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HomeMy WebLinkAbout026-1127-22-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division„ I INSPECTION REPORT Sanitary Permit No: 420352 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Marek, Todd I Richmond Township 026- 1127 -22 -000 CST BM Elev: Insp. BM Elev: BM Description: l�l � Cnr • s-�.l� TANK INFORMATION 9LEQATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI #T FS ELEV. 861# l "/( I ' 0 Septic Ber?chmarki&m � ! /D IoD, o Dosing / Alt. BM lr�423'- -4 o 3 . Aeration 7 Bldg. Sewer Holding St/Ht Inlet ,Z / TANK SETBACK INFORMATION St/HtOutlet �I 9d'.0 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic f i� / r Dt Bottom 3•S Dosing / �• f1l" Header /Man. I '73 Aeration Dist. Pipe.* P o , p 0 .? d o/ Holding Bot. System J PUMP /SIPHON INFORMATIN � ,�,L Final Grade / S , O IL /Oa?•S Manufacturer Demand St over GPM /c0 2. D Model Number ' 4­0 S' 2 , i 1 TDH Lift Friction Loss Systerq ilead TDH Ft 2 2 - 3.3 (3 1 ry ovuv Forcemain Le f Dia. h D st. to Well NOT / A/ G SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. O f Trenches PIT DI ONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / // /1� SETBACK SYSTEM TO PILL LDG WELL,k/or LAKE /STREAM L C G Manufacturer: INFORMATION Typ Of System: CHA ER OR I 1 Y FT / U T Model Number: DISTRIBUTION SY5ftEM / > . /',y - Header /Manifold �) Distribution x Hole Size x Hole Spacing Van to Ai Inta e Jul Pipe(s)� f —2 S g > � Z� It I j < Length D' Length I ( Dia pacin SOIL COVEk 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 'Y Bed/Trench Edges Topsoil Yes LJ No 1-i Yes Ji No COMMENTS: (Include4 de discrepencies, persons present, etc.) Inspection #1: / Q 2 Inspection #2: /� / 0 2 Location: 1416 134th Ave New Richm nd, WI 54017 (NW 1/4 SW 1/4 25 T31N R18W) Richmond Hills I 22 Parcel No* 2 .3C0 § 1.) Alt BM Description = R)d -& - �� r Y , 1�►+ � 3Tlvm,� /'� .5 V� ` U l') 2.) Bldg sewer length = 3q 14 '��� ",A,_ kle_ &4-- S�{d_ 4lrtU_4tXg- 6PW CAOd ! amount of cover = 3.) Contour Plan revision Req ' ed . s i� No I Use other side for additional information. SBDc*aO (R.3/97) Date Insepctor's gnature Cart. No. sd and cjinj — a r 201 W. Washington Ave., P.O. Box 7162 1 �7VVnsin Madhm WI 53707 - 7162 She Address Department of Commerce �� 3 Sanitary Permit Application qZ0 in accord wA Comm 8321. VHL Adm. Code. peru mil iotormadon yon F O Cbwk if Revision be used far Iiw s15. 1 L Appl�tioa Infor�on - Phase Pfd AR Information Soft Pkn I.D. Number Pew ownees Parcel Nos ms's Address QU Property I.ocaaon UN Tv 14 YJlt.S T • S �. Slam Code Z FIG I.ot Block Number Subdivision Name Number (.,c� � l IL of B»it� (died[ all that apply) ^� °�i �! or 2 Fkwt y Dwd nog — Number of Bedrooms J Ovww O %wirxounncrcial — �� .. 0 Smse owned • f s — Nearest Rmad III. Type of Pumit: (C>sea a* sae ban an lie A (numbeft sdmw for btw'W Use). Campkte line B if applCabk) Repbcem A 3 O eat of 6 O Addition In Foe Coumy use 2 O RepiaccuwM Sysnem Tank Dare lamed B. O Qleck if S owly Permit Previw* Issmd Permit Number ]W. Type of Penult: (Chedr an that rllply)6wnM ring scbtmte Is for interval use) Ofl . 44 O Non Pressed Ia Graoad 210 Mound 47 O Saud lfer 50 O Cooed Wedamd 22 0 Pmwriwd In Gmaod 410 Holding Tank 48 0 Single Pass 510 Drip Une 45 0 At -Glade 46 0 Aerobic Treatment unit 490 30 O odier V. Area 1>$olcam: Pin Raee Sysoem $kvadoa rod tirade Design Fksw (� Area Dispersal Area Soil APPS Req&W AO Rate{GatsJDayalS9.FL) (14in.1lacb) 4z JU s� /o 6 vL Tank Info cps► Nmnber � Prefab Si/e Sad Fiber Plastic Canoes Gallows of Taroks cownts Cousuoesed [Riess Sepae ar lieldi g Tu - Ntew �t Tads TaaYs ck i� pkim �, Statsa>am4 h for of the Pom sbown an the atfadred phmdser's Name (Prim[) phunbees Iken pRS Number Basisosxs Phone Number U Phdssrs Address WeeL CRY sw- 'e L C ' DaEe Issued Agent (No sm ) 3xmtM K Approved 0 Disopproved) pee (imchsdea Gromdwaeer 0 Owner Given hwd Adverse r M Cow of AppmYSIVReasm" far Disapproval_ / /1/� @0 W , . �� A � Swh g em pl t� 6o rev ee�.av °�1 ur nee e�aiem sew •a le.. aem aln s u mriee is dime SBD -6398 (R. 05101) . r ����.� s, six.... s;• .,� r r ir l P OT PLAN .4arek ADDRESS P.O. Box 148 New Richmond Wi 54017 ,4 SW 1 /4s 25 /T 30 00 /R 1 W TOWN Richmond COUNTY ST. CROIX MFRS Shaun Bird 2269 DATE7/20 /02 BEDROOM 3 CONVENTIONAL ; ATi-RADE )= CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 848 HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 125 # of chambers n one BENCHMARK V.R.P. Top of NE lot Stake ASSUME ELEVATION loo' Filter Zabel A -100 ❑ BOREHOLE WELL MH.R.P. Same as Benchmark O SYSTEM ELEVATION 99.5' B.M. 215' Property Line #1 Scale = 1/4 = 10' Tanks are to be properly bedded and provided with lockdown covers with approved warning labels 4% Area 15' Below System is to Slope remain undisturbed B -3 99' Grading is to be B-1 done to divert run- off away from system 100 ❑ DT B -2 B.M. #2 101' ST Well is to meet all ro setbacks found in ca V Comm. 83 Pro 3 0 Bedroom m House Town Road I� Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 "\ *isconsin www.commerce.stat ons Department of Commerce www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary August 16, 2002 CUST ID No.226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/16/2004 Identification Numbers Transaction ID No. 774009 SITE: Site ID No. 648652 Todd Marek Richmond Hills Lot 22 Please refer to both identification numbers, 140TH St above, in all correspondence with the agency. Town of Richmond, 54017 St Croix County NW1 /4, SW1/4, S25, T30N, R18W Lot: 22 FOR: New at grade system, 450 GPD Object Type: POWT System Regulated Object ID No.: 863940 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: ROM • This system is to be constructed and located in accordance with the enclosed approved plans and with the "At Conchth Grade Component Manual, SBD- 10570 -P (R.6/99)" and SSWMP Publication 9.6, Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems. sr • In the event this soil absorption system malfunctions so as to create a health hazard, the property owner must ENT OF follow the contingency plan as described in the approved plans. In addition, the owner must insure that the ' SAFETY operation, maintenance and monitoring duties as described the At Grade Component Manual are complied with. A copy of this information must be given to the owner upon completion of the project. — (70RRESF • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The maintenance plan for this system must be given to the owner of the POWTS. Key Item(s) • There shall be a total of 57 orifices in the laterals. The designer proposes to accomplish by using 56' laterals with 2' hole spacing. One lateral shall have the first orifice next to the tee and will have 29 orifices and the other lateral shall have the first orifice 2' from the tee and have 28 orifices. SHAUN R BIRD Page 2 8/16/02 Note • The designer proposes to install an effluent filter to achieve the requirement of wastewater particle size. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations. Reminder • The orientation of the at grade system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the at grade per At grade Component Manual. • Surface water drainage shall be diverted away from the system area. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. 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 Patricia L Shandor POWTS Plan Reviewer, Inte ervices WiSMART code: 7633' (715) 634 -7810, Fax: (715) 634-5150, M -F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 7/20/02 Own 7 " nr:Lot Ma Lnd Loca22 Hills Syst Manuals Used: At -Grade Component Manual version 1.0 SBD 10570 -P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST- SAS (01/81) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section T. S, 4. Pipe Cross Section /Pipe Layout mall 5. Pump Chamber Cross Section 0Mh RCE 6. Pump Curve AN 7-9. M in n n 9 a to ce and Contige cy plan 10 -12 Soil test or.oErvcE Shaun Bird Signature License number 226900 7/20/02 P OT PLAN PROJECT Todd Marek ADDRESS P.O. Box 148 New Richmond Wi 54017 NW 1 SW 1/4s 25 /T 30 /R 1 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7/20/02 BEDROOM 3 CONVENTIONAL AT RADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 848 HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1125 # of chambers n one BENCHMARK V.R.P. Top of NE lot Stake ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 99.5' B.M 215' Property Line #1 Scale = 1/4 = 1 Tanks are to be properly bedded and provided with lockdown covers with approved warning labels 4% Area 15' Below System is to Slope remain undisturbed B -3 99' Grading is to be �A- B-1 done to divert run- ❑ off away from system 100 DT B -2 yl � B. M. #2 101' ST Well is to meet all , setbacks found in Comm. 83 Pro 3 0 Bedroom m House r Town Road m L ON > 51 B > 5 i�— P V C Fo 4lGEMA1t�i > " 5 r r Z TURN — UPS" t-- DIsrAa&U L.ATIL.RAL W I A ' STASIU ZEb oBsERKAnbr► WE LL o � > 51 r8 . 1/6 B PL6 B l/2 B g= .3 1 t� L - F { CE of % a " Z /Z ArzGQEr.ATE. � = ate �t. • P&QPRb'tEb S- fMTaE - nL Fabric Distribution Lateral STAI 161r_b Observation- ---- -. .�U �� Soil Cover � t 12te Well 2't ` —� , .t l 6tt (: y . \ .�.' r ,�. \' PL6WF0 LAVE.2 > A %2` >5 %a 5 LofE- Flan View # an ss Section of Wisconsin At -grade Unit with a Single Abso on Area on a Sloping Site �J Si�+.to.-ruRE.: Page Of Distribution Pipe Detail For Two Lateral Network r Ae C E SS 8n X TuRN - uP (C.LF-Rr1ou T) Holes Loca On Bottom Are Equally Spaced PVC Force Main * PVC Distribution Pipe V X a - F X * Last Hole Should Be ;;ext To 7 �����O�C� ru ��Q - uP t�CN\ �( S P S Ft. Hole Diameter z 3 ll� Inch X Inches Lateral Diameter d Inch {es} Y �� Inches Force Main Diameter Inches # Of Holes /Pipe o? invert Elevation Of Laterals Ft. Signed: License umber: Z z b PO Date: 7..-� �Z r - MAU FA ms R "t M t fc. VC16IT CAP i wtATMCRrROAjr ~s APPI10vto t.OtKt�jf; an �tlo:� OoCR. � 1 .:0lUC'rs0AJ eaveR i�00wOtt r1tl�trt ! tt'K'aa. ORADC i dL am or i ! A1RTIOK* MA6 t f A j ��� • ! 1 ( t Ai.ARM i f ! A~E0 PIPE f . 3 wo O SOLID SOIL off COUGUTt 106 • KiscR MUT rtRAi O dkiLy tr TA1rI1t �+►wf►AeTL1RtR 14AI &WW4 Af+'ftOVt�1. Wft we a11eClRlGATlflRl � NtAUtit!`ACTidL1ER: 3 k%u%"R OF Dohs: PCs Il" 'wit fi1<' `� $� bAL,bpWS L10f= VW.YMi � 1 'wM�C1'ifRiftt irc0 ttICLYOi#iQ� IµCK��1Vt ��,� �wflY.tf Teti d s i ww ii OA D S p sse " on SwtTCM !rve= i M� AWD ALARM ARi Tb b! AMi1M111% OfiClflrROi RAYi f,/►� 2 StMOATt 4104UITS 4mritA16 8111410,91 t#f 1" wacht ftm b►* l ya Dayinsu m pri.. 15- L + MAR �►v«t wtTM►olt�c su1�.� ........ 3r ; sceT * ` f'CtT Oft P1 PAIN x 2 12. 6 .2 t ssl�rtteTlou *os.� z . LL/ an go ye"". 9"Amm. NtAO Gam.. l�teT tr'Rt Ai- QcAttA�i or rr►t�,tKs t.6Af bTh � iWtDTti .,. ,., 1 L OCP'!M +ri..r.. v�:!<G' s.tGC Al:1• vuM,6fi R: �t'�7 �t/ � .... Y y _ r- - 30 _.- a lrb t4 Nil 0 ,� 60 7t m - _ 16- 29 3S 30 33 ice 70 s _ - - r � 30 vk iidmsL OW. - - _ t. r . 8�716:- 7i Y :is+esto�s �-� ad =$ear �w sai - = _ ftd ®1998 tlydiaw" PWwp�. 14r a1O` /li ws Rwan'd - YwrA�o� VDROMTC NOML bFpff Maintenance and Contingency Plan for a At -Grade System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3 Effluent fitter i to be cleaned once a year Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 4. Once every 3 years the At -Grade is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below at -grade undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump with out float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If At -Grade fails, determine cause of failure, test another area or remove pipe and sewer rock, retill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715- 246 -4516 Pumper: Tom Mondor 715 - 246 -5148 St. Croix County Zoning 715 - 386 -4680 Shaun Bird #226900 7/20/02 . PLAN Page _ POWTS OWNER'S MANUAL- & MANAGEMEN SYSTEM SPEdR�►TiONS .E MFOitM 1!2N Septic Tan k CBPMW NA Now Septic Tank a NA �e[tttit Eff nerd Fier iAWuftCbM &Z ° NA tGN PARAMETERS D NA Fier Mode Af — e(9 E3 NA ithrnber'of Bedloom pjKWTw*CapaW ° NA ftmbW ofoo ukft 3� To E3 ° NA w3da"ft pump ftW (ate) .pimnP a NA dxi -`�? �J ... E3 NA Of K 400 Ram t t Sa Application tit wag= MbeitaueeLy Mir ° ° tit tamer F out & Grew (FOG) s3o mgn. ° Med AsraWn ° Welland :s220 noll. a �h :51 � Total Skaparded Solids .. Ce0(S) P Demand t1 120 man. ° ) a Mound S30 man- °other: t j s1o` duf10Ourd ° � WO Fecal Vak= rYPd �domesec c t Particle size •. z@PftbwkdM V NAKFEl�l SM SCH LE S r:F ce uency At lead Once every Servnt s) ULv nuan 3 yrs -) tnspt# Cp�on of VYhet► c anr�ted s and scum ng. thad (Y� of tank volume p out aothbents of tanl4s) O mwdths s) (UAAnwm 3 yrs -) lunaspeddispersd oe�(s) At !east once ever ° mom s) At cast once enrerY t At once every ° moms ` its) ° NA Inspect F04% p� 8` alarm months Yeats) ° NA Flush and pressure test At least once every O rnonft Q year(s) ° NA 011M At I�st once every Otl►a: At hst once enrery ° nwaga ° y�is) ° NA gWpTENANCE WsTR�U ca b s be made by an ihdivi�i ca+t1�+9 One Of Maw' moss of M PN�r Sewer: P01 ) icy any or txoken up S Tank I n clu de volume o f Serge and scum and 10 check foracct / t tram y aa ground � The fig) dM be inspect on the or p of edkmt in obs opeS and to the nun n ah of the local re y Sufflor tip suriaoe � ;�cate a fai6rg ti9 or more of the taNc vo kww% the VAM the owbined acaxha�Dn of sNdae and scum any tack a and asposed of in aocoodanhca *41h ch- NR entire Cordents of the tank s be renowd by a Sap Son* 113. WISOOnsin cow' and any POWTS component Adrnk'sUafiva Code. The secvidng a 'mat of 12 or less be p by W'Med POW1� t other n� or m !the lor.� re9 Y a 10 daps of complOw of any service even A servile tepaE or otW presence o f p*&* products START 1JP AND OPERATION use of the POWTS check U twdgs) for t ; For new cordon. p vealmen anoW daxaage the des that► d have the contents of the Will �v�ed by a Sept ser vicing i to use Page of System stmt up day not occur when sod condltions ate frozen at the itttDralive surface. asw9 poww outWw PWW Waft MW O above normal hWwi levels. When power is ms6ored the exC8= vwractewatar unto be aged to the dispersal mss) in one bqp dose, overloading the cell(s) and may result in the bacla or swboe of . To avid thds situation have the cogs of ft pump tatdk removed by a Septege Servkhg OPi pdorio restoring power b One efflusitpuinporconlacta Pkindw or POWrS Mdatairmto, assist in maraca/ the pump oontrots to restore normal levels with the pump tardL Do not drive or park vehicles over tattles and dispersal ceps. Do rot drive or park over. or oUmwise disk or compact, the area WOO 15 feet down slope of arty mound or atVrade sod abg pdon area Reduction or allminallon of the tal owing " the wastewal er stream may improve the pedonrrartoe and prolong the We of the POMYTS: arr�ioats Wby - b aonon s dentai GUS; diagmss; � fat; � � (umP pump) walw.11ruit and vegetable pee6rgs< 909011W 9 herbicides; meat scraps: medcadonK at 09FIft pro� p y tmrtpats; - and water sollenerr brine. ASYENT VW= g tVihe POWis artdtor is pertnan�tly taken out of service the fo®owig slaps shall to taken to lamne that the Wirer t - system is propm acct safety abandoned In compliance we ch. Cam 83.33. MisOav3ir Admirdstrallve Codes . Al pil" bo tanks and pas shali be disconnected and the abandoned pipe operrigs seated. • The contents of ad tanks and pits shall be removed and properly imposed of by a Sepbge Servkbv Operator. . Afiar pumping. ail tanks sad pfs dM be ocavated and removed or their covets removed and the void space tied wdh sA 9ravd or aro8rer inert solid m CONTINGENCY PLAN If the POW taps and cannot be repaired the *Mining measures have been. or must be tomk to provide a code t p q sdiable MiOrt has been evaiuded and may be uffled for the locedon of a replacement sag absorpdan sY�- The reggeoement ate should be protected from drsdu an baree d compaction and should not be infringed upon by nxpd ed setbacks from a m%V ark proposed lot RM and weds. Failure to protect the replacement area v M result in the need for a new sot and =*W igivaluman to estabfish a srdiabie re pl a cement area. Replacettrent systems must comply w M the rules in effect at that fine. O A suitable roarrerrt area is not available due b setback and/or sod drtItations. Baffk9 advances in POWYS as a last resort do the faded tatdcmay be + tednology a tending _ area. facture of the POWYS a sal and The site has not been eve tocabe a ,u ble area f ff no replacement area is available a site evaksanan ntuct be p hol ft w* may be irked as a last resort to replace the faded POW TS- it wbh s removal of the biorrrat at be neoorrsf<ructed place �: I d and crude sal absap6om such = comply the odes in t at that tiro. the ire sruface, Reconstruction systems <-lIIN©> SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CON LETHAL GAS ANIWR BISg FFIgE1�1T OXYGEN. DO NOT ENTERA S F A P PUMP FROM THE OF ATANK NAY -T OR MWOSS113M RESULT. RESCUE OF A - ADDITIONAL COMMENTS POWYS WSTALLER POWTS ttAA1NTAIlER tune Name .� Phone 7� — ` l •� P rorre � - 77 V ? T � — `' F�iraGE s ncwG OPM►� Local REGULATORY MMOR1TY S .5�. C� ` Name �►�- y1'1 Phone Phone 7� r this aoaenaM�sdraltod bYa�e s� er c�1eeA � Mwrjeft and Wash= CeuW Zwft and fteaft M& do A° � Th ,. Cann r , „ ia4 ord ts3.2ZMXIXdM and 4 n o). M & M " Adze da Co the d pis doarrr+ent does turf► (y tl+e pedommom of the POWTS- 'Wisconsin Department of Commerce SOIL EVALUATION REPORT Page l— of _ 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County S 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 refer%o, -p nt,(MM, 4rection and Parcel I.D. percent slope, scale or dimensions, north arrow, arlt! lod�tw and didtarSc610 nearest road. pe ndin g Please print all /hr0rP 4tion R wed by Date Personal information you provide may be used fo Jbcoondary pq 0 y Law, s. 15:04,(1) (m)). Property Owner Property, Location R ? L `' Govt..Lot NW 1/4 1/4 S 25 T N R (or) W Property Owner's Mailing Address -' ` Lot # Block # Subd. Name or CSM# 1868 Cty. Rd. C � "�tl'' 22 City State Zip Code '4t1l r* Nu l ❑ 01ty ❑ Village KC Town Nearest Road New RiChmondl WI 1 54017 (7I 'y 247 -5721. Richmond 1 40th. S t . f Rk New Construction Use: ❑ Residential / Number of bedrooms _ 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material glacial d r 1 f t Flood Plain elevation if applicable na ft• General comments and recommendations: mound @ el. 100.70', based on contour line of el. 99.70' Boring Boring # 1 ® pit Ground surface elev. 1 • 3 0 ft. Depth to limiting factor 38 _in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -8 10 r 3/3 none L 2msbk DSH cs if .5 .8 2 8 -20 10 r 4/4 none sici 2msbk mfr w 3 20 -38 7.5 r 4/4 none sl 2msbk mfr w na .5 . 4 38 -7 7.5 r 4 f1f7.5 r 5/6 s 1 2msbk ❑ Boring # Boring 2 © Pit Ground surface elev. 10 0 . 3 0 ft. Depth to limiting factor 42 i Soil A Iication 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 1 0 -9 10 r 3/3 none L 2msbk DSH cs if .5 .8 2 9 -20 10 r 4/4 none sil 2msbk mfr qw if .5 .8 3 20 -42 7.5 r 4 none sl 2msbk mfr ClW na .5 .9 4 42 -65 7.5 r 4 W scl 2msbk mfr nA nA .4 .6 ' Effluent #1 = BOD > 30 220 mg /L and TSS >30 < 150 mg /L t #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel �- 02298 Address Wateuation Co ducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 10-19-2000 715- 246 -6200 Property Owner RJC Development, Inc Parcel ID# pending Page 2 of 3 Boring # E] Boring F3 [ pit Ground surface elev. 8 ' 9 ft. Depth to limiting factor 6.— in. mil 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 1 0 -9 10 3 none L 2 9 - 4Z4 n one 2msbk mfr if 3 26 -60 7.5 r 4 6 none sl 2msbk n .5 .9 .4 .6 E Ong # E] 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 F-1 Boring # F1 Boring Boring Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD, > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 5 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- 2648777. SBD4330 (86/00) 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 townof Richmond (715) 246 -6200 lot #22- Richmond Hills I -- f =40' -BM= top of NE lot stake @ el. L99 ./Alt. BM.= top of 1" pvc pipe @ el. 103.00' 't D li ky'll C N Gary L. Steel 10 -19 -2000 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM I Owner /Buyer Mailing Address 11110�k Property Address a z t (Verification required from Planning Department for new construction) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location /4, ' /4, Sec , T W, Town of ) — — _ Subdivision , Lot # Certified Survey Map # �— , Volume , Page # �— 1 Warranty Deed # Z , Volume , Page # Spec hous yes ❑ no Lot lines identifiable ❑ ye SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix 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 s stem has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days oft liree yea a piration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I ) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of Y the p YIV ove, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT 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 ( 7 STATE BAR OF WISCONSIN FORM 2- 1999 6 8 6 1 6 2 WARRANTY DEED KATHLEEN H. UALSH Document Number ST. CROIX O CO. , WI This Deed, made between RJC Deve Inc., a Wis cons in RECEIVED FOR RECORD Cor poration, - - _... 08 -06 -2002 9:45 AN - - -- WMRMTY DEED Grantor, and Tod Marek EXEIPT i REC FEE: 11.00 TRANS FEE: 261.00 -- - -- 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®2 X 33 and 34, Plat of Richmond Hills in the Town of Richmond, St. Name and Return Address Croix County, Wisconsin. KRISTINA OGLAND ATTORNEY AT LAW P.O. BOX 359 HUDSON, W154016 026 - 1127 -22, 026- 1127 -33 & 026- 1127 -36 _ -..- Parcel Identification Number (PIN) This is not — homestead property. (1) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. M Dated this 2 day of July 2002 RJC D elo men nc. • *By:, hn H. Carlson, Preside AUTHENTICATION ACKNOWLEDGMENT Signature(s) RJC Development, Inc., a Wisconsin Corporation, STATE OF WISCONSIN ) by John H. Carlson, President ) ss. County ) authenticated this y of July 2002 -- -- -- - - -- — - Personally came before me this day of the above named « Kr istina Ogland - "— TITLE: MEMBER STATE BAR OF WISCONSIN - -- (If not, to me known to be the person(s) who executed the foregoing - - -- -- instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Huds WI 540 16 _— _ -- _ - -- My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) — •) " Names or persons signing in any capacity must be typed or printed below their signature. irto uon protessmals company, Fond du Lac, Na STATE BAR OF WISCONSIN 900855 -2021 WARRANTY DEED FORM No.2 • 1999 'iing 0 Office the appropriate Town Board for advice. OVERALL EAST -WEST 1/4 LINE: S89 ---------------------------------- S89 "E 2366.18' -�- E • 1760.78' BLOC( X 14' 215.00' 215.00' 215.01' BENCHMARK: ELEVATION- 1023.77 ►T 20 LOT 21 L T 22� LOT 2,3 L AREA: TOTAL AREA: T TAL AREA: TOTAL �IRfA: 78 SQ. FT. 98,902 SQ. FT. 98, T. 102984 SCt FT. ACRES 2.27 ACRES 227 ACRES 236 AQ'PES 1 0 0 N W � W W = M M W Y O $ O O � � N V1 "" O V) .... I I I I I ' .42' - - - - -- - - - - - - -- 215.00' --- - -_ - -- - - - - - -- 215.00' - - -- - - -- --- 115.00' - - -- M S89'S2'26 "E 980.42' - - - - - O 615.10' - - "� - - - t S8952'26 "E 299.67' - -- 4 ------ - - - - -- 309.00'------- - - - - - 33 ' 3 '-------- - - - - -- - - - - -- - -- O i \ • S'e I LOT 18 TOTAL AREA: ........... 90,515 S4. FT. I 2 08 ACRES F.F.E. 1006.0 rn • N O ni 17 N 0 ( Oa1 N LOT 31 LOT 30 ° °D i TOTAL AREA: , 1,33 S0. FT. TOTAL AREA; 89 ♦ I ♦ 90 SG! FT, W W 2.05 ACRES 2.07 A ORES 316.78' in 1r) — ..I P P 309.00' z z I N89'52'55 "W _ I 309.00' 372.38' oy Easement LOT 17 0 'd7o N TOTAL AREA: I � LOT 32 LOT 91,979 SO. FT. I i 2.11 ACRES F I TOTAL AREA: TOTAL AREA; 66 3 i 80,161 SO. T. F.F.£. 1006.0 1 • ®• I ;� N 97,663 So.. FT, .. l� 1.84 ACRES 2.24 ACRES