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County:
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM St. Croix
Safety and Building Division
' INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 430186 0
GENERAL INFORMATION State Plan 1D 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:'
Gunther, Thomas I Somerset Townshi 032- 2059- 90 -4A8-
CST BM Elev: Insp. BM Elev: BM Descriptioo Section/Town /Range/Map No:
/0 0, to /Do v _ 5-=� a�f 17.30.19.-73-7.4—
TANK INFORMATION & 4 T OL IA.0- 1Fy1dj::Le I DATA Z�
TYPE MANUFACTURER APACITY STATION BS HIS ELEV.
l7 ,
Septic Benchmark
/r- 2(o /rr / 0& o
Dosing t Alt. BM 2 / 2 . /09 7Y
Aeration Bldg. Sewer
07-017
Holding St/HT Inlet °
Zz /rr.28 17& .
TANK SETBACK INFORMATION St/Ht outlet 2
TANK TO P/L WELL BLDG. Vent to Air We Dt Inlet
4.51 q3.
Septic , $� r 'A 1 Dt ottom 3. I g � , b t
Dosing f f tl � f tM Head an.
0 S l a0 I �f'• f%oL
Aeration Dist. Pi g• /O6
ra / Z
Holding Bot. Systgm 6 'L
PUMP /SIPHON INFORMATION Final Grade S� 10
Manufacturer Demarfd St Cover i
�K GPM YIS-e VS Z /M• S'7
Model Number
ED 11 L z °' �c�� S i 3.z ���o z
TDH Lift Friction Los System Head TD
Ft
1 1-05 1 U • Z
Forcemain [ Len th , Dia., Dist. to Wg]I ✓/
SOIL BS RPTION SYSTEM vv��
B MENSION Width Length ' No. Of Trenchgs PIT DIME)1IS19NS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS r
SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM AC G Manufacturer:
INFORMATION CHA R OR
Type O System: d / UNIT
> Model Number:
DISTRIBUTION SYSTEM
if Header /Manifold ,[ Distribution x Hole ze x Hole Sp king Vent to Intake
�- �V f � Pipe(s) (.� /r
Length Dia Length 3. Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center / S l a A- Bed/Trench Edges Topsoil ?Yes ' No Yes ] No
COMMENTS: (Include c de discrepencies, persons present, etc.) Inspec i rI #1:�/�/ Inspection #2: // / 1412 1 0 - 3
Location: 1530 47th St Somerset, WI 54025 (NW 114 SE 1/4 17 T30N R19W) NA Lo
atce l No: 17.30.19.
1.) Alt BM Description
2.) Bldg sewer length
- amount of cover
Plan revision Required? Yes
Use other side for additional information. L
SBD -6710 (R.3/97) Date Insepktoes Vna e Cart. No.
' Safety and Buildings Division County - If
W 201 W. Was Ave., P.O. Box 7162
�scons�n Madison, WI 5 .��1b2 -- anitary Permi Number (to filled in by Co.)
Department of Commerce ( — ) 2 66$ ]a ,I�x/ 30
(��
Sanitary Permit Applica 'on to Plan I.D. Number
In accord with Comm 83.21, Wis. Adm. Code, personal inform lion yo a
2003 '7
may be used for secondary purposes Privacy Law, s15. (1)(m) oject Address (if different than mailing address)
I. Application Information - Please Print All Information
Property Owner's Na me D Parcel k� Lot # o7 Block k
2 >° a
Property Owner's M ailing Address Property Location at�
i
City, Sta Zip Code Phone Number
tk, ZZ ) ^ (circle
T N; R _Z�E oc
II. ype of Building (check all that apply)
1 or 2 Family Dwelling - Number of Bedrooms ame CS M�N_»
❑ Public /Commercial - Describe Use
❑ State Owned - Describe Use A44 CW //n e" ❑City_ ❑Village 0iownship of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A' New System ❑ Replacement System y p y ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System
B. El Permit Renewal El Permit Revision 11 Change of El Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWTS System• eck all tha apply)
❑ Non - Pressurized In- Ground Mound > 24 in. of suitable so El < 24 in. of suitable soil El At-Grade El Single Pass Sand Filter
El Constructed Wetland El Pr urized In- Ground . g Tank El Peat Filter El Aerobic Treatment Unit El Recirculating Sand Filter
❑ Recirculating Synthetic Media Filter ❑ Leaching tuber 0 Drip Line El Gravel-less Pipe El Other (explain)
V. Dispersal/Treatment Area Information: a4 Ae VU7 - 0 i
Design Flow (gpd) Des' So' Application Rate( st) Dispersal Area q , (sf) Dispersal Area opos ( stern Ele ion Q
•o ago o /a°/o ✓
VI. Tank Info apacity in oral Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units pD /� Concrete Constructed Glass
New Existing
Tanks Tanks �
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber
j
V1I. Responsibility Statement- 1, the undersigned, as sume responsibility for installation of the POWTS shown on the attached plans.
Plumber's ame (Print) Plumber' Si a MP /MPRS Number Business Phone Number
J, 19; 4�z, _
/ -
Plu tier's Addre ss (Street, City, State, Zi ode) `
^ - / JZ
VIII ount Department Use Onl
Approved El Disapproved Sanitary Permit Fee (includes Groundwater 11475 Issuing A nt Si a o Stamps)
Surcharge Fee) l (1 � El Owner Given Reason for Denial �
l I � Conditions f Approval/Rea
D // i _ sa � l
3 mgii 1471 Q�6�ct lit `Ce 3.413 —/ a it e
Attach complete p s (to the County only) for the system on paper a t fess than nn x 11 inches ' size
SBD -6398 (R. 01/03) -
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amt Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TD
#: (608) 264 -8777 erc
Visconsin www.m(isconsin.gov
.m(is c ons
.wisonsin.gov
Department of Commerce
Jim Doyle, Governor
Cory L. Nettles, Secretary
June 26, 2003
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: 06/26/2005 Identification Numbers
Transaction ID No. 877722
SITE• Site ID No. 660580
Tom Gunther Please refer to both identification numbers,
47th Street above, in all correspondence with the agency.
Town of Somerset
St Croix County
NW1 /4, SETA, S17, T30N, R19W
FOR:
Description: Proposed Four Bedroom Mound System
Object Type: POWT System Regulate sect o.: 908227
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.
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 enclosed approved plans, the "Mound
Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the
"SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ".
• 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.
LZ A state approved effluent filter is required. Maintenance information must be given to the owner of the tank
explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided
per Comm 84 product approval conditions.
• 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. Stats.
• 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.
Note: This approval allows for only one of the two proposed buildings to be connected to the POWTS at this
time. Permission to connect the other building to the POWTS must be obtained from the county after the
system is installed and an evaluation under Comm 83.25, Wis. Adm. Code has been completed.
f r . "Ta r
C41, • p
;_ -
.� KIM A O'CONNELL Page 2 6/26/03
Owner Responsibilities:
• Comm 83.52(1)(a) - 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 shall be considered a human health hazard. In the event this soil absorption
equ under s. Comm 83.54 4 ( )
system or any of its component parts malfunctions so as to create a health hazard, the property owner must
follow the contingency plan as described in the approved plans.
• The owner is responsible for submitting a maintenance verification report per Comm 8155, that is acceptable
to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s) utilized in the POWTS.
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
Balance Due $ 0.00
Gerard M. Swim
POWTS Plan Reviewer - Integrated Services
(608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm
jswim @commerce.state.wi.us WiSMART icode: 7
cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544
I
MOUND AND N PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: TOM GUNTHER
Owner's Name: TOM GUNTHER
Owner's Address: 1448 20TH ST
HOULTON WI 54082
Legal Description: NW- SE- SEC17- T30N -R19W
Township: SOMERSET
County: ST. CROIX
Subdivision Name; CSM 709136 VOL17-- PG4457
Lot Number: 2 Block Number:
Parcel I.D. Number:
Plan Transaction No.:
Page 1 Index and title
Page 2 Data entry
RECEIVE Page 3 Mound drawings
!� Page 4 Lateral and dose tank
E(iNJ I Page 5 System maintenance specifications
Page 6 Management and contingency plan
SAFETY & L D G S D1 Page 8 PLOT PLAN nd specifications
Designer: KIM A OCO NELL License Number: 224263
Date: 06/08/03 Phone Number: 715 - 755 -3145
Signature:
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 (03/01 /01) Page 1 of 8
g
DEPART«ENT OF M, Y ,E
IVI'SiON AF7YANL� 5U1t4f1
SEE CG -RE, ONIDENCE
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a
400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal
1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches.
600.00 Design Flow (gpd)
5.00 Site Slope ( %)
98.00 Contour Line Elevation (ft) ✓
25.00 Depth to Limiting Factor (in)
0.50 In -situ Soil Application Rate (gpd/ft
Distribution Cell Information
75.001 Dispersal Cell Length Along Contour (ft) = 8.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft
1 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest e2int
in the distribution Y
Pressure Disribution Information network? Enter Y or N
(c or e) E Center or End Manifold
4.00 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)
Est ima ted Orifice Spacing (ft) = 12,00 ft /orifice
2.0 Forcemain Diameter (in)
r 50.00 Forcemain Length (ft) Does the forcemain drain back? C Y
88.00 Pump Tank Elevation (ft) Enter Y or N
6.50 System Head (ft) x 13 8.16 Forcemain Drainback (gal)
10,75 Vertical Lift (ft) 67,38 5x Void Volume (gal)
0.48 Friction Loss (ft) 75.54 Minimum Dose Volume (gal)
17.73 Total Dynamic Head (ft) 20.60 System Demand (gpm)
Lateral Diameter Selection Manifold Diameter Selec
in. dia. options choice in. dia. 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/in Calculator (optional)
Treatment Tank Information 800.00 Total Tank Capacity (gal)
1260.00 Septic Tank Capacity (gal) 36.00 Total Working Liquid Depth (in)
WEEKS Manufacturer 22.22 gal /in (enter result in cell B49)
D Dose Tank Information Effluent Filter Information \\
800.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer
21.76 Dose Tank Volume (gal /in Al 00 Filter Model Number
WEEKS IManufa cturer
Project: TOM GUNTHER �w� - o 8
Mound Plan View
1
1 /10 l3 Observation Pipe J
....
1
:(� [ A
W ;I :
I
3 ........... :
L - --
Mound Component Dimensions
A 8.00 ft E 15.80 in H Ift ft K 8,73 ft
B 75.0 F 9.50 in I ft L 92.45 ft
11.00 in G 0.50 ft J ft W 22.97
` 600.00 (ft Dispersal Cell Area 1 1290,44 (ft Basal Area Available
8.00 (gpd/ft) Linear Loading Rate 1 7.50 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 100.71 (ft) ----0
.. G ♦ H
2
1
j F dispe 99.42 ( I
rsal ceii (ft) Lateral
98.92 (ft) —► — Invert
Dispersal C ell
1
• •
D
a
• 3 •
Elev ton i •E
,
4
ltd
'` > '7 i S' Il l � i � i v a � - ,, i � �`, n� � 1 t ^ ;` ,. a, �.d 1: i.`,r.�..'G a:`:. ...:.�'�'�.�'ias•x
I ^ > .. ,C,j \ a Y 1 !4 F 1 4 ! l ?�, i i , '• , o. ., i .,�Kr� l ?. _., . ,,h., ., r Y,.A .,
98-00 (ft) Contour Elevation
5.0 % Site Slope
Geotextile Fabric Cover
Shading Key Dispersal Cell See lateral details on
Q Topsoil Cap S 1.5 ft { Page 4 for number,
777 Subsoil Ca
0 ..,,,,.,, p a o s :..;. J, f1 s: size, and spacing of
ASTM C33 Sand
� i ��'�� •• ��•••�;:;< F laterals. Laterals are
Tilled La er c 0.5 ft Typical lateral
y '` : equally spaced from
Aggregate v o ':',: ?' <::y.4:;.:�: : ?• ,: >.1,
'., .:.:::;;:,,;.:'•,':.•;.'. >;:y.. 5 the distribution cell's
�--- A centerline in the
distribution cell (AxB).
Project: TOM GUNTHER Page 3 of 8
End Connection Lateral Layout Diagram
L aterals oentered over P dimension ♦: Turn -up wt bell valve or o leanout pluo
AN cal I<- x � I Hot as drilled on the bottom of the lateral S
equally spaced
oonnootion via too or oross to manifold at any point. Laterals & force main of PVC Soh 40
(per COMM Table $4.30 -6)
Number of Laterals 2 Orifice Diameter 0.125 in
Lateral Diameter 1.50 in Orifice (X) 3.06 ft
Lateral Length (P) 73.44 ft Orifices per Lateral 25
Lateral Spacing (S) 4.00 ft Orifice Density 12.00 a /orifice
Lateral Flow Rate 10.30 gpm Manifold Length 4.00 ft
System Flow Rate 20,60 gpm Manifold Diameter 1.50 in
Total Dynamic Head 17,73 ft Forcemain Velocity 2.10 ft/sec
Dose Tank Information Locking cover with warning
label and lockdng device and
sealed watertight
Electrical as per NEC 300 and ----►
Comm 16211 WAC Disconnect 4 In. min.
Tank component Is property vented ' 4 Alternate outlet
location
Foroemain diameter
WEEKS /U Manufacturer 2 in.
Capacityl 800.00 Gallons
Volume 21.76 gal /inch A
Weep hole or anti -
Dimension inches Gallons B siphon device
A 21.18 460.77
B 2.00 43.52 C , Pump off e levation ft
C 5.59 121.63 _t 1 88.67
D 8.00 174,08 D
Total 1 36.761 800.00
Dose tank elevation ft
3" Bedding under tank. 88.00
Alarm Manuafacturer ISJ ELECTRO
Alarm Model Number JH 10 0_ - _
Pump Manufacturer IGOULDS
Pump Model Number IWE031 1 L _ — J
Pump Must Deliver 20.60 gpm at 1 17.73 ft TDH
Project: TOM GUNTHER Page 4 of 8
Moupd System Maintenance and QReration Specifi, ations
Service Provider's Name KIM A OCONNELL Phone 715 - 755 -3145
POWTS Regulator's Name ST. CROIX COUNTY ZONING Phone 715- 386 -4680
Svsjem Flow a0d Load Parameters
Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1260 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 600 ft' Maximum FOG 30 mg/L
Type of Wastewaterl Domestic Maximum Fecal Coliforml >10E4 afu/100 mL
Service Freauencv
Septic and Pump Tank Inspect and /or service once every 3 years
Effluent Filter Should inspect and clean at least once every 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
Mound Inspect for ponding and seepage once every 3 years
Other
isceilaneoys Construgtion and Materials Standards
1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap,
and are secLred 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 .. • • • • • ...... • •. foe • • • • • • • • 9 009
Grade
6 -8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Bali Valve
Distribution
Lateral
w Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: TOM GUNTHER Page 5 of 8
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained In accordance with its' component
manuals (SBD- 10691 -P (N.01 /01) and �S$WMP Publication 9.6 (01/81)) and local 9r stutte rt se pertaining tq Sy ,�ain4,t a
maintenance reporting. ; 4
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 shag be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer as
POWTS components. „-
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness 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.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of to septic tank
shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet Otter 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 Otter is equipped with an alarm, the filter
shall be serviced if the alarm is activated continuously. Intermittent fitter 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 113 the liquid volume e of the tank.
If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shag advise the owner of when the next
service needs to be performed to maintain less than maximum scum and sludge accumulation in ft tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, If such products are
used they shag 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 filter is installed within the tank it shag 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 shag
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
as protection from freezing.
Influent quality Into the mound system may not exceed 220 mg/L BOD5,150 mg/L TSS, and 30 mg/L FOCI for septic tank effluent 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 flow
specified In the permit for this Installation.
The pressure distribution system Is provided with a flushing point at the and 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 6 Inches considered as an Impending hydraulic failure requiring additional, more frequent monitoring.
Contirwencv 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 componerrt(s) shag 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 dogged 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: TOM GUNTHER Page 6 of 8
Performance 6ubmersible Ettli
Curves P UMPS
METERS FEET
25 MODEL 3885
80 I SIZE 3 /4' Solids ,
WE15H -
70 -!-
20 WE10H — +--
Q
N 60
•WE07
15 50 t
40 WEOSH -�
10 30 WE07M - �1 i
-�-.
20 WE09
5
10
0 0
0 0 20 30 0 50 60 70 80 90 100 110 120 GPM
20 30 M
CAPACITY
[CGOULDS PUMPS, INC,
59E CA FrW S Pbw v i3we
METERS FEET
120 ___. , .
�' +--+ - MODEL 3885
35 110 W - _ - SIZE 3 /4 ' � Solids
100 t . , .�.: ,._ .__ .+__ .�..._ _
so
70 �.
20 _
o
60
15 50
40
10 1 1 T
0 0 H-I I I- I 1 -1 1 Itzt
0 10 20 30 40 .) 80 70 80 90 100 110 120 QP
o '
2U 30 ml/h
CAPACITY
1985 Goulds Pumps, Inc.
P,fl�QIIV� J�iy, 1965
� G7885
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`Alisconsi, °+ Department of Commerce SOIL EVALUATION REPORT Page I of d f 1
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must C
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. fZ�
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. R se
Govt. Lot wed b Date q ,t
Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). G/Y� 7 + u 3
Property Owner 1 Property Lo
(•� n "/ n e/ % Y /' W ` 1/ � 1/4 S �/ / T-70 N R f ( or) W
Property O er's Mailing Address Lot Block # Subd. Name or C
( 7? -2 0 fti S � 1 '70 75I 7 P q (F3
City State Zip Code Phone Number ❑ City ❑ Village B Town Nearest Road
�oQ %� 14 " --r �"ya8z (7 }s, SyY' Q rrte/".s 7�'�
® New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate 6 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material s h C2 Flood Plain elevation if applicable CI\ /C P1
General comments -� —
and recommendations: S ys ^- �L. � 7
JAN 0 3 2003
ST, CROIX COUNTY
FTI Boring # ❑Boring f(
® pit Ground surface elev. �v • ft. Depth to limiting factor < �2 q in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz2'Sh. •Eff#1 'Eff#2
0 -1 /01 % 1114 LS 1m � m �- c s 2 m 1
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F2-1 Boring # ❑ Boring
® pit Ground surface elev. r / ft. Depth to limiting factor 2 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Eff#1 I 'Eff#2
0 - I2 �� �i AV4 S6 2-rns�k P t a S 2 fl 0 . S` 0. q
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Effluent 1 = > 2 m /L and T >3 _< 15 /L Effluent # _
# BOD 30 < _ 2 0 g SS 0 0 mg fflue 2 GOD < _ 30 mg/L and TSS < _ 30 mg/L
CST N (Please Print) Sig ture CST Number
9" me 1 ',- Ia i , �c/I � 23/-7 /�/
Address Date Evaluation Conducted Telephone Number
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Property Owner �br'' (� (.�� �� ei Parcel ID # Page of
FYI Boring # Boring
❑
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in. Mu nsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2
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Boring # ❑ Boring
[] pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2
❑ Boring # E] Boring
Ground surface elev. ft. Depth to limiting factor in.
11 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
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
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)
0 VV R Page 3 of 3
i. Nan,:e Brian Parnell
Address l y 20IIIIJ4-. CST 231314
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732335
KATHLEEN H. WALSH
Document Number Document Title REGISTER OF DEEDS
ST. CROIX CO.. WI
St. Croix County RECEIVED FOR RECORD
07/28/2003 11:15AN
Occupancy Affidavit ZONING AFFIDAVIT
EXERT #
REC FEE: 11.00
Name — Owner Ty or p rinted TRANS FEE:
YP P COPY FEE: 2.00
being duly sworn , states, under oath, that: CC FEE:
PAGES: 1
1. He/she is the owner /part owner of the following parcel of land located in St.
Croix County, Wisconsin, recorded in Volume QQ Page 3 4 / 9 Document
Number 7, 757 St. Croix County Register of Deeds Office: Recording Area
1 of land located in the Name and Return Address
A
parce � '/. of the SF %. of Secti - om 5 G 4'r f (4 /-
T N — R 1 W, Town of 5 jmZ� 5 47' , St. Croix f -S-t,
County, Wisconsin, being duly described as follows (include lot no, and
subdivision/CSM or detailed lepl description):
�o+ A Pe cc rdJ t,.1 volume )7 t'A3 yyS7 03Z. -av5-ct
��u► 1/ v „4w 7o9l3to Parcel Identification Number (PIN)
As owner of the above described property, I acknowledge that the septic system serving this residence is sized for a
L bedroom home, or a design flow of t gpd. The design flow is calculated by assuming 150 gpd for 2
individuals per bedroom. There are currently Q occupants living in this residence; . 0_ occupants are permitted
based on the design flow. Therefore the septic system serving this residence is code compliant. However, i
understand that if there are intentions to exceed the number of permitted occupants, the system will need to be
modified to accomodate any increased wastewater flows and/or contaminant loads. I also acknowledge that I will make
this information available to any future parties interested in purchasing this property.
Dated this day of ` U Oo
AUTHENTI TI ACKNOWLEDGMENT
Signatures STATE OF WISCONSIN )
)ss.
aultmitcated this day of p St. Croix County. ) h
Personally came before me thi day of
OD 3 the above named
* aS �knlher
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Slats.) instrument and acknowledge the same.
L THIS IN WAS DRAFTED BY n
o
* iM( /� 4n2 be it
Notary Public, State of Wisconsin -
(Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. If not, sta ion e:
wry.) Date: 3 - I T "D `� q
"THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE"
TNs Irgbmwtlon must be completed by submfUor. docurnentift nam&retum arrd EM (K requkedl• Otfret as the
pran&V causes. /eager descrfpHon. eta may be placed on this hat page of the document or nNa be placed on ad600r of
document. bWL use of Ws cover page adds one page to your document and S2, 00 to efts n oonAw fee. Wsoonsln Statues. 50.517.
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner /Buyer i J /brJ? �nT� -p-I
Mailing Address /!Z At)/4
Property Address j'/ 7 5�� S-R�� G✓'j_ _�����
( eri iNhon required frorn Planning Department for new constructi n)
City /Stara - "f G✓Z Parcel ldentitication Number P v� 039 ,45 � _ `l6 - /00
LE GAL DESCRIPTION
Propert, Location - 7 ' /a, � 1 /q ) Sec. , T 3 d N -R�W, Town of
Subdivision Lot # a
Certified Survey Map # 702 /3w - ,Volume 1 -7 , Page #
Warranty Deed # 7,;?-�2`7s7 ,Volume aas� , Page # 3y9
Spec house O yes N' no Lot lines identifiable LX yes O no
i
SYSTEM MAINTENANCE
Improper use and maintenance of your scptic system could result in its premature failure to handle wastes, Proper maintenance
cunskts of pumping out the septic tank every three years or sooner, if needed by a licensed pumper, What you put into the system
an all'act 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, restricted plumber 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,
I /we, 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 septic system has bee maintained must be completed and returned to the St, Croix County Zoning Office within 30
days of the three year expir tion da
SIGNATURE DATE
OWNER CERTIFICATION
I (Nye) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property, escribed abo c, by vir e of a warranty deed recorded in Register of Deeds Office.
� S lay/ a3
SIGNATURE A DATE
* * * * ** Any information that is misrepresented may result in (lie 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 2252 P 399 722757
STATE BAR OF WISCONSIN FORM 1 - 2000
KATHLEEN H. WALSH
• Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO., WI
This Deed, made between Dennis R. Gunther and Maida J. RECEIVED FOR RECORD
Gunther, husband and wife Grantor, and Thomas Gunther, a single person 05/27/2003 08 :00AN
Grantee.
Grantor, for a valuable consideration, conveys and warrants to Grantee WARRANTY DEED
the following described real estate in St. Croix County, State of Wisconsin (the EXEMPT #
"Property") (if more space is needed, please attach addendum): REC FEE: 11.00
TRANS FEE: 84.00
Located in Part of the NW 1/4 of the SE 1/4, Section 17, Township 30 COPY FEE:
North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin, CC FEE:
PAGES: 1
more fully described a s Lot 2 of a Certified Suryty Map recorde on
February 10 2003 in Volume 17, page 4457, as Document No. 709136 at
the St. Croix County Register of Deeds Office.
l
Recording Area
Name and Return Address
Heywood, Carl & Anderson, S.C.
1200 Hosford St., Suite 106
P.O. Box 125
Hudson, WI 54016
L
Together with all appurtenant rights, title and interests. Part of 032 - 2059 -90 -100
Parcel Identification Number (PIN)
This i s not homestead property
(is)
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
easements, covenants and restrictions of record.
Dat d this 23r day of Ma 2003
* Dennis R. Gunther * Maida J. GuAer
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Dennis R. Gunther and Maida J. Gunther STATE OF WISCONSIN )
) ss.
ST. CROIX County )
authenticated this 23rd day of May , 2003
Personally came before me this 23" day of
May , 2003 the above named
Dennis R. Gunther and Maida J. Gunther
*
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same.
'CE •
THIS INSTRUMENT WAS DRAFTED BY L t
Heywood, Carl & Anderson, S.C., 1200 Hosford St., Suite 106 * / C treug
P.O. Box 125, Hudson, WI 54016 Notary Public, State of Wisconsin UJ t w
My Commission is permanent. (If not, state, aatQ d e:`
(Signatures may be authenticated or acknowledged. Both are not necessary.) Sw •)
INFO-PRO 800 655 -2021 www.in 6iti��or.iw.com
INF t+9P� for
Names of persons signing in any capacity must be typed or printed below their signature. ( )
STATE BAR OF WISCONSIN
WARRANTY DEED FORM No. 1 - 2000
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CERTIFIED SURVEY MAP
LOCATED IN PART OF THE NW1 /4 OF THE SE1 /4, SECTION 17, T30N,
Al 9W. TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN, BEING
LOT 1 OF A CERTIFIED SURVEY MAP RECORDED IN VOLUME 12, PAGE
3411 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE.
PREPARED FOR: SURVEYOR:
DENNIS GUNTHER DOUGLAS J. ZAHLER
421 LOCUST STREET S 8 N LAND SURVEYING, INC.
HUDSON, WI 54016 2920 ENLOE STREET
HUDSON, WI 54016
SURVEYOR'S CERTIFICATE
1, Douglas J. Zahler, Registered Wisconsin Land Surveyor, hereby certify that by the direction
of Dennis Gunther, I hove surveyed, divided and mapped port of the NW7 /4 of the SE1 /4 of
Section 17, T30N, R19W, Town of Somerset, St. Croix County, Wisconsin; being Lot 1 of a
Certified Survey Mop recorded in Volume 12, Page 3411, at the St. Croix County Register of
Deeds Office, described as follows:
Commencing of the South Quarter corner of said Section 17; thence NOO'16'48 "E along the
west line of the Southeast Quarter of said Section 17 a distance of 1318.90 feet to the
south line of the Northwest Quarter of the Southeast Quarter of said Section 17; thence
S89'19'38 "E along said south line a distance of 189.09 feet to the point of beginning;
thence continuing along said south line S89'19'38 "E a distance of 1117.27 feet to the east
line of the Northwest Quarter of the Southeast Quarter of said Section 17; thence
N00'08'08 "W along said east line a distance of 625.20 feet; thence N89'19'38 "W a distance
of 1112.74 feet; thence S00'16'48 "W a distance of 625.16 feet to the point of beginning.
Containing 16.002 Acres (697,038 Sq. Ft.). Subject to right —of —way of 47th Street and
subject to all easements, restrictions and covenants of record.
I also certify that this Certified Survey Mop is a correct representation to scale of the
exterior boundary surveyed and described; that I hove fully compiled with the provisions of
Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of St. Croix
County end ed the Town of Somerset in surveying and mapping same.
-- - - - - -- --
-- -- — — _ ---- - - - - --
Douglas J. hler L 2 45 Date
S & N Lan Surve n µ ' r�
2920 Enloe St.
Hudson, WI 54016 tt �y APPROVED
r-1) DOUGLAS t i ST. CROIX COUNTY
ZAkLER
S -274 5
� FEB 1 0 2003
<
HU SO
WIS.
i
S,uFRNN� a not record w ed ti .., ..
approval date approval val sila!I UL
I mill o.,.+,..:.
i
Each Parcel shown on this mop is subject to State, County and Township lows, rules and
regulations (i.e., wetlands, minimum lot size, access to parcel, etc.) Before purchasing or
developing any parcel contact the St. Croix County Zoning Office and the Town of Somerset
for odvice.
THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6239 DATE: 01/17/2003 SHEET 2 OF 2 SHEETS
Vol. 17 Page 4457