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HomeMy WebLinkAbout042-1004-50-040 Yasogrsn Deoanmenr n',^.n^.--a.ce. PRIVATE SEWAGE SYSTEM .St- Croix Sa'er, and Building Dmvur INSPECTION REPORT Nn 606941 GENERAL INFORMATION n.l I A "'t- C P=RIOIT} Stair -la- to Nit: e y,iW in•Jrnia,;m iro: ne -..at t used fu, seLgnGa, pmp,-u Ipi -all, n C4 , I•m; 3163854 "elma Ho1de"S Naluc P: 'JAia]e Tevmsois .1 Tax: Nc Roscon Properties LLC TOWN OF WARREN 042-1004-50-040 ~i:S' Bhr Fees Ins. IRA _I,, BPd ;)esa ln'ic' Se ti in lc'orlRa cPl4a. No. 4c ~~kz 03.29.18.37A-04 TANK INFORMATION ELEVATION DATA TYPE PAANLIFAC- LIRFCAPAC:-Y S I A I ION B.S. if FS ELEV ~N 5 ! pp 7, i~0 ICJ% Dosing At HM o fu 75' OPT a L zr 7' IOG/ ! ¢xr Ls Bldc. Sewer r~'so 9~-SS -1ni;1111i; - - SL'i: Idle: StrH: OUTICt TANK SETBACK INFORMATION - - WELL Ht DO iren in All I"rtnae BOAC' D: Inie: I ANK -C P• I)IJ K Sep:::: I i I Of Bottom . s 10© / u~- ~ a. Dosing - - Ileatletlfdan. - iL q0 Aeration Dist pipe, 3,9 V /03 . Holdinc Got Syste-T f, !lp` Final Grade ryry~~ lP`' PUMP/SIPHON INFORMATION D" UJ~.00 Mamifac ow. Demand S' JVCf q it Iftwe Model Number O TDH Lit. I irciiun Luss vStBin Head -D•- F' - _ - - - Forcemain Lengt~i [i.a ?s'. l•,;ae , SOIL ABSORPTION SYSTEM '7. ItV B_OrTRENCh 1 .^i~ lid x I -rain I Nn O' Tre -n.; PIT DIMFNSIONS No Cl' Pi's 1-.61,1- 1, a LrVam D, 't, DIMENSIONS I ^I r~ I 1 SETBACK SYSTEM TC PP. Hi IX, WEL_ LAKES-REAM LEACHING Mrnu•arturer INFORMATION CHAMBER OR yr- ev type D' $j•Ste' x, ` I UNIT LAOae', N,.^'.ne- I 1 ) / I 145' DISTRIBUTION SYSTEM 1 LaCer,P1 mio!tl Hoe 0111`: b I I / Lt c~ Hoe Size "o 41 YO G: Lacrb Q Jai .I:,BC. ~g SOIL COVER x pressure Systems Only xx Mound Or At-Grade Systems Only _ C pih 1:c 1 Dent, lie x i,nW x r,: yeoea!Sxtlctl i xx Ni1 ".j i'-.4re on Genlei i l Fs^n'Ian.I ~;lge•. T >oil / YUb N!. vCS N': COMMENTS: tIri code dtsdrepenaea +esons present et:: Inspection Inspection z3 lA/~o/ Iq _ocation: 1191121ST ST l" 1 t/q/l~ C"i Alt BIA DescnDGon = 1 or, ~4.. ,2u- •"'`NJ Diog sewer Jeri = J arrnunt of cover = "lart I j,v . r Aber ber siRequired" Yes No / nlI/`,l I ^ / I L1/f 'I~}.E 0(// r.- sltlc• for addilionai mfomlaGOn. L//U' 'V/ V/ l\~/ - - l L fY`~.- '!L-G-1 Jdlc I^SC; ]IO lgnalJi<. 'f.2r N!. Sa:ety and Bji?d;ngs Drvlstor. 4 O $ . ''T; asvngtUn Ave., ?.U. Box us 2018 200 W 7152 $ar:vu} -cart !`wnbc ,a„ be ;:Iles m by C a 1 P MA:sur.. lN' 53701-7562 C:ir, _jpmert I Sanitary Permit ppfiettien Nmbc In auwrd,m' w"th S)"' 393-21,'211 &o. b u r :a s i r fJ i. t rot [ d eD JM+"e[an) w 1 j J_ urcgnirnJ wx ro'b,z;ntYraatnu rip vl Not: 4pb y t'nml rs...L ome,~~AA N ~nro wo'n n_4 to t:•'.iat 4dires:il d:Hcrntt thm trvuac; aour> ' .hc Ugo:etoeat [ SYletl and Yruf•sswual vn4t-s Pns rd vnr c:Ga m ::c\ir ts;d [or sc mu:a-4 ~tr~ns„-S L~, arlan4:c aid ,h P_r..a:.y. ,50•rll-nl ~t rc. - - _ ~~~(Q3 ~a~ APDlicauon lnformanon Plea. Print _l Information k'n:',:,T:1 CL~a s \amc - Property Uwr i'S'.lailinn,.wthca+ - - --.-Q7•o"I•~g-•JO R'~' loD'D C4- rC Ptvl rau\ V 7:.~pcrv rKa:inu I S.elc al -'.r5^ r-N=b-- r o C ,:-adc ac t). }•pe of Building lcbak all that apply) FVfr>tiJ fsrtl? 1T4d Cn~ Nwuoa xol Bc 1 .r I_~( Q~ Onf / rsuwiviuJn Nano: U Yri ?v:L mm r ai - Iksat< list c"Y7~~ f'~"-" - _ I ' ' titatc Gaud III type of Prrmu ICbeck only one box on line A. Complete line B of applicablcl ( - t'Yl-a n <CI xi.LC[ t l Ahu I n nCY 1 G p :a c m Ti:nl i T m.4 tnhrt MOdrfica:.unt Fxm.ag Syrian texplatn) r R. .fir i } rnewal I ~ !'rmtn )tn ..c - ~ cviouz . uvtit Nmuccr and laB Lssued - - III ❑ t :nu,r. n!, iunih.r I "Ynr.t' !;tutu : i Gcw ~ 1 rs<s r E4 ~ r ~ L ~ ~4r TrLnCPUR fl Sv51eucCom onentDcyice: IChee 11 that aJ1 h - P 1- I r«4r < 'm.~nruYd _ I'ress < I r; rrl - 'k i ldcaxi ~ a rf rumble ,oJ 1.1 M1lumd ic., I sutwbie ad i iN~ u J ~i. ua ihh I<[s~l r;~m I... Fl it - IYCUrvmmnt llevr¢ xpIam DlspersalTreat e t Ana Informapou 1 1 xt Wi7 n ~arm:nY _ I _ ~w.:,ax AVaFtgarrd s 11u xv i4rca %rcpos tf, E.Ip4.aligr ~.T_n~~ YL Tank fnCo :aa :..-io Mann "a_m ".7'-'~ ' _ al(m _ GPI i trots I I I":u :1WIL5 itiw-fi~T~.w I I I C 9 H~ J. ~'II KeSpouslbtbn• $tutemr l L rbr uudrrsj~n s mr r apunsibility for tuatapauuo of the PO'A fS show" nn for attached ptaus. I a}r1/brr.. ~ -nc 'rii `f i'1/ , Si~._ume _ - - ;4R•. M1Wi:S V.ua^a ~-B~.ucaa"i~ne V Doer I lumber' gJSa i 5 mA,'. i t ate. > ip ~od ` y / _ I ~-L.!~--sue. C i l3 ~z__ /au ~L..- _ =f • r1.~e,~.~~ rat ( /yf/~~ / ` / /J// V1]i. Count, Department l_se /luly _ ` - ' - 1,?Lz i/~rtpprn4rl I r3aptro FMh':(Fce._- ">a'r suN uuJffffl~l--- ISa:ua:mr - Jl4 "n vn :a, Dmi:d $CS/ <oO~ 1 "f l g _ I _ Ia Condttionc of Approy easom f- Disapproval CL" C , ..I, 4,n 1 I I.r• ~ C I W i.WS . I I il=:u WI: t u .Iu II ai i1~-1 i : 11% - I!'d i rY~pny, ~.a I II h~71 il:j Ltl.ll li=~P.r r i-. .:r 1 P'r[' • t>♦F¢f~ Drl4lMWteY}lauJ fe'/lhi.~tarca and s"bmit to tas tuunry onl. ua P"per rim Irn IW o R v: 41: wrbc m m< 'rl {L•'4 L''i~1S:1kz SIiD-Ci ~9S ~R 11 r t I} System PLOT PLAN PRO,HtcT Roscon PrOOerlles ADDRESS 1253 Awatukee Trail Hudson Wi 54016 NW 1!4 NW 1r41S 3 29 N/R 18 'T'OW'N Warren CoCnrY ST. CROIX SYSTEM ELEVA'T'ION 101.0' 9..21:18 BF.DROONt 3 DATE CONVENTIONAL A'1'-GRADE XXX CONVEN 1'1 ONAL LIFT HOLDING TANK NIOLND SEPTIC TANK SIZE 1000 gallons LII~'1''1':1NK 51""/.t; DOSF TANK SIZE 630 HOLDING I'A %K SIZE LOAD RAI E .5 ABSORPTION ARLA 900 # of chandlers none BENCHMARK V.R.P. Base of wood lot line stake ASSUME ELEVATION 100' Filler Lifetime Filter ❑ BOREHOLE O W'I:LI. "II.R.P. Same as benchmark Scale = 1/4" = 10' 455' Property Line Huffcutt Combo Tank 1 0 0' B.M.' B-2 Grading is to be done to divert run-off away from 250' system 2% Slope ❑B - Pro 3 Bedroom House B-1 101' 102' Area 15' be, ow system is to remain undisturbed Well is to meet all WDNR setbacks 121st. Sl. C', ~0t T ST- CROtX COO iN'I' r SE]'"f K` T.~VIC IvIALNTFNi1iNCL : ti;RLFM]-,NT A?gill • OWNITSHIP Cha.l'll'ii'~\ I f(IN FORM Owucr., Buyer 17. Ds- c.Y1r._ rQ(D 9~..r-f7 Mailinp, Address Property Address -(Verification tcgt.tred fro-n) Planning! ti ZonittE Prep t.uncnt jut Ill!"? constnicliun CAM'Statc - - - - Ferree] ldcntiticatiou Nut Thar ISCAL DESCRIPTIOL\ - - - - - - - - Property Location ! JtII~ 1/4, Sec. P > V R /_JV, Toyvn of ~C Subdivision -_.Lot# JA - - - - - - Certified Survey Map ,11 _ y'r tome 7 / Page (t Warranty Deed - _ _ - . 1 plume _ Page Spec. house yes no Lot hill. no SYSTEM A'LAINTENANCE AND OWNER CERTIFICATION. Improxr use and owintcuance of your s¢phc svstcm could result 'it its pn•manrre failure it) handle w•astns. Proper rrh rintonaue,e consols of pumping out @ic septic tank evccy i}m e yen's or sourer. needed, by a hcensed panpe:. h: the system can afleeT file Inaction of the septic tank a; it treatmc n' stage in rite w•a3, e (fisposal system Uwncr feitnytrnvann.,eyou put into tespmustbiltiies are spec.hficd in g(.omtn. 84 S'1 1) and ur Cha:>tcr 12 ~St, t-rax Coumy Salutary Unlinaurr The property owner agrscs to submit to St. Cuhlx Counr.~ Planning Zoo rig Depan.ment it ca nlicahon intr. signed by rho owner and by a ncister pltuuber, iourneyma:h plmnbch, rose w(cd pluabnr or a licensed punyrer veil trying :hat (I) the nu-sitr w.usfcwater disposal system is in proper operauoj; ~.undition audfot (2) aitet insprwion and purnpmg Of necessary). the septic tank is less than I:3 full orsludgc. UNVe, die uardc1srt4ne(1 Lave read t:hn above require n rnt - • 10 treree In im-ili faun the private sewapc drapw,al s ,icur with the standards sot forth, herein, a: not t.) err I)gwu scot o: t_ olumc:-r, and tltc Dcpaotr,w of Naturai Rcsoutocs, State otlviscan:in. Certification atatiug that your septic svstcnr has be er, mniutanhed must h c , ornplete.l and returned to the tit. Crnix Count; Planning Zoamg Departntonf witnm 30 days of tf;e three year expiration date liwe certify that all statements on this form are true ro :hc best of uiy~out k nowle(k c. L'w•c arivaic the owncris) of the property described alwve, by v'hii O" a warranty deed recorded to Register of Dec. Is Office. Number of bed". S ATURL' 01 APP1,Fc'1M'(4)- DATE TE «**Any iulirrnmiion that is misigw-sctlted nay re:+ult it; ds' sandmv permit borne. i,v'oked by the t'latnnng & Zoning Departmcut. fuclude with tilts appiw.wion a recotdild ivananty deed fiorn tit,- Registrar of Deeds I. fftce and a copy of the certified stil aap a ictotetn;e is tirade a die warranty d=ed. (RYV. 08105) DIVISION OF INDUS I R' SCRVICES .,y... 3824 CRi=LKSUL LN HU ML14 W 5463-3-5466 \ Contac: Th rxtgh Relay S P httpJidsps W, goviprugiarlsAndustry services Scott Walker, Governor Laura Gutierrez, Secretary October 14. 2018 (1IS1 II) Ao. 226900 417A 1101I TS hislic"Jor SIL\CA R BIRD ZONING OI 1-IC 1. BIRD SELE STORAGE: ST ( ROI\ COL\ I ) SPIA 1432 120 I'll ST 1101 CARMICIIAH RD NLAV RIC-IIA10ND WI 51017-6409 HUDSOA WI '4016-7708 CONDITIONAL APPROVAL - - PLAN APPROVAI.I-APIRE_S: MI412020 Identification Numbers I ransaction ID No. 3163854 SITE. / Site 11) No. 854268 Itoc.'li11 1'roperties Please refer to both identification numbers. Lott 21 SI tit above. in all correspondence with the 'I oven of \\arren agency. _ St Croix Comm nNW '1 4, M'i 1 4. Si, T29\. RIM FOR: Object 'I Vpc: POAk I S Component Manual Regulated Object ID Ao.: 1799018 Maintenance required: 450 GPD Fluw rate: System(s): At-grade Component \1anual, Version _.0, SBD-1085.1-P (\.03 07. R. 1!1'_). Pressure Distribution Component Manual - ker. 10. SBD-10706-P(\.O1 01, R. 10 12): Effluent Filter The Submittal des,ribed above has been revlt'wc'd fur conlurmance with applicahle \\isconsin Administrative Codes and Wisconsin Statutes. the submittal has been ('ONDI I10N;\l"L)' APPROVFD. phis s\stcrn is to be con,urtwWd and located in accordance with the enclosed appiI plans and with any component manual(s) referenced above. Ilie owner, as defined in chapter 101.01(10), \\'isconsin Statutes, is responsible fir compliance with all code requiremenh. \o person may engacc in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06. slats. I'he 1611owing conditions shall be met during construction ar installation and prior to occupancy or rise: • '1 -his Systcm is to be constructed and installed in accordance with the approved plans and with publication SBD-10854-1)(\', 03 07). • the pressure network is to be conaructed in accordance with publication SBD-10706-P IN 0101, R. 10 12) entitled "Pressure Distribution Component Manual fur private Onsitc Sewage Systems" and based on pipe shim, methrxis contained in Small Scale \\'aae Management Projcel publication 9.6 entitled "Design of Pressure Distribution \ct.vorks for septic lank - Soil Ahsorhtion Systems." A copy of the approved plans, spt:,ilications and this letter shall be on-site during construction and open to inspection by authorised representatives of the Deparonem, which may include local inspectors. 111 permits required by the slate or the local nunkipalily shall be obtained prior to cotmnerlcenlCnt of construction installation operation. In granting, this approval the Division of Induary Services reserves the right to require chances or additions should conditions arise making them necessary for code compliance. As per state stats 101.12('), oothinn, in this review shall relieve the designer of the responsibility for designing a safe building. structure, or component. S11 VJ\ R BIKII I. Y.; 1:1s Inquiries concerning, this correspondence may he,,, ade to me at the telephone num her listed k-Iow, or at the address on this letterhead. I he atwe left addressee shall provide a copy of this letter and the PM I S management plan to the owner and an) others who are responsihle for the installation, operation or maintenance of the POWTS. Sincerel\, Pee Required S 250,00 Phis Amount \U1 Be Invoiced. „m When You Receive Ihatlnvoice. Matthew Allen Jan/crt Please Include d Copy With Your \Vasicwntcr Specialist . Division of Indu>n.\ ,er6cv, Payment Submittal. (715).;40-0407 . 1V iSMAR7'code: 7633 matthcw .janzcn:il;wi.gov Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. DITiOPJAL~Y New Richmond Wi 54017 APPROVED 715-246-4516 r`FPT OF SAFETY AND ) ESSIONAL.SERVICES n.~;~IgTOy,@F_MD STAY SERVICES Date:9/20/18 Owner:Roscon Properties F-F Location:NW 1,14 NW1/4 S3 T29 N,R18 W lot 11 121st. St. Warren Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page4 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specific tions Attachments: S i Test Shaun Bird Signature License nu er 226900 RFCEI\/F-F) 'EP 2 4 _ j0 iNDI18151Y SFR'ti'I3ES Page 1 019