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030-2097-20-000 (3)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes IPnvacy Law, s 15.04 (1)(m)) TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION MSooM- �[� 0% 40 PUlOff)'�ISIPHON INFORMATION / to Manufacturer E Model NumberOQ TDH 1-4, FncyQn ?j System H3ady� • j 4 , Forcemain Lent ) Dia 2N Dist. to Well f > 0 SUIL SUKPIIUN SYSTEM ENC Width Lengt DI 3 1 9l Do ILiquid Depth INFORMATION MavetiCA044 ystemCHAMBER OR UNIT Moer Ol —� DISTRIBUTION SYSTEM . n ' HeodarlMandol� Distribution x Hole Sae x Hide Spacing Vent to Air Intake Length •Q Dia Pi (s) Long Dia pacing SOIL COVER x Pressure Svatams Only YY fill nr At-Grada Svetame Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepancies, persons present, e1c.) Location: 590 132ND AVE 1.) Alt BM Description = 2.) Bldg sewer length - amount of cover xv. Plan revision Requkilil Yes 'X No T I Use other side for additional information- S1)6710 (R3197) n Date- qol CobftVi 1. Qt } V rspectlon #1_ �li-f1 p jl Inspection #2 ►3. 6 = 9G. is �-.t�# Insepctos SignaNre Cert No S�4N -')o.) ► — /37 ,.,. ,,.,,.. County - -- Industry Servkx's Dirision 1400 E Washington Ave SCCroix SNP Pit Number (to be filled in by Co.) \ P.O. Box 7162 Q 4 2U21 Madison, ,m 3707- 162 'r 633 3SIr In, �'P it Applieatio State Transaction Number In w�dr1ift set ee . o , submission of this form to the appropriate tall unit ' 0 S2 100 3r' _C is required p unorto o i6f ng a sanitary permit Note: Application forms for stateowned POWTS are submi to the Department of safety and Pro(essiond Services. Persmal information you provide may be used for secondary8 Project Address (if differem than mailing address) Purposes in accordance with the Privacy Law, s. 15. I Xm X Stets. 590 132w Avenue 1. Application Inrormation - Please Print All Information Property Owner's Name Parcel N Joseph k Amy Studnicka Revocable Trust �tjE �/ ^ 030-2097.20-000 Property Owner's Mailing Address Property Location 590 132"r Avenue Gov). Lot NE'4, SE Y", Section 28 City. Stale Zip Code Phone Number Somerset, WI 7 54025 0 (cncleone) T30N R 19Eorftpl 11. Type of Building (check all that apply) I I Lot N Subdivision Name ®1or2Family Dwelling - Number orBedroonu 7 eCQQ t9e#12 L �1olS91110f00TiaA) Birch Point Block N ❑ PubiWCommercfal - Describe Use _sll� xG I- rt ❑ City of ❑ State Owned - Describe Use ❑ Village of CSM Number ® Town of St. Joesph Ill. Tpe of Permit: Check only one box on line A. Com left line B if applicable) A. ❑ New System ®Replacement S ten ❑ Treamrem/Holdin Re g Tank Replacement Only ❑ Other Modification to Fxtsting System (explain) g ❑ Permit Renewal ❑ Permit Revision ❑ Change of Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber T27er 463113,10/1141004 IV. rype of POWTS S stem/Com nent Device: Check all thatapply) ❑ Non -Pressurized In -Ground Pmuuoad In-Groun ❑ At -Grade ❑ Mound > 24 inof suitable soil ❑ Mound ` 24 in of suiable soil ❑ HoldingTank ❑ Otter Dispersal Component rspe portent (explain) ❑ Pretrcatrnent Device (explain) 1 V. Db naVTreatment Area Information: Design Flow fgpd) Design Soil Applicalion Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 600 Ratefgpdsf) 857 900 95.W 0.7 VI. Tank Info Capacity in /_ �S Gallons lout Gallons N of Units p o `e (�l K Manufacturer 9 rd $ AV u New Teaks F.xruima Tanks 6. U in to rn$ u_ v a Septic or Holding Tank 1000 1000 I Weeks C. P. DosmIlChamber 750 750 1 Wieser Concrete VII. Respeasibility Statement- 1, the ■ ned, amuse respoinilbillity for lewliadon of the POW" shown on the attached plans. Plumber's Name (Prim) Pluntisr7siodature _[ MP/MPRS Number Business Phone Number John Schmin L ' � f'j`u/� l 223760 715.760-0486 Plumber's Address (Street, City, State, Zip Code) 596 Valley View Trail, Somerset, WI 34025 VIII. Coun rtmeet Use Only Approved ❑ Disapproved Permit Fee� Dar IIsssu d kii Ageet Sign IX. Conditions pro 13 l DTtfr-,pQAI'�- IAA u� vlk- SYSTEM OWN air 1. Septic tank, effluent otter and st �e� y� /Q� a A o�JtYCT+GdL �r dispersal cell must be rvi / maintain % (J as per management plan provided by plumber. old key- pfOUl flVl — as per applicable cotlENIf ffiW. puss wr me 131 aaa =I It me Caains r as teas tr4m a r I Inehn in Sire ' nee , SBD-6398 (1103/14) SYSTEM PLOT PLAN Studnicka 3-4 Bedroom Septic System °iµpn Flea ONGPD ded90 Bow �la4etlons for AttacProject Ave Address: 5e0132nt nw carher plans: mvr BMt SOW I L BM Elevat M fro m F (m tyywlay ( ASTM Standard BM Dena Wn: Ncdhes4h tut oahrr mmiss Tate" 36430.3 a 38490-5 Q BM Elevation: 91,W'.. 4' 3CN 40 PVC PO* ASTM• DI855 �ernp septic tank ovMt 4-3034 PVC Pf» A8T14 )WU Slope Gradient at Tested Ayer. (114) 1 4' 272p Part pip I Asym-02T29 Wes symbol (r oppk") Tt T2 G Proposed WLP750-MR pump W* Veh"' Usling V&P1DD0-MR SepticYNc wl Zabel A-100 Mluarht lilac Cn) i US ■B1 oft• SCH40 PVC / 3 �� e Mein owe GsgVps Dd~" l 1 9 \ �03 T3 ■ B2 t� 0-196 Slope T1- Existing XxW lrnbetar Quick 4 bench EI.- $9.83' 84 1 T2- Existing 3'xISV Infilbotor Quick 4 bench EL- 89.93' T3- Proposed 37r90' EZ Flow trench El.- 95.W / T4- Proposed 3'40' EZ Flow bench El.- 96.86' V/Bohhp bhom Lot 3 E1..99.50' �� SW lot comer sed tlMs Daft aWntbns ats oorubMht with Lot 2 slevatim LOT 3 AA LOT 2 5 L BM 132nIAve RAN Gore" I Lot aaner EI.W.54 May 3, 2021 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2023-05-03 Plan Review: PWTS-05210073 I -C JOHN F SCHMITT 616 150th Ave Somerset WI 54025 SITE: Stndmicks 590 !32nd Avenue Town of SAINT JOSEPH St. Croix County Total Amount: $250.00 FOR: Description: 600 GPD (4 Bedrooms - Replacement) Maintenance Required DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.vA.gov/programsAndustry-services www.vAsconsin.gov Tony Evers - Governor Dawn Crim - Secretary condalon•sy APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE [n-ground Component Manual - Ver. 2.0, SBD-10705- P (N.01/01, R 10/12) Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R 10/12) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Prober soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare If it crumbles site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Abandon Existing System per SPS 383.33 • Pump Floats to be set and verified per approved plan. Any changes may result In pump resizin¢ to meet TDH and GPM Specifications. • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the POWTS Dispersal Area must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. 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 Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Thanks,�/ r%iar vaor��ieaf POWTS Plan Reviewer — Wastewater Specialist Department of Safety & Professional Services I Division of Industry Services email: tim.vanderleest(a,wisconsin.gov Cell: 608-516-6134 CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Studnicka Replacement Septic System Owners Name: Joseph & Amy Studnicka Revocable Trust Owner's Address 590132nd Ave Somerset, WI 54025 Legal Description: NE1/4, SE1/4, S28, T30N, R19W Township St. Joseph County: St. Croix Subdivision Name: Birch Point Lot Number: 2 Block Number Parcel I.O. Number 030-2097-20-000 Plan Transaction No. Page 1 Index and title Page 2 Plot Plan Page 3 Septic Tank Specifications Page 4 Effluent Filter Information Page 5 Dose Tank Specifications Page 6 Dose Tank Cross section Page 7 Pump Curve & Specificatins Page 8 System Suing & Cross Section Page 9 EZ Flow Information Page 10 Pressure Distribution Network Page 11 Distribution Network Specifications Diagram Page 12 Existing Tank Certification Page 13 Management and contingency plan Page 14 Sanitary System Ownership/Address Form Page 15 Warranty Deed Page 16 CSM or Plat Attachment 1 Soil Evaluation Report Conmuonary APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DNISION OF INDUSTRY SERVICES SEE Designer: John Schmitt Licnese Number: MPRS 223760 Date: 4/12/2021 Phone Number: 715-760-0486 Signature: In -Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01) Page 1 SYSTEM PLOT PLAN Studnicka 3-4 Bedroom Septic System DMIs Flory s000M Aaadr design Now aataufdar a for Pro)W Address: M01S2rd Aw Col., 0CIM pkm: BM7 S7rnwQ� BM EMvdon: 100 M' PAS MaMMIs I ASTM StnnAwd BkIDe OVIllorr. Naewaltlslwnwamhu TasMs 384.30-]i]111430-5 /� y�yp,pal: Q By gsyMlp,,: y� r BCN 40we rq ASTM- WM ewrleea. EdMYq sepse Yrrs arAM 4.1074 PVC pipe I AST14D3074 Slops Gradlwx of Teslse Arse: 0%) 1 4- 7M Par pale ASTM-02729 Was SY^Dd (a apOM'/0Y) Proposed ALP750-61IR pump tank \ of 2' SCH40 PVC s Man `s Borinp Is Vom/Lot _ El.-gg.60' SW lot 04mM end VYa bong erevabom ere con dent W0, Lot 2 sisvagans LOT TI T2 E>d - IALP1000-MR septc MM wl ZOW A-100 411fueM filar i 64■ Eel i kAWFV 3 �jpgp Dnwnny / t / t / I I jl Erostap �:T4 T3 III B2 0-1 % slope T1- ExtaVrq 3W nfilrator QuKk 4 oanch El - AS 93' 4e T2- EloaVrrp 3'x6tr 1.01b to( Ousok 4 Vent/ El.- 89 67' TS Proposed 7'x90' EZ Flow Vents El -95.66' T4. Proposed 3'x90' EZ Flow Vents EI.- HAS* LOT Lot oomer EI..97.64 BM 132nd Ave RAM commerce.wi.gov isconsin Depwbrlem of Commerce February 16, 2010 WEEKS CONCRETE PRODUCTS RAY WEEKS 1832 215TH STREET NEW RICHMOND WI 54017 SAFETY AND BUILDINGS DIVISION Plumbing Product Review P.O. Box 2658 Madison, Wisconsin 53701-26M TTY: Contact Through Relay Jim Doyle, Governor Richard J. Lein inkugel, Secretary Re: Description: SEWAGE TANKS, CONCRETE Manufacturer: WEEKS CONCRETE PRODUCTS Product Name: SEPTIC, HOLDING, OR PUMP Model Number(s): 1000 (49 IN. L.L., 21.76 GALIN., 84 IN .MAX. DEPTH OF BURY 511 G.P.D. WHEN USED AS A SEPTIC TANK BASED ON A 3 YR. SERVICE INTERVAL FOR RESIDENTIAL WASTEWATER;. TANK DIMENSIONS. 84 IN. L X IN. W X 49 IN. H ) Product File No: 20100040 The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters Comm 82 through 84, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval Is valid until the end of JUNE 2015. This approval is contingent upon compliance with the following stipulation(s): • This tank must be designed to withstand the pressures to which it will be subjected. • The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the department's stamp of approval. The plans and specifications must be open to inspection by an authorized representative of the department. • When this product receives wastewater from dwellings and is used as a septic tank, it will produce an effluent quality with a maximum monthly average value for BOD5 of greater than 30 mg/L and less than or equal to 220 mg/L TSS, or greater than 30 mg/L or less than or equal to 150 mg/L TSS, and F.O.G. of less than 30 mg/L. • Approval is issued for this product as being equivalent to a floor outlet water closet when the fixture drain is installed in the vertical position. The design meets the intent of s. Comm 82.32 (5) (c) and 84.20 (5) (n), Wis. Adm. Code, which requires water closets to discharge through a minimum diameter 3" drain pipe or fitting and the bowl to conform to ANSI Standard All 12.19.2M. The intent of the code is met since this product provides the same functional performance as water closets that meet ANSI Standard All 12.19.2M. • BEDDING: Bedding material shall be used to provide a uniform bearing surface. A min. of 4-Inch base of sand or granular bed on top of a form and uniform base is recommended. The tank should not bear on rocks. Sites with high ground water tables should have specially designed bedding. Soils should be compacted under the tank. This approval supersedes the approval issued on 4/21 /2005 under product file number 20050106. This approval letter shall be incorporated with your previously approved plans and/or specifications approved under product file number 20050106. As of May 15, 2008, a copy of a successful water tightness test report for this product must be AVAILABLE FOR INSPECTION AT THE MANUFACTURER'S PLANT prior to this product being used as a POWTS holding or treatment tank in Wisconsin. The department is in no way endorsing this product or any advertising. and is not responsible for any situation which may result from its use. Sincerely, Jean M. MacCubbin, CST Engineering Consultant --Plumbing Product Reviewer Commerce; Safety 8 Buildings Div.; PO Box 2658, 201 W Washington Ave.; Madison WI 53703-2658 Phone: 608-266-0955; Fax: 608-283-7456; E-mail: Jean.MacCubbin@wisconsin.gov SBD-10%4-E (N.10197) File Ref: 10004003.DOC Page 3 PAGE 2 or 2 The interval for servicing septic tanks is set by stale and local code. Throughout the United States, there is a wide difference of opinion on what this interval should be, but most regulatory agencies suggest two to five years. The Zabel filter, which does not increase the frequency of servicing for the tank, should be cleaned when the septic tank is normally inspected and pumped. However, our fitter is virtually self-cleaning. The continued action of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fall to the bottom of the tank. If your filter contains a SmartFifter(& alarm, you will be noted by an alarm when the fitter needs servicing. Step 1: Locate the outlet of the septic tank and remove the tank cover. Step 4: While holding the cartridge over the access opening, rinse off the cartridge with fresh water, being careful to rinse all septage material back into the tank. Step 2: Remove the tank cover and pump the tank if necessary to prevent any solids from escaping to the the dram field when the filter is removed. Step 5: Insert the fitter cartridge back in the case, making sure the filter cartridge is properly aligned and completely inserted in the case. Replace the septic tank cover. Step 2: Firmly pull the filter handle and the cartridge out of the case. 0 Residential Applications Certified toANSVNSF Standard 46 Cwp N 2014, PoVok. kw, AN rights reserved Product(s) covered by one or more U.S. arrAlor iYrrWlonai pebnls Orner U S and Intematronal patents may be pending 1-877-765-9565 / www.polylok.com slide Page 4 4" CAST-A-SI x • N PUMP PAD CAST -A -SEAL its2 DIMENSK* WALL: 2 1/2- BOTTOM: r COMM: 5' MANNO i• 240 I.D. PRECAST CONCRETE RISER HEIGHT: 54' ourwE DIAMETER: r-W BELOW WILET: 42• UQLIID LEVEL: ar WEIGHT: 6,150 LBS. NAET AND OUTLET: 4' CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WSCONSIN, SEE DETAIL /10 (OTHER STATES SEE CHART) LIQUID CAPACITY': 20.28 GALAN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 790 GALLONS LOADING DESIGN: a' -or UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN j6 (NO FIBER) TANK: MIX DESIGN /f0 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT VKSER CONCRETE RENEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODIKTS NEEDED By: y•r m W R LIM �X Y � a �oco Z Lr) s � of yxS W_ 1 OF PAGE 5 OF 6 SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4'e Vern Pen >10 a flan BUWV 12' Min. or 2.01M above Ea1�4M ' Flood So ebon Nkw) _ IMPORTANT: Anchor tank(s) as necessary pursuant to SPS 383.43(ft) FVd~ Grade CAPACITIES @ 20.28 galAn =• Y Depth (in) Volume (gal) A 20 405.60 B 2.0 40.56 [C] 6 121.68 D j 9 182.52 *Pump Tank Liquid Level = 37 In Force Main Diameter = 2 in ED Force Main Length = 210ft Force Main Void Volume = 34.23 gal [C] Total Dose Volume (TDV) = 121.68 (5X total lateral void volume <TDV <0.2X ( + (force main drainback volume) MIN. PUMP DISCHARGE RATE = EW bkW mrst comply wMh SPS 316 and NEC 300 Extend rnanrole nser as necessary wow"rprEw Jurebon Boa Approved 11onhole wish Warrwx0 LaDN AMhdud IyW�I Cordurt 4' khm. or 2.02 above T%EwbhMnd` Flood VW)Elonaon ANgf ned 1s' W. 1* I Dpov�ed JoFrbf wIW roved Wpe ] 11 ono Asoled Gaxd (ypk�MP-OFF Aap VATION = A 87.83 ft+ p cIDE BOVATION = 87.08 ft r Approved a.edrp M mWW BWUW To* Vertical Head = 8.33 ft + Min. Supply Head =35ft gaUdose + FM Friction Loss = 2•97 ft 25 gpm + Fitting Loss' = sommmo� 1.05 ft (min. supply head x 0.3) = TOTAL DYNAMIC jffAD =15-85 eft PUMP TANK: SEPTIC TANK(S): Volume = 750 gal Total Volume = 1000 gal Manufacturer. Wieser Concrete Manufacturer(s): Wieser Concrete Pump Manufacturer. Zoeller Install approved effluent filter at the septic tank outlet Pump Model: 98 (Seeaas&md p„r p wrve) Immediately upstream of the pump tank inlet. Controls/Alarm Manufacturer: SJE Rhombus Filter Manufacturer. Zabel Controls/Alarm Model: AB Filter Model: A-100 Float switches contalnina mercury are prohibited. Co 25 t 6 20 15 0 4 10 �O PUMP PERFORMANCE CURVE MODEL 98 5 0 10 20 30 40 50 60 70 61 GALLONS LITERS 0 60 160 240 FLOW PER WIDE TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 98 Feet MesasM72273 5 1 S 10 3.0 1s 4.6 20 7.1 Sh"Host 23 .Dm Omen CONSULT FACTORY FOR SPECIAL APPLICATIONS f-7 exnm Electrical alternators, for duplex systems, are available and Vanable level float switches are available for controlling single supplied with an alarm and three phase systems Mechanical altemators, for duplex systems, are available Double piggyback variable level float switches are available for with or without alarm switches variable level long cycle controls Refer to FM1922 and FM0806 for temperatures above 130"F 99 aerie■ Control Seemed" Mead vas -Ph Mod. Anaps shnool Duplex Moe 115 1 Ado 9.4 1 4 N96 115 1 Non 9.4 2 or 3 4 DO 230 1 Ado 4.7 1 4 Ego 230 1 Non 4.7 2 0r 3 4 SELECTION GUIDE 1. Integral Boat operated mechanical swlt&, no extemal control required. 2- For automatic use single piggyback variable level float switch or double piggyback variable level Boat switch. Refer to FM6477. 3. See FM1228 for correct model of simplex control panel. 4. See FM0712 for correct model of duplex control panel or FM1663 for a residential alternator system. For nfomurbon an additional Zoeller products refer to catalog or Piggyback Variable Level Swtches. FM0477; Elecdeal AlNmsior. FMO486: Models" All n ow. FMO495, Sump! Sewage Basins, FMOW, Sit* Phase Simplex Pump Cnitid, FMISK Ahnn Systems FM0732. All installation of controls, protection devices and wiring should be done by a qualified licensed electrician, All electrical and safety codes should be followed including the most recent National Electrical Code INEC) and the occupational Safety and Health Act (OSHA). "Easy assembly" let» 6 6sch" pq OPTIONAL PUMP STAND PIN 10.2421 Reduces potential dogging by debris. Replaces rocks or bricti6 under the pump. Made of durable, noncorrosive ABS. Raises punp Toff bottom of basin. Provides the ability to raise intake by adding sections of 1% or 2' PVC piping. Attaches securely to pump. Accommodates sump, dewatenng and effluent applicabons. NOTE: Make win Bad Is free from obstruction. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAl iR P.O. 8Olf "W ZOA1115F of WW 36Mft KY 4Y edmaers a Lawlor. AY 4Wf-1961 �n• AMOV 5" AW www.aadler.com !O. / FAXIIIflmj 41% MR W~ / eo CapWW 2012 zoarsr Co. All rViM f..Mvaa. Pap 7 IN -GROUND PRESSURE DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down -sizing credit) GooftKilla_� TYPICAL SOIL COVER .._.:al . Il ,•�i�•• .�:-ice 1%��i��;CROSS SECTION mim. VWMh (No Scale) System i. • •• IL Provide Lateral Invert Elevation = 96-16 ft separation between trenches. I' TYPICAL TRENCH (Show force main, manifold, and flush valve locations on plan view.) PLAN VIEW (No Scale) 1.5 Schd140 OWwv&bMpP•'"""'"•"° Wmcbw b*. km wry. 10 ft PVC Lateral pbservailan P4m (typical) (typkMn B = 90 It (4view) w INSTALL PER TRENCH: A m 9 101 bundles @ 50 ff EISA/unit = 450 ft' + 0 5-ft bundles @ 25 ff EISAlunit = 0 ft - Proposed EISA per trench = 450 ft' A = 3.0 ft ("Cal) EZ1203H Bundle (typical) (mfd by IrDtrstar system.. Inc.) Inatell pursuart to m rkdackser'sIrrtucMons. Required Infiltration Area = 857 ft x 2 trenches = Proposed Total EISA = 900 W D m w O n 0) Installation Instructions for EZflow Systems in Wisconsin Wisconsin Department of Commerce, Safety and Buildings Division, has reviewed the specifications and/or plans for this product and determined It to be in compliance with chapters Comm 82 through 84, Wisconsin Admin. Code, and Chapters 145 and 160, Wisconsin Statutes. All sites must meet the 5k & Soil Conditions & Locations & Isolation distances as noted in local regulations. The approved products are 1203H (3-12' bundles with pipe in center bundle in 5' or 10' lengths) and 1203HP (3-12' bundles with pipe in each bundle in 5' or 10' lengths. A single pipe bundle contains a four inch perforated pipe sur- rounded by EPS aggregate and is held together with poy- ehtylene netting. A single aggregate bundle contains aggregate only and is held together with polyethylene netting. Materials and Equipment Needed • FZflow Bundles • EZflow Geotextile Fabric • EZflow Internal Pipe Couplers • Pipe for Header and Inlet • Backhoe/Excavator Installation Instructions The instructions for installation of EZfbw products are given below. This product must be installed in accordance with state rules defined in chapters Comm 82 through 84, Wisconsin Ad- ministrative Code, and Chapters 145 and 160, Wisconsin Stat- utes, as well as the local health department's current design manual. 1. After the local health department has determined sizing, configuration, and layout for the EZflow systems, stake or mark with paint the location of trenches and Ines. Be careful to set correct tank, invert pipe, header line or dis- tribution box and trench bottom elevations before instal- lation of pipe bundles. 2. Remove plastic EZflow shipping bags prior to placing bundles in the trench(es). Remove any plastic bags in the trench before system is covered. 3. This product must have geotextile fabric that meets re- ; quirements of s. Comm 84.30 (6) (9), Ws. Adm. Code, installed directly on top of the product and extending down along the sides of the product to a point at least six inches from the bottom of product. 4. When installed in a trench, the trench should be dug to a width of 36 inches. This not only saves labor in excava- ton, but also provides better load -bearing capacity after backfilling is complete. t1EZflowTU ry INFILTRATOR 5. The Absorption area (SF) necessary for a given site shall be sized based on maximum daily sewage flow (GPD) and the Permeability for the site. 9 certain criteria is met, the EISA sizing can be used in Wisconsin, resulting in a 40% smaller drainfleld. 6. Place EZflow bundle(s) in the EZflow configuration ap- proved by system design permit specified for the particu- lar site. The top or center -most bundles containing pipe are joined end to end with an internal pipe coupler. Any additional aggregate only bundles that may be required, should be tutted against the other aggregate -only bun- dles and do not require any type of connection. 7. The top of each GEO cylinder contains a filter fabric pre - manufactured in between the netting and aggregate. The fabric is inserted to prevent soil intrusion. The installer she] make sure the the GEO is positioned upward and is in contact with the fabric contained in the adjacent cylin- der before backfilling. 8. The EZflow Drainfield Systems should be installed in a level trench in all directions (both across and abng the trench bottom) and should follow the contour of the ground surface elevation (uniform depth), with all continuous adjoining 10-foot cylindrical bundles placed end to end, with central bundle distribution pipe interconnected, without any dams, stepdowns or other water stops. 9. The trench top shall be graded such that water will not pond. Backfill should be seeded or sodded immediately after completion to reduce erosion. 10. EZflow EPS bundles are flexible and can fit in curved trenches as may be necessary to avoid trees, boulders, or other obstacles. 11.EPS aggregate is lighter than water, therefore, it might be expected that natural buoyancy forces would tend to cause EZfbw assembles to float out of ground when ponding occurs. Field experience has shown, however, that this is not a problem when systems have a minimum of 6' of soil cover as recommended by manufacturer. 1209HGEO Ali r Material Page 9 PRESSURE DISTRIBUTION NETWORK 1. Distribution pipe sizing • Soil Absorption Area (2-3'X90' EZ Flow Cells) • Lateral per area: 2 • Lateral spacing: 7.00' . Lateral length: 90 • Lateral size: 1 1/2" • Orifice Spacing 48" • 1" orifice location 1.0' from end • Orifice size: 5132" • Orifices per lateral: 23 • Lateral discharge rate: 12.42 qpm Distribution network discharge rate: 24.84 qpm 2 laterals x 23orificesllateral x 0.54gal/orfice = 24.84 qpm 2. Manifold • Location: End • Length 7.00' • Diameter 2" • Friction loss: 7' x 1.37ft1100ft = 0.1 ft 3. Force main: • Diameter: 2" • Length: 210.00ft 25 gpm • Flow rate: 22:d4-aRm • Friction loss: 210' x 1.37ft1100ft = 2.87 ft 4. Total dynamic head: • Minimum supply pressure: 4.55 ft Vertical lift: 8.33 ft • Friction loss (forcemain) 2.87 ft Friction loss (manifold) 0.1 ft Total dynamic head: 15.85 ft Page 10 DISTRIBUTION NETWORK SPECIFICATIONS FLUSH VALVE DETAIL (No Scale) Ornm in — — Valve Box Center of Threaded Cap (insulation optional) for Head Testing (optional) ' 1 � Ball valve I (optional) / \ (No Scale) LaMral Speriq S= 7 SNdd orllws for gnwebon ppMwkm 1 Lateral Langtlt (P): 90 ft (rher pipes optional) 2 •0 Surd 40 PVC MWAAd 2 •0 Sutd 40 PVC Force Mein (slope to Pump tank r— for drain -back) First Offte (bpi) Laterals to be level Schdl 40 PVC Lateral 0 = 1.5 in (typical) Number of Orifices per Lateral = 23 OrMom equatiy spaced: Z Miscit a) OR b) below) _ 1 a) n slap bosom of lateral ` Odkes equably spaced Fkieh Valve r alortp bosom or lateral b) EL wwv bP d Istsral Assembly with every 5 tr hob (typical - see delal) ft� down Lasl OrIlIlIce Orifice Spacing (X) = 48 in LATERAL INVERT ELEVATION = 95.06 ft (bpicel) (bp") (typical) Orifice Diameter = .156 in OBSERVATION PIPE DETAIL (No Scab) crew -Type or Firbhed Grade SAP cap O��) -v'.. (mrlched & seeded) 4*0 PVC Piss �... ToP Cover Top of pipe to temiirvAs (min. 1 foot) at or above firtkhed grade (4) 114•-1 x Ir Sloh ® apart , Ancftaktp Device ..., :' : IMltrallon Surface Orifice Discharge Rate = .54 gpm Number of Laterals = 2 Lateral Discharge Rate = 12.42 gpm TOTAL DISCHARGE RATE. 24.84 GPM (typical) First Ortke END MANIFOLD Check (tyP1001) ❑� CONNECTION applicable box. M�dole Fist Odiw (rher pipe optlorW) (typical) X X/P X --i (bowl) ("wa, CENTER MANIFOLD (ter �) CONNECTION ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) 590 132nd Ave located at: NE 1/4, SE 1/4, Section 28 , Town 30 N, Range 19 W, Town of St. Jaeeph , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: Tank Capacity: 1000 Construction: Prefab Concrete x Steel _ Manufacturer (if known): weeks con"te Products Age of Tank (if known): 10115noo4 Permit number (if known) 463118 John Schmitt (L' nsed Plumber Signature) (Print Name) MPRS (Title) (Date) gallons Other minutes 223760 (License Number) MP/MPRS Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 Page 12 In -Ground Pressure Management Plan IMPORTANT: PAGE 6 OF 6 The owner of this in -ground pressure system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a reglstered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 600 gpd; BOD5 5 220 mgL"'; TSS 5 150 mgL-'; FOG 5 30 mgL'' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities (i.e., pump re -cycling, float switch settings, etc.) o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s l shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Slats. when the volume of solids In the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. Effluent fllter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturers specifications. A servicing period will always be greater than 12 months. o Distribution laterals shall be flushed once every 3 years or when necessary. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Schmitt & Sons Excavating Inc Phone: Local government unit: 715-760-0486 St. Croix County Community Development Phone: 715-386-4680 Local government unit address. 1101 Carmichael Road, Hudson, WI ZIP: 54016 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Continuencv Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed In -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin, Code. Page 13 S-r. C( 11N-l'Y SANITARY SYSTEM File #: OWNERSHIP/ADDRESS FORM °c.or.d tmed2ffice Only Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the Property Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer Joseph & Amy Studnicka Revocable Trust Mailing Address 590 132nd AvenueP.O.Box 32 City/State/Zip Somerset, WI 54025 Phone Number (required) 612-388-0914 Email Address (required) loestudnicka@gmail.com Parcel Identification Number 030-2097-20-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location NE y4 , SE 1/4 , Sec. 28J T 30 N R19 W, Town of St. Joseph Subdivision Plat: Birch Point Lot # 2 Certified Survey Map # , Volume , Page # Warranty Deed # 1091944 (before 2006)Volume , Page Number of bedrooms 3 Spec house 0 yes ■ no Lot lines identifiable ■ yes 0 no New Property Address (Staff Initials) OFFICE USE ONLY (Verification of new address required from Community Development Department for new construction.) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 5t. Croix County Government Center 715-245-4250 Fax cdd@sccwi.gov 1101 Carmichael Road, Hudson, WI S4016 WWW.sCCwI.ao Page 14 LOT 2 CERTIFIED SURVEY MAP VOL. I I , PG. 2993 N88*530470W 960.00' L,.OT 3 &M ACM M4.42 $9. " 927.00' — LOT ,i) a. a0 ACM 1",714 $0. ".. b w LOT 1 3.30 ACRES loom DRNIM ACIVOON AREA I i I i R ! 71 ''+�� '�•�..._.._ •� ,,,-----STREET- - W omm n Dwarumni of indm" La�nr ewd I-Unen ReWWrr oivion o, salitr a Bui,brws SOIL AND SITE EVALUATION REPORT I..'-' a uM m na uc. A�� r Pape 1 oi3 1„v w.0.inn w.v.+. ••w• •vn• wvcCOLINTY Attach complete rt. plan on paper na C Mai, *; n >< size. Plan must mace.. txn St. Croix PARCEL I.D.. not limited tD vertical and horizontal r pant (WA. % of slope, "a or eimeneior»d, north arrow, and dew* pending APPLICANT INFORMATION- E P,RIKi��I OR ON DATE �9Y S PROPERTY OWNER s f PROPERLOCATION TY Dennis Erickson � GOVT. LOT NE 114 SE 1r4.S 28 T 30 NA 19 bW W PROPERTY OWNER'S MAfUNG LOT • BLOCK I SU80. NAA�E OR rSM e 143 St. croix Trl. `� 2 na Birch Point CITY, STATE ZIP []VILLAGE OWN NEAREST ROAD Lakeland, W. 55043 -5211 St. Jose 60th. St. bd New CW&VUcicn Use sod Reaidlnlel I Nla W of bedrooms 3 ! 1 Addition b ens*V htd&4 J Replacement (j Pubis or =w4rcW describe Code derived daily few 450 IIDd Reowwwrioed desfpn loWk p rob • 7 bed. 9 tench ppdfR2 Awwpwri area repw 643 bK lt2 5563 tends, fal2 1kww d"V bftV rue - 7 bed, gpdnt2 .8 tench, WW RecamterWed nnr anion swiace efeouiogs) 96.41 q Las referred 10,1 pan bendenark) Additional design / Site cori4' ' 1 aortt na r1fiv Parent material outwash Flood plain Wrabc1n, if appic" na h $ . $�tlye br COINIIRIdY1L U• unstnlable br $S ❑ u YOtNp $ S ❑ u FR113UN AT:7tM0E SYST6r IN FlIl IIOLDNG TANK 0 u 0 S ❑ U ❑ S Mu ❑ S ® u Boring 0 in GGiound 99.76 . A Oeph b �9 +82.1 Gard 9�7bh. DIP b bw +82" SOIL DESCRIPTION REPORT ® •:. ra. .. a .,:, .. ®® � © t. , . --- —_ -® Remarks: mm OWWROW MINN 0J. ����•=* =M■ pWpfM0MMER Dennis Erickson SOIL DESCRIPTION REPORT PARCEL LD.8 bending Boring # s<:N 3 Groud 9M6, Boring S kkfltlltleG'"3 4 Ground do. 99.68 n, D"M b VA&V ISM +820, Borxip � �� Giou. d 9M.6tL Boring N Grand elan. Depm to ir*ng tanor Pipe 2 of 3 ' r Horizon Depth in. I Dominant Color Munsell Momes f]u. Sz. Cont. Color (Texture Structure Gr. Sz. Sh. ICarnertbnCe aotndtty Roots GPD/ft BW ,Tiench 1 0-7 10 r3 3 none 1 2c 1 mfr cs 2f 7-18 10yr4/4 none sil 2mabk mfr aw 1 f �b ' 3 18-3 10 r5 4 none sil lfsbk mfr gw 1 ".IC- 5 r4 4 none is osq mfr gv na .7 .8 40-90 7.5 r4 6 I none s osq mvfr na na .7 .8 Remarks: 1 0-11 10 r3 3 n Q,p; 1 — 0.0 '0.2 3 19-3 10 r5/4 none sil lfsbk mfr gv na 4 38-4 7.5 r4 4 none is oscr mfr lav na .7 .8 5 41-8 7.5 r4/6 none s osq mvfr na na .7 .8 Remarks: 1 0-9 10 r3/3 none 1 2f 1 mfr cs 2f D 2 9-36 10 r5 4 none sil lfsbk mfr v 1 .3 3 36-41 5 r4/4 none is osg mfr gw na .7 .8 4 41-8 7.5 r4/6 none cos osa mvfr na I na .7 .8 q4- 9s / g Remarks: Remarks: _6 . Gary L. Steel CSTM2298 MPR}SW-3254 f N 1"=40' &!.= top of NE STEEL'S SOIL SERVICE Dennis Erickson NEkSYk S28-T30N-R19W town or St. Joseph lot *2-Birch Point lot stake ! el. 100' Gary L. Steel 9-4-95 15M 200fh Ave. New RWw at, WI 54017 (715) 248-62W Wkwonsr, Dope b ,snr of Indv try. LAW, & d hhlt,sn Rehab" onoc\n of Sahaw A &,16nc. SOIL AND SITE EVALUATION REPORT Pape 1 of ---a - m awv,v w,u, ,u-,n o .wo. •.w. r .'. ww COUNTY St. Croix Attach aompleW site plan on page not loss not limited to Yen" and hcrizontal rater th in size. Plan moat indude, but % of dope, News or Pi1Fll D s Q l �, 3d-v� ((JJ d'mwnsioned, north arrow, and location a ., ' to ndaredt REV D APPLICANT INFO RMATION—PLE ffllll L V N PROPERTY OWNER: r„ ; '�i s� i PROPERTYLOCAnoN Dennis Erickson 'te _^ %, ` GOVT.LOT NE v4 SE ims 28 T 30 N,A 19 WW PROPERTY OWNER'S WRUNG ADD '� = �Gn LOT a 3 BLOCK s SUBD. WIDE OR CSM e Birch Point 143 St. Croix Trl. �. na Lakeland, �'' NUM E OWN NEAREST ROAD M. 55043 !4 ', St. Joseph68tir.-�t• )) j New Ccatrucom Use I A Re ider" / NumDw of bedrooms 3 j j Addition b sus q building I I Raw I ) PWkc or mmmw6al describe Cade derived daffy Now 450 gpd Recorrmndsd design badirq MIN • 7 bed. OP14 •8 trench, Pit' Absorption area requred 643 bed. tt2 563 trench, R2 M nwri design belt rat • 7 M. gpdM2 •8 trench, MdM2 Recom w4ed Mitration surface elevations) 98.00 4 (as re*rred to sit plan bdndmark) Additional design / sit corsidwalk rs na Pareni material outwash Flood plan elevation, d appkcabt na A S = Suede lor systm �NVENThON�I u= unsutathb or 1 ®45 ❑ u maw I as ❑ u NGnouNo /REaSURE $s o u ATGgAof Ms o U SYSTBA N FILL ❑ s 181.1 o s JOU Boring e 1 Ground 16t-v5fk Do* b wiling buftr Boring e 08010 kmov low +821, SOIL DESCRIPTION REPORT Horizon DeM In. DaminentColor Mansell man Q L Sz. cont. color Texture structure Gr. Sz. Sh. consistence Ow-dwy RoM GPD/tt Bed rernah 1 110 10 r3/3 none 1 2c 1 wfr cs 2f n .3 2 10-3 10yr4/4 none sil lfsbk mfr gv 1f .2 .3 3 33-36 7.5yr4/4 none sl 2msbk mfr gw Ina 1 .5 .6 4 38-8 7.5 r9 6 none cos osa mvfr na na .7!.8 Remarks: M . s ® . ©M MM PROPERrYOWNER Dennis Erickson SOIL DESCRIPTION REPORT Pape 2 d_3 PARCEL IAt bending e Boring N 4 GoiN 101.9i „. DOW to fi ov +2%0" Boring 0 4 Gmund 10_!� D� b 1110" W0182" Boring 8 .. 5 1" AIMM Ground 1016.16 it. Depb by" "84 Sonng N Gwuid elev. IL Depn Io bmq factor Horizon Depth in. IDommantColor j Moteea Munsell I Qu.Sz.Cont. Cobr ITexture Structure Gr. Sz. Sh. COroalBnCei tznMrylRoots I GPD/ft Bed iTwdi 1 0-1 v 2f n .3 2 10-3 10yr5/4 none ail lfsbk mfr gw if .21.3 3 32-3 7.5yr4/4 I none is osg mfr gw na .7 .8 4 38-9 7.5 r4/6 none cos osg mvfr na na .7 .8 Remarks: 1 0-11 10yr3/3 none 1 2msbk mfr ca 2f .5i.6 2 11-31 10yr5/4 none ail lfsbk mfr gw 1f .2i.3 3 31-34 7.5 r4 4 none is Osg mfr gw na .7 .8 one cos osa mvfr I na na .7 .8 �6 74e- vai I mil- q ,rob Remarks: 1 0-15 10 r3/2 none 1 2msbk mfr gw 2f .5.6 2 15-37 10yr5/4 none ail lfsbk mfr gw 1f .2`.3 3 37-4 7.5 r4 4 none is OsQ mfr 8 40-8 7.5 r4 6 none Cos 060 my Remarks: SBD-6330(R OM2) STEEL'S SOIL SERVICE Gary L. Steel Dennis Erickson 1554 200th Ave. CSTM2298 NEkSE} S28-T30N-R19w New Richmond, WI 54017 MPRSW 3254 town of it. Joseph (715) 246-6200 flot *3-Birch Point N 1"=40, BM.= top of SE lot stake @ el. 100' Y • \ county _ ln&nby Services Drvmw SLCroe r _ 1400 E Washinylon Ave Sanitary Permit Nrnaber (to be filled in by Co.) ' P.O. Box 7162 _ Madison\ WI 53707-7162 Sanitary Permit Application SuieTransaction Number In accordance with SPS 393.21(2) Wit. Adm. Code, submission ordds form to the rpproprimc goweememal em is required prior to obtaining a sioutory pamiL Now: Application Ems for maw -owned PONrfS we submitred to Address (if 6tRxent than mailing address) the Department of Safety and Prokniarl Services. Personal iJorIlllaioo you provide may be reed for secondary590 90 132� Aremc martioses in accordance with the PrivacyLaw, s. 15.040 m Sus 1. Applicadvin Imbrmadon - Plnsa Print AU lolls motion Property Owner's Nacre Parent a Joseph 3 Amy Stodmc a Rev aabk Treat 030-2o97-20-000 Property Owners Madilg Addras Property Location 5% 132� Avenue OBK Lot NE'/, SE'/., Sedim 29 City. Suite Zip Code Phone Nnanber Somerset WI 51025 o Icircle are) T 30 N R O E or M Type of Boddtng (cbeck all that apply) l ® 1 or 2 Family Dwelling - Number of Bedmomi; d C CQOO 2 a a Subdivision Now .ID/C 409S,9XJ0rWV Birch Point ❑ PubirXiinuaercial - Describe Use jL I?- r_ rf Block a ❑ City of ❑ Stork OiOed - Decribe Use ❑ Village of CSMNumber ® Town of St. Joseph IEL T of Perak- Chalets only one box as lice A Coati Use B It applicablei A. ❑ New System ® Replacement System ❑ Trestmenalolding Tank Replacement Only ❑ Other Modificoion to Existing System (explain) D. ❑ Permit Reewal ❑ Permit Revisice ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and D le Issued Before Fxpirrion Plumber Owner 463113.10/I5/2M1 IV. Tyve of POWTS S stem/Com enbMieviee: Check all that 1 ❑ Non -Pressurised Irtfrrourd ® pressurized WQmed ❑ AI-0mde ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable sal ❑ Holding Tat ❑ Oder Dispersal Compoeaa (exOW) ❑ Pretreatment Device (explain) V. l/Trestmmt Arm Mermaid": Design Flow (oil) Design Soil Application Dispersal Ara Required (sf) Dispersal Area Proposed (sf) System Elevation 600 RMdjpdsf) 937 Sao 95.66' 0.7 VL Took Info Capacity in yY u Gallon Toed (iallorlt Y of units Manufaarrer X V Lp �yySS! NM Tanks Fxudy Tanks 66 Septic or Holding Tart 1000 1000 1 Weeks C. P. Dosing Clamber 750 750 1 W iew Concrete VII. ReppoinabUily Strirmt- 1, the insdortillpead, acre romptandbift for hraallatioa or the POW S shown on the attached Plumber's Now (Prim) PI MPIMPRS Number Business Phone Number John Schmitt 223760 715-760-0496 Plumber's Address (Street, City. Strut. Zip Code) 596 Valley View Trail, Somerset, WI 54025 VIIL Coon sauces Use Only ❑ Approved ❑ Disapproved Permit Fee Dow Issued IssuAgent Siprttue Issuing Apo Owner Given Reason for Denis( IX. Conditions of ApprovaVRoasen for Disapproval waneveCompete prair Cowparson wovenveamr.wnytapwrP�srat a\\...\Coo �.. SBD-6398 (R03/14) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building DMaion INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal informadon you provde may be used for secondary purposes IPrivacy Law. 8.15.04 (1 Hm) INFORMATION TYPE MANUFACTURER CAPACITY Septic w Dosing Aeration Holding TANK SETBACK INFORMATION "�Wm® e 1 ®___�-, .. M entail �� PUMPISIPHON INFORMATION ��u AncAnn'rl^ 1 CVCTCaa Joseph, Town of ELEVATION DATA I�My. St. Croix 463118 0 030-2098-20-000 28.30.19.806 MEAM �. • -'llm� MrFIRM-1 MI WILEM MMEM -.. M -W .'.. /,... -MIr a ;.I , _mm� ---_ AN ENCH DI s I Length r No. Trendles Z PIT DIMENSIONS No. Of Pita Irulde Dla. Uquld Depth SETBACK INFORMATION SYSTEM TO P/L IBLDG WELL LAKEJSTREAM LEACHING CHAMBER OR UNIT Mart, 1 — Type Of System: I 2 I I �I Model War IM DISTRIBUTION SYSTEM h,.6. Ain _ D/1 _ _ _ _ _ (xl11011 _ __ _ — t t101B Slia Y Hole SparLp eM to Air Intake � e) �r Dla Die Speckq SOIL COVER x Pressure Systarm Only xx Mound Or At -Grade Systems Only Oepth Over Depth Over not Depth of a Seed"Sodded Mulched Beffrw ch Center BedlTranch Edges Topeoll �� Yee [] No k Yee O No rM EN S•(Indu ndes, moos present, tc.) Inspection #1: 3(,/ � Inspection #2:ce ��.� Von: 90 132nd Avenue Hu son, WI 54018 (NE 1/ S 1/ 28 T30N R19W) Birch Point Lot Parcel No: 28.30.19.808 , Q�� wool) � Aru1 I &D t DMA � _ - 1.) Alt BM Description = ''��2.) Bldg sewer length = 17 )Lf) ��Q./OR yr A�+ a -a*" Sh r `&WTS - amount of cover a u} Plan revision Required? It 11 Yet fiff No rser -2 Use other side for additional informWon. Dab Insepdoes SgneWre Cork. No. SBD-6710 (R.3197) Surly dnJ Buildings Division Cody 201 W. Washington Ave., P.U. Box 7162 _ Sanitary Permit Number (to rtl in byCo.) Madison, WI 53707 - 7162 ISCOI�S��, (608) 266-3 151 ' DB artment of Commerce' Sanitary Permit Application Stale Plan I U. Number N A In accord with Ce m 83.21, Wis Adm Code• purs<xral iniurnmumi you pro may bu useJ lift wxwlJ:uY pugwscs I'rirucy law, zU lW Ipr I'rojuet AJJrcv.(n Jdliww than nunbitguJJms.) D All lufurnrtia 1. Application Information - I'Itr*t priest ED Propen wner•s N� �r �� - OCT 1 2 2nnil- Parcel a Will lock 0 Pr6pEriy s Mailing d Property Int:*lion � S7. CRGIX COUNT !c City, Sfa Zip Cudc 7 uric T � N; R-A ype of Building (chock all that apply) 3 e _ 'JZ Subdivision Name CSi�AlurrMF or 2 Family Dwelling - Number of Bedrooms _ _ _ _ iC�7'/ �� ❑ Public/Commercial - Describe Use rQ� - ••l � . � � f �` ❑ Sou Owned- Describe use � W511 �W w (�'tIVH ❑City_❑viva p of Ill. Type of Permit: (Check only one box on line A. Complete lime B if applicable) A. Now System ❑ Repl000ment System ❑ Treounentniolding Tank Repliaement Only ❑ Other Modi ficatien to Existing System i -- i B. ❑ Permit Renewal ❑ Permit Revision ❑ (lrnge of {'ermfl'I'rwsfw ur New Win Proviars Tamil Number rid Usto Casual Ikrarclixpinak t I'Itlmber ()1YIl'1 I V.'rype orrowis S item: Check ail that up III;F id Non -Pressurized In -Ground ❑ Mound > 24 in. ol'sutabk soil U Mound c 24 in. ol'suitable soil ❑ At -Grade U Smith; No Sand Filler ❑ Constructed Weiland ❑ Pressurized n Graxld ❑ IloldingTank ❑ Wet Filter ❑ Acrobic'I'mmmmt Unk ❑ Rtcircu4tingsrd Filter ❑ Rtcireulri S thetie Media Filte l 'n Chamber ❑ Dri Line ❑ I -less Pipe.Other (lei V. Dls rsaVI'reatment Area In *tic Design Flow (&pill Design Soil Application grdaQ Dispersal Area R ai (st) Disperwl Arc* Proposed (s en luevation . V1. ask Info Copa:ity in Total Number Manufacture Prcfib Ctrtcrde Site Constructed Seed Fiber Glass Plastic Gallons Gallons orUnits New kximint Trio Trig soptb r Holdkra Trk AwvW Tnuano a Unit / Owiris Clmnbw VI1. Resplinsibility Statement- 1, the undersigned, assi respoissIbility for irtaedion or Ike pUWTS shown on the attached pbms. Plum I MI'/MPRS Number Uucinas Phone Number Plum bur' Addrmr (Strem6 City, S1.1001 Zip Coda) V11"ousity/Deportracit Use Only Approval ❑ UiapproveJ Swntury fanners fcc (�/n"wluJcssGGrrmtxl�r 5urch*rgc I�a:) Date Issued r 0, Is � � g Agent Sign • (N to )sl ❑ so Owner Given Reun fur Mnial -/r v 5— IX. Cooditioms of ApprovaVRessons for Disapproval 3 �iA� lgs�lllAya L YSTEM OWN V Ic tank, effluent filter and& piin d dispersal Cell must all m plan provided by plumber 5 42 as per management au yS Z—WseW1Ck r JGGw'""'v r7N e j `j 8• S c f as per applicable code/ordinanCes. ( J AtMeh eraplsrs rimer (to t►e Craq only) for the gatam as raper err WAS AV2 a I I � Tiz � d SBD-6398 (R. 01/03) AmAy f5r-C1z0&0UNW NO. 633355 STATE SANITARY PERMIT OWNER SWi+ f PLUMBE PREVIOUS NO. ITT LIC.# 22 TOWN OF '51`9 3ASefir SEC_N, R _I __ j6 AND/OR LOT BLOCK ANO.- paforssws� SUBDIVISION _ A A_ 145.13540 WISCONSIN STATUTES Me The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit (e) Renewal of the unitary permit will be based on regulations in force at the time renewal Is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. history: 1977 c. 168;1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. ISSUING OFFICER - DATE EXPIRES UNLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI 1/20)