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Safety and Buildings 4003 N KINNEY COULEE RD commerce .Wi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 sc o n s i n www.commerce.wi.gov /sb/ t i epartment of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary October 20, 2004 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: 10/20/2006 Identification Numbers Transaction ID No. 1070722 SITE: Site ID No. 691167 Oevering Homes Please refer to both identification numbers, 1405 138th Avenue above, in all correspondence with the agency. Town of Richmond St Croix County SW1 /4, NW1 /4, S25, T30N, R18W Lot: 14, Subdivision: Red Pine Corner FOR: Description: Proposed Three Bedroom At -grade System Object Type: POWTS Component Manual Regulated Object ID No.: 987329 Maintenance required; 450 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade System(s): At -grade Component Manual, SBD- 10570 -P (R.6/99), Pressure Distribution Component Manual, SBD- 10573 -P (R.6/99); Biofilter 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. 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 approved plans, and with publication SBD - 10570-P (R. 6/99) "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems ". • The pressure network is to be constructed in accordance with publications SBD- 10573 -P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ". • 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 area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. 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. P0 . ) �y.TS 011tait orally o6* Lk IF IN " m 1/r n SHAUN R BIRD Page 2 10/20/2004 • Comm 83.22(7) - 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. Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm jswim @commerce.state.wi.us WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 cr � 2 20 *Ot7 , 04 Cover Pag JOG s D IV e Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 010/06/04 Owner:Oevering Homes Location:SW 1/4NW1/4 S25 T30 N,R18W Lot 14 Red Pine Corner Richmond System type: At -Grade 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 T- A 1 S S S (0 /81) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and C 9 -11. Soil test W. `'_°` Df i MENT OF COMMERCE DIVISION DENCE EE GURR PON SAF Y AND BUILDINGS Shaun Bird 1 6 S EE License number 2 69 PLOT PLAN PROJECT Oeverina Homes ADDRESS 838 Summer Pines Circle Hudson Wi 54016 SW 1/4 NW 1/4S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 93.0' BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100° Filter Zabel A -100 ❑BOREHOLE O WELL *H. R. P. Same as Benchmark B. M. * Alt.B.M. top of survey iron @ 95.0' Property Line No- Grading is to be done to divert Tank is to be run -off away from system properly bedded and B-1 B-2 provided with 93.5 lockdown covers 93' with approved warning labels 92'5 Huffcutt Combo tank B -3 4% SlopejF Well is to meet all Area 15' below system to setbacks found in Comm. remain undisturbed 83 Pro 3 Bedroom House Property Line (not to scale) T 8th Ave Scale = 1/4" = 10' L } 5` g 5 > 51 �- 2 r / ITUR13— UPS � — Dtsrt%t Z aTtOPt LATZtiAL --f w A SrAg4LI ZED pftV YATIOPA WELL ID - � ° --� 5' � !/6 B j 1/68 !'''� i /2B A =t. L R. CELL. of ' fz, Y Z AGGAE -CaPKE vJ =�Z Pt PRdVFE b SYMTME'' L Fabric Distribution Lateral STRIB161&b Observation Soil Cover t2 Wei 1 ----� i t e WfE L Of-st 5 A 5 SLOPE. Plan vier and Cross Section of Wisconsin At -grade Unit with a Single Absorption Area on a Sloping Site S RE. L t£piSE At • Page of Distribution Pipe Detail For Lateral Metaork A� ce st' "T uKM • uP (CLt►tv40u - r) - PVC Force Main PYC Distribution Pipe P * Last Note Should Be Next To rut�N- uP P �� Ft. Noce aiatneter Inch X �- Inches Lateral Diameter 2 Inch {es} Y - inches Force Main Diameter 2 Inches of Holes /Pipe Invert .Elevation of Laterals Ft. Signed; License Number: Date: SEPTIC TANK � 4�MF C C {;l�MB£R ROSS S ECT" AND P SPELII ICgTZOt�S uEaTH£ftP t�f AFFRQV ED fit MIn, ?,BONE GRADS � j-ONCTIO $flX MAN110LE COYER rr VENT PIPE IIIAIDOW QR WITK Cf3AiI3UIT W/ PADLOCK �r y C ' FROM DOOR. �} WARliiNG LA$F� •• �b a R INTAKE `D Tp C1` F " c�� 0,51i - � MZN rry 4 r. � GRADE f � b sir" T > r i INLET GAS- � D --�" TIGHT = * v � � E WITH WATER TIGHT S _ A SEAL _ RLM ApPROM PIPE f P. _ 3 41 OM 4 ON SOLID SOIL AppQItED C i y OFF P 35QLtD �.� FT • ''"� SOIL pUp OF EL£Y • ----� D BEDDING UNDER TAN'C ONCRETE PAD AFFROV ED 3 > SPECIFI i�t3 3SBER DO SCS ?' DAY: SEPTIC / DOSE DOS v4Lume ZNCIdIOI GAL - FACTIIRER : £ F I.OWBAC TANK Tom' GAL . SEPTIC GAI.. J — INCHES TANK SIZES = DOSE CAPACITIES= A -- _ 3 4) GAL - 2 'INCHES AL+Ai M "NUrACIUltEA:: �, j GAL• jjoDEL WJ SER : C = INCHES SWITCH TYPE • GAL- ;RCHES _ PUM HpwjFACT�JRER : S' Z� D PER A LHR 15.23 WAC uvnt plODELC�NT't t � ./ pump �' ALARM iJIRZi1G GPM FEET TE TI ON pIP£ . •� FEET REQUIRED DISCHARGE ' D IS•FgZBU - FEET CE B£TW£EIi p;11�4P OFF AND - - f ACTQR / FEET VE1tTSCAL DZFFF.REN PPLY PRESSURE ggICTION J + MINIMUM IIETWDMK SU FT/ l0 D • FT T . NAMIC BEAD ET FORCEISAIN X =;;- "' TOTAL DY o DIAMETER t3F Fu MF TANK' LIQUID �_'�-- --�-"' I l�T£RNAL D IMEN5IOIS > DA='F-: LICENSE TOTAL DYNAM M "EA E CAP ACITY EFFLUENT AND DEWATERING HEAD CAPACITY CURVE MODEL 152/153 MODEL j 1 5 2 'J3 4 W Feet Meters Goi. Liters Gol. Liters `y 50 5 1 69 261 77 291 153 1 0 3.1 1 61 231 70 i 265 t5 4.6 53 201 61 231 12 40 152 167 52 19 1 20 6.1 I 44 ! L5 I 7.6 34 129 42 159 30 i 30 9. i 2� 87 125 33 I B _— - -- 22 ! 35 35 ,n7 20 40 12.2 1 -- i -- tt ! 42 c ?6.0 Ft. l i t.6m} 44.0 Ft. (13.4m) r I ock VOive: - otasoe 4 10 60 O 40 BO 100 GALLONS 7 5 t/o LITERS 0 80 160 240 320 - 3 27/32 ---t"a 5 /e-� ! FLOW PER MINUTE 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS _j a r ® 3 27/32 • Timed dosing panels available. led with { • Electrical alternators, for duplex systems, are available and supplied an alarm. ' I • Variable level control switches are available for controlling single phase systems. - • Double piggyback variable level float switches are available for variable I , level long and short cycle controls. I i • ons. See FM1420. Sealed Qwik -Box available for outdoor installati • Over 130 ° F. (54'C.) special quotation required. 12 15?N53 Series' I l 15TH M Con o Seleetl Model Volu h Mode $ e Sim lax 2 ex I1 N152 on 11 1 N s aN152 175 1 Auto 8.5 lntluded 2or3 E152 230 1 Non 4.3 1 2 or 3 RE152 230 1 Auto 4.3 Included 2 or 3 115 1 Non t0.5 1 2 °r3 SELECTION GUIDE N1 *BN 53 115 1 Auto 10.5 Included 2 or 3 back variable level float 3 230 1 Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggy 3 3 230 1 auto 5.3 Included 2 ar 3 switch. Refer t0 FM0477. AUrioN 2. See FM0712 for correct model of Electrical Alternator E-Pak. o c 3. Variable level or correct switch 10- l of 5 used as a control activator, speaty duplex (3) on devices and wiring should be done by a qua All installation of controls, proteed Of (4) float System. d be folowed including the most recent Nadonal Electric Code (NEC) andth O co cccupatlonal Safety l and Health Act (OSHA) - RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. _MAIL TO: P.O. BOX 16347 Louisviile,KY 40256-0347 Manufacturers Of.. SNIP T0: 3649 Cane Run Road [+ o � ® Louisville, KY 40211 -1961 Q[I�LITYPUMQ9,7 I9i�i9 PUMP � (502) 778 02) 774 0) 92 13 PUMP !" FAX (502j 774 - 3624 htgp.11WWW.ioei1er.com p Copyright 2000 Zoeller Co. All rights reserved. ENT PLAN Page of POWTS OWNERS MANUAL 8MS EM sP fFICATIONS • ) a1 0 NA Septic Tank CaPa� NA 1100RMAQ0 f® Septi To Manufacturer 1G Ow�r C2 N A Permfl Effluent Filter Manufacturer >2 DESIGN PARAMETERS 0 NA Effluent Filter Model a f� a NA 3 �? al NA Number of Bed�Tts NA Pump Tank Capacity NA I Units allda Pump Tank Manufacturer (' Number Of Comore now (a p NA vemaoe) Pump Manufacturer mated x t.5) :aVd y Mode{ 1Uf -�Z,.� Oesign flow (P"- (1 r �� aVda /1'tZ P� vatment Unit Son wpp Rabe average' Sand/C3revel Fitter D Peat Ftter Monthly p Wetland tnflueriMfl1uent Quality S.iO mg/L p lylect►anical Aeration Fats.. on & Grease (FOG) 5�fl IL ❑Other meal O � ge n Demand (BODs) :gi so Manufacture p Disinfection nded Solids SS) n r B STOW Sus average" Dispersal Ce![(s) ressurizsd) iuent Quality Monthly averag 1 - ground (graven`) O Mound in - gro und (p pfetr�eafied 530 mgJL rode O Mound g'iochemjoal o Demand (BODs) s30 mg/L At-grade ire ❑Other Total Suspended Solids (TSS) 5 cfull OOml � n non oom�T+e�n �"'st°w'S Fecal Coliform (geometric mean) vakws typ for domestic t Y. inch diameter effluent. LM�mum Effluent Pardde Size s tYP� for pretreated was tewater. MAINTENANCE SCHEDULE Service Frequency S Event C3 months ar(s) (Maximum 3 yrs.) S At Least once every 3 uais one Inspect eondrtion of tanks) When combined sludge and scum e4 third (4) of tank volume ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) [3 month At least once every – ar(s) inspect dispersal cell(s) p months At (east once eve ry g NA effl uent filter At Least once every 17 months K 1 C3 Inspect pump. Pump controls & alarm (3 months r(s) O NA At least once every 'S months fl years) O NA Flush laterals and pressure test At least once every Other p months f3 yea r(s) O NA At feast Once every Other . the effluent INSTR UCTIONS n one MAINTENANCE i ce tis shall be made by an individual carry S pector of the following licenses or r P01NTS Maintainer, SeptagO inspections of tanks and dispersal Sewer, pOWTS inspedoto !den* any missing or broken be turns.. Master Plumber. Master Plumber Restricted a and scum and t check for any back UP tor. Tank in must Include a visual Inspection of the rankle) check fluent levels h�. dentitY . Tank or leaks, rrreasure the volume of oortibtned elude The dispersal cell(s) shall be visually inspected t on the ponding of effluen or dware of effluent on the ground surface. nding of effluent on the ground surface authority. in the observation Pipes and to check for any Po uires the Immediate notification of the local reg ma indicate a failing condition and rest eq uals one -third () or more of the tank volume�� ground Surface Y e and scum in any tank of in accordance with when the combined accumulation of stu a Septage Servicing Operator and disposed entire contents of the tank shall be removed by and any in Administrative Cade- pretreat components 113, Wlscons a certified POWTS Maintainer. The servicing of effluent filters, mechanif:al or Pressurized POWTS compone��� by other malnteriance or monitoring regulatory authority within 10 gays at intervals of V months or less shall be Pe of completion of any service event A report shall provided to the local reg serer Prese of painting products or other START' UP AND OPERATION poWrS check treatment tanks) for the P� c hi h concentrations are For new aonybv edon, prior to use of the ersal cell( If 9 ' the rent process and/or damage the di5p nor to use chernicais that may Pd teatm removed by a septage servicing operator p detected have the contents of the tank(s) _..._ Page of �• t conditions are frozen at the infiltrative su is restored the excess Shall not occur when sor a normal high later levels. When pow d m result in the system start up fitt abov es pump tan trot oetl(s) in one large dose, overload theP P tank removed by a DuwastewaPower.,� discharged off et tit pe Ord this situation have mP e -co ntents a Plumber or POWTS Malntarner to or su rface disc hiSM z to the effluent ue ve backu Servic IN Operator prior to to restore normal levels within the pump tank ' ng the pump tc over, or otherwise dsbJrb or compact, as sist in manually Operate cells. Do not drive or pa r an d dispersal a. tarllCS n are Do not drive or park vehideS over of ant mound or at -grade soil absorptio the area within 15 feet down slope from the wastewater stream may improve the performance and prolong the fife of the following Teas Reduction or "el "rrnination cigarette butts: condoms: cotton swabs; d e g reasers; denfal floss: diapers; fine; tease; herbicides; meat TS_ of the POW antibiotics: �Y VAPS ump) water, fit k and vegetable peelings; g�O wat softener brine. . n dttain (SUMP P. d es; sanitary napkins: tampons: and rvat - medications; oit; t ng producW Ph shaft Lp taken to insure that the N1 ASANOOMFXT ntiy taken out of service the following s sin Administrative Code: pOyM falls and/or is p m 83.33, VYiscon s properly safety abandoned in compliance with ch- Com P ipe AI( PIP s sealed. in to tanks and pits shall be disconnected and the abandon oste o by a Septage Servicing Operator. The contents of all tanks and pit • g s hall be removed and properly .. s After pumping. all tanks and Pits shag be d ew � and removed or their covers removed the void space filled with soil, gravel or another ine CONTINGENCY PLAN snot be repaired me following measures have been, or must be taken, to Provide a code if the POWTS fails and Ca compliant replacement system nt'area has been evaluated and may be utilized for the location of a rept mad should not 0 A suitable r!eplaoeme cemen area should be protected from disturt�ance and compactio absorption system. The rep from exisng and Proposed structure. lot tines and wells_ Failure to be infringed upon by required setba protect the replacement area will result in t hus ed fc) y th Snieffect at that tlrne�b a suitable replacement area_ Replacement systems O A suitable re placement area is not available as due a fast resort o replace the failed POWT5ng advances in P OWTS ethnology a holding tank may be installed n failure of the POVVTS a soil and The site has not been evaluated to Identify a suitable replacement area Upon tacement area is available a evaluation must be performed to fotate a suitab r the failed POrVYTS i f no rep / h olding tank may be installed as a last resort to rep re moval of the biomat at Mound and at - grade soil absorption systems may be reconstructed to Pty follow r a at that time. ns of such systems must comply t-he Infiltrative surface. Reconstru�° e » TAJ+IKS MAY CONTAIN LETHAL GAS SES AND /OR INSUFFICIENT OXYGEN - <<WARNING PUMP AND OTHER TREATMENT CIRCUMSTANCES. DEATH MAY DO NOT ENTER A SEPTIC, PUMP O ROM THE PRIOR TAA�NK MAY BE IFFICULT OR IMPOSSIBLE RESULT.. RESCUE OF A PERSON F ADDITIONAL COMMENTS POWTS MAINTAINER POWTS JNSTALLER Name rLJ�rt/ Name �✓3� "r All Phone Phone '7, �--c� LOCAL REGULATORY AUTHORITY SEP7AGE SERVICING OPERATOR PUMPER Agency J fr ` �+ F Name /�-- O � :] Phone ,..- 2Y�'�' �fYd Phone �.�,.� �'3rS'� " j' / �� This document meets This tlocrrrnent was drafted by Cie staffs of of the Omen Lake. Marquette and Waushara County Zoning and Sari Vi U �f egs document does net the mWmum requirements of c1L Comm 83.22(-0(bXi)(d) &(fl and 83.54(l).(2) & (3). WeaOnsin A"'Wrati+re GMW (21D1) guarantee the pert ormance of the POWTS. Wisconsin Department of Commercb PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463133 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Oeverin , Ken Richmond Township 026- 1130 -14 -000 CST BM Elev: Ins p. BM Elev: BM Description: Section/Town /Ran a /Ma No: P _ 9 p /Or) t6 kM 1 5 25.30.18.874 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r^/' 7 Q n, DOd Benchmark Dosing c Alt. BMS j G . — S 9 . c� Aeration / Bldg. Sewer Iz.IS �(,.a5 Holding SUHt Inlet /3•� �4• Sly TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / O lt 27 ' 2 , Dt Bottom i� Tit-, Dosing j Header /Man. l - 2- 77 4-L 23 TS Aeration Dist. Pipe 4 . 2 ' 5 1 3.95 Holding Bot. System 5 7 J 92 1 PUMP /SIPHON INFORMATION Final Grade ) 0 T5 — - Manufacturer GP nand St Cover �. .-7 9 Z c) o s Model Number 1 I Za - , � / ` J r S . �j Z - C-1 TDH Lift Friction Loss ' V System Head TDH Ft l• 1 3.35 I Forcemain Length i Dia. Dist. to well SOIL ABSORPTION SYSTEM S BED/TRENCH Width Length j No. Of Trench s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Z Cq SETBACK SYSTEM TO P/L I BLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAM OR Type O Syste m : , UNIT Model Number. \ DISTRIBUTION SYSTEM Header /Manifold x Hole Distribution Size �� x Hole Spacing Vegtto Air Intake Pipe(s) �' j N-, -f Length Dia Length _ Dia ` Spacing ` ` 3 Z Z SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges ITopsoil ` ' g Yes No es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /6 / ZG / 64 Inspection #2: / / Location: 1405 138th Ave. New Richmond, Wl 54017 (SW 1/4 NW 1/4 25 T30N R1 8W) Red Pine Comer Lot 14 Parcel No: 25.30.18.874 1.) Alt BM Description= 5� L Ch J C q �o v� R •(�(� � ,(_ oo� 2.) Bldg sewer length = 0' 1 - amount of cover = j ; ✓� tA4 (� Plan revision Required? Yes > No Use other side for additional information. Date Insepct Signatur Cart. No. SBD -6710 (R.3/97) Safety and Buildings Division Count 1 201 W. Washington Ave., P.O. Box 7162 N *isconsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Depar�lnent of Commerce (608) 3 3 • Sanitary Permit Applicatio State Plan I.D. Number a � In accord with Comm 83.21, Wis. Adm. Code, personal infotmatio ou p 2 U 200 D7 may be used for secondary purposes Privacy Law, s l ) Projc ress (f different than trailing address) L Application Information - Please Print All Informati D ZONING OFFICE Property Owwes Now Parcel # Lot # Block # PWpAtY ms's Mail Property Location Z Q 7 > �� V4. �'� • r A Section � City, State Zip Code Phone 1 , jy N /i ts) #17 . R rW II. Type of Building (check all that apply) � � " r 2 Family Dwelling - Number of Bedrooms k ibliciCommercial Subdivi�lon N M Number - Describe d Ak 1 State Owned - Describe Use q _ 3.407X ' g f City_ Village ownship of i III. Type of Permit: ((deck only one box on line A. Complete line B U applicable) �' A ew System Replacement System Ttestment/Holding Tank Replacement Only Oder Modification to Existing System B. Permit Renewal on Change of Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration P tuber Owner j Co 3C; --7 (0 � IV. Type of POW TS System: (Check all that a 1 Non - Pressurized In- Ground Mound Z 24 in. of suitable soil Mound < 24 in. of suitable soil At -Grade Single Pass Sand Filter Constructed Wetland Pressurized fa- Ground Holding Tank Peat Filter Aerobic Treatment Unit Recirculating Sand Filter Recirculating Synthetic Media Filter Leaching Chamber Drip Line Gravel -less Pipe Other (ex lain) V. DignLsalfllreatnient Area Information: Design Plow (�gpd) Design Soil Applies Rate(gp" Dispersal Area Required (sf) Dispersal Area posed (sf) System Elevation 73 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New T Existing Taub aoks Septic or Holding Tank Aerobic Treatment Unit r Dosing Chamber 3 , _ 7 VII. Responsibility Statement- I, the assume responsibWty for Installation of the POWTS shown on the attached Isar Piu Natne (Print) PI igrtatute MP/MPRS Number Business Phone Number �Z_ - _ Q -. - / b Plumber's Address (Sheet, City. State, ) - v� vul. Co n f'De artment Use Onl 1( n7! j Disapproved Sanitary Permit Fee (includes Groundwater Date tied uing t Sigitatute Surcharge Foe) ,tea Owner Given Reason for Denial l Z D D GGi 'X�L IX. Conditions of ApprovaUReasons for Disapproval Qom..• � s- � � . ���� ��� t3 �� /0 A cDnq* a plans (to the County only) for the system on paper not less than Un x 11 inches in size nmo� n ■o ■�0 c @ • % @ K § ; § ° 9 J � E£ 2 E- � m CD w § 1 f ■ § � � O 2 0 0) i ( 0 0 ~ - E < 2 < 0 \ 0 Lo E + [ $ } § s° /� ƒq § OD gn CD � CD / f CL ■ $ U) $' % 8 £ F & m E § « e © f / > / ¢ i / > / % § \ / _ \ i / > 0 7 % � \ § % z Q z ƒ / % f / % � E / "*A, g � J o o 0 2 0 0 0§ .. Oro / I CO) ) § \ � U § § 7\ M a v- $( Q E f m\ @ ■ g 2 I \ � 2 - , ; � - e n % -4 w o § \ k c 0 \ i @ G 7� i 7 § E A CD k ° 2 a 0 ; ` \ \ \ 2 z CD CD z \ ; .. ■ M ■ M § E § E § 2 2 CA I k E k z& 7 z 7 m \ CD w k ® � � 7 D }k\0 § � \ g -0. / / % § § { / % c 2\\ƒ = \�' 2 %k § :E \ § 0 $ 2 0 $ § :3 % ED nE A _ to \ i {C o o � < < § _o -? �§ g � g C, 8 ( a, 2 1 V/ LV I L V V T L V. V T V V V 1 V V� V ./ V .+r r. rw s✓ ✓�✓ vv ITV ✓� PLOT PLAN PROJECT Oeverina Homes ADDRESS 838 Summer Pines Circle Hudson Wi 54016 SW 114 MN 1/46 25 /IT 30 N/R 1 a W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 93 -0' BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANS MOUND SEPTIC TANS SIZE 1000 gallons LIT TANK SIZE DOSE TANK SIZE 630 HOLDING 'TANS SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter 7abelA -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark .M. A B.M. top of survey iron @ 95.0' Property Line Grading is to be done to divert Tank is to be run -off away from system properly bedded and B - B-2 provided with 93• lockdown covers 9 3 with approved warning labels 92.5 Huffcutt Combo tank B -3 Slope Well is to meet all Area 15' below system to setbacks found in Comm. remain undisturbed 83 Pro 3 Bedroom House Property Line (not to scale) , Z I X Tolth Ave Scale = 1/4" = 10' 10/20/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 04 PLOT PLAN PROJECT Oeverina Homes ADDRESS 83a Summer Pines Circle Hudson Wi 5401 SW 1/4 MIN 1 14S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 93.0' BEDROOM 3 CONVENTIONAL AT -GRADE JOCX CONVEN'T'IONAL LIFT HOLDING TANK MOVND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 MOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter 7,abelA -100 ❑ BOREHOLE WELL #H.R.r. Same as Benchmark B.M. Alt.B.M. top of survey iron @ 95.0' Property Line Grading is to be done to divert Tank is to be run -off away from system properly bedded and B-1 B-2 provided with 93.5' - - lockdown covers 93' with approved warning labels 92.5 D Huffcutt Combo tank B -3 4% Slope Well is to meet all Area 15' below system to setbacks found in Comm. remain undisturbed 83 Pro 3 Bedroom House Property Line (not to scale) To 138th Ave Scale = 1/4" = 10' `, � = rn0 O (n r 0 * ma Z ? � m O Zic rn El m 0 m 70 -� Cf) X m O .. O --1 K� --4I 5 5 2 CO) m n m o C/) z c O � Z z ..q v c z Cl) Iiiiiiiiiiiiis m > � r � O Z - z N O Z c v C7 rn �= r � z z T C'� -+ r CO) -v m X c < x m _ r •�. m 111 n C O Z F) 0 my m Z •.. 0 m< c� c: < I z a 'R E CA s s an p .z a n « -4v Z Z O n � 3� F !.o ',a z Oa M m m Z x ~ 1 — 6 r � 1F 7S T g ar N 5 C g g � S a W 1 • z C m W C7 w N z � 10/20/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 01 I Buildings pest -it* Fax Note 7 1 oa pages l3 iULEE RD commerce.A.gov To Date 1601.1831 R Stc9 2e4 -e777 CoJDePt� Co. x wl.gov /sb, i sco n s i n Phone # • Phone * ,onsin.gov Department of Commerce (Al Ea0 Fax # r . M Fax # Govemor F Secretary October 20, 2004 CUST ID No_226900 AT77V. POWTS Inspector SHAUN R BIRD ZONING OFFICE . BIRD PLUMBTNG, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPRO PLAN APPROVAL EXPIRES: 10/20!2006 !dents$ � � en Nurr�bers' Transaction ID i. 1070722 SITE: Site ID No. 691167 • g n Oeveri Homes Please safe ;�io identilzcation o�imbers•, . ev th Avenue above in! W porres ondence isiith the. • en . Town of Richmond St Croix County SW1 14, NWl /4, 525, T30N, R19W Lot: 14, Subdivision: Red Pine Corner FOR: ! scripfeet 987329 intenance required; 450 GPD Flow rate; 40 in 5oi1 minimum depth to limiting factor from original grade System(s): At -grade Component Manual, SBD- 1.0570 -P (R.6/99), Pressure Distribution Component Manual, SBD - 10573 -P (8.6/99); Biofilter 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Depanment•per s.145.06, stats. 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 approved plans, and with publication SBD - 10570 - ,P (R. 6199) "At -grade Component Manual Using a Pressure Distribution System for private Onsite Wastewater Systems ". • The pressure network is to be constructed in accordance with publications SBD- 10573 -P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater.T.realment Systems" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01 /81 ". . • 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. Stets. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent falter is required. 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_ P . ®. ona APPROVrn COndz jl f 10/20/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 02 SHAUN R BIRD Page 2 10/20/2004 • Comm 83,22(7) - A cony of the agprovedplans specifications and this letter &.hall be on -site during constrdctio and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities. • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in. this approval. • Comm 83.52(1)(a) - The owner of it POWTS'shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83,54(4) shall be considered a human health hazard 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. The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 pei state stats 101.12(2), .nothing iri 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, Pee Required $ 175.00 Fee Received $ 175.00 Gerard M. Swim Balance Due $ 0.00 POWTS Plan Reviewer - Integrated $ervices (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 prn jswirnoeommerce.state.wi.us WiSMART; code: 7633 cc: Leroy G ransky, Wastewater Specialist, (715) 7262544 10/20/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 03 SAA T 1 � E ' zov� Cover Page Bj p �'� fl1V Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 010/06/04 Ownec0evering Homes Location:SW 114NW1/4 S25 T30 N,R1BW Lot .14 Red Pine Corner Richmond System type: At -Grade Manuals Used: At -Grade Component Manual version 1.0 SBQ 10570-P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Page# I. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -11. Soil test _ .•► -;.+R MENT OF COMMERCE pIV1510N YAND BUILDINGS Shaun Bird • Signature SEE CORR PONDENCE License number 221ZO 10120/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 05 L , > 5 1 2:5 i .�TLtR1►1 UPS t— ��sr,tts�r�o•t is►- rA.rsaL w EA smBiLI ZED Of l :kLV tI WELL > 5 E/6 B I /6B t /2B A L = 1 1 E Ft. CELL of %z' Z A&GAE.&O L v+1- 7- -Z- ft . hVem&dES Sym 1=abr;c Dis tribution Lateral STP410 Observation , 0 ,— Soil Cover Well � PLsw1FD LAIL& Z: 5, A 2 y 5' S LOPE a , - t radB Qs►� -L witl+ a plan Viav aad Cross gnteidt+ of A - 8 W� 9CQr�i.n Siaglt Absorprion Area on a SYopin Sit Ltc.EpiSE.. .�� C e ti N04TUitE 10/20/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 06 Page Of_ Dis triSutiOn Pipe DetAi1 for Lateral Ketwork e Co - .t TUKM - C1.ER�oe tT) :. PVC Force I{ain * N, PVC Distribution Pipe t P * List Hole Should Se Next To ruRA uP Ho le aiaseter X � i�he5 Lateral Diameter Y inches 2 ,�_ inch(es) �.6 Force Main Diameter Inches Z`7 Z� '# Of Holes /pipe Invert. Fl e vat ion of Laterals � Ft. Signed: License NuMber: Date: 10/20/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 07 K � F�iri? C ;j��� CROSS . S EC T z G hH� S ?ECti ICATIONS SEPTIC T� t EATHERpWOF tAH£- AI+gROY ED ��.. ?►BDVE GRAD E Ji3#CTIflli $OX OLE CO� E1t _„� WITH CONDUI W/ PAD'�x Lj L6 Cx V EIfT PIPE Id I NDow 4� WAIMI mr aIA ;KTAK� FRS 1 F l if � • � s, D - �Su sr►�#, aa rr .r T INLrT TZGNT � S VITH �:A•sER T-10 HT SET' SEAL •} RppitOrED PIPE _ - ALM ON 3ydLTC 50h C ! y OFF pI�pPAOV� �,.. . P OD 3 5OLID T EL£V - --' FT. O SOIL $ ��NG v�DEX. TAN Or1CRETE PAI 3 a A pPIt � 1F,�o SP= C =FICATZQ�S � . H133S9ER DOSES FIM #)AY SEPT,l F AC'i�lRER � £ v 4 KE F L a,cK TANK ir1A1W GAL- ��r�Tal'►L. SEPTICi. - ZY�T�ICS 'tA1i1C SIZES = S C},PAC;Tf �S = �" - 3 O GAL D OSE S = . �---� �FACZi3itER;� 7,.j GFsL. Ai� MaDiL r18ER = SINGEiES C — L+.r - z. ,,I'ICIR r1P£' a � YpCK£S 1 R� P PUKP ; ri AS 'ER 15.23 WA I £ gE3t : �/ri / WXltli� I1.NR xswYZ'CH TYPE: p r A..AR FEET PIPE REQU V' SC BATE DT TREfl CE gE - gEN p j4p OFF AN CTO D _ _ _ - ! �E PRESSURE - [Tx.OI� FA ER RFEb? vFRTZCAI- DIFF P p •X , �"� /�a�` FR ; DYNA ;C ? D �, . i K EXI1 M NETKD TOTAL pYAnEr — , L L EH5I0� 11��1�A D TM . D = ' LICE1dSL AMBER S�GPtED= }JOB I 'I 10/20/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 08 TOTAL DYNA M NUTS CAPACITr PER AND ATERING EFFLUENT' D C ITY CURVE HEAD CAPACITY EW 1 s� L rj2 53 rAoDEL 152 M ODE I Fee: Met"'. 021' Liters Gol. Liters 77 291 , 69 Z61 153 10 3.1 E1 231 70 1 255 1 $ 1 4,6 53 201 61 231 12 40 21) 5.1 15� 44 ; 167 3 2 197 g L5 7.5 34: 129 42 159 x 30 �D 9, t 23 B7 33 125 20 38 E; Lock VOlve: ,•D L cu�oe r , d ' 10 40 60 100 20 GALL NS 3�0 _ ] 27/32 LITERS 0 gD 160 240 I I FLOW PER MINUTE 3 27/32 , FACTORY FOR SPECIAL APPLICATIONS �3 CONSULT FA 3 ,. ®. I • • Timed dosing panels available. Electrical surnators, for duplex systems, are By all2ble and supplied with 1 sn alarm. • V-adable level control switches are available for controlling single phase 1 systems. • Double pi9gybacK vadable level Host snitches are available for variable level long and short cY cqe controls. I • Sealed QV14- available for oltd o inst plat ons. See FM1420 � . • Over 130 °F. (54 - C.) Pe q o 1a 1/s I 15?1153 Series' 15 � G n IS ■r n 6 a/9 a •5 Icy Modor y e ae.P 1 rdode 1 2 a1r rK2ea� N162 115 1 NO 5 5 Irac�ded 290 3 6N152 115 1 r>+�m 4.3 1 acr3 $1 230 1 NO 4.3 {ndudod 2 3 wig 330 1 .� td5 1 3 SELECTION GUIDE 1 1 1 Nc" 2 or 3 G p level float A BN1S3 115 1 WO 1a5 included back variable level fmat switch or double I99Ybadc variable 1 2 or 3 1. Sin Pi99Y FIN 29t) ; 5' incuadctl 2-3 2 see FMD7 12 for cor rect switch. Refer IP Fryt0d77. BE153 290 A model of El=uical AlWmBtor E•P G e a N Rea 3. V ariable level control swFa:h 10.0228 used as a control activator, speak duplex (3) AU insttdladon of controls, pres"on devices and wide should be don o h lncludU qualified the most . or (4) float system. licensed ale hwan. Aa el,&j +f and =f* cadet should be foAdwsd N atonal EIeClrie Code (NEC) 1111111012 Occupational Safety W d Heatda Act reeant RE SERVE POWERED DESIGN F ,Jnusu a( conditions a rsve safety factor is engineered Into the design of every Zoeller pump. ... ,rkal P.o. sox 16347 1 (AIlisole, KY 402WS47 _ Swp M,3049 We Run Road O o LeuWKq, KY 40211-1961 aufi' P ,t4f Ir /gyp: /hMwma►ler com PUMP � 1507J 77 A ( WV 77� sa,��'�A ® Copyright 2000 Zoeller Co. All rights reserved. 10/20/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 11 Wisconsin DeWrntlent of Commerce SOIL EVALUATION REPORT Page °f Division of safety and Buildings in accordance with Comm 85, Wis. Adm. Code County r ttach c Ornplete site plan on paper not less than 81 /2 x 11 inches in size. Plan must Awe but not Krnited to; vertical and haftontal reference pant (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road Reviewed by Date please print all information. Personal r,Bonnat)on veu vroviae may to used row secondary Oorpoxes (Privacy Law. x.15.01(1) (m))• propertytAwner Property Location 1 2 N e n 1/4 4 cj{ E( W l7� /7`''XJ Lot# Block orCSMN P r°perty owners Mai A dd / y ,' �� � rIvIlla To ` r 'Nearest Road State , Zip Code Phone Number /� Q `/ {is� l New Gonstruclim U Residential ign flaw rate / Number of bpdroorns Code derived des —� GPD Q Re acament rG or cvnlrnerclal - Describe; cable R. Flood Plain elevation if applicable Parent material. General comments and ramtrrrrler,dadons: Boring �/ in. Boring # Ground surface elev. R. Depth to GmitSrr6 factor � Solt iced - Rate Pit D/If Texture SttuCWre Consistence Boundary Roots Natron Depth pomir+ant Cow Redox geaQiptiotl 'Efr#1 'Efl#2 in. Murtse„ Qu. Sz. Cone Galor Or. Sz. Sh. G -� =,n eoring; # Boring y�� in. �t surface elev. � D epth W li factor .�--- Soil Application Rate Ground su XXXJJJ���'' GPDMt Hor>aon Depth Dominant Color RedoY Description Texture Structure Consistence Sourldafy Roots - E-01 -2_02 in. Munsell ou. Sz. Cont. Color Gr. � a 1 'Effluent #2 = SOD c 30 rrg1L and TSS < 30 mgA. Effluent 01 s BOD > 30 Zz0 milk and TSS 30 _ G r Number (:6T Name (PIkow Prirrtl naturR 226900 Bird Plumbing, Inc, Shaun Bird Telephone Number ! mate Evaluation Conducted 715246 -4516 Address /[ //J✓ 1 1008 192nd Ave, New Richmond, WI 54017 C7 10120/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 12 Property Owner Parcel ID # Page of CJ Bonng 1 © #it Ground surface elev. ft. Depth to lintddng factor in. Icadon Rat® Hortwn Depth Dominam Color Redox Description - r zture Structure Consistence Boundary Roots GPDfff° n. M"ell Qu. Sz. Cont. Color Gr. Sz $h. 'Eff#1 71102 Ll - Z— 13B i-S' C, D Boring ❑� ❑Pit Ground surfs® elev. ft. l>epd'r to limiting factor in. Solt aelkaffion Rate Horkm Depth Dominant Calm Redox Description Texture Stt+zmm Consistence Boundary Roofs GPD" in. Munsell ou. SZ Cont Gr. Sx. Sh. 'EMI 'EM Boring # ❑Boring ❑ Pit Ground woe ems' R Depot to dntidng facer — in. Soll Appks lion Rate Horbm Depth Dwkm . MOW Redox Description- Texture Strur*jre Ca aMence Dourrdary Roott GPM in. Munsell Qu Sz. Cont. Color Gr. Sm Sh. 'Eifffl *002 ' Eftient #1 = DOD z 30 5 220 mglL and TSS X30 _< 150 rrrgfL ' t:tfluertt #2 = BOD = 30 mg1L and TSS = 3D mVL The DepaMent 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 608266 -3151 or TTY 608- 264.8777. sew 7�o pt6�op) 10/20/2004 10:04 6087859330 SAFETY AND BLDGS PAGE 13 Soil Test Plot Plan Project Name Qevering Homes Shaun Address 838 Summer Pines Circle Hudson Wi 54016 CSTM #226900 Lot 14 Subdivision Red pine Corner pate 10/6/04 S W 1/4 N W 1/4S 25 T 30 N /R18 W Township Richmond 7 Boring 0 Well PL property Line County ST. CROIX BM or VRP Assume Elevation 10o ft. Top of Steel Fence Post System Elevation 93.0 *HppSame as Benchmark B. M. * Alt.B.M. top of survey iron 0 95.0' Property Line B -1 BW2 93.5 0 93' 92. B -3 4% Slope Property Line (not to scale) x To 138th Ave Scale = 1/4 = 10' Property Owner _ Parcel ID # Page of E Boring # .�P ring �t Ground surface elev. ft. Depth to limiting factor in. Snit 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 l 0 1.3 1 d 3/ ---- -- ( 2 - �<3 f s -8 s fW /D , ,vJ4 r _ / A� , a. , a Boring # ❑ 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/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 l Boring # E] Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I - Eff#2 Effluent #1 = BOD. > 30 < 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 (8.60)) I � - Soil Test Plot Pla Project Name Oevering Homes Sh n Bi d Address 838 Summer Pines Circle X Hudson Wi 54016 M #226900 Lot 14 Subdivision Red Pine Corner Dat 10/6/04 S W 1/4 N W 1/4S 25 T 30 N /R18 W Township Richmond ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 93.0 *HRPSame as Benchmark B. M. Alt.B.M. top of survey iron @ 95.0' Property Line B -1 B -2 93.5 93' 92.5 B -3 4% Slope Property Line (not to scale) X To8th Ave Scale = 1/4" = 10' Safety and Buildings Division City 201 W. W con Ave., P.O. Box 7162 l Viscomsin M. , WI 537W - 7162 Sanitary Permit Number Qp be filled in by Co.) Department of Commerce 608)266-3151 _ Sanitary Permit m ApIky"cation J -- staState Pla ° LD. In accord with Com 83.21, Wis. Adm. Code, personal information you S / may be used For secondary purposes Privacy Law, 915.04(lXm) Project (if different than mailing address) I. Application Informatien - Please ' t AIl Information / 5 (� A ve- o —/ - set Property - Owner's Na me B Lot Block M Property Owner's M ailing Address Property I p+ b d City, State Zip a hoee,�i>aattrer (circle one) Gcll S O - T -49 N; R Z2E- - II. Type of wilding (check all that apply) ✓ � Subdivision Name CSM Number 9K or 2 Family Dwelling - Number of Bedrooms 3 i!,v ❑ Public/Commercial - De Describe Use ❑ State Owned - scribe Use P; `� s� 7.3 []City []Village Rrowmhip of III. Type of Permit (Check only one boa on line A. Complete !AB if aAfficable) A ' &-New System ❑ Replacement System ❑ Treatment(Ho Replacement Only ❑ O odification o Iixis " -- B. ❑ Permit Renewal ❑ Permit Revision ❑ (arrange of Transfer to New Before Expiration Plumber O Iv. T of POWTS system: (Check all that apply) ❑ Non - Pressurized In-Ground VeMomd > 24 in. of suitable soil Mound < 24 . of suitable soil El At-Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland El Groun Pressurized Lt d ❑ Hokling T ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber rip Line ❑ ravel- ❑ Other (explain) E b V. Dis reatment Area Information: 0 . Design Flow (gpd) Design Soil Application Rate(gpdsf) Area Required (sf) D Area (so Elevation S'O hSl "• �.D SU /lZ� 1 D-2 3 /0/•0 VI. Tank Info Capacity i Total Num Manufacturer Prefab S Steel Aber Plastic GaUm Gallons of 7 6 Constructed Glass New Existing Tanks Tanks Septic or- Holding Tank _ Uoil Dosing Chamber — ®a - VII. Responsibility Statement I, the assume rvisponsibi ft for installation of the POVnS shown on the attached plans. Plumber's Na me (Print) Plumber's gnature -hIPfMPRS Number Business Phone Number Fogerty Plumbing pddc �7-X T/s - 3-5- F010 Ph"n Lts� �: ZIP 7/S - �3.5 = -s SO Spooner, WI 54801 6.i'i— ol- 06 C VIII C O - el ? 6 Approved 11 Disapproved Sanitary Permit Fee (includes Groundwater Dace Issued t S" o Stamps) Sunrharge Fes)j 3S O� Z� D ❑ Owner. Given Reason for Denial `+r IX. Conditions of APPro f�jxo J/ & S� T EM O WN /� ER: is an c, effluent filter and 7 � cJ ispersal cell must all be serviced I maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to Nhe Comfy only) for the system on Paper not less than 9112 x 11 inches in size O � N A+ • to b � IL 0 r4 O 'y n a O C rw a _ et II C � a p r p w w CD O Z tr'' u W A O m rA 00 Safety and Buildings 10541N RANCH ROAD commerce.wi.gov HAYWARD WI 54843 TDD #: (608) 264 -8777 isconsin www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary September 13, 2004 CUST ID No.224059 ATTN: POWTS Inspector ZONING OFFICE KEITH E STONER ST CROIX COUNTY SPIA 23220 WOOD CREEK RD 1101 CARMICHAEL RD SIREN WI 54872 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/13/2006 Identification Numbers Transaction ID No. 1056485 SITE: Site ID No. 688917 Oevering Homes of 14 Please refer to both identification 140TH St numbers, above, in all Town of Richmond I correspondence with the agency. St Croix County SW1 /4, NW1 /4, S25, T30N, R18W Lot: 14, Subdivision: Red Pine Corner Subdiv FOR: Description: New mound, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 978286 Maintenance required; 450 GPD Flow rate; 41 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the design manuals noted above. • 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, ha the o ration maintenance and pp p the owner must insure that operation, monitoring duties as described in section VIR of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Key Item(s) KEITH E STONER Page 2 9/13/04 • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • 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. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). Consult the Department of Natural Resources for well setbacks and exceptions to the setbacks. 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 Shandorf POWTS Plan Reviewer, Integrated Services 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 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Oevering Homes LLC Lot 14 Mound Owner's Name: Oevering Homes LLC Owner's Address: 838 Summer Pines Circle Hudson WI 54016 (715) 760 -0001 Legal Description: SW1 /4 -NW1 /4 Sec. 25 T30N - R18W Township: Richmond County: St. Croix Subdivision Name: Red Pine Corner Lot Number: 14 Block Number: NA Parcel I.D. Number: I.T.S. afzally Plan Transaction No.: Page 1 Index and title )F C M Page 2 Data entry WINGSC Page 3 Mound drawings Page 4 Lateral and dose tank SPONDEN Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan ````````\���� �JISC � Designer: Keith E. 4tonef . A - * ' License Number: Designer# 1575 -007 Date: 08/22/04s D. y 8 = Phone Number: (715) 653 -2324 Signature: �1a1,14 Vurs to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 450.00 Design Flow (gpd) 2.00 Site Slope ( %) 101.30 Contour Line Elevation (ft) 41.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd/ft) Distribution Cell Information 90.001 Dispersal Cell Length Along Contour (ft) F ____ 5 __ 0 _ 01 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution F Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elev (ft) 4 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) = 6.25 ft /orifice 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 91.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 16.31 Forcemain Drainback (gal) 10.47 Vertical Lift (ft) 81.25 5x Void Volume (gal) 3.12 Friction Loss (ft) 97.56 Minimum Dose Volume (gal) 18.13 Total Dynamic Head (ft) 38.77 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Concrete IManufacturer gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 602.821 Dose Tank Capacity (gal) JZabel Filter Manufacturer 11.821 Dose Tank Volume (gal /in) JA100 Filter Model Number Wieser Concrete Manufacturer Project: Oevering Homes LLC Lot I q Mound Page 2 of 8 Mound Plan View T 1/10 B . 3Q J K. :�. Observation Pipe — A W ....... ..... B ... ... ..... .. . .. ...... .......... . .. ' '.. . . . . . '.. .'. .' z L Mound Component Dimensions Down slop toe extension made. A 5.00 ft E 7.20 in H 1.00 ft K A17.57 ft B 90.00 ft F 9.50 in 1 7.50 ft L ft D 6.00 in G 0.50 ft J 5.07 ft W ft 450.00 (ft) Dispersal Cell Area 1125.00 (ft) Basal Area Available 5.00 (gpd /ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.59 (ft) - -► .,... G ♦ H 2 Jr!!! / /�,. 1 F Lateral fr }� Dispersal Cell 102.30 (ft) La f }. .. . 101.80 (ft) -► — Invert Dispersal Cell p = t Elevation E - - -- - -- -- -- -- - - - - - -- -- - - -- - -- -- -- - - - - -- -- -- -- -- - .: �.. .. .. 1. .. .�.. .. .. .. .. .�.. -. 101.30 (ft) Contour Elevation 2.0 % Site Slope Geotextile Fabric Cover Shading Key m o. Dispersal Cell See lateral details on 10 _ Topsoil Cap c °• 1.5 ft Page 4 for number, size, Subsoil Cap 0 and spacing of laterals. ©0 ASTM C33 Sand N ° F Laterals are equally Tilled Layer a 0.5 ft ", Lateral spaced from the c .c distribution cell's 5 ❑5 Aggregate o centerline in the A * distribution cell (AxB). Project: Oevering Homes LLC Lot 14 Mound Page 3 of 8 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical I P S A •= Turn -up wfball valve or X—)�IF02 I ef2�l Laterals & force main of PVC Sch 40 cleanoutplug per COMM Table 84.30 -5 Hales drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 44.28 ft Orifices per Lateral 18 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 f /orifice Lateral Flow Rate 9.69 gpm Manifold Length 2.50 ft System Flow Rate 38.77 gpm Manifold Diameter 1.50 in Total Dynamic Head 18.13 ft Forcemain Velocity 3.96 ft/sec Dose Tank Information Locking cover with warning label and locking device and �— sealed watertight Electrical as per NEC 300 and — 0 Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented �— Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in. Capacityl 602.82 Gallons Volume 11.82 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 30.75 363.42 C B 2.00 23.64 P � ump off elevation (ft) C 8.25 97.56 91.83 D 10.00 118.20 D Total 1 51.001 602.82 iE Dose tank elevation (ft) 3" Bedding uncTer tank. 91.00 Alarm Manuafacturer IS. J. Electro Alarm Model Number 101 -01H Pump Manufacturer Goulds Pump Model Number 1#3871 EP05 Pump Must Deliver 38.77 gpm at 7 — 8 - 1 - 3 - 1 ft TDH Project: Oevering Homes LLC Lot 14 Mound Page 4 of 8 - Mound System Maintenance and Operation Specifications Service Provider's Name Tri County Sanitation Phone (715) 386 -0114 POWTS Regulator's Name St. Croix County Zonin Office Phone 1 (715) 386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Moundl inspect for ponding and seepage once every 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished • ............. ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Oevering Homes LLC Lot 14 Mound Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the 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. 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD 30 mg /L TSS, 10 mg /L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Oevering Homes LLC Lot 14 Mound Page 6 of 8 Page 7 of 8 GOULDS PUMPS Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion • Farms manual operation. Auto- resistance. 10 Cmwd'a" Standards AWoOMM • Heavy duty sump matic models include • Water transfer Mechanical Float Switch ■Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "C" or "F ".) factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic Gary Pryp is ISO 9o11 MosWed FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. '14" maximum. ■ EPO4 Impeller: Thermoplas- N Power Cable: Severe duty • Capacities: up to 60 GPM, tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'/2' NPT. seal protection. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA -N elastomers. • Temperature: 104°F (40°C) continuous 140OF (60cC) Intermittent. METERS FEET • Fasteners: 300 series 10 stainless steel. 9 30 5 GPM • Capable of running dry without damage to B 2s F1 components. 25 ° a Motor: LW • EPO4 Single phase: 0.4 HP, v_ 6 20 115 or 230 V, 60 Hz, 1550 1 5 RPM, built in overload with o 15 automatic reset. a 4 EPOS • EP05 Single phase: 0.5 HP, o 115 V or 230V, 60 Hz, 1550 3 10 RPM, built in overload with EPO4 automatic reset. 2 • Power cord: 10 foot 5 standard length, 16/3 1 S1TOW with three prong grounding plug. Optional 20 ° ° 0 10 20 30 40 so GPM foot length, 16/3 SJTW with three prong grounding plug 0 2 4 6 B 10 12 m (standard on EP05). CAPACITY Goulds Pumps ® 2001 Goulds Pumps ITT Industries Effective May, 2001 B3871 O � c N A p In k w �k N o ?y a o � � a � r \ ► to (D II d 11 11 A 4.%CCD. y a b °�+ CD b dq fD M aNr x''d C N o a cC nod o 0 oz�r o 00. .II IN A O 1 p o0 00 00 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page -_ of 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 reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow 7 �nd_ , istance to nearest road. / y Please print q r a/ R iewe Date Personal information you provide may be u door condary gkposes (PrivaEy 4a s. 15.04 (1) (m)). 0 V Property Owner `� , , ;.) roperty Location vt. Lot SW 1/4 X1/4 S25 T N R (or) W Prope caner s al ing ress - # `= A t # Block # Subd. Name or CSM# �_� ; cRCix r ' 14 City e Zip C" '.\ Phone ❑ City ❑ Village ;Town Nearest Road `; ONINGOr New Construction Use: Residential / NumbeioP 4c$ Code derived design flow rate AM GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material glacial drift Flood Plain elevation if applicable na ft. General comments and recommendations: mound @ el. 102.30', based on contour line of el. 101.30' TI Boring # Boring ® pit Ground surface elev. 10 .6 ft. Depth to limiting factor 43 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 1 -1 3 17 -29 7.5 4/4 none sl 2msbk mvfr qw na .5 9 5 43 -65 5vr 4/4 f2d7 5 5/6 sicl M na na na 0 F 2] Boring # Boring pit Ground surface elev. 101 .6 ft. Depth to limiting factor 46 ® in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /f(? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 •Eff#2 2 12 -29 10yr 4/4 none sicl 2msbk mfr if .4 .6 3 29 -46 7.5yr 4/4 none sl 2msbk mfr 9w na .5 .9 4 46 -65 5yr4/4 f3d7.5yr 5/8 scl 2msbk mfi na na .4 .6 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg /L ffluent #2 = D < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel 02298 Address Date valuation Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 11 -15 -2000 715 - 246 -6200 i - T Property Owner OakWOOd Land DeV elOpment Parcel ID # pending Page 2 of 3 F- Boring # ❑ Boring 3 RJ pit Ground surface elev. 100.9 ft Depth to limiting factor 41 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 1 0 -12 10 2/2 none L 2msbk mfr Cs 2f 5 8 2 12 -21 7.5 4 none sicl 2msbk mfr aw if -4 -6 3 21 -41 5yr 4/4 none 4 41 -65 5yr 4/4 f 3d7 5 F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. T01:1Eplication 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] Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. 1:1 Pit Soil Application 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 < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or j need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SBD4330 (86/00) L r _ I , y STEEL'S SOIL SERVICE Gary L. Steel Oakwood Land DevelopmEjIt 1554 200th Ave. CSTM2298 SW4NW4 S25 T30N - R18W New Richmond, WI 54017 MPRSW - 3254 town of Richmond (715) 246 -6200 lot #14 -Red Pine Corner This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. r N 1 " =40' BM. = top of SW lot stake @ el. 100.00 •C Alt. BM.= top of 1" pvc pipe @ el. 103.70' V V � O ' r e' Cj 0 0 /0 ` n 0 � o o' I zg Gary L. Steel 11 -15 -2000 not 30 Oa, 09:39a FOCCRTV PLU"91"c 171GoaL - ST citoix C OUNTY SEPTIC TAM MAINMANCE AGREEMM4T ' AND OWNERSHIP CUTMCATION FORM Owner/Buyer .�� .Mailing Addmm ZYK Stfma � Al/ z: '-f-WiC ,�li��,✓ �•�r 6 Propedy Addr+eas - / Ya s d '`� ° (Vottfimm fmM Pt =W% DepOWMt for nnw aea.teuetioa) _ C;ty/State � -�'t Paree! JdmtiSeatio� Numba o.�.G — / /3o j4/_„_ -o_ = ✓ _ LEGAL DRSCRIPM g PsopertgLocation sce)_ �,. _ 'K, Set- - T F L W, Town of te «�v�•oo . Subdivision � 11 �x«�' Q K dZEL_ , Lot '- - Certified Surrey ?AUP - Volume Page # —� Warranty Deed # -7 Z f D9_ . Volume .2 5%13 . Page # Spec be= D yes 13"no Lot limed identifiable ['yes 0 no R'Y.�M_llllA�!ITlINANCB . bopl*W a ]wwrsepdCS o�diai iuib bi�talwiewres.l'seper ooaeids of �rmpig cat de wepde task aseigr ttwa 7!�a at a� ![ seded by a tiosawd ��ipes: Alsit raa pat aNa MK syllan can offam sc fiuetma of ie sa fde u* m a ftmftm ~ i a On sun di*m d mj*m lu papal) mmw spent & =wa M tL Oak Tip Dalsm d a o mmsm m isq AbvW by *W omW and y► a i!!■ i! �araea lfeaa�tdAnp.rat�tt(1�llieaa �e�atlewelerdi�IspMeo� is ri pliopet a j� aii�'fti: aiMilior� atksi�ytedisa■i ptnpitg �ate�l�,it aPdewat is bi ita 1/3 5i daled/t. tAra, aKmdetoiptiioAaeaibea` o. etel i .�dta.as�ter..i.�nitreiwAesee�e �1 � � eiesl�nd� - 2atfag*btiri§6=MbY D ism -in ChidgWadom st�gt>tityssr sq�ics�wtier cat. istiiaeso�t�eaea�ttac +i..s�dwisle. C..iRCiae�►Z.is OdGeaNtdit3o' _ DATE' OVEM CIIR17NCA.nm i t*d ccd!► sat as smiu m um ob rmw am rsia to So bat at my Nam baarle�e- Y (asd pa tai t;e "e'01i') !t the atiaioS, 6y since sea mmmmV aged aegwid iR Vagislet of Daei OWN* - , - Ir / 1 SMXklkft fLW%P fLWAW DATE- w*'a«• Any Wmm fm fist is Amy nmlt into apron pomit being m mj d by &o Zanisg mft" * **": •• bdok Idtb dh sppli¢daa; a sWVed Witmaty deed fi es ttosWw of Deeds office a calf of the oeetifm& senW map M=L-mm is nos& in the wuranty AmA U 2 5 2 3 P Q 3 3 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 1 — 1998 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number 03/0812009 12:30PN This Deed, made between Oak= n d Devel!Rr)ment, a WARRANTY DEED m` Corporation , Grantor, and eYl gu % Grantee. EXEMPT # Grantor, for a valuable consideration conveys to G+�tee the following described real estate in St. Croix County State of REC FEE:: 11.00 Wisconsin (the "Property"): TRANS FEE: 98.70 COPY FEE: CC FEE: PAGES: L Recordin Area Name and Return Address O ering Ho LLC X R in mer New ond, WI 54017 �-7sSa ��-� � • rU s5^ 026113014000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Lot 14, Red Pine Corner, Town of New Richmond, St. Croix County, Wisconsin. Together with all appurtenant rights, title and interests. None Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Sk f Dated this day of ` (SEAL) (SEAL) • Oakwood Land DeveC pert - (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) r y State of Wisconsin, s _ L'- •• ss. =__ _St. Croix County authenticated this day of �' . - 1 + � . ' P\errsonakiLY came before day of the above named Gregory J. Peterson as Vice President of Oakwood Land ev to nt Corpo rati on to me known to be the e Dme . a OrDO OR pe rson TITLE: MEMBER STATE BAR OF WISCONSIN who executed the foregoing Instrument and (If not, ac no dge the. me. authorized by §706.06, Wis. Slats) - C THIS INSTRUMENT WAS DRAFTED BY c_f2Z /.SP�a� COldwell Banker Burnet Notary Public, State of Wisconsin 1301 Coulee Road Hudson, WI 54016 My commission is permanent. (if not, state expiration date: 3 -65925 (Signatures may be authenticated or acknowledged. ) Both are not necessary.) • Names of persons slaning in any capaclU must be typed or orinted below their si nature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. 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