HomeMy WebLinkAbout026-1175-20-000
PRIVATE SEWAGE SYSTEM nIy St. Cr01X
INSPECTION REPORT Snnitnry°"n.il^°
GENERAL INFORMATION (AIIAGHTOPER'41T:, SIM,e in0No 615435
F, •r,,rT' [ on yCU otuvidc Tay de usec forseco^da'i Pu~coszz Ir'n:ayI a, s'S CA ',14m;Q
~n,it-el.ar' r.ariv JiIIa=TOWN~OF RICHMOND racelTaxn° 026-1175-20-000
Joseph & & Melissa Boumeester
.I IRJ I. r. Inrco R`d flr.~ GN ~cscripti°n 'oocU>MTOnmR, nqc bla:;
31.30.18.1420
TANK INFORMATION ELEVATION DATA
Tyn_ EIANL'FACTURE R CAPACITY STATIO`. Bs HI FS LLLV.
Septic Ba'rohr01'1,
Dosing t. BY
Aerat or. Bldg. Sees'
Ilolcirg SEW Wel
TANK SETBACK INFORMATION SLHt Oul el
'ANK TCi PIL .'.CLL B-CG. Yen: L0 h. r make ROP.D Dt nlet
ScCte D1 H::tbonl
DtI IleaderR.tar.
Ae alion Cyst. R Pe
-old rg Got. System
F mat Gracc
PUMPISIPHON INFORMATION
'utan.daCh.fer Demanc st c;o•:or
GPM
Model Nun•ra•
11111 L II r I Ct.:n LOSS Sysle'n -cac T"!H =1
roreerlain ength 7ia D'.t t°bVe
SOIL ABSORPTION SYSTEM
BEDITRENCH Yaitllh I e"]I^ No Cx Ifenches PIT DIMENSIONS %c ;?I = tz msda 1: a Liqu c :)=h
DIMENSIONS
SETBACK SYSIFNA'J P:L BLDG ,A-ELL LAKE:STRFW`d LEACHING Van.'ac:urer
INFORMATION CHAMDER OR
type QlSSler' UNIT V:,dt Number
DISTRIBUTION SYSTEM
Header'Marib d 10 s:fib,1c^ x He- S,ze " d". ;;..-ong 'Je"I I° A,, I^,aie
FIFC',SI
Larpt^ IcngIh. ]rr "rysnnq
SOIL COVER x Pressure Systems Only xx Mound Or At-Grado Systems Only
Cepth 0': er Cep:n Oref Ccpt' ^f xr S<ec¢c:5c4tletl xx `dub:h¢:
Decilrc^c- Cen:e' B"tc chE,;CS Tarsnil Yes No NO
COMMENTS: fllolude code dlscrepencies. persons present etc 1 hspechon #1 haperhon 92
Location: 1306 82ND ST
t', All Btd Descr plion
2.; Bldg sevver length =
a Mount of cove, _
Plan revrslon Recuired' Yes No
Use other side for addilional iilorrralion _
7a:e InSCPCIC• - f+ L.re Cert . N°.
i.. 710 If
i T .O, Safety and BtdarlingsDivision crawly
( X O1~
l t 201 W- Weston Ave., P.O. Btnc 7162
Mac kWn, Wl 5370 7-71 62 ~m Pemu NO~a (m be MW in try Cn.)
~ ..t 1 1.
U t 0:
- 1 S`~3s
a rardanne +Ib =VrW APof this femmOen V , Member
is required ff
unit
oh- the Deparaame of SWCty aad Prolesaprut 41- forms fm stzw wnW )'Owls we
to Project An*= rtfdff=m am ot~
m acmwrdaore with the 14ieac9 ia., s 15 Paseatd mterntntiort you pcovrde may be mod fe sexonday ermrTmg adzes)
i Z Appsir~o-- °Info?'m?~on-PleasePriat tl7nformation
o+a_xm~ std / 368 `rZ 5frr~'
I ~I~[Y Omtc'x td
et p
r Prnp,xtYOwn ,Mvtytg Ad P11 `F r /ooo
3 a 9 S - YLoramn 31. C.i$ Q
Goy. tc Oort. la 3v
t l lap Code Pbetc \tmbtr
'Plf. K_} 4 M i , N N) Y.,-N ini seetie,
It Typo of Butldmg (cheetc sU that apply) _L l:
S N: R1~EOrW
❑ t w2 Family Dwdfmg- Nmnha of Baboons I LAN Q
Stdtdivision lFmnc r
61a aD - now ► ; l,J I~ Ufa r=1j /
❑PnblicComme,.W-Deaaibe
° ❑ ~O_
❑ Slam Owned-Deacnbe Use ~1 r-f IT_- CSM Number ❑ laage of _n 1
V
Z L✓ 1 /d J t (~~Lc I1!Sklmm or 1.~rt.rvY
III. Type of Permit (Ch-, oefy a boz on Lee A_ Complete 1me B if applatame) -
} A. System I erg _ _ 0-
System System ❑ Tradmeatnioldiq? Tank Replacement Only ❑ OWc
ModiSoaoem to Exk tg SyWm (explain)
B. ❑ Pamir Rcnewai ❑ Pemm Revaiae ❑
Before 6vo,~ Ov-0ge of PlumiKr ❑ Peratii Transfer to New Lot P"C°"'mPcwm nNmmbtr aW Dore L9ucd
FV Check a9 that e t
Neat-Prtstonred tn{-mommd Preanmized tn-(;round d AlGrade UMound >24m ofmibhteW ❑-Mtmdc24 m. I
ofsmiteblc soil
- ° mn nher Dmp-i coin, ant (explain)-_ _
V- D' e,saVCt.aLnont Area lulcracatloa: ❑ P~'a1Oe (eL- -
OesiM Flow ) Drs%t Sea areadan R
ppmm Utspasat Area Remi,ed
I 4 S ~ ~ 9 (s() Disposal Area Prop
~(M SYsoam F]evatia,
Taak fefo D l t
C'spadty n Taut 9 of
Galaors Gallons Lnns Mm"m~ S
area Tam amt gTaatx C E (g °
F ~peie erxmldiag Teat ~ ~d SZ ` - ~ ~ =
_ m. n o rn s O p,
~D-MnCkamb~ iuuc kk
VII. Respotcsibility Stahemeat~a~,ea, mama, PWmdso'
_ rcsPOSSOMMY for installation of pe p01y~ skewer oa the atCried pytuv
1"1-ff -(Il a 5s F„~ndPRS Number BmsiDMA rr/m, mbrr
Plumba's ~(.Baas' Stma 7.ip Cear.) L as 4 n ' ' IS+V- 0 I 1
l o0 W * 3 N ~1 ueS ; ~t
VIII- oa F•[me.t f)se el -
wnttd ❑ Permit Fee
s
~IX. Can - Rawo for Denial ✓66 • ITS 2.6 ' `I
t. ..e. an;t appr°°al 3 t,VC
+I Ch%pdfl cell Host all
as per roarayemen! plan pro ,iaM Vv ylwnoe:.
2. All w
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SBD-6398 (R- 2181)
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CONVENTIONAL ^~}t47~GP7>_ntT DESIGN
ResidenL:ai AIyMica!i¢.r•
!NIJF-X AND TIT~L'c FA1:c
Project Name:
Owners Name: rr
OwrtEYs Adtlrzss: -
L,egol Des--nWivn' N Lv - ' ((t
~~_S 3 I T3o R
Township MCI,
_:nunry
Subdivision Name \Jv ~ 11 0 V IC ftl, CDJ
Lot Number n (
Pages ~ ittd6Xand iiNE
PeJS Z Plat ?(an
Page 3 S usm Sri , 2 L'rass }e~
Pace n Ffer
Paye., ~__fN~~ir;~eP.3l"C01r»a~naion
Page 6 'at=_nar-R ~ -
ti-ntrlan
Pane 7 st Croct Cty 5 Pkic Tank ~riair~te, nat>'cs_
Page b Form
_ ~n;arrenty Daed
Page 9 O8111 of Ral,
At6^chryreyft: Sail Tev, & !-louse PI<r-s
Dpsrr~ner/Pk.~,,; er
j~-
' ~ License tJwm&
Jate
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Technical Specifications
PL-525 EFFLUENT FILTER (COMMERCIAL)
I ~
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Pl;QSf&7ERHOU9RG i I1 t Y ♦ NM I
PPRI NO -3M OUS
YAIERIN_
HDAING-valPROCnM !j 1 F
GI1ILi BUSHNG,PVC
MALI MR i~ Ij•_~'ll
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IN
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ranalc a.u;rLnR cranmcE
PMTNQ wlasas - `
IIAIEMAI PO.IPROPnFNE V~ - 1 I ( I
S ! 9 _ y10
I 88,963 sq. ft. LOT 2
'O OG 2.42 ACRES
BENCHMARK
A ELEV. 933.7 - - L' 105473 sq. 1t.
- '-'2004E 100.00
(n i y S89-5626 W . 300-46
I~ LOT 21
x- 2.03 ACRES. \
p _ 88,202 sq. tt.. ,(p \
H F L130:,930.0
L/) \ \ y
N i 41 92113 / 4214t'. 81.7
\ 1.88
r
\ Of
0 52S
n 61 \
O m N76~ 1i \
Z. LOT 20
c 1.81 ACRES
P.®~ I ri
78.649 sq. M
Lao-9300 \ \
?~gJ9 6ENCHMAAH
' ELEV.=92951 Si
\ N `
LOT 19 N \
1.94 ACRES \ N4 N
84.295 sq. fl. 2
v I S 3t Q,
ct~i«' i ~ ~ I 2c+
LOT 18
02,075 sq. n.
w I 1.68 ACRES j `
Lao-9300
z' Al ~Vt30 &t
Di
~
X ~21
Nes 30se w
30423
SW CORNER ° I I
T. CROTX COUNTY
SEPTJC T.A NK v1A]NFMNANCE AGREEMENT
AND
OWNP.RSHTP CERTIFICATION FORM
(.h'.mer~uyer
Nailing Address "
roir'-rty Address
(b'erifitxtion ;courted fivm Planting & Zoning Uepa a br new consfiI 'on.)
C-it)JSrate &44M Parcel Identification Numb r
oa -f1
tf~ l , _
LEGAL DESCRIPTION ~ C
Q p t
Pro tcrty Location ~1 i'/•. ~i I!.) , See// l
C. I. T N R V Q, Towu of M G 1V f.~1
l~ Vf p
tiuhdivision Plat. i 1~ OW _ ; Lot
b_:ertified Survey Map _ Volume Page # _
'Warranty Dcrd #I (before 2007)Volume , Page k
Spec howst C yes D no Lot lines idenrfiable i i yes Ll no
SYSTEM DRAT MNANCE ANN? OW,R'ER CERTIbICATION
improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
,maintenance ccrosists of primping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
.?w system can affect the function of the septic tank as a trcau lent stage in the waste disposal system. Owner maintenance
n:sponsihilitirs are specified in §Comm. 83.52(l) and in Chapter 12 - S± Croix County Sanitary Ordinance.
1'he propciTy owner agrees to suhmit ro St. Croix County Planning Zoning Department a certification form, signed by the
o,rane- and by a master phtmber,joumeyman piurrtbm restricte-i plumber or a licensed pumper verifying that (1) the on-site
wasiewmer dis:wsal system is in proper- operating condition and/or (2) after insp=ion aid pumping (ifnrcesszry), the septic tank is
ws:: than 1/3 frill of sludge.
1/we, the =dersiened have. read the above. requirements and agree to maintain the private sewage disposal system with thr
smn.iards set forth, herein, as set by the Department of Commerce and the Deoarin en;. of Natal Resources. State of Wisconsin.
Certification sting dust your septic.sysiern has been maintained must he rnmpleted and returned no rbe St Croix County Planninc R
nning i)enartment within 30 days of the gcec year expiration date.
Vive certify that all sudem n's on thi rot arc -nit m the best of cryV/nor inrowtvAge. Dwe. am/arr eye owcer(s) of thr
P-?--'n' described above, by virtue of a w ty deed :-VWTdr_f: in Pepistrr of Deej. O'ficc-
Nnmbb f bed oms 3
s~ - -
CNAAF F API T IC kTj' S) 7 - .-11
i, DATE
'"Any informatirnr Uttar is misrepresM Ued may result in the sanitary permit being revoked by the Plantung & Zoning Department.
1:,..!mac -Ah this application a recorrlce war-anry deed from tine Register of Derck Office and a copy of the eewtificrl survey map ii
is made in thr waranty deed.
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of3
Division of Safety and Buildings
in accordance vrith Comm 85, Wis. Adm. Code n ~
Canty S Y • L r /
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 62 -7 S- )_6 .
percent slope, scale or dimensions, norm avow, and location and distance to nearest road. / J
Please print at/ information. R 'awed by Date
Personae iMWnmllon you provide may Oa used for secondary purposes (Pmact Law. a- 15.01(1) (m)).
Property Owner . / Property Lo cation
t'j'i _j 114 S• T jt~ N R E( W
tf,CXi.(:?t `J Lot rjtwo 1/4
CSMA
Fopedy Owners Mailing Address Lqt Block p SubdNang~~or
to 1 11 ^u LL fl I ~ G-
City Late Z4) Code Phone Nu beir ❑ City ❑ Vdpla9 e ;KIT Nearest Road
L Chi < Xal /71
( ) L.'6
New Construction Use: CgResidential / Number of bedrooms Code derived design flow rate GPD
❑Replacement ❑ Public or cormleraal - Describe:
Parent material 0(J-t' <J Flood Plain el vation if applicable ~L~ ft.
General comments [I ~ I O I
•~i c~ ,,,i e- hi ~7c-~1^~ I Q (i
and recommendations: .J
Boring N L ~
T F I Pit Ground surface elev. r ft. Depth to Bnuting facto in.
Sol Rate .#-I
Horizon Depth Dominant Color Redox Description Texture Structure Consistece Boundary Roots GPD1fP
M. Munseit Qu. Sz. Cont. Color Gr. Sz. Sh. 'ERNt 'Eff#2
9l S
1,;1" J
I
a+ 9 a
3v / -z
Bourg # 0 Boring
• Pit Ground surface ale. ft Depth to limiting factor Sod iption Rate
Roots GPDM
Horizon Depth Dtxnirmarml Color Redox Description Texture Structure Consistence Boundary
in. Mmmsell Ou. Sz. Con. Color Gr. Sz. Sh. 'Ef #l 'Ef #2
e e,4
? - ~c n,. onto C S Zr2j (p
t_
1 w,4? le y c ~ ~ I r 2 z
34 z-/73 2-
Effluent tit = BOD > 30 < 220 mg/L and TSS >30 c_ 11 ,2& ' Effluent #2 = SOD < 30 rngfl and TSS < 30 not
CST Number
no Please Address Date Evaluation Conducted Telephone Number
1,~V) /%lt~X ~e i P ! ti < c~Cc~ YO) 7 /a ^ -,z. % yv/
Property Owner Parcel ID # Page of
a Boring O Bonn9 l t.
I% pit Ground surface elev. _Z ft Depth to timing facto in. Soil Application Rate
Hoizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GPDIff
in. Munsea Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
'-I1 lu /z - Zr r rti~r~ < zfrl
Z 12 / _ L k ~l _ z 3 z
❑ Boring # ❑ Boring
❑ Pit Ground surface elev. ff. to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDrff
in. Munsell Ou. Sz Cont. Colo Gr. Sz Sh. 'Eff#1 'Ef#2
F Boring # ❑ Boring
❑ Pit Ground surface elev. R. Depth to limiting fader _ in.
Soil Application Rate
Horizon Depth Do ninant Colo Redox Description. Texture Structure Consistence Boundary Roots GPOM
in. Munsea Ou. Sz Coo. color Gr. Sz Sh. 'Eff#l -092
Effluent #1 = BODE > 30:< 220 nxyL and TSS >30 1150 rng1L ' Effluent #2 = BODr < 30 mgfL and TSS 130 nxyL
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 TI'YY 608-264.8777.
9{U UIO(1be01
i
Soil Test Plot Plan
Project Name David Railsback Shaun
Address 845 133rd Ave
New Richmond Wi 54017
CSTM #226900
Lot 20 Subdivision Date 12/12/02
SW/NW 1/4SW/NW1/4S 30/31 T 30 N/R 18 W Township Richmond
❑ Boring 0 Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Survey Iron
System Elevation 101.4,•'98.9' *HRpSame as Benchmark
All. 13M Top of Steel Fence Post (v 104.0'
445'
Property
Line
Please Vote: Tested area may not be
suitable fordesired building area.
Chuck system location before 40'
427' excavating. Soil test was done to satisfy
Zoning Requirement. 3-2
property
Line 120,
30'
B-3
9
Sh
B-1
I)3' 102'
104'
220'
Properly
- - line