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HomeMy WebLinkAbout026-1072-70-200 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 420558 0 ' (ATTACH TO PERMIT) GENERA INFORMATION 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 Parcel Tax No: Miller, Sam I Richmond Township 026- 1072 -70 -200 CST BM Elev: Insp. BM EI BM Description: Section/Town /Range /Map NO: ° f r CM -r C a.l,� Q ►'� u do 25.30.18.380A20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic E;15IL—e' t2 Benchmark 5 7 , 1 iRS I Dosing � � t L � Alt. BM Aeration 7 Bldg. Sewer Holding St/Ht Inlet 9.2fl 9� •�o TANK SETBACK INFORMATION St/Ht Outlet 9 ' I f 9(,? • 3 1 , TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet c � I • �Z 9la . og Septic - . - S-V + � Dt Bottom ' -r S -0 , 2. 1 1 .42 . `12 -38 Dosing I � 3 � Header /Man. Aeration Dist. Pie - p - �. g. Z I Holding Bot. System f 2 1 1-- 3 } � - PUMP /SIPHON INFORMATION Final Grade 6w� Manufacturer Demand St Cover 2M &LL_r_—fz GPM IW . 9 Model Number s 3 ID, I oo . Zg TDH Lift Friction Loss System Head TDH Ft 10 9 S }Z t Forcemain Lengtb Dia. Z tt Dist. to Well SOIL ABSORPTION SYSTEM J, Width 1 Le I_ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 13 �6 (3 SETBACK SYSTEM TO P/L BLDG IWE LL LAKE /STREAM LEACHING Manufa t f r: INFORMATION CHAMBER OR Type Of System: + ' fis + f _ UNIT Model Number: tt DISTRIBUTION SYSTEM Header /Manifold Distribution � xHole Size x Hole Spacing Vent to Air Intake Pipe > / 0, Length Dia Length Dia Spacing �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 g p D Yes E No [] Yes E] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:0 7 0 3 Inspection #2: Location: 1433 140th Avenue New Richmond, WI 54017 (NE 1/4 NW 1/4 25 T30N R1 8W) NA Lot 3 Parcel No: 25.30.18.380A20 1.) Alt BM Description = LJ e- ST er D T. w� . r..►�6 �+� C o4,4ri 2.) Bldg sewer length = Z I r u - amount of cover = > IQ; Plan revision Required? I 1 Yes , No Use other side for additional information. _j _ ^_— SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No f 6 r0 -5 Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 N visconsin - Madison, WI 53707 - 7162 Site Address D€ artment of Commerce 1q33 I W 4-4 Aco Sanitary Permit Application Sanitary Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Check if Revision �� Ss_' may be used for secondary Privacy Law, s15.04(1 m I. Application Information - Please Print All Inform State Plan I.D. Number Property Owner's Name Parcel Number S0 MAY mn, c�zrfl I 70 - zoc .3�A14 2a Property Owner's Mailing Address Property Location ?s ST. tm, - COUNTY ii OA SZJ T3C N, Rl O City, State Zip Code ber Lot Number Block Number n ( � Subdivision Name CSM Number J1�o� W r S Al -1% Z S L 3 � V. �y �d 11. Type of Building (check all that apply) / ` ocity is ❑ 1 or 2 Family Dwelling - Number of Bedrooms ✓ �,�M„ ❑Village C1 Public/Commercial - Describe Use ❑ Stare Owned 3 - le CA/ K = * 3 Wl� i 4A W ownship C (-t u c a 71 L / x I j ° /2 cam,,, c 1� �e f / cares[ Rd T � III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. 1 ew 2 10 Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use �stm Tank 0 kisft system B. Check if Sanitary Permit Previously Issued Permit Number Date Issued yzo ss'8 Il _ lla _ o Z N. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 11 Non - Pressurized In -Ground 210 Mound 47 ❑ Sand Filter 50 11 Constructed Wedand 22��Press<irized In -Ground 41 ❑ Holding Tank 48 11 Single Pass 51 ❑ Drip Line 45 At Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dbpersalffreatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevatio Final Grade Required Proposed Race(G (Min.Anch) Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plc Gallons Gallons of Tanks Concrete Constructed Glass New Exisaaa Tanks Tanks Septic or Holding Tank - �'rat� l yV � / i= rLti X Dosing Chamber ) ca to VII. Responsibility Statement- I, the under signed, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signs N P/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) VIIJ. County /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued ent Si Approved ❑ Disapproved gnature Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse �� 5 Determination g o J . c IX. Conditions of ApprovalfReasons for Disapproval Z ' - ,Av tLL �vto Attack oomptete p1m `- 0 0 County only) the "em on paper not lw than AM x 11 es In she SBb- - 6398 (R. 05101) S 4 One Q -P PLO ' CAL& L f _ z MAY -12 -2003 12:31 PM A.C.E. Soil & Site Eval. 715 248 7764 P.01 6 f 00" Tank Infom"on label enet loaais deMa � Electra a ee per NEC 300 and essw Wdwvgm Gorton to 2e WAC Dieoonneot 4 In, min. Terllt oomppnerrt M proper" "nis : ' F--� Alhrtde outlet loorllon Wleser C on`�crate Manufacturer Foroertreln drerneter Ga 780.50 Gallons 2 in. Volume 1 20.28 gaUnch A Dimension Inches Gallons 9 Wap hob or anti siphon devlo. ' A 20.08 407.28 G B 2.00 40.58 ♦ Puma oR - e le�aeon (it) 1 C 5.92 120.00 D 9.50 192.W D Total 1 37.501 780.50 T- -.LL 4i t�ase taNc 3" Betiding u er tank. J Alarm Manufaacuurer Lev elArm \ Alarm Model Number Pump Manufacturer Zoeller k Pump MoOel Number 153 i v� L4 0 1 J J 6 4r z COPY 2 9.Z 3 1 - 4 4r t, py) tc 0 �U') o U') ��� Z WQ �� L" D J o 0 ° ,^ F� N WW � N �o z Y� O F I ° �� �r� 1 0 O CY0 OF- J Q O_ I In d O 0 p m �k Q Z 0 O U O F �_ 00 J~ CL � " ' I d - O W J U J 0 0) (A w S (n Q Q w O' U �O aON JwW (7 �^ O c WN Q m F-Q W0N 00 JH M 0 Z N 04 o = OLJ mWW O a U O � to f- N Q W �M: N: Qw w�v LLJ }} J oa N J .. w - J D X ::) U ZF-J N v cii O�OF -03 DOY DOw Q QwQ w co 2-jr :c 052 Z Z. Zm Q ~F- 0 Y QooQwDwo_ Qd0 Quo U ODD 0 = N3mc��SOm� ZO< Z Z Z F— 0 0 0 w w w J Q m _ J J d 0 0 Q J S J ♦ r W „Zv J Z IN N Gj I I I ' D J Q � y9b Q F— N I c n H Z j ww „t�8 0 0 "o 1 - PAG F PUMP CHAMBER CROSS SECTION AKJG SPECIFICATIONS VENT CAP 4"C.Z. VENT PIPE 25� FROM DOOR, -T WEATHERPROOF APPROVED LOCKING JUNCTIOAJ BOX MANHOLE COVER WINDOW OR FRESH 12 "MIU. AIR INTAKE I GRADE i I 'i" MIIJ. r COQDUIT 18 "MIN• `� ---- - - - - -- 11� IIJLET PROVIDE I - - - -- AIRTIGHT SEAL A I I I I I I I ALARM 6 I iI I *APPROVED i I ow JOINTS WITH ELEV. FT. APPROVED PIPE 3' ONTO PUMP OFF o SOLID SOIL CONCRETE BLOCK RISER EXIT PERM17fED ONLY IF TAUK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFICATIOAIS DOSE TAMKS MANUFACTURER: �Ja S Q IJUMBER OF DOSES: PER DAy TANK SIZE: GALLONS DOSE VOLUME ALARM MANUFACTURER: Z& f A /tit IAICLUDIAIG BACKFLOW: GALLONS MODEL NUMBER: L y CAPACITIES: A= Z 02 1UCHES OR 4D' L$ GALLOW5 SWITCH TYPE: �• �� INCHES OR GALLONS i ZA � O p J = 'QZ l Zo. o PUM MAN UFACTURER: C - IAICHES OR GALLOIJS i MODEL NUMBER D= S� INCHES OR .C° GALLOWS SWITCH TYPE: .�[1G[. -�� Qty MOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS f VERTICAL DIFFERENCE BETWEEN PUMP OFF ARID DISTRIBUTION PIPE.. ' FEET + MINIMUM NETWORK SUPPLY PRESSUR ✓ . . , . . .. , , . • 2.5 FEET + -2- FEET OF FORCE MAIN Y, F ioo rt FRICTIOU FACTOR. FEET TOTAL DYNAMIC HEAD = FEET � fi r/ IIJT ERAI AL• DIMEIJSIOAI>: OF TAIJK: LENGTH 6q ;WIDTH - - ;LIQUID DEPTH � r 7 � ff SIGNED: LICEOSE MUMBER: DATE:g f� HEAD /CAPACITY CURVE N r � W LL HEAD CAPACITY CURVE EFFLUENT MODELS ` • - ^__ __ TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE EFFLUENT AND DEWATERING a3a6 SERIES 6)L9 97 M 107.109 lei IN lab 166 IM 1u IW M. . O.L L9r 0.1 1­11 Gal Lt;i Oal, Uri OH .L97 OaL LI) GW. Ln. I OM Ln. O.t lYi. GLL lra Oa Vi. 1.62 43 160 55 912 72 X273 104 304 1. 401 ai D1 al gal dr 220 156 617 15e 587 - 10 7106 34 129 46 174 61 '23i' 79 000 61 2'71r el Z31' W 220 l4 b!0 151 15 4.67 19 72 56 1J0 46 170 W 212 91 544: eo 2Z7.' ao 677 227 51 220 t12 S37 14S $" 20 a10. 16 67 25 96. 36 69 24 130 62 010' - eo ,227. 64 220 100 615 140 65J 26 I.42 742M` 67 711; S9 220. 61 220 126 4M 30 &14 66 241: 66 208 64 220 90 JW N .220 171 461 127 u1 W 1219 —� 186 60 .1624 b 174 46 172.. 66 206 76 :213 ,M 220 106 097 11� 71 SO- 00 125' 61 I91'.. 64 ..219 48 210 90 341 100 7.q 1 60 .. �. 16 57- 4J 161' Je •.I Ja 61 220 71 269 $6 52?' . - - T i 165 r' 70 11.04 00 114 10Je 62 197 N 19J 7o 266 -� SO 24.36 14 60 46 170 2S 100 S4 - — _7 90 27.40 2, 100 OQO 02 17'1 1 2 4 07 14.2 i 167 110 '3200 11 84 71 79 26 1 �� L-k Vow 19.26' 2076' 27' 26' ba' da' - 1 >' . . _ 73 115' EFFLUENT & DEWATERING _- - -' 165 Warning: Model 185 should not be subjected to less than 30 feet TDH. - 189 - Note: For Head Capacity on Model 112, industrial —' column- explosion proof pump, see FM 219. r 161 97 188 98 ---- SEWAGE& DEWATERING cALLOHS e— � _ 4 o__so_ _601 70 8o 190 100 �Ilo 170 due 110 1150 160 i WARNING: P�1odei 293 should not be subjected LITERS 80 i60 140 720 700 480 560 640 to less than 15 feet TDH. V 24 Bo T ! TOTAL DYNAMIF HEAD /CAPACITY PER MINUTE i 75 SEWAGE AND DEWATERING j 22 SERIES 262 tae 717 768 7e7 764 70 - - -}- 792 290 794 295 l FT. M Gal: Ltn Gal Uri. G.I. Un. Gal. Ur..' G.I. L115. Gal. 1.11., Gal. Lim Got, Lve. Gal LV. 361 ur. 65 20 _ 5 L5? 90 341 128 484 128 484 125 464 130 492 180 681 N % O 500 t 142 - ? 25 852 10 3 05 60 727 - 89 337 89 307 69 337 95 360 158 598 124 489 151 685 205 776 15 4.57 11.5 55 50 189 50 159 50 lee 63 23a 135 $11 t06 401 130 492 165 625 185 700 16 60 20 610 t0 76 10 38 10 35 33 125 106 401 Ba 333 n9 450 150 $68 168 636 25 7.81 - IS 288 66 257 106 401 176 515 153 Sf 0 I 55 I 30 9.14 16 40 17.19 43 163 47 178 90 340 1 ?t 45 8_ u0 Sb 1 5 19 SO 189 94 356 5.24 _ _2 1 50 1 - -- 50 - -1--- _ 16.29 58 210 _59 I37 14 70 21.34 13 49 SS 727 15 LOCa VU.a 18' 21,5' 21.5' 21.5' 26' — 75 95 35' 42' S0' I 12 10 75 10 i JO 297 25 -- 6 — 20 i I -- 15 4 282 10 2 T 292 — 5 - -- 262 266, 257, 268 284 294 295 GALLONS 10 __ 30 40 — 50 60 >0 80 I 90 100 110 120 130 140 150 160 170 180 190 200 210 220 270 I--- --� — t l LITERS 0 80 160 240 T_' -- - --i- -- I I 720 400 48U 560 640 77� - - -- - 81 500 880 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 20558 0 GENESRAI 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 Parcel Tax No: Miller, Sam I Richmond Township 026- 1072 -70 -200 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of eeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx S Yes [* No Fn] Yes X No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1433 140th Avenue New Richmond, WI 54017 (NE 1/4 NW 1JA 25 T30N R18w)) NAA Lott 33 Parcel No: 25.30.18.3 OA20 1.) Alt BM Description = c`.uQ - — 2.) Bldg sewer length - amount of cover = 0 Plan revision Required? 5J Yes [N] No LL Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Safety and Buil6k&S Division C° 201 W, , wuhizoon Ave., Y.O. Box 7162 i sconsin • WI 53707 / -Z 4 10 �' $ 1 4 2_� t 4p`{ .Js De artmeftt of Commerce S an i tary Permit Number ` Sanitary Permit Application .r-�zo 5 - V In accord with Comm 93.21. Wis. Adm. Code. personal information y ou provide ❑ Check if Revision tan v be used for Pri t Law 015. t m snag pun I.D. Number L APPS � - Phan Print All lnf �C � � ;\' Parcel Number Propom Owner's Name t 1 1 2002 o .X G - ( 01 - D P Location (/1 Property owmes l&i� Addran C.;tOiX C`J�P�T`; gT. OFFICE E [• S ILK' T N R '� Block Number © zip Code ne Number Lot Number 3 �� Sale Subdivision Name CSM Number S`�'� gig 3� G° 7�5' c s`K L z -3 Z. �� P 3 v ° ❑sky II. Typo of NdlAfng (� aB that apply) ❑ 1 or 2 Family Dwellios - Number of Bedrooms ❑vilottge ownshi r� N � o N 11 ❑ Publio/CammeteW - Desaft Use L h�m6a/S I`fG H Neatest Road 14 s 13 - ❑slue owned 3 — N � 3� 3� 8 j �"ro~+n��^ c �- -�� s I 1 6 1111111, A E -7c>7- A line B if applicable) fete 3 III. Type of Permit: (Cbecic only one box on line A (numbering scheme for internal U150- COMP heemem of 6 C3 Addition to " CIIty tae v A. 1 ❑ New 2 11 Replacement System Tank Oal stem stem permit Number Date issued B. ❑ Check it Sanitaq petmk pmviou* Isaed S Cbwk all thAt aPPly)(nlnnbering Scheme is for internal use) IV. Type of Ptutuit: ( 47 ❑ Sand Filter 50 ❑ Constructed W 44 ❑ Non - Presatrized Tn-0ralad 210 Mound 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Dtip-6fSe 22 ❑ Pressurized In- (around � -3D [1 Other ; 45 CI At -Grade 46 ❑ Aerobic Trc&=eat Unit 49 11 Rec V. Dispersal AttiaBon Area Soil Application Rate System Elevation Final Grade Dexp (�) Elevation >�rW proposed Rate(Gals./DaYd ) (�•/Inc J y ©. J d0 � 7-Co L V 3.0 a � p Siu Sleet Fiber Plastic N VI. Tank Info min N Manufacturer Concrete Coostttrtod Glass Tanks New Bsbdeg Taab Tents Sgxie or Iio{ding Taal / ZGC �� / s of the P V Statement - I, the undersigned, assume respo�bUy for installation OVV1 S shown on attached pones. the II, b11i MP/Iv�RS Number Business Phone Number S Plumber's Nano (Print) Plumber's Signature � / • �'rd S' / f L 7 o� I Andras Street, City. sate, zip Coda) J Plumber s 0 70 TE 12_ ' A v IJ,.S o iC/ , V. Corm /De ent Use Onl Date Issuod Issuing Agent Si (No Stamps) III Sanitary Permit Fee (includes Groundwater Approved ❑ Disapproved Surcharge Fee) ❑ Owner Given Initial Adverse �i _ 1//181 Z_ Determination DL Cooditioos of APPcovaU °OS for Disapproval s YS :E-J 6.4 Mz� Dino- -d ,�;�i:TS Ss : ° , "+ S(` �� ►^^ 9 ",�,�"`°" is °"x�/ 1 'C a (to the 7) for tuna gl/3 Inches is a>:e SPT) -6398 (R. 05/01) - 5y 1 v1 :Z lift i ell I $ 1 6 't'c Avg 4 07- 70 3 5 y Sf a-n•T F/ = 9 7, 2 S � izo• ya� '4.4` 3 j Lc1Lc i J wxe f rvc��E �, •y . 8i " f S J ' � r k ` iv ~! e' S rl'i'Yt /J 1 / L c" e- C S/r7 -0 Z 7 ,2- 3 G Fl, — 9 7, Z S 514./Ot r/ L ya� 44'11Jr Lt) C 4� b 2 � E fir c k � 5 - 7 E Ac N ti aT pp o ' d Q � z g6DepartmentofIndustry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 ^ '.- 1,AiJor and Human Relations Division of Safety r£ Buildings in accord with ILHR 83.05, Wis. Adm. Code • COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. CRoiX not limited to vertical and horizontal reference point (BM), direct atld % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to ^ qva , tod �` pending APPLICANT INFORMATION- PLEASE PRINT JI+iORM TION \ E IEWED BY DATE No�.l9 ro 2 - PROPERTY OWNER: PROPERTY LOCATION Steve Derrick GOVT. L�T NE 1/4 NW 1/4,S 25T 30 ,N,R 18 odor) W PROPERTY OWNER':S MAILING ADDRESS t LOT# BLOCK # SUBD. NAME OR CSM # 1438 CTY.RD. "G" k" `.'. c.. , �.��: 3 na csm CITY, STATE ZIP CODE H.OXE NUM13W,�u,%1 ❑CITY []VILLAGE E70WN NEAREST ROAD New Richmo WI. 54017 (1 T t �-. Richmond 140th. Ave. [x] New Construction Use [x] Residential / Numbe l boriooms 4 . [ j Addition to existing building (]Replacement [ ] Public or commercial descrl --- ' Code derived daily flow 600 gpd Recommended design loading rate _ bed, gpd /ft trench, gpd /ft Absorption area required 1500 bed, ft 1200 trench, ft Maximum design loading rate _ bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) 97.25 ft (as referred to site plan benchmark) Additional design / site considerations alt. area = 96.80' Parent material glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ® S El ® S El ®S ❑ U E] S ❑ U ❑ S aU ❑ S 11U SOIL DESCRIPTION REPORT �J'w U4--4 U --S J' t Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft ? .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITrench ................. 1 0 -13 10yr2 /2 none 1 2msbk mfr gw 2m .5 .6 1 2 13 -31 10yr4 /4 none scil 2msbk mfr gw lm .4 .5 Ground 3 31 -43 7.5yr4/4 none sl 2msbk mfr gw if .5 .6 10 6 ft. 4 43 -80 7.5yr4/6 none ms Osg ml gw na . .8 . } Depth to 5 80 -90 5yr4/4 none sl 2msbk mfr na na .5 .6 , limiting factor +90" 571,!4 Remarks: Boring # 1 0 -14 10yr2 /2 none 1 2msbk mfr gw 2m .5 .6 2 14 -29 10yr4 /4 none sicl 2msbk mfr yw lm .4 .5 ,• 3 29 -33 7.5yr4/4 none sl 2msbk mfr gw if .5 .6 S Ground elev. 4 33 -59 7.5yr4/6 none ms Osg ml yw na .7 .8 } 1 5 59 -89 5yr4/4 none sl 2msbk mvfr na na .5 .6 Depth to limiting q 99 factor Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Ave. Richmond I 54017 CST Number: m02298 Signature: Date: 4 -17 -2000 OWNER TY SOIL DESCRIPTION REPORT Page S . vP Tk�rri c-k 2 , PROPER _ PARCEL I.D. # pending Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft ................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench .................. 1 0 -10 10yr2/2 none 1 msbk m r - gw m 3 2 10 -29 10yr4 /4 none sici 2msbk mfr gw if .4 .5 Ground 3 29 -49 7.5yr4/4 none is Osg ml gw na .7 .8 elev. 101 ft. 4 49 -89 5yr4/4 none sl M na na na .4 .5 Depth to limiting factor S g I Remarks: Boring # 1 0 -12 10yr2 /2 none 1 2msbk mfr gw 2m .5 .6 41 2 12 -32 10yr4 /4 none scl 2msbk mfr gw lm .4 .5 AMA 3 32 -52 7.5yr4/4 none co s Osg ml gw na .7 .8 Ground elev. 4 52 -88 5yr4/6 none sl M na na na .4 .5 10 ft. Depth to - limiting factor +88" Remarks: Boring # 1 0 -14 10yr2 /2 none 1 2msbk mfr gw 2m .5 .6 <' S 2 14 -25 10yr4 /4 none sl 2msbk mfr gw lm .5 .6 3 25 -88 7.5yr4/4 none co s Osg ml na na .7 .8 Ground elev. 99 ft. Depth to limiting factor +88" Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) !� '4 STEEL'S SOIL SERVICE Gary L. Steel Steve Derrick 1554 200th Ave. CSTM2298 NE4NW4 S25- t30N -R18W New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #3 -csm N 1 =40' BM.= top of SW lot stake C el. 100.00 Alt. BM.= nail in Norway pine C el. 99.85 � � t I L )JL5 r �1 r� GAry L. Steel 4 -17 -2000 , e 133 .13,16 1h 4VE Bi cmff" .� r �■ �� . r �� .�� r r ,r, r �� r r r, � r _ �� ... � �� �� � �" �` �..■ HW End 0" Knockout Universal End Cal) Chamber 11" Stan- 14" High 16" High Av a i lable Dimensions lord Capacity Capacity i a 1' t i Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. I This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 14Zo Number of Bedrooms Design Flow - Peak (gpd) O Estimated Flow - Average (gpd) Do Septic Tank Capacity (gal) ?_f� c7 Soil Absorption Component Size (ft t-L m ✓m Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 4,0E 1 Z 13 *.t 10 w i W ee ) Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 7777 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years 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, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the s nd outlet filter shall be assessed at least once every 3 years by inspection. Th utlet filte shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed un ess provisions are made to retain solids iin the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge 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 an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the 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 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. Xr e Co �� -� 3 �� • G�{t7 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer tu t L-i- £ >z Mailing Address -0 1-5- 1 04 y DS 0 w t Property Address 4 / 3 3 / yo' 1 A w/ F E I) I e k wt o� `�� / (Verification required from Planning Department for new construction) City/State IV E b) ki e JM 6 N U W Parcel Identification Number CP Z �o — 10 72 -1 a LEGAL DESCRIPTION ,�!� Property Location �[ F ' / +, � ' / +, Sec. Z ��. TAN -R ��1' i own of LCIL—dl N J- C' # (o Z Z3 , 3 .�ltvisian Lot / Certified Survey Map # � 2 -1 Z 3 , Volume 7 , Page # Warranty Deed # 7 y `� , Volume `� , Page # 3 Z 7 Spec house yes ❑ no Lot lines identifiable C' yes ❑ no SYSTEM - CE r+aip Imper use and mtenance 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 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 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 retu.tned to St. Croix County Zoning Office within 30 days. the three year Wiration date. f" NA OF APPLICA DATE ER CERTIFICATION i,' I'(we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the own er(s) of the escribed above, b e of a warranty deed recorded in Register of Deeds Office. / ATURE O ) I.Y ANT DATE "'•" Any information that is miS- represented may result in the sanitary permit being revoked by the Zoning Department. " 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 i U 18 9 0 P 3 2 7 678 IS) 64 STATE BAR OF WISCONSIN FORM 1 — 1998 REGISTER OF DEEDS • WARRANTY DEED ST. CROIX Co., wI RECEIVED FOR RECORD Document Number 05 - 14 -2002 12:15 Ph This Deed, made between kw n vel Corporation , Grantor, and am E. Mi 1 er FGrantee. WARRANTY DEED Grantor, for a valuable consideration conveys to Grantee the following EXEMPT t described real estate in St. Croix County State of REC FEE: 11.00 Wisconsin (the "Property"): •a >' +'� �v)cs<� TRANS FEE: 314.10 COPY FEEL CERT COPY FEE: PAGES: 1 Recording Area Name and Return Address M r a X R Pln Comer New d, WI , 54017 u r rr- T t� �, L , 550 F0�v 026- 1072 -70 -000, 026 - 1072-70 -100, 026- 1072 -70 -200 Parcel Idenalication Number (PIN) This is not homestead property. (is) (is not) Lots 1, 2 and(S)Certified Survey Map filed In Vol. 14, Pa go 394 as Document No. 629236 located in part of the Northwest Quarter of the Northwest Quarter a`na part of the Northeas uarter o t e ort west Quarter all in Section 25, Township 30 North, Range 18 West, town of Richmond, St. Croix County, Wisconsin. Together with all appurtenant rights, title and interests. none Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this I Oth day of May, 2002. (SEAL) (SEAL) Oakwood L d Development (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, C Yt1 i ) as. entereewaty> County authenticated mks ^f�?B`�� � _ pU6tiC Personally came before me this 10th day of NOTAR May, 2002 the above named STATE _ Oakwood Land Development BY: Gregory J. Peterson, Vice President to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person who e cuted the foregoing Instrument (If not, and ackn wledge the s authorized by §706.06, Wis, Slats) THIS INSTRUMENT WAS DRAFTED BY Coldwell Banker Burnet Notary Public, Stat of Wisconsin 1301 Coulee Road Hu 54016 My commission is pe anent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. ) Both are not necessary.) Names of persons signing In any ca aci must be typed or erinted below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. WARRANTY DEED FORM No. 1 — 1998 Milwaukee, Wls.