HomeMy WebLinkAbout026-1147-19-000 Wiscrns n Department of Commer PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division 1'
INSPECTION REPORT � . sanitary Permit No: 429905 0
GENERAL INFORMAT1 � for (ATTACH TO PERMIT) -jy'7O State Plan ID No:
Personal information you provide may be secondary purposes (Privacy Law, s.15.04 (1)(m)]. 851(,3b : Tem p ,
Permit Holder's Name: City Village X Township Parcel Tax No:
Oeverin , Ken Richmond Township 026- 1147 -19 -000
CST BM Elev: Insp. BM Elev: BM Description: Sectionrrown /Range/Map No:
BVA# ( wQ,e s u0¢aQ 24.30.18.1077
TANK INFORMATION ELEVATION DATA rs (rr+
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
1�•i `mss
Septic ww
' �� Benchrpar4- r
,d�h..�
Dosing � (<5 � � Alf. BM
Aeration Bldg. Sewer G qj 4
Holding St/Ht Inlet
�•�,3 q3. S
TANK SETBACK INFORMATION St/Ht outlet �•
92 93.3/
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet �• ' Z -1,3, 12 /
Septic I Dt Bottom y, /
Dosing f / Header /Man.
Aeration Dist. Pipe T• °)b 8• zy
Holding Bot. System S.(-jo /
.� 9 .bo
PUMP /SIPHON INFORMATION 'Final Grade q `
( — . u he 12 -t -- a. 1
Manufacturer Demand St Cover
GPM
Model Number -A�-�
Q' T Lift Friction L System Head TDH i Ft
• .Sv 3. I os 3.25 3.a
Forcemain Length I Dia. 2 It Dist. to well ` C1 4•
3•Z`� 6o
SOIL ABSORPTION SYSTEM
TJk1ihlChh' Width / I Length 2 l INo. Trariet+es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 5,sp Q
SETBACK SYSTEM TO C7 P/L J BLDG WELL LAKEISTREAM LEACH �ModelNumber:
INFORMATION CHAMBE
Type Of System- 1 .4 �a / a r �_ UNIT
rrl [— (o
DISTRIBUTION SYSTEM LA --y L-V-{p trot. -be •L '•
Header /Manifold t Distribution V x Hole Size I' x Hole Spacing Vent to Air Intake
/
Length ? Pipe(s) Dia l l-ength _q o 'Z / Dia 1 1 Spacing 2 }S 3m 2 -
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 Topsoil
�1 a Yes U No [ Yes �'] No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: �l Inspection
Location: 1491 142nd Street New Richmond, WI X 54017 (NE 114 NW 1/4 24 T f0NN R18W) Rich m n d Meadows Lot 19 Parcel No: 24
1.) Alt BM Description = o
Q Cash' (r�6c -5 �{�4Q,.�Q. k -1� 6��f- :�t9�► -
2.) Bldg sewer length
3 - amo of cover Z,rf.`� c
Use other side for additional information. .��' Z Z
Plan revision Required? :' Yes No -
to Insepctoes Signature
- - -
SBD -6710 (R.3/97) r 1,� �,. I S
Safety and Buildings Division COMY
N v rilsconsin 20I W. Washington Ave.. P.O. Boa 7082 Madisaa, Wl S�ro� - 7082 S ite Am!
Department of Commerce, sl Permit
SaWt +n r� p Permit Application m moba
In accord wkh couna�83.21, Wis. Adm. Code, PCOIGM aformuion YOU provide D dock if Revision
be used for Law. sIS. 1 ai
L Appikadan bfornmation — PleMe Poirot AN Inf m a ulti Phu I.D. Nmaber
REC FD Y o
Property Owner's No %nd Number
U •i .z - 7 - -060
Properly Owner's M allWg Address Lomdoa
aw, Sere Zip Code Number ✓ Block Number , / C)7
Atriivision Name CSM Number
o/ /' 5 -z v
mL,xype or Building (Check all that apply.) OCi<Y
Or 1 or 2 Family Dwelli - Number of Bedrooms 3 O Vtltage
O PubIkICommacial - Describe Use wro
O State Owned MOdd uJ/ p & edhrv-� q' - Newest Rod
III. Type of Peimlt; (Check only one boxes tine A. Nombesing is for ' te uSe.) (Compk tine B, if app�bla)
A. I New 2O Repiaamremt System 30 Rgft mearof b0 Addition to For Comaty tae
S Tank OWY Exisd S ystem
B' OCheck if Sanitary Permit Pceviou i bsued Permit Number Due Issued
IV. Type of POWT System: (Check all apply. Nuadming is for internal Ilse.)
44 O Non Pressurized ha4rowtd 2111 Momd Z 49 O Sand Fiber 50 O Constructed Walamd
22 O Presauteed la-Ground 41 Hold Tank 6i 1 48 0 Sivgk Pass 51 O Drip Lim
451 At -Grade 46 OAaobk Treatment Unit 49 O Re A=htiog 30 0 0dor
V. reatmtmt Area Information:
Design Flow (gpd) Dispasat Area Dispersal Arcs Sal! Appliatim patolmion Rafe System Final Grade
�GBs /Da Itt.) them /tndt) 1- FJe►adom
(ZZIv 5 �; i , �2
S"o D s"o• . eq o '� 9T., T 99 L
VL Tank Info Capacity in Total Number Prefab Site Sad Filter Plastic
Gallons Gallons of Tanks l7 Coacrefe Constructed Gbas
New EXWO
v✓ /emu- - lU
Tanks Taatis
Sepmc or UMft Unk V
Daatvg (]amber . -
- I ov wee
VII. qty Statmmest I, the uodw peed, ansrmae reVansIlAky for h>stdatioa of the POW TS sho ma m the aqa bW pleas.
Pfimaber's Na tae (Print) I Phamber's '1M MPRS Number Bvamms Psrone Nmober
3 Fogerty Plumbing & Perk et�tittg z� /1
Pltureber's ss • . :Zip /S— ,> ^"
Spooner, WI 54801
VIML use S r
Approval O Owner Givens Initial Adverse sanitary Pamk Fee ( Granrdwafer Ihae (No)
D 2-5 Fec) 2'� 2 / O ;M
Couditiota of Approval/Reasons for Disappdnov _ . f o
5� rte s� -�°
3.
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Atlsc! Maas (to ady) as• the os paper sot sera a is rise
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3 O eVe+ rnJ P�, g Qf 9
yo , Lot s- 1 9 iZ, c,h mon d Mead ows
".of NE Sec.ZLJ T3OtJ-Rl'3VJ
R Mond - rwsp. - S Croi X CO,
P/P #1= Tpaf l "Pt/c P, pe
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• Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
isconsin www.commerce.state.wi.us /sb
Department of Commerce www.wisconsin.gov
Jim Doyle, Governor
Cory L. Nettles, Secretary
March 26, 2003
CUST ID No.221180 ATTN: POWTS Inspector
ZONING OFFICE
DAVID B FOGERTY ST CROIX COUNTY SPIA
28288 MCKENZIE RD 1101 CARMICHAEL RD
SPOONER WI 54801 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 03/26/2005 Identification Numbers
Transaction ID No. 851630
SITE: Site ID No. 656967
Ken Oevering Please refer to both identification numbers,
Town of Richmond I above, in all correspondence with the agency.
St Croix County
NE1A, NW 1/4, S24, T3 ON, R18W
Subdivision: Richmond Meadows - lot 19
FOR:
Description: Proposed Three Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 896317
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
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.
The following conditions shall be met during construction or installation and prior to occupancy or use:
General Approval Conditions:
• This system is to be constructed and located in accordance with the enclosed approved plans.
• A state approved effluent filter is required. Maintenance information must be given to the owner of the tank
explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided
per Comm 84 product approval conditions.
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
• Comm 83.22(7) - 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.
Owner Responsibilities:
• Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
• Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard. 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.
4
DAVID B FOGERTY Page 2 3/26/03
Owner Responsibilities Continued:
• The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to
the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s) utilized in the POWTS.
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 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
Gerard M. Swim Balance Due $ 0.00
POWTS Plan Reviewer - Integrated Services
(608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm
jswim @commerce.state.wi.us WiSMART code: 7633
cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Ownerffht r Aer/ 6�v�u•��
Mailing Address f f f sGt�cr �/c � pt vas GC�ec ��� / �crero� y �a
Property Address
(Verification required from Planning Department for new construction
City /State Parcel Identification Number -9-A4 - lz! t - i9 AP"
i
LEGAL DESCRIPTION
Property Location '/4, & ' /t, Sec. Zy , T o_ N -R _ W, Town of f ecc�ixo yy
Subdivision - A ,*r Avers _ , Lot #
Certified Survey Map # , Volume Page #
Warranty Deed # ?I Z,3 . Volume > > , Page # _ /a gg •
Spec house D yes Erno Lot lines identifiable 0"yes O no
SYSTEM MAI `
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 Zoning Department a certification form, signed by the owner and by a
masterplumber, 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 Resourcet, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days,o
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 (are) the owner(s) of
the pro above, by virtue of a warranty deed recorded in Register of Deeds Office. _
d3
SIGNA F APPLICAT DATE
* * + + *• Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Depa
"
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: Ken Oeveiring Mound 9.c► � ��
Owner's Name: Ken Oeveiring
�G
Owner's Address: 838 Summer Pines Circle
Hudson WI 54016
Legal Description: Prt of the NE 1 /4-NW 1/4 Sec. 24 T30N -R18W
Township: Richmond
County: St. Croix
Subdivision Name: Richmond Meadows
Lot Number: 19 Block Number: NA
Parcel I.D. Number: pZG —r /y7 /9— ^V
Plan Transaction No.: L. D
- -NT OF COMMERCE
- >.+N OF SAFETY AND BUILDINGS
Page 1 Index and title
Page 2 Data entry
Page 3 Mound drawings SEE CORR 0N0 ENCE
Page 4 Lateral and dose tank
Page 5 System maintenance specifications
Page 6 Management and contingency plan
Page 7 Pump curve and specifications
Page 8 Plot Plan
Page 9 Survey Map
Designer: Dave Fogerty License Number: Mprs# 221180
Date: 03W03 Phone Number: (715) 635 -9609
Signature:
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181)
Version 3.11 (R. 06/01) Page 1 of 9
I
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(r or c) R Residential or Commercial Design Note: Sand fill (D) caladations assurne a
300.00 Estimated Wastewater Flow (gpd) Table 8344 -3 in4W soil treatment for fecal
1.50 Peaking Factor (e.g. 1.5 = 150 °r6) coliform of - 36 inches.
450.00 Design Flow (gpd)
8.00 Site Slope ( %)
97.00 Contour Line Elevation (ft)
28.00 Depth to Limiting Factor (in)
0.40 In -situ Soil Application Rate (gpdM
Distribution Cell Information
82.00 Dispersal Cell Length Along Contour (ft) = 5.49 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest int
in the distribution Y
Pressure Disribution Information network? Enter Y or N
(c or e) c Center or End Manifold
2.75 Lateral Spacing (ft) If N above, enter the elevation ft
4 Number of Laterals of the highest point.
0.188 Orifice Diameter (in) (e.g. 0.25)
2.25 Estimated Orifice Spacing (ft) = 6.25 ft /orifice
2.00 Forcemain Diameter (in)
50.00 Forcemain Length (ft) Does the forcemain drain back? Y
89.00 Pump Tank Elevation (ft) Enter Y or N
3.25 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal)
8.17 Vertical Lift (ft) 73.86 5x Void Volume (gal)
2.24 Friction Loss (ft) 82.02 Minimum Dose Volume (gal)
13.66 Total Dynamic Head (ft) 47.19 System Demand (gpm)
Lateral Diameter Selection Manifold Diameter Selection
in. dia, options choice in. dia. o tions choice
0.75 1.25
1.00 1.50 x x
1.25 x 2.00 x
1.50 x x 3.00
2.00 x
3.00 x
Gallons/Inch Calculator (optional)
Treatment Tank Information Total Tank Capacity (gal)
1000.00 Se tic Tank Capacity (gal) Total Working Liquid Depth (in)
Weeks Concrete IManufacturer gal /in (enter result in cell B49)
Dose Tank Information Effluent Filter Information
805.12 Dose Tank Capacity (gal) Zabel I Filter Manufacturer
21.761 Dose Tank Volume (galrn) JAI 00 Filter Model Number
Weeks Concrete Manufacturer
Project: Ken Oeveiring Mound page 2 of 9
Mound Plan Vi
ou d w a e
-- - - - -- --
T
1/10 B ; observati n'fte Q' J
K. ..
•r•r.r• :r• • 'Jr
. . . . . . . . . . .
rr.
f .
W
1. � , p .
I
. . 1 � .
I
. I
J • '
. . .
. .
- . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
L
Mound Component Dimensions
A 5.49 ft E 13.27 in H 1.00 ft K 8.03 ft
B 82.00 ft F 9.50 in I 9.46 ft L 98.07 ft
D 8.00 in G 0.50 ft J 4.74 ft W 19.69 ft
450.181 Dispersal Cell Area 1 1226.22 (ft) Basal Area Available
5.49 (gpdtft) Linear Loading Rate 1 8.20 (ft) 1110 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Pe
Finished Grade
99.46 (ft) ----•►
Dispersal cea 98-17 (ft) Lateral
97.67 (ft)- -► Invert
Dispersal Cell
Elevation E D '
97.00 (ft) Contour Elevation
8.0 °,6 Site Slope
Geote)dile Fabric Cover
Shading Key �— Dispersal Cell See lateral details on
Q ®Topsoil Cap 1.5 ft . : ,� � ' Page 4 for number, size,
Subsoil Cap a o:r: and spacing of laterals.
g r: ; r?•�r:' ; rr:: Laterals are equal
ASTM C33 Sand •,�••,.•.• 4 h
® Tilled Layer C a 0.5 ftrc Lateral F spaced from the
�r:r:::r:r:r: r distribution cell's
❑5 r:r:f. Aggregate 10 o r:f'tr:,`•� f s' centerline in the
'-' A distribution cell (AxB).
Project: Ken Oeveiring Mound Page 3 of 9
Center Connection Lateral Layout Daigram
Force main connection via
tee or Dross to marFold at arry point. Laterals are identic al
� P S
.�k.
s Turrr up wf ball ralwe or *2+1 Laterals & force main of PVC sch 40
clvanoutpluy per COMM Table 84.30 -5
Holes drilled on the bottom of the literal.
Number of Laterals 4 Orifice Diameter 0.188 in
Lateral Diameter 1.50 in Orifice Spacing (X) 2.30 ft
Lateral Length (P) 40.25 ft Orifices per Lateral 18
Lateral Spacing (S) 2.75 ft Orifice Density 6.25 ft /orifice
Lateral Flow Rate 11.80 gpm Manifold Length 2.75 ft
System Flow Rate 47.19 gpm Manifold Diameter 1.50 in
Total Dynamic Head 13.66 ft Forcemain Velocity 4.82 ft/sec
Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and - ---- -►
Comm 16.28 WAC Disconnect 4 in. min.
Tank component is properly vented E — Alternate outlet
location
Forcemain diameter
Weeks Concrete Manufacturer 2 in.
Cap acityl 805.12 Gallons
Volume 21.76 gal /inch A
Weep hole or anti -
Dimension Inches Gallons B siphon device
A 19.23 418.46 C
B 2.00 43.52 P off _e levation (ft)
C 3.77 82.02 90,00
D 12.00 261.12 D
Total 37.00 805.12
Dose tank elevation (ft)
3" Bedding under tank. - 89
Alarm Manuafacturer S. J. Electro
Alarm Model Number 101 -01 H
Pump Manufacturer Goulds
Pump Model Number 1#3871 EPO 5
Pump Must Deliver 47.19 gpm at 13.66 ft TDH
Project: Ken Oeveiring Mound Page 4 of 9
Mound System Maintenance and Operation S ecifications
V De D
Service Provider's Name P 715
Tri -Coup Sanitation hone 386-0 114
POWTS Regulator's Name St. Croix County Zoning Office Phone 715 386 -4680
System Flow and Load Parameters
Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 450.18 ft Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL
Service Frequency
Septic and Pump Tank Inspect and/or service once every 3 years
Effluent Filter Should inspect and clean at least once every 3 years
Pump and Controls Test once every 3 years
Alarm Should test month)
Pressure System Laterals should be flushed and pressure tested every 1.5 years
Mound Inspect for ponding and seepage once every 3 years
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code.
3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Lateral Turn -up Detail
Finished •...........••. ...............
Grade
6-8" Diameter Lawn Threaded Cieanout
Sprinkler Valve Box Plug or Ball Valve
.......
....... .......
.......
Distribution
Lateral
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Ken Oeveiring Mound Page 5 of 9
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals (SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)) and local or state rules pertaining to system maintenance and
maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used
for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to
failure must be replaced. Exposed access openings greater than &-inches in diameter shall be secured by an effective locking device to prevent
accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank
shall be disposed of in accordance with NR 113, Ws. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at
Least once every 3 years by inspection.
The outlet filter shaft be leaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are
made to retain solids in the tank that may slough off the }titer when removed from its enclosure. If the filter is equipped with an alarm, the tter
shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm.
The septic tank shag have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank.
If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shag advise the owner of when the next
service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are
used they sling be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump ( dosing) tank shag be inspected at least once every 3 years. All switches, alarms, and pumps shag be tested to verify proper
operation. If an effluent filter is installed within the tank it shag be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shag be seeded
and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative
maintenance) on the mound is not recommended since sod compaction may hinder aeration of the Infiltrative surface within the mound and snow
compaction in the winter will promote frost penetration. Cold weather insWilationrs (October - February) dictate that the mound be heavily mulched
as protection from freezing.
Influent quality into the mound system may not exceed 220 mg/L BOD 5 ,150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L
BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu1100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified
in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed
of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the
system was installed to determine if orifice dogging has occurred and If orifice cleaning is required to maintain equal distribution witiwn the
dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shag be reported to the owner, and any levels
above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
COntinciencv Plan
If the septic tank or any of its components become defective the tank or component shag be repaired or replaced to keep the system in
operating condition. Pry
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shag be immediately repaired
or replaced with a component of the same or equal performance.
If the mound component fads to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in
its' present location by increasing basal area if toe leakage Occurs or by removing biologically clogged absorption and dispersal media, and
related
piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 5 of this plan for the name and telephone number of your local POWfS regulator and service provider.
Project: Ken Oeveiring Mound Page 6 of 9
e 7-
METERS FEE
10 I �[
e for MODEL 3871 / ^ . ► i
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3 t0
0 0 20 3030 40 so us GM
CM
0 2 a 6 8 t0 12 mmr
CAPACITY t
Pump Specifications Features and Benefits
' /to and ' /2 HP • EPO4 impeller- semi -open design
Up to 60 GPM with pump out vanes to protect
Maximum head to 32 mechanical seat.
Discharge size V12 NPT • EP05 impeller - enclosed design
Solids 1 4' maximum for improved performance.
Motor • Rugged glass-filled thermoplastic
All motors feature ball casing and base design provides
bearing construction superior strength and corrosion
Single phase 1151.1 resistance
Materials of Construction • Cast i ron motor housing for
Cast iron etficient heat transfer strength.
Thermoplastic and durability.
Stainless steel • Corrosion resistant threaded
stainless steel shah.
• Available for outoma anC
I manual operation
• CSA listed models available
a,, '0ooers are designed for continuous operation and feature stainless steel hardware.
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• �J.Qc�`I-h T i c+ Plan br C3rmh3 C�� Ve; rn9 P�,8of 9
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I
Wisconsin'DeparUt4nt of Commerce SOIL EVALUATION REPORT Page ( of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
S � _
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County Crr i
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. /17 O
Please print all information. viewed y D
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). `{,�
�3
Property Owner Property Locatio
&�AO.C6 P
Govt. Lot Iv L iMAJL01 /4 S24 T N R ($ E (or OW
Property Owner's Mailing Address Lot 11 1 Block # I S�d. Name or CSM# 1
P. 2 (g c- t 1_) „ U f {� I
City State Zip Code Phone Number
E] city Village aTown Nearest Road
Lk. ti c ()�� 1 1-
EP New Construction Use: EiIP Residential / Number of bedrooms Code derived design now rat d 71 GPD
❑ Replacement ( ❑ Public or commercial - Describe:
Parent material a �� ' Flood Plain elevatijiff plicable ft.
General comments e o 6 � 0 r 9- I e J q ( , o v REC VE and recommendations: S4 P 61 Q I e v , 6 - �aa p�s p, E" 9 rn APSR
ix CO
❑ Boring # f ❑� Boring ZONING p �E y
7F pit Ground surface elev. �N) ft. Depth to limiting factor
Soil App ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consis Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
1 - 10 10 z mfr- c S 1 v S, g
2 1 - 5( Cl h I ry-, �'r c 5 -- {
FZ P - 1.5 q/(P SL 2 rn. k -
❑ Boring # ❑�-77 Boring
lQY pit Ground surface elev. ! ft. Depth to limiting factor ` in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I •Eff#2
2 ► �_ � -- 2 r� �� c � _ 1. 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
CST Name (Please rim) Signature CST Number
JU a V ^ ��-
Address Date Evaluation Conducted Telephone Number
Ale
y
n
� n 8330 (R07 100)
1
wV .
Property Owner
fh Parcel ID # Page of
3 ❑ Boring
❑ Boring # ft Depth to limiting Z$ surface elev. �_ liiti factor in.
Pit Ground Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture structure Consistence Boundary Roots 'Eff#1 PD /ft*E�
in. Munsell Qu. Sz. Cont Color O
CS Iv
3 - �b r ��o r 2 P 1..5 / 5� Z►��i�k 5
❑ Boring
F
Boring # ft. Depth to limiting factor in.
❑ Pit Ground surface elev. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'E ff#1 ��
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
❑
Boring # Boring Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
❑ Pit
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots `Eff#� PD /ft Eff#2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
=
' 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 opportu e e mpl oyer. t 608 -266 3151 or d assistance 6 to� 877 services or
please contact the need material in an alternate format, p department
ssn -8330 (a.07ro0)
i y •
PAGE_OF?L
NAME .0 e So n LOT# 1 LEGAL DESCRIPTION V %NW 1 4 ,S T 3 o ,N,R, 1 R' E(or)�
SCALE: I
BM 1 ELEVATION Q. 4
BM 1 DESCRIPTION k p o -f / " AfC, +
BM 2 ELEVATION - 7�, �
BM 2 DESCRIPTION t®
SYSTEM ELEVATION
ALTERNATE ELEVATION w
CONTOUR ELEVATION q(
o
0
I�-
0
�1
s a-
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SIG ATURE
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716873
STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH
WARRANTY DEED REGISTER OF DEEDS
Document Number ST. CROIX CO.. XI
This Deed, made between Hillvale Development Limited Liability RECEIVED FOR RECORD
Partnership, a Minnesota Limited Partnership 04/11/2003 08:30AN
WARRANTY DEED
EXEMPT #
Grantor, and
Kenneth Oevering REC FEE: 11.00
TRANS FEE: 241.50
COPY FEE:
CC FEE:
Grantee. PAGES: 1
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
Recording Area
(DSt otCSrI0!1 1 and 42, Plat of Richmond Meadows in the Town of Richmond, Name and Return Address
County, W isconsin.
026 - 1147 -19- 000,026- 1070 -41- 000,026 - 1070 -42 -000
Parcel Identification Number (PIN)
This is not homestead property.
(9) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this day of April 2003
Hillvale Development Limited Liability Partnership
RICHARD NELSON T
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
<9 ss.
- u ( A
C County )
authenticated this day of Personally came before me this (M day of
April 1 2003 the above named
Hillvale Development Limited Liability Partnership, a
Minnesota Limited Liability Partnership
TITLE: MEMBER STATE BAR OF WISCONSIN to known to b e.person(s) who executed the foregoing
(If not, rhAtril t c the same.
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY «
Attorney Kristina Ogland Notary Public, State of Wisconsin
Hudson, WI 54016 My Commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) ti )
• Names of persons signing in any capacity must be typed or printed below their signature. Jnformallon onds prolassi company. Fond du LW, wl
STATE BAR O F WISCONSINNotary Public 1100406-2021 WARRANTY DEED FORM No 2 -1999 State of Wisconsin
R & LYNNETTE MILBRANT q " -1
`1440 COUNTY ROAD "G"
NEW RICHMOND, WI 54017 I
�QT_1
CZ11TJEIM -7 SLJ�-�Y -� STEVEN J. DERRICK
�QLUM�. IZ_PAGE_I44 "G"
,1 1438 COUNTY ROAD
!?_Q ATAI_L�lJ.M.mEB 1l�� NEW RICHMOND, WI 54017
__ -NORTH LINE OF THE NW 1�4���TT�� N A�,�
�IGh�IYA y G- ---- -_ s W .
EX
---o - _ IN1
S89 594.02'
8' S E
EX. 18 "CMP -
_ w
EX,
INV 'tNtls� INV =996.81 ' N V = 18 CMP EX. 18 "CMP
EX. 18 "CMP� 230,24 991.70 INV =991.37
�1001.96 1 ' _ —
:j20 (� INV = 1001 .49 o
EX. 41
7 $ 4 INV =9t
� i i a
SgFt �.
Acres
h ' 20ft. wide
DD i drainage easement, I
98685�SgF,t 20.00 -- E X.
2.27 Acres \ i OUSE
�JBA =Z.20
�
i$
$• ,�� I I EX. SILO
k ��10���
EX. BUILDING
wd
0
6 " A
40 9 , i
l,W k lqFt
cres
N�3A11.41 Acres /
�o 594.00' ------ - - - - --
Lh \ ` I /
"4
Y j15•
10°. .oq� X4,7 2 • 20.0o I I I UTILITY EASEMENTS ARE
--j
Bw 20ft( wide � I i SHOWN AS THUS:
drainage easement"
+ STREET
� 99 J q I i
Iwgo / , 61 9 SgFt I�
0 1.52 Acres In I
=1.06 Acre c1t1
`f l
� 158.79'
/ / —
�' j B 181 3� 179.2 " I O O
.l - er i N78°54 54 E h O O
A I b „drainagge `/ °
02 I ^ & utilify -� o °
o i easement i
87 p 848 `K, �'cn 135.21' I , o END OF
6E CO
1 Z: 33.0q, N I AT LA11ER DATE D
31- 33 S790 48*54 e 135.21 I / BEING REAR LINE
S� 9s' N8933'44 °D I J w G 12 FEET IN WIDTH,
R =s 6.30, J UNLESS OTHERWISE INDICATED
AND ADJOINING STREET LINES
°_'. o° .1 tl�g'�4'S1 w 1 35.21' ._