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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
430558
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:
Hirst, John I Stanton Township 036- 1067 -40 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
/ 0010 / a d (/ e M -411 29.31.17.437D
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic enchmark
Dosing 4S7Z) (I Alt. BM
Aeration Bldg. ewer
_--- S (.0 r 8• &s_ 9 7. Z�
Holding SUHt Inlet
TANK SETBACK INFORMATION Ht Outlet 9 Z 96 • �O
TANK TO P/L W LL Vent to Air Intake ROAD Dt Inlet
S t' > h f I � � �VVZ I Dt Bottom ' 3
osing f/ , ( 7 Heade JMan. 211 �" A
Aeration Ivt, t 1'\S Dist. Pipe T "�
5 43 11.3
Holdings Bot. System S Z
9 e
Final Grad r
PUMP /SIPHON INFORMATION
Manufacturer Demand St over r
GPM 1- Vh {-
Model Number > n B / _ rn �
TDH Lift r y Fricti n Los Sys mHee TDFJ Ft I
i
0 k
l Forcemairi Le th 11 Dia p Di
W I st. to II /b b ,
SOIL ABSOR ION SYSTEM
BED/TRENCH Width , Length No. Of Trenches PIT DIMENSION Of Pits Inside Dia. Liquid Depth
DIMENSIONS 0- 0 1 /
SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM L CHI Manufacturer:
INFORMATION Typ f System: f , � CRAM OR
Model Number:
DISTRIBUTION SYSTEM
Head /Manifold Distribution T
Ole Size Hole Spacing jVerA/t6/Air Intak Pipes) Dia /il (i ' / S 1 [ / ^ `'r
Length Dia Length - [ 1
SOIL C VER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over "- h Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center j t ]' Bed/Trench Edges Topsoil -i Yes i_! No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:11/ V/ 0 Inspection #2: Z11 d
Location: 1591 200th Avenue New Richmond, WI 54017 NE 1/4 NE 114 29 T31 RI 7W) NA Lot � Parcel No: 29.31.17.437D
1.) Alt BM Description = ! C
2.) Bldg sewer length = r ytQ,Gi7CA.ly N, !2
- amount of cover
Plan revision Required?
Use other side for additional ' Yes (No
information.
SBD -6710 (R.3/97) Date Insepctor's Sig e Dt Cert. No.
RECEIVED
N O V ANd Buildings Division co"'
1*A r 20ton Ave., P.O. Box 7082 scons nST. CR IX COU WI 53707 - 7082 San itary Permit Number (to be filled in by Co.)
De artment of Comm rce ZONI OFFI8) 261 -6546
Sanitary Permit Application State Plan I.D. Num - y' o & S 1 t5
In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide
lA . t
may be used for secondary purposes Privacy Law, s 15.04(1 Xm) Projec dress (if different than mailing address)
I. Application Information - Please Print All Information / / ,? 0 6 1
Property Owner's Name J � /` �� i Parcel # Lot # Block #
Q 36 - (06'+ - - Ot)a }
Property Owner's Mailing Address Property Location
/ c >?OO l 1 /4, �� ., Section
City, State Zip Code Phone Number
Nit a �-f e > 71 J ' q� -5 7 rcle one)
T N; R14E or W
II. Type of Building (check all that apply)
A 1 or 2 Family Dwelling - Number of ms pp nn
❑ Public/Commercial - Describe Use _ �� Y brdl • 10'0 ocv- a . '
❑ State Owned - Describe Use Im t ir City ❑Vill ownsh' f
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. 11 Pei. Renewal ❑Permit Revision 11 Change of ❑Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWTS System: ,- y C _ h _ eck all that appl
❑ Non - Pressurized In -Ground NMound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain)
V. Dispersal/Treat ent Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation
DO I , 5 1 6040 zoo 1 �U O I �
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holling Tank 5
Aerobic Treatment Unit ✓ 0
CJ ( /
Dosing Chamber 750 1
VII. Responsibility Statement I , the undersigned, assumeve4ponsibility for in llation of the POWTS shown on the attached plans.
Plumbeir n7 e Pri ) Plumber' a P PRS Number Business Phone Number
p 3S 2 s--
Plumber's Address (Street, City, State, Zip Code)
VII . Coun 7 rtment Use Onl
pproved Disapproved Sanitary Permit Fee (includes Groundwater a Issued is u' g Agent Signature Stamps)
Surcharge Fee) .�,,,,2
Owner Given Reason for Denial 3 5V dU• GrR2.7
IX. Conditions of Approval/Reasons for Disapproval �--
SYSTEM OWNER: 3� t 5� ',t � 11A�
1 Septic tank, effluent filter and
dispersal cell must all be serviced / maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code /ordinances.
�nvfl LA/PJ = __aWI✓ C
Attach complete plans (to the County only) for the systerli Pape r not less than 81/2 x I1 Inches In size
SBD -6398 (R. 08/02)
Scale
1.
7: Al
O S 1
x'
N Z PVC
�Op06H-c\ 1
o �
eE
f13r1'�wv�j
4J Pra CIM CAE' .
AP
c
�
\ v
R,LT BY4 it
so
i7 O VJ DT COwIt-fr-tT J
o 1Z D I I TVR 3 6 9
CO
NOTES:
1. Elevations shown are existing ground elevations unless
2. Install 4" observation otherwise noted.
3. Septic tank observation
be p with approved caps. ( Z required).
\ST" logo gallon capacity - „f., , *�,,. , a �. ��11T2{ ���
� ��1Z co),j * T� WLP ISU I'12 11'� Sl W f I� -16 UO Z-F'1 SLZ rlL
4. Bench marks S'
5. Divert surface water around systen to .
prevent ponding at the urhill si�:e.
Safety and Buildings
i 4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
I \
Visconsin www.commerc .wis ons
Department of Commerce www.wisconsin.gov
Jim Doyle, Governor
Cory L. Nettles, Secretary
November 11, 2003
CUST ID No.220254 ATTN: POWTS Inspector
ARTHUR L WEGERER ZONING OFFICE
WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA
PO BOX 74 1 101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 11/11/2005 Identification Numbers
Transaction ID No. 940965
SITE• Site ID No. 668291
John Hirst Residence Please refer to both identification numbers,
1591 200TH Ave above, in all correspondence with the agency.
Town of Stanton, 54017
St Croix County
NE 1/4, NE1A, S29, T IN, RI 7W
FOR:
Description: Four Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 930496
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes COnditt
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. A RK�
The following conditions shall be met during construction or installation and prior to occupancy or use: b F'ARTMENT
General Approval Requirements: N 0 E Tlc'
• This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRES
"Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1)'
and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION
2.0" SBD - 10706 -P (N.01/01).
• The changes made to this plan on 1 1/11/03 by this reviewer were acknowledged and approved by the system
designer.
• The existing septic tank must be inspected for structural soundness, size and baffles and must be brought into
conformance with the requirements of ch. Comm 83, Wis. Adm. Code. If it does not conform, a state approved
tank must be installed.
• Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance
information must be given to the owner of the tank explaining that periodic cleaning of the filter is required
• Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area.
Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal
are prohibited.
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
area. chs. NR 811 & 812c
ARTHUR L WEGERER Page 2 11/11/03
• 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.
I
• 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. Stat
• Comm 83.22(7) 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:
• Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
• Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• Comm 83.55 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.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
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
Charles L Bratz
POWTS Reviewer II , Integrated Services WiSMART code: 7633
(608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday
cbratz@commerce.state.wi.us
cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544
TITLE SHEET Page I of 7
FOUND SYSTEM
FOR
A BEDROOM RESIDENCE
This plan has been prepared in accordance with the Mound Component
Manual SBD 10691 -P and the Pressure Distribution Manual SBD- 10706 -P
(N.01 101) .(N.01 101)
LOCATED IN THE yE 1/4 OF THE 1 V� 1/4 OF SECTION Zq ,T 3 ) N,R 1 W,
TOWN OF N j ST . C \�tX COUNTY, WISCONSIN.
INDEX
PAGE 1 of 7 TITLE SHEET
PAGE 2 Of 7 SYSTEM MAINAGEMENT 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
IIECEIVEO ssq N Zoo -n+ A \jk _
NOV - 3 2003 N � 1 C1 irf,olJ� , �� l S'4 017
SAFETY & BLO GS DIV orally
PREPARED BY C OMMERCE
�( )NDEr4C CCEF�ER SL3 I L- AND .
DES = G�i S�Ri1 S CE
P.O. Box 74 421 N.1Iain St.
River Falls, WI 54022
Phone 715 - 425 -0165
/ # r
Fax 715- 425- 6864�,`���,
ART
C1Pt5 P ij
Et 3W HTV d
was.
�Q r �•� r �.r
P'�^9ry ti k , 3
1 0 - 3t -A3
JOB NO. C) ZOO
I -
Mound System Management Plan p age Z of j
Pursuant to Comm 83.54, Wis. Adm. Code
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 113 the liquid volume of
the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise
the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in
the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required.
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 shall be tested to
verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings 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 BOD5, 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 [S8D- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance
reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and
Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. es s
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.
Continoency 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 or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired
or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption
and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper
operating condition.
Questions about the operation or maintenance of this system should be directed to:
The County Zoning Office at -- I \S — Z) ?J b -4 b 5T ( --, w1X
The. system installer at — 7 1 — Z�$ �Q VTGPMD
The tank manufacturer at 3
The effluent filter manufacturer at "I)o - zZI _ S'lq Z - z-
The pump manufacturer at
7
Scale 1 "_ Page c
C n� 7, 5-
i
1
C� 7�;
x
1�tp�Z= wZ-LA—TN
G�Uh: (�`6r'1PUPtt�C'N�
r%
i
� 0 tvoT CDC Pry-�T ,
DR- t�1sTvt e ' B3 i J
Ck— CET2 L
NOTES:
I. Ele vations shown are existin g otherwise
2. Install 4" observation pipes iw approved t caps. u ( 1 Z required).
3. Septic tank to be 1ST' loo
o gallon capacity ga
w��iZ Cc»C w �- P 1 St)wt2 1NSL 3 'RI�S w ►� - t6uu
I Zpr RLT)� .
4. Bench marks S �ovc round �r s 'Sn yst '1'��l -z i b 3� yv �P �Sp _,•, rc
S. Divert surface water a� l
e� to prevent ponding at the urhill site,
• Pace
Approved Synthetic Covering
ASTH C33 Distribution Pipe
Medium. Sand
Topsail �_.H =W F
3 E „ p
I e
L(_ Z % Slope
Distribution Cell of Force Main Plowed
z" to 2- Aggregate From Pump Layer
D \ -y Ft.
E 1.66 Ft.
CROSS SECTION OF A HOUND SYSTEM - F 0 - `3 Ft.
G o -
A Ft. y v Fi.
Linear Loading Rate= 6- O GPD /LAN FT B �3 0 Ft
Design LoadLna Rate= 3 . 3 _.GPD /SQ FT
I Z Ft.
J Ft.
K 1 y Ft.
Position
o L �Z.O Ft.
.
Force Main W Z 6 Ft.
L
. 1
,} - Observation Pipe
G - - � • --------- ------ - - - - -- — °------ - - - - -- - - - - -- Box
W _�7 - - - - -- -- - - - = -- -------------- - - - - -- �o'�C'e
�� Distribuiio Ce of z" to 2
' Pipe aggregate ,
Observation Pipe
(Anchbr securely)
PLAN VIEW OF A MOUND SYSTEM
Distribution Pipe Lavout Pago s of /
Place the roles at the bottom of the distribution pipes
at equal spacing, Remove all burrs from the pipe and holes.
Extend the end of each latclal up with the use of long t or =f' ErL ns to a point withil six
inches of the final
grade. Te ninat th e ends of the latera -1s with a valve,:threaded cap or
. threaded plug. Protiide access from final fade for the valve; threaded 6a r) or thread e' plus.
7�trlc7-, L
Svc F`a� avC —
Later•i — Manifold
Laterf
x x x xr, xr x x x x
Uteri Lencth —t Laterl Lencth = F
Oistricuticn Une
. 1
L hf-Q \FJ�
C:-
P U_ �1-S Ft. Hole Diameter I J F3 Inch
S 3 Ft. Lateral 1 Inches)
X 3� Inches Manifold 1 1 Zlnches
Force Main " 'Z Inches
i of holes /pipe
Invert Elevation of Laterals
• f •
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE OF 7
VENT CAP
4 "C.1. VENT PIPC
WEATHER PROOF APPROVED LOCKING MANHOLE
2: 10' FROM .DOOR, JutJCTION 90X COVER WITH WARNING LABEL
WINDOW OR FRESH 12�MliJ. (
AIR 11JTAKE I
GRADE
I 18' Aw.
CONDUIT
IS'MIN. ---- - - - - --
11�
INLET , PROVIDE I ,-
-�"' AIRTIGHT SEAL I I
I I I
APPROVED JOINT A I I I APPROVED .JOINTS
I
i I
I I ( ALARM
e
171
• I I oN
c • I
LLEV.��_ �S FT. _ -�
PUMP —� OFF
O
U b, p o CONCRETE CLOCK
Y'
RISER EXIT P>:RMITfED ONLY IF TANK MAA1UfACTURER HAS SUCH APPROVAL3'•ADtovt ::
SEDO I �
SPECIFICATIOKJS
DOSE
TTALIAS MALIUFACTURCIt: WM9ER OF DOSES: S ' PER OAy
TAN SIZE: DSO GALLONS DOSE VOLUME z
ALARM 1 .AMUFACTURr S S, T.ZCT'Zo 5' -1ST g INCLUDING 5ACKFLOW: �'Z �- - GALLONS
MODEL WUMBER: 1tW - - -
SWITCH TZIPE: �� �1 CAPACITIES: A - WCHES OR GALLONS
8= I INCHES OR L10 6 G{ LLOIdS
pUMP 1AANUFACTURER: y \ -o S _ C= INCHES OR �' L-7 CALLOUS
MODEL NUMBER: � j' D s �, INCHES OR 1g � S GALLONS
SWITCH TYPE: Y-1 `� 1 A10TE: PUMP A1J -2 r T ec ° • -4
MINIMUM DISCHARGE RATE Z�-$8 GPM INSTALLED OIJ SEPAE CIRCUITS
VERTICAL DIFFEREMCE DETWEEN PUMP OFF A1,10.0ISTRIBUT10N PIPC.. I FEET
+ M IN I M UM NETWORK SUPPLY PRESSURE . • .. f • f f f . , 6s � FEET S - OA 1, 3�
+ IC' FEET OF FORCE MAIN X 1- I F YctCFKICTIOLI FACTOR. p.3 FEET
TOTAL 0y1JAMIC HEAD _ � `F EET
As per - manufacturer �O- Zg gal /in. Liquid dept
r
Goulds l ac �_�` - 7
Submersible
y: Effluent Pump
1
_ 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.
dry without damage to heat transfer.
•Effluent systems ■Motor Cover: Thermoplas-
• Homes components. tic cover with integral handle
Motor: Available for automatic and
• Farms manual operation. Automatic and float switch attachment
• Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points.
• Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty
• Dewatering RPM, built in overload with rated oil and water resistant.
automatic reset. preset at the factory.
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 ■ EPO4 Impeller: Thermo- construction.
• Solids handling capability: automatic reset.
3 14 " maximum. • Power cord: 10 foot plastic Semi -open design AGENCY LISTING
• Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for
mechanical seal protection
with three . o. CC anadianStandards Association
Total heads: up to 24 feet. prong grounding
• Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo-
plastic enclosed design for (CSA listed model numbers
• Mechanical seal: carbon- length, 16/3 SJTW with end in "F" or "AC ".
rosary /ceramic - stationary, three prong grounding plug improved performance. )
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104 °F (40 °C) continuous superior strength and
140 °F (60 °C) intermittent. corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel.
•
10
Capable of running -- r — I I -- - - --
dry without damage to s 30
components. i I -tea• - GPM
Pump: EP05 6 ;
Z5 FT
• Solids handling capability: 0 25 —
3 /4 " maximum. Q 7
• Capacities: up to 60 GPM. 6 i I
•Total heads: up to 31 feet. � - - -� -- - -- -� -- - - - - -_ __.. _.___ -..
• Discharge size: 1'h* NPT. z Iq
5
• Mechanical seal: carbon-
rotary/ceramic- stationary,
0 1s !
BUNA -N elastomers. 4 Pos --
• Temperature:
perature: 3 10
104'F (40 °C) continuous —'
140'F (60 °C) intermittent. 2 —
5
N.
1
—' 0 0 '
0 10 20 30 40 50
- GPM
0 2 4 6 8 10 12 m /h
CAPACITY
^� 1995 Gculds Pumos. Inc.
_ ,
1
366
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service
unty
Attach complete site plan on paper not less than 8 %x 11 inches in St. Croix
include, but not limited to: vertical and horizontal reference point (B ), di E l V ED
percent slope, scale or dimemsions, north arrow, and location and d Lance to nearest road. P reel I.D.
036 -1067 -000
Please print all information.
nV C 0 2003 R v'e d By Date
Personal information you provide may be used for secondary purposes (Pri y laMr s. 15 4 (t (m)).
Property Owner S POO* L&a1
Hirst, John I OFF` E 1/4 NE 1/4 S 29 T 31 N R 17 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1591 200TH Ave na na 10 Acres
City State Zip Code Phone Number _j City _j Village e Town Nearest Road
New Richmond WI 1 54017 1 715 - 246 - 6787 1 Stanton I 200TH Ave
New Construction Use: a Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement J Public or commercial - Describe:
Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable na
General comments
and recommendations: Mound design, system elevation 98.83ft based on contour line elevation 97.50ft. Minimum 16" of ASTM
C33 sand.
Boring # I Boring
II' Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 26 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDW
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -9 10yr3/2 none sil 2msbk mfr cs 2f .5 .8
2 9 -17 10yr4/4 none sicl 2msbk mfr gw 1vf .4 .6
3 17 -26 7.5yr4/4 none scl 2msbk mfi gw na .4 .6
4 26-60 5yr4/4 none scl om mfi cs na .0 .0
5 60 -85 5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0
Boring # Boring
Y' Pit Ground Surface elev. 98.10 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 *Eff#2
1 0 -9 10yr3/2 none sil 2msbk mfr cs 2f EA .8
2 9 -18 10yr4/4 none sicl 2msbk mfr gw lvf .6
3 18 -33 7.5yr4/4 none scl 2msbk mfr gw nor .6
4 33-40 5yr4/4 c2d7.5yr5/6 sl /scl 2msbk mfi cs na .4 .6
5 40 -60 5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0
* Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD <30 mg /L and TSS < 30 mg /L
CST Name (Please Print) Signature: CST Number
David J. Steel 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 10/24/2003 715 - 246 -5085
me ueparunent o> �,,uriunerce is an equai opponunny scrvrcc pruvrucr anu cmpruycr. a yvu uccu assrsuuwc w access scivi�ca vi
need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel 1564 Cty Rd GG
CST-POWTSM John Hirst New Richmond,Wl 54017
Lic. #248956 NEI/4,NEI/4,S29,T3 IN,Rl 7W Bus.(715) 246-6200
Town of Stanton, St. Croix Co. Fax (715) 246-9372
10 Acres Legend
L/I " = 40'
Benchmark Ele. 199-Ojkt
Top of '/2" PVC Pipe
Alt Benchmark Ele. 100.40ft
op of 1 /2" PVC Pipe
❑ = Borings
Boring Elevations
BI = 98.1 OFt
7- B2 = 98. 1 OR
B3 = 96.00ft ✓
00,00ft
----- ------
CIO -
Fi�IcP 7
7:2
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Vod
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4i
6
r4 75
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP C':.'RTIFICA T ION FORM
Owner/Buyer
Mailing Address
Property Address 1 5 – ?( 0?0 e�
(Verification required from Planning Department for new construction)
City /State Parcel Identification Number
LEGAL DESCRIPTION
Property Location --'14, � ., Sec. ' -WzW, Town of
Subdivision r-�Q Lot #
Certified Survey Map # . Volume — Page #
Volume Page #
Spec house 0 yes X no Lot lines identifiable ! f yes C3 no n
SYSTEM MAINTENANCE �►9 Gu = 3 16 Y + I C V. Q' IQ• NS 2) ' - 19 3 •�
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
masterplumber, journeymanplumber, restrictedplumber 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.
Itwe, 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
s of the three ye expiration date.
a v-,dlr . GNATURE OF APPLICANT r (/ /
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
e property des 'bed above, by virtue of a warranty deed recorded in Register of Deeds Office.
1
IGNATURE 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
J 2 16 5 P 4 1 6 2 7 1 2594 �5
KATHLEEN H. WALSH
TERMINATION OF DECEDENT'S INTEREST REGISTER OF DEEDS
USE BLACK INK ST . CROIX CO., YI
Decedent's Name RECEIVED FOR RECORD
Cherrill R. Hirst 03/10/2003 09:30AN
Address of Decedent at Date of Death City State Zip
1591 200th Ave. New Richmond WI 54017 EXEMPT #
Date of Death Social Security Number REC FEE: 25.00
December 3, 2002 352 -28 -3673 1 TRANS FEE:
COPY FEE:
Presentation of
CERT COPY FEE:
Death Certificate PAGES: 3
I certify that I have viewed a certified copy of the decedents death certificate.
IC e, N .Wgj 4 aW, 1V 3110 %3
Register of Deeds sign re V Date
This interest in real estate is terminated under (check one):
Record this document with the Register ojDeeds
_ s. 867.045 which pertains to real property in which the decedent was a joint tenant,* in the county where the real estate is located.
had a vendor's or mortgagee's interest, or had a life estate. *(You must provide a copy Recording fee is $15 as per s. 867.045, 867.046.
of the deed establishing joint tenancy.) Return to:
X s. 867.046 which pertains to (1) real property of a decedent specified in a marital Judith A. Remington t(
property agreement and also to (2) survivorship marital property. REMINGTON LAW OFFICES
P.O. Box 177
New Richmond, WI 54017
Present with this document a copy of the real property tax bill.
Tax Key No. 036 - 1067 - 40-000
Presentation of document establishing joint tenancy, survivorship marital property, or life estate.
This deed is found in volume /reel 498 page /image 552 document number 316571
volume /reel page /image document number
Legal description of the real estate. (attach riders if needed)
SEE ATTACHED
Description of personal property. (if any)
DECLARATION: (I), (we) declare that this document is, to the best of my (our) knowledge and belief, true, correct and complete and is in
conformity with the provisions and limitations of the Wisconsin Statutes. (if more space is needed, attach pages.)
Name and Address of Declarant Relationship to Decedent Signature Date
John H. Hirst
1591 200th Ave. Surviving Spouse l� i6� ✓G/ 8 " ��
New Richmond, WI 54017
Notarial Acts (NOTARIZATION)
The above named person(s) John H. Hirst
Signed and sworn to (or affirmed) before me on (date). ti
This document was drafted b (print r name below) o ebeo
Y (P type ) Signature of notary or other person ' : '' •, .
Judith A. Remington authorized to administer an oath i ( l �• t s V
REMINGTON LAW OFFICES (as Per s. 706.06, 706.07) 1 •v.;,
P.O. Box 177, New Richmond, WI 54017 Print or type name Judith A. Remington
State of Wisconsin, County of St. Croix •. �• ,.
Title Notary Public or Date commission ekpj}
Form HT -110 (8/00) (affix notary sea])
To order We form call INFO -PRO at 8006552021
DOCUMENT N0. STATF: nAR OF WISCONSIN -FORM 2
WARRANTY DEED
\h11ti ;;F'ncF: tiESERVED FOR REC OROiNG DATA
t;v j' REGISTERS OFFICE
'
_ ST. CR0
nt� hf . John . E. H� ascis i;vc li n I. t, liaarch, � Ix co., Wls.
husband h > c,
Reed for Record this_th
day of- dAtte ---- A.D.19
7
John H. Hirst & Cherrill P, K. -
-
un.nhr rv-• .+n 1 weru.m �. Nr -
Hirst, husband & wife, /tit
_ - - -_ ReRlstrt of �e'rte
n,l.. ,.,r:,<{,.r:rrr,•„ One Dollar & other valuable ' RFIORN 10
consideration
ih..f ,a1 , .w. „ }. , .Ir- .ri1 „•d r. ,a o:.tetr u. St. Croix c.•:nnv, s�,t.•,r w;.r :rr u:',
- .. _ , .- - r _. ironrfsl.•ar1 1n.• },rrt
Part of the Northeast One - Quarter of the Northeast One- Quarter
of Section 29, Township 31 North, Tfange. 17 West, describes as
follows: Commencinq at the Northeast corner of Section 29,
Township 31 North, Range 17 West for the point of beginning of
the parcel herein described; thence on an assumed bearing of South,
alon the East Line of said Section 29, 1105.00 feet to an iron
J ,i.NST. pipe; thence North 89” 22' 40” West, parallel to the North line
of said Section 29, 394.26 feet to an iron pipe; thence North
parallel to the Last line of said :section 29, 1105.00 feet to
the North lint of said Section 29; thence South 89 22' 40" East
along said North line 394.26 feet to the point of beginning.
to Township Road rictht -of -way along the Northerly 33 feet
of the above de =,cribed parcel. Cont.aininy 10.0 acres. Township
Of Stcinton, St, c'roi�: County, Wisconsin,
This cic.!ed is made in performance of a land contract
datc:ci February 23, 1973, recorded April 1.0, 1973, in volume 496,
Par 255, Document 4315440 between tliese. parties.
New. Richmond, vliscnnsin ) � �� May 73
r
t11 ";F 1, ANU '..F : \t I t IN P-1 ',I, :I 4
✓ John F. Ilaasch
f:
' Evelyn I. flaasch
(SEAL
�F AI.:
John V. llta.isch & Evelyn I. Il.aasch
May.73 _
L. R. Reinstra
.::n -1n �iF i�iFFh
WwAmY- urtdW';xc ��'tkSl�ac
1.1'AIF: 11F IIN,tiJN
. , . •. krr \.n 1. t.. Il,r i.... rr �i:„ v ::1.:1 11:. f'. r. :ri: r \,t r nl .:r.l ,.. V r:. l..1 } .1 Ilrr ... n:
rhr: rn tr nr:rrnl w.., .L .il.d I.y -
L, R. REINSI'RA, Attorney N "rr.r F'„F,f;, colrr.ty, W,,.
�..' "", " "" •.r n .n r.n\ , • t:s. try 1" tyl C', •.r } rnl a•1 FN•1nw th=•rr ;.rF nxt ntr A. .. (. �N G..v++®
WAIIRANI'Y IrFFif..."TA'1'F. F\Att'It Wri.'ONSiN, FOKM NO 7 - 10'1l
I
`J 2 1 6 5 r'' `I 6
ST CROIX COUNTY 02/07/2003
TOWN OF STANTON
2002 REAL ESTATE TAX SUMMARY
36 - 1067 -40 -000 29- 31N -17W Parcel # 29.31.17.437D
JOHN H & CHERRILL =______= PROPERTY ADDRESS
HIRST 1591 200TH AVE
SEC 29 T31N R17W 10A IN NE
1591 200TH AVE NE COM 394.26' W OF NE COR
NEW RICHMOND WI 54017 TH S 1105 W 394.26 N TO
N LN, TH E 394.26' TO POB
VOL /PAGE
487/ 538
Dist - School: 3962- #1 8020 - #2 1700- #3 -
10.000 Acres Assessed Land: 19900 Improve: 165400 Total: 185300
Ratio: 0.9300 Fair Market: Under Use Value Assessment
Gross Tax Other Credits Lottery Net Tax After Credits
3311.55 - 256.53 - 64.77 = 2990.25
Bill #: 37553 AMT DUE AMT PAID BALANCE Balance Codes
Tax 3055.02 1527.51 1527.51 P D =Delingent
Special Assmnt 0.00 - P =Postponed
Special Chrg 0.00 N N =No Balance
Delinqent Chrg 0.00 -
Private Forest 0.00 N Payments Source
Woodland Tax 0.00
Managed Forest 0.00 - L =Lottery
Interest 0.00 M= Municipality
Penalty 0.00 C =County
R =Redemption
TOTALS 3055.02 1527.51 1527.51
Interest is Calculated for February 2003
Lottery Claims: 1 Amount: 64.77
Note:
P 0 S T E D P A Y M E N T S
Date Receipt Source Tax Bal Special Wood Interest Penalty Total
12/01/2002 0 L 64.77 D 0.00 0.00 0.00 0.00 64.77
01/31/2003 24268 C 1462.74 P 0.00 0.00 0.00 0.00 1462.74
* * * * ** E N D 0 F R E P O R T * * * * **
ML
-:3
j
T-3 -N • R -17 -W STANTON DIRECTORY x
E
See Pages 135 - 140 For Additional Names. ( Residents -Owner or Renter
TOWN RD POLK CO.
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Elgin Rob
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■ a SReallpph u g LAKE a 0 I o o .oaks Raymund
I ^ i ° Robert Q � ■ I Wolf a Rard j ■ Donald
Mar m �aVolkert ■ 220th AVE ■ MAfflas Kellen
■ ■Eric 5 aCulver ■ ■ ■ ■ ■ ■ �e
Charles Bohl `'j'�/ j Anderson Unumb I p u I Swenson •Kropp
Lowell Krusch Ei ke v i ��J �
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■ ■ G ■ ■ Terry ■v ■ , Tracy ■ ■ ■ ■ ■Fredrick ■ ■ t ■ Merlin ■ Troy O a ;
Andersen e u EBevold a t: avld t Pasno u�3 Frank Vincent I I >
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Gro tenhuls ehrs ■Nick ■ E°..a Mc�amaza 2001h AVE lohns♦n a Gleason ■ Kram
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Barney ` w' e' Simon \ I ° . v A" Beach 1 I ,_� Karis
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I - 181stAVE K
RICHMOND PAGE 49 ERIN PRAIRIE PAGE 53
EGGEN'S SUPERMARKET
by
830 Tenth Avenue
Baldwin, WI 54002
Phone 684 -3316
Joe Simon ) 246 -3873
345 St. Crolx Al (715) 386 -3830 a Specializing in Fresh Produce & Quality Meats
New Richmond, WI Fax (715) 246 -2614 a Groceries, in Store Bakery, Amoco Fuels & Car Wash
E -mail: simonelec' simon- electric.com
69_