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HomeMy WebLinkAbout038-1223-09-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 487964 0 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: Dreyer, Vince I Star Prairie, Town of 038 - 1223 -09 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 'is, Sej (3 G - r 04.31.18.1246 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS I FS ELEV. I!, 4 r) Ts.SS Septic rj r 12 Benchmark C.'S1 W 1 Cam. Dosing Q O � AIt.�M jC 5, vw Bldg. Sew r Holding St/Ht Inlet \ TANK SETBACK INFORMATION SVHt Outlet TANK TO P /Lt WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' 5 4/ , - sy ! / Dt Bottom 13 $ $ 3S J 1G � r Dosing '5 I / i a � / o f Header /Man. 5 Aeration 7`i `v Dist. Pipe 45 Holding Bot. System PUMP /SIPHON INFORMATION Final Grade _ 77 n Manufacturer Demand St Cover ( �p�1 GPM C&OA-j— 6JO Model Number 32 77 �p d G ce, e, -t, Q (o Cs TDH Lift Friction Loss System Head TDH Ft Forcemain Length ,�© z r Dia. ri i Dist.towell SOIL ABSORPTION SYSTEM BEDITRENCH Width f Length / No. Of Trenc s PIT DIMENSIONS No. Of Pits Inside Dia Liquid Depth DIMENSIONS $' 7s G �_ �. SETBACK SYSTEM TO P/L IBLOG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHA Type f System: / (P'7 i �� / / ^ v 1 UN OR IT 5J / Model Number. OJ T DISTRIBUTION SYSTEM Header /Manifold Distribution / ( �(/ To le Size I x Hole Spacing Vent to Air Intake I '/ Pipe(s) 2 -7 1 �ll (o 6�p ' 1 - Length ' A Dia 2- Length 73 Dia Z Spacing a 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 ! -7 Bed/Trench Edges Topsoil l 1 r L �1 Yes Gi -; No Yes ] No COMMENTS: (Include code discrepencies persons present, etc.) inspection #1: 5 / T /b�o Inspection #2: Location: 1066238th Avenue New Richmond, WI 54017 (NE 1/4 NE 1/4 4 T31 N R18W) Loganberry Lot 9 Parcel No: 04.31.18.1246 F.s 1.) Alt BM Description = V 2.) Bldg sewer length - amount of cover = 7 l _T Plan revision Required? [ Yes >No 115 Use other side for additional information.) Date Insepctor' ignatu Cert. No. SBD -6710 (R.3/97) I ............. , I` Safely d Bui Ctxmty� t C eti / 201 W. Was n St on Madi n, WI 53707 - 7162 ® . aniUary Permit btx (to be tilled in y Co.) t 608) 2�rp 1 Department of Commerce State Plan 1. .Number Sanitary Permit Appli ati / 2 a p ii 3L In accord with Comm 83.21, Wis. Adm. Code, personal i 'ormatt ING OF Y �Ojea AddTas (if difYerent than mailing add } may be used for secondary purposes a Privacy _ 1. Application Information — Please Print All Information 1046 3 Property Owner's Name Parcel # MIN # ` t n I�ic e rl / 3 Owner's - G � Property Owns Mailing Address roprty e 2I .-� t < C V., lv ' /., Section City, State Zip C,odee Phone Number l f� P e- I,,) / t i� 1`1 CL WJ� �`Z U S t<7 T J / N; R �b E o ) / 7 n �l IT. Type of Building (check all that apply) // Subdivision Name CSM Number ( 1 or 2 Family Dwelling - Number of Bedrooms ❑ PubliclCommercial - Describe Use V ❑City ❑Village ❑ State Owned - Describe Use �7 ownship of f />tP �iP•¢ /� L' Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' New System ❑ Replacement System ❑ Treatment/Hotding Tank Replacement Only ❑ Other Modification to Existing System ----- List Previous Permit Number te Issues B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New and Da Before Expiration Plumber Owner IV. Type of POWTS S em: Check !A that a j ❑ Non - Pressurized In -Ground &MoW>24imofllitttblel ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized lit-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pi ❑ Other (explain) // V. DisversaVIrreatumat Area Information: Design Mow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area R aired (sf) Dispersal Area Pro (sf) System Elevation VI. Tank Info Capacity Total I Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank v" ZG (� ' W o `C S e o Aerobic Treatment Unit .. / Dosing Chamber VII. Responsibility Statement- 1, the undersidned, asinIpse responsibility for installation of the POWTS shown on the attached plans Plumber's Name (Print) Plum 's Si /MPRS Number Business Phone Number Plum 's Address (S ,/ � S Zip C ) 1, U G x 24 V L : un /De artment Use On pproved ❑ Disa Sanitary Permit Fee (' ludes Groundwater Dat Issued Issui Agent ignat (N ps) t Surcharge Fee) f0 O� o5 13 Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval S TEM OWNER: 17f �3 e vent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber.. 2. All setback requirements must be maintained aspul applicable to phtus (to the Com ety awy) for the system em papa" met ku them SM2 z 11 imeltes In size SBD -6398 (R. 01/03) J Lp CAN E N� k S t� NR It N y L Y k/ �( • 'f v w n Of PWA�i� e pe MP 3 1 y ,. 4 � p Oee �n l k .s'rap c 13 driv a ; c"°_� ,3 f N I,1 a l RED /(0 �` t M'► N ,4 i` ( rat 6 g w' }3 � 9 1 5, r, I SO # Ew C 6 6 ! s ee Safety and Buildings 4003 N KINNEY COULEE RD commerce'A.gov LA CROSSE Wl 54601 -1831 TDD #: (608) 264 -8777 sconsio www•commer sin.go www.wisco isconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary October 26, 2005 CUST ID No. 223475 ATTN.• POWTS Inspector JOE STANG ZONING OFFICE STANG PLUMBING & ELECTRIC ST CROIX COUNTY SPIA PO BOX 263 1101 CARMICHAEL RD WOODVILLE WI 54028 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/26/2007 Identification Numbers Transaction ID No. 1208936 SITE: Site ID No. 706469 Vince Dreyer Please refer to both identification numbers, Polk & St Croix Rd above;, in all correspondence with the agency. Town of Star Prairie St Croix County NEU4, NEIA, S4, T3 IN, R18W Lot: 9, Subdivision: Woodland Hills FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1047167 Maintenance required; 600 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01101); Biofilter 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. 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: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD- 10691- P(N.01 /01). • The pressure network is to be constructed in accordance with publications SBD- 10706- P(NOl /01) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81)" • 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 POWTS 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. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • 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. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(7) - A co of the approved plans, s ecifications and this letter shall be on -site durin construction and open to inspection by autho QrVVM&ives of the Department which may include local inspectors. Conditionally 'APPROVED - -- JOE STANG Page 2 10/26/2005 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - 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. 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 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 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 I MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Dreyer 4 bedroom mound I Owners Name: Vince Dreyer Owners Address: 2158 126th St. New Richmond, Wisc. 54017 Legal Description: NE 1/4 NE 1/4 S 4 T 31 N R 18 W Township: Star Praire County: St. Criox Subdivision Name: Woodland Hills I Lot Number: 9 Block Number: Parcel I.D. Number: 038 - 1223 -09 -000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry RECEIVED page 4 Lateral a nd dose tank oc j 1 9 2005 Page 5 System maintenance specifications Page 6 Management and contingency plan SAFE & f3UILI) P age 8 Plot�Plan and specifications Page 9 Soil Evaluation Report Designer. Joe Stang License Number: 223475 Date: 10/1 /05 Phone Number: 1- 715 - 684 -5166 Signature: 7 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691 -P (N. 01/01), and SSWMP Publication 9.6 DesiqftPARf fr® #Vetworks for ST -SAS (01/81) VISION 01-SAFETY AND BUILDINGS Version 4.01 (R. 09/04) Pagel of 9 SEE CORRE ONDENCE Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 % coliform of - 36 inches. 600.00 Design Flow (gpd) 10.00 Site Slope ( %) 85.60 Contour Line Elevation (ft) 40.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 75.001 Dispersal Cell Length Along Contour (ft) = 8.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /if) 1 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest p int in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 4.00 Lateral Spacing (ft) If N above, enter the elevation ft 2 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 12.00 ft /orifice x 2.00 Forcemain Diameter (in) 70.00 Forcemain Length (ft) Does the forcemain drain back? Y 75.00 Pump Tank Elevation (ft) Enter Y or N ?� 3.25 System Head (ft) x 1.3 11.42 Forcemain Drainback (gal) 10.77 Vertical Lift (ft) 119.79 5x Void Volume (gal) 1.60 Friction Loss (ft) 131.21 Minimum Dose Volume (gal) 15.61 Total Dynamic Head (ft) 32.77 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 3.00 2.00 x x 3.00 x Gallons /inch Calculator (optional) Treatment Tank Information 800.00 Total Tank Capacity (gal) 1200.001 Septic Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) Wieser I Manufacturer 22.22 gal /in (enter result in cell 649) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) JZabel Filter Manufacturer 22.221 Dose Tank Volume (gal /in) IA100 Filter Model Number Wieser Manufacturer Project: Dreyer 4 bedroom mound Page 2 of 9 Mound Plan View 1/10 B • . J Observation Pipe — K TAT A B _ Jam 4' . T . . . . . . . . . . . . . . . . . . . . . . . . . L Mound Component Dimensions A 8.00 ft E 15.60 in H 1.00 ft K 8.20 ft B 75.00 ft F 10.00 in z 11.29 ft L 91.40 ft D 6.00 in G 0.50 ft J 4.23 ft W 23.52 ft 600.00 (ft Dispersal Cell Area 1 1446.43 (ft Basal Area Available 8.00 (gpd /ft) Linear Loading Rate 1 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 87.93 (ft) -♦► G H ,rrf ��rr F 2 rrr�r,. - I F 86.60 (ft) Lateral Dispersal Cell 86.10 (ft) --10- - Dispersal Cell Elevation E D =: _ i _ i _ i �_ i i,. ,r, ,],. `i, i i i 'i, r ], i - i - i •' i -] �], ] ] -].. .. 3._ ,i, ;i, i, i, i ] ] i' ] .]. ri -] -i, ] -] -] - i . - i . A. ;i.. i A. _ i, %..� �, , {._: {._: ` 85.60 (ft) Contour Elevation 10.0 %Site Slope '- Geotextile Fabric Cover Shading Key m o. T Dispersal Cell See lateral details on 10 _ Topsoil Cap o °" 1.5 ft . - ' •,. •. *� ,; . Page 4 for number, size, Subsoil Cap a o w < and spacing of laterals. ASTM C 33 Sand `� `' ' ' Laterals are equally : � � .., .,,., "� f Tilled Layer m 0.5 ft ;' Typical Lateral F spaced from the distribution cell's Q5 Aggregate �r c , tl6. ' °y A ° " °* centerline in the _ distribution cell (Ax6). Project: Dreyer 4 bedroom mound Page 3 of 9 End Connection Lateral Layout Diagram Laterals centered over the A & B dimension • = Turn-up vW ba I l valve or cleanout pl u g I P All laterals are identical IE X—�I Holes drilled on the bottom of the lateral s equally spaced Force main connection uia tee or cross to manifold at any point. Laterals & force main of PVC Sch 40 (per COMM Table 84.30 -5) Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 2.00 in Orifice Spacing (X) 3.06 ft Lateral Length (P) 73.44 ft Orifices per Lateral 25 Lateral Spacing (S) 4.00 ft Orifice Density 12.00 ft /orifice Lateral Flow Rate 16.38 gpm Manifold Length 4.00 ft System Flow Rate 32.77 gpm Manifold Diameter 1.50 in Total Dynamic Head 15.61 ft Forcemain Velocity 3.35 ft/sec Dose Tank Information Locking cover with waming label and locking device and sealed watertight Electrical as per NEC 300 and - -► Comm 16.28 WAC 4 in. min. Disconnect _ Tank component is properly vented < Altemate outlet location Forcemain diameter Wieser Manufacturer _r 2 in. Cap acityl 800.00 Gallons Volume 22.22 gal /inch A Weep hole or anti - Dimension inches Gallons B siphon device A 18.10 402.15 C B 2.00 44.44 P � ump off elevation (ft) C 5.91 131.21 1 75.83 D 10.00 222.20 D Total 36.001 800.00 iF Dose se tank elevation (ft) 3" Bedding un er tank. 75.00 Alarm Manuafacturer SJ Rhombus Contr Alarm Model Number ITank Alert! Pump Manufacturer JGoulds Pump Model Number 3887 EP05 Pump Must Deliver 32.77 gpm at 15.61 ft TDH Project: Dreyer 4 bedroom mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Joe Stang ^ E Phone 715 -684 -5166 POWTS Regulator's Name St. Croix County Zonin Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1200 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Moundl Inspect for ponding and seepage once every 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure an her i d of disturbed areas will be seeded and mulched to prevent sod erosion and help reduce frost penetration. Lateral Tum-up Detail Finished ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral �I► Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Dreyer 4 bedroom mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. 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 fitter 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. 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg /L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 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 4 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 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 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. Project: Dreyer 4 bedroom mound Page 6 of 9 �outcrs PUMPS Submersible Effluent Pump EPO4 & E Series limb am !! �-AMMW . 110W NO Ig am iordte aad t�ckut impioMea - man a Mg Inrtgm . homms Ilrataiietaraalaaeaaca>Nl -a-vw WNW • Heatydugsttaip �lapesaNaaAelO■p6lc woe. ■toddsitcl�deMedwtM S NOW Cagh=for !Ih#� Fb ! �s . p atger�cttane.i6leaar beep p�esetatfefaalor} � Cg10MS l6AtIMES ■ mourCotwer:T�atopks.ic ayedeetm ■ El6+1 i�eier: Two- lost II I and *CApadks y►to60 r3FK P •Tod hawk vpwlfeet ptmpt�utwntesfioratedttrtir�ti ■ftwxGWSe eddq WWI sod •Medtenirat seat tatlton- aittadwalertes . W4o aoatiwous Roam FWT t O R do as 300so - -..__. s1�!$ sue, 9 O cApableOFt m 7 = i t 115or230q 60t1;,15W o is, ; • HM PIM Q51P. 3 t 1i5V4WM60Ht 1550 I -- _._t__- -- -- - ._. <__.__ WKk*bm*awkh 21 a 1 Ss 1 Oftw xtt 10foot 1 - - - -t - , - - - -- - staldetd 100A 1bf3 u io 20 30 9 20 �° sa cnN fooNetg�, f P ` 3� v►� thiet it 2 4 6 8 to 12 m�1b CAFACRY EN am Pc e @3M 4& 9T IndusWes G0t,11ds Pt�rr� w Ne m t,./1 NF YK N k s y t at NJ? t �. f 3 t Got k 4f YGA4 i �5� to ®t► "��� R l4J- �7 - ®s r NA, / � t i 71- ow �• Co SAC c f a C ` t Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 4 Division of SaFety and Buildings in accordance with Comm 85, Vft. Atha. Code county St. Criox Attach complete site plan on paper not less than 812 x 11 Inches in size. Plan must include, tut not li nited to: vertical and horizontal reference point (BM), direction and Pared I.D. 038 - 1223 -094M percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all intio mtfon. Reviewed by Dam Perso" Wdbnr ao- you Provide may be used for seoondary purposes (Privacy Law. s. 15.04 (1) (m)). PropertyOwnet arty 6-G Corporation Govt. tot NE 1/4 NE 1/4 S 4 T 31 N R 18 Property Owner's MaiCsrg Address Lot # Block # Subd. Name or CSW 58 Dunbar way 9 Woodland Hills City State Zip Code Phone Number ViNage ■ own Nearest Road Mahtomedi I Minn 55115 1 ( 1 PoWSt. Criox Road E] New Construction Use ] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD r] Replaoement Pubic or commercial - Describe: Parent material Till Flood Plain elevation if applicable Ws R General comments System Elevation 86.10 and Countour 85.60 Mound System D Boring 1�9 # n - ptr Ground surface elev. 81.6 ft Depth to knidng factor 40 n• Rate Horizon Depth Dokranart Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. ConL Color Gr. Sz. Sh. 'EW1 TRW 1 0-17 10YR2/2 — 81 2fgr mfr es 2m 0.6 1.0 2 17-40 10YR3 /6 — cost 2mgr mfr lam' if 0.6 1.0 3 40-48 10YR5 /4 — cost Om deh OF 0.2 0.6 4 48 -72 7YR4/6 fff7.5YR5/3 cal Om �r -- 0.2 0.6 E Boring # Bo w 85.55 42 pi( Ground surface elev. R Depth to krritsig fades n. Rate Horizon Depth Dominant Color Redox Desdiption Texture Structure Consistence Boundary/ Roots GPDff (n. Munsei Qu. Sz. Cent Color Gr. Sz. Sh. 'EW1 - EiM2 1 0-14 10YR3 /3 — sl 2fgr mfr cs 2m 0.6 1.0 2 14-72 7.SYR4/4 — cost 2vcgr mfr CIS if 0.6 1.0 3 <72 7.5YR3/3 — cost 2vcgr m f r 0.6 1.0 • EfiNrent #1 _ BOD > 30:5 220 m9ti and TSS >30 150 mgA- ' EMuent 42 = BOD _< 30 m9C and TSS 5 30 MOIL � CST Name (Please f?rint) Signdure CST Number Thomas W. Gedatus lot/ 962178 Address lustion Conducted TelisphoneNumber Stang Plumbing & Electric P.O. Box 263 Woodville, Wisc.54028 10/15/05 1- 715- 684-5166 l•TT p�.,ATMYVI\ Property Owner— 6-G Corpo Parcel ID# 038 -1223- 09-000 Page 2 of 4 3 ❑ �9 Boring E] pd Ground surface elev. 85.55 ft. Depth to krWnV 66N n Soil Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN in. Munsap Qu. Sz. Core. Color Gr. Sz. Sh. - EtT#1 1 0-16 10YR3/3 ---- sl 2fgr mfr cs 2m 0.6 1.0 2 16-46 10YR4/4 -- cosl 2mgr mfr gw I if 0.6 1.0 3 46-66 10YR5 /3 f1f 7.5YR5/5 fsl 1fgr mfi cs _ 0.2 0.6 4 �9 �9 # p pft Ground surface elev. 90.5 R to 9 factor 52 n Soil m Rate Horizon Depth Donara Color Redox Description Texture Structure Consistence Boundary Roots GPDIff in. Mures Qu. Sz. ConL Color Gr. Sz. Sh. 1 'E101 -EM 1 0-27 10YR3/3 --- sl 2fgr mfr cs 2m 0.6 1.0 2 27 -52 _ ccel 2 mfr gw if 0.6 1.0 3 52-62 IOYR5 /5 flf 7.5YR cost IN mfr L cs — 0.2 0.6 F Ground Pit surface elev. R Depth 10 6n &o factor n. Sol Rate Horizon Depth Dominant Color Redox Description Texture Structure Cor slenoe Boundary Roots GPDW n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EW I * Etlkm t i1 = 8006>30 mglt. and TSS >30 _< 150 ffQ& ' Et1Mlant #2 = BOD, _< 3o nV& and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an a tuTwte format, please coact the departrnat at 608- 266 -3151 or TTY 608 - 2644Th. T? ! N Ik Llaod A ., d W s Le-t C?a r a p n 1; � E 44 1p 1 q(Q,2)7:? i ,off t; 93- S s 5 .► l i'�'�` `r C3y' aD• go S o„. � g, rn SEP. 26.2005 2:48PM • EDINA REALTY HUDSON NU- 6911 V, a - ` tea M41� - � - � .. ' .t �• 1 2- 12 4 NW u.. - 11 • ter• J aw I ' f 7 I Sam _ - • - a r,Am 9GETN VE TE&"WaGTLT6 + St.S1,8£ paMlJLS•AL - fzM tiNIQ3 6b:8T SIB /a/60 RECEIVED Wisconsin Department of SOI EVALUATION REPORT Pa®e 1 of 4 Division of Safely and & t 9, n 85, Vft Adm Code County St. Criox Attach compiete sae plan on n$W in size. Plan must include, but not tented to: Ver I and direction and Parcel I.D. 038 -1223- 09-000 percent slope, scale or dimensions, n�417i n a distance to nearest road. Date please prW all information. / � Peraonei inbrnobon you pr We may be used for secorMary purposes (Privacy L—. s. 16.04 (1) (m))- i l v'�° Property Owner Property Location 171 El 6-G Corporation Gaut Lot NE 1/4 WE 1/4 S 4 T 31 N R 18 E (or) W Property Owner's Mailing Address Lot # Bock # Subd. Marne or CSW �,�� 58 Dunbar Way 9 s City State Tip Code Phone Nurnim village ■ own Nearest Road Mahtomedi I Minn 1 55115 1 ( ) Potk/St. Criox Road I] New Construction l)seE] Residential / Number of bedrooms 4 Cafe derived design flow rate GPD Replacement Q Public or cornrnercial - Describe: Parent material Till Flood Plain elevation if applicable w ft �n 00r "rn System Elevation 86.10 � Countour $5.60 " t / and � Mound System oBoring Boring M Pit Ground surface elev. 81.6 ft. Depth to Ierntiing factor 40 in. Soli Rate Horizon Depth DorninantColor Redox Desa"on TeAure Structure Consistence Boundary Roots GPQ ff in. Munson Qu. Sz. Cont. Color Gr. Sz. Sh. - Etftfl - ENif2 1 0-17 IOYR212 — sl 2fgr mfr cs 2m 0.6 1.0 2 17-40 10YR3/6 — cosl 2mgr mfr gW, if 0.6 1.0 3 40..48 10YR5/4 — cosl Om deh 9W — 0.2 0.6 4 48 -72 7YR4/6 fIf7.5YR5/3 cosl 0m — 0.2 0.6 2 if Boring <72 a Pit Ground surface elev. R Depth to Gm'�g factor in. Soli Application Rate Horizon Depth Dominant CoW Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. - EW 1 0-14 10YR3/3 — sl 2fgr mfr cs 2m 0.6 1.0 2 1 14-72 7.5YR4/4 — cosl 2vcgr mfr cs if 0.6 1.0 3 <72 7.5YR3/3 — cost 2vcgr mfr ---- — 0.6 1.0 Oft04 *1= BOD > 30 2M mg& and TW >30 < 150 ffQ& * 01t ent 02 = BOD < 30 a% and TS5 _< 30 mgll. CST Name (Please Prey _ Sig re CST Number Thomas W. Gedatus �� %2178 ess Addr Data Evaluation Conducted Telephone Number Stang Plumbing & Electric P.O. Box 263 Woodville, Wisc.54028 10115105 1- 715- 684 -5166 [ dYfI,TM41I,\ Property Owner 6 -G Corporation parcel ID # 038 - 1223 -09 -000 page 2 of 4 ❑ Borin # Boring g El Pit Ground surface elev. 85.55 ft Depth to limiting factor in. Soil — Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0 -16 10YR3 /3 - - -- sl 2 fgr mfr cs 2m 0.6 1.0 2 16-46 10yR4 14 - - -- cosl 2mgr mfr gW if 0.6 1.0 3 46 -66 10YR5 /3 fl f 7.5YR5/5 fsl 1 fgr mfi cs -___ 0.2 0.6 F 4 Boring # 0 Boring 90.5 JJ � pit Ground surface elev. ft. Depth to limiting factor 52 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0_27 10YR3 /3 - - -- sl 2fgr mfr cs 2m 0.6 1.0 2 27Z2 cosl 2mgr mfr gw if 0.6 1.0 3 52 -62 10YR5 /5 flf 7.5YR cosl lfsl mfi cs 0 0.6 ❑ Boring # Spit Boring Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 _ < 150 mg/L Effluent #2 _ - BOD > 30 < 220 mglL and TSS >30 - BOD < 30 mglL and TSS < 30 mglL 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- 2648777. san- 8330Yrest (x.07/00) W � n F* p R z r+ r Ill- ! _ CsT ' 1 IL - 63 e s tj � r tR /6 Q l 2. IV 4- t d t' a E SEP•26.2005 2 :48PM EDINA REALTY HUDSON NO. 6111 F. 0 _ • P olk 1 i 2 �. f - t 4 ud . i i s :s 30 , 9 ' • I - - p • 3�W'I/4� I/4 ' t • �C e y a -R y t 6M .9W'UN VESUE— TELi'86MUTS F G&VAM C) MilI1S•JLL - FzM UNIm 601M 908E /w/6O Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division 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. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner _ Property Location _�/ Govt. Lot 1 /4 S T N E (o) W Property Owners Maili ddress Lot # Block # I'Subd. Name M# City tate Zip Code Ph umber City ❑ Village P"Town Nearest Ro New Construction Use• Residential /Number of bedrooms Code derived design flow rate GPD ❑ Replacement Public or commercial - Describe: __— Parent material ez-4 Flood Plain elevation if a plicabR ft. General comments ,,,cc,, and recommendations: �� /!t,��/� LfU l✓ AUG 9 7 2003 1' " Z 71 ZO NING OFFIC �� # 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 - Eff#2 Z ✓ Boring # ring 0j 1-1-2 Pit Ground surface elev. f / ft. Depth to limiting fadorcG� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 n 2 - 5 6 XfL .s �yn _ .3 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 nW • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) r CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715- 246 -4516 _Z1 l L Property Owner _ �f' rcel ID # Page of FT Boring # ❑Boring Pit Ground surface elev. . Depth to limiting factor b`= in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 �� /irJ .3rz S .r F] 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F ❑ Pit Soil ication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF 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 130 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 -9330 (8.6(00) Soil Test Plot Plan V rd Project Name 6 -G Corporation Shat Address 58 Dunbar Way Mahtomedi Mn 55115 C M #226900 Lot 9 Subdivision Woodland Hills Date 7/24/03 W 1/2 NE 1/4S 4 T 31 N /13 W Township Star Prairie Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1 /2 Pipe System Elevation 100.0 *HRPSame as Benchmark Alt. BM Top of 1/2" Pipe @97.8' Please Note: Tested area may not be suitable for desired building area. Scale is 1" = 40' >, Check system location t before excavating. unless otherwise 0 noted Alt. 70' B.M. 0 , Please note: survey was not completed at time of testing, 25' setbacks from lot lines may change. Installer must verify B -1 0' all lot lines and setbacks before installation. 100' 75 9% Slope 15' B -3 B -2 97' 98' 99' 100' 517' Property Line �J" ST. CROIX COUNTY . SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer i e e. e 6 'e Mailing Address S (2 t h S-C Property Address (p a (Verificat required from Planning & Zoning Department for new construction.) City /State N in bite Par Identification Number Q 3 ff /12oZ3 --019— 666 LEGAL DESCRIPTION r/ Property Location � 1 /4 , �^ '/4 , Sec. , T .� I N R Ili W, Town of t# �1�rI , e e- Subdivision �? C� S ,Q ,Lot # . Certified Survey Map # , Volume , Page # Warranty Deed # P ( G , Volume �Z 1 S ^ , Page # 3 Spec house yes oo Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number f bedrooms / 3/ a SIGNATURFOOF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) 810313 �� U 2 9 15 P 3 6 9 REGISTER OF D EEDS ST. CROIX CO.. VI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 18/25/2005 01:30PN WARRANTY DEED THIS DEED, made between 6 -G Corporation, a Minnesota EXEMPT # Corporation, Grantor, and Vince E. Dreyer and Cara A. Dreyer, husband REC FEE: 11.80 and wife, as Survivorship Marital Property, Grantee. TRANS FEE: 278.80 Grantor, for a valuable consideration, conveys and warrants to Grantee COPY FEE: the following described real estate in St. Croix County, State of Wisconsin: CC FEE: PAGES: 1 Lot 9, Loganberry, St. Croix County, Wisconsin. Recording Area Name and Return Address: Edina Realty Title, Inc. 400 S. 2 St. — Suite 115 Z o warranties: l Exceptions t Hudson, WI 54016 Easements, restrictions and rights -of -way of record, if any. 488690 038 - 1223 -09 -000 Parcel Identification Number (PIN) This is not homestead property. Dated this 25 y, Octobe 2005. 6 -G Co a' a M' ota Corporation B ' r I B * J J. Brunner, President/Treasurer, 6 -G Corporation, a * Kev a is sident/Secretary, 6-G Corporation, Minnesota Corporation a Minneso orpo n AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ST. CROIX COUNTY. ) ss. authenticated this 25th day of October, 2005 � Personally came before me this October 25, 2005 the above named John J. Brunner, President/Treasurer, 6 -G lux * 1W . Corporation, A Minnesota Corporation and Kevin J. Kelly, Vice President/Secretary, 6 -G Corporation, A Minnesota TITLE: MEMBER STATE BAR OF 1!W 100 A Corporation to me known to be the person(s) who executed the (If not, foregoinn`7 rrtent d acknowledged the same. authorized by § 706.06, Wis. S THIS INSTRUMENT WAS DRAFTED BY *Cheri wn Peterson, Fram & Bergman — Steven H. Bruns Notary Public, State of Wisconsin 50 East Fifth Street, St. Paul, MN 55101 My commission is permanent. (If not, state expiration date: ) (Signatures maybe authenticated or acknowledged. Both are not necessary.) 3/11/2007 *Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2 -2000 I d I I t 1 j O S 2 U1 < 22p3j' X6 v>, / i 0 K Ir N 5 8 ° IN 24 30' 4' ' W I X ► �' � � 224817 S.F. p p ,8 , 10 / 5.16 Ac. ( I P 6 $�q ) LBO = 995.10' i IO p F HWE N TI 993.10 a �'Iq. o ICI \ \ 9 4f � W IN I3 e `DRAINAGE W can \ EASEMENT W 1O 10 m 1 167701 S.F. D\ 3.85 Ac, C o � \ y \ LBO = 995.10' d N N �D � w 33' 33' t \' q \��f { � \� (n r \ N AD � \ \ . N 79 °28 51 —I \ 1 N o\ o \\ 5175 D z m LIN W W \ o o — �° w \ ( (A) -� z ON \ N m ro ( 3 C3 o N N w Qa C m \ \ \ 248835 S.F. r, m cn z \\ \ \ \ 5.71 Ac. ro� v 1� 8 5 LBO = 1003,10' m •-. G? \ z gy m „ J '37'42' W v jr- 0 l\ � D I 3 Q DRAINAGE V)i D D HWE \ s EASEMENT r Ir D _ ` ° so 001,10 \p� / Z rrt d frl N ,F p Iu 00z c 54'46' 45,N S ss° ` Z o 67.50' �? �? 49, _ m m C _ FTI ss w o D '�. ^ . ' 2 ' 5 212. —i (� 8 5 � \ 547496 S.F. >>, o 12.57 Ac, o ; �o m T ' D