HomeMy WebLinkAbout040-1329-36-000i
wteconsinDepartment ofCommerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes (Privacy Law, 9.15 0/ (1)(m)I
Permit Holder's Nome. City Village Township
DCCI Investments TOWN OF
.. s
TANK INFORMATION
LI
VC
ELEVATION DATA
TYPE
r FACTUR
W
CAPACITY
Septic
W E5�2
ton
Dosing
Ae n
HOldl
TA SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
y
Dosing
33
Aer
Hol
PUMP/SIPHON INFORMATION
Manufacturer Demand
S GPM
Model Number E)
TDH Lift O Friction Loss System Head TDH Ft
nr (.S3 ,sp •c
Forcemain Lengl / Dia.2. 11 Dist to well - - - ~ 'J
M-401I-
' ' '
iim0
--®
:,
--®
i .
e
• I
[�i7l�l'ill+l��
IS Mat . TMER.RPM-
ME
arl
V M00%imr I lum aTo I tM
I
Cer6*
%t.0 -1
Width / Length f
EN910N3
INrAorehr
PIT DIMENSIONS No. Of Pns
Inside Dia.
Liquid Dept
S
SETBACK
SYSTEM TO
P/L
JBLDG
WELL
LAKE/STREAM
LEACHING
Manufacturer
INFORMATION
CHAMBER OR
Type Of System
f
g`
UNIT
Modal N r
Header/Mandold I II
7
Distribution I I ((
Pipe(&'y
x Hole Size
it
Hole Spacing
Vent to A❑ Intake
Length •1 Dia r
Length'•L'L Die 1 Spacing �z�
Q.'Z.� /g
2,0
Q/111 AArI�w
Dept Over
Bed/Trench Center
Dept Over
Bed/Trench Edges
xx Dept of
Topsoil
xx Seeded/Sodded
—,
xx Mulched
Yes No
vas J No
COMMF.HTS: Llnclude code Ispepenciestax-, persons present, etc.) Ins�pectio�n #1:� z Z e ZZ Inspection #2: ��Z Z�/1ZpZ Z
occaation�: N-oYAd�_dlr�2ess�A ait le 1 L �1Ce�+a►/ f � � f . �
1.) Alt BM Description - �1
2.) Bldg sewer length = 2 1
-amount of cover • 6 n,IF 11� LL
3)2 •d P w e1.tl tn►�+,h�d �.?.Q (,� 1 10��.
Plan revision Required Yes No
Use other side for additional information. f1 /�.
SBD-9710 (R.3/97) CO i o�Pzo z3� , 1� _ .L.ryrPoloia Signature
7t4 _ _
-
Carl No
Safety and Buildings Division I ST
201 W. Washington Ave., P.O. Box 7162 San
r
o t Application
In accordance with PS }8 j{ZA Code submiaaoo of this form m We appropriate Bin emu mnl wit
is required prior to o ts}tid06�+ permit. Note: Application forms for vote -owned POWTS are submitted to
the Department of Safety and Professional Servm' Pasonal information you provide may be used for secondary
is acoordaoc a with We Pri Law .15. 1 m Sins.
I. Bptloo IsfoFad"
— Please Ptist AB Information
Properly Owners Name
DCCI INVESTMENTS
Property Owner's Mailing Address
1505 HWY 65 PO BOX 445
City, State Zip Code Phone Number
NEW RICHMOND WI 54017
Q. Typed BoBding (check all that apply) Lot N
kI 1 or 2 Family Dwelling - Number ofBe*0006 di 4 S 36
Block 8
❑ Public/Commercisl - Describe Use
CSM Number
❑ State Owned - Describe Use
etc only one box on Bne A. Complete Bat B If app►fublt)
❑ Replacement System I ❑ Trestment/HoWing Talc Replacement Only
B. ❑ Permit Renewal ❑ Permit Revision I ❑ Change of Plumber ❑ Permit Transfer to New
Before Expnation finer
❑ Non -Pressurized In -Ground ❑ pressurized In{rrouod ❑ Atz ade ❑ Mound > 24 m. of stumble soil
❑ Holding rank ❑ Other Dispersal Component (#pbl) I � ❑ Pretreatment
I �T�
OIX
Permit Number (to be filled in by G
0 4Z2q�
onction Number
Adtess (if different Wan mulling a ^
n n ty 1. ftX'tJl
Govt. Lot
SE A, SE ,i, Section 17
(circle one
)
T 29 N; R 19 E or
Subdivision Nam
—I
❑ City of
❑ Village Of
® Town of TROY
❑ Other Modification so Existing Syahm (explain)
Design Flow (gpa)
600 .6 630 0&0 630 l9�9
Vl. Tank info Capacity in oral tl of 1�.��(j Mom�
' -t / Gallons Gallons Units PO^�0�t
ting lT�
New Taub ExisTaub ((JJ
sepucorHok>mgTask 1Y00 1200 WIESER
Dodos Chamber 800 800 Wieser
Statement- 1, the rr
VII. R adesalped, ssmme responsibility for InstaWtlon of the POWTS shows on the
Plumber's Name (Print) Plumber's Signature MP/h1PRS Nu
09aaa- ��_ 225410
PAUL R KOEHLER
Plumber's Address (Street. City, State, Zip Code)
321 WISCONSIN DRIVE NEW RICHMOND WI .
vin. Coos /De rtment Use On
Permit Fee Date
Approved ❑ Disapproved
_
$
❑ Denial
DL. Conditions of
SYSTEM OWNER.
w
1. Septic tank, effluent filter and
dispersal cell must be serviced I maintained
by
as per management plan provided plumber.
to tDf Ma
2. All setback requirements must be maintained
e. true ann it _ r• a 09eolah slam for me systaw and saam[t r [M G
< 24 in. of suitable soil
ystem Elevation ✓
100.8
245 2660
Zv ZI -U"1"
a „5 L h D P S p y i a�R. VA
fpvi� 51
ray eat.. paper sere r a s h daa
0
SBD-6398 (R. 11/11)
December 22, 2021
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2023-12-22
Plan Review: PWTS- I 22103173-C
PAUL R KOEHLER
321 Wisconsin Dr
New Richmond WI 54017
SITE:
dcci investemnts
lot 36 meadow ridge of troy
St. Croix
TROY
FOR:
Object Type
DescrfoNon: 6179 .Pn
Maitenance Required
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL
GREEN BAY WI 543045211
tntp l/ds wi. Contact Through Relay
Ps. gm/PmWamaindustry-swvkcm
www.wieoonsin.gov
Tony Evem - Governor
Dawn Crum - Secretary
APPROVED
o r. aIMAM
aunr aao raoRsaa>wµ
DOM" w anwn" aaava:aa
an oomsa.oama:a
EZFlow Mound Component Manual — December 2017
Version
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,
stets.
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 with the "Pressure
(N.01 /01). rn
Distribution Component Manual for Private Onsite Wastewater Treatmt Systems Version 2.0" SBDs re P
• This system is to be constructed and located in accordance with the approved plans and with the EZflow Mound
Component Manual, (R 7/12)
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
construction/instaMtion/opetation.
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 scats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
c c ZLc
P� 15 05 +1wYt3
o r^�
G /,1 Y'r1aM�uw N P1., o}'Vfdw
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6
' f'� ` ` QG..ca, rYv►r1L j. f � bd�aPp�`.2
/ (3°% , ` 63�1 J (3e•�c.1_�nn,vK Z 11001% Ta fii�
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<< 'o p
December 22, 2021
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2023-12-22
Plan Review: PWTS-I22103173-C
PAUL R KOEHLER
321 Wisconsin Dr
New Richmond W154017
SITE:
dcci investemnts
lot 36 meadow ridge of troy
St. Croix
TROY
FOR:
Object Type
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL
GREEN BAY NN 54304-5211
Contact Through Relay
http:lldsps.wi.govlprogramsfinduslry-services
www.vAsconsin.gov
Tony Evers - Governor
Daum Crkn - Secretary
APPROVED
oat. w.AMµon OM""wu_
onto» OF rroinM SERWW"
Al o"..10fiL%"
w coia...oldmm"
EZFIow Mound Component Manual — December 2017
Version
Desc&1ion: 600 GPD
Maitenance Required
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 planssin Statutes,with
an is responsible for cont mpliance
referenced above. The owner, as defined in chapter 101.01(t o),
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 he met during construction or installation and prior to occupancy or use:
e This system is to be constructed and located in accordance with the approved plans and with the "Pressure
Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P
(N.01/0 1).
• This system is to be constructed and located in accordance with the approved plans and with the EZflow Mound
Component Manual, (R 7/12)
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
construction/installation/operation.
right to require
In granting this approval the Division offorcode com fiance. As peustry Services reserves r state stars 101 12(2), nothing inadditions
this review
should
conditions arise making them necessary P
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 and the POWTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely,
Matthew Allen Janzen
Wastewater Specialist, Division of Industry Services
(715)340-0407
matthew.'anzen(@,wi.gov
.'
Safety and Buildings Division
1/4 201 W. Washington Ave.. P.O. Box 7162
County
ST CROIX
Saniietylatoit Number (to be filled in by CO -)
Madison, WI 53707-7162
�--
Sanitary Permit Application
State Transaction Number
in accordance with SPS 383.21(2), Wis. Aden. Code, mAm issia+ of this farm to the appropriate goveromen�al unit
forms lbr stateowsed POWTS are submitted to
Project Addresa (if diftermt than mailittg address)
is required prior to obtaining a unitary permit Notes Application
the Department of Safety and Profteaiooal Servise. Persooel information you provide may be used for secondary
in accordance with the Privwv Loty a 15. 1)[113), Stara.
Parcel M
I. Htatlon faformaum - Pilaw P'rlat All Information
Property Owner's Name
DCCI INVESTMENTS
property Owner s Mailing Address
Property [acabon
1505 HWY 65 PO BOX 445
Govt. td
SE 6 SE t Section%)17
Sou
yip Code
Phone Number
NEW RICHMOND WI
54017
T 29 N. R 19 (c ircle Eor1w
IL Type of Building (check all that apply)
Lai M
Snbdividon Name
`a 1 or 2 Family Dwelling - Number of Bedrooms 4
36
Block #
❑ City of
❑ PubliclCommercial - Describe Use
❑ Village of
CSM Number
❑ State Owned - Describe Use
® Town of TROY
III. Type
of t: (Cheek only one box on Hne A. Coupktte Hut B if apPHenbk)
A•
New System
❑ Replacemenu System
❑ TreahnmVNoldiog Talc Replacement Only
❑ Otter Modification to Eaisang System (eaplam)
❑ Permit Renews[
❑ Permit Revision
❑ Clumpof Plumber ❑ PesmR T mfer to New
t4R Previous Permit Number and Date Issued
B.
Before Expiration
O wner
IV. of POWf3 3 one NDeviees Check all that
❑ Not[-Ptesmved In-Orotmd ❑ prasaurbed I"w"I'd ❑ A443rade ❑ Mound> 24 is of suuabte sotll
® Mound < 24 m. of s u lble soil
❑ Holding Tank ❑ Other DispaW Component (explain) ❑ Prornermenl Device (explain)
V. reatment Are,Information: Ana (80 Area Proposed (afJ System EW'Atroa
Design Flow (gpd) Design soil Application Rate(ppdat) Dispersal63U
600 .6 630
100.8
VI. Tank Into
t m GallonsWow
TOW
0 Of
Units
Marnxfactucer
gg2
u
I
New
y 76
06
Septic m"eWingTank
1200
1200
WIESER
X
Doting Chamber
800
1800
Wieser
X
VIL ResponsibBi Statement 4 the aad;alpsd, assuaw respooslbitltY for installation of the POVYTS shows an (tie attacdad plans.
Pbooe Ntrmber
Plumbees Name (Print) Plumber's Signature: MP
MPRS Numb; Business
PAUL R KOEHLER 'r"°5NOW 225410
PtIsAddress (Street, City. State, yip Code)
321 WISCONSIN DRIVE NEW RICHMOND W.
VIM Cats net Use Only
Permit Fee Date IastxM Imtmg Agent Si�oe
❑ Approved ❑ DIsaPPmved S
❑ Owner Given Reason for Decrial
IX. Cosditions of ApprovaVResum for Disapproval
Ansco W CYoyw,c p..m m. , .�.....
SBD-6398 (R. 11/I 1)
EZFLOW MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name:
Owner's Name:
cirri investments
Owner's Address: 1505
box 445
new richmond wi
)tondftlonally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
ff4a . VOYAWV�
SEE CORRESPONDENCE
Legal Description:
lot 36 se 114 se 114 sec 17 t 29 r 19 w
Township:
town of troy
County:
st Croix
Subdivision Name:
meadow ridge
of troy
Lot Number:
36
Block Number:
Parcel I.D. Number:
Plan Transaction No.:
Page 1
Index and title
Page 2
Data entry
Page 3
EZFIow mound drawings
Page 4
Lateral and dose tank
Page 5
Distribution media
Page 6
System maintenance specifications
Page 7
Management and contingency plan
Page 8
Pump curve and specifications
Designer: Raul r koehler License Number: 225410
Date: 12/10121 Phone Number: 715-246-2660
Signature:.
Designed Pursuant to the
Eulow, Mound Component Manual (N. 06/03), and
SSW MP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)
EZFlow Mound Version 1.2 (R. 02104) Page 1 of 8
EZFIow Mound and Pressure Distribution Component Design
Design Worksheet
(r or c)
Site Information
Residential or Commercial Design
Estimated Wastewater Flow (gpd)
Peaking Factor (e.g. 1.5 = 150%)
Design Flow (gpd)
Site Slope N
Installation Contour Line Elevation (ft)
Depth to Limiting Factor (in)
In -situ Soil Application Rate (gpde)
r
400.00
1.50
600.00
13.00
99.54
21.001
0.60
Distribution Cell Information
9.00 Cell Width (ft) 3 4. 6. 7. 9, or 10 Only
1.00 Dispersal Cell Design Loading Rate (gpd/ft')
1 Influent Wastewater Quality (1 or 2)
Pressure Disribution Information
(c or e)
a
Center or End Manifold
Lateral Spacing (ft)
Number of Laterals
Orifice Diameter (in) (e.g. 0.25)
Estimated Orifice Spacing (ft) _
Forcemain Diameter (in)
Forcemain Length (ft)
Inside Pump Tank Elevation (ft)
System Head (ft) x 1.3
Vertical Lift (ft)
Friction Loss (ft)
Total Dynamic Head (ft)
3.00
3
0.125
2.00
2.00
50.00
94.00
6.50
6.37
1.91
14.78
Lateral
Diameter Selection
in. dia.
options
I choice
0.75
1.00
1.25
1.50
x
x
2.00
x
3.00
x
Treatment Tank Information
1250.001 Septic Tank Capacity (gal)
Wieser Manufacturer
Note: Sand fll (D) caicuwuorts assume a
Table 83 44 3 �n situ soli treatment for
fecal cdHorm of <: 36lnc es.
100.00 Contour Length Available (ft)
70.00 = Dispersal Cell Length (ft)
Are the laterals the highest oint
In the distribution Y
network? Enter Y or N
If N above, enter the elevation ft
of the highest point.
6.00 W/orifice
Does the forcemain drain back? Y
Enter Y or N
ForcemainDralnback (gal)
5x Void Volume (gal)
A
Minimum Dose Volume (gal)
System Demand (gpm)
Manifold Diameter
Selection
in. dia.
o tions
choice
1.25
1.50
x
x
2.00
x
3.00
Gallonallnch Calculator (optional)
800.001 Total Tank Capacity (gal)
35.97 Total Working Liquid Depth (in)
22.24 gaUn (enter result in cell B49)
Dose Tank Information Effluent Filter Information
800.00 Dose Tank Capacity (gal) I polylock lFilter Manufacturer
22.24 Dose Tank Volume (gatAn) 525 Filter Model Number
Wieser Manufacturer
Project: dccl Investments Page 2 of 8
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k
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1C1 O Cy N C It
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1 Y L
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v
End Connection Lateral Layout Diagram
Place Appropriate Lateral Diagram From Right Below
•. Turn-up+dbell vslw or dwnmA pup
t------ P
Z —Al d oriNce boated d Z IF x-41 AN Iderals W&WE1116 with orates eW* spaced
Face mein connection Ma tee or am to ..wo W at ry point. I- '� � T^Taae K404) VC Sch 40 $
a
Orifices poled up except every 51 one a dawn for drai+eye.
Number of Laterals
Lateral Diameter
Lateral Length (P)
Lateral End (Z)
Lateral Spacing (S)
Lateral Flow Rate
System Flow Rate
Orifice Diameter
In
Orifice Spacing N
ft
orifices per Lateral
ft
orifice Density
ft
Manifold Length
gpm
Manifold Diameter
gpm
Forcemain Velocity
Dose Tank Information
Electrical as per NEC 300 and —♦
Comm 16.28 WAC
Tank component is property vented
Wieser Manufacturer
Capacity 800.00 Gallons
Volume 1 22.24 gaUnch
Dimension
Inches
Gallons
A
18.38
408.67
B
2.00
44.48
C
4.60
102.21
D
11.00
244.64
Total
35.97
800.00
Alarm Manufacturer s' rombus
Alarm Model Number s trot
Pump Manufacturer Ids
Pump Model Number e 5
Pump Must Deliver 43.25 gpm at 15.53 ft TDH
Locking cover with warning
label and locking device, and
sealed watertight
4 in. min.
E-- Altemate outlet
location
Forcemain diameter
--- 1 2 in.
Weep hole or anti -
siphon device
elevation n
94.92
Dose tank elevation k=
94.00
Project: dcci investments Page 4 of 8
EZFIow Distribution Cell Media Layout
9.00 to Lateral (ft)
ArrangementsDistribution Cell Cross-section
Drag appropriate drawing to space below.
0"(84"0"
1�. .i�1 .�15� ►SS1�.i � 1 .151�111 ��� • ►1►1111 .11111►1..►� �1111111' 11111►1�11' 1�111 ►1111` 1�111
®
6" EZFIow Bundle - EZ0601A. 5 or 10 Foot Lengths
®
12" EZFIow Bundle - EZ1203H, 5 or 10 Foot Lengths
12" EZFIow Bundle - EZ1203HP, 5 or 10 Ft Lengths
0
4" Distribution Pipe With Pressure Lateral Inside
Tumup Enclosure — — — — Lateral
Distribution Cell Plan View Layout - Typical
9.00 Cell Width - A (ft) 70.00 Cell Length - B (ft)
Center Connection Lateral Layout Diagram
Drag appropriate drawing from left to space below.
Eft
Mound System Maintenance and Operation Specifications
Service Provider's Name countryside plumbing Phone 715-248-2660
POWTS Regulator's Name Phone
System Flow and 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 1250 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 630 ft2 Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL
Septic and Pump Tank
Effluent Filter
Pump and Controls
Alarm
Pressure System
Mound
Other
Service Freouencv
Inspect and/or service once every 3 years
Should inspect and clean at least once every 3 years
Test once every 3 years
Should test month)
Laterals should be flushed and pressure tested every 1.5 years
Inspect for ponding and seepage once every 3 years
Miscellaneous Construction and Materials 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 EZFlow mound component manual.
2. Dispersal cell media conforms to FZFIow products approved for use with the EZFlow Mound
Component Manual approved 6W3. EZFlow media Is covered with an approved geotextlle fabric.
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 VM
Diameter LawnSprinkler Valve BoxLateral Ends at Last Ori ice Wh
Variable Length Cleanout Begins
......... •.....
Threaded Cleanout
Plug or Ball Valve
1111111111�11111�1�11-►1�1 • • :. • r .
45 Degree
Diam er as Lateral
�11111y1111111y11�1�111111111111�'
2.16 Feet
Lateral Cleanout
,� 4�} �1111�111�11�111111
Project: doci investments Page 6 of 8
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
This system shah be operated In accordance with Comm 82-84 Wis. Adm. Code, and shall maintained In accordance with Its' component
manuals [EZFlow Mound Component manual 6/3/03 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, Ms. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or
subject to failure must be replaced. Exposed access openings greater than B-inches In diameter shall be secured by an effective looking
device to prevent accidental or unauthorized entry Into a tank or component
Seotic To
The septic tank shall be maintained by an Individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic
tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of" septic tank and outlet filter shall be
assessed at least once every 3 years by Inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions
are made to retain solids In the tank that may slough off the filter when removed from Its enclosure. If the filter is equipped with an alarm, the
filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous
alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of
when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance Is generally not requYed. However, if such products
are 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 filter Is installed within the tank it shall be Inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from ircet penetration. Traffic (other than for
vegetative maintenance) on the mound is not recommended since soh 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 mgfL BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30
mg/L BODY, 30 mg/L TSS, 10 mg/L FOG, and 104 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 aocumulated solids at least once every 18 months. When a pressure testis performed it should be compared to the initial test
when the system was installed to determine if orifice dogging has occurred and If orifice cleaning Is required to maintain equal distribution
within the dispersal cell.
Observation pipes within the dispersal cell shell 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.
Continency Plan
It 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.
It the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately
repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or
replaced In Its' present location by increasing basal area It 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: dcci investments Page 7 of 8
n c C- z In Vtst
I &OS HWYLS
Mc^Juw N A ti of l(
Loin Icontbor
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J (3ehc1-`nnrrK 2 �I 1Dd9S Ta�iPrt
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rs.
R 19to
Iob Sownp Ct�
AfLf.t. (o
164'
Illy
4' CAST -A -SEAL III I
I
024 I
m
InI
FILTER ill I
-------- IIrI'III
g
iD
II
� r�l
i7
SIDE VIEW
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
I :0•
'W'Pul IN
24 1?9 ML
DIMENSIONS:
WALL: 3'
BOTTOM: 3"
COVED 8'
MANHOLE 24' I.D. PRECAST CONCRETE RISER
HEIGHT: 53" O.D.
LENGTH: 164" O.D.
WIDTH: 96' 0.0.
4" CAST -A -SEAL BELOW INLET: 41' O.D.
LIQUID LEVEL: 36'
WEIGHT: BOTTOM 12,000 LBS.
COVER 8,170 LBS.
INLET AND OUTLET:
4' CAST -A -SEAL BOOT OR EQUAL
GASKET, CAST -A -SEAL BOOT OR EQUAL
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN, SEE DETAIL 010
(OTHER STATES SEE CHART)
LIQUID CAPACITY: 33.48 GALAN (SEPTIC)
22.24 GAL/IN (PUMP)
LOADING DESIGN: 8' D' UNSATURATED SOIL
TANK CAN BE USED AS:
SEPTIC/SEPTIC. SEPTIC/PUMP
OR SEPTIC/SIPHON
4' VENT
COVER: MIX DESIGN j8 (NO FIBER)
TANK: MIX DESIGN /9 (SMALL FIBER)
CUSTOMIZED TANKS; -
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
a
Or
M
PUMP PAD DRAWINGS SUBMITTED
FOR APPROVAL
APPROVED BY:
APPROVAL DATE:
PRODUCTS NEEDED BY:
Lu
W
� IE
00
Y � 00
r1 s �?
0
.+i
mot. x- iat.
hwVANm M htna Drasyr Zabel•
e Wdnraw lraaan A DWWW d PAhJl t he
PL-525 Effluent Filter
PL-525 Filter
The PLr525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has
525 linear feet of 1/16" filtration slots. Like the Polylok PLrl22, the Polylok PLr525 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.
Features:
• Rated for 10,000 GPD (gallons per day).
• 525 linear feet of 1/16" filtration
• Accepts 4" and 6" SCHD 40 pipe.
• Built u1 gas deflector.
• Automatic shut-off ball when filter is removed.
• Alarm accessibility.
• Accepts PVC extension handle.
PL-525 Installation:
Ideal for residential and commercial waste flows up to
10,000 gallons per day (GPD).
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 FL-525 filter into its housing.
5. Replace and secure the septic tank cover.
FL-525 Maintenance:
The FL-525 Effluent Filters will operate efficiently for
several years under normal conditions before requiring
cleaning. It is recommended 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.
1. Locate the outlet of the septic tank.
4. Remove tank cover and pump tank if necessary.
3. Do not use plumbing when filter is removed.
4. Pull PLd25 cartridge 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 Mtn is properly aligned and comply inserted.
7. Replace and secure septic tank cover.
IA6" Filtration Slots
10,000 GPD
Accepts 4" k 6"
SCHD 40 pipe
Alarm Switch
(Optional)
Accepts 1" PVC
Extension Handle
Rated for
10,000 GPD
525 Linear Ft.
of 1/16-
Filbabon Slots
®Cared to
NSFlAN5I Standard 46
i*
Outdoor Smart Filter® Alarm
Polylok, Zabel k best filters accept
the SmartPiltea switch and alarm.
Gas Deflector
Automatic
Shut-off Bell
r f—
Extend do Lokw
Easily installs
into existing tanks.
Polylok, Inc. 3 Fairfield Blvd. Wallingford, Cr 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.potylok.com
POWTS OWNER'S MANUAL & MANAGEMENT PLAN
FILE INFORMATION
Owner DCCI Investments LLC
Permit I
DESWN PARAMETIMS
Number of Bedrooms
4 ❑ NA
Number of Public Facility Units
XA
Esti naoed flow faveragel
aUd
Design flow Ipeak), (Estimated x 1.5)
al/d
Soli Application Rate
g&VdaytW
Standard Influer t/Effluent Quality
Monthly average•
Fats, 00 & Grease (FOG)
530 mg/L
Biochemical Oxygen Demand (BODs)
S220 mg/L XXNA
Total Suspended Solids ITSS)
5150 mg/L
Pretreated Effluent Quality
Monthly average
Biochemical Oxygen Demand (SOD.)
530 mg/L
Total Suspended Solids (TSS)
930 mg/L Xr"A
Fecal Coliforn Igsometric mean)
S1W cW100ml
Maximum Effluent Particle Size
Ye in dia. j( !q
Other.
❑ NA
'Values typical for domestic wastewater and septic tank effluent.
MAINTWANCE SCHEDULE
SYSTEM SPECIFICATIONS
E:
r
Pap i of Z
Septic Tank Capacity
1200
al ❑ NA
Septic Tank Manufacturer Wieser
❑ NA
Effluent FRter Manufacturer PolyLock
❑ NA
Effluent Fitter Model
525
❑ NA
Ptrnp Tank Capacity
8W
al ❑ NA
Pump Tank Manufacturer Wpqpr
❑ NA
Pump Manufacturer
Goulds
❑ NA
Pump Model
EP04
❑ NA
Pretreatment Unit
❑ Sand/Gravel Fitter
❑ Mechanical Aeration
❑ Disinfection
❑ Peat fitter
❑ Wetland
❑ Other:
Dispersal Call(s)
❑ In -Ground Igrwity)
❑ At -Grade
❑ Ddp-Une
❑ NA
❑ In -Ground (pressurized)
)"ound
❑ Other:
Other.
❑ NA
fir.
❑ NA
Service Eva.
Service Frequency
Inspect condition of tank(s)
At least once every:
3 month sl (IYlaxleatm 3 yeas)
❑ NA
Pump out contents of tankful
When combined sludge and scum equals one-third (Ye► of tank volume
❑ NA
Inspect dispersal call(s)
At least once every:
s) (Maxkrtum 3 yeas)
year(s)
❑ NA
Claweffluent filter
At least once every:
1�1 earfs) a
❑ NA
Inspect pump, pump controls & alms
At least once every:
t, month(a)
year(sl
❑ NA
Flush Wera s and pressure test
At b
least once every:
❑ m r(s))
❑ yearfe)
❑ NA
Other:
At least once every:
O rmoomms)
❑ NA
Other.
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector, POWTS Maintainer, Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(sl to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and sotun and to check for any back up or ponding of effluent on the ground surface.
The dispersal call(s) shell be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent an the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory suthority.
When the combined accumulation of sludge and scum In any tank equals one-third IY3) or more of the tank volume, the antis
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, Including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at Intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Page Z of -Z.-
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal cable). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when so$ conditions are frozen at the infiltrative surface.
During power outages pump tanks may fib above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(a) In one large dose, ovarloeding the cells) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal Weis within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
wRW 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS; antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; santtary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS falls and/or is permanently taken out of service the following steps shall be taken to insure that the system is
property and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator.
a After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another Inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or,must be taken, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the' need for a new sob and site evaluation to estabbah a suitable replacement area. Replacement systems must
comply with the rules in affect at that time.
0 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
W/'� aluati t`ank
b ai � DFltB rriza ¢b R.� IJ CoAJSJ'Rdc.7L pN
❑ Mound and at -grade soil absorption systems may be reconstructed In place following removal of the biomat at the
infiltrative surface. Reconevuctions of such systems must comply with the rules In effect at that time.
< < WAfiMNG> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POINTS MAINTAINER
Name Counftyside P&H Name Paul Koehler
Phone 715-246-2660 Phone 715-246-2660
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Darrels Septic
Phone 715 425-1025
Nam
S . C I Zo�lr�cl
Phone
-Its- 3gC0- (o a
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(4)ar(f) and 83.6411), (2) & (31, Wisconsin Admir"ustive Code.
Depatment of
>I= Safely and
`` (•_ .L' Omfoecinnnl Cnnrirm
SOIL EVALUATION REPORT
in accordance v*h Comm 85. Wis. Adm. Code
#2131
Page 1 of 3
Sothmw Soil Testing, Inc.
µ
Attach p complete she plan on paper not less than 8% x 11 inches in size. Plan must
Include, but not Iinlbd to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print aN Mformatyon.
Personal Information you provide may be used for secondary Purposes (Pfi'acy Law, s. 15.04 (1) (m)).
County
St. Croix
Paroel IJ].
--
Reviswvd By Date
Property Owner
DCCI Investments, LLC
PropertyLocatiori
Govt. Lot SE1/4, SEIM, S17, T29N, R19W
propmV Owners hAWng Adel M-
1505 Hwy 66
City State Zip Code Phone Number
New Richmond WI 1 54017 1 612-599-4244
Lot* I BlodrR subd. Now or CSMN
36 Meadow Ridge Of Troy
L City F j Visage ® Town Neerast Road
Troy Meadow Rkl2e Trail
Gr j New Construction Use: p j Residential / Number of bedrooms 4 Code cached design flow rate SOD GPD
U Replacement F1 Public or commercial - Describe: —
Parent material Glacial till (Santlago Series) Flood plain elevation, if applicable NA ft.
General comments Area Is suitable for a mound splam. System sievow is 100.80' based off the contour line established at. 99.54'. Slope of the aea
and recommendations: is 13%. Depth tolimilirgfac(oris210,
Boring #1 P M0 Ground surface ebv. 95.09 R Depth to smiting factor 29 In. Soil Application Rate
tiortzon
Depth
In.
Dominant Color
Muroell
Redox Description
Qu. Sz Cont. Color
Texture
Structure
Gr. Sr- Sh.
Consisteneg
Boundary
Roots
GPDIT
*091
•East
1
0-8
10yr3/3
none
sit
2mgr
mvfr
as
2vf
0.6
0.8
2
8-15
10yn4/4
none
ell
2fsbk
mill,
gw
Jvf
0.6
0.8
3
15-21
IOyr4/6
none
sid
2msbk
mfr
qw
1vf
OA
0.6
4
21-29
7.5yr5/6
none
9d
3msbk
mfr
at
0.4
0.6
5
29+
10yr6/6
FRACTURED
LIME
STONE
—
—
OA
0.0
Boring 0 ❑ Boring
lei Pit Ground surface elev. 96.14 it, Depth to limiting factor 21 In. Son AgaplEF Rats
Horizon Depth
In.
DOminantcolor
Munsell
RedoxDesalptim
Qu. Sr- COM. Color
Texture
Structure
or. Sz 3h.
Boundary
Rools
��
1
0-8
10yr3/3
none
s11
2mgr
mvfr•
as
2f,2vf
0.6
0.8
2
8-12
10yr4/4
none
sil
2fsbk
mfr
gw
2vf
0.6
0.8
0.6
3
12-21
10yr4/6
none
9d
3msbk
mfr
as
if
0.4
4
21+
10yr6/6
FRACTURED
LIME
STONE
—
—
—
0.0
0.0
E4hwni v - BOD5> 30 4 220 mg& end TSS >30 < 150 mglL emawm we
CST Name (Please Print) 9gnatun� CST Number
Number
227
Thomas J. SChmld w --
Address Sdwr t Soh Testing, Inc. Dale EhrWuatloln ConnduLisd TeMphoorna
1595 72nd St. New Richman i, WI 54017 Srt6f2021 715 7E41878
101aA71oo)
Property owear DOa Investments, LL.0 Parcel to s �+fl t: Pap. -3-of 3
1 - I ".-w' r^j PI Ground $oats elev. 1WR4 n. LVIM to an+wo now 51 in.
Application Race
Horizon
Depth
In.
Dorrrfmnt Color
Mlurrel
Raft Description
Ou. Sz. Cont. Color
Texkn
Structure
Gr. fad. Sh.I
Boundary
Roof
OPO4f1'
ern
Ensa
1
0-10
10yr3/3
rKm
so
2fsbk
mvfr
as
2vf
0.6
0.8
2
10-15
7."14
none
A
2Fsbk
mfr
gw
1vF
0.6
0.8
3
15-26
7.5yr4/6
none
ski
2msbk
n*
gw
lvF
0.4
0.6
4
26-37
7.5yW4
none
grsl
2msbk
mfr
gw
----
0.6
1.0
5
37-51
7.5yrV4
none
grsl
lmsbk
mfr
as
—
0.4
0.7
6
51+
lorr"
FRACTURED
U 4E
STONE
-
-
-
0.0
0.0
o...fww a u ta+a
Boring 0 ❑ ea"r'ti
U Pit Ground surface My. ft. Depth to Vsn&V fartor In. IWApplicallon
Horizon Depth I Dominant Color I Radox Description Texture Strum" ConNgenp Boundary Roof I GPDW
In. Murom I Oo. Sz. Cant Collor I I Gr.Sr-,cQL I I -EM I OEe@
Mani e1 a 90053,30 <_ 220 mg& and TSS 40 g150 nnpll
• Effluent 02 . BODE < 30 mplt and TSS -s 30 mg&
The Depimbno t of Co mmrce is ad equal opportunity eavice provider and empk*w. Ifyou need assimume to aocaa servioes or
need material In an alternate format, please contact the deponmmt at 6N-266-3151 or 77Y 608-26"777.
MmUMOROW0 5dr yet Sat Telft ac
Conducted by:
Schmitt & Sons Excavating, Inc..
Thomas J. Schmitt, CST 227429
586 Valley View Trail
Somerset,Wl 54025
Phone: 71 60-1978
si
o. �-r ,26 Xbz/
■ Backhoe Pit
Bench Mark 1 El. 100.00' Top of 2" PVC pipe
Bench Mark 2 El. 100.45' Top of 2" PVC Pipe
Slope= 13%
Scale 1"= we Contour Llne El. 99.64'
13 % �Lr
t[.Tl ti'
Ref 2131
Page 3 of 3
Conducted For.
Name:
DM Investments, LLC
Address:
1605 Hwy 65
City, State, Zip:
New Richmond, W1 U017
Subdivision:
Meadow Ridge of Troy
Lot No.:
36
Legal Description:
SEIM SEV4 917 T2914 R19W
Tmvmship, County.
Troy Toweseip, St. Croix Cooly
Contour Llne Length 1W
L, v T 3 6
0f
�---ees n—+
r/
(�O r tI
LOI
rr�r rrl r
rlr1J�/ /
--88.5 8-�
ourFriawE�-sE
arRnicwEsa-sa /
�I r
OI r
�r J I
OI N r
• I
Z '
36
72,52150, FT.
1.672 Arta
S�r�'4t
\ 37
\ 74,918SQ
1.720 ACF
_ I
35
�`_ , u.
I` 46,329SQ. FT,
I
�Y'r • \% 18.aS' 1.064 ACRES
ST CR.3 rvTY SANITARY SYSTEM File
eUseOnly
"` OWNERSHIP/ADDRESS FORM Office
Community Development 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.
OWNER/BUYER INFORMATION
Owner/Buyer DCCI Investments LLC
Mailing Address 1505 Hwy 65, PO Box 445
City/State./Zip New Richmond WI 54017
Phone Number (required) 715-246-2320
Email Address (required) sskinner@derrickbuilt.com
Parcel Identification Number not yet assigned - County assigned address: 326 Shelby Court
(found on the property tax bill)
f y s
Property Location SE 1/. , s F V. ,Sec. ? T 11 N RJR° W, Town of Troy
Subdivision Plat: Meadow Ridge of Troy 1st Addition . Lot # 36
Certified Survey Map # _ _ Volume . Page #
Warranty Deed # 7B5-U53 (before 2006)Volume . Page #
Number of bedrooms 4 Spec house O yes ■ no Lot lines identifiable ■ yes O no
New Property Address 34P 5W1
I
of new address—r�OAj'irecl from Community�D"Ioprnekt Department for new construction.)
.. .
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
Wd@sccwi.aov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.aov
U 2731P 551
UMMM WANtAMrY ]DMM
Document No.
M& Deed made between VA.UW LAM
COWANY, a Mimraota cvrpontion, Glwft and
DIM LAM n AMGM.%IN , Grantee
Wit•mmmmti, That ite aid (iractcr conveys to
Grantee amtsip tad Carats a St. Qvk Ccuaty, State
Of Wia0001in,1926 y demon'W on Exhibit A haetO
(the"Property"),
Togetba with mH and dagnlmr bm dbma*
and mpputenown dwamb belaaging
7A30',:53
Kiei.M A. ruse
NW19M OF t>leM
Sr. CNDIK CEL, W1
eMTO Fm eomRc
un4r2M •isem
VARRMM om
UC Fur 15.80
Tim rn, st>.»
cc Fe
PAM: 3
This ccavryance h wAmd wamo4Y.
except G mdor covemmnb and represcro the
Chaaft has not motile, dome executed Or Tax LD.:
ruffled any ad or thing whereby Poo above- ,
dcwnbed property or may put th gag, mw or
at as time havaft, shU or wry be Jew - -
ampailed. charged or owumbered in any
manner. mmd GzvMm wr71 warnmt tick to &e
above described property wm* all pemons
chiming the same 8om a through Grantor w
a remuh of UT such so or thing provided, however, that the conveyance hereby wade and the
warranty of Grantor u hmlha limited by and subjed to %ome matter met tbrtb on &biW B bareto.
Dated this _ day of Jm merry, ZOOS.
FT-&'Ak'(ll'A'lJ1
STATE
COUNTY OF ) SS
Personally came before we this /,1(�day of Jstamy, 2005, the above named Gwy B. Vift as
President of valley Land Cowry, Mim mI corporation, having fur] autboity to do so sod
tO we iwOWn to be the pa son who e:oeatted the faegndng im� and admowieI ire
?14 iodic, State of
I►� I� 1111111111111
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111111111111 . � III - , I� �-
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DERRICK HOMES 715-246-2320
ROCSTAD RESIDENCE I I
LOT 36, MEADOW RIDGE, !ST ADDITION
S' w HUDSON. WISCONSIN �)���/
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ROGSTAD RESIDENCE
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Pape 1 of 3
Schmitt Soil Testing, Inc
a420
Croix k-um",
Attach complete site plan on aper 1t vie nt in size. Plan must
include, but not limited to: ve itai rence poim (BM), direction and
percent slope, scale or dime ns, north arrow, and location and distance to nearest road.
P/ease print all information.
Personal information you provide may be used for secwdwy purposes (Privacy Law. s. 15. o4 (1) (m)).
County
$L Crypt
� 1 Q _ •�$ b
Ott
R ed Daft
Property Owner
DCCI Investments, LLC
Property Location
Govt. Lot SE1/4, SEIM, S17, T29N, R19W
Property Owner's Mailing Address
1505 Hwy 65
City Stela Zip Code Phone Number
New Richmond WI 1 54017 1 612-5994244
Lot # Block lit Subd. Name or CSM#
36 Meadow Ridge Of Troy
City Village `1 Town Nearest Road
Troy j Meadow Rkige Trail
G New Construction Use: [X ] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
L. Replacement I Public or commercial - Describe:
Parent material Glacial bit (Santiago Series) V4hIjA(n 4 ?'N Flood plain elevation, if applicable NA ft.
General comments Area is suitable for a mound system. System elev lit tatlah 00.W based off the contour line established at 99.54'. Slope of the area
and recommendations: is 13%. Depth to limiting factor is 212,
oBoing. Boling
- Pit Ground surface elev. 95.09 ft. Depth to limiting factor 29 in. Sol Application Rats
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence Boundary
Roots
GPOW
'EM1
1011112
1
0-8
10yr3/3
stone
ell
2mgr
mvfr as
2vf
lvf
0.6
0.6
0.8
0.8
2
B-15
10yr4/4
none
Sil
2fsbk
mfr
9w
3
15-21
10yr4/6
stone
Sid
2msbk
mfr
9w
as
lvf
0.4
0.4
0.6
0.6
4
21-29
7.5yr5/6
rtorne
Sid!
3msbk
mfr
5
29+
10yr6/6
FRACTURED
LIME
STONE
—
—
----
0.0
0.0
BorNg a Pit Ground surface elev. 96.14 R Depth to limiting factor 21 in. Sal Appkelion Rift
Horlmn
Dqo
in.
Dominant Color Redox Description
Munsell Qu. Sz. Cont. Color
Tiedme
Structure Consistenos
Gr. Sz Sh.
Boundary
Roots
GPD/R'
'EM1 'EM2
1
0-8
10yr3/3
none
sil
2mgr mvfr
as
gw
2f,2vf
2vf
0.6 0.8
0.6 0.8
2
8-12
10yr4/4
aorta
sit
2fsbk
mfr
3
12-21
10yr4/6
none
sd
3msbk
mfr
as
if
0.4
0.6
4
21+
10yr6/6
FRACTURED
LIME
STONE
—
—
—
0.0
0.0
Effluent $1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOOS 130 mg/L and TSS <30 mg/L
CST Name (Please Print) SignatureCST Number
Thomas J. Schmitt / 227429
Address Schmitt Sat Teding, Inc. / Dots Evaluation ConducMd Telephone Number
1595 72nd St. New Richrnord, WI 54017 5/2812021 715-760-1978
SBD4330 (It07lvs)
Properly owner DOCI Invesbnents, LLC ParoalID• - Jlr Paps 2 of 3
a Boring x Boring
Pit Ground surface alatr. 100.44 ft. Depth to limiting factor 51 in. Soil Application Rate
Horizon Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure Consistence
Gr. Sz. Sh.
Boundary
Roots
GPD/fl'
'Etfat
'Etla22
1
0-10
10yr3/3
torte
sil
2fsbk
mvfr
as
2vf
0.6
0.8
2
10-15
7.5yr4/4
none
sil
2fsbk
rnfr
gw
lvf
0.6
0.8
3
15-26
7.5yr4/6
none
Sid
2msbk
mfr
gw
1vf
0 44
0.6
4
26-37
7.5yr4/4
none
grsl
2msbk
n*
gw
0.6
1.0
5
37-51
7.5yr4/4
none
grsi
Imsbk
mfr
as
0.4
0.7
6
51+
10yr6/6
FRACTURED
LIME
STONE
—
—
—
0.0
0.0
Boring a Pit Ground surface elev. R Depth to limiting factor in,
— Soil Application Rafe
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture Structure Consistence Boundary Roots
Gr. Sz. Sh.
GPOMI
'Elfat 'Etla2
❑ Boring
� Pit Ground surface elev. ft. Depth to limning factor In. FS it Application Rate
Horizon
Depth
in.
Dominant Color Redox Description j Texture
Munsell Qu. Sz. Cont. Color
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDW
-Vol
I -EM
Effluent 01 = BOD5> 30 < 220 mg/L and TSS >30 <_ 150 mg/L ' Effluent A2 = BOD5 < 30 mg/L and TSS <30 mg/L
The I)rpwtment 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 TfY 608-264-8777.
SBDe iio 4 R oirooz Sdriwt Son Tes&,V, Inc.
Conducted by:
Schmitt & Sons Excavating, Inc..
Thomas J. Schmitt, CST 227429
586 Valley View Trail
Somerset,Wl 54025
Phone: 71 - 60.1 ��
ads =a6
■ Backhoe Pit
Bench Mark 1 El. 100.00' Top of 2" PVC pipe
Bench Mark 2 El. 100.45' Top of 2" PVC Pipe
Slopes 13%
Scale V= 60' Contour Line El. 99.
R
FAI
Ref 2131 Page 3 of 3
Conducted For:
Name: DCCI Investments, LLC
Address: 1505 Hwy 65
City, State, Zip: New Richmond, WI 54017
Subdivision: Meadow Ridge of Troy
Lot No.: 36
Legal Description: SE1/4 SE1/4 S17 T29N R19W
Township, County: Troy Township, St. Croix County
54' Contour Line Length 100'
13 % �!_1
SLOW IB I r
LOT 36
G1
/ (4 vMV&ACOOK)
0 X couNnr
STATE SANIT
r, C# 3.4 She
OWNER
PLUMBE
TOWN
AND/OR -LOT
IALIC.#
54410
NO, 642246
RMIT
145.135 (2rWISCONSIN STATUTES
if11111111VErpose 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 maybe 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.
(f) The sanitary permit is transferable.
History: 1977 c.168; 1979 c. 34,221; 1991 c. 314
Note: If you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
ISSUING OFFICER - DATE
SS RENEWED
fs-61744
RE THAT DATE
POST IN PLAIN VIEW
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (RI 1/20)