HomeMy WebLinkAbout032-2134-90-000 /* CPL `. � , O 'ce...:►.eGQ
111E.9oonsin Department of Conxnerce PRIVATE SEWAGE SYSTEM
C ounty:
Safety and 6uTdings Division
INSPECTION REPORT 3t. Croix
GE.AERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.
Personal intomtation you provice may be used for secondary purposes (privacy Law s.15.04 (f xm)).. 84280
Permit Holder's Name: ❑ city 0 vilinge Town o : r e-il
o Plan ID No.:
Bel her Somerset Township �
CST BM Elev.; Insp. SM E ev.: BM Description: Parcel Tax No.: ,
�•� c)D, o l -" = CSi u� 32- 2134 -90 -000 `
TANK INFORMATION U ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Q Z !,)g Benchmark Ld r8( 6 •�� t
Do CV6 It BM 2,
Aeration Bldg. Sewer 'Z� 3 Co •S+ l
Holding St /Ht Inlet
J , z o W. po'
TANK SMACK INFORMATION St/ Ht Outlet I
TANK TO P/ L WELL BLDG. Air intake ROAD Dt Inlet 10.19 th . n
Septic -)..75-4 }�` r - NA Dt Bottom 9.7�( 9 3-24'
Ong > �� 1 �S r / NA Header Man.
Aeration NA Dist. Pipe IZ• /3
Holding Bot. System
(2,q,5' oo.dS'
PUMP IPHON INFORMATION _ Final Grade
Manufacturer ( DemandE t Cover
Model Number 0&3 (LL 1° GPM yU `�'1 13- �3.J (� •�
�t TDH Lift •Ox Friction •'S't System`. TDH X 1Ft
V H
d• Forcemain Length 3 Dia. Lrx Dist.Towell
SOIL ABSORPTION SYSTEM
BED / TRENCH Width , Length / o. f TTenEkes PIT No. f Pits Inside Dia. Liquid Deptt
D IMENSIONS an Z. ) DIN I
SYSTEM TO P / L BLDG ELL LAKE / STREAM LEA anu acturer:
SETBACK WELL C
C B
INFORMATION Type , Model Numbe
a ) cl
System: 3 I
DISTRIBUTION SYSTEM �2 -�•�•) (9 , S — = Cw✓
Header/Manifold Distribution Pipe(s) f 4 x Hole Size x Hole spacing vent To Air Intak
Length Dia. Length - 4 Dia. _�12. Spacing 36_ 1 f /�" I I f - , 8�
SOIL COVER -- Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed/ Trench Edges Topsoil Yes ❑ No ❑ Yes Q No
COMMENTS: (Include code discrepancies, persons p # � /116% 1 Inspection #2.- ---f --
Location: 2052 66th Street, Somerset, WI 54025 (SW 1/4 NE 1/4 23 T31N R19W) - 2331191195 Whitetail
Trails -Lot 16 Cr � = r�
1.) Alt BM Description =
2.) Bldg sewer length = Sq
- amount of coverll- ��q2
3.) contour = 0 (j.30 r �S
Plan revision required? ❑ Yes b(No �!
U ther side for addioral inform 2 `� J up
4o ggp-01 f 0 R`3 ry � r "�• p Date '' nn Inspector Signature Cert N�
S) �,M.x q Q v,n stv�ndc 4. 611,. a 1 + Sb i Gpu.er ths� - tOL eCil� �-
W - `f 1 o-nz
0 Sanitary Permit Application Safety & Buildings Division
ton Ave.
In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington
` See reverse side for instructions for completing this application PO Box 7302
�StiOn.S�h Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of Commerce [Privacy Law, s. 15.04(1)�m)] (Submit completed form to county if not
state owned.)
Attach complete plans (to the county copy only) f s e ,?oh. a&"ot less than 8 -1/2 x 11 inches in size.
County State S i Permit Number if revision top oy pplication State Plan I. D. Number
-'
I. Application Information - Please Print all Informatio _f, . Location:
Property Owner Name 4 ' ` Property Location
Zz
Property er's Mailing Address ICO 6T Cif i Lot Number Block Number
l
X Z ONMIGOFFI
City, State ZipCode t ?7e Number
Subdivision is_ i� a or CSM Number
1 s )C s
II. Type of Building: (check one) V ❑ city
J9 1 or 2 Family Dwelling -No. of Bedrooms: ❑ Village
❑ Public /Commercial (describe use):_ 'Town of
❑ State - Owned
2-134 2 -- Nearest Road
OD a2 ?�) �� - �S Parcel Tax Number(s)
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable)
A) 1. ❑ New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to
System System Tank Only Existing System
B)
11 Permit Number Date Issued
A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply) -�, -(BD
• Non - pressurized In -gro d t l AMound ❑ Sand Filter ❑ Constructed Wetland
• Pressurized In- ground � l • 3D / ❑ Holding Tank ❑ Single Pass ❑ Drip Line
❑ t -grade , .' u ❑ erobic T eatment Unit ❑ Recirculating ❑ Other:
(o ItTo f " fl (o It O �
V. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation
J �
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
❑ ❑ ❑ ❑
❑ ❑ ❑ ❑
-r
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
kPlifffiber mber's a ' Plumber's igna o stamps • MP/MPRS No. Business Phone Number
Address (Street, City, State, Zip C de) J s — S
IX. County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued s ' g Agent Sign (No stamps)
WjApproved ❑ Owner Given Initial Adverse Surch ge Fee)
Determination
X. Conditions of Approval /Reasons for Disapproval.
- VOW"/ - -: - &-
SBD -6398 (R. 07/00)
.� L r 4Jr
I
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a
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° �41
a i
is 43;
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Safety and Buildings
10541 N RANCH ROAD
HAYWARD WI 54843
TDD #: (608) 264 -8777
isconsin www.wisconsin.gov
. wis c ons
w.wisonsin.gov
Department of Commerce
Scott McCallum, Governor
+ Brenda J. Blanchard, Secretary
June 26, 2001
CUST ID No.224263 ATTN: POWTS Inspector
ZONING OFFICE
KIM A O'CONNELL ST CROIX COUNTY SPIA
504 3RD AVE 1101 CARMICHAEL RD
OSCEOLA WI 54020 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 06/26/2003 Identificati bers
Transaction ID lIK649752
SITE: Site ID No. 630916
CHRISTOPHER BELISLE Please refer to both identification numbers,
207TH ST above, in all correspondence with the agency.
TOWN OF SOMERSET
ST CROIX COUNTY
SW 1/4, NE 1/4, S23, T31N, R19W
FOR: NEW MOUND, 600 GPD
OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 795602
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 �(Ia
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: r
General Approval Conditions:
SA
• This system is to be constructed and located in accordance with the enclosed approved plans and with the 0'V 5� � F
"Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P
N.01101 and SSWMP Publication 9.6 "Design Of Pressurized Distribution Networks For Septic Tank- S ' �C)R
( ) � SE
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,
e owner must insure that the o maintenance and monitoring th P � g 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.
Site Specific Conditions:
• 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.
KIM A O'CONNELL Page 2 6/26/01
• Maintain well and waterline set backs per COMM 83.43(8)(i).
• 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.
• Holes must be drilled with 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.
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
c
cc: CHRISTOPHER BELISLE
r
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: CHRISTOPHER L BELISLE
Owner's Name: CHRISTOPHER L BELISLE
Owner's Address: 499 192ND AVE
SOMERSET WI 54025
Legal Description: SW- NE- SEC23- T31N -
Township: SOMERSET
County: ST CROIX
Subdivision Name: WHITETAIL TRAILS
Lot Number: 16 Block Number: T•�•
Parcel I.D. Number: 030 - 1060 -50 -000
Plan Transaction No.: i �E CON1M ILD GS
QTY AND B IL0
Page 1 Index and title
Page 2 Data entry ES NDENC
Page 3 Mound drawings
Page 4 Lateral and dose tank �� S
Page 5 System maintenance specifications
Page 6 Management and contingency plan
Page 7 Pump curve and specifications
Page 8 PLOT PLAN
Designer: KIM A OCON L 1 License Number: 224263
Date: 05/24/p 1 P one Number: 715 - 755 -3145
Signatur
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 (03101/01) Page 1 of 8
06/20/2001 07:14 7152473038 BELISLE EXCAVATING I PAGE 03
Mound and Pr Distribution Component Dmipn
Design VYOrksheat
(r or c) t .en
d 111 or Coatr�rerciel d co► attttlutns
ated WtttaRew &W Plow (Wd) Table 83443 MAW soil bIWIM Mr %W
*V Factor (e.g. 1.5 -1") o WWM of — 35 i id".
w f=low (ppd)
Bile Slope (9f►)
OIL Cor4our line Elevadw (ft)
99. Depth to LirrMtir►g Factor (in)
Q In.dW OW Applicatim Rene (WdW)
M oaN tnlbrrnaiittwr
Dtxpm - W CON Length A" A Co tX (R) � 8.00 Cell 1Nldth (R)
pis(oNIM Cell Deaign Loedinp Rate (gpd4e)
rouw t Wooewatew Quality (1 or 7) Are the laterals the Mghe•t
in the disMtxrtion Y
MIQL-3iglo WbtNlon W rrrlaeion netvuoW Eller Y or N
(c or e) Center or End Maw�#Od
Lateral Spacfg (it) if N above, enter IM •levaIM t
Numbw of Laterals of the highest point.
Orititoe Diameter (in) (e.g. 0.25)
4. E91111111M Orifice SPN*V (ft) " 12.00 ft
LO ForCana n Diameter (in)
W401 Forcmrrain Length (14 Does the force drain tack Y
�. Pump Tank Elevation (R) Enter Y or N
5.50 System Head (ft) x 1.3 5.71 orcemain Drainbeck (gal)
7,03 Vertical Uft (ft) 90.29 5x Void Volume (gal)
0.34 Friction toss (ft) 95.99 Minimum Dt9e Volume (pal)
14.47 Toted D)rnan'mic Head (ft) 20.80 system Demand (Wn)
Lateral DWAWW SOW60n ManlMd Diameter 5eleciion
im diio. options dM100 in. dia. vas choice
0.75 1.25 x
1.00 1.50
1.25 x 2.00 a
1.50 x X 3AO
2.00 x
2.00 1 x
QrrltorMMrtch Calrule�or (optiorid)
Treaalr»nt Tank hwa motion 1000.00 Told TarNc Capacity (pal)
1 S• is Tank Capacity (gel) 1 :32.00 TOW Wbritinp Liquid 000 (in)
tnlesics Mar Dock rev 1 19.29 gelAn (enter result M 00 04)
Dow RMbrna*m EAlusrrt FOW WAOrenaWM
Dose Tank Capacity (9W) zabel Filter Mara, OMM
111,04 Tank Vok mtb (galAn) A100 Fitter Model Number
AIFeN wAwd rw
PmiW CHRISTOPHER BELIBL9 Par 2 of 8
Mound Plan View
J
1/10 B
Observation Pipe Q :
4 K -T
O
5 A
W
B
i
L
Mound Component Dimensions
A 6.00 ft E 10.32 in H 1.00 ft K 7.42 ft
B 100.00 ft F 9.50 in z 7.87 ft L 114.83 ft
D 6.00 in G 0.50 ft J 4.56 ft W 18.43 ft
600.00 (ft Dispersal Cell Area 1387.20 (ft Basal Area Available
6.00 (gpd/ft) Linear Loading Rate 1 10.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 101.59 (ft)
–.._. H
G
F ais . 100.30 (ft) Lateral
99.80 (ft) -�► — Invert
Dispersal Cell
Elevation E D Q
- --- --- .30 (ft) Contour Elevation
6.0 %Site Slope
Geotextile Fabric Cover
Shading Key & rsal Cell See lateral details on
1❑ Topsoil Cap 1.5 ft a p T W
Page 4 for number,
5 o /�'(�
[� Subsoil Cap ❑
size, and spacing of
Ci I; ASTM C33 Sand :5 Z � / F laterals. Laterals are
[� Tilled Layer 0.5 ft Typical Lateral equally spaced from
Aggregate a the distribution cell's
�---- A centerline in the
distribution cell (AxB).
Project: CHRISTOPHER L BELISLE Page 3 of 8
06/20/2001 07:14 7152473038 BELISLE EXCAVATING I PAGE 02
End connection Lateral Layout Diagram
evK •• Tuw WprMballwhrearvleare�rr<otwl ,I
AN tame" , a* 54~W NF x --qo) ► ow& aa" on "0 trwtbtmn or so 4"** S
Waft wom"d
f �fJfOQ 111Y�104f D11011 Yia k�P BOA OIOLYr t0111J11��bfd �k �t� D Diff %.OW i k joist In4o j "c a o, 4a
rjw COMM T.W* 64"-%)
Number of laterals 2 Orifice Diameter 0.125 in
Lateral Diameter 1.50 in Orifice Spacing (X) 4.10 ft
Lateral Length (P) 98.40 ft Orifices per lateral 25
Lateral Spacing (S) 3.00 ft Orifice Density 12.00 11
Lateral Flow Rate 10.30 gpm Manifold Length 3.00 ft
System Flow Rate 20.®0 gpm Manifold Diameter 2.00 in
Total Dynamic Head 14 -47 ft Foncemain Velocity 2.10 ftNI e
Dose Tank Information cow vs" ,,,,w"
IabN and tool" drA w Arid
sealed vuatartlgl>t
F-MCUtal as par NEC WO end —�► "�
Comm 18.28 WAC Dwconned � 4 in rrpn
N th Tw1k wnpvm t is property wrilAd F ARe aUtkt
k+oation
Forcenvin dWwnd r
weeks Manufacturer 2 in.
Ca %� 64 Gallons Volume gtaUirich A
vVssp hole or ar►ti-
Dimension Inches Gallons B Whon dr**
A 24.57 482,48 C
8 2.00 39.28 �il�tion R
C 1 121.14 92.57
D 157.12 D
- T - o — tal= 4013 800 -00
fJoas tank abvM'IM (R)
3 Bedding urxter
tank.
Alarm ManuafaCturer S.J. ELECTO SYSTEMS
Alain Model Number HW 101
Pump Manu(ac Curer G LD3
Pump Model Number WE0311t
Pump Must Deliver 20.80 gpm at 14,47 ft T
Project. CHRISTOPHER BELISLE , Page 4 of 8
Mound System Maintenance and Operation Specifications
Service Provider's Name KIM A O Phone 715- 755 -3145
POWTS Regulator's Name ST CROIX COUNTY ZONING I Phone 715- 386 -46W
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 1260 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 600 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 monthly
Pressure System Laterals should be flushed and pressure tested every 1.5 years
Mound In spect for ponding and see me once every 3 Years
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 Turn -up Detail
Finished
Grade
6 -8" Diameter Lawn Threaded Cleanout
Spdnkler Valve Box Plug or Ball Valve
.............................
Distribution
Lateral
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: CHRISTOPHER L BELISLE 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 shalt maintained in accordance with its' component
manuals (SBD- 10691 -P (N.01 /01) 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
POWrS 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.
Sentic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank
shall be disposed of in accordance with NR 113, Wis. 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 filter shall be cleaned as necessaryto 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 fitter 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 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 maybe made around the mounds 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 riot exceed 220 mgA_ BOO 150 mg/L TSS, and 30 mg& FOG for septic tank effluent or
30 mg/L BOD5, 30 mg /L T SS, 10 mg /L FOG, and 10 cfull00 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 -ot each lateral and-lt is recommended that each lateral be flushed
of accumulated solids at least once every 18 months. When a pressure test's performed it should be compared to the initial test when the
system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the
dispersal cell.
Observation pipes within the dispersal cell shall be checked for efhkaent pending Ponding leveisshatt-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 sarne 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: CHRISTOPHER L BELISLE Page 6 of 8
Performance
L.jb m rssib I E ff I u le n
Curves
METERS FEET
— — - -r f -- MODEL 3885
25� 80 SIZE 3 /4 " Solids
WE15H
70
2 20 F WE10H
Q 1
60
O WE07H - -, -- - - - -- — -
15 l� 50
WE05H --
10 C 30 WE03M 1
; 4 0 L
10
n I
0 10 2 30 40 50 60 70 80 90 100 110 120 GPM
0 10 20 30 m °/h
CAPACITY
�GOULDS PUMPS, INC.
S$4E{A FALLS PEW YOM 13148
METERS FEET
351 120 MODEL 3885
- —+— — SIZE 3 /4" Solids
110 WE15HH
100
30 I
4 -- --t-
25 � 80
70 f _
H 60
i
O
4 WE05 50
HH
40 ---}-
1
10 C 30
20
5 � 10
30 10 50 50 70 80 90 100 110 120 GPM
0 0 20 30 m' /h
CAPACITY
985 Goulds Pumps, Inc Effective July. 1985
C38R5
A
1-7
1156
56
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Wis —npin'DepartmentofIndus", SOIL AND SITE EVALUATION REPORT Page 1 of 3
1 4and Human Relations
on of'Safety &,Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
St. Croix
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), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. peILA
APPLICANT INFORMATION- PLEASE PR L'L,INOOR ION IEWEDBY
-
PROPERTY OWNER: PROPERTY LOCATION
Forest Oaks Condos, Inc. / ` ; ' "'r GOVT. LOT SW 1/4 NE 1/4,S 23 T 31 AR 19 iE (or) W
PROPERTY OWNERS MAILING ADDRESS IOT # I BLOCK # I SUBD. NAME OR CSM #
11160 190th. ave. N.W. M • " "r 16 na Whitetail Trails
CITY, STATE ZIP CODE ' PHONE �IU�� CITY ]VILLAGE 2 TOWN NEAREST ROAD
Elk River MN. 55330 (612) 8888 ! Somerset 205ht. Ave.
[x] New Construction Use (x] Residential / Number of bedroom.a' 4 ( ] Addition to existing building
[ ] Replacement ( ] Public or oo 'rbia� '�clLb
Code derived daily flow 600 gp d Recommended design loading rate • 5 bed, gpd /ft • trench, gpd /ft
Absorption area required 500 bed, ft2 500 trench, ft Maximum design loading rate • 5 bed, gpd /ft • trench, gpd/ft
Recommended infiltration surface elevation(s) 100.30 ft (as referred to site plan benchmark)
Additional design / site considerations system P1 based on contour 1 i ne of el - 99 --.3Q'
Parent material glacial drift Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem I ❑ S ® U C S ❑ U ❑ S ® U EIS N U ❑ S MU ❑ S ® U
SOIL DESCRIPTION REPORT PaZ 3 ] ZOX) -- ) I
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 0 -11 10yr3 /3 none 1 2msbk mfr gW 2f .5 1.6 S
2 11 -22 10yr4 /4 none sl 2msbk mfr gW if .5 .6 ,
Ground 3 22 - 46 7.5yr4/4 none sl 2msbk mfr gW if .5 .6 ,S
10 4 46 -84 5yr4/4 none sl M na na na .3 • %.4
. . 3
Depth to
limiting
factor
+84"
Remarks:
Boring # 1 0 -9 10yr3 /3 none sl 2msbk mfr gW 2f .5 .6
.::::.........<: >:
2 2 9 -22 10yr4 /4 none sl 2msbk mfr gW if .5 .6 S
3 22 -33 7.5yr4/4 none scl 2msbk mfr gW if .4
Ground
elev. 4 33 -70 7.5yr4/4 c2d 7.5 r5 8 sc1 M na na na np .2 _-
1 00.1 ft.
Depth to
limiting
factor
33"
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715 -246 -6200
Address: 1554 200th. e. New Richmon WI 54017
Signature: Date: 4 -18 -2000 CST Number: m02298
4= L
L ,
PROPERTYOWNER Forest Oaks Condos SOIL DESCRIPTION REPORT Page 2 of
PARCEL I.D. # pending
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
3 1 0 -11 10 r2 2 none 1 2msbk mfr 2m .5 .6 •y
2 11 -23 10yr4 /4 none sl 2msbk mfr gw 2f .5 .6
Ground 3 23 -46 7.5yr4/4 none sl 2msbk mfr gw if .5 .6 ,S-
elev.
9 7-3 ft. 4 46 -65 10yr5 /4 c2p 7.5yr5/6 sil M na na na np .2
Depth to
limiting
factor
46"
Remarks:
Boring #
[3
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
Remarks:
SBD- 8330(8.05/92)
Il STEEL'S SOIL SERVICE
Gary L. Steel Forest OaKS Condos, Inc. 1554 200th Ave.
CSTM2298 SWgNEq S23- T31N -R19W New Richmond, WI 54017
MPRSW -3254 town of Somerset (715) 246 -6200
lot #16- Whitetail Trails
ll" =40'
" BM.= top of 1 pvc pipe C el. 100.00
'Alt. BM.= top of 1 pvc pipe C el. 96.75
i
0
150 IIz
Gary L. Steel
4 -18 -2000
l
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer S t6,Ph
Mailing Address 49q qa Av�� so mf - 4o z5
Property Address
(Verification required from Planning Department for new construction)
City /State Som�erSz Vy2� Parcel Identification Number 0 30 - I'd 6o - 50 „ 0 �
LE GAL DESCRIPTION
Property Location 5yJ ' /4, N £ '/4, Sec. ' , T 3 1 N - R 1 W, Town of s2merSel`
Subdivision Wh 'j l�e +c% I �i tS , Lot # � .
Certified Survey Map # N A , Volume , Page #
Warranty Deed # (_0 3 3 '� , Volume 16 5 ' 4 , Page # 4f3
Spec house 0 yes 031 no Lot lines identifiable ® yes O no
SYSTEM MAINTENANCE
Improper use and maintenanceof 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 of a three year expi tion date.
NATURE 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 prope described above, b a warranty deed recorded in Register of Deeds Office,
S ATURE OF APPLI N - 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
• VOL 1557 48 16331 17
STATE BAR OF WISCONSIN FORM 2. 1999 KATHLEEN H. WALSH
Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO., WI
This Deed, made between Forest Oaks Condos, Inc. _ RECEIVED FOR RECORD
— 11 -06 -2000 10:00 AN
YARRANTY DEED
-- EXEMPT M
Grantor, and Christopher L. Belisle _ CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 104.70
— RECORDING FEE: 10.00
PAGES: 1
Grantee.
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
Recording Area
Lot 16, Whitetail Trails in the Town of Somerset, St. Croix County, Name and Return Address
Wisconsin. W e LIS - Zc c5o e) Lv 1
(P S m W T — 5 -4 01 c�
030 -1060 -50-000 _
Parcel Identification Number (PIN)
This is not homestead property.
Ot) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this Qj tir day of October 2000
Forest Oaks Condos, Inc.
•• Geral resident
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Forest Oaks Condos, Inc., by Gerald Smith, its STATE OF WISCONSIN )
President, ) ss'
�MNGW T County )
day of October 2000
Personalty came before me this day of
the above named
STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing
instrument and acknowledged the same.
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.) __ I )
Names of persons signing in any capacity must be typed or printed below their signature. id n iion Protaeiomis compery. F du Lac va
ecoass -zort
WARRANTY DEED STATE BAR OF WISCONSIN
FORM No. 2 - 1999
Z w
a o
z z
1 i '
LOT 15
136, 919 SO. FT 1
3.14 ACRES
zi NW3154 E c
412.04'
F_
J
�i LOT 16
od 131, 030 SO. FT
A 3.01 A ORES
WEST QUARTER CORNER
v ECTION 23- 31--19
ALUMINUM COUNTY
ONUMENT)
N88'37'S4 "E 412.04=
12' UTIL EASE
— -- — — — — —
S88'38'39'W =� `\ 28.49' —
28.20' �o -" - -
\ 8 0 � EAST —WEST
— QUARTER
CENTER QUARTER ; _ UNPLATTED LANDS
SEC77ON 23 -31 -19
LO 2 NI�
C_ERT _SU_RV_EY_ M_A N l� L
VOLUME 11 PAGE 297 z
1
SOUTH QUARTER CORNER
\ SECTION 23 -31 -19
♦ (ALUMINUM COUNTY MONUMENT)
1�
Safety and Buildings
10541 N RANCH ROAD
HAYWARD WI 54843
TDD #: (608) 264 -8777
,scons n www.w
www.commerce.state.wi.us/sb
isconin.gov
Department of Commerce
Scott McCallum, Governor
Brenda J. Blanchard, Secretary
June 26, 2001
CUST ID No.224263 ATTN: POWTS Inspector
ZONING OFFICE
KIM A O'CONNELL ST CROIX COUNTY SPIA
504 3RD AVE 1101 CARMICHAEL RD
OSCEOLA WI 54020 HUDSON WI 54016
CONDITIONAL. APPROVAL
PLAN APPROVAL EXPIRES: 06/26/2003 Identification Numbers
Transaction ID No. 649752
SITE: Site ID No. 630816
CHRISTOPHER BELISLE Please refer to both identification numbers,
207TH ST above, in all correspondence with the agency.
TOWN OF SOMERSET
ST CROIX COUNTY
SW 1/4, NE 1/4, S23, T3 IN, RI 9W
FOR: NEW MOUND, 600 GPD
OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 795602
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 /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.
Site Specific Conditions:
• 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.
KIM A O'CONNELL Page 2 6/26/01
• w waterline set backs COMM
Maintain well and ate ks er CO
P
• 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.
• Holes must be drilled with 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.
Sincerely, f FEE REQUIRED $ 175.00
i 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. W I. US
cc: CHRISTOPHER BELISLE
I