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HomeMy WebLinkAbout026-1127-20-000 County. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM S t. CfOIX SatE t and Building Division INSPECTION REPORT Sanitary Permit No 506197 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 Parcel Tax No: Marek, Todd R. I Richmond, Town of 026 - 1127 -20 -000 CST BM Elev/ Insp. BM Elev: BM Description: Section/Town /Range /Map No: Q . (� (its /. P 25.30.18.830 TANK INFORMATION ELEVATION bATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark ? /o8r Z Dosing \ A lter_ Aeration Uv Bldg. Sewer c M L10 Holding SU t Inle� /r [f 2 �] l TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet � q Septic / ,l Dt Bottom Dosing ! V Heade an. 3.(S Aeration Dist. Pipe rnaw�, .3 - r / o 3. Z Holding ot. System g 3.9 1 3- / D - 33 Final Grade PUMP /SIPHON INFORMATION p Manufacturer [e.i 12,- and St Cover i R oy Model Number �� // / 3_ k- I TDH Lif Fri�on Los System Head Tpji Ft !(o , ! y.r3 Forcemain Tsb r Dia _ Dist. to SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 10 /' () / �- SETBACK SYSTEM TO 4' � v P/L BLDG EL LAKE /STREAM ACHI Manufacturer: INFORMATION CHA Typ UNIT Model Number: DISTRI N SYSTEM rr Heade anifold Distribution /� x Hole Size x Hole Spacing / Ve o i a e g Pipe(s) / p acin g . t' O y T Length Dia PS Length Dia ' � � acin C SOIL COVER x Pressure Systems Only xx Mound & At- ade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded �)� 1 XX ul ed & Bed /Trench Center Bed /Trench Edges Topsoil / Y o COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: r 7 i r � Inspection #2:_ / ss t Location: 1408 134th Avenue Ne Richmond, WI T30N R1 W Richmond Hill Parcel No: 25.30.18.830 TI 54017 (NW 1/4 SW 1/4 25 $ 1.) Alt BM Description 2.) Bldg sewer length = yc - amount of cover = > d—j .� Plan revision Required. Yes Use other side for additional information. I -7 1 -- Date Insepctor's Si nature Cert. No SBD -6710 (R.3/97) I 0� COmmereeml.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix MlepwbnervtofCommeroe s e o n s i n Madison, Wl 53707 -7162 Sanitary Permit Number (to be filled in by Co.) -5a -� Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental l 3 q 4 6 9 unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned PO I S are pro (if different ling address) submitted to the Department of Comrtterce. Personal information you used for / 1 / � „ p p urposes in accordance with the Privacy Law, s. 15. 1 m 1 Ave Ue I. Application Information - Please Print All Info ation Property Owner's Name P el # (`l ( �1 O a Todd Marek 2 v b 1 l ~/ - o' Property Owner's Mailing Address lion IWAr P. O. Box 228 CRpIX COUNTY vt. Lot ( . 9, 36) ity, State Zip Pho N '/. SW '/. Section 25 1 Richmond, WI 54017 (Cheek One) H. Type of Building (check all that apply) Lot # T 30 N; R 18 ❑ E Q W ❑✓ 1 or 2 Family Dwelling - Number of Bedrooms 4 20 Subdivision Name 4 7 11 Richmond Hills Public/Commercrir- be Use �J Block # City of State Owned - Describe Use CSM Number ❑ Village of 0 Town of Richmond f0ft III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A- ✓ New System n Replacement Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) System B. Permit Permit Revision Change of Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner Expiration IV. Type of POWTS System/Component/Device: Cheek all that a Non - Pressurized I.Ground Lj Pressurized In- Ground Ej At-GtadC Z Mound 2:24 in. of suitable soil 0 Mound <24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) 0Pretrea V. Dispersal/Treatment Area Information: i s l[ r ie A Design Flow (gpd) it Application te(gpdsf) Dispe712-rea Required ( rsal Proposed (sf1 System Elevation 600 r D 600 6� 600 Z O 104.1 VL Tank Info Capacity in Total # of �y ufacturer Material Gallons Gallons Units New Tanks Existing Tacks Septic or Hokling Tank 1200 1200 1 Wieser Prefab Concrete Dosing Chamber 800 1800 1 1 Wieser Prefab Concrete VIL Respons ibility Statement - 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' i e MP/MPRS Number Business Phone Number Roger Nelson �j MP 226497 715 - 2734444 Plumber's Address (Street, City, State, Zip Code) 122 East Summit Avenue Ellsworth, All 54011 VIIL County/Department Use Onl Disapproved Permit Fee , Date Issued ing Agent S Hato _ Owner Given Reason for Denial CQ IX. Conditions of ApprovWReasons for Disapprov SYSTEM OWNER: � 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained , as per management plan provided by plumber t F and sob 't to the Cann only on ger pa nat lea+ an th 8 la a l l iveheaj as per applicable co a ordinances. G -�,10 sBB ( R 01/07) Valid thrure 2L �� f�«� G `2� °`U t aA.e 141�1 r Todd Marek P.O. Box 228 New Richmond, WI 54017 NW %,SW%,S 25, T30N,R18 W Richmond Hills Lot # 20 [3 m 2 Richmond Township 2 S A Croix County a Scale P= = 40' 1' U Weiser 12001800 tank . P,. BM #1= 100.00' top o-'NW lot stake 7 �� BM #2 = 103.70' top of 1 "PVC pipe 30' of 2 "force main a i � b O y L i I 82 �a ,��• y ,C3�d r.o.•, .9 Wft4 lay f�/4V�K� Page 8of8 Safety and Buildings PO BOX 7162 commerce.Wl.gov MADISON WI 53707 -7162 TDD #: (608) 264 -8777 isconsin www.w www.coe.wi.gov/s / Department of Commerce isconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary May 16, 2007 CUST ID No. 226497 ATTN.• POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMMIT AVE 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/16/2009 Identification Numbers Transaction ID No. 1394469 SITE: Site ID No. 725177 Todd Marek - Dwelling Please refer to both identification numbers, 134TH Ave above, in all correspondence with the agency. Town of Richmond, St Croix County NW1 /4, SW1 /4, S25, T30N, R18W Lot: 20, Subdivision: Richmond Hills FOR: Description: Mound Object Type: POWTS Component Manual Regulated Object ID No.: 1130387 Maintenance required; 600 GPD Flow rate; 31 in Soil minimum depth to limiting factor from original grade; 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 system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. R c The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code 00114 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, I stats. DEPA T E DIVISIO Al 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 SEE C(MR1 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. 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. ROGER D NELSON Page 2 5/16/2007 Sincerely„ Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 c ter E P gel Private Sewage Planviewer, , Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pete.pagel @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Todd Marek 4 bedroom Mound system Owner's Name: Todd Marek Owner's Address: P. O. Box 228 New Richmond, WI 54017 Job address: 134th Avenue Legal Description: NW 1/4, SW 1/4, S 25, T 30, N R 18 W Township: Richmond County: St. Croix Subdivision Name: Richmond Hills Lot Number: 20 Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings VV T S, Page 4 Lateral and dose tank f! Page 5 System maintenance specifications o�1`r jj Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan o OA, E Np U DINGS SPON CE Designer: Roger Nelson License Number: MP 226497 Date: 04/30/07 Phone Number: 715 - 273 -4444 Signature: 14 / t/1, i 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 (01/81) Version 4.0 (R. 04/03) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 600.00 Design Flow (gpd) 3.00 Site Slope ( %) 103.60 Contour Line Elevation (ft) 31.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd/ft) Distribution Cell Information 60.001 Dispersal Cell Length Along Contour (ft) 1 10. 001 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 10.00 ft /orifice 2. orcemain Diameter (in) 0.0 orcemain Length (ft) Does the forcemain drain back? Y 93.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 4.89 Forcemain Drainback (gal) 10.77 Vertical Lift (ft) 55.93 5x Void Volume (gal) 0.41 Friction Loss (ft) 60.82 Minimum Dose Volume (gal) 17.67 Total Dynamic Head (ft) 24.72 System Demand (gpm) Lateral Diameter Selection Manifold Dia meter Selection in. dia. options choice in. dia. options choice 0.75 x 1.50 x x 1.25 x x 0 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser 800 - 325- 84 56 1Manufacturer gal /in (enter result in cell B49) Dose Ta nk Information Effluent F ilter Info rmation 800.001 Dose Tank Capacity (gal) JZabel 1-800-221-574,fl Filter Manufac 22.241 Dose Tank Volume (gal /in) IA100 I Filter Model N Weiser = Manufacturer Project: Todd Marek 4 bedroom Mound system Page 2 of Mound Plan View 1/10 . [ 3 .. J Observation Pipe — K A ... . B . L Mound Component Dimensions Down slope toe extension made. A 10.00 ft E [AO.50 in H 1.00 ft K Eaft ft B 60.00 ft F in 1 10.00 ft L ft D 6.00 in G ft J 4.87 ft w . 600.00 (ft Dispersal Cell Area 1 1200.00 (W) Basal Area Available 10.00 (gpd /ft) Linear Loading Rate 1 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 105.87 (ft) —► H t .,,,,,, .. G F : ; : € 104.60 (ft) Lateral Dispersal Cell 104.10 (ft) — Invert Dispersal Cell t Elevation E D 3 J J} J J { ! t{ l -k, J Y J .1 AA J J LL 5 1 103.60 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell See lateral details on 1Q Topsoil Cap c ° 1.5 ft Page 4 for number, size, Subsoil Cap a c 5 and spacing of laterals. ASTM C33 Sand ` Z F Laterals are equally =Tilled Layer m 0.5 ft Typical Lateral spaced from the 05 E Aggregate v 55 _ distribution cell's - j- centerline in the A ` —* distribution cell (AxB). Project: Todd Marek 4 bedroom Mound system Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over the A & B dimension •— Turn- upvWball valve orcleanoutplug P _I All laterals are identical I<- X ----->I Hol es drilled on the bottom of the lateral S equally spaced Laterals & force main of PVC Bch 40 B (per COMM Table 84.30 -5) Force main connection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.08 ft Lateral Length (P) 58.52 ft Orifices per Lateral 20 Lateral Spacing (S) 3.33 Orifice Density 10.00 /orifice Lateral Flow Rate 8.24 gpm Manifold Length 6.67 ft System Flow Rate 24.72 gpm Manifold Diameter in Total Dynamic Head 17.67 ft Forcemain Velocity 2.52 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 LForcx" Alte rnate outlet location main diameter Weiser 800 - 325 -8456 Manufacturer # 2 in. Capacityl 800.00 Gallons Volume 22.24 gal/inch A _ Weep hole or anti - Dimension Inches Gallons B siphon device A 21.24 472.30 B 2.00 44.48 C P ump off elevation (ft) — t - C 2.73 60.82 93.83 D 10.00 222.40 D Total 1 35.971 800.00 Dose tank elevation ft) 3" Bedding uncTer tank. 93.00 Alarm Manuafacturer IS. J. Electro Systems Alarm Model Number 1101 HW Pump Manufacturer JGoulds Pump Model Number I PE 41 Pump Must Deliver 4.72 pm at F ­ 17 _ 6M ft TDH Project: Todd Marek 4 bedroom Mou ystem Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Installed by Nelson Plumbing Phone 715- 273 -4444 POWTS Regulator's Name St. Croix County Zonin Phone 715 - 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1200 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600 fe 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 monthl Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 ears 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 comp onent 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 •..,......•.•. a ......... Grade 6 -8" Diameter Lawn —� Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Todd Marek 4 bedroom Mound system Page 5 of 8 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 8- 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, Wis. 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 fitter shall be cleaned 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 fitter when removed from its enclosure. If the filter is equipped with an alarm, the fitter 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 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 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall 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 shall 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 soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (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 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 cfu /100 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 clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails 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 dogged 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 POWTS regulator and service provider. Project: Todd Marek 4 bedroom Mound system Page 6 of 8 GOULDS PUMPS Submersible Effluent Pump PE SPPARfJITtONS MGM ifFJ1T1N1E wrap Co": Geaual: ■ corrosion resistarc • Discharge: I Iff WT • Singte Ovae construction• • Temperature: 104 °F (4M. • 60 Heat ■ Cast'ron body. matirmw coniMuan when • 115 volts ■ T1lemloplsstic rand k* submb-ged • &A-in ftmd overload pro- cover. Solicit tecdon with airbmak resat. a Upper sleeve and lower maximum sphem • Clan B inwielbn. heavy duty l*-1 bearing • Autorrlatic models klude • 01I-fdled design. cor»rucdon. APPUCATI0lyS float swkth. • High strength carbon steel ■ htm is permanently Specially for the • Manual models available. shaft• lubricated for attended following uses: • Pumping range: see PE31 Moto. service life. • Mound Systems performance dart or ouve. • .33 HP, 3000 RPM ■ Powered for ew*ojrus • , Systems PE311P1rrnp: • 12.0 Maximum amps lll! ation • Low Pressure pipe Systems • Maldmum capeidt)r. 50 GPM • Shaded Pak design ■ ratings are within the woddng liners of the motor. • g�� p�� • 1Aardmura head: T5' tOH 1•[41 Motor: a disaorMlect • • .40 HP, 3400 RPM Power a"dtY 60 GPM • 7.5 Maximum amps cord, 20' standard i • Maldnaan head 29' TDN +lln EM NEMA 5.11 SP, three prong. PES1 PuW PE51 Ma tor 115 volt grounding plug. • Maximum cPdt)r. 70 GPM • •5o HP, 3400 RPM • Complete unit Is he" duty, • Mexiom head: 3T TUH * 9 Mwdrmm amps AA i� seal com carbon. MEMS FEEr ceramic, KW and stainless Wow! rt31. W41• Pal 10, :r _ }.+ i -r -: 2GPAl i AGPJC USTIM 30 1 FT FH �.. ..a.. ..y. »,...,_ ... -..« .. ... C0 l u S » ....a.. , .: ..f .- t...�.. " - -.. _•i ..�.- ..!... i r .. �. ;...�...._ . ;.a_.. 20 To" to ff1.77fI and CSA Z22 108 Slwd" is MOM" it IS01gtq lllp>rlrrnd 10 .�._.,_..' 0 ` 0 0 10 20 30 40 so 60 ' 70 GPM so pa9� 0 s �. 7.2 caA40 i n�lF GOt11dS PtN'nps to 2002 Goulds M Freer. Pm , 762 � ITT Industries apf31N1 Todd Marek P.U. Box 228 New Richmond, WI 54017 NW %,SW%,S25,T30N,R18W 1 • Richmond Hills Lot # 20 C3� 2 Richmond Township 2 S St. Croix County Scale 1 "= 40' h Weiser 12001800 tank BM #1= 100.00' tap of NW lot stake \ o BM #2 = 103.70' top of I" P VC pipe ' 30' of 2"force main a i � b t i X o / r t B2 v � a � j Gal C L �GO I'rois, C Dii !t ►✓s WELL i � I 1 � 3q Ave. Page 8 of 8 f Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, 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 not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and locatitmird distance to nearest road. Please print all lnfoogaii4lr . a awed by Date f r r Personal information you provide may be used for segbgZfeTY•purpose Privacy Law, s. 15 (1) (m)). �� I Property Owner pV.- Prope Location PO vt: Lot' r]�] 1/4 1/4 S 2 5 T 3 ON R 1 (or) W Property Owner's Mal Ing Address '. f r t of # __ Block # Subd. Name or CSM# nd Hills tat City Se Zip Code `Rhotte Numbe G pr�N ❑Silyi El ® Town Nearest Road 17 H 47L Richmo [�{ New Construction Use: ❑ Residential / Numbers€ bid :i ` -' Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Descr'Se -- ` Parent material glacial drift Flood Plain elevation if applicable na ft• General comments and recommendations: mo d at el. 104.60', based on contour line of el. 103.60' Borin ❑ Boring # Bo 103 80� 1 ® 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 /fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 2msb USE cs if 5 .8 2 -18 10 4/4 none sicl 2msbk mfr gw na .4 .6 3 18 7 4 none 2msbk mfr qw na .5 .9 440-84 7.5 4 4 c1d7.5 5/6 sl M na na na .3 .5 2 Boring # 0 Boring 31 U pit Ground surface elev. 1 03.80 ft. Depth to limiting factor In. Soil liration Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 2insbk cs if .8 2 9 -17 10 4 4 none sicl 2msbk mfr gw na .4 .6 3 17 4 I none sl 2msbk mfr qw na • 9 4 31 7 5 4 4 none scl M na na na .0 .0 I ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg /L ' Effluent #2 = B D < 30 Th and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel 02298 Address ffate 5valuatioretonducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 10 -20 -2000 715- 246 -6200 I Property Owne r Inc. Parcel ID # pendi nq Page 2 of 3 3] Boring Boring # ❑ 3 pit Ground surface elev. 102.70 ft. Depth to limiting factor 31 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 I - Eff#2 r -7- S—Rr 7-5yr414 n2p7-S)jr 3/1 1fQ r-j-qg rM7 1- gw na D Boring # ❑ Boring ❑ 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. Pit ❑ Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD, > 30:5 220 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 opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (8.6/00) STEEL'S SOIL SERVICE Gary L. Steel RJC Development, Inc. 1554 200th Ave. CSTM2298 NW'SW' S25- T30N -R18W New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #20- Richmond Hills "N `1 " =40' top of NW lot stake�e 1 Q0 Q0 top fo 1" pvc pipe @ el. 103-D' 41 3 � Gary L. Steel 10 -20 -2000 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer TO �� G Mailing Address C) toys, D a < Ne,�a Property Address f q () t3 !t '-�' 4 (Verification required from Planning & Zoning Department for new construction.) City /State �uc.�l�i -raw n c� (� Parcel Identification Number 0 a ( o a r7 — a O ` 0 0 (p LEGAL DESCRIPTION Property Location P �3 '/4 , s �3 ' /4 , Sec. a � , T 3 0 N R W, Town of i G�Ma rJ Subdivision i CA . \ MOI( - \G t Lot # . Certified Survey Map # , Volume , Page # Warranty Deed # 1 1 a ( , Volume 4 q 3 Page # 13 a Spec house yes no Lot lines identifiable yes SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 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 Planning & Zoning Department within 30 days of the three year expiration date. 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms _ SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) U 2H93P 132 . - 7s 1 92> GE, STATE BAR OF WISCONSIN FORM 2 - 1999 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between RJC Development, Inc., A Wisconsin RECEIVED FOR RECORD Corporation Grantor, 01/16/2004 09:30AN and Todd Marek Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEMPT # the following described real estate in St. Croix County, State of Wisconsin REG FEE: 11.00 (if more space . eeded, please attach addendum): TRANS FEE: 465.60 Lots 10, 1 , 20, 46 and 48, Plat of Richmond Hills in the Town of COPY FEE: Richmond, roix County, Wisconsin. CC FEE: PAGES: 1 Recording Area Name and Return Address KRISTINA OGI_.AND ATTORNEY AT LAW P.O. BOX 359 HUDSON, WI 54016 026- 1127 -10 -000; 026- 1127 -19 -000 026 - 1127 -20 -000: 026 - 1127 -46 -000: 026 -1147 -48-0 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of January 2004 RJC Development, Inc. v AUTHENTICATION ACKNOWLEDGMENT Signature(s) RJC Development, Inc., A Wisconsin Corporation STATE OF ) By: CQnA ) ss. V /l County ) authenticated this day of January 2004 — Personally came before me this — day of the above named * K ristin Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Hudson, WI 54016 Notary Public, State of _ My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du lac, WI STATE BAR OF WISCONSIN 800- 655 -2021 WARRANTY DEED FORM No. 2 -1999 NOTE: The parcels shown on this map are subject to State. Coun It,j ' laws, rules and regulations ( i.e. wetlands, minimum lot size. CCC etc.). Before purchasing or developing any parcel, contact the St. t Zoning Office and the appropriate Town Board for advice. UNPLA TTED LANDS I OVER, ------------------------------------ - - - - -- S89 'E I S89'52'26 "E 248.00' 215.14' 215.00' 215.00' =EaEVA'nON-1023.77 RK: LOT - 1 - CERTIFIED SURVEY LOT 20 LOT 21 LOT 2 j ----- - - - - -- MAP I TOTAL AREA: TOTAL AREA: TOTAL AR, 100,178 SO. FT. 98,902 SO. FT. 98, 902 SO °o I VOLUME O 2.30 ACRES 2.27 ACRES 2.27 ACRE ° O j PAGE_ 3900 � IW io I M = to I M M Iz I r o N 1 O j I z I. ............................... I 1 S89 52'26 "E 248.00' 4 I , 215.00' -- - - - - -- 220.42' - - - - -- -- - - - - - -- 215.00' --- - - - - -- - - - - - -- 215.00' -- S89'52'26 "E 980.42' M to ;- TOWN ROAD ' S89'52'26 "E 615.10' M tos.00 - -- -- 306.10' ----- - - - - -- •g' • S89", -- ------- - - - - -- 309 . 00 '-------- - - -- i i 33' 33' r ---- - - - - -- I O I LOT 18 , I H. W4 . - -- -�� I I LQT, TOTAL AREA: i I I .... I I ..... ........ ............ 90, 515 S4. FT..... I I 1 TOTAL AREA: : ' ° ' 2.08 ACRES N w 89, 925 SO. FT. �' ° o 'n a) F. F. E. 1006.0 O o 0 2.06 ACRES in N rn O rn F. F. E. 1006.0 f o N V N N Nj ° N I N W$ g 1 z i ac OD w _ °c t4 Z1 I I I 3 O I I I I W I : I to I 589'52'55 "E 616.78' in ' W 130.9 00' 1' 1 309. _— ... o I I 8 307.78' 1�... —.1 — ... —...— �. o I I%- ;244.40' z I z ' LLJ 2 C14 : ID 1 I to � \ r �o' Drainage Easement — 372.38 — — N ; ; — _ J i �. LOT 17 o ' o b �I I .W: � O ^, TOTAL AREA: N I N 91,979 SO. FT. , 2. F.F. 1 ACRES E. 10 � 06.0 I• r • ° N • • .... 9 ' 5 "N _ _ �• \ 1 1 `1 ... 141.85' W 1 1 \ \ M LOT 16 TOTAL AREA: 1 110,775 50• FT. I 2.54 ACRES MIN. F.F.E. 1006.0 �' ��� 49.74' , • ©\ S53'20'56 "W r ,- 33.00' ` <� • 321.00' \ • 4 �� 44 -- N89'52'26 "W 354.0 4 w-' �, ! S 58.01'