Approval:
• 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.
Sincerely, Fee Required $ 225.00
,... / Fee Received $ 225.00
Balance Due $ 0.00
Patricia L Shandorf
POWTS Plan Reviewer , Int grated Services WiSMART code: 7633
(715) 634 -7810, Fax: (7 634 -5150 , M -f 7:45 am - 4:30 pm
phhandorf@commerce.state.wi.us
cc: Leroy Jansk Wastewater Specialist, 715 726 -2544
Y Y� P
Shaun R Bird, Bird Plumbing, Inc
11ECEIV
Eli
Property Owner Parcel ID # iJ , 5 2004 Page of
®
Boring # C3 Boring z ' cRUIX Cp
o Pit Ground surface elev. ft. Depth to lim) �N/ (I in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boun Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2
�J I Boring # Boring Q
iii /// III �it Ground surface elev. (� " ft. Depth to limiting factor in.
Sal Application Rate
Horizon Depth Dominant color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont Color rAr. Sz. Sh. 'Eff #1 'Eff42
Z
F Boring # a Boring
Pit Ground surface elev. ft. Depth to limiting factor in.
Sal Application Rate
Horizon Depth Dominant Color Redox Desc iption. Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
Effluent #1 = BOD. > 30 220 and TSS >30 150 m Effluent #2 - BOD < 30 and TSS < 30
m9A- < _ 9n- E
s _ tnglL. _ mglL
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.
SBD0.8330 (R.6(00)
Soil Test Plot Plan
Project Name ly2 j �(' 7g Shaun Bir
Address 12� -7 3
/vex a , r,� �ti `� Ol) CST #226900
Lot ----- Subdivision ---=r /y(2 Aa rpa Date -5-- 3
Sl
14 . 5,J 14, %2 T 3 N/R W �
Fj Boring Q Well PL Property Line County
BM or VRP Assume Elevation 100 ft. �o�o
System Elevation *HRPSameas enchmark
Alt. BM B ottom of Siding @ 100.0'
Entire Parcel is own and
leased from City of New
Richmond Property has no
�I _ � �� � � 1 lot line setbacks. The
hangars are on a 100 year
W ell is to meet al I lease, lot I i nes need not
Tested area has 0 setbacks found i n apply.
Slope and thus no Comm. 63
contours
Airport Road
Total GPD = 153
Please note: Septic stem is to
Hangar p y
Originally this serve toilet and
2 employees hangor was to be floor drain waste
and 1 floor only! A catch basin
System is to be drain apart of this is not be installed
installed within 10' system, it is no and attached to
of hangars, a longer the case system
�
variance is required B.M. Alt. B.M.
B -4 B -1
n n n B -2 n B -3
Hangar
2 employees Leased lot line
and 1 floor
drain
Property Owner _ Parcel ID # Page of
Boring #
❑ Boring
pit Ground surface elev. � ft. Depth to limiting factor in. mil A pp l ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftt
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
3 "0 rr
i
F-1 Boring # E] Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication 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
Boring # ❑ Boring
F El Pit Ground surface elev. ft. Depth to limiting factor in.
Soil liication 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
Effluent #1 = BOD > 30 < 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.
SOD -6330 (8.6/00)
11
Soil Test Plot Pla
Project Name Mike Jacobsen Sha' Bird
Address 716 Bear Trap Lane
Amery Wi 54001 TM #226900
Lot --- -- Subdivision N.R. Airport Date 5/3/03
SW 1/4 SW 1/4S 24 T 31 N /R18 W City New Richmond
❑ Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Bottom of Siding
System Elevation 92.5' *HRPSame as Benchmark
Alt. BM Bottom of Siding @ 100.0'
Entire Parcel is own and
leased from City of New
Richmond Property has no
Scale = 1 �� = 40 hangars line setbacks. The
hangars are on a 100 year
lease, lot lines need not
apply.
System must be installed
Tested area has 0% within 10' of hangars, a
Slope and thus no variance is required
contours Airport Rd. n,�n
Total GPD = 153
Ha ngar 1 1 -11 Hangar 11 -10
Septic system is to
2 employees serve toilet and
2 employees
and 1 floor and 1 floor floor drain
drain
drain waste onlyl A catch
basin is not be
B.M. Alt. B.M. installed and \
attached to system
Leased a rea Line 0 0 ri
B -1 B -2 B -3
COUNTY EN;1
ST CROIX C E AGREEM
SEPTIC 'T MAIWENAN
AND
yvNERS' CERTIFICATION FORM
O ,
. or
pwnerBuY
•leg Address /
- fl ✓-�'
Property Address d planning Department for new construction)
(Verification require
parcel Identification Number
City /State
r P SCRIPTIO T L ��/ of
i,�vr� ,r�rj -'7—L /
Property I o
canoes lr,�.. %. �• Lot
Subdivision Volume Page #
- - ---- -'
Certified SurYey Map Page #
Voluine
Warranty Deed ## es 0 no
fiable Y
Spec house O Ye %n° Lot lines identi
p remature failure to handle wastes. Proper maintenance
e•rr,'M Mr w TN'['E tic system could result in its p ed umper• What you Put into the system
d � c nanee of yowc aeP � or sooner, if sucdea by a livens . P
a uSe tic task every thTet Ye waste disposal system.
consists of pumping cut sbe sep as a treatment stage in the by owner and by a
can affect the functi of the septic teak artmeat a Ce cation form. aiga osal system
to St. C`,roix Zoning DeP 1 the on -site waatewai� � of sludge.
The p operty °� agrees to submit lumber or a licensed pumper verifying septic tank is less than e.
r ,
masterplumber, journeyman condition and/or private m•`'pe,tion sad ruMPing ('f necessary) stem with the standards
is in proper operates a to maintain the private sewage dLSpo Certification
d have read the above eats and agree eat of Natural Resources, State of Wisconsin w ithin 30
erce and the Depart
Uwe, the � et by the Department of C��t be completed and' named to the St. Cro County Zoning
set forth, sy stem has been main /
sti cpiration date. / ���
%SIGNA:l DATE
aF AMICANT
waer(s) of
g ICA'I'I N true to the best of my (our) k I (we) em (are) the o
OWr1ER that all statements ou this foraz are R of Deeds Office.
I (we) certify of a wa rranty deed recorded in Reg
the property
dcscrib d about, by virmc i
DATE
i ;UR i E OF APPLICANT ermit being revoked by the Zoa4 Department.
Any information that is clk- representod M2y result in the sanitary P
ister of Deeds office
d warranty deed from the Reg de the warranty
deed
lication: a sffitnPe if reference is trla
«« Include with this app a copy of the certified survey Map
e
HANGAR AREA LEASE
THIS AGREEMENT, made and entered into on the date indicated below by and
between the City of New Richmond, State of Wisconsin, a municipal corporation,
hereinafter called the Lessor, and Mike Jacobson, hereinafter called the Lessee.
WITNESSETH:
WHEREAS, the Lessor owns and operates an airport known as the New
Richmond Municipal 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. Property Descriptio :Lot =Row f the Airport Layout Plan -New
Richmond Municipal Airport. Leased Property equals 6,400 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 ten (10) years
commencing on July 1, 2000 and ending on June 30, 2010.
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 $640.00, 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 safe and convenience of all concerned, all equipment
ui
t5 q P
necessary for the safe hangaring of the Lessees aircraft, the right of ingress to and egress
from the demised premises, which right shall extend to the Lessee's employees, g uests,
g P g
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, an reaso
g d from all loss or damages by n 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 Alirport
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 snaking any inspection it may deem expedient to
the proper enforcement of any of the covenants or conditions of this agreement.
2
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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. Signs: The Lessee agrees that no signs or advertising matter be erected
without the consent of the Lessor.
0. 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 mendment
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.
I
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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. Floor Height The Lessee agrees to erect a building on the leased premises
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. Taxiwav 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 /t/o .�,� 2 , in the City of New Richmond,
St. Croix County, Wisconsin.
LESSOR:
Airport Manager, Mike Demulling
LESSEE:
Mike Jacobs 7
Tracy Jacobson
5
HANGAR AREA LEASE
THIS AGREEMENT, made and entered into on the date indicated below by and
between the City of New Richmond, State of Wisconsin, a municipal corporation,
hereinafter called the Lessor, and Mike and Tracy Jacobson hereinafter called the
Lessee.
WITNESSETH:
WHEREAS, the Lessor owns and operates an airport known as the New
Richmond Municipal 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. Pro pert Descri do Lot 6, Row 15 f the Airport Layout Plan -New
Richmond Regional Airp r . eased Property equals 5920 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 ten (10) years
commencing on July 1, 2000 and ending on June 30, 2010.
CO
1
c i
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. 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 mendment
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.
COPY
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. Floor Height The Lessee agrees to erect a building on the leased premises
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.
upy
4
IN WITNESS WHEREOF, the parties have hereunto set their hands and seals this
Z�� day of U i ,,��t- in the City of New Richmond,
St. Croix County, Wisco sin.
LESSOR:
` t
�. �C_
Airport Manager, Mike Demulling
LESSEE:
Mike Jacobs
ads
Tracy Jacobson
5