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038-1239-27-000
C � 11 Wisconsin Department or Commerce 3;-40ewTvaLPRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Jeff & Julie Landt I TOWN OF STAR PRAIRIE CST BM Elev Ilnsp. BM Elev. IBM Descripti� � I TANK INFORMATION LT ELEVATION DATA TYPE MANUFACTURER Qv' CAPACITY 1 Septic Dosing g00 Aeration ------------------- TANK SETBACI INFORMATION TANK TO WELL BLDG. Vent to Air Intake R49AV Gu K Septic Ll / • o' 3 ' ' ' �s o Dosing 2-71 Aeration Holding PUMPISIPHON INFORMATION p i Manufacturer I 1 -1 1- IDemand r ,, IDist. to SOIL STATION BS HI FS ELEV. Benchmark 41� I,y' t0V O Alt. BM Bldg. Sewer I SUHt Inlet a,7 / 7 SUM Outlet 1 , i L Dt Bottom 3 , (I��.r eaderfMa 2.0 L s . Pipe Bol. System LQ 1 41, 101,15 Final Grade St Cover 13.1 ,S b.1S q1, 3 BED/TRENCH DIMENSIONSlo, Width Lent 0' No. Of -X __ /tj 3 PIT DIMENSIONS No. Of r Inside Oia. Liqui epth SETBACK SYSTEM TO P/L 5 JBLDG JVVELL LAKE/STREAh4,r LEACHING Manufacturer: INFORMATION Type f ystem :- U / �. !Y>I u.1 1'� I V O 1 'i' �)FIAMBER OR UNIT Ir✓ Model mbar Ij,W iWU1I IVN SYSTEM `Yfl- I Header nifold Distribution Pie s x Hole Size x Hole Spacing Vent to Air Intak o of SOIL COVER dx Pressure Svstems Only xx Mnund Or At-Rmde Ructnma rinly C e I th Ov 1 r e r t n Depth Over BedlTrench Edges , I % N xx Depth ot� Topsoil / '1 f L� xx Seeded/Sodded yes No — � Yes No C9bIMENTS:` (Includi code discrepancies, persons present, etc) nspection #1: 1.1 /D /i� Inspection #2: _/ /7-01W Location: 959 218TH AVE l�V� 1.) Alt BM Description=?Vr>�P (OkrJ I wi lk-aro, WASyb+c4w 2) Bldg sewer length = - 18'' - amount of cover - Plan revision Required? I] Yes No Use other side for additional informati n. SBD-6710 (R 3197) Set l U P , L-0 o rr"VAI. All tb k c,1►AC-illij -er,or is Ptnw per o�,bc f �� prw or-. Date sap 's Signature Cart. No. ��►n�.,a,t _ 87 safety etd*w Dvision I- rig i d 1 g 2019 and 2� we�f Oon Ave.. P.O. Bat 7162 rfaae�r vin s37o� 71air wir yRas 16imba obo ro filed by Go.) N�� i �oantl' e ohcauoj� >a�oe.a�eey��0�r�slcz)wanae it ��bⅇre SW Tr�tim Ner omb 1119b2`f3$-C �t 6 eegmWpnabobamogamdayI i NOW Appfembnn iorea far do"weed POWlS ere abdr:T'to of S wid P the Dapmtimit ofSoftandwPriw dSarni Paamd =EOMSloto, 700lamedc nag be med br Y Pit Ad&= (if ddRffetebt� aaaa9 gad&m,,,) /"�� w mt oe ITS ti. ( SIY. ZI Vol L LRraatim-Pkaee mat AO lioputY1 Owom's I ``yy 1 _I Paid 1 ft"rty owmeas fltdigAdbea N"'tY"I`T,31. 8. la 8'D Gout Id a9. 7ipCode PbnaeN®bv f S` T N. R_/ E ljpe ofB�(ckeek aB Wtapply) I.otR I e 2 Frmdy Dwe➢®g-Nrmbw oof �°� T'I� <Beb9oo�!®/ ❑ City of _ - ❑SW.Owmd-DeamleUw - r 11VMWof CEMNomba ! k ! MDUN Ce-LL ,t alTasof UL Type of Pve1111h (CIl aaly aae bm m boo A. Campkk Bae B if appitalli A. 14New SYM. —�� ❑ RVI--Wt SyYm ❑ T Tdc remedHddmg Repfmmrert Ody ❑OWa Mati6edYbTmaag Sl'wee (epim) B_ ❑Pami Rmewd ❑Peaii Rehm ❑ Cbmge ofPkobe ❑Pewit TresFrb New I.iri Aavio®BrmCNdobcodDY:IYd tWaer. I" Oame e! N+, Z' IV Type ofIPOW1S Cbeck a6 tiat r ❑ Non-P--td ba1aamd ❑ Pemoimd EWAo nd ❑ AVGriii e ❑ Momd> 2a u of.Wwbk wd O Mad <2a m ofaidb{e awl TJ ❑ Hdd-g Task ❑ Od—Dirpted Compmwt (e*..) ❑ ftmmmmt Devi c (=vbw V. Dbpenallfrreattacot Arm Llaeotiow O Deign Fknr(gpdy Deoge3aS APpbmIiw Ram Digm- lAb (SO D4wsd Are PA (aft Sy�ElewOm / S VL Tank lab cpeeiry'/m Toed of va,� Madames Wl Plylo �'� "g s NarTatks T�tagT� 3a 9 syacwtta"iraTek Dmins ore T- Va StNkw 2*-dw aWtYed phY PI®be'S MPMQItSNabe BaaomH Numb= f - ' Nuiaws (Sweet. ow &p Code) VBI Use Club zs� Pa®tFm s T �. Datelasd )as®g Agmt ' ❑ forDmw UL Coa"Ttff(Beasoe ?mil R1f Condlf+'onS !n SfaF� 1. Septic tank, effluent fitter and dispersal cell must be.geryiced /. maintained as per management plan provided by plumber. 2. All setback requirements must be maintained L v� ZO Zip _ �Df;. - ieaYA/t VII C.Q y IJ ' n / DASile SBD-6398(R. IIn1) TOTAL DYNAMIC HIAD 0 all ■ I'm fill m November 7, 2019 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2021-1 I-07 Plan Review: PWTS-111902438-C KIM A O'CONNELL K.O. CONSTRUCTION 504 3"D AVENUE OSCEOLA, WL 54020 SITE: JeffLandt 218Tn Avenue Town of Star Prairie Saint Croix County NW, NE, S17, T31N, R18W Total Amount: $250.00 DIVISION OF INDUSTRY SERVICES 2850 MIDWEST DR STE 104 ONALASKA WI 54650 Contact Through Relay httpJ/dsps.vA.gov/pmgrams/Default.aspx www.wiscorsin.gov Tony Evers - Governor Dawn Crim - Secretary Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE FOR: Description: Four Bedroom Mound System \ Sloping site Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01/01, R 10/12), Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01101, R 10/12), 600 GPD, 15" depth to limiting factor from original grade, Maintenance required, Effluent filter, New construction 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 any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per a.145.06, stets. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of See. 145.20(2)(d), Wig. Slats. • A stale 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. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • 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. A copy of the approved plans, scecifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which mjjy include local inspectors. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state slats 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gtia'U4 M. " Gerard M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892 —voice \ (608)785-9330 — fax jerry.swinicOwi.it MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Landt Owner's Name: Jeff & Julie Landt Owner's Address: 1138 Peninsula RD New Richmond W 154017 Legal Description: NW NE-sec17 T31N-18W Conditionally APPROVED Township: Star Prairie DEPT. OF SAFETY AND PROFESSIONAL County: S7 Croix SERVICES DIVISION OF INDUSTRY SERVICES Subdivision Name: Squaw Lake Estates Lot Number: 27 9 Parcel I.D. Number: 038-1239-27-000 SEE CORRESPONDENCE 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 Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Page 10 ATT soil evauation Designer: Kim A Oconrtell License Number: 224263 Date: 10/27/19 Phone Number: 715-381-7917 Signature: Designed Pursuant to the Mound Component Manual for POINTS Version 2.0 SBD-10691-P (N. 01/01, R. 11112). and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for STSAS (01181) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10112) Version 7.0 (R. 11112) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet (R or C) Site Information Residential or Commercial Design Estimated Wastewater Flow (gpd) Peaking Factor (e.g. 1.5 =150%) Design Flow (gpd) Site Slope (%) Contour Line Elevation (it) Depth to Limiting Factor (in) In -situ Soil Application Rate (gpolft2) R 400.00 1.50 600.00 8.70 100.00 15.00 0.50 Distribution Cell Information 60.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/"2) 1 Influent Wastewater Quality (1 or 2) (C or E) Pressure E Disribution Information Center or End Manifold Lateral Spacing (ft) Number of Laterals Orifice Diameter (in) Estimated Orifice Spacing (ft) _ Forcemain Diameter (in) Forcemain Length (ft) Pump Tank Elevation (ft) System Head (ft) x 1.3 Vertical Lift (ft) Friction Loss (ft) In -line Fitter Loss (it) Total Dynamic Head (ft) 3.33 3 0.125 3.00 2.00 190.00 78.00 6.50 23.58 2.57 0.00 32.6B Lateral Diameter Selection in. dia. options choice 0.75 1.00 1.25 x 1.50 x x 2.00 x 3.00 x _ Note: Sand fill (D) calcutabons assume a Table MA-44-3 irnsilu sal treabnent for fecal cdiform of <=.%inches. 10.00 Cell Width (ft) Are the laterals the highest �oin�t in the distribution U network? Enter Y or N If N above, enter the elevation ft of the highest point. 10.00 ftZlorifice Does the forcemain drain back? �Y Enter Y or N Forcemain Drainback (gal) A 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) Manifold Diameter Selection in. dia. options I choice 1.25 x 1.50 x x 2.00 3.00 Gallonslinch Calculator (optional) Treatment Tank Information 1200.00 Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) 1 36.001 Total Working Liquid Depth (m) Wieser JManufacturer 33.33 gal/in (enter result in cell 1349) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) I PoMok Filter Manufacturer 22.241 Dose Tank Volume (gal/in) PL-525 Filter Model Number Wieser I Manufacturer Project: Landt Page 2 of 9 1 Mound Plan and Cross Section Views ..... 4,4n n ............ . L Mound Component Dimensions Al1O.D011ft E 31.44 in B1 60.00 ft F 9.50 m D 21.00 In G 0.50 It 600.00 (ftz) Dispersal Cell Area 10.00 (gpd/ft) Linear Loading Rate H 1.00 it K 11.93 ft z 15.88 ft L 83.86 ft J 7.24 ft W 33.12 it 1552.77 (ft) Basal Area Available 6.00 (it) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.54 (ft) 1 F ~ Elevation 8.7 % Site Slope Call Dispersal Cell Shading Key �1 ® Topsoil Cep 02 Subsoil Cap ASTM C33 Sand i . t Tilled Layer © Aggregate 00 a = 1.5ft N O �2 c 0 Dispersal 0 G I I" 102.25 (ft) Lateral � Invert (ft) Contour Elevation Geotexb7e Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the disldtwfion cell (A>d3). Project: Landt Page 3 of 9 End Connection Lateral Layout Diagram Cent« the lateral: ww the A 6 B dimension •�Tum-up »t Wllvalwwol.anoutpiuD P Is All lAwalz we Wentioal IFX—iI Holtz drilled on the G ttomol the lakwai 9 pwtly zDaved Laterals Aforce In Soh 4e PVC per SPS Tel 394.W0 6 Fora. main oonneoeon We lee o1.1.zz to ntanllold at .0 pol rt. Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 3 1.50 in 58.52 ft 3.33 ft 8.24 gpm 24.72 gpm 32.66 ft Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank information Electrical as per NEC 300 and —0 SPS 316.300 WAC _ Tank component is pmpedy vented Weser Capackyl800.00 Volume 1 22.24 Manufacturer Gallons gaVinch Dimension Inches Gallons A 19.96 443.83 B 3.00 66.72 C 5.01 111.53 D 8.00 177.92 Total 35.97 800.00 Y -_ A i B C Alarm Manuafacturer ISJE Rhombus - Tank Alert Alarm Model Number 101-01H 159-PCmp Manufacturer [Goulds Pump Model Number IWE07H Pump Must Deliver 24.72 gpm at F 32.66 ft TDH Locking cover with warning label and locking device and sealed watertight 4 in. min. t_ Alternate outlet location Forcemain diameter 2 in. Weep hole w anti - siphon device Pump off elevation ft 78.67 Dose tank elevation (it) 78.00 Note: Switches containing mercury may not be used in this system. Project: Landt Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name _ YOUR CHOICE Phone POWTS Regulator's Name ST Croix County Zoning Phone 714-386 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 Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once Every 3 years Should inspect and dean at least once every 3 years Test once every 3 years Should test month) Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384,30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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 _...-... _ _..._... ..:. Lon Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Landt Page 5 of 9 Mound System Management Plan Pursuant to SPS 383.54, Virl Adm. Code General This system Mall be operated in accordance with SPS 382-84 W is. Adm. Code, and shell maintained in accordance with I& component manuals (SBD-10691-P (N.01101, R 11/12). SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manuel Ver. 2.0 SBD- 10706-P (N. 01101. R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump lank since dangerous gases may be present that could muse death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, W is. Adm. Code when the tanks am no longer used as POWTS components. Sapfic or pump lards manhole risers, access dsers and rovers should be inspected for water tightness and soundness. Access openings used for service and assessment stall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure most be replaced. Exposed access openings greats than 8-inches indiameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shag be maintained by an individual certified to service septic tarries under S. 281.48, Slats. 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 Mier 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 lank that may slough off the figs when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced H the alarm is activated continuously. Intermittent fitter aternhs 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 we not removed at the time of a triennial assessment, maintenance personnel shag 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 adrition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shalt he approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shag be inspected at least once every 3 years. All switches, alarms, and pumps shag be tested to verify proper operation. If an effluent filter is installed within the lank it shall be inspected and serviced as necessary. Around and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mourhds perimeter, and the mound shag 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 nompadon may hinder aeration of the Infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather inrstallat ins (October -February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mood system may not exceed 220 mg1L BODs, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODs, 30 nglL TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit or this installation. The pressure distribution system is provided with a gushing point at the end of each lateral, and it is recommended that each lateral be gushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial lest when the system was installed to determine if orifice dogging has occurred and if orifice Gearing is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall he checked for effluent pending. Pending levels shay be reported to the own", and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monttoning. Contingency Plan It the septic tank or any of Its components become defective the tank or component shag be repaired or replaced to keep the system in proper operating condition. If the dosing lank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall he immediately repaired or replaced with a component of the same or equal performance. If the mound component falls to accept wastewater or begins to discharge wastewater to the ground surface, it will be roofed 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 SeePage 5 of this plan for the name and telephone numb" of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of menanagament and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Landt Page 6 of 9 a Al p 1 qaj a V 5. POYVT5 BUSMn7AL (check all that apply— Incomolste forms mev result m amaeaenna defeat NEW ❑ Aerobic Treatment Unit(s) ❑ CMorinator ❑ Tank Replacement Only LJ REPLACEMENT LI [] Commercial System ❑ UV Dtsinf*otlon Unit ❑Add Effluent Filter SYSTEM TYPE(a) NOTE Submit separate sheets for each system B submitting multiple systems on the same site Enter Fee Q Revision to previously approved plan $116.00 ❑ Mleaesnsous Review (la, replacement of a septic bsnh, addition of an effluent filter or pretresbnerd device to an existing system, ate.) $e011v ` 1Z Component Manuel Ali treatment components are PreViOLWY approved At -Grade Component Manuel - Ver, 2.0, SBD-10664 (N,03/07, R, 1112) Desig❑ Wastewater Flow In under s, BPS 384.10 (2) of (3): ❑ In-yound Component Manuel - Ver, 20, 8S610706.P (N.Dt/01, R 10112) GWIons Per day Mound Component Manuel — Ver. 2,0, SBD.10691-P (N,01/01, R tOH2) Design wastewater flow of the proposed system: Pressure DlspUputlon Component Manuel — Ver.2.0, SSD-10706-P (N.01/01, R 10/12) ,, � DPD 1,000 gpd or lose $ 260,00 �s fre Or -Please ape* 1;001-2,000 gpd $326.00 2 001— 5,000 d 400,00 Q Sall Based Individual Site Desgn• One or more treatment components are not At Grade previously approved under a. BPS 384.10 (2) or (3): (Individual aka deapMdevle0on from component Non-Proeaudasd I"round Design . manuals and use of components without product ProseurizedIn-ground WeetewetsrFlow In approval), Mound Drlp•Ilne Gallons Per day Design wastewater flow of the yes g proposed system: ❑ Constructed WetlartlB • Documentation must be provided to support treatment and dtepersal claims, In a separate GPO 1,000 gpd or less $450.00 1,001— 2,000 gpd $600.00 statement, provide rationale for the project and attach supporting documents (code sections, lest 2,001-5,000 gpd $750.00 reports, technical papers, reeaaroh ankles, etc,) greeter than 5,000 gpd $900.00 plus $0.08 for asoh gallon over 5000 gpd State-owned faclUtles; Design Ho! tanks previously P Y approved under e. BPS " [3 Holding Tank Component Manuat, Ver. 20, 8BD.10966-P /07 (N,03, R1/12p W� Flow In 384.10(2X3). System,DeoP' wastawter flaw of the Gallons Per day Non-staa owned Commercial and Residential Holding tanks that completely utilize this manual 8,000 gpd or lees $ 00.00 and have an estimated daily flow of leas than 3000 gallons per day must be submitted to the 5,001 — 10„000 gpd $160.00 8PProP6040 govemmemel unit for review instead of the Department Case BPS 383,32(3)(SN GPD greater than 1D,o00 gpd $226.00 ❑ Holding Tank Individual Site Design", (I.e. site constructed, 4 day holding capacity, Co- mingled wastewater, at--)Dealgn Holding mitts Including eke consrrudted tenets NOT Plea" opacity: Wastewater Flow In previously approved under a, BPS 364.10 (2) or (3). Design wastewater low of the proposed system: — Gallons Per ley ' Documentation must be provided to support the rationale for the pro)ect In a separate Moment 5,0DO gpd or less $180.00 _ please In4wde all coda seotbne, test reports, teoMleal papers, research articles, ate,) 8,001—10,000 gpd $300.00 GpD greater than 10,000 gpd $460.00 ❑ Sol Seturotlon Delarnkatim Report (using observation pipes) ❑ Interpretive Determination $240.00 —.. ❑ F.xpedmentel System (Ors time additional fee), Sutmdt fee for Individual System as per appropriate above system type) Experiment Number _ $400,00 Plarity Raview, (enter same amount as normal review fee listed above) $ 610 Enter Tales o om do to SN nawst dollar) BPS-10677 Qt 4118) ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERBHEP CERTIFICATION FORM Cox" 1 -J0, hi ism"; _ � .f'�a' 104" (Verification required from Phiming & City/State LEGAL DESCRIPTTON Property Location AuL_ r/4 , ef—'/. , Sec. J;L, T q�N R1&-W, Town of Subdivision Plat Lot #,-2 7 Certified Survey Map # Volume Page # Warranty Deed # (before 2007)Voltume Page # Spec house ❑ yesxno Lot lines identifiable/yes C no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Imp: open 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 it 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 responsrbilities are specified in §SPS. 38352(1) and in Chapter 12 - St Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix Comity Planning At Zoning Department a catrfication form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper vm*mg that (1) fat 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 regw=enis and agree to mainlam the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department ofNateral Resources, State of Wiscousm. Certification shoring that your septic system has been maintained must be completed and retained to the St (ruia County Planning & Zanmg Department withm 30 days of the three year expiration date. Uwe certify that all statements on this form are tie to the best of my/ors 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 rr� —SIGNATURE 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. 04112) r E 8 C qQ� fi c 8 L c J Y � G ��S °i� m L c J ti N S s�� �� 3w Parcel #: 038-1239-27-000 Valid as of 06/04/201911:57 AM Alt. Parcel #: 17.31.18.1288 TOWN OF STAR PRAIRIE ST. CROIX COUNTY, WISCONSIN Owner and Mailing Address: Co-Owner(s): JEFF R LANDT LANDT, JULIE R JULIE R LANDT 1138 PENINSULA RD Physical Property NEW RICHMOND WI 54017 Address(es): 959 218TH AVE Districts: Dist# Description Parcel History: Date Doc# Vol/Page Type 3962 ISCH DIST NEW RICHMOND 17110 WITC 03/29/2019 1079587 WD 8050 SQUAW LAKE RHAB & MANAGE 11/20/2013 989350 / WD Legal Description: Acres: 2.010 08/19/2010 921020 / WD 02/12/2010 911845 / QC SEC 17T31N R18W PT NW NE SQUAW LAKE ESTATES LOT 27 I more... Plat Tract (B-T-R 40Y41601/4 GL) Block/Condo Bldg 10-044-SQUAW LAKE ESTATES COUNTY PLAT LOTS 1142 038-05 17-31 N-18W NW NE LOT 027 2019 Valuations: Class and Description Acres Land Values Last Changed on 10/10/2013 Improvement Total G1-RESIDENTIAL 1 2.0101 27,600.001 0.001 27,600.00 Totals for 2019 General Property j 2,0101 27,600.001 0.001 27,600.00 Woodland 1 0.0001 0.001 0.001 0.00 Totals for 2018 General Property 1 2.0101 27,600.001 0.00 27,600.00 Woodland 0.000 L 0.00 0.00 0.00 2019 Taxes Taxes have not yet been calculated. Key *- Primary KIYY.L ��' ,Af i i 1 \ SBB'36'Ol" 322.87 LOT } 9e1.4 / a / 122,613 sq- "T 2.81 acres L.B.O.=964.4• / / LOT24 3.54 acres �� ` s�.� • / 1 - Area to O.H.V LOT25 3.15 acres '`.` I `r'`s�,`� ' :.• / • / o a 246,66E R. •l F :'• N 566 acres i H.W.= �______._�,` h 9� : •' *? o Area to aH.W.M.: y s 95fi9' ,yh09 P. DO \y0•� LOT26 C 305 acres t `Lv `ar+iS` 1OZO02 sq- . `\___: -.� : • • • x.W.L=958.9' ,y'r(./y� a to a es .1\ Area to O.H.W.M. .OTp . : •__. \ac�S Oh 2.25 acres ft t 788 sq. 69 acres / /9� • : dg g)7p4j+ - _ fib' Jdnf �'• � � \ �—� \ on�.,r.r c L 27 e°semenr: /°' /^� / 2.07 acres 575793g f r Po U' rym Are, to O.H.W.M.: 3pg ' ! !' S1.81 acres t l: m ?� 11 I 277 r"/ / / 658,01"E 1 1100,446-3 r '� I :••..--'.� LOTS 124,730 sq. ft %� I ~235. Ak \ \ 286 acres Ilp QO' a 0, \ \ I 11 a �� re ,ti, to O.H.W-M.: Ak \I o n i) \ . 271 acres t i N n LQT21 H 3 I :✓ �y / L.B.O.=944.1' 946.3 /.r�r• \ 1 1 \- 1\ 3 83,067 sq. ft. o : '�\ xwt.- 3 E 21 00II \ \ 'a i 91 acres I �� 1 1 1\ n w zo : }\ 942.1 r` Pig3'0710166 1. m 11 N 1 \ o I0 o `��,i h5 t_ 89�30.55 LOT29 � IYc 1)1 �% v ra f r^ {�.y ^^ 98,601 sq. ft 226 acres r I o •., ♦ P Area to O.H.W.dt: Z �� \ ,p41 lops kk 1.72 acres t 1 Il GtidA+orY 0\� t LBO.-959.7 = 1 1\ Water Mmk \\ \ I• •off \ n idt .•�- 0�- NB3.1407" iV.= Sy9,6 r *Bp.00' ems. 94a \ 111 .1 j 'do 1 m,n 95i.r' `' s2r.98 _ / 1 by �/ 3•e5 �•^ ��'�; \ x. w.L= `�$�349.66' S7 J 788 a (\\ l' N : c r°�9e N , LOTso . pbg• VRM1' aw \ Ease'4p°t J 4 114264 sq. ft ryA%\a^ ``�-ry.WL=\� y zro2.60 acres .../// G Ae \O� Area to O.H.11!,}/•: 60 t `L LOT94 \ 2.19 acres /: /�`a63/ :'»98b so. ft. %'•. \ L \ L.B.O.=959. f' ':a • n \�— _`? / 1 WiisconsinDepartrnentofCommerce SOIL EVALUATION REPORT ,� Division of Safety and Buildings in accordance with Comm 85, Ws. Adm. Code i U I 1 Attach compote site plan on paper not less than 8% x 11 inches in site. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St Crob percent slope, scale or d'mernslom, north amr, and location and distance to nea2sl road. Parcel I.D. 031 `a 3 please print all information. Personal information you "We may iax'-,�. 15.04 (1) (m)). / / j , <- Dab f 1283 1 of 3 Tom Schmitt Grand Properties, LP I I Got Lot NW 19 NE 19 S 17 T 31 N R 18 W Property Owner's MOng Address SEP 2 7 2004 Lot # Block 0 Srbd. Name or CSW 712 Rivard Streeet, Suite 300 27 1 Squaw Lake F_states City Slob ZP ONIN a City M Village 16 Town Nauaect Road Somerset I WI Star Prairie I 218Th Ave. ✓_f New Construction Use: ✓I Reetderrial l Number of bedroan 3 Code derived design flow rate 450 GPD Replacement I Pubic or cansnrdN - Dmcrli. Parent material Glacial Till f loud plain elevation if applicable na General comments a IV e.S /2sri-r. /e -es ~-✓' /'stJ/ Oe ireau'ea/ o0�ra.kr (,�- and rerxmmenclalions: Area is suitable for aLm�ound system. System elevation is 101.84based off of contour line established at 99.92'. Slope is 6%. Depth to limiting factor is 13". Boring # J Boring Opt Ground Surface elev. 100.02 ft. Doh to limiting factor 29 in. Sot AWicabon Rate Horizon Depth Dominant Calm Redmr Description Texture Structure Consistence Boundary Rook GPDff 'Eff#1 'E111112 1 0-8 10yr3/4 none sl 2fsbk mvfr cs 2f .6 1.0 2 B-19 1Oyr4/4 none at 2msbk mfr gw 1f .6 1.0 3 19-29 7.5yr4/4 none sl lmabk mfr gw .4 .7 4 29-48 7.5yr4/8 ° 7 5yi 6 at 2msl* mvrr 6w - .6 1.0 5 48 68 7.5yr4f4 t" jdp � ail 1 msbk mfi - - .4 .6 Boring # i Boding S Pi Grand Surface elev. 100.17 ft. Depth to rmMN factor 15 in. Sit Application Rals Horizon Depth Danirard Color Redw Domptlon Texture Structure Consistence Boundary Roots GPDfIR 'Efl#1 'Ef= 1 0.8 10yr4f3 none al 2fsbk mvfr ce 21 .6 1.0 2 8-15 loww none grvsl 2rsbk Mir gw 1f .6 1.0 3 1532 7.5yr418 a17.5yr&1/6 ad lmsbk mfi gw - .2 .3 4 32-45 7.5yf4l4 mid 5yr5/1 el 1 msbk mfi cw .4 .7 5 45 62 7.5yr4/8 told A sid 1 msbk mfr - - .4 .6 I ' Effluent #1 = BOD,> 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mgrL and TSS <_30 mg1L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt '"�•-' , 'lt� 227429 Address Tom Sow& ate Evaluation Conducted Telephone Number 1595 72nd SL, New Richmond, W154017 9/3104 715-247-2941 Property Owner Grand Properties, LP Parcel ID Page 2 of 3 # In Pit Ground Surface elev. 96.56 ft. Depth to Iirrltirg faGa 13 Shc Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence BaaxWy RootsGRDM •Eft#1 'Ett#2 1 0-7 110yr3I3 none aI 211abk mvfr ce 21 .6 1.0 2 7-13 10yr4/3 none d lmabk mfr gw 1f .4 .7 3 13-34 7.5yr4A3 elil ad lmsbk mfr gw if .2 .3 4 34-49 10yr5/4 mis SyrT6/2 sl lmebk mfr gw — .4 .7 5 49-63 7.5yr4B m 5 5 r 6 aid 2fsbk mfr — .4 .6 ❑ Boring # / Borng / Pit Ground Surface dw. fL Daps to firriBng factor in. Soil Application Rate HAw Depth Domiard Color Raft Desorption Tedwe Structure Careelance Banxrdry, Roars GPDff 'Etf#1 •EfW Boring # 'j Boring Pit / Ground Surface elev. fL Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Room Description Texture Structure Consistence Boundary Root GMM •EIf#1 •Eff#2 • Effluent #1 = BOD 5> 30 < 220 myL and TSS >30 < 150 mg7L • Effluent 02 = BODs< 30 r i and TSS -,V mglL 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. pne3of3 3 Ref No. Comucted W Evaluations ��nitt Soil and Site Lho� J• Scott CST 227429 1595 72nd St. 4017 New pdchm° Phone: 715-247- 9 1 CorOAwted For: NOW - Address' City, State, Zip.. SuhdNalae' Lot 140.: L.0 Deception: TOwoshiP of: EL loo.00! Top of 2" PV0 � pvc Pipe $each1vlark c1 /03,2✓ To 9.9,9-� Alternate Bench 1Vl S1oP�� Scab 1 40' to Grand Properties, LP. 712 Rivard St. Suiteloo S,rnerset, WL 54025 Squaw Lake Estates ��►�4 S17 T31N R18W /y�114 /� St. Croix COuntY Star Prairie, time to test markers m w location st'w+n. � t No pwmane lot our use, or in done to fuifiii� maayi O mea •fit be suitable for Y 'This soil 110 area in wh ch corrduct�. a ((����GG0i'mil'Se,115 -(9WisconsinDepartmentofSaf �P-rePageDivision of Industry Services N SOIL 9V LUATIAR EPORT �o�nt 5t.lWi 385, Ws. Adm. Code County i Attach complete site Ian on paper no I Y p p p p egsdl� 1 inches in size. Plan must include, but not limited to: vertical and horizont rence point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. 3 Please print all information. Revie Date Personal information you provide may be used for secondary purposes Pri Law, s. 15.04 1 m . 3 20 Property Owner Property Location ❑ Govt. Lot 41MJ Y. % S T N R E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# City 9 State Zip Code Phone Number ❑ City ❑ vlAage Town „ Nearest Road•, JDNew Construction Use: ® Residential l Numberof bedrooms Code derived design flow rat w [I Replacement % . [I Public or commercial - Describe: R �a[�W n Parent material / z Flood Plan elevation if applicable A 7 S- General comments and recommendations: /r W rn Boring # Boring M Pit Ground surface elev. U2 ft. Depth to limiting factgr-;Z�S- In. s^d en, ®®� 0 M- �.Y..�i' ://1►7.�iii�/�'"�Ie�iiS.ZiTII4�������i�� ® Boring # ❑ Boring nn�/ .® Pit Ground surface elev. 7S7 ft. Depth to limiting factor 1Q in Soil Amoll i.tion Rate wtMenr M = HOD_ > M 5 22n mnn ant TSS > an 5 15n mniv • FflhreM ll2 = Rnn > an G 22n mnn and TSS > :in 5 15n mM CST N P riM Signature CST Number _ > Address A,Q Dale Evaluation Conducted Telephone Number -:5ya:io buuisssu (t2u4115) © Boring # ❑ Boring y j,Pit Ground surface glev./��ft. Depth to limiting factor. Soil Aooll ication is I Boring # ❑ Boring p Pit Ground surface slev. _ ft. Depth to limiting factor _ in. Anil Annlil rAtinn Rwrw DorViinant Go or Mtlnsqll ❑ Boring # ❑ Boring ❑ — Pit Ground surface elev. R Depth to limiting factor _ In. SoilAool Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD1W •Eff#1 I 'EMN2 ' Effluent #1 = SOD, > 30 s 220 mg/L and TSS > 30 s 150 mg/L ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 s 150 mgrL - u � s --- - - - I I r- - i o .. wI \�\�\�4\�� z �i - / ✓ Cilit s 1 � 6 At .r Gf Nf 14AI GRADING NOTES ------------ ».......... I Yr"�x �- •..rr rsm m.