HomeMy WebLinkAbout032-2135-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety aid Building Division Sanitary Permit No:
INSPECTION REPORT 399532
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:
Gruba, Mik Somerset Township 032 - 2135 -10 -000
CST BM Elev: Insp. BM Elev: I BM Description:
01 (06 ' 13r'L
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic ' / y� „ / _ J j Benchmark •� io .� f O I
Dosing / � /� Alt. M
0 �i b /. (" 1a2'o
Aeration Bldg. Sewer
a• 6 y 3. a
Holding St/Ht Inlet 2-1 C / z
TANK SETBACK INFORMATION St/Ht Outlet / 15 ' Z• - ZA
TANK TO I P/L WELL BLDG. vent to Intake ROAD Dt Inlet
w sr /. to 2 . o
Septic ' Q 3 2 Dt Bottom : Ys 0�
U i O
Dosing \
Aeration Dist. Pipe
3.23 /00 .
Holding Bot. System
FIZ2LQEade b �S
PUMP /SIPHON INFORMATION 'rD'? I' • D 0/ ' (�
Manufacturer /�ojS GPM nd StCo�✓e_ oA
Model Number U � �
W�O3(l 1. '�()
TDH Lift Friction Loss System H d TDH ,
Forcen Length 0 f Dia. h Dist. to Well
+. I�
SOIL ABSORPTION SYSTEM
BED/TRENCH Width t Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L JBLDG IWELL LA STREAM L CHI Manufacturer:
CHA OR
INFORMATION Type Of S stem: , 1 1V z `' : � / Model Number.
DISTRIBUTION SYSTEM 7 5
Header /Manifo d Distribution _yl
t ze x Hole Spacing rVentir Intake
Length Dia Length Dia Spacing
SOIL COVER x 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 ❑ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 / : `^ Q Inspection #2: 1 Y Z �
Location: 664 205th Avenu �erset, WI 54025025 (SW � 1154. 23�1t��Whi�etai Ridge L Parcel No: 23.31.19.1197
1.) Alt BM Description = s�4' Z n�
2.) Bldg sewer length = - Z
- amount of cover = 3/
3J Contour -
Plan r i equired? ❑ Yes [ /No F
Use other side for additional information. 0
Date Insepctoeh Signature Cert. No.
SBD -6710 (R.3197)
-- - - `� Count
Safcty and buildings Division
County
201 W. Washington Ave., P.O, Box 7162
..
Madison, WI 53707 - 7162 Site Address
con
sin
i
Department of Commerce ��� ���
Sanitary Permit Number
Permit A licatio
Sanitary PP � 530--
in accord with Comm 83.21, Wis. Adm. Code, personal info 4 y+ou'dr4vid ❑Check if RE
ma be used for sce-condarY PuoMOscs Privacy L4 5. 1 m State Plan I.D. Number
I, Application Information - Please Print All Information �p'\ .� l \ / _-2�p'
tU !
Property Owner's Name = Parcel Number , lo
PT
{
Property Owner's Mailing Address ST C"X Property Location
frf
1 r u �a ; N. R
City, State Zip CWe ti. r' hone umber Lot Number Slock umber
Subdivision Na CSM Number
-,
11. Type of Building (check all that apply) ❑City
I or 2 Family Dwelling - Number of Mrocnis �_ - - -. - __ - - -i✓ [)Village
O Public /Commercial - Descnbc Use f'Ibwnship
O Sate Owned Nearest Road
III. 7�pe of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line )3 If applicable)
1 Ncw Replacement System 3 ❑Replacement o! 6 ❑ Addition to For County use
system Tank Onl y ing S stem
Date Issued
B. k if Sanitary Permit Previously Issued
Permit Number
IV. Type of Permit: (Check all that a
W1111 `
eying scheme is for internal use) = 16 �•
44 11 Non - Pressurized In•Ground =:4Tank 47 ❑ Sand Filter 50 ❑ Constructed Wetland
22 ❑ Pressurized In- Ground 48 ❑ Single Pass 51 ❑ Drip Line p
45 ❑ At -Grade 46 Q Aerobic reaamew Unit 49 ❑ Recirculaan 30 ❑ Other
V. Dispersal/T Area Information: '
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Perc tnc
olation Rate System Elevation Final Grade
Required Proposed kate(Gals. /Day /Sq t.) (Min./h) Elevation I
� wiec{IC�
C� I
VI, Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing W I qv.�9e-` P<ILb
Tanks Tanks
Septic or Holding Tank
Dos4 Chamber
VII. Respg nsibWty Statement- I, the undersigned, a responsibility for installation of th POW TS shown on the attached plans.
Plumber' amc (Print) Plumbe s Si MP/MPRS Number Business Phone Ntunber
Plumber's Address (Stru(' City, Sate, Zip Code)
3t _
VIII. Count /De artment Use Onl
❑ Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Approved Disapproved
Surcharge Fee)
❑ Owner Given Initial Adverse
1�� s-o d ��� j� /p�
Determination
Condi of Approval/ for Disapproval it , t
f �• Irx 5l �eK. w(/ -� f l' U((t'CD✓1� y �t'if'�. "ZbNG L
pro per• acv i� retie ���`tib�e�ev -ICe Eye �wT� eP� e� l{ t.d tmavl v �rer 5 5 p'�rts .
(b'e "t � (� be 6 c� xg C+-Pt --. {1�¢ I�OwTS �t.�L u�E( wt ih. tf� Sb � �'✓o wt SOt) t�So�Ptt�6titta trL�
�VZS �Inct,�C 1�. r��� -emu � �vtcwrce
Anacb complete pkwu (to the County only) for the em oo payee ant kw Wan SV2 s 11 taeb s 10 rise
`� SBD -6398 (R, 05101)
�',� 36.1 0.���� ,8 /�✓y - �
9y
uy9
ra' a
3
/Gj
o'
3,B�c° /7�iL5 L
� �•rC' t tJk ��
i
1 6'Itl6la 7uc.c
i
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TD
#: (608) 264 -8777 ero
visconsin www.vAsconsin.gov
www.comm .vAs c ons
.wisonsin.gov
Department of Commerce
Scott McCallum, Governor
Philip Edw. Albert, Acting Secretary
October 10, 2001
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: 10/10/2003 Identification Numbers
Transaction ID No. 678936
SITE: Site ID No. 637081
MIKE GRUBA RESIDENCE Please refer to both identification numbers,
205TH AVE above, in all correspondence with the agency.
TOWN OF SOMERSET
ST CROIX COUNTY
SW 1/4, NE 1/4, S23, T3 IN, R 19
FOR:
DESCRIPTION: THREE BEDROOM MOUND SYSTEM
OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 815135
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:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1)
and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST (0 1/8 1)
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the
owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the
Mound manual, and the pressure distribution component manual are complied with. A copy of this letter
including instructions and information relating to proper use and maintenance of the system must be given to the
owner and each subsequent owner upon completion of the project.
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
area.
• Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance
information must be given to the owner of the tank explaining that periodic cleaning of the filter is required
• Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1). In addition, the owner is responsible for submitting a maintenance verification report
acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate
for the component(s) utilized in the POWTS.
KIM A O'CONNELL Page 2 10 /10 /01
• Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the
initial installation of the POWTS in accordance with an approved management plan shall be conducted by a
person who holds a registration issued by the department as a registered POWTS maintainer.
• 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.
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/instal lationtoperation.
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
shalt 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
Charles L Bratz
POWTS Plan reviewer [I- Integrated Services WiSMART code: 7633
(608) 789 -7893, Mon. -Fri. 7:45 AM to 4:30 PM
cbratz@commerce.state.wi.us
cc: MIKE GRUBA
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: MIKE GRURA
~.ers Name: MIKE GRURA
I
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BLAINE MN 5b"
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Legal Desu 6 JYV - iVC - 'JCLi tv i v iiV i.7YV
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Q Name: TGA11 O
Siubdiliision Name.: V VI i t i L i ZiL 1 i .1
Lot Number. ib 8 Number:
Parcel l.C. Numuer:
Pian Transaction No.: Iy1
Pr- 1 .i .., X. •li.A
r aiyc 1 1 dex a iu tel:
Page ? Data entry
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APPROWD Pans d La an
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Page— .. V f.1i,G: i i i i igii ilGi i...i i'vv vi.. v'veI i'vCili:J{ i.7
Page F Mananement and contingency nian
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Page R PLOT PLAN
WA CORRESPONDEWA
Designer ; KIM 6 rN FI I inence N1 224263
Date: ug ► 13iu1 chore Number:
Signature:
; t;rgn d Pul:;ua;r. is :ixr
Mound ommnent Manual for POWTS Version 7 _gno_1o691_P !N ni tni l an{d
`�w(�aat� //����� n n. 1� r....a: r r� Q n s n- ..�_.. �' y� L...L:.. AI,,,,l� -4� f O 0AQ n.4 /a.4
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Vereion 3.0 (03/11/01) Page 1 of 8
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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 83443 in -situ soil treatment for fecal
1.50 Peaking Factor (e.g. 1.5 a 1 SO%) coliform of <= 36 inches
450.00 Design Flow (gpd)
.00 Site Slope (%)
x,20 our Line Elevation (ft)
Ds+pth to Limiting Factor (in)
0.50 In -situ Soil Application Rate (gpW)
Distribution Cell Information IT
75.00 Dispersal Cell Length Along Contour (ft) = B.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpolft
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest Wnt
in the distribution Y
Pressure Disribulion Information network? Enter Y or N
(c or e) a Center or End Manifold
3.00 Lateral Spacing (tt) It 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 C kifice Spacing (ft) - 9.00 ft /oritice
2.00 Forcemain Diameter (in)
120.00 Foraemain Length (ft) Does the forcemain drain back? C �
91.00 Pump Tank Elevation (ft) Enter Y or N
O.DUI Oystciti iicau (it) ii i.o iy.5r I ► i iaiii LA iaiiil:>vC.k (ycu)
8.53 Vertical Lift (ft) 67.38 5x Void Volume (gal)
1.16 Friction Loss (ft) 86.96 Minimum Dose Volume (gal)
16A Total Dynamic Head (ft) 20.60 System Demand (gpm)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options Choice in. dia. options choice
0.75 1.25 x
1.00 1.50
1.25 x 2.00 X
1.50 x X 1 3.00
2.00 x
3.00 x
Gallonsllnch Calculator (optional)
Treatment Tank Information F 1000.00 Total Tank Carty (tom)
1000.00 S iC Tank Capacity (gal) 1 52,001 Total Working Liquid Depth (in)
weeks Manufacturer 1 19.231 gallin (enter result in cell B49)
Dose Tank Information Effluent Filter Information
BM.00 Dose Tank Capacity (gal) lZabel Filter Manufacturer
19,641 Dose Tank Volume (galAn) . r A100 Filter Model Number
weeks Manufacturer
^;eject: MIKE GRUBA r Q
a ��vi P
i
""a — .- . - na , A Plan Vie
- -__ ._ -
r
�7 J
1/ B Clbservadon Pipe
f�7r1
�'. K
�5 A
{
B ........
z
.....:: ........
.......
..•. ,,...... ,
L —�
trot t:v:::jrva::c vit::ar5aIV11s
It
1
UV 1.
r 7 2 5.00 B ft F 3.5f} in i 7.87 ft L 85.83 ft
D 6.00 in G 0.50 ft J 4.56 ft w 18.43 ft
a5u.W (tt a Dispersai Ceii Area �uau.au (Tr) Basai Area Avaiiabie
6.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement
ggr egats, v: sper .sal Are-a
r: -.. •_ti __. �..__.. _. •.�� •� ism.
rttushed Glade :V t.49 (:y ►�. --
_.
F Bispe wl Cali 100.20 (ft) Lateral
99.70 (ft)* � -.
Invert
Dispersal Cell
Elevation C 3
E <<.
. .20 (ft) Contour Elevation
� (1 �s. .:ita �Inna
_._ ._ _.__ _._r_ Geotextile Fabric Cover
Shading Key _� J&ij;e rsal Cell See lateral details on
Topsoil Cad, 1.5 ft — Page 4 for number,
Subsoil Cap c 10 0 size, and spacing of
It
ASTM C33 Sand :5 F laterals. Laterals are
Tilled Layer 0.5 ft Typical Lateral � equally spaced from
[gf Aggregate O the distribution cell's
A — centerline in the
dictrihufinn Gall (AVR)
:,�:i::t: :v::r._ ...rsl.aBA raa: v ut v
f
C ri 1 ��hho��s L- WAL° I --@ of L09i� • om
-
OVet th soon • Turn up w ball •Jarve or aleanautplug
AN laterals are "d*C*i" HFOIes *1004 On the b*"h Ot the latetar $
e"A! ��
FoM male 00"het" vla tee a eto" to rnat*M at aM PO". laterals > lice main dr 1'tlC srh w
[per CON" Tame 84-30 -5)
Number VI Lzitefall r L VI II II.0 L ACII I1MVI r V. I L:1 111
Lateral Diameter 1.50 in Orifice Spacing (X) 3.06 ft
Lateral Length (P) 73.44 it Orifices per Lateral 25
Lateral Spacing (S) 3.00 ft Orifice Density 9.0C1 2 /orifice
Lateral Flow Rate 10.30 gpm Manifold Length 3.00
System Flow Rate 0. pm Manifold Diameter in
Total Dynamic Head Forcemain Velocity 2.10 ft/sec
nee Tor.b I..fi.�w,o +ii.r.
Locldng cow NAdh warning
ianel and locking gewce ana
sealed watertight
Electrical as per NEC 306 and —�►
Comm 16.2B WAG Disconnect 4 in. min.
Tank uxnponent is properly vented E-- Alternate outlet
location
i
Forcemain diameter
weeks Manufacturer _ 2 in.
Capacityl 800.00 Gallons A
Volume 19.64 gal/inch A
Weep hole or anti -
Dimension Inches Gallons B siphon device
A 25.95 509.69
C
B 2.00 39 -28 urnp off elevation (ft)
C 4.78 93.91 1 91.67
D 8.00 157.12 D
Total 1 40.73 800.00
T 1 I 1 ..Dose tanK ewmion rrt)
3" Bedding under tank. 91 -00
Alarm Manuafacturer I S.J. ELECTO SYSTEMS
Alarm Model Number HW 101
Pump Manufacturer GOULDS
Pump Model Number WE031IL
^ -.-- -__
Pi.ilI1N iviiiSt IJ4'l LV.W `p►lil dt
16. IS t Tvi
rw c r vl t�
„�:..... M1KL GrtU L rs �. a
Mound System Mai nten and Operation S2g% , .1 4 91tiati0A n�a
Service Provider's Name KIM A OC ONNELL - - Phone 715 - 755 -3145
POWTS Regulator's Name ST CROIX COUNTY ZONING Phone 715- 386 -46W
Systems e aiidloid 1'araiiieaci'a
UCS1y11 rIUV11- Y'Cdl, 4J 14pu IWiflclllll11t1 IIIt1UC1 ll rOtUI;IC 014C I%O III
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 Catiforrri >10E4 cfu/100 mL
Service Fr ;i
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 for and a once every 3 ears
Other
rviiscellaneous Construction and Materials Standards
A 11L..... 1..µ...J .J a...:..1.. ., i..... a.. T.. L.I .. /�.......... O A OA L.... .., a...i..L.i
Lrwaal`ia Juli opus
are JIULL U c17 iU tilCi. 11dIJ Col ii Ui lii iU . cl LA -0 iisii Li'+..3u i, iiciVi U tlYC3(¢.iil� iii cap,
and are sec in as shouin in the mound comnonent manual_
n n'......- .....1 ... It J.. J' J.. /�...... .M CA 9n /& %Ii% 1AG�. A.J...- n...d..
ts l3tJai3tii cell agi3 :a}�acc wi suirTi iu vull:il: vv..r lU /ii /: vv:3. r.U:ii. vuUC.
't G11 ora and nrgssl ire ninino materials conform to the requirements in Comm 84 VVic arlm, C-Ode_
I Tillage Uf the basal area IJ accoi i i l sled V vitiii d 1..o1d UUdru or l.9iiJVi Fiiu v:
h The mo stmicture and other dic bed areas yell ha seeded and mi:Inhed to / nt sell erosion
an 4 i fei tr i ouu:, c i i U3i pGiieI. a. '{U:1.
I ateral Tm Lii�n 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
n J. 1111VC ^1111 ion n r J O
in1r\L_ vnuu rage .J ul u
i
' ItA�a mil Cv�inm M�r�owe er�4 QIwn
' fifVYiiOi 'gjjt36triii iflQfi44�4f[Y4II::, II
(
U. iYrf�i\ .0 ^ Sr.':. YYS ft l .V' , iY C RYffi. VLVG
uc uz n:
i system sy5t8 shall be Gp6fSt@d In accordance w; fi CG(Tiir. -54 `r �.s. Adm. i-oae, and snail rnaintaineCl In aGGurdSnG@ YJiCfI iw Gi3rTipC3li8ilt
.u. �uais iSi3u- 10631 -P (MOUD1) and SS UVIVrP Publication 9.6 (01Z i )j and local or state ruins PU1aining to system maintenance and
maintenance reporting.
No one should mrnr enter a scptic or pump tans; since dar•gcrc,us gam, racy be prig - scnt that could caul, dcath.
S and nump tank ahandonment &hart be in acccrdanra ;•.'9h Comm P? zq 1nrs ndm Code when the tanks ore nn longer used as
S components.
septic or pump tank manhole risers access risers and covers should be Inspected for water tlahtness and soundness. Access openings
for Gast Ncc and a: .cot: hall :,coIw . ntcrtlght upon the comp!c• ion of sc .tca An opc^ ^g doc—.cd unsound, d0octiM, or su"oct
f ilur e must be replaced. F)pc°..ed acGe_-; openings -m-ter f n diameter shall h =ecu ed f ect
i ;,� gr hen 8 inches � i am 4 ! e by ar, e f, .:e (ocFin^, dw.dce to
�ircvcit accidental or unauthorle'0d entry into a tank or comporierit.
Septic
The septic tank shall he .ma intained b y an individ -dial certified to n^ - °.epos tanks cinder v 281 48 Coats The . ntcntc of the Gerd;_ tank
r h..(l h` d' spo".�cd cf ( accordartcc vr,•IttS ^;° 113, V:�a. Adm. ^cdc T he cN..rati, ^, send. ".ic„ . ^f the � - tan!' .,rid o:. *.!� `:ltcr shall be acN.�^:! �.
tar U1 ice every 3 years by insper::iui1.
The oldief filteir shall he clfant-d ac nnr P_saary to Pnstire nropw nnpratinn The filter cartridnp should net he rPmnman unlmc nrnvif inn-. art-
ma a to reta .,duds rn the tank that m slough off tt filter When r e r,v from by enolu,....rC if the f i s equip pe-d ith ar r alarm the filter
If the alarm is actRrstcd cant(n::c::slY. !ntcrn Rent fl "c; alarm^ may indicate s, flows or an impe-nding continuous alarm.
Tile tiepiic Lank 511n l l u-m its cunlwlzi remuvIud when the vu(unte Ui bludge anti sown iii the Wilk exuevis iia tiW;iyuiu wiume U1 the Wiii:. ;i
the cnntantn of ". tank are not removal at the time of a triennial aasf±c_s nPnt, maintenance npx.gnnnP.l shall advise the nwnPr of when the nP.i&
to be performed to maintain less, than ,Ma..,rr,,UM _ curt r and sludge acou- m ;:!aticn in the tangy_
Thi add *' In of blclage -al Cr chCm'Ca! addrtN yto cnhanc- soptic+ank plorfo manta, is gc,e_,nlly nos roquir d !-!m ii %uch products nro
ua•W they % "1 be appiuvud lui woAie taiik ut;e by Uie De- Imitnierii ui Cut nr let Ue.
P uma Tank
Thr u, (d^s,(nr tonic shall be in octod lca t ^ ? rill ^ .^t ^h.^^ °farm^ and sha be t �w to rif „^
•- pump 1 a) =� ,,.« ...wry � ya,ars. ,, . _. _ ,,.� pumps r..rr y prop: -r
If an effluent finer is installed within tahe tank it shall be inspected and si .iced a., ne.cess
.ry.
rlowid anal Fres:.we D;:54(iinAiuri sv i.reui
No trpp-q nr chnih4 should hp nlantt-Af nn the mnund Plantinnc may hP. made arnund the mound's nP.nmftpx. and the mnund shall
he seeded an`f mulched to ea o and to ide mtectinn from frost penetration. TraKKn (atker tkan for eta it
i -. _ wr nn•v .,., o r.w.- w .r..r•weaar pr, .. . some pie r
. nrr ,-.,n frost p. +e, . r_rr. .a. v� ... .,rr r + :+�... .m
aintcnancc) an the mound Is not rce- omm,-- od sr, r, _ sail compacticr, may hinder acra~.ion cf the inh"'ot c _: rfocc % thln the ;round and sno
i.oiiipuciiuri in lice withal will ptvrnuie hood peneiraiiun. Wd - .._uUier inSiaiiaiiuns (vciuWr- Feliivatyj diciaiu i;iui Lite muunu be iludwy 111Ulc1e:3
as nrcrtartinn from Imannn
in fln
unt aliF i�o file nd s rata.,+ not exceed = m A BOO 150 m A Taa a nd '1X.,,1 Ir FOG f . ept.o tank e ffl ue nt n
.__e- • :,;i.rayr _ a Mound �•ylw,n rr + °y,r_ ..•,�_ rr j,� .-.�, rng,� u, . ,�,... .. _r ... .. effluent �.. sr
30 m A AnC 30 m n Tae 101 m A C yr? a nd 1n + nfu /100 m` for hi tr ed e
Inflrranf fin n a naa m macs n Fln
,,.�,� , . g.� ..�,� , .rr ...., ,,, , ar ,.
aipucinei in the permit for this installation.
1 he pressure distribution system is om%Aded with a flushin_a point at the and of each lateral, and it is recommended that each lateral be flushed
« u ^c,m 1lata! scFds a, l =st since mnry 18 months, When prcssurc t,,..+ in orform.,.l iI, should b `L mnnr.,rr t th., i�if W.! tr* , .A n th-
K'a., r -s installed to determine if crfice clogging has orrur red and if erfice c!na rr „ is required to maintain a! distributinn. .thin the
r;spersai cell.
unservation pipes within the amowsal cell shall be checked for amuent pondina. Pondlna levels shall be reported to the owner, and any levels
^ A i „c hm c.Cnsi.de d as an i, di h 4 -- lic'a�l ^dd *:o, ral, r,a r c sr snit m . ^., ".or r
p:^ , , rg r y ,�, rig . ana rig.
Cnrg;nWnn��y Plan
rr ii.e Sdpt(G iUM ILA U11y U1 (t:i UJ1npUnel)i:a uumpwienL `Shui; be itrpaii LAS ui iuviaGeu iU iwep the 5yUeiri
in nrnpas npoinitina r~itinn
If 41,e .f s n took, FLrrp. pimp n^r,,+arnls o ! °r,,, a., ,elated :.0 n; f•ew�me� doF°'.:t�. ° 4 the de i'.. oomponer sha:l! be '4iat�y
o or ropla^4 od with a 1 „mponc t of the sa.r no ,,... :,�u °! perfc, r, M.•,1--.
uie 1nUU11d Uvrnpunetlt fails iu ac ceps wa «ewcz:er ur begins Iv uiSCiiatye waSievaier tv the gruunu suriave, ii will be lepailed Ur tepl uvu III
rts' nrp_cpnt I ncatinn by lncrpafiinn nasal area t trip laakane ncriim nr by remnvinn hininn_ ;rally Crnnnani ahcnrntinn and dicnercal mftdia, and relatM
rid r her ° deem +n bri +ha tam i .tin ndifin
repplaoi•y said cram s a.r .m neo••_ssaryt ring, a .,y-_.em , . pro r ,,, r„g oa„ ,_,,
5^^ Pagcl9of this plan for the name and tcicpho „c number of your I=! POI rc r..= and s r .,a c pm—,14 !o,
S
IVIIr\C l '- '.9W8 U UI U
• �c ry s
Pump
METERS FEET
N10DE1
' SIZE 3 i," Solo s
g 70
zv WE r- --� - ' -
15 s� _,_.__ �.�_.__�_ ate\. I.. - i - -- - { - — 1-- - - -•I - -i
40 �I —r—
0 0 -
0 10 D 00 W w w 70 w SO 1G0 I 10 1 :0 G M
0 10
CAPACITY n 1
.i ^,I ' :'!NS %•�;'.;�'!!'�r"T.'�� ,i�� ( • �•' • �.I�.� c �� ?rY� ..'�. �.iOUIO:) 1"UI, I�
METERS FEET r— �--- -- ^�
120 r — — — ,-- 1-- , — —, N ODEL K
SIZE 3 ,V So
110 w E 15nN
1 00
g
70
�._.
o - _. L - .. _ .. ...- -- 1 _. _ 1._ ,
WEOSnN
.r- -T_ —�—
rr�i
0 0
0 10 20 X 40 SO w 70 w I W 110 I:'0 GPM
0 i 0
CAPAC 'r/
• I v00 01T/11�• PVmpl, InG. - tA�fYr� �ry i ,�;
CIA.
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Wiscanain Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor did Human Relations
Divisio , of Safety 8 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' ' e. Plan must include, but St. Croix
not limited to vertical and horizontal reference point (BM), d' i firm pe, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to aro _ / = pending
APPLICANT INFORMATION- PLEASE PRINTI�� FIO N VIEWED BY DATE
l0 31
r' / 1 0
PROPERTY OWNER: PROPtR LOCATION
Forest Oaks Condos, Inc. ] '_ ju ',' a ,,Q VT. LOT ` SW 1/4 NE 1/4,S 23 T 31 N,R 19 R(or) W
PROPERTY OWNER':S MAILING ADDRESS r T # LOCK # SUBD. NAME OR CSM #
11160 190th. Ave., N.W. �u�u � 18'. / na Whitetail Trails
CI -Vjjj g River, M. 55330 P 12 Nr} 8888 ()�F ❑ Y, VILLAGE ]f OWN NEAREST ROAD
'. Somerwset 205th. Ave.
�c ] New Construction Use [x] Residential / Number of be ras_ _ 4 [ ]Addition to existing building
] Replacement [ ] Public or commercial describe
Code derived daily flow 600 g pd Recommended design loading rate • 5 bed, gpd /ft • trench, gpd /ft
Absorption area required 500 bed, ft 500 trench, ft Maximum design loading rate • 5 bed, gpd /ft • trench, gpd /ft
Recommended infiltration surface elevation(s) 100.20 ft (as referred to site plan benchmark)
Additional design / site considerations system el. based on contour line of el. 99.20' —
Parent material glacial drift Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem I ❑ S C2U IN S ❑ U ❑ S CC PIS Elu ❑ S g] U I ❑ S C2F
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 0 -1 10yr3 /3 none 1 2msbk mfr 2f .5 I .6
La
2 12 -31 7.5yr4/4 none sil 2msbk mfr gW if .5 .6
Ground 3 31- 5 7.5yr4/4 none sl 2msbk mfr gW if .5 .6
99 ft. 4 55 -78 5yr4/4 c2d 7.5yr5/6 sicl M na na na np .2
Depth to
limiting
factor
5,
Remarks:
Boring #
1 0 -10 10yr4 /3 none sl 2msbk mfr 9W 2f .5 .6
2 2 10 -42 10yr4 /4 none sl 2msbk mfr gW if .5 .6
3 42 -53 7.5yr4/4 none sicl M na gW na p .2
Ground
elev. 4 53 -10 5yr4/4 none sl M na na na .3 .4
9 7.0 ft.
Depth to
limiting
factor / — _F
42 "
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200th. Am.. New Richmo d WI 54017
Signature: Date: 4 -19 -2000 CST Number: m02298
PROPERTYOWNER Forest Oaks Condos SOIL DESCRIPTION REPORT Page 3
PARCEL I.D. # pending ,
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Barry Roots GPD /ft
.................
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends
..................
.................
..................
.................
:« 1 0 -10 10yr3/3 none sl 2mgr mvfr 2f .5 .6
........3..``� 2 10 -40 10yr4 /4 none is Osg mvfr if .7 .8
Ground 3 0 -60 7.5yr4/4 c2d 7.5yr5/6 US Osg mvfr ria na .5 .6
elev.
9 7.0 ft.
Depth to
limiting
factor
40"
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)
` STEEL'S SOIL SERVICE
Gary L. Steel Forest Oaks Condos, Inc. 1554 200th Ave.
CSTM2298 SW4NE4 S23- T31N -r19W New Richmond, WI 54017
MPRSW -3254 town of Somerset (715) 246 -6200
lot #18- Whitetail Trails
N
1 =40'
BM.= top of 1 pvc pipe @ el. 100.00'
Alt. BM.= top of 1 pvc pipe @ el. 97.95' —
�zg-
( ^ la y pp ��� �� � ,� ✓
W P
Q
�
'i n ` 3 a1 ✓
I `
V
Gary L. Steel
4 -19 -2000
From Mike Gruba To. 17152473038 Date: 10 /18/01 Time: 9:02:44 PM Page 3 of 3
101161'2001 16:03 7152473038 BELISLE EXCAVATING I PAGE 82
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwncrBuycr A
Mailing Address /01 3 tiol !26 & & 9, tJrl
Property Address ( *4 ; s - w 4 vit_
( Verification tcgaired from Planning Department for new construction)__,
City /Stara )D/11FKSE�7 parcel Identification Number
LEGAL DESCRIPTION
Property Location t /., �/4, Sec. 3 T,,,;l _N•R„jW, Town of ,ii7 r lgSS
Subdivision i �� ►1 f Z q l �Y� I t -I , Lot # .
Certi[ied Survey Map # . Volume � Page #
Warrauty Died # _ Volume , Page # .
Spec house ❑ yes ❑ no Lot lines identifiable D yes O no
SYSjgH MAINTENANCE
improper use and mainlenanceof your septic system cculd result in its premature failure to handle wastes. Proper maintoaspes
eonstata of pumping out the septic tank every three years e$ sooner, if needed Dy a licensed pumper. What ypu pWt into the system
ca:1 affect the function of the acetic tank Ws it treatment stage in the waste disposal system.
The property owner agrees to submit to St, Croix Zoning Department a certification fort, signed by the owner sad by a
a nasterpiurriber, joumbymanpiumber, restviotedplumber or a licensedpwitperverifying thu(1) the on-site wmtewaterdisposai aystetu
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is iM IUD 113 full of sludge.
l the undersigned have read the above requirements and agate to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce tied the Departmtnt ofNiimral Resources, State of Wiscortsia. Cc tifiCatioe
stating that your septic system has been maintained must be completed and returned to the $t, Croix County Zoning Office within 30
days oNbe three yearypiration date.
Sr R OF APPLICANT DATE
CE
I (wel certify that sill statements on this form are true to the best of my (our) knowledge. 1 (we) am (ate) the owner(t) of
rise property desoribed ve, by virtue of a warranty decd recorded in Register ofDeeda Office,
St ' ATU OF APPLICANT DATE
000 Any information that is mis- represented may result in the sanitary perrtrit being revoked by the Zoning Department, ••i ° °'
°• Inelade with this application: a stomped warranty deed from the Register of Deeds office
P copy of the cenified survey map if reference is made It the warranty deed
L ft3 /O
• STATE BAR Of WISCONSIN FORM 2 - 1999 652662
h;ATNLEEN H. WALSH
Document Number WARRANTY DEED REGISTER OF DEEDS
sr. CROIX Co., WI
This Deed, made between Forest Oaks C ondos, Inc., a_ M_ innesota RECEIVED FOR RECORD
Co rporation, _ _ _ 08 -01 -2001 9:30 AM
WARRANTY DEED
Grantor, and Mic J. Grub EXEMPT A
__— CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 110.70
- - - -_ -. — 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 18, Whitetail Trails, located in the Southwest Quarter of the Northeast Name and Return e� TM E, INC.
of Section 23, Township 31 North, Range 19 West, in the Town of SUITE 200 CLi
Somerset, St. Croix County, Wisconsin. 1900 SILVER LAKE ROAr)
NEW BRIGHTON, MN 5511:
FILE NO. TS(O�by`(
0 32 - 1060 -50 -000 _
Parcel Identification Number (PIN)
This is not homestead property.
LA) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this day of July 2001_
Forest ks Condos, c.
« • Gerald J. Smith, esident
«
AUTHENTICATION ACKNOWLEDGMENT
Signature(s)
STATE OF WISCONSIN
County X
authenticated this day of
Personally came before m4t T away-of
July '- > .4th a wZnamed
Forest Oaks Condos, In by Gera ;bit reslt�nt,
TI'fLl„ MEMBER STATE BAR OF WISCONSIN — - --
to me known to be the person(s) who executed the foregoing
(If not,
— —- - — ins Wand pal ged the same.
authorized by $ 706.06, W is. Stats.) ' THIS INSTRUMENT WAS DRAFTED BY -
Attorn Kristine Oglan Notary ublic State of Wisconsin
Hudson, W 53 y 016 _— ,., _ My Commission irparnTznT - (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) � ! )
'Fames of persons signing in any capacity must be typed or printed below their signature. Intormat— Protessonais company. Fond du Lac, w1
800655 -2021
WARRANTY DEED STATE BAR OF WISCONSIN
FORM No. 2 . 1999
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