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HomeMy WebLinkAbout032-2041-20-000 L w 0 100 1 V T n X cn3 T. - 0 z U) x - D z — 0 0) CD 0) w 0 0 ra 2) 0 (A CD CD CD :3 CD r, CD 0 K) 0 i cS CL U) CA CL Cl) CD CD w [ 0 R CL @ 0. @ 5* . 0) O' :3 a 4 6 -0 CD 0 1O n 00 o r (D 0 3 3 -4 a a y M c 0 c -4 Cl) z cn z U) z z CD > > 0 > (a > CL =1 -0 I W < 3 > CD CD c m CD CL a CL CL 5D Cyl 3 0 0 a 0 CD 0 CD CL 3 O z z z 0 r a 0 0 0 0 C, cc w c cr T V T ti z z 000 0 J�g 0 C) 0 0 1 0 C5 C5 CO) C#) CO) Ln m 0 m 0 C O 5 IS m a 3 m cr M V = m 0 :3 m CD CD U) lei (D rr 0 D 3 N) D CL CL CL U) z z Z z 9 0 > > @ 0 0 Er 3 CD X cn CD a :r c CD O Z 5� z 0 0 0 Z: z ID Z: z o G) 0 0 0 Z o Z 0 Z co Lq. 5 - QM (a --t WIC 0 > 0 �uw ca, CL (D 0 0 CL S�-� @ CD In -0 'n Z 0 0 = 0 0 qa 0 :3 CD C 0 CD C 0 0 ) C c 2) (a CL M O R 0 -m—vr U) =r Z 0 2- " cr Z X CD CD M 0_ CD 2) 0 - , @ - C -0 0 5 �� = * 0 D M - CD CD 0 0) 0 0 ID 0 D (D 0 ) 1 = CD :3 0 0. 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U) y ,�- O Q =a M 41 N 0 0'7a (D CD 7 O 0 N ' (D y 0 0) 1 C n N C ff (D o> ? N N % 7 �. d 7 C C 0 �, I � CD aa aam y CL Ob 1 =0 a ooOo 1y aCD ° o am a 01 'O N 7 y N yC fD N C 'OD S fD C '00 =r .y r!O + O y O N 0 d O N f7 ? e - 7 R - M fD - 41 N > > Ca C a 0 0 N G) y 9 a C G) y N W c x v� �' x v 0 > >3�v�i> >'3 0 o -O.. 7Z' N R N O ° J ° cn V a tA K o 0 1 O O Do m +� o o o o c "' CD Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM ount • St. Croix � Safety and Building Division INSPECTION REPORT Sanitary Permit No: 453440 0 GENERAL INFORMATION (ATTACH TO PERMIT) Sate Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. OZ ©6W T . /A Permit Holder's Name: City Village X Township Parcel Tax No: Miller, Scott I Somerset Township 032- 2041 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: SectionrTown /Range /Map No: X . v / a Guesf� 2 1/G P,` 11.30.19.635D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. /C'& , !2 ioa•a Se 7 / v 6)D Benc mares 44 ' C Dosing w AI M 7 Aeration t4 Bldg. Sewer �7/ 3 a.5- y� /Z Z . -7,f Holding Ht Inlet__ TANK SETBACK INFORMATION SUHt Outlet TANK TO � � WELL BLDG. Veneto Air Intake ROAD Dt net 2� r '7 Septic , � r >, / Dt Bottom Dosing Header /Man. 36' � 35 S7- , g Aeration Dist. Pipe A) 3 4— 33 Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufactur r Dim St Cover p (/T GPM I'/ S- S Q /'Q• ! O Model Number � 0. �O _ t � D .> N Z V DH 1ift riction Loss System Head / TDH Ft a .g3 2 a I m Forcema Lent 5 I Dia. Dist. to Well � 20 SOIL ABSORPTION SYSTEM BE Width Length No. Of renches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth - 15 1 — MENSIONS Z - SETBACK SYSTEM TO P/L PLDG PVEL LAKE/STREAM L ACHING Manufact r: INFORMATION CHAMBER OR Type Ryfiystem: ( U ~ 30 / �o' �-- el Number: . DISTRIBUTION SYSTEM Header /Manifold ft Distribution x Hole Siz / x Hole Spacing Vent to Air Intake r Pi l / r Length 3 ' Dia ? 1 Dia Z Spacing L - 11 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes [] No `11"' Yes No M M - n ENTS: (I de code cre ncies, persons present, etc.) Inspection #1: / / 6 nspection #2: / /_, `C k-too rae -J- /h 2 f Lbcation: 707 170th Ave. Somerset, �I 54025 (NW 1/4 NW 1/4 11 T30N R1 9W) metes .19.635D 1.) Alt BM Description = � 2.) Bldg sewer length = 0 iJ _ _u - amount of cover = �` - -- z3, Plan revision Required? [ Yes No Use other side for additional information. L__ SBD -6710 (R.3/97) Date InsegctorLS grture Cert. No. wl p/ i 1 _ Satr,ty - in liuiVogs Division Cou(�my l *201 W. Washington Ave,, P.O. Box 7162 Mfl Madison, WI 53707 - 7162 Sanitary Pemlit Nwnber (pt filled in by Co.) ent ce (608) 266 - 31St • lan LD. Number Sanitary Permit Application State P 1 2-. 000 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s 15.04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Information / Property Owner's Name Parcel # Lot # ek # Property Owner's Mailing Address Prope Location x' r City, State V Zip Coda PhoneNttmber , , /., Section -�� Z (circle )^' -'-- r �3 1I. Type of Building (check ail that apply) N; RE o(� Al or 2 Family Dwelling - Number of Bedrooms � 77� �CaJ ubdivision Name CSM Num ❑ Public/Commercial - Describe Use ❑ State Owned - Describe Use b ) 4h 0 ❑City_ ❑Village gTownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision 11 Change of C1 Permit Transfer to New List Previous Permit Number and Date Issued, Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground Mound > 24 in. of suitable soil V41 < 24 in. of suitable soil ❑ At -Grade . ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank Feat Filter Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) 111 V. Dis ersaVrreatment Area Information: Cc J Design Flow (gpd) I Design Spil Applicat' n Rate(gpdst) Dispersal Area Retiumlso Dispersal Area Pro osed (sf) System Elevation t VI. Tank Info Capacity in Total Number Manufacturer refab Site Steel Fiber Plastic Gallons Gallons of Units oncrete Constructed Glans j New I Existing i Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chambet D -` VII. Responsibil Statement- I, the undersign: -d, ussu msponsiWlity f or installation of the POWTS shown on the attached plans. i Plumb is ame riot} j Plumber's i�nat MP /MPRS Number Business Phone Number Plu ber's Address (Street, City, Sle, Zip Code VIIIXoui6ty /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (inciudes Groundwater Date Issu d suingAgent i M ps) Surcharge Fee; ` t 3 p� 3 (J Owner Given Reason for Denial _ IX . Conditions of Approvallijeasons forDisupprovgl!1 n 5 STEM OWNER: j� Septic tank, effluent filter and dispersal cell must all be serviced / maintained O as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable ,code /or dinance s . _ Attach compieaa plutu (to the Cou at es l,i _ , �a paper not less than 81/2 x 11 It" a in alTf" SBD -6398 (R. 01/03 r I c w aA„rJT o : /d -tale . e3lAoc Co. Of X333 ly 9 r , / v' lj -. rwrrw+r`..« .w.wr. �.�.««tw.r�.!I.wr.yw � � , ya •r�. « ?-;..t ... t" `..�., - v MwF:�r�n,Try r' 'Miw+r+n'fiMr •».� {.�.+�,..: .,«,yl, 3 ' • ~pra r'+ >k t' � ' ,Bid A Py. c 0 1 } I _ 1, y "� a0 Co Safety and Buildings commerce 10541N RANCH ROAD g HAYWARD WI 54843 TDD #: (608) 264 -8777 ' ��O �' www.cwmmerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary July 23, 2004 CUST ID No.224263 ATTN.• POWTS Inspector KIM A O CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07 /23/2006 Identification Numbers Transaction ID No. 1020007 SITE: Site ID No. 686535 Scott M Miller Please refer to both identification numbers, 707 170TH Ave above, in all correspondence with the agency. Town of Somerset St Croix County NW1 /4, NW1 /4, S11, T30N, R19W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 969214 Maintenance required; Replacement system; 450 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101) 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 Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • 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 "SSWMP Publication 9.6 Design of Pressure, Distribution Networks for ST -SAS (01/81) ". G f, • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. Changes to the approved plan must be submitted for review and approval. Failure to ` °• ' . properly attach the approval and index page to plans that match the copy on file with the Department may result in enforcement action under s. 145. 10, Stats. D � i �r rr - 1 ` A copy of the approved plans, specifications and this letter shall be on -site during construction and open to J 4 f 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. KIM A O CONNELL Page 2 7/23/2004 _ c 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. Since y, Fee Required $ 175.00 J Fee Received $ 175.00 Balance Due $ 0.00 Thomas E Devereaux Plumbing / POWTS Reviewer II, Integrated Services WiSMART code: 7633' (715)634 - 3026, 7:15 am - 4:00 pm Mon. - Fri. tdevereaux@conimerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 . r MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: SCOTT M MILLER Owner's Name SCOTT M MILLER Owner's Address: 744 JAMES AVE ST. PAUL MN. 55102 Legal Description: NW- NW-- SEC11- T30N -19W Township: SOMERSET County: ST. CROIX Subdivision Name: Lot Number: Block Number. Parcel I.D. Number: 032- 2036 -95- 000 - --032- 2041 - 20-000 Plan Transaction No.: Page 1 Index and title Page 2' Data entry 1 j • Page 3 Mound drawings Page 4 Lateral and dose tank Ily Page 5 System' maintenance specifications �, ■ Page Management and contingency plan - Page 7 Pump urve and s T r.� r r� M iR DINGS p s sa � Tv N� Page 8 PLOT PLAN OESPONDE o a owl Designer KIM A OC NNELL License 9 Ltce se Number. 224263 Date: 07/11/04` Phone Number: 715- 755 -3145 Si natur '� 9 - Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP" Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01101) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand Au (D) caloWatlone swum* a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 k►4W soli treatment for feat 1.50 Peaking Factor (e.g. 1.5 =150°x6) couronn of <■ 38 kxtm. 450.00 Design Flow (gpd) 15.50 Site Slope ( %) 94.00 Contour Line Elevation (ft) 22.00 Depth to Limiting Factor (in) R , 0.60 In -situ Soil Application Rate (gpd /ft 2 ) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest 22int in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) E Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimat Orifice Spacing (ft) = 9.00 ft /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 83.001 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 12.00 Vertical Lift (ft) 67.38 5x Void Volume (gal) 0.39 Friction Loss (ft) 73.91 Minimum Dose Volume (gal) 18.89 Total Dynamic Head (ft) 20.60 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. die. options choice 0.75 1.25 x 1.00 1.50 X 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 1000.00 Total Tank Capacity (gal) 1 Se tic Tank Capacity (gal) 52:00 Total Working Liquid Depth (in) WEEKS Manufacturer 19.23 gal /in (enter result in cell 849) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) lZabe Filter Manufacturer 21.76 Dose Tank Volume (gal /in) JAI 00 lFilter Model Number WEEK Manufacturer Project: SCOTT M MILLER Page 2 of 8 Mound Plan View T 1/10 B J Observation Pipe 4;-1 :. . ✓L ,7 7 t {::�L ?��{j{ ? i'•' 'ft: "'? A . J �• ....... J , . , is f• , ::.,• ♦ W ..• B Y'. i I J 3 :: L 0 Mound Component Dimensions A 6.00 ft E 25.16 in H Aft ft K 10.27 ft B 75.00 ft F 9.50 in 1 ft L 95.54 ft D 14.00 in G 0.50 ft J W 30.03 ft ,G s ea 1875.00 (ft Basal Area Available' AU O 450.00 (ft) Dispersal Cell Ar /� 6.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 96.96 (ft) ' H Ifff� �Iff G t � ..ffffJ,fff „Iff, Ifff,,.fff „If, ,IJ,Ifff „J,fffffJ,ff fffff,.Jfffffffffff t F Dispersal CeM 85.67 (ft) Lateral 95.17 (ft) ---► ♦ Invert Di II •• 1 Ce Di s C •3 . E Elevati evat i on i ♦. A i r "1 1 I y [] S i ' s• ��� 94.00 (ft) Contour Elevation ��',:��,•.z.�.� ,...t:,..,� a..,. 15.5 % Site Slope Geotextile Fabric Cover Shading Key $,� Dispersal Cell See lateral details on 0 Topsoil Cap S >� 1.5 ft Page 4 for number, Subsoil Cap N o size, and spacing of ,Iffffff ASTM C33 Sand ']'• ♦t <f''' °t F laterals. Laterals are Tilled Layer 0.5 ft ! Typical Lateral equally spaoed from J �y Q�3.. a o , ;:} r't; the distribution cell's Aggregate centerline in the distribution cell WS). Project: SCOTT M MILLER Page 3 of 8 End Connection Lateral Layout Diagram Laterals centered overt the A 9 dirntnslon • - Turn-up vW bal I valve or olean outplug .I P AN laterals are Identica IF X--+J Hol es dr iued on the bottom of the lateral equally spaced Force main owleotion via tea or cross to manifold at any point. Laterals tx force main of PVC Bch 40 (per COMM Table 64.30.5) 4 Number of Laterals 2 Orifice Diameter 0.125 in iO Lateral Diameter 1.50 in Orifice Spacing (X) 3.06 ft Lateral Length (P) 73,44 ft Orifices per Lateral 25 Lateral Spacing (S) 3.00 ft Orifice Density 9.00 ft /orifice Lateral Flow Rate 10.30 gpm Manifold Length 3.00 ft System Flow Rate 20.60 gpm Manifold Diameter 1.50 in Total Dynamic Head 18.89 ft Forcemain Velocity 2.10 ft/w Dose Tank Information Looking cover with war*Q label and locking device and sealed watertight Electrical as per NEC 300 and --- 0 Comm 18.28 WAC Disconnect 4 In, min. Tank component Is property vented a 4 ARemate outlet location Forcemain diameter WEEKS Manufacturer 2 in. Capecityl 800.00 Gallons Volume 21.76 gal /inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 22.57 491.10 B 2.00 43.52 C P ump off e levation R . C 4.20 91.30 —t 83.67 , D 8.001 174.08 D Total 36.761 800.00 f Doe„ s Itank elpf!2 rt V Bedding under tank. 1 83.00 Alarm Manuafacturer JSJ ELECTRO Alarm Model Number I HW 100 Pump Manufacturer IGOULDS Pump Model Number IWE031 1 L Pump Mist Deliver 20.60 gpm at 18.89 ft TDH Project: SCOTT M MILLER Page 4 of 8 [qGOULDS PUMPS Submersible .Effluent Pump MODEL 3885 WE Ser PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. APPLICATIONS ■Shaft: Corrosion- resistant, Sing le phase ( 60 Hz): can be operated colnuously stainless steel. Threaded • Capacitor start motors for without damage when fully Specifically designed for the design. Locknut on all models maximum starting torque. submerged. following uses: to guard against component • Built -in overload with ■ Bearings: Upper and • Homes damage on accidental reverse automatic reset. lower heavy duty ball bearing • Farms rotation. • S1TOW or STOW severe duty construction. • Trailer courts ■ Fasteners: 300 series oil and water resistant power a power Cable: Severe duty • Motels cords. • Schools stainless steel. . 1 /3 and'h HP models have rated, oil and water resistant. • Hospitals ■ Capable of running dry NEMA three prong Epoxy seal on motor end • Industry without damage to grounding plugs. provides secondary moisture • Effluent systems components. • 3 / 4 HP and larger units have barrier in case of outer jacket ■ Designed for continuous bare lead cord ends. damage and to prevent oil Wicking. Standard cord is 20'. SPECIFICATIONS operation when fully Three phase (60 Hz): Optional lengths are available. submerged. • Class 10 overload protection Pump In must be provided in 0 -ring: Assures positive • Solids handling capabilities: MOTORS sealing against contaminants separately ordered starter and oil leaka 3 /4" maximum. •Discharge size: 2 " NPT. ■Fully submerged in high- ; unit. . • grade turbine oil for lubrication • STOW power cords all have AGENCY USTINGS Capacities: up to 140 GPM. Total heads: up to 128 feet and efficient heat transfer. bare lead cord ends. • Tested to UL 778 and TDH. ■ Class B insulation on ■ Designed for Continuous CM ® CSA221 108stanaar& • Temperature: ' /3 - 1 ' /2 HP models. Operation: Pump ratings are Standards Amodadw 104 °F (40°C) continuous ■ Class F insulation on 2 HP within the motor manufacturers us ik y 140 °F (60°C) intermittent. models. recommended working limits, - Goulds Pumps i W 901 R • See order numbers on reverse side for specific HP METERS FEET voltage, phase and RPM'S 40 130 _ ___ __ __ SERIES: WE - — - SIZE:'/' SOLIDS available. 120 RPM: 3500 & 35 _.. — - - . .. - 110 .W 2 -µ - - ►}t SGPM FEATURES 100 T L _ 30 -- 5FT ■ Impeller: Cast iron, semi- 90 open, non -clog with pump -out 25 so — — vanes for mechanical seal -- - -- - - -- -- - -_ .._ _ _. __ . _._ ._ — __. __ P 20 smooth o erati a rotection. Balanced for P 60 o 70 0 H ,..- .� - -..- __.I,. _� _• .. -_. — _ _ • - - on. Silicon _ ......_...._ wto bronze impeller available as 15 50 — - ._ - - o. an option. 0 40 ■Casing: Cast iron volute type to .. for maximum efficiency. 30 2" NPT discharge. s 20 - - -- -- - -- -- -- -- --------- ■ Mechanical Seal: SILICON 10 CARBIDE VS . SILICON 0 0 0 10 201 30 40 50 60 70 80 go 1o0 110 120 130 140 150 160 GPM CARBIDE sealing faces. t , 3 Stainless steel metal paKS, 0 5 10 15 20 25 30 35 m /hr BUNA -N elastomers. CAPACITY Goulds Pumps C 2003 Goulds Pumps ITT Industries Effective July, 2003 www.goulds.com w 83885 w � S wr ) !t. i � ( I a I Y t M� a ��,.} �...r. � i Fr >Y vN rt r�ma1w «w �+r�«'�NiI�M(t« wt {�rwr{r.! • . '+n «. y.� \ nr •l , i�x Y► .1dY, ! n.y M, w w A) &0 Al �. ,✓ /I(� / eta f�C ,u CO r t .0 3 9S S�'x O/03 , I' I Mound d S ystem Mainlenance and O peration Specifications Service Orovider's Name I KIM A OCONNELL Phone 71 -765-3146 POWTS Regulator's Name ST.CROIX COUNTY ZONING Phone 715-3861880 System Flow and Load Param9tqM Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow- Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfufl%mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once eve 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Moundl Ins ect for ponding and seepage once every 3 ears Other Miscellaneous Construction and tp erials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum -up Detail Finished ..•�••�........• .........••••.. Grade .. . 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral ---- -- Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: SCOTT M MILLER Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Ms. Adm. Code Oener This system shall be operated in accordance with Comm 82-84 Wis, Adm. Code, and shall maintained in accordance with IW component manuals [SSD- 10691 -P (N.01 /01) and SSWMP Publication 9.6 (01/81)) 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 am no WW used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be Inspected for water tightness and soundness. Access openko 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 8dnches in diameter shah be secured by an effective looking device to prevent accidental or unauthorized entry into a tank or component. 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 Wk shall be disposed of M accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet iNW shin be assessed at least once every 3 years by inspection. The outlet filter shall be deaned as necessary to ensure proper operation. The OW cartridge should not be removed unless provisiorm we made to retain sokle in the tank that may slough off the filter when removed from Its endosuro. If the filter is equipped with an alarm, the fter shall be serviced If the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an Impending contirtuous alarm. The septic tank shall have its oontents removed when the volume of sludge and scum In the tank exceeds 1/3 the liquid volume of the to* 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 road 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, N such products we used they shall be approved for septic tank use by the Department of Commerce. 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 fitter 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 soli compaction may hinder aeration of the infiltrative surface within the mound and avow compaction In the winter will promote frost penetration. Cold weather installation (October - February) dictate that the mound be he** muWW as protection from freezing. lnfluent quality Into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank eftluad or 30 mg/L BOD5, 30 mg/L TSS,10 mg/L FOG, and 10" cfu/100 mL for highly treated effluent. influent flow may not exceed maximum design low 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 Worst be lushed of accumulated solids at least once every 18 months. When a pressure teat Is performed it should be compared to to kh U tat when the system was kstakd to determine N orifice dogging has occurred and If orifice desnkg Is required to maintain squat distribution VA*i the dispersal cell, Observation pipes within the dispersal cell shaft be checked for effluent ponding. Ponding levels shad be reported to the owner, and any levels above 6 Inches considered as an Impending hydraulic failure requiring additional, more frequent monitoring. ,Cgntinaegg Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep to system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wbUg becomes defective the defective oomponent(s) shall be Immediaft repaired or replaced with a component of the same or equal performance. If the mound component falls 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 N toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider, Project: SCOTT M MILLER Page 6 of 8 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buye"r Mailing ' Property :ddres ((�' � VeriFlealion required from Planning Department for new construction) City /State Jp,�„�. �'t} ?-�, � S C Parcel Identification Number 632- 00 W :, ZZjf6t� LE DESCRIPTION Properry Location NiJ '/" /v u '/, Sec. , T 3Q N - R — ZfLW, Town of Subdivision , Lot # Certified Survey IYIap # , Volume , Page # Warranty Deed # � ��� Volume , Page # Spec house 0 yes O_no Lot lines identifiable ' dyes D no SYST MAINTENANCE Improper usc° 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 properly owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumperverifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, hr.rein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained trust be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expir Lion date. SIGNATUI..L. OF APPI 1CANT DATE OWNIER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the propecry described abov , by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. �R ♦ #i4i y * 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 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 8 112 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. t 92-7 - - Please print all information. R ew Date Y p Y b _ Z Lo Personal information you provide may be used for seco ndary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 1/4 1/4 S T N R Z ILe / (or) W Property ner's Mailing Add Z ss Lot # I # Name or 1W City 9t&e Zp Code Phone Number ❑ City []Village Town Nearest Road ❑ New Construction User, Residential / Number of bedrooms Code derived design flow rate GPD Replacement ❑ Public or commercial - Describe: Parent material ��! Flood Plain elevation if applicable 1 ft. General comments and recommendations: Boring # Boring ® Pit Ground surface elev. ft. Depth to limiting factor -?PJ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN in. Munsell Qu. Sz. gont. Color Gr. Sz. Sh. ff#1 *Eff#2 -3 S _ — S 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 GPDN 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 CST Nam Ple a PrintX Signatu CST Number Address Date Evaluation Conducted Telephone Number s =1 Property Owner Parcel ID # Page of F —1 Boring # ❑ Boring 0 Pit Ground surface elev. ft. Depth to limiting facto in. - go — ilApplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. S . Cont. Color Gr. Sz. Sh. *Eff#1 *Eff42 11s ALIS VZ 19 ❑ Boring # E] E:] ❑ 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ❑Boring Boring # Ground surface elev. ft. Depth to limiting factor in. El 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 (R07 /00) /Or irJ� ,� >B�..�r�- ,�,•�,a �°�_ - �C /ono ` .s� aGsF S" IWAI /�8 LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 2041 -20 -000 Parcel Number 11.30.19.635D OWNER NAME: First SCOTT M & ANN L Last MILLER PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 707 170TH AVE SECTION 11 TOWN 30N RANGE 19W 1 /4160 1 /440 Line Description Line Description TOTAL ACREAGE 12.700 PLAT LOT BLK 01 SEC 11 T30N R1 9W PT NW NW 15 02 W727.63' OF N 1025.3' LYING 16 03 N OF RR 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit r - U 2 `I 4 7 P 10 7 7453n 1 STATE BAR OF WISCONSIN FORM 1 - 2000 WARRANTY DEED, KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIX CO., MI This Deed, made between James P. Donnelly, a single person RECEIVED FOR RECORD 10/31/2003 12:50PH Grantor, WARRANTY DEED and Scott M. Miller and Ann L. Miller, husband and EXEMPT tl wife as survivorshi p marital property _ REC FEE: 13.00 Grantee. TRAITS FEE: 447.00 Grantor, for a valuable consideration, conveys to Grantee the following CC described real estate in St. Croix County, State of PAGES: 2 Wisconsin (the "Property") (if more space is needed, please attach addendum): See Attachment Recording Area Name and Return Address Title One Premier Group, Inc. 706 19th Street South Hudson, WI 54016 032 - 2036 -95 -000 032- 2041 -20 -000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is 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 Roadways, Easements, and Restrictions of Record. Dated this 30th day of October , 2003 * J s P. Donnell AUTHENTICA ACKNOWLEDGMENT Signatm(s) STATE OF WISCONSIN j St. Croix County. ) authenticated this day of Personally came before me this 30th day of O G 3 October 200 the above named * uj�- James P. Donnelly TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person who executed authorized by §706.06, Wis. Stats.) the fore of i nt wledged the same. THIS INSTRUMENT WAS DRAFTED BY Michael H. Forecki , Attorney Nok6 Public, State of Wisconsin Eau Claire, Wisconsin My Commission is permanent. (If not, state expiration date: r ( Signatures ma be authenticated or acknowled ed. Both are not necess December 12 Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000 tt.: Michael H Forecki 1830 Brackett Ave, Eau Claire WI 54701 -4627 Phone: (715) 835 -3029 Fax: (715) 835 -4112 Title One Premier Group T5720317.ZFX Produced with ZipForm"' by RE Formstlet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383.9805 U 2447P 108 Addendum to Warranty Deed A parcel of land located in the Northeast Quarter of the Northeast Quarter (NE% of NE'/.), Section 10, Township 30 North, Range 19 West, Town of Somerset, described as follows: All of said NE% of NE% lying Northeasterly of the Soo Railroad right of way, EXCEPT the North 33 feet for town road easement; and a parcel of land located in the Northwest Quarter of the Northwest Quarter (NW /. of NW /), Section 11, Township 30 North, Range 19 West, Town of Somerset, described as follows: Beginning at the NW comer of said Section 11; thence N.89 °34' E. (true bearing) 727.63 feet along the North line of said Section 11; thence S.0 °01'E., 1025.3 feet more or less to the Northerly line of Soo Railroad right of way; thence Northwesterly along said Northerly right of way line to the West line of said Section 11; thence North along said Section line to the point of beginning; EXCEPT the North 33 feet for town road easement. 5' Lr in rasa . ; 0 100 p 200 300 400 500, 1. /7VTM MN COR 209.17' 202. 17 SEC. 11 I, w t1~D ,�1t7. Z2 ( yJ8 �. c i LOT 3 LOT 4 LOT N q ° 635 F 63 635 6 D 0 - N - O - 10 4/I 10, PG_ 8 5 - 1 1 � 1 655 C ., n N O 3-0 0 d C) c 3 '* °—' CD err n Z °� Cl) 3 CD CD 3 w ^� fD O N fJ o O 0 O 1 = o rn ? o f o to 4 p y c O ° m .. D N a ? a W CD O co o W 3 !� li lei Z °° n c �+ ° � m III N Q T 'o v °.: • O C O 5 rr3- CO) CO) 0 � 33 e � m U) CD M 3 3 g C .. y N D a O o Z m m a "A• m CD C D d y to ? c CD p� N m ? -► -1 N U y p Z ID v 3' G CD U) Z e A ° C z ° w ZZ CCCO D ? W N N W� y -• 01 \ O � �. C _ N C : y a v y Z C °-' CD 0 ) ° 'a Q 0 N N y O c C N W °. °. N ^" a ° 0 = p y Qc y = a (D ►1 CD 6 0 , o ° z CD m o = a m odc� ve o = CL y � (D Co d y n N CD a ° s W = t0 N r , N C N ° A O b a 69 0 ti t O CD ti Kevin'Grabau Subject: 2:30 pm -- 170th - -Scott Miller -- #453440- -Kim O'Connell Start: Mon 5/23/2005 2:00 PM End: Mon 5/23/2005 3:30 PM Recurrence: (none) I i