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HomeMy WebLinkAbout032-2158-80-000 n co O 3 w n C O �1 41 M m 0) D A N f y D W CD fD O N `Al A G. 0 y C J S fD CO pp o 1 N CL 3 7 14 z CO O N 0 0 J o 0 M c m ' o m T z> a 2 CD (n D I� a T (D ° N 3 Q CL N — 00 CL A 0 A i CD CD CD C4 z 000 Or o co 1 c O ;0 1 0 S C ca 41 cp m OG 3 Q vvv(D o v cD A N m l co _ m d y < .r N = y d . Ln CL Oi N z 3 !T cn 1 x n O c s' Q 'o a R CD O c 3 w iD O a 3 a I _ o c I 'P T 0 m j N 0 Q p z 0 97 CD C 3 O N O C z W co li O. m < O 3 z 0 A ;U O Z t0 y Z fD ? I CL am = D y m mvd a j -0 - o, v 3 o a n CD � (D 0Q O o n0 a CD (a 0 3 d c y O 0 y N 0 0 C dam 0 ° —a y CL 0 ° 0 n 3 m 3 0�nCD m 1 SaQ� C O CD Cn CD CD CD 00) q co b fD in N c O ' ;r CD N N O 7 0 a EE O _ (D CD O N O_ CD < V1 Q ° Cl ti Wisconsin-Depar`ment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 430607 0 GENERAL INFORMATION 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: Glen Johnson Construction Somerset Township 032 - 2158 -80 -000 CST BM Elev: //11 Insp. BM Elev: BM Descriptio Section/Town /Range /Map No: V / Q •- 0 I I aU • 0 � Q 09.30.19.1368 TANK INFORMATION EL VATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. l08- Septic / n / ` Benchmark o g- l�l Dosing Alt. BM Aeration r Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION SUHt Outlet �- TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �� Dt Bottom C Dosing p er. Header/ l�3 • T 3 Ae a rtion Dist. Pi Y Holding Bot. Syste mA '7 -7 n/ / PUMP /SIPHON INFORMATION (�'� Final Grade Manufacturer 6 Demand St Cover GPM 2 / rt5 - e rS �(o, 3 Model Number ® 3 2 - -�- Cox. 101 . (� TDH Lift Friction Loss System Head TDH t ,2 Z.("3 1 (o.S Forcemain I Length Dia. Dist. to well , -7S 6h 7 .t1S SOIL ABSORPTION SYSTEM CcJv . S-e.¢ Shc6�L ht BEDITRENCH Width I Length No. Qf T hes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid De DIMENSIONS 1 Y Q / ! SETBACK SYSTEM TO P L BLDG WEL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Qf Syst , em: , ( �l �� si U T Model Number: DISTRIBUTION SYSTEM - 3 HeaderjM anifol Distribution x Hole Size it x Hole Spacing Vent to Air In ak Pipe(s) i/ 7 Length Dia 2 Length Dia Spacing / 23 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded 1 xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil f � Yes ( No j`1 Yes :; No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /A /09 Inspection #2:�! 2 0 /� Location: 1684 56th Street Somers t, WI 54025 (NW 1/4��N 1/4 9 T30N R1 9W) R oy Ridge Lot 8 Parcel No: 09.3 / .1�8 1.) Alt BM Description = ��� 7 e to c- ' Sw �j� W 2.) Bldg sewer length = 7 0} CpYI�' - amount of cover = Sh��/ c2V�-�- lldf as s`i.Glv/f a 6 �51_ pl t n j2 itU -� - Plan revision Required? ; Yes [__;.'No Use other side for additional information. Date Insepctors Si attuujrep[, D —, / Cert. No. SBD -6710 (R.3/97) /' l � 42> � ' , aj — (Try— OK Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ' Madison, WI 53707` - 716 Sarti ry Permit Number (to be filled in by Co.) , sconsla Department of Commerce (608) 266 -3151 Y30 (DO ) Sanitary Permit Application State Plan I.D. Num.ber In accord with Comm 83.21, Wis. Adm. Code, personal information you provi Y Z o o (rs • I!) may be used for secondary purposes Privacy Law, Project Address (if different than mailing address) I. Application Information - Please Print All Wormation Property Owner's Na me _U7`__ 0n l Parcel N O T Lot C � Block M - � l �e 1. ) G Property Owner's M ailing Address Z�ONING OFF r Property Locatio ,Section City, State Zip Code i Phone Number ��- /. 1la S e '1 / �� (circle o r T �3 C� N; R���E oo 11. Type of Building (check all that apply) — �t 1 or 2 Family Dwelling - Number of B drooms Subdivision Name CSM Number Public /Commercial - Describe Lf (Ol• t w ; � © ,� r _ ❑ State Owned - Describe Use X dio ® ' .t) !Z ❑City ❑Village Ii'fownship of Sa.rrG � < III, Type of Permit: ( Check only one bo on line A. Complete line B if applicable V % 0 32 _ 2r _ _ per . 3 8 � __ New System ❑ Replacement System ❑ Treatment/Holding Tank. Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS Sy stem: (Check all that ap 1 } ❑ Non - Pressurized In- Ground Mound > 24 in. of suitable soil J 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 Sy nthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Grave] less Pipe ❑Other (explain) V. Di pe rsal /Treatment Area Inf ormation: _ Design Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation �Sd ySd — ySl� VI. Tank Info Capacity in Total t Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons ! of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank lid 1 �st°Y Aerobic Treaunent Unit - - - -� Dosing Chamber + i '0 1 __��. VII. Responsibility Statement- 1, th undersigned, a ssume responsibilit for install of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature - j P PRS Number Business Phone Number Plumber's Addre ss (Street, City, State, Zip Code) VIII. Count /Departm Use Only jApproved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Is uing ent Signature (N Stamps) Surcharge Fee) e-�1 _ ❑ Owner Given Reason for Denial 3 .� V 9 t s ' IX. Conditions of A royal /Reasons for Disapproval - SYSTEM OWER: 3) �� c 1 80ptle tank, effluent filter and S O•r• dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained t} , 0 3 as per applicable code /ordinances, Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) + PLOT PLAN • Scale 1 "= y O' Page -- S o f 0 , J X �C, S6 S , , �CA" C � \ J v � f J � 2 O -�v o SA COP tzFL C� 8_ Jam" �y C NOTES: �b B� > So' �R M MOVPt PAUD > ZS' Ply 1, _ - 1. Elevations shown are existing ground elevations �Vf herwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 1110 So gallon capacity manufactured by > FS ��2 CW (wI-P \M. ' So M � w Aft (boo Z^B QL Fi L-` tZ 4. Bench mark S Szz ersovE S. Divert surface water around system to prevent ponding at the uphill side. RECEIVED Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 ND V O TDD #: (608) 264 -8777 2 2003 www.commerce.state.wi.us /sb wi Vhsconsin www.wisconsin.gov s consin. g Department of Commerce S ZONIN O G OFFICE COUNTY Jim Doyle, Governor Cory L. Nettles, Secretary November 18, 2003 CUST ID No.220254 ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 11/18/2005 Transaction ID No. 942888 Site ID No. 668528 SITE: Glenn Johnson Construction Please refer to both identification numbers, 56TH St above, in all correspondence with the agency. Town of Somerset, 54025 St Croix County NWI /4, NE1 /4, S9, T30N, R19W Lot: 8, Subdivision: Roy Ridge FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 931594 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes C'4y1d) and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in ON chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. APH The following conditions shall be met during construction or installation and prior to occupancy or use: DER RTMEW OF ' General Approval Requirements: SEE CORRI • This system is to be constricted and located in accordance with the enclosed approved plans and with the µ "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 (8.6/99). • 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. • 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 • Com 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. ARTHUR L WEGERER Page 2 11/18/03 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 for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 r 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@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 RECEIVED TITLE SHEET Page \ of � NOV - 7 1003 MOUND SYSTEM FOR `SArUy & BLOGS 01% 3 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10572 -P and the Pressure Distribution Manual SBD- 10573 -P C Cz. LOCATED IN THE V0 1/4 OF THE 1/4 OF SECTION CI , T 3a N, R W TOWN OF SOIL S`� , ST• C—�z 1.9 COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR �L�J J D1i;1JSOry S y o l b 'tonally . *Ov OF COMMERCI: PREPARED B Y 'Ey ND DINGS W a (3 r= F2 S i7 S L T E S T I N G _SPpNDE AND. DES I CCtq SEF:ZV S CE P.O. Box 74 421 IT.Main St. River Falls, WI 54022 � Phone 715- 425 -0165 0 Fax 715- 425 - 6864 `,. *,u`" " � GYP U - t 1 1 r l W[ : L JOB NO. Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code ]?age Z of - 7 Seoti� c Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be leaned 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 sou tank. The addition of biological m and sludge accumulation in the However, if such products are used they shall be ap roved for septic tank �use by the Department of Commerce, Safety and Buildings Division. Pum —o Tank The pump (dosing) tank k shall be inspected at least east once eve 3 ears. At( switches, ' every ches al nfy proper operation. If an effluent filter is installed within the tank it shall be inspecte and serviced as necessary led to veri Mound and Pressure Distribution S stem 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 BOD5, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] and local or state l reportin a rues pertaining to system maintenance 9 and maintenance 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. Contingency 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 The. system installer at 1 LS The tank manufacturer at VUb ���Z$ — $ S6 L^J LC�3�sl? The effluent filter manufacturer at Ftoo ZZ l S�CjZ Z Lst The pump manufacturer at PLOT PLAN Scale 1 " =y0' Page � o f 0 � s� J O G � �\ �J�v�' / B 3.3 GSM Th Z / ^o 8 OTES : - 1-0 B C > S r- - UVwp D > ZS' F'1 'TA . Elevations shown are existing ground elevations unless otherwise noted. . Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be lk A S u gallon capacity manufactured by w a ES �Z CpU C V2 (w \-P l nu ZJ*VB Qt. n L 4. Bench mark S S3oV� 5. Divert surface water around system to prevent ponding at the uphill side. Face G. i Approved" Synthetic CO'verlag ASTH C33 Distribution Pipe Medium Sand Topsoil —� - �_- _= 7 . °a Slope Distribution Cell of Force Main Flowed 2 to 22" Aggregate From Pump Layer D \ Ft. E 1. b3 Ft. CROSS SECTION OF A_ MOUND SYSTEM F 0 8 Ft. G 0, S Ft. A Ft. Ft. Linear Loa Rate = OGpD /IN FT 6 5 �L 0. Ft. Desicn Loading Rate =p G D /SQ FT I ( Ft. y J 6 Ft. K O Ft. L 1 o Ft. F w. ►. W Z 9 Ft. . �} -Observation Pipe Ao------ X68 - -- --- - - - - -- -------- - - - - -- - - - -- - W � -- - - - -- - - - - -- -- ---------- ------- - - -�—o Force in Ma �Qistribuflon 1 „ �, Pipe Cell of z to 2 2 ! aggregate Observation. Pipe (►achbr ser•.uely) PLAN VIED OF A MOUND SYSTEM Distribution Pipe Layout pace of Piave 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 fitting to a point within six inches of the final grade. Te.- urinate the ends of the laterals with a valve cap or . threaded plug. Provide access from final grade for the valve, threaded can or threaded plug T`tP1Ct� L FvC PyC Lateral Manifold �v ra Later) X x x x x/2 V2 x x x x Lateral Lenoth — Lateral Length — p Distribution Line • P -� � t�c.��"S.s bflx h t's1.11 F-J L:- S Q — — PVC i o— G o t� P Z Ft. Hole Diameter ' Inch S 3 Ft Lateral Inches) X Z-3 Inches Manifold 1 'IZ -Inches Force Main " 2 Inches I of holes /pipe 13 Invert Elevation of . Laterals 02: SFt. �.3y�p_V1 _ 5,33 x 6 � 3t.q$ 6Ph1 _ - Combination Sept4c;Tank and PUMP CHAMBER CRO55 SECTION AND SPECIFICATIONS ' PAGE OF NEWT CAP � WEATHER PROOF JUIICTIOII BOX . 'i'C.I. VEMT PIPC APPROVEO LOCK IMG 1 10' FROM OOOR. 1 COVER P0 �sp�5101J (�Ipc - +INDOWOR FRESH 2 wAttfJIIJG LAgE(,. w /PncL�stN —rnp AIR IQTAKE cclaDu�r I^1IJIS1� 6`.^w. L t Y�H111. 18 MIAI. - -- -- -- T� ±- PROVIDE —_ — NJLE I —_— T — AIRTIGHT SEAL I I • � riFFt� ..�' I I I I Approved Z � �� A i III Approved joint w/ — \4300 ! I joint w/ PVC pipe o .I Ii ALARA PVC pipe I I -T I I oIJ I , CLEY. o10.U0 FT I 1 PJMP - -� 1 ` OFF 0 • CoucRETE - R EXIT PERMITI•EO O►JLy IF TA►JK MA�;UFACTURER HAS SUCH A ?PROVAL 3��ApPFtfl.F *_ -ISEDO' N 4 RISE SEPTIC F SPECIFICATIOQS COSE TAWKS MAQ UFACTURER: w `�� Z ��C�Z E QUMgER OF DOSES: 5 3 PER DA,. TAMK SIZE ASO GALLOQS DOSE VOLUME z ALARM MA" FACT URI`R: s� �' SLI ST�I IAICLUDIAIG 6ACKFLOW: GALLON,C. MODEL IJUMBER: *A J CAPACITIES: A= � � 30 6 IWCHCS OR GALL01ac SWITCH TZPE: - 7 l/ IUCHES'GR 3 T G(+ LLOU$ PUMP MAIJUFAGTURCR: 0>0U� >> S (� C= IuCHES OR LIZ MODEL NUMBER: �P CJ S GALLOWS D= \Z iRlCHES OR �� GALLOMS 5WITCH 'TbIPE: — Eq-Cu► -L- IJOTE: PUMP AUD ALARM RE TO 6E" MIMIMUM DISCHARGE RATE 3 �, q �, GpM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEREMCE DETWEEIJ PUMP OFF A PIPE .. � Z ' S � FEET 1 -3 -2' + MIKI METWORK SUPPLY PRESSURE , 6 ^5o FLE:T �S .OK L, 3� + 1, FEET OF FORCE MAIIJ X �'�� F �oFZFKICTIOU FACTOR.. :�-�lI FEET TOTAL OtIWAMIC HEAD = Z1 �[ 1 2 3 -- FEET 2 � ' J 4As per manufacturer .p gal /in. Liquid depth 3 �. y Goulds PrlJE of • Submersible Effluent Pump 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 RP points. • Water transfer RP M, , built in overload with 230 V, Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering automatic reset. preset at the factory. rated oil and water resistant. • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. plastic Semi -open design /a maximum. • Power cord: 10 foot with pump out van for AGENCY LISTING vanes • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal p rotection. es Total heads: up to 24 feet. with three prong grounding SP Canadian standards Association • Discharge size: 1 NPT. plug. Optional 20 foot IN EP05 Impeller: Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for rot improved erformance. end in "F" or "AC ".) ary/ceramic - stationary, three prong grounding plug p 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. 10 j • Capable of running -- dry without damage to 9 - 30, —�--- f components. I ! °y � Pump: EP05 8 • Solids handling capability: 0 25 maximum. a 7 • Capacities: up to 60 GPM. _ ! • Total heads: up to 31 feet. 6 20 • Discharge size: 1 NPT. z 5 • Mechanical seal: carbon- c 15 ! j rotary/ceramic - stationary, _j 4 BUNA -N elastomers. 1 • Temperature: ° 3 10 ! ! - 104°F (40 °C) continuous I j 140 °F (60 °C) intermittent. 2 - -- 5 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 nnth CAPACITY 21995 Goulds Pumps. Inc. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County - Attach complete site plan on paper not less than 8 1/2 x 11 in es t include, but not limited to: vertical and horizontal reference po t (B � Parcel I.D. percent slope, scale or dimensions, north arrow, and location Ind distance to nearest road. Please print all information APR 2 2 2002 Revi ed by Date Personal information you provide may be used for secondary purpos (Privacy Law, s. 15.04 (1) (m)). Dec . `� Property Owner tion ZON NG 8M ICE 1/4 /(/ 1/4 S T V! Cj N R 9 E (or) 40 Property Owner's Mailing Addresss Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village ® Town U Nearest Road 510 ;. (7 f S) 2 ' Y �3 / So tom- 4- / a 0 New Construction Use: [� Residential I Number of bedrooms 3 Code derived design now rate 5'Saf l O d GPD Replacement /I ❑ Public or commercial -Describe: Parent material T��(/ Flood Plain elevation if applicable ti� ft. General comments Sy ` < e&? P/! V, 4 0 and recommendations: n ` o v F_(1 Boring # ❑ Boring ® Pit Ground surface elev. KgM ft. Depth to limiting factor 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 ( 01 lou 313 5L 2motbk mPr C_5 V 5 .9 2 1? -28 Ih r3AO 5L rnab r C5 — 3 2 Q r if C2 MA- _ — 9 Boring # ❑ Boring ® pit Ground surface elev. 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 b - l0 3 --- 5 L 2 tk tr c g . '9 p q I(� �Co F 2 P - 1 r `t C9 S i — ' 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 YN Address Date Evaluation Conducted Telephone Number S1. 0 ( At (-CA--(, wl. Z s q- - �- -a Z 7 WO SBD -8330 (1107/00) i Page � of n / ^ Parcel ID # g Property Owner / V 53 1 Borin Boring # � ^ t /o/ �/e i Ground surface elev. ft. Depth to limiting factor Lam_ in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont 601or Gr. Sz. Sh. 'Eff#1 •Eft#2 f 0 - 1 5 /O I3 - C-D I v . 5 c l 15 -25 I 3/( k c5 - 3 25 -40 r 3 11 , 7, `f S L ❑ Boring # Boring pit Ground surface elev. ft. Depth to limiting factor (�• 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 F-1 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. '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) PAGE 3 OF 3 NAME /may v\ TOT# O LEGAL DESCRIPTION NW X V E Z ,S T,36 ,N,R, SC : 1 "= BM EVATION �(� • O BM 1 DESCRIPTION c la� q! ALEVATION qg. O C BM 2 DESCRIPTION ,p Py C SYSTEM ELEVATION /O/ 0 ALTERNATE ELEVATION /v 14 CONTOUR ELEVATION 100 .66 L � � A i U o � c� SIGNATURE ��_- "E - DATE ST CROIX COUNTY SEPTIC 'TANK MAINTENANCE AGREEMENT AND �- OWNERSHIP CERTIFICATION FORM OwnerBuyer _ . / �`e Mailing Address 4 ,649 �D � Property Address S (Verification required from Planning Department for new construction) City /State Parcel Identification Number o52- - 21$8 -9D-CM(. 134R LE GAL DESCRIPTION Property Location � '' /., ,4,L %, Sec. , T 30 N -R _W, Town of d eel - s-e i� Subdivision 9 , Lot # a Certified Survey Map # , Volume , Page # Warranty Deed # GO / 1 3 0 -5 - , Volume � , Page # 5W Spec house O yes [ono Lot lines identifiable D yes GY no SYSTEM MAINTENANCE Improper use and maintenanceof 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 b� a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that ( I ) the on -site wastewater disposaI 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 se c systen as been manuauned must be completed and returned to the St. Croix County Zoning Office within K days of three y r expi on date, SIGNATURE APPLICANT ` DATE OWNER CERTIFI I we) certify at all s t ents on this form are true to the best of my (our) knowledge.. I (we) am (are) the owners) of the prop describ d bove, virtue of a warranty deed recorded in Register of Deeds Office. _ 17 SIGNATURE PPLICANT 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 U 1910r' 590 STATE BAR OF WISCONSIN FORM 2- 1999 6 6 1 8 0 5 Document Number WARRANTY DEED REGISTER H WALSH DEEDS ST. CROIX CO., VI This Deed, made between Jame D. Henry and Al C. Nyhagen RfiCEIVED FOR RECORD 06 -17 -2002 8:30 AM WARRANTY DEED Grantor, and Glen Johnson Construction, Inc., a Minnesota _ EXEMPT # C orporation, 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): Recording Area (See Attached Exhibit "A ") Name and Return Address IG 0 v4/. � Pt 032-2 Parcel Identification Number (PIN) This _ is not homestead property. L (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of Jun 2002 — _ _ -- -- • J mes D. Henry - - - -- `. * Allen C. N yhagen AUTHENTICATION ACKNOWLEDGMENT Signature(s) James D. H enry and Alle C Nyhagen STATE OF WISCONSIN ) ) ss. County ) authenticated this 14 i of J une 2002 °- — Personally cane bet'ore me this _ day of the above named • Kristin 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 § 706.06, W is. Staff s.) THIS INSTRUMEN'r WAS DRAFTED BY ttorney Kristine Ogland Notary Public, State of Wisconsin H udson, WI 540 _ My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) _._ .._ , -_ _.) ` Names of persons signing in any capacity must be typed or printed below their signature. Ird"ation Professionals company. Fond du Lao. Inn STATE BAR OF WISCONSIN 8W455-2D21 WARRANTY DEED FORM No. 2 - 1999 0 191 Lj 591 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 °1 1'44'E 180.00 feet along said South line; thence N01 °41'50"E 60.01 feet along the East line of said Lot 1; thence N89 180.00 feet; thence S01 0 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 needs Office; thence S01 59.72 feet along the West line of said Lot 4; thence S89 "E 220.97 feet; thence N01 "41'50'E 59.72 feet; thence N89 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 °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; thence N89 1'44 40.00 feet along the South line of said Lot 2; - thence N01 °41'50 "E 60.01 feet; thence S89 1'44E 40.00 feet to the point of beginning. Lots 3, 4, 5, 6, 7 and So the Plat of Roy Ridge Estates, ALL in St. Croix County, Wisconsin. kry I txw i ina DRIVE 47 N88'2\4T'W f OI o f f WET . _ >� •. A�j�ol. WITS �� -L22- 589°11 %rK 388.09' o� � H. WIDE 7V S' �• �'� \� DRAINAGE 0 �. \ EASEMENT @ LOT $ (1 ; SO. Fr.) M .IL • 9162. I I / I r S8 H.W.LP�990.0'� 8°18'10'E 300.00' i LOT 7 3.252 ACRES (141674 SO. FT.) INC EASEMENT 3.034 ACRES (132,173 SO. FT.) �� / / % / a y �•�._. YY/ � EXC EASEMENT I // / V WET H.W.L. = 960.0 % / i D H.V1�.L 967.0 ; ; uMrrs M.F.F.. = 962.0 NO 33.ar 502.8T S01 °15 489.8T ' ��� I 2 •t '05'1N •�, 66 3120' �.�• � \ H 88 1 11.11' CH MARK: TOP 80' RADIUS TEMPORARY (NW16S7M IRON / CUL-DE-SAC EASEMENT TO ATION 970.5 BE EXTINGUISHED UPON I EXTENSION OF ROAD SOUTH LINE OF THE NW1 /4 OF THE NE1 I ►[�(pL�G;I� u CAD dQ nMD� O�f�I D L3�`l @T 1 LISHED FROM 33 MONUMENTS )R. THIS M7fBJMENT DRAFTED BY: W UJAM KANE JOB N0.8001-01 DATE OWOVAN RIEVISED: C der= ,a.�