Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
012-1008-60-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 641926 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(ni 032200459-C Permit Holders Name: city Village Township Parcel Tax No: Chase & Jesse Paulson TOWN OF ERIN PRAIRIE 012-1008-60-000 CST BM Elev: Insp. BM Elev: BM Description: SectionFrown/Range/Map No: 02.30.17.22B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. I Dist. to Well SOIL ABSORPTION SYSTEM STATION ES HI FS ELEV. Benchmark Alt. BM Bldg. Sewer SUHt Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BED/TRENCH DIMENSIONS Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO Type Of System: P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer. Model Number. DISTRIBUTION SYSTEM Header/Manifold IDistiribution 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 eeded/Sodded xx Mulched Bedrrrench Center Bedr-rench Edges Topsoil Yes 0 No r syd Yes Fi No COMMENTS: (Include code discrepancies, persons present, etc.) Location: No Address Available 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑ Yes Ro No Use other side for additional information. L Date SBD-6710 1 Inspection #1: Inspection #2: Insepctors Signature l__ 1_ Cert. No. "LFU � <-AA1 Cq5 .+ .Rr"r� Mk 4 Industry Services Division County Y e�L� 4822 Madison Yards Way, ' Sanitary, Permit Number (to be filled in by Co.) ' ` Madison, WI 537051. 1' g y w` >`• _ /y� St Cr-,'iv LnJOLY munll Development P.O. Box 7162 n Madison, WI53707-7162 -( `l ! I Sanitary Permit Applicatio State Transaction Number b 3 ZZ©1V81 - L In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) is required prior to obtaining a sanitary permit Note: Application fors for sia to the Department of Safety and Professional Services. Personal inforation you provide may be used for secondary purposes in accordance with the Privacy Law, s. IS.D4(l )(m), Scats. /-7,/� [ D Print I. Application Information — Please All Information Property Owner's Name Parcel N Property Owner's Mailing Address Property Location Govt. Lot Section City, tate Zip Code Phone Number T N R E o II. Type of Building (check all that apply) Lot 4 Subdivision Name rOI or 2 Family Dwelling— Number of Bedrooms ablie/Commercial — Describe Use Block i4 [—]city of fate Owned — Describe Use illage of CSM Number? C 3 OJk 7� �►e(A�1 Zf%N L 3 ` a /� % Mown of M. Type of POWTS Permit: (Check either "New" or "Replacement" and oth r applicable on line A. Cheek one box on Roe B. Complete line C if applicable-) A. ew System t—J—� []Replacement ]Replacement System Other Modification to Existing System (explain) Additional Pretreatment Unit (explain) B' [:]HoldingTank in-GroundrVI �4t-GradeVsMound Individual Site Design Other Type (explain) P (conventional) C. ❑ Renewal Before ❑Revision Fof Plumber ❑transfer to New Owner List Previous Permit Number Date` ued r r pol Expiration IV. Die ersalffrea ent Area and Tank Inform OV C h U f? Design ow ( Design Soil Application sf) Dispersal Area Required t) Dispersal Area Pro SO System Elevatan >✓ n 8D Tank Information Capacity in Gallons Total Gallons of Units Manufacturer e� Po lylcik: 6� " '� d New Tanks Existing Tanks ns r ( U 8 " 2 3 ii E5 1 rn m Sepic or Holding Tank 6 G — Dosing Chamber V. Respopsibilily Statement - L the oadersigned, assume re"onslibilio for installation of the POWTS shown on the attached pleas. lPlum s S^ Plum r' Nam7r,�Lo/) MP/MPRS Number Business Phone Number s - r Plum rs A (Street, City, S p, Zip Code) 1�� _s7 VI. Coon /De artmeniusconly Approved Disapproved Permit Fee s Date ssued 3 Z8 Z 4❑ Issuing Age![ S re for Denial ( Owner Given Reason Conditions of Approval/Reasons for Disapproval 3 A-1' to-4 1�,�[/ti/'7�,�, / n s/ �r4PLA ( r SYSTEM OWNER: ---•--. :! QK ACT1`i"G� Gt% / �� !�/�� IhNc t 72 1. Septic tank, effluent filter and dispersal cell must be serviced'maintained - tl �Vyy 6(^ VN__ leAA 14.4 t!�%t'jtJ7�(%�[. SYj V^ �lA(ti, t GC as per management plan by J provided plumber. �p� ` 2, All setback rtyuirpments mu§t be maintairltd lI�L�1^1sI kT7r/h p ►" * -e)1 6t�3he t� . ) M per applicable cede/®rdlflAllCe4. (( / F)woWws1x A,4_ ix S d 1AS14 . wlraM ro Compere p roc me syasem aw moour w me a-000ry only" pa ovr ,car ma" a ...... SBD6398(R.03/21) S'U�e_�3ob � 44k" r/1/tr- oa DIVISION Of INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54E43.64W Contact Through Relay http„bps-wf. www. Womnaln.gov - '•""''�" Tony Even • 3ovwiwr Owwn Cram • 9" Mny March 23, 2022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2024-3-23 Plan Review: PWTS-032200489-C Kim Oconnell 504 3,d Ave E Osceola, WI SITE: Paulson .....1901h St Town of Erin Prairie St Croix County SW X NE N S3 T30N R17W 13i11; Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Description: 3 bedroom-450 GPD — 37" to limiting factor- Effluent Filter - Maintenance required. SEE CORRESPONDENCE Mound Component Manual — Ver. 2.0, SBD- 10691-P (N.01/01, R 10/12) Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12) 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 any 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. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the Mound site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. • Components and soil removed from an existing drain field shall be properly disposed of so that there is no risk to public or environmental health. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 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 state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • 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. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(1). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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 Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, j�Roi.vzey Joshua Rowley POWTS Plan Reviewer, Division of Industry Services (715)813-9111 Joshua.rowlev@wisconsin.gov APPLICATION FOR REVIEW Private Onsite °s-Complete act pages- Wastewater Treatment P i S ;r: NOTE: Personal information you provide may be used for secondary purposes [Privacy Law s.15-04(1)(m), Stets.) Systems Division of Industry Services For Electronic Plan Submission provide SharePoirn User name below: For plan status, check our website at httpJ/www.d5m.wi.Eov Several counties have been delegated certain authority to review plans in lieu of Division of Industry Servu-es. For a current fist of those counties and their delegation check our website at httpl/www.dsos.wi-gov 1. Project Irdormatlan - FIB in at known information. 7 Project/Site Name %-49445on/ Location, Number 8 Street of project (if upimown, indicated nearest road) / %G r ST Legal Descnp orc S In f- g -Sr e .3 fl. 3G.t/ - �/71,,./ County T () City () Vill" YJ Town of ZZZd M} Confirmation of assignment to a reviewer. Transaction to - Previous Related Trans. ID: Estimated Completion Date: Assigned Reviewer. Assigned Office: Mall to your office of choice below. Hayward, LaCrosse, Waukesha 2. After plans are reviewed, Please: (check all that apply) Call customer 1, 2 (cede number)` Plans to be E-tiled (Enter NOTE: We reserve the right to re -distribute plans to _ Requesting party will pick up SharePdnt User Name Above) another office if needed to reasonably balance turnaround times. Check httpJfdsps.wi.gov for office Mall plans to customer 1, 2 (circle number)* availability and next available review date *Refers to customer number from below a. Complete the following designer/owner/requesting information. Utilize the cheek boxes when designer, owner or requesting party is the same to avoid repeating information. Designer Irdonnatlon (Customer 11 DSPS Fiat h > Last Name Customer Number Cry Address G1y - _ Soft Zlp`4 (96gits) Phone Nu "r (area code) Feror Internet cell phone Check P applicable ( ) Owner Other Please Specify Below (Customer 2) DSPS First Name Last Name Customer Number Company Name Address City - \State Lp+47(9d'gits) Phone Number (area code) Fax or Internet cep plro Check if applirabe a specify relationship (Owner ( )Other-specifyrelationship- 4. Information and Plan Submittal Checklists. POWTS scheduling is not available. Plans will be assigned to a reviewer after receipt of plans- If you select a specific office your estimated completion date maybe considerably greater than what would be possible in another office. Submittals received without a specific office indicated on the form may be assigned to offices other than the receiving office depending on reviewer availability. Submittal checklists can be found in each applicable component manual. You may email technical code questions to DSPSSBPowtsTechO-wLgov. Hayward DSPS 10541 N Ranch Rd Hayward WI 54843 715-6344870 Fax: 715-634-5150 Email: DspsSbPlanSchedule vn.aov LaCrosse Area DSPS 3824 N Creekside Holmen W154636 (NOTE CHANGE) 608-785-9334 Fax: 606-755-9330 E-mail: UspsSbPlanSchedule(cDwwi.gov Make Checks Payable to: Division of Industry Services OR Waukesha DSPS 141 NW Barstow St 4r' Floor Waukesha WI531W3789 262-5484%W Fax:262-548-8614 Email: DsosSbPlanSchedu1c(&Wi.eov ❑ Check box to invoice designer and sign below I TOTAL AMOUNT DUE= Review Code 7633 Designer Signature SPS-105T7(R 3114) S. POWrS SUBMITTAL (check all that apply - Incomplete forme may result In processing delays) NEW () Aerablc Treatment Units) () Chlorinator () Tank Replacement Only ( REPLACEMENT O Commercial System O UV Disinfoc0on Unh O Add Effluent Filter SYSTEM TYPES) NOTE: Submit separate sheets for each system If submllWg multiple systems on the same site. Enter Fee () Revision to previously approved plan ;55.00 O Miscellaneous Review (i.e. replacement of a septic tank, addition or an effluent filler or pretreatment device to an existing system, etc.) ;801hr j2f Component Manual All treatment components are porn previously approved Design under s. SPS 384A0 (2) or (3): () AI -Grade Component Manual - Ver. 2.0, SBD-10854 (N.03r07, R. 1112) Wastewater Flow in O In -ground Component Manual - Ver. 2.0, SBD-10705-P (N,01101, R 10112) Gallons Per day Design wastewater now of the proposed system: Mound Component Manual -Ver. 2.0, SBD-10691-P (N.01/01, R 10I12) Pressure Distribution Component Manual ' - Ver. 2.0, SBD-10708-P (N.01101, R 10112) 1, 000 god or less ; 250.DD O Drip -Line Dispersal Component Manual, SBD-10057-P (N.6/99) GP 1,D01 -2,000 gpd ; 325.00 O Other - Please specify 2,D01 - 5,000 god ; 400.0D/-., ,f-- ❑ Solt Based Individual Site Design' One or more treatment components are not previously Design approved under s. SPS 304.10 (2) or (3): (Individual O At Grade Wastewater Flow In ails design/deviallon frorn component manuals and use () Non -Pressurized In -ground Gallons Per day of components without product approval): () Pressurized In -ground O Mound Design wastewater flow of the proposed system: () Drip -line GPD () Constructed Wetlands 1.000 gpd or less $450.00 1,001 - 2.000 gpd $S00,00 Documentation must be provided to support treatment and dispersal claims. In a separate statement, •provide 2,001 - 5,000 gpd $750.00 rationale for the project and attach supporting documents (code sec0ons, lest reports, technical greater than 5,000 gpd ;900.00 ptus;0.08 papers, research articles, etc.) for each gallon over 5000 gpd Slate -owned facilities: Design Holding tanks previously approved under O Holding Tank Component Manual, Ver. 2.0, SBD-10855-P (N.03/07, R1112)' Wastewater Flow In a. SPS 354.10 (2)(3). Design wastewater flow of the Gallons Per Day proposed system: •Non -stake awned Commercial and Residential Holding tanks That completely utilize this manual and have an estknated daily flow of less than 3000 gallons per day must be submitted to the appropriate governmental unit for review Instead of the Department. [see SPS 383.32(3)(a)) GPD 5,000 gpd or lase $90.00 5,001 - 10„000 gpd $150.00 greater than 10,000 gpd $225.00 ❑ Holding Tank Individual Site Design% (I.e. site constructed. <5 day holding capacity, Co -mingled Holding tanks including site constructed tanks NOT wastewater, ale) Design previously approved under a. SPS 384.10 (2) or (3). Wastewater Flow In Design wastewater flow W the proposed system: Please specify: Gatione Per Day 5,000 gpd or less ;180.00 • Documentation must be provided to supportthe rationale for the project. In a separate statement, please GPD 5,001-10,000 gpd $300.00 greater than 10,000 gpd $450.00 Include all code sections, test reports, technical papers, research articles, etc.) () Sall Saturation Determination Report (using observation pipes) () Interpretive Determination $240.00 O Experimental System (One time additional fee). Submit fee for individual system as per appropriate above system type) Experiment Number $400,00 Prior approval from a section chief Is required for a priority review. If approval Is granted, the priority will be reviewed within 5 days of receipt. Priority review fee Is double the normal review fee. Priority Review (enter some amount as normal review fee listed above) ; Enter Total (rounded to the nearest dollar) MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name. Paulson Owners Name: Chase & Jess Paulson Owner's Address: 1740 190th ST New Richmond WI 54017 Legal Description: SW-NE-sec3-T30N-R17W Township: Erin Prairie County: St Croix Subdivision Name: CSM Lot Number: 2 Block Number: Parcel I_D. Number: pending Conditionally APPROVED Plan Transaction No.: DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank SEE CORRESPONDENCE Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Page 10 ATT soil evauation Designer Kim A Oconnell License Number Date: 03/09�/22 .- Phone Number: Signature: 224263 715-381-7917 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 9 Mound and Pressure Distribution Component Design Site Information (R or C) R 300.06 450.00 7.00 99.00 37.00 0.60 Design `o1'cr;-csheet Residential or Commercial Design Estimated Wastewater Flow (gpd) Peaking Factor (e.g. 1.5 = 1500/'u) Design Flow (gpd) Site Slope (%) Contour Line Elevation (ft) Depth to Limiting Factor (in) In -situ Soil Application Rate (gpd/ftz) Distribution Cell Information 76.00 Dispersal Cell Length Along Contour (ft) _ 1.001 Dispersal Cell Design Loading Rate (gpd/ft2) L _--1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (C or E) E, Center or End Manifold 3.001 Lateral Spacing (ft) 2 Number of Laterals 0.125 Orifice Diameter (in) 2.501 Estimated Orifice Spacing (ft) 2.00i Forcemain Diameter (in) 90.00 Forcemain Length (ft) 90.001 Pump Tank Elevation (ft) 6.501 System Head (ft) x 1.3 9.331 Vertical Lift (ft) 1.22 Friction Loss (ft) 0.00, In -line Filter Loss (ft) _ 17.05 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options choice 0.75 1.00 1.25 x 1.50 x x 2.00 x 3.00 x Note: Sand fill (D) calculations assume a Table 383-44-3 in -situ soil treatment for fecal colifonn of <= 36 inches. 6.00 Cell Width (ft) Are the laterals the highest point in the distribution network? Enter Y or N If N above, enter the elevation R( ) of the highest point. i 7.50 fe/orifice Does the forcemain drain back? I� Y Enter Y or N 14.68 Forcemain Drainback (gal) 67.32 5x Void Volume (gal) 82.00 Minimum Dose Volume (gal) 24.72 System Demand (gpm) Manifold Diameter Selection in. dia. options choice 1.25 x 1.50 x x 2.00 _f 3-00 Gallonslinch Calculator (optional) Treatment Tank Information 1000.00 Total Tank Capacity (gal) LI 1000.00 Septic Tank Capacity(gal) 36.00 Total Working Liquid Depth (in) 'Wieser Manufacturer 27.78 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.001 Dose Tank Capacity (gal) ,Polylok Filter Manufacturer 1636; Dose Tank Volume (gal/in) PL-525 Filter Model Number (Wieser !Manufacturer _ Project: Paulson Page 2 of 9 450.00 (ft) Dispersal Cell Area 1 1079.91 (Ill Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 1 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.29 (ft) ♦ H G1 F D�apersai cen 100.00 (ft) Lateral 99.50 (ft)--- ► — Invert Dispersal Cell] Elevation D Q 99.00 (ft) Contour Elevation 7.0 % Site Slope /-*� Geotextile Fabric Cover Shading Key $ x 1Q Topsoil Cap o a I 1.5 ft Q2 0 Subsoil Cap n o © ASTM C33 Sand 0 Tilled Layer ©0 Aggregate a c Dispersal Cell fl Typical Lateral F IF A M See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cells centerfine in the distribution cell (AxB). Project: Paulson Page 3 of 9 End Connection Lateral Layout Diagram Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 2 1.50 73.37 3.00 12.36 24.72 17.05 Orifice Diameter I Orifice Spacing (X) Orifices per Lateral Orifice Density pm Manifold Length pm Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and —0 SPS 316.300 WAC Tank component is properly vented Wieser Capacityl 600.00 Volume 1 16.76 Manufacturer Gallons gal/inch Dimension Inches Gallons A 19.91 333.64 B 3.00 50.28 C 4.89 82.00 D 8.00 134.08 Total 35.80F 600.00 T A B C D tank. Alarm Manuafacturer :S�JE Rhombus - Tank Alert Alarm Model Number 1101-01H� Pump Manufacturer Gout Ids Pump Model Number ;PE 51 r. Pump Must Deliver 24.72 gpm at 17.05 ft TDH Locking cover with warning label and locking device and sealed watertight 4 in. min. z� I— Alternate outlet location Forcemain diameter --1 2 in. Weep hole or anti - siphon device p _Pump off elevation (ft) 90.67 _Dose tank elevation (ft) 90.00 Note: Switches containing mercury may not be used in this system. Project: Paulson Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name I Phone; POWTS Regulator's Name St Croix County Zoning_ 7 Phone) 715 386�680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Moundi Service Frequency Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test month) Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years Miscellaneous_ Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the mound component manual. 2 Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code 4 Tillage of the basal area is accomplished with a mold board or chisel plow. 5 The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished Grade 6-8" Diameter Lawn Sprinkler Valve Box Distribution Threaded Cleanout Plug or Ball Valve t Sweep 90 or Two Je ree Bends Same Diameter as Lateral Project: Paulson Page 5 of 9 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01t01, R. 11112). SSWMP Publication 9.6 (01181). and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01/01, R. 10/12)) 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 SPS 383.33, 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. Septic Tank The septic tank 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 fitter 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 finer is equipped with an alarm. the fitter shall be serviced if the alarm is activated continuously. Intermittent fiher 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. Pumo Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erasion and to provide some protection from frost penetration Traffic (other than for vegetative maintenance) on the mound is riot recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS. and 30 mg/L FOG for septic tank effluent or 30 mg1L BOD,, 30 mg/L TSS, 10 mg1L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and lt 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 6 inches considered as an impending hydraulic failure requiring additional. more frequent monitoring. Continency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component faits to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition, See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project, Paulson Page 6 of 9 Wastewater METERS FEET 1 40:... 0 S 10 15 m3AI CAPACITY PERFORMANCE RATINGS PE31 ToW Head (feet of ruler) c2m 5 52 10 42 15 29 20 16 25 0 PE41 TOW Had Rom of water) GPM 8 61 10 S7 15 46 20 33 25 16 PE51 Trial Hand (fed of warm) GMA 10 67 15 59 20 50 25 39 30 26 35 8 PAGE: a ST. CRo UNTY SANITARY SYSTEM File #. ` t `'`"""f` OWNERSHIP/ADDRESS FORM Create Use Only creaeed z/Iort Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you Can do so by using the Property Files Scanned weblink. OWNERIBUYER INFORMATION Owner/Buyer 6+ASf: Pp?-"C.SD^J v (W&SSe- apaLSOa Mailing Address /96 r' 67— City/Stage/Zip .Ve-W defCA /A40.Ve 71 A01 Phone Number (required) '!/S 1jVS----7.S IC - Email Address (required)- _ OCbo.V/e/99$� Parcel Identification Number n/.? - /OD$ - too - ccx> (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property LocatiorO li '/a ,4�L 1/4 , Sec. , T-24 N R-L,7W, Town of g&/w A.w Ase- Subdivision Plat: , Lot # . Certified Survey Map # J) ti��j Volume 131 Page # -Zd 7.L, Warranty Deed # (before 2006)Volume Page # Number of bedrooms Spec house O yes PILno Lot lines identifiable $ yes 13 no OFFICE USE ONLY New Property Address 17 45Q 9 & Ti4 s-F (Verification of new address required from Community Development Department for new construction.) 31z$12Z (Staf' Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: include with this form 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. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cdd(@sc--wi.gov 1101 Carmichael Road, Hudson, WI 54016 wwtv.so_w v Wisconsin Department of Safety and Professional Services Page __L of Division of Industry Services SOIL EVALUATION REPORT In accordance with SPS 385. Wis. Adm. Code Carty Attach complete site plan on paper not less than 8 112 x 11 itches in size. Plan must include, r but riot firnited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. 0 Please Print all information. Reviewed by Date Personal information you pro%Ade may be used for seconds Pri Law, S. 15 i XMIJ. Property Owner Property Location ❑ L % s GovL Lot V. '/. S T v N R E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Citv % r / Sitate Zip Cqde Phone Number ❑ City ❑ Village Town n Neat RoaV % Q( New Construction Use:a Residential/Numberofbedmoms3-.I-'Codederived design flow rate PD — 4;W ❑ Replacement ❑ Pubic or commercial - Describe: Parent material /. &S:W Flood Plan elevation if applicable _ R General comments and recommendations: ` �p a Boring # ElBoring ® Pit Ground surface elev.W/ ft. Depth to linking factor_ ? s/ in. c..0 e....�s;.... sere Boring # ❑ Boring ® Pit Ground surface elev.w-vR Depth to limiting factor .4 In. c.a e� ramie �r MWMA r, ■�r�� c.�s.Tf�f7Ai TS:t+T2T�'r7'7� _-- CST ( t� Signature I CST Number Address f Date Evaluation Conducted Telephone Number On � /Of 149% 1117 1-z0v-7 FilBoring # Boring pp ���� Pit Ground surface elev./LeL It. Depth to smiling factor_ in. Soo Audication Rate . me rra�in` n!i ON WMM ❑ Boring ❑ Pit Ground surface elev. ft. Depth to Wn" factor — in. .. it Mnliration Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Fe •EfW1 •EM Boring # ❑ Boring ❑ Pit Ground surface elev. _ It. Depth to smiting factor _ in. Sal Application Rate Horizon Depth In. Dominant Color Munses Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDf e •EfW1 -E-ff#z • Effluent #1 = BOD. > 305 220 mg/L and TSS > 30 5 150 mg/L • Effluent 02 = BOD. > 30 s 220 mg1L and TSS > 305 150 mq& Wit- Ak'— 47—�;1�730AI- isL' A r�i.Ji `/%ace / �ma{//��Pc� - c✓��,v 9� /k- OD Or Sm&lEVEL e 1N'�'d 30 OESISN LLC Arc Aitsetuel Services NOTICEI aueamrovoawuLi s¢es_wowrwionsr I UPPER LEVEL II A4 IIFew.II�M ' 1Q]NOOA-IOIRLL.GY[ WRCOx1]yP.TpF M PPPm ] r p MYMV4IP\MO T ��� s o YPP�I.�eT' X�.Iv PPIIIYYIPIOMIP\e1.P. '� Ir �� 6 sasa:xxfon� 30 DESIGN LLC .m.FPeamnaalre i ' ��i � ySrff�f�T �� b[Aite[bnl Se rrluF (715)248-3010 yq ;"— as,LAM COIEaEO QAIRf IIVEq gIp1P BCIEENEO �..i�ni NRCM 1100A1 FOaLX � uw _��. ATYw,i:' > I AR w-�•ya^Pew •omuweeeenwt ne .mnoay.mo ,� �1 n..orx[anuee[s u•.. o.uyo BONUS y m..PuvERWllo FWM NOTICE] ��Y' .wY.mn.w.e •7 . x O34VAC FANry WgLL 1'ETA0. 1? • 1'd oxm wa nFIRLaECTIX1 �1? • 1�P Ilsm. 9N Chase 6 Jan Paul ■'" uoY ""' wPi lel]ene.e4 ov1 xorz: "" .....,y SECTIONS a C 0 MINI" 1Wl®2 M 2 Y-P T-T 9-P s-P Y-Y f•Y OBL XLNO 0&XIMa UM IbN FA IpN FA B_P T-]t!• a-P 1'-1]! >-1]! 1'-Il! M N ]J1fYgBEN 1 1 1 ruAu µp �� ro. Io xlu nw.x osPY IY Y"'X' �XB' 104 !-P >-f OaLNWO LgYFA 'f•014 i-1]! /Ja MN Y A5 /1 F !-C IIMEa9EN 1 ON :It Y n s:::u=•xss� ©t•�xr°�� . a (eye..—.11.1, Otnnrtetevwvtsrt te•. tv 2015 SQ. FT. 678 SQ. FT. 889 60. FT. MAIN LEVEL BONUSROOM GARAGE/UTILITY 30 OESISN LLC Aalitvetnvt SetvleAA NOTICEI I ELEVATIONS I Al Wisconsin Departmen slq al Services Page Of, Division of In 1U1 v �G 1J C SOIL Dmr tzvurT SEp 0� VIA In ordance with SPS 385, Wis. Adm. Code County Attach complete si a plan on paper not Iles an 8 1/ x 11 inches in size. Plan must include, S but not limited to: rtical arj4 @*poi t (BM), direction and percent slope, Parcel I.D. pe&* Of scale or dimension north NO distance to nearest road. —� — Comm�Please print all information. Rd by Date Personal information you provide may be used for secondaryy purposes Priva Law, s. 15.04 1 m . l/ r Property Owner / Property Location ❑ f A 10 I S Govt. Lot 1/. A&I Y. S T O N R E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# �3' S i� erdi City Sfpte Zip Cgde Phone Number ❑ City ❑ Village 19 Town Aearest Roadl,O/ / New Constriction Use: jo Residential /Numberofbedroom�-� Code derived design flow rate—X,PD — G�%O ❑ Replacement ❑ Public or commercial — Describe: �( Parent material y� r1 O—W.Q j± ar-i-e Flood Plan elevation if applicable _ ft.S� Ysk M ft% � X General comments and recommendations: [y] Boring # ❑ Boring ® Pit Ground surface elev.,qEk ft. Depth to limiting f or � in. .,,nil Annliratinn RatA • •-. Dominant .. Munsell a -••E, • .®� C• •. '•. �� / MA�' , �_ 17w��� � Boring # ❑ Bering ® Pit Ground surface elev.�ft. Depth to limiting factor in. Snil Annlicnfinn Ratc Dominant Color � 1�1�11r�WA P—M Ml IM o WOM �M CST a (Ple a 'nt Signature CST Number Address Date Evaluation Conducted Telephone Number \�1 bnu-usiu (KU4110) .f Boring # Boring Pit Ground surface elev. .9 ft. �? 3 , Depth to limiting factorf,3_ in. Soil Application Rate MW .. ..J.w-..... �.. ®®Mmw���� � �l�W- 1.!.�//��LWIM .,-�- .�� I MMA, � i �#�ll� R� ���OA ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ft. Depth to limiting factor in. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Fe 'Eff#1 `EN#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 'Ef1#1 `ETf#2 * Effluent #1 = BOD, > 30 <_ 220 mg/L and TSS > 30 5 150 mg/L * Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L Boring # Boring pit Ground surface elev.&-;� ft. Depth to limiting factor_ in. Rnill Annliraflnn Rata I • • -. �. : ..A ' -.. , , • . ®®-lamww Consistenc � i���0 i tILl�1 t WMAW M�� ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. —ft. Depth to limiting factor _ in. Cnil Annlirafinn Rath Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 I •Eff#2 ❑ Boring # ❑ Boring ❑ pit Ground surface elev. _ ft. Depth to limiting factor _ in. Snil Annlirafinn Ra}o Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Fe *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30 <_ 220 mg/L and TSS > 30 5 150 mg1L * Effluent #2 = BOD, > 30 <_ 220 mg/L and TSS > 30 < 150 mg/L - j [,.Cll PIV! A I I /I I -------------- W QCIO �r N a E L..: O v A to w' ® �J W _u C/1 aA N a N d C> w M �y 3 w O Z H 2 Q Q l/7 ✓� �Mz Xz ,,ozz W Q O x r _`7- zwz O s LL �L O w O M CD s..i ^� N NCE r Z N w o co 3 3 Gf) x • p } r w<('4 — M r � Z � Z O M p o to M V)<� — ,o W W= L v 3 w 3 o 0-4r � LL �( o < CD Lo I --I W cr z cc owa Q c z a Qi a o a W z� C3c:: o CD x CD o o z Northeast Corner VNPI TEQ Section 3-30-17 LAMS Aluminum Cap "This map contains areas that are subject to UNPLATTED Shoreland Overlay Zoning District and Floodplain LANDS Overly Zoning District Additional restrictions apply. Contact the Community Development Department for further information.' Lot 1 and Lot 2 are zoned R-1, Residential District, which allows 1 principal dwelling per 10 acres, 0 additional lot splits are available while zoned as R-1. Please contact the Community Development Department for more information. UNPLATTED 01- CA95s XV 101k C� w LANDS UNQ c R LOT > ? 438,607 ; sq.ft. 10.069 acres swell rg driv o� e In vat �S , SePf; 52A6ti9.92 �.�'� SOpN51N%�� UNPANDS 0 1311.98' a 01 � to M to � N to ri ro w i� to to o iO in _ S_89'01'37"E__ S13i3.56� � 411� 1�� �`A LOT 1_65M Vol. 7 PQ7936 UNP�ATTf,D N I LANDS Mo i P ^J V. P� East Corner 40 Section 3-30-17 Aluminum Cap N89'57'59"E 975.72' 1335.72' -------------- FEMA Firm // g� , Ll 30.00, i N45'11'12"W Notched area ,! Is 66'x30' access_ea_sement 30' wide Doea ingressmeegess ease n -5-90- (Serves all parcels) Doe. imnXx Serves Lott and shared access to Unplatted Lands (See page 3) oximate Flood UNPLATTED SCALE: 1" = 400' per FEMA Firm LANDS 155109CO235E. 0' 400' 800 Each parcel on this map is subject to State and County laws, rules and regulations(i.e. wetlands, minimum lot size, access to parcels, density limitations, etc.). Before purchasing or developing any parcel, contact the Community Development Department and Town Board for advice. 2671.44' UNPIAM2 d 1 89'57'59"E Wkcla L 360.00' 3 N89'57'59"E `_ N 00 vm gNorth 1/4 Corner Section 2-30-17 v u, Aluminum Cap t " gCOly O AUDT screw OLSOM C,.. 1` DRAFTED BY: Joel A. Brandt �\5 JB Surveying LLC Completion Date September 2021 LEGEND 10...... Found Government Corner a.,.... Set 3 4" x 18" Iron Rebar ryy weig ing 1.502 lbs./foot e...... Found 1" Iron Pipe *...... Computed Position North is referenced to the PREPARED FOR: East Line of the Northeast B.J. Olson Quarter of Section 3-30-17, 1740190th Street which bears N01°01'55"W New Richmond, WI (St. Croix County Grid System) -5 �Ld roo von . Croii:COUNTY NO, 641926 STATE SANITARY PERMIT ns �lgp holk 54- PR�yJ6US�U� +I- qk,., zowwe owrvse r- UfZe AVArou, PLUMBER kit TOWN OF E^.M LIC.# Zz SEC 'S 9T �O N, R l'? E S AND/OR LOT Z BLOCK THIS PE tw EXPIRES POS SUBDIVISION 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c.168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. - "CER - DATE RENEWED B VIEW THAT DATE VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI 1/20)