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034-1044-70-100
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E. avidECar /a � /60 Sfan /e t Marc/ � tl j 3 fi C /.moo / ft "B�y,o/� C C E V v,an Y1 /man !"✓a /demar Vincent Nyhus 0 C� � y o uc� y /zo • 11 C .. yC 600fh 731 b V 0� Ev<c C O�0 T9er /e do w o�Haro/ z ao E. �,1 73 Chan /es a`' �ons Fiai,cs D.• M n < v,.0 �1 �iTUR/ > :tn se / %� u Q �� e/o S :th 'v Fern yen Ms Gee aF /zo H des •4a y . 40 V Mahon c J 40 ✓76 7 da A A /2O e�ux G✓m.4Ce V L as • Sher. < � C Wi //� go ' � go � C v 79 9eCA, Maha�ey oscan A /an j Kath 3 v �' K fa �fH Ti / pson QaascJ7, Bi W ,bent fM ° u Lo.a /rye ` v Ct C v ,8 /oom y b co C/O so� • Newhouse y o Nyh.zs /6 0 •gLarsan �V O Lea. u KennefhE C' 9 C a d C CO/ Te Char /es c° Dc %"e t LO /'7afsoncy u7�enson v° v c p � o E�nesf � C ° + h � v bunr� V a �� Cry Lechner v .- D 0 ° a v ° ao eo 5 Man v • Bo e %r Ba e¢a / l0 lu U out /as l U •° C a mars - i j 0 ow K cn 0 o Se/ V 0 u G Tfio Pson tl /sy g nhu e /90 /60 •4d CQC Bo oo° ao a CToFin ,PS�o /fs d v 3776 /ib. /3 �l O� ,P.cJard F B /oo ��.`C, 0' f/PP e" \� d • U� /Y« / I Ciee 3 /' P • ,io V tl v C Ch—/ ao t 6o cia/ o v 7 B o C u 40 At _ 90 ° C/Q ton v 0 /s¢e¢ d Norman f B y O � eh4f Chan v £J � � �9 � /ti 'de 4 y� pp t Env,n �y'erbent h'e /en ��. ` rB6s Tar eph,ne a/_ 0 3 /y _ Loue // � S 8oi fir/ Noneen �i T.bbatt 'Dow /ss bao� 2 9 O `� � :. TS. •n :'. 7ig B/ C4 ^ rz as Char /es �• cTohnso� i s U /fenfis , 1 0 Ohve N• R EY: Ma .Dow 7 �benl rr \ d a W p 0 B Y �{ tl . s � y �:7 s-,<ad 4 Lois 40 • tl � ° � OsP v e ^ U N o..d M`Grzrne d a y O� ei Bo d Y a ma.� 7g Cv / ✓.n E 3 e V ° J •/% 7�zne do V Ne(so /bo « - ?40 S �� • WQ �o V cl rr,^. • s \1 L • 64 • "J /077 '� 3 . k 29 • • • • iTohn Rueb W en7 E 7h m O Puff W"/, Tohn- Esa • •n: C - ,yern7 s _ oy Sore 0 � ohnson �4`i ems• son �5n ;�by Jas h .Dean aZe a 773 r7 oa on 40 • Q v Se /mer' - s Wayne Thom /27/4 �� L O d. Za �f/ambau ,E h Ine3 U / 9'/ NN 3 i son �vp °�� v F � Bo Bo /60 '/ C o • o /sari S/a � ��l 7J. B 1 60 ZBo /os e c • 32 u C °' - vG, W /son ry.4B. %sere M aynarcL u 0^ • ,Pudo7Ph S v O (L x lock GL a, s n/oe Cc then �C � 12 La r c. sa ° ccce c v C 0 y r: F O ✓ohn s Al o ° v Edward g o� o v y ° H� Dorothy o\ Bauer Weirs Ee t u a F�/ o fs h oC o t \ au' s h v`4 7 - h w.n9 80 ;y V _ugs,::::: :::✓e:a�, , c/97 1 .eo .E fond /yap ub /s., Inc., Rev. /974 � SEE iMGE 23 S�Croix Coun>�W STEINER SURGE SALES & SERVICE, INC. SURGE THE WORD THAT MEANS SERVICE IN DAIRY EQUIPMENT & WATER SOFTENING YOU'RE A STEP AHEAD WITH SURGE PHONE: 684 -3261 or 698 -2588 or 684 -2038 or 698 -2958 BALDWIN, WISCONSIN commerce.Wi.gov Safety and Build' s Division County 201 W. Washington P.O. Box 7162 scons Madison, WI 7 - 2 Sanitary Permit Number (to befilled byCo.) Department of Commerce Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the a ro n / pp p gove ental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owne WTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information condary p urposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. lJ 1. Application Information - Please Print All Information Property Owner's Name Parcel # + 4 2007 3 t' c e rr � . o y, - Property Owner's Mailing Address Property Location 7k� l�G �, '1 S „Z �U �� ST. CROfXCOUNTY (. _3om) City, State t Govt. Lot l / J Zip Code 7 f e� S �L/ U Z ! (O l ��5 �� / �� / S� / <, Section � i ✓, circle one) 11. T e of Buildin T L' �' N, R I E or W YP g (check all that apply) � Lot # 1 or 2 Family Dwelling - Number of Bedrooms Subdivision / Name � 1 � Block # ❑ Public /Commercial - Describe Use V Z ❑ City of ❑ State Owned - Describe Use _ s � CSM N ber ❑ Village of t?/ // l -2,? 3 Town of I11. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. _ ❑ w System eplacement System � 11 3Tr tm ent/Holding Tank Replacement Only El Other Modification to Existing System (explain) B. nit R enewal Ell Perout Revision ❑ Change of Plumber El Permit Transfer to New List P evious Permit Number an D t� ss Before Expiration Owner U� /I Z VOS IV. Type of POWTS S stem /Com onent/Device: Check all that a I El Non-Pressurized In- Ground El Pressurized In- Ground ❑ At-Grade Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil /y ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) V. Dis ersal/Creatment Area Information: 6r Q _ Design Flow (gpd) Design Soil Application Rate(g sf) Dispersal Area R ufred (sf) Dispersal Area&o sed (sf) System Elevation c { s—ry _ , /153.X �r 5�_ V1. Tank Info Capacity ifi Total # of Manufactur Gallons Gallons Units o U New Tanks Existing Tanks (/j / /7 / � �w w 5 a U in Septic or Holding Tank coo , . /tC&Fa U!' n w C7 a Dosing Chamber ! (AJ VII 1. Responsibility Statement- t, the undersigned, as me respon'sibil' for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum s Signaru� ] T�PRS Number Business Phone Numb Plumber's Address (Street, City, State Code) l j r VIII. ount /De artment Use Onl Approved El Disapproved F nnit Fee Date Issued Issuing Agen ignature ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval F Attach to corniplete plans for the systein Ind submit to the County only on pa not less than 8 t/i x t 1 i 21 "lize SBD -6398 (R. 01/07) Valid thru 01/09 PLOT PLkNL Page 3 of Scale EEY-Vs - " h, G TA"k �o tivur c.FJr,P� -T- oa 1 S IP 3 BD Rk'1 _ 6 C so /a 6 n P� i eoh,�v�z QL T E L EL. Rz.sy' L Nt-" CST PtiZU��''R'T'l LLA/k py. I f, L�ryt°EI CT► -I- fl" :0N TDB OF TELQN*iWfl�. Peter. L - - 58.6 '01j 6 ROOD PFT Bf - %e - of %wl!�yL NOTES: �� 1. Elevations shown are existing ground elevations less otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be I /6S0 gallon capacity manufactured by W l �'��Z C01V eCZL TL'` w / /-}- L8o o Z►°n3 �Z- Lz 4. Bench mark 5 g l9-gp V E 5. Divert surface water around system to nrevent nondinc at t he „nhiii chip_ commerce.wl,gov Safety and Buildi s Division County 201 Washington P.O. Box 7162 .� W. s V o n s i n Madison, WI 7— 2 Sanitary Permit Number (to be filled' by Co.) Department of Commerce Sanitary Permit Application State �J / , C_ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropri ove ental �" t ��� / e J unit is required prior to obtaining a sanitary permit. Note: Application forms for state -ow ne WTS are Project Address (if different than m ailing (Jli address) submitted to the Department of Commerce. Personal information condary p urposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. �l _�� 1. Application Information - Please Print All Information 0, Property Owner's Name Parcel # .t,, DEC 14 2007 v 3 _2 Property Owner's Mailing Address Pro Locatio I py n n ?'� ,�Z t�U �� !/G ST. CROIX COUNTY (. 3 63A Govt. Lot City, State / t Zip Code n / OFFICE �(!7 e� — y U (� b G � f� �� '/a S� %a, Section — l � circle one) 11. — Type of Building (check all that apply) Lot # T N, R � S E or W YP g hk ( PP Y) 1 or 2 Family Dwelling- Number of Bedrooms Subdivision Name �'Lc.C� - - -- Block # a ` IA El Public /Commercial - Describe Use Z2 Im � V G Z El city of ❑ State Owned - Describe Use CSMM /N her �7 7 ❑ Village of 7 / O 3 Town of e Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. - i -- _ ❑ New System eplacement System ❑ Tr atment/Holding Tank Replacement Only El Other Modification to Existing System (explain) B. ermit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List P evious Permit Number an Dat ssued Before Expiration Owner /I 21 2 V0 5 IV. T e of POWTS System /Component/Device: onent/Device: t a I he C ck all tha ❑ Non Pressurized In Ground El Pressurized In Ground ❑ At M��AEenl El Mound < 24 in. of suitable soil El Holding Tank El Other Dispersal Component (explai Device (explain) V. Dis ersal/1'reatment Area Information: U y L Q Design Flow (gpd) Design Soil Application Ra e(g sf) Dispersal Area R wired (sf) Disper� I Area.Rro sed (sf) System Elevation t� sz ' , " �U � 153 , c �is� d l�- VI. Tank Info Capacity i Total # of Gallons Gallons Units �New Tanks Existing Tanks j{� `Q /�� u U w u Ul a U cn t� 0.. Septic or Holding Tank iG GG Dosing Chamber V11. Responsibility Statement- 1, the undersigned, as me respo sibil' for installation of the POWTS shown on the attached plans. Plumber's Name (Print) ,t[ Plum s Signatu& PRS Number Business Phone Numb Plumber's Address (Street, City, State, 4 Code) 6 0 7 VI If. ount /De artment Use Onl Approved ❑ Disapproved Permit Fee Date Issued Issuing Agen ignature (lU ❑ $ Owner Given Reason for Denial IX. Conditions of Approval /Reasons for Disapproval Attach to co Clete plans for the syste • d submit to the County only on pa not less than 8 1/2 x I 1 i n size SBD -6398 (R. 01/07) Valid thru 01/09 - - 1 PLOT PLAN - Page Scale EEY-`s G 9 x y i A 1p'ur 1 S If* a Vj 6 3 8D VL" o 6.1 `. 50 c= 6 \ r-11 PQ C J F. Y1 \ \ \ 00 6 NL'' -SST l�tiZ o� 1rJ LL)Vk f, 'elm :ON To►- OF �'Ptiwft� PE _ eZ. X18.6 ' cw G ULK-0 AT W3E 01 w 110 L-Q- . NOTES• OP 1. Elevations shown are existing ground elevations gless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be ►p A S0 gallon capacity manufactured by C01KJ e-2L r w / - U800 Zrri3EZ- F4 LT 4. Bench mark 5_ 5. Divert surface water around system to nravent nondina at r ha „nhiii Qirlp_ 11 Department of Commerce County: p PRIVATE SEWAGE SYSTEM S _, ix Safety and Building Division , INSPECTION REPORT Sanitary Permit No X63 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: Marvin, Lucinda I Springfield Townshi 034- 1044 -70 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 19.29.15.303A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet oeo_!� SUHt Outlet TANK SETBACK INFORMAT N TANK TO P/L WEL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dosing Rn. ot � Aeration Holding m e PUMP /SIPHON INFORM ION Manufacturer D G k. 11 Model Number r ) F — 7 — TDH Lift Friction L s tem Head TD Ft Forcemain Length Dia. Dist. to Well Z i SOIL ABSORPTION SYSTEM C. 00100" Z BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits In ' Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO PiL BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT odel Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 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 F-! No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: Location: 2752 80th Avenue Woodville, WI 54028 (SW 1/4 SE 1/4 19 T29N R1 5W) NA Lot 1 — Parcel 19.29.15.303A 1.) Alt BM Description = L "_" " J E Per /n 17— L, 2.) Bldg sewer length = �t%tYU� - amount of cover = V �l✓ 3.) Contour = Plan revision Required? Yes No Use other side for additional information. 1 Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) t= of11f11 @t+.LVI.CQV Safety and Build' s Division County t 1ePartmerA 201 W. Washington .O. Box 7162 o / sco n s ■ Madison, WI 7 - 2 Sanitary Permit Number (to.be filled yn by Co.) of Commerce Sanitary Permit Application State Transaction Number _ / .i 1 I In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropri ove ental O unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owne WTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information condary _� / u oses in accordance with the Privac Law, s. 15.04(1 )(m , Slats. 0, 64- I. Application Information - Please Print All Information Property Owner's Name Parcel # t, �4- 1970e lea" 1( ! tt ,a 4 2007 0 3 y l�cl V -7v -/Ilc, Property Owner's Mailing Address ' / Property Location 3V �� \ 7 5 Z �C1 � f� U G- Code ST. CROIX COUNTY r• V /` City, State Govt. Lot Zip p � 1 / / / t / (�O �! A > V, S� /a, Section UG G G' V t (l Lt/ I �t� U Z 6 A5 9 h L / S Cclrcle one) T L N; R EorW II. Type of Building (check all that apply) Lot # ; i or 2 Family Dwelling -Number of Bedrooms {/ Subdivision Name Block # ❑ Public /Commercial - Describe Use _�� /!� G ❑ City Of ❑ State Owned - Describe Use -" 1 ` S� CSM Nafriber ❑ Village of f/ Town of �� Q ` �� t G - 7 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System eplacement System ❑ Tr atment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) _ / /q o B. ermit Renewal El Permit Revision El Change of Plumber ❑Permit Transfer to New List P evious Permit Number an Dat ssued Before Expiration Owner Tbq/ - IV. Type of POWTS System/Component/Device. Check all that a El Non-Pressurized In- Ground El Pressurized In- Ground ❑ At -Grade Mound > 24 in. of suitable soil El Mound < 24 in. of suitable soil /� El Holding Tank El Other Dispersal Component (explain) Pretreatment Device (explain) i " " Off V. Di etsa11T atment Area Information: G'� L. LPL; _ Design Flow (gpd) Design Soil Application Rate (g sf) Dispersal Area R wired (st) Dispersal Area�ro sed (sf) System Elevation C C tc �l 5 U v - t � �lSl VI. Tank Info Capacity i Total # of Manufactur Gallons Gallons Units / ,� , ��f/ �) V c R New Tanks Existing Tanks Vv�� ��1� `S c L o :? � ca ,I w a Septic or Holding Tank ! G G G (A� �c Dosing Chamber 5 I VII. Responsibility Statement- 1, the undersigned, assume respooibil' for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb s Signatu PRS Number Business Phone Numb 6 ' 0 7 f Plumber's Address (Street, City, State, Code) VIII. ount /De artment Use Onl Approved ❑ Disapproved Permit Fee L ✓ Date Issued Issuing k Agen gna tur El Owner Given Reason for Denial $ �� IX. Conditions of Appro for Disapproval Attach to co lete plans for the systein • d submit to the County only on pa r not less than 8 1/2 x I I in size SBD -6398 (R. 01/07) Valid thru 01/09 PLOT PLAN - Page 3 of Scale 1 " = �c�s G '` �k �p rvur c.nkti� Pr�Z" o�z w �. �.. Q � s - tu�.e � �c►z.��A , k gy 1p�ur y''P J GM2 *0ME t tptitC 6 �' \ �. C 80 I eo>u� �t , q � • o -� NC'.'PCCL -t,� i P�Z.UP�R'fy LL/t/t t�rti Ft• Z � Ar V �7 _ '� -- _'__..fit- •._too ,p'. :mj Toi> OF TO-IL"Pti 6i P . R►'� -? :�: _ L.L.. 98.6 ' Ury 6 UU) -V PFr B"e— OF % WZt PO LQ' . NOTES : _.. _ ... pP ._ . 1. Elevations shown are existing ground elevationsiless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 10 A SO gallon capacity manufactured by VIJ L kM Z COk j clZ.�' !.y f /- _ L800 Zr Ft L`f Inz 4. Bench mark , ;, , _ SQ P-gp V C . 5. Divert surface water around system to prevent ponaing at the uphill side. Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 �sconsin www.commerce.s i www.wiscon isconsin.gov n.gov Department of Commerce Scott McCallum, Governor Philip Edw: tary /, A. / February 15, 2002 ! r�'\1�0 " -? CUST ID No.267341 A7TN. POWTS Inspector J ��n? ARTHUR L WEGERER ZONING OFFICE T �� �.. WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA �k F PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/15/2004 Identification N umbers Transaction ID No. 708195 SITE: Site ID No. 641119 Lucinda Marvin - 2752 80th Ave Please refer to both identification numbers, St. Croix County, Town of Springfield above, in all correspondence with the agency. SWl /4, SEl /4, S19, T29N, R15W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 829279 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R 6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10573 -P (R 6/99). • 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 lation/operation. Owner Responsibilities • A copy of this letter including instructions and information regarding proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • 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. p c A nDRWED i ARTHUR L WEGERER Page 2 2/15/02 Owner Responsibilities Continued: • An activities noted in the approved management for this design relating to evaluation and monitoring of Y PP g Sn g g mechanical POWTS components after the initial installation of the POWTS, must be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 eerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jswim@commerce.state.wi.us I TITLE SHEET Page of I FOUND SYSTEM FOR A BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD -1057 -P and the Pressure Distribution Manual SBD- 10573 -P CCZ. b /-W C2. 6199 LOCATED IN THE Stn) 1/4 OF THE SE 1/4 OF SECTION 1° l , T Z9 N, R IS W, TOWN OF Ste_ Co ` - COUNTY, ZU X WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR 1 Q woowl6L� /4 PREPARED BY WECGEi::ZEF2 !S C3 S L TEST I NC AND. IDES I Ca" SERW ICE P.O. Box 74 421 N.Main St. % tut+ River Falls, WI 54022 0 �CC��+7- 4 Phone 715 425 - 0165 ,,,...»....,•. /� Fax 715- 425 -6864 y � �.�•`° . O aP r'ttF? 4 • . ` S woRr�. 15 P ERCE K�s ? DEPARTMENT Of COMMUILDINGS W DNISION O E Y S DENCE + ' I � S I G 14 SEE COR JOB NO. 0 2 -18 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Pa Z- of �7 Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the 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 1/3 the liquid volume of the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution S tem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L SODS, 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 [SBD- 10572 -P (R. 6199)] arid 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. Cade when the tanks are no l onger u ses 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 ucon the completion of service. Anil ccenina deemed � or subject to failure must oe 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. Continaency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same re equal performance. q 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 about the operation or maintenance of this system should be directed to: The County Zoning Office at "1 lS— 35 6- Q1 8o ST• C' �2U LX The system installer at tS 6 4 & - Z Z6 6 SZno0i C. The tank manufacturer at 6 w les eTz- The effluent filter manufacturer at The pump manufacturer at b 3O — - $ 11L GOUT — ©S ' PLOT PLAD3 1 . page 3 o f i Scale 1 " = 3(3 EXV1 6 Z)O tivuZ' cOnpP�T OSZ L L tJ '` L S 'Ri-lS P�1Z�rA g Y SIP ti 3 BD RLIAI ~ 2 ftMC ��IDVC / �. •� ° rg C 6 i g .z d z rn i 1-n can, Tom OF TEUcP t mll i B" -2 - — . _ Ez. 98.6 ' CAj 6 Uux z PrT Druz of %wc z. ['u LQ- NOTES: I. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be ) A S0 gallon capacity anufactured Y by I•y l �'� C pQ eCZ L'1 L` �! / /� - L80 o Z►°� Lsz � LTA 4. Bench mark SL _ pi.eo V c 5. Divert surface water around system to prevent ponding at the uphill side. Page H Of 7 Approves Synthetic Covering ASTH C33 Distribution Pipe Medium Sand Topsoil -" _ y +' _La 3 E D y 8. % Slope Distribution Cell of Force Main Plowed z" to 2- Aggregate From Pump Layer D •`�y Ft E Ft. CROSS SECTION OF A MOUND SYSTEM F o 8 Ft. G 0.5 Ft. A 9 _ Ft. H V0 Ft. Linear Loading Rate= Q -0 GPD /LN FT 8 SO Ft. Design Loading Rate= 0 -3q GPD /SQ FT I Ft. J Ft. 4 K 9 Ft. L 6 8 Ft. ><sa -cm.1 W Zq Ft. • I j - Observation Pipe E � K A o -�-- -- -- -- - - - - - -- ------ - - - - -- ---- -- �- o-- � _ _ __ __ Force Main �Distrib Cell of z" to 2 2 Pipe " aggregate Observation Pipe (Anchbr securely) PLAN VIEW OF A MOUND SYSTEM Distribution Pipe Layout Page S of - 7 Place the holes at the bottom of the distribution on i es . equal pipes Q spacing. Remove all burrs from the Pipe and holes. Extend the end of each lateral up with the use of long turn or 4S° fitting to a point within six inches of the final made. Terminate the ends of the laterals with a valve,- cap or . threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. PVC F�1C PV C Lateral Manifold Lateral X x x x Xa x11 X x x x ' Lateral Length — Lateral Length — p Distribution Line a- _ • P �� r� clas ��X — -o hps1.1 \F�� S PVC ► = o1ZC� rt,}� o -- F t. Hole Diameter / 8 Inch - S 3 Ft. Lateral n Inches) X Z3 Inches Manifold " Z• Inches Force Main " Inches # of holes /pipe , Invert Elevation of.Laterals &S VFt. 13Xp.�l= S.33X� = 3l•g$ Gp vy c . ._ _. Combination Sep4c: and PUMP CHAMBER CROSS SECTIOKI AMD SPECIFICATIOKIS ' PAGE 6 OF 7. VEUT CAP WEATHER P900f JUUCTIOIJ BOX . ti C.Z. VEKIT PIPE APPROVED LOCKIKIG 110' FROM DOOR, &WHOLE COVER AJIV :iIAIDOW OR FRESH wP+RIJIUG L A6EL., 1+U 3 P10>J �iPE A�IKITAKE couDUir ~ ► �� lHicLTIS tFT'zrc? f !j F1 tv igI{p Fz l GL t I Y� HIIJ. + -; PROVIDE I IAILET AIRTIGHT SEAL I I A I I� Approve z��. ��� I Approved I joint w/ joint w/ F} — AL&RM PVC pipe PVC pip 81. 0 I CLCV. F'E PUKP OFF D COW CRETE $ b • OO I �' BLOCK RISER EXIT PERM17rED OIJLy IF TAUK MAIJuFACTURER HAS SUCH APPROVAL S "A9Pt2fl+�. 6FDt� I>v4 SEPTIC E SPECIFICATIOUS DOSE TA MAIJ UFACTUR.CR: w l2 MM 120'li WMBER OF DOSES: L4 - a PEEL DAw TAKJ 10 A S K .,IZC : O GALLOK! S DOSE VOLUME r ALARM MAIJUFACTUFLER: S S Z7Z4 SL- ,SlreK'C IAICLUDIAIC, 5ACKfLOW: GALLO&I: MODEL 1JUMBER: 101 1 `El.y CAPACITIES: A= 1 WCHES OK 3o GALL0115 SWITCH TyPC: - LZC��L/ 8= Z IIJCHES'OR � =_1_ G�LLOUS PUMP MAKIUFACTURER' GUULp S C= 4 �D IWCHE5 OR 11 Z GALLOUS MO �P 5 DEL KJUMBER: � D. ZZ INGHESOR ZO CALLOUS SWITCH TYPE: "(2-Z�°UlZ -L1 ►JOTE: PUHP AUD ALA0.M TO bC MI MIMUM DISCHARGE RATE 31 - b GPM INSTALLED OKI 5EPARATC CIRCUITS VERTICAL DIFFEKENCE OETWCEKI PUMP OFF A►JD..D15TRIBUTIOW PIPE.. FEET j f MIfJIMUM METWORK SUPPLY PRESSURE . So - Ff.CT �S - l>YL- I-) l- � + So FEET OF FORCE MAIM X �'�q F . FtFRICTIOW FACTOR.. �-' LO FEET TOTAL DtIUAMIC. HEAD = 1 _ - r FEET As per manufacturer 1 (3 gal /in. Liquid depth z `I Goulds 1eE1 ai= Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Available for automatic and • Farms Motor: , and float switch attachment 0.4 HP, • EPO4 Single phase: manual operation. Automatic • Heavy duty sump g p models include Mechanical Dewatering RPM, built Points. • Water transfer 115 or 2 V, Hz, Float Switch assembled and ■ Power Cable: Severe duty • in overload with automatic reset. preset at the factory. rated oil and water resistant. SPECIFICATIONS • EP05 Single phase: 0.5 HP, . ■ Bearings: Upper and lower 115 V, 60 Hz; 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with construction. ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING /a' maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. • Total heads: up to 24 feet. with three prong grounding Q. Canadian Standards Association • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F or "AC ".) rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: therrrr . _ -Lic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 1 I i .,r • Capable of running I- RJ dry without damage to s 3o i '� f5. comp onents. Pump: EP05 e i - -- - YLz Fr • Solids handling capability: 0 25 1 /4 maximum. a 7 i _ • Capacities: up to 60 GPM. i • Total heads: up to 31 feet. 6 20 • Discharge size: 1 NPT. z 5 - ± i • Mechanical seal: carbon- c 15 i rotary/ceramic- stationary, _j i BUNA- Nelastomers. 4 EP05 -- • Temperature: ° 3 10 ' 3 V C1 i� 1041(40 °C) continuous 140 °F (60 °C) intermittent. 2 — 5 1 , 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m °/h CAPACITY ®1995 Goulds Pumps, Inc. Effective May, 1995 83871 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Diulsion of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ,. Please print all information Re 'ewed t � Date Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1) (m)). Property Owner Property Location 1 ST CADX L ve t ,vo Yn p6xv i N cam-SW 1/4 1/4 S -- rA.-1 TM l ~ r w Property Owner's Mailing Address Lot # Block # Subd. m Nae o CS # v City State Zip Code Phone Number ❑ City E) Village ® Town 'temvitRoad W a) \- I L-L� wI Sg 0�.8 ( 648 -24Lt 'S - p 1Zifv G FgF2.b I sO`rr} E ❑ New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate QS 0 GPD I$ Replacement ❑ Public or commercial - Describe: Parent material L Q`,J E"R_ `la 1 \.1.. Flood Plain elevation if applicable N r ft General comments and recommendations: uU' /C) r X $ 0 �ISZIZI $ U v Iv rq LsZL , OF SA,-"b 1• LL. `NQ�Z- el. ate o� a Boring # [] Boring ' 1 0 pit Ground surface elev. 0 1 - 3 ft. Depth to limiting factor n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 1 0 -$ Io -t fL alz sit Z�Sbk ►►�`� ew S .f3 Z 2( it41Z31 - Sit Zi Yn CLv • -B 26�{ �•s�tyt ply 'F1� -S 4Z stg 1 0 S Boring # ❑ Boring ® pit Ground surface elev. C N - b ft. Depth to limiting factor_ in. Soil Aoolicaticn Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef f#1 'Eff#2 rz� Z `Fs 6 IT Z \2 -21 X0`-1 cz31 — sl. J 1`F 1es1�1� m v �S • �1 •6 3 q -uS 10`12 5 S ' -112 Slt3 1 � � as Yn VTt- O tri wti`F S Q S • Effluent #1 = B00 > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 m n _ a _ gIL an TSS < _ 30 mglL CST Name (Please Print) Signa CST Number Arthur L. Wegerer 0 A L C p/, . OZ.-1a 220254 Address : l e g e r e r Soil Testing &. Design Service Date Evaluation Conducted Telephone Number 421 N. - Bain St. River calls, (7I 54022 Z_8_0Z 715 -425 -0165 Property Owner Z V LN Parcel ID # Page of D 3 Boring # 1❑ Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /f1 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z g -ZO 10 `2IL Ba - sz y Z6 3b lo�rZ X16 sLl RS I8 ❑ Boring # ❑ Boring ❑ pit Ground surface eiev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (R.N00) PLOT PLAN Page -3 of 3 Scale - T 'k z) rv UT c.D Pftt -r OR yy wit. L �' r &o! 6 eo ova EL. q o LIAJE CAFFI-L EL. R'1.$ SO PQ f, L3ry Lz. X8.6 G t Qm0 ►4T nfse of VbwZ Pu Li . it. 2_�d -OZ 715 -425 -0165 220254 OZ -)g CST Signature Date Telephone No. CST No. Job NO. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer n CIA Mailing Address ? Property Address S4 (Verification required from Planning Department for new construction) City/State "d e- 4' � ! i Parcel Identification Number 0_3q " / o - 7 ` /0 - 303 �) LEGAL DESCRIPTION Pro G /I Location 1 /4 ✓ ` 1 /4, Sec. T 1 , - 1 N R L 5 W, Town of Prop 1 � , Subdivision , Lot # - Certified Survey Map # . Volume . Page # 239z Warranty Deed # L( 7 �2' ? 5-1 . Volume 3 Page # S�G Spec house ❑ yes &-ho Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and mamtomeeof your septic system could result in its premature failureto handlewastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastor plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days f the three a date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the rty described above y virtue of a warranty deed recorded in Register of Deeds Office. — /2d/ d SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.' «« Include with this application a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed i DOCUMENT NO. THIS SPACE RESERVED FOR RECOROING DATA ij WARRANT DEED 472857 !STATE BAR OF WISCONSIN FORM 2 -1982 -_ -_- - "� - l3PAGt _ J - RE %J OFFICE _ - - ST. CROIX CO., _ .... ......... R„ c'd for Record SUE TANGCN a /k /a SUE S. TANGEN - ............ ................. .. .. .... ....... ......... ................ .......... . .. ..- . ............. .._... u.. •� c S1 Grantor, 11:05 AAA convey and v'arrants to . LUCINDA A MARVIN,._a single person ............. .. . - •..... .... .... Register Of� _ ..... ................... I ...... ..... _ ..................- _ - .....---...-- - ................ ............. ........ - - ......... .. r -• . . -- ... .... ... ... .......... -. ................... -. .. RETURN TO ... ..... .. .. ... ... ..... .... . ... .. -. ..- ......... .... ..-..- .. -_ -.. ,....- - - - - -. - -- the following described real estate in .....- St. Croix County, State of Wisconsin: Tax Parcel No ............................... Part of S14 1/4 of SE 1/4 of Section 19, Totrnshin 29 Range 15 West, St. Croix County, Wisconsin described as follows Lot f Certified Survey Map filed August 22, 1991 in Vol. 3�page 23n2, Dcc, o. 472733. Mtkald � Ds $T al. , FEE This - ..- .. _- . --- - -- homestead property. (is) (is not) Exception to warranties: Subject to easements, reservations, rest- ictions and rights -of -way of record, if any. I I 1 Date-1 th ; - _.. v%i'/. --- - - ---- --- - - - - -- day of ... _. 19 -9/ i - -- ------- ... -... - -- ...(SEAL) ISEALJ Sue Tangen - - - - -- ---------- . - - -- --- -- - - -- --- -- - - -- -- .... ........ .. __._. - ---- --- --- --- --- - ---- - -_ -- -- .._(SEAL) _ _... - _.._..... __(SEAL) AUTHENTICATION ACKNOWLEDGMENT i Signature(s) ..................... .. ---------------------------------- STATE OF WISCONSIN ss. _St .._CrQiX------ - - - - -- -- --- County. Z T authenticated this ........ day of ........................... 19..._.. Personally came before me this .-. .......... ...day of ........ ....... ---- - - ---- 19..91-. the above named ...----•-------------------•---••- •-•---- --- -.......--- ••- -• --.. _.._..._-- .._... . - Sue Tliiigen; - Sue •-• .I ----------- _ ---------- •• - - - - -- ------------- -------------- - - - - -- '--- •----- ...--- -• - - -- ---- •--- - -• - -- ------ - - - - -- - - - - - -- .......... _ - - - -- - -• -- TITLE: MEMBER STATE BAR OF WISCONSIN ��.. (If not, - -- --- - -•- - -- ........................ ----------- .. - - -- - �t)12Lt authorized by § 706.06, Wis. Stats.) ..y3'�x to me known to be the person � r �'1f4;81ce1eG�'fhe foregoi ins ru t and aclti►wi�ge t)Ie same. .. THIS INSTRUMENT WAS DRAFTED BY . ..... . . .. .. .. ...... ...... ...-- ..- ._.. -.... ......... Barry C. Lundeen, Attorney GILBERT, ?1tJDGE Pbf�T12 11j 1DEt� - Hudsoq 540 ............ ......... ...................... Nota -y Public ---- - St.._CToix.....- - - -. -- County, Wis. (Signatures may be authen :icated or acknowledged. Both _My Co fission is permanent. (If not, state expiration are not necessary.) date: ------------ 19 ?e— ) "Names of persons signing in any capacity should be typed or printed below th. ie.:ignaturen. WARRANTY DEED - STATE BAR OF WISCONSIN Wi—, -in 1. R,I I la— t' -- Inr FORM ?;a. 2— to ±2 ,.ow. ", LL';.. DESCRIPTION A parcel of land located in the Southwest quarter of the Southeast quarter of Section 19, Township 29 North, Range 15 West, Town of Springfield, St. Croix County, Wisconsin, described as follows: Beginning-at =the South quarter corner of Section 19; thence North 00 degrees 56 minutes 56 seconds West 1245.72 feet (bearings assumed); thence North 89 degrees 03 minutes 04 seconds East 474.69 feet; thence South 02 degrees 19 minutes 13 seconds East 82.1.67 feet; thence North 82 degrees 28 minutes 15 seconds East 661.57 feet; thence South 00 degrees 56 minutes 56 seconds East 505.74 feet; thence South 89 degrees 19 minutes 56 seconds West 1151.58 feet to the Point of Beginning, containing 914,760 square feet (21.00 acres) more or less, and being subject to all easements, restrictions and covenants of record. I, Harvey G. Johnson, registered Wisconsin Land Surveyor, hereby certify that I have surveyed and mapped the above described property; that such plat is a true and correct representation of the exterior boundaries of the land surveyed; and that I have fully complied with the provisions of Section 236.34 of the Wisconsin Statutes, the St. Croix County Subdivision Ordinance, and the Town of Springfield Subdivision Ordinance to the best of my professional knowledge, understanding and belief. "" % 11 19 1`S coNSi,�i' Harvey C A9,on i -1899 }: > HAgygy Q. Johnson Surveying, Inc. 4D JOHNSON s Hudson, Wisconsin 54016 • 5- 1899 s HUDSON < W!S . ff ,,• y .� 4 • 111 �� SUF`� ,,'�% This parcel is subject to the Department of Natural Resources Regulations. The buildings shown on the face of the map are not in violation of the County Ordinance. They predate setback requirements. Setbacks shown to conform with St. Croix County Ordinance. are The wetlands shown on this map are protected by Wisconsin Department of Natural Resources and county regulations. Any alteration of the wetlands without prior approval will be a violation of the regulations. VOLUME 8 PAGE 2392 472783 CEP T I FI ED S UP VE Y MAP Located in the SW 1/4 of the SE1 /4 of Section 19, T29N, R 15 W, Town of Springfield, St. Croix County, Wisconsin. N1/4 Corner Section 19 Owned by: Sue Tangen T29N R 15W 80th Ave. PK set, Berntsen cap to be set. Wilson, Wi. 54027 O (715) 772 -4639 z APPROVED F \< N 89' 03' 04' E 474.69' �� A1;C�N • � AUG 2 2 1991 x �MA 1JEXPAW IVIY C►dxCO' � r EMFf ti LEGEND N C)l Section corner monument, ZI .� Berntsen cap. < a 1 "X24" Iron pipe weighing 1.68 lbs /lin. ft. set. Fq V LOT 1 W Fenceline N � n Bearings referenced to the South line of the SE1 /4 of Section 19, assumed Cy v iv S89' 19'56 "W (Q o _ N 82'28' 5 "6 0 F o WI 914,760 Square Feet (21.00 Ac) �� IV- Including right -of -way. r~ W QI z 0 BARN 876,758 Square Feet (20. 13 Ac) a D a) QI O DECK Excluding right -of -way. a- Q� WELL AR � G �SEPTIC VENT Z 11 0 HOUSE - BUILDING SETBACK LINE O Z � lL_..11 IOd O S89 ° W DRIVEW S 89'19'5 1151.58' �_ N .• 14 98.23'••. 33.00' 33.00' o - - - -=5 89'19'56'W 1151.58 - - -- 1 D_ S1 /4 Corner UNPLATTED LANDS SE Corner Section 19 _ _ _ — — — — — — — — — Section 19 PK set, Berntsen cap to be met. Go S Berntsen cap. SCALE IN FEET I "% 200' HARVEY 0. JOHNSON 0 200 aoo eod $ H I WIS N This instrument drafted b Im2 �� � 491 -1916 Y VOI�1•E 8 PAGE 2392 Wisconsin Department of Commerce County: Safety and Building Division PRIVATE SEWAGE SYSTEM St. Croix INSPECTION REPORT Sanitary Permit No:, —*8804T 0 GENERAL INFORMATION (ATTACH TO PERMIT) 1Parce tate PI 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 Tax No: Marvin, Lucinda I Springfield, Town of 034 - 1044 -70 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 19.29.15.303A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic o Dosing H der /Man. Aeration Dist Pipe Holding ot. Final rade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 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 i COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 2752 80th Avenue Woodville, WI 54028 (SW 1/4 SE 1/4 19 T29N R1 5W) NA Lot 1 Parcel No: 19.29.15.303A 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = -- — _ Plan revision Required? Yes j No ` I Use other side for additional information. Date Insepctor's Signature Cart. No. SBD -6710 (R.3/97) I Safety and Count 2 a y W 201 W. Washington Ave., P.O. Box 7162 d'r C Z < ` �scons�n Madison, WI51707 — itary Permit Number (to be filled in by Co.) Department of Commerce (60 E� C �I Sanitary Permit Applicat t n c Sta Plan I.�D Number In accord with Comm 83.21, Wis. Adm. Code, personal informn you pS�vilde 20 2005 may be used for secondary purposes Privacy Law, s15. 1)(m) U C lr Proj ct Address (if different than mailing address) I. Application Information — Please Print All Information ST. CROI Property Owner's Name Parcel # Lot # Block # Property Owner's Mailing Address Property Location G �( 14 U ) � '1A S t ' /., Section 7 `` City, State / Zip Code Phone Numb /er ) - J T '2 N, R 1611 1 'I / Type of Building (check all th t apply) S 0 or 2 Family Dwelling — Number of ]34rooms SM Number El Public/Commercial — Describe Use L 7 L ❑ State Owned — Describe Use Z ❑City_ ❑Village ®Township of 5, /, I11. Type of Permit: (Check only one box on 1 e A. Complete line jtif applicable) A. ❑ New System eplacement System Treatment/Ho mg Tank Replacement Only ❑ OtLyw ^ Modification to xis g Sys m B• ermit Renewal ❑ Permit Revision List Previous Permit Number artd Date Issued ❑ ange o ❑ Permit Transfer to New efore Expiration , Plum Owner Li 3 U G 6 5 IV. Type of POWTS System: ( Check all that apply) 1 ❑ Non — Pressurized In- Ground 141Mound > 24 in. of suitabl oil Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holdi g Tank eat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Cham r ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate( sf) Dispersal Area Re Xturer persal Area Proposed (sf) System Elevation �/Y VI. Tank Info Capacity in To I Number M Prefab Site Steel Fiber Plastic Gallons Gal ons of Units Concrete Constructed Glass New Existing J Tanks Tanks / Septic or Holding Tank C1 LG da J i t Aerobic Treatment Unit / Dosing Chamber t/ ` O t t VII. Responsibility Statement- the undersigned, assume responsibility for installation of the PO S shown on the attached plans. Plumber's Name (Print) Plum is Signatur PRS Number Business Phone Number kq- Plumber's Address (Street-,City, Sta , Zip de) A6- 86V �?G3 4Jo 6 C��, VIII. County/Department Use Onl Approved ❑ Di roved Sanitary Permit Fee (it ludes Groundwater Date Issued Issuin Agent Signatur (No Stamps) Surcharge Fee) ❑ Own ven Reason for I D 2 z S IX. ConJition pprov al 3) SYSTEM OWNER: 1 Septic tank, effluent filter and Gb Q er dispersal cell must all be serviced /maintained - _ as per management plan provided by plumber. 2. All setback requirements must be maintained a "� t S as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) DEC . 2 2- t Zt� - RECEIVED Safe and Buildings Division Coun /I 2�✓. W hington Ave., P.O. Box 7162 J Z Cleo f N*1 J Ma n, WI 53707 - 7162 Site Address 2 �s`� Department of ., I , Cou^rry S'ani F I E at1Uri Sanitary P i t Number `t3o&6,3 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary purposes Privacy Iaw, s15. 1 m I. Application Information - Please Print All Information Plan I.D. Number Property Owner's Name ,�1s) w- Parcel Number X 30 3A. t4 C t e l" aI' 1 0 2' - 1 - I Property Owner's Mailing Address Property Location,,. f 2"2 [iG t � (, J 'i , 14: S T N, R / City, State 0 Zip Code Phone Number Lot BlMrNamber S++h a CSM Number II. Type of Building (check all t apply) ❑City ❑ 1 or 2 Family Dwelling - Number o ooms ge ❑ Public /Commercial - Describe Use. p = 9 - 4• onship 11 State Owned 1 / X ' Nearest Road It M. Type of Permit: (Ch box on line (numbering scheme for int al use). Complete line B if applicable) A For County use 1 ❑ New 4 3 ❑ Rep went of 6 ❑ Addido to Sy stem Tank Onl E ' ' S m B. ❑Check if Sanitary Permit Previously Issued Permit N r Date Issued IV. Type of Permit: (Check all that applly)(n scheme for ' ternal use) 44 ❑ Non - Pressurized In -Ground 21L`!'Mound k101- culating Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank e Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 11 Aerobic T ent Unit 0 ❑Other V. DispersablTreatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area it Application Percolation Rate stem Elevation Final Grade Required Proposed te(Gals./Days/Sq. (Min./Inch) Elevation cl-'jv N ov 1. inl q1. VI. Tank Info Capacity in Total N r Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Concrete Constructed Glass New Existing Tanks Tanks kk Septic or Holding Tank (j G U I.t� �'G Si Dosing 5U ti l LX VII. Responsibility Statement- I, the unde ed, ponsibility for installation of the POWTS sho on the attached plans. Plumber's Name (Print) Plum Signs /MFRS Number Business Phone Number ffely- 4.4 Plumber's Address (Street, gity, State, Zip e) VIII. Count /De artment Use Qky Pr. Approved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Is ing Agybt Signature (No Stamps) Surcharge Fee) / 11 Owner Give Initial Adverse 35. 1 _� . /1 7 Deter V 1X. C s OW OWNER easons for Disapproval 3 ) � � S S�l�n.� 1 Septic tank, effluent filter and °y dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained (to the County oWy) for the system on paper not less than gin x 11 inches to sae SBD -6398 (R. 05101) Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 _\ Vhsconsin www.commerc .wis ons Department of Commerce www.wisconsin.gov Scott McCallum, Governor Philip Edw. 'Albert, Secretary ti f February 15, 2002 `E ����E� CUST ID No.267341 ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA ` �`. wa PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/15/2004 Identification Numbers Transaction ID No. 708195 SITE: Site ID No. 641119 Lucinda Marvin - 2752 80th Ave Please refer to both identification numbers, St. Croix County, Town of Springfield above, in all correspondence with the agency. SW1A, SE1A, S19, T29N, R15W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 829279 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R 6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R 6/99). • 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 /installation/operation. Owner Responsibilities • A copy of this letter including instructions and information regarding proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • 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. I _ ARTHUR L WEGERER Page 2 2/15/02 Owner Responsibilities Continued: • Any activities noted in the approved management for this design relating to evaluation and monitoring of mechanical POWTS components after the initial installation of the POWTS, must be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ` Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Oerar M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jswim@con