HomeMy WebLinkAbout032-2109-10-000 partment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
.wilding Division
INSPECTION REPORT Sanitary Permit No:
479306 0
,ERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
onal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
ermit Hole Name: City Village X Township Parcel Tax No:
Senn, Rbnald & Linda I Somerset, Town of 032- 2109 -10 -000
CST BM Elev: Insp. BM Elev: BM Des c tion: Sectionlrown /Range/Map No:
dv , D 160 .0 ;l u 05.30.19.1019
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION • BS HI FS �ELEV.
Septic Gn ^ ` Benchmark
Dosing 6o Alter_- I
Aeration - Bldg. Sewer SC / P7- L.4
Holding SvHt WIAL-
p.R/ J .7
TANK SETBACK INFORMATION
2 AO 17:X-'� SVHt Outlet L �
TANK TO P/L WEL BLDG. VenttaALln take ROAD Dt Inlet
Dt Bottorry / s
Dosin , Header an T
7
Aeration DisoV Pie ! f nnJ !• 3/ /��
Holding Bot. System 7
Final Gr a �-
PUMP/SIPHON INFORMATION f �•
Manufacturer Demand S Cover 1
`�rt�7G GPM IZ rr crr Z• 0 99 - at
Model Number �� , r C ! �•
TDH Lift •�Z Friction oss System ead TDB I, � 114 _ �/ • �
7 • &Z R/�
rForcem in n t Did, Dist. to W I �
p � v i e!:T
SO ABSORPTION SYSTEM /a ��-�
BEDITRENCH Width Length No. Of Trenches PIT DIME No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG
J' o LAKE /STREAM EACHING Manu�e�
INFORMATION CHAMBER
Typ yst� � �' � UNI Model Number.
DIST U SYSTEM P0 /0
Head r /Manifold Distribution / x Hole Size x Hole Spacing Ven o Air In ke
Pipes) 3 ' 3 Y A /
Length Di Length Di / -S Spacing 7
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Ol
Depth Over �- Bed/Trench Edges Topsoil Depth Over xx Depth of xx Seeded /Sodded xx Mulched v
Bed/Trench Center /
J Yes ] No (-] Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: -7 ,,S /� inspection /
ecc n #2: / /
Location: 523 180th Avenue Somerset, WI 54025 (NW 1/4 NE 1/4 5 T30N R1 9W) Cedar Valley Est ti Parcel No: 05.30.19.1019 4--
1.) Alt BM Description =JT
*3 ((f y(/ 71 s G�—n— 7 gQ U 0
2.) Bldg sewer length = (N 1 _ I e
- amount of cover - , Gv g /1j1 e� /' ern•
IIICCC... /1T t�
J
Plan revision Required? 1,,, Yes
Use other side for additional information. ��_ I L
Date Insepctoes i nature Cart. No.
SBD -6710 (R.3/97)
1
Safety and Buildings Division County - 7/ 3 %X 80 - 'SA(c so
201 W. Washington Ave., P.O. Box 7162 y- R o x
,sc0ns,1� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
Department of Commelce� I. �et (608) 266 - 3151 47 ? 36G
Sanitary Permit licati State Plan mmber
� AA
In accord with Comm 83.21, Wis. Adm. C p sl info 7 0
may be used for secondary purpoe w, s ` em s)
5 ]go v�
I "Application Information - Please Print All Informa ' i o g 2005 7�
Property Owner's Name Parcel # of # BI
S �r70i' COUNT'
O L 1 ' �� t✓ O S er+I! l
Property Owner's Mailing Address Property Location
, L
AV r/., Section
City, State Zip Code Phone Number
A4AY G .S 0 O/ 7 /X 7 (C irc le e)
T �Q N; RC � or�
11. Type of Building (check all that apply) „�'�
X 1 or 2 Family Dwelling - Number of Bedrooms 7 Subdivision N�a�me d CSM Number
❑ Public /Commercial - Describe Use G EQi/R (�i0`L G ri0ti'!S
❑ State Owned - Describe Use GEity 9*&age fi't'ownship of
}-
III. Type of Permit: (Check only one box online A. Complete line B if applicable) 3 Z O— D
A' ANew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B- ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Penn it Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
i
IV. Type of POVVTS System: Check all that apply) / = D .
❑ Non - Pressurized In- Ground OMound ? 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. Dis rsal/Treatment Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed Of) System Elevation
Coo /, 0 Edo �aa 99. �o.✓ 99. ! cam ram
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units 1 STF - IC Z Concrete Constructed Glass
New Existing
Tanks Tanks tl�
Septic or GEerlding-Teak
Aerobic Treatment Unit
Dosing Chamber .� �„ 7.J-o tt it ✓
VII. Responsibility Statement- I, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plaits.
Plumber's Name (Print) Plum�Si
MP/Mf Number 7Busin Phone Number
84 S If ff/- Sf/a 9
Plumber's Address (Street, City, State, Zip Code) / 7-7-05--
VIIL County/Department Use Onl
Approved ❑ =iyen „i Sanitary Permit F (includes Groundwater Date Issued Issuing gent Signature (N, Stamps)
Surcharge Fee)
❑ Reason f Denial Z ?Cod K,
IX Conditions Approv !� ; /1����" it
SYSTEM OWNER I V 1 ,�,,Q t,r o h C 19�0(t t�oLS (Syt1
Septic tank nt filter a �"r "" °
9 Se c�r+eC 1�►a
p , eAtue er and /
dispersal cell must all be serviced / maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code /ordinances di-vt 54
Attach complete plans (to the County only) fort system on pap4r iot less than 81/2 x 11 inches In size
SBD -6398 (R. 01/03)
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5
Safety and Buildings
10541 N RANCH ROAD
commerce.Wi.gov HAYWARD WI 54843
TDD #: (608) 264 -8777
i sco ri s i n www•commerce. o
www.wisconsin.gov
Department of Commerce
Jim Doyle, Governor
Mary P. Burke, Secretary
I
July 06, 2005
CUST ID No. 232816 ATTN: POWTS Inspector
RUSSELL E RYAN ZONING OFFICE
CERTIFIED INC ST CROIX COUNTY SPIA
350 SUNDAY DR 1101 CARMICHAEL RD
ALTOONA WI 54720 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 07/06/2007 Identification Numbers
Transaction ID No. 1151685
SITE: Ron & Linda Senn Site ID No. 701105
Town of Somerset, St Croix County Please refer to both identification numbers,
NW 1/4, NE 1/4, S5, T30N, R19W above, in all corres pondence with the agency..
Lot: 1, Subdivision: Cedar Valley Estates
FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1027063
Maintenance required; 600 GPD Flow Rate
System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), and
Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01)
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.
No person may engage in or work at plumbing in the state unless licensed to do so by the Dept. per s. 145.06, stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of
the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening
used to service the filter shall terminate at or above finished grade with a watertight cover.
• This system is to be constructed and located in accordance with the approved plans, and the "Mound Component
Manual for Private Onsite Wastewater Systems Version 2.0" SBD - 10691- P(N.01 /01).
• The pressure network is to be constructed in accordance with publications SBD- 10706- P(N01 /O1) "Pressure
Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the
sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS
(01/8 1)".
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.
RUSSELL E RYAN Page 2 7/6/2005
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
Leroy G. Ja sky, Wastewater S cialist
Integrated Services Bureau WiSMART code: 7633
(715)726 -2544
Ijansky@commerce.state.wi.us
t
RO.W.T.S.
Conditionally
APPROVED
DEPARTMENT OF COMMERCE
DIV, SON OF SAFETY AND UILDINGS
SEE C RESP DENCE
Private On -Site Wastewater Treatment System (POWTS)
Index and Title Sheet
Owner: LiNoo acv„ / 1 11516 '
Project Name and System Type: lw"+
Location:
Street Address
.c14 -?,0 e4 19 <✓ Lc 4 - 11 0' 15 N4"'s
Legal Description � 7
l� oar,✓ of �a�so'�s� � �r; Ci¢a �x moo.
Township /County
Contents: Page 1: Ay.0 ,o.ro ;ir« -Sy"�e -r
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Page 7 : Dowrs o.v.✓r.e s �,+,�w,.� �yo.�/v��ir�,✓r o�.,✓
Page 8:
Page 9:
Attachments:
Plumber r: Si ned: ,
Credential Number: Date:
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Page S Of 9
SEPTIC TANK V PUMP CHAMBER CROSS SECTION'AND SPECIFICATIONS
IA
4" Cl. VENT PIPE 12" MIN. ABOVE GRADE 6 WEATHERPROOF
?' /0' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED
FRESH AIR INTAKE WITH CONDUIT MANHOLE COVERS
W/ PADLOCK E
f./,vl.rvro WARNING LABEL
s�,� Wl �+ -� ,—•} 4 MIN.
18 "
IN.
i
INLET ;
WATE TIGHT SEALS GAS-
TIGHT )\/aPPROVED
A SEAL _ JOINTS WITH
APPROVED -- ' , rlv l ro l L APPROVED PIPE
PIPE 3' $-- ��crE•c, ON 3' ONTO
O{ {YO SOLID SOLID SOIL
C S rf - /ooAt
SOIL' PUMP OFF ELEV . &,S - FT. —i-- VrA OFF ' * RISER EXIT
D PERMITTED ONLY
IF TANK '
MANUFACTURER
HAS APPROVAL
3" APPROVED BEDDING UNDER TANK
CONCRETE .PAD
SPECIFICATIONS
SEPTIC./ DOSE'
TANK MANUFACTURER: 1, �.✓c.i� NUMBER DOSES PER DAY: s:3 /9�)
TANK SIZES: SEPTIC 4?so GAL. DOSE VOLUME INCLUDING �i39 t,?3
DOSE 7so GAL.. FLOWBACK: /,3� 9 GAL.
ALARM MANUFACTURER: Q.yo.r�as CAPACITIES: A =? _INCHES 9 GAL.
MODEL NUMBER: ` ,d,,,,� E,►r Z
SWITCH TYPE: �,r�,,,�y /� /� B 2 INCHES = _�.,� GAL.
PUMP MANUFACTURER:
rie_ C INCHES GAL.
MODEL NUMBER:
SWITCH TYPE: , D. = 8 INCHES = _ lie.7 GAL.
REQUIRED DISCHARGE RATE GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC
,, VERTTCAL'DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE /�.8 FEET I
.+ MINIMUM NETWORK SUPPLY PRESSURE -?,3 FEET
+ _ FEET FORCEMAIN'X AFT /100 FT. FRICTION FACTOR , FEET
TATAL DYNAMIC HEAD = FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH S'S ; WIDTH 80 ; DIAMETER —
LIQUID DEPTH
1 11
T picot Application' High Head Effluent and Dewaterin Typical Application` High Head Effluent and Dewatering
(opacities to 63 GPM (4.0 I /s) Capacities to 88 GPM (5.5 I/ s)
Heads to 63 h (19.2 m) _ Heads to 90 It (27.4 m) _
Electrical 115V,1e,14.5FLA, 60Hz; 20OV, 1 o, _WFLA76_Wr Electrical 20OV, Is, 12.1FLA, 60Hz; 230V, Io,12.1FLA, 60Hz
230V, 3e, 3.1 FLA, 60Hz; 460V, 3e, 1.6FLA, 60Hz; 230V, 3e, 5.8FLA, 60Hz; 460V, 3e, 2.8FLA, 60Hz;
575V, 3e, 1.2FLA, 60Hz 575V, 3e, 1.9FLA, 60Hz __ _
Motor (single phase) -1 /2HP Split phase w /start capacitor Motor r (single phase) -1 HP Split phase w /start capacilor and
thermal overload protection, 3450 RPM ; thermal overload protection, 3450 RPM ;
(three phase) -1 /2HP polyphase, 3 . 450 RPM _ (three phase) -1HP polyphase, 3450 RP
Minimum Recommended Simplex = 24" (609.6mm) Minimum Recommended Simplex = 24" (609.6mm)
Sump Diameter Duplex = 30" (762mm) Sump Diame Du = 30 " (762 mm)
------ - -- - -- --- - - -- --
Auto_ma Operation Wide-angle loot switch (le only) ( a Automatic Operation Wide -angle float switch (le only) (manual av
Materials of Construction Class 30 cast iron Materials of Construc (lass 30 c ast iron
— --- - - - - -- - - - - - -- -- ---------------
Impeller Thermoplastic non-clog_ Impeller Thermoplastic non-(log
Discharge Size 2" (50.8mm) _ _ Discharge Size 2" (50.8mm)
Solids Handling 3/4" (19.1 mm) Solids hander 3/4" (19.1 mm)
Power Card 1 e - 20' , S1TW, STW -A(30' optional); 3e - 20', Power Cord 1 e - 20' , S1TW, STW -A(30' optional);
STW -A(30' optional) _ 3e - 20', STW -A(30' optional)
Superior Features • Carbon /Ceramic type 21 mechanical seal Superior Features • Carbon/Ceramic type 21 mechanical seal
• Oil filled motor w /automatic reset thermal • Oil filled motor w /automatic reset thermal overload for
overload for maximum protection maximum protection
• Upper & lower ball bearing construction • Upper & lower ball bearing construction
• Piggy -bock plug available for easy maintenance • Piggy -back plug available for easy maintenance
and replacement and replacement
• Patented inlet design for better solids handling • Patented inlet design for better solids handling
• Capacitor start for increased starting torque • Capacitor start for increased starting torque
30 r 100
I
24 � 80
I
18 W 60 T SHEF100 010 SW�t A'
tZ o Q�� �9
° SHEF50
= 12 40
0
6 2
i
01 0 –
Capacity-U.S. G.P.M. 0 20 40 60 80 100
- -- – -- - -- — —1 --
Liters /Second 0 2 4 6
POWTS OWNER'S MANUAL AND MANAGEMENT PLAN
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner t ,,�
Septic Tank Capacity SD [3 NA
Permit # Septic Tank Manufacturer s .c O NA
Filter Manufacturer - ❑ NA
DESIGN PARAMETERS Efflue n t
f Bedrooms 100 droom ❑ NA went Filter Model TF ooA2 ❑ NA
Number o E3 NA
Pump Tank Capacity O
Number of Commercial Units - N Pump Tank Manufacturer ,r ❑ NA
Estimated flow (average)* oo g I/day Pump Manufacturer rc p NA
Design flow (peak), estimated x 1.5* po g al/day Pumv Model - Es' So ❑ NA
Soil Application Rate 40 g al/day ft Pretreatment Unit Iff NA
Influent/Effluent Quality (NA❑) Monthly Average" ❑ Sand/Gravel Filter ❑ Peat Filter
Fats. Oil & Grease (FOG) < 30 mg/L ❑ Mechanical Aeration ❑ Wetland
Biochemical Oxygen Demand (BODD <_ 220 mg/L p Disinfection [3 Other:
Total Suspended Solids (TSS) Manufacturer: Model:
<_ 250 m Dispersal Cells)
Pretreated Effluent Quality p Monthly Average*** ❑ In- ground (gravity) ❑ In- ground (pressurized)
Biochemical Oxygen Demand (HODS) 5 30 mg/L ❑ At -grade (Mound
Total Suspended Solids (TSS) <- 30 mg/L Cl Drip-line ❑ Other:
Fecal Coliform (geometric mean) <10 cfu/100m1 17 Leaching Chamber Manufacturer
Maximum Effluent Particle Size 1/8 inch diameter Model Laying Length/Chamber
*Wastewater Flow Verification and Calculations: Soil Application Rate_ ft,
Td/ft Area Req.
Other than bedroom based)
Infiltrative Surface/Chamber -ESIA Rating ft
Minimum Number of Chambers
❑ Aggregate Desi Flow/Loading Rate- fe min
•
** Values typical for domestic (non - commercial wastewater Materials. all materials must comply with WI Adm. Code
and septic tank effluent. COMM84 and be instal led per manufacturers specifications
***Values ical for pretreated wastewater. and approval letters.
DESIGN CRITERIA
p "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990)
p "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler.
Publication 15.22
❑ "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6
p "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis - ASAE Publications 5 - 77 and "Design Manual -
Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980
p SBD - 10570 -P (8.6/99) "At -Grade Component Manual Using Pressure Distribution"
❑ SBD - 10567 -P (8.6/99) "In Ground Absorption Component Manual"
❑ SBD - 10705 -P (N.01 101) "In Ground Soil Absorption Component Manual" Version 2.0
p SBD - 10628 -P (N.6/99) "Recirculating Sand Filter System Component Manual"
❑ SBD - 10656 -P (N.6199) "Split Bed Recirculating Sand Filter System Component Manual"
El SBD - 10572 - P (8.6/99) "Mound Component Manual"
Gd - 10691 - (N.01 /01) "Mound Component Manual" Version 2.0 ❑ SBD - 10595 P (R.6/99) g .6/99 "Single Pass Sand Filter Component Manual"
E3 S BD - 10657 -P (P -6/99) "Drip -line Effluent Disposal Component Manual"
°< Co mponent Manual
p SBD - 10573 - P (R 6/99) Pressure Distribution Co po ��
Version 2.0
"Pressure Distribution Component Manual
Pressure D stn
�( SBD - 10706 -P (N.O1 /O1) I�
❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units
MAINTENANCE AND MANAGEMENT
MAINTENANCE MONITORING SCHEDULE
Service Event Service Fre uenc
Inspect condition of tank(s) At least once eve ❑ months 3 ear(s) (Maximum 3 s.)
Pump out contents of tank(s) When combined sludge and scum equals one -third (1/3) of tank volume
Inspect dispersal cells At least once every ❑ months _?a year(s) (Maximum 3 .)
Clean effluent filter At least once eve months O year(s)
Inspect pump, pump controls & alarm At least once eve p months 3 ear(s) ❑ NA
Flush laterals and pressure test At least once every ❑ months 3 0 year(s) ❑ NA
Valves At least once every ❑ months ❑ ear(s) NA
Other: At least once every ❑ months ❑ ear(s) ❑ NA
Page 7 of
START UP
For new construction, prior to use of the POWTS check treatment tank(s) 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.
OPERATION
The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity
and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving
appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water
softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface
whenever possible. Note: this does not include laundry waste, showers, dishwater, etc.
This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fait
peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only
paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins
condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint,
disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS
and contaminate your drinking water supply.
Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components.
Compaction of snow over the dispersal unit may cause it to freeze up.
❑ Valves
Valves shall be operated in the following manner:
X Alarnis
Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service
POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any
problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing.
INSPECTIONS
Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master
Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule).
Septic Tanks Component
Tank inspections must include a visual inspection of the tank 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 backup or ponding of effluent to the ground
surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any
defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective
locking device to prevent accidental or unauthorized entry into the tank.
When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank 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.
The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's
specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more
frequent intervals than stated in the maintenance schedule to keep the system operating.
Pump Chamber/Treatment Tanks Component
The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be
made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters.
Any service needs or repairs shall be promptly taken care of.
❑ In- Ground Gravity Component Dispersal Cells
The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending
hydraulic failure necessitating more frequent monitoring.
Page 8 of 9
Mound, At- Grade, In- Ground Pressure
The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure
necessitating more frequent monitoring.
The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals
should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to
ensure that equal distribution of effluent is occurring to promote the longevity of the system.
REPORTS
Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative
Code.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is
properly and safely abandoned in compliance with Ch. 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 steal! be removed rrid 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 other 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 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 maybe 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 CONTIAN 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 RgTERIOR OF A TANK MAY BE DIFFICULT OR
IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name Asr y4.1 />'a - .?-F.? s/. Name
Phone Phone - ya 9
SEPTAGE SERVICING OPERATOR (Pumper) -C/ ald LOCAL REGULATORY AUTHORITY
Name Agency r 411,11"M ellvle
Phone Phone 38L - Ada
KAWPDATMEHRPOWTS OWNER'S MANUAL.doc
Page_2 ofj
PTEssLdre.(H1tErs 4)etart�a arawtngs anakr LtiL riles to LAr
r r^ (" DWG f ats are av?rilaSIF to i
O CQEC I�� r fllWS �^ r w(J `your blueprint and drafting ne
�
Sg tept . compgnERts l CAD f ercC the sent to you on dif, CI
wnloaded from our w ;
r ACCESSOCIES r C^ E"` r _' • r ff
r (" r rE ., .gag sir
r r C � s �. �, mtnC VfreEVVay.p(
STF -105
Wire cage
Mounts in filter screen.
Prevents debris from re- entering the pump.
STF -102 STF -104
Type 347 stainless steel screen, Optional filtration socks .\
filters .062 inches in diameter Polyester knit 600 micron (.023)
(installed in all filters) 150 -190 micron (.006) �.
Thermal nylon
100 micron (.0039)
STF -100 Job ready
Sim/Tech Filter - prefitted with 2" Sch. 80 union & 2" STF -101
inlet pipe w /fitting (2" NPT)
Adjustable pressure
alarm switch
adjusts from 3 to
24 lbs. standard
STF -100A2
Sim/Tech Filter - field assembled unit
2" inlet / 2" outlet STF
Tank alert rt w/ w/
' latching light
STF -100A3
Sim/Tech Filter 3" inlet / 3"
outlet (socket weld)
STF -103
Filter lid/screen removal
wrench
40" long -
holds lid after removal
STF -103A
' Filter screen removal tool
for use w /optional socks
34" long
n
r r
We cystom bdild filter/ manifold
�rpssembfi S to dpet most commerci:
r _ _ _ and residential filtraffon systems. ,
ST. CROIX COUNTY
_ WISCONSIN
ZONING DEPARTMENT
— ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016 -7710
Phone: 715 386 -4680 Fax 715 386 -4686
Memo to File
From: Pam Quinn
Date: 8/23/2004
Re: On -site Soil Determination (NW % NE % Sec 5 Town of Somerset — Lot 1 Cedar Valley)
On August 20, 2004 an on -site soil determination was completed to confirm conditions described
in a soil evaluation report completed by Brian Parnell, CST #231314 on 7/7/04. This on -site was
required as part of state plan review process for a mound design. Two other soil evaluations on
the same parcel had different profiles from CST Parnell's. Staff (Pam Quinn) has determined
that the conditions reported were accurate and that this site is suitable for a mound septic
system.
The day was clear and sunny with temperatures in the upper 70's. Two excavated pits were
completed in the vicinity of borings B 1 & B3. The proposed mound is located on a knoll, with
slopes >12% falling away on both east and west sides. The soil profiles observed in these two
pits were essentially the same as those reported by CST Parnell. Loamy sands were encountered
in the A- horizon, which did not appear to be a result of filling or other man -made changes to the
site. The lack of silt loams in the first horizon may be due to erosion and movement of the
lighter particles from the top of this knoll. It may just be a sandy deposit - the soil survey (map
26) indicates there are many "sandy spots" in this NE '/a of section 5, one shown at the south
property line on this lot.
Gary Steel and Kim O'Connell also have completed soil reports for this same lot. The locations
of their tested areas lie north from Parnell s, away from the sandy spot", which may account for
the differences in profiles described.
Wisconsin Department of commerce SOIL EVALUATION REPORT Page I of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code ' ( / - 0 t
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County . J r
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 22
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ( 7 �� ` �' s N-0&0
Please print all information. Reviewed / , Dat
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I 01-/
Prope Owner Property Location /�, (�`��'
C X S �-. Govt. Lot Gv 1/4 /V�1/4 S S� T N R ! (or
Property Owner's Mailing Address Lot T# Block # Subd. Nape or CSM#
/ *k CePe
City State Zip Code Phone Number ❑ City ❑ Village C� Town Barest Road
. SO &net"
a New Construction Use: Residential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material /'�` J' e'.` n G IQC.`t Flood Plain elevation if applicable ft.
General comments fI glgo i q On- .fi k V`eI t f"y C�c 7 �-► —
and recommendations: /
1 iin �,�� a ✓/va.S G/nsGr-✓ tie - rv► at� U� y es i h/l S 4 ay
GGvId
Boring #
❑ Boring X s �q a 3
Pit Ground surface elev. D' ft. Depth to limiting factor < 3 6 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 'Eff#2
Z Z / - -30
o- �� loY � z� 7 z S� /r 6� ��� �� >< D.
y (/0- At r 5I' s YY , z JL 6�� i / ✓f e,2 0
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 GPD /ft
in. Munsell Qu. Sz. Cont. Color I Gr. Sz. Sh. 'Eff#1 I 'Eff#2
2 20 -2�1 DY yz S� /4 c iti 1 �, 0
-
3 3 0 / S 7,s e SL 11'2s 4k ��� Q s I .4 0 0, 7
`/ 3 -16 S Vb dh,3 srrl �s1� A SL Cdr, A -- 0.,2
__T
' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L
CST Name (Please Print) / ,Signature CST Number
✓ r fe , � i � P .2 , 1 13 /
Address Date Evaluation Conducted Telephone Number
7 7 /.S
I
SBD -8330 (R07 /00)
Property Owner / ''�i �l¢�v» ��' ✓ S 6 v1 Parcel ID # Page 2 of
❑ Boring
Boring # Q /
3 ®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/ftz
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2
G I
2 /D_� 7.s� y / G c D. 0,7
0,7
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 i GPD/ft
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.
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 'Eff#2
' Effluent #1 = BOD > 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
need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777.
SBD -8330 (R.07 /00
I f
� r ,
OWNER Page 3 of 3
Namb - r i rn )-- �G�u -� �Sv Brian Parnell
Address '17 7 t4 At y, h CST 231314
S D►�h ��z t r �� Date 7— O
AL Benchmark 1 76, 1111-ow f ��• h <D
A Benchmark 2
❑ Soil Boring
I - W
L Suitable Area
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S88
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429.00' 24 14 W 196.71
17.29' 3
ELEV.:855.65' -- S88 ° 45'0"Wl_ "� 4
USGS DATUM 1929 86,57'
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ST. JOSEPH 'E' PAGE 46
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page --L of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. O 3
Please print all information. Re ew Date
r
Personal information you provide may be used for econd4 6%E [Vs w, s. 5.04 (1) (m)).
E-
R11 ( a
Property Owner Property Location
---ig �1 �� — V S E P 16 2nnj G t. Lot 1 /4 1/4 S T N R E (or)o
Property ner's M Address L # Blo c # Subd Name or SM
ST. CROIX CUUNTY - —
City State Zip Code City ❑ Village [}Town Nearest Road
i' s (7/ — �
New Construction Use: Residential/ Number of bedrooms Code derived design flow rate GPD
❑ Replacement , ❑ Public or commercial - Describe:
Parent material / , Zf'&.o 1/'? � 'fir Flood Plain elevation if applicable ft.
General comments
and recommendations: S 10
a
T Boring # ❑ Boring
pit
[i] Ground surface elev. � Q ft. Depth to limiting factor � in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
D- s
6k �°
� B
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 GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
7 r S
' — / 9
*
Ef9uent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L
CST Na a eas ri Signatur CST Number
Address ate Evaluation Conducted Telephone Number
SBD -8330 (R07 /00)
i
I ,
Property Owner � l dY Parcel ID # Page of
F-31 Boring # Boring
J4 Pit Ground surface elev. A!> 2. 1 ft. Depth to limiting factor -?2Z 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
r
F ❑ Boring # E] 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 GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
I
❑ Boring # ❑ Boring
El 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 /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD > 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
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777.
SBD -8330 (R.07 /00)
o
a ,
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0 1 C \r
A
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,�'��
NORTH LINE OF THE NEI /4 OF SECTION 3
S88 ° 24' 14 "w ' 429.00' — "S88 ° 24'14 "VIA 196.71' 46
-- 17.29'
ELEV.= 855.65' -- S88 ° 45'08 "W'_ 4
USGS DATUM 1929 86.57' 1 L M Th
(860.0)
i 0 -
bi
M
0 co in
2� M
A R .,cc� IN g o�
10
Vol ACRES
- . 5�3, _ .. 2 r!� 152, ?55 So. FT, I 33 ,
° i I 1�-- --
w ---� I too
1
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1 ► si t
, � 1
l led
N I
S88 0 2444 ° W 429.00 I
L6 1` L1 W S88 ° 24' 14 "W 336.35' \ h � ►
\ (874.5) 1
\ 8
3.44 ACRES
149,782 80. FT. �\ �i 3.35 ACRES
N w \ 145,793 SQ. FT.. p,,
3,33 ACRES EXC. R/W �F
144, 945 SQ. FT.
M
co
0
0
N88 ° 28' 54 "E 363.00'
Nos 4 + 100'
S 4 22 W I
4 89.94
3.20 ACRES - G5 GIi
139,293 $Q FT. \
r \
r
e ^oeparenentofIndustry SOIL ANd SITE EVALUATIQN REPORT Page of 3
Labor a Relations
"ion of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
- Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must include, but St. Croix
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 0 2-2017-30
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R WED BY DATE
.I
PROPERTY OWNER: PROPERTY LOCATION
Mike Lurldberg GOVT. LOT IOW 114 NE 114,S 5 T 30 ,N,R 19 * (or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK* SUBD. NAME OR CSM #
2040 Oriole Ave. N. 1 1 Cedar Valle y Estates
CITY, STATE ZIP CODE PHONE NUMBER OCITY []VILLAGE [MOWN NEAREST ROAD
{ )
[x] New Construction Use is J Residential 1 Number of bedrooms 3 [ J Addition to existing building
[ Replacement (] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate -5 bed, gpd/ft ' 6 tre ,
Absorption area required 375 b h2 375 trench, ft Maximum design loading rare • 5 bed, gpd /ft • trench, gp
Recommended infiltration surface elevation(s) 100.00 ft (as referred to site plan benchmark) � , 1
Additional design/ site considerations system el. based on contour line of el. 99.00' W, J
Parent material vitted glacial drift Flood plain elevation, # applicable It
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FLL HOLDING TA
U = Unsuitable for s stem ❑ S ®U II S ❑ U CIS ®U El S �Ei U CIS ®U ❑ S INS
SOIL DESCRIPTION REPORT
Boring# Horizon Depth Dominant Color Mottles Texture Structure Consisterloe Roots GPD /ft 1.
in. Munse11 Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench —
.�:.... 1 0- J
1
Yew 2 16 -50 7.5 r4/4 none s1 2csbk mvfr gy if .5 .6 S'
Ground 3 0 62 7.5yr4/4 wet sl lcsbk mfr na na .4 .5
elev.
9 8.1 ft.
Depth to
limiting
factor
Remarks:
Boring #
;i`:� 80s&* 1 0 -12 10 r4 3 none sl 2 r m vfr 2f .5 .6
2 K
2 12 -27 7.5 r4 4 none sl 2csbk mvfr qW if .5 ': .6
Ground 3 27 47 5 r4 4 wet: scl lcsbk mfr na . 2 ' .3 . Z
e 4 7 -60 1 r4 4 c2 5x5 8 Cl m na I n 9 n
98 It.
Depth to g,FCEI
limiting
or 11 t t�j F X99
�.- GOUNN
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -62 . =�
Address: 1554 2001boo., New. h WI 54017 i
Signature: w Date: 5 - - CST um r: m02298
T�
PROPER1110WNER Mike Lundberg SOIL DESCRIPTION REPORT page 2 of 3
PARCEL I.O. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consience Buxtr r Roots GPD /ft
E in. Munsell Qu. Sz. Cont Color Gr..Sz. Sh. Bed lTmr&
3 3-12 1 r3 3 none S1 21= mvfr 2f .5 .6 s
� 2 2 7.5 r4/4 none sl 2msbk mvfr aw if, .5 .6 b
5yr5/2
Ground 2 5yr4/4 c2 5 r5 8 sci m na na na no .2
elev.
99.3 ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth W
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
Hmiting
factor
Remarks:
Boring #
Ground
elev.
ft
Depth to
limiting
lackir
STEELS SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 Mike Lundberg New Richmond, WI 54017
I tPRSW 3254 NWV0 S5 T30N - R 19w
town of Somerset 15 ) 246 - 6200
lot #1 - Cedar Valley Estates
N
1"=40'
BM-= 1'k" pvc pipe C el. 100'
Alt. BM.= nail in Elm tree C el. 98.20'
1 sow` �-
,t 67 0
Jb`
I
Gary L. Steel
5 -23 -97
1
03/23/1995 02:25 715 -726 -2549 S &B CHIPPEWA FALLS PAGE 01
1
Safety and Buildings
10641 N RANCH ROAD
commerceml.gov HAYWARD wl 54843
TDO #: (608) 264 -8777
sco www.commerce.statemi.uslsb
DeMwIlli Brit of Commerce www.wisconsin.gov
Jim Doyle, Governor
Cory L. Nottles, Secretary
August 13, 2004
OUST ID No, 224263 Fee Required $ 175.00
Fee Received S 175.00
KIM A O CONNFI,1. Balance Due $ 0.00
K.O. CONSTRUCTION
504 3RD AVE
OSCEOLA WI 54020 1 WiSMART code: 7633
REQUEST FOR ADDITIONAL INFORMATION '. Identification Numbers
Transaction ID No. 1028554
SITE; Tim Larson Slte ID No. 184192
Town of Somerset, St Croix County refer to both identification numbers, above,
NW 1/4, NE 1/4, S5, T30N, R19W in all c4rres all with the agency.
FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 973695
Maintenance required; 450 GPD Flow rate
The submittal described above has been placed on HOLD and the review and approval is pending suhiect to receipt
of the ADDITIONAL INFORMATION and /or revised plans requested by this letter. Upon receipt of the additional
information and /or revised plans, the plans will he reviewed for compliance to applicable Wisconsin Administrative
Codes and Wisconsin Statutes.
The following must be corrected /revised and accompany the resubmittal:
1. Verification of soil conditions for a mound system completed by the county or department.
2. Corrected manifold diameter. Note that flow through a manifold must be at least 2 ft/sec. To increase manifold
diameter total system flow must be about 22.1 gpm to use a 1.5 inch dia, manifold, and 19.6 gpm to use a 2 inch
manifold (formula v W q/2,448 *d').
Send your resubmittal into the address listed above, unless otherwise noted, and the department will review the
resubmittal within 5 working days of receipt date, Please include a copy of this letter with your resubmittal,
If you have any questions, after reading the above comments and related code sections cited, please call me at the
telephone number below, If the above requested information and/or plans are not received within 30 business days
of the date of this correspondence, this submittal will be returned denied. No fees will be refunded, and anew fee,
application form, and submittal of plans/specifications will be required should you desire to continue with this
project. The code in effect at the time of new submittal would apply.
Sincerely,
Leroy G. risky, Was water , ialist, RPSS
Integrated Services Bureau
(715) 726 -2544 Voice
(715) 726 -2549 Fax
1 j ansky@com me rce. state. w i . us
cc: Zoning Office St Croix County SP1A
06/28/2005 15:21 FAX 715 247 5086 TOWN OF SOMERSET Q001
Town of Somerset
Driveway Permit Applic alien
Parch `C) y - 0-WD Permit Number.
Name & Address of Applicant:
Phone Number and/or Fax Number of Applicant:
C S � V� L ftM Lot Number:
Subdivision Name:
Road Name: S
Descri •MY of th 4 - V4 of S., -Uo wnship
0 North, Rm* :
Leo pt�
Estimated Start & Completion Dazes: 00 I L
c ! ;
(Circle 000)
Proposed Land Use: - g��ntiai
2
Required ihanage Structure; E.
Description of Proposed Worit Special DescriPdms, I mo, Sight Wne �-'
Distmm and Sketch Site Plan Below:
!
All driveways shall have at least a 200' separation on the same side of the road ano 400
site distance. All driveways must have a minimum top width of 14' and a height �Q
I must be level or 1' below the mad right of way. All
clearancx ea at least 14'. D veway l lat. You must put the _di Y
- develapmeaat maps have driveway locations marked on p culverts -15 26' minimum, gvaniDOd stesll
in where it is designated. No plastic al of the driveway +�
required. No decorative rocks around culvert allowed. The
i shall be the resom ibilny of the property owner. L�suance of t hi s permit shall acct be
construed as a waiver of the applicsurt's obligation to cfp'y'wrth any more rest
i by local or county o. No installations during road
"� ffdriv expire one year from date of issue.
' _ Datee: r
Applicant Appro Y Town s Signature.
i
b _ r
Fee: $25.00 Check Number.
L O U Bf �� Somerset. WI_ 54025 i
Return to: i - �y
i
04/13/2005 07:11 7152686545 CEBERY EXCAVAT /TRUCK PAGE 02/02
va a.:I uV.. ur•ai rna r►r avv vv•au as .�i� +.� .,v +•a„" ••
SEM e� � S y T, a wix C AO
AND Av6
D
OWNE CER7MCAMN FORM 3
dwa"um t1
► a, a�s� 341 ,J Jell {'x'14C �2, ��-� 0,1,
isroy Arideasa 1-o 4 �✓�
(Vod�wutivR rsquirad from P1RaaiitS Dsportmo:at�v�r t�sw ec>�rttcti )
C{ rg n/ �� Ltil ?wool Id"9ifw d 06 N=ba
CZ&C prc3pt�rLocatio>y � Y�, h���, &,�c, s , �' �(' ' N R,..1 `L,�Tcv of 1�_�✓12es x .�.:
st,ri e Lot .,L.,..._
wan"* Dad t* � � ? 1 - _ . Volpaat; Z p
�Z � � � ? z Vs
spec a yet �o rot Ibm *Auwle ®aa
7t�dl�°
lmpropec asa sad des of yaar srptia system could tsnuit in Ifs parmolue mum to hadk wwow. Pmlet
asaaatsa�ne arms[ oft aS om ffis so* ask dvely duwe yem nr sooner. if nesdod by ■ lkawd pub, I bat yew put into
tba gm WW *o ftaillosw of the tw& tank se a tnats+sttt stems in the wam d*ossl VOM Owner u9n ' OKWO
teSpaosibllltips al 609W In I COO* IS.r7(1) sad do Cbapar 12 . St. CA* C:MW SWtOY Clydiaau M
The ptoputy a a spas to wdymtt to St, Cmix O Zack pquts W 4 "AMUdca h1a, 4pod: ► *m owaw snd
by a mser pb�abaa,iaumeytt rsq{dagd pluatbes or S A >i tfixt (1) des oaa�Site w. mewater duparoi
ryesM la in pcvper opeaft =+or a) Aff inspt+ctfon Sad P to a(woossmi im septic W* is !oL . u= 16 "d
Vft. do aadw4xd lira reed 9w show regusraments sad Bpa t4 t>Wlt aW *e ppss�',VAW eswsSe yet a with r6s
standsnb set *4 bode, u sot by the Dspttnatwm of Wmae m Sad floe DepaeSStettt of 7r><ewn= f 1Vltcou, .
Ceauatioo stafma Nut your septle sAMM 1us been M-IModaad must be OMMIaud and td mod to the St, C WX C'. U* Zoaius
wrifb 30 dxys of tba florae yswr owbredan date.
JA1
SlaNATUREV APPLICANT DATE
�LWvs
*di - 4 IN an thin Am uuo to the bast of mr lour kWIV latigre. I/we *nVsre tlso awi 0) abbe
�MY. WWVII by ' i' sd in 3GoSist.r of Deeds Office �/� O
�T dF APP = ANT DATE
Any infi mtiml Sd is meted toy WWt In the sot IWy plt%t bainq tevoircd by the Zon4 D q riaw ML * ** Msr
,laalude �vlth dais a rmraped �rraaey deed.:&wm den Rb$irtet of Dtsdr Od11os utti Dopy al the csr�sc mep Il`
rekacoaoe is made idea wm"I*di"o,
rt
U 2 8 2. 3 P 2 y 5
State Bar of Wisconsin Form I - 2003 KATHLEEN H. WALSH
WARRANTY DEED REGISTER OF DEEDS
Document Number Document Name
ST. CROIK CO., MI
THIS DEED, made between Tim Larson, a married person RECEIVED FOR RECORD
06/15/2005 01:05PI[
( "Grantor," whether one or more), WARRANTY DEED
and Ronald W. Senn and Linda C. Senn EXEMPT # 8
( "Grantee," whether one or more). REC FEE: 11.00
TRANS FEE:
COPY FEE:
Grantor, for a valuable consideration, conveys to Grantee the following CC FEE:
described real estate, together with the rents, profits, fixtures and other PAGES: 1
appurtenant interests, in St. Croix County, State of
i in ( "Property") (if more space is needed, please attach addendum):
of 1 Cedar Valley Estates, Town of Somerset
Recording Area
Name and Return Address
Title One Premier Group
706 19th St. South
Hudson, WI 54016
032 - 2109 -10 -000
Parcel Identification Number (PIN)
This 0 IS hlb'r homestead property.
(is) (is not)
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except:
Dated s
X HEIDI L. WALDOCH
pJKI •
* T m ar on eettt I*m its. r. MAMA
• WALD�H
H ,y1NMEgptA
(SEAL) 31, lOCI
* * M16 r
AUTHENTICATION ACKNO WL
ISE E
Signature(s) STATE OF W6IdS'i Q ffi yll'C5' 7
authenticated on � O Y),ss. ' V Iw+',e. i 411400 r7
Personally came before me on L V' N,' w -
the above -nam d
TITLE: MEMBER STATE BAR OF WISCONSIN to me known a be the person(s) who executed the
(If not foregoing instrument and ac owl d ame.
authorized by Wis. Stat. § 706.06)
THIS INSTRUMENT DRAFTED BY:
*
Michael H. Forecki , Attorney at Law Yotary Pub c, Sfate of Wiscrosin
Eau Claire, WI My Com fission (is permanent) (expires:
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2003
*Type name below signatures.
Atlomey Michael H Forecki 3452 Oakwood Hills Pkwy Ste 1, Eau Claire W154701 -7928 Phone: (715) 835 -3029 Fax: (715) 835 -4112 T6917179.ZFX
Merilm 3. Bune Produced with ZipForm- by RE FormsNet. LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 3839805 www ziororm.com
\..(ZVfJ1 41✓VIV I I VV I%J IV..JII .
'ounty and Tovr.sb.p laws, rules and regulations (i.e., vetlands,'
sg or developing any parcel contact the St. Croix County toning
UNPLATTrE
r -- NORTH LINE OF THE NEI /4 OF SECTION 5
I
429 _ — ` S88 ° 24' 14 "W 196.71 ' 48
7.z9' /a�� T FAR
S 5,,'88 -
-LE 8!55.65' __ A6.57' - ,
USGS DATL)M ;x+29 42 ` --
`\ M
cyy 41 1 M 1
1860.0) �/ 0-
/ N
0 CID
1
N 1
3.50 ACRES
� 1 33 33'
152,255 �,u FT I 1 )
1 too, i X 1 1 1 1 i
1 1 OO
-r 1�
w 1 `
1 1 1
0 1 � r
M 1 4 BII 810 _
0 1
V)
1 W 1
1 �
l � 1
1
i 429 00' S88 336.35' W 1
E2 -- - - ---� 1 1 t
12
w (856.2)
\ \\ 1 O uo
4 _ N G
\�
3 . 3 5 ACRES �.u� 13
Sri
;Q� FT. N 145,793 So. FT.
w
\ 1
IES ExC. R r+
CEDAR VALLEY ESTATES
LOCATED IN PART OF THE SWI/4 OF THE NEI/4, PART OF THE NWI/4 OF THE NEI/4 AND PART
OF THE NEI/4 OF THE NEI/4 ALL IN SECTION 5, T30N, R19W, TOWN OF SOMERSET, ST
CROIX COUNTY, WISCONSIN
UNPLATTED
PAR-EL IN ya- 775, P- 220
7 527 71
.. .... .. ..
PAR"� L N
274 19
20 _52 :4
6
2
16
15
17
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5
4
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