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HomeMy WebLinkAbout032-2158-60-000 Parcel #: 032 - 2158 -60 -000 02/15/2005 10:18 AM PAGE 1 OF 1 Alt. Parcel #: 9.30.19.1366 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s,): * = Current Owner * ANDERSON, GREGGORY B GREGGORY B ANDERSON NUESSMEIER PAMELA J NUESSMEIER PAMELA J 1675 56TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1675 56TH ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: cre 4.097 Plat: X423 -ROY RIDGE ESTATES 02 SEC 9 T30N R19W PT W NE LOT 6 ROY RIDGE Block/C9ndo Bldg: LOT 6 ESTATES Tract(s): (Sec- Twn -Rng 401/4 1601/4) 09- 30N -119W NW NE Notes: Parcel History: Date i Doc # Vol /Page Type 05/22/2003 722470 2250/396 WD 06/17/2002 681805 1910/590 WD 10/30/2001 660467 1749/203 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 11758 288,800' Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.097 53,400 191,500 244,900 NO Totals for 2004: General Property 4.097 53,400 191,500 244,900 Woodland 0.000 0 0 Totals for 2003: General Property 4.097 53,400 0 53,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Dated 12/04/1998 Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: � �- � (ATTACH TO PERMIT) , 429986 0 GENERAL INFO MATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Johnson, Glen I Somerset To nshi 032- 2158 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: I Section/Town /Range /Map No: ylr0 -r—j— lob. P p ;�e 75' 5 -'f -i« T-tsec.,v— 09.30.19.1366 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �) j S r Benchmark / Dosing ,7 5Q Alt. BM S T r Aeration Bldg. Sewer U 4 9 Holding St/Ht Inlet - Z� 70 9� TA SETBACK INFORMATION St/Ht Outle 7 9 61� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet d Septic - t , Dt Bottom 31 �- 71 3 Dosing 1 , Header /Man. > 13 S`' �Z�� ' z � 3S" 49.7s Dist. Pipe y.q 99.7 Holding Bot. System O 99 vS O S Z- oK Final Grade PUMP /SIPHON INFORMATION a` °�"o N ° + 3.3 / / Manufacturer /1 C(S Demand o St Cove v `! o Model Number -7 3/ , ors $ - 7-L C �a•l rJ G 97.2-- TDH Lift Fiction Los System Head TDH Ft 7 -�� reo S- /7.I Forcemain Length Dia. Dist. to Well r8 >IUC, SOIL ABSORPTIO S i I U C /G- BEDITRENCH Width No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth It, DIMENSIONS SETBACK SYSTEM TO /L NI WELL LAKE /STRE i M L NG Manufacturer: INFORMATION CRAM OR Type Of System: NIT Model Number: i W DISTRIBUTION SYSTEM Header /Manifold Distribution ( / x Hole Size x Hole Spacing Vent to Air Intake f o� Pipe(s) +� r ' � " n(IA Lengt Dia Length Dia j_ Spacing 4 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of t i xx Seeded /Sodded xx Mulched Bed/Trench Center �t Bed /Trench Edges Topsoil Yes L No M I Ye I i No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:�/�/ 63 Inspection #2: / L7 / 0-3 Arw ccu .cQ� 1 !' Lo n: 75 ome t " �° Parcel No: 09.30.19.1366 I t3" a.- trJ, e o u .vr a t, rr G� P a g ,[ 1.) Alt BM Description = Pre �jrN i oc. 2.) Bldg sewer length = f Z� - amount of cover = f t C C v Y r w� L S� ,` ti 6 -- -- __� - Plan revision Required? Yes j No L-9 5(� � � — — Jse other side for additional information. 7 Date I cior!s Signature Cert. No. 1D -6710 (R.3197) I I , Ls� POP z-L 6 � Safety and Buildings Division ' County A 201 W. Washington Ave., P.J. Box 7162 �C'✓ *Iscons Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Dep artment of Commerce (608) 266-3151 A `� 8 o ' . ' Sanitary Permit Application rate Plan T.A. Number In accord with Comet 83.21, Wis. Adm. Code, personal information you provide �1 1 1 3 ( 0 4 S a C ; P -: 4-- ) may be used for secondary purposes Privacy Law, sl5.04(1)(m) Project Address (if different than mailing address) 1 I. Application Information - Please Print All Information Property Owtxr's N me (, ,Sa C E I V E p Parcel Lot # Black x I Property 0 's M ailing Address MAY 1 5 200 Property Location / 2 at- etEl .� -7 ' la,_14,Soction C City, State Zip Code Pho�� SIN G OFFICE d!1/ !-G e T J� N; R��E o �(circle !! @/ II. Type of Building (check all that apply) -6 �if�1 3 Subdivision Name CSM Number ;9l or 2 Family Dwelling - Number of B ootns S Q PubliOCommercial -Describe We is _ ❑ State Owned - Describe Use t x �ti ` ❑City_❑Viltage township of ! , 1!'pty1fyT c III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 03 Z - 2( — 60 0L7(3 . t� A. New System ❑ Replacement System ❑ Treatment/Hotding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal 0 Permit Revision ❑ Change of 11 Permit Transfer to New List Previous Permit Number and Dale Issued Before Expiration Plumber Owner N. Type of POWTS System (Check all that a ply) ❑ Non - Pressurized In- Ground > su Mound < 24 in. of sviitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Bolding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pi ❑ Other (e)( lain) V. Dispersal/Treatment Area information: Desiga Flow (gpd) Design Soil Application Rote( gpdsf) Dispersal Area Required (s0 Dispersal Area Proposed (sf) System Elevation �•d .as S�J �S'C� lbo• Vo VI. Tank Into Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or lioiding Tank Aerobic Treatment Unit Dosing Chamber f VIL' Responsibility Statement I, the ttntlersigned, assume responsibility Por ilwallation of t e POWTS shown on the attached plans. P Na me (Print) Plumber's Si gnattue Y PRS F Phone Number Plumber's Addre ss (Street, City, State, Zip Code) r VIII. Count /De tment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued f lss in gent Signature o Stamps) Surcharge Fee) 13 Owner Given Reason for Denial IX, Conditions of Approval/Reasons for Disapproval o tit /i [ aLQ� Atya cam an paper not l 112 x 11 inches in size "I �SB 'T D- -6398 (R. 01/10 Safety and Buildings t 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 8*isconsin www•commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary RECEIVED May 06, 2003 MAY 0 9 2003 CUST ID No.220254 ST. CROIX COUNTY ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/06/2005 Identification Numbers Transaction ID No. 864882 SITE: Site ID No. 658683 Greg Anderson Residence Please refer to both identification numbers, Town Rd above, in all correspondence with the agency. Town of Somerset, 54025 St Croix County NW1 /4, NE 1/4, S9, T3 ON, R19W Lot: 6, Subdivision: Roy Ridge FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 901897 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes Cond"il and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in APPR chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: DERARTMENTI General Approval Requirements: ®LT • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORREI "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat ' 1 ARTHUR L WEGERER Page 2 5/6/03 • Comm 83.22(7) 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. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible f n in maintenance verification report acceptable to the or submitting a ma to po p county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 alm'Zi�� � Fee Received $ 175.00 gr Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART: code: 7633' (608)789-7893, 7:45 am - 4:30 pm Monday - Friday cbratz@conimerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 I TITLE SHEET Page of 7 FOUND SYSTEM FOR A 3 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10572 -P and 1_ _ t e Pressure Distribution Manual SBD -10573 P CCZ. C 61` 9g LOCATED IN THE NW 1 /4 OF THE QE 1 / . 4, OF SECTION � T 3� N R 6d , , , TOWN OF 5 S1'. L° LLC11x COUNTY, WISCONSIN. LoT ( O1= — INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MAdAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW- CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR RECEIVED 13 MAY - 5 2003 S4 T3 b Z SAFETY & BLQGS DIV.. Ow ,F PREPARED BY � N WI- CGEFcER SO I L . TEST I CS 3PONDEN E AND. DES2GN SERVICE P.O. Box 74 421 N.Main St. River Falls, WI 54022 Phone 715- 425 -0165 ��m1a�� Fax 715- 425 -6864 �@S';�'�� Ant1va wECeata C *9t5 p ELLJWOR7w. � ' Ms1 •..N JOB NO. _ (Y3 - Mound System Management Plan page Z of - 7 Pursuant to Comm 83.54, Wis. Adm. Code • Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L 6005, 150 mg/L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBO- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. on in Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at 1S -3 h- 1 -1 643 p Sr The system - installer at 3 IZI SC 1�1a The tank manufacturer at l) 3ZS _ ��13 ►,vI Ll The effluent filter manufacturer at _ X00- Z-Z.[ - S7i(Z. Z"Lst- The pump manufacturer at lj 33- `6Z.O- Q p Q GOV�t� r - Pace Of 1 1 Approved Synthetic Covering ASTH C33 Distribution Pipe Medium. Sand H G Topsoil C _ - _ ____� b0. +J , ,• F Elev. 3 E �f p b \Z % Slope Distribution Cell of Force Main Flowed 2" to 2- Aggregate From Pump Layer • 0 1. � Ft. E -y _Z Ft. CROSS SECTION OF A MOUND SYSTEM F 0. Ft. G 0. 5 Ft. A 6 Ft. H 1.O Ft. Linear Loading Rate= 6.3 GPD /LN FT B S Ft. Design Loading Rate= p.Z.SGPD /SQ FT I 1 Ft J - 7 Ft. K 1 Z Ft. A 4 4 e*Ra4e Position L - C� Ft. o Force Main W Ft. L J - Observation Pipe —I K C - ,--------------- - - - - -- --------- - - - - -- - - - - - -- o A _ W �_,�__ - - - -_ - -- ----- _ = - - - -- -- J SRI �Oistribution `-- Cell of s to 2 ' Pipe aggregate Observation Pipe (anchbr securely) PLAN VIEW OF A MOUND SYSTEM Distribution Pipe Layout Pape S of -1 Place the holes at the bottom of the distribution pipes at"equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 45 ° f rr ng to a point within six inches of the final grade- Terminate the ends of the laterals with a valve,.threaded = or - threaded plug. Provide access from final Bade for the valve; threaded cap or threaded plug - 7 -t P.1 Cr, L Cis S FVC F��� PVC Latemi Maniroid Laterl x x x x xQ x!Z x x z x Lateral Lsncth — Laterl Lenvth — Distribution Line IT F -- i � t�CL�tis SpX _C P 3 7 Ft. Hole Diameter �� Inch 5 3 Ft. Lateral n ) Inch(es) X ZY Inches Manifold Z• Inches Force Main " 2. Inches # of holes /pipe Invert Elevation of.Laterals Ft. `�.-�� • PUMP CHAMBER CR055 SECTION AND SPECIFICATIONS ' PAGE (- OF 7 VCIJT CAP - `i'C.Z VENT PIPE JUUCTI WEATH ER PROOF APPROVED LOCKING MANHOLE 7 1 '— 10' FROM DOOR, JUIJCTIOJJ BOX COVER WITH WARNING LABEL WIMDOW OR FRESH I2�MIU. AIR IJUTAKE 7 I GRAOC 4 AIM. CONDUIT -- __________ 19 "MIN. 11� MULCT PROVIDE I = AIRTIGHT SEAL I APPROVED JOINT A I I APPROVED JOIAITS I I I I II ALARr► e �I II . I I c I I ow 'I I -- CLEV.1 2d FT--- -J PUMP --�, OFF 0 O CO U CKETE &LOCK Y KISEK EXIT PERMITTED OWLtJ IF TAWK MAIJUFACTURER HAS SUCH APPROVAL 3'•ApPS2ove:: SPECIFICATIOAIS DOS E w L_p Z S u ►l cZ TA"KS MAJJUFACTURCR: 64 JIeS co �jL' NUMBER OF DOSES: 3 ' 8 s PER DA.y TANK SIZE:- -IS GALLONS DOSE VOLUME Z ALARM __MA4UFACTURER: - S S� - TZZU S�LS INCLUDING 5ACKFLOW: ���'' GALLONS MODEL NUMBER: IC) l �i CAPACITIES: A_. - � WCHES 09 3-Zy,s - LOAJ -- IIJCNES OR GAL s LOy SWITCH TSPE: � C=CJQ B = Z I OR alb' � OfLLOLIS Pump IAAMUFACTURCR: SOU r 7 IUCKE5 OR D "LLOIJS MODEL NUMBER: �V Pc S 0 _�? 1 ?4CHES OR GALLONS SWITCH TYPE: — �L A�- )JOTE: PUAP AND ALA MAR TO BE S MINIMUM DISCHARGE RATE 21 • �b GPh1 INSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFERENCE OETWEEW PUMP OFF AUD.DISTRIBUTioU PIPE.. FEET + MINIMUM NETWORK SUPPLY PRE55URE ... • . _ . • . , • 6 SO FEET C S px t. 3� + 5 S FEET OF FORCE MAIN X Z' D g F o fL FR1CT1ou FACTOR. FEET TOTAL DyNAMIC. =-FEET - -� - - As per - manufacturer • ZO.ZI;b gal /in. Liquid depth 37 it } f,E o � 7 • ' . - Goulds _ Submersible Effluent Pump 11 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and • Farms manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, construction. Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING 3 /a° maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal rotection. " ' • Total heads: up to 24 feet. with three prong grounding p . Canadian Standards Association =� • Discharge size: 1 1 /2" NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in 7" or "AC ".) rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. to- Capable of running dry without damage to 9 30 components. Pump: EP05 e • Solids handling capability: 0 2s 3 /'maximum. a I • Capacities: up to 60 GPM. _ • Total heads: up to 31 feet. 6 20 ! i • Discharge size: 1 NPT. z 5 - • Mechanical seal: carbon- } rotary/ceramic - stationary, _j 4 is j i BUNA -N elastomers, • EP05' Temperature: 3 10 104 °F (40 °C) continuous j 1 iiMA 40 °F (60 °C) intermittent. 2 s ` 1 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 . CAPACITY ©1995 Goulds Pumps, Inc. ectiv? Ma v tcc5 FROM : Schumaker F_umbinq FAX NO. : 7153$53121 Mar. 27 2003 03:14PM P1 17{T1 iR:lb F?,:t 71t S!i3 ;8tH 5'1' Ch.1 tt� Ll: \1 ".G Wk UUu Wlsmnxirb Depsrlment of Comrnetee S OIL EVALUATION REPORT Asps / Of aivicion of St'd'ety and bd:dlnpa in d =dana with Comm 85, Wfe, Adm wda cWtv ACaCN complete Wts phW 0e paper I t ltaa f 1811 112 x 11 irr:h" in s4 PUr mlat fACWO, Cut rat IAnited 10: ve ttcal atr9 hooux 1W roflfw ew pa11t tally. dirsoon 9110 percent OW4, am% or dh"Rz corm norm an M. "iecaden end dlatance to neaFo 10991 CEIVED Please plfutal i�f4rnssL'on. Revfrwvea i�rte s Prior a intrmo on you iMMe ma W u$W la aveentlliY ►uroesaa SpN�aeY Law, s. 15.Ca (1) 03. A 2 2 0 rt U Frowzy Mme* 'pr � lWp gg � :RQIX 000NTY CavLLo1 ,V&U 1f�UZoA(N&fflF 30 A li(00 Pro)7tln ? Owners 5 M aft rocs Lot la& 9 or l a y 4 r f r Zip Gods ne ber (3Cily E vmsp Town No&;& f.'v-r' i 5 'Y r,+� • New C=trud)W Use: teeaidsnu�ni Ir TJUnlbet of bedroerns 3 !� - -- COO Carved des;pn flow rats Rap6matnent �r (3 Pubbc or a Ir'.tneme(• Dexa bm Ram%trtateriat ! � 1 r'Wd Ptah 41W* " it app5wti r 6erresat commontt: � ry1 f ti �W ' o soft and rseommsaotdans: �o n .{ ou � � �' y ' �• Sd t F kv Fie Ground star a situ. 96 , 5' tL t "Jh to gr'UV tactat Werizort Depth Oominsnt CAtw Re iox Dfsa'ypwl 1"enhtm structure Co+wmas SCLNsry Roots 4►0/fl' hL tduraw Qv e: Curr1. Gr. Sz. Sri, 'E!!pI 'ltfY¢ t 2 — i Tf c S t v�' Ij 5r �5 Le i ve F —:. r L SL Borfnp ® PU tBrW-4 s� r.4 Ve ,. 9 6 d It 0s01h to laaor , L4 ^ In o„ 04 lmon Depth na most GdaT ^ I edou oosq;iow Tub" i Sirur3ury Conslawnce ft nldM Roole In. tMlirrc►Crt C 1 wsz. COrTt CAIa Gs. ft-VL 'F.tiM �lrrl2 Zcrr ' vowt. t i a Boos Y 3t) c V! mg1L am TSS >30 < 1301119b ' �Atsent r►2 " 60D <,'qp "V% end i S6 c 8D tngll. � L� tdarns ( eas rti�� � �� CST M a�m,rmakor "dr ess - to 2n G+,+ducmd trumbw � w.r:llRt)7e'�D) l r -- ` WisconsimDepartment of Commerce SOIL EVALUATION REPORT Page / of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and ar percent slope, scale or dimensions, north arrow, and location and distance to nearest road. RE CEIVED Please print all information. Reviewed by ate Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). APR 2 2 200 [ � 3 Property Owner Property Location ST. CROIX COUNTY +�� N Govt. Lot RW 1/4,(/ 0l��lCi FI O N R E or l � cf� c� 3 /Y ( ) Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 13 3 1 Y - -- ( rrt" n D (0 1 1 R City State Zip Code Phone Number ❑ City ❑ Village Town U Nearest Road R.'V !l5 Ibi I I 5 1 (7 /5')yz(o -7131 So&'-krS-P- A 1 „— [� New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate O 6 GPD Replacement r E] Public or commercial - Describe: Parent material / i / I Flood Plain elevation if applicable ft. General comments S y 160 • Co 0 and recommendations: g d Boring # ❑ Boring bQ pit Ground surface elev. qG' y� ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture 4Gr.Sz. e Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color h. 'Eff#1 'Eff#2 - 5 ID 2 S i l rr)-p C!5 I v Z 5 -1 I `t�3 5 f 2,-, b J c.5 3 -? f0 F 7 E) r 9 )kj 5 c.1 Zm5 bk n4r [-2-]Boring # ❑ Boring ® Pit Ground surface elev. 9 G' y d ft. Depth to limiting factor ilk_ 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 'E11#2 1 0- 1p r 3 2 — rrvcr C g I v .V 5 8 to - I l v /3 rn--r c5 - 'q . Cc 1(p-31 !v - r3 /co F' - 7 _5 r'4 to 1 2m5 t er - - , 4 ' 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 JVJ ct WN tmak m _ als3 Address Date Evaluation Conducted Telephone Number all 3 f" S So M e rsef 1 60 1• S t/� (��S ") -/ Ssn ( 1107/00) 1 Property Owner �H Parcel ID # Page 2 of 3 [] Boring Boring # 9ff. Fjd ft, Depth to limitin factor in. !9 pit Ground surface elev. g 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 s r l 2 r C I v� f $ 3 S i C J 3 Ica F2P .5 0v / 2 rn :s K F-1 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 ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # Boring Ground surface elev. ft. Depth to limiting factor in. ❑ Pit 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. 'Ef1#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.07100) a • J Property Owner N Parcel ID # Page 2 of 3 F'51 Boring # ❑ Boring /,_ 4d Pit Ground surface elev. 9� �d ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPD/ft Eff#Z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 4 ilk 31 5il 2 K r C Iv� S 8 Z fi -I I 3 i cl 3 I p F2P .5 /(v 2rn5b Boring # F ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in ' coil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence I Boundary Roots *Eff#1 Eff#2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ❑ Boring Q Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPDift Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 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. SBD4330 (&07100) PAGE 3 0F OF� NAME �J -. V) TOT# & LEGAL D SCRIPTION V ty 1 4NE Z ,S `l T - -'e o ,N,R, / f E(or) SCALE: I"= go /BM 1 ELEVATION 0 BM 1 DESCRIPTIO / QJt— BM 2 ELEVATION 7-/ 0 A BM 2 DESCRIPTION J'C P I SYSTEM ELEVATION lev, G U ALTERNATE ELEVATION CONTOUR ELEVATION 2 r a o g'• Z- 1 a� 0 �r SIGNATURE G DATE ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer &6� � Mailing Address _T? r1r1 � k ?d Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number LEGAL DESCRIPTION Property Locatior_ !411'1'� 1 /4, /,, Se.,. , 'I ,N ? W, Town of Sd:n Subdivision Q€�°1r e-i JCL , Lot # Certified Survey Map # , Volume , Page # (o S 1 � Warranty Deed # , Volume ,Page # Spec house ❑ yes 9 no Lot lines identifiable V yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restrietedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septi syste s been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days three ye xp' ' n date. SIGNATURE OF PLICANT DATE OWNER CERTIFICATION I (we) c Le, all ements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pr rty des 'bed irtue of a warranty deed recorded in Register of Deeds Office. - SIGNATURE APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 1 U 191101 59Q Ij STATE BAR OF WISCONSIN FORM 2.1999 6 6 1 8 0 5 Document Number WARRANTY DEED REGISTER OF EEDS ST. CRDIX CO., MI This Deed, made between Jame D. He and Al C. Nyhagen RECEIVED FOR RECORD 06 - 17 -2002 8z30 AM WARRANTY DEED Grantor, and Glen Johnson Constru Inc a Minn esota EXDPT 1) C orpora t ion, - _ REC FEE: 13.00 — - TRANS FEE: 960.00 COPY FEE: Grantee. CERT COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the PAGES: 2 following described real estate in St. Cr _ County, State of Wisconsin (if more space is needed, please attach addendum): (See Attached Exhibit "A ") Recording Area Name and Return Address IL 0 W.r Xl P t 032- 2 -60 -00 Parcel Identification Number (PIN) This_ is not _ homestead progeny. Ott (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this t day of Jun 2002 + • J mes D. Henry ' + Allen C. C. N yhagen AUTHENTICATION ACKNOWLEDGMENT Signature(s) James D. H enry and Alle C Nyhagen STATE OF WISCONSIN ) ss. County ) authenticated this 1` i da of J une 2002 Personally came before me this _ day of the above named + Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN -- (If not, to me known to be the person(s) who executed the foregoing - -- - instrument and acknowledged the same. authorized by 0 706.06, Wis. Scats.) THIS INSTRUMEN f WAS DRAFTED BY Attor Kristina O gland Notary Public, State of Wisconsin H udson, WI -54 — My Commission is permanent. (If not, state expiration date: (Signatures maybe authenticated or acknowledged. Both are not necessary.) Names of persons signing in any capacity must be typed or printed below their signature. inf r atm Proreasionau company. Fond du tee. vw STATE BAR OF WISCONSIN BW x55 -2021 WARRANTY DEED FORM No. 2 - 1999 1 EXHIBIT "A" Lot 1 of the Plat of Roy Ridge Estates excepting the following: Commencing the Southwest comer of lot 1 of the Plat of Roy Ridge Estates; thence S89 1'44"E 221.13 feet along the South line of said Lot 1 to the point of beginning; thence S89 0 11'44'E 180.00 feet along said South line; thence N01 °41'S0'E 60.01 feet along the East line of said Lot 1; thence N69 1'44"W 180.00 feet; thence S01 9 41'50 "W 60.01 feet to the point of beginning. Also including the following: That part of Lot 4 of a Certified Survey Map recorded in Vol. 15, Page 4239 at the St. Croix County Register of Deeds Office, further described as follows: Beginning at the Northwest comer of Lot 4 of a Certified Survey Map recorded in Vol. 15, Page 4239 at the St. Croix County Register of Deeds Office; thence S01 °32'13"W 59.72 feet along the West line of said Lot 4; thence S89°i1'44'E 220.97 feet; thence N01 9 41'50'E 59.72 feet; thence N8901 1'44'W 221.13 feet to the point of beginning. Lot 2 of the Plat of Roy Ridge Estates excepting the following: Commencing at the Northwest comer of Lot 2 of the Plat of Roy Ridge Estates; thence S01 0 41'50"W 263.92 feet along the West line of said Lot 2 to the point of beginning; thence S01 °41'50"W 60.01 feet along said West line; (hence N89 0 11'44'W 40.00 feet along the South line of said Lot 2; thence N01 °41'50'E 60.01 feet; thence 889 *11'44E 40.00 feet to the point of beginning. Lots 3, 4, 5( 8,) 7 and 8 of the Plat of Roy Ri a Estates. 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