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HomeMy WebLinkAbout026-1288-08-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building *Division INSPECTION REPORT sanitary Permit No: 515215 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Marek, Todd R. I Richmond, Town of 026- 1288 -08 -000 CST BM Elev: Insp. BM Elev: BM Des do Sectionfrown /Range /Map No: `1 `t _7 26.30.18.1451 TANK INFORMATION r ELEVATION DATA TYPE MANUFACTURER .�,( a - CAPACITY STATION BS HI FS ELEV. r ✓ Septic + ! / z� Benchmark --7 ld Z. 95 - 7 Dosing ._A 1 AIt� - M 3, 99', Aeratton , Bldg. Sewer 0 /� Po t 4l - .5Z5 Holding V St/Ht Inlet /o. f4 9/. C/ TANK SETBACK INFORMATION gga St/Ht Outlet TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet i Septic 1 A -7-601 uO ♦ Dt Bottom f � Dosing IA 756 '7 'S _ Header /Man. Z�� �Qd.Z�p Aeration /V/-r d Dist. Pipe .Z' /Da ' Z Holding Bot. System Z. !,. / 9 J , PUMP /SIPHON INFORMATION Final Grade /0 oe Manufacturer Demand St Cov Mtj 3' GPM J Model Number Lf 24 L O ' TDH Lift Friction Loss System Head TD Ft it - y / Head ul G Forcemain Lengt Dia. /! Dist. to Weil 1 /► _ �] Z 161, �r SOIL ABSORPTION SYSTEM /V /t A BED /TRENCH Width Length / No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /D ,0 1 SETBACK SYSTEM TO P/ BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR \ Type System: 3to ! Icy ! � p �A— UNIT Model Number: Odr1 uD Tom' DISTRIBUTION SYSTEM Header/Manifold / Distribution J 7 // x Hole Size I I x Hole Spacing Ver�to Air Inta Length V 11 (.7 Dia 1' z Length Sg Dia / s Z5 Spacing 0 � I 3' O$' rfJ� SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of Seeded /Sodded xx Mulched Bedfrrench Center Bedf Edges � Topsoil t P+ I / Yes E] No Yes ] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: C O / 1 Y1 / / 6 Inspection #2: / / Location: 1381 134th Ave�l `yi Richmon , W 17 (NE 1/4 SE 1/4 25 T30N R18W) Stone Run Estates Lot 8 Parcel No: ,2¢.30.18. 51 s�J�. PI 1.) Alt BM Description = 2.) Bldg sewer length = 75 Row (" - amount of cover = / i j -- '1J Plan revision Required? ❑Yes Use other side for additional information. 1 - -- Date Insepctor's ature Cert. No. SBD -6710 (R.3/97) r commerce.wi Safety and Buildings Division County 201 W Washington Ave., P,O. 71 2 W. ' S V O n S i n Madison, WI 53711 �nitary Permit Number (to be filled in by Co.) Department of Commerce '515215 Sanitary Permit Application fate Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary /� /�� ur oses in accordance with the Privacy Law, s. 15.04 1 (m), Stats. I. Application Information — Please Print All Info ti Property Owner's Name Parcel # Dp .� r / 4 2 l o -/z - ors- o -n Property Owner's Mailing Address Property Location /� C 0 Y Z Z ST. CROIX COUNTY Govt. Lot ` J City State Lip Code /per , / <, j ✓ , ^ � /��� � � , ! O � it/ y � /,, Section _ circle on T N; R r//( E IL Type of Building (check all that apply) � Lot # 4 4 or 2 Family Dwelling — Number of Bedrooms `/ Subdivision Name Block.. ❑ Public /Commercial — Describe Use ❑ City of ❑ State Owned — Describe Use CSM Number El Village of �p /0 X l�0 0✓ ^/� y Town of Gc�( G ✓J/llJ't�� III. Type of Permit: (Check only one box on line A. ( Complete line B if applicable) A. lew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. El Permit Renewal ❑Permit Revision 0 C ange of Plumber ❑ List Previous Permit Number and Date Issued Permit Transfer to New / Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) goTaq r ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade AMound 1 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil � El Holding Tank 11 Other Dispersal Component (explain) ❑ Pretreatment Device (explain) 6.4 L X _ V. K rsal/Treat ent Area Information; Deow (g pd) Design Soil Application Rate(gpds Dispersal / B � Area Required ( Dispersal Area Proposed Q yttem Elevation 6j / c . / D� ; p 1 r Z VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units -C o ,� New Tanks Existing Tanks c o 2 6 a. U v� ti v) W. 0 a Septic or Holding Tank Dosing Chamber t /} � C.l t � VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) lumber's Signature MP /iNumber Business Phone Number Plum er's ddress (Street, City, State, Zip Code) tGLSW6X -4--( lcJ( o l VIII. County /De artment Use Onl pproved 11 Permit Fee Date Issued Issuing a Signature $ (pZrj ! Z Z 1 .1 MM ❑ wner en Reason for Denial IX. Conditi8W6q' `�Pkpp4easons for Disapproval 1 1. Septic tank, effluent filter and � �- dispersal cell must all be services / maintained as er management Ian provided b lumber. P 9 P p YP t 2. All setback requifements must be maintained ^^ 5 as W applicable Code / ordinaftm. Attach to complete plans for the system and submit to the County on on paper not less th n 8 1/2 x 11 inches in size 1 ? r41414—, SBD -6398 (R. 02/09) Valid thru 02/11 9 134th Avenue Todd Marek PO Box 228 New Richmond, WI 54017 0 Z Stone Run Estates lot # 8 NE 1/4, SE 1/4, S 25, T 30 N, R 18 Richmond Township St. Croix County BM= 99.7' top of survey iron Scale 1" = 40' K--- w drivewa Well 0 garage 4 bedroom house a� c 0 .. r1200140 , 0 ea w 3% slo inc Copy 1 BM 9' 98' South lot line Page 8 of 8 134th Avenue Todd Marek PO Box 228 s New Richmond, WI 54017 0 z Stone Run Estates lot # 8 NE 1/4, SE 1/4, S 25, T 30 N, R 18 Richmond Township St. Croix County BM= 99.7' top of s rv�e iron Scale 1" = 40' K w /dr drivewa Well 0 garage 4 bedroom house m c 0 3 Wieser 0 1200/800 tank B2 c ca w 3% slo B3 B1 BM 9' 98' South lot line Page 8 of 8 Safety and Buildings PO BOX 7162 commerce.Wi.gov MADISON WI 53707 -7162 Contact Through Relay i sconsin www.w www.coe.wi.gov/s sin.go / iscosin.gov Department of Commerce Jim Doyle, Governor Richard J. Leinenkugel, Secretary December 15, 2009 CUST ID No. 226497 ATTN. POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMMIT AVE 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/15/2011 Identification Numbers Transaction ID No. 1746073 SITE: Site ID No. 753623 Todd Marek - Dwelling Please refer to both identification numbers, 134TH Avenue above, in all correspondence with the agency. Town of Richmond, 54017 St Croix County NE1 /4, SE1 /4, S25, T30N, R18W Lot: 8, Subdivision: Stone Run Estates FOR: Description: Mound Object Type: POWTS Component Manual Regulated Object ID No.: 1250593 Maintenance required; 600 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /O1); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code P. f requirements. Con, 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. D A copy of the approved plans, specifications and this letter shall be on -site during construction and open to DIV 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 SEE CGR 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. ROGER D NELSON Page 2 12/15/2009 Sincer y Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 eter agel Private Sewage Plan R iewer , Integrated Services WiSMART code: 7633 (608)266 -2889 , M - F, 0600 - 1430 Hrs pete.pagel@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Monday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www.commerce.wi.gov/SB/SB-BuildingContractorProgram.html MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Todd Marek Owners Name: Todd Mark Owners Address: PO Box 228 New Richmond, WI 54017 Legal Desaiption: NE 1/4, SE 114, S 25, T 30 N, R 18 W Township: Richmond County: St Croix Subdivision Name: Stone Run Estates Lot Number. 8 Block Number: Parcel I.D. Number. Plan Transaction No.: Page 1 Index and tide Page 2 Data entry Page 3 Mound drawings ;.1� P age 4 Lateral and dose tank of « Page 5 System maintenance specifications r Page 6 Management and contingency plan AO Page 7 Pump carve and specifications' l or Page 8 Plot Plan rYA Q E DINGS E SP O NDE E Designer. Roger Nelson License Number. MP 226497 Date: 12101/09 Phone Number. 715- 273 -4444 Signature: A, b A Designed Pursuant m the Mound Component Manual for POWYS Version 2.0 SM10691 -P (N. 01101), and both SSWMP Publication 9.6 Design of Pressure won Networks for ST-SAS (01/81) and Pressure Diolftution Component Manual Ver. 2.0 SB1)-10706 -P (N. 01101) Version 5.1 (R. WM) Page 1 of 8 i Mound and Pressure Distribution Component Design Design Worksheet Site Infornation (R or C) R Residential or Commercial Design Nate. Sand IN (o) CSWUWJWW SIVA* 2 400.00 Estimated Wastewater Flow (gpd) Table 8344-3 M -situ sole babYW9 for IWO 1.50 Peaking Factor (e.g. 1.5 =160%) cowann of <_ 36 wodw. 600.00 Design Flaw (gpd) 3.00 Site Slope (%) 88.70 Contour Line Elevation (ft) 30.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd/fl?) DlsMbution Ceti Infonnadon 60.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) Eml Dispersal Cell Design Loading Rate (gpolfe) Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Press wre DiisrNwtlon Inton Oon network? Enter Y or N (C or E) E Center or End Manitoid 3.33 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of laterals of the highest point. 0.125 Orifice Diameter (in) 3.00 Estimated Orffice Spacing (ft) = 10.00 fl /orific:e 2.00 Forcemain Diameter (in) _ 30.00 Forremain Length (ft) Does the fonemain drain back? Y 80.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 4.89 For amain Drainback (gal) 8.87 Vertical Lift (ft) 55.93 5x Void Volume (gal) O 0.41 Friction Loss (ft) 60.82 Minimum Dose Volume (gal) In -line Filter Loss (ft) 24.72 System Demand (gpm) Total Dynamic Head (ft) 3 V Lateral Dim mebr 8Nectiat ManKold DlemeW Selection in. dia. options choice in. die. qeLions choice 0.75 1.25 x x 1.00 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Galloralinch Calcubdor (optional) Treatment Tank InfonnaWn Total Tank Capacity (gal) 1 200.00 §Moq Tank Capacity (gal) Total Working Liquid Depth (in) Wieser ' I Manufacturer 9" (enter result in cell 1349) Dose Tank Mformatbn EfNu FOW hwf amedon 800.001 Dose Tank Capacity (gal) Poly LoC I Filter Manufacturer 22-241 Dose Tank Volume (gain) 525 Filter Model Number Wieser Manufacturer Project: Todd Marek Page 2 of 8 Mound Plan and Cross Section Views .. ......... —* K } O Q A W .. _ I L -- Mound Component Dimensions A 10.00 ft E 9.60 in H 1.00 ft K Aft ft B 60.00 ft F 5.25 in I 6.83 ft L ft D 6.00 in G 0.50 ft J 4.87 ft W 600.00 (fe) Dispersal Cell Area 1009.62 (fe) Basel Area Available 10.00 (gpd4t) Linear Loading Rate 6.00 (R)1 /10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.97 (ft) — H F p C 99.70 (ft) Lateral 99.20 (ft)—►� -- Invert Elevation) Coil E .70 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key T Dispersal Ceti I See taterai details on Q Topsoil Cap 1.5 ft Page 4 for number, sine, © 11111 Subsoil Cap ® T and spacing of laterals. ASTM C33 Sand 0 ' F s from equally ® Tilled Layer c 0.5 R Typicm � fion stribu oe�'s Aggragete .. �. Ana In the - A distribution call (AxB). Pry Todd Marek Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over the A & B dinwasion 0- Turn -up %W ball wlw or olaooutplup P p Fora.*main dentioal iE x --) I Hol drilled on the bottom oI te lateral ew+ril a speed Laterals & force mall of RrVC Soh 40 onneotion via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter Lateral Diameter 1.25 in Orifice Spacing (%) an Lateral Length (P) 58.52 ft Orifices per Lateral 20 Lateral Spacing (S) 3.33 ft Orifice Density 10.00 fe /orifice Lateral Flow Rate 8.24 gpm Manifold Length 6.67 ft System Flow Rate 24.72 gpm Marifold Diameter 1.25 in Total Dynamic Head 15.77 ft Forcemain Velocity 2.52 New Dose Tank information Lodth C ,,,, Vft , Wal and 10*ft device and waled nratertipht Ebeftel = per NEC 300 and --� Caron 16.28 WAC Dboornred 4 M. mire. Tank component b propedy veiled 4 AftMde OUdd krc�tion FOM@ ain diameter Wie Manufacturer 2 in. Ca 1 800.00 Gallons Volume 1 22.24 gaVinch A Weep hob or anti- Dimension Inches Gallons B siphon dsvioe A 21.24 472.30 B 2.00 44.48 C ebvation C 2.73 60.82 �• D 10.00 222.40 D Total 1 35.97 800.00 t8nk elevation 3" ing un&r tank. 90.00 Alarm Manuafacturor IS. J. Ele Systems Alarm Modal Number 101 HW Pump Manufacturer Goulds Pump Model Number PE 41�_ ^� Pump Must Deliver 24.72 gpm at 15.77 ft TDH Project: Todd Marek Page 4 of 8 Mond Svs .,, Maim and QR20 SusciflcdM Service Provider's Name Nelson Plumbing Phone 715 - 273.4444 POWTS ReguiaWs Name St. Croix Zoning Phone 715 386 - 4680 Sy Mom Fir and = Parameters Design Flow - Peak 600 gpd Maximum influent Particle Size 118 in Estimated Flow - Average 400 gpd Maximum BOD5 220 MOIL Septic Tank Capacity 1200 gal Maximum TSS 150 MOIL Soil Absorption Component Size 600 ft Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfW100 mL Somice Fraoueney Septic and Pump Tank I and/or service once every 3 yews Effluent Filter Should inspect and dean at least once 3 years Pump and Controls Test once gM 3 years Alarm Should test month Pressure System Laterals should be flushed and pressure bested evew 1.5 years Mound Inspect for i and seepage once overy 3 rB Other 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are osecured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(1), Vft. 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 accomplish with a mold board or chisel plow. 5. The mound structure and other disturbed arm will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detall Finish ...••......••• *0000000 # Grade 6-8" Diameter Lawn __.____� Threaded C learlout Sprinkler Valve Box Plug or 68N Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project Todd Marek Page 5 of 8 Mound System Management Plan Pursuant bar Comm 83.68. Ylfls. Adm. Code amoral This system shall be operated in adoordancs wth Comm 62-84 Wis. Alm. Cods, and shall maintained in accordance with its' component manuals ISSO- 10691 -P (N.01/01), SSWMP Publication 9.8 (01181), and Pressure Distribution Component Manual Ver. 2.0 380 1W106 -P (N. 01/01)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gone may be present that could caws death. Septic and pump tank sbandomrent shall be in accordance with Comm 83.33, Wis. Adm. Cods when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, some dears and covers should be mspeused for water tighbess and soundness. Access openings used for service and assessment shall be sealed watsrtigM upon the completion of service. Any opening downed unsound, dsrec tivs, or subject to failure must be replaced. Exposed access openings greater than 64nc es in diameter shall be secured by an inflective loci ft device to prevent accidental or unauthorized entry into a tank or component. 8110111c Tank The septic tank stets be maintained by an individual csrOW to ssrvios septic tanks under s. 261.48, Stets. The contents of to septic tank shall be disposed of In ac , m ' r 1 with NR 113, Vft. Adm. Code. The ap 1019 condition of the septic tank and cutlet titter strait be assessed at least once every 3 yam by inspection. The outMet filer shell be cleaned an necessary to ensure proper operation. The filler cartridge should not be removed unless provision are made to retain solids in to tank that may slough off the ilter when removed from its enclosure. If the filter is equipped with an agnnm, the flitsr shall be serviced if the alarm Is activated continuously. invw mittent rifler slams may wicate surge flovrs or an impending continuous Name. The septic tank shat have its coo risnde removed when the volume of sludge and scum in the tank smorn ds 1/3 tie lqufd volume of to tahlc. If the owlents of the tank are not rernoved at the time d a triennial assessment, moiNavnae pe on el Nell advise the owner d when the nerd service needs to be pwbnnW to maintain Man than maodmum spun and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank perbrmence is gereraly not required. However, 0 such products are used they shall be approved for septic tank use by the Department of Carureroe. PUMD Tank The pump (closi tank shall be Inspected at Iseet once every 3 yaws. Al - cos, slams, and pumps shill be tested to verily p up sr operation. B an eflkent Star Is Installed within the tank It shat be inspected and serviced an necessary. No tress or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter. and the mound shat be seeded and mulched an necessary to prevent erosion and to provide toms protection from frost penetration. Treffle (other than for vegetative maintenance) on the mound is not recommended since sot compaction may hinder aeration of the inlltrative surface within the mound and snow convection In the winter will promote frost penetration. Cold weather installations (October- FeMuay) dkxate that the mound be heavily mulled an protection from *s**W Influent quality into the mound system may not owned 220 mg& BOO& 150 mg& TSS, and 30 mg1L FOG for septic tank aibo nt or 30 mg& SOOs. 30 mg/l. TS3,10 ng& FOG. and 10 du/100 mL for highly treaded erlNrerat bAuM flow may not aowescl eeodmwm design riow speclbd M to psmhl for this istaladim. The pressure distribution system is provided with a flushing point at the and of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure tell is performed It should be compared to the kftl test when the system was Installed to dstwmito t orifice clogging has occurred end toil dan ft is required to mai equal disiributlon whthie the dispe" cal. Observation pipes within the di We"cell Nat be decked for oft" ft Pondig levels shell be reported to the owner, and arty levels above 6 lades considered as an impendimp hydraulic faWre requiring additiomd, Mors Usquent mwft ft. r&ANZO if the septic tank or any of its components became detective the tank or component shad be repaired or replaced to keep the system in proper operating condition. If to dosing talc, pump, pump controls, alarm or related wing becomes defective the defective conponat(t) shat be hmrnedlO* repaired or replaced with a component of the same or "" performance. If to mound component fats to scoapt wssfmalsr or begins to discharge wastaweter to the ground surface, it will be repaied or replaced in its' present location by kave ig basil was if toe leakage occurs or by removing biobgi sly dogged absorption and dNapersN rmedia, and rela0sd piping, and replacing said oomponarts as deemed necessary to brig the system into proper Operating dorndiM Sea Pape 5 of this plan for the nacre and Waphone number of your kcal POWTS reguldor and service provider. The iafamatioh and ad*" of mananager Brat and maintenance for pretreatment devloes such as aerobia treatment units or disinfection whits are attached as separate docrmerhis and we considered part of to overall management plan for this system. Project: Page 6 of 8 S'. . GWLDS PUMPS • Submers�bie Effluent Pump PE now MOTOR f1FAniW !E�Z ": CONW: ■ c owm reskun 1 � P corm ion. t: lo4°F (WO � w coo iron body. maximum, tondnuous when Theranoplostic and aulx+ ed. • Bu" the and Wallow po- cover. • Sdids handling: h" ad ion with rAwatitrmt. ■ upw sleeve and lower moot n sphm • am 0 iasuWWL heavy dory bail baring APKICATIOW • Aubyw is modes kxkWe a • 0114iNid dasloL conovedon, float switch. • H'igh *a* carbon steel w Motor is parrnarteMly for the • Manud models ovaiaWe. Shag krb►IGaltd for el�ellded • penforrtana chaR or aave. X33 H�3000 RPM a P°wwod +or aondmxws Efkw*Vosirg Systems PE31. Pump: Pre 0 ss 12,0 Maxi m n amps wlgtin the LOW une Pipe system Maximum capedty: So GPM Shaded pole design g limits die motor • B"em" t Ora" • MaKWOR head: 25' -M P641 Motor. 9 Dt�► Sumpo P641 Pow • .AO HP, 3400 RPM w Q� dbaonned power +g • Main aped 60 t o • 7.5 NNudrrrun arg►s cord, 2w swmw kn^ • MadnMan head; 29'1Dll • PSC desip heavy dory I SJTW with HEMA S-1 SP, #m gong, PE51 Puma PEM1 Motor: 11S vast grounding pWg. • Maximum OPKIty; 70 GPM • .50 HP, 3400 RPM ■ Comptda unk Is heavy dory, • Maximum had: 37' TON • IS Maximum amps MOM PUT • PK deslp ■ M ail seal is ohm i 40 ceramic, 61XU1 and Owes MOD" M1, PRO. MI 311001. ..« -.- w ...i -.1... ...f... - ,. ■ Stainless sled fastenras 2 tiPAA ..... . �...,_... T - T �..... .. . »:.. Tealed b UL 778 and '' ., ty4rw�nlMrlwiAwouW 10 t tleatalalea .i.. ....T_.j.. •.�....... «L- _ 4 eorrarreruollora�trMr.d s { _,_ :irk.» _. ° Z0 30 40 SO 60 70 GPM 80 o S 2y. 72 to �s M3# Gauids Pt�lltps G, 2= Goukls Form ` N 3 1141 °"u"bi a.E3 „�� ITT Industries L ss n Wisconsin Department o f Com1S(JIL VALUATION REPORT Page - of 3 Division of Safety and Buildings N 85, Wis. Adm. Code Attach complete site plan on x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (B arceM), direction and Parcel I.D. 11 p' h percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Q d �d U Please print all information. Revi ed by Date - �) Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04(l) (m)). Property Owner Property location Govt. Lot 1/4 f 1!ZorCSNW T�(, N R E( j Property Owner's Ma' . Address L Block # Subd. Nam cit tate , Zip Code Phone Number ❑ City ❑village Town Nearest Road New Construction Us Residential / Number of bedrooms ..'3 Code derived design flow rate GPD ❑ Replacement / Public or commercial - Describe: - - - - -- - -- Parent materia Flood Plain elevation if applicable // ft General comments / !�i ✓c�. "/ and recommendations: Boring I Boring �/� Pit Ground surface elev. ' ft. Depth to limiting factor _S — SC__ in Soil Application 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 �_I CJ 1 yvj 1 —� 2 lz -36 Boring # Boring y n it Ground surface eley L ft. Depth to limiting factor � in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 9 "/ r Effluent #1 = BOD > 30 <_ 220 mg1L and TSS >30 1 uent #2 = BOI _< 30 ntgll and TSS < 30 mglL ignature CST Number CST Name (Please Print) 226900 Bird Plumbing, Inc. Shaun Bird Telephone Number Address 715- 246 -4516 Date Evaluation Conducted 1008 192nd Ave, New Richmond, WI 54017 /�_ Property Owner Parcel ID # Page of ❑ Boring #� Boring q � /'"'� it Ground surface elev. l 0 ft. Depth to limiting factor • in. Sal Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/T in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef1#1 I 'Eff#2 2 Z3 C L ❑ Boring # ❑ Boring C1 pit Ground surface elev. ft. Depth to limiting factor in. Sofi ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efr#1 •Eff#2 ❑ Boring # ° Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Pit - Sol Appication Rate . Horizon Depth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPD/FF in. Munself Qu. Sz. Cont. Color Gr. Sz. Sh, •Eff#1 'Ef1#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1150 mg/L ' Effluent #2 = BOD _< 30 mg/1. 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. SM41330 (RAW) • Soil Test Plot Plan Project Name Bryan Schaefer Shaun Address 1336 140th St. New Richmond Wi 54017 CSTO #226900 Lot 8 Subdivision Stone Run Estates Date 12/1/04 NE 1/4 SE 1/4S 25 T 30 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1/2" pipe /616 System Elevation 99.5' *HRpSame as Benchmark Alternate Benchmark Top of survey iron @ 99.7' Scale is 1" = 40' 18' Property Line unless otherwise noted 98' 99' 30' B -2 45' 0' B -3 3% Slope 90' B -1 20' * Alt. B.M. B.M. 185' Property Line pop U N PL A TTE"D LANDS' ` VNPLA 0 - -- �� 418' I v \ OD 0 CA `\ \ N (D . 1h \ .\ 418' \ v / -4 \ OD � n1 00 \ \ a LA CD �1 I QN a ~ : // S G� 418 'C rn `�' o0 o Q Y3 OD L / ' - - c a n• CD — — �- PO 00 LA _ OD CD • I 418' o0 to / I J i. IN00'25'35 "E / 406. 8' I I \ I ' ST. CROIX COUNTY ` SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer f-ff Mailing Address -P O Fok Z Z 8 Alg 6f-I 41L/ *a- w Property Address R I I � 44 A- (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number _ o o o LEGAL DESCRIPTION Property Location _ I Q6 1' C ' / y ,Sec. 2 --✓ , T N R W, Town of �� o,c./Q Subdivision Plat: �`� Aft , Lot # � . Certified Survey Map # , Volume , Page # Warranty Deed # 20 �1 (before 2007)Volume , Page # Spec house (yes [. no Lot lines identifiable ryes Ci no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and /or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am /are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms r i . 7/ 24 S NAT RE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) 282.88' 184.97 1 4.95' L�8 S89 '52 26 E 759.7 0 6�. N89'52'26 "W 759.93' 2 W ° 185.00' / 85.00'— - 185.00' 185. (V 0 ......( .................... J.............. J.. 0 x Z 3 = 3 3 �0 6 "0 7 8 �g 9 77,330 sq. ft. o 77,330 sq. ft. or° 77,330 sq. ft. o 77,330 s T 1.78 acres 1.78 acres 1.78 acres 1.78 ac C O I 185.00' ' W c 185.00 185.00 185.06 O� h N89'52'26 "W 94T8 8' SOUJN LINE OF THE N£ 114 OF NE S£ 1/ Q Ma 6- LOT 3 j I CE RTIFIED SURVEY M �. VO LUME 9 PAGE 25 CURVE TABLE RADIUS DELTA ARC CHORD CHORD BEARING TANGENT BEARINGS : 167.00' 60'02'42" 175.01' 167.11' N60'06'1 3"E S8952'26 "E N30'04'52 "1 67.00' 27'28'54" 80.10' 79.34' N7623'07 "E S89 6"E N62'38'40 "E 67.00' 3233'48" 94.91' 93.64' N46'21'46 "E N6238'40" N30*0 '52 "1 $3.00' 60'00'00" 296.36' 283.00' N60'04'52 "E N30'04'5 "E S89'55'08 "E 7.00' 60'00'00" 227.24' 217.00' S60'0452 "W N89 55 - 08 "W S '04'52 "1 .00' 60'02'42" 244.18' 233.16' S60'06'1 3 "W S30 §2 N 9'52'26 "V .00' 3'00" 90.35' 89.78' S41'11'22 "W 430'04'52 "W S '1.7'52 "W 00' 3749'42" 153.83' 151.06' S71'1 2'41"w 452'17'52 "W I N89'52'26 "V BASED ON AN USGS NAVD 1988 DATUM. RENCED TO THE EAST LINE OF THE SE 1'/4 OF SECTION 26, T30N, ;` A $$UMED TO BEAR SOO'25'35 "W. a. . - INII{ 11111{ N111l IIIIIIIIIII lIIIIIIIIIIII1illIIII * 8 5 2 0 7 1 1 State Bar of Wisconsin Form 1 -2003 85207 WARRANTY DEED KATHLEEN H. WALSH Document Number DocumentName REGaISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 06/06/2007 01:35AM THIS DEED, made between 6-G Corporation WARRANTY DEED ("Grantor," whether one or more), EXEMPT t and Todd Marek a married person REC FEE: 11.00 ( "Grantee," whether one or more). TRANS FEE: 405.00 PAGES: I Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Recording Area Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Estreen & Og�and Lo ( — Lots 4, 8 and 9, Stone Run Estates, St. Croix County, Wisconsin 304 Locust Street ho�?9 ( Hudson, W154016 026- 1288-04 - 000.026- I28&08- 000 -I2 8- 09-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: easements, restrictions and reservations, if any, of record. Dated n �_. 6-G Corpor _(SEAL)R . x (SEAL) * *Kevin ell c rgsi en (SEAL) X �� EAL) # *Jo runner, its resident AUTHENTICATION ACKNOWLEDGMENT Signature(s) 6 -G Corporation, by Kevin Kelly, its Vice President and John Brunner, its President STATE OF ) ) ss. authenticated on COUNTY ) Personally came before me on *Kristine O nd the above -named TITLE: MBER STA TE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Notary Public, State of Kristina Ogland, Estreen & Oeland My Commission (is permanent) (expires ) 304 Locust Street, Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 • Type name below signatures. 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