HomeMy WebLinkAbout026-1172-01-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
0' - 479418 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 I Richmond, Town of 026- 1172 -01 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No:
rv\ 1 T 35.30.18.1362
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic , .5 Benchmark
DS 1a5. /a0
Dosing Alt. B ; e.
g� 95. 1
Ion ZC� � / Bldg. Sewdr � O 40-7 14•g8
Holding St/Ht Inlet
IS . F9 . `Z
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet _.
Septic Z7 t AIA r;r / ' V-' Dt Bottom 19 , 75.3S
Dosing j � g Header /Man. Z , ( /bz •S/Z
Aeration i � Dist. Pipe &Z - 3
Holding Bot. System y 5 / � j ` �
3.3t�
PUMP /SIPHON INFORMATION Final Grade 1 .b�j /� N Z-
Manufacturer Demand St Cover
p �,,,. 5 GPM � �. -� 94•
Model Number G 2� / ll
TDH L �-, Friction Loss System Head TD2 Ft
x.45 Z
Forcemain Leytth Dia. it Dist. to Well
� � 60 Z
SOIL ABSORPTION SYSTEM
BEDITRENCH Width y Length No. Of Trenc PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS tr 7 �
SETBACK SYSTEM v TO v P!L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer.
INFORMATION CHAMBER OR
Type Of System: ` / N f , \ t UNIT Model Number. `
DISTRIBUTION SYSTEM (p I7' �V f
Header /Manifold 1 Distribution x Hole Size j � x Hole Spacing Ven to Air Intak
P C 0 Q � �G✓�.
i Lpngth_ Dia ' ` Length * `� Dia � Spacing q g 3 `
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 1. 7 3 Bed/Trench Edges Ns Topsoil 1 Yes No es No
COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / t Z- / 65 Inspection #2:
Location: 1298 138th Street Ne � Richmond, 1 54017 (NE 1/ 1`� 1/4 35 T30N R18W) Sunset Hollow Lot 1 91 P N :35.3 18.1362
'Told a ��u •. :.1+� Gz .�Q. f o1v_1 L
1.) Alt BM Description
2.) Bldg sewer length = ��
- amount of cover =
ySiature Plan revision Required? �] Yes �No Q Use other side for additional information. ZZ' __ Date Insepct Cart. No.
SBD -6710 (R.3i97)
I
Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162 St. Croix
,0��,� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
Department of Commerce (608)266 -3151
Sanitary Permit Application \ \1 State Plan I.D. Num r O z ctG) 3 _ 7 AM. 16
In accord with Comm 83.21, Wis. Adm. Code, personal information you provWe L U �- 6 c S t 1 -
may be used for secondary purposes Privacy Law, s15.04(1 )(m) t ress (if different than mailing address)
L Application Information - Please Print All Information 138th Street Property Owner's Name C Block #
Todd Marek ��9618
Property Owner's Mailing Address perty Location
P. O. Box 228 1XGO�� E NE 35
City, State Zip Code Pho G 1 /4, /+ Section
New Richmond, W1 54017 30 �gcircleone)
t T N; R N
r
II. Type of Building (check all that apply) 4 t� f - S �+ '
I Subdivision Nam CS�unber
211 or 2 Family Dwelling - Number of Bedrooms Sunset Hollow
❑ Public /Commercial - Describe Use
❑ State Owned - Describe Use ❑City ❑Village Qrownship of Richmond
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) p& - Z - p/ -- t9D , /362
A, 0 New System y ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
l tl 11 I
IV. T ofPOWTS System: Check all that a = / 2 ,0
❑ Non - Pressurized In- Ground 0 Mound > 24 in. of suitable soil 0 Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ® Gravewess Pipe ❑ Other (explain)
V. Dispe rsal/Treat ent Area Information: _ 140.(20
Design Flow (gpd) Design Soil Application Rate(gpdsf) ispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation
600 0.4 ( 1 � 600 600 101.60'
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units W/ A A _�Op Concrete Constructed Glass
New I Existing
Tanks Tanks
septic - Holding Tank 1200 1200 1 Wieser x
Aerobic Treatment Unit
Dosing chamber 800 1800 1 Wieser x
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number
Roger Nelson MP226497 715 - 273 -4444
Plumber's Address (Street, City, State, Zip C e)
122 East Summit Avenue Ellsworth, WI 54011
VIII. Coun /De artment Use Onl
X Approved ❑ Di prove Sanitary Permit Feecludes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Surcharge Fee)
❑ Owner Given Reason for Denial �j 4M 24P
IX. Conditions pprov al
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be serviced / maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code /ordinances.
Attach complete plans (to the County only) for the system on paper not less than 81/2 a 11 inches in sin
SBD -6398 (R. 01/03)
odd Marek
Y �
P.O. BOX 228
New Richmoni4 WI 54017
NE %,NE 4, S35, T30N, R 18 W
N
Sunset Hollow Lot # I
Richmond Township
St Croix County
Scale 1 - 40
Weiser 12001800 tank
BM #1= 100.00' top of % "PVC pipe
BM #2 = 100.65' top of % "PVC pipe
150' of 2 "force main
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Page g 1 8
Safety and Buildings
4003 N KINNEY COULEE RD
com,merce.Wl.gov LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
isconsin www.w
www.coe.wi.gov/s
sin.go /
iscosin.gov
Department of Commerce
Jim Doyle, Governor
Mary P. Burke, Secretary
August 17, 2005
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: 08/17/2007 Identification Numbers
Transaction ED No. 1182993
SITE: Site ID No. 702976
Todd Marek Please refer to both identification numbers,
138TH Street above „in all correspondence with the agenc
Town of Richmond
St Croix County
NE1/4, NEIA, S35, T30N, R18W
Lot: 1, Subdivision: Sunset Hollow
FOR:
Description: Four Bedroom Mound System
Object Type: POWTS Component Manual Regulated Object ID No.: 1033752
Maintenance required; 600 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade;
System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101); Biofilter
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, Condit
t
stats. A RP"R The following conditions shall be met during construction or installation and prior to occupancy or use:
DEPARTMENT(
Approval Requirements: N OF FTE
• This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRE;
"Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01)
and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST (0 1/8 1)
• Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area.
Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal
are prohibited.
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
area. chs. NR 811 & 812c
• 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 POWTS 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. Stat
ROGER D NELSON Page 2 8/17/2005
• Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction
and open to inspection by authorized representatives of the Department, which may include local inspectors.
Owner Responsibilities:
• 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.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible
for the installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Charles L Bratz
POWTS Reviewer II , Integrated Services WiSMART code: 7633
(608)789-7893, 7:45 am - 4:30 pm Monday - Friday
cbratz@commerce.state.wi.us
cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544
9
MOUND AND PRESSURE DISTRIBUTION COMPONE &SIGIV�B
Residential Application ® k y 420
INDEX AND TITLE PAGE ��1., `�
Project Name: Todd Marek 4 bedroom Mound system
Owner's Name: Todd Marek
Owner's Address: P. O. Box 228
New Richmond, WI 54017
Job address: 138th Street
Legal Description: NE 1/4, NE 1/4, S 35, T 30, N R 18 W
Township: Richmond
County: St. Croix
Subdivision Name: Sunset Hollow
Lot Number: 1 Block Number:
Parcel I.D. Number:
Plan Transaction No.:
Page 1 Index and title
Page 2 Data entry
Page 3 Mound drawings
Page 4 Lateral and dose tank
Page 5 System maintenance specifications 1, ;Je1,11V
Page 6 Management and contingency plan
Page 7 Pump curve and specifications '
Page 8 Plot Plan �Rcc ,
NG
CO)N DENC
Designer: Roger Nelson License Number: MP 226497
Date: 08/02/05 Phone Number: 715 - 273 -4444
Signature:
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81)
Version 4.0 (R. 04/03) Page 1 of 8
i
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a
400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal
1.50 Peaking Factor (e.g. 1.5 = 150 % coliform of <= 36 inches.
600.00 Design Flow (gpd)
5.50 Site Slope ( %)
100.60 Contour Line Elevation (ft)
24.00 Depth to Limiting Factor (in)
0.40 In -situ Soil Application Rate (gpd /ft
Distribution Cell Information
76.001 Dispersal Cell Length Along Contour (ft) = 8.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft)
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest oint
in the distribution Y
Pressure Disribution Information network? Enter Y or N
(c or e) a Center or End Manifold
4.00 Lateral Spacing (ft) If N above, enter the elevation (ft)
2 Number of Laterals of the highest point.
0.125 Orifice Diameter (in) (e.g. 0.25)
3.00 Estimated Orifice Spacing (ft) = 12.00 ft /orifice
2.00 Forcemain Diameter (in)
150.00 Forcemain Length (ft) Does the forcemain drain back? Y - �
82.00 Pump Tank Elevation (ft) Enter Y or N
6.50 System Head (ft) x 1.3 24.47 Forcemain Drainback (gal)
19.27 Vertical Lift (ft) 46.79 5x Void Volume (gal)
1.45 Friction Loss (ft) 71.26 Minimum Dose Volume (gal)
27.22 Total Dynamic Head (ft) 20.60 System Demand (gpm)
Lateral Diameter Selection Manifold Diamet Sele
in. dia. options choice in. dia. options choice
0.75 1.25 x x
1.00 1.50
1.25 x x 2.00
1.50 x 3.00
2.00 x
3.00 x
Gallons /Inch Calculator (optional)
Treatment Tank Information Total Tank Capacity (gal)
1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in)
Weiser 800 - 325 -8456 1 Manufacturer gal/in (enter result in cell B49)
Dose Tank Information Efflu Filter Information
800.001 Dose Tank Capacity (gal) Zabel 1- 80 - 221 -57 42 1 Filter Manufacturer
22.241 Dos T ank Volume (gal /in) A1 Fitter Model Number
Weiser IManufacturer
Project: Todd Marek 4 bedroom Mound system Page 2 of 8
f
End ram Connection Lateral Layout Diagram
y g
Laterals centered over the A & B dimension = Turn -up vdball valve or oleanoutplug
rFOFCQ P dentica l k- �{ --3 Holes drilled on the bottom of the lateral S
equally spaced nnection aria tee or cross to mardold at .any point. Laterals & force main of PVC Sch 40
(per CMW Table 84.30 -5)
Number of Laterals 2 Orifice Diameter 0.125 in
Lateral Diameter 1.25 in Orifice Spacing (X) 3.06 ft
Lateral Length (P) 73.44 ft Orifices per Lateral 25
Lateral Spacing (S) 4.00 ft Orifice Density 12.00 ft /orifice
Lateral Flow Rate 10.30 gpm Manifold Length 4.00 ft
System Flow Rate 20.60 gpm Manifold Diameter 1,25 in
Total Dynamic Head 27.22 ft Forcemain Velocity 2.10 ft/sec
Dose Tank Information Locking cover with warning
label and locking device and
J sealed watertight
Electrical as per NEC 300 and --- 0
Comm 16.28 WAC 4 in. min.
Disconnect
Tank component is properly vented iz Alternate outlet
location
Forcemain diameter
Weiser 800 - 325 -8456 Manufacturer 2 in.
Capacityl 800.00 Gallons
Volume 22.24 gal /inch A
_ Weep hole or anti -
Dimension In ches Gallons B siphon device
A 20.77 461.86
B + 2.00 44.48 C Pump off elevation (ft)
C 3.20 71.26 � 82.83
D 10.00 222.40 D
Total 1 35.971 800.00
Dose se tank elevation (ft)
3" Bedding un er tank. I 82760
Alarm Manuafacturer IS. J. Electro Systems
Alarm Model Number I 101 HW
Pump Manufacturer JGoulds
Pump Model Number PE 51
Pump Must Deliver 20.60 gpm at 27.22 ft TDH
Project: Todd Marek 4 bedroom Mound system Page 4 of 8
Mound System Maintenance and Operation Specifications
Service Provider's Name Installed by Nelson Plumbing Phone 715- 273 -4444
POWTS Regulator's Name r St. Croix County Zoning I Phone 715 - 386 -4680
System Flow and Load Parameters
Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L
Septic Tank Capacity 1200 gal Maximum TSS 150 mg /L
Soil Absorption Component Size 600 ft Maximum FOG 30 mg /L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL
Service Frequency
Septic and Pump Tank Inspect and /or service once every 3 years
Effluent Filter Should inspect and clean at least once every 3 years
Pump and Controls Test once every 3 years
Alarm Should test month)
Pressure System Laterals should be flushed and pressure tested every 1.5 years
Moundl Ins ect for ponding and seepage once every 3 ears
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code.
3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Lateral Turn -up Detail
Finished ...............
Grade
6 -8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Lateral
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Todd Marek 4 bedroom Mound system Page 5 of 8
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its'
component manuals (SBD- 10691 -P (N.01101) and SSWMP Publication 9.6 (01/81)) and Vocal or state rules pertaining to system
maintenance and maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access
openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,
defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an
effective locking device to prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic
tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be
assessed at least once every 3 years by inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions
are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm,
the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending
continuous alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of
when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such
products are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent filter is installed within the tank lt shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for
vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the
mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the
mound be heavily mulched as protection from freezing.
Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30
mg /L BOD 30 mg /L TSS, 10 mg/L FOG, and 10" cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design
flow specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be
flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test
when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution
within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any
levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in
proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately
repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or
replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal
media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Project: Todd Marek 4 bedroom Mound system Page 6 of 8
�(6, GOULDS PUMPS Su bmersible
Effluent Pump
J
PE
SPECIFiG1T m MOTOR FEATURES
Purnp — General: General: ■ Corrosion resistart
• Discharge: 1'A" NPT • Single phase construction.
• Temperature: 104 °F (4M • 60 Hertz 8 Cast ;ron body.
maximum, continuous when • 115 volts ■ Thermoplastic impeller and
fully submerged. • Buih -in thermal overload pro- cover.
• Solids handling: V tection with automatic reset ■ Upper sleeve and lower
maximum sphere. • Class B insulation. heavy duty bail bearing
APPUCATMS • Automatic models indude a • OiWHIed design. construction.
float switch. • High strength carbon steel ■ Motor is permanently
Specially designed for the • Manual models availlable, Shaft lubricated for extended
fadlowing uses: • Pumping range: see PE31 Motor: service life,
• Mound Systems performance dart or curve. • .33 HP, 3000 RPM ■ Powered for continuous
• EffluenWosing Systems PE31 Pump: • 12.0 Maximum amps operation.
• Low Pressure Pipe Systems • Maximum capadty: 50 GPM • Shaded pole design ■ An ratings are within the
• Basement Draining • Maximum head: 25' TDH PE41 Motor. worldrg limits of the motor.
• Heavy Duty Surro PE41 Pump: • .40 HP, 3400 RPM ■ Quick disconnect power
Dewatering • Maximum capacity. bo GPM • 7.5 Maximum amps cord, 20'standard length
• Maximum head: 29' TDH • PSC design heavy duty W3 SJTW with
NEMA 5.15P, three prong,
PE51 Pump: PE51 Motor 115 volt grounding plug.
• Maximum capa&y: 70 GPM • •50 HP, 3400 RPM O Complete unit is heavy duty,
• Maximum head: 37' TDH • 9.5 Maximum amps portable and compact.
METERS FEET • PSC design ■ Mechanical seal is carbon,
40 ceramic, BMA and stainless
....._ ...:...:.....
s t .. r,�ooel s: rat, rfa+. PES�
i .....
35 Nk d3, . as, so ■Stainless steel fasteners.
i
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2 GPM AGENCY U5 KS
.. i 4 A r• i ..,.. -4 1 Fr ,. .4..1.
25 t CM us
- 1 i 1._ 1. i ; -JAY.. J- 1 - •
20 J
q. i r i
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I l i i......r. a..
Tested t0 UL 778 and
.. }.._ t 3.. � . _ CSA 22 106 Sbffd"
..
... r' T" GWWPuerpsiS1509001Bl WAVIN&
0 L 0 0 10 2 30 40 50 60 ' TO GPM so
p 4 v e- ,
0 5 6G 10 15 rnj� Gwids Rimp5
CPPACITY
C' 2002 G Dvmps 61
Effclire NoRmde., 2002 <k ITT Industries
BPf31 /4'
Todd Marek
P.O. Box 228
New Richmond, WI 54017
NE%,NE%, S 35, T30N, R 18 W 1 •
Sunset Hollow Lot # 1
Richmond Township
SG Croix County
Scale 1 " = 40'
Weiser 12001800 tank
BM #1= 100.00' top of 1 "PVC pipe
BM #2 = 100.65' top of % "PVC pipe
150' of 2 "force main
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Page 8 of 8
LEVED �?
1370
Wisconsin Department of Co mere S IL EVALUATION REPORT Page 1 of 3
Division of Saf ety and Buildi s ce wi Comm 85, Wis. Adm. Code Steel Soil Service
S County
Attach complete site pl on papeches n size. Plan must St. Croix
include, but not limited t . imensnsno BM), direcction and
percent slope, scale or dio, rth arrow, and location and distance to nearest road. Parcel I. D.
Pending
Please print all information.
eview y Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
R.J.C. Development, Inc. Govt. Lot na NE 1/4 NE 1/4 S 35 T 30 N R 18 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1868 CT Hwy " C " 1 na Sunset Hollow
City State Zip Code Phone Number _j City _j Village a Town Nearest Road
Somerset WI 1 54025 651 -488 -3051 Richmond 1 130Th Ave.
0 New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement _I Public or commercial - Describe:
Parent material Benches and large drainageways of ground moraines. Flood plain elevation, if applicable na
General comments
and recommendations: Mound Design, system elevation101.60ft based on contour line elevation 100.60ft. Minimum 2" If
ASTM C33 sand.
Boring # _I Boring 3
01 Pit Ground Surface elev. 101.20 ft. Depth to limiting facto ' pr. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -10 10yr3/2 none sit 2msbk mfr cs 2f .5 .8
2 10 -24 10yr4/4 none sicl 2msbk dfr gw 1vf .4 .6
3 24 -38 7.5yr4/4 none Is osg mvfr gw na .7 1.2
4 38 -72 5yr4/4 none set om mfr na na .0 .0
'AR ZG i—o u ( -�
4a LAA 01
`vHs s D
Boring # I Boring
bpi Pit Ground Surface elev. 101.20 ft. Depth to limiting factor 64 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -10 10yr3/2 none sil 2msbk mfr cs 2f L.4 .8
2 10 -27 10yr4/4 none sicl 2msbk dfr gw 1f .6
3 27 -64 7.5yr4/4 none sl 2msbk dfr gw 1vf .9
4 64 -80 5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0
* Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L
CST Name (Please Print) Signature: / CST Number
David J. Steel c' 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 11/10/2003 715 - 246 -5085
'
I LOT _3, C.S.M. N.' An of thi NE 114 - --- TED LANDS Right
18 VOL. _9, P — — — —t S89'49'4 ° E 2606.6 — — Cent
S89'49'43"E - -- 966.32' r
- - - - -- - 4 TH --- - AI/ENUE-_- - - -
- 208' - _ ►v �v 355
C5 \
3 \ "'79 240 sq. ft. \ N \
1.82 acres
o �
-82,410 sq. ft. v 1 I I I t t
z I 1.89 acres
Q\ \ 308' I o
of
It
I 280' \ cn . ►- \ o \
z
71,002s
q. ft. ` \ h \
s / �o ,� �- \ o 1.63
i h , .LOT
,79, 060 sq. ft.' ' N l / 275' 1
1.81 acres
LOT 7
`
288 : 1 N ' Tr - 74,251 sq. ft. N
1.70 acres\
\:
\
\ t _ _ \
\ \ h \ \ : \ 275
\ o LOT 3 - N \ 190' \ 190'
\ 0 w \79,J19 sq. ft.
\ ° r ° X1.82 acres o \ \\
-IN
N\,
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
owner/Buyer F) n JL 12 GS
Mailing Address g o X Z 2 S 1 J& W
Property Address Z. ±
(Verification required from Planning Department for new construction)
City/State Parcel Identification Number 6 0
o2G - I /�2 o /- o�al.�3loZ.)
LEGAL DESCRIPTION I property Location 11L�. V4, V4, Sec. 3�T N -R�W, Town of -V0
Subdivision u ^� �� I� LA-) . Lot # _
Certified Survey Map # . Volume . .Page #
Warranty Deed # g d -;�, 73 5- . Volume - 2- � Page # .�.•
Spec house 0 yes ❑ no Lot lines identifiable 50 yes ❑ no
SYSTEM MAINTENANCE
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.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
mastCrplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal 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.
Uwe, 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 Zoning Office within 30
days of the three year expiration date.
a� �r
SIGNATURE OF APPLICANT DATE
OV44ER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner($) of
the pr operty described above, by virtue of a warranty deed recorded in Register of Deeds Office.
91 qt� O p
l I/ 115
SIGNATURE OF APPLICANT DATE
** * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department."""
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
i
i i
U 2 8 6 9 P 14 1 63 03735
XATHLEEN H. WALSH
State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS
WARRANTY DEED ST. CROIX CO., WI
Document Number Document Name
RECEIVED FOR RECORD
08/17/211105 02 : 86P)l
WARRANTY DEED
Eiil_ 1 #
THIS DEED, made between RJC Development. Inc.
REC FEE: 11.00
( "Grantor," whether one or more), TRANS FEE: 363.00
and Todd Marek COPY FEE:
CC FEE:
PAGES: 1
( "Grantee," whether one or more).
Recording Area
Grantor, for a valuable consideration, conveys and warrants to Grantee the following p �
described real estate, together with the rents, profits, fixtures and other appurtenant Dav d J. Estreen W `
interests, in St. Croix County, State of Wisconsin ( "Property") (if more space 304 Locust Street
is needed, please attach addendum): Hudson, WI 54016
Lo 1, and 17, Sunset Hollow. St. Croix County, Wisconsin.
026- 1.099 -60- 050: 026- 1099 - 10-000
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated RJC Development, Inc.
(SEAL) r`-' (SEAL)
* *By John H. Carlson
(SEAL) (SEAL)
* s
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) RJC Development, Inc.
By: John H. Carlso STATE OF )
authenticated ) ss.
J�&� COUNTY )
%ristina Qgland Personally came before me on ,
TITLE: MEMBERISTATE BAR OF WISCONSIN the above -named
(If not, to me known to be the person(s) who executed the foregoing
authorized by Wis. Stat. § 706.06) instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
*
Attorney Kristina Ogland Notary Public, State of
Hudson, WI 54016 My Commission (is permanent) (expires: l
(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 0 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003
` Type name below signatures. INFO -PROTM Legal Forms 800 -655 -2021 www.infoproforms.com
{
SUNSET HOLLOI
(A COUNTY PLAT)
Located in ,Dart of the Northeast 114 of the Nor
of the Southeast 114 of the Northeast 114 of Sec
North, Range 18 West, Town of Richmond, St Crc
nor North line of
1 - I LOT 3 , C.S.M. - the NE 114 I LOT 7, C. S.M_
�m VOL. 13, PG. 3712
VOL. 9, PG. 2551 ------ - - - - --
- - - -- _ - - - -- - - - - - - - -- -
Cente - _ - S89'49'4 "E 2606.6 =
w S89'4943 "E 966.32'
4,3 "E 34.54' S89'55'11 "E 130TH A VENUE ° j 933
- 207.56' • 66.00' 354.80'
• _�' 659.81'
1036.35 #' S00'04 - 49 "W
N00'04'49 " 9 E P. > 21.59'
21.59'
33
............ . . 33 .. ......... LL•OT 5 .............. w ..........
LQ Z w =+
79,240 sq. ft.
CA , 8 ft. �• 1.82 acres 00 0 D
N 1.89 acres °' W
L.B.O.-102J.0' N °
�W N S89 5"E
307.85'
12.E 00' 1 > p C
N711 4 0.40* O? >
Droln e K 4 0 . q
to .SB94915 E •� > d? p
g EOSe/fl en t :k 1 Bp' i Oo
gg• '1 .'� L ' • N
�
Ila
i LOT m o
H. WE
_ • N
1019 0 8� i1�295'� r w N1 71,002 sq. ft. o O
g N "Z2 IE 1.63 acres o
NJ
SM 6 6' 0 C."
OD
cD 4a
N I
LOT 2 N w §89'49'15 "E
cn
0 79, 060 sq. ft. -- 275.00
o ,
1.81 acres Ln
L. B. 0. =1023.0'
o
N N
§89'49'15 "E 288.24' 1 o I o LOT 7 0 0
RECEIVED
! 1370
Wisconsin Department of ' mere O V 13 2003
S IL EVALUATION REPORT Page I of 3
Division of Safety and Buildi s in accordance wi Comm 85, Wis. Adm. Code Steel So il Service
ST. CROIX COUNTY" County
Attach complete site pl on pape7(i �1 inches n size. Plan must St. Croix
include, but not limited' . BM), direction and
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D.
Pending
Please print all information, eview y Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
R.J.C. Development, Inc. Govt. Lot na NE 1/4 NE 1/4 S 35 T 30 N R 18 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1868 CT Hwy " C " 1 na Sunset Hollow
City State Zip Code Phone Number J City _I Village 01 Town Nearest Road
Somerset I WI 1 54025 651 - 488 - 3051 Richmond 1 130Th Ave.
Id New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement _ I Public or commercial - Describe:
Parent material Benches and large drainageways of ground moraines. Flood plain elevation, if applicable na
General comments
and recommendations: Mound Design, system elevation 1 01.60ft based on contour line elevation_ 100.60ft. Minimum 2" f
ASTM C33 sand. ��
FE 16 Boring # .1 Boring 3
Pit Ground Surface elev. 101.20 ft. Depth to limiting factor ' gr Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2
1 0 -10 10yr3/2 none sil 2msbk mfr cs 2f .5 .8
2 10-24 10yr4/4 none sicl 2msbk dfr gw 1vf .4 .6
3 24 -38 7.5yr4/4 none Is osg mvfr gw na .7 1.2
4 38-72 5yr4/4 none scl om mfr na na .0 .0
Boring # I Boring
1/ Pit Ground Surface elev. 101.20 ft. Depth to limiting factor 64 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0 - 10 1Oyr3/2 none sil 2msbk mfr cs 2f .5 .8
2 10 -27 10yr4/4 none sicl 2msbk dfr gw 1f .4 .6
3 27 -64 7.5yr4/4 none sl 2msbk dfr gw 1 of .5 .9
4 64 -80 5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0
Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD S30 mg /L and TSS < 30 mg /L
CST Name (Please Print) Signature: / CST Number
David J. Steel �/ 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 11/10/2003 715- 246 -5085
Property Owner R.J.C. Development, Inc. Parcel ID # Pending Page 2 of 3
F Boring # Boring
1I Pit Ground Surface elev. 98.50 fl. Depth to limiting factor 24 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Mm-
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -9 10yr3/2 none sil 2msbk mfr cs 1 f .5 .8
2 9 -24 10yr4/4 none sic[ 2msbk dfr gw 1vf .4 .6
3 24 -32 10yr4/4 f2d 7.5yr5/6 sicl 2msbk dfr gw na .4 .6
4 32 -60 5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0
F-1 Boring # Boring
I
Pit Ground Surface elev. fl. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # I Boring
J Pit Ground Surface elev. fl. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Court. 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
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel 1564 Cty Rd GG
CST - POWTSM RJC Development Co. New Richmond,WI 54017
Lic. 4248956 NE1 /4,NE1 /4,S35,T30N,R18W Bus.(715) 246 -6200
Town of Richmond, St. Croix Co. Fax .(715) 246 -9372
Sunset Hollow, Lot 1
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your
use. The location of this test may or may not be as shown, as permanent lot lines were not established at
the time the soil test was conducted. Legend
1 " =40'
= Benchmark Ele. 100 t
p of 1/2" pvc pipe
• = Alt Benchmark Ele. 10 0.65Ft
op of 1/2" pvc pipe
❑ = Borings
Boring Elevations
B 1 = 101.20Ft
B2 = 101.20Ft
B3 = 98.50Ft
73 3 9 ,�// � i B4 = OO.00Ft
1 -311 5f
d
0 ho 6�
e
1 LOT 3, C.S N.' line of j1h NE 114 --PLATTED LANDS Right
18 VOL. _9, PG. 2551 5894 9 '4 3 ° E 2soss -- _ _ cenr
S89'49'43"E 966.32' �o _
- - -- vENVE ---
-A - - -
- — ~ =208'
-_ T
cn �� -- ►v o
O
\ 33 x `79, 240 sq. ft.
` — \ 1
_'1.82 acres
o� 82, 410 sq. ft.
z i 1.89 acres
Q I - 308' 1 I I
° I
of
C I 280'
\� tv \ 71,002 sq. ft.
/ ry a �� �_ \ Co 0 \ 1.63 acres
h LOTR� -t" / I
N ,79, 060 sq. ft.- - / 275' /
� J 1.81 acres
LOT 7
\ \�
288' - 1 N T 74, 251 sq. ft.
1.70 acres \ \
\ h \ \ ' \ 275'
\ o LOT 3 :` N ••. \ 190' \ 190'
\ o �79319sq._ft. -
\ ° �\ _1 82 acres