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HomeMy WebLinkAbout026-1172-05-000 Wi nsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Sa ty and Building Division INSPECTION REPORT Sanitary Permit No: 488186 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal ir&nnation 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 -05 -000 CST BM Elev: Insp. BM Elev: I BM Description: Section/Town /Range /Map No: /ap Q) GS 35.30.18.1366 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE CAPACITY STATION BS HI FS ELEV. Septic Benchmark ` Dosing � l gOv Alt. BM J 3 Z AeraHert Z , Bldg. Sewer ZO '73-17 o Ing Ysa� /4 t t In a TANK SETBACK INFORMATION t utet \ TANK TO P/L WELL BLDG. Vent o it Intake ROAD Dt I ep Ic 2- 1 IJW- 5 1 , '51 1 B ottom l k. D? $j . osing / N IA-- 5 t , S 1 ea er an. J (. B c? ` 4Z 2-) R .J era Ion Dist. F o Ing Bo t. bystern 4.,04 s• X7.0 - 7 Ina ra e PUMP /SIPHON INFORMATION m anufacturer & GPM n over �t 1 ' • t 95'. 3 model um er 2� •�\ 4.3? 9 $l IC10 /. LOSS ys i t, $Z m 3 9§07 /�� r z// J�A Cn�.d -cx,r (p•�T7 x'7.5 DIMENSIONS INFORMATION CHAMBER OR UNIT c 1 Length �' Dia t/ t Length S4 Dia Spacing x Pressure Systems Only xx Mound Or At -Grade Systems Only Bed /Trench Center / lBedrFrench Edges \ Topsoil ' A-. ? es 11 No s _I No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / 3/ / Inspection #2: Location: 1395 130th Ave Unknown (NE 1/4 NE 1/4 35 T30N R18W) Sunset Hollow Lot 5 Parcel No: 35.30.18.1366 1.) Alt BM Description = r ` �a i'� "'t 2.) Bldg sewer length - amount of cover Plan revision Required? ] Yes > No T Use other side for additional information. $ •3 � - �}�� Nb _� — �nsepcto SBD -6710 (R.3/97) I I Safety and Buil ( to be gs m m 201 W. Washington ve., x 7Ib� - t Croix �scons�n Madison, 537 - 62 Sani r b acrnit Nu filled in Co.) Department of Commerce (608 AY �� State P a Num er �� Z Sanitary Permit Apphca o s f , (j_ . In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Z may be used for secondary purposes Privacy Law, sl5.04(1)(m) ddress (if different than mailing address) I. Application Information - Please Print All Information 1 � ]� Property Owner's N y e Parcel # Block # 7 l�/ Todd Marek l/ - 5 \ 5 Property Owner's Mailing Address Property Location PO Box 228 NE v. NE y, Section 35 City, State Zip Code Phone Number New Richmond, WI 54017 T N; R r,[cirelf one) /, 13 (o(o H. Type of Building (check all that apply) OK CL5 w6M i l 1 or 2 Family Dwelling - Number of Bedrooms 4 Subdivision Name CSM Number ❑Public/Commercial - Describe Use Sunset Hollow ❑ State Owned - Describe Use to / M 16 o y CL []City_J]Village Township of Richmond III. Type of Permit: (Check only one box on line A. Complete Hue B if applicable) bZ _ /✓ -7Z _ A ' IJ New System ❑ Re System y ep y ❑ Treatment/Holding Tank Replacement Only 0 Other Modification to Existing System B. ❑Permit Renewal 13 Permit Revision 13 change of 11 Permit Transfer to New List Previous Permit Number and Date Issued � Before Expiration Plumber Owner IV. Type of POWTS System: Check all that a o ❑ Non - Pressurized In Ground ❑ Mound ? 24 in. of suitable soil ® Mound < 24 in. of suitable so il ❑ At -Grade ❑ Single Pass Sand Filter 13 Constructed Wetland Q Pressurized In- Ground Q Holding Tank Q Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filt ❑ / Recirculating Synthetic Media Filter ❑ Leaching Chamber .33 Chamber 13 Drip Line 13 Gravel -less Pipe 13 Other (explain) = V. Dispersalff restmcut Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area oared (sf) Dispersal Area Pro ed (sf) System Elevation 600 � 0.4 ✓ 600 p 600 1500 0 , F . VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units // Concrete Constructed Glass New Existing Tanks Tanks !✓ 1 aloc.� A 100 septic or Holding Tans` 1200 1200 1 Wieser x Aerobic Treatment Unit Dosing Chamber 800 1800 11 1 Wieser x VII. Responsibility Statement- I, the undersigned, tame responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Sign MP/MPRS Number Business Phone Number Roger Nelson MP226497 715- 273 -4444 Plumber's Address (Street, City, State, Zip 122 East Summit Avenue Ellsworth, Wl 54011 VIII. Coun /De artment Use On pproved sapprov Sanitary Permit Fee (includes Groundwater Date su Issuin gent Si o S Surcharge Fee) C C x 5 ✓ 7 / ven Reason for ial IX. Conditions of Approval/Reasons for Disapproval 3 � ^ J'\ �� SYSTEM OWNER: l� 1�-,J o Lj O QA- 'M '" o` 1. Septic tank, effluent filter and ��� 11-0 �� dispersal cell must all be.servit:es / maintained P as per management plan provided by plumber. 2. AN setback requirements must be maintained . �, 66 v i i a A,5 ' ^ 5�``� d �2 as per applicable code / ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 z 11 inches in size SBD -6398 (R. 01/03) • 7 • Todd Marek P.O. Box 2 29 New Richmond, WI 54017 NE %,NE%, S35, T30N, R 18 W N Sunset Hollow Lot # 5 Richmond Township St. Croix County Scale 1 " = 40' Weiser 12001800 tank C �� G� BM #1 = 100. 00'top of Y "PVCpipe Q , 2 BM #2 = 99.30' top of % "PVC pipe 3 25' of 2 "force main a S� 63 s � o a a � b 0 5• 0 D y I Page 8 0 rg i Todd Marek P.O. Box 228 New Richmond, WI 54017 NE%,NE%, S 35, T30 N, R 18 W 1 • Sunset Hollow Lot # 5 Richmond Township St. Croix County Scale I" = 40' Weiser 12001800 tank BM #1 = 100. 00'top of % "PVCpipe g, Qrh l BM #2 = 99.30' top of % "PVC pipe , 3 25' of 2 "force main �l as B3 r' a C� b' 5 o t� \ R 4 WELL /V aed ooh � •O�t Ste. ` Page 8 0 r8 L oT 13 Safety and Buildings r 4003 N KINNEY COULEE RD commerce.wi.gov LA CROSSE WI 54601 -1831 ■ TDD #: (608) 264 -8777 seons nw.co www.wisconsin.gov mmerce.wi.gov /sb/ i Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary May 10, 2006 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: 05/10/2008 Identification Numbers Transaction ID No. 1268242 SITE• Site ID No. 712541 1. Todd Marek Please refer to both identification numbers, 130th Avenue above, in all correspondence with thew enc . Town of Richmond St Croix County NEIA, NEIA, S35, T30N, R18W Lot: 5, Subdivision: Sunset Hollow FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1074554 Maintenance required; 400 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -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, 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 enclosed approved plans and with the component manual(s) referenced above. • 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. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. 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. • 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. P.O.W.T.S. Conditionally P P R Off' E D 1 pp— ROGER D NELSON Page 2 5/10/2006 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - 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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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 $ 100 0.0 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633' jerry.swim@wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 O MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE s 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 / 3 o - Ave„ a. Legal Description: NE 114, NE 1/4, S 35, 30, N R 18 W Township: Richmond County: St. Croix Subdivision Name: Sunset Hollow Lot Number. 5 Block Number. Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry ,,I�� Page 3 Mound drawings Page 4 Lateral and dose tank MAY r 1 ZDU6 Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications SAFETY & BUILDINGS Pa 8 Plot Plan Designer: Roger Nelson License Number: MP 226497 Date: 04 /28/06 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 -SRS (01/81) Version 4.0 (R. 04/03) C ur Cort,fA:_KCE Page 1 of 8 � ION OF SAFETY AND BUILDINGS E CGt iRES DEN CE 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 indies. 600.00 Design Flow (gpd) 5.00 Site Slope ( %) 97.50 Contour Line Elevation (ft) 20.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 1 50.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/f 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Diaribution Information network? Enter Y or N (c or e) a Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.50 Estimated Orifice Spacing (ft) = 11.76 t /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? �� Y �,,\\ 86.00 Pump Tank Elevation (ft) Enter Y or N l'V (jam 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) `� lJ 12.50 Vertical Lift (ft) 35782 5x Void Volume (gal) 0.40 Friction Loss (ft) 42.35 Minimum Dose Volume (gal) 19.40 Total Dynamic Head (ft) 21.01 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x x 1.00 x x 1.50 x 1.25 x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallonslinch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser 800 - 325-8456 Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effl Fitter in formation 800.001 Dose Tank Capacity (gal) Zabel 1- 800 - 221 -5742 Filter Manufacturer 22.241 Dose Tank Volume (gallin) IA100 Filter Model Number Weiser IManufacturer Project: Todd Marek 4 bedroom Mound system Page 2 of 8 Mound Plan View T 1110 8 .. .. . -;� ; • J .. .Ot�servation Pipe K ... L•S• •4 L S S • S • , L • ' y ' _ r�r:•.,•�l.r {���{ • � ' {1ri�.r�l�J:��l��.r:r.l.�J�:J. ' • .r.r; ' • ,�L• .. + .. + 5 ... •. :. A r•. •v r ` :r J • • .l': :r•1.1•l� • +1 +. •r +. •J•r•+ J r•r • { r r r r r :•: l.ffl:l �l• _ A& • + •B. . . . -r .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L Mound Component Dimensions Down slo toe extension made. A 10.00 ft E 22.00 in H Aft ft K 10.00 ft B 60.00 ft F 9.00 in 1 ft L 80.00 ft D 16.00 in G 0.50 it J ft w 31.74 600.00 (ft Dispersal Cell Area 1 1500.00 (ft Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 1 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.58 (ft) ---► H � f /rfrflr/ p f /!r /lrf.. G F ::: Dispersal Cell .... r 99.33 (ft) Lateral = : 98.83 (ft) —10 — Invert Dispersal Cell ; : : :: t D .. .. .. ..... .. Iv . .. . ..... ... E e atlon - ' 4 X 4 4 97.50 (ft) Contour Elevation 5.0 %Site Slope Geotexxtile Fabric Cover Shading Key $, T Dispersal Cell See lateral details on Topsoil Cap a 1.5 ft .• • Page 4 for number, size, •J J J;r•1 r • r!!!/ Subsoil Cap 5 • � • r::•: and spacing of laterals. ASTM C33 Sand .o r J; J•Jr• +: • r �, : r F Laterals are equally ® Tilled Layer m 0.5 ft Typical Lateral spaced from the Q r• rti: L Aggregate .� r'•f:jsj� �';iyrL:`ryr distribution cell's *_ A �!� centerline in the distribution cell (AxB). Project: Todd Marek 4 bedroom Mound system Page 3 of 8 End Connection Lateral Layout Diagram Cenw the taterals over the A t, 13 dimension •- Turn -up wf boll vslvo or of plug P _ All laterals are iderxical IE X --- � th aces drilled on the bottom of e lateral s equally sped laterals 6 force main of PVC Soh 40 S (pet COP~ Table 84.30 -5) Forty main cotwwation via tee of cross to mar�oid at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.00 in Orifice Spacing (X) 3.66 ft Lateral Length (P) 58.56 ft Orifices per Lateral 17 Lateral Spacing (S) 3.33 ft Orifice Density 11.76 ft Lateral Flow Rate 7.00 gpm Manifold Length 6.67 ft System Flow Rate 21.01 gpm Manifold Diameter 1.25 in Total Dynamic Head 19.40 ft Forcemain Velocity 2.15 ft/sec Dose Tank Information Locking cover with warping label and locking device and sealed watertight Electrical as per NEC 309 and —^--► Disconnect Comm 16.28 WAC 4 in. min. Tank component is property vented y MForomemain Alternate outlet location diameter Weiser 800 - 325 -8456 Manufacturer 2 in. Capacityl 800.00 Gallons Volume 22.24 gal/inch A Weep We or anti - Dimension Inches Gallons B siphon device A 22.07 490.77 B 2.00 44.48 C Pump off _ elevation (ft C 1.90 42.35 86.83 D 10A0 222.40 D Total 35.971 800.00 ta nk elevation ft 3" Bedding uncTer tank. 1 86.00 Alarm Manuafacturer IS. J. Electro Systems Alarm Model Number 110 1 HW Pump Manufacturer JGoulds Pump Model Number PE 41 Pump Must Deliver 21.01 gpm at 19.40 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- 2734444 POWTS Regulator's Name St Croix County Zoning 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 fe 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 monthl Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound lns for ponding and seepage once every 3 years 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 Tum-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 for 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.01/01) and SSWMP Publication 9.6 (01181)] and local 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 kxger 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 shag be sealed watertight upon the completion of service. Any opening deemed unsound, de%c ive, or subject to failure must be replaced. Exposed access openings greater than 84nches 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, Slats. The contents of the septic tank shag be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter Shea be assessed at least once every 3 years by inspection. The outlet fitter 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 fitter when removed from its enclosure. If the fitter is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent fitter &terms may indicate surge flows or an impending continuous alarm. The septic tank shag have its contents removed when the volume of sludge and scum in the tank exceeds 113 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. Ail switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shag be inspected and serviced as necessary. Mound and Pressure Distribution Svstern 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 serration 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 BODY, 150 mg/L TSS, and 30 mg1L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg& FOG, and 10 du110() 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 dogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal con shall be checked for effluent poding. Pooling levele shag be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency 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 some 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 W 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 POW TS regulator and service provider. Project: Todd Marek 4 bedroom Mound system Page 6 of 8 L@1 GOULDS PUMPS Submersible Effluent Pump PE > mom W►ln►l1s Pmp _ GwWal: General: t Corrosion resistant • Discharge: I'A" NPT • Single phase construction. • Temperature: 104 °F (4WQ • 60 Hertz ■ Cast icon body. M ntinu um, continuous when • 115 volts a Thermoplastic Opeller and fully submerged • INA-in thermal overbid pro- cover. • Solids handling: V" tection with automatic reset- ■ Upper sleeve and lower maximum sphere. • Class 8 insulation. heavy duty bail bearing • Automatic models include a " 011 -14led design. construction. APPLICATIONS Roth switch. • High strength carbon steel • Motor is permanently Speciahy designed for the • Manual models available. shah. lubricated for extended Wowing uses: • Pumping range: see PE31 Motor, service life, •Mound Systems peftmanoe cl art or cwve. • .33 HP, 3000 IPM a Powered for carKnnu+us • lNuenOosing Systems PE31 Pump: • 12.0 Maximum amps operation. • hoer Pressure Systems • Maximum capacity: 50 GPM • Shaded pole design ■ AN ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor. working limits of the motor. • Heav}• Duty Sump) PE41 Pump: • .40 HP, 3400 RPM • Quick disconnect power fereglh, Dewatering • Maximum capacity. 60 GPM • 7.5 Maximum am card, 20' standard amps card, duty 1W3 d ten with • Maximum head: Z9' TDH 9n NEMA 5-1 SP, !free prong, PES1 PMOW PE51 Motor: 115 volt grounding plug. • Maximum capadty: 70 GPM • .50 HP, 3400 RPM to Complete unit is heavy duty. • Maximum head: 37' TDH • 9.5 Maximum amps portable and compact. • PSC design a Meftnical seal is carbon, METERS FEET ceramk RM and stainless 3 , ' AoW)M$-* M31, F'E4 P!S steel. " aa, .4D, -so ■Stainless Steel fasteners. 35 x, r h 0 < + } —► 2 GiM ; �- r A�SOXY LISTINGS r • ..t..F.,r. . {..-.- r•- r ♦ -_!.. _ s +—+ - 1 .. a .. !.. i...;... .... .. -4--i­ ­4­ _i ........ .. CO l u 5 • t — - _. ...... , ... j .._... t ..._.. Tinted b UL M and k3 t -? i• 7 1 { �.�� �� a r r 7. # . �• t t a' 1h Ca wdm slan�ardr ArAOaatlr. T.. �.. _.,.. i .�-..�..t. ..�.. . r * ,.. r .,.- .•a.. rioakltlrnupsblS09001 M9Erf;rMl. 10 _ ,. �..,...; .. ,_. ,...,... ,...� T .,....... _t s.. . i 0 L 0 0 10 2 30 40 50 ti0 ' 70 GPM 80 '9e 0 5 10 15 mat Goulds Pumps 2l •Ol CAPACITY �+ 2002 Gouts Dvmps Efr4cdve hov*MW, 2002 ITT Industries svesria� s RECEIVED 1374 Wisconsin Department of Com I rce N 0 V 13 2003 SOI EVALUATION REPORT Page 1 of 3 ��U ST. CR�I Division of Safety and Building rdd � County with omm 85, Wis. Adm. Code Steel Soil Service • Attach complete site plan n3(kW9V%Q%FxlCM&ches in ize. Plan must St. Croix include, but not limited to: verlical ano nonzomal rere r ) direction and percent slope, scale or dimensions, arcel I.D. sions, north arrow, and location and distance to nearest road. Pending Please print all information. viewe Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ` 5/ 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 Property Owner's Mailing Address Lot # Talk # Sutxi. Name or CSM# 1868 CT Hwy " C " 5 na Sunset Hollow City State Zip Code Phone Number J City J Village r/' Town Nearest Road Somerset I WI 1 54025 651 -488 -3051 Richmond 1 130Th Ave. 16 New Construction Use: iM Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD I Replacement J 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 98.83 ft based on contour line elevation 97.50 ft. Minimum' of ASTM C33 sand. 0� a Boring # J Boring d Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 48 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -15 10yr3/2 none sil 2msbk mfr cs 2f .5 .8 2 15-48 10yr4/4 none sicl 2msbk mfr cs 1f .4 .6 3 48 -72 5yr4/4 c2d7.5yr5/6 scl om mfr na na .0 .0 Z t Boring # J Boring u e Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 20 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftT in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2 1 0 -10 10yr3/2 none sil 2msbk mfr cs 1f .5 .8 2 10 -20 10yr4/4 none sicl 2msbk dfr gw 1vf .4 .6 3 20-48 5yr414 c2d7.5yr5/6 scl on) dfi na na .0 .0 * Effluent #1 = BOD 5 > 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) Sig ature: - 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 P f r R.I.C. Develo ment Inc. Pendin P age 2 0 3 P Ow e P Parcel ID # 9 9 IT] Boring # J Boring 1�' Pit Ground Surface elev. 95.60 ft. Depth to limiting factor 21 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3/2 none sil 2msbk mfr cs 2f .5 .8 2 9 -21 1 Oyr4 /4 none scl 2msbk mfi gw 1 of .4 .6 3 21-48 5yr4/4 c2d7.5yr5/6 scl om mfi na na .0 .0 F] 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef1#1 *Eff#2 F-1 Boring # I Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD s30 mg /L and TSS S30 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. i 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. #248956 NE1 /4,NE1/4,S35,T30N,R18W Bus.(715) 246 -6200 Town of Richmond, St. Croix Co. Fax.(715) 246 -9372 Sunset Hollow, Lot 5 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. 100.0017t Top of 1/2" pvc pipe • = Alt Benchmark Ele. 99.30Ft Top of 1/2" pvc pipe ❑ = Borings Boring Elevations B 1 = 98.10Ft B2 = 98.10Ft B3 = 95.60Ft B4 = 00.0 F YZW1 K �o7 �z ,5 Do � ��� X36 J)o1111 L3 3 S o�e f l y 4 ne_ x I rsignt— ui —rruv ( iuuii ✓ lC1L. 9, PG. 2551 C enterline -- -- — — — — 09 49'4 ° E 2606.6 -- — — — — n _ S89 49 - E 966.32' �o 130 _7H_ -_ - -A VENUE _ =208 '— N • � • N ---r— `355' — ,. f' -305� I N3 Q3 ON LOT 5 -� 33. 3 \ \ \ X79, 240 sq. ft. \ \ � "� h 1 LOTS 1.82 acres \ 1 `�I 78, 304 sq � � \� \ �• � \ \ \ 1 \ t 1.80 acrE L�T 1 f \ 1 1 1 1 / . �, Vii'\= 1 -82,410 sq. ft. 1.89 acres \� • v\ t ° \ \ I l I I i 1 0 / \ \ I I { J08 l ( , \ ` o l IN, \� j 1 - I i -_ � � � I 305 76,251 sq. -- 1-�T cre �+ \ o \ \ 1.75 a 280' - �' "� \ \ \ 1 _ 11 ►�, . 71, 002 s . ft. q 72,954 sq. ry a \ \ o o \ 1.6,3 acres \ `�' \ _l. 67 \ crn Joint LO T loll v 79,060 sq. ft. ° - N _ / // r 275 /� / I i i - 5 1.81 acres _N 76,251 s < l o ;SLOT 7�� \ ^° o 1.75 oc 288' 1 I N ' C '74, 251 sq. ft. \ N 1 1 N.B.A. = _ , \ 1.70 acres \ \ 72, 928 sq { \ 11.67 aci LOT 3 :_` �• Aso' '\ 190' v \79, 319 sq. ft. --- \ , -1.82 acres o \ IN, 6 1'9 9 4B S State Bar of Wisconsin Form 2 -2003 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI Document Number Document Name RECEIVED FOR RECORD 03/06/2006 11:20AN WARRANTY DEED THIS DEED, made between RJC Development. Inc. EXOPT Ii REC FEE. 11.00 ( "Grantor," whether one or more), TRANS FEE: 357.00 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 described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, tate of Wisconsin a If more ace Estreen & Ogland tY, (" m, ") (� p (� 11J is needed, please attach addendum): 304 L OCUSt Street Lots 5,10 and 11, Sunset Hollow. St. Croix County, Wisconsin. Hudson, WI 54016 6r) )-b 026- 1172 -05 -000; 026 -1172- 10-000: 026- 1172-11 -000 Parcel Identification Number (PIN) This is not homestead property. i (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way orrecord, if any. Dated 1/ RJC Development, Inc. r 1 SEAL (SEAL) * *By: John . Carlson (SEAL) (SEAL) * AUTHENTICATION ACKNOWLEDGMENT Signature(s) RJC Development. Inc. B : John H. Car STATE OF ) authenticated on ) ss. I K A I COUNTY ) *Kristine Qgland I I Personally came before me on , TITLE: MEMBER STA 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: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 • Type name below signatures. INFO-PRO" Legal Forms 800 - 655.2021 www.infoproforms.com SUNSET HOLLOW • (A COUNTY PLAT) part of the Northeast 114 of the Northeast 114 and part hecst 114 of the Northeast 114 of Section 35, Township 30 , ge 18 West, Town of Richmond, St Croix County, Wisconsin. Yne of LOT 7 , C. S. M . Northeast Corner I I 114 I - - - _ - -' - Sectlon 35 -30 -18 VOL. 13, PC. 3712 (found 718" rebar) I - � S89 49 4 E 2606.6 S89'49'43 "E 966.32' E _ 130TH A VENUE 933.37' 66.0 0' 354.80' -- 305.01' n 4�S00004'49 "W 659.81' 33' 33' P �" 21.59' 33 ► 3s Ir ............ . ... .........Lori$ N L'OT 5' ' I I 79, 240 sq. ft. � ° 78, 304 sq. ft. 0 I l. o to 1.82 acres ° 0 1.80 acres 0 � I Jbht DHv*woy N ; � Easement S89 5"E S89'49'15 "E F ; _ 307.85' 305.01' Ln I y T� a :A 0 ra,►o' o i • '- C5 co 2a06 •:,;4; :LOT6 NN I � --� n mo � o I R C .) ,,,I 71, 002 sq. ft. o 0 0 c �• �sT 1.63 acres Ct LOT 12 0 76,251 sq. fi. s I s rn 1.75 acres §89'49'15 "E 275.00' S89 5"E 305.01 N O I 0 -j N LOT 7 0 o LOT tl o I 3.24' z o 0 0 0 76,251 sq. ft. , 0 O ? 0 74,251 sq. ft. o o. 1.75 acres CS I n 1.70 acres ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buye (2n Mailing Address Q Q 2 /vim tCffll e N Property Address (Verification required from Planning & Zoning Department for new construction.) T City /State Parcel Identification Number - t')7k4 /zz, LEGAL DESCRIPTION Property Location 1116 1 /4 , Al C 1 /4 , Sec. , T .?C�N R 9 W, Town of Ae1Gh -iD 'qlD Subdivision S U AJ J. e4 C, L O "L," _ , Lot # Certified Survey Map # Volume , Page # Warranty Deed # / , Volume , Page # T Spec house no Lot lines identifiable (2�>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. 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms — Sl /V SIGNATURE OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) I� Parcel #: 026- 1172 -05 -000 05/17/2006 03:36 PM PAGE 1 OF 1 Alt. Parcel #: 35.30.18.1366 026 - TOWN OF RICHMOND Current ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 04/27/2004 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner - DEVELOPMENT INC O RJC DEVE RJC DEVELOPMENT INC 2028 100TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1299 H_ST SC 3962 NEW RICHMOND ' I SP 8020 UPPER WILLOW REHAB DIST /3 T5 30 SP 1700 WITC Legal Description: Acres: 1.820 Plat: 10/02- SUNSET HOLLOW 026/04 LOTS 1/17 SEC 35 T30N R18W PT NE NE BEING SUNSET Block/Condo Bldg: LOT 05 HOLLOW ('04) LOT 5 (1.820AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 35- 30N -18W NE NE Notes: Parcel History: Date Doc # Vol /Page Type 01/16/2004 751924 2493/129 WD 10/29/2003 745128 17/4640 CSM 07/18/2003 730816 2319/598 TD 07/23/1997 1238/544 TD more... 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/21/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.820 27,300 0 27,300 NO Totals for 2006: General Property 1.820 27,300 0 27,300 Woodland 0.000 0 0 Totals for 2005: General Property 1.820 27,300 0 27,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00