Loading...
HomeMy WebLinkAbout040-1265-60-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division It INSPECTION REPORT Sanitary Permit No: 479304 0 GENERAL INFORMATION (ATTACH TO PERMIT) tate Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. I's0 '1 Q14+t1t. IAgF Permit Holder's Name: City Village X Township Parcel Tax No: Brushy Mound Partnershi p Troy, Town of 040 - 1265 -60 -000 CST BM Elev: Insp, BM Elev: I BM D cription: Section/Town /Range /Map No: 6D • 0 y 16.28.19.1438 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM 0 l Pa � Aeration 2 / P t ! l� _� Bldg. Sewer r Hol 7 Z st/Ht �nlet ' q 2- St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent t.9 Intake ROAD Dt Inlet Septic y _ / > / 0"� I Dt Bottom 10,13 - Dosing f Heade an. t , • l 3 3 a 4 z �f, 3o of Aeration Dist. Pipe Holding Bot. System , Final Grade PUM PHON INFORMATION S� • D Z.`� Manufacturer GPM nd St Cover ,v $ t 3. s3 g 3 �0 Model Number �t�S `0 S 0 ,8 H Lift •�' Frictio • Loss System: T2 Ft p � Forcemain Lengt�yt , Dia. , Dist. to Well / �, A ^ �r-1 5.�� y f t � •�� SOIL ABSORPTION SYSTEM D RENCH Width Length No. Of irenehea PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ENSIGNS & L7D .�yrrMj SETBACK SYSTEM TO P/L BL WELL LAKE /STREAM NG Manufac re�� INFO B C Type f System: > 1� UNIT Model Number. r 5/ L' DISTRjELUTION SYSTEM_ Head anifold Distribution �� x Hol Ve x Hole Spacing Vent to Air Intake p ' 0` g , a 2� N L Dia 2 ti Le L e n gth ' aR• is Spacing 3. SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Y Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center I l Bed/Trench Edges Topsoil Yes No Eg Yes [ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: - , / > Inspection #2: Location: 317 Gandy Dancer Circle River Falls, WI 54022 (SE 1/4 SW 1/4 16 T28N R1 9W) NA Lot 77 �� ,,P�,arc¢el No: 16.28 .1.1 38 1.) Alt BM Description = ST OO O #Z P/ 01 '," ' O � w�^" 4 6609 - 2.) Bldg sewer length = 3 � � Sp�O �� (/k �� � � Z �' Skir -- - amount of cover = / Plan revision Required? =` Yes No Use other side for additional information. Date Insepctor' S natur Cart. No. SBD -6710 (R.3/97) Dcr M 2Ae �. jZfS7/ \ - -- - •" � � and y county I Ave t� ` - , r'' D rtment of Commerce 315 'tk Ntttrn6a t"D Wed in by Co .) aS$lE'll any Ap D _ ir, Plant.n_ Nu In t—ord Walk Carom $3.21. Wis. Ades. Code. pe"mal MY be used for smoedary purposes PriracY Law. sl > �X : Ui ^ i In 3 �} " OF � Atidresx (if diffveat than mailing tdd►ess) 1 I h Apps _ Aeee POW Ad hitarmttlap �" jy �raptY owan � ( f Parcel �R rK Btock� Property Owwr'r M Adders u r1� jYLS da�L I _ Ucy N Property Location � ij city, state Zip Cndt pnttae Ntastlnr S � sr , . , Secum I Lo (�it�l� NKA CSr++ i'fpe kireck all that apply) T N; R�E 1 or 2 Family wdi S wt t y � - Number of Bedtoorm Sttbdivisitm Name CSM Nu ben • Public/Commercud - Describe Use Chi h 73 State State (?wood - Describe Use � J L. }city (?Village owttship of t`O UL Type of Piral w (t�eelr sob are boat as i`e A. Iiwe d V a pplleable) A. _ t 1 New System I� Raplacemcul System 0 Treautrettt/Holding Tactic Replacement Only {._) Odw Modification to Enisting System B. Permit Renewal ❑ Prrmn Revision {. } Clow Of { } Permit Trtttisf. New List Previous Permit "amber and Date issued - - - -- Before Ex*atitm Plumber Owner IV. of POW7"S Nos ptessttrtxed ta-Gromw a►. of suitable soil {_} Moms! < 24 in. of adtbie soil {.l At -Grade I_} Si n& Wedard tttgle Pats Sand Filter j i i Ptrs: _Md la-iitoattd U Tank I I pew Filter U Aerobic Treatment Unit Recircuhmax Sand Filter S Media Filter ❑ Chamber U Drip Live val- P Odier ( am) V. Aria Flow (OPO MOP 308 Apppatrioo Ana dl lM 00 ired (s rea Disp A Proposed (sf) System Elevation VI. Tank Info capacity en Taal Numb _ tuat _C � er Mfaixurer prefab Site Sttx i Fiber Plastic Gnu" of units c Concrete Constructed Clan 1 NEW Extstarg Tanks Toots He" Tadt QC Aerobic Treattrom unit CAaatber Y, _ Oct _,� •__�____ Vp. rWilNl� - I, the awe 's Na tor( et me POWYS s4awn as UM atladMA prpos. � j � MPRS unabet Business PhQtte Number t 'hrmber'3 Addrr m (Street, City. Stte. Zip code) 19 Log � 1 �� � U ^ /V C�, r a Disapprovtd S&MOrY Ptah Fee ( Or Date Issued lsau Agent Signature (No Stamps) — cb X. Co.dkltlotl O A Surarp Fee) eves25 J� !/ ?16PS SYS NER: Led- 1 Septic tank, effluent filter and / �► dispersal cell must all �t § §rviced / maintained S t to S as per management plan provided by plumber 2. All setback requirements must be maintained as per applicable code /ordinances. Ataastewa trrun its are t' � a� Fir Iha w tt+tM*' w lass laser ieQ >< 11 lssolaa is Plot �L� a P-)s rn u A 4 rli wo r-L S '/ S w S f (a,t o r ell �/ � �S a R I�{ uJ P. p• {� yt S f i rey � -cT C.rn`yC kph 71 +6, rr o n6 � cto h d d, 1 -O� - 77 ��� X alb 3f lgcxvt nCsi.. C� r r r/ Aa &fir' G x i i I aoQ /gQ?J"„7J' S'kfC -C-/Pu i ' ► °*'t /tu`� S •Q. S oo"bl-s�lt"', 'A ;4 /f Am f4x el A Ppp.OX 4� 30C� ! TO DAlkXE C IRCLe e' Q q' d' --- / oo , 5v t r+ ----}— 9 COPY ��f Safety and Buildings 4003 N KINNEY COULEE RD corhmerce.Wl.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.w www.coe.wi.gov/s sin.go t Department of Commerce iscosin.gov Jim Doyle, Governor Mary P. Burke, Secretary June 28, 2005 CUST ID No.220537 ATTN.• P 0 WTS Inspector CALVIN W POWERS ZONING OFFICE POWERS EXCAVATING, INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/28/2007 Identification Numbers Transaction ID No. 1150315 SITE: Site ID No. 700724 Brushy Mound Partners Please refer to both identification numbers, 314 Gandy Dancer Circle L above, in all correspondence with the agency. Town of Troy St Croix County SE1 /4, SW1 /4, S16, T28N, R19W Subdivision: Glover Station 5th Add'n - lot 77 FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1025686 Maintenance required; 600 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade System(s): EZflow Mound Component Manual, (N.6/03), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /O1); 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 enclosed approved plans and with the EZ FLOW Mound Component Manual (June 6, 2003). • The pressure network is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD - 10706 -P (N.01/01). • The distribution pipe being inserted into the 4" corrugated pipe located in the EZflow product shall have one out of every five orifices installed at the 6 o'clock position. The remaining four orifices shall be installed at the 12 o'clock position. The laterals shall drain fully after every dose. • The manifold and lateral turn -up ends shall extend out past the exterior end of the cells at both ends. The observation pipes shall also be located in between where bundle(s) come together. These requirements must be followed so that the aggregate bundles will not be damaged during the installation process. • 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. • The area within 15 feet horizontally below the system shall remain u ' rM. a icular traffic or soil compaction in this area is prohibited. Conditionally . . 1% .0. APPRO WD y CALVIN W POWERS JR Page 2 6/28/2005 • 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 copy of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter 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 jswini@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 DATE: 0 0.S TITLE SHEET PAGE_J_OF MOUND SYSTEM FOR A BEDROOM RESIDENCE This plan has been prepared m accordance with the EZFLOW Mound Component Manual VERSION 2.0 (N. 06 /03)and the Pressure Distnbution Manual VERISION 2.0 SBD- 10706 -P. . 01/01 LOCATED IN THE 1 / 4 OF THE SW 1/4 OF SECTION RaW, TOW OF ,, ST. CROIX COUNTY, WISCONSIN. t `ik a r7 INDEX PAGE l OF 8 TITLE SHEET PAGE 2 OF 8 PLOT PLAN ocrr`'4 ar-0 PAGE 3 OF 8 PLANVIEW CROSS SECTION PAGE 4 OF 8 DISTRIBUTION PIPE LAYOUT 005 PAGE 5 OF 8 PUMP CHAMBER CROSS SECTION PAGE 6 OF 8 SYSTEM MANAGEMENT PLAN A 4 s:. F OjL0*AG 7 OF 8 PUMP CURVE GE 8 OF 8 CROSS SECTION OF E Z FLOW PREPARED FOR V>.o 1( N, mon P D BY It 1 220537 OWE EXCA TING INC. 1969 185 AVE. NEW RICHMOND, WIS. 54017 PHONE: 715 -246 -5135 FAX: 715 -246 -5135 CELL: 715 -381 -9920 Dki'A pF SAFETY AS5 BUILDINGS DIVISION A SEE �;ORRESPONDE C Q to • tks V Y s IU P, !Q U-) A.Q� �x Y44S I�ro /CT C rr o nc� , w 5 ,S t p l 7. c t o i3 �.^ S �t �o«, 5 /� d, 1, t3� # 7 7 m�LL OA IAb i X /O 9 / AV � ao ®1gQ� „�n.sz s� f`� ,�.� �' �c��'L�� -, /i�`� �s .e, s �o•vt�oc�l�� (Ue�`E�. 3 Did �f V ol A P PROx, d�AND`1 DAB 4 IRCLe Q� 1 f _.. a Approved Barrier Cover APP C er A5rh - 633izill Material G Distribution Cell +Cap. G _ D 3 cam ! ed Ares S� Slope Figure I Detailed cross- section of a mound Cross Section Of A Mound System Using F ` � E For The Absorption Area F G -�--- A Ft. M 8 /00 Ft. K ' S Ft. L _LL F t . j 6 o(o Ft. Position I /D Ft. of w Iv Ft. Force Main L d + Observation Pipe- A Df• - � ---------- - - - - -- ------- ___ -� -- -- --�±?- mac W i.— Dis tribution ��� Of / Flo (A) S Pipe I Observation Pipe Plan View Of Mound Using A Bed For The Absorption Area � UISTRIBU "i'!ON PIPE LAYOUT Page_�_of Place 4 holes on the top side of the pipe and every 5"' hole on the bottom of the pipe. Extend the end of each lateral up with the use of long turn or 45* fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a valve threaded cap or threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. 4 Lateral Manifold Lateral 1 x x r, acl2 xJ2 X X x Lateral Len th Lateral Lenqth Distnbubon Leine Lateral Access bo Marntold ;> Force main P, ft Hole diameter /Q inch S fi ' lateral inches) x -– al Manifold -t inches Force main Y inches # of holes/pipe-- Invert Elevation of Laterals Ft. NOM' LAST W 1r-1c G IN EACA4 LATERAL_ 1S 1' 99oN1 TIDE trM4 of TNT. CELL A SVT >ta � n 4" Cl VENT PIPE 12" MIN. ABOVE GRADE & WEATHER PROOF ? 25' FROM -DOOR, WINDOW OR JUNCTION BOX APPROVED WITH CONDUIT FRESH AIR .IidTAKE MANHOLE COVER W/ PADLOCK � C C o TANK AGCE55 + SEGVRtT'��R � WARNING LABEL M�( 134: 24 (7) 4,xt. Aim • 4 MIN. 19 I N 3J LET 1' ` 'WATER TIGHT SEA GAS- ;--� TIGHTi , ; P A SEAL APPROVED aI PIPE A � ALM JOINTS W/ CI 3' ONTO B i ON SOLID SOIL PIPE 3' ONTO 31 ON °�' SOIL PUMP OFF ELEV . FT. •- — -- i ►-' off �'t RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE S TANK MANUFACTURER: NUMBER DOSES PER DAY: TANK SIZES SEPTIC �J 00 GAL. DOSE VOLUME INCLUDING DOSE S bO GAL. FLOWBACK: GAL. ALARM MANUFACTURER:, CAPACITIES: A = INCHES = 4 GAL. MODEL NUMBER: 10 /, GAL. SWITCH TYPE: cx�`t B = 2 INCHES = ___ PUMP MANUFACTURER: �t4� ,•- C = 419 INCHES = GAL. MODEL NUMBER: lJ G SWITCH TYPE: D = LTA AL. INCHES = a _ REQUIRED DISCHARGE RATE GPM PUMP 6 ALARM WIRING AS PER I LHR 16.23 WA( VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE S FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . .%. .5 FEET + f D FEET FORCEMAIN X ,3 FT /100 FT. FRICTION FACTOR , FEET ----- -J-- -- _ EET F TOTAL DYNAMIC HEAD INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH ; DIAMETER LIQUID DEPTH •�S - ajj( // i ' POWTS OWNER'S MANUAL & MANAGEMENT PLAN page of •• sitsrfetri ��► O �ORMA'IEIOM � Tartk Martutald+ur� W i'eS�rs rOW1 17 NA r PM,Iit# sari a nee ❑ �+• t 0 �' Tank Manufaatccrar l.t�i.�sa�s �� � 0 �► lEfllfMt t AiliE 0 NA © Saiptic C) VOL oC7 gar of 8adroexr� ❑ NA Number of Public Fac�y DNA Fri y �' Estimated Iff"w"et flow 0 0 Effluent Filt4t Modal MwKdsctww D NA Design Ipow flow : eted x 1.51 p o �D ^,� Application Ante PunrP me" C► brit ❑ NA Standard Mfl m tIE"krsnt t Y MOB Filter p Past Fitter Farts, Od & Girease (FOG) 530 mgll gib Oxygen Demand (t30D 5220 am O NA 0 M Aeration ❑Wetland Total St�Solids fT entled Soli &150 MOIL O D Other: Pretreated Effluent Onality Monthly rEl anufaetunu � ❑ NA 8iocherrdcat 0XV9erx Demand (SODO 530 mQ& O a kn. l Iptassurized) Total SUWWWed Solids tTSS) 530 W411L ❑ NA ln- tiround IW*V y) Feted Coliform 1ge is mean) S10• cfui100mi At -Grads E3 O the : die. 0 NA ❑ MaX�rr+ Effluent Particle Size Y. � cn Dew -Lkw ❑ NA ❑ NA Othe ❑ NA *Vakres tYPic 1 for domestic wastewater aid septic talc ems' Sar+rir�e Event SL-3 FnqmWV 1st p 9 ) E3 NA Inspect condition of tenkfs) At least once every= When c ommbined sludge and st one' 3) of tamic volume ❑ NA Pump out torus of tardcts) 0 Wtven the high water 01011 l Lj ttneeOW VA.W wm $ years 0 NA inspect dispersel eaM(s) At least once everw EI (s) ❑ NA Clean effluent filter At krast orate every: 0 morrthls? D NA inspect Pump. PLwnp controls & alarm At least once every: 4' 14M . Rush laterals and pressam teat At least once &vary: 3 menthis) ❑ NA • At beat once every: 0 NA MAINTENANCE POSTFOXTiONS c ona of the following ROOM" OM" or c�ertilications: inspections of tanks and dispersal tails shall be Made by an irdlvidual arrl►Ir�9 S OPeretor IPU"4wr Master Paunber: Master Plumber Restricted Sewer, POWTS kwPactor: POWTS Maintainer: Septa�Oe y cracks or T � nest itnclude a, visual motion of the tankisi to identify any is idar or broken hardware. rtNY and a for WW back up or P of atfkMnt on the goon) leaks, measure the volume of combin sludge and s cum to die the affluent kaveis nr the obse w*m P hws WW to check for any Pvndkv ffhiant an the cA 81180 be Mace. The PM+k9 °f � on ttve ground surtwe malt Ir►r�ate s f rem the irnrrtedete notification of the local regdWtorY ftAh riW- of tank volum t tank equals once -third (Ye) or more the e. the When the combined aecurnuhdwn of sludge and scum ai any treatrrnen of in accordance with chapter NR 113, entire contents of the tank dvall be rarnaved by a S Q and Wisconsin Admirrative Cods. All other services, including but not limited to the servicing of effluent • mec of pressurized components. Pmtreatm&n' units. and any sw Ac kv at intervals of 512 months, shah be performed by a c er6fied POWTS MairH *w- A service report she$ be P to tha kenos) regulatory authority wWlin 10 do" of completion of any service event. Gates 12/021 Page or START UP AND OPERATION I - For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or othei. chemicals that may impede the treatment process and /or damage the soil diiiipairssl call(s). if high concentrations are detected have the contents of the tank(s) removed by a saptage ser#k*q operator prior to use. System start up shall not occur when soil conditions we frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwatw levels. When power is restored the excess wastewater wN be discharged to the dispersal ceft) in am large dose and may overload them resulting in the bodaip or surface discharge of effluent. To avoid this shun ion tw a the comtbnrts of the pump tank removed by a Sept*" SeMcing Operator prior to restoring power to the effluent pump or coact a Mwnbw or POWTS Maintainer to as min I in mains ally operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal calls. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade sob absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; conidoms, cotlon swabs; degreasers: dental floss; drapers: disinfectants; fat: foundation dra n (sump pump) discharge; fruit and vegetable peep gasoihme; gross*; herbicides; meat scraps; medications; oil, painting products; pesticides; sanitary napkins, tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanendy taken out of service the following steps shall be taken to insure that the system is Property and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Alt piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system; 0 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement arm should be protected from disturbance and compaction and should not be infringed upon by required setbacks from wdMinng and proposed structure, lot Fines and wed. Failure to protect the replacement area will result in time need for a now NO and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at !fiat tune. 11 A suitable replacement area is not available due to setback end/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the foiled POWTS. O The site has not been evaluated to identify a suitable replacement am. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement sea. if no replacement area is evall" a holding tank may be Installed as a last resort to replace the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomet at the infiltrative surface. Reconstructions of such systems must comply with the riles in affect at that tine. < <WARNWG> > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANOIOR INSUFFICIENT OXYGEN. DO NOT ERM A SEPTIC. PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS ALLFR POINTS MAINTAINER Name Mane Phone I S Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL DILATORY AUTHOIIiY Norma Name � V`D� f1 � Phone Phi S� This document was drafted by the staffs of the Green lake, Marquette and Watmhaw County Zoning orb Sanka6m agerm le, in c om0lance with chapter Comm 83.22(2)tb)(1)(dl &(f) and 83.5411). 12) & (3). Wisconsin AdmW*4mtive Code. vat1 wnli 10: PA 431 4021 F IRST SUPPLY HC PLBG 10002 ru Su er Effluent Pum P P�� 3885 M OSURANCE AMMILMI E FOR RESM*NM APPLKAT10N5. APP! fKAnm Shalt Conasaon resistara r Single Osase: ■ Bearings: Upper and Specilially for the stainless steel. rVeaded • Built-m overload Wth lower heavy duly ball bearing following uses: design. Locimu t on three phase automatic reset. construction. • Homes models to guard against • AN single phase models ■ Power Cable: Severe duty • Farms wMxiiient damage on feature ca!padtDr start Iated, oil and water resism. • Trailer courts accidental reverse rotation. motors for mauimum Epoxy seal on motor end • Motels ■ Fasteners: 300 series g torque• provides secondary moisture • Schools stainless steel. •'/1 and % HP —1 W3 SJIDW barrier in case of outer jacket • HospiWl ■ Capable of running dry with 115, 206 and 230 Volt damage and to prevent oil • Industry • Effluent systems c panes '' OW with Optional collage. ■ Designed for ccxr6rxuohrs T� : ■ Assures positive 91 opwation when fully • Overload protechon must seating against contaminants shutrnerged. be provided in starter unit and of Wdkage. PUM •'A-2 HP -14/4 STOW with • Solids handling capabilities: W maximum. MOTORS bare leads. AMY LiSTIMA • Discharge size: 2' NPT. • Fully s&nw* in *it- w Desigred for Contimuous • Capacities: up to 140 GPM. grade turbine oil for lubricabon Opeadow Puenp ratings are Trifeal•lJOU ad • Total heads: up to 128 fleet and efficient head transfer. vAft the imm rnarwfaciurees ! can W roe $ TDH. ■ Class B irhshdadion. neaomrriended w011*9 (units, 6rcM§" • Temperature: an be operated confr u xisly Oc us He 104 without damage whence GouMlcAwpcaIS1D9001 . 140OF (60 intermittent submerged- See order numbers on NMETM reverse side for specific HP, 130 vokage, phase and MVs rte: 3865 SgE: V SOIID5 availalbk- 39 1 RP -. 3500 a 110 sw4a - WATURB 30 1 s rr 90 N tmpder: Cast iron, semi- 2s OW. too -clog vim phm "ut vanes for mechanical seal 2 m protection. Bad for 60 smo operation. eration. %con 4 1 s bronze Impeiter available as g an option, t, 10. 30 ■ �ing: Cast Son type for ma idmu n effidency. 2° NPT disthwge. 10 el Medhardiml Se W: SRKDN CA1R V5. SKIM ° 0 0 10 20 30 50 w 70 80 90 100 110 120 130 140 150 160 GPM CARBNDE sealing faces. , ' Stainless steel metal parts, o s 10 1 s carter zs 30 3 nV/h� BUNA -N ei�mers. " ( ' Goulds Pumps 0 2002 r 1 / p, ITT Industries K11000 ! 00013K 2002 ` `1p WWW.goUWCDm 63665 2 `�� • Y't: F IT _. V 4 0 t w o cr '� .�...,.., < 7C" ,o tv CAD R to CL C 3 phi so co 0 lb C p-�ps t l 0• vl tp ► p �p '0" a tp O O �? 0 Og a� Sao .ao a � ' N a a :E cr Oy 78 1 jj » axe ow L ,. :t • a (v a t � w� G C fu c ` C t71 r, !° O °° A Cx� 4 � O Q C C Wi sconsin b or and and Human Rela department Industr Labor SOIL AND SITE E V A L U A T I O . PORT Page � of 3 ++-- Divi of Safety & Buildings in accord with ILHR 83.0 \ COUNTY ` .A, S-7, C2p lX Attach complete site plan on paper not less than 81/2 x 11 inches in " i; an mustl,.f� ' not limited to vertical and horizontal reference point (13M), direction a rpf slope, scaje of =' : PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road APPLICANT INFORMATION— PLEASE PRINT ALL INFORM _ION � � `�tj DAY DATE PROPERTY OWNER: ` P ATION 1 /4,S 1.Ij T ,N,R g E ( w PROPERTY OWNER':S MAILING ADDRESS • LOT # / rtgc�x NAME OR CSM # L � SMo)u 5 F"Jlb - CITY, STATE ZIP CODE PHONE NUMBER CITY []VILLAGE OrOWN ' NEAREST ROAD 1ZtU� - '(2.. �CLS --S w1 S�LoZ'ZhLSI �iZS- g16t �zA�f Gr,►.,fly Y cutre,� New Construction Use Residential / Number of bedrooms [ j AdditiQn to existing building (j Replacement [ j Public or commercial describe Code derived daily flow 'o t30 gpd Recommended design loading rate _ gpd/ft � trench, gpd1ft Absorption area required SrJb bed, ft SOO trench, ft Maximum design loading rate • S bed, gpd/ft2 'b Iench, gpd/11 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/ site considerations "u"-) WAS �CLO o ' t2�>vC�{ . Y� lti - �z u = Fr LL Parent material LuIES.S o�-M r—jLA � LbKez) Flood plain elevation, if applicable 1�1;� ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem CIS U U I EIS O U I CI S ®U CI S I1 U EIS ®U [IS o U SOIL DESCRIPTION REPORT t3oring# Horizon Depth Dominant Color Mottles Texture Structure Cortslstence Barlc}ary Roots GPD /ft in. Munsell I Qu. Sz Cont Color I Gr. Sz. Sh. i Bed ffrit �� I {. o — L`Z 10 `12 � z � si 1 2.`{ b 1Z m�>^ � 1'�' • S . 6 . �P F ?- ti 2 10 2 s t I 3sbk mfr �s - . -S , b Ground 3 Z6-3�7 - ).S `12 y/y _ S11 l ds l ti►t �y. �s — Z 3 10 b ft Z6 `-l /y �IS'tiRS /B S) CA �eSbk M�1- _ �Z ;.3 Depth to limiting factor 3 " Remarks: Boring # C LC tl2 3LZ 1- Z Z g -zg VC) t P- 3 11, _ si 1 Zh2 sbt-c - • 5 • •r Ground elev. LSB R - _ kip ' )JP 9.3 fL Depth to limiting factor Remarks: T Name: — Please Print Phone: Arthur L. We erer 715 - 425 -0165 egerer Soil T sting & I}esign Service -P.O. Box 74 River .Falls,WI.54022 Signature: Date: S _ 0 —0 CST Numbe 2 0 ' /+ oo- lu3_�> d 5 � w PROPERTY OWNER 8`1;� l SCt{U�'tZ SOIL DESCRIPTION REPORT Page? of PARCEL I.D. p Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft Consistence in. Munsell Qu. Sz. Cont. Color y Roots Gr. Sz. Sh. Bed Trerxh o --7 ILL — s 1 Z�P -sb� n�`Fr- _ Ground 2p z6 Z S y 2 31Y t- elev. . 2 ft. Zb _ Lo Lm (v3 N�?,Jp r - Depth to limiting factor Z6 11 i Remarks: Boring # z g Ground elev. f t. Depth to — limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: 3oring # around ;lev. it. )epth to imiting actor Remarks: _ PLOT P LAN Pa of 3 Q-n 1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND z,� OWNERSHIP CERTIFICATION FORM Owner/Buyer 1 wcS "k/ tvtd 4 x'10 le- Mailing Address R b 60Y. 4 +r, , W4z4v Ptc.-&4 40 t Property Address 3 l � �/ Ccvz -tom' (Verification required from Planning Department for new construction) City /State 14,MtOS o "t I Parcel Identification Number t - LLa 6 0 -ODO LEGAL DESCRIPTION Property Location %4, '/4, Sec. , T 2- % N -R W. Town of d/ Subdivision _ ��`'"`- 51 -fir d Z;T� Lot # -- Certified Survey Map # , Volume , Page # Warranty Deed # T; 1 ®� i . Volume 2 4 T V , Page # Z� Spec housex yes ❑ no Lot lines identifiabl Xyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the, system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification foam, signed by the owner and' by a master plumber, journeyman plomber, 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, h in, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating your s 'c system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days o e thr y az e ate NA OF APPLICANT DATE OWNER CERT IFICATION e) certi at all stateme this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro @ec ed ov , A a arranty deed recorded in Register of Deeds Office. G / S NATURE APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** I ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed # 6/30/2005 16:36 St. Croix County Sharon Fuller-)�Derrick co -Amy 2/2 U 2488 P 128 - 7s:Lm�3- STATE BAR OF WISCONSIN FORM 1 - 1998 KATHLEEN H. WALSH REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO. • WI Document Number RECEIVED FOR RECORD This Deed, made between C. M. Bye, individually, and Dennis R. _ 01/09/20" 89 s 45AN and Sandra C. Schultz Revocable Trust, Dennis R Schultz and Sandra C. Schultz, trustees WARRANTY DEED EXQDT 0 17 Grantor, and Brushy Mound Partners, L.L.P., a Wisconsin limited REC FEE s 11.60 partnership TRANS FEE: COPY 1- CC FEE: PAGES t 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (The "Property"): Rcoordinst Arm Name and Return Address C. M. Bye Lots 77, 78, 79, 80 and 81, Glover Station 5th Addition, Town of Troy, St. 258 Riverside Drive Croix County, Wisconsin P.O. Box 167 River Falls, WI 54022 040 -1266- 00-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) This deed is given in satisfaction of that certain Land Contract between the parties dated July -, 2200 and recorded in the office of the St. Croix County Register of Deeds on July 25, 2000 in Volume 1529 of Records, page 216 as Document Number 627002 and later assigned as recorded in the office of the St. Croix County Register of Deeds on June 5, 2002 in Volume 1929 of Records, pages 107 and 108 as Document Number 684421. Additional PIN numbers: 040- 1265 -60- 000, 040- 1265 -80 -000, 040 - 1265 -70 -000, 040 - 1265 -90 -000. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements and restrictions of record and will warrant and defend the same. Dated this day of - rA- - /Av y • c am — Aj 4 Z✓ * Dennis nnni 1R. Schultz C. M. Bye � S ma C. Schultz r AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signaturc(s) )35. Sir (1ra IX County. ) Personally came before me this day of authenticated this day of OtM 0►•- -� a'bo c named Dennis R. Schultz, nndra C. Schultz and C. M. Bye TITLE: MEMBER STATE BAR OF WISCONSIN '• �� r , ` rr , (If �� to me known to be the persons y ' e T • vg instrum and acknowledge thb L IZL-.. " authorized by 0 706.06, Wis. Stats.) t � ^`A +� t , all THIS INSTRUMENT WAS DRAFTED BY J.�r C. M. Bye Attorney at Law Notary Public, State of Wisconslp y ` . , i4 (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent (Ii!nQf�stg eScp tG iuti4aate: necessary.) • �� ) 'Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY nasn STATE awe on WISCO t 70 / 66 7 ) - -- i N a i t 72 ' 15,513 S.F, • ?� S sA � uj D 7 50 A 73 I r+ y .762 ACRES O 1 6O S F. , 120.325 S.F. M/ ~ 1 cr - ih I y n 7 80 ^ 3. SF J I 2.50 1 ACRES I Z 108.943 S.F. LOT 1 t T 1/4' - - - - - - - - y 2574 ACRES C.S.M. 112,126 S.F. � ' �" ! ,/ DOC ; # 328790 t ���y o FOR f `& N 7 ' 4, t LOT 76 78 ,. Z603 ACRES W 3.735 A r , 113,373 S.F. , r 162,712 S.F. $ 8.668 ACRES 1 + �• 8 1 11 i 299,175 S. ' V) I 8 a• , a 4.104 s78o S.F. � ,I A , / _ + uj .... ......... r..... ..... . .... �..... ...... h • ¢I H SVIS' 09" w 1317. LANDS z JNPLATTED i t t t DETAIL OF DRIVEWAY EASEMENT DETAIL OF DRIVEWAY EASEMENT FOR LOTS 73 AND 74 FOR LOTS 76 AND 77 SCALE: 1" 50' 75 SCALE: 1" •• 50' 58.82 GANDY DANCER a CIRCLE i i 4 R 'p is - a+ � l Trial And Road Map For Glover Station r 7 --►i6 _........� . .........�. .... r 9 8 7 6 5 4 10 3 1 o OMAHA ROAD 2 0 11 °C 19 20 21 22 23 q 1 12 24 25� � 13 0 18 � 17 30 31 26 MwLwr �b 16 14 15 27 28 29 32 40 35 41 39 39 38 37 36 33 4 34 2 44 47 s°u►►E7tN pAp 11O Y 48 45 0 46 59 52 53 b 54 55 50 68 49 60 67 b 56 f 57 69 58 70 62 61 5� 91 66 71 6 3 90 64 72 65 74 73 86 93 79 80 SCALE IN FEET { 0 mo 75 5 w 94 95 ; 0 200 400 w 84 76 77 78 81 L E •°� 83 96 97 98 , , O - LDTGR�IEZEO MA INTAINE D A BY iNE�FgME OOWERS ................ zo• • ASSOCIATION (2W WIDE WITH 50' MIUS CURVES 82 CHATTANOOGA DRIVE OT MDT b QGDEN f_AiG Co. 2cr NON- MOTORIZED RECREATION Civii engineers & Surveyors 101 TRAIL. TO BE MAINTAINED 113 W. WdmA S Fak MA 340 25 - 7631 100 99 IATION WIDE. 103 102 THE EI LOT L CLIENTS 's C.M. BYE AND DIANE L. BYE DENNIS R. SMTZ AND SANDRA C. SCHULTZ 30 O P.0• BOX 167 711 25 1/2 AVM RIVER FALLS, WISCOHSNN 54022 ONKRLAND. WISCONSIN 54529 y 1 . 4* dr ... y E ,r, • D DGI? `"• av Z_ °� 1", CLEAR L I� 766 5PM <7 "• -. • ''��` _ '_____._ U. • ^ >fiDS n,,m �� MI CERTIFIED SURVEY MAP s Located in part of the Northeast Quarter of the Southwest Quarter and part of CERTIFIfiD SURVEY MAP the Southeast Quarter of the Southwest Ouarter, all in Section 16, Township 26 REC IFI 13.00 North, Range 19 West. Town of Troy, St. Croix County, Wisconsin; being Lots COPY FEE: 3.00 77 -80 of the Plat of Glover Station Fifth Addition as recorded in the St. Croix PAGES 2 County Register of Deeds Office. Prepared for and at the request of: BEARINGS ARE REFERENCED TO THE NORTH -SOUTH Brush Mound Partners. LLP QUARTER LINE OF SECTION 16. TOWNSHIP 28 N., RANGE 1505 Hwy 65 19 W. WHICH IS ASSUMED TO BEAR N01 49'24'E. New Richmond. WI 54017 Drafted by. Hai wd H. Her ild III CURVE TABLE CURVE RADIUSI DELTA I ARC CHORD CHORD BEARING TANGENT BEARING C1 80.00 6' I a 7.13* 82.89 1 I'll 37E 'E C2 883.00 13'54'31' 1 214.35' 1 213.82' 1 N39 15.5" N46'24'31'E N3 730' C3 1 600.00 7' S7 200 ° 200 \ GLOVER STA 7701V No TH GRAPHIC SCALE FOURTH ADD %T /ON SCALE IN FEET: 1 inch - 200 feet \\ 66 NORTH 71 CUWER pPP VED 72 \ - -- SfC 16 -28 -f9 ST. CZen" �C U NT NT:L 64 ¢� \ Pluxdng Zen" alp PaAu Commw `` NOR7N- SOUni� JUN 0 2004 LINE 74 I 1 f not npccwd with a au be 73 O \(��(� ry •. 1 1 1 0 null a{iQd P.O� \ a� - I $ 86 G I:1 200.732 SQ. FT. ° D LOrn n 4.61 ACRES — �_ /e, O 158,040 SQ. FT. g mss' : Zi ,/ 3.63 ACRES o ;., : 80 3 �� AS SHONlV fi � ; • . .. /' .W `moo+ \/ `p � aF r GL '33Z5. '`°�`rS° �� - SrAnON r` Aawncw �n ` .� yo 5 7g•20 41 �- ^aD :. ' 3p0.00 co 76 40T77 o � S V 0 41.873 S LOT78 203.685 SQ_ FT_ :'so• 3 81 �► �, RES _ 4.67 ACRES crI 183 N � R N• � � � I .� _ 300.00..... r :........ • •450.00' to N8 9' 1 8'0 ° W I N8918 Ow 750.00' 357.34' ! f UMPLA TIED_ LANDS o 82 N07E. 7H /S IS A REWN17GURA AUN OF LOT UN£ LOCH MW HEMEN 4 LOTS 77 -8Q ALL C0149VANM REWR/C77ONS. EASEMENM E SNOMN ON 7HE PLA T or 'QCOVER STA 77GN /-7F7H AOID/77ON' APPLY 717 L078 HEREON. C 2 JOB / VA057SU155 1 EGERIb 2 v = N� Prepared by. Section Comer Monument v # IK" of Record 2 �. SIG • Set 1' x 18' Iron Pipe weighing � Phone No. (715) 246 -4319 1.13 pounds per linear foot Z I Fax No. (715) 246 -3830 0 Found 1' Iron Pipe P.O. Box 325 ® Found 1 -1/4' Iron Pipe New Richmond, WI 54017 Sheet 1 of 2 O Found 2' Iron Pipe - - - - Building Setback Una (As Dimensioned) Vo1.18 Page 4766