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HomeMy WebLinkAbout032-2134-60-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 408208 0 GENERALINFOWATION (ATTACH TO PERMIT) State Plan ID No: I 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: Allen Wittstock I Somerset Township 032- 2134 -60 -000 CST BM Elev: f Ins'p BM Elev: BM Description uo.a oL -- C fgvvt 1 TANK INFORMATION U ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark WD .3 -1 /as ' Dosing � 5 O u v Alt. BM 0 - q � �- / Aeration U Bldg. Sewer ��• t Holding St/Ht Inlet 12 , i s / •``� 1 St/Ht Outlet / 2 .30 7 ' TANK SETBACK INFORMATION q�. 3Z TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ' J3,a 0 1 0, fo2 Septic t � Dt Bottom * 5(ft C o % Dosing 1 1 Header /Man. S t v I Aeration Dist. Pipe Holding Bot. System •Z 9a• Final Grade SOC_ K PUMP /SIPHON INFORMATION * Manufacturer Demand St Cover _ 13 GPM C Model Number 2Q � ? z , d l ool (_0 6C>3(( L_ / Z DH Lift Friction Loss System Head TDH Ft Forcemain Lengt I Dia. Dist. to Well SOIL ABSORPTION SYSTEM E Width ' Length I No. Of 1`renehes>• PIT DIMENSIONS No. Of Pits Inside D' uid Depth ENSIONS ;Z SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACH Manufacturer: INFORMATION CHAMBE Type Of System: 5`f t U odeI Number: 37� L (Y,) DISTRIBUTION SYSTEM 4 w*- ..•>rk. Header /Manifold q JP�pestribution � x Hole Size � x Hole Spacing 46 Vent to Air Intake Length 3 ' 0 Dia Length �y� a _ Spacing 3.O (p 3.06 1 SOIL COVER x Pressure Systems Only xx Mou Or At - Grade Systems Only ( ' Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil Yes No ® Yes 0 No OMM NTS' (Intl de c Is epencies, p glLsipris present, etc.) Inspection #1: 2, D� Inspe4on #2: Oa' / s / a L ca 2070 66th Street Somerset, WI L 025 (SW 1/4 NE 1/4 23 T31 N R19W) Whitetail Trail 1 Pa el No: 2331.19. 1.) Alt BM Description = Mr L_fs4� Sir fk1 - r�ao�nS -t B'+ 71B�,.d 4A.140 / 2.) Bldg sewer length = CS - amount of cover 3. ) _c�r 12"4 � �IVV j aFpc '°o v.•d� Plan rrev�isionrRequirt c ? j Yes XNo j Use other side for additional information. Va 02 Date to i nature /I Cert. No. SBD -6710 (R.3N7) 0 l ` -�1 bl ° o At �J f _ Safety and Buildings Division County J 201 W. Washington Ave., P.O. Box 7162 i seonsin Madison, WI 53707 - 7162 Site Address }� De artment of Commerce Sanitary Permit Number Sanitary Permit Application �0�� -0� in accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary ses Privac Law, s15.04(1 m I. Application Information - Please Print All Information State Plan I.D. Number _7�53 Owner' Name ( Parcel Number Property Ow E ECF1 ®. Property Owner's Mailing Address roperty Location ZZ 6� 2 5 `Loot _ Si IL City, State Zip Code Phon� -N4m rl COUP I I `i" t Number Block N ber 0V f Subdivision Name CSA4•- #aa+ber JT H. Type of Building (check all that apply) — ❑City WSJ 1 or 2 Family Dwelling - Number of Bedrooms 3 ❑village ❑ Public/Commercial - Describe Use � s ownship ❑ State Owned / "lOWrld Wld,c -A Ca &X -75'1 AP / eQ e � G � ,1 Nearest Road III. Type of Permit: (Check only one box on line A (numbering kheme for internal use). Complete line B if applicable) A. For County use 1 0 New E20 Replacement System 3 ❑Replacement of 6 ❑ Addition to System Tank Only Existing stem B. ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 ❑ Non - Pressurized In-Ground 21,9 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Du ersal/Tt'ea tment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days /Sq.Ft.) (Min./Inch) .T,a,60ye Elevation / O / VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 5 Dosing Chamber — X w VII. Responsibility Statement- I, the undersigned, assujne responsibility for installation of the POWTS shown on the attached plans. Plumbe 's (P Plumbe 's Signa MPIMPRS Number Business Phone Number ` Plumber's Address (Street, City, State, Zip Code) ` I c oust [Department Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Iss' u gent Signature (No Stamps) Approved ❑Disapproved a Surchar _/a Fee) El Owner Given Initial Adverse 2 0 ,:;�_ j Determination J EX. Conditions of A RR provttUReasoas for Disapproval i n � rn�� CJ.l—��� ,4d A.+...) K343 ALUac �F r�1�Lvrl, vii,' complete plans (to the ounty only) for the system on paper not less than 8111 a 11 inches in size )ale) SBD -6398 (R. 05101) fzl� Safety and Buildings 10541N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 I • �consin www•oommerce.s i in.gov www.wiscon isconsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary June 21, 2002 CUST ID No.224263 ATTN. POWTS Inspector KIM A O'CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL r PLAN APPROVAL EXPIRES: 06/21/2004 Identification Numbers Transaction ID No. 755344 SITE: Site ID No. 645631 John Wittstock 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 Object Type: POWT System Regulated Object ID No.: 854626 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in P.0. chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. Co II th The following conditions shall be met during construction or installation and prior to occupancy or use: WPA General Approval Conditions: C N l • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P ( N.01 /O1) and SSW Publication 9.6, "Design Of Pressurized Distribution Networks For Septic T Sots"` SEE S E E CO Absorption Systems." CQiZR) • 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. Note • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • The revised soil test on which this approval is based shall be recorded with the original soil test. �t KIM A Or -ONNELL Page 2 6/21/02 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. • 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)(i). • Provide frost protection per COMM 83.43(8)(c). • Holes must be drilled with a sharp bit and all burrs and foreign matter removed before installation. 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 shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation r tenance of the POWTS. Sincer Fee Required $ 175.00 Fee Received $ 175.00 c ,' Balance Due $ 0.00 Patricia L - andorf POWTS Plan Reviewer tegrated Services WSMART code: 7633 (715) 634 -7810, Fax: (715) 634-5150, M -F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: JOHN WITTSTOCK Owner's Name: JOHN WITTSTOCK Owner's Address: 1782 85TH ST NEW RICHMOND WI 54017 Legal Description: SW- NE- SEC23 -T31 N -R1 9W Township: SOMERSET County: ST. CROIX Subdivision Name: WHITETAIL TRAILS Lot Number: 13 Block Number: ,, T - S_ — T7 -r: Parcel I.D. Number: ion ully Plan Transaction No.: D v OF COM Page 1 Index and title Page 2 Data entry Page 3 Mound drawings isPONDEN Page 4 Lateral and dose tank Page 5 System maintenance specifications /0 65 3� Page 6 Management and contingency plan / Page 7 Pump curve and specifications Page 8 PLOT PLAN Designer: KIM A OCONNELL _ License Number: 224263 Date: 05/09/02 Phone Number: 715 - 755 -3145 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SD &10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01/01) Page 1 of 8 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: JOHN WITTSTOCK Owner's Name: JOHN WITTSTOCK Owner's Address: 1782 85TH ST NEW RICHMOND WI 54017 Legal Description: 6W- NE- SEC23 -T31 N -R1 9W Township: SOMERSET County: ST. CROIX Subdivision Name: WHITETAIL TRAILS Lot Number: 13 Block Number: Parcel I.D. Number: Plan Transaction No.: 5- Page 1 Index and title 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 and specifications Page 8 PLOT PLAN T Designer: KIM A OCON License Numbei=: 224263 Date: 06 /16/02 Phone Number: 715 - 755 -3145 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01/01) Page 1 of 8 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 63 -44-3 k-aitu soil treatment for fecal 1.50 Necking Factor (e.g. 1.5 = 1b0 %) coliform of <: 36 helm. 450.00 Design Flow (gpd) 0 Site Slope ( %) 96 Contour Line Elevation ft 40.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd/ft Distri "on Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest po int in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) E Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.00 ft /orifice 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.50 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 13 16.31 Forcemain Drainback (gal) 6.10 Vertical Lift (ft) 67.38 5x Void Volume (gal) 0.97 Friction Loss (ft) 83.70 Minimum Dose Volume (gal) 13.57 Total Dynamic Head (ft) 20.60 System Demand (gpm) Later Diam Selection Man ifold Di Seloctio in. dia. options choice in. dia. options choice 0.75 1.25 x 1. UU 1.5U 1.25 x 2.00 x 1.50 z z 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 800.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) WEEKS IManufacturer 21.62 gal /in (enter result in cell 1349) ,Dose Ta nk Information _u Filter Information 9 vQ , 6755 r]o3S Tank 'vaNavny ( y01 11 1 r nevi mm iuiaa.tu rn 21.76 Dose Tank Volume (gal /in) A100 Filter Model Number WEEKS Manufacturer Project: JOHN WITTSTOCK Page 2 of 8 Mound Plan View T 1110 B ::::::::.:...... J Observation Pipe 3 K O Q A W I i - I z L Mound Component Dimensions Down slope toe extens made. A' 6.00 ft E 9.60 in H 1.00 ft K i.33 fit B 75.00 ft F 9.50 in z 9.00 ft L 89.65 ft 0 G 0.50 ft J 4.67 ft W 19.67 ft 450.00 (ft Dispersal Cell Area 1125.00 (ft' Basal Area Available 6.00 (gpd /ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area F inished Grade 98.89 (ft - -► f 1H F Dispersal Cell 97.60 (ft) Lateral invert Dispersal Cell , 3 . :�:.:.:.:.:.. • ...•,,.•...,...• t F D 1 ... 96.60 (ft) Contour Elevation 5.0 %Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on Q Topsoil Cap .a 1.5 ft n -�- Page 4 for number, vuvovtt vC� - I W4VI, of lu bvtn t l VI RA ASTM C33 Sand 2 F laterals. Laterals are TiIIAri I avar ,I (I �; Ty Lateral _ 4' 0.5 ft ypi I ont fllly enon�l frnm © Aggregate u the distribution cell's A centerline in the distribution cell (AxB). Project: JOHN WITTSTOCK Page 3 of 8 End Connection Lateral Layout Diagram L aterals centere d overt the A & la dimension ; - Turn -up wlball valve or oleanoutplug 1 E P All laterals are identioal I<- X __41 Hol es drilled on the bottom of the lateral equally spaoed S Foroe main oonneotion via too or oross to manifold at any point. Laterals Or force main of PVC Soh 40 (per COMM Table 84.30 -8) Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.06 ft Lateral Length (P) 73.44 ft Orifices per Lateral 25 Lateral Spacing (S) 3.00 ft Orifice Density 9.00 ft /orifice L,plaral Flow Rate 10.30 gpm Manifold Length 3.00 ft System Flow Rate 20.60 gpm Manifold Diameter 2.00 in Total Dynamic Head 13.57 Forcemain Velocity 2.10 ft/sec Dose Tank Information Locking cover with warring label and looking device and sealed watertight Electrical as per NEC 300 and - -► Comm 1628 WAC 4 in. min. Disconnect Tank component is properly vented F— Attemate otAlet location Forcemain diameter WEEKS Manufacturer _� 2 in. Ca acit 800.00 Gallons %Inh oma 1 21 7R nq!!inch A Weep We or anti - Dimension Inches Gallons 4 B I I siphon device A 18.48 402.10 _ C B 2.001 43.52 I I I Pump off e levatio C 4.291 93.26 T L. 91.50 D 12.00 261.12 D I I I T Oiai t 3S.7o1 QVU.001 - I Dose elevation R le- ';" Raelrlinn ii in or flank, qn Fn r Alarm Manuafacturer 1SJ ELECT J Alarm Model Number I HW 1 r Pump Manufacturer 60111 nS Pump Model Number WE0311WE0311 L� Pump Must Deliver 20.60 gpm at 1 13.57 ft TDH Project: JOHN WITTSTOCK Page 4 of 8 f Mound System Maintenance and Oaeration Specifications Service Provider's Name KIM A OCONNELL Phone 715 - 755 -3145 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 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft Maximum FOG 30 mg/L Type of Wastewaterl Domestic Maximum Fecal Coliforml >10E4 cfu/100 mL Service Frequency AA Send Pump Tank Inspect and/or service once every 3 ears + Effluent Filter Should inspect and clean at least once every 3 years IV Y Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Misceiiansous V. and Mazeriais 5tandaras 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 Turn -up Detail Finished •...•.......••. ............... Grade \ it :.:.;:; ::.::: ... . . 6 -8" Diameter Lawn Threaded Cleanout ' HI Sprinkler Valve Box Plug or Ball Valve .... ........... ............. ........... /* ............ ..... ..... ........... .... Distribution ...... ... ... ..... `��. r --- Long Sweep 90 or Two L.--- 45 Degree Bends Same Diameter as Lateral Project: JOHN WITTSTOCK Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained to accordance with ► component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01181)] 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 ect used to for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective device to prevent failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by n accidental or unauthorized entry into a tank or component. Sep tic n 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. Adm. Code. The operating condition of the septic tank and outlet filter shag 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 fitter 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 fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume 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. Eu Ajok T The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution 5YA11m No trees or shrub s should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall a tative be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than or v ge maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed when the of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared equal I itial test within the system was installed to determine if orifice clogging has occurred and If orifice cleaning Is required qu is dispersal cell. the owner, and any lev e P be re orted to pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall p Observation P p above 6 inches considered as an impends n additional more frequent monitoring. n hydraulic failure requiring g y 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" be repaired or replaced in its ' I area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and present location b Y increasing bass 9 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: JOHN WITTSTOCK Page 6 of 8 Performance Submersible Effluent Curves Pump METERS FEET 90 MODEL 3885 25 80 - SIZE 3 /4 " Solids p WE15H Q 70 W 1 20 E10H 60 1 1 141 1 11 O WE07H t5 50 _ WE05H i 40 10 30 WE03 ' �� WE031 ��• 1 20 C 5 - -- - - - -- - - 0 0 0 10 20 30 40 50 60 70 60 90 100 110 120 GPM 0 10 20 30 m'/h CAPACITY �GOULDS PUMPS. INC. SeEC.A FALLS NEW YOPK !)14r. METERS FEET 120 — MODEL 3885 — 35 - SIZE 3/4" Solids it0 WE15HH 00 30 90 — 25 80 a 7 0 4t 1 20 J H 60 O F 5 50 WEOSHH 40 I 20 5 10 30 5(1 0 70 80 90 10Q 110 120 GPM I � 0 30 m'ih CAPACITY �?` Gnu415 a nns Ins EnPCtm- it w 10- i i /� 4/1 �ely h. Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor', -M Human Relations °j'visk.&of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code FPARICELI.D St. Croix Attach complete site plan on paper not less than 8 1/2 ize. Plan must include, but not limited to vertical and horizontal reference poi �� too... �'ndj f slope, scale or .� #�2R �tlin� dimensioned, north arrow, and location and dist e�tp fiearestload. APPLICANT INFORMATION— PLEASE ` ALL !9� TIO'N ', DB DATE PROPERTY OWNER: 1 71 1 PR PERTY LOCATION � ' ° ? ° G . LOT SW 1/4 NE 1/4,S 23T 31 ,N,R 19 1E or Forest Oaks Condos, Inc. i �-�� � I W PROPERTY OWNERS MAILING ADDRESS LYl # I BLOCK # 1 SUBD. NAME OR CSM # 11160 190th. ave. N.W.:';� na I Whitetail Trails CITY, STATE ZIP CODE PHON NUMBER CITY ❑VILLAGE [JfOWN NEAREST ROAD Elk River, M. 55330 Irst12} - 441.- Somerset 207th. Ave. (K] New Construction Use [x] Residential/ Number of be rooms 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 4 bed, gpd /ft2 - 5 trench, gpd /ft Absorption area required 500 bed, ft2 500 trench, ft Maximum design loading rate • 4 bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) 97.60 ft (as referred to site plan ) Additional design /site considerations system el. based on contour line of el . 96.60' Parent material q a i a1 drift. Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S EK 12S ❑ U EIS ®U KI S ❑ U ❑ S ®U ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 0 -10 10yr3 /3 none sl 2msbk mfr gw f �. LU 2 10_2E 10yr4 /4 none sl 2msbk mfr gw if .5 I .6 Ground 3 25-41 7.5yr4/4 none sl 2msbk mfr 9W na .5 .6 97 ft. 4 1 41-70 5yr4/4 dj� 7.5yr5/6 sicl M n a na na np �.2 Depth to limiting Aetq 41" Remarks: Boring # 1 0 -11 10yr3/3 none sl 2msbk mfr gw if .5 .6 2<`' 2 11-23 10yr4 /4 none sl 2msbk mfr 9W if .5 .6 3 23-4C 7.5yr4/4 none sl 2msbk mfr 9W if .5 .6 ::................ Ground elev. 4 40-84 5yr4/4 flf 7.5yr5/6 scl M na na na np j.2 9 7.4 ft. Depth to mit 4 Remarks: CST Name: -- Please Print Gary L Steel Phone: 715 246 - 6200 Address: 1554 200th New Richmond 154017 Signature: Date: 6_14 -2000 CST Number: m02298 i PROPERTYOWNER Forest Oaks Condos SOIL DESCRIPTION REPORT Page = df 3 PARCEL I.D. # pending I Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxli 1 0 -9 10yr4 /3 none sl 2msbk mfr gw if 3 2 9 19 10yr4 /4 none scl 2msbk mfr gw if .4 .5 Ground 3 19-54 7.5yr4/4 none sl 2msbk mfr gw na .5 .6 elev. 9 5.2 ft. 4 54-84 5yr4/4 none sl 2msbk mfr na na .5 .6 Depth to limiting factor +84 11 Remarks: Boring # Ground elev. ft. Depth to - limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) PROPERTY OWNER Forest Oaks Condos SOIL DESCRIPTION REPORT Paget - 3 PARCEL I.D. # Pending Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed I lTrench 1 0 -9 10yr4 /3 none sl 2msbk mfr gw if »3 2 9 -19 10yr4 /4 none scl 2msbk mfr 9w if .4 .5 Ground 3 19-54 7.5yr4/4 none sl 2msbk mfr yw na .5 .6 elev. ) 5.2 ft. 4 54-84 5yr4/4 none sl 2msbk mfr na na .5 .6 Depth to limiting factor +84" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor 1 r - STEEL'S SOIL SERVICE Gary L. Steel Forest Oaks Condos, Inc. 1554 200th Ave. CSTM2298 SW4NE S23- T31N -R19W New Richmond, WI 54017 MPRSW -3254 town of Somerset (715) 246 -6200 lot #13- Whitetail Trails N 1 =40' BM.= top of 11 pvc pipe C el. 100.00 Alt. BM.= top of 1" pvc pipe @ el. 97.85 a ' �3 �cy G Gary L. Steel 6-=14 -2000 I _ Safety and Buildings 10541N RANCH ROAD HAYWARD WI 54843 TD #: (608) 264 -8777 erc Nvisconsin www.wisconsin.gov .wis c ons .wisonsin.gov Department of Commerce RECEIVEp Scott McCallum, Governor Philip Edw. Albert, Secretary 2002 C Y June 21, 2002 S' FFICE Z0NNG OFFICE CUST ID No.224263 ATTN: POWTS Inspector KIM A O'CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/21/2004 Identification Numbers Transaction ID No. 755344 SITE: Site ID No. 645631 John Wittstock Please refer to both identification numbers, 207TH Ave above,; in all correspondence with the agency. r Town of Somerset St Croix County SWl /4, NEl /4, S23, T31N, R19W FOR: New mound, 450 GPD Object Type: POWT System Regulated Object ID No.: 854626 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P ( N.01 /O1) 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. Note • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • The revised soil test on which this approval is based shall be recorded with the original soil test. • KIM A O'CONNELL Page 2 6/21/02 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. • 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). • Provide frost protection per COMM 83.43(8)(c). • Holes must be drilled with a sharp bit and all burrs and foreign matter removed before installation. 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 shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Patricia L Shandorf POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (715) 634 -7810, Fax: (715) 634-5150, M -F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM a Owner/Buyer - f lov, Mailing Address _1 Property Address L. (Verification required from Planning Department for new construction City /State C ti 12.T Parcel Identification Number LEGAL DESCRIPTION Property Location 5 ' t"' /,, /,, Sec. , T N -R 1 Town of c7y - eyS - e � , 5 f Subdivision 1,2bJe_ JAd 4Y I , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # � X10 /� , Volume ! .1 S9Z — , Page # Spec house O yes .'no Lot lines identifiable J2r'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 wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, 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 of the three ye r expiration date, -iz_ �� , SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION 1.(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 property 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 rooked 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 U 1898P 234 STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRANTY DEED This Deed, made between Michael P. Goveronski 6 8 0 1 6 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., MI Grantor, and Allen J. Wittstock and Judith A. Wittstock, husband RECEIVED FOR RECORD and wife, / 05 '24 - 2002 2:45 PH _. EAR # DEED Grantee. REC FEE Grantor, for a valuable consideration, conveys to Grantee the 11.00 following described real estate in St. Croix County, TRANS FEE: 116.70 COPY FEE: 2.00 State of Wisconsin (if more space is needed, please attach addendum): PAG CERT COPY FEE 1 Recording Area Lot 13, itetail Trails, St. Croix County, Wisconsin. N Retum Address 17 5 s - New h?;chmond. WZ y0/ 0 32 - 2134 -60 -000 umber (PIN) This is not homestead property. (is) %X00 Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of May 2002 * * Michael P. Goveronski * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Michael P. Goveronski STATE OF WISCONSIN ) ) ss. County ) authenticated this 3 day of May 2002 Personally came before me this day of the above named * Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ') * Names of persons signing in any capacity must be typed or printed below their signature. information Professionals c ompany, Fond du Lac. wa eao-656-2021 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 - -- - -- - -- - � H IS 0 -� - - - - - -- NO2'12'41 "W 5295.92' --- - - - - -- o - - - -- NO2'12'41 "W 1319.33' - - - -- .71' NORTH — SOUTH QUARTER LINE � 237.06' 316.04' � -, � ,- ------ 1292.84' -- - - -- - -- - , �� r I I I t o r v w -� PD r v� ti O m �+ GJ ~ y S02'12'41 "E • ' �° �6`' �S 338.28' cn LJ \ ` c \ ` � i O •33.89' Q) r z = C) A �, w I � t \ � t o z C r \ \ t t t S02'1 2'41"E 395.84' maw p 1 1 r N N 1 1 oa Cb 1 1 o 1 . v' R l I �� _ I _