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HomeMy WebLinkAbout026-1286-17-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division w INSPECTION REPORT sanitary Permit No: 488191 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)). 2. �, Q = Permit Holder's Name: City Village X Township Pa el Tax No: Sunset Ridge LLC I Richmond, Town of 026- 1286 -17 -000 CST BM Elev: Insp. BM Elev: IBM Description: - Section/Town /Range /Map No: 1 00 -0, �g 1 34.30.18.1439 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 1580/ 36 Benchmark A ry o�:laa j Dosing � Cx9��p,p 1.1 Alt. BM� Aeration _ - Bldg. Sewer r 102- 40 o ding St/ Ht Inlet 1 S t /Ht Outlet TANK SETBACK INFORMATION TANK TO P7E__ -- VVEEL BLDG. V ent o Air IntaKe ROAD Dt In ep Ic Z > 12 _ B ottom � 2—Z) I using 1 ea er an. ; A eration Mist. Pipe 2,30 3� 1 R olding B o t. System Ina Grade PUMP /SIPHON INFORMATION y w � u die + M anufacturer _ eman over _ �1 l C� lt4nf l GPM 1 I�. Ilo.� 3 �� O� - tO M odel um er �S' L14511/ 3. 111 oq,z1 I nc Ion oss systern Rea -„ J •30 ID 0 Lengin vv, mr SOIL AI35QKF1IUN5TbTLM DIMENSIONS C I 1 � ur% INFORMATION f CHAMBE q;;;;� vl ol& t S > / o' . - - .- . . f\ — ��Pddnq II Length Dia ' .0 Length 2L Dia Z ' Spacing bull VtK x Pressure Systems Only xx Mound Or At - Grade Systems Only Bed/Trench Center Bed/Trench Edges Topsoil Yes No Jl Yes L GO ENTS• (Include co a is7ricies, peirsons present, etc.) Inspection #1: Z Inspection #2: 1, to s hr a5 ��•5��4 ( LocZ on: 1223 121st Street New Richmond, WI 54017 (W 1/2 SW 1/4 34 T30N R18W) unset)Kicige Lot 17 Parcel No: 34.30.18.1439 .� 1.) Alt BM Description = `roQ 2.) Bldg sewer length - amount of cover - Plan revision Required. Yes XNo ,�q Use other side for additional information. ' `�' � nattlfe - - - - � . SBD -6710 (R.3/97) Safety andBui � ingsE VE ounty 201 W. Washington ve., P.O.7oz 7I - 4t' ) Madison, WI 3707 — 7162 Sanita Permit Number (to be filled in by Co.) VVIrsconsin (608) 21 6- 31 5MAY 1 6 2006 Department of Commerce Sanit Permit A hcati State P an 1.13. Number r3' pP . CROIX COUN Y In accord with Comm 83.21, Wis. Adm. Code, personal informatio ou pr l Z (p c0 3 3 (. may be used for secondary purposes Privacy Law, s15. ect Vddress (if different than mailing address) I. Application Information — Please Print All Information t` r �.ZZ7j Z'• Property Owner's Name / Par camel # / Block # Property Owner's Mailing Address Property Loca © 1 b Lt/ � /< Section , City, tate Zip Code / Phone Number a� / ,/ c, 11. Type of Building (check all that apply) b C-5 !;LA0 f %; Subdivision Name CSM Number r 2 Family Dwelling — Number of Bedrooms 4 "` u lZaelt-_ 12 ❑ Public /Commercial — Describe Use /D k 9d T0. ❑City_❑villag ownship of ❑ State Owned — Describe Use CJ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 6Z A ' w System El Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. El Permit Renewal ❑ Permit Revision ❑ Change of El Permit Transfer to New Before Expiration Plumber Owner IV. Type of PO WTS S stem: Check all that a 1 ❑ Non — Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ade ❑ Single Pass Sand Filter ❑ Constructed Wetland El Pressurized In- Ground El Holding Tank [I Peat Filter ❑ Aerobic T atment Unit ❑ Recirculating Sand Filter Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) 0 v V. Dispersal/Treatment Area Information: 13esi Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Propose (sf) System Elevation -4 /ems ' v 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 Aerobic Treatment Unit Dosing Chamber VII. Responsib4P.nt) ement- T, the undersig nine responsibility for installation of the POWTS shown on the attached plans. Plber's Name (—� Plumber' ature MP/IvIPRS Number Business Phone Number Plumber's Addresity, State, Zi e) d &_A 3�p proved C un /De t Use Onl Sanitary Permit Fee (includes Groundwater Date ssu Issuing ent Signa re Stamps Disapprove Surcharge Fee) C C !� 1 G 66 O iven Reason r- IIenial J J ! IX. Conditions of Approval/Reasons for Disapproval 3 \ � `, (� _ • s, ��, SYSTEM OWN _ J �+, n o �� �.,. \A ow c a j 0-f— v 1. CON must ON servit<es / malntafrted c- �� n per maragentent plan provided by plumber. n . — ro vim- 2. AN setback raWWements must be maintained 4) Ce • d t a ^^ ` ^ 1 1 f 1P_ l•� . as per apple code I ordkmr%M. I Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in size SBD -6398 (R. 01/03) I - 1 � a i a?r'alf !l r.+lnill Vj'Br Iit 1 - �;Yt`'4'��t: , vj'�J 9MbltJ�ie,�gt� •,af, stfe PLOT PLAN PROJECT Sunset Ridae LLC ADDRESS 838 Summer Pines Circle Hudson Wi 54016 W 1/2 SW 1 /4S 34 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 105.0' BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none hk BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter �8betp0 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark Scale = 1 /4 11 = 1 O' 120th St. Property Line AL Grading is to be done to divert run -off away from system Pro 3 Well is to meet all Bedroorr setbacks found in Comm. 106' House 83 105 B -3 104' ❑ B -1 Huffcutt Combo Tank 10% Slope Tank is to be properly bedded and provided with lockdown covers with approved warning labels Area 15' below system to B-2 remain undisturbed B. M. 458' Property Line PLOT PLAN PROJECT, Ridae LLC ADDRESS 838 Summer Pines Circle Hudson Wi 54016 W 1/2 SW 1/4s 34 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 105.0' BEDROOM 3 CONVENTIONAL AT -GRADE XXXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none kk BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter er Zhbd*--1W ❑ BOREHOLE O WELL H. R. P. Same as Benchmark Scale = 1/4" = 10' 120th St. Property Line Grading is to be done to divert run -off away from system Pro 3 Well is to meet all Bedroom setbacks found in Comm. 106' House 83 105 B-3 104' B -1 Huffcutt Combo Tank 10% Slope Tank is to be properly bedded and provided with lockdown covers with approved warning Area 15' below system to labels B-2 ❑ remain undisturbed B.M. 458' Property Line i Safety and Buildings 141 NW BARSTOW ST FL 4TH commerce WAUKESHA WI 53188 -3789 TD #: (608) 264 -8777 isconsin www.w www•commer isco sin.go / De irtment of Commerce isconsin.gov p Jim Doyle, Governor Mary P. Burke, Secretary May 12, 2006 CUST ID No. 226900 ATTN.• POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/12/2008 Identification Numbers Transaction ID No. 1269136 SITE: Site ID No. 712800 Sunset Ridge Lot 17 Please refer to both identification numbers, 120TH Street above, in all correspondence with the agency. Town of Richmond, 54017 St Croix County W1/2, SW 1/4, S34, T30N, R18W Lot: 17, Subdivision: Sunset Ridge FOR: Description: At- Grade, 3 Bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1075367 Maintenance required; 450 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System(s): At -grade Component Manual, SBD- 10570 -P (R.6/99) 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 requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the approved plans, and with publication SBD - 10570-P (R. 6/99) "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems ". The pressure network is to be constructed in accordance with publications SBD- 10573 -P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" d/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Netw i -SAS (01/81) ", r In the event this soil absorption system or any of its component parts malfunctions s s to cA�tu ealth hazard, the property owner must follow the contingency plan as described in the approved plans. n ditio<the owner must comply with the operation, maintenance and monitoring duties as described in section I� the at -grade component manual. A copy of this information must be given to the owner upon completio'of the project. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. SHAUN R BIRD Page 2 5/12/2006 A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Julia Lewis- Osborne POWTS Reviewer 2, Integrated Services WiSMAP code: 7633 (262) 548 -8638, Fax: (262) 548 -8614 julia.lewis@wisconsin.gov Cover Page Shaun Bird RECEIVED Bird Plumbing Inc MAY - 8 2006 1008 192nd Ave SAFETY & BUILDINGS New Richmond Wi 54017 715- 246 -4516 Date: 5/6/06 Owner:Sunset Ridge LLC Location:W1 /2 SW1 /4 S 34 T30 N,R18W Lot 17 Sunset Ridge Richmond System type: At -Grade Manuals Used: At -Grade Component Manual version 1.0 SBD 10570 -P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01 /81) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -11. Soil test Shaun Bird Signature g ,. License num r 226900 <� , L > B y 5 PVG FafILE.M R l ...� 2: 5' = 2 "T UR►4- tl _- -_ _..._ - - -- -- i t— �t51'Rc`,�- iTtQwi LDIT�RAI. "f w EA VJE L� - L o Ir �' ' 1/f B A i- " /LTA • — CELL of %z - ?- %2 A A&E.+C A-TE P,fe"%me, SymTHE Fabric � Distribution Lateral S MIB1 1V-b Observation- --_.,_ ,�; t2 �--- Soil Cover Well zt r ,},, � 2 � ��v+IED �wYER plaza V and Cross Section of Wiscor►sin At -grade. Unit with a Single Absorption Area on a Sloping Site Str:.wwruKE.: UtEP-tSE = Pag � � S OWNER'S MANUAL & MANAGEMENT PLAN POWT SYSTEM SPEGIFICATION(S Fa fNFORNtATtON Septic Tank capacity gal ❑ NA S L'a� �-' Septic Wank Manuf Luxes vt, t1 NA owner Penn - Effluent Fitter Manutac kwer a NA DESIGN P�M� p NA Efguent Etter -Mom I3 NA Tank Capacx�Y .� DNA Numbef of Sw Pump NA A[A Number of Gornrrrerpat Una aVd pump Ta Manu mr Estimated flow {avenge) Pump Mar�ufac�uref � �1-�✓ [1 NA c al/d ay - 13 fin r(pea4, (Estimated x 1 sUd 1ft� Pump Model Soli Apps' �� Pret�tment Unit - © Peat Fitter Monthly C3 SandfG�el Fitter p Wetland InffueriVEm� Quality , 530 mgn p Mechanical AeraSan pats, Off & Grease (�G) 522 rrtgn- on n Other 0 Demand (BODE m iL M nu1 ct e� BiOCfie � ��� �rlas S) - Manufaurer Monthly average"' aispersai Oeit(s) 13 in-ground (pressudred) p Effluent Q uality . S30 mg1L In-9 r. and (gravrtY) p Mound en Demand (SOD,) -grade q Othe B " "�ochemi al S ded Solids (TSS) s30 mg1L. [3 Oro ne Total uspen s10` efu11 o0ml Fecal C000= otm (geo metric mean} Valaes Wjcaa for domestic (r�on car r ,KasbsrraLu old Y inch diameter 5ePw tank eRlueM Ma)amucn Effluent Particle Size values types for pretsaw MAINTENANCE SCHEDULE Service Frequency Service Event Q months f(s) (MaIdMu: n 3 yrs.) At least once every oats one -third (yp of tank volume Inspect condition of tank(s) when combined sludge and scum eq f(5) (Maximum 3 yrs.) Pump out contents of tank(s) p months At least once every � f(s) Inspect dispersal celI(s) At least once every �, i3 months . p months s) ❑ NA Clean e ffl uen t fliter At least once every .� s) p NA Insped pump PUMP contorts 8. alarm At least once every Q months 0 year(s) O NA Flush later and Pressure test p months At least once every [3 months months II years) O NA At least Once every omen n one of the following licenses or CE INS RUCTIONS l Cells shall be made by an individual carzY 9 tamer. SePtW of tan r POWrS fns 3e�r. idwi frS any or broken lnspet�Ons tanks and d%Ve Plufnt� Restsscted Sewer o of the tank( to idenSfY any rn�rn9 back up mss: Master Plumber. { and to d>e for any tior. Tank inspections trust in a visual Inspection a and scum Sew opera or leaks, ire the vot to c h e ck the effluent levels ursie of combined slu thardwaM idenw any n -as sh be removed by The dispersal oeU(s) stiali be visually Ponding Of effluent on the or porArmg of etftuent on the ground surface nding of effluent on the ground surface. ulatory authorihf in the o� pipes and M check for iii n an rNurOs m immediate notification of the loco[ r�eg ind:ca� a fatTin �d�'D tnd (Y� Of mtlre of the :tank volume the R ground surface mss a and scorn in any tank eQuals ono -thi of in accvndance '"�' ch When the combined accumulation at sludg a Septage Servicing Operator and disposed th tank entire cont" t �ponents; and any 113, Wisconsin Administrative Code. re5surized POWTS components, pfetreattmen pOWTS MaintaIner of effluent filtiers. meChania or' P rformed by a 'ti'le ling at interarats of 12 months or less shall be f>? teflon of any service event otttermatnttmanae orb Pro n�nn� to the loco[ regulatory attfftoriiy within 10 days ofcomp A Sew mPo4 shall ms products or other START Up AND OPERATION use of the POWTS rheCk.treatment tank( for the presence of p�gting P t are cell s if high concentm For newton auWon. Prior to and/or damage the dispersal { �- diemi�s that may imP�e the treatm ent P rocess a septage se d0ctSd haft the contents of operator' prior to use_ the tank(g) removed by • Page Of • Distribution Pipe Detail For Lateral Xetwork ACCe s- TuKK - (CLERV40ur) -' - PVC Force Win PVC Distribution Pipe _ P * Last Hole Should Be Next To c Tu RAi - UP Q� ! P - --�3 -- Ft. Note D X � Inches Latera Di ameter Inch(es) Y 2-q Inches Force Main Diameter Z Inches #� Of Holes /Pipe 7 Invert Elevation Of Laterals /O,S Ft. Signed: License lumber: ZZ. 6? u—D' Date: • l•d e6Z :L0 00 V0 6ny CROSS SECT ►U'N P+�D SQECII ICATICTI+rS SEPTIC TANK E PUKP Ct.RC3� V 'GRADE E vrEATHERPR IOF APPROVED y ++ G} 'SENT PIPE I�'+ HYN _ ABO E jUNCTION BOX idINDO OR WITi4 CONDUIT MANHOLE srD�ER > �Q` FRO D04K. W! PADLOCK FR£SI: ' IR INTAKE �(�l" �,�WAIWLNG LABEL rimy- : =a° �(o T 19" INLET ' • GAS- R4YF0 { .ATER TIGHT S�� SkiH T TIG itfS WITH A , • � a ALM APPROYO PIPE 3 ©ltiTO Fs ! s ON S. ID SOIL APPFOVO �, + c. T PIPE 3' S ��, FT. ONTO OLID SOIL p�3l+4F O£'F EL£V - _--- D TAN BEDDTRG UNDEit K' 3+* AFPROV ED CONCRETE PAD rCIFICATIaNS � ^PS c� /�s�v �;Wl/1. =ER DAY SEPTID / DOSE � h DOSES Gt c Ds ,Cr,: NG !-- s4319K KANUFACTURE DOSE V'o IN I GAL - GAL. FI.a418r/�_ .�--� -�) GAL• YRNX SIZES: SEPTIC � GAL. :� ZrCRES DIDSE =-��6 /' / . �/@ fi�' S / CAPACIYZES : ii MANUFACTURER,- = 21+ICHES GAL • = 3 r A3ARr! MODEL Nt�3iSER = �' t/ _ ?7 S GAL SWITCH 'TYPE: ,.� ��JJ' — / C = S INCHES _ / -- � -- TFACTURF•R = D = Zt�CKES GAL pV HP + I �R 16.23 WA !lODEL lIf31"F$ER : " 4• L� _ I e - /f W IR T to AS PER SXZTC =; 'TYPE- _ ar.I�il' £ AL.4R?i FEET n ` G ?K PIPE .j:Cpj2RED D11- CE ARGE RATE �— I - IOt�1 - FEET Piz M P OF AND D I STR _ _ a� / __.� FEE 'T ENCE gE'ZiJEieN F `G FEET eERT2CAL URE gIFP''ER PRESS E .�_ •FRiCTTOI� ACTOR - ;1�1L....._ MINIH�IM NETWO-R x i3�. T /l04 . TOTAL flY�`, MIC IilA � + _ r Ffl. � ; Dl�r�sT P UMP TANK: LENGTH I�VT£RNAL D Lt"�EN5 IDY►t5 4F LIQi3ID ����________• /' ZZ � C �� DA •� LTCEISSE 1�3M�r• -� SIGNED: Z•d t=6Z :L0 00 t0 6ny SAFETY WARNING — Risk of electric shock. This pump is SAFETY GUIDELINES supplied with a grounding conductor and /or grounding 1. Read all instructions and safety guidelines type attachment plug. To reduce the risk of electric thoroughly. Failure to follow the guidelines and the shock, be certain that it is connected to a properly instructions could result in serious bodily injury grounded grounding type receptacle. and /or property damage. 2. DO NOT USE TO PUMP FLAMMABLE OR Your 115V' effluent pump is equipped with a 3 -prong EXPLOSIVE FLUIDS SUCH AS GASOLINE, electrical plug. The third prong is to ground the pump to FUEL OIL, KEROSENE, ETC. DO NOT USE IN prevent possible electrical shock hazard. Do not remove EXPLOSIVE ATMOSPHERES OR HAZARDOUS the third prong from the plug. A separate branch circuit is LOCATIONS AS CLASSIFIED BY NEC, recommended. Do not use an extension cord. ANSI /NFPA70. FAILURE TO FOLLOW THIS WARNING CAN RESULT IN PERSONAL INJURY When a pump is in a basin, etc. do not touch motor, pipes AND /OR PROPERTY DAMAGE. or water until unit is unplugged or shut off. If your 3. During normal operation the pump is immersed in installation haswaterormoisturepresent ,donottouchwet water. Also, during rain storms, water may be area until all power has been turned off. If shut -off box is present in the surrounding area of the pump. not accessible, call the electriccompany to shutoff service Caution must be used to prevent bodily injury to the house, or call your local fire department for when working near the pump: instructions. Failure to follow this warning can result in fatal electrical shock. a. The plug must be removed from the receptacle The flexible PVC jacketed cord assembly mounted to the prior to touching, servicing or repairing the pump. pump must not be modified in any way, with the exception of shortening the cord to fit into a control panel. Any splice b. To minimize possible fatal electrical shock hazard, between the pump and the control panel must be made extreme care should be used when changing within a junction box and mounted outside of the basin, and fuses. Do not stand in water while changing fuses comply with the National Electrical Code. Do not use the or insert your finger into the fuse socket. power cord for lifting the pump. 4. Do not run the pump in a dry basin. If the pump is The pump motor is equipped with an automatic resetting run in a dry basin, the surface temperature of the thermal projector and may restart unexpectedly. Projector pump will rise to a high level. This high level could tipping is an indication of motor overloading as a result of cause skin burns if the pump is touched and will operating the pump at low heads (low discharge restriction), cause serious damage to your pump. excessively high or low voltage, inadequate wiring, incorrect 5 Do not oil the motor. The pump housing is sealed. motor connections, or a defective motor or pump. A high grade dielectric oil devoid of water has FLOW- LITERS /MINUTE been put into the motor housing at the factory. Use o 80 160 240 32 of other oil could cause serious electric shock 60 and /or permanent damage to the pump. 15. 0 6. This pump's motor housing is filled with a dielectric lubricant at the factory for optimum 40 12. motor heat transfer and lifetime lubrication of the bearings. Use of any other lubricant could cause Li 10. o damage and void the warranty. This lubricant is U- 30 non - toxic; however, if it escapes the motor housing, it should be removed from the surface C 20 ' S quickly by placing newspapers or other absorbent �o•tt = Q material on the water surface to soak it up, so s. 0 1,J z aquatic life is undisturbed. 10 —2.5 7. In any installation where property damage and /or. personal injury might result from an inoperative or ° 0 leaking pump due to power outages, discharge o Zo 4 6o so 100 line blockage, or any other reason, a backup 2S " system(s) and /or alarm should be used. FLOW G L ❑NS /MINUTE PUMP PERFORMANCE CURVE I- 115V 60HZ J1'IaDEZ q 3 r Sys startup shall not occur when srnl'COndifions are frozen at the infiltrative surface. D h power outages pump tanks may 9 above normal highwater levels. When power is resttNed the excess � be disci anted to the dupe ,erasnztirater cell(s) in one large dose, overloading the I (s) and Wray restttt in the rsal backup or discharge of ett�t To avoid this situation have the contents of the prim re p tank moved by a She g pnor.tid- Ong power to the effluent pump or contact a Plumber or POWTS Maintainer to aSSi5t tit iflatltldlly OP n9 dw pump conbzfs to restore normal fevefs within th pump tafslc Do not wive or park over taffies and dispersal c 9a. 00 not drive Or park over- Or ofherwlse dishmb or compact the aeon within 1 feet down slope of ally mound or at-grade soil atrsorgf2on area. Reduction or- elimination of the �g from the wastewater sir8am may improve the performance arts prolong the fife of the POWTS: antlblo6Cs; - W. Ajar butts; condoms, cotton swabs; de :dental bass; dtapets; diafi {sump pF3 wafe fruit and vegetable peelings; gasoline; gar herbiddt"�; meat drsin#ec�ttts: fat pesticides: sanitary napkins. tampons: - and water soften/ brine. stmt, mss; og: n5 P % AW01004WENI fatten out of service the falfowing steps stsafl i taken to Insure that the the POVjM fans and/or is permanetrtly system is property anri Safi* abandoned in eomprrancp_ w'fh ch. Comm 83.33. Wisconsin Admtreist M&e Code: All plping to tanks and pits shaft be disconnected and the abandoned pipe openings seated- The contenLs of an tanks and pits snail be removed and properfy disposed of by a Septage Servicing Operator: After pumping all tanks and pits shag be excavated and removed or their covers removed-and the void space filled with soft, grave! or another inert solid material CONTINGENCY PLAN if the POWI'S fads and Cannot be repaired the following measures have been or must be taken, to Provide a code compliant replacerrtent system luated and may be utilized for the location compaction a replacement sod t3 A suitable repfaoerrtent a(�ea has been eva from disturbar absorption system. The replacement area should be protected lot e and Frees and d we ll wis- - Parlors to and should not be infringed upon by required setbacks from e)dsbng and proposed structure, tot e protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time- 0 A suitable replacement area is not available due to setback and/or soil limitations_ barring advances in POWFS technology a holding tank may be moiled as a last resort to replace the faded POWTS. The site has not been evalL aced to identify a suitable replacement area Upon failure of the POWTS a so @.and site evaluation must be perfored a to Locate a suitable replacement are If no replacement area is available a m holding tank may be installed as a last resort to replace the failed P0VVTS_ of the biomat at mound and at -grade sotT absorption systems may be reconstructed in place fallowing M infittrative surface RewnstFUctions of such systems must comply with the rules in effect at that tune_ <<WARNIN ©> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDfOR INSUFFICIENT Q7Cl'GEI+1. DO NOT ENTER ASEPTIC. PUMP QR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH'RAY RESULT RESCUE OF A PERSON FROM THE INTER10R OF A TANK MAY BE DIFFICULT OR IMPOSSI ADDITIONAL COMMENTS POWTS INSTALLER POWT'S MAINTAINER Name Marne Phone Phone �j Z, SEPTAGE SERVICING OPERATOR PUM{' LOCAL REGULATORY AUTFIORf 7 Name Agency /' Phone i ��, ! — -� Phone /✓ ustts MW Waushara Courlly Zoning and Sanitati on This d� m This Qoa menLwas d afad by. aw atafis of the Green Lift. Mart( Cer4G U M Mki'U" n MQUkVn t+ts of cfL Cerrr+r� 83217 2 )(1)(<)&l and 83.54(1). (2) & ( Wisconsin Admfnlstratim se Of this document Q006 e (,tom (1!01) a guarantee the performance of the PGWr•S. LUATION REPORT Page of Wisbonsin Department of Commerce Division of Safety and Buildings o RFJ _GF / c� 1. in actor n 't om i e rParcd �. ( t x _ Attach complete site plan on paper not less than 8 1/ ni size. Plan must include, but not limited to: vertical and horizontal referen I t it n� ((�� percent sl ope, scale or dimensions, north arrow, and locat r _tTr e5 t ad. 4 Z I am, R by Date Please print all informat n. ST. CRO i COUNTY /f / Personal inforrnation you provide may be used for secondary pu Prey u ew1 C(Q (m)). 0 / Property Owner Property Location yy �, 1) s l ! ot 1/ �d� 11/ S T_ ® N R E (o W Property Owner's Mailing Address l ock # Name or CSM# , 11 2 s city. State zip Code Phone Number ® City �❑ Village own N est Road X A New Construction Use: esidential /Number of bedrooms _ -_ �_ Code derived design flow rate GPD ❑ Replacement ,ry Public or commercial -Describe: _ -_ - - - - - -- - -- - - -- Parent materia __ _ ___ Flood Plain elevation if applicable General comments l and recommendations: Boring M ❑ . Boring # — f . De to limiting factor `r in. it Ground surface elev. P r'9 Soil igtion Rate Horizon Depth Dominant Color Redox Description _ - texture Structure Consistence Boundary Roots •Eff#1 Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. z�Z Boring Boring # =irl pit Ground surface elev. t. Depth to limiting factor Rate Horizon Depth -" Don ' inant or Redox Description — Texture Structure Consisten in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1 cal r rn �— Effluent #1 = BOO > 30 < 220 mglL and TSS >30 _` 5- 'Effluent it2 = BOD < 30 mg/i and TSS <_ 30 mglL CST Name (Please Print) turn CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5401 ��—� 715 - 246 -4516 Property Owner _ Boring Parcel !D # _ � / Page of [31 Boring # ❑ �i it Ground surface elev. —3 ft. Depth is ;imifing factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture :- !(Aura Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color z Sh. 'Eff# Eft#2 1 I a � C S Boring # ❑ Boring in. E] p Ground surface elev. ft. Dept :o limiting factor it licatlon Rate Horizon Depth Dominant Color Redox Description Texture : >tr re Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color 1. _ 3z. Sh. •Eff#1 'Eff#2 ❑ Boring # Boring Ground surface elev. ft. Dept - .c) limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture — `' , ti uctire Consistence. Boundary Roots GPDlff in. Munsell Qu. Sz. Cont. Color C:r. Sz. Sh. `Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mgtL and TSS >30 < 150 mglt. ` Effluent #2 = BOD, < 30 mgn- and TSS < 30 mg1L The Department of Commerce is an equal opportunity service provider aid employer. If you need assistance to access services or need material in an alternate format, please contact the deparment at 608- 266 -3151 or TTY 608 -264 -8777. s9D -8330 (RAW) + Soil Test Plot Pla Project Name Sunset Ridge LLC s un B' Address 838 Summer Pines Circle Hudson Wi 54016 STM #226900 Lot 17 Subdivision Sunset Ridge Date 4/15/05 W 1/2 S W 1/4S 34 T 30 N /R18 W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 10o ft. Top of Survey Nail /Iron System Elevation 103.0' *HRpSameasBenchmark Scale is 1" = 40' unless otherwise noted 210' Property Line B -1 B -3 80� 30' 106.5' S0' 0' 10% Slope 103.5' B -2 B.M. 458' Property Line ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailin g Address S Property Address (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number 6 Z6 , /Z% (a ' 7' 06b LEGAL DESCRIPTION (� i/ ✓ W 1 /a , Sec ` / , T ,3 v N aW, Town of Property Location �, , Subdivision _� Lot # Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house es no Lot lines identifiable 9 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. Itwe 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 d scribed above, by virtue of a warranty deed recorded in Register of Deeds Office. SI ATURE OF PPLICANT(S) DATE * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Deparnneni. * ** 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. 08/05) U 2660? 306 774940 STATE BAR OF WISCONSIN FORM 1 - 1999 Document Number WARRANTY DEED KATHLEEN EGISTER OF DEEDS ST. CROIK CO -, WI This Deed, made between Herman W. Keller, Sr., Herman W. RECEIVED FOR RECORD Keller Jr and Karen M. Keller, husband and wife 09/21/2004 1e:25AM Grantor, and Sunset Ridge, LLC Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEIPT # the following described real estate in St. Croix County, State of Wisconsin REC FEE: 13.00 (the "Property") (if more space is needed, please attach addendum): TRANS FEE: 1440.00 See attached Exhibit A COPY FEE: CC FEE: PAGES: 2 Recording Area Estreen & Ogland 304 Locust Street Hudson, WI 54016 Together with all appurtenant rights, title and interests. 026 - 1098 -20 -000: 026- 1098 - 30-000 Parcel Identification Number (PIN) This is homestead property (is) 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 this i) *114 day of V 2004 * Herman W. Keller, Sr. * Herman W. Keller, Jr. K ren M. Keller AUTHENTICATION ACKNOWLEDGMENT Signature(s) Herman W. Keller, Sr., Herman W. Keller, Jr. STATE OF WISCONSIN ) and Karen M. Keller, husband and wife ) ss. ST. CROIX County ) authenticated this 7/? da of V!W 2004 Personally came before me this day of 2004 the above named Herman W. Keller, Sr., Herman W. Keller, Jr. and Karen * Kristina Ogland M. Keller, husband and wife TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Kristina Ogland, Estreen & Ogland 304 Locust Street, Hudson, WI 54016 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, w1 STATE BAR OF WISCONSIN 800. 655 -2021 WARRANTY DEED FORM No. 1 -1999 t1 2660P 307., EXHIBIT A Located in part of the northwest quarter of the southwest quarter, and the southwest quarter of the southwest quarter of Section 34, Township 30 North, Range 18 West, Town of Richmond County St. Croix, State of Wisconsin described as follows: Commencing at the southwest comer of said Section 34; Thence North 00 degrees 08 minutes 04 seconds East along the West line of the southwest quarter of said Section 34 a distance of 484.68 feet to the POINT OF BEGINNING; Thence contiue North 00 degrees 08 minutes 04 seconds East along said West line of the southwest quarter 2157.27 feet to the West quarter comer of said Section 34; Thence North 89 degrees 50 minutes 54 seconds East along the North line of the southwest quarter of said Section 34 a distance of 1018.75 feet; Thence South 00 degrees 08 minutes 04 seconds West on a line parallel with the West line of the southwest quarter of said Section 34 a distance of 2007.79 feet; Thence North 89 degrees 59 minutes 59 seconds West 694.55 feet; Thence South 00 degrees 08 minutes 04 seconds West along a line parallel with said West line of the southwest quarter 164.50 feet to the northeasterly corn6r of a Certified Survey Map recorded in Volume 5, Page 1400; Thence North 87 degrees 49 minutes 24 secons West along the northerly line of said Certified Survey Map 324.40 feet to the POINT OF BEGINNING and there terminating. St. Croix County, Wisconsin. � ------------------------------------------------------------ ------------------ - - -- - - - - - -- - --- - - - - -- 1S iZ i - �� 0 ww.�++rwws r..r,r e>ww wr MR r —li— 4 — L I I e v+ FROM :OEVERING HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10 :14PM P12 a w - -- ----- - - - - -- - - -- n — 4 0a y • ti ink IIITT a 1 ` N - � -- r d r a FROM :OEVERING HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10:14PM P11 1 N aka spa a +s E t c) ) .. aim M •• _._--------------------- N N I Parcel #: 026- 1286 -17 -000 05/19/2006 08:38 AM a_, PAGE 1 OF 1 Alt. Parcel #: 34.30.18.1439 026 - TOWN OF RICHMOND Current )X(I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 08/26/2005 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-owner 0 - SUNSET RIDGE LLC SUNSET RIDGE LLC 838 SUMMER PINES CIR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1223 121 ST ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.951 Plat: 10/073- SUNSET RIDGE LOTS 1 -21 026/05 SEC 34 T30N R18W PTS NW SW & SW SW Block/Condo Bldg: LOT 017 SUNSET RIDGE LOT 17 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 34- 30N -18W NW SW 34- 30N -18W SW SW Notes: Parcel History: Date Doc # Vol /Page Type 08/26/2005 804638 10/073 PLAT 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 02/10/2006 Description Class Acres Land Improve Total State Reason Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00