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HomeMy WebLinkAbout038-1237-02-000 r - Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix S b' uilding Division * INSPECTION REPORT sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID N r Personal information you provide may be used for se ndary purposes [Privacy Law, s.15.04 (1)(m)]. 1 '�v -'7- rj Permit Holder's Name: �� City Village Township Parcel Tax No: /237 dz- cso� CST BM Elev: Insp. B El BM Description: ction/Town /Range/Map No: b /K W, 31 • ' g r 12 - 3 k TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER r ' CAPACITY STATION BS I HI FS ELEV. Septic r� Benchmark J /Z 6n 3 1, /a/• Z /(Z Dosing �6 sPFwtti g O•nn.b 6ai Ste Aeration /6 P e� ��� Vito �7 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet kJ � � Septic Dt Bottom Dosing i 3 Header /Man. 73. - Aeration Dist. Pipe 34 Holding Bot. System � PUMP /SIPHON INFORMATION Final Grade 1 - 7 - 6 3 �7 /. 8 . 3S � • c.7 Manufacturer / i d St C GPM over a%j L� # .53.�8 ��• Model Number LJ / O C,' � Zq 7 � C. 7 1 6 TDH Lift Friction Los L System Head T3 , Ft Z5.3L / • 4i3 , & Forcemain Length IDia. Z Dist. to Well / SOIL ABSORPTION SYSTEM /(J DIMENSIONS Width No. Of Tlenc PIT DIM IONS No. O Pits side Dia. Liquid Depth DIMENSIONS IONS SETBACK SYSTEM TO P/L JBLDG , WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION Type Of m: CHAMBER OR UNIT Model Number: o� � Fez N � DISTRIBUTION SYSTEM Aid (' Header /Manifold , Z5 I Distlribution I x Hole Size r /I x Hole Spacing / Vent to Intake r- r Pipe(s) /� Length 6- " 7 Dia Length ' Dia 1 ' 6 Spacing 3 - 3 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded 1 xx ulched Depth Over Center Depth Over r Edges Topsoil 1 / ' i � Yes � No Yes ® No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / Z d / Inspection #2: Location: �-•� , r b9j Parcel No: 1.) Alt BM Description PIo I,.J 2.) Bldg sewer length - 1-7, - amount of cover = 1 E L-. Co., s S 5 a Plan revision Required? ® Yes No Use other side for additional information. SBD -8710 (R.3/97) Date Insepctoe ignature Cert. No. 5 commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave�Op X72 i s c o n s i n Madison, WI 53 7 i Hilary Permit Number (to be filled in by Co.) Department of Commerce #? 3 7 q Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental / O unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are roject Address (if different than mailing address) submitted to the Department of Commerce. Personal informatio ou provide may be used for secondary p urposes in accordance with the PrivE Law, s. 15.04 1 m), Stars. Z I. Application Information - Please Print All Info tin Property Owner's Name Parcel # O3 � 2 3 '7 D� coo Property Owner's Mailing Address Property Location / (, 2 Q s T. CROIX COUNTY City, State Zip Code Govt. Lot /� M c> �� — / < -�A ` /a, Section /v� �L Clt �� 7 /�Jfcycle 71 one) T_ N; R l I� E tl[� II. Type of Building (check all that apply) Lot # A 4 - or 2 Family Dwelling - Number of Bedr000 Subdivision Name A a .1'S.G. Block # ❑ Public /Commercial - Describe Use /at 0^_ El city of ❑ State Owned - Describe Use _ t ^ CSM Number ❑ Village of 45p_ i( — VS Town of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' Flew System y El Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System (explain) B. El List Previous Permit Number and Date Issued Permit Renewal El Permit Revision El Change of Plumber [I Permit Transfer to New 1 Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) 0t. J �z ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil * Mound < 24 in. of suitable soil El Holding Tank El Other Dispersal Component (explain) ❑Pretreatment Device (explain) V. Dispersal/Treatitlent Area Information: D n Flow (gpd) Design Soil Application Rate(gpds Dispersal a Required (s Dispersal Area Proposed ( System Elevation p _ !/ 5� o 11y / 7, .5 VI. Tank Info Capacity in Total # of Manufacturer c Gallons Gallons Units Z New Tanks Existing Tanks �O k 5� U D o v 2 a '� � u. C7 a. Septic or Holding Tank •7 (,� �7D _ Dosing Chamber 30 �_ TX/U ( t VII. Responsibility Statement I , the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number 6 0-7z– � eht_ "4—t ZZ6�g7 �� ZT3 Plumb s Address (Street, City, State, Zip Code) VII ount /De artment Use Onl Approved ❑ Permit Fee Date sued Issuing ent Signal e Ow en Reason o I $ lvZ5 • IX. tank efflue Condit' 1. Sep easons for Disapproval / arL •�/�. 1'8G91 ...Y /r 1 p ik: . rtt-filter and dispersal cell must all be ser0ces / maintained �° L4 44A.g rQ� • �' as per management plan provided by plumber. 2:, All seftaCk raquirbments must be maintainsd �. Attach to complete plans for the system and submit to the C unty o y on paper not less than 8 1/2 x 11 inches in size , / - �� (**2 P a `` er- SBD -6398 (R. 02/09) Valid thru 02/11 t �-- �f°`�'`^� wodt� ham, l esa �- Et,e►,... `o � °l �': 219' North lot line BM1 BM2 B 98'B 96' 0 94' Z 3 92' a� C o _ 0 T Garage Driveway 4 O N Bedroo House �i o Well rD 0 ' T 219' South lot line Todd Marek PO Box 228 New Richmond, WI 54017 Maple Haugen lot #2 NE 1/4, NE 1/4, S16, T31N, R18W Star Prairie Township St. Croix County Scale 1 " = 40' BM 1 = 1 00' top of 3/4" pvc pipe BM2 = 99.2' top of 3/4" pvc pipe Weiser 1200/800 Tank 120' of 2" force main Page 8 of 8 t Safety and Buildings commerce.Wl. OV 141 NW BARSTOW ST Ft. 4TH g WAUKESHA WI 53188 -3789 Contact Through Relay t(lc sc O n s' n www.commerce. o sin.gov e partment of Commerce www.wiscnin.gov Jim Doyle, Governor Aaron Olver, Secretary September 21, 2010 CUST ID No. 226497 ATTN: POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMNUT AVE 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 09/21/2012 Transaction ID No. 1854590 SITE: Site ID No. 760224 Todd Marek Please refer to both identification numbers, 108TH St above, in all correspondence withthe Town of Star Prairie, 54026 agen St Croix Coun NE 1/4., Croix , 516, IN, R18W Lot: 2, Subdiv> ion: Maple Haugen FOR: Description: Mound, 4 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1280922 Maintenance required; 600 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 101); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with 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: 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.0 1 /0 1). The pressure network is to be constructed in accordance with publications SBD-10706-P(NO 1/0 1) '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) ". O In the event this soil absorption system or any of its component parts malfunctions so A health hazard, the property owner must follow the contingency plan as described in the approved pf% n the owner must comply with the operation, maintenance and monitoring duties as descri in sectig of the mound component manual. A copy of this information must be given to the owner upon cd Ietton of the project. FF All holding/treatment tanks are to comply with Comm. 84.25(7)(a). ¢ Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is reauired. Access to the filter for cleanine must be Drovided oer Comm 84 Droduct aDDroval conditions. ROGER D NELSON Page 2 9/21/2010 A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. 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. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis - Osborne POWTS Reviewer 2, Integrated Services tiSMARI` code,. X633; (262) 397 -6005, Fax: (608) 283 -7481 julia.lewis@wisconsin. gov Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66 the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: w-ww. commerce. wi. gov/ SB/ SB- Building_ContractorProgram.html , MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Todd Marek Owner's Name: Todd Marek Owner's Address: PO Box 228 New Richmond, WI 54017 R ECEIVED Legal Description: NE 1/4, NE 1/4, S 25, T 31 N, R 18 W SEP 1 52010 Township: Star Prairie tS,q��TY ���L�rNGS County: St. Croix Subdivision Name: Maple Haugen Lot Number: 2 Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Designer. Roger Nelson License Number. MP 226497 Date: 09/13/10 Phone Number. 715- 273 -4444 Signature: T Designed Pursuant to the Ly�� jl Mound Component Manual for FOWTS Version 2.0 SDB- 10691 -P (N. 01/01), and both, ® SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) 0, ,0 Pressure Distribution Component Manual Ver. 2.0 SBD- 10706 -P (N. 01/01) q , J,y Y Npe��RCF Version 5.1 (R. 06/06) Page `F c�N ��CF Mound and Pressure Distribution Component Design Design Worksheet Sits Information (R or C) R Residential or Commercial Design None: SwW fa lo) caWWww a 400.00 Estimated Wastewater Flow (gpd) T" 83-"-3 WH to aM for fecal 1.50 Peaking Factor (e.g. 1.5 =150%) coMOM of `s 36 hxtw& 600.00 Design Flow (gpd) 14.00 Site Slope (%) 96.00 Contour Line Elevation (ft) 18.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (9pdffe) DWbuUon Cell Information 1 60.00 Dispersal C M Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpdfle) 1 Influent Wastewater Quality (1 or 2) Are the laterals the higheet point in the distribution Y Pressure Diedbution information network? Enter Y or N (C or E) E Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) 3.00 Estima ted Orifice Spacing (ft) = 10.00 ft lorifice 2.00 Forcemain Diameter (in) main Length (ft) Does the forcemain drain back? Y Pump Tank Elevation (ft) Enter Y or N --A-U System Head (ft) x 1.3 19.57 Forcernaln Drainback (gal) ertical Lift (ft) 55.93 5x Void Volume (gal) 1.63 Friction Loss (ft) 75.51 Minimum Dose Volume (gal) 0.00 In-fine Filter Loss (ft) 24.72 System Demand (gpm) 29.29 Total Dynamic Head (ft) Lateral Oh"M er Selection Manit M Diameter Selection in. dia. options I choice in. dia. options choice 0.75 1.25 x x 1.00 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallonnslpnch CalculaW (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (M) Wieser IManufacturer gal/in (enter result in cell 849) i Dose Tank Nntormatlon EffhnsM Filter b In vwtlon 8W.001 Dose Tank Capacity (gal) Poly LoC Filter Manufacturer 22.241 Does Tank Volume (QWAn) 525 Filler Model Number Wieser IManufacturer Project: Todd Merck Page 2 of 8 Mound Plan and Cross Section Views 1/10B • ..:.... . ....... ©.:. J ... . . . .. . ... . K � A W ............... . . ......... _ ... ................................ .......... .... " ......................... .......... ............................... ....... ................ ............ I .......... *.............................................................. ................ ........ ................................ I ........ ........................................ ................................. . ........ ...... ......................... . L Mound Component Dimensions A 10.00 ft E 34.80 in H 1.00 ft K 11.91 ft B 60.00 ft F 9.25 in z 21.57 ft L $3.83 ft D 18.00 in G 0.50 ft J 5.85 It W 37.43 ft 600.00 (fe) Dispersal Cell Area 1894.40 (ft) Bad Area Avaiiable 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1 /10 8 Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.27 (ft) F Di;p;r"I 98.00 (ft) Lateral 97.50 (ft)—► Invert Dispersal Cell :D t Elevation E 96.00 (ft) Contour Elevation 14.0 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on t Topsoil Cap '� 1.5 It = ` Page 4 for numd r, size, - 7. T Subsoil Cap and spacing of l ASTM C33 Sand � . Laterals are equally Tilted Layer 0.5 ft 7ypkr Laa�,i F spaced from the Aggregate distribution call's centerline in the ""—'— A distributlon call (AxS). Project: Todd Marek Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over dw A 6 8 dknension •- Turn -up urr bell votww or of Nn out plug P AM laterals are identical W X--) I Holes dri"d on tM bottom of tM lautal Q equally spaced LxN (pot COMM TaWe ".90 -5) S Foroe main ootrwodon via tee or oross to manifold at" Pok Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.08 ft eral Lat Length (P) 58.52 ft Orifices per Lateral 20 Lateral Spacing (S) 3.33 ft Orifice Density 10.00 fl /orifice Lateral Flaw Rate 8.24 gpm Manifold Length 6.67 ft System Flow Rate 24.72 gpm Manifold Diameter 1.25 in Total Dynamic Head 29.29 ft For+cemain Velocity 2.52 ft/sec Dose Tank Information , c ,, y , w wo am kv WW and WddM devise and Elecirifaii as per NEC 300 and ---{ 0 i�r sstied wateAipht Carom 18.28 WAC Diewnned 4 in. min. Tank opmpannt is propariy Venbd le ANanale outlet bCation Fomw*n diameter Wieser Manufacturer 2 in. Ca pacdyl 800.00 Gallons —?— Volume 1 22.24 gal/inch A VJWV hots or wdl- Dimension Inches Gallons B siphon davioe A 20.58 457.61 B 2.00 44.48 C Pump off elevation R C 3.40 75.51' 76.83 D 10.00 222.40 D Total 1 35.97 800.00 �Doae bw` eMvW°n 3" Bedding urwThr tank r 76.00 Alarm Manuafacturer IS. J. Electra Systems Alarm Model Number 101 HW Pump Manufacturer Goulds Pump Model Number PE 5 Pump Must Deliver 24.72 gpm at 29.29 ft TDH Project Todd Marek Page 4 of 8 Mound Svsbm Makftmnce and Operation Specifications Service Provider's Name Nelson Plumbing Phone 715- 273.4444 POWTS Regulator's Name St. Croix Zoni Phone 715- 386 -4880 __. Sttem F ft and Loa Param212rs Design Flow - Peak 800 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 800 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coldorml >10E4 cfu/100 mL Se Ffecuenev Septic and Pump Tank Inspect and/or service once every 3 Effluent Filter Should inspect and dean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly - Pressure System Laterals should be flushed and pressure tested every t .5 ears Mound ! for and once 3 Other N11"Isneous Conatnstlogn and Msbriais 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)(1), 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 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 10. Threaded Cleanout Sprinkler Valve Box Plug or Bali Valve Distribution Lateral L or � Long Sweep 90 Two 45 Degree Bends Same Diameter as Lateral Project: Todd Marek Page 5 of 8 Mound Sy"un Mar�agsmenit Plan Pub Ito Comm 83JK WhL Adm. code 920" This system shad be operated in accordance with Comm 82.84 Wle. Adm. Cods, and shalt maintained in accordance with its' component manuals [SOD- 10691 -P (N.01101), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SOD 10706-P (N. 01/01)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should over enter a septic or pump tank since dangerous pass may be prseenrt that could caws deslln Septic and pump tank abandonment shall be in acoor rim ruoe wtti► Gomm 83.33, WIL Adm. Code when the tanks an no longer wed n POWiS components. Septic or pump tank manhole risers, socess risers and coves should be kapeceed for water tightnea and scantiness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or su*d to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective loddng device to prevent accidental or unauthorized entry Into a tank or component. Sooft Tank The septic tank shall be maintained by an bx#vM" cwbftd to service septic tanks under s. 281.48, State. The caMsrnis of the septic tank stall be disposed of in accordance with NR 113, Wis. Adm. Cods. The op owxWom of the septic tank and outset Aar afar be assessed at least once every 3 years by Inspection. The outlet filter shad 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 slam, the filter shad be serviced 9 the alarm is activated continuously. Intermittent filter alarms may Indicate surge flows or an Impending continuous alarm. The septic tank shell have Its oo 1 1 - removed vim the w0umo of sledge and scum In the tank onesds 113 So NOW vokwo of the tank. N the contents of the tank are not rwow ed at ems tine of a triennial a - - a n remsrui, mai personnel Kali advise tie owner of when the read service needs to be performed to maintain has than maximum scorn and sludge sorsrnulation in the tank The addition of biological or chemical additn to enhance septic tank performance is generally not required. However, If such products are used they shad be approved for septic tank use by the Department of Commerce. Prmn Tank The pung (doskg) tank shall be' i: at Meet once every 3 years. AN ewilclas, slema, and pumps shat be tested to ww* proper operation. M an eAkent filter M Iggdled vAtMn the W* it shall be I opedad and serviced as necessary . No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shad be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Troffk (othor then for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infil move surface **On the mound and snow compaction in the wMbr will pr note frost penetration. Cold weather installations (Oetober-Feb uwy) MCUO that the mound be heavily mulched as protection from f eezir g. Influent quality lento the moved system may not exceed 220 ng/L 8006,150 mglL TSS, and 30 mg& FOG for septic tank eftw t or 30 mg& SOD& 30 mgt. TSS,10 mgtl FOG, and 10' clu/100 mL for highly treated dlkent. hnl w Now may not exceed m odmum 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 soft at least once every 18 months. When a pressure teat is perfomeed it should be compared to the initial test when the system was Installed to determine If willos dogging has occurred and if orgios cleaning is required to maintain equal distribution wdlmin the diepsreal car. Observation pipes within the dispersal oar shall be chop ed for aAluor pondkmg. Pondirrp levels shat be reported b the awmer, and any levels above 6 knchnes coraidaed as an YmpancWng hydraurc failkrs regmdnkeg addrbnal, more firrqusnt rmmonrorkg. Comdnoenk v Pion If the septic tank or any of Its components become defective the tank or component shad be repaired or replaced to keep tie system in proper operating condition. If t dosing tank, pump. pump controls, alarm or related wiring beoomes defective the defective component(s) shed be immediately repaired or replaced YAM a component of the same or equal performs nce. If the mound component fails to accept wale alter or begins to dMdarge wensbwabr to tin ground surface, it win be npehed or replaced in its' present location by kroress ft bass anon Win leakage ooare or by rantwh biologically dopge0 abeorp" , and ersperi is media, and related piping, and replacing said components as deemed necessary to bring the system Into props operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and servioe provider. P.oftUftdGCrOt Units The intornalion and schedule of eananagement and maintenance for pebrebrent devices such as aerobic bmerabmmeemt units or disirdec tint wits are 11 8s, aaparMe docu nests and are oon side ed part of ft overall haves ant pine for this sysbm. Project: Page 6 of 8 • LSOULDS PUN1P5 Su Effluent Pump PE 11014 MCIti01t farim !EZI* Gorses!: • cofloo n r"W", (No • 60 llertt ■ cart iron body. aw*Mm, when • 11 S vo+ts • namophssk impeller and k* subn w*. • &" tend end orerbad Po. cover. • S" handing: 'A' ado with e gebC1!!!!. 8 Upper d1eve and bwer mwdmum spho • Class B igsul IML heavy duty bml bee" • Auwnalic models indnde a • 004A d design. a n stnsadan. A}P K A ,n m PAN Swill. • HIO Mongsh ad= Mel a m"is porma owy Spy, dmWW fo lhe • Manual Modds available. shag bbritased for es4ended • Prrnping range: see PE31 Moor Mvioe me, . Mound Pte► oe chm or ojw • 33 HP, 3000 RPM a raw" for aoMtlrucws • O&WODaaing Systems PE31 PmMp: • 12.0 Ma &WO Mops • tow PMMM NO SysWM • Ma hto copmly: 50 GPM • Shaded pole doMp M A1 the raoeor • Bes"ro t Draining • Ma+dtmm head: 25' 1DH PE41 Mom ftw oy %w Pal pump: - • A W. 3400 RPM M QW& power 9 • Meedmun capadty: 50 GPM • 7.S Maidmum asps OCK 20' standard bm^ • Ma4MM head: 29' 1DH • PSC design duty 10 S)Tw wwlohh NEMA 5.15P, fm prong, PE51 Puuw PE51 Motor; 115 volt gww drag phng. • irhu"M apadt3r. 70 GPM • .50 HP. 3400 RPM M 4 • MLdffw head: 3T 1DH • 9.S Mwftam amps PSC dedp a Msdtanicai seal is arbor, aerandc BONA and ssabless i .t. „j_..�' . • -i. . }. {..�.. . {..} }t r .... t Sit. 4�. 30 N S ad /5. E CO 4 U P S •^ ..a_.i -.�. �r.�... }.,;.. _ice {�� ...}.r�....,• - • }•. ...t . •• }•_ _ .L. .$.. ' 1. !. -. . �...r.._r..i.... }' •+- •- j,..r. zo _ . ; .. a:.,. .. # is 10 ° - .r - + t }_ �.. 40” P" pi 6 doom 0000" M +q- t ° ° o so se 70 cOM eo pQ�e o o � S a e-1 " ?`rAPr►cm n s � colro� 0 2M Go" POM MOM Pr''f pMrK1 <& 17T Industries A 219' North lot line BM1 BM2 B1 -B -. � t: 0 94 Z 3 92' a� c a° 0 o CO Garage Driveway 0 °O 4 N Bedroom House �i o Well t 0 r 219' South lot line Todd Marek PO Box 228 New Richmond, WI 54017 Maple Haugen lot #2 NE 1/4, NE 1/4, S16, T31N, R18W Star Prairie Township St. Croix County Scale 1" = 40' IF 40 BM = 100' top of 3/4" pvc pipe BM2 = 99.2' top of 3/4" pvc pipe Weiser 1200/800 Tank 120' of 2" force main Page 8 of 8 % 4sconsin SOIL EVALUATION REPORT #1698 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service, Inc. Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but notlimited to: vertical and horizontal reference point (BM), direction and percent slv di n ' ns, north arrow, and location and distance to nearest road. Parcel I.D. 0 3 — / �J�0 a t aRMEWE D Reviewed By D�a'te �-c•V Personal information you pro used for secondary purposes (Privai y Law, s. 15.04 (1) (m)). Z.7 Property Owner JU '? i 2005 Property Location Gronquist, Nels Govt. Lot na NE1 /4, NE /4, 516, T3111% R18W Property Owners Mailing Address S T. CROIX COUNTY Lot # Block # Subd. Name or CSM# 416 8Th Ave. NE ZONING OFFICE 2 1 na MapleHaugen City State Zip Code Phone Number City [] Village ❑ Town Nearest Road Minneapolis MN 1 55413 1 715 -248 -7278 Star Prairie 1 220Th Ave ❑ New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe na Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable na ft. General comments M ound desig system elevation 99.75ft based on contour line elevation 1 00.25ft . and recommendations: F 1-1 Boring # [] Boring Pit Ground surface elev. 98.75 ft. Depth to limiting factor 18 � 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. 'Ef1#1 'Eff#2 1 0-6 10yr3 /1 none I 2msbk mfr cs 2c .6 .8 2 6 -18 10yr4 /4 none sl 2msbk mfr cs is .6 1.0 3 18 -96 5yr4/4 fif 7.5yr5/6 sl om mfr na na .2 .6 I I F2 Boring # Boring ® pit Ground surface elev. 98 -7f5" ft. Depth to limiting factor 28 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 01#1 'Eff#2 1 0 -7 10yr3 /1 none I 2msbk mfr cs 1c .6 .8 2 7 -20 10yr4/4 none sil 2msbk mfr gw lc .6 .8 3 20 -28 5yr4/4 none sicl 2msbk mfr gw if .4 .6 4 28 -50 5yr4/4 c1d 7.5yr5/6 sic! 2msbk mfr gw na .4 .6 5 50 -96 5yr4/4 fif 7.5yr5/6 sl om mfr na na .2 .6 pp d/ ' Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD s30 mg /L and TSS <_30 mg/L CST Name (Please Print) Signature: CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th SL Baldwin, WI 54002 6/16/2005 715- 760 -0347 S131"330 (R.07/00) Property Owner Gronquist, Nels Parcel ID # pending Page 2 of 3 • F3 ]Boring # Boring ® Pit Ground surface elev. 94.10 ft. Depth to limiting factor 53 in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f1 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0 -7 10yr3 /1 none A 2msbk mfr cs 2c .6 .8 2 7 -18 10yr4 /4 none sic[ 2msbk mfr cs 1c .4 .6 3 18 -53 5yr4/4 none ISM 2msbk mfr gw is .7 1.6 4 53 -96 5yr4/4 f1f 7.5yr5/6 sl om mfr na na .2 .6 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/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # Boring [] Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 <150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (R07100) sbm's SON Service, Inc. STEEL'S SOIL SERVICE INC. 3of3 David J. Steel Nels Gronguist 994 200' St. CST - POWTSM NE1 /4,NE1 /4,S16,T31N,R17W Baldwin, WI 54002 Lic. #248956 Town of Star Prairie, St. Croix Co. Direct 715 760 - 0347 MapleHaugen Sub. Lot, 2 Fax 715- 684 -3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend N 1 = 40' ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 99.20 ft Top of 3/4" pvc pipe O► = Borings Boring Elevations B 1 = 98.00 ft B2 = 98.00 ft B3 = 94.10 ft B4 = 0.00 ft Vl-, 6 " ri d 06 61 l�ar?o� rye E \ _�;. 1 � It MI x f ,� AM ,� 589'48'39 " 337.37 /. !, 20 1Al 4340 A p, /' c 1 / - // c°.r , Na 0. H. W. �`•'' 373 .�,��`��� �' ` � / ��,�; M. AL IL I !' ), \ VAI � E �L.eo-93?0•v� •�. I .� 1368, I �-. . do F 1 Ir I �L N g / / / — ,: / •ate. - -.. . 07.E / 1 f z 41 347' ` L.B. O. =952 0' A f j` / o Drainage ~ t l Easement / _ , �1 �- t 1 '•( / •� /�,: l HWL =930. Q � / I / Drainage •- =>.: �8 = �` \ / / Easement' LO 7t7/ i B. O. =9320 0 N IT ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer — 42%w ,� G Mailing Address E ' o Property Address Q / g -�1 (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number 0 3 2 ? j - 7 G Z D 6 LEGAL DESCRIPTION Property Location IVE '/4 , Al � /4 , Sec. , T _:�LN R Town of Subdivision A-V a f,' A/ Lot # . Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house (zDno Lot lines identifiable( 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 9 9 10 qj�_ 12q1 /D SIGNATURE OF 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) 8 0 9 17 0 3 7 9 State Bar of Wisconsin Form 6 -2003 SPECIAL WARRANTY DEED BETH PABST REGISTER OF DEEDS Document Number Document Name ST. CROIX CO., WI THIS DEED, made between The RiverBank,( "Grantor," whether one or more), and RECEIVED FOR RECORD Todd Marek Construction, Inc.,( "Grantee; ' whether one or more). 06/15/2010 1:22 PM Grantor, for a valuable consideration, conveys and warrants to Grantee, the following SPECIAL WARRANTY DEED described real estate, together with the rents, profits, fixtures and other appurtenant EXEMPT #• interests, in St Croix County, State of Wisconsin ( "Property ") (if more space is REC FEE: 11.00 needed, please attach addendum): TRANS FEE: 255.00 PAGES: 1 Lots 1 2 3, 6, 7 and 8 of MAPLEHAUGEN; Being � -- of Lot 4 of Certified Survey Map in Vol. 16, Page 4342, as Document No. 684958; Located in that part of the NE '% of the NE %. of Section 16, Township 31 North, Range 18 West, TOWN OF STAR PRAIRIE, St. Croix County, Wisconsin. Recording Area Name and Return Address Todd Marek Construction PO Box 228 Grantor warrants that the title to the Property is good, indefeasible, in fee simple and New Richmond, WI 54017 free and clear of encumbrances arising by, through, or under Grantor except: All 038 - 1237 -01 -000 easements and restrictions of record. 038- 1237 -02 -000 038 - 1237 -03 -000 038 - 1237 -06 -000 038 - 1237 -07 -000 038 - 1237 -08 -000 Parcel Identification Number (PIN) This Is Not homestead property. Dated: �C: /O�Uj D The RiverBenk (SEAL) (SEAL) * * by Jeanine Sandberg, Chief Fin cis Officer (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATEOF WI ) ) ss. authenticated on Polk COUNTY ) Personally came before me on 10, ,Z O / d * the above -named Jeanine Sandber - -� TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) � i* � tt � // � ` * � M instrument and acknowledged the same. ,,,, THIS INSTRUMENT DRAFTED BY: ,`',.�: ''•.'.� Louis J. Jr. .� otary Pub tc, State of WI Andrew Law Offices, SC LIT Q I 0 y commission (is permanent) (expires:) S= /1 — /.3 (Signs sy hrbut6en fed o Rt wiedged. Both are not necessary.) NOTE: THIS IS A STANDARD AffY MI FICi tt&TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. SPECIAL WARRANTY DEED ( ®2003 $T7 jrAR OF WISCONSIN FORM NO. 6-2003 *Type name below signatures. INFO - PRO Legal Forma • (OW )6 55 -2021 • inroprdams.eom 1 of 1 Located in art of the e North eas t 114 of Lot 4 of a Certified Survey Map recorl North 114 Corner Section 16 -31 -18 (Established From Ties of R ecord) _ Nort line o f the N -114 _ _ _N89.5 _ _22_0T_N_A V ENUE __ _ _ 66, 1312.45' �— 337.35' . N 8958'0 2 ° E 16 49.80' _ 34J:n �W _ LOT 1 o CSM,_VOL._16, N I o N PG._4342 o N o 0 Z N� I � LEGEND / RECORDED AS 337.27' S89'4839 "E 337.37' -E section Corner Monument of Record f 3 >et 1 -1/4" x 18" Iron rerod Neighing 4.3 Ibs /linear foot ound 1" O.D. Iron Pipe LOT 1 65, 778 S0. FT. : 'Co ►�i Z ound 1 -1/4" O.D. Iron Pipe c 1 .51 ACRES =1D 1\ I luilding Setback Line N = N 50' from R—O —W, 75' from Navigable Wetlands) I L 'roposed Driveway Location 2' Utility Easement Line N82.53'24 "E N )rdinary High Water Mark 339.50' �U') : 990.0 IN F dge of Delineated Wetland Areas • • tiU t )elineated Wetland Areas LOT2 0) 69, 906 S0. FT. • '5 —year High Water Level v N 0 1.60 ACRES c 3 anchmark (Top of Iron Pipe) o W N N .� owest Building Opening N82.53'24 "E )T CORNERS ARE MONUMENTED WITH 0 373 IRON PIPE (WEIGHING 1.13 LBS. PER 000 989.9 UNLESS OTHERWISE SHOWN. J ifted by Michael H. Lynskey = O 00 LOT 3 00 79,522 50. FT. 00 1.83 ACRES L. B. D. =950.7' _ 1 d- N8933'54 "E 1 `,dpun�atrnrNiyg�i�. I i� zR7 7Z' i � 4 i r F- � W " CN 33 LO - �w g g U 9 � N p CL CD rl: LO ov co LO vi CT) — oi Q — cat r u. J � _ca � o c C y CL v 216. 201.2 182.88 478.08 E L K ..,....... , ._.... __.... .._ _ _._..... "_ . O V a� LE N —° i A n N r [qGOULDS PUMPS Submersible Effluent Pump MODEL 3 88 5 WE S eries PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. APPLICATIONS ■ Shaft: Corrosion - resistant, Single phase (60 Hz): can be operated continuously Specifically designed for the stainless steel. Threaded • Capacitor start motors for without damage when fully following uses: design. Locknut on all models maximum starting torque. submerged. • Homes to guard against component • Built -in overload with ■ Bearings: Upper and • Farms damage on accidental reverse automatic reset. lower heavy duty ball bearing • Trailer courts rotation. • S1TOW or STOW severe duty construction. • Motels ■ Fasteners: 300 series oil and water resistant • Schools stainless steel. power cords. ■Power Cable: Severe duty • Hos itals •'/3 -1 HP models have rated, oil and water resistant. P ■ Capable of running dry Epoxy seal on motor end • Industry without damage to NEMA three prong 9 provides secondary moisture • Effluent systems components. grounding plugs. • 1 HP and larger units have barrier in case of outer jacket SPECIFICATIONS ■ Designed for continuous bare lead cord ends. damage and to prevent oil operation when fully wicking. Standard cord is 20'. Three phase (60 Hz): Pump submerged. Optional lengths are available. • Solids handling capabilities: -Class 10 overload protection a 0 -ring: Assures positive 3 I 4` maximum. MOTORS must be provided in sealing against contaminants • Discharge size: 2" NPT. ■ Fully submerged in unit r ordered starter and oil leakag • Capacities: up to 140 GPM. high -grade turbine oil for • STOW power cords all have AGENCY LISTINGS • Total heads: up to 128 feet lubrication and efficient heat bare lead cord ends. TDH. transfer. Tested to UL 778 and ■ Designed for Continuous CSA 2Z.2 108 Standards • Temperature: ■ Class B insulation on ® By Canadian Standards 1047 (40 °C) continuous '/3 -1' /z HP models. Operation: Pump ratings are Association 140 °F (60 °C) intermittent. ■ Class F insulation on 2 HP within the motor manufacturer's CM us File #LR38549 • See order numbers on models. recommended working limits Goulds Pumps is ISO 9001 Registered. reverse side for specific HP voltage, phase and RPM'S METERS FEET SERIES: WE available. 4° 130 VI E, sH i -- - - -- 120 _ RPM. 3500 &DS FEATURES 35 110 1750 wt2H i - -- i — —4— I —. GPM ■ Impeller: { eller: Cast iron, semi - 30 100 -- , - -� - -� — p �- 5 FT open, non -clog with pump- 90 —I out vanes for mechanical W 2s 70 Bo - -- — — - - - -- seal protection. Balanced for � - -; smooth operation. Silicon 20 to r, bronze impeller available as so r - '— - -- — - - -- - -- - - an option. a 15 50 WE05 . ■ Casing: Cast iron volute ° 40- - -- - - -- - - -- - -- _ - -__- �� _ —! type for maximum efficiency. 10 30 2" NPT discharge. 20 ■ Mechanical Seal: SILICON 5 CARBIDE sea SILICON 0 Bo 90 100 110 1zo CARBIDE sealing faces. ° 0 10 20 30 40 50 60 70 130 140 150 160 GPM Stainless steel metal parts, , I I i I I I I I I I I I I I , BUNA -N elastomers. 0 5 10 15 20 25 30 35 m3 /hr CAPACITY Goulds Pumps WaterTechnology, Inc. E ITT Industries D ecember, 2004 www.goulds.com V�j 83885