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HomeMy WebLinkAbout026-1127-21-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420315 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. — 1 Permit Holder's Name: City Village X Township Parcel Tax No: Danin er, Mike I Richmond Township 026 - 1127 -21 -000 CST BM Elev: Insp. BM Elev: IBM Description: to y /s 1 /0Y•/s I eA-_<7 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION / HI FS ELEV. Septic /a Uv Ben mark � 7 / L Dosing Ry_D Alt. BM u Aeration Bldg. Sewer T o-� 9t. - 7 6 Holding 1-It Inlet 10 t p St/Ht Out TANK SETBACK INFORMATION - f TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet b i Septic , / y / Dt Bottom Dosing 0 der /Man. Aeration Dist. Pipe Holding Bot. Syste J lo'rS � 0 .( -/- PUMP /SIPHON INFORMATION Final Grade bri �Si4 0 Manufacturer Demand 5-Cover GPM Model Number TDH Lift q Frictio Loss pp S TD Ft / O 5 + Forcemain Lengt 1 Dia a it Dist. to � ll SOIL ABSORPTION SYSTEM BEDITRENCH Width Length U No. Of Trenches PIT DIMEN NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS D/1 ASM SETBACK SYSTEM TO P/L E BLDG IWEL L LAKE /STREAM L C G Manufacturer: INFORMATION GHA R OR Type Of System: �� NI U f Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution yK x Hole Size I x Hole Spacing =Ve / tl Pipe(s) riY ! 2y 1 Length Dia a Length / Dia _Spacing_ / ` (J SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over 4- Depth Yes rp] epth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center ' Bed/Trench Edges To soil g p No ❑Yes f ] No COMMENTS: (Include c e discrepencies, persons present, etc.) Inspection #1: - i « /— IIn ection #2: Location: 1412 134th Avenue New Richmond, WI 54017 (NW 1/4 SW 1/4'25T30N i�18 R mondHills C% 21 earcel No: 25.30.18.831 /'lp IOC�'W'�_ GN1G�� 1. Alt BM Description = 2. ) Bldg Sewer le 9 - amount of cover 3.) Contour --/' Plan revision Requr {ed ?o3�so i - - - -_ -- -- � -- -- - -- - -� L f-/ No Use other side for additional information. SBD - 6710 (8.3/97) ,._ - Date Insepctor's Si ature Cert. No. — - Safety and Buildings Division County .. 201 W. Washington Ave., P.O. Box 7162 &4 j Madison, WI 53707 =° 7162. : e Site Address ISC ®J`1� /lI ` . . Dep artment of C ommerce ayf —DL A� fD3 /�'� 3 fr - Sanitary Permit Application Sanitary Permit Number In accord with Comm 83.21. Wis. Adm. Code, personal information you provide �� 31,5 ma be used for secondary Privacy Law, s15.0401(m) ❑ Check if Revision I. Application Information - Please Print All Information State Plan I.D. Number Property 's N , L Parcel Number �� erg 0ZCP �12� z,- t»C.�3 Property Owner's Mailing Address .- ' -; Prope 1v rty L�o+caaOn 10 St4rr ri4 l ,o 40 �J10 54:Sv' T- N. Ar City, State j Zip Code , U Lot Number Block Number_ NeW ��`> /�✓ 1 `� �� r j� Subdivision N CSM Number H. Type of Building (check all that apply) f o" p` 4 ''`"r• ❑City U1 or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public/Commer ' - scribe Uownship ❑ State Owned 03 u t N earest Road x Ito I o = ©.� Cs•� �3 Ave III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A For County use.. 1� New 2 11 Replacement System 3 ❑Replacement of 6 11 Addition to Sys In Tank Only Existing System B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 ❑ Non - Pressurized In- Ground 21R Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dis ersaUTreatment Area Informati Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate I System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft..). (Min./Inch) Elevation ddb �b� X00 i /f VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank V _ /�Gv' is er x Dosing Chamber t` VII. Responsibility Statement- I, the undersigned r espoacibllity for a POVM shown on the attached plans. P( is Name ) Pi ignature MP Business Phone Number Plumber's Address (Street, City, State, Zip Code) 09 0 ) 10 o C u /s �I', s'road VIII. Coup /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signatures (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse,, t Determination �- IX. Conditions of Approval/ for D' ppro - M Attach oomph Phu (to tha Conoq aalr) far the sYA— m papa not lm than Ka x U Inches In sin SBD -6398 (R. 05101) :, YLUT PLAN • -Page � of � Scale 1 "= y0' z\s' L07 U J (Z l v 0. 0' o ry 13 E LoT CO2hJ'Tz S rp,- E fltT -e: _10 .15'0).1 1:: 1" 1-VC PIA i i I O wl aF t- : � 3- L-- 0 � ti o v G. e'M t Z 4 qD `0 I G t'r2 I e I All , i 30 OF i. I i j x 4 t ss ° I � ,-° i 1 y� 111 ST Tt+ A _ NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 11 /g(3 gallon capacity manufactured by w1 CCAjG - ?-M W /P� —tgo0 74C�n3tst »L 4. Bench mark S tUV� �. Divert surface water around system to prevent ponding at the uphill side. Safety and Buildings 401 PILOT CT STE C WAUKESHA WI 53188 -2439 °�' i' a..l - �� TDD #: (608) 264 -8777 \Vhsconsin www www•commerc . o ns ov .wiscnsin.gov Department of Commerce 0 6 2002 Scott McCallum, Governor Philip Edw. Albert, Secretary August 01, 2002 CUST ID No.267341 ATTN.• POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAIN APPROVAL EXPIRES: 08/01/2004 Identification N umbers Transaction ID No. 774051 SITE: Site ID No. 648665 Mike Daninger Please refer to both identification numbers, Town of Richmond above, in all correspondence with the agency. St Croix County NW1 /4, SW1 /4, S25, T30N, R18W Lot: 21, Subdivision: Richmond Hills FOR: Description: Mound, 4 Bedroom Object Type: POWT System Regulated Object ID No.: 863972 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: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10573 -P (R.6/99). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the pioperty owner must follow the contingency plan as described in the approved plans. In addition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of mound component manual. A copy of this information must be given to the owner upon completion of the project. 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 Sanitat'y Pb ' t must be obtained from the county where this project is located in accordance with the req*rre ents of Sec: and 145.19, Wis. Stats. Inspootion,of the private a system installation is required. Arrangements for inspection shall be made with the design d c6, offic' * with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the a �ed plans, specifications and this letter shall be on -site during construction and open to inspection by i0orized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. ARTHUR WEGERER Page 2 8/1/02 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. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Julia A Lewis- Osborne POWTS Reviewer 2, Integrated Services WiSMART code: 7633 (262) 548 -8638, Fax: (262) 548 -8614 jlewis@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 TITLE SHEET Page 1 of - 7 14OUND SYSTEM FOR A L4 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD -1057 P and the Pressure Distribution Manual SBD- 10573 -P C [Z. b /9.9� C1a. (Zl�q� LOCATED IN THE 13vJ 1 /4 OF THE SW 1/4 OF SECTION Z S. , T 3 N, R 1B W TOWN OF �j COUNTY, WISCONSIN. CoT Z 0� 7 1WIW- 1 1 0bv7 141 !_LS INDEX RECEIVED PAGE 1 of 7 TITLE SHEET JUL 19 2002 PAGE 2 Of 7 SYSTEM MANAGE2.4ENT PLAN PAGE 3 of 7 PLOT PLAN SAFETY & BLDOS. DIV. PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR Pr�j 1 lv (S PREPARED BY WEGEE�ER SL? 2 L . TEST S NG ANN) . DES I CCTV S1 Y CE P.O. Box 74 421 N.Main St. River Falls, WI 54022 Phone 715 - 425 -0165 Fax 715 - 425 -6864 C�NS / � i 'zmz � wEGEREa D91S► Sl1SWORTR, �.. � 4� srcrti o � i JOB NO. Mound System Management Plan Page Z of 7 Pursuant to Comm 83.54, Wis. Adm. Code Seotic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. T east once every 3 years by inspection. Th erating condition of the septic tank and outlet filter shall be assessed at l utlet fi lt shall_h� r!PanPd as necessary f� ensure Proper o erati n. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may off the filter when removed from its enclosure. If the 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 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, Safety and Buildings Division. _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 filter 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 for frost protection. .Influent uali into • q ty the mound system ma not exceed 220 m Y g/L BODS, 150 mg/L TSS, and 30 mg /L FOG. 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 v e ery 18 months. When a p ressure testis perform p P o ed it should be compared to the initial test when the system was in required y stalled to determine if orifice clogging has occurred and if orifice cleaning is q ed to maintain 9 equal distribution stribution 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual _ P al SBD -10 ( 572 P (R. 6/99)J 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. C ontinoencv 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 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 clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at 1 l S — 3i� �� �� 0 Sr• L 1'�1 The system installer at 4 ZS — q 9S8 L —h/G The tank manufacturer at Abp 7 3ZS 8qS � L-i tI�M2lZ The effluent filter manufacturer at -, o -Z-ZI The pump manufacturer at � 3Q— S ZD_ 4 PLOT PLAN y0 Page of •, Scale 1 "= ' z� S' LUT L) tiJ s� 3r1 0 0 0 T QE LwF CoTi _Y IE�z. '0)' _T_�F OF t" PVC Pl�� I i I Corv`rov,Z ,'.C \ �' c2. 10 3 .s �U`f`fUwl OP t L J \ ° \ \ C, ,J 0Z 6 , a I ti Z pvC F. wt_ I 61-2 I Q � S i f 30' OF I / j q ` PVC' I ' I 4 aD R-" ! E X w �oh1 0 ss : t� rr- 5T NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required) . 3. Septic tank to bel1 /g gallon capacity manufactured by w1 LZ eU�.lC1 `fE W / goo ZA-�, F1 017---R 4. Bench mark SUU 5. Divert surface water around system to prevent ponding at the uphill side. Pace Or" 7 Approved Synthetic Covering ASTM C33 Distribution Pipe Medium. Sand H l _- fG T opsail P F Elev. I O 3 E 0 I b 5 % Slope Distribution Cell of Force Main Plowed to 22" Aggregate Z From Pump Layer D ©. Ft. E 1, O Ft. CROSS SECTION OF A MOUND SYSTEM F O - b Ft. G 0,S Ft. A (� Ft. H O Ft' Linear Loading Rate= 6 - GPD /LN FT B 1 Op Ft . Design Loading Rate= p_33GPD /SQ FT i Z Ft. J Ft. K Ft. A Position L b Ft. of Force Main W Ft. . I i j - Observation Pipe K -t W '�__�__ - -- - -- ---------- - -'�'' Distribution `•— Cell of 2 to 2 Pipe aggregate Observation' Pipe (Ancsbr securelY) • PLAN VIEW OF A MOUND SYSTEM Distribution Pipe Layout Pace S of '] Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each Iateral up with the use of long r= or 45' frt ng to a point within Six inches of the final made. Terminate the ends of the late..-als with a valve,threaded = or • threaded plug. Provide access from final grade for the valve; threaded cap or threaded plus. T`-tP1CT, L C% SS .5 �`i1V 1 �7 \3 C. PVC Lateral Manrtold Laterl X x x x12IV2 x x x x Lateral Length —`P Lateral Length — P Oistribu"on line F � � crcc.. =^mss stx C • II - --a P Ft. Hole Diameter S 3 Ft. Lateral " Inches) X Z� Inchas Manifold 2 Inches Force Main " Indies l of holes /pipe Z S Invert Elevation of.Laterals SXO- 1 = 10 '2s q _ 411- 0 G P Combination Sepl4c: and PUMP CHAMBER CROSS SECTION AND SPECIFIC ' PAGE OF 7 NELIT CAP_ WEATHER PROOF JUIJCTIOIJ BOX . `I'C.Z. VEMT PIPC % APPROVED LOCKING 10' FROM DOOR. MAIJHOLE COYER PJM 3DQ=4pt,1 :ilUDOW OR FRESH wARtJ1t.IG LA6EL. P IPE ALIIJTAKE cot tpu�r ` • w !tt r}Z�sttT r•frP � t i FI INI gii© 6 ,nu.'.y� U Sf I j If MIM. UJLET `" PROVIDE I �AtRTtGHT SEAL I III V I I Approved ZEE uw °'� I I�( Approved joint w/ p_`gpp j I II I joint w/ PVC pip ALARM PVC pipe a I I I I I C I I ou G3•$3 I I CLEY FL � PUMP __J � OFF D COUCRETE ZL. 3. U O et.oCK - RISER EXIT PERMITTED OQLy IF TAW MAUUFACTURCR HAS SUCH APPROVAL a 3"ApPQotiEp . B r=DO t tv 4 SEPTIC F SPECIFICATICKJS DOSE T MAUUFACTURCR: wLESf- C Jal° T� S,Q AJUM51R OF DOSES PER DA TAM SIZC GALLOAIS DOSE VOLUME r ALARM MAUUFACTURCR: - S`S� -�TR S�l 1(� IWCLUDIIJG 5ACKrLOW: ' GALLOht$ MODEL WUMBER: l': W CAPACITIES: A= i8 IMCHES OR �� 3 C U � GALLOtJS SWITCH TyPC: $ _ � IA7CHE5'OR S PUMP MAUUFACTURCR: 6ov� -�S G�LL041S C =� I OR � 3 'y GALLOLIS MODEL IJUMHER: ��� S LZC'Uvz- D= 1� INCHES OR Z�' GALLOMS SWITCH TYPE: u OTE: PUMP AtJO ALARMARE Tp�pC 6 MIMIMUM DISCHARGE RATE 1ql -O Cp INSTALLED OAJ SEPAR I M ATE CIRCU TS VERTICAL DIFFERENCE BETWEEW PUMP OF I FEET •� F AUD..015TRIBUTION PIPE.. g� + MtuIMUM METWORK SUPPLY PRESSURE SD FEET �S,.Ox + FEET OF FORCE MAIN X 3 �I " F jOFCFRICTIOAI FACTOR.. FEET TOTAL OtIWAMIC HEAD = Z 0 ' , FEET As per manufacturer ZZ. 2 4 gal /in. Liquid depth 3 btt Goulds o' 7 Submersible Effluent Pump - u 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and Farms manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical ROM, points. • Water transfer 230 15 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, , built in n ovv erloto ad with automatic reset. preset at the factory. rated oil and water resistant. 0 Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller. Thermo- /4' maximum. • Power cord: 10 foot • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING with pump out vanes for ,---� •Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP• Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding _ • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- (GSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F" or "AC ".) rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 ! I • Capable of running dry without damage to 9- 30 components. Pump: EP05 8 i • Solids handling capability: 0 25 3 �4 " maximum. a 7 ' ! W ---- - -- • Capacities: up to 60 GPM. s 20 zo • I • Total heads: up to 31 feet. L . I ; •. � I • Discharge size: 1 NPT. z 5 • Mechanical seal: carbon- 'c rotary/ceramic - stationary, 4 j BUNA -N elastomers. — (EP0 • Temperature ° 3 10 104 °F (40 °C) continuous 140 °F (60 °C) intermittent. 2 I ! V -- 5 ! ! ( I J I I 1 0 00 10 20 30 40 50 GPM L L 0 2 4 6 8 10 12 m -1h CAPACITY 0 1995 Goulds Pumps, Inc. Effective May, 1995 83871 Wisconsin,Department of Commerce SOIL EVALUATION REPORT Page 1 _ of 3 Division ot'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 St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and loca4oa to nearest road. din Please print all infoink''_ R viewed by La Personal information you provide may be used for se otkl�cy {iurpose Privacy Law, s. 15.Q4 (1) (m)). Y " 7„ Property Owner ,� ' Prop" Location R J C Develo t Inc Govt. Lo NW 1/4 SW u4 s 25 T 30 N R 18 K(or) w Property Owner's Mailing Address ;. z 4 0 - Lot # : M _ 2 Subd. Name or CSM# 1868 Ct Rd. C _ y , x 21 Richmond Hills City State Zip Code Phone Numbe �: 1 t [j city/ Village ® Town Nearest Road New Richmond I WI. 54017 (7,15 ). 24 YZIP Richmond Ut New Construction Use: ❑ Residential / Number of, bedropMs , — '- Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Des'cii&, - Parent material glacial drift Flood Plain elevation if applicable ft. Ila General comments and recommendations: mound @ el. 104.15', based nn contour line of el. 103.15' ❑ Boring # f�1 Boring 1 Pit Ground surface elev. 11 _ f15 f15 ft. Depth to limiting factor 3� in. Soil lication 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 2 8 -18 10 4/4 none sicl 2msbk mfr qw if .4 6 Boring # El Boring 2 104.05 ® Pit Ground surface elev. ft. Depth to limiting factor 28 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 -17 10 4/4 none sicl 2msbk mfr aw if 4 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L Eiggent #2 = BOQ 30 mg/L nd TSS < 30 mg/L CST Name (Please Print) Signature . CST Number Gary L. Steel 02298 Address Date Efaluation0onducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 10 -20 -2000 715- 246 -6200 Property Owne , Inc. Parcel ID # 17endinq Page 2 of 3 -3] F Boring # ❑ Boring Pit Ground surface elev. 102.25 ft Depth to limiting factor 37 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 2 9 -21 7.5 4 none Sicl 2msbk mfr I aw if 2 7-5yr 4/6 none R1 2m--,bk mfr cisa nA - S -9 4 3 7– E Boring # E] Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. 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 F-1 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. pit EENplication 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 alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (8.6=) I • STEEL'S SOIL SERVICE Gary L. Steel RJC Development, Inc. 1554 200th Ave. CSTM2298 NW4SW4 s25 T30N - R18W New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #21- Richmond Hills .111 "=40 -I�M= top of NE lot stake @ el. 100 ' /Alt. BM.= top of 1" pvc pipe @ el. 104.15' U , s V �s, o N, �s L Z m 3 n� Y Gary L. Steel 10 -20 -2000 ST CROIX COUNTY SEPTIC TANK MAIN AGREEMENT AND OWNERSHIP CERTIFICATION FORM Own c u 1 0° 4 e Mailing Address A/0 5&r 6 !` e A A e 4e- Age U � .S�5 �e n . Property Address (Vui&catioa required from PlaaniQe Department for new coastmctioa) Cityrswc, 9CN //e ��, - P arcel Idcnttfication Number � / JAGAL D C 1'TXON 6 a6 - OAF - 9 l 't�JDd Propa[y IACatIOa Soc _ T J�Cr N �w. Town of Subdivision _bV (.t;�%�/✓ Lot # / .l CeCftf"�ed Stuvey Map # Volume . Wage # Watraaty Deed # 1t� Volume 7 /o'� _ Page # 5 Ya II O Lot lines idauti5able a ye p, no _ Imaaseaad � mp �cof7�rsysdcaieaoatdnaaltiai� . j .. , �� . consists afpaappmggontt5caepfiedwkcvcty6mycma PaGfaJeoeet�olia :udtcvr:st�es.Proper as :ffodtbea�Bie agc�o�ast a00°w. ¢uoadodbjltiarsodpamapc� Wb3�yo¢p� F° yownetap=to wbmit to St CAaix2A dwc iLM n sigood by8,ao�o�xsndby s or =Ti°ca1A "(t)dre;edb aste�aGadss uisyduk a ` ' °0it -C¢ the kis less Am fidtofdodgc- _ 1 od ine oa�tt me abo,� ,ad,�ax to a:ai o P die t sys4cm. &C sadmdstds �etfaoe4,laeig�tsatfry , - '���' Sdtcofwmooasia.. d ofd GM dtt,- n�beoo odaadrebumodto me s`t c�Coumit3+? gOl�oe t S'[Gl`TA'IURB OF APPII DATE OCAtiON Y tom) oe * that all zWcm=ts oa this foaa an; twc to &c best of my (out) ImawLod I (wc) am ( &o owact( of above. by vitt u of a wamuq dwd rcm�cd is Rc&cr of Deods OW., S[GMTM OF CANT 10 9 DATE ssssss AW k&=tift tlimt is mis - t*dmay cestrlt is flue unitary pcanit being wwolwd by the Zoaiag Department- `••••s ss Cadade hdth tuts appticadoa: a stumpod wunnty dcod EMM the a Dopy of the eaeetitiod �' of Doods otY'ioc Y map if mf=occ is oaadc in the w& nasty dcod J 192 2 )1 STATE BAR OF WISCONSIN FORM 2- 1999 6 6 4 5 0 3 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIX CO., MI This Deed, made between RJC Development, Inc., a Wisconsin RECEIVED FOR RECORD Corpo ration, -- `- - -" 07 -18 -2002 11:15 AN _ WRRRRNTY DEED Grantor, and Michael J. Daninger EXEMPT 4 - - - -- - - _._ REC FEE: 11.00 TRANS FEE: 93.00 _ COPY FEE: CERT COPY 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 Lot 21 Richmond Hills, St. Croix County, Wisconsin. Name and t s SUITE ?_OO 19W SILVER LAKE ROAD NEW BRIGHTON 026-1127-21 Parcel Identification Number (PIN) This is not _ homestead properly. i (X) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this -A-'--/f day of July 2002 RJC DU`V By: J hn H. Carlson, P - AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) - - ) ss. - St. C roix County ) authenticated this_ day of - —' - Personally came before me this 14 y '44 day of June 2002 the above named RJC Development, Inc., a Wisconsin Corporation, by John H. +— - C arlson, President TITLE: MEMBER STATE BAR OF WISCONSIN to me known to he the person(s) who executed the f ng (If not, _ instrument and acknowle ed the same. authorized by § 706.06, Wis. Slats.) y/ -0 7 THIS INSTRUMENT WAS DRAFTED BY + Notary P IIC Attorney Kristina OglandtB MTII - Notary Public, State of Wisconsin Hudson, WI 54016 - My Commission is permanent. (If q nnot, state expiration d e: (Signatures may be authenticated or acknowledged. Both are not necessary.) - /?7. -/ . ___ , aL ) -) Names of persons signing in any capacity must be typed or printed below their signature. ldom,arion Froresaiaab compny, tuna au lac. VN STATE BAR OF WISCONSIN 800-655 -2021 WARRANTY DEED FORM No. 2. 1999 i i 40' 07 26" 5 /9' 43' 3 5y' 39" by W N OU IL 41 W 38'10'05" 580'42'180'1'41 "W S61'37'14 "W 267' 55' 19" 15' 3.4' 561' 37' 14" W S 30' 27' 27" E 41' 09' 21" N 44' 55' 465' 30' 26" W N 24' 21' 05" W ' 90' 07' 26" N 20' 42' 324' 21' 05" W N 65' 46' 21" E i Z 83' 46' 12" S 72' 20' 365 46' 21" E S 30' 27' 27" E ' 35' 41' 05" N 17' 44' 37.5" W 35' 35' 10" W N 00' 05' 55" E a I y I� I� I O I I I I Z UNPLA TTED LANDS 1 --- ---------- - - - - -- ' WEST LINE OF THE SW 114 ' .SEC770N 25 -30 -18 33. 0 -< N00'25'35 "E 460.01' • U) — — — — — — — — — — — — — — — -- — 10' ----- - - - - -- i 66.00' ; 00 — = l0 66 i i M 8 33' I N �� i� n y ;C ID 10 ....... O orr imis r '' ID I I I u 1 1 N JL4 IW I I �£N 0 91 � � 10 i� ' O 10 m I < 1 o Im I IZ O I I O :Q ______ N00'25'35 "E 460.01' ____________ ^. (A . ; a N I 1 I m I I 5 I I N w Oy o r 35' I I o o a p 0 ' 33' c I � 1 a I o I I I t0 S00'13 53 E 460.01' I I o r as ' pp I o° 33' I i h� v I 1 I � j 1 I o �� I � ...... N N °por 2� N I o I I A n a p I O I � I 3 - - - -- i 1 I I o a S00'13'53 "E 460.01' h'02Y N4101 I cn o I aD • a I 90'------ - - - - -, I t (J1 m i I I N I I ° m 0 ��•, i A D N 1 y L4 I . m rq D S00'13'S3 "E 460.01' U) I N I � I 1 1 (n I I 0 .