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HomeMy WebLinkAbout032-1060-60-000 Wisconsin DeparAnt of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix .Safety and Building Division INSPECTION REPORT Sanitary Permit No: 404936 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Erickson, Colin I Somerset Township 032 - 1060 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: U' /d0 , ! " C� TANK INFORMATION U ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION rZ (0 BS � I 2 FS ELEV. Se Benchmark "Z d L I Dosing Alt. BM > 4Ur_ Aeration Bldg. Sewer Z , Holding SUHtlnlet CA) /3./3 3•oZt TANK SETBACK INFORMATION St/Ht Outlet 13.38 Q2. TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet �C,1 JAS � 2, Z IL Septic 1 Dt Bottom Co f �°� cq.�3 t� 95.6 Dosing D / / / Heade Aeration Dist. Pipe —7 ! 3 3 cy �` 11 Holding Boy. System �•. d g o+ � Tft 0 Final Gra PUMP/61PHON INFORMATION Manufacturer Demand St Cover CCU � GPM r► Model Number O C 6 ` I) L �I n _ _ 1 _ ` G 7 TDH Lift Friction �L System e� TDH �� Ft ��In� "L �. t- ( , (� �ofe,l / (SO• b Forcem in Length Di I Dist. t4W 1 SOIL ABSORPTION SYSTEM rJ BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS +, / -7 S 1 1 19- / �^ SETBACK SYSTEM TO P/L Vj BLDG IWELL LAKE /STREAM LE C G 'i Manufacturer: INFORMATION CHA R OR Type Of System: ' �— N Model Number: DISTRIBUTION SYSTEM �' Header/Manifold s Distribution 2 x Hole Size - `� Hole Spacing Vent to Air Intake 1 1) Lengt Dia Length Dia �� Spacing " ! !' p SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only I t D ps"< E 7 4 Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center ' 9 Bed/Trench Edges Topsoil / - 7 Y !•; No Yes ' No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:� /�/ (� Inspection #2: / 497- .31 Location: 668 207th Ave Somerset�Wl 54025 (SW 114 NE 1/4 23 T31N R19W)�1Whlteta r ^ Whitetail Trails Lot 11 Parcel N : 93 .1 1.) Alt BM Description = f; P of PVC 4.0 � r �� be4uow `i F �� � �f a �"►� n en' � 4,d, ' ' _ 4-0 t 2.) Bldg sewer length = , / YYt A 40 - amount of cover = 3.) Contour = G1 Plan revision Required? Jo i ' "' Jse other side for additional information. Date Insepctor's Signature Cert. No. :710 (R.3/97) �N �b S O YJ J� i 1 .� Safcty and Buildings Diviswn County NI Vi sconsin 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 7162 ' Address '/ I De artment of Commerce I fd oe R O Tn Sanitary permit Application S'"� P ` OTI In accord with Comm 83.21, Wis. Adm. Code, personal information ❑ Check U Revision may be used for seco purposes Pnvac Law, s15 ! r I. Application Information - Please Print All Information ' \ Sate Plan I.D. Number Pro Owner's Name t � C^ Parcel Number Property o c � Zia � �- �-000 i L.l +�� �r L �k Property Owner's Mailing Address t fv , 7 7 Property Locadon � T C^90 u u N, R 19 1 City, State Lot Number Block Nwpbct Subdivision Name CSM Nurntocr lI. Type of Building (check all that apply) J M.S. ev S "^^ Doty 1 or 2 Family Dwelling - Number of Bedrooms — ❑Village ❑ Public /Conunercial - Describe Use _ _ ._ ownthi , S () Sate Owned .1_ Nearest Road III. Type of Pe (: (Check only one box on line A (numbering scheme for internal use). Complete line B If applicable) A ' 1 ;@ Ncw 2 C1 Replacement System 3 ❑ Replacement of 6 ❑ Addidon to For County use S stem Tank Ord Exis ' S stem B, ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(munbering scheme is for internal use))t • - i I 44 ❑ Non - Pressurized In-Ground 21 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland i 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Lire 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit Recirculating 30 ❑ Other _ V, Dispersal/Treat ent Area Information: ,5 Design now (SIA) Dispersal Area Dispersal Arca Soil plicauun Pcrcol Lion Rate System Elevation Final Grade Required Proposed Kate(Gals. /Days /Sq,Ft.) (Min.Anch) Elevation 1. Tank 1nfo Capacity tin Total Numbcr Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank _ llemo Dosing Chamber _ 4 1 ) �E� ---� X VII. Responsibility Statement- I, the undersigned, asfiume responsibility for installation of the POWTS shown on the attached plans. Plumber' Plumber' Si re MP/MPRS Business Pbore Number Plumber's Address (Svect. City Sta ,Zip Code) VIII. County /De artment Use Otti X Approved ❑ Disapproved Sanitary Pernik Fee (includes Groundwater Date Issued Lssuing Agetlt Sigraturo (No Sumps, Surcharge Fee) •❑ Owner Given Initial Adverse Dcter 1 [t � � rnina6un _ 3z S. LK L.J lt- - IX, Conditions of Approval /Reasons for Disa pp� " r�o�v " al /, - �E AA Se {p«_c �g vv� t t+ 6,— rv.a,���as�nsedt 0-4 Auach caWpktc pow (to the County ode) for the "to on papa not loran tun &La s 11 weba in w" SBD -6398 (R. 05101) , I i3[YJ��� 'S's ,E - - - — — av - - -- -- '� t Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TD #: (608) 264 -8777 V scons/n www.w www.cornrnerce.s isconin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary March 01, 2002 CUST ID No.224263 ATTN. POWTS Inspect or KIM A O'CONNEI.L 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: 02/29/2004 Identificati bers Transaction ID N 709714 SITE: ID No. 641428 Colin Erickson Please refer to both identification numbers, 207TH Ave above, in all correspondence with the agency. Town of Somerset St Croix County SW1 /4, NE1 /4, S23, T31N, R19W FOR: New mound, 450 GPD F3 ANNA Object Type: POWT System Regulated Object ID No.: 830480 C'oa d it ioll The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Cod _ Z and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in L � chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. O a MEtNT OF Cl The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) O©R RESPI • This system is to be constructed and located in accordance with the enclosed approved plan d with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P ( N.0 1 /01) and SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems." • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • 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. • The maintenance plan for this system must be given to the owner of the POWTS. • The actual gallons per inch for the specified pump tank is 21.74 and the liquid level is 37" per product approval. The proposed pump settings have been adjusted provide a dose volume that is greater than 5 times the void volume and less than 20% of the design wastewater flow plus drain back. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. r KIM A O'CONNELL Page 2 3/1/02 • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). • The designer proposes to install a state approve outlet filter to achieve the requirement of wastewater particle size. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations. 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. 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 shal ovide copy of this letter to the owner and any others who are responsible for the installation, operation or m ntenance the POWTS. Sincer Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Patricia L Shandorf POWTS Plan Reviewer, Int ated vices W SMART code -. 7633 (715) 634 -7810, Fax: (715) 634-5150, M -F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: COLIN ERICKSON Owner's Address: COLIN ERICKSON PO BOX 415 ROSEMOUNT MN 55068 Legal Description: SW- NE- SEC23 -T31 N -R19W Township: SOMERSET County: ST. CROIX Subdivision Name: WHITETAIL TRAILS Lot Number: 11 Block Number: N/A Parcel I.D. Number: 032 - 1060 -60 -000 ' - ti n V ER Plan Transaction No.: i Page 1 Index and title . CE Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve ano specifications Designer: KIM A OCONNFEL L License Number: 224263 Date: 02/22/02 r 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 (03/01101) Pagel of $ 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 300.00 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. 450.00 Design Flow (gpd) 3.00 Site Slope ( %) 97.40 Contour Line Elevation (ft) 42.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd/ft Dis . 'on Cell Information 75.0 Dispersal Cell Length Along Contour (ft) = 6.00 ell Width (ft) Dispersal Cell Design Loading Rate (gpd/ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) E Center or Eli Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft t � 2 Number of Laterals of the highest point. �l �y 0.188 Orifice Diameter (in) (e.g. 0.25) 4.00 Estimated Orifice Spacing (ft) = 11.84 ft /orifice 2.00 Forcemain Diameter (in) 125.00 Forcemain Length (ft) Does the forcemain drain back; Y 83.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 20.39 Forcemain Drainback (gal) 14.73 Vertical Lift (ft) 67.38 5x Void Volume (gal) 1.72 Friction Loss (ft) 87.77 Minimum Dose Volume (gal) 19.70 Total Dynamic Head (ft) 24.90 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. op tions choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x 1.25 2.00 x 1.50 x 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information 1000.00 Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) 1 49.001 Total Working Liquid Depth (in) WEEKS IManufacturer 20.41 gal /in (enter result in cell 849) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) JZabel _ Filter Manufacturer 19.641 Dose Tank Volume (gal /in) LA100 Filter Model Number WEEKS Manufacturer Project: Page 2 of $ Mound Plan View T 1 /10 B 3 J Observation Pipe — K" p A ....... .. B ...:............:- - .:: :: r 3 :. . L i Mound Component Dimensions A 6.00ft E 8.16 in H 1.00 ft K A17.43 ft B 75.00 ft F 9.50 in 1 6.50 ft L ft D 6.00 in G 0.50 ft J 4.93 ft W ft 450.00 (ft Dispersal Cell Area 1 937.50 (ft) Basal Area Available 6.00 (gpd /ft) Linear Loading Rate 1 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.69 (ft) ---♦ H ' .fflflif fflfffs... G .eIfIIIIIt !I f!!ff!!I!! . 1 .fllllfftltfff!!!f! Z fltllfllltlKlf/ . F Dispersal cell 98.40 (ft) Lateral 97.90 (ft)—► Invert Dispersal Cell ....� .. ... ...... .... ......... .:,............ E > ;; D s Elevation �:.:- : - :•:. 97.40 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key m T Dispersal Cell See lateral details on Q Topsoil Cap c 1.5 ft Page 4 for number, 0 " " " "` Subsoil Cap size, and spacing of Q ASTM C33 Sand F laterals. Laterals are m 0.5 ft Typical Lateral ® Tilled Layer c 0 equally spaced from Q Aggregate o the distribution cell's �-- A } centerline in the distribution cell (AxB). Project: Page 3 of % End Connection Lateral Layout Diagram Laterals centered over the A & B dimension = Tu rn -up w1 be I I va Iva or cl ea n out pi u g P .I PForce dentical IE X--3I Holes drilled on the bottom of the lateral s equaliy spaced onneotion via tee or cross to maniFold at any point. Laterals & force main of PVC 5ch 40 (per COMM Table 84.30 -5) Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 4.08 ft Lateral Length (P) 73.44 ft Orifices per Lateral 19 Lateral Spacing (S) 3.00 ft Orifice Density 11.84 ft /orifice Lateral Flow Rate 1 Manifold Length 3.00 ft System Flow Rate Manifold Diameter 2.00 in Total Dynamic Head Forcemain Velocity 2.54 ft/sec Tank Information Locki ng coverwtth waming label and locking device and sealed watertight Electrical as per NEC 300 and -i Comm 16.28 WAC 4 in. min. Disconnect _ Tank component is properly vented 1E Altemate outlet location Forcemain diameter WEEKS Manufacturer 2 in. Capacityl 800.00 Gallons Volume 19.64 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 25.94 509.52 C B 2.00 39.28 Pump off e levation (ft) C 4.79 94.08 83.67 D 8.00 157.12 D Total 1 40,731 800.00 Dose tank elevation (ft) 3" Bedding under tank. 83.00 Alarm Manuafacturer JSJELECTRO SYSTEMS Alarm Model Number 1101 H Pump Manufacturer IGOULDS Pump Model Number WE0311 L Pump Must Deliver 24.90 gpm at 19.70 ft TDH Project: Page 4 of $ Mound System Maintenance and Operation Specifications Service Provider's Name I " ^-] Phone POWTS Regulator's Name ST. CROIX COUNTY ZONING Phone 715 - 386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 118 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency 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 ears Mound Inspect for ponding and seepage once every 3 ears Other 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 mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum -up Detail Finished .............. • Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Page 5 of $ 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.01101) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from 'sts enclosure. If the filter 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 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. 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 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 BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 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 end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice diogging 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. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(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 if 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: Page 6 of 8 Performance Subm ersible Efflu0m Curves Purnps METERS FEET 90 �. 25 - -, MODEL !Olids 8° O ; WE 1 5 70 = 20 WE10H J H 60 WE07H• — -.• -- _� 15 50 40 10 30 WE03M i 20 WE03L _ — 5 10 0 ° 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 0 10 2 _ 30 m'/h CAPACITY (D GOULDS PUMPS, INC. S&C-CA FA115 PEW YM Owe METERS FEET 120 MODEL 3885 35 110 WE15HH - I SIZE 3 /4 " Solids i r -- - 30 100 -{- --, 90 I , 25 80 p � , Q 70 P 60 O _ _ WE05HH 15 40 i I 10 i 20 5 10 0 0 � 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 10 20 30 m CAPACITY 0 1985 Goulds Pumps, Inc. ElNcuVe Joy. 1985 • C]88; Q i i r Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor *nd Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM ip % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distanc ggerso .d' c'; pending � ` � REVIEWED BY DATE APPLICANT INFORMATION- PLEASE PR Attt INFp MATIO' `� AT u o r PROPERTY OWNER: PRO ERTY LOCATION Forest oaks Condos, Inc. QQVT) LOT SW 1/4 NE 1/4,S23 T 31 N,R 19 (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 11160 190th. Ave., N.W. jT`"Ru ! 1 na Whitetail Trail CITY, STATE ZIP CODE P NE N Y ❑VILLAGE MOWN NEAREST ROAD Elk River, MN. 55330 -$ 207th. aVe. {K] New Construction Use [x] Residential/ Numbe r rhs 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd /ft .6 trench, gpd /ft Absorption area required 500 bed, ft2 500 trench, ft Maximum design loading rate • 5 bed, gpd /ft •6 trench, gpd/ft Recommended infiltration surface elevation(s) 98.40 ft (as referred to site plan benchmark) Additional design / site considerations system el. based on contour line of el. 97.40' Parent material glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem El Z U ®S ❑ U ❑ S Ei:U [2s [I U El E3d1 ❑ S gl U SOIL DESCRIPTION REPORT ( S Depth Dominant Color Mottles Texture Structure Consistence N Roots GPD /ft #i Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench .................. 1 0 -10 10yr2/2 none 1 2msbk mfr gw 1f .5 .6 g 2 10 -22 10yr44/ none sit 2msbk mfr gw if .5 I .6 g Ground 3 22-34 7.5yr4/4 none sicl 2msbk mfr 9W if .4 i .5 gg 1 ft 4 34 -55 7.5yr4/6 none co s Osg mvfr gw na .7 .8 Depth to 5 5 -70 5yr4/4 c2p 7.5yr5/8 scl M na na na np .2 limiting factor 55_ 7 Remarks: Boring # 1 0 -11 10yr4 /3 none sl 2msbk mfr gw if .5 .6 S 2 2 11 -26 10yr4 /4 none sl 2msbk mfr gw if .5 .6 S' 3 26 -42 7.5yr4/4 none co s Osg mvfr gw na .7 .8 3- ............... . Ground elev. 4 42 -70 5yr4/4 c2d 7.5yr5/6 scl M na na na np 1 .2 98 ft. Depth to limiting fac or Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715 -246 -6200 Address: 1554 200th. Ave. New Richmond I 54017 Signature: Date: 4 -19 -2000 CST Number: m02298 f - 1 PROPERTY OWNER Forest Oaks Condos SOIL DESCRIPTION REPORT Page 2 qj 3 PARCEL I.D. # pending Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botxdary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 0 -11 10yr2 /2 none 1 2msbk mfr gw if .5 .6 r- >..3.... 2 11 -2 10yr4 /4 none sit 2msbk mfr gw 1f .5 .6 5 - Ground 3 22-4E 7.5yr4/4 none co s Osg mvfr gw na .7 .8 9ei 9 ft 4 46-65 5yr4/4 c2p 7.5yr5/6 scl M na na na np .2 Depth to limiting factor 46" Remarks: Boring # Ground elev. ft. — Depth to - limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor I Remarks: 'i SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Forest Oaks Condos, Inc. 1554 200th Ave. CSTM2298 SWQNE4 S23- T31N - R 19W New Richmond, WI 54017 MPRSW -3254 town of Somerset (715) 246 -6200 lot #11- Whitetail Trails 1 =40' top of 1 pvc pipe C el. 100.00' = top of 1" pvc pi el. 98.80 �Qr� ( ' 4Z ZS - 03 A 6.3 g. z off° Gary L. Steel 4 -19 -2000 r ST CROJX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ��,/,�,� 12 Mailing Address P6. OGk& Property Address (Verification required from Planning Department for new construction) City /State �,� �� Parcel Identification Number LE GAL DESCRIPTION Property Location _­�'r,J '/4, Z/ ; '/4, Sec. .5 , TAN -RAW, Town of Subdivision It J' 12 " 4 _ — , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # '7 /�S , Volume � � Page # Spec house D yes X no Lot lines identifiable j4 yes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper, What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The 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 wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days o Lhe three year expiration date. i SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) 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 p described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * « * ** ** 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 I vo►1841Pa STATE DAR OF WISCONSIN FORM 2.1999 6 7 1 a 5 2 RATHLEEH H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIB CO., MI This Deed, made between Fore Oaks Co Inc. _ RECEIVED FOR RECORD 02 -22 -2002 9t30 AN Grantor, and Colin K . Erickson and Jennifer S. EXEIDT i Ericks husband an wife, REC FEEL 11.06 TRANS FEE: 110.70 COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. C roix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 11, Whitetail Trails. Name and Return Address i David J. Estreen I „ St. Croix County, Wisconsin. I 304 Locust Street /) ere-)s,e- I Hudson, WI 54016 I 032 - 1060 -60 -000 Parcel Identification Number (PIN) This is not homestead property. 04) (is not) - -- Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 9th day of - Janu a� __ 2 002 Fares sks Cond Inc. • • Gerald J Smit resid AUTHENTICATION ACKNOWLEDGMENT Signature(s) Forest O aks Con dos, Inc., by G J. Sm STATE OF WISCONSIN Presiden ) ss. - lr - -- County ) authenticated this of F. 1 2 002 — Personally came before me this _ day of the above named • Kristi Ogland TITLE: MEMBER STATE BAR OF WISCONSIN - — - - (If not, - to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized by § 706.06, Wis. Scats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristian Ogland _— Notary Public, State of Wisconsin Huds Wl 5401 __ My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) — ) ' Names a persons signing in any capacity must be typed or printed below their signature. irr mration Prora.ionaLs company. Fond du Onn WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2- 1999 r : =•;� t c cl c c'c .•,r. �. `• °.FYI ►;.i Jig ^ 1 g ; 3 � a,� . � o + .�, O „� ,., • � 1�. •_ i �s ' .. 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