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HomeMy WebLinkAbout026-1149-28-000 Wisconsin,Department of Commerce Count PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: • 420651 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Marek, Todd I Richmond Township 026- 1149 -28 -000 CST BM Elev: Insp. BM Elev: BM Description: / 00. D 60• �.- TANK INFORMATION ELEVAliON DAT TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /a 5�' 10- �p.3 !oo • a Dosing UV Alt. BM 7 (o To o;F ¢� A/oa 1A / Z /o6. 23 Aeration O Bldg. Sewer C/o % S it /- JZ 23 Holding SUHt Inlet F /J /v 1/43 °��, SZ TANK SETBACK INFORMATION St/Ht Outlet --- TANK TO P/L WELL / BLDG. Vent to Air Intake ROAD Dt Inlet Septic r0 + ` ' hS P Dt Botto i m t0 IS & , v — t9 7 go. C) - Dosing �� Header /Man. - �j�s 3� T S Aeration D ist. P ipe Z to r . O- 3 Holding Bot. st m�� Final Grade PUMP /SIPHON INFORMATION — s. (o f 3. /0(• s Manufacturer dLF'_ Demand St Cover r� y GPM - G Z S� 1' ♦'0• l /Dy Ia Model Number l S �- Z yy 4- rR 5 S do /d�o6 TDH Lift O Fric on l,ps System ead TD Ft '/� S • 10 g i Forcemain Length Dia. D; . to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width / Length / No. Of Trenches n PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS !o-C. SETBACK SYSTEM TO P/L JBLDG WE / J LAKE /STREAM ACH Manufacturer: INFORMATION CHA R OR Type Of Syst t ^� / r �/ t /� N Model Number: DISTRIBUTION SYSTEM / 7 / Header /Maaniff I ) Distribution / �j x Holelt x Spacing Vent t r Intake ,Dr L t/ Pipe(s) N - 7 0 / Dia Length I Length 2� Dia Spacing SOIL CCIVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No � Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 r/ ( D ( D 3 Inspection #2: / / 03 Location: 1282 142nd St New Richmond, WI 54017 (NW 1/4 NW 1/4 36 T30N R1 8W) Torey Pines Lof28 Parcel No: 36.30.1 1.) Alt BM Description =CilcAg Poll � l (�l1L J1 f c�ia.., fa. CO'1C a0 2. Bldg sewer length � 30 / sat, C6 rtGlt fiJ - amount of cover = Plan revision Required? 0 Yes MJ No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's S nature Cert. No. Safety and Buildings Division County ® W 201 W. Washington Ave., P.O. Box 7082 isconsin Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.) Department of Comme (608) 261 -6546 O 5- p merce '� to I Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide # tZ7 % may be used for secondary u ses Privacy Law, s 1 5.04 1 m Project Address if different mailing P rPo Y O( ) 1 ( en I g address) I. Application Information — Please Print All Information 2SZ �2. 02 - - -v?-00V . 112 Property Owner's Name � arcel Lot Block # C ` � Property Own iling Address Property Location er's a & Section ICl City, State Zip Code Phone Number /V(circ on ) II. Type of Building (check all that apply) �Cltl S w 6 rw+ or 2 Family Dwelling — Number of Bedrooms t Subdivision Name CSM Number ❑ Public/Commercial — Describe Use ❑ State Owned — Describe Use ❑City illag wn p of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. System y ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B - ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that a l 0 X 2 ^Cn ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soi 8t -Grade t Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Desiglt ©ti (gpdj Design Soil Application Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation c VI. Tank Info Capacity in Numb r Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks /14-40 rlellk� Septic or Holding Tank S Aerobic Treatment Unit A Dosing Chamber VII. Responsibility State" 1 , the undersigiled responsibility for installation of the POWTS shown on the attached plans. Plutebar:s ame (Print) Plumber' i re MP/MPRS Number Business Phone Number Z 6 6) 7i� = 2 , �✓ Plumber's Address (Street, City, State, e) VIII. County /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date issued Iss in gent Sign re o S ps) Surcharge Fee) 3 2 s -, 6 ) Z n � ❑Owner Given Reason for Denial 7 !NV IX. Conditions of Approval/Reasons for Disapproval iM 0 1 ttach complete plans (to the County only) for the system on paper not less than gl 111 inches n ize SBD -6398 (R. 08/02) PLOT PLAN To y^! R:ga ADDRESS P.O. Box 228 New Richmond Wi 54017 / f ` 1/4 f 1/4s 36 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX 1/8/03 4 BEDROOM MPRS Shaun :i 226900 DATE CONVENTION AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SIsPTIC TANK SIZE 1255 Gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING T:\' %E LOAD RATE .5 ABSORPTION AREA 1210 # of chambers none BENCHN] N'.R.P Top of Survey Iron ASSUME ELEVATION loo' Filter Zabel A -100 ❑ BOREH 0 O WELL . H. R • P. Same asBenchmark SYSTEM ELEVATION 103. V B.M. • Property Line SCale = 1 /4" = 10' Area 15' Below System is to 102' remain 103' undisturbed B-2 104' Well is to ' meet all setbacks 5% found in Slope Comm. 83 Grading is to be done A to divert run -off o away from system r o m -3 `< r cn Huffcutt Combo Tank Tank is to be properly bedded and provided with B-1 ` lockdown covers with 4 approved warning labels cfl o 0 m Pro 4 .� Bedroom House L CD * _W n Road ' Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 IscOns,n www.commerce.statemims/sb www.wisconsin.gov Department of Commerce James Doyle, Governor Corry L. Nettles, Secretary January 14, 2003 CUST ID No.226900 A7TN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/14/2005 Identification Numbers Transaction ID No. 827032 SITE• Site ID No. 654854 Todd Marek Torey Pines Lot 28 Please refer to both identification numbers, 140TH St above, in all correspondence with the 'agency. Town of Richmond St Croix County NWI /4, NW1 /4, S36, T30N, R18W Lot: 28 FOR: New at grade system, 600 GPD Object Type: POWT System Regulated Object ID No.: 887837 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. C(! a ' The following conditions shall be met during construction or installation and prior to occupancy or use: }� General Approval Conditions: ` tYtF l� vF S • This system is to be constructed and located in accordance with the enclosed approved plans and with the "At Grade Component Manual , SBD- 10570 -P (R.6/99)" and SSWMP Publication 9.6, Design Of Pressurized .�. Distribution Networks For Septic Tank- Soil Absorption Systems. j • In the event this soil absorption system malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described the At Grade Component Manual are complied Reminder • The orientation of the at grade system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the at grade per At grade Component Manual. • Surface water drainage shall be diverted away from the system area. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). • Insulate building sewer per COMM 82.30(11)(c). A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation T SHAUN R BIRD Page 2 1114103 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, opera 'on or - main nance of the POWTS. Si" Fee Required $ 175.00 Fee Received $ 175.00 / Balance Due $ 0.00 Patricia L Shandorf POWTS Plan Reviewer , egrated Services WiSMART code: 7633 (715) 634 -7810, Fax: (715) 634-5150, M -F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 1/8/03 Owner: T Marek Location Lot 28 Torey Pines System pe: At -Gra Manuals Used: At -Grade Component Manual version 1.0 SBD 10570 -P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST- SAS (01/81) Page# dry a aiJ� 1. Cover Page , 2. At -Grade Plot Plan r 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout E>or .1v � 5. Pump Chamber Cross Section 6. Pump Curve � 7 -9. Maintance and Contigency plan 10 - 12 Soil test Shaun Bird Signature License number 2Z000 1/8/03 PLOT PLAN PROJECT' Todd .:1cq ADDRESS P.O. Box 228 New Richmond Wi 54017 NW 1/4 r, 1/4s 36 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MFRS Shaun . a 226900 DATE 1/8/03 BEDROOM 4 CONVENTIO:' AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND S1 TANK SIZE 1255 Gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING r LOAD RATE .5 ABSORPTION AREA 1210 # of chambers none BENCH.11 . , V .R.P. To f Survey Iron Top o S ey o ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREII WELL *H.R.P. Same asBenchmark SYSTEM ELEVATION 103.1' B.M. ^roperty Line Scale = 1/4 = 10 ............. Area 15' Below 102' System is to 103' remain undisturbed B-2 1 04' Well is to meet all 50/co setbacks Slope 1 found in Grading is to be done Comm. 83 to divert run -off o away from system - - v 0 - a co -3 3 Huffcutt Combo Tank 1 Tank is to be properly i bedded and provided with B -1 lockdown covers with o . approved warning labels 0 m Pro 4 Bedroom House 'own Road y �r 8 > 5 5' ' fe-- PvC Fa�MA� tit 2 " T U RtJ— to pc" _ W A L n,s r��8u r,oW AL �STAeILI F p$SER`tAr,BN V JCLc 0 — �O !/2 B i A= � >•t• - G CELL of /z ' G' /Z AfsGRE &ATF- Ft. RPPRa SYMTftnL Fabric Distribu Lateral STP 101 r6b Observation --- , , y P f1 Soil Cover Wel ` 12 " . PLOWED L P&A 2:5 q ---5, SL oFE Plan Vier and Croas Section of Wisconsin At -grade Unit With a Single Absorption Area an a Sloping Site Si& ATUALI Late s Page UT Distribution Pipe Detail For Two Lateral Network ACCESS 150Y. ts TufkN -UP (cu tNou1) t les Locaftd On Bottom e Equally Spaced PVC force Main * Y X PVC Distribution Pipe P P 1\J � (V -,-&� IZ * Last Hole Should Be Next To ruRN up P Ft. Rote Diameter � , 2 Inch X Inches Lateral Diameter Inch(es) _jV Y � Inches force Main Diameter Inches # Of Holes /Pipe Invert Elevation Of Lateral s /.yFt. Signed: License Number: Date: Maintenance and Contingency Plan for a At -Grade System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 4. Once every 3 years the At -Grade is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below at -grade undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump without float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If At -Grade fails, determine cause of failure, test another area or remove pipe and sewer rock, retill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715- 246 -4516 Pumper: Tom Mondor 715 - 246 -5148 St. Croix County Zoning 715 - 386 -4680 Shaun Bird #226900 MA NUAL & MANAGEMENT PLAN pOWTS OWNER'S f�nA SYSTEM SPECT2NS F S+1FOiz1utATtON S� Tw* t Il S O NA owner Septic Tm* � DNA _ �{2a (��I liu� a WA pF, l PARAW -WtS Etf and Fifr`Modd OE03 DN ofeedvoOM _ 'DNA of Oomme�! Tardc Me d Aar (a Wo") _ t (Fed x 1.S) PtffP Model D taA SW ApMpfiledlon gw�� Unit Rate _ oftWMWd P" Filtar � (8�1 �- o u� a Other. " Told S Sogds CAS? 5190 � avmao" Ct' Is = nd su� Protruded = TOM xy� s3o "1911.- 0 s30 mg1L s10• ch �loona a Fwd Coffmm ( geonv *= mean) • va lise b� roraon�c C� "ras°M'a1°r °"° S Cam. MNrEHpNCE gCHEDUt E Service Frequency sew Event At least once evenN .3 o nxmft (mum 3 yrs.) i"spedc � sl oorrtt d sludge and scum equals one4jmd (V of t� `r°tua`e p out cone of hwKs) o monfhs ]Near($) (Maximum 3 ym.) irlsped mss) Aft once every 3 At feast once every 0 months Yew(s) [ ERfltlMlt t At feast once every 0 s) a NA inspect P. ! Qpnapls 8c asaxm 0 month g) 0 NA W d P test Art least once every o month 0 years) o NA Oder. At feast 0108 every one /� least once every D months 0 yew(s) D NA MAINI'H+"CE ROTEWCM14S s hall be m � e hY an ildvidusi � of g" fdb"V or hape o f talks and � Resbsc•'ted S te% POI l�I s ' POWYS ' or broken Servfdnp Opp T � tr>ust file voanne of combined shldge and SWM a<1d� *w � Web '► °�(s) shad be the or pmft of & V m t WW m for arry of a g1 1he noM;caim of do foca3 mvimmy m doft- in title * a<1d u1e _ 9 ire a faftV con the eqLu O nq4Wd (V or aim Wt1er1 collftwed av °n of A dge arid scxrm in Servit�llg Opm of in accccmdance vdh ch. NR eire consents of tlm tardc stray be removed by a SePtaW 113. W POWTS cow• �� j�- The s .vk*V of r 12 mor>tl1s or less shad be p by ottler toe or mon 9 Y w ain 10 days of W serves of any s event. A report shag be proms START UP AND OPERATION s for she Prey °f pa pro d u cts or other to use of the POWTS �� tam ) are F now cam• P rior p to damage the ceks). if high cheaft* that may the co<1 l by a o Prior to use -- didected have r 2 Z System Start uP Stt� not occur hNther� soil cons atilt frozen at the Ind Surface. S puniP tmft mW tg above na vd � bevels. When plower is rewsfaad #W excess of will be db&1arged lb dw &WOMM ce in one lame d0sei ovubaft do OdKs) and MW MU& it tit thadatfp or svrfaoe disdhage of of ant- To avid this soon hams the conl eats of the pump tank removed try a t Septege Servk qg Operator' Pdo ' nmk � power !D the eilluent pxnp or contact a Pknnbero POoW1S Ito assist in y the pnrap om kois to restore owed bevsb vlf*ft the pnnp Es<hic- Do not drive or park vahides over fahlos ad coal cd& Oo not ddve or park over. or ot>ezwise dte wb or compac the area wMhi1 15 feet down d*9 of any mound or atVrade soil dmkpton area Re& thou cr ankraton of the * MWAV from the wadwm ter aft m may the p mW P con hg the ft of the POWM � ill " capon =f," degne=9W densret lboss< diapers > fanid on did (sump pump) wafer; "and vegetable P666W gasolM g hwbiddes; meat stxapq rnedicctior» oih hg p ! Y napWh% bmponK and water solierm brine. ABANDONOMW When tim POWYS andior is per# y aken out of service the fuNowfnyy stepe dwA Ive talm b kv mre Out the system Is artd safely abardoned In eompMahce wb ch. Cam UM, VVIseonsin Adrnidstcativ a Code: • AM p% ft b tantks and pits d*M be disconnected and tie abandoned pipe openings sealed. • The conlenft of all tarries and pis dial be removed and property disposed Of by a Sepfage Swvkdng Operator. • Mbar plumping. all tardm and pis shall be eommated and removed or their covers removed and the void space flW vA h soil. gravel or another inert wild matte CONTINGENCY PLAN if the pOWTS lab and cannot be repaired ed the Ubwktg measures have been, or must be taken. to provide a code ant mpboerrent system: 11 A stile � am has been evaluated and may be utSaed for the location of a replacement son TIO replacenmt area shard be protected from disturbance and compaction and should not be inki upon by from e70sli"9 and pnVosed strucUv6 lot Ines and wdl& Fa to protect rte replacement area will result in the need far a new soil and sft evatuadw to establish a suhtable r rherrt area. Replacement systems must comply Wth the rules In effect at that tune. ❑ A sulable replacement area bs not available due to setback *Wor soil GmMaft s. Baiting advances in POWYS tedinotogy a twWk g tank may be wed as a last resort to replace the faded POWYS. ' �e site has not been evaluated to Identify a suitable reptaaceam t area- Upon faalm of t1e POWYS a sod and / she evaltiallon must be perlom ed to khca6e a stile replacement area. If no replacement area is available a ' twM tw* may be Installed as a last resort to replace the faded POWYS. of the bbmat and atIpade soil ahbsorplim systems may be reconsbucted in place faMowhh9 at the kd& surface, Reeonstnrciions of such systems must comply with the ndes In effect at that time. <<WARNING» SEPTIC. PtlMP AN OTHE TREA TMENT TANKS M CO LETHAL GA At e I NSUF FMIENT OXYGEN. 00 O T ENTER A SEPM PUMP OR RESUL O THER MAY T. RESCUE OF PERSON FROM THE tYT�R OF A TAN LT NPOSSIBly ADDITIONAL COMMENTS POWYS WSTAL POWYS MA NTAWER Name ��u.✓ i Nagrhe �S` ,B Phone SEPTAGE SERVIMTOR LOCAL itEGULATORIf AUTHORITY . Name A9 Y 'A ce Phone 1 = T � aa�a br+fb ids oru.e ctae•th tom, erratviteme > �>w the rtdhainaan teQn perrEg ofadh. Comm Xd� � �ttl. t2) � M �!^�N° � Use aHNs docxhm0d P101y g uaawfte th>g of VIM PONS. vaae ur SEPTIC TANK 6 PUMP Ct {AMBER CROSS SECTION AND SPECIFICATIONS MIN. ABOVE GRADE E WEATHERPROOF vn Cl VENT PIPE I WINDOW OR JUNCTION BOX APPROVED 2; MOON DOOR' WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE W! PADLOCK 6 FINISHED GRADE WARNING LABEL I.ata`.+►. �" MIN. a++t" C.Z. pl6E lot 3. D. 1 6" IK- rNTR. �,� IS { lip INLET WATER TIGHT SEALS GAS s ` '� TIGHT : Ep F11.TER - A SEAL ' JOINTS WITH .,.}._. LM APPROM PIPE APPROVED � ON 3 �ISOIL PIPE 3 ONTO SOLID �T. --�- -- FF SOIL PUMP OFF ELEV .� D 3" APPROVED BEDDING UNDER TANK N��CRETE PAD SPECIFICATIONS SEPTIC / DOSE ER DOSES PER DAY: TANK MANUFACTURER: NUMB TANK SIZES: SEPTIC �-r-� GAL. DOSE VOLUME INC � � . �j ALARM MAPJI ACIURER: ��C s CAPACITIES: A :✓ 'INCHZS =�� GAL. MODEL NUMBER: L B _ .2 INCHES a GAL. SWITCH TYPE: . ��._ — C :/1�INCHES Pump MANUFACTURER: f � - _ 7 9AL . MODEL NUMBER D = INCHES SWITCH TYPE: I5.23 WAC REQUIRED DISCHARGE RATE . GPM PUMP ALARM WIRING AS PER ILHR FEET VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE FEET T i FEET + MINIMUM NETWORK SUppLy PRESSOR T - 0 * FT. FRICI ON FACTOR . FEEL- } FEET FORCEMAIN X TOTAL DYNAMIC HEAD = r 7 DTN DIAMETER INTERNAL DIMENSIONS 'Or PUMP TANK: LIQU D ��• LICENSE NUMBER= DATE: SIGNED: 1 /88 TOTAL DYNAMIC HEAD /CAPS PER MINUTE HEAD "CAPACITY CURVE EFfLtSEW OM BRATS" MODEL 152/153 152 153 50 Feet Meters GW. Liters Gol. Liters 5 1.5 69 261 77 291 153 10 3.1 61 231 70 265 12 40 152 15 4.6 53 201 61 231 20 6.1 44 167 52 197 s 25 7.6 34 129 42 159 3wo 8 30 9.1 23 87 33 125 $ W35 10.7 -- -- 22 85 20 12.2 �1. 11 42 Valve. 38.0 Ft. (1 m) 44.0 FL (13 4m) 4 ernes 10 0 60 80 100 20 � 6 1/4 LITERS 0 80 160 240 32 - 327/32 4 5/8 FLOW PER MINUTE 377/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS _ y ® 327/32 • Timed daft Pamb atra • E agN1>a�'s. for dt�le�c • are avada6le and supplied +�' . an atarrrl. srrlldfras are walabte for oOrS 01ft slrrmle pm ' • VadWe level 00001 I • Oatble pi bads wdrleble lens! 5og swddm are awabW for varl'a6le bW"and short cycle See FM1420. • Se" (A_ft avdEne far "ouWW �• 4 • ova MR (54•C.) spy � 12 1A 1521133 Series 5 1/8 N452 415 f 85 1 116 1 or3 aKSn 8NiS1 115 Aab 6.5 tub" 2ar3 E152 230 i No 43 4 tar, BEf52 23a t Aub 43 M*xbd 2or3 N153 4 4 103 f ear SELECTION GUIX ammo Aub 165 tarirded 2ar3 Et53 23D . 1 Nea 53 f 2ar3 1. aPTg9 1 0aeL aw3d eorajaukl ®PTpWbeckva� X1 230 1 Aldo 53 Ise>,rdsd 2ar3 fir. RdwbFM0477. 2 See FMO712 *90Mednr0dd of Ebel" A6eaWN E4 & Ay dooehok,Pm OS�wb� badaaeblla4 3. vwkw �elaOelrolsrri1dr1402? wwasaw"8ciiafnr. rdupl�rC31 ..IYla ebaearsa+2lr sbwababo radbdsft0»m0d or (4) Wd sydeaL ea eLtbeo�reoarrctxd.tt�f�ffia o � ► slydtwldr Act RESERVE POWERED DESIGN o�0veryza�er For MOW MOM a e sa Wy Taft r 161N 1Q: P.Q."46 Lm uft KY among Afapr Msersar• . X*CW � �tIB273f•4[a�9�PIMIP e r- nllvriaht 200D zoeper Co. m rights reserved. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 in� (� include, but not limited to: vertical and horizontal reference poi (BM) ED P I.D. percent slope, scale or dimensions, north arrow, and location a id distance to nearest road. Please print all information. II ,L��j n vi wed Y Date Personal information you provide maybe used for secondary purposes Pr -cyt" d. 1 S 04� 4. I 3 Properly Owner ST. F 1 4 S V T N R E Property is Mailing Address Lo # Block # Subd. Name or / z z 'T 8 I - I a City State . Zip Code Phone Number ❑ City ❑ Vil a rwn Nearest R d 4d,� Construction Use• esidentiai /Number of bedrooms Code derived design flow rate GPD ❑ Replacement mmercial - Describe: Parent material R = 11 co Flood Plain elevation if applicable /fo'V 14 ft. General and recommendations: Ong # 0 Boring F 71 CT Pit Ground surface elev' �v " � ft. Depth to limiting factor in. Sal Applicarticiri Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 U s/ Boring R # Boring .� 1 , Pit Ground surface ele+/ ft. Depth to limiting factor Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fE in. Munsell Qu . Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff42 s .� Effluent #1 = BOD > 30 220 TSS >30 150 mglL ' Effluent #2 = BOD < 30 mg& and TSS < 30 rrgll. CST Name (Please Print) — Signature CST Number -71 20 6y Addr Date Evaluation Conducted Telephone Number ZLZ i Property Owner Parcel ID # Page of ® Boring # Boring 0 Pit Ground surface elev. 0 � > ft. Depth to limiting factor 3 in. Soil Application Rate Horizon Depth Dominant ColoF Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 F Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appli caton Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 I •Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. fl. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Ou. Sz. Cont Color Gr. Sz- Sh. `Eff#1 `Eff#2 Effluent #1 = BOD > 30 220 mg1L and TSS >30:E 150 mglL ` Effluent #2 = BOD < 30 mg& 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. S8134330 (RAM) Soil Test P t Plan Todd M r k Project Name a e Shaun Bird Address P.O. Box 228 New Richmond Wi 54017 CSTM #2'f000 Lot 28 Subdivision Tory Pines Date 12/30/02 N W T /4 N W I /4$ 36 T 30 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 0 ft. Top I- u rvey Iron. _ PV OI System Elevation 103.1' * H R pSame as Benchmark Top of Steel Fence Post @ 103' B.M. 200' Property Line Alt. 102' 103' 104' 0' 5% Slope B -3 175' 0 ' IF 5'B- 30' ,, o a o � Pro Town Road ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND WNERSHIP CERTIFICATION FORM 1 owner/Buyer Mailing Address a, Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number I LEGAL DESCRIPTION pro PAY ` Location � / 4 , '/ +, Sec / 71 ` T - R W, Town of 'vision �,..c/ Lot i . Subdivision Certified Survey Map # � , Volume � . Page # Warranty Deed ## 3 . Volume 2- ©68 . Page # Spec ho u p no Lot lines identifiab!pd yes O no SYSTEM MAINTENANCE failure to handle wastes. Proper maienance Improper use and mainbenanceof Your septic system could result in its premature consists of pumping out the septic tank every three years or sooner, if needed by a licensed P%Wq r. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a 1 masterplumber, journeymanphunber, resbrictedPlumberoralicensedpumper, verifying that ( ) the site wastewater&vosal "stem is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 15 full of shrdge. Uwe, the undersigned have read the above requirements and agree to maintain the Private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.. Croix County Zoning Office within 30 days o three expiration date. / L6 C SIGNATURE OF APPLICANT DATE OWNER WICATION the owner(s) of (we) certify that all statements on this form are true to the bat of my (our) knowled I ( we ) am (are) the o descri hove, by virtue of a warranty deed recorded in Register of Deeds Office. /,b,eo DATE SIGNATURE OF AI ;PLICANT * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department * * * * ** ** Include with this application• a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings ' In accordance with Comm 85, Wis. Adm. Code County f Attach complete site plan on paper not less than 812 x 11 inches in size. Plan must Include, but not limited to: vertical and horizontal reference point (BM); direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. _ Please print all information Reviewed by Date Personal kdormadim you provide may be used for secondary purposes (Privacy l.aw, s. 15.04 (1) (m)). Property Owner Property Location r1 e� L Govt. Lot N 114N Lk) 1 /4 S 3 T N R E( Property Owner's Mail' g Address Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City _; vdlage QTOwM Nearest Road 60-k IMN I 5btto I ( 153&0 -2000 New Construction Use: ®- Residential / Number of bedrooms 3 -. Code de7lveddeslgn flow rate C� 6, o o GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plailielevation If applicable General comments C,. C erY\ , / Ili /- SU , . and recommendations: II ; " C'0 h - 6 t7 r el/ eU . fOf/ .S0 l l _ r Boring # ❑ Boring ® pit Ground surface elev. ft. Depth to limiti ng factor 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. Sli. 'Eff#1 •Eff#2 n -? I v • 5 2 IZ- l0 Si cl k ,nr, CIS - Co (� CZP •t> C>, S[ 2msbk F Boring # ❑ Borg , C) [� pit Ground surface elev. ft. Depth to limiting factor in. R*Eff#1 cation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D/ft= in. Munsell Qu. Sz. C ont. Color Gr. Sz. Sh. 'Eff#2 2 mfr C- L4 I l 2m rr)�r C-s. - (P 1 � C22 15 r SL - - . Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) i nature CST Number i am ch er' _' 253309 Address Date Evaluation Conducted Telephone Number 7 C )2-Y7- -gd6,9 Property Owner PmQ fwe3 L L�- Parcel ID Of Page 'of i Boring # ❑ Boring "= : ❑ Pit Ground surface elev. 101- O R Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. Mu nsell . Qu. Sz. ConE Color:`. ,_ ", Gr. Sm Sh. •Eff#1 r Effn 0 - 1 I ca 1 i V 2rr o b 2 L 1 5 i r S - . 3 2 - 10 411b CZP L 1 — IS .9 F1 Boring # ❑ Boring ❑ pit Ground surface elev. R Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description.-- .. .Texture .- Structure Consistence Boundary Roots GPD/ft= in. Munsell Ou. Sz. Cont. color Gr. Sz. Sh. •Eff#1 'Eff#2 ❑ Boring # ❑ Boring _ ❑ Pit Ground surface elev. R Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 - • Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD, < 30 mg/4 and TSS < 30 mg/L r ; 'Me 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. Sean" (RO7100) PAGE 3 OF N A ME r OT# 'LEGAL DESCRIPTION Nu% Y,tw Y ,S T 3v N R K E(or) SCALE: V BM 1 ELEVATION /o y • o BM 1 DESCRIPTION 4..)D o�- / P�'" e BM 2 ELEVATION BM 2 DESCRIPTION 400e o f 0 C e SYSTEM ELEVATION ALTERNATE ELEVATION N I W CONTOUR ELEVATION /DU Sd V t� a Y opt 4 C r� s SIGNATURE i DATE .r 1 2 0 6 3 1' `I 8 4 . KATHLEEN H. WALSH ' STATE BAR OF WISCONSIN FORM 2 - 1999 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX Co., MI RECEIVED FOR RECORD This Deed, made between Ames Investment Corporation, LLC, a 12/04/2002 10:30AIt Minn esota Limited Liability Company _ EXEMPT 11 REC FEE: 11.00 Grantor, and Todd Marek Construction, Inc. TRANS FEE: 233.10 COPY FEE: CERT COPY FEE: - - - -. — PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Address 28 Lots 27, d 29, Plat of Torey Pines II in the Town of Richmond, St. Gf /7 "`�Q Croix County, Wisconsin. por 026 - 1101 -80 -050 Parcel Identification Number (PIN) This is not homestead property. QE) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of Dec ember 2002 Amen e t nt Corpora on, LLC + AUTHENTICATION ACKNOWLEDGMENT Signatures) — STATE OF WISS ONSIN ) ) ss. County) authenticated this day of , -- Personally came before me this 2—/7 . day of December 1 2002 the above named Ames Investm Corporation, a innesota Limited Liability Company �✓.� TITLE: MEMBER STATE BAR OF WISCONSIN (If not, RCOER Q to me know d ged the same. to be a pers (s) who executed the foregoing ru n authorized by § 706.06, Wis. Stats. inst THIS INSTRUMENT WAS DRAFTED BY + Attor Kristina Oglan Notary Pu tate of Wisconsin Hudson, y 'o fission WI 54016 M p dat" _ � (Signatures may be authenticated or acknowledged. Both are not necessary.) is crmane . (If not, state expiration -') • Names of persons signing in any capacity must be typed or printed below their sig rc. Information Professionals company, Fond du Lac. W 4100655.2021 WARRANTY llEEll STATE BAR OF WISCONSIN FORM No. 2 - 1999 i I 1 d04 8 RAU _ Nei I l�O� � �oJoUUllo �UV I i SOWGW "E 636.97- FIEYATION= d_OO STORM WATER 4 UO G°3CI POGvJC RETENTION AREA . .. ------ - - - - -- o LOT 30 H.W.E. ='i0 1.0 2.630 ACRES (114,570 SO. FT.) MIN FFE = 1033.00 I� S 86 E 511.87' G 4OG°3C `l pO�nlC � J LOT 29 - - - - - - - - - - - - - 2.152 ACRES (93,744 SQ. FT.) I EtFVAnoN- �o5o.ss N 89°51'34" E 490.37' -- - - - - -- I 33'33' N _D 4 3_P_ AU S LOT 28 1 2.252 ACRES (98,076 SO. FT.) N 89 E 490.39 LOT 27 g 0 2.252 ACRES (98,081 SO. FT.) CA OD ELF1/ATION- 103125 O d@ 9 ON N 89 E 490.42' :i �4 7@ L. 1,3 P@,. mil aot •---- - - - - -- 1 i i p w 8 LOT 26 2.252 ACRES (98,086 SO. FT.) j m BENCH MARK I TOP OF IRON PIPE ELEVATION- 1028.11 — — — — — — — — N 89°51'34" E 490.44 O ONi : I