HomeMy WebLinkAbout026-1127-23-000 Wisconsin Department of Commerce + PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
399681 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
Permit Holder's Name: City Village X Township Parcel Tax No
Marek, Todd I Richmond Township 026 - 1127 -23 -000
CST BM Elev: Insp. BM Elev: BM Description:
Db' 1 l DD' _ "tJ - W GV
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
S 29 Z I C7. 11 Inc,
Septic Benchmark I +
S p V;,49• obL `l• to Il +iu of Old •O
Dosing Alt. BM 3.33 O• it-T
S � J
Aeration Bldg. Se,-,-, ! S i
�••`1S o6.
Holding St/Ht Inlet' os
St/Ht Outlet
TANK SETBACK INFORMATION 1.20 O 0
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 1
O�
Septic �`/ �l t DtDt Bottom. 34: S t
Dosing
�j Header /Man. II __ y
1 l C j l / � � � • � ` lam~ � U'• 3
Aeration Dist. Pipe
rid". 3•� 3
Holding Bot. System U '
r t7` .o
Final ade -
PUMP /SIPHON INFORMATION `Z • 3S l rnre s fir).
Manufacturer Demand over S 2• s-�� +� C�•
14
- 3 0
r�i, -,, a
Model Number C)
S
te-6
um d� f lor 3.8 0�.
TDH l,jft s / Frictign System Head I r T j ` Ft L �
((' 7 I V '�D 1�-• I
Forcemain Len th Dia
2 // Dist. to Well I
L ABSORPTION SYSTEM
BEDfYRENCH Width �/ Length No. Of Trenches PIT DIMEN NS No. Of Pits Inside Dia Liquid Depth
NSIONS `/ — I I t "
SETBACK SYSTEM TO P/L BLDG W LAKE /STREAM LE CHIN Manufacturer:
INFORMATION CHA OR
Type Of System: / IT Model Num
W5 �I ���
DISTRIBUTION SYSTEM
Header /Manifold I D istribution 1 / x Bole Size
x Hole Spacin� Ven Air Intake
t �l Pipe(s) �j \
Length Length Dia Spacing `� / /00
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only a
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center / Bed/Trench Edges Topsoil Vi�aa Yes ?, No 1! Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection # (7+•/ �b N Inspection #2:
)� D l� Fa p
Location: 142 134th Avenue New Richmond, WI 54017 (NW 1/4 SW 1/4 25 T30N R18 .) Richm6gd Hills Lot 23 Parcel No: 5.30.18.8
e,F tou a 61, vn utLd ' � ru Lv" S u r d ry
1.) Alt BM Description = Ti4 eLv Ma-1 - 1 fc reC& S l �o✓ -�trr c5
f
sewer l ength = .�•
2.) Bldg 34 . e..._ �,e.. �j /3a y��6tf�2�� fie, 0,
-amount of cover = . a{•Z "�;� t��"� t .^-„ a� 1 ('r` Qom+ `S
Plan revision Required? Yes No
Use other side for additional information. I - - --
Date Insepctor's Sign ure Cert. No.
j k SBD -6710 (R.3/97)
Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162 ;
I sconsin Madison, WI 53707. Site Address .f
Department of Commerce r� / ZQ ; I-� JET
Sanitary Permit Applic do Sanitary Permit Number
In accord with Comm 83.21, Wis. Adm. Code, personal i
ti
ma be used for second purposes Privacy La 1-5:04(1)( t ' Check if Revision
I. Application Information - Please Print All Information _, ��� to Plan I.D. Number
Property Owner's Name ar cel Numbir
Z f�4,
/
Property Owner's iling Address Property Location
T _-V N, R E
City, State Zip Code Phone Number Lot Number Block Number <) 3 3
Subdivision Name CSM Number
F'c c��t dl i CLJ
II ype of Building (Check all that apply.) l O City
Ifl — I or 2 Family Dwelling - Number of Bedrooms ❑ age
• S
• State Owned rcial - > cri be se - ownshi �
State wned l.e wtou+ earest Ro
8 x - +g - t n11 Du = 1.0 1Z )Ssof I/
III. Type Permit: heck only one box on line A. Ndmbering is for internal use.) (Complete line B, if applicable.)
A- ";; ew 2 ❑ Replacement System 3 O Replacement of 6 ❑ Addition to For County use
System Tank Only I Existing System
B. ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued
IV. Mvpe of POWT System: (Check Numbering is for internal use.) - 'kZ046t, - !00 .
n�ressurized In- Ground 21 ound 47 O Sand Filter 50 O Constructed Wetland
22 [] Pressurized In- Ground mg Tank 48 [] Single Pass 51 Drip Line
45 ❑ At -Grade 46 ❑Aerobic Treatment Unit 49 [] Recirculating 30 [] Other
V. Dispersal/Treatment Area Information:
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade
Required Proposed Rate(Gals. /Days /Sq.Ft.) (Min. /Inch) Elevation
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
IF Gallons Gallons of Tanks Concrete Constructed Glass
t Existing
Tanks
Septic or Holding Tank
Dosing Chamber -
VII. Responsibility Statement- I, the undersigned, responsibility for / installation of the POWTS shown on the attached plans.
Plunlbeds (dame (Print) � Plumber's Si to MP /��§Dpber Business Phone Number
Plumber's Address (Street, City, State, Zi
VIII. County Department Use Onl
Disapproved Date Issued Issuin Agent Si
Approved C Owner Given Initial Adverse Sanitary Permit Fe (inc rotwwater 8 t g \ !'name (No Stamps)
Determination Surcharge Fee) 3
IX. Conditions otApproy a or Disapprov
a
M&V
�°-�'� Attach �romplete plans (to the Cotmty only) for the system on paper not less than Sl/2 x 11 inches in size
,Aarek PL PLAN
DDRESS P.O. Box 148 New Richmond Wi 54017
�W 1/4 25 /T 3p R 1g W Tow Richmond
COUNTY ST. CROIX
r
4 RS Shaun Bird 226900 1/17/02 4
VVENTIONAL DATE BEDROOM
IN-GR �D IN -GR D PRESSURE CONVENTIONAL LIFT
-- _� HOLDING TANK
UND X)000 SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE
DOSE TANK SIZE 800
,DING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600
# of chambers none
1 ENCHMARK V.R.P. Top of NW Lo t Stake ✓
BOREHOLE WELL
ASSUME ELEVATION 100' Filter Zabel A -100
�J •H.R.P. Same as Benchmark
SYSTEM ELEVATION 107.0
Plans Designed Usin g
Conventional Powts
Manual Version 2.0
B.M Property Line
Scale = 1/4 = 10'
Well is to meet
Area 15' all setbacks
Below System found in
IS to remain Comm. 83
undisturbed 104' 105'
106'
0 r,
B -3 B -2
5% 1
k Slope
Tanks are to be
properly bedded
and provided with
lockdown covers 460'
with approved
warning labels
Property Line
`
Grading is to be done DT , � weeks ST
to divert run -off 3Q
awa y from
� - --
Pro 4
system Bedroom
House
Pro Town Road
Safety and Buildings
10541 N RANCH ROAD
HAYWARD WI 54843
TDD #: (608) 264 -+3777
iscons n www.commerce. Asco n s i
www.w r..gov
iscosin.gov
Department of Commerce
Scott McCallum, Governor
Philip Edw. Albert, Secretary
January 24, 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
Idfi on N rs
PLAN APPROVAL EXPIRES: 01/24/2004 IDi
Transaction ID o. 702036
SITE• Site ID No. 64048
Marek, Todd Residence Please refer to both identification numbers,
140TH St above, in all correspondence with the agency.
Town of Richmond
St Croix County
NW 1/4, SW 1/4, S25, T30N, R18W
FOR: New mound, 600 GPD
Object Type: POWT System Regulated Object ID No.: 827218
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. A <
The following conditions shall be met during construction or installation and prior to occupancy or use:
General Approval Conditions: u fi
Of co
• This system is to be constructed and located in accordance with the enclosed approved plans and with the `` "`� AFETY Atd'
"Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 1069vi
( N.01 101) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment
Systems" SBD - 10706 -P (N.01 101). SEE CORRESPO
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health `
hazard, the property owner must follow the contingency plan as described in the approved plans. In addition,
the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of
the mound component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
• 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. Slats.
• The maintenance plan for this system must be given to the owner of the POWTS.
Site Specific Conditions:
• The orientation of the mound 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 mound per Mound Component Manual.
SHAUN R BIRD Page 2 1/24/02
• Surface water drainage shall be diverted away from the system area per Mound Component Manual.
• Materials shall conform to the requirements of COMM 84.
• The bottom of the distribution cell shall be level per the Mound Component Manual.
• The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component
Manual.
• The actual gallons per inch for the specified pump tank is 21.76 and the liquid level is 37" per product approval.
The proposed pump settings have been adjusted provide a dose volume that is greater than 5 times the void
volume and less than 20% of the design wastewater flow plus drain back.
• Maintain well and waterline set backs per COMM 83.43(8)(i).
• The designer proposes to install a state approve outlet filter to achieve the requirement of wastewater particle
caner f the tank explaining that periodic cleaning of the
size. Maintenance information must be given to the o o g
s g P g P
septic tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations.
• Provide frost protection per COMM 83.43(8)(c).
• with a sharp bit and all burrs and foreign Holes must be drilled matter removed before installation.
�'P
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 sha provide a c py of this letter to the owner and any others who are responsible for the
installation, operation or intenance of the POWTS.
Sincer Fee Required $ 175.00
Fee Received $ 175.00
a an e- $-0.00
a 'cia L S dorf
PO lan R` r , Integrated Serv' es WiSMART code: 7633
(715) 634 -7810, Fax: ( 15) 634 -5150 -F 7 :45 am - 4:30 pm
pshandorf@commerce. te.wi.us
cc:
i
Cover Page
g
Shaun Bird
Bird Plumbing Inc.
1008 192nd Ave
New Richmond Wi 54017
715- 246 -4516
Date: 11/8/01
Owner: Todd Marek
System type: Mound System
Manuals Used: Mound Component Manual version 2.0 (01/31)
Pressure Distribution Manual version 2.0 (01/31)
Page#
1. Cover Page
2. Mound Plot Plan JNGE
3. Mound Cross Section
4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section
6. Pump Curve
7 -9. Maintance and Contigency plan
10 -12 Soil test
Signature
License nuroer 226900
1/17/02
PtRI AN
PROJECT Todd Marek ESS P.O. Box 148 New Richmond Wi 54017
NW 1/4 SW 1/4s 25 /T 30 W TOWN Richmond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 1/17/02 BEDROOM 4
CONVENTIONAL IN-GRdWD PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND XXXC SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE 800
HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none
BENCHMARK V.R.P. Top of NW Lot Stake ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 107.0
Plans Designed Using
Conventional Powts
Manual Version 2.0
B.M. Property Line
Scale = 1/4" = 10' Well is to meet
all setbacks
Area 15' found in
Below System
is to remain Comm. 83
undisturbed 104' 105'
106'
B -2
B -3
5%
Slope
Tanks are to be
properly bedded
and provided with
lockdown covers 460'
with approved
warning labels
B -1
Property Line
Grading is to be done DT Weeks ST
to divert run -off
299 away from
Pro 4
system Bedroom
House
Pro Town Road
r
Aesigae ^mow ✓� f ,J� -_.. no C� 9 r�C� r
Z_
4" Observation P:tpe Perforated Non -Woven Filter Fabric
Below Filter Fabiric 'Distribulion Pipe
ASTR C -3:3 S a rid
/1 G
Topsoil
�... ', Slope 0 6• to
bed Of fi 2 %= Forte Main ♦Flowed
Drain Rock From Pump Layer
,
Cr oss Section Of A Mound 5Istem Using
A Bed For The Absorption Area F
G
A 11.. ,Ft. s 5.
6 S— Ft. iDg 9S
I 11 10 Ft..
Ft.
K Ft.
L Ft.
W + Y Ft.
L
---
4Observation Pipe
-
A ( Forge Main
c From Pump
C
p Distribution Bed Of�— 2 L
Pipe Drain Rona
i
4Observation Pipe Permanent Market
Pipe or Rods
Pion View Of Mound Using Abed For The Absorption Ar*0
P�rtorolea �+ a Qet0i1
E no View
.1+ PVC Pipe
e
��d�' MOltt L04416d On 80110m-
Are [006"1 used I el
�j4
PVC force MOM
1 t t KST VIOL}: Nsx� T O c.nfw awn
PVC
A4000fold Pipe
� s��Q�'�. OHf r hDyf�Otl
T4 — ea.�c►,r , Distribution Pipd Lorotit
P 7�Ft.
R. R.
/ X Q21 Inchet
Inches
`, s
Signed: � olm Diameter Inch
License Nu er; Lateral " c2 Inch (e
Date ; �— Men i fol d <0_ Inches
s � v Force Main " .
cz. ,, Inches
# of holes /pipe
Invert Elevation of Laterals _ Ft,..
1 + t wi:�ar �'> ^P o gOVC O 1400.14,4)& w is 0 A n,� 9040t, 1 .i7yt + :0 �•1 bOx ' Ml CO VLR
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- r^wst size.- d 6At,.t.Q/n)T< DAif V06WMC
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S W ITt" 1 e- .
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M+M+i" UM 0186 cA11 R st Tit 1 ONS?A4449 01d aRM►l�ATZ RIRRyiTA
vt4rtcA6 DIFF RCMC4 jjRT M/RRN punt" MI
rtt�sT:au tr:� =.. T liar 7�
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7 ..
• • Deta
Performance Data
40
30 '
Pump Ch aracteristics
tq�ft URN Se
Nluueel Nledele SHEF40M1 SHEf40N1;!
Antesralk Mettek $1040A1 I SNEF40A2 ) 0
H 4 10
Full !ad 1 6.5
mewy P@6 (4 Pale) 0
UA I sse 10 20 30 SO 60 70
!hose I GPM
11s 230
Mork 60 Totes! Head (foot) 10 14 17 ! Z1 ZS 48 30 35
k2! MOM 120• F ". Flwd UW — Fr 4.3 3.2 1 6.1 7.6 8.3 8.8 10.7
WAA a A GPM (US GPM) 70 60 SO 1 40 30 40 10 0
teseeallee OnsA (r'torrs sec) 14.4 3.8 3 .2 1 2.3 j 1.9 i. .rte -�
s" on ", 4 ""' Dimensional Data
28 IbL 3.718" a see• (,se .�7) - n 1 - All dimensions in inches. (Metric for
Ironer cord 18/3, S1TW, 20 Std. 1 (se. a" (127) in te mational use).
3 2> 2. Component dunensitms may
M of Construction vary t 1/8 inch.
roI'r'ss s 3 Ire° 'U` 3. Not for construction purpose
oat use ax; DISC
unless certified.
t � - FLOAT
SWriCH 4, Dimen and weights are
A c awaximate.
10 ""n' /C+rac 5. We reserve the right to make
SAeIt r0 �'s revis{ons to our product and their
SWIM Spedficafts'WNW notice.
{286 ) 1o3tle''
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a... a .
I L o 1998 HydromaticO Pumps Aihlo , Ohio a ll Rights Re"m ,
"Ir MYDROMATI ® Your Authory
of tri uto(
1840 8aney Rod Ashland, ON 448oS Tel: 414.289.3042 fax 419.281 -4481
Web SHe: W".AentuirpM.W
SALES OFFICES IN All MAJOR CITIES AND COUNTRIES s�
Refer to "Pumps" in the ytdbw pages of your phone directory for yon local Distributor ai f/
itemk. W-02.6680 1198 5M ,:► �,�� � 1
PovvTE; OWNER'S MANUAL $ MANAGEMENT PLAN Pac, of
FILE i 4FORMATION SYt3TEM gpgpt+ICATfONS
Owner _ Septic Tank Capodly d t O NA
permit #. _ Sepda Tank Manuf*61urer e , O NA
DE81t;iN PARAMETERS Eftwd Flyer Manufac kM a O NA
Number of 8edruorrta _� O NA went Filter Model . r O NA
Number of CommoroW Units _ NA ".Tank Capa ft O NA
f ms#ed f10W ( ) primp Tack ManufiflCturer — O NA NA
f>esipn flaw 000td� (Estimated x 1.5) - Pump Manufsc�urer "� O NA
Sop Apppaation Rate _ aUd Pump Model . U
Infltrerrtmuent Quaaty Monthly were ge" pretreatment Unit NA
Fc7G) 530 mgn. O
0 � Filter O Peat FpMr
Fats, OA & Grease (FOG) Meohankxd Aeration O Wetland
Biochemical oMan Demand (1301 %) 5220 mgA. p Dlsinbcdon O Other:
Total Suspended Solids (T5S$) :050 m ufact M_r
prelreeted Effluent Quatty O Nok Monthly average" Dispen w t.sll(s)
BiochemW Oxygen Demand (fjolDs) SW mgA O In -ground (gravity) 0 In -ground (pressurized)
Total Suspended Solids (7ISS) 530 mgA. 0 At-graft end
Fecal Coftrm metric mmin) s10' CN1100" O
Maximum Effluent Partide Size K
inch dtameter vows t for d omada (rAn•o0n1�wrd$Q rw�tevv�Mr .red
- .•• Values tyolCN ror rxrt fOr prtltiMled MftlitO�NdOr.
MAINTENANCE SCHEDULE _
8
Service Event ervke Frequency
Inspect condition of tank(s) _ At least once every O months r(s) (MAXimum 3 yrs.)
Pump out contents of tank(s)
When oombined skrdge and scum equals one -third (y,) of tank volume
Inspect dispersal 0011(s) - At least once every � C3 months r(s) (Maximum 3 ym.)
Chan affluent fllNr At least once every O months . s) ►
inspect purnp. pump cAntrols &alarm At least once every
p months s} O
Flush tttterals and prt�ssure test At least once every j a months s) O
- 00W . At least once every O months (3 years) 17 NA
o0w. - At least once every O months a year(s) O NA
MAINTENANCE INSTRUCTiON3 one of the k4owing Iloenses or
inspections of tanks and dispersal Cells shah be made by an individual carrying POMITS Maintalner; 8801199 certiftedons: Master Plumber, Masb3l' Plumber Restricted Sewer, POVYT3
In of ( ) identity any m*skV or brokan
i nsPec�Ion
ServkklQ Operator. Tank inspections m ust inducts a visual _and scum a nd to check for any back up
hardware, kieMlfy any cracks or leaks, measure the volume of ombbW sludge in to check the eMuent levels
or ponding of etltuent on the ground s»rfacs. The disc s l Wl diet surface. The ponding of effluent on the
in the observation Pipes and to check for any ponding f offl the immediate notification of the local regulatory authority.
ground surface may indicate a failing txxW tlon and mq
When the comWned socumuiation ol° �;Kxige and scum M any tank equals one m
-third (yj or ore of the tank v �� R
entire contents of the tank shall be removed by a Septage Servicing Operator and disposed Of In
113, Wisconsin Administrative Code, at components, and any
urical or ssurized POWTS components. pretreat�me talner.
rs med+s pre g Main
vent MO VS. POWT
of etfl rtifled
The r main tenance at intervals of 12 months or less shall be perfomnw by a N
other mahttenance or monitoring at completion of any service invent.
A seMge report shah be provided to the local regulatory authority within 10 days
START UP AND OPERATION acts ar otlr►er
For new construction Prior to use of the POWTS check treatment tank(s) for the presence of painting Prod
high c
chemicals that may Impede the tree tr'mt process and/or damage the dispersal o l(s�lto use. trations are
detected have the contents of the tank(s) removed by a septage servicing ppetat p
i
System start up shall not oocurwlten soil'oonditions are frozen at the tnMrative surface. Pogo or
During power outages Pump tank" may fill above normal highwater levels. When power Is restored the excess
wastewater VAN be dlsaharil" b 06 dispersal C611(a) in one large dose, overloading Me 080(s) and may rae in the
badalp or surface disdmMe of el ; t. To avoid this situation have the contents of dw pump tank removed by a
se~ a Opea*w prkor 'WEtna power to the emuent pump or aant;t +a Pi nW or POWTS MalntWner to
assts! In manually opertating the PIWW controls to restore normal levels within the pump tank.
Do not drive or parts vehicles over tanks and dispersal cNts. Do not drive or park over, or otherwise disturb or compact,
the area WPM 1a feet down sloix
of a mound or at
sod
r7 �yrade sb9orptlon area.
Reduction or•etlrrdr ation of like fdikrAfng from the wastew*W suvam may improve the per ftmonce and prviatg the ft
of the POWTS: antlbbttce; bs y ' ss: Riga 111to bulls; condoms; cotton F*Vbs; degreasers; deroW floes; dtapere;
d�Ntfeotsltby; totrttdWort di it (si M PunWf water; tt k and vegetable peatMgs: gaa 011ne gee; herbloides; meat
Maps; maVcaOna; A PWndng IVokrde; P sanitary napkins; tampons; and water eattener brine.
ASANOONNUENT
When► the POWr[S %U andfor is E.6rtttanently taken out of service ttre Wining steps shag to taken to Insure that the
system is property and aately a bandoned In comptlence with ch. Comm 83.33, Wisconsin Adminktrattve Code:
+ AM PONtg to taM(s and pits shall be discorutected and the abandoned pipe openings eeated.
• The contents of al lasso and pits shd be removed and property disposed of by a Septage SerWo ft Operator.
e After pumping, all tanks end pits shall be excavated and removed or their covers removed and the void space
Bled with soil, gravel or a inert solid material.
CONTINGENCY PLAN
if the POWTS fells and cannot be i>vpairad the following measures have been, or must be taken, to provide a code
compliant replaoement system:
17 A suitalbfe reptacement'area has been evaluated and may be utilized for the location of a replacement soil
absorption system. The replacement area should be proteded from disturbance and compaction WW should not
be InMnoed upon by required setbacks from existing and proposed structure, lot lines and wells. Fairure to
Protect Me replacement an w wll result In the now for a new soil and site evaluation to establish a suitable
replacement area. Reptaa Lment systems must comply with the rules In effect at that time.
O A suitable replacement am is not available due to setback and/or soil amltatlons. Barring advances in POWTS
technology a holding tank nny be Installed as a last resort to the failed PO
replace WT5.
site has not been evaluated to kWWfy a suitable replacement area. Upon falure of the POWTS a Moil and
ttita evaluation must be per brined b locate a suitable replacement area. If no replacement area is avdable a
hd4kV tank may be ku talkd as a last resort to raplaoe the failed POWTS.
Mound and at -gntde ad absorption systems may be reconstructed in place f gcrMng removai of the biomat at
the Infiltrative surface. ReoxnVuedons of such systems must comply with the rules In effect at that time.
«WARNING»
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGF.N.
DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCgg. DEATH MAY
RESULT. RISSCUE OF A PERSONI FROM THE INTERIOR OF A TANK MAY BE DIF=FICULT OR IMPOSSIBLE.
ADDITIONAL CCM IAEM
POWTS INSTALLER POWTS MAMTAMER
Name ksv Name f1° r'fl
Phone �—,� �.- Phone
SEPTAGE SERyIti OPERATOR ( � LOCAL REGULATORY AUTHORITY
Name
--�._
Phone Phone
Thb doaxrrert( cloned t►y file stab of the r3rses take, Marquette and W aushara County Zoning acrd Sa action
the mhtknum requ&ements of ch, Comm 83.23!(2)(b)(1 xd)RQ and 83.54(1), (2) & (3). Wisconsin Ad+►�inlsk ttre C.eds this dooum+ent dose net
guanaMee the performance or the POWrs.
GMW (emu
Maintenance and Contingency Plan for a Mound 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 filter is 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 mound 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 mound 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.
10. Effluent Quality is not to excede the requirements found in Comm. 83
Contingency Plan
1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if
needed then bypass float and t with out float. If this works, float is bad,
YP pump P GYP um P
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 mound 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: Thomas Mondor 715 - 246 -5148
St. Croix County Zonin 71 386 -4680
Shaun Bird #226900
1/17/02
Wisconsin Department of commerce SOIL EVALUATION REPORT Page _ _ 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 St • Croix
include, but not limited to: vertical and horizontal referprc, po(nf �BNi);direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and.lo"tidn and distance'to nearest road. p endin a
Please print all,11*�rfiation Re wed by Date
p � Z
Personal information you provide may be used fol'SecoXclary pie 4y Law, s. 15.04 (1) (m)).
Property Owner Property Location
R J C Develo ment Inc. la ��7 Govt. L NW 1/4 sW 1/4 S 25 T 30 N R 18 �{(or) W
Property Owner's Mailing Address Lot # Block # Sutxi. Name or CSM#
1868 C �� -� 2 na Richmond Hills
City • State Zip Code pho * Nuq Wk W-" ` Q �ty ❑ Village ® Town Nearest Road
New Richmondl WI.1 54017 H 71 1
Er- New Construction Use: ❑ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable ft.
General comments
and recommendations:
mound @ el. 106.80', based on contour line of el.105.80'
Boring
Boring
❑ #
® Pit Ground surface elev. 1 0 6 . 3 0 ft. Depth to limiting factor 53 in. Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fft
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
sicl 2msbk mfr Lw if .4 .6
3 19 -31 7.5 r 4 none sl msbk mfr qw na .5 •
4 31-53 r none scl 2msbk mfr n .4 .6
5 53 -80 5 4/4 wet sici M na na na .0 .0
2 ] r
Boring El Boring
g ❑X Pit Ground surface elev. 10 6 • 3 0 ft. Depth to limiting factor 3 _ _ in. Soil plicabon 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 -10 10 r 3/3 none L 2msbk DSH cs if .5 .8
2 10 - 7.5 r 4/4 none sicl 2msbk mfr gw if .4 .6
3 21 -33 7.5 r 4/ none scl 2msbk mfr gw n .4 .6
4 33 -70 5 r 4/4 f1f7.5 r 5/6 scl 2csbk mfr I na na •4 •6
` Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L nt #2 = B :5 30 mgQ1 nd TSS < 30 mg/L
CST Name (Please Print) Signature ' CST Number
Gary L. Steel 02298
Address Date valuatio Condu Telephone Number
1554 200th. Ave., New Richmond, WI. 54017 10-19-2000 715- 246 -6200
l
Property owner R J C Development Inc. Parcel ID # pendimf Page 2 of 3
Boring #
❑ Boring
® pit Ground surface elev. 10 3 . 9 0 ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consi ence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 '042
1 0 -9 -1 r if .5 .8
2 9 -22 7.5 r 4 none sicl 2msbk mfr I uw if .4
3 22 -35 7.5 r 4 none scl 2msbk mfr Qw na .4 .6
4 na
F-1 Boring # E] E] ❑ 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
❑ 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/fP
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 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- 264 -8777.
SBD -8330 (8.6/00)
f
i
STEEL'S SOIL SERVICE
Gary L. Steel RJC Development, Inc. 1554 200th Ave.
CSTM2298 Nw4sw4 S25 T30N - R1 8W New Richmond, WI 54017
MPRSW -3254 town of Richmond (715) 246 -6200
lot #23- Richmond Hills
11 " =40'
fBM.= top of NW lot stake @ el. 100.00
/Alt. BM.= topof 1" pvc pipe @ el. 103.40'
�b
l ��
Gary L. Steel
10 -19 -2000
ST CROW COUNTY
SEPTIC TANK MAINTENANCE AGRE EMENT
AND
OWNERSHIP CERTIFICATION FORM
owner/Buyer
Mailing Address p o , jo7L I q k eo
Property Address `+ a 13
�I.
(Verification required from Planning Department for new construction)
i
City/State Parcel Identification Number
LEGAL DESCRIPTION
Property Locatio / /., Sec` T N- W, Town
S ubdivision Lot V
Certified Survey Map # , Volume . Page #
e
Page #
.� Velum g
WAI'1'AIIt3' Deed #
Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no
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, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewater disposal system
is in 1�'� ro rating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
P
Vw% 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 Zoning Office within 30
days tliree44ar xpiration date.
r l �l0L
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the o desc ' above, by virtue of a warranty deed recorded in Register of Deeds Office. r
1 / 7/Q2—
SIGNA OF PLICANT 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
f
voi. 1821PAG 22
STATE BAR OF WISCONSIN,FORM2 -,4999 669065
KATHLEEN H. WALSH
Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO., WI
This Deed, made between RJC Development, Inc., a Wisconsin RECEIVED FOR RECORD
Corporation 01 -23 -2002 9:30 AM
WARRANTY DEED
Grantor, and Todd Marek, EXEMPT #
CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 82.80
RECORDING FEE: 11.00
PAGES: 1
Grantee.
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
Name d eturn Address
Lot 23, Plat of Richmond Hills in the Town of Richmond, St. Croix County, #7, t
Wisconsin. U y
veuw Q `✓- yU� 7
026- 1127 -36 _
Parcel Identification Number (PIN)
This is not homestead property.
CK) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this day of January 2002
RJC � op / t, In .
y`
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
) ss.
St CQcy / County )
authenticated this day of ,
Personally came before me this , 0 day of
January , 2002 the above named
RJC Development, Inc., a Wisconsin Corporation by
TITLE: MEMBER STATE BAR OF WISCONSIN it's —�
(If not, to me known to be the person(s) who-executed the ®oing
instrument and acknowledged the e. v
authorized by § 706.06, Wis. Stats.) g
THIS INSTRUMENT WAS DRAFTED BY +
Attorney Kristina Ogland Notary Pi Stat Wisconsin (� =
Hudson, WI 54016 M C mission is permanent. If Mt, state ex ration te:
(Signatures may be authenticated or acknowledged. Both are not necessary.) y ?T5 )
' Names of persons signing in any capacity must be typed or printed below their signal e. Information Professionals cen+fverW, Fond du Lac, N
STATE BAR OF WISCONSIN 900-655.2021
WARRANTY DEED FORM No. 2 - 1999
®
/ . ............................... N
-- 3
00
LOT 28
C)
M
b rn TOTAL AREA: N
N
v 106,274 SO. FT. i I
• • • LOT 29 2.44 ACRES
TOTAL AREA: i 1 00 I O
92,560 SO. FT.
Z
2.12 ACRES i 3
N N89'52'55 "W I I
364.80'
iU-) I i�
' r
U ^E I O 4
59 1 O
r1'1 33� 6a Z i
J '
I
i
_ LOT 35
w
00 LOT 34 3 I
N � I
J 'rMi o TOTAL AREA:
�p TOTAL AREA: ;v N
O
94, 079 SO. FT. N 106, 765 SO. FT. o .
0 �
p 2.16 ACRES Z 2.45 ACRES i 33 33'
Z
............. .......... ............................... i I
I I I
I
I i I
i __
N ---------- = ---- - - - - -- ----- - - - - -� • I
N89'52'55 "W 363.97
N89"52'55 "W 364.38' "
•
1 ®
30.04 - - - - -- 334.34 - -- - -- »5.59' --
Cb
♦ Q
LOT V y w�
I 1
..... .••..••.....•.......•••.:...... I I I
• • 3 TOTAL AREA: I 0
°r° * 97,927 SO. FT. OR W J;Z s
1014.0
LOT 12 a 00 2. 25 ACRES o in LC
W p N MIN. F.F.E. � �r
U) - TOTAL AREA: v ' I i
N N - I T
.i I
;� °D 83,663 SO. FT. m \t. E i C
g n• ........... 1.92 ACRES °= . �• L-12 e.. folai
i
Z ' o
N
N 0
N89"54'22 "E 360.04' N89'55'11 "E 349.48' 0
MA 7 C LINE
SEE SHEET 3. LOT 9 j LOT 10
`0 '`- 'r�+�s1 e,�lq•�1j! �.�..�y L - f. T1n s_: cti 4�