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HomeMy WebLinkAbout026-1130-20-000 V- 1isconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420383 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you i arovide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ----—" Permit Holder's Name: City Village X Township Parcel Tax No: Miller, Sam I Richmond Township 026- 1130 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic JMD Benchmark �J L i , 7 V01 0 Dosing Alt. BM , G- , •�.�..�J Id`f- 3•oS 110 -t5 Aeration Bldg. Sewer �1 Holding St/Ht Inlet 41 tQ� C p� -g� 9• Y-z 9 s• �e TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet t Septic �t 1,60 Dt /J /�• ` �r - �r Dosing c r u 2 4 Header/ n. C¢ �• 3�- 160' Aeration b+ �` I (,, t t • S Holding Bot. S sterrT 7.6% 4S: SO PUMP /SIPHON INF ORMATION Final Grade 604-CID SZ �p , 3 Manufacturer - - Dema St Cover D olltq� S• �� Il•ss Model umber 416l 1 5 — 1 � i TDH Lift Friction Loss System Head TDH g. Ft yam O Fqr6emain Length t Dist. to W SOIL ABSORPTION SYSTEM ( BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS f q.� - 2 SETBACK SYSTEM TO � P/L JBLOG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of System: CHAMBER OR ce" fi t 1 2cr UNIT Model Number: v s DISTRIBUTION SYSTEM y-(o Header /Manifold Distribution x Hole Size ix Hole Spacing Vent to Air Intake Pipe(s) Length�Dia Length Dia Spacing 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 Fm Bed/Trench Center Bed/Trench Edges Topsoil Yes ] No] Yes if No COMM SNTSb (I nCI Ue a c��s ` p ns �e�e ,etc.) I �� All Inspection #2: / Lo ation: 1416 1L3'8t`_h'AtvelANeew(Ricchhm jA, "11 f 5�40 0 17(NW 1/4 NW 1/4 25 T3 R18W Re d Pine Corner Lot 20 Parcel No: 25.30.18.880 1.) Alt BM Description ='�p� � • �� �/ u� """`r �� 2.) Bldg sewer length = l(c N > Q�f� —OD 6PAl - amount of cover = T 2`t s • / Plan revision Required? ' :> Yes No Use other side for additional Information. ? SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7082 �"'� C_ ( Y, �scornsin Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608)261 -6546 47-o 3—R-3.0 Sanitary Permit Application State �� I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, sI5.04(1)(m) Project Address (if d'fferent than mailing address) I m I. Application Information - Please Print All Information -- Property Owner's Name ^ C (` Parcel # Lot # - Z.40 Block # Lo. -2 K`v pZ & - lam - Ze- Omo Property Owner's Mailing Address fl �oo Property Location �- DEC Yr �/ a Ctty, SOe � Zip C L> ZQ 1 /4, �' /s, Section 71 14 r' l gT. C Fi r (ls.D �1/ l ( o circle o g g II. Type of Building (check all that apply) ? f �Q T S-P `i — � 41 1 T � Q N; R El or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number El Public /Commercial - Describe o) T j j � p � 04%C' 14 0- S � ' X / / 3. 7.-V ❑ State Owned -Describe Use f 7 +d t 1"is _ t�C � S �'r t `1 3 _F p"r4 f []City ❑Village ownship of : C- It III. Type of Permit: (Check only one box on line A. Complete line B if applicable) / A. 02 System y El Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B - ❑ Permit Renewal ermit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner Z i 3213 • /40 IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland \P ressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: De si n Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Regdred (so Dispersal Area Pro sed (sf) System Elevation y q ; VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1 000 ,1 6,00 G I �S Aerobic Treatment Unit Q Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. 11114F, 2_1 /� 'n �: Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) ® 70 1,4 (al' cv l� c� o✓k- VIII. County/ e artment Use Onl pproved ❑Disapproved Sanitary Permit Fee includes Groundwater Date Issued Iss in gent Signatur No Stamps) Surcharge Fee) 12-1 0 2, ❑ Owner Given Reason for Denial IX. Conditions of pprov ` e for Disapproval . A GL' Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 08/02) I O O ti Z U o �LJ Q CD 0 d fA �'-� J V �NQ /y Z _ C� o I O r W C 0 � z I O n ) t1 10 ag ❑ �oLn Od\ 0 Of O Q - I �mQ zz ❑ nnn � 0UW 0 O OJ J 2 \\ ¢ I - - I O ��N O W ¢ U -- N /A p W N¢ ¢¢ Z x 0 0 J W ` rI ��♦♦ p � �N Jww c�C� p n �iNO Of V m C) Q � O N a0 c0 � .J ¢ //�� _ ao r w O Y. 0 L() N� mww r� 0 n O Z �� /.� " pO -Jn �I-Q V) F-- N n 3 ¢ O VI Me NLO �: J94 W U LLJ T- Z Y J� °0?J DOf �Zx U N 7 0 i 3 O ?iC) OOW 00W Q W Q pJ : >Z�?Z��jO Zm¢ ZOO U O �— z �m0M=J m7i ¢src� ¢�..� ❑ Z o J J o ¢ 0 p Z Z J J 1 W Zip F. J u Z I I 1 I w � I I O J ¢ I U N N N I I � 1 I N �5 I I F— I I Z 1 I W I I I I I O I I W J H utiE ..6E „9S I ' w r HEAD /CAPACITY CURVE o: w W HEAD CAPACITY CURVE EFFLUENT MODELS I TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE i EFFLUENT AND DEWATERING 6366 i SERIES 67.&9 97 W 167.1 a9 tal Iaa 166 tab le8 lu Iu — Fr. W. GA L91 G.J. L" GA iii Gal. LIN G.L Le G.1, Lei G.1, l ri. o.l Irv. GA I r,. cu E - L5' G. 1.62 43 183 56 V,. 912 72 273 104 344 100 .401 61 23 1 01 gal M 220 166 647 166 $47 70 606 >4 179 46 171 al " 79 300 100 370 al 235; 41 231 68 220 146 660 1sl 671 4.67 19 72 06 IW 45 170 64 242 at 344: 60 277 dp 227 bB 720 Ia2 5,11 I 549 _ 20 1,10. IS '67 26 %:. Ja 100. S2 310: 60 223.. 60 .227 64 2m , ]a 616 140 640 26 7.612 1 30., 74 280 21; 60 623 66 710 129 414 ,65 600 -...�. i 30 .: AIF. 66 445 66 204' 64 220. 90 f340 N ,220 121 461 121 441 W :1219 " 186 60 1624 44 174' 46 172 66 ?A6 76 .'Zi0 '64 220 106 397 n ul 1 _ - 21 40 l0 125 61 192. _ba .219 6a 220 90 641 100 3,-9 I —�— 1 60 ..11,79 ' - 16 '67 43 147. u I :104 N 210 71 2® ab 321' 165 70 21,34 30 1]a 10 36 62 197 61 . 194 70 266 00 27.60 90 ,.2146 14 60 46 170 29 100 6r 7 ' _ - - =- -, -r 100 '4048 32 171 2 4 )7 1401 163 119 a200 14 M N T9j -- 7 1 a wi - L"k YW.; 19.26' 21 2a' ZQ' 17, - _ 73' 115' 91' EFFLUENT & DEWATERING Warning: Model 185 should not be subjected to less _+ than 30 feet TDH. 189 - Note: For Head Capacity on Model 112, industrial — column- explosion proof pump, see FM 219, 161 97 188 98 .55, 7.59 IS 119 CALLON$ � " , ate SEWAGE•& DEWATERING so_ so 7o eo 90 loo 110 120 ue 140 1 >0 16 " c i WARNING: P.lodel 293 should not be subjected LITERS 8 L' 160 240 320 400 480 560 640 to less than 15 feet TDH. r � W � 1 ---- W I 1 7-7 24 80 TOTAL DYNAMIF HEAD /CAPACITY PER MINUTE 75 SEWAGE AND DEWATERING 22 70 SERIES 262 266 267 264 212 2" 292 Gil, FT. M , L 194 293 Gal: Lill Cu Llrs. Gal. Lira. Gal. Lln: C41. Uri Gal. . LIr1. GU. Lim Lim , LP Gal lus S. G %.%f% 20 _ I 5 1.52 90 34, 128 454 128 464 124 484 170 492 180 881 140 530 196 742 225 652 65 10 3.05 60 227 _ 89 347 89 337 89 337 95 360 156 598 124 469 181 685 205 776 i 15 4.57 22.5 85 50 189 50 189 50 189 63 238 13$ 511 106 401 130 497 165 625 165 700 lE �_ 60 20 6 10 10 38 1,0 78 10 38 73 125 106 401 88 333 lit i50 150 568 168 636 25 7.81 _ 76 288 68 257 106 401 136 515 153 5v T 55 30 9 ,1 16 50 1 43 183 47 I?B 90 340 121 45 8_ _ 140 530 SO 1514 524 5 19 50 189 94 Is U _ _ _ _ 50 60 18.29 —_ 58 22o ]37 14 — 70 21.34 U 49 59 223 45 LO k Vsl,o , 8 21.5' 21.5' 21, 35' .5' 26' — 25 95 4T 50' 61 )7 12 40 35 10 30 8 293 25 -- I 5 — 20 15 - -- 4 282 ' 10 r 292 2 — 5 -- _ 262 266, 267, 268 284 294 295 0 GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 210 220 230 IITEFS 0 80 1 60 240 - - r T 1 — __ -1 - ----...__ 320 400 48u 560 640 720 800 880 'Ail L? ,. , Dose Tank Information Locking caver„ith warning label and locking device and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC � ; 1 nneC 4 in. min. Discof r ; � _ Tank component is properly vented �— Alternate outlet location';' • ForcemaCn diameter 2 in. Wieser Concrete Manuacturer fi Ca aci 603.36 Gallons Volume 16.76 gal /inch `A ^� " Weep hole or anti - Dimension Inches Gallons B t x• siphon device �. ). ,� A . 17.95 300.79 C B 2.00 33.52 Pump off elevation (ft) C 5.55 93.07 D 10.501 175.98 D Total 1 36.00 603.36 Dose tank elevation (ft 3" Bedding un er tank. 8 ' Alarm Manuafacturer LevelArm Alarm Model Number I DLV F •ors -. ... v.............. Pump Manufacturer Zoeller z Pump Model Number 198 # 1416 136 Sanitary Permit Application Safety &Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. PO Box 7302 NVI See reverse side for instructions for completing this application Madison, WI 53707 -7302 Personal information you provide may be used for secondary purposes Submit completed form to if not Oepertment or Commerce (Privacy Law, s. 15.04(I)(m)] ( P count a �- �/.,,- 1-0 z_ state owned. Attach com lete plans to the county copy only) for the system, on paper not less than 8 -1/2 x I 1 inches in size. County State Sanitary Permit Number ❑ iEMyiisio to previous application State Plan I. D. Numb 1. Application Inf rmation - Please Print all Information a Location: Pro Property Owner Name l A t V p /4 /ca Lo tion f W I W 1 /4, s72-'5'T 3 ,N, lr or r L property Owne ?s Mailing Address Lot Number Block 1 umber 4..� IS / A-I v O Subdivision Na CSM Number City, State zip Code P o ho 3 `6 i R F: I N E eaRAE2 ❑ city II. Type of Building: (check one) , ❑ Y e ❑ 1 or 2 Family Dwelling -No. of Bedrooms: wn of r ❑ Public/Commercial (descri se):_ G {� (/y� a to R ❑State -0wned�' A� Nearest Road �t2.1` N �N.Ir S�3 93,7 ' G�4rndFla S I Ort t ` S'f Parcel TaxNumber(s) bZ(o 1 130. o 3 r 0 �l u sat S k (� 'T III. T ype of P tt: Check only one on line A. Check box on line B if a lie 5 6. ❑Addition to A) 1. ew 2. ❑ Replacemen 3. ❑ Replacement of 4. Existing S stem System System Tank Onl Date Issued B) ❑ A Sanity Permit was previously issued Permit Number IV„F9Pe of POWT System: (Check all that apply ❑ S � t 3W ❑ttuctetland ,Non- pressurized In - ground \Iud nd ❑ Pressurized In- ground ing Tank ❑ Sin s ❑ ip Line L7 At- de bic Trca nt Unit ❑ Re n the V. Dispersal/Treatment Area Information:: 1. Design Flow (gpd) L. Dispersal Area 3. Dispersal Area oil Application 5. Perco Rate 6. Syst Ele Elevat o Required Proposed (GalsJday /sq. ft.) (MinJinch 9 `f s 9 0 0 193 — ° Ca acit� in Total o P 1 b Fiber- lastic VII. Tank p r f ufacturer or; C g Information Gallons_ Gallons 'arks New Existing Crete struc Tanks Tanks ❑ ❑ ❑ / 0 ❑ ❑ Vi1I. Responsibility Statement 1, the undersigned, a ssume res onsibi • for installation of the POWTS shown on the attached tans. p incss Phone Number P!umlxr's Name (print) mhc 's Si ature stamp h1P/hIPRS No. Plumber's Address (Street, City, State, Code) IX. CountylDepartment I Only Sanity Permit Fee (Irtclu s Groundwater Date Issued Is Agent Signature (No stamps) C3 Disapprov ed n' &: suin Approved ❑ Owner Given Initial Adverse Surcharge Fee) $ ZZS � I < Determination \ X. Conditions of Approval /Reasons f r Disapp ov 1: .��. �� 9;. _, i1 �. � , ��� �,� �� � :�; �- ,�►y 1o:2 � �� — too . o 00 �— a- 7kjeA/C-NE-s 3 0 C 1hgrPr S G� r G- TIeIFNC ' z -o _ loo e ' � 0 o � 3 , G�: 3 , ---- -� y r 14 S wr /yo 't \ a Cl 1 r� N I le - ( �VVL 4 Icro CIO N " 6m - T 14 ,A,/ C- A) E x 13, 5 6 - J c T 14 N C (q '14 1 Ni Ir c � � 71, Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 _ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St . C r oix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location gnddistance to nearest road, p endi n g Please print all infofination. R iewed by Date Personal information you provide may be used for secondary purposePrivacy Law, s. t5(1) (m)). Properly Owner �' ",i PrbptS Location :. o tot NW 1 /4NW 1/4 s25 T 3 0 N R 1 8)E (or) W Property Owner's Mailing Address Z W tot 0, _ Block # Subd. Name or CSM# 1611 Hwy- 10 N. E cFCatY 2 d Pine Corner City State Zip Code Phohe Number COJr1 Fir ! ❑ Village R1 Town Nearest Road Spring Lak Park, MN.:43?� 6�- ,� New Construction Use: [a Residential / Number bedfoOm I Code derived design flow rate 6 00 GPD 11 ❑ Replacement ❑ Public or commercial - Desc 9e -- . — ` Parent material gl ari a 1 rlri ft Flood Plain elevation if applicable na ft• General comments and recommendations: trenches starting @ el. 96.50', spaced to code, 4.00' below grade Boring # Boring 99.70 +90 1 ] pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 0 -16 10 r 2 none L 2msbk mfr gw 2m .5 .8 — 9 16 10yr 4/4 none sil 2msbk mfr gw 1m -5 -8 3 30 -75 7.5 4/6 non ms osg mvfr gw if -7 1.2 4 75 -90 5vr 4/4 none sl 2msbk mfr na na .5 Borin g # 1n�1 Boring 1 00 2 +84 ]�J Pit Ground surface elev. .5 ft. Depth to limiting factor ❑ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -10 10 3/3 none L 2msbk mfr gw 2c .5 .8 10-24 10 4/4 none sil 2msbk mfr gw 2m -5 -8 3 24 -84 7.5yr 4/4 none sl 2csbk DH na if .5 -9 S Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L (fluent #2 = D < 30 mqj and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel r 02298 Address Date valuation Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 11 -15 -2000 715 - 246 -6200 Property Owner OakWOOd Land DeV . Parcel ID # pendincq Page 2 of —_ Boring # ❑ Boring 3 ] pit Ground surface elev. 97 ft. Depth to limiting factor +84 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 2 8 -21 10 4/4 none sicl 2msbk I mfr 2m .4 .6 3 21 -31 7.5 4/4 none is Oscf mvfr qw 1f .7 1.2 5 53 -84 7.5 4/4 none sl 2msbk mfr na na .5 .9 —4] ❑Boring Boring # ®Pit Ground surface elev. 97 70ft. Depth to limiting factor +84 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 0 -8 10 2/2 none L 2msbk mfr ClW 2 2 8 -19 7.5 4 none sil 2msbk mfr I aw 2m 5 8 3 19 -31 7.5 4 none sl 2msbk mfr 1 4 31 -84 5w 4/4 none 1 2 F-1 Boring # ❑ pit Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Kplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BOD > 30 :5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = SOD 5 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 (R.6=) Property Owner OakWOOd Land DeV . Parcel ID # pending Page 2 of 1 3] Boring # I❑n Boring 97.50 4� pit Ground surface elev. ft. Depth to limiting factor +84 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 2 8 -21 10 r 4/4 none sicl 2msbk mfr qw 2m .4 .6 3 21 -31 7.5 4/4 none is 0SCI mvfr qw if .7 1.2 5 53 -84 7.5 4/4 none sl 2msbk mfr na na .5 1 .9 ❑ Borin g # ❑ Boring ® pit Ground surface elev. 97.7O Depth to limiting factor +8 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -8 10 r 2/2 none L 2msbk mf 2 8 -19 7.5 4/4 none sil 2msbk mfr aw 2m 5 8 3 19 -31 7.5 4 none S1 2msbk mf 4 31 -84 5 4/4 none l 2 k F-1 Boring # ❑ Boring El 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 Effluent #1 = BOO, > 30:5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (86/00) STEEL'S SOIL SERVICE Gary L. Steel Oakwood Land Development 1554 200th Ave. CSTM2298 NW4NW4 S25- T30N -R18w New Richmond, WI 54017 town of Richmond 715 246 -6200 MPR$W -3254 lot #20 -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. I N , 1 " =40' ABM.= top of 1" pvc pipe @ el. 100.00' / Alt. BM.= top of 1" pvc pipe 2 el. 98.40' V i Gary L. Steel 11 -15 -2000 ) • • Bi S • i Chmim End We w 4' Knockout UniverSal End Cap Av a i lable Si zes Chamber 11" Stan- 14" High 16" High � Dimenrions dard Ca,�acity Capacity ,yMnyMyffjfr *,� „i'K�Y.N V.• ' � �., �i � e.?j Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 4 f2o V3 Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) Septic Tank Capacity (gal) �■�' �QO Soil Absorption Component Size (ft') 53 r, FT z Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component P P Design Flow - Peak (gpd) Maximum Influent Particle Size (in) 178 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 I I Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years I F Soil Absorption Component Inspect once every 3 years 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se and outlet filter shall be assessed at least once every 3 years by inspection. T e outlet filteO shal be c leaned as nec essary to.ensLnp_ " 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 Management Plan for a Septic Tank and Soil Absorption Component 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 scum and sludge 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 an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm.83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water n the installation of water conserving plumbing conservation practices b all occupants and h 9 P 9 P Y P fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. EC� w,, ��' 5,,� -•ors g G7 L 3 ST CROIX COUNTY ' SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION DORM S / Owner/B � . Mailing Address / Property Address (Verification required from Planning Department for new construction) Parcel identification Number © Z� t Fc AL DESCREM I N Ld I/. Sec. �' '� 3 N -RAW, Town of Property Location Nu) / � T Z Lot # ivitioD ° 4 ` ♦t ` � CerWed Survey Map # �o 7 - Volume $ Page # Warranty Deed # ' Volume Page # 2 -- Spec house yes ❑ no Lot lines identiftabl ya ❑ no i tea SYSIMM LmpQOper use and mainteaaoeeof your sy stem could result in its premature failure to handle was � the tic lance every three yeah or sooner, if needed by a licensed pumper. What you put into the system is cons is of P�PmB out septic can affect the function of the septic tank as a treatment stage in the waste disposal rys to ' ed b the owner and by a 'fica lion form, sign Y D a cert ification The property owner agrees to submit to St. Croix Zoning pumperen n that the on -site wsstewaterdlsposal system ber, restricted plumber or a licensed pumper Eying 1 () 1/3 fVll of sludge. ber, j corn 'tank is less than master cum , J Y� p the he P u is proper operating condition and/or (2) after Inspection and pumping (if necessary). septi w ith the standards maintain the private sewage disposal system w� uirennents and agree to ma p C er t ification IM, the undersigned have read the above req set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. i . within stating that your septic system been maintained must be completed and returned to'the St. Croix County da e eu ex ira ' n te. �D L DATE SIt3 F AP 4 ' ?" .10 MR CERTMCAn (our) knowledg. y a ( tit�r we) cer that all statements on this form are true to the best of my of Deeds Officcee I (we) am (ace) the owaerts) of de�eti bov , virtue of a warranty deed recorded in Register . 0 DATE 44 0 4-A A P eat. •••••• •••••• Any infonrLation that is mis- repreanted may result in the sanitary permit being revoked by the Zoning Department. office •• Include with this application: a stamped warren ed rrvemm t he R e g ist e r of Ds m de in the Warranty deed s copy of the certified Y p • U '19 6 - rp� `" r8 2 STATE BAR OF WISCONSIN FORM 1 —1998 6 8 a 9 3 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI Document Number RECEIVED FOR RECORD This Deed, made between Oakwood Land Development, Inc., a 08 -28 -2002 1:30 PM Corporation , Grantor, and Sam E Miller, Single , Grantee. Grantor, for a valuable consideration conveys to Grantee the following WARRANTY DEED described real estate in St. Croix County State of EXEMPT # Wisconsin (the "Property"): REC FEE: 11.00 TRANS FEE: 95.70 COPY FEE: CERT COPY FEE: PAGES: 1 Recording Area Name and Return Address er Nw Avenue Ric hm d , WI 54017 `1 \ M' o '`►K 5� 4 35 026- 1130 -20 -000 Parcel Identification Number (PIN) This is Not homestead property. (is) (is not) D2O, ed Pine Corner. 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 Dated this 27th day of August 2002 (SEAL) (SEAL) —••� r ��' N1 ,96' M /N. F.F.E. 985.5 56 b•46' 1 2 w •• ��,� ` �T� /••' LOT 23 \\ `S'e7b5' Op - w _ ` _ 147.47' >W \ 23.89K� \ ti 70, 362 SQ. F7 / ` $ s `\ DRAINAGE .EASEMENT ,q "c 1.62 ACRES \ \ 41NA6E EASEME MIN' F,F. NT M s ' �� \ � E. 985.5 S \ �s h� o° 210 NT i X52'26 "E /, E e '.95.82' gy p° 5 °O Z �'W . ^ 5 1 � j `� s �'• s �' \ • , 560 .25 i DOE \ �,It� g.3 • ,�� S �\ Nip 09 '4 E � .. � � 27) 7 "►y 0. 1 T 2.2 . N8479 J6 9 9 £ 19. ,. 000 S4. FT. �, --� �`�0 \ 22 iY F' o O 40 5 EASEMENT +� to LOT 21 11.0 LOT 3w'Ey ti 66,000 S4. FT. 90,932 S4. ,cw '� 6' 152 ACRES / o S '14 f J 2. 09 ACRES o MIN. F, F. e 98,9, con M FAQ ° \ r / W nor �'o :� w 66 „386 50. FT. c e LOT 25 0 152 ACRES ('68,716 S4. FT o J F.FE. 985.5 � 55 , • \ / bo r ¢6 i Ave LOT 18 3 .. . 66, ,. 4 S0 FT. `'� .00' \ 153 ACRES /`� /\�° <o i' S N �o .OT 26 2 ' 1 4k 23 r o, 0!?0 S4. FT. �`� co � r � 52 ACRES o LO ^ ; ' � ,' LOT 6,5 6 56 T T7 y ; i�' 66,953 So. F; SQ. FT co ^ 1.54 ACRES C'4 1.51 ACRES �i yv�. � i c 4 THE NW co 6' � / • E 330.00' Of NG141N L/Nf Of 7NE SW 1/4 .7 — �NW 114 L / — • / _ O • �i� 1.4 y NE LOT 27 0 N s88 09 "W 306.1 '' 10 LOT 12 MA MH L /NE SEE S HEFT 2 LOT 16