HomeMy WebLinkAbout026-1172-16-000 Wis4)nsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
' Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
515214 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Marek Todd R. I Richmond, Town of 026- 1172 -16 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
JD� Nt 1 6 35.30.18.1377
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
r
Septic y 6 / / z � Benchmark � 7Z
Dosing p 3 i Alt. BM t,6,, �.o ` '-Z- 9g , S
Aefal' ^ (� `� S Bldg. Sewer 9 11'. `7l0
�4 N cJ
Holding St/Ht Inlet
c
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO E P/� WELL BLDG. Vent to Air Intake ROAD Dt Inlet /lllf;J
Septic �-� (/t ^ '9 4 Dt Bottom 13. W, 32
Z
Dosing /Z5 / �� G � �� / Header /Man.
Aeration Dist. Pipe
Holding Bot. System -�z.
Final Grade ���� �7 .g7
PUMP /SIPHON INFORMATION 3 �S7
Manufacturer C Demand St Cov�rl �.O J �, Z . SZ ��•
GPM
Model Number /a/ / ZCr, 7Z f r 65
TDH L Friction Loss System Head EJ DH t
0 4 Ail 4.154
Forcemain Len Dia. Z Dist. to Well AJ4--
SOIL ABSORPTION SYSTEM
BED /TRENCH Width / Length No. Of Trenche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Dee t�
DIMENSIONS /d `a 4..JP
1.
SETBACK SYSTEM TO P/L [BLDG _ LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System: (P6 / /6L/ +A �� UNIT Model Number:
`, 60 , q `^ y V 4 —�
DISTRIBUTION SYSTEM
Header /Manifold Distribution 3 / x Hole Size / x Hole Spacing / Vemo Air Intake
Pipe(s) �!� T� ( t
Length Dia J Length �' Dia �' Z 5 Spacing �' ` 4 — )
SOIL COVER x Pressure Systems Only xx Moun Or At - Grade Systems Only G
Depth Over Depth Over ` xx Depth of xx Seeded /S dded xx Mulched
Bed/Trench Center 7 3 Bedrrrench Edges Topsoil 1 /1t Yes 0 No �es L No
COMMENTS: (Include code discrepencies persons present, etc.) Inspection t # / 1 / /S Inspection #2: ! !
Location: 1 (
3 128th Ave Ne Richmond WI 54017 SE 114 SE 1/4 35 T30N R1 8W Sunset Hollow Lot 16 Parce o: 35.30.1 .1377
1.) Alt BM Description = ' "'i 60 Z
2.) Bldg sewer length = rs 5aeK1s 1 t CD I yppy��
- amount of cover = /. 6�6du -s 40 va , CJ— ke.AA— +—
F ------ -- — --
Plan revision Required? rt Yes No q 131 I ►
Use other side for additional information. ___ —_ _ - - - - --
Date InTtore's ign re Cert. No.
SBD -6710 (R,3/97)
Ii
commerce.wl.gov Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162
i s co n s i n Madison, WI 53707 - 7162 Sanitary Permit Number o be filled in by Co.)
Department of Commerce E D T
5 2J
Sanitary Permit Application Transaction Number
In accordance with s. Comm. 83.21 2 Wis. Adm. Code submission of this form to the appropriate tal / �D
( ), overnmen
g
unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address)
submitted to the Department of Commerce. Personal information you provide may be used for secondary
ur oses in accordance with the Privacy Law, s. 1 5.04 1 (m), Slats. / / /Z µ�
I. Application Information - Please Print All Infor t' J / r
Property Ow is Name pEC,V Parcel # OZ
Property Owner's Mailing Address o Property Location /
Y_ z z DEC 200 t / /3 77
Govt. Lot 2
City, State Zip Code P QIj�COUNTY -' / <, /<, Section
N lt - VV (L 0A1 Q / P NNING8 ZONING OFFICE nn (circle one)
T(/N; R 18 EorW
II. Type of Building (check all that apply) Lot
�rl or 2 Family Dwelling - Number of Bedrooms Subdivision Name L
Block
❑ Public /Commercial - Describe Use t7K C►d
e ` ❑ City of
❑ State Owned - Describe Use CSM Number ❑ Village of
! -. 1 AT10wn of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A ' X-New System ❑ R System y p y ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain)
B. ❑ Permit Renewal El Permit Revision El Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner
IV. Type of POWTS System/Component/Device: Check all that apply)
4 r
❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade 9,Mound > 24 in. of suitable soil ❑ Mound < 24 in. itable oil 6 I
El Holding Tank 11 Other Dispersal Component (explain) ❑ Pretreatment evice (explain) . S q Fit
V. Dispersal/Treat ent Area Information:
Desi n Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required Dispersal) Area Prop os f) System Elevation
D v I k U i °b •
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units „ o
New Tanks Existing Tanks Q o 2
ti V)
Septic or Holding Tank
Dosing Chamber t i
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POW shown on t he attached plans.
Plumber's Name (Print) Plumber's Signature 9 MP/MPRS Number Business Phone Number
Plumber' Address (Street, City, State, Zip Code)
E C C-S6�L) w ( }CO(�
VIII. Count /De artment Use Onl
"I � Approved isap�'a $ Permit Fee Date sued l Issuing nt Signature
iven Reason 1 Z5 /Z 2 //401
IX. ConditiSiY Pk4Vd RleasonsforDisapproval 3) &A �'i 1 J�✓!< / � � r0 ✓�� � �ldvhtD•✓
1. Septic tank, effluent filter and V
dispersal cell must all be services / maintained
as per management plan provided by plumber.
Z. AN setback requirements must be maintained
Its pst apply" code / "Mm".
Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size
SBD -6398 (R. 02/09) Valid thru 02/11
263' street to BM 128th Avenue
Todd Marek
PO Box 228
New Richmond, WI 54017
Sunset Hollow lot # 16 Driveway
NE 1/4, SE 1/4, S 25, T 30 N, R 18 W
Richmond Township
St. Croix County
4 bedroom Garage
House
Scale 1" = 40' !-- 4a o` --jl
BM= 100' top of 1/2" pvc pipe o Well
BM2= 99.85' top of 1 /2" pvc pipe
It
b
I
Wieser
1200/800
tank ° B2 Z
e �Q Q
3 \°
I ' b B1
63 99.55'
0
M
97.45'
a�
s M to
96.25' �
0
y
t0
W
South lot line 230' Page 8 of 8
263' street to BM 128th Avenue
Todd Marek
PO Box 228
New Richmond, WI 54017
Sunset Hollow lot # 16 Driveway
NE 1/4, SE 1/4, S 25, T 30 N, R 18 W
Richmond Township
St. Croix County
4 bedroom Garage
House
Scale 1" = 40' I 4& �`-- -�
BM= 100' top of 1/2" pvc pipe o Well
BM2= 99.85' top of 117 pvc pipe
�Q
D
Wieser
1200/800
tank 0 B2 Z
1b. B1
B3 99.55'
0
M
'n 97.45'
C M
... to
° 96.25'
c
� o
fA
t0
uJ
South lot line 230 Page 8 of 8
� v
Safety and Buildings
PO BOX 7162
commerce MADISON WI 53707 -7162
Contact Through Relay
i sco n s i n www•commerce.wi.gov /sb/
www.wisconsin.gov
Department of Commerce
Jim Doyle, Governor
Richard J. Leinenkugel, Secretary
December 15, 2009
CUST ID No. 226497 ATTN: POWTS Inspector
ROGER D NELSON ZONING OFFICE
NELSON PLUMBING ST CROIX COUNTY SPIA
122 E SUMMIT AVE 1101 CARMICHAEL RD
ELLSWORTH WI 54011 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 12/15/2011 Identification Numbers
Transaction ID No. 1746071
SITE: Site ID No. 753621
Todd Marek - Dwelling lease refer to both identification numbers,
g
128TH Ave above, in all correspondence with the agency.
Town of Richmond, 54017
St Croix County
SE1 /4, NE1 /4, S35, T30N, R18W
Lot: 16, Subdivision: Sunset Hollow
FOR:
Description: Mound
Object Type: POWTS Component Manual Regulated Object ID No.: 1250590
Maintenance required; 600 GPD Flow rate; 31 in Soil minimum depth to limiting factor from original grade; System(s):
Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version
2.0, SBD- 10706 -P (N.01 /O1); Effluent Filter
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed
and located in accordance with the enclosed approved plans and with the component manual(s) referenced above.
The owner, as dined in cliaj ter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code
requirements. F ,
CCI7ZI
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. A P
D 7
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to DIVI 5
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
constructionlinstallation /operation.
SEE CORF
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.
I _
ROGER D NELSON Page 2 12/15/2009
Sincer Fee Required $ 250.00
Fee Received $ 250.00
n Balance Due $ 0.00
agel
Private Sewage Plan R 'ewer , Integrated Services WiSMART code: 7633
(608)266-2889, M - F, 0600 - 1430 Hrs
pete.pagel@wisconsin.gov
cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Monday, 7:00 A.M. To 3:30 P.M.
Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in
Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings
Division of the Wisconsin Department of Commerce.
"Construction business" means a trade that installs, alters or repairs any building element, component,
material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform
dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to
87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the
delivery of building supplies or materials, or the manufacture of a building product not on the building
site.
For further information, go to our website: www commerce.wi. gov/ SB/ SB- BuildingContractorProgram.html
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: Todd Marek
Owner's Name: Todd Marek
Owner's Address: PO Box 228
New Richmond, WI 54017
Legal Description: SE 1/4, NE 1/4, S 35, T 30 N, R 18 W
Township: Richmond
County: St Croix
Subdivision Name: Sunset Hollow
Lot Number: 16 Block Number.
Parcel I.D. Number:
Plan Transaction No.:
Page 1 index and title
Page 2 Data entry
Page 3 Mound drawings Ij v;r.
Page 4 Lateral and dose tank
Page 5 System maintenance specifications
Page 6 Management and contingency plan
Page 7 Pump curve and specifications
Page 8 Plat Plan Fry
tN
Designer. Roger Nelson License Number. MP 226497
Date: 12/01/09 Phone Number: 715- 273.4444
Signature:
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDO- 10691 -P (N. 01/01), and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and
Pressure Distribution Component Manual Ver. 2.0 SOD- 10706 -P (N. 01/01)
Version 5.1 (R. 06/06) Page 1 of 8
I
f
Mound and Pressure Distribution Component Design
Design Worksheet
Sib Iniorf mam
(R or C) R Residential or Commercial Design ice: Sand flu (0) cda,asiaw assume a
400A0 Estimated WastswaW Fir (gpd) s" 83.4" km to soN Vednwnt for has
1.50 Peaking Faces (e.g. 1.5 =150 %) coftm of 4.- 36 hhes.
600.00 Design Flow (gpd)
3.30 Site Slope (%)
98.55 Contour Line Elevation (ft)
31.00 Depth to Limiting Factor (in)
0.50 in -situ Soll Application Rate (gpd/f'e)
Db Umillon Cell Information
1 60.00 Dispersal Cell Length Along Contour (ft) g 10.00 Cell Width (ft)
7.00 Dispersal Cell Design Loading Rate (gpdife)
1 Influent Wasbwater Quality (1 or 2) Are the laterals the highest point
In the distribution Y
Pr+omrs Disribudon Infornation network? Enter Y or N
(C or E) E 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)
3.00 Estimated Orifice Spacing (ft) = 10.00 f /orifice
2.00 Forcemain Diameter (in)
30.00 Forcemain Length (ft) Does the forcemain drain back?
80.00 Pump Tank Elevation (ft) Enter Y or N
6.50 System Head (ft) x 1.3 4.89 Forcemain Drainback (gal)
8.72 Vertical Lift (ft) 55.93 5x Void Volume (gal)
0.41 Friction Loan (ft) 60.82 Minimum Dose Volume (gal)
0.00 In -line Filter Loss (ft) 24.72 System Demand (gpm)
15.62 Total Dynamic Head (ft)
Lateral Dim
asbr Selection anifoid Diamsfier Selection
t>
in. dia. lions choice in. dia. options choice
0.75 1.25 x x
1.00 1.50 x
1.25 x x 2.00
1.50 x r 3.00
2.00 x
3.00 x
Gailons/lnch Calculator (optional)
Treatment Tank lnformatbn Total Tank Capacity (gal)
1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in)
Wieser IlWanullOcturer gal/in (enter result in cell 849)
Does Tank Information Ef ent Finer h►fornwrtion
800.00 Dose Tank Capacity (gal) Poly Loc I Filter Manufacturer
22.241 Dose Tank Volume (gal/in) 5 Filter Model Number
Wieser Manufacturer
Project Todd Marek Page 2 of 8
-
Mound fla and Cross Section Views
1/� ob.srwdon POe p. J
.. .. .. .... ...
o p A
w
B
[:
• ....... ...............................
— L
Mound Component Dlommlone
Down slo toe extension made.
A 10.00 ft E AO.50 in H A4.83 ft K 7.31 ft
B 64.00 ft F in 1 ft L 74.62 ft
D 6.00 in G ft J ft W 24.83 ft
600.00 (fe) Dispersal Cell Ares 1200.00 (fe) Basal Area Available
10.00 (gpdt t) linear Loading Rate 6.00 (ft) 1110 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 100.82 (ft)�,..,, H
1 ......� 2 ......: G
Z
I F 99.55 (ft) Lateral
99.05 (ft> –► Invert
Dispersal Cell
Elevation E D
,...
•.
.55 (ft) Contour Elevation
3.3 % Site Slo" Geotextile Fabric Cover
Shading Key g - Dispersal Cell ge See kderai detaAs on
1 Topsoil Cap $ 1.5 ft Pa 4 for number, size,
Subsoil Cap O
Q5 end sparing of werels.
to tends we equegy
• • ASTM aye Sand 0.5 It Typical Lsbrsl F spaced them the
Tilled Layer disbibudon cabs
�, 5
� in
t r centerline the
A ---- 1ti distribution cell (Aa).
Project: Todd Marek Page 3 of 8
End Connection Lateral Layout Diagram
Center the laterals owr the A 6 B d1monslon 4P - Turn -up %W bell we two or oi"n out plu9
P --�
qP
AM laterals aro Idera" 14. X --i I Hof** drOod on tM bottom of the lateral S
eq-aft spaued
lateraK & foroe main of PVC Soh 4o f3
(per CC*~ Table 64.E -5)
iorw main oormeot{on %44b to* or cross to mar#old u ary pant.
Number of Laterals 3 Orifice Diameter 0.125 In
Lateral Diameter 1.25 in Orifiice Spacing (X) 3.08 ft
Lateral Length (P) 58.52 ft Orifices per Lateral 20
Lateral Spacing (S) 3.33 ft Orifioe Density 10.00 felorifice
Lateral Flow Rate 8.24 gpm Manifold Length 6.67 ft
System Flow Rate 24.72 gpm Manifold Diameter 1.25 in
Total Dynamic Head 15.62 ft Foroemain Vekay 2.52 ft/sec
Dose Tank information cmw YM wwnft
_._ W" and io*" deice sad
"OW Waftftht
ElsdtiW as per NEC 300 and
COMM 16.28 WAC � 4 in. nNn.
Tatty( ootttp W t is propery vett4ed E— Afoenmft cadet
bcador►
FonosmaM diameter
Wieser Manufacturer 2 in.
800.00 Gallons
Volume 1 22.24 gal/inch A
Weep hole or antl-
Dimension in Gallons B siphon dwAm
A 21.24 472.30
B 2.00 44.48 C Pung off
C 2.73 80.82
D 10.00 222.40 D
Total 1 35.97 800.00
tsni( eisv'ff°n
3e Bedding u r tank. 90.00
Alarm Manuafacturer IS. J. Electro Systems
Alarm Model Number 1101 HW
Pump Manufacturer [ P E �ouMs
Pump Model Number 41
Pump Must Deliver 24.72 gpm at 15.62 ft TDH
Project: Todd Marek Page 4 of 8
Mound System l , hhdmance and Operation Sasciticedons
Service Provider's Name Nelson Plumbing Phone F 15 - 273-4444
POWTS Regulator`s Name (� St. Croix Zoning Phone 15 -386.4880
§nM Flow and Load Pammd=
Design Flow - Peak 800 Igpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 400 gpd Maximum BODE 220 mg/L
Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 600 f Maximum FOG 30 MOIL
Type of Wastewaterl Domestic Maximum Fecal ColilorM >10E4 cfu/100 mL
JAXW Freauencv
Septic and Pump Tank inspect and/or service once TM 3 years
Effluent Filter Should in and clean at least once eve 3 years
Pump and Controls Teat once every 3 rs
Alarm Should test month
Pressure System Laterals should be flushed and pressure tested every 1.5 Yom
Mound in for and once 3 ra
Other
1. Observation pipes are slatted and materials conform lo 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)(1), 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 DOWN
Finished ..���,........ ...............
Grade ....
60 Diameter Lawn ...� Threaded Cleeumout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Lateral
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Todd Marok Page 5 of 8
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Alm. Cod.
This syalsm shMI be operated in accordance with Comm 62-84 VVle. Adm. Code, and shall maintained in accordance with !tar'
component manuals ISBD- 10891 -P (N.01/01), SSWMP Publication g.6 (0181), and Pressure Distribution Component Manual Ver. 2.0 SOD
10706 -P (N. 01/01)) and local or state Hass pertaining to system maintenance and maintonance 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, VVle. Adm. Code when the tanks are no longer used as
POWT'S comimm".
Septic or pump tank .,md a rtsero, socees rlesro and coven should be iMpI AN for welter tightness and soundness. Access
openings used for service and assessment shall be sasled watertight upon the completion of service . Any opening dsared unsound,
detlektivs, or subject to fell ma must be replaced. Exposed access openings greater than &4nd s In dhmaler shall be secured by an
effective baking f 1 m , I to prevent socklahlad or unauthorized entry Into a tank or component.
22M Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stab. The contents of the septic
tank dal be disposed of In accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and eurtist ANe shat be
assessed at best once every 3 yeas by inspection.
The outlet fitter shall be cleaned as necessary to ensue proper operation. The fitter cartridge should not be removed uhlsss provisions
as made to robin soAhe In the tank that may Nourgh df the Ater when removed from its encoaure. N the titter It equipped with an alarm,
Ue fbsr stets to serviced ti the alarm Is activated continuously. Intermittent fter alarms may indicate surge flows or an Impending
continuous alarm.
The septic tank oha8 lame its ccrnkm removed wlawh the volume of skndge and atom in the tank exceeds 113 the (quid voNwne cf the
lark. N tie oorhlerhb of the tank are not removed at the tiros do triennial asesamsrrt, msantana ce personnel shall advlee the Owner of
when the nod service needs to be performed to maintain lees than m odm rn scum and sludge accumulation In the tank.
The addition of biological or chemical additives to enhance septic tank perbmance is generally not required. However, N such
products are used they Mull be approved for septic tack use by the Departrnaa at Commerce.
The pump (dosing) tank Mull be Inspected at Nast once every 3 years. AN switches, aMrtra, and WW shall be bebd to verity proper
operation. M an eftent fitter a installed within the tank 4 shelf be Inspected and serviced as necessary.
No troes or shrubs shwold be planted on the mound. PNntlps may be Trade around the mound's psrIneber, and the mound OW be
seeded and mulled as necessary to prevent erosion and to provide some prOtedfon from frost penetration. Tratflc (other than for
vegetative maintenance) on the mound a not recorwrended since so compaction may hkxW aeration of the Infiltrative surface within the
mound and snow compaction In the wkter will promote frost penetration. Cold wreathed InataNetiore (October-February) didds that the
mound be heavily mulched are protection from freezing.
influent qusaflty Ito the mmmd system may not exceed 220 mglL. BODe,150 mgA. TSS, and 30 mg1L FOG for septic tank a fluent or 30
mglL. BOde. 30 nVL TSS,10 nV& FOG, and 10' c W100 mL for hW* located effluent. homert flow ray not eorosed .nmiki m design
lbw specified in the permit for this Fallon.
The pnisan distribution system Is provided with a flushing point at the end of each lateral, aid it Is reconwWw W that each tabai be
Ached of accumulated maids at lsset once every 18 months. When a prossure tai Is performed it should be compared to the MW lest
when the system was In MIW to determine N ortftos dogging has occuned what N critics clearing is required to maintain equal On
WNW the dope" a".
Obowation pipes within the dlepenod cell shell be ducked for eAkent ponds g. Pondtrg lavela MA be reported to the owner, and any
levels above 6 inces considered as an impwx ft hydraulic failure rekluiring additional, more frequent mor NAV.
ConwWwrrav Plan
N the septic tank at any at its componerb become detective the tank or oomponsm step be repalrW or replaced to keep the system In
proper operating condition.
H the dosft tank. pwV, purrg eonbvb. Mmm or related wklg becomes dsbctiw Uhe dsfactive comkporert(s) stall be krnnsdietey
repaired or replaced with a component of the same or equal performance.
N the mound component foals to accept w Woo star or begins to dledawge nanatewaMr to the ground surface, its* be regaled Or
replaced In iW present bcWon by Inaesekg b "sea N toe eakags o=n or by remov" biologk*ly cogged abeorplbn and dispersal
modle, and related *", and replacing said components as deemed necessary to bring the system Into proper operating oohattion.
See Page 5 of thle plan for the nacre and telephone number of you lope POINTS regulator and servos provider.
The Infomafbrn and ad*" of mwwnmgerent and mainio adnce for pretreatment device such are aaoblo treatment units or
d sk*cdon units we attached as aeparale docutenb and we considered part of the OMW maagemwt plan for thle system.
per Page 6 of 8
j ! G0JLDS PUMPS
Submersible
Effluent Pump
PE
SPMCAPONS MOTOR WATi1RE5
pump General: ■ Corrosion resbtant
• ft rge: l'h" NPT • Single phase construction.
• Temperature: 104 °F (4WC) • 60 Kom ■ Cast iron body.
maximum, continuous when • 115 volts ■ Thermoplastic impeller and
fully submerged. • RO in therriiai overbad pro- cover.
• Solids handling: '%' tedlon with auaomak reset. a Upper sleeve and lower
maximum sphere. • Class B insulation. heavy duty ball bearing
APPLICATfONS • Automatic models include a • Oi14died design. construction.
float switch. • High strength carbon steel ■ Motor is permanently
Speciagy designed for the • Manual models available. shat lubricated for extended
fdlowing uses: • Pumping range: see PE31 Motor: service life.
• Mound Systems performance chart or am. • .33 HP, 3000 RPM ■ Powered for cor tinuc+us
• EffluenyDosing Systems PE31 Pump: • 12.0 Maximum amps oper atm.
• Low Pressure Pipe Systems • Maximum c pW.. 50 GPM • Shaded pole desk ■ Ali ratings are within the
• Basement Draining • Maximum head: 25' TDH PE41 Motor. woddng limits of the motor.
kngth
• ��Duty Sump) PE41 Pump: � .40 HP, 3400 RPM ■ Quick disconnect power
length,
J Maximum capacity: 60 GPM 7.5 Ma card, , 20' standard
Maximum amps ivy duty 1613 d hen
• Maximum head` 29' T1 9n NEMA 5.15P, three prong,
PE51 Pump: PE51 Motor. 115 volt grounding plug.
• Maximum capacity: 70 GPM • .50 HP, 3400 RPM a Complete unit Is heavy duty,
• Maximum head: 31' TDH • 9.5 Maximum amps portable and compact.
Mt:Tt:as FEEr
PSC design ■ Mechanical seal is carbon,
40 _ ceramic, MW and stainless
;.. �._ _.i...i. ;._.: ,..�..,.... _.;.. MODELS: PE31. 1E41. PESI steel.
t...�..... �....:: '�...,...,...
;..;._ ...: .... ..:........�..._�...,......;._; ,.. . - .:... N a�, .a..so ■ Stainless steel fasteners.
C... s _ ; ' —► 2 GPM
10 4 '
.• :. - + -- - -•.1 ...� _ _i �::.,.. �.. r �._... �. AGENCYUSfINGS
30 1 FT
MOW :,- ..,..
t ... ...
t... .. ...
i.. }.. .. �� .. ... ...... ... *.a...1... ...�.....�.. }....._... 0
20 TQ5W ID Ul. 7n and
/�,� c �. � .- i• - -�.. ...; ..�_.�..*. ..: ,. i._ __ +..;...�.. - ..� . fi � a.. ; � t .� � � � , , :: 108 Standards
.. .. .......... . . .
E t ....�.....i ..' ....*.., ......_ .1. ..�... �: i ..?.. Garldr rhaapn k 150 W ".,,,.R'°
10 G .
0 L 0 0 10 f 20 30 40 50 60 ' 70 GPM 80 �Q9
0 5 .2 10 15 M GO( S rptlflt�5
CAPACITY
E o, 2002 ITT Industries
PE31/41 < &
L CEIVED
1384
Wisconsin Department of Comm V 1 3 200901 EVALUATION REPORT Page I of 3
Division of Safety and Buildings in accordance with C mm 85, Wis. Adm. Code Steel Soil Service
CR0Ix COUNTY County
Attach complete site plan on : �1 es in s' . Plan must St. Croix
include, but not limited to: v direction and
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D.
Please print aff information. viewed 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 SE 1M 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 " 16 na I Sunset Hollow
City State Zip Code Phone Number J City _`J Village 01 Town Nearest Road
Somerset WI 1 54025 1 651 -488 -3051 Richmond 1 140Th St.
16 New Construction Use: 0 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement f Public or commercial - Describe
Parent material Benches and large drainageways of ground moraines. f=lood plain elevation if applicable na
General comments 05
and recommendations: Mound design, system elevation 99�, o r
based on contour line elevation 98.55ft. Minimum " of ASTM
C33 sand. Q� (a N�
Boring # I Boring
Mm Pit Ground Surface elev. 99.55 ft. Depth to limiting factor 96 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKe
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 *Eff#2
1 0 -12 10yr3/2 none sil 2msbk mfr cs 2f .5 .8
2 12 -23 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6
3 23 -96 7.5yr4/4 none scl 2msbk mfr na na .4 .6
Boring # Boring
W1 Pit Ground Surface elev. 99.55 ft. Depth to limiting factor 31 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftx
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -10 10yr3/1 none sit 2msbk mfr cs 2f .5 .8
2 10-19 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6
3 19 -31 7.5yr4/4 none scl 2msbk mfr gw na .4 .6
31 -72 5yr4/4 none sl /scl om mfr na na .0 .0
'Y
Ye a stratified layers of sl and scl in horizon 4 water at 72"
� -I'e
* Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD S30 mg /L and TSS < mg/L
CST Name (Please Print) nature: CST Number
David J. Steel 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 11/11/2003 715 - 246 -5085
Property Owner R.J.C. Development, Inc. Parcel ID # Pending Page 2 of 3
3] Boring # J Boring
Pit Ground Surface elev. 96.25 ft. Depth to limiting factor 53 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
1 0 -26 10yr3/1 none Sil 2msbk mfr cs 2f .5 .8
2 26 -43 10yr4/4 none sicl 2msbk mfr Cs 1f .4 .6
3 43 -53 7.5yr4/4 none SI /scl 2msbk mfr gw na .4 .6
4 53 -96 7.5yr5/6 c2d7.5yr5/6 Is /SCl om mfr na na .0 .0
F-1 Boring # I Boring
J Pit Ground Surface elev. ft. Depth to limiting factor 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
F-1 Boring # I Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
' Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
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. #248956 S E1 /4,NE1 /4,S35,T30N,R18W Bus.(715) 246 -6200
Town of Richmond, St. Croix Co. Fax.(715) 246 - 9372
Sunset Hollow, Lot 16
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. 100.00Ft
Top of 1/2" pvc pipe
• = Alt Benchmark Ele. 99.8517t
Top of 1/2" pvc pipe
❑ = Borings
Boring Elevations
B 1 = 99.55Ft
B2 = 99.55Ft
�2 B3 = 96.25Ft
9 B4 = OO.00Ft
?
Ow"
owh
l 3 / 0
�- r A[
a3
, V`
. . .................................... ... .....................
i
2 Z
0 O
Or O 0
/ 1 O W w W
01 sq. ft. w W Lor n o .01 0 acres o w LOT 16
2 -99&0' o L0r 1J 121,901 sq. ft. 130,109 sq. ft. f
N 2.80 acres Ln 2.99 acres
121,901 sq. ft. w o 0
2.80 acres o °
O o
r
1ge
ent
8 33.0
2 S89'49'1 5 "E 935.88'
00' 230.00' 1 230.00' 245.88'
N89 "W 968.88' 101502 IL
(recorded as 968.81) c
c
L OT 2 C.S.M. IN VOL_ 17 LOT 1 °�
P 4_6_40_
East 114 Corner--
Section 35 -30 -18
(Found Survey Mark Noii�
NG TANGENT BEARINGS NOTES
S00 "W S13'46'31 "E ELEVATIONS ARE USGS NAVD 1988 BASED ON GPS OBSERVATIONS.
S13'46'31 "E S00'08'25 "E
N00'08'25 "W N13'46'31 "W BEARINGS ARE REFERENCED TO THE EAST LINE OF THE NE -1 /4
N1 3 N00'04 -49 E OF SECTION 35, WHICH IS ASSUMED TO BEAR SO0 "E.
THE PARCELS SHOWN ON THIS MAP ARE SUBJECT TO STATE,
COUNTY AND TOWNSHIP LAWS, RULES AND REGULATIONS (I.E.
WETLANDS, MINIMUM LOT SIZE, ACCESS TO PARCEL, ETC.).
BEFORE PURCHASING OR DEVELOPING ANY PARCEL, CONTACT
THE ST. CROIX COUNTY ZONING OFFICE AND THE APPROPRIATE
TOWN BOARD FOR ADVICE.
I - _
X289'
– _ J 78, 851 sq. ft._ _ 78,851 sq. ft.
° \ =� — \ \ \ 1.'81 acres `1.81 a cres
/ o
,o
/
79,426 sq. ft. —
/------------- 1=1.82 acres — _ ` ------------------ --�-_ ` ...........
! /
' -L AA - 190' =- 190. \
�
All- - - - 646 � 322 _ POS - - - 968 128/ /7 ,�-- - A ' VE 1�
\
, 2j0' -V-230'
TOE
..1... \ \ - ..._L._. . --
/
LOT 14 \ ` LOT > \ \ �, \ \
121,901 sq. ft. 121, 901 sq. ft. `'� \121 sq. ft. \
–
-2.80 acres \ 2.80 acres \ \ \ \ \2.80 acr \ \ \
1 994 I 230' 230' 230' \
-�S89'49'15 "E� \ \ 966 88' \ \
{ LOT 2 �� { \. \ \� LOT 1�
\` - - -- C_S_M_ IN VOL XX \\ \
_PG._XXXX
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner /Buyer
Mailing Address �(� Z z 8�?
Property Address _ 1 -- �3 �� 11',O k
(Verification required from Planning & Zoning Department for new construction.)
City /State Parcel Identification Number 0 z,6 — j 7 Z — / 6 — o o O
LEGAL DESCRIPTION n l�
Property Location `J � `� '/4 , l C- /4 Sec. 3 �d N R ) ( 9W, Town of lC6� 4, ? , ,d �� .
Subdivision Plat: _.!5rGt 41 5�� � p La �,�/ , Lot # A .
Certified Survey Map # , Volume , Page #
Warranty Deed # � 5 2 0 _70 (before 2007)Volume , Page #
Spec house *-yes i =l no Lot lines identifiable Ayes i_! 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.
1 /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on this form are true to the best of my /our knowledge. I /we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms
V / o�
SIG A OF APPLICANT(S) DATE
** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * **
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
I I { {! {! I {!I! {I!I{ !I {!I { {I!I I { {N {N! {I {I {I 11 {III {!
# 0
State Bar of Wisconsin Form 1 -2003 8 5 7 0 1
WARRANTY DEED 8
KATHLEEN H. WALSH
Document Number Document Name REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
06/06/2007 01:35AM
THIS DEED, made between Matthew E. Walstad and Jennifer M. Walstad, husband WARRANTY DEED
and wife EXEMPT N
( "Grantor," whether one or more), REC FEE: 11,00
and Todd Marek: a married person TRANS FEE: 148.50
( "Grantee," whether one or more). PAGES: 1
Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area
estate, together with the rents, profits, fixture: and other appurtenant interests, in 5t•
Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach Estreen & 0gla 1d w f r
addendum):
Lot 16, Sunset Hollow, St. Croix County, Wisconsin 304 Locust Street
Hudson, W! 54016
026 - 1172 -16 -000
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Grantor wan-ants 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 � t U._} 7.
(SEAL) (SEAL)
*Matthew E. Wals ad *Jennifer M. 1
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Matthew E. Walstad and Jennifer M. d
Walstad, husband and-wife STATE OF )
authenticated on ) ss.
COUNTY )
*Kristina land Personally came before me on ,
TITLE: MEMBER SATE BAR OF WISCONSIN the above -named
(If not, to me known to be the person(s) who executed the foregoing
authorized by W is. Stat. § 706.06) instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
*
Kristine Ogland, Estreen & O land Notary Public, State of
304 Locust Street, 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. 1 -2003
" Type name below signatures. INFO -PROTM Legal Forms 800 - 655 -2021 www.infoproforms.c=
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