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032-2096-30-000
Wisconsin Deoartrrrent of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Buil4ing Division INSPECTION REPORT Sanitary Permit No: 483986 0 GEI IFRAL 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: Linden, Jim I S merset, T wn of 032 - 2096 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Q Section/Town /Range/Map No: jfb / , J G b S 1 14.30.20.931 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 1C�0 Benchmark � � Y CJU Dosing Alt. BM Aeration Bldg. Sewer Holding SUHt Inlet s � St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic i Dt Botto tl 7 17 � kj/ Dosing Head an. 2 Ca Aeration _ Dist. Pipe s '� Holding Bot. S s PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand Cover S — 7 Z 77� GPM [Nrvm 5 Model Number 6� TV Lift `�� Friction Loss Sys 3 �� T�� � Ft - S Forcemain Len t Dia. IDist. to Well SOIL ABSORPTION SYSTEM 17 .-°r't cZ,t� 7`°'n�c� �, A H BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS f 1 1 66" SETBACK SYSTEM TO P/L LDG WELL LAK T M t CHIN Manufacturer. INFORMATION CHA OR Ty f System: �' OD, UNIT Model Number: DISTRIBUTION SYSTEM S e�f ,.� ��J2Rara(ec/c Heade anifol Distribution f r x Hole 'Size I x Hole Spacing Ven to Al r Irytake Lengt Dia L Length Dia! Spacing 3 / a SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Sys s my D ed/Tre O nch Center Bed/Treench Edges Topsoi of f F eeded/So ed c � Yes No Yes No MENTS (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: /0 l I 1548 Oak Ridge Lane Ho�ulton, WI 54082 (NE 1/4 SE 114 14 T30N R20W) Green Acre Counntry y Estates Lot 3 Parcel No: 14.30.20.931 , :Option ription = ' "� Wit" r lCt igth = � 1 / �1.� SC ��S�t " ��t'ol GC "7j" -. sr, v = 7 Yes W ,I information. Date Insepctor's Signatu a Cert. No. TOTAL DYNAMIC HEAD /FLOW PUMP PERFORMANCE CURVE PER MINUTE kw" MODEL 140/4140 EFFLUENT AND DEWATERING 371 65116 55 4 se 16 MODEL 140/4140 8 Feet Meters Gal. Liters O 329/32 5 1.5 86 326 ° 14 45 10 3.0 80 303 + 15 4.6 73 276 ° 0 12 40 20 6.1 66 250 25 7.6 59 223 11/2 111@NPT 140, 4140 35 30 9.1 49 185 10 35 10.7 38 144 = 30 40 12.2 28 106 45 13.7 17 64 a 25 010940 Shut off Head: 50 8. 15.2m 0 iQ 0 ~ g 20 1213!32 I 15 4 } t0 45132 SK1524A 2 5 0 111111 1 10 20 30 40 1 50 60 70 80 90 GALLONS r lLer-agglawil LITERS 0 80 160 240 320 f FLOW PER MINUTE 37re r-- 651e J 4518 CONSUL FACTORY FOR SPECIAL APPLICATIONS O 329132 Electrical alternators, for duplex systems, are available and supplied with an it ° J- alarm. • Mechanical alternators, for duplex systems, are available with or without 110. NPT alarms. - Control alarm systems are available for 1 phase pumps used in simplex system. See FM0732. - Variable level control switches are available for controlling single phase sys- tems. • Double piggyback variable level float switches are available for variable level long cycle controls. 16,/8 • Sealed Qwik -Box available for outdoor installations. See FM1420. • Refer to FM0806 for applications above 130 °F (54°C). --(- 4 S32 — 4 1 1 SK1524B SELECTION GUIDE 140/4140 MODELS Control Selection 1. For automatic use single piggyback variable level float switch or Model Model Volts -Ph Mode Amps Simplex Duplex double piggyback variable level float switch. Refer to FM0477. p p p 2. See FM1228 for correct model of simplex control panel. N140 N4140 115 1 Non 12.0 1 or 2 3 3. See FM0712 for correct model of duplex control panel. E140 E4140 230 1 Non 6.0 1 or 2 3 BN140 BN4140 115 1 Auto 12.0 * - -_ A CAUTION All installation of controls, protection devices and wiring should be done by a qualified BE140 BE4140 230 1 Auto 6.0 * _ -_ licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). *Single piggyback switch included. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. _._.._ . _ _ ......... ___.. _._ .. _ _. __._._ .. _.. .. . MAIL TO: P.O. BOX 16347 Louisville, KY 40256 -0347 Manufacturers of.. %7, SHIP , K Cane Run Road Louis isva� KY 40211 -1961 h =lrrRWRY FN CE 1ffF p��� �O (502) 77 8 - 2731 FAX (502) 7736248 -PUMP Q www.zoelleccom /— © Copyright 2004 Zoeller Co. All rights reserved. CD °��, " co g 17 N Z o w r (n g CJ y Z o A r (n o n m m o 0 0 w� ° v 3 `� m o 0D 3 w w �-+ • 00 m �' �• a c m m R S d(D ^' W R !i N A A oo do R '+' m f/! p I "' Q ti N U W CD ! m O N to N N N a 3 Q N 3 ` O o m D O` ., O p C cn oft N N N N R �p N N I N R, ] y N tD w O N O O) N� CD c O (D W m p 0 (D T ' m z E C Q m o cn a a � v > ID `aD � CD m H a m ? cn a ' A A O co W Q . :3 W Q ., a c w o o o x ° °° c p x N N N Q Qo to 3 �l O O O fD O O O m a m Z CT O R fD v W !. m i • O0 N N m to CD c a to m °° y I N p c \+ m o CD c o o m j T CL 000 E 000E'I y N N N n N N N? w Q N cr �V < I� C �7 • ' CD wy'' ! I D o m A p m p Q lu 00 ju 00 3 IM N N 3 DJ N 3 m (D o Z Z z N p° ° D D o D D o 0 O O ;I CD W Z 3 a I A CD O m of t O O 6 a Q m A 7 O O W 'O m O A CL 3 ° 3 A z :* 1 (A N N Z y� II m G CD m CD I A W W I � o w m Q W o= T o a m 7 OD 0 R C W e C RCD_ 7 T � O TI N y C O O O W C ° a a (n < m o CL m Z A�m m o m m � H O Oo :3 m N f a O Q •y0 m CD m ° x CD o U: v a 3 ? C) o m 3 5 O m ° o c ° o Q c O O O R l n m o'o c'R e 3 m 0 C y N O °o0 o o 0 - ° o I a CD m Fn O o Q commert;e.wt.goV ty and Buildings Division County hington Ave., P.O. Box 7162 1 5 r. C /Z o r_ >< co nsin 0 M 'son, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) department of Commerce 9 9 �o Sanitary r it App 'cation State Transaction Number In accordance with s. Comm 83.21(2), Wis. Adm. Code, submission of is o ropriate governmental t 8 q ma a I unit is required prior to obtaining a sanitary permit. Note: Applica on [ WTS are Project Address (if different than mailin dress) submitted to the Department of Commerce. Personal information u rovide s ry p urposes in accordance with the Privacy Law, s. 15,04 1 m , Slats, I. Application Information 'Please P Information Property Owner's Name JQJ r��) Parcel # 3RJV�ES z'J� .. C LU 01a - AP Property Owner's Mailing Address Q d ZONI Property Location �3 k, KT D G E L R ^� °F>: jC Govt. Lot , 7 City, State Zip Code Phone Number y., S E ' /., Section JL N O 0. 1 :5 , , q LTO At WX O 9 a, 7t S- 5 — S'5'-o (circle one T �_ N; R � O E or 11. Type of Building (check all that apply) Lot P4 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name (2) Q '� Q Block # A vL .*; 0 PubliciCommercial - Describe Use _ City of 0 State Owned - Describe Use / CSM Number 0 Village of _ 60 )MM J K Town of 111. Type of Permit: (Check only one box on line A. Complete line B if applicable) A 0 New System a lacement System g Tank Replacement Only ❑ Other Modification to Existing System (explain) y T�,K p y ❑ Treatment/Holding p y g Y' ( P ) B. ❑ Permit Renewal 0 Permit Revision 0 Change of Plumber 0 Permit Transfer to New LJP Numb�r�n¢ Issued Before Expiration Owner �` CC���� �/ , IV. Type of POWTS System/Component/Device: Check all that a 1 i 0 Non - Pressurized In- Ground 0 Pressurized In- Ground 0 At -Grade 51 Mound? 24 in. of suitable soil 0 Mound < 24 in. of sugable soil j 0 Holding Tank 0 Other Dispersal Component (explain) 0 Pretreatment Device (explain) !I V. Dispersalfrreatpmot Area Information: Design Flow (gpd) Design Soil Application (gpdsfl Dispersal Area Req (so, Dispersal Area Pro ed Q System Elevation 1 Al 8 : ts" 12, ✓ ' 0600 too.5 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a 2 o New Tanks Existing Tanks a` U n ti rn a C7 w Septic or Holding Tank / O d A (� _ S �{, X t Dosing Chamber �G e.O 1ri S 0 T PI Ks K VII. Responsibility Statement - 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number 64 N CCi4VZ:L..E L'� oV 7710 - 1 S- 7� - ��aZ2 Plumber's Address (Street, City, State, Zip Code) 4(0 1 0 � (o s' �0 8 Lr�t'S wi Syoz VIII. Count /De aftment Use Onl Permit Fee Date I ued Issuing A Signature PProved El D' PProved g ( •� Gf �/� ❑ iven Reason for Denial / IX. Condit' - 1� soos for Disapproval ► t (� �,�, are - L Attach to complete plans for the system and submit to the County only on paper not less than 8111 x 11 inches in sue SBD -6398 (R. 02/09) Valid thru 02/11 i 03 W.% 3T WO ant Tlt�i®iYi:►t3^t tr'. ,7 3 i'IS :'N;Y >t� $R1 �i9i'�lt'��'AJ - .., h _ - . '. � t,.+.�lwa .i.:.. •� �r.'; :AIL I �I a a6 9G��� ri scat 0 1 . 0 s o -. 'Zo / CY v Safety and Buildings ov PO BOX 7162 commercemi. g MADISON W 1 53707 -7162 Contact Through Relay i scons � n www•commerce.wi.gov /sb/ , t Department of Commerce www.wisconsin.gov Jim Doyle, Governor Aaron Olver, Secretary August 19, 2010 CUST ID No. 226375 A7TN: POWTS Inspector ROBERT W ULBRICHT ZONING OFFICE ULBRICHT & ASSOCIATES CO ST CROIX COUNTY SPIA 2812 10TH AVE 1101 CARMICHAEL RD SPRING VALLEY WI 54767 HUDSON WI 54016 CONDITIONAL APPROVAL ' Identification Numbers PLAN APPROVAL EXPIRES: 08/19/2012 Transaction ID No. 1842681 SITE: Site ID No. 759350 Jim Linden - Dwelling Please refer to both identification numbers, 1548 Oak Ridge above, in all correspondence with the agency. Town of Saint Joseph, 54082 St Croix County NE V4, SE 1/4, S14, T30N, R20W FOR: Description: Mound Object Type: POWTS Component Manual Regulated Object ID No.: 1277427 Maintenance required; Replacement system; 450 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.O1 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01101); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to P Q.' inspection by authorized representatives of the Department, which may include local inspectors. All permits Con i 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 t' `i' R N1 g g Pp y g g q g DI'Ji;,i N pFl 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' ; _ CORRE 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. I I I i ROBERT W ULBRICHT Page 2 8/19/2010 Sincer Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 eter E Pagel Private Sewage P9viewer, teg rated Services WiSMART code: 7633 (608)266-2889, M - F, 0600 - 1430 Hrs pete.pagel@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 828-5902, Monday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www. commerce. wi. gov/ SB/ SB- BuildingContractorProgram.html U1.13RICHT & ASSOCIATES CO. • Re e . Desi Hers of Engineering S stems 9 28i 2 10th Ave. Spring Valle WI 54767 g 9 � y Private Sewage Consultants 715 -772 -3442 RECEIVED AUG PROJECT INDEX SAFETY S JILDIPJG j Plan I.D. # Date �'bU'' 7' °;2 o/O Owner I lV - Phone 7 Sq? • 5501 Address 15q 0.4 LN. o UGj - o, t� W /. yb d'� - Legal Description 1p jm fl �� 5'�0 • 30 • 0 ©d GoT 3 bRF�N A At 000.AjTRy ZA7e•S ,,3 E It 56 SEC. 14 T 3 or i, R Z d w Town of 5•�- 7 0 County 5 T• G R 01' K C.S.T. '�•- 1b(��G�7- ZZ(e37S Installer Local Authority/ Supervision 5 r- GR x c.7ty. zoAalfx D awQ PROJECT DESCRIPTION 7 IS • &0 4 (�P /�c�ME A) 7 - 1 g400,uD s ys� M roR A FAi 4 l 9 yf O to X) p 5 yS i lM , 0 Z► t,- i AVA• L t+0M E �t y y) s y s T � - ,� 404 -5 �i� - r� t 3 I3aWN3 , all 55n�Yh -rte D�icy .�� ; f,� fid CO N� U; ,B �4-.s� c. � a v�o A IzE� s b a r� Ike d,� b s Flow v u�rZ ,acs fti �,v R s U �l f 2c u scv �,�,•� G'o ��- r4}'� 20��D C0lft3 o T4�vk s sr��1 /�uG� �p�� PROPER- F, Y /A) U/y G h -1 �3 E � �' D /4 l J0 (c1 Fo p , Fu+vkC T ````O`\Nccnccucarrrnryrii r/ v' �� " • �• r Aaa* W A 1@ m ti11,t~0 Z r y t�f�f c nk ' liuusoN. Wa ( B i IN Pg.1 PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS (REVERSE SIDE DETAILS INSPECTION PIPES & FABRIC /TOP FILL DETAILS) Pg.3 PIPE LATERAL LAYOUT (REVERSE SIDE SHOWS DETAILS OF LATERAL CLEAN OUTS) Pg.4 DOSING CHAMBER CROSS SECTION & SPECS. Pg.5 PUMP PERFORMANCE SPECS (REVERSE SIDE SHOWS PUMP DETAILS) Pg.6.OPERATION, MAINTENANCE REQUIREMENTS (REVERSE SIDE SHOWS SITE & SPECIFIC PROJECT DETAILED INFORMATION,UNIQUE TO LOCALE AND GOVERNMENTAL UNIT AREA) The attached plans and specifications are based on the following approved manuals: "Mound Component Manual For Private Onsite Wastewater Treatment Syeteme , (Version 2.0 SBD- 10691- P(N.01 /01) and "Pressure Distribution Component Manual For Private Onsite Wastewater Treatment Systems" (version2.0) SBD - 10706.- P(NO1 /01). A A �,ro �a !� ia� OA 0 1 o r ri I � oL .� ? us I c I o I I CR OSS SEGT100 OF M ouo D wi rtt I Bee 13to of" ro - 7�rSTRi(3t�T�dN I i AggerSATF G , rk eek4 e s s pi P '#-) 6- oP To soil w/ - reRh141w- sYsr C� p'S � E I EvA l UMi iFO$?M Toe N ©, S0 RRTiO µms 8 • • ' - ' SAap i Plewao TopSo�•,� ll/ /l1 uN F RM Z a'► slo FORCE StIVAP O VA30ER MAW f•0 Fr. — MLEVADOP-N S E 1. /Z Fr. " INVF-RT o f l IATCRA(S �� / • F FT-�I-g •j o f R ock • TO H F T. O I RTER A I5 1 PLAM VI OF MOULD wirti 'C3ED a 2" cc a-r j�>A-L Race MR A 6 FT• Fr k /a Fr ----------- .._..______.� Fr FT k -�� ( T Fr W W 3/ �. rU N Sao ofr�." Puc cAppep To Ii" pq'�R!`G Of3 SERVh't►oa Pipes MCA7-lli&J5 f0 r-77, PEOMAO&oT MAekERs (T*jdS► - ® f CIC. Ov1 s`v4 -w- ) R e(qui RED BASAL AQeA = ^t��/ �hsrE'Fl Q &00 APACIT t 2 D IGTP QOT)0 �J PGPE I-AYOUT CE)V R AL MAN 1 b L, I C pv� R .3 Fr Fo RAE MAI'&j q Fr_ o f p U G --- ---_ roc y VARI'A(3t_E TOTAL, V (9 1 D V b I t) h r~ �o G A I S . 'D I' ST^ P ,,3 C ft 3 7D 74L, IIDitJ�l� H oui b"AME - MR jI 11ucNr =S �A��R�L lNt1 {E5 Eu'r h 1. MAWF / 5 . FopcE- MAIN Z 1uc.µes . H01E5/ p 1-7 -s MOVERr ELp_UATIOK OF LATE►RAI S .3 /0/.o TEPM i IAA L_ C/O T) C 774!' L, `' f�>= R � U_ Re"ova - All TRitl B V RR5 � Y W_ , �2 ! Y s pA to . W M STRI' BUr1oml DISchAR &E RATE r E�RCh LAT` ERiL v v� a 1'O l�i 1)i5C FA T E r-O 1° Nr�F W O R K GA M • ' M 1 Zvi rte. � 5` N! M l�P— A . . HEADI 1 116 CADACITY 1110 50f� 1 055 - CURVt �° t 28 } — 95 EFFLUENT 2 2 �° WMWOOEL and a DEWATER/N = 20 a } 1 55 F 19 50 MO L C t MODEL F- 14 5 _ 188 12 + ' 35 10 __ MODEL F2L 137,139 -MODEL SEWAGE and S 1 85 DEWATER/NG a 20- MODEL 15 MODEL 161 4 g7 ra 2 MODEL W W 5 53, 55, - 4 57,59 0 GALLONS 10 20 30 40 SO 80 70 80 90 10G 110 24 � - • LITERS 0 80 180 240 320 400 75 22 FLOW PER MINUTE 70 20 "137" Cast Iron Series «139 Bronze Series HEAD CAPACITY ? UNITS /MIN Feet Meters Gal. Ltrs. 5 1.52 104 394 � � • Automatic or Non - Automatic 10 304 79 300 • i /2 H.P., 1 Ph., 115V, 200 -208V or 230V. 15 4.57 64 242 • 'h H.P., 3 Ph., 200 -208V or 230V. 26 6.10 36 136 6 • Non - clogging vortex impeller design. 25 7.62 30 Lock Valve: 26' • Passes 5 /a inch solids (sphere). • 1'/2" NPT discharge. ^� • Float operated, submersible (NEMA 6) 2 pole mechanical switch. • Automatic reset thermal overload protection. / `Q .. • Stainless steel screws; bolts, guard, handle and Zff L`fT �f arm and seal assembly. *Bronze motor and pump housing, switch 3260 Old MXW Line case, base and impeller. P.O. BOX 16347 Mercury float switches are available for non - automatic models. � LOulsvift Kentucky 40216 FLOW PER MINUTE Pg. 6 ' of 6 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code . s The septic tan . ' P k shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retainsolids in the tank that may slough off the filter when removed from its enclosure. if the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. if the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. Hovmver, if such products are used they shall be approved for septic tank use by the De artment Buildings Division. p of Commerce, Safety and III pu mp Tank The pump (dosing) tank shall be inspected at least once every years. All switches, alarms, and pumps shalt 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 ry Distribution 5 tem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shag 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 for frost protection. Influent quality into the mound system may not exceed 220 mg /L 8005, 150 mg /L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and It is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice 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 effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual (SBO- 10572 -P (R. 6/99)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Continaenc n v Pla 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 shall be immediately repaired or replaced with a component of the same or equal performance. if the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by Increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintenance of this system should be directed to your county zoning or health Inspector. SEE REVERSE SIDE Pg -6 FOR MAINTENANCE TO TIfIS SITE, DESIGN, AND COMPONENTS REQUIREMENTS SPECIFIC I i 'paloadsuT ATIeTnfiaar aq osTe ttegs TTaO sql uT buTpuod quanl33a 3o soua t 3uaui��a�� s.wa sds 441eaq sanTOAUT q XIOA 9 1 4 , �'.A3 BABI J axa d�a3es .Aas I q,I A PaT9TTenb dTxedo�d pesueaTT a d=uo - (aTa buTmao3.xed a eut as uosarad anoge pe400T a eTA) s�ue�. aq, tiu u ma "As ara/ punoxb sTearaIET 0 4 4 buTutaTD pue buTgsnT3 3 0I - d 81 It aqs ' paaTxnesaxd e4l uo sTeuTmia, anoueat��•usaa �e '$TezayeT IanaT �uenT33ej- ease Tese ( dtd uoT4oadsuT q M -sq.zod page uaag aye q punom aq-4 uo :wagsds aqq 04UT s pue sadTd ual joadauI -Xjessaaeu sAusb�e sTtt 30 a[auwo ARa Aq suoTgaadsu 31poT . P. uTe - 4ulRm Q auoTe quejoij ns •xMaeoo�1 7� u'� uanT338 i ilig -&SAS V HaA0 I�tQI.LK.I `J apt ma�sX�• eq- O,L )LHVSS333N SI '4I --ma sAs y�iM A`I�K'IflO�g � a ,� q dox sa yea � ue a q zo aoT�,edato •azn. P osTe oT33p.z uo a ET�e3 01 Peat uea (OATauasax T� tnsuT sTZau aq - 4) 3aA00 04 sq, 3o g08t15aM •r •aoTApe Joi dtajeTpa=gjj 20T1e4suT 2nod ITusuoo • squnome 4082303 eq-4 buTsop. 01 uxnlaar 01 dwa a ' xuiel, bu'l eop 'aqg d�dtaa xadtund pasuao ql bu TAOT T E ST II • { abt eaT) TI a TT a 4egq Papuammooaa< q� goedwT dTasiOApe A�em qa A . aql admn Tq as . P d fiuTaq �uanT33a 3o PeoTsaao �x TT e YlBax o4uT A . xodtua� a u, � T eon a sT a darn � . 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PasuaoTZ • -+C �� tY 1n� Z : szojz>adsuT /AjTxogjn.e Te4uatuuaiano0 S1NH9VV 13V1NO3 DzAa13adS 'saT1Tatog4ne' buTTT0.z -.uoo au-4 o-4 sgaodaa ua a oo A TTaadsuT /a ulem . AzESSaoau ITe 4Taigns 0 P q �pa.x tnbaa< sT zauA.o all •magsds sTq ` ;o uoT Exado AR Teats ayes 6114 ao; Aaessaoau sr FiuTaTdxas pue suoTloadsui oTpoTzad zeTnbag •uta sds s y 8- M40 aoueu alUTEt1I pue uojge.xado Jadoxd so; azgTsuodax BT (xauA0pueT) SIXod Sass,cs. azsds_ r ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer (, Mailing Address �5�� ® "_.z 64, Property Address (Verification required from Planning & Zoning Department for new construction.) p I City /State ` Parcel Identification Number o 3 Z LEGAL DESCRIPTION Property Location tJC ' 4 , 5 %4 See. , T 3 a N R 9 a W, Town of V _ Subdivision Plat: �„f„ �.y„ Q Gum. -� , Lot #. Certified Survey Map # , Volume , Page # Warranty Deed # 4 o ; (before 2007)Volume f y � 3 , Page # X? 7 i Spec house CI yes f%* no Lot lines identifiable Kyes ❑ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 frill 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe 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. Numb drooms 4214 r /o IGNATURE OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) f,5 8 oJi. R ' located at: IJ k 1 /4, 5L� '/4, Section / y , Town 3o N, Range .2 o W, Town of S 0W , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service 8 ` / ° /d Did flow back occur from absorption system? Yes No )C (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: V ° o - 7 S Construction: Prefab Concrete X Steel Other Manufacturer (if known): t.1 tam Age of Tank (if known): Permit number (if known) U) i- r r ,C /V 15 c 1 4 V _' z- L E (Licensed Plumber Signature) (Print Name) -4V7 - 7 to (Title) (License Number) MP /MPRS q -r� -ro (Date) Form to be completed by licensed plumber (Dept of Commerce Chapter 5 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 9/2008 V01:1423PAa277 60370 STATE BAR OF WISCONSIN FORM 2 — 1982 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS DOCUMENT NO. ST. CROIX C O., WI RECEIVED FOR RECORD James A. Furseth 05 -03 -1999 8:00 AM WARRANTY DEED EXERT # 17 CERT COPY FEE: conveys and warrants to James E Linden n and Di anne C. Linden COPY FEE: TRANSFER FEE: husband and wife, as joint tenants, RECORDING FEE: 10.00 PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St. Croix County, 1 U State of Wisconsin: 032 - 2096 -30 -000 PARCEL IDENTIFICATION NUMBER Lot 3, Green Acre Country Estates, Township of Somerset, St. Croix County, Wisconsin. AND ALSO, A parcel of land located in part of the SE' /. of NE % and the NE % of SE' /. of Section 14, Township 30 North, Range 20 West, Town of Somerset, St. Croix County, Wisconsin being part of Outlot 1 of the Plat of Green Acre Country Estates, further described as follows: Beginning at the SWIy comer of said Outlot 1; thence N73 0 27'12 0 E, 542.88 feet to the Wly line of the town road (Oak Ridge Lane); thence S16 0 3248 "E along said Wly line, 285.04 feet to the point of curvature of a 267.00 foot radius curve, concave Wly, whose central angle measures 37 °19'39 ", whose chord bears S02 -5"W and measures 170.89 feet; thence Sly along the arc of said cury the point of beginning. e and said Wly line, 173.94 feet; thence N64 0 04'21 "W along the Sly line of said Outlot 1, 661.89 feet to This deed is given in fulfillment of that certain Land Contract between the parties hereto dated March 18, 1999, recorded March 25, 1999, in Vol. 1413, Page 431, as Doc. No. 600084. This of homestead property. (is not) Exception to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 27th day of April A.D., 19 99 (SEAL) (SEAL) * * James A. Furseth (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County authenticated this day of 19 Personally came before me this 27th day of April 19 99 the above named * dames A. Furseth TITLE: MEMBER STATE BAR OF WISCONSIN (If not, i authorized by §706.06, Wis. Stats.) — �,ZY '•,0 to me known to be the person who executed the foregoing :tnstrum t and acknowledge t s THIS INSTRUMENT WAS DRAFTED BY �'rL� Attorney Kr�stina Ogland F,u�;L G :e V - G,•„ irgin a R. Gartman Hudson, WI 54016 • • � .. • •' • r.. �' Notary Public, St. Croix County Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is p ermanent. If not a p ( st ate e date: necessary.) p January 30. 20G0 • Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. Form No. 2 — 1982 Milwaukee, Wis. M 1 0 O bq O O � c `o 0 o LO 0 0 N W ai ° � I 7 L tl I 3 5 C v o m Z o N CL a z o ca c LL t 0 N Q Z v I 3 0 a) Z £ N U) = C Z N d C0 CL am �z!'. I c o z za' u it r w d Z a c M cu J !mil C 11� O O O • N N V U N m v - � O w w o Q I', Z Z o z o N Z 3 U i is 12 0 m o Q T N_ N ` O D a p � N N N y j C7 c� 'n al z �000 .. CL o m } C f- Cl) 0 o J ca A W _ O O N N N O O � '0 E 00 In IT N N N N O m c a 00 0 d Q cn m N CO m a� 0 O a N c ++ o ° ; ,n o` v E O U C 7 d O O O O N rO M F - E V CFq O N e C O U N 7- N N N Ca N O O N� Y N 0 0 .c C N w w v 't ~ M O C CO O Vl O N t6 U • �1 o (A l M r Z �' Z Y cn v c � a I! L: a • `; ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner :Tifn Property Address . i City /State 011V 5HOee �b Legal Description: n .. Lot'_ Block ` Subdivision/CSM # 6 re /7 r u a f VE '/4 56 '/4, Sec. fq, T N -RaO W, Town of mPr Se 1N # U SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer `s Size ST/PC / &50 Setback from: House - 7,./ Well —' P/L Z -5 �L Pump manufacturer /Ya11 L er 5 Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: IQttAd Width Z— Length Number of Trenches Setback from: House 7/0 Well 7 0 P/L If -2 - Vent to fresh air intake 716 ELEVATIONS Description of benchmark e 1�/'✓1 �� Elevation Description of alternate benchmark 14u c Elevation Z0� Building Sewer �U/• ST/HT Inlet `1 ` ST Outlet PC Inlet PC Bottom � S Header/Manifold l0 S• 3 Top of ST/PC Manhole Cover Distribution Lines () 2 () ( ) Bottom of System () 0 M7 53 () ( ) Final Grade () b () ( ) Date of installation / /e' / Permit numb r ��d State plan number • D/ I /� n � Date�Z /� 1 b r s sig License number f P um e g � �� Inspector )i n viol Complete plot plan � I f NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. c � PLAN VIEW X 0 �L INDICATE NORTH ARROW «WiscBn$in bepartment of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Bbildings Division INSPECTION REPORT 'GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No -: IX Personal information you provice may be used for secondary purposes [Privacy Law s.15.04 (1)(m)). 338901 PerrTt�iQldQr Nam T ❑ Citys❑ VER9S Eq CST BM ii Ievv. Town of: State Plan ID No.: E - Insp. BM Elev.: BM Description: Oju Parcel Tax No.: (,(?n.t7 66.0 q _ 032- 2096 -30 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / e A ark t °'4 . . `ew, 0 Dosing Aeration Bldg. Sewer /D,� /do, Holding ©t /A Inlet & 70 q, D'T TANK ETBACK INFORMATION TANKTO P/L WELL BLDG. Vent to ROAD Air Intake Septic > r 3 ( NA Dt Bottom 7 S Dosing 5 u 3 ( NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System 3. 20 /0 -, 5'3 PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand PI'S. 5- /o$'. 4 ( 7 _._ odel Number t 3 GPM TDH Lift (Z. Friction �_�- Systema, TDH I(,- Ft oss Forcemain Length 7 0 Dia. h 2 `` Dist. To Well SOIL ABSORPTION SYSTEM BED TRENCH Width Length f s PIT No. Of Pits inside Dia. Liquid Depth DIME N .Zf DIMENSI SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER �� Mo el Number: System: LI Xo D OR UNIT DISTRIBUTION SYSTEM Header/ Manifold Distribution Pipe(s) �/ K x Hole Size x Hole Spacing Vent To Air Intake Length_e� Dia. Length Dia. I / 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 I Topsoil ❑ Yes ❑ No ❑ Yes []No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: SOMERSET 14.1 0. 2 31,NE,SE 1548 OAK RIDGE LANE V ) Plan revision required? Yes foNo P se th r sid_ a f ition I infor ation. 01 O 3 SBD- 6715(R.3/97) -a"`"' a 00 Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' F 1 ' 2 i v i e ° r � e # t i .. ....e. , a� a ° t # y v f v 5 # 1 # e. - e- .wee t � . r � t S e . e v { t F, 2 t i 3 I a t .- fl h i r m m r a v { E i i k c v a v { s v�. # i 3 k .. t f € s v t F x v� e < F { 4, a a a t # { { # ..m.. e . a , e ..e... e e I { e f i e s E # 3 .� e d >#• b 4 ..... ..... .. , _ _ .. .. ... .. _ .,. { n 3 . i r # W iscomiriDepartmentofCommerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit ST CR IX Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 338901 Perri r Naryi El City El Village Town of: State Plan ID No.: �J1 SOMERSET CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 0 32 - 2096 -30 -000 TANK INFORMATION ELEVATION DATA 9900160 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG_ Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction Syestem TDH Ft L oss Forcemain Length Dia. FFii Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type O Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing _ i 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 discrepancies, persons present, etc.) LOCATION: SOMERSET 14 . 3 0.20.931,NE,SE 1548 OAK RIDGE LANE Plan revision required? ❑ Yes ❑ No (� Use other side for additional information. I SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' 1 P 1 E j e 4 L m � � 3 L e i r s i P 2 � 3 e a e � j � 4 e e e .... ..,., em, E ..... .... �.,, ... '+ �. r L t m, F F 3 t e . m. � F F 1 e ; � 8 fl i 4 - � a zm 3 e € s 5 eme� E a f �, 2 € � v x e 9 i i B e € a 9 i E 4 i .... E ... -.ee _ ......�.m. ...a, ,.,�..� ..w .., .__ ,..., .. .�. ..e § € . 4 3 t J e E 3 } t t i 3 ? a € 3 b Safety and Buildings Division 201 E. Washington Ave. It SANITARY PERMIT APPLICATION e +consin P.O. Box 7969 artment of Commerce accord with ILHR 83.05, Wis. Adm. Code p e Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. CQ2. J�( • See reverse side for instructions for completing this application State Sanit ry Permit Number The information you provide may be used by other government agency programs C] Check it to pre3ioR�-tion [Privacy Law, s. 15.04 (1) (m)]. State Plan .D. Number O I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION ! 0 b Z O Property Owner Nam P pert Lotion N a 1/4,5 T N, R? (ol� Propert Owner's Mailing Address Lot Number Block Number c.c Joarp C + City, State Zip od�� (hoe umber T Subdivision N� a�g CS �(I Nu b 2 6 C MG . TYPE F BUILDING: (check o ❑ State Owned o qt Nearest Road vG Q Public 1 or 2 Family Dwelling - No. of bedrooms Town OF SC6va+ COQ l� III BUILDING USE (If building type is public, check all thatapply) Parcel Tax Number(s) I Li . 'jo Z So. p.41 SI 1 E] Apartment/ Condo d 3 z—ac < c (P — ' -6 O0 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 I] Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on tine A. Check box on line B, if applicable) A) 1 New 2. ❑ Replacement 3. ❑ Replacement of 4 ❑ Reconnection of 5_ ❑ Repair of an ^ _System System Existing System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 G&Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallo s Per Day 2. Absorp_ Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade � f� Required (sq. ft.) Pro osed (sq. ft.) (Gals/day /sq, ft.) (Min. /inch) EI v tion ✓ (/ � �— 0 Feet Feet Capacit VII. TANK in gallo Total # Of Prefab. Site Fiber- Plastic Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con Steel glass App. New Existin structed Tanksl Tanks Septic Tank biet~dnt[1'1`0111C ❑ ❑ ❑ ❑ ❑ Lift Pump Tank iMm,-E+t her ❑ 1 ❑ Cl I ❑ 1 ❑ ESPONSIBILITY STATEMENT It I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb 's Na� (P Plumber' ignatur tamps) MP/ No.: Business Phone Number: Z7 273 -WY Plum dWs Add ess (Street,, State, Zip C de): w 6 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing Agen ignature (No Stamps) Approved [:]Owner Given Initial z;[—O0 /lrc argeFee) 3197 Adverse Determination J / X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBO -6398 (R.11/96) DISTRIWTIOM: OrigkW to County, One copy To: Safety & Buildings Division, Ow#w. Plumber — -- INSTRUCTIONS t 1. A sanitary permit is valid for two (2) years. I date and at a time of renewal an 2. Your sanitary permit may be renewed before the expiration y new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code z dministrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. Vli. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. Vill. Responsibility statement. Installing plumber is to fill in name, license number witf, appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 112 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. r Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 Visc TD D #: (608) 264 -8777 0ns n www.commerce.statemi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary April 22, 1999 CUST ID No.267341 ATTN: POWTS INSPECTOR WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST 101/ ! Jrr ST CROIX COUNTY SPIA PO BOX 74 2> . ✓ 1101 CARMICHAEL RD RIVER FALLS WI 54022 DSON WI 54016 , f i RE: CONDITIONAL APPRO i APPROVAL EXPIRES: 04/22/2Q001' ,� `�`'' a inE Identification Numbers jT CRCs +x f I Transaction ID No. 220870 CC)1SNT`f Site ID No. 170620 SITE• Zt>^IIIVG "�' Please refer to both identification numbers,'' ST CROIX County, Town of SOI *SET / above, in all correspondence with the agency. NEIA, SETA, S14, T30N, R20W —____� Lot: 3, Subdivision: GREEN ACRE COUNTRY ESTATES JIM LINDEN FOR: Description: MOUND SYSTEM Object Type: POWT System Regulated Object ID No.: 462920 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. 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. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincer DATE RECEIVED 04/14/1999 i FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 E PAGEL W S PLAN REVIEWER II BALANCE DUE $ 0.00 Integrated Servic s (608)266-2889, M - F, 0745 - 1630 HRS PEPAGEL @COMMERCE.STATE.WI.US WiSMARpod 763; Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE ► 1/4 OF THE SE 1/4 OF SECTION 1 , T N, R Zp W, TOWN OF SO ►�1 Sl • C \YoIX COUNTY, WISCONSIN. t„oT 3 OF G_RjE9i13 gcCzE 000N S INDEX PAGE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION: PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT .PAGE 5 of 6 PUMPING CHAMBER O PAGE 6 of 6 PUMP PERFORMANCE CURVE �s PREPARED FOR Z6Z3 �6E14joo PREPARED BY WEGEiZEF;Z SQ I L TEST I P4 ca AND ®cm0 ��, F.O. BUS 74 421 K. WAIN ST. C n ;�V, r �+ RIVEF FALLS. WI 54022 :{ ARTH ER A ati oh a jl 115-42`., -015 fiuswoanr. R� y Ws. DIV/ U� F OF C � ••.....„.••'• sq N o E - ��•• ��'S I GN �' YA CO JOB NO. r Page 3 Of Approved Synthetic Covering Distribution Pipe Medium Sand _ H �G Topsoil F Elev'. 1 0 - 1.5 3 E b (., % Slope Force Main Plowed Trench of k"-2k" From Pump Layer Aggregate Undisturbed D 1•N3 Ft. Soil E 1, 3 Ft. Cross Section Of A Mound System Using F o•8 Ft. I Trench For The Absorption Area G Ft. A S Ft. H I. S Ft. B - )S Ft. I \5 Ft. Linear Loading Rate= 6-3 GPD /LN FT J 8 Ft. Design Loading Rate= 6.3 GPD /SQ FT K 1 Ft. L OL Ft. ai n - W ZS Ft. L — Force B K Main A W Distribution Trench Of Pipe Aggregate Observation Permanent 1 Pipes Markers (anchor securely) Mound Using I Trench For Absorption Area Page q Of b Perforated Pipe Detail 0 End View Perforated End Cap b\c� PVC Pipe t � ar c° Install permanent at end of each lateral Holes Located On Bottom. Are Equally Spaced Q End Cap * ti PVC Force Main 0 lt)Uti Pipe Last Hole Should Be Next To End Cap Distribution Pipe layout P 36•zs Ft. X a p Inches Y 3p Inches Hole Diameter 'IV Inch Lateral 1 Inches) Force Main Z Inches # of holes /pipe 15 Invert Elevation of Laterals 10 8.o Ft. tl Place lst hole \S " from tee with succeeding holes at 3 intervals. Last hole to be next to the end cap, Combination Sept and PUMP CHAMBER CROSS SECTION AIJO 5PECIFICATIQIJS ' PAGE 5 OF ( o VE1JT CAP WEATHER. PROOF jv1JCTJOI1 BOX y'C.I. VEIJT - PIPC APPROVED LOCKIMG lO' FROM ODOR. MANIiOLE COVER wIv j '.JIJJDOW OR FRESH 2 wAgrJJrJG L.14gEL.. Ai IIJTAKE cos�Du�T I b�i - tPrK. y plPt PROVIDE I -� IAJLE T AIRTIGHT SEAL I { I i 8 0. I1 r APPROVED JOIAIT A { , APPRDYED JOIWT. { I { W /C.I. PIPE�Ivc W(C.I. PIPE OR Tank construction { { I I ALARM shall comply with ILHR 13.15 and 33.20 a I I I { ow C I I I ELEY. __J PUMP -� OFF D COAICRETC BLOCK 3" APPR-4b RISER EXIT PLF MITTED ONLY IF TAWK MAWUFACTURE.R HAS SUCH APPROVAL BEDDING SEPTIC f SPECIFICATIOt.lS DOSE TAWK MAUU FACT URC CD1.)�\ E JJUMbER OF DOSES: 3 PER D" R: TAWK SIZE : to y� � O GALLOWS DOSE VOLUME Z ALARM MA►JUFACTURCR: S ., . L�l,��D s`t S " , S 1"'cLUDIIJG 6ACKPLOW: \ 2 % • 2 ) GALLONS MODEL NUMBER: Lo 1 ti CAPACITIES: A= \$ I OR 3 0120 GALLOWS SWITCH TyPC' F1 13 = IWCHES OR 33 GrLLOUS PUMP iAAJJUFACTURER: M C. 8 I WCHES OR 133.$ GALLONS MODEL IJUMHER: F L10 D= INCHES OR '`a GALLONS SWITCH TYPE: w'1�1'ZC.V�S( MOTE: PUMP AMD ALARM RE � TO f5E MIMIMUM DISCHARGE RATE 35 ' 1 GPM INSTALLED OIJ SEPARATC CIRCUITS VERTICAL DIFFEREMCE DETWCEJJ PUMP Off AUD.DISTRIBUTIOU PIPE.. �Z 33 FEET t MINIMUM NETWORK SUPPLY PRESSURE .. 2.50 FEET - RO F EET OF FORCE MAIM Y, FYofr.FRICTIOW FACTOR_. x FEET .._. TOTAL O JAMIC HEAD = �� Z FEET Pump chamber DIAMETER _ 3�a IIJTERIJAI. DIMEJJSICILIi OF TAWK: LELIGTH ;WIDTH ;LIQUID DEPTH BOTTOM AREA — - 231= - GAL /INCH = 7 GAL INCH AS PER MANUFACTURER t6- � / ME40 Series M WW 4/10 HP Effluent and Drain Water Pu mps p Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 N 30 W tL W H 25 8 f Z O ~ Z 20 6 J `� •02 2 F-- 15 Q 4 O 10 2 5 0 L 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 K3326 7/91 Printed in U.S.A. w +xonsinCiepartmentofIndus" SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labar and Human Relations 'Division :.Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches imsize. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM), direction arisf % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location arid'distance to nearest rod f . pending APPLICANT INFO RMATION- PLE$SE'PRINT� ALL INF68MA . RMEY DA l h \' V PROPERTY OWNER: T .:� PROPERTY LOCATION Lero Urhammer ��� 4 GOVT. LOT NE 1/4 SE 1/4,S 14 T 30 N,R 20 �(or) W PROPERTY OWNERS MAILING ADDRESS � � ' LOT # BLOCK # SUBD. NAME OR CSM # 1501 Scout Camp Rd. ,`i�C'_ 3 na Green Acre Country Estates CITY, STATE ZIP COD d U. ❑CITY VILLAGE K TOWN NEAREST ROAD Houlton, WI. 54082 , (47jgj5AQ -6.497 Somerset ISCout Camp Rd. New Construction Use [ Residential / Number of bedrooms 3 (j Addition to existing building (j Replacement (] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 4 bed, gpd/ft - 5 trench, gpdtft Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate .4 bed, gpd/ft .5 trench, gpd/ft Recommended infiltration surface elevation(s) 107.86 It (as referred to site plan benchmark) Additional design / site considerations system el. based on contour line of el. 106.86 Parent material glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLD TANK U= Unsuitable for system ❑ S ® U I CA O U -0 S ❑ U 13S 0 U C3 S EM ®U ❑ S ING ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trertdt 1 0 -7 10 r2/2 none 1 2msbk mfr gw 2m .5 .6 1 2 7 -28 10yr4 /4 none sicl 2msbk mfr gw 2f .4 .5 Ground 3 28 -67 7.5yr4/4 none sl lfsbk mvfr gw na .4 .5 elev. 4 67 -80 10yr6 /6 none fract red limestone 10 Depth to limiting Remarks: Boring # 1 0 -8 10yr2 /2 none 1 2msbk mfr cs 2m .5 .6 `< 2 2 8 -15 10yr4 /4 none sil 2msbk mfr 9'W 2 f .5 .6 3 15 -29 10yr4 /4 none sicl lfsbk mfr gw if .2 .3 Ground elev. 4 29 -53 7.5yr4/4 none sl lmsbk mfi gw na .4 .5 107 ft. 5 53 -70 5yr4/4 none scl M na na na .2 .3 Depth to limiting factor 7 — — +70 Remarks: CST Name: — Please Print Gary L. Steel PI10ne 715 -246 -6200 Ad dress: 1554 200th. Ave., New Ric ond,W 54017 cstm 02298 Signature: Date: CST Number: L. Urhammer 1 PROPERTYOWNEA SOIL DESCRIPTION REPORT Pege 2 stf PARCEL I.D. # pending ^ Borin g # Horizon Texture Depth Dominant Color I Mottles Structure I GPD /ft " + in. Munsell Cau. Sz. Cont. Color Gr. Sz. Sh. � Bed iTmr& Consistence Roots 1 -8 10yr2 /2 none 1 2msbk mfr gw 2m .5 .6 3 on>«< 2 -29 10yr4 /4 none sicl 2msbk mfr gw If .4 .5 - e 1 lms f 3 9 54 7.5 r4 4 non s bk mf na 4 5 Y � Ground i el 104 ft. 4 4 -70 10yr6 /6 none fract red limes one Depth to limiting factor 54 " 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 Leroy Urhammer 1554 200th Ave. CSTM2298 1 1 NE4sE4 s14 T30N -x20w New Richmond, WI 54017 MPRSW 3254 town of Somerset (715) 246 -6200 1 lot #3 -Green Acre Country Estates N 1 =40' BI.= top of NE lot stake of lot #3 -csm v -1 -pg. 226 at el. 100' ` X i down` � t5��va -P 8 i 7-0 4. z k jj -1 �0 Gary L. Steel 9 -14 -95 II _ Monday, May 03,1999 02:00:13 PM Page 1 of 1 V5/03!/99 MON 11:32 FAX 715 386 4886 ST CRI CO ZONING 14002 ST CROIX COUNTY SEPTIC TANK MAIIVTENANCE ACtR1113hIENT AND OWNERSHIP CER.TIFICA'I FORM ' 1N Owns riuyer � ` MAM Address oaD (4 I l C w M D$2 Prole i Address L� (Verification requirM rMM planning Depw=Wn for aa;w voustauctioa) . ate W i Parcel Identification Number �'� City / 6 LEG, CPI I r Prop r' Location 1y 1 /., 1 /4, Secq�L T3 -R tJ W, Town of Subd nion C2 L154 CO(t 5- -f Lot # _ 7j� Certi A Survey Map # . Volume _.___ Page # � iJ Z Deed Volume pae, # War D ed # �, 142 Spec muse Ci yes W no Lot lines identifiable W yes 0 no Sys I%l HAMULANWCE Laipr oysr use and maintenance of your septic System could result in its pre=tara fhiltre to baadle wastes. Preperknz" t =cs it of pwntping out the goptie teak "cry tbree yrtM or sooner. if needed by a liemsea pumper. WU&t you put into tho system cons curt a1 :t the inaction of the aepuio rank as a treatment Renee in the waste disposal system bmit to St_ Croix mont a cord ieahQu form, signed by the o9mor and by a 7�xe Pmpech' owner agrees to sa ��B Depatt malltt y.3 1jumber 'ourae mnaP er. restricted lumb lumber or a lieewed pumper vertiying that (1) the on -city w"towatcr disposal ayscem p is is t E►e:' operating Conde lion auwar () after 2 " utivu and Pu=% (if saeoeaoary), the septic tank is less than 113 full of sludge. � Vwe, ; midernigma have road the above requiremoato and agree to maintain the private sewage disposal System with the standards set fo heron n an net by the De partmen t t of ConkJnexee: and the Deparpuont of Natural Resources, State Of Wiseonsim Certification ddin :cat your *optic system has boon maintained must be completed and returned to the St. Quix county Zoning offte witch 30 t 9IF RE OF APPLI DATE RR CE RTIFXQATION i t (we) certify that all statemenn on thin form are true to the best army (our) knowledge_ I (we) wn (are) the owru:z(s) of ..rty downbed a oven vide of a warranty deed recorded in Register of Deeds Office. � c st L "U SIt31' RE OF APP) ICA DATE * }e e t bas revolted the 7imi De trtve +M Any information that is mss- t�cpt+eaented may acsult in the saoStaty permit nS b!' *+S patf�ut• *a L ude with this aPgiteatinn: a damped warranty deed from the Register of Deeds affioe a copy of the certified survey map if referent is made in the warranty dead 1 -20 -1995 6 :52PM FROM THE STONE GOOSE 612 351 9212 P_3 '.. uu. .r•. �tr� iv�.f ..wcI k�lmo #nrwliw -1117- 1-1 1 • f ik N LAM . SURVEYING - �W f i f n • �r7►i S 71 i 25al Scant. omp trail Soultou, wx 54"2 � w a L O T v nexus ao. sr. i - ♦ s l! i aq,r� or . t OAM, ,% ' 3 3« 00 Aa. i � - 9L �• t t J"ft •13, 1997 I� r 01/03/1995 18:53 7152737753 NELSON PLUMBING PAGE 01 Safety and BuNdings 4ivision � 5�1NITARY PERMIT APPLICATION 201 E. Washinglhinglonw-e. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 i'� Department of Commerce . Madison, WI 53 707 -7 96 9 • Attach complete plans (to the county copy only) for the system, on paper not less County 'than 8 1R x 11 inches in size. 5, - '•r• .7 ' i • See reverse sid''a for-in for Completing this application State Sanitary Permit Nurnbtr The information you provide mmy be used by other government agency programs Q Check d !vv'sAN pr J•auon 1privacy Law, S. 15.04 (1) (m)1• State Plan I.D. Number I. APPLICATIONINFORMATIOIN IINT ALL INE M T Property Owner Nem pert Laration �' —? , — IVJ /3J /V /Vja `- t /a, S T j 4 N, R •.� t� (oR Prop e t Jr. wne 1e19 Lot Number Block Number ✓�' City. State `� Zip e Phone Number Subdivisio me S Nu bet p ► Nearest Road II: TYPE OF : (check one) ❑ State Owned _ ) o Public 1. or2 Fami1 Dwellin - No. of bedrooms Tow or ovtA.5 III. BUILDING USE: (if building type is public, check tij that apply) Parcel Tax Num her(s) 1 Apartment/ Condo n 3 _� �� o 00 2 ❑ Assembly Hall 6 Q'Medieal Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground` 7 ❑•Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church / School 8 ❑ 'Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑, Office J Factory 13 ❑ Other specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) AI 1 New 2_ ❑ Replacement 3. ❑ Replacementof 4 ❑ Reconnection of 5. ❑ Rep of an System ------ S tern Tank Only -- Existing -- - -_ - -_ Exlsting System - - - -- - - - - - -- -- ..------------- - -- ---- - - - - -- $ System - - -- El) ❑ A Son "try w&s previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check,od on jp )*- AIOn Pressurized DWrubutron PF+eSS rued Distribution Experimental Other 11 ❑Seepage Bed ound 30 ❑ Specify Type al [] Holding Tank 12 ❑ Seepage Tr erich -Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System- In- a=i~fl. y VI. ABSOR PTION. SYSTEM INFORMATION: 1. Galjqns Per Day 2. Absorb Area 3. Absorp Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade � 5j R tAired (!q. ft.) Pr sad (sq. ft,) (Gals/day /sq. ft -) (Min. /inch) EI v tion ((( 03 0 7,, 5Feet Feet VII. TANK apa;ill in gallq*v.1 . Total aft of Prefab . site rrber' p lows Ex INFORMATION: Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App New Exls% strutted x rtk ' Septi[ Tenk j gi1L ❑ ❑ 0 I ❑ ❑ Lift Pump Tank i bar 5 e :,!?AW ❑ El ❑ ❑ ❑ VIII. - RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installatio%of the onsite sewage system shown on the attached plans. Plum s Nam (Pgint} Plumber' ignatu;ln' !Stamps) MP No.: business Phont Number: Plum ors Address'(Streot, City, State, C OUNT hr 10 ]'Dis :�, Permit Fee a.crvJe�Cr.v.dW,to. h,o�`tUe (swing Agent Signature (No mamiw y.� to M swot er rh) (/ Approved , ❑ OIAFn��i a(1i Or i' . � �.. r' f �• F'.i X, CUDITIO NSIP - APPROV ALI ftlEArON9 FOR DISAPPROVAL: 01/03/1995 18:53 7152737753 NELSON PLUMBING PAGE 02 5atety and tsuiidings PO BOX 7152 MADISON WI 53107 -7162 TDD #: (608) 264 -8777 www.commerce.slate.M.us Depar of Commerce J Tommy C Thompson, Governor Brenda J. Blanchard, Secretary April 22, 19+39 CUS'f ID 1!lo.267341 A77N.' POM INSPECTOR WEGE1eCER SOIL'1EST[NG & DESIdN ZONING OFFICE 421 N 4 am ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RP4 $ALLS W1 $4022 HUDSON WI 54016 U; C1 T1ONAL A1PPMO VAL adeniificatioA' Numbers ,APPROVAL EXPIRES: 04/22'/2001 Transaction 110 No. 220870 Sits ID No. 170620 Slrl'E :' PC�hse refeY w yoth: identification numbers, sT cKoIx County, Town of SOW(ERSET above, in all'•coimspotidrnce with the agency. N$1 /4, 1%1/4, $14, T3014, RAW Lot 3.. Subdivision GREEN ACME COUNTRY ESTATES lII1 1fi4DEN 1RQR: .. . Dttctipoidn_ MOUND'SY X Object Type: pOWT System . Regulated Object ID No.: 462920 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDL"1'IONALLY APPROVED. Tine owner, as defined in chapter 101,01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. A copy of the approved plans, specifications and this letter shall be on -site duriAtg construction and open to inspection by authorized representatives of the Department, which may include local inspectors, All permits requited by the stau or the local municipality shall be obtained prior to commencement of consutydtibo ,(ui5tallationfapyxation. Inquiries concerning this correspondence may be made to the at the telephone number listed below, or at the address on this It4tietiiell S DATE RECEIVED 04/14/1999 FEE REQUIRED S 180.00 t FEE RECEIVED S 180,00 AItG I. - lalrAN REVIEWER II BALANCE DUES 0.00 Integtabswd •Servic (609)2.66 4039 , - F, 0745. _ 1610 URS PEPAGEL@COMMERCE.STA'I'EMLUS I WiSM 9;&R`� de ^;1633, 01/03/1995 18:53 7152737753 NELSON PLUMBING PAGE 03 _ Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE 1/4 OF THE SE' 1/4 OF SECTION y_,T N, R 2A W, TOWN OF SU m e% t "f' ST - CCtOLX COUNTY WISCONSIN. DoT 3 'or QTte9J PamE CouNTR.Y I NDEX - PAGE I - of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN • PAGE 3 of 6 PLAN 'FLEW -CROSS SECTION: PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUKING CEAMBER < x`930 PAGE 6 of 6 PUMP PERFORMANCE CURVE �G+� O PREPARED FOR 2 bZ� mGEW Uop �T. s��,`h,.�c. , Y►N s So a Z PmPAlw BY WEC�EF?EF� SO Z L TEST Z NG� Al AND. ecsyow ��s = t3nr sE=Ffztv z cE �aN iy P O P.Q. on 74 4zl K. !SPIN ST. L' ' • �V, r 111M ffus. N[ m ozz 4 all pis- �is -etis:, _ ATM. y .0 � RO 4b .- .�_...�� E� y� SIGL3 SSE L4 -e - JOB No. 99 -63 01/03/1995 18:53 7152737753 NELSON PLUMBING PAGE 04 L > F-, Z OAF L.aT � ' � � � •� \Z5, $ 3 S 6-1 G. L Z h 2 NOTES •1- Elevations shown are exi Z. Install permanent marker 3. Install 4" observation p 4. "Septic tank to be 1bD4 65C i 5 Bench Mark Sgt t, 6. blvert sur ace water arc I✓ C7 01/03/1995 18:53 7152737753 NELSON PLUMBING PAGE 05 Page � ter b ApProved Synthetic Covering Distribution Pipe Medium Sand. N G f i . F Elev. 3 E R D 'Y6 Sldpe ( Force Main Plowed Tt -ench of k--2k From Pump Layer Ag.gre"gate (u *beef D 1,a Ft. Soil g \. 3 Ft. Cross Section Of A Mound System Using F o.'B Ft. I Untch For The Absotption Area G N - im Ft. A 5 Ft_ H i- S Ft_ g - )5 Ft. I \ S Ft. Linear Loading: Rate= 6 -OGpD /W FT a Ft. Design Loadirig '.hate= 0; %SQ k'T K \1 Ft. L q'? Ft. . in.- W _ Z8 Ft, L J Force K Main 11Y Qisiribotion � Trench Of 2 - 2 � E►-.o Pipe Aggregate 'da!'ser�gtion Permanent Pr s Markers - obi .se,eurelx) oand Using 1 Trench For Absorption Area 01/03/1995 18:53 7152737753 NELSON PLUMBING PAGE 06 Page ut o Perfor4fed Pipe Dole" 0 )POrferated End trop a i PVC pipe IL Install permaaent at end of each lateral Holes Located On Bottom. Are EVvouy Space0 End Cap Q , PVC Face Main dstitpulion Pipe Lost Hale 5h"d 8.9 Next To End Cop Dislributign Pipe Uyaw P 36.zs Ft. X 30 Inches Y 30 Inches Hole Diameter '/y Inch Lateral if ! I li Inch(es) Force Main Inches # of holes /pipe N'S Invert Elevation of Laterals M -o Ft. Place 1st hole X 5 from tee with succeeding holes at 30 " intervAls . Last hole to be next to the and cap. 01/03/1995 18:53 7152737753 NELSON PLUMBING PAGE 07 1 V /' \l {�nM7- �►J4�\ V.1\tIJ� JF�- rwr ntyy .�� L-•41 ll.N11UNJ ur V F WCATHEK PROOF -VEWT CLIP JUUCTIOIJ 801E Y - 4 c.I_ vEUT PIPE APPROVEO LOCKIAJG IO' FRCnrOOOR. "%41JN0LE COVER w111i vtUOOti+Opt FRCS" WARNING L.��EL . A-Qj WTAKE f cawOUtr t r I 18•Pc1u. y "tw39t�har•1 �� ��� — — -- PROVIDE i ILILE T AIKTIrxHT SFAL I ! I I I APPROVED JPIIdT APPROVED Jolt17;' W /C.i. PIPCaR Tank construction ! i!( wlc•=. PIPra«� shall comply with i II ILHR " 3. 15 and 83.20 I I ou c I I 9 5- b^I i CLCY. FT PUM Orr P —_J O CO%JCRETE 3" AVP12ahu KISEK CXIT PERK11TED OULtI IF TALJK MALt1FACTURER RP S SUCH APPROVAL g�pD� SEPTIC f SPECIFICATIOUS 005E TxsJR J"SALUFACTUILLK'- `�`� � WUMDER OF DOSES: PEK DAJ TAWK SIZE: - _`p bU� I,0 D GALLOWS DOSE VOLUME t ALAR11 AAWUFACTUR.ER: 5�3I IIJCL -UDIUG BACKrLOW' AOOCL UUMBCK' LO t 1 �e, �W CAPACITIES: A= 1$ U,IC3415 OR 3d4' GALLOuS SWITCk T3PC: �e �- "Y 8 = Z IUCNES`OR 33 �y G�LLOUS Pur" P%AWIJFAC. � C x , , 8 ( ,S OR X � GALLO MODEL uU)1DER: _ ME 14.1Q) D- IWCHES OR 1 �'S OALLOtJ6 ` xs = 5wiTC1I TSPE: MOTE: PUnP AUD ALARM ARE TO 5C MIWIIAIJM DISCK^RGE - RATE 3 S._�� GPrti INSTALLED OW SEPARATE CIRCUITS VERTICAL. DIFFEREIJC6 DETWECU PU l"kP OFF AUO.DISTRIMUTIOiJ PIPE.- 1Z � 3 FEET + ntuiP ►uh NETWORK SUPPLY PKEs$UR , ....... . _ 2 5O FC,CT _ FEET OF FORCE MAIt`1'X ?' F /o p1LFi�IGTIOV FACTOR 2 �� 9 FEET TOTAL 1390041C. KEAb — �� Z FEET Pump 'chamber DIMETER 36 \I JUTERIJAL DIALIJ610LIf OF TAUK= LEWOTH ;WIDTH ;1LIQUI0 DEPTH r.�..,_.. BOTTOMS AREA — c 231- - CAL /INCH AS PER MANUFACTURER = 16. GAL /INCH 01/03/1995 18:53 7152737753 NELSON PLUMBING PAGE 08 • �,' PEE ( o OF- IV E40 series 4/10 HP Effluent and. Grain Water Pumps Perf ormance Curve MODEL W40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE O 50 100 150 200* 250 300 350 40 12 35 10 30 w cr W N 2 5 e F Z 20 6 J ".e = F 15 -I O Q 5 2 0 0 0 10 20 30 40 50 60 .70 80 90 100 CAPACITY GALLONS PER MINUTE L19AW114 FAX i1 No 44805 -1923 K9326 7/91 Printed in U.S.A. Z 2enT �-0r L1rjt 01 ll7 �P W N H z N m m z N w o \ m n b ft cn (D rt (D IL 1 rt n F N S � 0 n�..a IP m O v w O Lo ft \ \ v n C r H• a (D a V) ( m c it C � o 1 0 rt W O F. : 1 4 rt a 00 p V J p 'wrt`� rt w n rr N• w m O o I rvI (n cL N cn m H• G (D n Fi. � r (� 10 Qj (D Fi. (Tf Fi. v m F'd cn rt F,. 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