Loading...
HomeMy WebLinkAbout026-1141-16-000 ST. CROIX COUNTY f� �,, WISCONSIN ZONING OFFICE liming ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 FAX (715) 386-4686 Tuesday, March 19, 2002 P.C. Collova Builders, Inc. 1197 121 t Street New Richmond, WI 54017 Regarding septic inspection for P.C. Collova Builders, Inc.. Location of Property in St. Croix County: Municipality: Richmond Township Subdivision or Plat: Duck Pond Escape Certified Survey Map: Lot: 16 Address: 1197 121th Street Dear Applicant: A septic inspection of the above reference property was conducted on October 22,2001. This property is located in the SE 1/4 SE 1/4 of Section 33, T30N R18W, Duck Pond Escape (Lot 16), Richmond Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a 3 bedroom home. Permit was transferred from Brady Utgard-$50.00 fee paid 10/18/01 If ou have any questions regarding this, please contact our office at 715.386.4680. n re e r-4 Rod Eslinger Zoning Staff cc: file OL Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix safety and building Division I INSPECTION REPORT Sanitary Permit No: 399475 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: P.C. Collova Builders, Inc. I Richmond Townshi CST BM Elev: Insp. BM Elev: BM Description: 4 ?f j s � TANK INFORMATION C.0 ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic w 1 D 0^ too. Benchmark I fr� (O 1 O Dosing Alt. BM Wu-n.o S S" Aeration Bldg. Sewer S, �• JET" Holding S Inlet `4 � 341► TANK SETBACK INFORMATION ; Outlet 69 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic r N /+ Dt Bottom 9Q► `7� Dosing i1 Header /Man. 97 Aeration Dist. Pipe Holding Bot. System .p PUMP /SIPHON INFORMATION Final Grade :?o� Manufacturer //�� Demand St Cover _ Q Model Number GPM Z•6 ( 7 �'Z 3D 39 /'V t �. 3 -Or 017, TDH Lift� Friction Loss System Head / TDH Ft b ,0 Forcemain Lengt 7 of Dia N Dist. to I !V SOIL ABSORPTION SYSTEM BED/TRENCH Width Length o. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth r ) 1 DIMENSIONS t - SETBACK SYSTEM TO P/L BLDG JWELL LAKE /STREAM LEACHING Manu u r UNIT INFORMATION CHAMBER OR r Type Of System: / .,I. '], Model Number. M r a 1 Mop DISTRIBUTION SYSTEM Header /Mani11 Id Distribution x Hole Size x Hole Spacing Vent to Air Intake rf Pipe(s) _ Length Dia ` Length 3.7� Dia _ Spacin 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 Topsoil Yes � No � Yes 0 No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 11 D / /7 / G/ Inspection #2: Location: 1214 120th Street New Richmond, WI 54017 (SE 1/4 SE 1/4 33 T3 R18W) Duck Pond Es Parcel No: 333. .3_0.,1,8. 1.j Alt BM Description = � ,fL S`( y'> 4 ' �r I�c f r VO I ) 2.) Bldg sewer length =�$�j. L6 S.� ��1� WT bfar'I lJ - amount of cover = tw T 48 Sb 11► �e•) V`w w+c ��.,.�� ok. � �."J` Ll�.,,,,.�,e�,J2�'�e �S 3} t Z Ft b , 4k,.- tom„ S t..,a e L PI fired? Yes No j0 yZ OI , S Use other side for additional informa on. W Date Insepct s Signature ert. No. SBD -6710 (R.3197) I ` tudi%Vl( r- 1 In 6r; b 10 1 0 K It y ' N S 1, rcYtz q I y e Sc� I c s bye -� Ls -3 I�YKS� "ZS`ttcS S 05 `- 7 <5 - -7 3 Z�L b { z� Sr�J Sanitary Permit Application Safety & Buildin s Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. IV&COnSin See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned.) Attach complete plans (to the county copy onliZZ the system, on paper not less than 8 -1/2 x I 1 inches in size. Coun State Sanitary Permit Number Check if revision to previous application State Plan I. D. Number I. Application Information - Please Print all Information Location: Property Owner Name P=epeftt ion 6 2 ,oiler c 1/ Property Owner's Mailing Address Lot Number Block Num r 1Z / F Z� -- City, State "Lip Code Phone Number Subdivision Name or PM Number I of Building: (check one) ❑ ity or 2 Family Dwelling - No. of Bedrooms : �' ❑ Village ❑Public /Commercial (describe use):_ wn of • State -Owned lei / �4,L� Nearest Road Z 4A t Parcel Tax Nu ber(s) III. Type of P r mit: (Check only one box on line A. Ch eck box on line B if applicable) p, / 1 � . Ozz A) 1. ew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date sued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) on- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetlan / ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: , V. Dispersal/Treatment Area Information: \, 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System f levation TFinal Grade Required Proposed Rate (Gals,/day /sq. R.) (Min. /inch) Elevation T 506 VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks �/ ❑ ❑ ❑ ❑ 7 1 VIII. Responsibility Statement I, the under signed, assume res ponsibility for installati9p of the POWTS shown on the attached plans. M 's Name (print) Plumber's na ( stamps): MP/MPRS No. Business Phone Number lo ZLC Plumber's Address (Street ity, State, Zip e z-� 6v s IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issu Agent Signature (No stamps) Jj Approved ❑Owner Given Initial Adverse Surcharge Fee) � to /:7 /a� Determination X. Conditions of A /Reasons for Disapproval: / SBD -6398 (R. 07/00) PLO PLAN PROJECT P.C. Collova Builders Inc. DRESS 705 Countv Rd E Hudson Wi 54016 SE 1/4 SE 1/4s 33 /T 30 / 18 w TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/7/01 BEDROOM 3 CONVENTIONAL IN -GRO SURE CONVENTIONAL LIFT XXx HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE 800 gallons DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .9 ABSORPTION AREA 500 # of chambers 30 IL BENCHMARK V.R.P. Base of Siding ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 96 121 Ave Pro 3 189' P lans Designed Using Bedroom Conventional Powts House M anual Version 2.0 B.M. ' 25' System elevation 2-3'X AL 30' set @ k!9"t,Below 94' Cells grade?-- with >3' B -1 40' Spacing 25 1 i 5b 120' 0 B -3 85' B -2 1% Slope B.M. #1 B -1 a : 35' � o B -2 r 80' B.M. #2 50' 0 M 10' Please note: revision B -3 3% done due to Vent Slope original tested area only o N suitable for 80' > 12" Sidewinder High a mound system of Cover Capacity Leaching Chamber 6' Long 16" Grade at System Elevation 34" ounty Road E i gad .,...... ! Wf.ArWCAFK00F I� i APPROVED 60C.KWG Ll c+!®,'^+ cocR, C"sQu box �MA uOt.0 CCVt1r - afk;aaw OR rR VS AIQ W I 0KAOC yy y L' S G01uDWIT -✓� 1 � -� � F6f lMtiAl, /',sF.1, � ...... ,.... rM j I C • APPROVED f I O►a JO W ITm I Fr APPROVED PIPE 3' ONTO •UP"sP -•.,� �� ptr 0 SOLID SOIL. GQtJCRI4Tfi t/�QC.it RIfPr•A CXl7 ACR�tI7t">Ep oyLy IR TAtrIK MA1Ni.#FACT�yRCR HAS SWCH APPOILOVA6 sPPTi ; p► ECiFiG AYIb�$ cost &U MAAiURACT6IR90t: PdR PAN d16:R 266 - ---r -- eA�.io�s cost voLUMc /� 4 .:.► 1 wA 41 tIiA+CT1dRtPr>;; Ye!'r sAICiNOtAlC� dACkPr.Owr w dl►��Oki AGOCL SWITCIi TyPti •WCA16 OA luvocs Olt �ltjtwtlll 04 � ✓ .���y�a1►L60�Ib 1 " MUMRik;s 3 MtITC11 T11pt: NICE! PUMP AV4 A6AIkM Altl TO O! Alwi y wm OP6 R+�TC PNdrAi+.tO ON 3CPAIkArt: CIRt41TA vtltrtcAL 0 fF?gfcQcj 1lRYWRtPj P UMP pfr AAI>D 01IM"r:ou pipt.. r ntJimuM NCTW*IIK SIJPPLd F 4 + � Fcr:r or raActc MA IN x oarct� ►t'� +ou F,. cet�.. r•ttY TOTAL. 0 0JAM IC, MEAD ae �' •I' WTC><fLtAt, DIMCN idAJ OF TAAJK,' ; LIQUID OCPT'N O g'�4.iE �, +GCtil.E nluneEK; `�`�� ENGINEERING DETAILS - SW25/33 Performance Data 32 Pump Characteristics Pump /Motor Unit Submersible Manual Models SW25M1 SW33M1 LL 2 6 1/3 HP Automatic Models SW25A1 SW33A1 a x Horsepower 1/4 1/3 U Z 1s Full load Amps 8.0 10.0 > 1/4 HP Motor Type Shaded Pole (4 pole) a R.P.M. 1550 0 $ Phase 0 1 Voltage 115 0 Hertz 60 0 10 20 30 40 50 60 CAPACITY -U.S. G.P.M. Operation Intermittent Temperature 1201 Ambient Total Head (feet) 4 6 8 10 12 14 16 18 20 23 24 NEMA Design A 1/4 HP 44 41 36 33 29 26 23 18 12 6 0 Insulation ClossA `' PM 1/3 HP 47 45 43 40 37 34 30 26 22 16 10 Discharge Size 1-1/2" NPT Solids Handling 1/2" Dimensional Data Unit Weight 30 lbs. 1. All dimensions in inches Power Cord 18/3, SJTW, 10 1 std. 4-1/2 3 -1/2 5-7/8 — p. Component dimensions may (20' optional) vary ±I /8 inch 1 -1/2 NPT 3. Not for construction purpose 3 -1/2 DISCHARGE unless certified Materials of Construction 4. Dimensions and weights are approximate 5. On /Off level adjustable Handle Steel 3-1/2 6. We reserve the right to make revisions to our Lubricating Oil Dielectric Oil products and their Motor Housing Cast Iron specifications without notice Pump Casing Cast Iron Shaft Steel Mechanical Seal Faces: Carbon /(eramic Shaft Seal Seal Body: Anodized Steel Spring: Stainless Steel 11 -118 Bellows: Buna -N PUMP ON Impeller Thermoplastic 10 -1/8 9-1/2 Upper Bearing Bronze Sleeve Bearing DISCHARGE HEIGHT Lower Bearing Single Row Ball Bearin Strainer /Base Plastic 3 3 -1/2 PUMP Fasteners Stainless Steel OFF z n w Z Z AURORA /HYDROMATIC Pumps, Inc. L) 1840 Baney Road, Ash6nd, Ohio 44805 Y (419) 289 -3042 .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 r b 1 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 and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner , Property Location ? ��� Govt. Lot S 1/4 r 1 /4 S � 3r N E r) W Property Owner's Mailin ddress _ Lot # Block # Subd. Name or CSM# O� 9 ! , , l r ;a �s City State Zi C , sZ e hone'Nu e City ❑ Village % Town Nearest Road ILL 11 N , I ew Construction Use: sideati Number of mf�ie bedrooigas Code derived design flow rate GPD U ' Replacement y ut or is cribh:_:" Parent material ST �d IIUJ/ Flood Plain elevation if applicable ft. General comments �:' B and recommendations: � � l�'G'�� tf ' � t,-� f OV& 0 ❑ Boring # Boring �{ -Pit Ground surface elev. ft. t Depth to limiting factor �� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I 'Eff#2 s cis �� All) - Boring # ❑ Boring p. � ❑ pit Ground surface elev. Depth to limiting fac o in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg /L an OrSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L C�17e (Please Print) Signature CST, Number Address Date Evaluation Conducted Telephone Number SBD -8330 (R07 /00) Property Owner (� ti * V Parcel ID # Page of ®Boring # ❑Boring "l it Ground surface elev. [ n. 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 Lv s' - F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # El Pit ❑ Boring Ground surface elev. 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 * 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 p need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. J�� D -8330 (R.07 /00) Sanitary Permit Application Safety do Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. Madison, WI 33 ?07 -7302 j See reverse side far instructions for completing this application I'O Box 7302 lsconsi'n Personal information you provide tna be used for secondary purposes Department of Commerce [Nvacy Law, s. 15.04(1)(m)] (Sub comp form to county it not state owned. Attach Com late lens (to a coup co only) the system, on paper not less than -1/2 x 1 l inches in size. C ounty— State Sanitary Permit Number Q Check if revision to previous application State Plant. D. Number I. App Il cation Information - Please Print all Information Location: perry ner here / ' / V 4.1 at/ SC i/4 5f Im, s3 T Property s M td (or) Lot wn 74 lty, nft Lip ode "e um ber Subdlv a on Name or CSIR Number S f rC� �' f'o C II ype of Building: (check one) City 1 or 2 Family Dwelling -No. of Bedrooms: ❑ Village blic/Commercial (describe use):_ Q C i ^ ?R� J of Ci State -Owned �`' S caou"7y Nea 1 2!1 ' - I Tax Nulfiws) 11. Pe of P j ji m Check only one box on line A. -Check box on if a licable A) I. 2, 0 Replacement 3. 13 Rep acemen 4. / j 5. Addition to S seem; . stem Tattle only �r a 5 c,� a ._ ,E. isd S A. Permitwas rcviousl issued t as slued _ _3 3 . IV. Type of POWT System;'(+Check all that eppiy) — pILIJ& -pressurized In- grottaci Q Mound ❑ Sand Filter ❑ Constructed Wetland LTNess4 In- ground 13 Holding Tank ❑ Single Pass d Drip Line ❑ At grade 0 Aerobic Treatment Unit ❑ Recirculating ❑ Other: _ _ �- V. Dis ersaifrreatment Area Information; 1pt taw ispen Area " 3: Pisp ersalArea 4., o pp canon 5, Percolation Rafe 6 yswm El vgtion k7 Grade Fi Required 100 0 Pro sed, j /y ✓ Rate (Gals. /day /s ) (MinJinch) j 6levatJort V11. Tank Capacity in Total # of Manufacturer Prom ite Steel Fiber - Plastl c Information Gallons Gallons Tanks Con- Con- glass New 77E , . crew stnucted Tanks flanks l (3 b ❑ _ Ll. _ D 13 13 VIII. 'Respor>ut 'i ity.statement _ I, the enders' ed, assume , • ibili for in z ation of the POWTS shown on the attached laps. (no stamps): N+a, us sa. None WR Plurhbe - (ftet, City, SW, tp Ix oustfr Pt► at se_ y tsapprgved " anitery Permit Fee ncludes undwata Data uod' n gent Slo ature stamps) Approved (3 Owner'GNiin Initial Adverse Surcharge ee) Determination 5Jf 0v f / r ,' ott itiot l+ f re on9t Ott d VWAY1 Change in plumber. ' 2. Entire chamber must be installed in natural soil and there shall be >12 inches of cover. 3. System shall be installed < 3$ inches below uniform contour line to ensure adequate separation distanee.from a limiting factor. 4. At time of previous approval, structure -less fs was determined to be .4, but the state has since stated -that the loading rate is actually .5. 5. All setbacks to system and residential structure must meet applicable code requirements. SRS =fi3gR f#t (17�t r, PLOT AN PROJECT P.C. Collova Builders Inc. AD , ESS 705 Countv Rd E Hudson Wi 54016 SE 1/4 SE 1 /4s 33 /T 30 /R 8 W TOWN Richmond COUNTY ST. CROIX MPR 10/7/01 BEDROOM 3 Shaun Bird 2269 S u 00 DATE CONVENTIONAL XXX IN -GRO D RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .9 ABSORPTION AREA 500 # of chambers 30 BENCHMARK V.R.P. Top of 1" PVC Pipe ASSUME ELEVATION loo Filter Zabel A -100 ❑ BOREHOLE WELL +H. R. P. Same as Benchmark O SYSTEM ELEVATION 100.0/99.5 121 Ave 189' Plans Designed Using Pro 3 Conventional Powts Bedroom Manual Version 2.0 House 30' T 2-3'X 94' Cells 50' with >3' B.M. #1 Spacing Please note to county: B -1 A Fine sand a that is structure less has a loading rate 35' of .5/.9 B a -2 80' B.M. #2 10 , 0 M 30 Vent B -3 Slope o N 80' ALo Sidewinder High Capacity Leaching 6" Chamber 34" Grade at Sy stem Elevation County Road E PLOT AN PROJECT P.C. Collova Builders Inc. AD ESS 705 County Rd E Hudson Wi 54016 SE 1/4 SE 1/4s 33 /T 30 /R 8 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/7/01 BEDROOM 3 CONVENTIONAL XXX IN -GRO D RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .9 ABSORPTION AREA 500 # of chambers 30 BENCHMARK V.R.P. Top of 1" PVC Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL - H.R.P. Same as Benchmark SYSTEM ELEVATION 100.0/99.5 121 Ave 189' Plans Designed Using Pro 3 Conventional Powts Bedroom Manual Version 2.0 House 30' T 2-3'X 94' Cells 50' with >3' B.M. #1 Spacing Please note to county: B -1 A Fine sand that is structure less >; has a loading rate a 35' of .5/.9 o B-2 80' B.M. #2 0 M 10' B -3 3% Slope 0 N 80' jL Sidewinder High Capacity Leaching Chamber 34 Grade at System Elevation County Road E - I te! 27 3 6- (2 z Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 84sconsi Personal information you provide may be used for second purposes Madison, WI 53707 -7302 i az'Y P rP Dep of Commerce p (Submit completed form to county if not [P rivacy Law, s. 15.04 1 m )� [P Y O( state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County - State Sanijry Permit gumber ❑ Check if revision to previous application State Plan I. D. Number I. Application Information - Please Print all Information Location: Pro rty Owner Name Property Location ( 1/4 5Z- 1/4, S 33r -54, 4, R Jam) Property Owner's Mailing Ad A of Number Block Number City, State Zip Code Phone Number .; Subdi 'sion N or 7umber II. Type of Building: (check one — cis✓S ❑ City � _ 1 or 2 Family Dwelling - No. of Bedr ms: yam P an¢ , ❑ wn of ❑ Public /Commercial (describe use):_ % - To n ❑ State- Owned t� -tom / Nearest Road J Gf ^ .. I I / � S — C" J X ' Pazce T NU - 1 5,91K III. Type of Permit: (Check only one box on line A Check box on line $ if applicable S A) 1. ANew 2. ❑ Replacement 3. ❑ Nlacement of 4. 5. 6. ❑ Addition to System System Tank ly ;7 Existing System B) it Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ HoldingV ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 8 .6 O Mao, 1. Design Flow (gpd) 2. Disperse 3. Dispersal l 4. Soil Applic n 5. Percolation Rate 6. System Elevation 7. Fi al Grade Required Proposed Rate (Gals. /day/ ft.) (Min. /inch) Elevation VII. Tank Capacity in Tot # of Manufacture Prefab Site Steel Fiber- Plastic Information Gallons Gal ns Tanks Con- Con- glass New Existing ° crete structed Tanks Tanks e ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume respon ' ility for installation of the POWTS sh wriop the attached plans. Plum e ri n Plumbe ' ignature ( s s): MP RS No. Business Phone Number Plumber's Address (Street, City, S , Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing ` gent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination ZZ ,�-. Z� l X. Conditions of Approval /Reasons for Disapproval: 4-- 3 f �,,�,� .� t,� � Sl CC : ! - : S6 : o p C�a� n 12 " tares aver 6Y cAA � t4_ c Mud �If 1 5 dWj/A k&&U1he SBD -6398 R.07 /00 III 1600 Y� l� o© ( 13 P& -� 3 N 8 t, SOIL EVALUATION REPORT Pap I of VI W - n Department of Commerce Division of Safety and Buildings in accordance with Comm 85, VA& Adm. Code • cat,nty C� . C ro Attach complMe site plan on paper not less than 8 W x 11 ink in size. Plan must include. but not limited to: verUcsll and horizartai reference point (BM), direction and Parosi I.D. percent slope, scale or dimensions, north arrow. and boon and distance to nearest road. Date by please print SN kdbrrnaff9rtr 3 2w 1 Pomona, information you px'wMe n 15.04 (1) (m)). be used f secopday ( . s LocanDn Property Owner PAY Govt. Lot 5 E 114 SE 1M S 33 T 3 o N R I $ E (or)� Owner's MaBrrg Address I at Block # Subd. Name or CSW Property - U k CSGu b 5 C (d r State Tp Code+. Number i f J.City ❑ Vd ®Yawn Nearest Road R O M ► hmond I C- ) t New Canstnidwn time: [D Residential l Nt rnf bedrooms - Code derived design flaw rate �f� // �O GPD �..... ....E ^ .f ❑ Replacement ❑ Pubfic or commek* , 'D B: X-11 f r� ft Parent material `--- -`" Flood Plain elevation if appli " General commenis S y S rn 2 e JI• g and recommendations: r¢ L f- 2(c U c19 Sd F I ❑ Baring "I ILL Boring # ® Pit Ground surface elan. f 0 Z • 3 ft. Depth to biting factor b• 1 777 Rate Horizon Depth Dominant Redox Description Texture structure Consistence Boundary Roots in. Munsell Qu. Sz. Cons Color Gr. Sz Sh. a 313 S L 2 nr-)r k m -Pr C - 5 I 9 2 5-lob 10 SL Z b rYr�( CS - . .9 3 ly 1�� r�llly L 3 mSb k a-k-r S .5 y _Si 10\ r `I F i r S >a ' a # © Pit Ground surbM.elev. /o/ ft. Depttn to CCHrriitircng facto , y in soil Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GPD1fF in. Mumsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef t 'Etl#2 1 p -I Ili 3 Si I 2 k c I VI • 5 $' 2 3^ d ly SL 2 rgSb rn- ►Y- l- 5 — . 1 LS Ins mv- r• - 7 '{ - l4 ►b r8 �5 m cw `-( 5 _88 10 r 91 1 C2 1.5 y 1 v JP S C5 m I J-4 i ' Eflurerrt #1 = BOD > 30 220 mall- and TSS >30 150 mall. ' Effluent 02 = BOD < 30 mall- and TSS S 30 mglL CST Number CST Nana (Please Print) m Ted Ntirrtber Address Date Evaluation Conducted pmperty Owner Co t 10 v parcel ID # 1, o f I to page Z of 3 • G a Bor # pit Ground awface elan. - /0/'/ ft. b q Z Sol GPD/ Rate Horn or► Depth Doniarant Redax Description Texture Struckm Core 13oundat�► in. Munsd Qu Sr. Cont. Color or. Sz. sit 'EfM1 'Eff#2 0 -12 r3) — 2m5bk c 5 I V-P .5 5 Lk r� 5 9 2 /2 -yZ f LS I mS m V -�r c.5 _ 7 1 2 3 42 -9 �o s 18 `� 4 2 -uo I gl l U P . C C8• o qq. 2.i a5 # ❑ Boring F1 pit Grand surface elev. 8. Depth to MAN s bCtDr '". soil Rate Horizon Depth Dom�carrt Redox Dam Texture Struct Coke Bo Roots Gtr in. Munn" Qu. SL Coat. Color Gr. Sz. Sh. 'Ei#F1 - EM D B aring # El Boring Ground surface elev. ft Depth to lvniting factor in. 1:1 pit Soil . Rate Hori¢on Depth Don*wd COW Redox Description Temb" Structure Consistence Boundary Roots GPDff in. Munsell flu. Sz. Cont Color Gr. Sz. Sh. •Ett#1 'Effft2 • Mont #1 = BOD > 30 220 mglL and M >30 1150 MWL ' B&m t #2 = BOD <_ 30 mg& and TSS < 30 mglL The Department of Commerce is an equal oppordmitY serAce provkkr and employer. If you need assistance to access services or creed material in an alternate format, please contact the departreent at 608- 266 -3151 or TTY 608- 264 -8777. sel}5390 (207110) I PAGE_� _OF_3 NAME CCJ I (o u a LOW l LEGAL DESCRIPTIONS L' ' /ay' /a,S 33 T 3o ,N,R 16 E (or) A SCALE: I"= VO -/BM I ELEVATION /CYO U , BM I DESCRIPTION Abp QUc. 12:12c - 2 ELEVATION q $S GG • 3 BM 2 DESCRIPTIO o -f J " Ptrc, SYSTEM ELEVATION 9• (po -�- ALTERNATE ELEVATION 9 • S CONTOUR ELEVATION Anor k i ■ 6M� w N �7 O � Z n(ynno 6M Z 62 Y 6� �I E SIGNATURE DATE ,✓ /� -o / I ST CROIX COUN'T'Y SEPTIC TANK MAIN'T'ENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer IJ. 1 b I I oVA 8 1 d n S �ti c.._ Mailing Address 70 00 . / �0450.0 U Property Address - C / mood/ (Verification cquircd from Planning DcparQncnt for new construction) City /Stale N.f tk) (CE /,y1r)1/C� ` - iicel Identification Number 4x15f'N OZLo lD lb 7o 000 LEGAL DESCRIPTION 6 w &� t o/A+ Property Location Std ' /,, aft %,, Sec. 3.3 . T 3� N -R I S W, 'Town of Subdivision 4ea t,,l �JN� F- S t7,q )�_ Lot 11 / l'� Cel Survey Map 11 A n S-C/ Volume J c— Page 11 / Y00 Warrauly Deed It �1� 1-3 q , Volume 140.a 0 Page 11 Spec house Xyes ❑ uo Lot lines identifiable Xyes ❑ no SYSITM MAINTENANCE Improper use and niainlaianceof your septic system could result in its premature failure to handle wastes. Propermaintcnance consists of pumping out the septic lank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic lank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zouiug Dcpattntcut a ccclificalion fonu, signed by the owner and by a Ilia slerplumber, journeyman pluurbcr, restrictedplumberor a licensed pumper verifying that (1) the ou -sile wastewalerdisposal systcnt is in proper operating condition and/or (2) afler htspeclion and pumping (if necessary), the septic tank is less than 1/3 full of studge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system will the standards set foith, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic systcnt has been mahtlaincd must be completed and returned to the St. Croix County Zoning Office within 30 da o (lie r year expiration date. -4 -3/ o f NATURE O APPLICANT DATE OWNER CERTIFICATION I (we) certify that all stalcnlculs on this form arc true to the best of my (our) knowlcdgd. I (we) am (arc) the owrtcr(s) of tl► cscribed above y virtue of a rranly deed recorded in Register of Deeds Office. �, ` I Z3/ of G A1UR OF APPLICANI' DATE + + + + ++ Any information drat is mis- represented may result in the sanitary pcmtit being revoked by the Zoning Department. + + + + ++ +� Include with this applicaIloll: a stamped warranty deed from file Register of Deeds office 8 copy of the certified survey trial) if reference is made in (lie warranty decd 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 shall include information and procedures for maintaining the system within System (POWTS ) ent agent, Y approval b the departm g d 84 and the conditions of app Y the parameters of Comm 83 an , 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 g Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms -3 Design Flow - Peak (gpd) Estimated Flow - Average (gpd) Septic Tank Capacity (gal) Soil Absorption Component Size (tr) Domestic Type of Wastewater Table 2: Soil Absorption Component - Limits of Reliable b o perati Component Septic Tank Component Soil A Design Flow - Peak (gpd) 1/8 Maximum Influent Particle Size (in) 220 Maximum BOD (mg /L) 150 Maximum TSS (mg /L) 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 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 Trenches, Taks, pmps Pri vies, or Portable Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Restrooms). The operating condition of the se ' and outlet filter shall be assessed at least once every 3 years by inspection. T outlet filte shall be cleaned as necessa t re proper o e The filter cartridge to ' be removd unless wheneemoved f its enclosure. If the re ain solids in the tank that may slough off the filter -- -� - - -I -�� rrl co co I m I o o1-, i s1.so' - - - - -- 233.72' - - - --I � Ln I -P - -- — N 89 35'53 W M m :if — — O S 89'35'53" E 425.32' ``� Z - - - - 187.85' - -- 189.87' - - -- ] I CA CA O I m z I n L i i O — I 0 LOT 15 i OT 16 1 0 68637 Sq. Ft. d 66635 Sq. Ft. c ,,, I m 1.57 Ac. 1.53 Ac. I I ' o o I c I < m I I - -- I IoI I (�I I I NII � CD -- 194.05' - -`— - -_- 181.18' - -- J � I 0 w. — � W SOUTHEAST CORNER, SECTION 33' 1 33' 33'1` T3ON, R18W, SET P.K. NAIL FROM I h COUNTY TIES I I� I� I I D � HE SOUTHEAST 1/4 OF SECTION 33, AINAGE EASEMENTS SHALL HAVE A AN TWO FEET ABOVE THE HIGH WATER FTED BY: JASON THOMAS SHEET 1 OF 2 P, m nnn t _. Z o Z N O I I I V jO - N : Z < o I ,..I I ml m = m ^ � w f_ mw a W�• � I ° � z1 I ul I �I wo NF z 6 < z w 0 W W ' w _ OWNED 8Y: U O n; ZONING: AG -RES. Z H_EMAN JH K R N E E < O E w y < a m w S[ Jw E IS LL. R < _ I v 7�I� Wlw I 0 00 OJ 0 r" -W& UNPLA LANDS ° T � �I I �' I 5I Q w r F Uz m z 3 5 00'2107 W EAST LINE OF THE SE 1/4 OF SE�ION 3J� ° y.( I )'I,I,I r rca z 1 j o w ti F' _ .16569 S 00'j4'07 W 990.2 -. __. - 1q - __ - O F 0 o ....... \` - ' �. -A.4! ^ ttc> . 111 . 5 rrJ I°n 3 v�i m 0 ? ? z ° x } — S o0'24 07 W 040.11 1 7` "': -- �- • I - -- 1p i i i I II / I '111 I o =o x io z �• \ !� k �tlaJI Z Yl Q a I \ \ " n I mo: I � � I x s �a o o << w v �/ I I w� m \r 0o tQ i 5" � a z z ..,. : �, M g f i t Z_ 0 o I T. Ia I/ / I z o Zo = ° o ci z° q� o� W j • i I i -. \ \- q. IJ "londl // m ''' 4 a a 5 o 3x WCL d I I v � a 0LA �Z Y zi - 1 _.I °z1 za zz 0 Quo ■■ o�0m / I - �� \/ \. 3 / F \,I I of a S<< zu Z / 4 ° oa / - - \ l \ X e ,fi; i! �Y I i1 I m Z m 'a3 S' u O= f I x, ML J O a �m a x x a J 0 az�o Q L L I �Y. Z ZZ \ \ \� F eR / I II +'I Or� W , N 1 y:,1 F V s] I Vl tj UM cc wa 01- <I \ \ \ N $Y ti I / 1 i" l o / F o8 �i `� I \ G In Q zom A Z v ON ir 0w Fp owl <i I \ \ \a I ', JdN1 -- ] Jf .- 1 1 lV z bl =oaW wl 1 \\ \ �..r. 11 lI I cc W N w z i �� I\ \ 1 \_ H CC Z °om °z X q i' ty \� I I \�\ 0\�� \\ tl , a O \ °.mu°rzl �'I\\�� I I ° � I w ml�l Rz CL -o �n al ^ b ; �'-0 +�. ✓:a., \. �� \ �� ?: Fin: �:, ml• hl WON --o- , \�� \' \,s y`��� \ \� 1I Q oo u wa R U. \ Y�l \iy �� /; y I hl= oul Z zz \ n ooMzlry I - p..1K.' \ J\/ a // \\` \ \ \91 �\\ 0 . 0 ox �00I\ mw W ° N > u , I �� / //1/ n / X1 I {ri > > o Q �o\zn 1 ,\ t 4 \ / \ /' r a 1 I W 00 oo> aP �oO Uuu L zw rcz \ \�\ •_ \\ i In 01 kox�o �l ai 0 ON t 00 n \\ f 1 ° E bi 1f ° l. q\ \( / i l nroo.I I I I I ° zW �n 11 B Y, bl �$\� l / f 4 '*r \ \.1 \ � \\ yc . _ i--t II I tri Oci uo� s a X U c x €\ / \ \ V a 1' ; I_ ___ _ v �rc -n z as Q ro 8 I \ � f r �\ ', \ I� �' 11 I a o0 4w °qnn y' °I cc 00 = oot D °aoo E \� \\ \ \ \� I wl 1r w mm ,_ 0 W.. I FN-�^ �oJ � aoc O" l <` \ e Imwlul 1 111 aa�u a �s�� 1 •� / 1 I 19 1 � I s 0 JJ7< 3 7070 al_7� s °a zzzz I 0 ' I 4 3 \ \ I l< Z o g N ea \ \ 1 ' -lo t O m Ir 1 \ X1 I ° I Z 21 m � , �� \\ n i I I of ° °ICI wN u ° u]mLo $ H g nt 4 a 4NNa� =� �o °a o Y 4 4 a IL N 00'36'41 E 932.35' I\� a 4290.05 \ \ \ \ I a� w W mQm am / "N 00'36`41* E 983.86' \ \ \ e 1100 a wmNuw 20NING: �G -RES. WEST LINE OF THE SE 1 4 OF SECTION. }S OWNE D L D �.Yi\ I 1 I I ^& .,- atn //- — — — - -- UNPlAT1ED LANDS b _GREENFIELD 1 1.1' I ' I g Z ir � t-� NZJ 3 4N¢11.m_ YQ!.162OPAG1 6'07 STATE BAR OF WISCONSIN FORM 2 - 1998 451-4 3139 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Kenneth L. Brown and Kathleen B. RECEIVED FOR RECORD Brown, Husband and Wife 04 -18 -2001 9:45 AM WARRANTY DEED Grantor, and P. C. Collova Builders, Inc. EXEMPT I CEAZ•COPY FEE: COPY FEE: ,TRANSFER FEE: 828.00 RECORDING FEE: 10.00 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Record ing Area Name and Return Address That part of SE 1/4 SW 114 and SW 114 SE 1/4 Sec. 33- T30N -R18W described David J. Estreen as follows: Lots 1, 2 and 3 of Certified Survey Map recorded in Vol. 13 of 304 Locust St. Hudson, WI 54016 Certified Survey Maps, page 3698 as Doc. No. 607591. St. Croix County, Wisconsin g 026 - 1096 -60- 000,026- 1096 -60 -200, a } 026 - 1096 -70 -000 CAk '5K u Parcel Identification Number (PIN) f rte. This is not homestead property. (is) (is not) J - e cw_g Exceptions to warranties: Existing highways, easements & rights of way of record. Dated this 3d" day of April 2001 Z * . Kenneth L. Brown _A� ' Ali * Z Kathleen B. Brown AUTHENTICATION ACKNOWLEDGMENT STATE OF Wisconsin ) Signature(s) St. Croix ) SS. County. ) Personally came before me this day of authenticated this _ day of April 1 2001 the above named Kenneth L. Brown and Kathleen B. Brown J. k„. TITLEObfE ATAR OF WISCONSIN to Down to be the person(s) who executed the foregoing i ment and acknowledge the same. ge fw 06,.06, Wis. Stats.) Ep WAS DRAFTED BY Aft avid J. Estreen 304 L6eusQSt:; Hudson, WI 54016 Notary Public, State of Wisconsin (Signature y be authenticated or acknowledged. Both are not My Commission is permanent. not, s expire Ion a e necessary.) ) *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2. 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 800-655 -2071 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 conservation practices by all occupants and the installation of water conserving plumbing 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. 3 Apr`7 -01 09:43A P-02 PAGE 4 ALTERNATE SYSTEM AREA AS SHOWEN ON SOIL TEST, MUST BE LEFT UNDISTERBED. IF ALTERNATE AREA IS DISTERBED, REPLACEMENT AREA MAY NOT BE FOUND. ANY QUESTIONS PLEASE CALL I .. .........................(715); Z q/ - ys OR ST. CROIX COUNTY ZONING .......... (715)386-4680 i