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HomeMy WebLinkAbout030-2070-20-200 C d $ C O fD C N 11 cn .Zl Z U z 0� - n cn O W < C) lG O N G -.. 4 L W Iii. CC 7 a (D r 0 p O N N a CD rr O p1 CA O r (D m � cD Z � Np Jo C 1 N a �_ 'a n S O O 7 CD N O W C p N Q o = N 3 a 3 w+ o . C 7 O Cn Z D m a a CD cc D a w W o - o 3 rw co W CD .. a) o c cn �+ cn (31 .. a z O O O Z D r2 o w D n y � y N N N 1. - 0 G O 0 O N 0 y N N m 3 77 rr `° N Z v o D ^0 O 3 � C p p f p N • rn l �,i l l ro - . N V y c n CD `+ W D A a n 3 n � Z t 2 C p CA 3 A c A I C= j A Z o N y CD O. 3 I a' W � o am Q Z C :► Z N 3 m Z _ CD � A A D CL a 0 T � C i � Q N I 1 I y A ,A A N O i O A O O A r O l e (A O „ e O CD a CD 1093 Wisconsin Department of Commerce SOIL EVALUATION REPORT p age 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must St. Croix 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. 030 - 2070 -20 - atI v Please print all information. Rpvie d Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location O'Kane, Edward Govt. Lot na NW 114 NE 1/4 S 36 T 30 N R 20 W Property Owner' Maili Address Lot # Block # Subd. Name or CSM# 1300 27th St. na CSM Peadiag (� j City State Zip Code Phone Number ity Village ✓ Tow , Ne*gst.R�p Hudson I WI 1 54016 715 - 549 -5587 St.Joseph ✓ New Construction Use: V Residential / Number of bedrooms 3 Code deriv d,, of ign fl Jllaf~e?'T 4S ` GPD Replacement Public or commercial - Describe: [ y `/'�1 Parent material Outwash Plain Flood P!i6,eleva) of 8ppltcab e�'� ria General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd /sgft rating: d��OSSible � at(:ddvs 85.0 . System is on a 10f ?_ o slope. — �'. Bo # ✓Boring Bo ng Pit Ground Surface elev. 97.03 ft. Depth to limiting factor > 1� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *E GPD /ft*Etf#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 - 10yr3/2 none 1 2mgr mfr cs 2m .5 .8 2 9 -22 10yr4/6 none scl 2fsbk mfr gw 2f .4 .6 3 22 -28 1 Oyr5 /4 none scl 2fsbk mfr gw 1 f 4 6 4 28 -28 1Oyr5/6 none sl 2msbk mfr cw - -- - -- .5 •9 5 48 - 1Oyr5/3 mip�5y6r /1!6 sl 2msbk mvfr cs - --- -- •5 .9 6 60 -118 1Oyr5/6 none ms Osg ml - -- ------ .7 1.2 Borin # ✓ Boring g Pit Ground Surface elev. 94.39 ft. Depth to limiting factor >119 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *E GPD1 t�Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 - 15 1Oyr3/2 none sil 2fsbk mfr cs 2m 5 8 2 15 -29 1Oyr4 /3 none sil 2fsbk mfr gw 1f .5 .8 3 29-48 1Oyr4/4 none sicl 2msbk mfr gw 1f 4 6 4 48 -65 10yr5/3 m1 55yyr,5�6 sl 2msbk mfr cs - - - - -- .5 .9 5 65-119 1Oyr5/4 n ms Osg ml - - -- - - - --- .7 1.2 " Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD < W mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 1/4/02 715 - 549 -6651 / e -34.3 j J s o q3 17 +� AP i / = qo � E � ' fo 8� a� t3pl Q .315/ e p ipe Z, A) 0, b t"� r �t��� k?T' % QG..�G,. - � C.� �?wt� IJ�/�w�a1� i 7ACl —L ;h �� 3 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 487908 0 GENERA!, INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1 xm)]. Permit Holder's Name: City Village X Township Parcel Tax No: Franta, Nick & Wend St. Joseph, Town of 030 - 2070 -20 -200 CST BM Elev: Insp. BM Elev: BM Description: Section/rown /Range /Map No: A-1 36.30.20.611H TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I 7. 5 P4- Benchmark 4 1�- bv"N Z. b Ia3, �Fl io ► , �r I Dosing Alt. BM T 0�r�:0 :oXie o vb - Z. Z"7 161 1 q Aeration Bldg. Sewer Holding St/Ht Inlet \\ TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Z5 N IBS - g(� + �(] / Dt Bottom yl TS +',9 Dosing 7 2 5 A A— � + g � / Header /Man. (p, Z� 77, 1(P Aeration /V � Dist. Pipe Holding Bot. System '�5ej (�6' d t� Final Grade PUMP /SIPHON INFORMATION Iao.,_ Manufacturer Demand St Cover 5 A --o 9 7. , 45 o v GPM $ E> �,,� \ e - Cou Model Numb i e , / u gatz. ! \ O TDH Lift Friction Loss System ad TDH Ft y-� 4 / Forcemain . f Dist. to well • 1 SOIL ABSORPTION SYSTEM /v BED/TRENCH Width + Length + No. Of Trenches PIT DIMENSIONS No. Of Pits Insid Dia. Liquid Depth DIMENSIONS 3 _dw .f- lob Z a SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHA ER OR Type Of Syste n UN 5 /� �— A / /1. Model Number. Q J DISTRIBUTION SYSTEM 'ZS "r ZO Header /Manifold // Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) \ �.l C,�a Length Dia Length Dia Spacing \ SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only 5 Depth Over IDe pth Over xx Depth of xx Seeded /Sod, ed xx Mulched Bed/Trench Center Bed/Trench Edges \ Topsoil \1 Yes 1E No ;Yes ,a l No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1304 27th Stre W Hudson, WI 5401 (NW 1/4 NE 114 36 T30N R20W) NA Lot 3 Parcel No: 36.30.20.611H 1.) Alt BM Description =V �� FOJ✓ tr�✓� �� ��er5 2.) Bldg sewer length = 'go - amount of cover = + Plan revision Required? Yes >< Use other side for additional information' _'_`�1_ �-� _! __- -.. - - - - -- — Date Insep or's Signat Cart. No. SBD -6710 (R.3/97) I i 4 41 Safety and Buildings Division County l W. Washington Ave., P.O. Box 7162 . C QQ �����,� Madison, WI 53707 - 7162 Sanitary Permit Number (o be filled in by Co.) Department of Commerce (608)266 -3151 ,c C� g Sanitary Permit Applicati ���� State Ian I.D. Number / In accord with Comm 83.21, Wis. Adm. Code, onat rma yo may be used for secondary purposes �t f roject ddress (if different th m in res 1. Application Information - Please Print All Information +fi Property Owner's Name 5 _ - 1 . �- rL =; a ©Z o 7q Lot # Block # Prope Owner's Mailing Address n Property Location D 0 , 5 - I ryc 4 6, -S - � %, WE %, Section City, State Zip Code Phone Number / �n j17LL1 t) t /V q )T1 AJ r d O S ad `x.20 I l z T 30 N; R�E 11. Type of Building (check all that apply) k h . S Subdivision Name CSM Number ( I or 2 Family Dwelling - Number of Bedrooms /6�i 7 z ; to go? 17 Sl ❑ Public/Commercial - Describe Use ,.I I _� El State Owned - Describe Use 2 �t Ls + Z-3 ry ❑City_ ❑Village ( Township of Sr �OSEoi 111. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New�n P Y g p Y Other Modi ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner N IV. Type of POWTS System. Check all that appl 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 Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Desi n Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required Dispersal Area �Pr Wise (sf) System Elevation 60 L,z 4-6 V1. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing z-U A) W Tanks Tanks Septic or Holding Tank J Aerobic Treatment Unit Dosing Chamber,- pG VII. Responsibility Statement- I, the undersigned, assume respons' ility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb Signature MP /MPRS Number Business Phone Number Q C. e le NESS © ,J ZZ �e 7 Plumber's Address (Street, City, State, Zip Co VIII. County/ e artment Use Onl pproved ❑ D' approved ` Sanitary Permit Fee (includes Groundwater Date Issue issuin ent Signal ire Stamps) Surcharge Fee) r ❑ Owlte�9fven Reason for Denial J�V � IX. Conditions of Approval /Reasons for Disapproval +t ��rrallr 11N►#�►�1� M !. t1r srMek - 11— 7 0 110-11111111 per appNeW cob / adYwlo�s. Attach complete plans (to the County only) for the system on paper not less than 81/2 x I1 inches in size S13D -6398 (R. 01/03) i _ i I i . y , -UNA04 vo now M4M 6WM* M Od WAn SM OMMLON toWn VA S ,4WM * ` ooa, dftWqo wq w L04 PLAN AD 83 �k Of 9 b L � U go-f' pc / Z&v f -t 2 "P vc A IV I G Iz e A y ,� 63 �L t fey" �k a e b �lU� (zovst s R IM /0 2 "r vc L. L i 1149 WisaDnsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 030-2070-20-900 Please print all info Reviewed By Date Personal information you provide m be use(�r�e i c� rivacy L , s. 15.04 (1) (m)). 446 Property Owner Property Location O'Kane, Edward Govt. Lot NW 1/4 NE 1/4 S 36 T 30 N R 20 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1300 27th St. IT CPIOMC — r - y 3 Proposed CSM City Statel Zip City Village ✓ Town Nearest Road Hudson I WI 4016 715 - 549 -5587 St.Joseph I 27Th St ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd /sgft rating. Possible system elevation for Area I is (Upper) 96 94.70'. Slope is 18 %. Boring # Boring ✓ Pit Ground Surface elev. 99.70 ft. Depth to limiting factor >110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0 -11 1Oyr3/2 none I 2mgr mfr gw 2m,2f .5 .8 2 11 -19 7.5yr5/4 none sl 2fsbk mfr gw 2f .5 .9 3 19-52 7.5yr5/6 none s Osg ml gw ---- .7 1.2 4 52 -72 1'Oyr5/4 none grs Osg ml gw - - - - -- .7 1.2 5 72 -110 10yr5/6 none s Osg ml - - -- - - - - -- .7 1.2 F2] Boring # Boring ✓ Pit Ground Surface elev. 99.70 ft. Depth to limiting factor >103 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 - 1Oyr3/3 none sl 2mgr mfr gw 2m,2f .5 .9 2 5 -12 1Oyr4/4 none sl 2msbk mfr gw 2f .5 .9 3 12 -32 7.5yr5/6 none s Osg mi cw .7 1.2 4 32 -54 10yr5/4 none grs Osg ml cW - - - - -- .7 1.2 5 54 -103 1Oyr5/6 none s Osg ml - - -- - - - -- .7 1.2 * Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD 130 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt _ �, , ti � 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St. New Richmo nd, WI 540 12/15/02 715 - 247 -2941 Property Owner O'Kane, Edward Parcel ID # 030 - 2070 -20 -000 Page 2 of 3 F 3 7] Boring # Boring Pit Ground Surface elev. 94.40 ft. Depth to limiting factor >101 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -13 1Oyr3/2 none sl 2mgr mfr gw 2m,2f .5 .9 2 13 -23 1Oyr4/4 none sl 2fsbk mfr gw 2f .5 .9 3 23 -35 7.5yr5/4 none s Osg ml Cw --- -- .7 1.2 4 35 -71 1Oyr5/4 none grs Osg ml Cw - - - -- .7 1.2 5 71 -101 1Oyr5/6 none s Osg ml — - -- .7 1.2 ❑ 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 GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or naafi m�tariol in �n oIt—t. fnr f -1—. n f—f 0— Aan—e.,,a„t ut ll1R_'/!.(._2I G1 `.r TTV rnR-7f.A_2777 z _ _ �^ LID _ 1 .r 5 ° �9 � - i 04 st7 > ✓s` poy- A) ( �- W 6 N9 Y rX 4 1'J4A COMBINATION SEPTIC/DOSE CHAMBER TANK & PUMP SPECIFICATIONS PER COMM 84.25 CODE CHANGES 2/1/2004 Access Opening, not top of cover, Access Opening, not top of cover, must eidend to a point no greater must adend at least than 6" Below Finished Grade 4" Above Finished � G ! ade Cover with WCA'M Eg V wry ' C, . f 0 Lockm Device X/ 6 '69X APPS CA (typical) / Finished Grade lZ "/y�N�l�r vm Jul Lu'l I ;Ir Sew i Min. 23" > 30 } �a Access Opening o f2 LA's T pi � Min. 23" Access Opening Oulet Effluent Filter ! ! 0 777 �'�✓c S '� i union AwR jYEP PIPE 3 Pr, Inlet Baffle i C � Pu p __j 3 ",Sand or ravel cn y urn Pl ; will, een -ler 2,. /06u Qd�ps Two ComparFment SepticJPumpTank (h ezo ��Q� e n 0�ide GCXt j SPECIFICATIONS TANK MFR: l f. e DOSES PER DAY: TANK SIZE: SEPTIC (ZD'D GAL. DOSE VOLUME: Z GAL. DOSE �, GAL. (INCLUDES FLOWBACK & <20% OF DWFF) ALARM MFR: CAPACITIES: A = Z UCHES = � / GAL. MODEL # la I , Switch type: �i/iv,/ -� B = 2_INCHES = /1 z GAL. PUMP MFR: 0 C = INCHES= / , ? GAL. MODEL #: SWITCH TYPE: " 4-4- D = INCHES = / 23 4 GAL. REQUIRED DISCHARGE RATE ..7� Z. GPM PUMP & ALARM WIRING PER COMM 83.43(8)(e) VERTICAL DIFFERENCE BETWEEN PUMP OFF & DISTRIBUTION PIPE (LIFT) I I FT. MINIMUM NETWORK SUPPLY PR SSURE (DISTAL & NETWORK PRESSURE) _ + d FT. 3Q_ FT. OF FORCEMAIN x FT. /100 FT. FRICTION FACTOR ...... _ + FT. TOTAL DYNAMIC HEAD (TDH) _ INTERNAL TANK DIMENSIONS: LENGTH ; WIDTH ; LIQUID DEPTH MP/MPRS SIGNATURE: LICENSE NUMBER: P ,�< 9',7 i CONVENTIONAL SYSTEM CROSS SECTION NO SCALE / (C K 4 lw i 12" COVER 12" COVER 12" COVES ; >;:•':,�:; .v r , r CWO Date: Time: ly:i::l:i::i:.;.:'7 " >v.' t ? >l'I':i:'i' ',:`l'.;'!s,:•£..�k-;4;L:;; ,t� +.�. ,.il;i' +' '•:.l`r kY..;�:�r. ��' �I��ij� iii`` '.,ti.y;. i :<i;��:i;:` , ; {,�:�i i .,2: .t,l;l,i: �:: +, i;$S;dij,! • :1 .. I . L�i:''.;.: ��,.. �rv;'; ? ;.i'1� t ''��k!lui�E•::k'::Or:: {��� .:'4'�t• ` ?Viii ,,� •" :. +•:r,; •:,• � ,ti..,,,.. ,!,' %r Ji !r•3.. , � r �,: +!:.. ;:bra�i ..J; :.v •rd''.l` ' tz;. a: }iji,rr'sr:�.'rty'sq '�C:Iti ` �Ji' :;ii 'tii�: sa t a ' .: From. �i�l:: ii�l'1" , �I:i '.:1::1�. •.l. k,j,i�. ;i'v %. .y4ti� h ' .:il �l ''7 J.J t' i� :ill: ..,�, !J�� "1 + ,txf�,�ii: :�y:.:�:•.;i Subject: 1361 y ;: ;iiG� i•u :,. ,: .4'in!q' .14:f �,1�;t; "iYb' %; :!'�: - <'I.t:; ,��J: .. t, i s {iiri�.: . r,�.l•:��::•.s::,f:;;ti:� �:;;�i,;r; +.'! >: 1 � J1 /�1�'_ 'illii f °' li r: £ ����'� "; .•.:::C£i:,, -.Ji:: ,i. r:r ^,.�,:�L. '�li;j "k ..30.: 2 i; ° .I'll' l: ` h • '�'• '�f, I'i �.. rj!•S'ajj iJ r`uid: <: :::: ..e, 'y'4 �i .nit' "a; ai: �•'' #`: `C� ^.. ei, ':4y ^iil... ��Si. :i�i ')q. � L .:{ •a�i'!`i11., , . t.,t,.��y;n: ".;: � ...,. RAN IN SITU SOIL %TO.R DIMENSIONS: 1 Badgerland Printing Q 715- 874 -5149 "Dedicated to printing excellence. i I i i APR -12 -2005 16:28 FERGUSON ENT HUDSON 715 386 6144 P.01 KGOULDS PUMPS IJ lc�:K cf- 06-4 y Submersible A-rj+A- Effluent Pump PE 114 4-W: k"! 4, "WaNT PUMP e•� SPECIFICATIONS MOTOR FEATURES u Pmp — General: General: ■ Corrosion resistant • Discharge: 1' 'A" NPT • Single phase construction. • Temperature: 104 °F (40 °C) • 60 Hertz ■ Cast iron body . maximum, continuous when • 115 and 230 volts a Thermoplastic impeller and fully submerged. • Built -in thermal overload pro- cover, • Solids handling: 1 4" tecaon with automatic reset, E Upper sleeve and lower maximum sphere, • Class B insulation. heavy duty ball bearing APPLICATIONS ' Automatic models include a • Oil- filled design, construction. float switch. • High strength carbon steel ■Motor is permanently Specially designed for the a Manual models available. shaft, lubricated for extended following uses: • Pumping range: see PE31 Motor service life. • Mound Systems performance chart or curve, • .33 HP, 3000 RPM ■ Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 115 volts operation. • Low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the ( • Basement Draining • Maximum head: 25' TDH PE41 Motor working limits of the motor, `�_.. • Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM ■ Quick disconnect power Dewatering • Maximum capacity: 61 GPM • 115 and 230 volts Cord, 20' standard length, • Maximum head: 29' TDH • PSC design heavy duty 16/3 SJTw with PE51 Pump: PE51 Motor. 115 or 230 volt grounding • Maximum capacity: 70 GPM • .50 HP, 3400 RPM plug. . • Maximum head: 37' TDH • 115 and 230 volts ■ Complete unit is heavy duty, • PSC design portable and compact. METERS FEET ■ Mechanical seal is carbon, 40 , , I _ ceramic, BUNA and stainless • PE51 � � I I I 1 I.S. PE31, PFa Pesr Steel. 35 `' ' I ! I I ►+r, .ss, .ao, .so ■ Stainless steel fasteners. 30 I '� 2 GPM I i I j 'AGENCY LISTINGS t I 1 F I , Z Z5 � ,..� I I � i � i ��• U us ° 1 i Tested to UL 778 and I '' I I I I I � �_F I j I j CSA 222108 Standards 1 5 ! I - By Cana" standu* AssodaWn 10 I I I' ..L _ I r 1 I• Goulds Raps i iso 9001 ftLq rca, ' A 5 1 E I • ° 0 0 to 20 D • • .. j . 50 6o 70 GPM 8o 0 5 1° 15 m Goulds Pumps ® 2004 ITT Water Technology, Inc• CAPACTY Effective June, 2004 ITT Indu I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer r 74 Mailing Address jn D O 6 - -f R q nIC L-= -F— D iay d o M A), -5 Property Address C� v� c� t} (Verification required from Planning Department for new construction) City /State Parcel Identification Number U ' - W6 - Ze) LEGAL DESCRIPTION Property Location 4&2- i/., A I E '/., Sec. 9 � T - jQN -R A W, Town of S T1 10 S Ems Subdivision R-v P e D C Lot # . 2/ If Certified Survey Map # to 50 Volume Page # -5-1 Warranty Deed # 9 7 f j Z , Volume Page # Spec house ❑ yes 0 no Lot lines identifiable Byes ❑ 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 li censed pumper verifying that (1) the on -site wastewaterdisposal 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 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 dan of the three !7 date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of th a scri abo y virtue of a warranty deed recorded in Register of Deeds Office. /� SIGNATURE OF APPLICANT DATE ** * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** *« Include with this application: a s pp ' tamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I � - U 2819P 4 06 State Bar of Wisconsin Form 11 -2003 c3 1 8 LAND CONTRACT KATHLEEN H. VALSH (TO BE USED FOR NON - CONSUMER ACT TRANSACTIONS) REGISTER OF DEEDS ST. CROIX CO.. VI Document Number Document Name RECEIVED FOR RECORD 8 6/09/2805 18:15AM CONTRACT, by and between Edward P. O'Kane, Trustee of the Edward P. LAND CONTRACT O'Kane Living Trust dated August 2, 2004 EXDPT # ( "Vendor," whether one or more), and Nicholas Franta and Wendy Frants REC FEE: 17.88 TRAITS FEE: 444.00 COPY FEE. ( "Purchaser," whether one or more). CC FEE: PAGES: 4 Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance of this Contract by Purchaser, the following real estate, together with the rents, profits, fixtures and other appurtenant interests ( "Property"), inO`�1IIg Area St. Croix County, State of Wisconsin: Name and Return Address Located in the NW 1/4 of the NE 1/4 of Section 36, Township 30 North, Range 20 Heywood, Carl & Anderson, S.C. West, Town of St. Joseph, St. Croix County, Wisconsin; being Lot 3 of the 816 Dominion Drive, Suite 100 Certified Survey Map recorded on May 15, 2003 in Volume 17, Page 4519, as P.O. Box 125 Document No. 721641 Hudson, WI 54016 Subject to Road Easement as shown on Certified Survey Map and recorded in 030 - 2070 -20 -200 Volume 2213, pages 439440. Parcel Identification Number (PIN) This is homestead property. (is) (MM) This is a purchase money mortgage. (is) *clot) Purchaser agrees to purchase the Property and to pay to Vendor at 1300 27th Street, Hudson, WI 54016 the sum of $ 148,000.00 in the following manner: (a) $ 69,000.00 at the execution of this Contract; and (b) the balance of $ 79,000.00 , together with interest from the date hereof on the balance outstanding from time to time at the rate of 7.00 % per annum until paid in full as follows: Payments shall be made monthly in the amount of $1,000.00. provided the entire outstanding balance shall be paid in full on or before January 28, 2006 ( "Maturity Date "). Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. CHOOSE ONE OF THE FOLLOWING OPTIONS: IF NO OPTION IS CHOSEN, OPTION A SHALL APPLY ® A. Any amount may be prepaid without premium or fee upon principal at any time. ❑ B. Any amount may be prepaid without premium or fee upon principal at any time after ❑ C. There may be no prepayment of principal without written permission of Vendor. State Bar Form 11 -Page 1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of Z FILE INFORMATION SYSTEM SPECIFICATIONS Owner Nfi Septic Tank Capacity - Z ero a l 13 NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer L„ ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units --, ❑ NA Pump Tank Capacity 077D gal ❑ NA Estimated flow (average) g al/day Pump Tank Manufacturer Z-A ❑ NA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer g ❑ NA Soil Application Rate gal/day/ft' Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD.) 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD,,) 530 mg /L jr In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510° cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 2 ❑ month(s) (Maximum 3 years) ❑ NA y ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank,volume ❑ NA Inspect dispersal cell � year(sl s) At least once every: ❑ month (s) ) (Maximu 3 years) ❑ NA Clean effluent filter At least once every: ® m on th(s) ❑ NA Inspect pump, pump controls & alarm At least once every: :3 ❑ month(s) ❑ NA 0 year(s) Flush laterals and pressure test At least once every: ©year(s) • m ) ❑ NA (s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on ,the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tan4 volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page Z of G. START UP AND OPERATION For new.const(uction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: • A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. • A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. • The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. i ADDITIONAL COMMENTS i POWTS INSTALLER POWTS MAINTAINER Name lVt—Z 5 g.v Name Phone Z 7 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name C � Y Phone Phone O This document was drafted in compliance with chapter Comm 83.22(2)(b)(UM &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 0 ? _ M T (D cr . 3 \ ¥ rr 0 E} 3({ § k\ 0) § m § / } =r ® ° k ) \ 0 § E k ' / j k \ } \ v 2 / \ § 0, § k 2 CD § k q b /./ ` ( I E EL \ ! 8 « g c C.0 ° = ( / \ (D / / f ( < m / = / ® $ 2 @ . \ � \ § ) ( / \ (o .. � . co) o c 0 k j o o o \ \' g � ■ ■ ■ — � \{ /7 777\_ o § P to A M \ M \ 41 z , \ _ � ƒ 3 ( / 0 o : / CD c } D \ z 2 / \ __ o _� — ■ _ � \ § % \ / / m ( / / $ o < z § / z — W CD \ 4� � \ aak \ \0 § CL E % \ E F \ 0 E \ \ \ ) � /$ o = r 4 \0 \ « \ \ \ % � \ S � e � ® . ) / \ � ® Parcel #: 030 - 2070 -20 -300 05/24/2007 11:07 AM PAGE 1 OF 1 Alt. Parcel #: 36.30.20.611 -1 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - O'KANE, EDWARD P TR EDWARD P TR O'KANE 1300 27TH ST HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description 1300 27TH ST SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 4.832 Plat: 4519 -CSM 17 -4519 030/03 SEC 36 T30N R20W PT NW NE FKA LOT 1 CSM Block/Condo Bldg: LOT 04 6/1590(8.394AC NKA CSM 17 -4519 LOT 4 (4.832AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 36- 30N -20W NW NE Notes: Parcel History: Date Doc # Vol /Page Type 08/17/2004 771868 2639/166 QC 05/15/2003 721641 17/4519 CSM 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.830 126,300 176,200 302,500 NO Totals for 2007: General Property 4.830 126,300 176,200 302,500 Woodland 0.000 0 0 Totals for 2006: General Property 4.830 126,300 176,200 302,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00