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030-2121-50-000
o �'o offm o d �1 o fD v(D rr v d O O` N Q O ' O n o v m N p O N) O o w !r • c m c a m 3 3 c w a w° k Q N co j 00 00 a N jJ N r 7 N [A\ fD 7 CO NJ O C C V 1 O C 1 3 (D N N N N Q 7 7 7 N � co .z O CD (D m c 0 co o b o a O 3 'A < 3 < O p V) W CD IA CD c N o cn z D m a 3 0 ID cn D ° m �• D y CL m I y d = W N O W y ° .. r N 3 O co °' r V r rn o CD Z a 0 "r O 0 0 a) i -< O O O O O C n r a v y� N N D 3 r . 000=r ° 000? �• gg O z ro o CO) (4 w ch to �cwn �; ao o Icr O O ao n Iro A N N N c CD �• W N O T a :; a � 3 3 °—' D 3 °—' D ? (D m CD M N N p z z N o z z K D D o r l N° D D o c n o O c Q O Q 0 N m M 0 - o H � CD I CD � m y �►4 C 3 C 3 t o l m N O N CD �' 0) l CD v v A C 3 w w G G W O 0 0 3 a O " O m m z y CD <, A W W N 3 z D rn� D m°° n xw a n o O G � tp < w ' r ° v � 3a c ;D z c O 3 ° c c z a o m 0 y; y N N c =r �' v CD m co m c Z7 N X, m N v N C o N CY 7 N 03 n 0 0 c V O Q O N y w O x fD 0 0 b CD (D cfl O En O to p p C as O Q 0 Wisconsin C j rtment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and IT-ling Divis on INSPECTION REPORT sanitary Permit N • 399 0 GtNERAL'.'NrORMATION (ATTACH TO PERMIT) State Plan I 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 N Gold Ea gle Investments LLC, Don Schaaf I St. Joseph Township - 121 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: /00 /OU - TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS Ht FS ELEV. Septic Benchmark /D aU •yS / OD: d Dosing Alt. BM Si h 6,00 T Cd r S dy.y n os EHEditn on Bld g. Sewer g — St /Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Veto Air Intake ROAD Dt Inlet -� S�Cu� Septic ' Dt B tt S Dosing Header an. r/ 2 3• o o/- Aeration Dist. Pipe 3 Holding Bot. System 1 "/ 0 -b— r 9 s 3. final Grade PUMP /SIPHON INFORMATION Manufacturer /� Demand Std 9� 0 8' / `' GPM Model Number 6D �� L Z TDH Lift Friction Loss System Head TDH t , Cod &"..1 3 -2 Forcemain Lengt h Dia 1 Dist. to Well SOIL ABSORPTION SYSTEM c TRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth -NSIONS SETBACK SYSTEM TO / P/L BLDG W LL LAKE/STREAM L CHI G Manufacturer: INFORMATION Type _,„ ` / / CHA TOR Model Number: /�,{t111 d — 1 b J DISTRIBU ION SYSTEM C'� j Head Manif Distribution u i I x Hole Size x Hole �Spacing 11 Vent / / to Aiirrtlntake d � length Dia 2 Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade S ystems Only lc:2 JftR Over j L o¢ Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed rench Center j Be /Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection Location: 358132nd Ave Hudson, WI 54016 (NW 1/4 SE 1/4 30 T30N R19W) NA Lot 5 Parcel No: 30.30.19.987 1.) Alt BM Description 2.) Bldg sewer length - amount of cover = 3.) Contour= • Z Plan revision Required? (J Yes I No f Use other side for additional information. Date Insepctor's ignature Cert. No. " D -6710 (R.3197) M E Series mvem 1/3 through 1 -1/2 HP Effluent Pumps Performance Curve CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 400 450 100 28 90 80 24 ME� cc LLJ F- 70 � 20 W 2 W Q z U- 60 O o MF)S 16 = i Q 50 2 � M Q 40 �SQ 12 0 F- 0 F- 30 8 M 20 X3 3 4 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 130 CAPACITY GALLONS PER MINUTE F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 � Printed in U.S.A. Safety and Buildings Division County 6 / V V . isconsin 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 7162 Site Address Dep artment of Commerce S-' S -Oz— m /� Df 6 — Sanitary Permit Application Sanitar lieriRt � ber 3 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide if Revision may be used for secondary purposes Privacy Law, s15. 1 m I. Application Information - Please Print All Information State Plan I.D. Number O - 7 - 740 Prope Owner's Na / (� m �_� Parcel Number �a l g 91 x 1 d :L P a � � .:.v. Z z- Property Owner's Mailing Address Property Location 2002 ti4V -A SeA: T30N, // City, State Zip Code Phone Number Lot Number Block Number �- Subdivision Name CSM Number 4 ti S AN H. Type of Building (check all that apply) 3 v 1 la"— ❑City P -1 -or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public /Commercial - Describe Use p wnship lj S ff 5 P ❑ State Owned / X/ aO 6 /X -7 ��' �2 �_ d _ Nearest Road elf D M. Type of Permit: (Check only one box on line A (ntrdtbering scheme for internal use). Complete line B if applicable) A For County use [ ji tew 2 ❑ Replacement System 3 ❑ Replacement of 6 , ���io; m to Tank Onl Permit Num Date Issued B. Check if Sanitary Permit Previously Issued IV. Type of Permit: (Check all that y bering sch 'for internal use) 1 44 ❑ Non - Pressurized In -Ground 21�.Mo 47 [1 Sand Filter 50 El Constructed W es{ '�C �✓ Z , Zt ' 22 ❑ Pressurized In- Ground 41 Holding Tank 48 ❑ Single Pass 51 ❑ Drip Li ff OO�� 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. D' nt Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate tern Elevatign Final Grade Required / Proposed Rate(Gals./Days/Sq. t) (Min./Inch) Ob _ Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic /7—�t� Concrete Constructed Glass Gallons Gallons of Tanks New Existing &"/ Tanks Tanks Septic or HoUing Tank m (, J e� C-7\ Dosing Chamber 6 6,&?, ee VII. Responsibility Statement- I, the undersigned, assume respops for installation of the POWTS shown on the attached plans. PI ber's Name (Print) P1 be 's Signature MP/t�RSNumber Business Phone Number NAG �Z 2 73 Ic Plumber's Address (Street, City, State, Zip ) G- L f tom✓ off- �� f J 0 oust /De artment Use Onl Sanitary Permit Fee (includes Groundwater D Issued Is Ag Signature o Stamps) Approved ❑ Disapproved Surcharg Fee) 5� El Owner Given Initial Adverse Determination IX.�conditions of Appr val/Reasons for Disap r�� J A l �t't.at'�'`1 / a'Qlv,✓ Gt�R� G� �/� 0 � 3 ) /kl sf 83 jtp (w the Count? only) ror the system on less than Stn x 11 lnche: to size SBD -639 ) 1 1TS /4 4 � 0 PLOT PLAIN Scale page 3 of L o-- a rj L1 7 g. S Z nn Ivy a I c 'n p �11 , j 4Go� O! 3Bb\Z.M i J� C*�L p�J>U S 3 il� `VV 2S Lo A-n 01,J 0 y� L I IMt 33s 3� onj'oP OF 3 /y" S`fZEL P1A�z . NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be t o00 /6S0 gallon capacity manufactured by W _18 0� ZfrS L R C.I 4. Bench mark : Ste, "UV� �. Divert surface water around system to prevent ponding at the uphill side. Safety and Buildings 401 PILOT CT STE C WALIKESHA WI 53188 -2439 _ - TM #: -(608} 264- 8777 - \ *isco ' nsin www.commerce.state.wi.us /sb - -- __WWW_iWsconsin gov-- - - Department of Commerce Scott McCallum, Governor Ph ilip Edw. Albert, Secretary August 08, 2002 CUST ID No.267341 A7TN. POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/08/2004 Identification Nunber� Transaction ID No. 776267 SITE: Site ID No. 649040 Dan Schaaf Please refer to both identification numbers, 132ND Ave above, in all correspondence with the agency. Town of Saint Joseph, 54016 St Croix County NW1 /4, SEl /4, S30, T30N, R19W FOR: Object Type: POWT System Regulated Object ID No.: 865597 Description: 450 gpd design wastewater flow mound system. 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: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD- 10572-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be given to the owner of the tank explaining that per cig Ot a filter is required. Access to the filter for cleaning must be provided per Comm 84 prod a onnyr • A Sanitary Permit must be obtained from the county where this project is 1 ted and the requirements of Sec. 145.135 and 145.19, Wis: Slats. S�� � 4► c � • Inspection of the private sewage system installation is required. Arrangements fol' tion shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d , is. Stats. 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 ARTHUR L WEGERER Page 2 8/8/02 y required by the state or-the local municipality shall be obtained prior to commencement of - - - - -- -- — - - - -- - -- construction/instal lation/operation. 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 Balance Due $ 0.00 Thomas P POWTS Plan Reviewer ; Integrated Services.` (262)521-5064, 7:30 -4:00 tperkins@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 TITLE SHEET Page of �7 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD -1057 P and the Pressure Distribution Manual SBD- 10573 -P C a b! g9� C tz. b 14 q� LOCATED IN THE NW 1/4" OF THE SE 1/4 OF SECTION 3 D ,T 3 0 N,R 19 W TOWN OF 1 � (_MV COUNTY, WISCONSIN. \-Z,1' S 01= T'vr-Z %Pn:ICTU .V INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR 1. X10 b L��t. i�v �►v 1�v1`�S 0 K , Lv ► S u o L ` AF PREPARED BY JUL 2. 5 2002 WEGEF =tEFR SC3 2 L_ . TEST I M 1 SAFETY & BLD68. DIV. AND . DES I Grd S] SCE P.O. -Box 74 421 N.Main St. River Falls, 14I 54022 C01V P h o n e 715-425-0165 ,••"••" °•••• Fax 715- 425 - 6864 AR!M/q i MEGERER+�` 1 D9is� 1 O d OZ F JOB NO C) ��1 -Mound System Management Plan Page Z of 7 Pursuant to Comm 83.54, Wis. Adm. Code Sept4c Tank y1�t ��� 3.)-7 The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter 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 tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms 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 are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L BODS, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance reporting. , No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at L S — c� li- 4680 S7 - C t - UJ�)C The system installer at LS _Z — ��VY IV �Ets The tank manufacturer at The effluent filter manufacturer at guQ The pump manufacturer at t-4 [q - Z,'q- 11gV r L'RS PLOT PLAN Scale 1 - Page 3 of L'3 a ry L4 18, 8 Z' n 0 8M WI c� o .I q� � 3 .y v S' Cey vw ►� � a QP i � • i e Ot 3g�� rn JA 2II { JI 0 x �t1Z j 1 - j> o S� 1N@Z S 0 �i i 1 7 s o. LS 1 UYT twit 33s 3� { e } Z.. ( 1 z )0 , 0' ON SOP OF 3 Iy u S�Z- �' / NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be t 000 65o gallon capacity manufactured by W IZ GOBI C Z'1_ W/ FF -k 8 0Z Z� R L � 4. Bench mark S S� "L)\j 5. Divert surface water around system to prevent ponding at the uphill side. p ace L). 0z Approved Synthetic Covering AST! C33 Di stribution Pipe f 0 �- Medium. Sand G Topsoil _H 10 —, f ,• F Ele 0.5 3 , D „ b lb ° Slope istribution Cell of . Force Main Flowed to 2 z" Aggregate 2 From Pump Layer )F Ft. CROSS SECTION OF A MOUND SYSTEM F p_b Ft. �---� C D -S Ft. A )Ft. H 1. p Ft. Linear Loading Rate= � . O GPD /�� FT S Design Loading Rate= 0,1"2,GPD /SQ FT j J G Ft. K 1 Ft. n L t Ft. o-f- - F•� P n W 3 Ft. L I } - Observation Pipe fi K Q- f - --------------- - - - - -- --------- - - - - -- - - - -- Sax A � f �b B, � _ O - - - - --- -------------- - - - -_ W �[ —_�' —� — -- - - - - -_ � Force Main - Distribution `— Cell of %" z to 2 Pipe aggregate , Observation Pipe (Anehbr securely) PLAN VIEW OF A MOUND SYSTEM Distribution Pipe Layout pAoe S of Place the holes at the bottom of the distribution pipes at'equal spacing. Remove all burrs from the pipe and holes. Extend the end of each Iate:j up with the use of long turn or 4f' f rdns to a point within six inches of the final grade. Tem2inate the ends of the Iate.-als with a valve,:threaded = or • threaded plug. Provide access from fnal grade for the valve; threaded cap or threaded plus. L LASS FVC - F�J� PVC Latent Maniio(d Laterl x x x x!I1Xa z x x x Lateral Lenath — Lateral Lnath — Distecution line � IT P Ft. Hole Diameter 3 )1 �Inch - S 3 Ft. Lateral Inches) X Z �_ Inches Manifold - 7- Inches Force Main " Z Inches 'w. J of hole /pipe lq Invert Elevation of Laterals 1ol -b Ft. • ��x.o.bb = �z.s� x � = So_1b 6�y Combination Sep4*c;Tank and PUMP CHAMBER CROSS SECTIOM AMD SPECIFICATIOUS PAGE OF � •VEJJT CAP WEATHER PROOF JUlJCTIOIJ BOX . 4"C.I. VEIJT PIPC APPROVED LOCK IMG 110' FROM DOOR. MA)MOLE COVER c`7P'it't :iINDOW OR FRESH wA(tNl►JG LP.6EL. sp ta>v PIP` A.LR WTAKE co,atw�r i /FraLn s ttr ewp s , Ft iv tSp}© 6`'^w. � X 19. � � � Y MUJ. G 9 - 0 VO UJLET i" PROVIDE I -- '' � AIRTIGHT SEAL 8 A�Lt I Approved/ Z '� i I�f Approved joint w/ R 1800 ! I III joint w/ PVC pip ALARM PVC pipe c I CLEY O O FT J PUKP __ OFF • y D CoILICKETE BLOCK 1 RISER EXIT PERMIT(ED 0►J1.y IF TAN MAJJLIFA HAS SUCH APPROVAL SEDOINr,, �BbDt� t tv 4 SEPTIC F SPECIFICATIOKIS DOSE Q TAwKS MA►JUFACTURLR: LAJ1 qS�Z CA tJUM$ER OF DOSES: y' 1 pER D TAMK SIZc : Q / SCE GALLOQS, DOSE V OLU M E _ ME I ALARM MAIJUFACTURCR: S,� • �-�ZU S { ��� 1 '�S MICLUDWC, 6ACKFLOW: GALLOMS MODEL KWABER: CAPACITIES: A INCHES OR 30 b GA LLOIJS SWITCH T:JPC: — �C�y� 8 = IA}CHES'OR 3 G�LLOU5 PUMP P AMUFACTURCR: MLtml C= IUCHES OR l� Z GALLOUS MODEL MUMHER: Y-1F '4. ) D= � IJ�ICHES OR ZlO T GALLOAJS SWITCH TYPE: uOTE: PUMP AUO ALARM ARE q � To 6L MIM IMUM DISCKARGE RATE 50.1 K INSTALLED OIJ 5EPARAT6 CIRCUITS VERTICAL DIFFEILEIJCF DETWEE)i PUMP 0 D15TRIBUTIOM PIPE., q. O FEET + MIIJIMUM METWORK SUPPLY PRESSURE , 3 �-S FEET + 6 FEET OF FORCE MAIN X S IF Zoo fLFRICTIOW FACTOR.. 3 LO L FEET TOTAL DyIJAMIC. HEAD = ls'Z6 .FEET Z As per manufacturer 1`1.17 gal /in. Liquid depth aA� C) M E40 Series M 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP` CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 . 30 W hW W W M 25 8 X Z Q M Q 20 6 J F 4 10 so .16 2 5 0, 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE 1101 Myers Parkway, Ashland, Ohio 44805 -1923 Y Y i 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 K3326 7/91 Printed in U.S.A. Safety and Buildings 401 PILOT STE WAUKESHA WI 53131 88 -2439 9 TDD #: (608) 264 -8777 I N Visconsin www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov 2 002 Scott McCallum, Governor Philip Edw. Albert, Secretary Zf August 08, 2002 CUST ID No.267341 ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN ST CROIX COUNTY SPIA SERVICE PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/08/2004 Identification Numbers Transaction ID No. 776267 SITE: Site ID No. 649040 Dan Schaaf Please refer to both identification 132ND Ave numbers, above, in all Town of Saint Joseph, 54016 correspondence with the agency. St Croix County NW1 /4, SE1 /4, S30, T30N, R19W FOR: Object Type: POWT System Regulated Object ID No.: 865597 Description: 450 gpd design wastewater flow mound system. 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: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • In the event this soil absorption system or an of its co arts malfunctions P Y Y p p 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 in section VIII of mound component manual are complied with. A copy of this information must be given to I ,� the owner upon completion of the project. ARTHUR L WEGERER Page 2 8/8/02 • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. 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. 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 Balance Due $ 0.00 Thomas J Perkins POWTS Plan Reviewer, Integrated Services (262)521 -5064 , 7:30 -4:00 WiSMART code: 7633 tperkins @commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 ``' Wisconsin0eparhnentof C mmerce SOIL EVALUATION REPORT Page f IxyWon of Safely and Bui in accordance wkh Comm 65. Vft. Adm. Code Attach complete site plan on paper not loss than a 112 X.1 ches In size. Bolan must County Include, cut not rated to; vertical and hortzcrtal dlrazxlon and parcel 1. Percent elope, scale or dimensions. north d Is to nearest road Please print on. N; Rmowe I by Date P pwner Lat�i'ion . Lot Ali d 1 N R E UU7 tti . T '`mTY X • , " Slockp Subd N or Cam 19 A. S e Tap Code �' tatty YTags Fa Town Newest goad C New Corrshucdon Use:1$ Residential / Numt)er of oomS � Code derived design kw rate �; 'G Ze_ GPd ❑ Rep aoemem ❑ lic ar cammendal Parent material -,�' a ��' °f r Flood Plain elevation If go= to _. R General axrrr ma f - and reeomrnondattow GJD.+115vu f /,J,E Age M �� # ❑ Bating ® pit Ground surface eiev. 99, tL Depth to Ntnft fsoa'e• -�.Z Z In, W tion Rate i lOriton NPh Dominant Colcri Redox Desu#w Texture Structure Corodenc , Boundary Roots GPDIrr. Ns. Mtanael (2u. Sze coot color Gr. Sz Sh. •eml 'Efhl2 2✓ 1� pit Groundsurface elev. ,, ft. pep>t/r jo Lmidng fac�crt Irt, Rate Hortron Depth Dominant Color Ftedox Desctpt" Text" Structure Consfstene Boundary Boots QPDAF In. Mum Ou. SL. COAL War Or. Sz. SK '811112 6� a Y -6Z 'nem Ef- - ----- J EMUM #1 +� BOD > 30 < 220 mWL snd TSS a30 K 150 n%;L 12=6C ).: 30 meB, and TSS : 3 0 nV L CST MT Number l4dti*eC5 f ' Date vefwdon Condt CR 'M40=4 Nurbef TT01M 512.0Z 00 YU1 Z5 999t I9S STL Y'd 60:60 fun ZG SZ1L0 Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 Site Ad _ T ��ol I sin Madison, WI 53707 - 7162 Zees if f l Dep artment of Commerce (O' Sanitary Permit Application Sanit Pe rmit q F ee, In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary purposes Privacy Law, s15. 1 m I. Application Information - Print o ation i State�an I.D. Number 1(f J Si Property, ne 's ame Parcel Number v r 9 (1 Property Owner's Mailing Address r I N Property Location �� J is t 'k �A; S T 4 N, R A7 4r City, State Zip Code one N 'r' 14 Number Block Number o-, Su 'vision Name CSM Number H. Type of Building (check all that apply) _, ; .• ❑City 1 or 2 Family Dwelling - Number of Bedrooms i ' Village ❑ Public/Commercial - Describe Ae I Township ❑ State Owned Nearest Road M. Type of Permit: (Check only one b on line A (numbering sch a for internal use). Complete line B if applicable) A. 1 V 2 ❑ Replacement System ❑ Replacement of Addition to 950 useS stem T Onl xis ' sum B. ❑ Check if Sanitary Permit Previously Issued t Number ate 04F IV. Type of Permit: (Check all that apply)(numbering he a is for internal use) 44 ❑ Non - Pressurized In- Ground 210 Mound (4 K � 47 ❑ Sand Filter 1 Constructed Wedand 22 11 Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Trea Unit 49 ❑ Recirculating 30 ❑ Other V. Dispersal/Treatment Area Information: _ qdN l Zjr S C 3 Design Flow (gpd) Dispersal Area Dispersal Area Soil A 'cation Percolation Rau System Elevation Final Grade Required Proposed Rate(Gals. ays /Sq.Ft.) (Min./Inch) Elevation . Tank Info Capacity in Total lumber Man acturer Prefab Site Steef Fiber Plastic Gallons Gallons f Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank O - Dosing Chamber . VII. R 4 nsibility Statement- 1, the uncle assume respo ility for installatio of the POWTS shown on the attached plans. Plumbe • N )` Pi t MP/IviPRS ber Business Phone Number 1 1 _ Pl 's Ad ss treet, City, Sta , Z' Cod VIII. Count /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Approved ❑ Disapproved Surcharge Fee) / ❑ Owner Given Initial Adverse � 3 Z Qv I ( L Determination � 4 ( 1') 4-4-� 17X. Conditions of Approval/Reasons for Disapproval 1. Effluent filter to be installed and maintained per manufacturer's recommendations. 2. Any filling and grading that will affect the capacity of the HWL retention area is prohibited. Attach complete plans (to the County only) for the system on paper not less than 81/Z x 11 inches in she SBD -6398 (R. 05101) Safety and Buildings ` 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: P08) 264 -8777 Visconsin www•commerce state s www.wisconsin.gov in.gov Department of Commerce Scott McCallum, Governor Brenda J. Blanchard, Secretary August 27, 2001 CUST ID No.224263 ATTN: POWTS Inspector ZONING OFFICE KIM A O'CONNELL ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 08/27/2003 Transaction ID No. 669598 SITE: Site ID No. 634666 DAN SCHAAF Please refer to both identification numbers, OLD E WEST L above, in all correspondence with the agency, TOWN OF SAINT JOSEPH ST CROIX COUNTY NW I /4, SE1 /4, S30, T30N, R19W FOR: DESCRIPTION: THREE BEDROOM MOUND SYSTEM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 808041 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01/01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01/01). • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. KIM A O'CONNELL Page 2 8/27/01 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, 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. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, W is. Stats. • 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 Sec. 145.20(2)(d), Wis. Stats. 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 /instal lation /operation. 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. Sincerely, FEE REQUIRED $ 175.00 /� FEE RECEIVED $ 175.00 K /L' BALANCE DUE $ 0.00 Charles L Bratz POWTS Plan reviewer 11- Integrated Services WiSMART code: 7633 (608) 789 -7893, Mon. -Fri. 7:45 AM to 4:30 PM cbratz @commerce.state.wi.us cc: DAN SCHAAF MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: DAN SC:HAAF '.�.L1Zw t itiaCCter:. vi7iv + :rir - 01An&s Address: 1006 LAURE IRE AVE I !11 /'L,1 ,Ali CAµd/^ nlu;,vt� J`; iv LegaiDescri iv�cv v�- vwvv- T3v "v- °1�Gv T lj1M lI. iii./. JT. I vJ L I � Coun VU /11 - V t L'i 'Vif� Subdivision Nao%> THE 3ANC: T UARY I t Nu h.... . LGi i i i . C J Block N u mb er. Parcel I.D. Number: Tian Tian 11YV.. 7 e raijC i it Index and Title R ECEIVED C©nffl&nulry page 2 Data ntry ■ lIl[l(! �[L C 2 � ,, Ul avvii fjo 10 2001 APPROV r ay a M L vuriu ui avvu iyo AUG A � i Cr 1 and ri an 4 1 n y " _ 3l . a, ose a, . r, c n a.. yy •r: a•.. �� 1„ rctg J JyJ liiaintenzince speciiica i muy & Bums O' MINIIIIANIM =OF Pan R k4 ti anan an contingency r r r'aye ' r ii7 p curve and specifications n Daa R DynT PLA BirE CQRRESPfJNDEN E �Y Designer: KINA A 0C0N 1 _irenge Number, 774763 Date: 08rQi/ l y Number: 715 - 755 - Jtgi IQtlil ne-foned Pursuant to the Mound Component !'1 anu -n! for PO%ArrS Ve;Yi^n 2,0 Sr -1 i6gt -p (KI, niniN, and JJVVIYIt' t'tJUiitiC{UVI) �.0 IJG�i�ii Ui ricssiiic uistiiuutioii ivcivi+�iks, iii ST -SA3 (0 1/0 Vercinn ,i n tn.. / i t01) pan 1 of 8 _�, i Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300A0 Estimated Wastewater Flow (g) Table 83-44 -3 in -situ soil treatment for fecal 1.6 0 Peaking Factor (e.g, t.5 = 1509Ci) coliform of <= 36 inches. 450.000 Design Flow (gpd) 10,00 Site Slope (%) 96,10 Contour Line Elevation (ft) 21,00 Depth to Limiting Factor (in) 0,50 In -situ Soil Application Rate (gpdJft Distribution Cell Information 75,001 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpolft) 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest Writ in the distribution Y Pressure Distribution Information network? Enter Y or N (c or e) a Center or End Manifold 3.00 Lateral Spacing (ft) If N above enter the elevation fl 2 Number of Laterals of the highest point. 0,125 Orifice Diameter (in) (e.g. 0.25) 3,00 Estimated Orifice Spacing (ft) - 9.00 ft /orifice 2,00 Fo"main Diameter (in) 36.00 Forcemain Length (fl) Does the forcemain drain back? Y 91.50 Pump Tank Elevation (ft) Enter Y or N r—i O.5V 3yJlCl I I Head { { It) X 1.3 a. i I I FVI l:Cl l Icllf 1 U1 clll IUcIl4R (yCII) 7.68 Vertical Lift (ft) 67.38 5x Void Volume (gal) 0.34 Friction Loss (ft) 73.09 Minimum Dose Volume (gal) 14.52 Total Dynamic Head (ft) 20.60 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. o tions choice in. dia. options choice 0.75 1.25 x 1.00 1.50 X 1.25 x 2.00 1.50 x X 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information 1000,001 Total Tank Capacity (gal) 1000.00 Se is Tank Capacity (gal) $2.001 Total Working Liquid Depth (in) weeks � Manufacturer 19.23 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter I 800.001 Dose Tank Capacity (gal) lZabel Filter Manufacturer 19.641 Dose Tank Volume (galtin) JAIOO _ Filter Model Number weeks 771manufacturer FIVj nn�i onun F ra n I o F vac .. vntr vv, ,n�i� ra e c of N A .......................................... ............................... 11 t� Observation Pipe .. K — .. T o Ei A W > — I B z 0 ..... ....... ..:... i L —� Mound :orirNGilent Dimlenslons Nl o.vv it E cc.w ii _i n i.v0 it K I i0. `i BF 75.00 ft F 9.50 in t 13.46 ft L 95.05 D F 15.00 in G 0,50 ft J 5.87 ft W 3 L 4,)U, 00 (ft) Dispersal Cell Area 1 14,)9.621 (ft'j Basal Area Avaiiabie 6.00 (gpdtft) Linear Loading Rate 7.50 (ft) 1110 B Obs. Pipe Placement M %O 14%A vi va¢ via%, U 9 a V1 VV ,_,ggregatc v BperSal r, re, r.e_,__� G___,_ n _ iu�ucu vlaut; 101. 14 -- H 2 — G 4 * F - p;��;i �, _ 99.85 (ft) Lateral 9 t)♦' -: __ Invert Dispersal-c ell [] Elevation E p Q:.. ............. a 9 .10 (ft ) Contour Elevation 10 n c� Site Clan r v �..� Geotextile Fabric Cover Shading Key persal Cell f See lateral details on 0 Topsoil Cap 1.5 ft Page 4 for number Subsoil Cap a .Q size and spacing of ASTM C33 Sand Ci f F laterals. Laterals are ❑Tilled Layer m 0.5 ft Typical Lateral equally spaced from 5 Agg re g ate s ❑ ❑ a the distribution cell's -- A centerline in the dittrihi itinn i-ell 14 RX M—; a. nnr.i c+nu�n� r: u�ac.t. un vv +, r c Pag of 3. is I%A vW3It I vievi i s- CA L%rz c'c� � s'a� v��c �1VA j, l alII " ats o %per the mensVcm ♦� Tum- upvalballealveoroleenoutplug J P AN laterals am identical �� DC —3 ( Mdtt dr�llyd tVr e bottom Of "* litttil Spa—d F�rtra mein ctrmreriun v1� twa � orate to rnsn�F7 � x�g 4' litr~rilt � worn miir al FYG sir, ao fpet COMM TaWe- gUO -61 Number), Lateral) X 21 GrIliceDiarnetel �V�111 Lateral Diameter 1.50 in Orifice Spacing (X) 3.06 ft Lateral Length (P) 73.44 ft Orifices p er Lateral 25 Lateral Spacing (S) 3.00 ft Orifice Density 9.00 ft Lateral. Flavv Rate 10.30 gpm {Manifold Length 3.00 ft System Flow Rate 20.60 gpm Mar - Wald Diameter 1.50 in Total Dynamic Head 14.52 ft Forcemain Velocity 2.10 ft/sec bo i pi 1 f� I� {VI ",G 161 O Locleng cover with warning label and locking device and sealed watertight Elet:trirai as per NEC 300 anti —� _-, ._G _ ^Drum ', E _'3 v /Ae- Disconnect X 4;n. m;n. Tank component is properly vented d`- Alternate outlet location Forcemain diameter weeks ^� Manufacturer 2 in. Capacity 800.00 Gations volume 19.64 ga!Ancft A Weep hole or anti - Dimension Inches Gallons B siphon device A 26.09 512.46 C B 2.00 39.28 um off elevation (ft) C 4..64 91.14 92.17 D 8.70 157.12 D Total 40.73 800.00 � moose tank elevation (ft) 3" Beetling ureter tank. � �- 91.50 Alarm Manuafacturer I S.J. ELECTO SYSTEMS Alarm Model Number HW 101 � �- Pump Manufacturer IGOULDS _ Pump Model Number WE0 � - Pullila Must Deliver j Ly, y g Jill at I 1� ft T DH n.... :....1. n A A I =L -1 n ,,, o f p 1 «,A r c -: v RA.-..•nd C rate IVI&I n�eri =.�-.n .ILrIrl (lr�er Cr.nn V I C.4'�.nn • Mound it Y.Z ii - ii r i/ Iii Rli iiGiiC.: ::sG Ri1V: �iJGi Rii Vii V�GLiilVl i i Vila: Service Provider's Name KIM A OCONNELL Phone 715. 755-31+15 POWTS Regulator's Name _ ST CR OIX C OUNTY ZONING Phone 715 - 3-4680 a71'siCai : ill VV ;'tit4 LVQi[ r'at QlltC iCi is LJesllgll Flaw- Peak 4Du 1YPd IVaxiillu111 influent Particle SILO 110 111 Estimated Flow- Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Ceriiire Crequencv Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested eve 1.5 year Mound Inspect for ponding and seepffle once every 3 ems Other AA'.+.... 11 ...+..... ... l�......a..•... a: .... ..1 RA a...'.•1.. Ca.....l..r� :;23L4'i iiCi:: ±:: - v: V;i33i t4'v'.iiJ:l AIiL11�ItZ LCil4t.? VtA7lt1U41 .3 C h ai - e a ..l fl ..a...+..1.. r a.. T /'� O A 7(\ h a .6:.. 1-4 .. v: J.. v: �J�i:::; i.: irvJ. ��:• rv.:; VCCCl:aii'�iiiGL-1;. i:- ;vlr:vt:vrti:i{:J+f.Jtl i� 11t3Yt7d VY� lel Ualll Lail, and are secured in as shown in tha mni nd rrmmrnnent manual, l r1: 1 11 a.,, i.....�. S /'a...... O A ,']!\ /C /:\ I A r... AIM f' o 4 Lns pei°�i ce;; aggregaiC 1^ilJnttJli1IJ to Vlil1iiii U-+ --U \V } \iJ, YYIS. tlu :.,ude. Z III nravitu and nro tra nininn materials conform to itta rA.,� l iremer?ts in C ^lYllF1 gd \f�fjc, Adm, C-od a e. ..... J r r r Z _ 4. Tillage o` the basal area is accomplished 'vvith a mold board or chisel plov -.1. 5 The mound structure and other disturbed areas -ill be Seeded a nd mulched to prevent coil erosion and help p r eei frost pei ietr ativi 1. L ateral Turn -SIC Detal1 Finished Grade / 6 -8" Diameter Lawn `) Threaded Cleanout Sprinkler Valvc Box Plug or Ball Valve Distd bution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral ^reject: Dr SCi lrv r"-age 5 in u °, 11Ai.¢fr.rl C% - +om RA 01on er.:�u;c:a ::yaz,;.:s; :reu¢:c:�•..ee:..res. :�:s ' Pur3uaii� iv L�i1iiii 83.54, if ti3. Adm. Coda General i his syaaTl Silaii be toperaved III accordar ICs VVllr 11 i%'O lm V s V 1 Y YIj, fium. i oda, and shall main adned in accordanca van its wmponant Manuals r LSBD - 1060 i -P (iV.v iiv 1) - an - .' SSryiJfP P UbliCatiGn J.G (v I iv )j ana lvca! Gi afite ru!e"a p2liainingg to system maintenance and m3 i ntnn•anne reporting i'v'G one S1 lould e'v'er 2niEr a sG QC Gr PU1T1p i'a'nK SfiICC Qan gCtQUS gasou May Ve pi canTi inai CGUIG CaUsc Qeaiil. Septic and pump tank abandonment shall be in accordance with Comm 83.33 Wis. Adm. Code when the tanks are no longer used as PnIArTS nornpnnnnt�,_ Qan +in r �,t7 took m �n1..z,io _ „..., , 9 < -.�. ,. _ _, _ „n.i n chn„Lf 4.o cnto.f fn = " ti Jh+n - c ;;nr1 rn:7n�n f1 ^ Jc i:^ used for scr'vw2 ails asSwsl?'ic1'S'i sila!i be Soa!w'.vawrtiy.;, ii ilia CG:Tip!,aiGn Cf ser "Ace. An o pe n ing do` Unsound, a2f2i'tr iY2, Gi sub) to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to nrn, r.nt nnnidnntnl or „nU „fhnri..,r1 onto, into ., +nnli or corn nnnnn+ Serf*-- Tanh T hu `.,uplit; "unk `.hilt!! bt3 iiiwnitiined V cii; indiviuutii C'd11111tK: lu :iL''f ` :;cE: L, 4-- Ul ; Luniv'i ulidui ;i. G:, t . SLaLzu. Thu VVnlHlltu Ut Lim uwWLic lurk chill he dicnncod of in accordance with NR 11 i, Wic Adm C ndo Thn nnnmtin! condition of thn cnf in tank and niMet filter shall he aftsPlasfrd at 1.,r: t�f cnce e ,,. e r y 3 ;ears by inc.pvotion Thn -, —+A.4- lMnr i! in!! b �!..uii as i,�"t; hn n ..r, r +inn TL,n ANnr n- +A.lnn n not . r(:iii{�": �ifi!' .�rC r n propn, - ^per,-Vn , y .. prn.,_ o, r� .r. iiil:;y StUiiy;; Ui; ii ;E iiiaf ::; ;::i; ;C';iC'.'.34 ii Viii ti5 HiiGi "J5U((3, it tiit ItkHi i5 w ufppeu W0.fi tlli gitlllii, Uid it lt3i chn 11 he cP.rylr PA If the alarm Ic activaterl rnntlnt joi 7RIv IntermlttRnt filter alarms may indicate si imp.. fInWS or an Imnendinn Cnntintini lR Marm The Fmpflc tank shall ha ,o hc• c on t en t s r em o \.,ho fho r,ln„ of c•Itid Jc 3nd s c l t n n in the tank n tti° ilC:;i". `. ^v!:;n,. nF FVio t�.iL li thn n t +` of th n tnnl r n not rr!rnn, r.d nt thn t o f n tr;onni non ,v.nn+ n+np ! nhnll ad,—A1 the n,"n, or of, tho rn.A ftrn :irri'.iG4-' ill lU Vid i.ict H:i;iiicJ lV liiiiii iCliii; lc':.ici lliuii fiianl(i;U(ii SCUfiI afla `SIUU'y'G' dGGUifiUlliiiVii it, i(ie l'dii!C The addition of hiolonical or chemical addltdvlac to PnhnncP cPntir. tank performance is generally net renuired However, if curh prndur:ts are u sed tti sh be na r n ' o± f ^, °r }i: ± i o by the n , n + of Commerce Or.r..n TvnL T pump tank shall be inspected at least G1 icc uror'y' 3 years. lilt &,witci vz, alarms, and pumps Si �a!l be tested tG mrffy prDPCr operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mo und a nd D ren - v �11 dicri C...•tern In shrubs --ho, M 1... pinpt„d art tho moumd. Dl�ritinnc b`. mado - .roun th,n,�.,� Jnain pnrimctor and tho. mound s.hn!l bt_' Z:i �e i and niulQhw lV p if w.4 eitriiuii and to piovide Witte piutwtiun itufii firm pvfwiialiun. T iglus (Wier than iui v::ytAUUw maintenance) on the mot ind is not rPr:nmmended cinap sndl compaction may hinder aeration of the infiltrative stirfaee within the mound and snow pn pp�c+i ;., the ,"inter wi promote frnst penetration C old ;. l»ther ;p�tanat!nn� ono ±nher Fet rt;ar y) dic tate that the mou be he t:9ly m;:!: h� f nr tot n a r f. .,,,,_, .,,_.,,H?t.,,_ �, .n.� �...,....::.., .. -.inn liiliui;i ii " " "'It" Ii IIV lilt i11VUl;a 5 'Lill I(id fiVi VXGEillii li ifi GvtJ IJV iliWiL i ", allU JJ III !L 170(:7 IVf w I,IC 1uiik ulliwll VI 1� � 4 W 30 mg! non ?r y n Tam 10 nn! cnrr n" Id ,., r(! � � �. . (iy i i PY' X 'T1:1X;rT Urti S C °:IBC fl ' nnifind in thn nnrrn Fnr thin inntnlinfinn _ .. . ... ... _ ... _ The nress„re d;�- Fr'L�C.ttnn o,.c- +of,•, nr • �ac.� ,.kith fl�,oL,;nn nn;n : 1 Vi,o and f,f oonl� I ?fo.ol ?n� i4 is rpnn ed that each 1 fl,7ohc.f ..t r r... .° i .,n`^ .. ,,....,,.,,, ; int -a :. ^imend h.. ... l a t eral !^P , __ , _ . V. accumulated solids at least onc e'v'ery 1 1 S months. V v Vi an a pressure test i3 performed it should be compaiad to the initial taut v. -han the system was installed to determine it orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the divpersn! soli. nthcnn ?tine ,.�ithin, the di e cell shall he checked for effluent nainn Dnn,4;nn lo.�.cic shall be reported to the n."mer and any )panic ab'o've v incrius considered as an impending hydrawk failure requiring aaditiGnai, more ffequ2nt morikoring, Corvtinnenry P lan If the r -en +lc tank o, an,. of ho componen +o become defective the tank nr nnrr,nonent shall be repa or replac tn keen the q, Iri r nr rat!n.+ nnndi+l`n . pr pr„ opc „ !i ilii3 1,fiYoli its ldf ik, pUiiip, pu rri� C:Ufit7Ul'a, Liidffil Uf IE-'IHIE'¢i Wit 7(ty trL'CiUlill"i CVL�ieCiifYL-'tli{' aetCC:t;VE'CiUiil�UfiElil(S) Sha be inwivj repaired or mplanerl with P rnmponent of the samP nr Paual performance !f the mnund component f� to oc e p± y "rota °ter or begirs to discharge waw er to the ground surfane ;t vill be r !red or replaced in An' 1 _rncnn+ Inn.i+inp b innrnnninn hnnnl nr-,rj if ton Innknnn n_ _u _ o r by r^'rnn,Ann hi. l0g ; Il y iIngat -fit oh znrpt"m artdd �!npnr.+, modin and re.-latod " ki(iu f"v" dGiii Sw'Ci GJfri' "'d .w w5 aBE.'(f(' iii3iJc w Llri''s c' .aiY ii'iU V"8i tydiH 'Uii vL tiiri i, t.,pn ig, I,iY y . ,.1 pivf,. f.... 7 ,.. .ry : oY.. Pi M r g 7Ui QU; Sen Pane 8 of fhic Nan for the name and fsk -ohnne niimhar of vour local POWTS mqulator and ;Pr\ ir.e nmvidfir din i. A AI O/'• A A C rir.r. v F O L. t i�JU%, �r U % H. UM r ayy8 v: v J 1 t: 1 1 V 1 J 1 i �.1 1 1 V li •.-• •• . 7o' 3 Cu rves P umps mmlii FEET — 'MODEL 3865 - 7 Solids WE15H — 70 —� —. O - to - WL03 to .— - oL 0 ^� _ 0 10 20 00 40 50 60 70 60 50 100 110 I N G P PA 0 1 ?0 ,0 m'/1t CAPACITY hjf . tY r, P��.+ �,, r, 1 °•r. ., t :. i' ' �.. - `GOU LDS PUMPS, INC METERS FEET tp —� MODEL 3885 35 C!r_I SIZE 3 /4 Solids 110 WE1511H 00 . 60 � 70 o _ t FT 30 5 20 I - t- ---j 0, 0- 0 10 20 00 40 w GO 7 ! r w t W )IQ 1 OPM L L - --- --- — 0 to !0 ;t0 in 1/h CAPACITY •tt�p Ow10� Pvmpa, Inc. Erg Jury. 1tw� C) /A. �r Q �t a p A).ed Wisconsin Department of Commence SOIL EVALUATION REPORT Page _/_ of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 81/2 x 11jriches in size. Plan must Include. but not limited to: vertical and horizontal direction and Parcel I.D. percent slope, scale or dimensions, north a , a Is to nearest road. Please print I rma on.� rs ~ °%� Re 'awed by Date personal information you provide may be use for dory .04 (1) (m)). 114 Property Owner A, t � ! ' ►'tY Location /' Lot 1/4 _ 1/4 S T N R E (or Property Owner's Mailing AddressT C�'X °} Block Subd. or CS 9 - 7 �n Wedy n City Ze Zip Code O City Yllage Town Nearest Fbad (� New Construction Use: (2� Residential / Number of rooms _f Code derived design flow rate - GPD ❑ Replacement ❑ PuOlic or commercial-,Describe Parent material �'/ a /� , '� f=lood Plain elevation if applicable ft. General comments i and recommendations: ,'dw ae 1.6.c 9d/ a Boring # [] Boring ® pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfif In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2 �• f / ✓ ./ Bo ring Boring # ❑ Pit Ground surface elev. _ ft. Depth to limiting factor in. S App lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Lure Consistence Boundary Roots GPDff In. Munsell Qu. Sz Color Gr. Sz. Sh. 'Eff #1 •Eff#2 3 V • E uent #1= BOD > 30 1 220 mg& and TSS >30 1 150 mlyt • Eftlu #2 = BOD _< 30 mg& and TSS < 30 mg& CST CST Number Address Date Evaluation Conducted Telephone Number Property Owner 20 6 Parcel ID # Page of 17 Boring # ❑ Boring ® Pit Ground surface elev. 257:�_ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 e Li 36 8✓ .� ✓ F Boring ° Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sal — Appl ication 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 'Eff//2 F Borin Bori ° ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil 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#1 'Eff#2 Effluent #1 = BOD > 30 220 ffV& and TSS >30 S 150 rng/L ' Effluent #2 = BOD, < 30 ffV& and TSS 130 nV& 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. 3eos330MAMI) Owner a Property �=- iA�f1�t� Parcel ID # Page of 13 # ❑ soft ® Pit Ground surface elev. ft. Depth to brrdting factor _ � in. Soll Awfication Rate Hort m Depth Dominant Color Redox Desaiption Texture SbmctL" Consistence Boundary Roots GPD/fft In. Munsell Qu. Sz Cont, color Gr. Sz Sh. •Eff#1 'Eff#2 Borhv � S / r - ✓ Boring ❑ F # ❑pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Cokw Redox Description Texture Structure Consistence Boundary Roots GPD/ft'• in. Munsell OU. Sz. Cont. Color Gr. Sz Sh. •Eff#1 'Eff#2 F 9 # ❑� ❑ Pit Ground surface slay. ft. Depth to knbV factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff; In. Munsell Qu Sz. Cont. Color Gr. SL Sh. *E f#1 'Eff#2 • Eftent #1 = BOD, > 30 <_ 220 rrtgll. and TSS >30 S 150 nV& ' Effluent #2 = SOD, 130 nV& and TSS 1 30 mg& 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. a as 62 V i ii � .__: i � I I - � .. � , i �J � � 'i � ' � - i T '., I I ` _ � - _ - -._._ _ __ ., _. _ _ __ __.. _, I __ -__i__ '. '.. III _.._ _.. ._ .,. -_ _ __. ___ _.. _ _. -_._._ _. _. _ ST CROIX COUNTY . SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer co r E ca- �— Mailing Address Property Address ( (Verification required from Planning Department for new construction) City /State wQ V'j Parcel Identification Number -3e LE GAL DESCRIPTION Property Location A L '/4, r S '/4, Sec. _, 0_, T .?D N- R,f__W, Town of . Subdivision Lot # Certified Survey Map #I- , Volume , Page # Wargo U� 1 Z e # ,Volume !� D , pag , Spec house yes 0 no L& l� identi� es 0 no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes, Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification at ptic sys has been maintained must be completed and returned to the St, Croix County Zoning Office within 30 days of three r ex ' ti n da Gr l 1 6 2 1 SIG TURF A PLICANT DATE T I w ) c' statem t on this farm are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of t e prope esc ' e ab ve, vi ue f a warranty deed recorded in Register of Deeds Office. /1O l SIGNATU OF A PLICANT DATE * * * * ** 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 DOCUM "T NO. ATE BAR OF WISCONSIN -FORE/ 3 GUIT CUIt?A DEED THIS PACE RESERVED FOR RECORDING DATA 473 v oL 9►15 rw 545 Joseph A. Nolde, Jr. and Shirley R. NDlde. a /k/a Shirley A. sr. No lde, a /k /a Shirley J. No_ ldehis wife C " quit - claims to SEP 2 0 991 Allen V. Thoisen and Korean R, TheiRe herehand - and w1 M 8.30 A. as jo int tenants — the following described real estate in St. Croix County, State of Wisconsin: RETURN To Lot 4 (Four) of CSM `iled as Document Number 457750 on April 20, 1990, in the St. Croix County Courthouse as Volumn 8, page 2196, St. Croix County, Wisconsin. Tax Key No. _ . fi e✓ , yr r This is not homestead property. (is) (is not) � �, � � ���� Dated this day of ! ig- L. 1 (SEAL) { �� (SEAL) e h (SEAL) �\ � 0 11 " I (SEAL) Shirley R. olde AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this_ day of STATE OF Yt&SCORSW 19- 7 as. Ti- iJ County. T Personally came before me, this /�I day of T.-. t e above named TITLE: MEMBER STATE BAR OF WISCONSIN Joseph A. Nolde. Jr. and Shirley[ R. Nolde (if not, a /k /a Shirley A. Nolde. a /k /a Shirley J. authorised by 1 706.06, Wis. Stats.)' Nolde R This instrument was drafted by - // ` to me k wn to be the person B_ who executed the tote - � ✓xWSO&+ i Kt�QtS r going trument and ac , oed the sa "e. �� G.ti ✓-c• -� /mac � � � t �3- r ih N s -- (Signatures may be authenticated or acknowledged. Both Notary P date- . - b i County, Wis. are not necessary.) M I I to expiration 4 5� 0 y C >5°!, > 9� •) 1rVxShi(!()tC11 CJililly s. �A t aerniSsiI.!1 Expires &5/94 /yam -- �/ - � M� QVIT CLAM DRID -STATE BAR OF wIECONSTN, FORM NO. 7 -1977 STOCK ��V. IiVo ' C ,= I ao I I I LIOfi . Z C5- w Z .........1•' • — 1 I Z w I v\ I Q LL, V) . I � ( D 1N3W3Sb'3 o w I I : -� 30VNIV80 t i V1 „90 , S ,9l'69Z 100'Otl ,00 ZZl ,OOZ 19l 3 ,.9_ 0 1 Ko0� N c ' m I I I I I � I I m to I II I I / Q t I I 00 I ! I Cl? U-) ' � w M / J, I w I rt ...............,•.� ry <v ,pp• �Lb'£ l ti �N3W3SF/3 30 bNlby I �, �o^� /\ ' o .�/., O 00� 0 00.01 ZZ� / 1 I ao w W cr p� Q 0 , w © V 0 0 I - - - N 16 ,• / -� a I w U. I i U N I ,.• �`� I S O p L C LO re) I� M� Q � ... w N Z w m N I d It i I N _w U)(� I , LA- S U Ln 1 = I d�err.is N (D Z O M O I M '- N I I I0 r I I `IO I I O 3 00 , v)N I z I Z � I 0 0 ,96'901 156'9Z l ,5Z'l56 W L S 89 °17' 35" W �`'�' ia` L23 N 26 E 5 . ? ° 55.00' L24 S 67 044'19" E 205 .27 L 10 ` S 00 42 26 E 160.00' L25 S 10 °00' 00" W 345.56 L 11 N 00 W 30.00' I W, L 12 S 89 W 1 L26 S 89 °25' 54" E 95.00' L 13 N 00 °42' 25" W 70.84' L27 S 00 °34' 06" W 121.713' I L14 N 28 °00' 00" E 78.32' L29 N 42 L28 S 720 51 57 1 ' 57 " E 160.00' L15 S 290 00 , 00" E 70.00' E 70.01)' 0 NOTES: 1. ALL LINEAR MEASUREMEN ONE HUNDREDTH OF A FOOT AND ALL E A LLLANGULLAR T MEASUREMENTS T 0 HAVE BEEN MADE TO THE NEA R BM1 TO THE VALUES SHOWN. REST FIVE SECONDS AND COMPUTED 2. BENCH MARK #1 (BM1) IS THE TOP OF A NAIL IN THE NORTH `,S IDE j1 OF AN 8" POPLAR TREE, ELEVATION= 929.37. BENCH MARK #2 i (BM2) IS THE TOP OF A NAIL IN THE SOUTH SIDE OF AN 18" OAK oo TREE, ELEVATION--931 .27. BENCH Ilk 3 ,(813 o N A I L IN THE SOUTH S I D E OF A 15" ' POp'LAR TREE LEYAT! �=927.79. ;gyp Q (ELEVATIONS ARE REFERENCED TO NAVD88.) 'I� Q 3. LOTS MAY BE SUBJECT TO FUTURE SPECIAL ASSE SSMENTS FOR �� v ANY UPGRADES AND IMPROVEMENTS TO THE ROAD, 4. DRIVEWAYS EXCEEDING 300' IN LENGTH MUST HAVE A TURN ICI AROUND IN ACCORDANCE WITH ST. JOSEPH AND ST. CROIX I COUNTY CODES. I �I 5. THE PART OF OLD "E" WEST WITHIN THE PLAT Z I TO BE DEDICATED TO THE PUBLIC. BOUNDARY IS I 6. OWNER AND SUBDIVIDER: GOLDEN EAGLE INVESTMENTS, LLC 1006 LAUREL AVENUE HUDSON, WISCONSIN 54016 7. THE FOLLOWING LOTS SHALL HAVE A MINIMUM FLOOD PRO ELEVATION FOR HABITABLE STRUCTURES AS FOLLOWS: T 1_932.0; LOT 2= 932.0; LOT 3= 927.0; LOT 4= 928.0; LOT 5= 925.0; -- 41.02' LOT 6= 928.0; LOT 7= 931.0; LOT 8= 931.0. (ELEVATIONS ARE REFERENCED TO NAVD88.) 0 SURVEYOR' S CERTIFICATE I, JAMES D. FILKINS, REGISTERED LAND SURVEYOR, HAVE SURVEYED, DIVIDED AND MAPPED THE: SANCTUARI THE SE 1/4 AND THE SW 1/4 OF THE SE 1/4 OF SECTION PART OF LOTS 2, 3 AND 4 OF THE CERTIFIED SURVEY MAP PAGE 2196, DOCUMENT NUMBER 457750, TOWN OF ST. JOSEF STATE OF WISCONSIN. THAT I HAVE MADE SUCH SURVEY, LAND DIVISION AND GOLDEN EAGLE INVESTMENTS, LLC, OWNER OF SAID LAND, C MORE OR LESS, BEING 1,209,042 SQUARE FEET OR L FOLLOWS: COMMENCING AT THE S 1/4 CORNER Of SAID SECT (BEARINGS REFERENCED TO THE NORTH -SOUTH 1/4 SECTION I ASSUMED TO BEAR N 00 0 43'05" E) (PREVIOUSLY RECORDED S 00 W)800-65' ALONG S A I D NORTtSOUTH 1/4 SEC - B E G I N N I N G ; THENCE N on ° 4.� n� r OR 11) .. _.. _