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WisconsiriDepa+tment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 463442 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. S Permit Holder's Name: City Village X Township Parcel Tax No: Krug, Tom Troy, Town of 040 - 1293 -80 -000 CST BM Elev: Insp. BM Elev: 7 Descri ion: Section/Town /Range /Map No: 1 0 1) .o AOjJ . D 17.28.19.1683 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 7 7• LO o� d Septic 5� Be hmark S 0 / o r I Dosing r� ) 7 J v Alt. BM ` ?/ /OU• Aeration n Bldg. Sewer ' 2 7 Holding Ht Inlet s 234 9, / TANK SETBACK INFORMATION St/Ht Outlet / TANK TO P/L W� BLDG. Vent to 'r Intake ROAD Dt Inlet > Septic Dosing ' ✓ Header an. 2 6- J off' Aeration Dist. Pipe Holding Bot. Sys tem Final Grade PUMP /SIPHON INFORMATION / Manufacturer Demand St Cover t r isP�c� 6-k - A Model Number / S 3-3 S - �,/ kJt� 7 V , TDH Lift I Friction Loss System - ead JTDH Ft / � Z3. Forc main Leng / D - Z a. Dist. to VVI ' / �i S ILA SORPTION SYSTEM BEDITRENCH iWidth Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P1L BLDG WE�.L LAKEISTREAM Al� Manufacturer. INFORMATION CH OR Typ f System: i / �� / N Model Number. l� 1 DISTRIBUTION SYSTEM Header / Manifold Distribution x Size x Hole Spacing Vent t Length_ Dia H Length 5"� Dia -S Spacing �" J ' (o N 3 -5 s� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over _ Depth Over xx Depth of xx Seeded /Sodded xx Mul ed Bed /Trench Center J Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include de discrepencies, persons present, etc.) Inspection #1: /� Inspe�cYon #k 6 Location: Road Hudson, WI 54016 SE 1/4 NE 1/4 17 T28N R19W Pine on s 8 = 1 9arcel`��I } o: 17.28.19.1683 ocatlo 496 East Cove R s ( ) Y `P 4 �- �v4 -9 b /zZ /os� 1.) Alt BM Description = 71 .- D 2.) Bldg sewer length = r � ,. _ 1— / �y� - yy� - ��LQ tk / - amount of cover Plan revision Required? Yes o - 7 G�' Use other side for additional Information. _ - - - -- Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) I Safety and Buildings Division County 1 *hs AN 201 W. Washington Ave., P.O.2 on�,n Madison, WI 53707 - 7162\ ' Sanitary Permit Number (to be filled irLby Co.) Department of Com mer ce �_ mer ce -� 8 wky Sanitary Permit Application O State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04 m roi.ect Address (if diff ent than mailing address) I. Application Information — Please Print All Information , N07 �Le Eris '" - Property Owner's Name E007 # t # Block # Property Owner's Mailing Address /� 03AI ty ., Iy E V- , Section City, State Zip Code Phone Number v 4 - ) ,,C, ) - -` ,,Cj ' p 1 � T N, R�E W 11. Type of Building (check all that apply) ` r 2 Famil y Dwelling N Sw►�^� -� Subdivision Name CSM Number 1 ng — umber of Bedrooms ❑ Public /Commercial — Describe Use 1 �, ❑ state Owned — Describe Use ❑City_❑ illage *ownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal Permit Revision ❑Change of ❑Permit Transfer to New List Previous Permit Number and Date Issue Before Expiration Plumber Owner a S 3 IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground Mound > 24 in. of suitab ound < 24 in. of suitable soil ❑ -Grade El Single Pass Sand Filter 11 - Constructed Wetland C1 Pressurized In- Ground El Holding Tan ent Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip ine ❑ Gr vel -less Pipe p ❑Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application te(gW Disp s a eq ired f) Dispersal Area Propo d (sf) System Elevation aCMI 0 ' 5 ic e� T oo. -� VI. Tank Info Capacity in Total Number M ufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit A Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsikil4y for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum igna MP/MPRS Number Business o ne Number B st ss Ph Plumber's Address (Str , City, State, Zip Code) la . VIII. oun /De artment N Onl IU/ Alp,,,.d ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issue Issuing Ag t Si=reS mps ) Surcharge Fee) �f / o �V l 22 ❑ Owner Given Reason for Denial �l (p Q IX. Conditions of Approval/Reasons for Disapproval 0 n At tach � com "Wplans to the ly) for th stgm o� per SBD -6398 (R. 01/03) less tha 81 11 inches in Y W 44 / ✓, l G � ' �� a4 � J jl 0 40 - 0-91 9c>- (Doft! - 518 Z-711 I 3 e CIP CR�tk L2ZiI4 �-�-59,2.1t' JQ On ' Safety and Buildings I1 mercemi. ov PO BOX 7162 CO g MADISON WI 53707 -7162 TDD #: (608) 264 -8777 i s c a n s i n www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary June 03, 2005 OUST ID No.225094 ATTN.° POWTS Inspector MICHAEL P ROGERS ZONING OFFICE ROGERS PLUMBING ST CROIX COUNTY SPIA E4457 HWY 12 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/03/2007 Identification Numbers Transaction ID No. 1140506 SITE: Site ID No. 697361 Don & Joyce Rodahl - Dwelling Please refer to both identification numbers, 496 East Cove Rd above, in all correspondence with the agency. Town of Troy, 54022 St Croix County SEl/4, NEIA, S17, T28N, R19W Lot: 8, Subdivision: Piney Woods FOR: Description: New Mound System / 600 gpd Object Type: POWTS Component Manual Regulated Object ID No.: 1019524 Revision; Maintenance required; 600 GPD Flow rate; 34 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 /01); 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: P. �► This system is to be constructed and located in accordance with the approved plans and with the U)1 ! 7! component manuals listed above. 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 0lV1SLE construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should ` CORP"_-, 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. MICHAEL P ROGERS Page 2 6/3/2005 /EPagel Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Private Sewage Plan Revie er, , Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pepagel@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Don & Joyce Rodahl - Mound Revision to Transaction # x // 3%0 95 Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD- 10706 -P (01/01) Location: Lot 8, Piney Woods SE t /4, NE %4, Sec. 17, T 28 N, R 19W ,\ Town: Troy County: St. Croix Date. May 20, 2005 ` �� �►�' Owner: Don & Joyce Rodahl Address: 597 Chinnock Lane River Falls, WI 54022 Plumber: Mike Roge s Signature: x License: MP 225094 Attachments: SBD -10577 - Plan Approval Application SBD -8330 Page 1: cover 2: design criteria & calculations 3: plot plan , 4: system cross section y 5: plan view, lateral detail ' .„` 6: pump tank exit detail c s ��fL T pump curve -Yk °`� , U1 �N s 8: system management page 1 of 8 UPONDENC , i Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 gallons /day hydraulic load i D 'gn lations In situ designed loading rate gallons /sq. ft. per day Depth to estimated high ground water 7 " 3 in. Depth to bedrock in. Cross slope at system °' ° % Force main length /57 ' ° ft. of 2 in. q Manifold/header length ft. of �`� Z in. n L Drain -back S �� gallons Lateral length 3 @ 5 o ft. of Z- in. Lateral elevation k W • o ft. @ bottom of lateral Lateral hole size �A6 in. @ 4 z ° in. ( S� ft.) Spacing � holes /lateral S holes total Lateral volume l S 45 b gallons Total lateral discharge rate 3 gallons /minute @ 2 ' �� ft. head Network pressure 1 compensation losses Elevatwa- difference 0 ? Friction-loss 3 y ° `� ft. @ 3 s' gallons /minute Total dynamic head `� ' ° 2.. ft. Pump /sip*on gpm @ ° ft. of head Manufacturer Model # k S 2 - Dose volume \ 01.1 gallons Li ft/ sip'hbn tank eA _:� Jb gallons Septic tank t t� k J"3 gallons Effluent filter 0 r Q- 1 - 0 C3« 0 ,LS � F1 -ka- Measurement pump on and off S' in. Height alarm from tank bottom in. Reserve capacity Qr ° l gallons specs.calcs.res Page Z ' of f � 1 3 z S c a,� � � � 3 t7 � � 1,,,, S � � �sc�• r(,.� CD L5 �o L 1 o cu.� CRS t2t� -99,2-V f , SA 4L 3 r oe t� .. %.hre VAa& i a R` O o, 1 C7 •g p ', 4� � V L c . � O� � air v ► �M•i �'�. rr... a i l � '!�' � a � o �.. � t • � M� `o t; �I.v...1 %bow __, }�o�► a. •�• lrocy� U clo O r o lo i q C36 I I I I V•� l 1 u Q.L +� �"./ `!•,`V f- VJ•WaL OrK:Vr1.�OM�'F V C S C.. �"1 dro O r t M A •. ""� j " A/ o � o � � o � 1 .� ate. � � o,..� �. ra o o \ : _ � � � �" o, �►� � �. 5 s o� VEWT CAP 4 C.I. vENT PIPE WEATHER PROOF APPROVED LOCKINIG JUAICTIOtJ BOX MA WHOLE COVER > 2 = R OM DOOR, ,� �� waRH G wwCOW OR FRESH �Z L AQre L AIR IIJTAKE I GRADE � 4 � COQDUIT -- \ 2 PROVIDE I - -- — — \ c ( AIRTIGHT SEAL I APPROVED }Vo I I I W/ PIPE y I II ALARM EXTEIJDIUG 3' 01JT0 SOLID SOIL I I OM 1h• o" PUMP � OFF _ BLOCK �o, Zg o I. r TOTAL DYNAMIC HEA6 /CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING MODE 1 3 w MODEL 152 153 50 Feet Meters Col. Liters Gal. Liters 153 5 1.5 69 261 77 , 291 12 40 152 10 3.1 61 231 1 70 265 0 15 4.6 53 201 61 231 w U 30 20 6.1 44 167 52 197 z 8— 25 7.6 34 129 42 1 59 0 30 9.1 23 87 33 '2- 20 35 10.7 -- 22 - - - �� - 0 40 12.2 -- -- c2 4 1 Lock Volv 138.0 Ft. (I 6rrm)1 ee 0 r; (' ?,ern;' -- — — 714503 0 20 40 60 80 100 GALLONS LITERS 0 80 160 240 320 ° 3 27132 4 5/8-x- FLOW PER MINUTE -- CONSULT FACTORY FOR SPECIAL APPLICATIONS T • Timed dosing panels available. ® e • Electncal alternators, for duplex systems, are available and supplied with 3 an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. �— • Sealed Qwik -Box available for'outdoor installations. See FM1420. • Over 130•F. (54•C.) special quotation required. 7 7 1521153 Series 152/153 MODELS Control Selection Model - Volts Mode AMPS Sim lex I Duplex N152 115 t Non 8.5 1 2 or 3 14 r �— BN 152 115 1 Auto 8.5 Induced 2 or 3 ` 6 5 2 5 230 1 Non 4.3 1 2 or 3 sK2064 _ BE152! 230 1 Auto 4.3 Included I 2or3 N153 115 1 Non 10.5 1 2 or 3 BN153 1 t Auto 10.5 Included 2or3 SELECTION GUIDE E153 230 1 Non 5.3 1 2 or 3 BE 153 230 1 Auto 5.3 Included 2o( 3 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. O CAUTION 2. See FM0712 for correct model of Electrical Altemator E•Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10 -0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system, RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. U411 TO: P.O. BOX 16347 Louisville, KY 40256-0347 � Manufacturers ol. . SHIP TO: 3649 Cane Run Road e )778-273, KY (800) 9 Q=IrY PUMPS SVCF /939 http://www.zooller.com PUMP !O. (502) 778.2731 1(800) 928 PUMP FAX (502) 774.3624 0 Copyright 2000 Zoeller Co. All rights reserved. System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715 -235- 1132, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. If possible, the upslope toe of the mound system should be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run -off; final settled slope should be 2 -3% over the system or 2 -3% diverting surface run -off around the ends of the system. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner ( j e t Septic Tank Capacity gal ff NA Permit # 0 Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS` Effluent Filter Manufacturer ❑ NA Number of Bedrooms 104gpd/bedroom ❑ NA Effluent Filter Model —( q p ❑ NA Number of Commercial Units NA Pump Tank Capacity gal ❑ NA Estimated flow (average)* gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), estimated x 1.5* p© gal/day Pump Manufacturer ❑ NA Soil Application Rate gaUday Pump Model [3 NA Influent/Effluent Quality (NAM) Monthly Average ** Pretreatment Unit 13 NA ❑ Sand/Gravel Filter ❑Peat Filter Fats. Oil & Grease (FOG) 5 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) c3 Disinfection In Other: Total Suspended Solids (TSS) 5 220 mg/L 5 250 mg/L Manufacturer: Model: Pretreated Effluent Quality ❑ Monthly Average * ** Dispersal Cell(s) 13 In-ground ( gravity) ❑ jn- ground (pressurized) Biochemical Oxygen Demand (BODs) 5 30 mg/L ❑ At -grade ound Total Suspended Solids (TSS) Fecal Coliform (geometric mean) 5 30 mg/L [3 Drip r Other: _ <10 + cfu/100m1 ❑ Leaching Chamber Manufacturer Maximum Effluent Particle Size 1/8 inch diameter Model Approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate __gp d/f1 Area Req. (Other than bedroom based) Absorption Area Credit per unit ft Minimum Number of Chambers ❑ Aggregate Design Flow/Loading Rate= fe min * * Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications * ** Values typical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ ` Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990) `� ,"Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ . "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis — ASAE Publications 5 -77 and "Design Manual — Onsite Wastewater Treatment and Disposal Systems". EPA 625/1 -80 -012 October 1980 ❑ SBD 10570 —P (8.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD — 10567 P (8.6/99) "In Ground Absorption Component Manual" SBD - 10705 -P (N.01 101) "In Ground Soil Absorption Component Manual" Version 2.0 SBD - 10628 —P (N.6199) "Recirculating Sand Filter System Component Manual" SBD - 10656• -P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" SBA - 10572 P (R.6/99) "Mound Component Manual" BD - 10691 —P (N.01 101) "Mound Component Manual" Version 2.0 SBD 10595 —P (R6199) Single Pass Satid Filter Component Manual" ❑ SBD - 10657 -P (8.6/99) `Drip -line Effluent Disposal Component Manual" SBD - 10573 P (R 6/99) "Pressure Distribution Component Manual" BD - 10706 -P (N.01 101) "Pressure Distribution Component Manual" Version 2.0 En Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every 3 Cl months ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (1/3) of tank volume Inspect dispersal cell(s) At least once every ❑ months ear(s) (Maximum 3 yrs.) Clean effluent filter At least once every ❑ months years) inspect pump, pump controls & alarm At least once every ❑ months ear(s) ❑ NA Flush laterals and pressure test At least once every 5 ❑ months year(s) ❑ NA Valves At least once every 3 .❑ months years) in NA Other: At least once every ❑ months year(s) V NA Page of STARTUP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System startup shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever P ossible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit solids such as those p roduced b a garbage peels and seeds, bones, and food h p Y g g disposal should be minimized. Toilet tissue is the only such as baby wipes, tampons, sanitary napkins items su into the stem. Other non-biodegradable y P P �?' P a er that should be discharged system. PP g condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. 'Valves Valves shall be operated in the following manner: Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INFECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Septic Tanks Component a visual inspection of the tank to identify Tank inspections must include pe tify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Pump Chamber/Treatment Tanks Component equipment such as pumps, The inspection must include a test of all electrical equip p P , alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. M In- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any Pa evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory g � authority. Pending at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. page of Mound, At- Grade, In- Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All 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 properly 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 other 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: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a. new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a now soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available 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 biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. « WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER 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 INSTALLER POWTS MAINTAINER Name Name Phone Phone SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY ame Agency Phone Phone K- AWPDATAW "OWTS OWNER'S MANUAL.doc Page ' of I , Private On -Site Wastewater Treatment System ( POWTS) Index & Title Sheet Owner: b M-C G - K C Lt Project Name and System Type: i '61.1. Location: �-c)LQ '(,t ± [� U� P o.j Street Address �5E_ VA- J E VA , 3- 11 Ta 8 ill Le al Desch tion Y a i Towns /County Contents: Page 1: Sanitary Permit Application Page 2: Plot Plan Page 3: Soil Test Page 4: State Approved Plans Page 5: Septic Tank Maintenance Agreement Page 6: Warranty Deed Page 7: POWTS Owner's Manual Management Plan Page 8: POWTS Owner's Manual Management Plan Page 9: POWTS Owner's Manual Management Plan Page 10: Certified Survey Map Page 11: Copy of House Plans Attachments: Plumber/Designer: Mike Rogers Signed: Credential Number: 225094 Date: l i,t ,Y1�. g . 2�,DO� t ORIGINAL Visoons SOIL EVALUATION REPORT #2240 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Certified Soil Testing, LLC Attach complete site plan on paper not ^than 8% x 11 ncheslid�y /eta County St. Croix include, but not limited to: vertical an tal referen point( a iYi$G1dA percent slope, scale or dimensions, w, and to ion and distance to nearest road Parcel I.D. 040-1293- Please print a i a " n MAY 1 g 20 Reviewed By Date Personal information you provide may be used fors n p ses (Privacy Law, s. 15.04(i (m)). $ 1-2r j5 Property Owner ZONI tion Rodahl, Don & Joyce F E SE1 /4, NE1/ , S17, T28N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 597 Chinnock Lne I Piney Woods City — State Zip Code Phone Number City [:]Village ® Town Nearest Road River Falls I WI 1 54022 715 -425 -6742 1 Troy 1 1 496 East Cove Road i New Construction Use: ® Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial - Describe Parent material loess over till Flood plain elevation, if applicable NA ft. General comments and recommendations: install 10' x 60' rock cell mound on 100.0 contour as upslope edge of rock w/ 05 sand fill Boring # ❑ Boring ® Pit Ground surface elev. 97.2 ft. Depth to limiting factor 38 in. Soil Application Rate Horizon Depth Dor' * A CAft;�r. ! Redox Description Texture Structure Consisten Boundary Roots GPD/ft in. futunselt Ctu. Sz. Cont, Color Gr. Si. Sh. • Eff#1 *Etf##2 1 0 -7 10YR 3/2 - sil 2 m gr mvfr cs 1M .6 .8 2 7 -14 10YR 3/1 - sil 2 f sbk mvfr gs lm .6 .8 3 14 -31 10YR 3/1 - sil 2 m sbk mvfr gs lm .6 .8 4 31 -38 7.5YR 4/3 - sil 1 m abk mvfr gs 1M .4 .6 5 38 -45 7.5YR 4/3 f2d 10YR s l 6/3 sil 1 m abk dh m .4 .6 / 9 6 45 -51 7.5YR 4i4 f2f 7.5YR 4/6 10YR 6/2 sil 0 m dvh - lm 0 .2 horizon 1 is erosional deposition w/ some 10YR 7/3 fs inclusions; common gy si coats on peds 31 -45" 2 Boring # Boring ® Pit Ground surface elev. 101.6 ft. Depth to limiting factor 34 in. Soil Application Rate Horizon Depth Dorniinant Color Redo) Description Texture Structure Consisten Boundary Roots GPD/ft - in. 1}if03611" f S . Cont. C,oior Or. S2- -Efr#1 *Efr#2 1 0 -6 10YR 3/1 - sil 2 m gr ds gs 2m1c .6 .8 2 6 -12 10YR 3/2 - sil 2 f sbk mvfr gs lm .6 .8 3 12 -20 7.5YR 4/4 - sil 2 m sbk mvfr gs 1m .6 .8 4 20 -28 10YR 4/4 - sl 1 m sbk mvfr gs 1m .4 .7 5 28 -34 7.5YR 4/4 - sl 1 c sbk dsh gs 1m .4 .7 6 34 -53 7.5YR 4/4 f2f 7.5YR 5/3 sl 0 m dvh - - .2 .6 7 53 -63 10YR 7/3 SSBR * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent = BOD < 30 mg /L and TSS < 30 mgL CST Name (Please Print) Signature: CST Number Henry F. Grote 222774 Address Certified Soil Testing, LLC Date Evaluation Conducted Telephone Number E. 4366 353rd Ave. Menomonie, WI 54751 5/6/2005 715 - 233 -0398 SBD -8330 (K07 100) Property Owner Rodahl, Don & Joyce Parcel ID # 040- 1293 -80 -000 Page 2 'of — 3 F 2 ajBoring # El Boring ® Pit Ground surface elev. 101.6 ft. Depth to limiting factor 34 in. Soil Application Rat Horizon Depth Dominant Color RedtfX 01111l; pti n Texture ' Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Si. Cont. Cola Gr. Sz. Sh. 'Eff#f 'Eff#2 SSBR by general resistance to penetration w/ some loose pockets of fs Boring Boring # ' ' Pit Ground surface elev. 101.6 ft. Depth to limiting factor 35 in. Soil Application Rat Horizon Depth Dominant Color Redox Description ` 'Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Colas Gr. Sz. Sh. I 'Eff#1 I 'Eff#2 1 0 -10 10YR 3/1 - sil 2 m gr ds gs 1m 6 8 2 10 -21 7.5YR 4/4 - sl 2 m gr ds gs im .6 1.0 3 21 -30 10YR 4/4 - Ifs 1 f sbk ds gs lm 5 1.0 4 30 -35 10YR 5/4 - fs 0 sg dl cw lm .5 1.0 5 35 -65 IOYR 713 - fs 0 m dh - 1m 0 0 horizon 5 has general resistance to penetration, effective SSBR w/ some loose pockets fs & bands 10YR 4/4 Ifs (O,m,mfr) @ 41 -43 & 53 -58" F-1 Boring # I I Boring — Pit Ground surface elev. ft. Depth to limiting factor in Soil Application Rat Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft 2 in. Munsell Qu. Sz. Cont. Cola Gr. Sz. Sh. 'Eff#f 'Eff#2 I ' 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 (R.07 /00) Certified Soil Testing, LLC T ,r J6 t, 4o �4o- o -c>am' �.l - N� -��_ -1qw o t3�3,z3 1 N 3 z ��-1►. tzi +� VA / ��,Q� b w o � ( i k a � 2v o� Q�� .sm S fety and Buildings Divisi -" County 'fu AM yr 201 W { 2 �O�r�J� 4 WI 4 Sanitary Permit Number (to be filled in by Co.) lJ 8) 266-3151 Department of Commerce Sanitary Per Ap iorMAY State Plan 1.157 Number In accord with Comm 83.21, Wis. Adm. Code, persotion you �,�t y6NZ' 1! 3 /� �5 may be used for secondary purposes Privac04(14i6OtW�G OF JGE roject Addre s (if different than mailing address) I. Application Information — Please Print All Information / 7 / Je. Q<,dL Property Owner's Name �, I Parcelz Lot # Block # Property Owner's Mailing Address rRperty Location 7 1 C d- t / City, State Zip Code 60,x% Pho e Number — /a, �1 /e, Section l r� ctrcle one II. Type of Building (check all or 2 Family Dwelling - Numb that apply) T �N; R�E o� Number of Bedrooms L 6� a3 per Subdivision Name CSM Number 11 PubliciCommercial - Describe ❑ State Owned - Describe Use k 7 IT ❑City_ Village �ewnship of III. Type of Permit: (Check only one bo line A. Complete line B A. ew System y Replacement Syste ❑ Treatment/Holdin ❑ ter Idification B. ❑ Permit Renewal ❑ Permit Revision ange of ❑ Permit ansfer to New Lis re ' us 1 r d Date Issued Before Expiration Plum Owner IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil Vound n. of suitable soil ❑ At -G rade 11 Single Pass Sand Filter Constructed Wetland ❑ Pressurized In- Ground El Holding Tank El Aerobic Treatment Unit ❑ Recirculating Sand Filter El Recirculatin S thetic Media Filter ❑ Leachin Chamber C _ J 00 S 1n g ❑ Drel -less Pipe ❑ Other (explain) o V. Dis ersaUTreatment Area Information: q Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area equ d (sf) Dispersal Area Propos (sf) System Elevation ec� � � t� Fe ® v /pp .� VI. Tank Info Capacity to Total Number Manuract r Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank /ae C C CA e -, Aerobic Treatment Unit Dosing Chamber 4 I e cf VII. Responsibility Statement- I , the undersig assume r sponsibility for installation of the POWTS sh on the attached plans. Plumber's Name (Print) Plumber's Si ature MP/MPRS Number Business Phone Number � Plumber's Address iStreet, City, State, f tp Code) VII Coun [De artment UWOnl K pproved ❑ Disappr Sanitary Permit Fee (i eludes Groundwater Dat Issued Issuin mt Sign a re Sta s) Surcharge Fee) Z_ OD d El Owne en Reason Denial IX. Conditions of Approval/Reasons for Dis royal 10411 apoo jed se MICROS 111x' 7 3Y= A QlAfNER; _lagwn,M pM l`saririces'(Iti�intained O fM11c, NIIIINIt I[iflK ifld PK ided by plumber. ad 1111111111d M 2. AM k requirements must be main :! MflIR11MI1�OM pot Root _. i.,i ^In 2 X41{ - -T loud he n1u11�i1nd ee roe annlirahle OMinanels Attach complete plans (to the n County only) for the system on paper not less t han 81/22 x 11 inches in size Cow� d-i o n.s i v`, 5�a.� a�l foJ�JC� IP.gU' a,�L ,�✓�� G� � c.c_�' SBD -6398 (R. 01/03) g"', pa � • a J T f r ._ 91jNW(' 1A3TtYt 'ire teA1R�t�lA�► "Mn�O� °t;:W $ni x 1nsUIR9 ?I►1s! aifq�i% . t wK its: "ns >P9 Isa1UC�b t�9:1'.�.t:lyl.,ife�i � .r r' �nyln�+k.?.r.!lt 'Noll as ,.. L)sn*hiam ee t"I" a,nwtw%4m rSS�+e an PLOT PLAN Scale 1' =Sp' 13$.23' ` °o • B - 1 AdW E X4 , rr4 5AY 3'3 7 4.es4 e+k:10- 4zv a�4 S \� ol L,rL too fp N N4ytge, a j 7rrcC . lob:q 01%j `l`'.'tvtzc v 01 N 0 Cc m for Lot` 8 LUT 9 Vip ewe Tzon> A � COPY IQ i \ \ \\ \ \ °' o°iI / oo - - x F o rn \ Z x o rn \ \ \ \ a° / V \ x r x ao CE Q c-, � (Ni 00 " -� 1 Q \ > S 00'Q 342.10 FT rn vi Q a a x `� / 1� � © I 0 04 00 CN 4 u7 » \ 01 W I x x © / �N- �3" W 78. 1 1 FT\ V�b —N8Z%1 LL cr \ z ZDz , \ _rn I , I 1 O � m of t- 0 — C ) 0 " E � 78 24 FT. � v I i \ LZ I I Ln \ - I I x in oc \ 1 I l Ln CY) x l \ L \ CN 37 .74 rT. ' b�l x N, N, F(un) V \ ,• — " �I � m 4 ` Safety and Buildings ov PO BOX 7162 commerceml. g MADISON WI 53707 -7162 TDD #: (608) 264 -8777 isconsin www.comm vAsco ov Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary April 26, 2005 CUST ID No.225094 ATTN.• POWTS Inspector MICHAEL P ROGERS ZONING OFFICE ROGERS PLUMBING ST CROIX COUNTY SPIA E4457 HWY 12 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/26/2007 Identification Numbers Transaction ID No. 1131095 SITE• Site ID No. 697361 Don & Joyce Rodahl - Dwelling Please refer to both identification numbers, East Cove Rd above, in all correspondence with the agency. Town of Troy, 54022 St Croix County SETA, NE1 /4, S17, T28N, R19W Lot: 8, Subdivision: Piney Woods FOR: Description: New Mound System / 600 gpd Object Type: POWTS Component Manual Regulated Object ID No.: 1014696 Maintenance required; 600 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01); 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: 1. This system is to be constructed and located in accordance with the approved plans and with the component manuals listed above. 2. On page 1, there are nine (9) pages in this set of plans, some of which are not numbered or referenced in f the Index. Con 3. On page 4, an effluent pump was not specified. Based on the performance curves shown on the last page, � !_ i l , a Model No. 153 pump manufactured by Zoeller Pump Co. will be used for this installation. DEP ; i7 A copy of the approved plans, specifications and this letter shall be on -site during construction and open to Divisl 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. I L CO<<f E 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. MICHAEL P ROGERS Page 2 4/26/2005 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. ?eter e , , Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Pagel Sewage n Reviewer, Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pepagel @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: mound Owner's Name: Don Rodahl Owner's Address: 597 Chinnock Lane River Falls, WI. 54022 Legal Description: SE1 /4, NE1A, s17, t28n, r1 9w Township: TROY County: St Croix Subdivision Name: Pineywood Lot Number: 8 Block Number: Parcel I.D. Number: Plan Transaction No.: C o-M — ge — T -- ) Index and title Data entry Pa e 3 Mound drawings CCRRECTICIN N1 ED L:D ge 4 Lateral and dose tank ��� G�RREap�NDkNCE age System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Designer: Mike Rogers License Number: 225094 Date: 04/18/05 Phone Number: 715 - 235 -1132 Signature: Pte' Designed Pursuant to the�� T v Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.0 (R. 04/03) Page 1 of 7 s a L, yX r ki C t /NCS 3pO F Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 600.00 Design Flow (gpd) 1.00 Site Slope ( %) 100.00 Contour Line Elevation (ft) 38.00 Depth to Limiting Factor (in) 0.20 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 78.001 Dispersal Cell Length Along Contour (ft) = 7.70 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft Linear loading rate may be too higt 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 2.57 Lateral Spacing (ft) If N above, enter the elevation (ft) 6 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 7.70 ft /orifice 2.00 Forcemain Diameter (in) 50.00 Forcemain Length (ft) Does the forcemain drain back? Y 89.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal) 11.00 Vertical Lift (ft) 73.12 5x Void Volume (gal) 2.60 Friction Loss (ft) 81.27 Minimum Dose Volume (gal) 16.85 Total Dynamic Head (ft) 51.12 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 1.25 x x 2.00 x x 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Trea Tank Information Total Tank Capacity (gal) 1250.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser Manufacturer gal /in (enter result in cell B49) Dose Tank Information Effl Filt Information 750.001 Dose Tank Capacity (gal) JZabel Filter Manufacturer 16.121 Dose Tank Volume (gal /in) IA100 Filter Model Number Wieser Manufacturer -- Project: mound Page 2 of 7 Mound Plan View F /10 B .:.:.: .:.:.:.:.:.:.:.:.:.:....'.'.'.' ...'..:.:.. J Observation Pipe ; 3 ; • ; • ........... . . . . . . . . . . . . . _d ' } W .--0... .•. . . . . . .' 2 .'.D.'.'.'. . ..'. ..'.'. L Mound Component Dimensions Down slope toe extension made. A 7.70 ft E AO.50 in H 1.00 ft K 6.93 ft B 78.00 ft F in z 30.76 ft L 91.86 ft D 6.00 in G ft J 5.16 ft W 43.62 ft 600.60 (ft Dispersal Cell Area 1 3000.00 (ft Basal Area Available 7.69 (gpd /ft) Linear Loading Rate 1 7.80 (ft) 1/10 B Obs. Pipe Placement Linear loading rate may be too high Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.27 (ft) —► H G F : ::::: Dispersal Cell 101.00 (ft) Lateral 100.50 (ft) Invert Dispersal Cell Elevation E D . • . . : . :�. :::::::: • . ,: •. .- 100.00 ft) Contour Elevation ( 1.0 % Site Slope Geotextile Fabric Cover Shading Key m o. Dispersal Cell See lateral details on 10 Topsoil Cap c Q- 1.5 ft ". •. " " "_ " "•. _ _ • "__ " ". Page 4 for number, size, Q jjjjj' Subsoil Cap Cn o 5 ° • :� „'' ";; �. °” and spacing of laterals. cd ��,r" ;.; °?: ° °: Laterals are equally © � ASTM C33 Sand :a � =R .d..._ : °.: °•: ": %•�° F ® � Tilled Layer �_ d t5ft ;'- Typical Lateral �;� „ „.” spaced from the distribution cell's ❑5 :• Aggregate v o: " „: ":'r: "=°: ••:`s ° ; ° :'• °.M + centerline in the A distribution cell (AxB). Project: mound Page 3 of 7 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical S y P s • = Turn -up wlball valve or I(- X-- sr24l Laterals & force main of PVC Sch 40 clean out pl u g per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals 6 Orifice Diameter 0.188 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.06 ft L es Lateral Length (P) 38.25 ft Orifices per Lateral 13 p Lateral Spacing (S) 2.57 ft Orifice Density 7.70 ft /orifice Lateral Flow Rate 8.52 gpm Manifold Length 1 5.13 ft System Flow Rate 51.12 gpm Manifold Diameter 2.00 in Total Dynamic Head 16.85 ft Forcemain Velocity 5.22 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and —� LL Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented ::: E— Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Capacityl 750.00 Gallons Volume 16.12 gal /inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 27.48 443.05 B 2.00 32.24 C Pump off elevation (ft) C 5.04 81.27 90.00 D 12.00 193.44 D Total 1 46.531 750.00 Do elevation (ft) 3" Bedding un er tank. 89.00 Alarm Manuafacturer Alarm Model Numberl CORRECTION NEEDED Q ZE� CORRESPONDENCE l Number � Pump Must Deliver 51.12 gpm at 16.85 ft TDH Project: mound Page 4 of 7 Mound System Maintenance and Operation Specifications Service Provider's Name Mike Rogers �� Phone 715- 235 -1132 POWTS Regulator's Name St Croix Zoning 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 600.6 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Moundl Ins ect for ponding and seepage once every 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure 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 . ' • ' • ' • ' • ' . ' . . ' . . Lateral - Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: mound Page 5 of 7 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281 .48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 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. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: mound Page 6 of 7 PLOT PLA21 Scale 1' =5Q' 13 a. Z3' L- a.°t-q Level Moue. m tN • 7s I i p YJ r0 2 ` rev ri+i `n A ve, w /�a m d �br Lot- 6 LllT- 9 , _ -_ eN RopYA LL PUMP PERFORMANCE CURVE TOTAL DYNAMIC HEAD /FLOW 50 MODEL 151/1521153 PER MINUTE 14 45 153 EFFLUENT AND DEWATERING 12 40 MODEL 151 152 153 w 35 182 Feet Meters Gal. Liters Gal. Liters Gal. Liters 10 = 30 5 1.5 50 189 69 261 77 291 a 10 3.0 45 170 61 231 70 265 0 8- 25- 151 15 4.6 38 144 53 201 61 231 20 6.1 29 110 44 167 52 197 e 20 25 7.6 16 61 34 129 42 159 30 9.1 23 87 33 125 15 35 10.7 22 85 4 40 12.2 -- -- -- - 11 42 10 Shut -off Head: 30 ft. (9.1m) 38 ft. (11.6m) 44 ft. (13.4m) L d 2 5 0145088 0 10 20 30 40 50 60 70 80 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE 014508A Model 151 Models 152/153 C ONSULT FACTORY FOR �_ 6 7 b 1/4 SPECIAL APPLICATIONS � 3 7/8 � 4 5/8 � 3 27/32 4 5/8 I I • Timed dosing panels available. ® 3 7/8 ®. 3 27 /32 • Electrical alternators, for duplex systems, are available and e supplied with an alarm. - a • Variable level, control switches are available for controlling OO 3 7/8 ° 3 2/32 single phase systems. e e • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik -Box available for outdoor installations. See FM1420. � I • Over 130 °F. (54 °C.) special quotation required. I � I 1511152/153 Series 11 11 /16 12 1/8 ( A 151/1521153 MODELS Control Selection 4 3/6 5 1 3 Model Volts -Ph Mode Amps Simplex Duplex N151 115 1 Non 6.0 1 2 or 3 ^� BN151 115 1 Auto 6,0 Included 2 or 3 E151 230 i Non 3.2 1 2 or 3 BE151 230 1 Auto 3.2 Included 2 or 3 151 SK2064 N152 115 1 Non 8.5 1 2 or 3 BN1521 115 1 Auto 8.5 Included 2 or 3 E152 230 1 Non 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Non 5.3 1 2or3 SELECTION GUIDE BE153 230 1 Auto 5.3 Included 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. A CAUTION 2. See FM0712 for correct model of Electrical Alternator E -Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10 - 0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. RESERVE i:'t)V RED E&G- I For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 ` Louisville, KY 40256.0347 Manufacturers of. . SH IP TO 3649 Cane Run Road / qp SECTION: 3.20.014'- ` _4L /7YAUMPB 51NOr / ,9i1,7 � r s - FM1919 1 gr 0403 y Supersedes Product information r R conditions here reflects at time of_/�,+ 1202 publication. Consult factory regarding discrepancies or MAIL TO: P.O. BOX 16347 • Louisville, KY 40256 -0347 visit our web site: inconsistencies. SHIP TO: 3649 Cane Run Road • Louisville, KY 40211 -1961 http://www .zoeller.com (502) 778 -2731 • 1 (800) 928 -PUMP • FAX (502) 774 -3624 ZOE1616ER ON -SITS WASTEWATER PRODUCTS MMODI "Ne SO Fla ON -51TE `DOSz-A rv PUMPS .00wiPARE THESE FEATURES Durable cast iron construction. 1511152/153 EFFLUENT SERIES v Model 151 comes standard with a glass - filled polypropylene base. (For Pump Prefix Identification see News & Views 0052) Corrosion resistant powder coated epoxy finish.; a _ Stainless steel lifting handle. l "' Assembled with stainless steel bolts. Non- clogging engineered thermoplastic vortex FOR SEPTIC TANK - LOW PRESSURE PIPE (LPP) impeller design. AND ENHANCED FLOW STEP SYSTEMS Model 151 1/3 HP passes 1 /2" solids. SSPMA EFFLUENT MEMBER Model 152 - .4 HP passes 3 /d' solids. SUBMERSIBLE sour ® - ANO SEWAGE Model 153 - 1/2 HP passes 3 /4" solids. PU WRS.ASSN. 1 NPT DISCHARGE 3 CRA�� Motor - 60 Hz, 3450 RPM, oil- filled, hermetically sealed, automatic reset thermal overload protected. Model N152/N153 Carbon /Ceramic seals. C US High Head Tested to UL Standard UL778 Effluent g Upper sleeve bearing and lower ball bearing running and Cerfified to CSA standard CSA22.2 No. 108 in bath of oil. IVIOt) AVAILABLE 20 ft. UL Listed power cord with molded 3 -wire plug. . N151/N152/N153 & E1511152053 nonautomatic Y 1 NPT vertical discharge • BN151/BN152/BN153 & BE151/BE1521BE153 packaged with Piggyback Variable Level Float Switch BN and BE standard models include a 20 ft. variable • 1/3_4 & 1/2 HP, 1 Ph 115V or 230V level float switch. • Operates at temperatures to 130G F (54° C) in — — effluent applications. • All models include a 1 x 2" PVC adapter fitting. Note: The sizing of effluent systems normally requires variable level float(s) controls and properly sized basins to achieve required pumping cycles or dosing timers with nonautomatic pumps. N POWDER COATED .. �y TOUGH' ` Zt7. Model 8N152/BN155 Manufacturers of... High Head Effluent �® Qaau7 J aZl"PS SINCE Iv3SI „ © Copyright 2003 Zoeller Co. All rights reserved. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code - County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. fit_ "1V� 1J G percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Pleas Re ewed b s pant all information. Y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). AA Property Owner Property Location N A'1J O C.E R-OD Pr N L GGW- of SEE 1/4 I\IE 1/4 S l I T Zb N R 9 E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# S 0 -W1t-- NvQ�c- City State Zap Code Phone Number ❑ City ❑ Village ® Town Nearest Road R1 L2. Fft'US I by I Sq U Z-Z 1 (7 lS ) L4 ZS- LN Z '1�� ��Pt`3T COu t_ �ZD New Construction Use: Residential / Number of bedrooms L— Code derived design flow rate b GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material L O S 0 SiZ 'n L.L Flood Plain elevation if applicable A. ft . General comments CO c and recommendations: -G \?�j'\:l_ S�-i S`i'�"1 In Z L° iaLLS ) eftc -} 10 - I S kJ 6 , E CE �o�a b ts�zi BU�tv� Pi — e-L 3 quo. s ' �� .1A±V 0 4 2;102 ST Cry Boring # ❑ Boring 3dt>�Ilil QFvftt Q 'plt Ground surface elev. 10 fL Depth to limiting factor 3 in. ih 4 a Horizon De th Dominant Color p Redox Description Texture Structure Consistence Boundary Roots ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 o_g �oL!tz3t>> - s z�� m ud,- i . 3 3�'-S3 SCR 3�y T1+ 7S 4v--SIEs L c>> CQ Boring # ❑ Boring Pit Ground surface elev. G9 ' S ft. Depth to limiting factor 7 q ik in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qvj. S?. Cont. Color Gr. Sz. Sh. 'Eff"1 •crw2 I Z Z -31 l�yl� 1b s) l Z►�i sb k ?n `F►- �lv — • S • 8 • (� 5 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = 130D,, 30 mg/L and TSS < 30 mg/L CST Name (Please Print) g ture CST Number Arthur L. Wegerer i[ L -31 `6 - a 220254 r Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Hain St. River Falls, WI 54022 1Z_to)_p 715 -425 -0165 1 Property Owner �Zb L - Parcel ID # V- l lv G Page Z of 3 Boring # ❑ Boring ® Pit Ground surface elev. 0 i .9 ft. Depth to limiting factor ' �-� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texlwe Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 I o tZ S — z� sb k �A - a,s - . 5 • s b 6 -Z3 )Qm 3 _ _ Z s l 1 2.'f s bk tin.�l- CS • 5 - 0 3 Z3 -32 — 7 - S `12.31 �S • - 2 t. Z - 7 •,F4 1 I — y s I lcsbk ❑ 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 •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 (R.6/00) PLOT PLAN Page 3 of 3 Scale 1' =50' 38.23' 'O a�tt-1 �. IFL qq.Q ' o S y„ • s � ��� t Z � t1 °A s f ps II ►^'I �-- _ fit. t U U.0 � oN . 6 " Y'htiC: �_ ��' S[:i 4t•f t 0 �1 ' OtV - 1 1 TALC - , 31 y "_bj - -- ►� N r c r m Lor L oT b LU 9 F�T�Z�, �8i Co UL , RDY'�D ��fM i,�: r✓r'+� \Z_1q -01 715 - 425 -0165 220254 _ CST Signature Date Telephone No. CST No. Job NO. POWTS OWNER'S MANUAL MANAGEMENT PLAN • FILE! V ORMATION SYSTEM SPECIFICATIONS Owner �,� j Septic Tank Capacity o gal ❑ NA Permit # Septic Tank Manufacturer e ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 100gpd/bedroom ❑ NA Effluent Filter Model 1 3f-1 w ❑ NA Number of Commercial Units NA Pump Tank Capacity pd gal ❑ NA Estimated flow (average)* gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), estimated x 1.5 * gal/day Pump Manufacturer ❑ NA Soil Application Rate gal/da y Pump Model y ❑ NA Pretreatment Unit El NA Influent/Effluent Quality (NAM) Monthly Average ** p Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) 5 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) -< 220 m [I Disinfection ❑ Other: Total Suspended Solids (TSS) Manufacturer: Model: 5 254 mg/L Dispersal Cell(s) Pretreated Effluent Quality [I Monthly Average * ** ❑ In- ground (gravity) ❑ In- ground (pressurized) Biochemical Oxygen Demand (BODs) < 30 mg/L ❑ At -grade ❑ Mound Total Suspended Solids (TSS) Fecal Colifonn (geometric meant 5 30 mg/L ❑Drip -line ❑Other: <10 ❑ Leaching Chamber Manufacturer Maximum Effluent Particle Size 1/8 inch diameter Model Approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate Req. (Other than bedroom based) Absorption Area Credit per unit ft Minimum Number of Chambers ❑ Aggregate De sign Flow/Load Rate= Wmin ** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ** *Values typical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At-grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.a1.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ . "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis — ASAE Publications 5 -77 and "Design Manual — Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980 SBD — 10570 —P (8.6/99) "At-Grade Component Manual Using Pressure Distribution" ❑ SBD — 10567 —P (8.6/99) "In Ground Absorption Component Manual" ❑ SBD — 10705 —P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD — 10628 —P (N.6199) "Recirculating Sand Filter System Component Manual" ❑ SBD — 10656 —P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572 P (8.6/99) "Mound Component Manual" (M -SBD - 10691 —P (N.01101) "Mound Component Manual" Version 2.0 ❑ SBD - 10595 —P (8.6/99) "Single Pass Saud Filter Component Manual" ❑ SBD - 10657 P (8.6/99) "Drip -line Effluent Disposal Component Manual" p SBD - 10573 —P (R 6199) "Pressure Distribution Component Manual" ❑ SBD - 10706 -P (N.01/01) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ❑ months Zjfyear(s) (Maximum 3 yrs.) Pump out contents of tank(s) en combined sludge and scum equals one -third (1/3) of tank volume Inspect dispersal cell(s) It least once every y ❑ months 40-year(s) (Maximum 3 yrs.) Clean effluent filter t least once every _3 ❑ months SXyear(s) Inspect pump, pump controls alarm At least once every 3 ❑ months ear(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ayear(s) ❑ NA Valves At least once every O months ❑ year(s) cNA Other: At least once every ❑ months = ❑ year(s) <0 NA Page of START UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. Valves Valves shall be operated in the following manner: i p Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INFECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). CM -S,eptic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. d /3' or more of the tank volume the entire contents of sludge and scum in an tank exceeds one-third I � , When the combination g y ( of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NRI 13, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Ct5kh Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. p In- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page of ❑ , 1viound, At- Grade, In- Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All 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 properly 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 other 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: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. L7 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. CEI —Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. « WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER 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 EMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name / P '9r, Name Phone 2 k_S / 3Q Phone SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY Name Agency 54-1 o; Phone Phone K:\WPDATAT"OWTS OWNER'S MANUAL.doe Page of ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND • OWNERSHIP CERTIFICATION FORM Owner/Buyer i rtn C4 r t C— jet y L, Mailing Address (09/ (4, 1"'11 ( Li hJ tki' 6 � °s 1C, (r Ooq Property Address `s L • �v� e gu i so rl W" (Verification required from Planning Department for new construction.) City /State 4 � Su✓t CAJ i Parcel Identification Number 6'16 - 12-9 3 - 96 - OM LEGAL DESCRIPTION Property Location L %4 , %a , Sec. t, T 8 N R 1 0 1 W, Town of y�J Subdivision 4t n.I4 Oooc) S , Lot # _ Certified Survey Map # , Volume , Page # Warranty Deed # —/ e q U 3 ("�' , Volume a 7 a9 , Page # Spec house yes no Lot lines identifiable yes 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. 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 Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Department within 30 days of the three year expiration date. SIGNAtURE 6F APPLICANT DATE OWNER CERTIFICATION Uwe certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property ab e y virtu.c- a- warranty deed recorded in Register of Deeds Office /-Z7/OS - SIG AT OF APPLICANT DATE • * * * * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. WisconsinDepartmentofCommerce SOIL EVALUATION REPORT Page �. of 3 _,,�ision of Safety and Buildjings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County Include. but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. �CP)O 11j G percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, S. 15.04 (1) (m)). Property Owner Property Location N If'ND Pr 14 L 6evts W 1 S E 1 /4/JE 1/4 S 1 T Z�!) N R 9 E (or W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# P L 5 `12 CI4 �l.Je � — E`t 1 NOOL'�� City State Zip Code Phone Number ❑City ❑Village RD Nearest Road z�� FPcLLS f�v� s402Z t BLS ) 4ZS- 6 - ) 4Z �-f �ZA3T �_ 1Lt New Construction Use: ® Residential / Number of bedrooms �_ Code derived design flow rate Q GPD ❑ Replacement ❑ Public or commercial - Describe: Parent ma terial _ l 11 �3 CU �Z 'f 1 t_l. Flood Plain elevation if applicable ►U • 1R ft. General comments and recommendations: Z°_ELLS I L? t L4 10'K - IS ' LOkJ 6 M Boring # ❑ Boring pit Ground surface elev. 1 � y • � ft _Depth to limiting factor 3 9 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1pytZ3i.' 3 3$-S3 S�tIZ -B IV �L`�' �S �t(Z -SliEs El Boring # ❑ Boring pit Ground surface elev. e19- 5 ft. Depth to limiting factor 7 in. Soil Application Rate Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz Z,. � 31 l Oyl� 31 b — s )1 Z h'1 sb k yn fit- • �w — • s - B 3 3l - �l�! �•Sti y/ S } �v� 4r-� — . 3 • S Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = 90D < 30 mg/L and TSS < 30 mg/L SST Nafne {Please . CST Number Arthur L legerer . ;21 g acre c) �` -31`a 220254 Address 4>le g erer Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. F-lain St. River Falls, UI 54022 lZ_t°�_p 715 -425 -0165 15 ' V 2 7 2 9 P � 6 9 784636 WALSH STATE BAR OF WISCONSIN FORM 11 - 1982 KATHLEEN O DEEDS REGISTER OF DEEDS LAND CONTRACT ST. CROIX CO., MI Individual and Corporate RECEIVED FOR RECORD (TO BE USED FOR ALL TRANSACTIONS WHERE OVER Document Number 525,000 IS FINANCED AND IN OTHER NON- CONSUMER 01 /11 /2085 08:00AN ACT TRANSACTIONS) LAND CONTRACT CONTRACT, by and between Donald O. Rodahl and Joyce J. EXEMPT t Rodahl, husband and wife as survivorship marital property, ( "Vendor ", REC FEE: 15.00 whether one or more) and Timothy R. Krug and Darlah J. Krue, husband TRANS FEE: 270.00 and wife as surviorship marital property, ( "Purchaser ", whether one or COPY FEE: more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full CC FEE PAGES: 3 performance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interest (all called the "Property "), in St. Croix County, State of Wisconsin: I.ot 8 Piney woods subdivision , Town of Troy Recording Area Name and Return Address Leo A. Beskar, Attorney RODLI, BESKAR, BOLES & KRUEGER, S.C. 219 North Main Street, PO Box 138 River Falls, WI 54022 (' 2 040 - 1293 -80 -000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at such place as reasonably directed the sum of $ 90,000.00 in the following manner: (a) $ 9,000 at the execution of this Contract; and (b) the balance of $ 81,000.00 , together with interest from date hereof on the balance outstanding from time to time at the rate of 6% percent per annum until paid in full, as follows: Monthly payments of principal and interest of $683.52 per month, commencing March 1, 2005, and monthly thereafter during the term of this contract. The balance will be paid in full on or before two (2) years from date of closing. Provided, however, the entire outstanding balance shall be paid in full on or before the 31st day of January , 2007 (the maturity date). Following any default in payment, interest shall accrue at the rate of 12% per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). [�t�P XiFC1iiH $IllC �� Aaliii�EY�3EFe tI�Idli)IIIZ]tI�X3I�1D7C Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount maybe prepaid without premium or fee upon principal at any time after date of closing. , XXXX fD?Edl)XFffKW K In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: Easements, covenants and restrictions of record. Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property on date of closing. , XXXXX • Cross out one. STATE BAR OF WISCONSIN INFO -PRO (800)655 -2021 www.infopmfoms.com LAND CONTRACT - Individual and Corporate FORM No. 11 - 1982 ' U 2729P 070 Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest in it and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils and such other hazards as Vendor may require, without co- insurance, through insurers approved by Vendor, in the sum of $ full and insurable value (land only), but Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor ofthe Vendor's interest and, unless Vendor otherwise agrees in writing, the original of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair ofthe Property damaged, provided the Vendor deems the restoration or repair to be economically feasible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property in good tenantable condition and repair, to keep the Property free from liens superior to the lien ofthis Contract, and to comply with all laws, ordinances and regulations affecting the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, except any liens or encumbrances created by the act or default of Purchaser, and except: no exceptions. Purchaser agrees that time is ofthe essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of 30 days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of 30 days following written notice thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this contract and Purchaser's rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if purchaser fails to redeem); or (ii) Vendor may sue for specific performance ofthis Contract to compel immediate and full payment ofthe entire outstanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion thereof, or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet -title action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession ofthe Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of V endor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shalt be added to principal and paid by Purchaser, as incurred, and shall be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure ofthis Contract, Purchaser consents to the appointment of a receiver ofthe Property, including homestead interest, to collect the rents, issues, and profits ofthe Property during the pendency ofsuch action, and such rents, issues and profits when so collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long -term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date ofthis Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then due under this Contract. Purchaser may make any such payments directly to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All terms ofthis Contract shall be binding upon and inure to the benefits ofthe heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution ofthe deed to be made in fulfillment hereof.) Dated this 5th day of January 2005 �- R f- �� U #Q a � (SEAL) (SEAL) * Donald O. Rodahl * T R. Krug (SEAL) (SEAL) `( .Joyce Y Rodahl - • Darlah J• Krug AUTHENTICATION ACKNOWLEDGMENT Sianature(s) STATE OF WISCONSIN ) ) ss. PIERCE County ) authenticated this day of PeT§onally came before me this day of J a 11 I E-4 the above named _ �J�t�, Donald O. Rodat .Joyce J. Rodahl, _ * �s 4 TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the persons) who executed the fore¢oina (lf no t, instrument and acknowledged the same. authorized by 6706.06. Wis. Slats.) J THIS INSTRUMENT WAS DRAFTEDE •`� At torney Leo A. Beskar ,v. lti RODLI , BESKAR, BOLES & K _ 12� : L A y : 's lic, State of isco in mmissio n is.permaseez{. fn_ot, state expiration date: (Signatures maybe authenticated or acknowledged. Both Are r76l�lefyar�L) `� �: � Y) � Zc o � ) � •- v D e • Names of persons signing in any capacity should be typed or prip ,. j3 t> kb Stu ;t. INFO -PRO (800)655 -2021 www.infopmrom�s.com WISCONSIN LAND CONTRACT - Individual and Corporate ..F,SjIZy7.MO: - 1982 • Parcel #: 040 - 1293 -80 -000 05/03/2005 08:07 AM PAGE 1 OF 1 . Alt. Parcel #: 17.28.19.1683 040 - TOWN OF TROY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): ' = Current Owner RODAHL, DONALD O & JOYCE J DONALD O & JOYCE J RODAHL 257 SADDLE RIDGE LA RIVER FALLS WI 54022 -8121 Districts: SC = School SP = Special Property Address(es): ` = Primary Type Dist # Description " 496 E COVE RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.200 Plat: 2331 -PINEY WOODS SUBDIVISION SEC 17 T28N R19W SE NE LOT 8 PINEY WOODS Block/Condo Bldg: LOT 08 SUBDIVISION Tract(s) (Sec- Twn -Rng 401/4 1601/4) 17- 28N -19W SE NE Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 418/476 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 28420 79,800 Valuations: Last Changed: 07/23/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.200 80,000 0 80,000 NO Totals for 2004: General Property 1.200 80,000 0 80,000 Woodland 0.000 0 0 Totals for 2003: General Property 1.200 60,000 0 60,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Private On -Site Wastewater Treatment System ( POWTS) Index & Title Sheet Owner: f-0 C /1 Project Name and System Type: Location: Cam' g 4 2 7Z Lez,e Street Address Legal Description Township/ ounty Contents: Page 1: Sanitary Permit Application Page 2: Plot Plan Page 3: Soil Test Page 4: State Approved Plans Page 5: Septic Tank Maintenance Agreement Page 6: Warranty Deed Page 7: POWTS Owner's Manual Management Plan Page 8: POWTS Owner's Manual Management Plan Page 9: POWTS Owner's Manual Management Plan Page 10: Certified Surygy Map Page 11: Copy of House Plans Attachments: Plumber /Designer: Mike Rogers Signed: Credential Number: 225094 Date: S