HomeMy WebLinkAbout038-1185-70-000 (2)
PRIVATE SEWAGE SYSTEM St. Croix
5arepsnr. ❑_I drt1p jraslpll
INSPECTION REPORT 1-1.1, Pcvnrt he
) 615358
GENERAL INFORMATION ;A[ IACH TC' PERMIT l
::ne Plan IC •.c
rclnon-I InloRnd?Cn ~:n1 InGaidf mai s ...r! IL" ieDJOda'y puri1D5e511'nvbl:Y La A. 5 % o< i • Y;I
GORIIII YplCef:: r~lrll!' (jly b, 11RpC IOWIGhip F':nCr TaK \D'.
Chuck and Melissa Olson TOWN OF STAR PRAIRIE 038-1185-70-000
.:SI 81.1 Flcv m5p BM -r: BI,1 CencnP or _ _ - jeNCmilowlu'Range.'Nap
1N39.
.31.18.938
TANK INFORMATION ELEVATION DATA
-1'PC MANO1 ACTJREh ;AMAC I'Y SI A'IDN HS H 'rS CLEV
Scphc.
_
n tier:^h jr,
- j .ire I'I y I ' ~ T:1 ji:Y?. ;a 71 -Hn
luxm;t All. M
crnner
Bldg Sewer
Ioldmp - St11it Islet i r I=
I'
TANK SETBACK INFORMATION 'WHt June: TANK-r. P;I
L'd L'Lhr; vent :D in Inla.r R'iA;i IMyt
I)nsmg 1 leaderRdan
r l I ,J'~ i i>
tw-Tallon Jlsl. PIP)(
I lulliln~ ~ L~~ 11 "Y%1
Bol. Sysh-n
jr PUMPISIPHON INFORMATION renal grade y ^r f
Nauu'a::hu=~ U:~nran.y ~
J:i..OVHr
1 r'
block'. NH'nbet' , -
l%H Ldt FriCn4n L oss 1 St, c- • Head Try F'
P 4r(;elnaln .'Hnn(hi )i3 I1.:.'. Ip W-1
SOIL ABSORPTION SYSTEM
BFDTRENCH 9n r cm f/ 'n Trencncs PIT DIMEN.t'\SIONS N ! R": - m;me 71,, _'x d Dep'
DIMENSIONS
SETBACK SYSTFM TJ WI CILU- !v''.IFLL I AKFIjTRCAlv1 1 FACHING Man.laamc
INFORMATION CHAMBER ON - 'r 11,-•
'..•Ff SV1p~T
I V
{'v 2~,t_„ i t rr' ~p~ I1NIT A!onnl ^.umper
IN
DISTRIBUTION SYSTEM ✓ riJ
Fipe',51 x hole ;n . II . T-1nq Air InGAc
Lcn L _ - _ 4
pl C1, I :va;h - Gia_ -~.u--mp ~J LI\~
SOIL COVER x Pressure systems only xx Mound Or At-Grade Systems Only
~colr ',rpfh cr r;tn c' -cced:::1 a:e.- x.: la:rc•x•d
Be.1' I
EC>es j' T...+r -
COMMENTS: jmdudc rode di(.erepcrn:nes Persons present, eta. Insoeellon St. InsOcc11(1 m~.
Location: 13-4 2"TI I AVI-
1.; All 91v1 Ucsumlmn
2.1Dloq sc5w1 lengtp
amount of cover - \
Plan revision Required Yes No i
use Ptne' sick fo• addiliona mfovnatinn 1• _ ~~I 7j
SIiC , . - , Cdt{ L•:..pLtG - 9 W,r -,n Itic -
r•~'~ S I'J-0?0Jq /Gss
tt. 5
It. Safety and Buildings Division St. Croix
S 2 4 2019 201 W, Washington Ave„ P,O, Box 7167 Smular, Permit Numtier (lotx• Idlcd in by co )
P Ill . !,N Madison, WI )3107-1162
CSI - Store Tlurict Numhlr
~ntdy-15~rmit nppllcat' lq
I In,lccordars.c wah MIS .;S} '1( L N 1dn, ( Ja. u:Lnu o:.ai.:.tn,o h• Ibc.yq,nyninte polrnuuaanl unit
ray o of pit. , I'wining.:+. (rny pcu:ul. N,¢1 .lppl i.:a. , (•:nr. 1., •:rna owrnJ 14M IS arc auh....Md Io t n I«I A,1,1,s ill d11fcrcni thus m.d...p uddrev)
j the Ucp:a lnmm , 1-~.0 'ctr and fool.:l.ion:d ?cn,c. I'uc:.ma1 it l: rn,.:non on pro'. air m:m Ir .11111 1„r sacnnd..
pnrp.,.c.In ::.:..,rd:,ne.: wdh Ihc. Pnc:u v I.,,,, 151,111 Hill, e1.e.
- 1374 211 th Ave
~ 1.:\pplication Informati~uQ • ~Please 1111nfunwttiuu
N.nuc / L, Jt"✓ IU P.cccl
Chuck or Melissa Olson 038-1185-70-000
Pollen, (hvn. r'a MA...g AdJoo. Pngx~rt) I.,;,I inn - ~ .
j 1374 211th Ave
(.11 aid. Zip Codc Phone Number SW SE i, Scm,on 13
New Richmond Wi.
.I 31 N. K I: ,r
IL'1)pe of Building (chock all that apply) 3
c
ki I.n .`I:un11>Uaacll:uy N..mlrc: ..l'ncdou:m (t _ - 7 tiuhdn i.i•m N:un
n 1)
W►)~ ^ P n„1k rJ Prairie Flats
19,hIicH :nnn,lm,al Uascnhc La 1
❑ Cn, of
xl:d1 0111"'I Uc..cnfs 11%, . (-W Montle, ❑ Vdlopa: ul
Star Plante -
to~- Ce,115
Ill.'hypeof Permit- if hecppk~t nnK onehayaline A. Complete line B if applicable)
J13-B0II,rc Vcaa Nynila 91 Itallnecmenl eyaem 'f reaament1h4dme lank Keplacemenl Onl)' ❑ Other MoJAieuh,m to fxvaing s, stem (espluno
P__-
Nctmd Krnawal I'emul Kcvlsnay .I'luud•a J 1'a mu'Irm)xt@r h, Ncw I r4 I'ic ,...u.. Permit Nmnhcr Inn! L Mir {c I"uld
,
BXfolann uwn" 324720 /Z// 5/c? 9,
1\ I1 - Nvatem/('nor InentlDeyice: heck all that apply) - 32. -SWn,1 n+
N, n 1 ra..'.:ni..J In (noun ❑ Prc+.o uJ 1 ('un4, I .1t-( h: do n wolnj - I in. ul'suitubic .,I ❑ Mound '4.n of sudahlt• sod
, L7 OIF:r Uiy,e c.fl I \,mPonent (exPlaml ❑ I'felivalmQ11 Ueeiet (explain) t^/ ~
Dis ersal'froa lent Area Inform
atio .
U1.I n 11, , Iupdt . Ih~I.n SoJ ,1pphc:Ile Ke¢ti.•)xlal I)iyan:d A.c. lilquu .f) Uupcrx.J .??ow Propnsod (s) System Ide,uI.,
450 .7 643 65a . 4 89.5
NT rank Into t dl,a h it I'olul !J nl M r I:,cln:e, 1
Gallon, (,,hens Mons c c >
.,•a yanks Lx 1hnp, 1'nnk. P01y l0k 525 s a x
v~
N yhea lkyding I ank 1000 1000 {{I11 Weeks X
Ih,sing(Uard
VI I Responsibility Statement- 1, the ender rxned, a ume respunsihilily for i elation of the t ON I S shn%n on the atteehed pries.
I b mhcr'a Nam. tPrnn) - I'l.1mbct /;silgn~n,lur ' \IP MITS Nilotic, Bu1nav- Phanx. Numtwr
Keith Knudtson _ ter` t'l- 648443 651-470-1737
1'lumber< A,Llratc Phrel,( hy. elide, Lip A ode)
927 150th St. Roberts Wt 54023
\71 ounIN/Departnient l se Only
1ppn,a cd ( T - I'cmutFm Bra-I..w-d I~.wn gaol Nlc,zvlur
- ' S6d t Z7 /4
U i~mrarQi cu Rc:.v.:, G.., Ih it
IX. Cnndit~t/~'M1fRIJNBtUtearons for Disapproval
1. Seph: tarp, frilLl- i1tp-.'ni 3~ /v0 1/ 5yf4 ~ iti
Ils per mar3gemerl plcn.Tc noe•1 by plu.ntic.
2. Au ulhvk rKUF ,inns meat uu i-.c.rkli:f i
a PV lppilwlEle calf I :K-Uwbl,
Mach to ru,uptete pbm for the rystem and svhmtt to be tounq only an paper not I", than a Ia , 11 Inch- hill-
181) 6:v8 i R. I I' I I I
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KNUDTSON PL;- 6 17
CONTRACTII:."., -
027150TH ST, E4 a c c_-~ 9 r
ROBERTS M
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name Olson Sewer
Owner's Name Chuck Olson
Owner's Address: 174 211111 Ave
Ncw Richmond Wi. -
Legal Description: SW 1.4 SL U4 S 13."I'? I.R I W
Township. Star Prairic
County St. Croix
Subdivision Name Prairie I lats
l of Number 7
Parcel ID Number: O38-1185_70_000
Page 1 Index and title
Page 2 Plot Plan
Page 3 System Sizing & Cross-Section
Page 4 Filter Specs
Page 5 _ Maintenance Information
Page 6 - Management Plan
Page 7 St. Croix Cty Septic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 CSM or Plat
Attachments. Soil pest & House Plans
Designer/Plumber: Keith Knudtson License Number: 64844'
Date: j " Phone Number (65 1) 470-1717
Signature
Designed pursuant to the In-Ground Soil Absorption component Manual for POWIS Version 2 0 SBD-10705- P (N.Cl/01).
Page 1
~fa k1
' ? - - 1,37-5
B_u ~~eJr ,
~t e e "A4<
46 3
e n 4-31
1 J~ ~
KNUDTSON PLI;:''_ `1 KL j~ 5 6!?
CONTRACTIn' - L,
927150THST.6•;8447::
ROBERTS,Wl 54023-
CELL 6y1-470 17:✓
Soil Absorption System Cross Section
911.00
ft
Final Grade
4' Schedule 4K_§y-atem PVC Vent PipV ft Vent Cap ft
Leaching 9.50
Chamber ft
elevation
ft 4. ft
Soil Absorption System Plan View
ft
ft
ft Leaching Trench 1 -
Vent Or Observation Pipe Chambers R
4' Dia.
Trench 2 Header
Leaching Chamber f3M fications
Manufacturer And Model
PISA Rating 20.00 sq ft per chamber Soil Application Rate 0.70 gpd/sq ft
450.00
gpd Design Flow+ ~'~t~ Soil Application Rate + 20 EISA = - Chambers
16.00
2 rows of chambers each.
Page of
PL-525 EFFLUENT FILTER
525 Filter is rated for
F _ -3,000 GPD (gallons per day) 1116" Filtration Slots
a -g it one of the largest filters _ tee,,
s Ciass. It has 525 linear feet = ' r
-S' filtration slots. Like the -
A=MPVC
ok PL-122, the Polylok Erzl mH A M
=_5 has an automatic shut
::ail installed with every filter.
the filter is removed for
__an"sng, the ball will float up and
L-zorarily shut off the system so
effluent won't leave the tank,
sasr~„a.a,n6a -
other filter on the market can rmrehasim ~ ~
ke that claim.
10.WO GPU ~
Pi--52 9239E7`dIsa3caP,cI~: as"'aono~
--e PL-525 Effluent Filter should
Iterate efficiently for several years
_-der normal conditions before 0
-squiring cleaning. It is recom
-ended that the filter be cleaned
s: ery time the tank is pumped or
least every three years. If the
-"stalled filter contains an optional
alarm, the owner will be notified
~)y an alarm when the filter needs
servicing. Servicing should he e;
cone by a certified septic tank
LIurnper or installer.
- ~ t
AWpneli Shur OR
ll Ni[eni Nui: 6,015,488
1. Locate the outlet of the ► 1 8iM.Fiheris
rm.ronu
s,an,c,4u
septic tank"
2. Remove tank cover and pump
tank if necessary. 3" Glue the filter housing
3. Do not use plumbing when the 4" or 6" outlet pipe. If
filter is removed. Ideal for residential and com- the filter is not centered
4" Pull PL-525 out of the housing. mercial waste flows up to under the access opening t
5use a Polylok Extend &
10,000 Gallons Per Day (GP[ .
. Hose off filter over the septic Lok or piece of pipe to
tank" Make sure all solids fall 1. Locate the outlet of the center fitter" See page
back into septic tank. septic tank. 19-21 for Extend & Lok
6. Insert the filter cartridge back 2" Remove the tank cover and information.
into the housing making sure pump tank if necessary. 4. Insert the PL-525 filter
the filter is properly aligned into its housing.
and completely inserted. 5" Replace and secure the
7. Replace septic tank cover, septic tank cover. rr
- d
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I ol?
FILE INFORMATION SYSTEM SPECIFICATIONS
net Chuck Olson Septic Tank Capacity 1000 gal C NA
Permits Szotic Tank Manufacturer Weeks tJ NA
DESIGN PARAMETERS Fffluent Filter Manufacturer_ POI/-IOk C NA
Numbor of Bedrooms C NA Fffluent Filter Model 55255 p NA
Number of Public Facility Units )C7 NA Pump Tank Capacity gal M-NA
Estimated flow (average) 300 qa;/day Pump Tank Manufacturer LYNA
Design flow (peak), (Estimated x 1.5) - 450 gal/oay come Manufacturer ff NA
Soil Application Rate gallda f ' Pump Model - ETNA
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit sJ NA
Fats. Oil & Grease (FOG) -30 rng1L C Sand!Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand IBOD;.) _220 mg:t. C NA C Mechanical Aeration C Wetland
Tota! Suspended Solids (TSS) _1b0 rag/L p D!sintertion C Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) L] NA
Biochemica! Oxygen Demand (BOD,) :30 rag;L 2 lo-Ground (gravityl 12 In-Ground (pressurizod)
-otal Suspended Solids (TSS) <_30 mg,'L C NA C At Grade C Mound
Focal Colifonr ;geomotric meanl <10" cfu,'1OOml ❑ Drip-Lion _L] Other:
Maximum Effluent Particle Size Y, In dia. ❑ NA Tor' p NA
O;hor... C NA Other: - - C NA
'valum typical for domestic wastewater and septic lank erficent. Colter. p NA
MAINTENANCE SCHEDULE
Service Event Service Frequently
Li rroonthisI
Inspect condition of tank(s) At least once every: yparIsI _ (Maximum 3 years) p NA
_T
Pump out contents of tankts) Whon combined sludge and scum equals nine-third (}~I of tank volurne C NA
C month(s)
arlsj (Maximum 3 years) Ll NA
Inspect dispersal cell(s) At least once every: p-yearls)'
At least once every: Li month(sl C NA
Clean effluent filter y: I I l U-gearts)
Inspect pump r controls & alarm At least nice even'' C monthls) NA
pump, yearlsl
- _ ' p monthls! i21NA
Flush laterals and pressure test At least once every: p year(sl _
Other. - - I J rnonthW P-94
At least once every: ❑ yeads)
1`3 NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications;
Master Plumber; Master Plumber Restricted Sewer; POW 1 S Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visua3 inspection Of the tank(s) to identify any missing or broken hardware, identity any clacks or leaks,
measure the volurnc of combined sludge and scum and to check for any back up or ponding of effluent on the, ground surface.
The dispersal cell(s) shall be visually inspectod to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The pending of effluent on the ground surface may indicate a tailing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (Y,) or more of the tank volume. the entire
eDntents of tire tank shall ne removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services. including but not limited to the servicing of effluent fitters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of <_72 months, shall be performed by a certified POWTS Maintainer.
A servre report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Pan- __y n`
START UP AND OPERATION
For new construction, prior to use of the POWTS check Treatment tankls) for the presence of painting products or other chemicals
that may impede the treatment process andlor damage the dispersal collls). If high concentrations are detected have the contents
of the tank(s) removed by a suatage servicing operator prior to use.
System start up shall not occur when soil conditions are frown at the infiltrative surface.
During puwor outages purnp tanks may fill above normal hig.`,water levels. When power is restored the excess wastewater will be
discharged to the dispersal cellist in one large dose, ove-k>ading the cells) and may result in the backup or surface discharge of
affluent. To avoid :his sitaalion have the contorts of the pump tank removed by a Septage Serviriny- Operator prior to restoring
oower to the effluent pump Or contact a Plumber or POWTS Maintainu to assist in manually operating the pump controls to
restore normal levels within, the pump tank.
Do not drive or park veiiQles over tanks and dispersal cells. De no; drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POVt?5: antibiotics; haby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; tat;
foundation drain isurnp pump: water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; modicationz; a;
painting products; pesticioes: sanitary napkins; tampons; and water softener brine.
ABANDONMENT
V,nen the POWTS fails andlor is permanently taken out of service the following steps shall be taken to insure :hat the system is
properly and safely abanooned in compliance with chapter Caroni 83.33, Wisconsin Administrative Code:
• All piping to tan Ks and fins shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed o' by a Septagc Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed w their envois temovesi and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS tails and cannot be repaired the lodowing measures have beun, or must be taken. to provide a code eornpiiant
mo,a:PuTm t system:
IJ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement aroo should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area wili
result in the hued for a new soil and site rvaluation to establish a suitable replacement area. Replacement systems must
comply with lice rules in effect at that time..
❑ A suitable replacement area is not available dun to setback andlor soil limitations. Barring advances in PONS
technology a holding tank may be installed as a last resort to replace the tailed POWTS.
t of W-lan at the POW
T
Thy--pas-rtes -e'rten
rI alua niTT1g tank
hit - Kate, 'RDI-/f 5 rta✓a IDP- 46v~l a 57-9 0 e~t C)
❑ Mound and at grade soil absorption systems may be. reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< < W ARNING > >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC. PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS - -
POWTS INSI ALLER POWTS MAINTAINER
Name. Name
Phone - 651470-1737 ~hnne
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
home P15 246L5738 Waste Prone --JlSC .C;) / ~~T` :14J
;tits =uniem wnt; matted in compliance mm chapter Comm G3.??(2)(b)(1)nb&(F arui n.64111, :21 & (3). Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer Chuck or Melissa Olson
Mailing Address 1374 211 th Ave
Property Addnss Same
(Verification required from planning & Zoning Department for new construction.)
City/State New Richmond Wi. Pamel Identification Numbcr038-1185-70-000
LEGAL DESCRIPTION
Properly Location SW ''A SE A, SM 131T31 N R 18 W, Town of Star Prairie
Subdivision Plat: Prairie. Flats Lot # 7
Certified Survey Map # , Volume Page #
Warranty Deed # 593486 (before 2007)Volume 1385 Page # 540
Spec house❑yesE3to I.ot lines idenlifiable0yes❑no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your sepii- system scold result in its premature failure to handle wastes, Proper
maintenance consists of pumping out the septic t-wil: f e•e Are^_ years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tar:.. =z 1::., tr :cr;+yr,age in the waste disposal system. Owner maintenance
responsibilities are specified in ;;SPS. 383 5211; ;1- St. Croix County Sanitary Ordinance.
The property owner agrees to submit t: Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, joumcyinan plu r'c<,,-.!,~;•`rtd piwnher or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating, sad•+ic!: io,ilzr (2) al(er inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
Vwe, the undersigned have read the above requirements and arme to maintain live private sewage disposal system with the
standards set forth, herein, as set by the Department of Safety /1rd Professional Services and the Department of Natural Resources,
State of Wisconsin. Certification slating 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.
1/vm certify that all statements n this form arc true to the best of my/our knowledge. 11we am/are the owner(s) of the
property described above, by virtue of~warranty deed recorded in Register of Deeds Office.
rms 3
Number b 'o
Z-Z7
SIGNATI E P A PLICAN7 (S) DATE;
--*Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. ••0
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 decd.
(REV. 04/12)
Scanned with CamScanner
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC 7 ANK(S)
This is to certify that 1 have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address) 1314211th Ave. located
at: sw /4, Sr r/+, Section 13 Town 31 N. Range 31 W.
Town of Star Prairie St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requiremcnts of SPS. 3R 1.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service 6110119 -
Did flow back occur from absorption system? Yes Nox
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
Tank Capacity: 1000
Construction: Prefab Concrete X Steel Other
Manufacturer (if known): weeks
Age of Tank (if known): 1999
Pcrmit "it nber (if knSN~'il) 324720 _
Keith Knucitson
tl.i ed Plumber Signature) (Print Name) -
648443
(Title) (License Number) MP/MPRS
W17+19
(Date)
Dorm to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 1 13 Wisconsin Administrative Code)
Rev. 2/2012
THIS INSTRUMENT DRAFTED BY ED FLANUM
OWNERS
DANIEL AND BETTY CASEY
323 SAWMILL LANE
NEW RICHMOND, VA 54017
UNPLATTED LANDS
89'43'27" W 2582.09
4.69' 352.64' 37.50
S / / 3
0
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83.584 SQ. FT. o
1.92 ACRES w m
83.587 SQ. FT. z
M
spa 1 I rn
0 590'00'00'F
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00
y'cb 15 W
1.80 ACRES o
78,212 SQ. FT. c
O ~J..I
I p 1 ~ Z J
I n I S 90'00.00' E
sw SF~'S/ T3►xA~f w esT,,.., 3S'~4
LOT 7
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PROPERTY ONMER:cas ,lIN,, SOIL DESCRIPTION REPORT Page 2 of
4ARCELL0.9 (Mlle T.ki a F:'x.,,tui . h.
Horizon Depth ! Dominant Color Mottles Structure GPD
Texture ! Consistence', Boundary Roots Bed Trench
in. Munsell Qu. Sz Cont. Color Gr. Sz Sh.
3 1 0-13 7.SYR2S,it SIL ! IFABK MVFR AW IVF 2 3
2 - !1.3 29 7.5YK4/6 ~ CL ~ IFABK I--MVFR ~ AS IVF I - 2 .3
Ground - -
elev 3 29-9(i 7.5YR5/3 S O-GR MI. 7 8
Depth to 1 - ~ - -
ling I - y
factor
-96 in-- - - - -
Remarks:
4 l-I 0-14._-- 75YR2.5/1 SII. IFABK MVFR AW I IVF .2 3
CL I FABK
2 14-44 7.5YR4l6 - S (?(iR MVFR AS~ IVF 2 3
Ground
elev i - - 44-96 7.5YR5/3 ! ML - - - f ---7 8
-
cri.
Depth to
IrMng
r
factor I
Remarks:
S 1 0-16 I 7 SYK2 5/1 SIL IFABK MVFR AW 1 VF .2 3
2 16-44 7.5YR4/6 Cl. IFABK MVFR AS IVF .2 3
Ground
- -T -
elev 9 144-96 7 SYRSl3 I S 7 8
O-GR ML I I
9o. l7 -
Depth to
- I -
IimNn9 t - -
fachx
'16
Remarks: -
- -
Ground
elev - I I 1
- - - - _4- - i -
Depth to
lun6rlg - - ,
1
factor !
Remarks:
ST. CROIX COUNTY ZONING DEPARTMENT]
AS BUILT SANITARY REPORT ; A [(t
TSVEO
Owner ew c~
Property Address 3 2 1 /,W, LL-
:f s, +o x
City/State
COUNTY
ZONINGOFRCe
Legal Description:
Lot,7 Block - Subdivision/CSM # /r te
Ss.~'~SL'1•, Se-c.-a T~LN-R•Z,~L`W, Town of e it PIN # v 3,o - -7&
/'331.18.938
SEPTIC TANK - DOSE CHAMBER - HOLDING TANK INFORMATION:
Tank manufacturer L~ 40-609.1 Size ST/PC/Q(JO/ Setback from: House ~~Wellti
Pump manufacturer Model
Alarm location
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air?nt4c _ i Water Line
Meter location
Alarm location -
SOIL ABSORPTION SYSTEM:
Type of system. /41 1'.G Width -S LpngthJtS Number of~'rcnet~es 6
Setback from: House ~ Weller P/L Vent to fresh air intake 2- 0
cvf1~_1!
ELEVATIONS:
Description of benchmark _ /~~o~, vr~r r Elevation ZLS2 O
Description of altematebenchmarf Elevation V
v_
r 61
Building Sewer`' I_ ST/HT Inlet 6 ST Outlet` 1 PC Inlet'
PC Bottom r Header/Manifold, z. G Top of ST/PC Manhole Cover
Distribution Lines O _ O O
Bottom of System ( L ()G,, J~ ( )
Final Grade 4 O G~, Q ( )
Date of installation/2//y ermit n ber3l~2yYZ2J State plan number
Plumber's si ture License number aV 9vj Datef~/
Inspector. Complete plot plan v
wlseonslnDepartment ofCommerce PRIVATE SEWAGE SYSTEM ounty: /
eatery endBuldlrrpe oFnslorl INSPECTION REPORT
rt .70
GENERAL INFORMATION (ATTACH TO PERMIT) anrtaryP~rm
ILq
Personal Information you pro nee may be used for secondary purposes [Privacy Law. s.1s.00 (1)(m)). J
Permit Ho der s Name: ❑ City r7 Vi age n o : Stale Man ID No.:
S r//4fYl~•
C TBME v.: Ins° BME v.: BM Description Parce Tax NO.:
0 ttla~~~os?~x
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS H[ FS ELEV.
cad Be Br s /.3 98.7 oa
Dosing
Aeration Bldg. Sewer G.1r7 __!12- wi:i
Holding switiFiniet 6r,
TANK SETBACK INFORMATION / outlet 1-7-27- 90%
TANK TO P/ L WELL BLDG. Arr Intake ROAD Dt Inlet
Septic /C> ; c/Sr NA Dt Bottom
Dosing WIA Header / Man. q~
Aeration NA Dist. Pipe j.yL 'l l.48
Holding Bot. System e • G?
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer - Demand f, `y~ y6 c/.a7
Model Number GPM
TDH Lift Fri System TDH Ft
Forcemain Length Dist To wee
O ON SYSTEM
SOIL
~Ak
BED TR Width / Lengths` 1 o. Of Tr arches PIT No Of Prts Inside Dla.
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING _ rj/ S~
INFORMATION ype 1 .r G y CHAMBER M e Nu
Syste v
DISTRIBUTION SYSTEM
ilea er/Manifoli Distn cin Pipes r sHOeSae eTpa<ing Ve Air Iota e
Length _1~ Dia. f Length 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 Topsod ❑ Yes n No D Yes n No
COMMENTS: (Include code discrepancies, persons present, etc.)
WG( ( kaf c4,4id ad to Flit,
YI~6~ fl
l~ , M _TQp ccP~T~--0 (2
f1ZVL
c~, 4 rrx i7y( 1~u4 ..619 Rai t CJhd~~
Pla then s dd7 ~ ❑ Yes No I ' ~ C 1 -mil i ~ b 1
Use other side for for additional information.
SED-9710 (R*"7) Date Inspector's Signature s No
Wisconsin Department of Commerce SOIL AND SITE EVALUATION
Division of Safety and Buildings Page of
Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code
Attach complete site plan on paper not less than 8 11'2 x 11 inches in sue. Plan must County
include, but not limited to: vertical and honrontal reference port (BM), direction and r p
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. e
APPLICANT INFORMATION - Please print all information. R try Dab/
Personal rnlolmatxM you nmwde may be usen for secrxxlary purposes IPrrvacy law, s 15 or (t) (m)).
Property Courier l Property Location
Glu, ` D/ Grivl. Lot C~ 114SE 1M,S T?/ N,R IY E
Property Owners Mailing Address Lot a BlocJdt quo Name or CSMM
iyo; 6 7
City Stale Zp Qwje Phone Number Ll City ( j voila ga Town Nearest Road
5`4017 ( > -
New Construction Use: SR'Residenbal 1 Number of bedrooms __2 Addition to existing building
❑ Replacement ❑ Public or commercial - Describe. - - v -
Code denved daily flow / gpd Recommended design loading rate - Lbed, gpd1h2 ' td~ trench, gpd'W
Absorption area required b 3 bo , ka✓d tren/ch, tt? Maximum design loading rate, 7 bod, gpd'W ' O . Vanch, gpdM2
Recommended infiltration surface elovation(s)~;g YZ- 7- ft (as mlerred to site plan benchmark)
Additional design site considerations / - - - - -
Parent material Flood plain elevation. if applicable 104111
S = Suitable for system Conventional Mound In-Gmund Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system k5s ❑ u &S ❑ u Ms Flu ®'s L] u ❑ s KU ❑ s u
SOIL DESCRIPTION REPORT
Boring N Horizon Depth Dominant Color Momos Texture Stmcturo Consistence Boundary Roots GPD/lt2
in. Munsoll Ou. St. Cunt Color Gr. Sz. Sh. Bad Trench
41
Ground
l ele
Depth to
- -3 -
limiting Q
7 Remarks:
Boring q
G1roou d
h
7
limiting
factor
/B in. Remarks: _
CST me (Please Print) Signature Telephone No.
Address Dale CST Number
-9 a 6900
PLOT PLAN j ? !fit r F'
PROJECT Chuck Olson ADDRESS
SW 1/4 SE 1/4s 13 /T 31 (18 w-aO~yN Star Prairie COUNTY ST. CROIX
~r 12/13/98 BEDROOM 3
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GAOL PRESSURE CONVENTIONAL LIF-r HOLDING TANK
1000 Gallons [.IF-r TANK SIZE DOSE TANK SIZE
MOUND tiBPI'IC TANK SIZE
HOLDING TANK SIZE LOAD RATE .8 ABSORPTION AREA 572 1t of chambers 18
BENCHMARK V.R.P. Top of Wood Post ASSUME ELEVATION 100'
❑ BOREHOI.F. O WELL •H.R.P. Same as Benchmark
AIL BM SYSTEM ELEVATION 90.5
Top of Steel Fence Post (u) 101.6
* U.NAlt.
352' Property Line 110'
12'
N
B-4 VenNew Testing was done o
;-2 '
30' on this sight for no
Slope evidence of the first test o~
could be found. eb
Dimensions and q<
B setbacks of boring did r-
'
55' S not fit this sight.
30'
B-I
B-5 15 5'
10'
2-3'X 56' Trenches with 6' Spacing
10'
tn ~ _ li
Bedroom
303' House
Propert
Line
Garage
E
1<
247' P'ro Line New Road
To Highway 65