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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal mformahon you provide may be used for secondary purposes [Privacy Law, s 15 04 (1)(m)I TANK INFORMATION ELEVATION DATA TYPE MANUF CT RER gr CAPACITY Septic Z O a Dosing K%bo Ono r' P/ low Z5 Holding TANK SETBACK INFORMATION Lr-4�6 ,�- / / TANK TO P/ LL WELL BLDG Vent to Air Intake ROAD Septic Z!' �7 CJ , Dosing >�/ . 1 r qo • Aeration Holding PUMPISIPHON INFORMATION / fI��,4u 3% Manufacturer 7 / �Ae/Y r- Demand GPM Model Number O 'tss TDH t 48 Fncb?.!-q ((//� Systertyjeagy� --// ��jj TDz o zFt Forcemain Len2h . Dia , s Z Dist to Wall> 76 SOIL ABSORPTION SYSTEM STATION 11! HI FS EV Benchmark Alt BAD � / r ✓J r Bldg. Sewer G.�{ �/•�5 St/Ht Inlet J 7 St/Ht Outlet Of Inlet Ot Bottom � e 7 -7`7o.� Header/Man. a4/ 41 1 Dist. Pipe 3.� 9q.y 3 1 Bot. System Final Grade St cey r z. l i5. Zy �ohslour S• �.�,o `( a3 BEDITRENCH Wdth , Leng$t,h r e PIT DIMENSIONS No Of Pits Inside Dia. Liquid Depth DIMENSIONS �fej .' lot Js SETBACK SYSTEM TO JPJLJJ BLDG WELL LAKE/ST AM LEAC ING Me fact er INFORMATION CHAMB ROR Type OfS ste y 3o v / 5 ^J O� • Model Nu r UNI v {O 77 DISTRIBUTION SYSTEM Header/Mamfold 1 �)y— �`-' Dlstnbuhc r , I C , Pipe x Hole Sze •S ,. x Hole Spacings Ve to Art Intake Length Dia Length Dia Z Spacing 3Z �GL SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only /tr 1' IV /, Belrm-er Depth Over xx Depth p(_ xx Seeded/Sodded zs Mulched BeIN e07 Cente4 7x BedfTrench Edges Topsoil / s J ! Z )(Yes �� No ✓ Ves No COMMENTS: (Include code discrepencles, persons present, etc.) Inspection #1. I [Aj f oI MIZI Inspection #2: Location: No Address Available 1.) Alt BM Description = rI i4te tov4r 2 ) Bldg sewer length = 34 - amount of cover = Z/ 2- Plan revision Required9 _ Yes No Use other side for additional Informab SBD-6710 (R 3/97) 9;p/Pis, 5.'ZQ. 4 l /owy J, N7io/l••'�d PI va~.�, lo_ z9 z1 Date Insepctors Signature Ced. No. Wiscon�ennty 'a*gadSt_ C�fOlx Department Sa ety ad& 2 2 201 �, Mks� - Sanitary Sanitary Permit Number (to be filled of by Cc ) Professional Se ices Co Iv 3�8�� p 10 . catio State S nitts=L State Plan LD Number 21O r39 rotX .,ours In accord with SPS 383 21 (2) Wis Adm Code submission of thistg ftY q(ttalunit Project Address(if ditTerent than mailing address is regwred prior to obtaining a fetyary permit Note Servicesm submitted to the Department of Safety and Professional Services Personal information you provide �� may be used for second' purposes m accordance with the Privacy Law, s 15.04(1)(m), Stats 1. Application Information - PIIase Print all Information property Owner's Name ' Parcel # RossStanshufv 611&v-1D2_5 Property Owner's Mailing Address (` Property Location 910 1"Street I of +; Gor Lot N E '/., N W'/a, Section I City, State Zip Code P e Number GleDNGOd Cit\. Ai 1 1401 : 71� 781-4121 T 30N/R 15W 11. Type of Building (check all that apply) Lot Nt L Subdivision Name X 1 or 2 Family Dwelling- Number of Bedrooms Public/Commercial - Describe Use Block # City State Owned -Describe Use CSM Number Village of Z.oKIP- i( 3)-4pIf0 TownofGlenNood III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. X New System Ys Replacement System ❑ TreatmentMolding Tank Replacement Only ❑Other Modification to Existing System B. Permit Renewal El Permit Revision Change of ❑permit Transfer to New List Previous Perini[ Number and Dale Issued Before Expiration _ Plumber Owner IV. Type of POWTS System: Check all that apply) _ Non -Pressurized In -Ground Pressurized In -Ground _At-Gmde \ _ _Mound <24in of suitable sod — Holding Tank _Other Dispersal Component (explain) Pretreatment Device (explain)v ��p/ Sol.el0 U r-1 _ V. Dis ersal/Trea[ ent Area Information: v v r - Design Flow (gpd) Design Soil Apphcahon Ra gpdsf) Dispersal Area Required Dispersal Area Proposed y System Elevation 600 0.6 1000.0sq.U. 1416.0sq.ft! I9;"75� V1. Tank Info Capacity in Gallons "Total Gallons Number of Units aynufacturcrr t Pc,, /10 x 5'-✓ Prefab Concrete Site Constructed Steel Fiber Glass Plastic New L=,ng Z Tanks Tanks ! Septic or Holding 1200 1200 1 NCISir COr1Crl'CB Y Tank DosingCha,nber S00 800 ] Combo N VI 1. Responsibility Statement- 1, the and 'fined, assume responsibility for installation of the POWTS shown on the attached plans. Plumbers Name (Print) Pin er's Sign r MP/MPRS Number Business Phone Number Jacl :A. [3ovvnan / �y�, NIP ... 8,9 71� 418-1349 Plumber's Address (Street, City State, Z ode) N13.137 4,,, Street. Rideeland. 1 �;4W) VIII. ounty/De artment Use Only Approved ❑ Disapproved Permit Date Issued Issuing Age Signature ❑ Owner Given Reason for 'Fee Denial W / IX. Conditions of ApprovaUReasorufor-Disapproval3 A �l (:or�,}joky �� ,S R. v4i SYSTEMOWNER- X -/I G(1 ��^_ 1. Septic tank, effluent filter and it) r4 / L. c�C Id- w r ILL Tvli$T 1Aee,#ft(L per al / irvided eta" �r 1. mcellmuttbese �.,' as i9V %�r !'t'i,vslt D/'CVf' �•, ,skA_7 -- +n74*100t&C as per management plan provided by plumber, l I 2. All setback rep *L f, ` uirem 4 ants Must maintained r"YI'lp.�+oa-r - 85 pEi applicable tdtle/ormnarices. 6 C£7Jjy Attach complete plans (to the County only) for the system on paper not less than 812 a 11 inches in size SBD-6398 (R. 01/03) Ross Stansbury NE %< N W'/,, S 12T 3 0N/R 15 W Glenwood township St. CIoix county LEGEND IBM: 100.0' top of concrete pad 2BM: 93.0' top of spade of flagged steel post 3BM: 93.0' top of spade of flagged steel post r �$F-- back hoe pits No SPS 383 setback Problems Scale 1"-40' q; Except where indicated System elev. 93.75' on contour 93.0' Part of a 2A.C. parcel I (DB I C7b�X Ze Site Plan �Of K��e.�� O� (L., bv�J�.HI•E SP i A Soo 6 �! project: STANSBURYpage 10 of 10 v' 2s 1 9 o:p V P P` May 20, 2021 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2023-05-19 Plan Review:PWTS-052101039-C LORETTA LARRABEE N2089 County Road Y Menomonie WI54751 SITE: Stansbury County X Town of GLENWOOD St. Croix County Total Amount: S250.00 FOR: Descriodon: 600 CPD (4 Bedrooms —New Construction) Maintenance Required 2331 SAN LUIS PL GREEN BAY WI 54304-6211 Contact Through Relay httpl/dsps.wi.gov/programsrindustry-services W .WIscenirLgov Tony Evers - Governor Dawn Cram - Secretary Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE Mound Component Manual— Ver. 2.0, SBD-10691-P (N,01/01, R 10/12) Pressure Distribution Component Manual — Ver, 2.0, SBD-10706-P (N.01/01, R 10/12) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 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: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (PO WTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and sbrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption 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. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of contraction/installation/operation. In granting this approval the Division of Industry Services 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 shalt provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. POWTS Plan Reviewer —Wastewater Specialist Department of Safety & Professional Services I Division of Industry Services email: tim.vanderleestanwisconsin eov Cell: 608-516-6134 Private On -Site Wastewater Treatment System (POWTS) New resident system Mound and Pressure Distribution Component Design Index and Title Sheet Project Name: STANSBURY Owner: Ross Stansbury Location: County X Legal Description: NE.NW,12 30,N/R15W Township/County: Glenwood township, St. Croix county Contents: Page 1: index and title Page 2: general information & lateral diagram Page 3: mound drawings Conditionally APPROVED Page 4: dose tank DEPT. OF SAFETY AND PROFESSIONAL Page g 5: um pump information SERVICES DIVISION OF INDUSTRY SERVICES Page 6: septictpump tank detail Page 7: septic filter information Page 8: management plan 7/omt Page 9: contingency plan SEE CORRESPONDENCE Page 10: site plan Attachment: soil test to state plan Deflection worksheet Designer's name and license no.: address: phone: cell: e-mail: Loretta Larrabee license# 1872-007 N2089 Cty Rd. Y Menomonie, WI 54751 715/664-8184 715/505-1628 Ian1PeirtestinUCr�k"wt net Designer's Signature �< I the undersigned submitted these plans under my authority ` L0ReTTA e., n ' LAR E ' t Mound component manual for POWTS Version 2.0 SBD-10691 P (N.01/01; R, 10/12), and Pressure Distribution component manual — Version 2.0 SBD-10706P (N.01/01; R, 10/12) page I of 10 Proposing 600 6.0% slope sys� mDWF 7'1 soil -applicationarea 27" llnttin rate 1200/80pfactor gal ombo Wieser w/ Polylok 525 Septic tank filter lVwnber of latera►s Lateral din 4 Lateral sPac 43.75& Manifold ding (S) 3.Sg• Force main dia. I in. 2.0 in. 1.75' (21 ")I project: STANSBUp GENERAL INFORMATION Center fed system w/4 laterals linear 6.78 design loading rate orifice /1.0 effluent qsty #I LATERAL LAYOUT Center DIAM GRA Fed systein °Ol to scale) s*. see page 9 of 10 a box 5/32 in. (0.I56' 30in. (2.5' ) ) ]Sin. (1.5, 18 ) 9.72gpm Mis 38•88gPm Construction for tum_up detail finish grade S 3.5' (42 orifice din oti fice spacing orifi Ce spacing ces per lateral lateral discharge to System raratete .+ ------ P Orifices located on bottom oflateral X Last orifice next to z fitting Force main 2" dia. Page 2 of 10 i LHL\ V Le, YY VP 1V1V Uil" k11U1 Ul Jl:ale) A = 7.0' D= 0.75' (9") 7 = 5.0' required bed 600sq.ft. B = 88.5' E=1.17' (14") I = 9.0' proposed bed 619.5sq.11. F= 0.83' K = 8.5' required basel area 1000.Osq.ft. G= 0.50' W = 21.0' proposed basel area 1416.Osq.ft. H= 1.00' L=105.5' observation pipe @ 9.0ft. Observation pipe IJ W O S p Q, 21.0 ~� R5. 0 88.5' I 1011=11 Mound Cross Section View (not to scale) Finished grade elev.95.54' ❑ 1 Lateral invert elev.94.25' Dispersal cell e1ev.93.75' ///// / // / ! 4 dispersal cell $ 2" -- __--- -- 04laterals I -- -- --- - Aggregate bed 6" ` E-- — — -- -- D -- tilled layer 6% site slope Numeral Key 1 topsoil cap 2 subsoil cap 1.5ft. 3 ASTM C33 sand 4 synthetic cover over cell 5 aggregate flange secure observai io 0.5ft. W tilled layer contour elev. 93.3' 4in. dia. observation pipe with 1/4in slot project: STANSBURY page 3 of 10 �epiicipump comoo cross section (No Scale) .Approved Locking Manhole Cover With Warning Label Attached g„ Weatherproof Approved Warning Label Junction Box Vi A 1 Uri an^. L12" Minimurzi L Final Grade y � 14 Minimum Qick 18" Minimum 1 I I I I.L_ I I_11-H1 --. — Disconnect 11 1 i 1 1/4" Weep Baffle - Hole APlproved Joint R e. V/ q"sA40 Pipe A Ex -tending 3' Alarm Qv Onto Solid Soil B Approved Joint On , W/40 SCW l4pes C Extending 3' Eaev_ g5.$ Off 6' Onto Solid Sod 3" of Beddinq Under Tank untee Pump and Alarm Are On Separate Circuits Conc. Blocs; ;�o`7a bwF = /d .O aalln_ csl�— Tank Manufacturer: �QAo_7, Czr,t s1-., 4:4a. vaQane 9318' 4AA". /a3.3 ca/s Tank Size-Septic/Pump: %a oo /g oo 11:1, Gallons Alarm Manufacturer: 5,7'. Rho � or s�ror :1,w �reaw� Model Number: Capacities: A j9 inches orVM.S( Gallons Switch Type: + B a. nches or yyyrrGalIons Pump Manufacturer: i-`.eeller + C S inches or///,AoGallons Model Number: ti y $ + D j; inches or a,yo Gallons Minimum Discharge ate: 39 Total....._�inches or8bo,6 Gallons Vertical Difference. Between Pump Off and Distribution Pipe: &7-rFeet 9a-l-An 2.2'24 Minimum Required Supply Pressure:_ Z. Js F t' 3 ...+ y,ss Feet a0 Feet of Force Main x 3,30 Friction Factor/100 Feet: +dam) eet 2 Inch Diameter Force Main Total Dynamic Head: ... = 3.%Feet project: STANSBURY page 4 of 10 `, �� l I w I PUMP PERFORMANCE CURVE 25 6-4 20 10 GALLONS LITERS MODEL 98 10 20 30 40 1 50 M 160 FLOW PER MINUTE FI:K MINU I t EFFLUENT AND DEWATERING MODEL 98 Feet Metas Gal- Liters 5 1.5 72 273 10 3.0 61 231 15 4.6 45. 170 20 7A 25 95 Sh"Head: 23fl.(7.11m) OW1 60 70 e0 240 CONSULT FACTORY FOR SPECIAL APPLICATIONS wil. Electrical alternators, for duplex systems, are available and • Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. Mechanical alternators, for duplex systems, are available • Double piggyback variable level float switches are available for with or without alarm switches. variable level long cycle controls. • Refer to FM1922 and FMO806 for temperatures above 130"F. 985eries Control Selection Model Volts -Ph Mode Amps simplex Duplex M98 115 1 Auto 9A 1 4 N98 115 1 Non 9.41 2or3 4 D98 230 1 Auto 4.7 1 4 E98 230 1 Non 4.7 2 or 3 4 SELECTION GUIDE 1. Integral float operated mechanical switch, no extemal control required. 2. For automatic use single piggyback variable level float switch or double Piggyback variable level float switch. Refer to FMo477. 3. See FM1228 for correct model of simplex control panel. - 4. See FMO712 for correct model of duplex control panel or FM1663 for a residential ahemator system. For Information on additional Zoeller products refer to catalog on Piggyback Variable Level Switches, FM0477; Electrical ABemelar, FM0486; Mechanical Alternator, FM0495; Sump/ Sewage Basins, FM0467; Single Phase Simplex Pump Control, FM1596; Alarm Systems, FNW32. G CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electrical Code (NEC) and the Occupational Safety and Health Act (OSHA). "Easy assembly" 1W r p a escharge PI e not i,.IW d_I OPTIONAL PUMP STAND PIN 10-2213 • Reduces potential clogging by debris. • Replaces rocks or bricks under the pump. • Made of durable, noncormsiveABS. • Raises pump 2 off botom of basin. • Provides the ability to raise intake by adding sections of IV or 2' PVC piping. • Attaches securely to pump. • Accommodates sump, dewatering and effluent applications. NOTE: Make sure float is free from obstruction. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. pro iecit S 1 Rs�l `SQ>tAF y fctw 5 .r t. MAIL. TO: P.O. BOX 16347 CwasvNe. KY 4025"247 y.. �p /SNLoT0:le-K Cane RunRoad/ Z L Louisville- -1(8M 91861 PUMP !O_ I50477az731.1fsool9z6P ntP 4�n P/ 5.✓cF /999- www.zoellercom FAXMM 774=4 164" _YI II 4" CAST -A -SEAL IIII 'I mz4'CL,,- FILTER TrP / III GII OR Hill II BAFFLE 1111 - - - - - - - --.,�,�==C TOP VIEW 0 a to INLET — — _ — — to ` m 3" fi Lo WLP1200/800-MR TANK SPECIFICATIONS DIMENSIONS: O WALL• 3" BOTTOM: 5" COVER: 6" s MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 51�" O.D. LENGTH: 104" O.D. WIDTH: 96' O.D. BELOW INLET: 43" O.D. 4" CAST -A -SEAL LIQUID LEVr_L 36" WEIGHT: BOTTOM 14,800 LBS. COVER 8,170 LBS. I INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET, OAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: WISCONSINI, SEE DETAIL �10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 33.46 GAL/IN SEPTIC) 22.24 GAL/IN PUMP) LOADING DESIGN: 8' 0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC/SEPTIC, SEPTIC/PUMP OR SEPTIC/SIPHON 4" VENT COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESICN #9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE �I = PUMP PAD I DRAWINGS SUBMITTEDII FOR APPROVAL APPROVED BY: r Z a U F {il APPROVAL DATE: 1 ll-� TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS 11PRODUCTS NEEDED BY: "I �A 1 I $ y Filters PL-525 EFFLUENT FILTER (COMMERCIAL) Polylok, Inc is pleased to add its new commercial filter to its existing line of quality effluent filters. The PL-525 is rated for over 10,000 GPD (gallons per day) making it one of the largest commercial filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the new Polylok PL-525 has an automatic shut off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. No other fitter on the market can make that elarm r PL-525 Maintenance: The PL-525 Effluent Filter should Operate efficiently for several years under normal conditions before requiring cleaning. It is recom- mended that the filter be cleaned every time the tank is pumped or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. I. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the fitter is properly aligned and completely inserted. 'F 1 Alarm ae-� accessbility <--z� Accepts PVC extension handle 525 linear feet Of 1110' filtration slots <!i Rated for over 10,000 GPD Accepts 4'& 6'...- - scm. 40 Pipe Gas deflector _ Automatic shut-off ball when filter tl_S_ Patent NOR 6,015,488 is removed s,s�l,sao PL-525 Installation: Ideal for residential and com- mercial waste flows up to 10,000 Gallons Per Day (GPD). 7. Replace septic tank cover. fr,j,�h : STrinse"y xP. '7oFlo 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4' or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 fitter into its housing. 5. Replace the septic tank cover. Mound System Management Plan Pursuant to DSPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with DSPS 382-384 Wis. Adm. Code. and shall maintain in accordance with the component manuals 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 DSPS 3 83 33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manholes 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" 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 the septic tank shall be disposed of in accordance with NR 113, Wis. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slip off the filer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. 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 personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings maybe 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 compaction may hinder aeration of the surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations dictate that the mound be heavily mulched as protection from freezing. 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 at least once every 18 months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred, if clogging has occurred orifice cleaning is required to maintain equal distribution within the 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" considered impending failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank or its components become defective the defective components(s) shall be immediately repaired or replaced with a component of same or equal performance. If the mound fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replaced. Increasing basal area if toe leakage or by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. Seepage 9 of this plan for the name and telephone number of your local POWTS regulator and service provider. project: STANSBURY page 8of 10 Mound System Maintenance and Operation Specifications Service Provider's Name: Jack Bowman Phone: 715/418-1349 POWTS Regulator's Name: St. Croix County Zoning Dept. Phone: 715/386A680 System Flow and Load Parameters Design Flow — Peak 600gpd Maximum Influent Particles Size 1/8in Estimated Flow —Average 400gpd Maximum BOD5 220mg/L Septic tank Capacity 1200gais Maximum TSS 150mg/L Soil absorption component Size 619.5 sq.ft.bed Maximum FOG 30mg/L Type of Wastewater residential Maximum Fecal Coliform >10E4 cfu/100mL Service Frequency Septic and Pump Tank -----Inspect and/or service once every 3 years Effluent Filter ---------Should inspect and clean at least once every 1- 3 years Pump and Controls ------Test once every 3 years Alarm ------------Should test monthly Pressure System ------Laterals should be flushed and pressure tested every 1.5 years Mound ----------Inspect for pending and seepage once every 3 years Other ---------------------------- Initially filter should be checked Nearly to determine service schedule Avoid surge flo�N s of water: try to spread laundry throughout the week Avoid winter traffic such as sliding or sno�wnobiling which might lead to mound freeze-up Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table DSPS 38430-1, have a watertight cap and are secured as shown in the mound component manual. 2. Dispersal cell aggregate conforms to DSPS 384.30 (6)(1), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in DSPS 384, 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 6. Lateral Turn -up to finish at grade or above, enclosed in a 6-8" diameter lawn sprinkler valve box or similar product (lateral turn -up consists of a long sweep 90 or two 45degree bends same diameter as lateral) 7. Lateral Turn -up on end of distribution laterals after the last orifice. project: STANSBURY page 9 of 10 Ross Stansbury NE%a NW'/a,S12T30N/R15W Glenwood township St. Croix county LEGEND 1BM: 100.0' top of concrete pad 2BM: 93.0' top of spade of flagged steel post 3BM: 93.0' top of spade of flagged steel post X back hoe pits No SPS 383 setback Problems Scale 1'- 40' t6 sp' lk Except where indicated System elev. 93.75' on contour 93.0' Part of a 2A.C. parcel Site Plan 1 0 5 a N s i 30 S{ -- CAKaa -wt q l slewc a project: STANSBURY page 10 of 10 Mound Deflection Worksheet Four bedroom - 600DWF Formula 8 5.Oft. divided by 84ft. = 0.059523 0.059523 times 100 = 5.95% deflection Formula 9 5.95% times 0.00265 = 0.015773 plus 1 = 1.015773 1.015773 times 84ft. = 85.32ft Required 85.5ft cell length Proposing 88.5ft. cell length project: STANSBURY Linda Geraghty From: Ross Stansbury <rstansbury@tractorpartsasap-com> Sent: Thursday, August 19, 2021 11.53 AM To: C D D Subject: FW floor plan Attn RED This email originated from an external source. Verify the legitimacy before clicking links or opening attachments. From: Ross Stansbury Ross Stansbury Safety Coordinator, Downing WI P:855-530-3389 F: 715-643-4071 r.stansbury@tractorpartsasap.com 1 Subject floor plan From Ross Stansbury <r.stansbury@tractorpartsasap.com> To lanlperctesting@wwt.net <lanlperctesting@wwt.net> Date 2021-04-1912:31 Ross Stansbury Safety Coordinator, Downing WI P:855-530-3389 F:715-643-4071 rstansbury@tractorpartsasap.com ST. CROJ AI*,LJN7'9 ?W 5t CrOiY Pc 2loP SANITARY SYSTEM ERSHIP/ADDRESS FORM File #: Office Use Only created 212021 Community De4rop—ment Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the Property Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer �AUSL Mailing Address City/State/Zip Phone Numbe Email Address Parcel Identification Number 0 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location 1 1A , IVrV 1/4 , Sec. Ai , T _ QN R 1, J W, Town of raIPYI0fid TbWnShir) Subdivision Plat: Lot # J—. Certified Survey Map # /13G Z 6% Volume 31 Page # qqg Warranty Deed # a3 & 9t,% (before 2006)Volume Page # Number of bedrooms Spec house 0 yes 0 no Lot lines identifiable 0 yes 0 no ``� / 1 OFFICE USE ONLY —7 li New Property Address I to / 7 I `' �Lc y, r (Verification of new a ress required from Community Development Department for new construction.) VIVV 7 1-7 / 2oZl (Staff Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department— Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cdd@sccwi.cgov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.aov MINOR LAND DIVISION File#: ST. C RO ' UNTY Office Use Onl APPLICATION y Revised 2/1021 SITE INFORMATION Total Acreage: 2.0 Size of Original Parcel: 35 Number of Lots: 1 Number of Outlots: Property Location: SE 1/4, NW 1/4, Sec. 12 T. 30 N., R. 15 W., Town of Glenwood Parcel #: 016 - 1025 - 95 -001 Zoning District (Check one): ❑ AG-1 ❑ AG-2 ■ R-1 Overlay District (Check all that apply): ❑ SHORELAND — — 0Lo Ex SY. Alt. Parcel #: 12 30 15 196A-01 ❑ R-2 ❑ R-3 ❑ C-1 ❑ C-2 ❑ C-3 ❑ 1-1 ❑ 1-2 ❑ RIVERWAY ❑ FLOODPLAIN ❑ ADULT ENTERTAINMENT Make a sketch in the box showing how the new lot(s) fit within the original parcel. APPLICANT INFORMATION Property Owner: Dan Stansbury Contractor/Agent: Mailing Address: 3245 170th Avenue Mailing Address: Glenwood City, WI 54013 Daytime Phone: (715 ) 761-3041 Daytime Phone: (_) Cell: (_� Cell: (_) E-mail: E-mail: Surveyor: Ron Jasperson-Auth Consulting Daytime Phone:( 15 ) 232-8490 MailingAddress: 466 Technology Drive East, Suite A Menomonie, ras erson authconsultin com E-mail; 1 P @ 9 Applications are due on the 1" Monday of each month. 1 attest that the information contained in this application is true and correct to the best of my knowledge. Property Owner Signature: Date Contractor/Agent Signature: Date 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cddCo)sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 wwwsccwi.gov 1CS7-air - Oqs Wis. Dept. of Safety and Professional Semite 3 O "61L EVALU • U Page L of 3 . Division of Safety and Buildings n, CCDPMWW Win J1'0 30D, yyla. MITI. -We � Si/2 x TT inches m size. Plan must include, but not fa\ltttt Met reference point (BM), direction and Attach complete sitetr!lease percent slope, s M, orth arrow, and location and distance to nearest road print aN information. Personal information you provide may be used for secondary purposes (Privacy Law, s 15 01 (1) (in)),` County <�N . arc Parcel LD. )'a}e ' ( . 02$•��1 S- 601 Reel by Date S S Property Ovmer(� 11 1 oss J1t ry plu Property Location � 1 Gov Lot /yE 1/4ry�1/4 S N R IS(o Property Owner's Mailing Address q,C) �ree+ -) Lot Block # --ram Subd. Na or CSM# , City State Zip Code Phone Number ienwca� Q WI -I SVol3 I (`I IS )781-j j;tl ❑ City []Village Town earest Road New Construction Use. li Residential / Number of bedrooms '�- _ Code derived design flow rate �'C� GPD ❑ Replacement ❑ Public or commerctal - DesGpnbe' '� Parent material SS ' S o � e,, Aa.,.R off.,.. Flood Plain elevation if applicable ft. General comments ; o. �'Yn .�A J,.. �z.n �r1 ]"v »e we-� Cv AAo 93.0 and recommendations 105 t ,. l ow�a-n JLau ct3,'I S 1 9-1Sand I. .r Boring # Boring ,, 11 Pit Ground surface elev. q Z•`f ft. Depth to limiting factor A'7) in Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Desdipbon Ou. Sz. Cont. Golor Texture structure Gr Sz Sh. onsistence Boundary Roots GPDIft ' 111#1 ff#2 1. - �'0 3�a g'k m alk -t' 'V CS st, to .g a. 18- Z') 10 �i 4/y St c m u611 ilrv- 1-31 10 �I�y/i 75 Rb� *5/8 StI n�^ Ab rr s la 0.6 `i. 1- 40 1 O` R `I/b .a.�. 7 S P.4I0'S�8 Sk i i- S�ok -M�r —r -.- -i ill .6 ❑Boring a' # Boring (, jK Pit Ground surface elev. `l 33 ft. Depth to limiting factor in. Soil Application Rate Honzon Depth in. Dominant Color Munsell Redox Description Ou Sz. Cont Color Texture Structure Gr. Sz. Sh. onslstence Boundary Roots GPD/ft ' 111#1 ff#2 I. Cb IO o V Via S° rr\' q6K m r i g a. 10-111116 0 VI2'114 of lok -%Y\ II 11 Effluent #1 = BOD - > 30 < 220 mq/L and TSS >30 < 150 ri ' Effluent #2 = BOD , < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number _ t �. l{irrr.ta z IU Address Dale Evaluation Conducted Telephone Number 0 10g 4 t enoitiiot.s WI- s st 114 4-at 111 669 -wq SBD-8330 (RI Ill 1) V Property Owner�Oss J ^S �"-4 Parcel ID# Page 2 • of '-'I, 3 "" Boring # ❑ Boring �-1 Pit Ground surface elev. 1 ft. Depth to limiting factor_ in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. onsistence oundary Roots GPD/ft ff#1 Jf#2 1. 10 1nyR 3�a tIn, CO.k Ay.�r q1 a. 0 38 0 9 ° m ck6 r qw iti$ $- 4 S 4 "/b C2 d h S Y R% `'Ve S t-1sc, S + It I, I.4. lO tRs�b S s sr tn�� —Y 4 cis (a a ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Aod�icatipn R Horizon Depth in. Dominant Color Munsell Redox Description Co. Sz. Cont. Color Texture Structure Gr. Sz. Sh. onsistence Boundary Roots GPDtft ' ff#1 ff#2 ❑ BoringBonng # Ground surface elev. El Pit ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. onsistence Boundary Roots GPD/ t r ff#1 Iff#2 Effluent #1 = BOD s > 30 < 220 mg1L and TSS >30 < 150 mg/L • Effluent #2 = SOD s < 30 mg/L and TSS < 30 mg/L the Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. sn"13n IRII I I i Property Owner oss Parcel ID # Boring # ❑ Boring wPit Ground surface elev. q1 •r ft. Depth to limiting factor in. Page 2 • of -3- - c. I r,,...f— II,.,,fi.... M.,,� Horizon Depth in. Dominant Color Munsell Redox Description OF Sz, Cont. Color Texture Structure Gr. Sz. Sh. onsistence Boundary Roots GPDlft ' if#1 (f#2 n © y/ ` to v- w IMF S "A d h 5 R bto s/b g t� Sc - S + (t. I, b 4.4q,loVks/t, S �F, S� n� mtt + y b aBoring # ❑ Boring El pit Pit Ground surface elev. ft. Depth to limiting factor in. c ii,, n.,.f— I' r o�#. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. onsistence Boundary Roots GPDIft 01 ff#2 Boring Boring # ❑ Pit Ground surface elev_ ft. Depth to limiting factor in. Snil Annl�inn Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. onsistence Boundary Roots . GPDIft 2 tf#1 ' 02 Effluent #1 = BOD s> 30 < 220 mg1L and TSS >30 < 150 mglL . Effluent #2 = BOD 5 < 30 mglL and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-b3ID IRI III 11 O� tit Ross Stans NEV, N W %a,S l 2T30N/R15 W Glenwood township St. Croix county ✓Ioretta L a6& CSTM224588 LEGEND 1 BM: 100.0' top of concrete pad 2B'91: 93.0' top of spade of flagged steel post 313M: 93.0' top of spade of flagged steel post X — back hoe pits No SPS 383 set back Problems Scale 1 "- 40tko Except where indicated Soil Evaluation Site Plan page 3 of 3 ! a X / �i Y. J n y I' II hl nl nl 31 n of o I m o i� � II w I _ zh O �K0 Zuo oia W r (D ' =O Z Z co O K Z oz O G2 2 32 O a DZ� � co < a Ca G _ O W = U = U X NORTHWEST CORNER SECTION 12, TJON, R15W Im FOUND IRON AXLE I= �-9 �n unn ro --- _- - - - 2J4.57' 3 z ACCESSE ENT - 1353 96'3 5' TJSII 99') 33' ll 50' I i I i I i I xl it I I zIi ~II UI I 0 0 (N89'S0't1"�W) W NI- ��O JJ' 50' LEGEND = FOUND 3/4"IRON REEAR = SET 1 "O D X18" IRON PIPE WEIGHING 1 13 LES PER LINEAR FOOT = GOVERNMENT CORNER AS NOTED = RECORD DATA w �w Z ci LLOO O F O Eac parcel on this map is subject to State and County laws, rules Q w regulations (i a wetlands, minimum lot size, access to parcels, W G N Z UJ etc). Before purchasing or developing any parcel, contact the St Croix County Zoning Office and Town Board for advice LL ZOO FWW W OW "This map contains areas that are subject to Shoreland Overlay Q Of Z Zoning District and FloodolJyl� LZn Zonng Additional restrictions apply W U Q 3: Contact the Community Development Department for further UO D O J C7F information " LOT 1 CSM VOLUME 29 PAGE 6630 (N89'J6 JYW 9] iB') S89.35'08"E 250.00' r -1 v I SHED I l¢o I I L---- J 0 LOT 1 o ZI B-3 ,II � X TOTAL AREA o e1 87,250 SO FT =� 2.00 ACRES d h 0 B-2 v J N X O 0 Z B-1 X N89'35'07"W UNPLATTED LANDS Sheet 1 of 2 Sheets I I 92.47' PREPARED FOR: DAN STANSBURY 1681 COUNTY ROAD X GLENWOOD, CITY WI SURVEYOR: RONALD D. JASPERSON O AUTH CONSULTING & ASSOCIATES O 406 TECHNOLOGY DRIVE E. SUITE MENOMONIE, WI 54751 M 3 !n m l 0 O J O of � K J1 o_ z �I 01,40�' BEARINGS REFERENCED TO THE WEST LINE OF THE NW 114 OF SECTION 12 MEASURED AS N00'00'04"W. (Wis. CRS ST. CROIX COUNTY ZONE NAD 83 (91)). CORPORATE OFFICE BRANCH OFFICE 406 Technology Drive Seat 406 Technology Drove Seat Suite A Suite A Menomonie, In 54751 Menomone, T1 54751 Tel 715-232-8400 Tel 715-235-8841 Pax 745-232-8492 Pox 715-292-MD2 men®e.theonsWU g.eom mne enlauthc.unite.. Auth • Consulting/associates Nelsen land Surveying S4. C -. �, COUNTY &dr00 ru*x NO. 633899 STATE SANITARY PERMIT QTW�W�a� �nCi �% PRvxs OWNER jZaQ, Q- S�N Ouh/ PLUMBER. TOWN OF SECJZ 9T •3a N /OR LOT Is LIC.# ZZ BLOCK CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (t) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Not;: If you wish to renew the permit, or transfer ownership of SUBDIVISION the permit, please contact county authority. AUTHORIZED ISSUING OFFICER - DATES Z7 z l THIS PERMIT EXPIRES Z ZoZ3 UNLESS RENEWED B�FO THAT DATE POST fN PLAINVIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI 1/20)