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HomeMy WebLinkAbout040-1318-00-029 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix •Sa V and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 515269 0 GENERAL INFORMATION 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: Wilson, Larry & Fern I Troy, Town of 040 - 1318 -00 -029 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: t� (� 65 11.28.19.2104 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER t CAPACITY STATION BS HI FS ELEV. Septic , - Benchmark Wit lzao t AN7s,4-/¢ Dosing `� � � � � Alt. B (� � `07� ftfai*em �G ,Q / t/ 1 C � l✓i �1 , � / o A A_ JZ B g. Sewer C � � a 7 (p 1674• r7 Holding St/Ht Inlet `1 /67Z TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet j ors -1.... `\ \ Septic 1/7 / �� �Q Dt Bottom Dosing 7 / / Header /Man. J TZJ A 77.E Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover /I u C GPM �• I rl��o� j Model Number 1. ) � I1 ��r C- - , P d S N: 6C S, ►9 �67(,� ( TDH Li i v 0 Friction Losss System Head L TDH � �y ,F 7 Forcemain Leng; I Dia. Z 11 Dist. to well / c D J SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 16 6 SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of stem: CHAMBER OR ( 7 t. UNIT Model Number: O IL) 7 DISTRIBUTION SYSTEMS ( Zbp Heaoer /Manifgd 1 / Distribution x Hole Size p f x Hole Spacing Vent tp Air Intake Length 3 Dia J r Z� Length 5 6 Dia l Spacing 3 ! O z• 61 lYl✓ SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges S Topsoil l lr � , i'es�. - °,] No es � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 8 / Z ( O / - Inspection #2: / / Location: 750 Mount Curve Chase Hudson, WI 54016 (NW 1/4 NE 1/4 11 T28N R19W) Hills of Troy Lot 29 "1 Parcel N : 11.28.19-2104 "— 1.) Alt BM Description = G � �a �'� =C'�tv e'zk (5 Move A / kkr 2.) Bldg sewer length LILS = I- p e�5 a ,(, �G16�-C,(� I tJ - amount of cover = I / Az� a Plan revision Required? Yes X<o f Use other side for additio al infor atio' n.' 1 Ea ! L_ __ ___ — � Date Insepctor S na /''` �/ f SBD -6710 (R.3/97) 1 ! /� i /'� n ���t C`'j -ft(%e Cert. , /Zi' e AV Flip commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box W162 St. Croix t ria s Madison, WI 53707 -7162 Sanitary / erm it umber (to be filled in by Co.) nt of Commence Z Number Sanitary Permit Application State Transact In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental 17 53 / 7 �� ' unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information yo purp oses in accordance with the Privacy Law, s. 15.04 1 m , Stats. R II I. Application Informat' — Please Print All Information ;t# 7 Ot/�t1' Property Owner's Name Parcel # 040 - 1318 - 00 - 029 Larry & Fern Wilson Property Owner's Mailing Address Property Location 1325 102 St. E • Z S i...,-,,.,i ;\ �,uviV i Y Govt. Lot City, State Zip Code NW %4,NIE' /., Section 11 Inver Grove Heights, MN 55077 (circle one) II. Type of Building (check all that apply) Ok � Lot # T 28 N; R 19 W ® or 2 Family Dwelling — Number of Bedroo11C) Subdivision Name �' °' 29 Hills of Troy MI # ❑ Public /Commercial — Describe Use Na City of ❑ State Owned — Describe Use ) /1/) _ _ CSM Number ❑ Village of (o )<-/&D e L I Na ® Town of Troy III. Type of Permit: (Check only one bog on line A. Complete line B if applicable) A. New System Replacement Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) System B. Permit ❑ Permit Revision ❑ Change of ❑ Permit Transfer to List vious Permit Number and Date Issued Renewal Before Plumber New Owner Expiration (p� IV. Type of POWTS S stem /Com onent/Device: Check all that a 1 Non- Pressurized In- Ground Pressurized In- Ground ❑ At -Grade 0 Mound > 24 in. of suitable soil 0 Mound < 24 in. of suitable soil Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) It V. Dispersal/Treatme Area Informati CL Design Flow (ggd) Design Soil Applicati Rate(gpdsf) Dispersal Area Requir sf) Dispersal Area Prop ed (sf) System Elevation 600 ,// 1.00 Lp 600.00 sq. ft. / 600.00 sq. ft1130 1077.10' @ 6" above V • VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units / o New Tanks Existing Tanks ,V 1 1, k 5Z s O � 'C Q a a CL U Septic or Holding Tank 1250 1250 1 Wieser C ncrete ❑ ❑ ❑ Dosing chamber 750 750 1 Wieser Concrete ❑ VIL Re"nsibility 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 Bill Schumaker 227990 715) 386 -3121 Plumber's Address (Street, City, State, Zip Code) 1070 Scott Road, Hudson, WI 54016 VIII. Coun /De artment Use Onl pproved _ Di d Permit Fee Date sue Issuing t Signature _Owner Give or Denial $ / 25. C6 /O IX. Condit %A�/Reasons for Disapprova 1 f/ , 1. Septic tank, effluent lifter and dispersal cell must all be services / maintai e �� �G{`,rw. as per management plan provided by plumber. 2. All setback requirements must be maintained as pm apWic" code / . Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD -6398 (R. 01/07) Valid thm 01/09 ® .So,/ F ✓a /.cca-�•or� P%f � levy : /0 7�5. G � ' k. s, 6.5, 30' 24 c 0 T. oF/ — , - ov �•� a 5 ro, cc LS 1. \ �\ CJ \ s.T /ioc 5.2 W114 11 •ar a u.� / c'�. io7da' gr c 3 �e Si dance+.- U y 0 o Q �v 0 U-�Q I I O Cafi0�1 O� 'I�f •s.6.s. �o ca t�e d - 5 EX. �'de e /e(/ao� \ cc le. / 30 � Lj N I � � Loy 2 /J c.Jyy /7 Sec O �\. /9uJ,,T.oFJ�ro , \ �•� � � \ ZS �lzso Asa- ►nkcscz►r,50. S.T�iOC. �Jitt.�fy� t� it o u�le1. _ - 1o7do' � aray �� �{ be ba/ /ding der 3 K.eS: dchu� U y 0 0 Q 0 �(�� v�.�el I loca� o� Cu.we I - Safety and Buildings commerce.wi. OV 10541N RANCH ROAD g HAYWARD WI 54843 Contact Through Relay isconsin www.w www.co sin.go / Department of Commerce iscosin.gov Jim Doyle, Governor Aaron Olver, Secretary May 26, 2010 CUST ID No. 227990 ATTN: POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/26/2012 Identification Numbers Transaction ID No. 1793144 SITE: Site ID No. 756528 Larry & Fern Wilson Please refer to both identification numbers, 750 Mount Curve Chase above, in all correspondence with the agency, Town of Troy St Croix County NW1/4, NEIA, S11, T28N, R19W FOR: Description: Mound, 4 br res Object Type: POWTS Component Manual Regulated Object ID No.: 1265677 Maintenance required; 600 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade; Systeip(s)i, Mound Component Manual -Version 2.0, SBD- 10691 -P (N.01 /01), SSWMP Pub. 9.6; Effluent Filter ((;;v The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes �MEM A a' and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed 50 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. SEE GOBI 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: Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health j hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • This system is not designed for and may not be sited on a concave slope. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. WILLIAM C SCHUMAKER Page 2 5/26/2010 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Insulate building sewer per COMM 82.30(11)(c). 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 atricia an do POWTS Plan Re iewer, , tegrated Services WiSMART code: 7633 (715) 634 -7810, ax: 5)634-5 150 , M -th 8:00 - 4:45 pat.shandorf@wisconsin.gov ' cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Monday, 7:00 A.M. To 3:30 P.M. 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 buildingproduct not on the building site. For further information, go to our website: www. commerce. wi. gov/ SB/ SB- BuildingContractorProgram.html WILLIAM C SCHUMAKER Page 2 5/26/2010 • Surface water drainage shall be diverted away from the system area per Mound Component Manual, • Materials shall conform to the requirements of COMM 84. + Maintain well and waterline set backs per COMM 83.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Insulate building sewer per COMM 82.30(11)(c). 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 atricia ando POWTS Plan Re iewer, , egrated Services WiSMART code: 7633' n (715) 634 -7810, ax: 5)634-5 150 , M -th 8:00 - 4:45 pat.shandorf@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Monday, 7:00 A.M. To 3:30 P.M. 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: www.commerce.wi-gov/SB/SB-BuildingContractorProgram.html MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Wilson 4 bedroom residential mound Owner's Name: Larry &Fern Wilson Owner's Address: 1325 102nd St. East Inver Grove Heights, MN 55077 Site Address: 750 Mount Curve Chase Legal Description: NW1 /4 NE1 /4, Sec.11, T.28N., R.19W. Township: Troy County: St. Croix Subdivision Name: Hills of Troy Lot Number: 29 Block Number: Na Parcel I.D. Number: 040 - 1318 -00 -029 o ral O� Plan Transaction No.: CAM 0� Page 1 Index and title Er Page 2 Data entry Page 3 Mound drawings �ppNp� 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 Site Plan 1 Page 9 Attached soil evaluation report Designer: Bill Schumaker License Number: 227990 Date: 04/19/10 Phone Number: (715) 386 -3121 Signature: lJvu Designed Pursuant to the Mound Component Manual for POWTS 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) and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706 -P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 9 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 t 400.00 Estimated Wastewater Flow (gpd ) Table 83 -44 -3 in -situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150 %) fecal coliform of <= 36 inches. 600.00 Design Flow (gpd) 6.00 Site Slope ( %) r 1076.60 Contour Line Elevation (ft) 30.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 1 00.0 0 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) _ c; Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft)_ 4 Number of Laterals of the highest point. F 0.126 Orifice Diameter (in) 2.00 Estimated Orifice Spacing (ft) = 6.00 ft /orifice !_ 2.00 Forcemain Diameter (in) 85.00 Forcemain Length (ft) Does the forcemain drain back? � 1071.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 13.86 Forcemain Drainback (gal) 5.60 Vertical Lift (ft) 62.76 5x Void Volume (gal) 2.96 Friction Loss (ft) 76.62 Minimum Dose Volume (gal) 0.00 In -line Filter Loss (ft) 41.19 System Demand (gpm) 15.06 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice _..__. _...- - -.._. 0.75 1.25 x 1.00 ; _ -_- - - -- i 1.50 x 1.25 x I _ - x� 2.00 x x 1.50 x - 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treat ment Tank Information 757.64 Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) 47.00 Total Working Liquid Depth (in) Wi eser Concrete Manufacturer 16.12 gal /in (enter result in cell B49) D_ ose Tank Information Effluent Filter Information _757.641 Dose Tank Capacity (gal) Pol Lok Filter Manufacturer 16.12 Dose T Volume (gal /in) PL -525 Filter Model Number Wieser Concrete I Manufacturer Project: Wilson 4 bedroom residential mound Page 2 of 9 Mound Plan and Cross Section Views ................... ............................... T 1/106 :::... J Observation Pipe :... _ I K::�i -- ♦: :: r 1 5 A - W .... ........... .......... B :::::: :.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:. :.:.:.:.:.:.:.:.:.:.:.:.:.:.:.: z Q: .. .............. ............................... L Mound Component Dimensions A 6.00 ft E 10.32 in H 1.00 ft K EAft ft B 100.00 ft F 9.25 in 1 7.80 ft L ft D 6.00 in G 0.50 ft J 4.50 ft W 600.00 (ft Dispersal Cell Area 1379.57 (ft) Basal Area Available 6.00 (gpd /ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 1078.87 (ft) —► ,,.... A0,.... ,,,,,,,,,., ,.. G t H I F 1077.60 (ft) L atera l Dispersal Cell 1077.10 (ft) — Invert Dispersal Cell [ Elevation :•:•:•:••:•:: D :: •:•:•:•::•:•.•.•::•:•:•:•:•::•. � 1. • { • 1. _•�.. .l •)_' _ • .4 :L � ": {�:l _•`:J- _ ?` � " =4 h � • "'�. :3 ~ J. ' A ?. %`_•. ,:], :a: j), { -�). ,%�A � ")ji�� �3, A. 1. J ., 1 S� " '�J_:�'� 3 :..:1~�:�%. 1,:�...t .l l l. .4 ,sl��,.' +.. {�1��;�.{ 1. •~ ..; ��~{� :,. {:' ��a:. { »;. .��.. ' 1076.60 (ft) Contour Elevation 6.0 %Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell m See lateral details on 1❑ _ Topsoil Cap o 1.5 ft •r � •i Page 4 for number, size, ❑ " " "" Subsoil Cap c and spacing of laterals. ©0 ASTM C33 Sand .6 6 Laterals are equally F a d 0. ft : Typical Lateral ti.. spaced from the Tilled Laye ® c y y distribution n cell's ©0 ,:. Aggregate o� centerline in the A } distribution cell (AxB). Project: Wilson 4 bedroom residential mound Page 3 of 9 Center Connection Lateral Layout Diagram Force main connection via tee or cross to manifold at any point. Laterals are identical IP S I � •= Turn -up hiball valve or 14- X----> I(- X12 I x12 +I Laterals b force main of PVC Sch 40 olsanoutplug per COMM Table 84.30 -5 Wits dried on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 2.01 ft Lateral Length (P) 49.25 ft Orifices per Lateral 25 Lateral Spacing (S) 3.00 ft Orifice Density 6.00 ft /orifice Lateral Flow Rate 10.30 gpm Manifold Length 3.00 ft System Flow Rate 41.19 gpm Manifold Diameter 2.00 in Total Dynamic Head 15.06 ft Forcemain Velocity 4.21 ft/sec Dose Tank Information Locking cover with warning 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 F Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer ... 2 in. Ca aci 757.64 Gallons Volume 16.12 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 28.25 455.34 B 2.00 32.24 C P ump off elevation (ft) C 4.75 76.62 1072.00 D 12.00" 193.44 D Total 47.00 757.64 Do elevation (ft) 3" Bedding uncler tank. 1071.00 Alarm Manuafacturer LevelArm Alarm Model Number'DLV Pump Manufacturer Goulds Pump Model Number 3871 EP05 Pump Must Deliver 41.19 gpm at 15.06 ft TDH Project: Wilson 4 bedroom residential mound Page 4 of 9 Mound _System Maintenance and Operation Specifications Service Provider's Name Bill Schumaker —� Phone 715 386 -3121 POWTS Regulator's Name 1--s—tcroix County Zonin De 't. 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 1250 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 Mound Inspect for ponding and seepage once every 3 years 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 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 Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Wilson 4 bedroom residential 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), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD - 10706 -P (N. 01/01)] 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 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continaencv 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. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 9 � r GOULDS PUMPS Submersible Effluent Pum 3871 EPO4 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems • Homes Available for automatic and thermoplastic design provides AGENCY LISTING superior strength and corrosion • Farms manual operation. Auto . Canadian Standards Association • Heavy duty sump matic models include resistance. $P • V ater transfer Mechanical Float Switch ■Motor Housing: Cast iron Goulds Pumps is ISO 9001 Registered. • Devvatering assembled and preset at the for efficient heat transfer, factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. maximum. ■ EPO4 Impeller: Thermoplas- ■ Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'/z" NPT seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA - elastomers. • Temperature: 104 °F (40�C) continuous 1402F (60:'C) Intermittent. METERS FEET • Fasteners: 300 series 10 + - -- stainless steel • Capable of running 9 30 ��fsGPM dry without damage to 8 �2 s FF components. 25 Q 7 Motor: _ • EPO4 Single phase: 0.4 HP, 6 2 15 or 230 V, 60 Hz, 1550 c RPM, built in overload with A6�Z s S automatic reset. T_iy. 4 • EP05 Single phase: 0.5 HP, a EPOS 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. 2 EPO4 • Power cord: 10 foot 5 standard length, 16/3 1 SJTOW with three prong grounding plug. Optional 20 0 0 0 10 zo 3o 40 so GPM foot length, 16/3 SJTW with three prong grounding plug d on EP05). 0 z 4 s PP9y - re2,d m'in lstandar y �/ � �.r, ,rt "ni�11 u m Sk AcITv Goulds Pumps �'O ,;ds P ,,, mps ITT Industries Efi =ctive. September 2002 7o,`9 a Ir Wisconsin Department of Comrfierce � I EVUATION REPORT Page 1 of 3 Division of Safety and Buildings' E� in accorda ' h Co m 8 ,ors- 4dO.. Code County ST. CROIX Attach complete site plan on paper not less than 8 1/2 x 11 inch s i must include, but not limited to: vertical agd poin (BM), dire and Parcel I.D. percent slope, scale or dime*ions, ngrt490w���p' Ecation a distance to nearest road. Please print allinforma ion. e / ate Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 / 7 U6 Property Owner Properly Location NORTH DAKOTA STATE UNIVERSITY c/o Leo Beskar Govt. Lot - --- NW 1/4 NE 1/4 S 11 T 28 N R 19 ©r)© Property Owner's Mailing Address of # Blo # Subd. Name or CS M# Beskar, Boles & Krueger SC, 219 N. Main Street N29/(hL � bf Troy City State Zip Code Phone Number QViIlage ■ Town Nearest Road River Falls, WI 1 54022 ( 715 425 C.T.H. U New Construction LlseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD n Replacement Public or commercial - Describe: Parent material loess over till Flood Plain elevation if applicable NA ft. General comments Mound System - -0.50 ft. sand fill -- 0.6 loading rate and reco rNnendat� (If pre - treatment system -- below- ground drip irrigation -- 0.8 loading rate) Boring # Boring Q Pit Ground surface elev. 1074.50 ft. Depth to limiting factor 30 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 I *Eff#2 1 0 -5 10YR3 /2 - sil 3f -mgr ds cs 3vf -co 0.6 0.8 2 5 -14 10YR3 /2 -- sil 3f -msbk ds as 2vf -co 0.6 0.8 3 14 -30 10YR3/4 sl lmsbk dh cw lvf -f 0.4 0.7 4 30- - lsbr -- -- -- Horizon 3 has some gr. U Boring # Boring 1076.60 31 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 1 0 -5 10Y3/2 sil 3f -mgr ds cs 3vf -m 0.6 0.8 2 5 -16 10YR3/2 - sil 3fabk ds as 2vf -m 0.6 0.8 3 16 -31 10YR3 /4 sil 3fabk dh cs 2vf -m 0.6 0.8 4 31 -33 10YR3/4 flf t0YR4 /6 scl Om deh -- -- 0.0 0.0 33- -- - lsbr -- -- -- * 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) ignature CST Number Mary Jo Hollister W � 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 09- 17-05 (715) 426 - 1775 Property Owner _ NDSU (Lot N29) Parcel ID # ( Pending) Page 2 of 3 FC] Borinq # Boring Ground surface elev. 1074.10 ft. Depth to limiting factor . 32 in 0 Pit 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 -4 10YR3 /2 -- A 3fgr mvfr cs 3vf -m 0.6 0.8 2 4 -12 IOYR3 /2 sil 3fabk mvfr as 2vf -m 0.6 0.8 3 12 -20 10YR3 /4 -- sil 2fa &sbk mfr cs lvf -f 0.6 0.8 4 20-32 10YR3 /4 -- sl lmsbk mfr as lvf -f 0.4 0.7 5 32 -34 10YR5 /6 c2d 7.5YR5/6 c Om mefi cw -- 0.0 0.0 6 34- -- -- lsbr orizon 4 has some gr. F-1 Boring # n Boring 11 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 F-1 Boring # ID 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 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- 8330Te l (R.07 /00) . Plot Plan for Hills of Troy Page 3 of 3 Town of Troy, ,St. Croix County, Wisconsin Lot 2-9 1 99 = 40 ft. Legal Description -A; x ,,1 4 a T .�� NVA. , 1 , f 2 ft. contours fvr vii - mwk , Cf:- = Backhoe pit BENCH -MARK. \ \ TOP OF 1 1 /4 " IRON PIPE ELEVATION = 1 0757 • e BE ARK: R- TOP 0 1 1/4" t -� ►may IRON PIP, 1b ?b.7`/" 30 Y � o • \ 89B SL �® SL x - A00 B -93A j �� R -ssA, \ ! ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer C' V ( -2 ✓1 ti t I SCE r� Mailing Address Property Address 60 14 o n k v V e �S l /� f (Verification required from Planning Department for new construction.) City /State 1` ) d 'soyl i Parcel Identification Number O v4 — 13 /6? " da- LEGAL DESCRIPTION Property Location ALL 1 /a , N %a , Sec. / , T Z, N R ! W, Town of I v Subdivision f -�i � a Lot # a Certified Survey Map # , Volume , Page # Warranty Deed # �o� �� , Volume , Page # Spec house yes Cn)o Lot lines identifiable yes no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle waste . 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 ma' itenance 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 Zoning Department a certification form, sign by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site i vastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is I ss than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage dispos d system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, Stat of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix Founty Zoning Departure t w' 30 days of the three year expiration date. i SIG TURF OF APPLICANT DATE OWNER CERTIFICATION I/we ify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the ov mer(s) of the property sc ' ed above, vi e f warranty deed recorded in Register of Deeds Office /y SIGN URE OF APPLICANT DATE Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning 6epartment. Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certifi d survey map if reference is made in the warranty deed. �I� STATE BAR OF WISCONSIN FORM 2 - 1998 I IIIIII VIII VIII VIII VIII VIII 11111111111111 I'll WARRANTY DEED * 8 8 4 2 6 0 1 Document Number 894260 BETH PABST This Deed, made between Troy Development Corporation REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD Grantor, 04/28/2009 02:20PM an d Larry J. Willson and Fern M. Willson, Husband and Wife WARRANTY DEED as survivorship marital property EXENPT i REC FEE: 11.00 Grantee. TRANS FEE: 274.50 Grantor, for a valuable consideration, conveys and warrants to Grantee the following PAGES: 1 described real estate in St. Cro ix County, State of Wisconsin: p^ra'din9 Area Lot 29 of the Pl at of Hi 11 s of Troy, Town of Troy, St. Croi x _ .. -- - b- County;- YT Name and Return Address Subject to the teens and conditions of the Declaration of Covenants Larry and Fern Willson and Restrictions for Hills of Troy recorded January 17, 2006 as 1325 102nd Street E. document nulber 816569 and the terms and conditions of a Landscaping Inver Grove Heights, Md 55077 Easement recorded January 17, 2006 as document nunber 816571 all being recorded in the office of the - Reegister of Deeds for St. Croix County, Wisconsin and FURTHER being subject to easements. restrictions, reservations of record, or in use, and the "Buyer" obligations and 4 -00-0 inner (PIN? conditions contained in the Purchase Agreement for this lot and any addendim thereto between Grantor and Grantee herein, which includes. This is not homestead property. without lirMtation, requireients for approval of plans by an (is) (is n ot) Architectural Review Committee 1 of home builder b G aPP►"°va y an , compliance with Grantor's approved builder requirements and potential '75 � � � � v C U V v 2 fees related thereto and commencement of construction deadlines together with related rights of redarption and /or lot maintenance fees, all of which shall survive closing and conveyance of this property and shall be binding upon Grantee, and his /her /their successors and assigns. Exceptions to warranties: - 3} Dated this day of Apri 2009 , it (SEAL) (SEAL) li i . Courtnie Kirvelay, Vice -Presi T roy Development Corporation (SEAL) (SEAL) i ,l AUTHENTICATION ACKNOWLEDGMENT w Si State of \1r1�JfMi1, yi s A ss. NOTARY PUBIC- MINNESOTA Anoka County. ; authenticated this f Personally came before me this /� day of April , 2nog the above named it Courtin a Ki rve y Vice -President `Troy I opment Corporation _- TITLE: MEMBER STATE BAR OF WISCONSIN LO 4i (If not, me known to be the person who executed the foregoing authorized by §706.06, Wis. Stats.) instrument and acknowledge the same. is 3� THIS INSTRUMENT WAS DRAFTED BY Troy Development Corporation Notary Public, state of Anoka County. Minnesota if Charles S. Cook, Pre My commission is permanent. (if not, state expiration date: III (Signatures may be authenticated or acknowledged. Both are not ) necessary.) Nar I V l l bOf� atgn ing In any capacity must be typed or printed below their signature. I STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc. WARRANTY DEED FORM No. 2 - 1998 Mllwaukea, WW. x