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HomeMy WebLinkAbout014-1053-40-200 Wisconsin Dso <trtment of Commerce County: ��., PRIVATE SEWAGE SYSTEM St. Cr oix Saaty and Building Division INSPECTION REPORT Sanitary Permit No 499125 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: City Village X Township P I T x No Anderson, Russell & Carol Forest, Town of v14 — 105 40 CST BM Elev: Insp. BM Elev BM Description: Section!TnwnfR� r .lap Nn 25.31.15. 1 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER s CAPACITY STATION BS HI FS ELEV. 7. Septic _',� g Benchmark I'eSe�_ /606 to `� /d( - _f/ Dosing Alt BM s 7. 6 99. 8Z a AsK2tien Bldg. Sekv Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet p `+ Se tic � 5� I 33 1 / Dt Bottom �' JV � Dosing 75 N 33 j 3 1 Header /Man. Aeration Dist. Pipe 3. / ,c Holding Bot. System 3. g 163 Final Grade PUMP /SIPHON INFO RMATION Manufacturer DP and St Cover/ J 7-W 9cy $Z d 1 ' `J Model Number TDH Lift Friction oss Sys em Head TDH Ft 3.Z Forcemain Length Dia. /i Dist. to Well Zoe_ 1 L J SOIL ABSORPTION SYSTEM BED /TRENCH Width i Length No. 0 renc s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth t_ \ DIMENSIONS $O e SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Typ f Syste ' 7 5 /1 / / . J� ; U W UNIT Model Number / I I 0 +.. J Dt..) V DISTRIBUTION SYSTEM Eapb Header /Manifold � Distribution / II �/ /� x Hole Size x Hole Spacing Ver�t.[o Air Intake Pipes) i1D 1 1-ength _34 Dia Length T Dia t Spacing 3 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only 1 :xx Mulched Depth Over // Depth Over xx Depth of dded Seeded /So Bed/Trench Center Bed/Trench Edges Topsoil I 4 Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 16 / / O( 0. Inspection #2: 1 / 0 ( , -- Location: PENDING Un own (SW 1/4 SW 1/4 25 T31 R1 5W) NA Lot 2 , Parcel No: 25.31.15. 1.) Alt BM Description ='�` Ca✓ e " G1� ^� �-- �`� J � 4m 2.) Bldg sewer length 5 � 1-.o IBS 3 amount of cover = 3 3 1 7 -7 5 7 7 � 7( FO Plan revision Required? I % Yes I ` No Use other side for additional information. - - -- - Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) to C-e . i. Safety and Buildings Di n County ` 201 W. Washington Ave., P. x 7 2 S (-/'Q �O��l�� Madison, WI 53707 — Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608)266 -31 1{Ig1zs Sanitary Permit Application Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, person /3Z) 6 = S . �Q• may be used for secondary purposes Privacy w, SIR Y _ Project Address (if different thane mailing address) 1-"t I. Ap lication Information — Please Print All Information � 1 ? 006 3 !a S+• p wG 2 1 2 Properly Owner's Name Parcel # Lot # Block # A 5d�ROIXCOUNTY Property Owner's Mailing Aidress Propertoocation 2 / ' /., S41 Section City, State Zip Code Phone Number . ..(circle II. Type of Building (check all that apply) � / �/� (� T,J_g) RE tt .� r fwlr✓vK�� s'rabdivisioerl'imne l$1 or 2 Family Dwelling- Number of Bedrooms ❑ Public/Commercial - Describe Use ❑ State Owned — Describe Use u ` % ❑City_❑ Village Township of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T ype of POWTS System: Check all that apply I .0 5&,14 ❑ Non - Pressurized In- Ground > i s itsbfi� oil Mound < 24 in. of suitable so' ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Jeime ❑ Gravel -less Piix er (explain) V Dis ersaL/Treat Area Information: K M = 02 Design Flow (gpd) Design Soil Application Rate(gpdst) Di s 5 �[ Area Required (sf) Dispersal Area Proposed (sf) System Elevation r 0 , © 752). �(. OC,a.�I ! �6 v . (o VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank al / r! ( l pe `a Y r fi Aerobic Treatment Unit ✓1 r Dosing Chamber G r k VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print ), Plumber' Signature VM S Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) :3- s k1111 1 Y )b/1 VIII. County !De artment Use Onl A pproved ❑ Ls pre re Sanitary Permit Fee ncludes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) e teen Reason for Den' Z �j IX. Conditions o pr v easons for Disapproval SYSTE R: 3 ) IV. 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained 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 81/2 111 inches in size SBD -6398 (R. 01/03) N ANDERSON SITE PLAN SW- SW 25- 31 .15W 310TH STREET TOWN OF FOREST W E ST. COUNTY, WI (Duane Hill Subdivision - lot #1) PARCEL DESCRIBED AS 2.0 AC. S SCALE 0 20 40 (UNLESS SHOWN OTHERWISE) WILLIAM J. BERGH WISCONSIN CERTIFIED SOIL TESTER DESIGNER OF ENGINEERING SYSTEMS CUSTOMER ID 227819 PLACE UPSLOPE EDGE OF CELL ALONG FLAGGED 102.00' CONTOUR L ` --0 #z #1 ° o ° 80.0'X 6.0' DISTRIBUTION CELL ( 0 WITHIN A MOUND COMPONENT ° 41 #3 -30' - 4" ASTM PVC. ( // BUILDING SEWER LINE ILLLLLL I L L L L L Q 1 SO'- 2" SCH 40 PVC FORCEMAIN 1 L PROPOSED 3-1311 I (must drain back to pump tank) 1 BUILDING SITE ! L i_ i_ i_ ; (� ILLLLLI ll I_L_.t I_j HUFFCUTT MODEL 1000/600 SEPTICIPUMP TANK (w /approved outlet filter) BUILDING SEWER MUST COMPLY WITH COMM 82.30 WAC (11)(C) LOCATION OF WELL MUST COMPLY CO WITH WDNR CHS. NR 811 & 812 3ENCHMAR7K ELEVATION = 100.0' • top of iron pipe OCATION OF SOIL BORING(S) - OCATION OF SOIL PIT(S) 40 APPARENT COMM 83.43 SETBACKS )ESCRIBED LOCATION OF LOT LINE OCATION OF RIGHT -OF -WAY 'ENTERLINE OF DESCRIBED ROAD PAGE 3 OF 1 r Safety and Buildings coftl'1I11B= v PO Box 7162 i� MADISON WI 53707 -7162 M TDD #: (608) 264 -8777 t scon s' n www.commer is wn sin. ov of Com meme www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 01, 2006 CUST ID No. 227819 A77N. POWTS Inspector WILLIAM J BERGH ZONING OFFICE GEO TECH ST CROIX COUNTY SPIA 2667 113TH ST 1101 CARMICHAEL RD CHIPPEWA FALLS WI 54729 -6575 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/01/2008 Identification Numbers Transaction ID No. 1307164 SITE: Site ID No. 716299 Russ Anderson Please refer to both identification numbers, 310TH St above, in all correspondence with the agency. Town of Forest, 54012 St Croix County SW 1/4, SWIA, S25, j73 IN, RI 5W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1089537 Maintenance required; 450 GPD Flow rate; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This sysfw is to to p . and looted in wconlance with the enclosed approved plans and with the comp0001t 1n=U i(s) relia+ d'a e• The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders i • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD - 10691- P(N.01 /01). • The pressure network is to be constructed in accordance with publications SBD - 10706- P(NOl /01) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ". 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. l r - WILLIAM J BERGH Page 2 8/12006 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Duane R Steiner Wastewater Specialist, Integrated Services WiSMART code: 7633 (608)235-0609, W 7:154:00 pm dsteiner @commerce.state.wi.us cc: Glen Pelke Plbg Htg & Well Drilling Inc (Plans Mailed To) Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 I TOM SOIL TMWASEMDEMNEmm P roudly Serving the C hippewa Malley Since 1994 i e c h -" . COVER SHEET Collditionally RUSS ANDERSON A PP R OV 1 909 310` Street — Glenwood City, WI 54013 pEPAR7MENT Of COMMERCE � 9� pi y 1S►0N Of SAFETY AN') ► L O 91�UND COMPONENT —USING EZFLOW LEACHING UNITS NDENCE Reference Component Manuals SEE CORRES pressure Distribution Component Manual SBD- 10706 -P (N.01101) -version 2.0 Ring Industrial Group — EZflow Mound Component Manual f Y! Job Location: 310 STREET SW %4, SW Sec. 25 T 31 N, 15 W ys Town: FOREST County: ST. CROIX Designer's name and license #: William J. Bergh (License No. 1577 -007) I the undersigned state that these plans were ' ned and sub ' ed under my author�fy. Designer's signature: '� , 1 Designer's address: 2667113th St ,7 '.••• G ••• o"fj" Chippewa Falls, WI 54729 r••��yIy4.,3 Designer's phone number: 715- 723 -5555 voice 715 - 723 -7535 fax ? : IL AM J. 715 - 577 -6838 cellular o BERGH Z soiltesting(-@charter.net email I . .,���•'� '4 YONAL O .•' Contents Page 1 cover sheet Page 2 system calculations Page 3 site plan Page 4 cross section of EZflow mound component Page 5 plan view of EZflow mound component & distribution lateral schematics Page 6 EZflow manufacturer specifications Page 7 septic & pump chamber schematics Page 8 manufacturer pump curve Page 9 maintenance /management & contingency plan Page 10 maintenance /management & contingency plan 3667113th St. • Chippewa Fells, W1 36729 LOCAL.' (715) 723 -5555 FAX: (715) 723 -7535 w w w. g e t t i n g dirty. c o m Page 1 of 10 SYSTEM CALCULATIONS USING HUFFCUTT COMBINATION TANK residential dwelling with total of 3 bdrm calculated at 450 gpd design wastewater flow LLR (linear loading rate) 5.6 gal /day /ft DLR (design /soil loading rate) 0.6 gal /sgft/day 750.0 effective basal area depth to limiting factor 17 inches system area cross slope -11% percent forcemain length 150 feet using 2 inch - SCH 40 PVC manifold and /or header length 3.0 feet using 2 inch - SCH 40 PVC forcemain volume 24.5 gallons length of each lateral 40.000 feet using 1 1/2 inch - SCH 40 PVC total number of laterals 4 invert elevation 104.10' (bottom of lateral). orifice diameter 0.1875 = 3/16 tenths /inches 103.60' system elevation distance between orifices 24 inches or 2.00 feet total orifices per lateral 20 total orifices all laterals 80 lateral volume (each lateral) 3.68 gallons 13.20 lateral discharge rate system discharge rate 52.8 gallons calculated at 3.25 distal pressure x 1.3 ft. vertical lift 15.0 feet friction loss in the forcemain 8.3 _ feet calculated at 52.8 gal /min discharge rate TDH (total dynamic head) 26.5 feet minimum pump discharge 52.8 gpm at 26.5 TDH (total dynamic head) pump manufacturer ZOELLER model number 140 estimated total dose volume 98.1 gallons 80.1 actual dose (total - forcemain) pump tank model 600 actual tank size 627 gallons septic tank model 1000 actual tank size 1029 gallons manufacturer of tank(s) Huffcutt pump float on /off measurement 7.0 inches alarm float from bottom of tank 19.0 inches �� Q 2 O Page 2 of 10 N ANDERSON SITE PLAN SW- SW 25.31.15W 310TH STREET TOWN OF FOREST ST. COUNTY, WI w E (Duane Hill Subdivision - lot #1) PARCEL DESCRIBED AS 2.0 AC. S SCALE 0 20 40 (UNLESS SHOWN OTHERWISE) WILLIAM J. BERGH WISCONSIN CERTIFIED SOIL TESTER DESIGNER OF ENGINEERING SYSTEMS CUSTOMER ID 227819 PLACE UPSLOPE EDGE OF CELL ALONG FLAGGED 102.00' CONTOUR -.d #2 #1 ° 80.0'X 6.0' DISTRIBUTION CELL WITHIN A MOUND COMPONENT ° ° (102) #3 �TCOMpq T�S•9pp � /`l.. -30'- V ASTM PVC BUILDING SEWER LINE 1 L_ L_ L_ L_ Lr L I L_ L< L_ L_ L_ O 150'- 2" SCH 40 PVC FORCEMAIN 1 i PROPOSED 3-BR I (must drain back to pump tank) I BUILDING SITE I L< L_ L_ L_ L I I 1L.. -J— I <J--J_LJ R HUFFCUTT MODEL 1000/600 SEPTIC /PUMP TANK (w /approved outlet filter) BUILDING SEWER MUST COMPLY WITH COMM 82.30 WAC (11)(C) LOCATION OF WELL MUST COMPLY WITH WDNR CHS. NR 811 & 812 9 BENCHMARK ELEVATION = 100.0' - top of iron pipe o LOCATION OF SOIL BORING(S) LOCATION OF SOIL PIT(S) k NO APPARENT COMM 83.43 SETBACKS D DESCRIBED LOCATION OF LOT LINE D LOCATION OFRIGHT-OF_ AD PAGE 3 OF 10 CENTERLINE OF DESCRIBED ED ROAD EZFLOW MOUND COMPONENT CROSS SECTION (typical) 4" OBSERVATION PIPE >12" SOIL TO PROMOTE SUITABLE PLANT GROWTH DISTRIBUTION CELL 1 1 SYNTHETIC MATERIAL DISTRIBUTION LATERAL(S) INVERT ELEVATION = 104.10' >12" UNDISTURBED Is "I I6" I SOIL & VEGITATION CAP � 1211 19" 26.9 LEVATION = 102.00' ASTM C -33 6" fill material PLOWED/TILLED AREA 1.1 5.8' 6.0' 14.7' 2.3' 29.9' EZ1203H (10' length size - 30 sq. ft per product) 20 EZ1203H (5' length size -15 sq. ft per product) NA CUBIC YARDS OF SAND (minimum) 180 SYSTEM AREA SLOPE - 11% SYSTEM AREA LONGITUDINAL (long axis) SLOPE NA ALL MATERIAL & PIPING SPECIFICATIONS AS PER THE EZflow MOUND & PRESSURE DISTRIBUTION COMPONENT MANUALS DRAWING NOT TO SCALE PAGE 4 OF 10 PLAN VIEW OF EZflow MOUND COMPONENT (typical) Yp ) * All piping & material specifications per the EZflow Mound & Pressure Component Manuals 6.9 ' -10, UNIT DISTRIBUTION CELLS FORCEMAIN /MANIFOLD 3.0' �(` I F DISTRIBUTION I`( 6.0' [ -�.... LATERAL(S) I- 1.5' 29.9' OBSERVATION PIPE(S) 17.0' per Table 3 - EZflow Mound Manual 8.7' . 80.0' I 8.T 97.4' Distribution laterals terminate at the end of the distribution cell Access box covering threaded plug at the end of each distirbution lateral EFFECTIVE BASAL AREA Ii {) DISTRIBUTION CELL EZflow COMPONENTS DISTRIBUTION LATERAL (typical) * All discharge orifices are located per the EZflow Mound Component Manual <6" final grade final grade <6" threaded cap 11/2" DISTRIBUTION LATERAL threaded cap access box access box 2" FORCEMAI N/MAN I FOLD 39.0' � I 24" 24" 12" X/2 X 78.0' last orifice(s) are located 12" from end of cell Discharge orifice diameter 3116 = 0.1875 X/2 spacing 12" Number of orifices per lateral 20 X spacing 24" Total number of orifices (all laterals) 80 ORIFICES MUST BE LOCATED IN A (4 UP -1 DOWN) SEQUENCE (DRAWING IS NOT TO SCALE) PAGE 5 OF 10 EZ1203H v° ° - -_ _ - °o °v °v° °v °v°°° _ ° °v°°°° vvvvvvv °° _ - - °v° °v °v _ v°° 12„ vOV - ' -3.. - - - °°v vVV d - �!. V Vv 24" °v° _ - _ _ V °v vvv ovo vv° 4.625" o00 - � °°° ovo 1/2 Circ. = 18.84" vvv vvv vvv V vvv vvv ovo v vvvvvvv vo vovvvoovvvvo vvvvvvv ovvvvvv v vvvvv ovvvvvv ovvvvvv vvvvvvvw vvvvvvvVVVVVVV VVOVVVV V VOVVVV VVV - - - vvvvvvv vvvvvvv 24" Bottom 36" 12-1/2" DIA. (typ.) Void Volume Soil Interface Area In. to Ft. Sic Ft Void Coefficient in Aggregate given at 57.4 %. Sidewall (2 Sidewalls) 2 * 18.84in - 3,14 O.D. of 4" pipe = 4.625 inches 12in lft Void volume per linear ft. = 3 - 14 * r 2.3125in 1 * 3 Bottom P l J Ift= 0.117ft 2.00 12in /ft Total Soil Interface Area 5.14 SQ.FT O.D. of center cylinder= 12.5 inches Void volume in aggregate of center cylinder= 3.14 6. in 25m 3125i 2. n /fr n l 2 1 * ( 12 / _ 3 * l / JI s 574 = 422 ft /ft l l 12i l O.D. ofoutside cylinders = 12 inches Projected Trench Area ` Void volume in outside cylinders = 2 * 3.1a( bin J Z *.574=.901 ft' Sidewall Height = 12 in. *2 ° 2.00 Sq.Ft. ll 12in / ft 11 Bottom = 36 in. = 3.00 Sq.Ft. 24in 6in l 6in l z Void volume at bottom between cylinders = ( 12in /ft * 12in / J - in /ft (3.14( J JJ = 0.215 ft' Projected Trench Area = 5.00 S Ft. fl l \12 JJ q Void volume at outside bottom corners (1/2 of void volume between cylinders) 0.215 / 2 = 0.108 ft' Total void volume = 0.117 + 0.422 + 0.901 + 0.215 + 0.108 = 1.763 cubic ft / ft Gallons per ft = 1.763 X 7.48 = 13.2 eallons per linear ft. EPS Aggregate Trench System EZ1203H IMAL OW Ring Industrial Group 65 Industrial Park Rd. Oakland, TN 38060 SCALE FlLE NAME FZ1203H -vs1 SHEET: 1 of 1 11 -27 -01 4 INSPECTIONS Inspections shall be made by a person carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule) ✓ Septic Tank Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks of leaks, measure the volume of combined sludge and scum and to check for any backup or surface discharge of effluent. Access openings used for service of assessment shall be sealed and /or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental of unauthorized entry into the tank. The outlet(effluent) filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank during cleaning. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating properly. ✓ Pump Chamber/Treatment Tank(s) Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must me made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. ✓ Mound, At- Grade, In- Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Additionally, due to the excessive slopes, the toe of the component must be inspected a minimum of once annually for seepage. Refer to the "reports" section of this agreement for filing requirements. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. All piping to tanks and pits shall be disconnected and the abandoned pipe opening sealed. The contents of all tanks and pits shall be removed and properly disposed of be a Septage Servicing Operator. After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system. o A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure(s), lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. o A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. o The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ✓ 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. WARNING SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OF OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. Page 10 of 10 i Wisconsin Department ofCommerce SOIL EVALUATION REPORT Page 1 of 3 Dfvision d? Safety and Buildings in accor ce with Comm E ouMy St. Croix Attach complete site plan on paper not less than i si an u include, but not limited to: vertical and horizontal reference point ection and Pie( D. pending percent slope, scale or dimensions, north arrow d di nce t UTjregt rya to J1 `u Reviev by Date Please print all irlfor�"atioil. Personal information you provide may be used for secondary purposes (Priva Law,S'hSWAj"QU TY Property Owner • Russ and Carol Anderson Govt. Lot SW 1/4 SW 1/4 S 25 T 31 N R 15 E (or) W Property Owner's Maifing Address Lot # Block # Subd. Name CSM# 1909 310th St aZX Duane Hill City State Zip Code Phone Number sty Q ViRage ■ Town Nearest Road Glenwood City I 310th St. ty ( ) 0 •' New Construction Use[D Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD 0 Replacement 0 Pubic or commercial - Describe: Parent material Loess over bedrock Mood Plain e levation if appROA-ble ft. General comments This site is suitable for a mound system and recommendations: Bedrock being the dominant controlling factor Boring Boxing i i j 24 _J El Pit Ground surface elev. 102.13 ft. Depth to smiting factor L. r* A Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft? in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#2 1 0 -8 1Oyr3/2 sil 2msbk mfr as 2.6 .8 2 8=24 sil 2lilsllk ^' cw l f .6 .8 1U 4/4 6 3 24 -28 1Oyr4 /4 ftt7•syrsts sil lmsbk mfr cw if .4 4 28 -40 10yr5 /6 M7.5yr9g sicl lmsbk mfr _ - .2 .3 2 gig # Boring 106.35 17 Q Pit Ground surface elev. ft Depth to limiting factor in. Soil Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *EGPD Eff#2 in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -8 10yr3/2 sil 2msbk mfr as 2f .6 .8 2 8 -17 1 4l4 sil 2msbk mfr cw if • .8 3 17 -30 Bedm I i Effluent #1 = BOD > 30 220 mglL and TSS >30 < 150 mg/L ` Effluent #2 = BOD <_ 30 mg/L and TSS _< 30 mg/L CST Name (Please Print) Signature '" CST Number Thomas C Nelson �''�'"�- `— 227387 Addr ess Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, Wl 5/15/06 715 -246 -2454 I ' Russ Anderson Lot 1 f'= NE lot corner 106' 10 82 102' 100' 98' 17 °° atop ■ BM2 r Scale 1" 40' BM1 Top of iron pipe 100.00' BM2 Top of iron pipe 101.25' , 81182.13 82106.35 8398.85 64101.90 Thomas Nelson 227387 i Aug, 9, 2006 4:23PM No, 2763 P. 1 ORIGINAL REC ST. CROI[X COUNTY EI VED SEPTIC TANK MAINTENANCE AGREEMENT AND AUG 5 2006 OWNERSHIP CERTIFICATION FORM ST. CROIX COUNTY Owner/Buyer ca V Mailing Address Property Address 103 3j� rr�� (Verification required from Planning Department for new construction.) City/StateTU vm4 W t Parcel Identification Number LEGAL DESCRIPTION Property Location y-, '/. , Sec. _Z5 T � R - 6W, Town of � Subdivision , Lot # Certified Survey Map # , Volume z , Page # Warranty Deed # 1—Ad (C7 , Volume , Page # Spec house yesxno Lot lines identifiable yes no SYSTEM MAINTENANCE - Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix County Zoning Department a certification foam, signed by the Ammer and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning T y = 0 X ( ;3 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION . I /we certify that all statements on this form are true to the best of my /our knowledge. I/we am/am the owncr(s) of the pr des 1 . 4 ve, by virtue of a warranty deed recorded in Register of Deeds Office. I NATURE OF APPLICANT DATE 0000 Any information that is misrepremted may result in the sanitary permit being invoked by the Zoning Department. 006 Include with this application a stamped warranty deed front Ae Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Z r-A / QAa r a V ,so-is F b• 3 A lk ` V � �R 1�+ • p L! 9 Q' �Cb g _ I -Gi l N UM) l 'd ' °N AV S :6 9002 '8l '$nd STATE BAR OF WISCONSIN FORM 3 - 1998 d -3 0 1 0 3 QUIT CLAIM DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Number ST. CROIX CO., NI - — =- - -- - RECEIVED FOR RECORD This Deed, made between Du N Hill and_ 07/20/2006 03:45PM [ - ' Judith - A Hill, husband and wife _ QUIT CLAIM DEED '_- — Grantor. DLEMPi R G .and Russell J Anderson and Carol L Anderson REC FEE: 11.00 Husband and Wife Survivorship Marital Property TRANS FEE: COPY FEE: _ CC FEE: Grantee. PAGES: 1 Grantor quit claims to Grantee the following described real estate in St Croix County. State of Wisconsin: R.c-di,,2 Area Name and Realm Address C -- TIMOTHY T SEMPF C/ 1 �NOVITZKE GUST SEMPF & WHITLEY 314 KELLER AVE N #399 I� AMERY WI 54001 Part of 014 - 10 5_3 -40 -100_ Parcel Identification Number (PIN) 1� This _SS not homestead property. 1 (Is not) �f Lot of Certified Survey Map recorded in Volume 21, Pale 5�23�8 as II ocu nt No. 829,511 and located in the Southwest Quarter of the 4o`uEhw s u er er ection 25, Township 31 North, Range 15 West. Together with all appurtenant rights, title and Interests. f Dated this 19 day of ...8�• (SEAL) _ --mot" (SEAL.) J Duane N Hill Judith A Hill - -- - -- � (SEAL} (SEAL) 9 AUTHENTICATION ACKNOWLEDGMENT Signature(s) Dua N Hill and State of Wisconsin, Judith A Hill ss. County. authenticated this 1 day of O g.( Personally came before me this day of the above named Timot T Sempf TITLE: MEMBER STATE BAR OF WISCONSIN to (If not, me known to be the person who executed the foregoing authorized by §706.06, Wis. Stats.) Instrument and acknowledge the same. i THIS INSTRUMENT WAS DRAFTED BY ._ Timothy T Sempf #1019141 NOVITZKE GUST SEMPF & WHITLEY Notary Public. State of Wisconsin Amery WI 54001 My commission is permanent. (If not. state expiration date: (Signatures may be authenticated or acknowledged. Both are not •} necessary.) Ne,..ea of P-- signing In any opacity muu 6e typed or Prtnted below STATE BAR OF WISCONSIN Wisconsin Lapel != .. Inc. it t W JT CLAIM DEED FORM Ne. 9 - 1998 M'N'a. I l FORM NO. 985 -A 31 y P.i.t 6..i......... 8 C EO 5 I I Stock No. 26273 VOL 21 PAGE5238 KATHLEEN H. WA'L SH REGISTER OF DEEDS RECEIVED FOR CERTIFIED SURVEY MAP 0 '1 /13/2006 08:00AM VOLUME 21 , PAGE 5238 C URVEY „AP R FEE COPY FEE: 3.00 PART OF THE THE SOUTHWEST QUARTER OF THE PAGES: 2 SOUTHWEST QUARTER OF SECTION 25, TOWNSHIP 31 NORTH, RANGE 15 WEST. TOWN OF FOREST. ST.CROIX COUNTY West 1/4 Corner LOT 2 _ Section 25 - 31 - 15 '1 Set Survey Mark Nail 218,901 sq.ft. 208,039 sq. ft. c°. � _ per found ties 5.03 acres 4.78 acres •'" incl. r -o -w not incl. r -o -w warn c1i ; v N W UNPLITTED I NW corner ::9 S89'00'25'E 1331.78' LANDS SW/SW I 1 S89'00 "E 665.89' ( NW /SW � NE /SW I rl 101• 632.88' S89'00'25 "E 665.89' SW /SW SE /SW sod t ests z LOT 2 w l ale ; 8 0 OWNER: 1 CA IN ' u m Duane & Judy Hill ioj it 1909 310th St 632.56 Glenwood City, WI N89'03'28 "W 665.57' �t7 (.nl I 133.OP I I N 8 i8 I ' I , setb0cg line $ PREPARED FOR: 1v w k I� o OC/TL OT �, Russ & Carol Anderson `; 1,311,719 s ft. 1,228,566 ft. o :9 1;d I ' q s 4 ' N m I I 1 30.11 acres 28.20 acres 0 UNPLATTED I incl. r - o -w not incl. r -o -w p - __ - LANDS I I 1 (401.42') _ 1 33.01' 401.37' Centerline /� 434.38'(434.43') 1 pog N89'12'13 "W c` DRAFTED BY: (188'43'03'E) U Joel A. Brandt I~ - ^' JB SURVEYING LLC I C p Lot 1_CSM N ^, I° o °' 966 Rustic Rd 3 w Vol. 11, Pg. 3086 t existing field Glenwood City, WI entrance 1� c building setback line SE corner _ _IN N89' 0 SW/SW ' (434.43') f 3') [� 5.01 I cr 75.01 1329_19' - J ,1 -- S89'11 2'38"E oo N89'12 "W to 894.79' S89'12'38 E (N88'43'03'w) c Q O Southwest Corner — _ — — „ — ;,— — — — — — — — — — — — — — — — — —t — — ' South 1/4 corner Section 25 -31 -15 STH — 64 " 2658.38' Section 25 -15 Found concrete nail (N88'43'03'W) (2658.469 Fd 3/4' iron rebar replaced w /Survey Mark Nail UNPLATTED LANDS Note: Each parcel on this map is subject to State and County laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and Town Board for advice. Note: Outlot 1 is to be used for agricultural and recreational use only. No building development is allowed unless resubmitted for approval as a "lo " LEGEND 1 p r ; ' JOK A. •` Q5 .........Government Corner (as noted) Set 3/4 "x 24" Iron Rod weighing T • 1.502 lbs. /lineal ft. M Found 1.25" Iron Pipe SP to North 1s referenced to the West line of the Southwest `�- Quarter of Sec. 25 -31 - SCALE: 1" = 300' (p which bears N00 °13'52 "W (St. Croix County Grid System) 0' 300' 600' Page 1 of 2 1 of 2 Vol 21 Page 5238