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HomeMy WebLinkAbout026-1149-29-000 Wisconsin Department of Camrntrce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division: INSPECTION REPORT Sanitary Permit No: 420649 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)]. $Z I ! .1U• Permit Holder's Name: City Village X Township Parcel Tax No: Marek, Todd Richmond Townshi 026- 1149 -29 -000 ST BM Elev: Insp. BM Elev: Description: e...,ed2�e �°K n.,� 1e1 3 & BM at k —T ANK INFORMATION ELEVATION DAT TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic WC--CL, S �&• Be chmark Dosing — " W �'!— Alt. 13M 2.Z� ro•; •-al Aeration U Bldg. Sewer I X0.9 9y•sb Holding St/Ht Inlet C • `� . 3 Y I TANK SETBACK INFORMATION St/Ht Outlet //• �y 3.96 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic t / Dt Bottom > is 1 9 $•y-e -t- lf.a.} �s L D3 Dosing / # Header /Man. s 2S C� �• $ ­30 3 •sue IVz .0 Aeration Dist. Pipe p 1 3• •�T X02 - o Holding Bot. System �. 20 �fl1.3o Fi nal Grad PUMP /SIPHON INFORMATION - - „u fj2 � Manufacturer tom. Demand St Cover I �' GPM •lob- �D•ZT Z.O 5 odel Number �Q H Lift Friction Loss System Head O TDH . Forcemain L ` Dia.� II Dist. to Well SOIL ABSORPTION SYSTEM Zt� BED/TRENCH Width , Length No. Of Tftmehes PIT DIMENSION No. Of P' Inside Di . Liquid pth DIMENSIONS ' V I 1 SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHIN facturer: INFORMATION Type Of System: t CHAMBER O �4L �� 5 � A � ^� —. UNIT Model um DISTRIBUTION SYSTE Lli,6 Header /Manifold Distr on t x Hole Size x Hole Spacing Vent to Air Intake to Length Dia Length 0 �ia Z— Spacing (3 Z - Z I f SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes [] No Yes E No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1• ZZ 2.0 Inspection #2: a #1 Z2 C"Zop Location: 1286 142nd St New Richmond, WI 54017 (NW 1/4 N 1/4 36 T30N R18W) Torey Pines Lot 29 Parcel No: 36.30.18.1129 1.) Alt BM Description = % 2.) Bldg sewer length = 9 { {{ - amount of cover = t� "t• Plan revision Required? F�_! Yes No e ther sid for a�diti = al inf ation. O.T. D e 1 r ins e ctor" � gi���tur �[ J rt S - 3/97 --• a— 4_`h • 7 ?�{ W'01� � V e� III PLOT PLAN PROJC Todd Marek ADDRESS P.O. Box 228 New Richmond Wi 54017 NW 1/ 4 1/4s 36 /T 3 N/R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 1/8/03 BEDROOM 4 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260Gallons LIFT TANK SIZE DOSE TANK SIZE 805 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1210 # of chambers none IL BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Fitter Zabel A -100 ❑ BOREHOLE O WELL - H.R.P. Same as Benchmark SYSTEM ELEVATION 102.4' B.M. * Property Line C I = 1 /4" = 1 ' 103' 102'8 -2101' Grading is to be done to divert run -off away from system 8% RECEIVED Slope Area 15' Below JAN 2 2 2004 ` System is to remain m ST. CRax COUNT r undisturbed ZONING OFFICE B -3 r . Well is to a meet all setbacks - 1 found in Comm. 83 Huffcutt Combo Tank Tank is to be properly bedded and provided with lockdown covers with A. approved warning labels 0 0 Pro 4 T CD Bedroom -. r« House r CD Pro Town Road 1 repti, f.AJG Sf'f;tic_i�A�'iQi►1$ /""��r•••� YC iJ T t AP � i � G.L. MLf►! Hs)<` `*+•r+ 1"� .►►s�tOtrftn i.OLNSAIL # wtATtdCIlstl,pDF . tr4 *COs+ OOCft. JLRiG'•'%oU •a>t •+�aW>«fOti! tCViR AcR tAt�ANe • � 4 MCA fi= ! t 'wapiti. MIN dL doom W MY. 1 c fuDYiT WMIMMI WAIN. rotovica Mir I F AeRTtGitT !CI►� f f • A R�8 f E � ♦i,ARM 1 f g * A"ROV90 ! ow J01193 KITf� f man v APPROVED PIPE 3 ONTO n! O SOLID SOIL � -04, `�► ore y� cow RtTt OLOCK +7r RI>sllt U'r ftILAMM OW4.11 10 Y'AWK mAM fACT4RtR 14A4 41iiM wft i0Yl f"iµftifACTNRR %wn"a Of Ooitf: isi0 11" ftwK miss. '�� bI►f.1.pUff 0069 V061dM9 /3d, �OOti. AIYM�iR� CAPACiTitf= A� A QK 5 1Vtf'PClt '1' lii �h°' 02 ' �.. as � Ni to '� OR &6664111A 9: A<.TYRSb3 � wt.cfs Owl i .T� 1.rsW iMOO« >11 meam. SZ D ( .� S ••••�••�••••••••�•••••• 'Uhlltr i� M Of1L�0111i SWIT T>rIO ETC PUMP AfyC A16&RM ^It 'TO K At1rWA OIfCNA KATi G ►� "TAW-90 OW O PWRA1% G1ft4W'Ti offMAL fill R4gW ft r4 et, PNIY Offs MA Oli}TRfO - r1lo ,f pit .. Lr.iC�.. Pliff r ' j s�i1�4 MCTwou suP►L� ''�� t ii�t ........ ; : 6 Mir "SG... o tliT Os ! sag MMiil X Lei j stlrAftTfOi�f f P!=T sc TOTgi, O'I W MIG INSAO s PLC? 77 MMA6 80 is �;wIIvTM i IQUID DCP '!M- 3 ..� ..... JAN 2 2 2004 $T. CROIX COUNTY ZONING OFFICE I Safe" Buildings Sivision County �� r lv W 201 W. WHitington Ave., P.O. Box 7082 sconsin Madison, WI 53707 — 7082 Sanitary Permit Number (t%be filled in by Co.) Department of Commerce (608) 261 -6546 :�_ -/ _-7, (, �, ti. Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide `: 3 a ' + 0 2-1 =7 may be used for secondary purposes Privacy Law, aI5.04(I)(m) Project Address (if different than mailing address) I. Application Information — Please Print All Information * 12 g(. 1 � 2_ 5 +. Property Owner's Name PaSc Il a;� Lot # Block # b oz(a - II q 2q Property Owner's Mailing Address Property Location o I 0 7— 3 &4� V4, 31 City, State Zip Code Phone Number /•, Section J y ` (circle e) II. Type of Building (check all that ap I / a S s u - ten. T N; R�E o o Par 2 Family Dwelling — Number of Bedrooms nS . Subdivision Name CSM Number or an ❑ Public /Commercial — Describe Use ❑ State Owned — Describe Use ❑City_ ❑Vi e$l .)"ip of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. w System ys ❑Replacement System ❑ Treatment/Holding Ta<:!c Replacement Only El Other Modification to Existing System B - ❑Permit Renewal El Permit Revision El Change of El Permit Transfer to New List Previous Permit Number and Date issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that apply) O X 121 - e ❑ Non — Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil At -Grade Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment nl ❑ Recirculating Sand Filter ❑ Recircul Synthetic Medi Filter ❑ Leaching Chamber ❑ Drip Lin ❑ Gr avel -less Pipe ❑ Other (explain) V. Dispersal/Treat ment Area Information: Desi low (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 61 �G - S c2o0 �' • o�. VI. Tank Info Capacity in Total Number Manufacturer Prefab Site S el Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank r Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, ssu a responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's S MP/MPRS Number Business Phone Number �SS 21, 9 1- d 0 Plumber's Address (Street, City, State, Zip C e S V o ) 2 VIII. County /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing ent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Reason for Denial 14 7 IX. Conditions of Approval/Reasons for Disapproval / n 4_1 IQ`�a vwAd n¢cQ ed ,•I,i Cep ce / vlo�t�NavtLe$ Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches In size SBD -6398 (R. 08/02) i ,d Marek PLOT PLAN =� ADDRESS P.O. Box 228 New Richmond Wi 54017 1 /4S 36 /T 30 — N/R 18 W TOWN Richmond RS Shaun Bird 226900 COUNTY ST. CROIX z CONVENTIONAL 18 /03 AT -GRADE DATE BEDROOM 4 CONVENTIONAL LIFT MOUND SEPTIC TANK SIZE 1 255 Gallons — HOLDING TANK HOLDING TANK SIZE LIFT TANK SIZE DOSE TANK SIZE �— LOAD RATE .5 ABSORPTION AREA 1210 BENCHMARK V.R,P, To p of Survey Iron # of chambers none ❑ BOREHOLE (D 'WELL ASSUME ELEVATION 100 'H.R.P. Same as Benchmark Filter Zabel A -100 SYSTEM ELEVATION 102.4' B. M. ' Property Line I 1 031 10243-2 101 Grading is to be done to divert run -off way from system 8% Slope Area 15' Below System is to f remain 0 B-3 undisturbed _0 m r Well is to CD meet all setbacks Huffcutt found in Combo Tank Comm. 83 A Tank is to be properly bedded and provided with lockdown covers with v 1-4 proved warning labels Pro 4 Bedroom House �-- T r`.�". l4 Pro Town Road Safety and Buildings r' 10541N RANCH ROAD M A, HAYWARD WI 54843 TDD #: (608) 264 -8777 �sconsin www.commerce.s i www.wiscon isconsin.gov n.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: 0111412005 Identification Numbers Transaction ID No. 827029 SITE: Site ID No. 654853 Todd Marek Torey Pines Lot 29 Please refer to both identification numbers, 140TH St above, in all correspondence with the agency. Town of Richmond St Croix County NWl /4, NWl /4, S36, T30N, Rl8W Lot: 29 FOR: New at grade system, 600 GPD Object Type: POWT System Regulated Object ID No.: 887835 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. The following conditions shall be met during construction or installation and prior to occupancy or use: r General Approval Conditions: t' • This system is to be constructed and located in accordance with the enclosed approved plans and with the "At pt Grade Component Manual, SBD- 10570 -P (8.6/99)" and SSWMP Publication 9.6, Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems. / �L�wE CO • 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)(1). • Insulate building sewer per COMM 82.30(l l)(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. SHAUN R BIRD Page 2 1/14/03 i In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, �. Fee Required $ 175.00 / Fee Received $ 175.00 mm____ Balance Due $ 0.00 Patricia L Shandorf POWTS Plan Reviewer, Integrated Services WiSMART ode: 7033 (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 D : r TS703 wner: Todd Marek L cation: Lot 29 Torey Pines Sy m type: At -Grade Manuals s 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# 1. Cover Page 2. At -Grade Plot Plan d`a'isi 3. At - Grade Cross Section ' 4. Pipe Cross Section /Pipe Layout r orc ..ern Ncs 5. Pump Chamber Cross Section ,_ 6. Pump Curve 'k DEN 7 -9. Mai ntance and Contigency la c3 2 D Z� 10-12 Soil test Shaun Bird Signature License number 22640 1/8/03 i PLOT PLAN PROJECT - Todd Marek ADDRESS P.O. Box 228 New Richmond Wi 54017 NW 1/4 NW 1/4s 36 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 1 /8/03 BEDROOM 4 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1210 # of chambers none BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 102.4' B.M. Property Line Scale 1/4' 10 3' 1 02'13- 21 01 Grading is to be done to divert run -off away from system 8% Slope Ln -1 Area 15' Below System is to 0 remain -0 CD undisturbed B -3 Well is to m meet all setbacks - 1 found in Comm. 83 Huffcutt Combo Tank Tank is to be properly bedded and provided with c lockdown covers with 0 approved warning labels Pro 4 CD Bedroom House r Pro Town Road I L 5' f•r- Pvc Fot�.E.r+►Af tit > 51 Z -- "TURt3— UPS' — W t bisro%iftUT104 t.ATILRAL J A �srwgIL aeb oftERMA WELL ` o y 1/6 B 1/613 1/28 a= p F { ' GE L L o F %a ' Z %Z AGGot f_&arE RPPRoVED SYUrNgnc. Fabric E Distribution Lateral STaff,i3Lb tJbservatsan-- ....,,,.. „ . — Soil Cover Well 12 :y �i.eMl� LAVER ?, A =2 ''5 Plan Viaw and Cross Section of wisconsin At -trade Unit with a Single Absorption Area on a Sloping Site S1CaNATu AL : LmcwsE � Page Of Distribution Pipe Detail For Two Lateral Network ACCESS BOX to TuRN -UP (CL rtf out) Holes Located On Bottom .JJJ Are EqualiY Spaced PVC Force Main * X PVC Distribution Pipe Y . P P v LJG 1 N �.� r`'F—Q- ✓ * Last dole Should Be Next To T UP P �v Ft. Note Diameter Inch X � Inches Lateral Diameter Inch(es) Y Inches force Main Diameter 2 Inches # Of Holes /Pipe -A Invert Elevation Of Laterals �� Ft. Signed: License Humber: Date: _ I F&Qe Ur SEPTIC T ANK PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS . I „ " MIN. ABOVE GRADE 6 WEATt�RPR00F Cl MOM PIPE I WINDOW OR JUNCTION BOX APPROVED 25 Dom• WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE �-� WI PADLOCK 6 --WARNING LABEL FINISHED GRADE 4 " MIN Aw Ion IN. k: MtM• INLET GAS - WATER TIGHT SEALS - T - TIGHT PLNKED A SEAL JOINTS VITH FILTER LM APPROM PIPE APPXWED B ON �t� IL PIPE 3' ! . ONTO SOLID FT . , C c OFF SOIL. PUMP OFF ELEV . D 3 " APPROVED BEDDING UNDER TANK CONCRET� - PAD SPECIFICATIONS j 2- a: C SEPTIC / DOSE NUMBER DOSES PER DAY: TANK MANUFACTURER: 36 GAL. DOSE VOLUME INCLUDIIIC `;t5 GAL. 36 TANK SIZES-- SEPTIC GAL. F LOfdBAC t ; ;• ��„_,_......... DOSE 6s , i A • C CAPACITIES : _�� INCHES � .ill J�iAL. ALARM MANUFACTURER. 2 INCHES = GA MODEL NUMBER: B = ,_, 2 SWITCH TYPE: C = NCHES = A92-3 - 44L. PUMP MANUFACTURER: I MODEL MMSER: D = IICHES = 2 L ' SWITCH TYPE. .� 16.23 WAC REQUIRED DISCHARGE RATE ___- GpM PUMP F. ALARM WIRING AS PER ILHR FEET VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE •- �/ FEET rEET + MINIMUM N£'1`UIORK SUPPLY PR SS FT ;I;D *FT. FRiC'tION FACTOR FEET FEET FORCEMAIN X TOTAL DYNAMIC HEAD j // ' LENGTH �� W TH a ; DIAMETER INTERNAL DIMENSIONS OF PUMP TANK' LIQUID fft "t`Fr...__..J--.-- LICENSE NUMBEK' DATE: SIGNED: . �I88 TOTAL DYNE HEAD/CAPA PER 1NNll1E HEAD :CAPACITY CURVE EFLvM AM DMTl MODEL 152/153 MODEL 152 153 � ''- 50 Feet Meters 6d- Lite 5 1.5 69 261 77 291 153 10 3.1 61 231 70 2 12 152 15 4.6 53 201 61 231 20 6.1 44 167 52 197 25 7.6 34 129 42 159 -- __ 8 30 9.1 23 87 33 125 a )-4 .98 35 10.7 22 85 4 20 40 12.2 -- 11 42 t ock vdve 38 0 Fl (11.6m) 44.0 FL (13.4m) 4 or4�e 10 0 60 80 100 20 40 3 3 6 1/4 tliERS 0 80 160 240 320 - 327/32 4 5 PER MINUTE 327/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS _ -- _ 3 27/32 • Tlmed dosing L 8v9 • dots, for duOm sysl". are avalme and st pow wi�l andom • Variade j" caMrd are avadabie for oonb�o n9 O we vfjwm var�lle lend g" smV= are av�le for vardble I • Doubb piggyback r level long and abort cyde cm*01s. See FM14� • Sealed (*-� ava fOrniridoor �• • Over 130•F. (54T.) spelial q r 12 1/8 152M53 Series 5 1/6 VesaPL 1 2or3 N152 115 1 s 2or3 Bm 1151 i Aeb 8S iaCllded E152 280 1 Non 43 1 2or3 p 2or3 8E152 280 1 Apb 1 2or3 SELECTM GUME � 1 1 Nco 181153 115 1 AW iad{ ei1 2or3 1. p levdg*N #Aordmdriepi9 bvdkd E153 230 1 53 Nr9udad 2or3 swWL RdatoFbg4 6E153 230 i Aab 2 See FM9712 jar anedmoddofBec"ArE -Pak � CA1rilOM be d oaeblra Q>� 3. Yaiebiebsvela� WwAiehl0-07� moasaconbdad+�alor.aP�f►deP (3) dwAm trod �bould ,. cod,Wgmdg°�°Ai H r arµ)tieoet S YSIML RESERVE POWERED DESIGN wwwew b* S� �� For oonmons a msw* safely falter is MILT* Ra WK 18317 � SW To " CmRoPAW t� 77a z7a1 feoll ,rte:►. -� PUMP !O -_ FaMn4,WX 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 i 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 i P LAN P� � MANAGEMEN P POWTS OWNER'S MANUAL SYSTFJR SpECMN M O W-ORW ON SepticTankt l ..� DNA E Owe Tw* N� DNA 11 t�attrdtt. � Ombcbm O NA pECtiS d NA �Modd DNA Number of Bed Links tHA pump Tank t l �S� ❑ NA Number of OotM pump Tank � DNA E�rnated Aow (ateetaP) _ DNA .t?iutiP t7es)gn flaNr lea . t x 1.Sj , �.. pump (Node DNA Sol Apps Rate e � Unit ant Sengare / MCI O � �' O Peat Fll�ar S30 mglL D Unhwilcel Agitation D wellana :s220 mglL ° p,n o t TOM Sow OSS) n othe ave dhffKftf sts0 C dy rage" pispen�ai Cea(s) �� T Suspended SoWs oe mana �_s) 130 mgr- ° t� o t"' s30 mgR. r. mom,) :5,10 � ° - K � llAaudctaun Pattie She MAINTENANCE p E Smvice Frequency Event ❑ moMlus (s) (Maximum 3 yrs.) !�� ao Son of t s) At test once e .3 combined std a nd scum a ate -+d (ill of tank v�,rne W Pump out of tank(s) ° moruths years) (MaxMwun 3 yrs ) i nspect Mks) At least once evety ,3 tt At least once every / ° months y O NA At (east once every ° inspect pump. P" c ontrols &alarm anoe ° moms s) O NA Fiume bdelds and pressure 63A At months ° year(s) 0 NA o if� At least once suet)/ At least once t'araty D mCWhs D years) D NA Offoc MANTENAHM ONTR shall be made by an Cw ft °ng of the Mowing 6=16 a t orts Seww. PoWrS In spector PoWTS : $ems M W O BW= Master Plumber;. Maser a visvat ittspe�ott the(sj Men* an 9 or broken ServidnA Tatdc the vakow of combined Aktdge an scum a id t che at fo any ba d or Wd din � cracks Or . The. t ( a shalt be Wo un d ur The a, the t and to check the ittmn$dwbe nog&mow of the kxm d reFft"Y - he a W" the 9 con+b� won of sludge and seam in any wk equals Jd ( accordance vrM d'- NR of the tank slr.dl be � a � ,enwe contents 113. Wisconsin a Pam �• 4s� ss The senrtdng of 12 months or less stuait be p monkoft at Cow be to am ocat negul�Y 10 � Of � of any event A PW WW s for Ure presence � p products or ofha' START UP AND �MN u� of the POWTS check �) g If � are For new uc6on. prior arm "n . 09e the � )- t � =Or p c that may of the tar Ks) mmo� by a s~ t dekded have the contents -- Page _ of System start up shall not o=W wheri soii•coaciffib s am frozen at the intlitradve surface. ta above normal h%lbwater levels. When power is restored d1e samosas h� /W tit wasl awater will be dbdmged M the dispersd cell(s) In one brge dose. ouedoaft 80 GAS) and tai result in the ba*W or uram dbdha of To avoid this sbidion have tine contents of the pump tank removed by a b the eilluernt corrtact PNarrbec POWiS I to b resiorirtp Power PAP or , 00941 11 d pump oontrohs to tostore normal levels vr�in the pump tank. � assist ti / aperatirng - - Do not drive or park vet aver tanks OW dispe" cep. Do not drim or park aver. or od wbe disturb or compact the area vrithln 45 feet down slope of any mound or at-grade soli atwbrpdon am Reduction or eBminaMon of go foroAng from the wastewater stream may irnpwm the performance and prdong the Me. ofthe POVVTSr - � -c�etetft b� cotnd(� K cotton swabs; degneaWW dental those~ diapers; faC foisida�an dials (sump pump) water. t�nritand vegetabie peeiinM 90190110% 90 BE gG hrerbicklm. meat scraps: rrredicaf W of 0 0 g g P M&XAK P Y UgWor� and watersoAerrer brirne. ABANDONT out of service the steps shell to taken >p than the system V{flnerr the POVYlS f� andfor is perrrarner�j► is mad sd* abandoned h compliance wW dL Comm 83.33. Wisconsin Adm>nisfraliVe CO(W • AN p to tanks and pas shall be disooMected and the abandoned pipe operr>ngs seeied. • Th con of ail tanks and pks shall be removed and properly disposed of by a Sept W Servicing OPerAw. • + tan at d pit &hart saw and removed or their covers removed and the void apace tilted gravel CONTINGENCY MAN if die POWTS bb and cannot be repaired da tr>lowft mearsues have bem or must be taken, to provide a code content r+epiacerrm t sY O A M le tepbCOMBIC81 has been eve and aay be ublmed for the location of a rnrpiaoemeM sort The mpgacement area should be protected from ctistwbanee and compaction and shoWd riot be k* q pd uPon by re*dred setbacks from existing a W Proposed struct lot line and wells. Faihme to proW the oepiaoement a+aa wS result to t� nr�s eft at OW a e re area. Replaoemerd systems Im O A sutid61e nWiscemert area is not ava�le due to a ndfor sal 6rrdtatiorrs. fi advances POVV7 S technology a holding tank may be Installed as a last resort to rem the failed POINTS. e site has not been everted to identify a e replacement area- Upon fie of the POYVTS a son and / she enalitation need be performed to tocade a sulahle replacement area if no replacement area is ava&WA a hakft lank may be installed as a last resort to nq tace the failed POVYTS. renwvai of the biomae at xW and atIpgde soil absorption systems may be nxx n tructed in place the irdballve solace. Recoiubudions of such systems must comply with the odes in effect at OW time. c<WARMN©> SEPTIC. PUMP AND OTHER TREATMENT TANGS MAY CONTAIN LETHAL GASSES ANDFOR RISUFFICIENT OXYGEIL 00 NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CKWUMSTANCM DEATH MAY RESULT.. RESCUE OF A PERSON FROM THE KMPJOR OF A TANK MAY BE DWFWMT OR WPOS . ADDITIONAL COMMENTS POVYTS iNSTALlF.ft P0VVrs MANNTA R Nave Marne 'r Phone _ Phone, --� SEPTAGE SHt1Ilt:1[�IG OPERATOR LOCAL REa1LATORY AViHORI <Y Narrne �- �� 2 Agency F c./1 Ph�>e ?i PPho� l T,. dO..d.A,.s iMftd by WA ands GCVW Mess LdmL U=qusas and WmNlmra CounW Zocft and S q Tlds dodgy " ,**m m**muds of din. oom 83.22MXI) and t). M b (3L W swadn � CO Q. Use of 05 dOGUrlel 1 doss GL4W (?JDr) guaf arme die pemce of Vm P'OAA M I - , ' A( Wisconsin Department of Commerce SOIL EVALUATION REPORT page l of T ' Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 1 inch= , include, but not limited to: vertical and horizontal referen point an Parcel I.D. percent slope, scale or dimensions, north arrow, and I 'on and distance to nearest road. Please print all informa n. ,SAN 0 2 2003 Re ' ed by Date Personal information you provide may be used for secondary (Privacy Low. s. 15.04(l) Property Owner ocatio ZONiN 1/4/f/�4 S ,�TJ j � N R E(o W Property Owner' ailing Address L Block # Subd. Name or CSM# Ci/t�y� State Zip Code Phone Number O city ❑ Village FTown Neeaarrreesttt Road New Construction Use: Residential /Number of bedrooms Code derived design flow rate � 10 - 10 GPD ❑ Replacement / �] ub9c mercial - Describe: Parent material C Flood Plain elevation if applicable All ft. General and recommendations: lax F T1 Bonng # Boring l Pit Ground surface elevoe , - ft. Depth to limiting factor n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efl#1 'Eff#2 ® # Boring Pit Ground surface etev ft. Depth to limiting factor in. Sol icabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. M unseil Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 'Eff#2 " 1 13-21 1 02 , ---- - i -3 P- • Effluent #1 = BOD > 30 220 mg/l. >30 < 150 mg1L ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L l (Please ) Signature 2 2 L A a, v Address Date Evaluation Conducted Telephone Number ® Property Owner _ Parcel 10 # Page of Boring # ❑ Boring , Pit Ground surface elev. Q ft. Depth to limiting factor in. r *Eff4#1 oil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 / ® —1 1 c'-f �— s t -d F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sal lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Effif2 F Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor �. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsel Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = BOD > 30 1220 nxYL and TSS >30 1150 mgA. • Effluent #2 = BOD < 30 mg/- and TSS 130 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. sBn43w(x.6=) Soil Test Plot Plan z Project Name Todd Marek Shaun B Address P.O. Box 228 New Richmond Wi 54017 CS #226900 Lot 29 Subdivision Tory Pines Date 12/30/02 NW 1/4 NW 1/4S 36 T 30 N /R W Township Richmond F1 Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top -` Survey Iron System Elevation 102.4' *HRpSame as Benchmark Alt. BM Top of Steel Fence Post @ 103.5' B.M. 50 203' Prop Line Alt .M. 30' 102' 101' 103' - 80 8% Slope B -3 a� 25' a >, 30 o B -1 Pro Town Road ST CROIX COUNTY SEPTIC TANK MAIriTENANCE AGREEMENT` AND - OWNERSHIP CERTIFICATION FORM Owner/Buyer na Q t» ! Mailing Address U i Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number l LEGAL_ DESCRIPTION / property Location ' /., V, Sec. '�' �" . T N R W, Town of kl Subdivision Lot # Certified Survey Map # , Volume . Page # Warranty Deed # Volume 2 ° . Page # `� S q Spec house yes ❑ no Lot lines identifiable ❑ yeiAno SYSTEM MAIlVTENANCE failure to handle wastes. p maintenance Improper use and maintenanceof your septic system could result in its premature put You What into the system consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. 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 ourneymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on wastewaterdisposal system masterphmrber, j � ank is less than 1/3 full of shrdge. is in proper operating condition and/or (2) after inspection and pumping (if necessary), septi c t 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 t your sep . system has been maintained must be completed and returned to the St. -Croix Cotmty Zoning Office within 30 dam a e three expiration date. SIONK I'URE OF APPLICANT DATE OWNER CERTIFICATION knowledge. I (we) am (are) the owner(s) of I (we) certify that all statements on this form are true to the best of my (ours p above, by virtue of a warranty deed recorded in Register of Deeds Office. t � / 1610 3 — DATE SIGNATURE OF APPLICANT * « * « «* A information that is mis- representedmay 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 Attach complete site plan a n paper not less than 8112 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 information you provide may be used for secondary purposes Fdvacy Law. s. 15.04 (1) (m)). Property Owner _ Property Location A LLC GovL Lot 1/4 1/4 S T N R E (or) W Property Owners Mailing Address Lot # Block # Subd. Name or C 3t. Perir t - Pd �q - i n>° S City State Zip 5 Code Phone Number ❑ City illage .Town Nearest Road N i T i L 0 �. New Construction Use: Residential I Number of bedrooms Code derived design flow rate 5 U e. dU GPD ❑ Replacement II ❑ Public or o6mmercial - Describe: , Parent material t i 1 I Flood PW efevatlon If applicable N 1A fL General comments ss`�� -e %ev, qQ 5 and recommendations: w � ®fie% �7, w s r Boring # 1 ❑fit Boring 5-0 © 6tit Pit Ground surface.elev. ft. Depth to limiting factor in. .. Sa'I Application Rate FHorI74 Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz In. Munsell Qu. Sz. Cont. Color Gr. Sz. S6. 'Eff#1 'Eff#2 3l -- - S I 2 rr bk rr r r2 _ 2 k) l0 ILA — 5 cl ZmSbk m�� C s 3 - y5 l d r 3 to r_ s i ►S fir- f 5 2 Boring # ❑Boring a ® pit Ground surface elev. fl Depth to limiting facor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munseli Ou. Sz. Cont. Color Gr. Sz. Sh. 'EfI#1 'Eff#2 I 0-12 2 k r es � 5 . Z c5 C2 — i ,5 r 9 l \ 45 m t — _y . Effluent 41 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOO 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ignature CST Number r 253 309 Address Date Evaluation Con u ed Telephone Number WADI aa5 _. _ �- �/- �f7 -� �� C�1�)2�F� i Property Omer Arm Inw5tmenL Parcel ID# Page � ' of 3 V a Boring # ❑ Boring � � Pit Ground surface elev. R Depth to limiting factor 5 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Struct Consistence Boundary Roots GPD/ft In. M ansell Ou. Sz Cone Color "; Gr. Sz. Sh. •Eff#1 •Eff#2 I O - 1 Z l0 312. Sk 9-Ma& i rv-,f r cs \X Z IZ -Z _ )bVr Ll IL( :5d 2_ ryvnb k mfr C 3 2 (� r 3I� �S Ims r c5 rf)5 7] F Boring # ❑ Boring ❑ Pit Ground surface elev. it Depth to Limiting factor in. Soil Application Rate Horizon Depth i 2 th Dominant Color Redox Descri lion.. _ T e Struchue Consistence Bound Roots GPD/ft P P _. _ Boundary In. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. •Eff#1 'Eff#2 F-1 Boring # ❑ Boring _ ❑ P•if Ground surface elev. it Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPD/1`1 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/la 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. s8n•2330 crtmroo) PAGE�OF_,S NAME V�`e- 5 TOT# , 1 T G L D S RIPTION � w 1 4 ,S Ike T 30 .N.R. I E(or� BM I ELEVATION IOU . BM I DESCRIPTION � ?v p o l BM 2 ELEVATION - 4-6 BM 2 DESCRIPTION SYSTEM ELEVATION q q s ALTERNATE ELEVATION M' I�- CONTOUR ELEVATION 15,00 CSC) 1 p as U ° lo Yk o 5 J L 2 I SIGNATURE DATE 1 2063 i' 98 `f KATHLEEN H. YALSH STATE BAR OF WISCONSIN FORM 2 - 1999 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX Co., NI RECEIVED FOR RECORD This Deed, made between Ames Investment Corporation, LLC, a 12/04/2002 10: 30AM Minne Limited Liability Company _ " -^ EXEMPT / REC FEE: 11.00 Grantor, Todd Marelk kstruction, 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 and Return Lots 27, 28 an 29 Name an R P lat of Torey Pines [1 in the Town of Richmond, St. 1 Gf /7 "-/ Gt �/ � Croix County, Wisconsin. G I 026- 1101 -80 -050 Parcel Identification Number (PIN) This is not homestead property. CK) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of De 2002 Amevin�le�t nt Corpora on, LLC AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF IS ONSIN ) — - = f-- County ) authenticated this day of — Personally came before me this day of December 2002 the above named Ames Investments Cor oration, V 245 innesota Limited ` -. -. -- — .. - - -- Liability Company /✓7 TITLE: MEMBER STATE BAR OF WISCONSIN to me kno to be a erg (s) who executed the foregoing (If not, f�(� authorized b instru d n ged the same. y p 706.06, W is. Sta\. THIS INSTRUMENT WAS M(AFTED BY • (� Attor Kristina Oglan Notary Pu , tate of Wisconsin Hudson, WI 54016 — — My 'o fission is permane . (If not, state expirat //ir�on,, daty: (Signatures may be authenticated or acknowledged. Both are not necessary.) ' Fames of persons signing in any capacity must be typed or printed below their sig re. Information Proress+onaie Company, Fond du Lac, VVI STATE BAR OF W ISCONSIN 800-655 -2021 WARRANTY DEED FORM No. 2 -1999 I I I I?gaa 'I NOW51 I 66.E S86°5VI VE 6W.97- ELEVATION= 1030.5 )4 77 UDL a4 STORM WATER RETENTION AREA ---- - - - - -- N o LOT 30 H.W.E.= •1031.0 2.630 ACRES (114,570 SO. FT.) MIN FFE = 1033.00 S 86°54'16" E 511.87' )4 PLIM = N - oO - I C�7 [PO[t�m w LOT 29 - - - - - - - - - - 2.152 ACRES (93,744 SO. FT.) I ELEVATION 1050-96 - N 89°51'34" E 490.37' 8 LOT 28 2.252 ACRES (98 SO. FT.) _ I I i N 89 E 490.39 : I � N LOT 27 0 ° 0 2.252 ACRES (98,081 SO. FT.) p ' � N O , Z OD ELEVATION =103125 Op v N 89 E 490.42' w g LOT 26 m $ 2.252 ACRES (98,086 SO. FT.) A BENCH MARK I TOP OF IRON PIPE ; ELEVATION-1028.11 — — — — — — — N 89 E 490.44' I 0 I � I