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HomeMy WebLinkAbout040-1259-60-000 ,n Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix and Building Division INSPECTION REPORT Sanitary Permit No: 399664 0 F erger, ENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: ersonal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ermit Holder's Name: City Village, X Township Parcel Tax No: B David I Troy Township 040 - 1259 -60 -000 CST BM Elev: Insp. BM Elev: BM Descrip ion: i TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic B I " 7 , enchmark Dosing Alt. M ]I // ` Aeration I I B]dg.'Sewer 17 Holding St/Ht Inlet TANK SETBACK INFORMATION TANK TO PIL WELL BLDG. Vent-to Air Intake I ROAD Dt Inlet , Septic I t Bottom, Dosing Header /M /3" l i 1 - - r, Aeration Dist. Pipe f3 : i '7 i • C- Holding _ Bot. System i�r �, / Z v" PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cov r GPM Model Number ^ j C _ TDH Lift Friction Loss System Head TDH Ft Forcem in Le , /Y Dist. to Well SOIL ABSORPTION SYSTEM /5 BEDITRENCH Width i L Len h No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS T (; SETBACK SYSTEM TO P/L JBLDG JWEL v LAKE /STREAM LEACHING Manu pc)b rer,: /' J INFORMATION CHAMBER OR ( tic Typfc pf System: � UNIT Model Number: ' (( l/lb afLp h' l , DISTRIBUTION SYSTEMj /tic/ Header/Mani f Id Distribution Yri C, x Hole Size x Hole Spacing Vent to Air Intake ' t/ Pipe(s) C ; � Le th r Dia Length Dia Spacing > SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over f Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center f Bed/Trench Edges Topsoil ,, j Yes n� No ; ] Yes � �41 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: // Inspection #2: Location: 377 Deer Valley Drive Hudson, WI 54016 (SE 1/4 NE 1/4 18 T28N R19W) Deer Valley Lot 6 I Parcel No: 18.28.19.1385 v 1 ill, ., i LY 1.) Alt BM Description 2.) Bldg sewer length = I T • l ,1 o Y� - G/z 1s�� - amount of cover C�7 �a� ✓l L t t I - A 4t Plan revision Required? VYe ljl / No ' G I Q itiona rmation. L -- _ _; _I_od Date J� p Insepctorr's nature Cert. No. SBD -6710 (R,3/97) d ( ' _" 5 s� L� tai -1v1 � i V o, I S aGONS ' o • , SEPTIC /PUMP CHAMBER CROSS SECT10 d Donald A. Proulx CV 1 (DRAWING NOT o+;�VED 221675 ' • ® • ® MAY 2 g 2002 ° °�-9��'�•- ......- •'' 00 Final grade Access riser®yr-�'i�ri�lct it r gvv� (slope ground awa from ST (cover . CROIX CO must' be �ils,�� rr�hXarked risers for drainage ZONING U OFFICE with an approved warning label) Actual depth may increase OF power & a arm see COMM 82.30 (must use seperate power (11), (c) and (d). and alarm circuits) tank vent (externally mounted) — � junction box � „ min. I force main access riser 18" rni _ bottom of inlet invert 3 " filtered reserve I water level effluent inlet % f I t � alarm ,/ r on j 4" inlet tee or baffle approved effluent filter off, required on tank outlet j / • Minimum of 3" of suitable bedding beneath tank pump pad EFFLUENT FILTER Tank manufacturer fTT DWF (daily wastewater flow) septic /pump chamber capacities s� Number of dialy doses (DWF / actual dose volume) Alarm manufacturer J'G.(Q��LO BKa /v v f orcemain volume Alarm model number Az / - � Oh E�G�ly Actual dose volume (gal) A/ Type of float switch �� 47" ! (total dose vol. — forcemain vol.). tl ��� /// CAPACITIES Effluent pump manufacturer �� �(�_� i 7S� reserve above alarm Z Inches g allons = t' alarm above pump on 2 inches = 341 gallons Effluent pump model number Q on /off measurement 6--5V inches _ 112 ' �y gallons Minimum pump discharge rate. (gpm) off to tank bottom ,1 inches = 110 14 gallons /1 /5 10 TOTAL inches = 17"- gallons Vertical lift (pump off to lateral elevation) � ! PU MP CHAMBER DIMENSIO d System head (distal pressure x 1.3 ft.) � length width �g Friction loss in the force main Z _� liquid depth gallons inch re& Total Dynamic Bead (TDH) ��' �� . _ X101 Read. �dsoti vin St. Cj COU11ty p151 i666 •ax Zoning Office Fax From: I V- To: Fax: pages: Date: Re: CC: 0 Urgent a For Review ❑ Please Comment ❑ Please Reply 0 Please Recycle e comments: �11/��C` /� "'�{/�cC� -� `'' t ( ice- ✓; ?/ / L �I� c 9e 4 u -ThIVY ME40 DIMENSIONAL DRAWING MW50 DIMENSIONAL DRAWING �\ "ON' E O N 14.76 °OFF" � c r co cl Cm Ln r r M' E �_ _ .- I — -\'- 6.25 E _ J' ID 6 L / I . -2.06 r� 1 -1/2" NPT ' — • V � bischarge \\� rn Q cF6 r E _ 9.04 -� M L j t O (� 5.66 � - 5.44 r (144mm) 11.68 1 1.42 (296.5mm) ME40 PERFORMANC MW50 PERFORMANCE CAPACITY LITERS PER MINUTE LITERS PER MINUTE 0 100 200 300 400 500 0 50 100 150 200 250 300 350 30 10 40 12 ail 25 35 8 10 30 K 1n F W 20 -� —�__ Y____ — W ryy� F W 8 F LL 6 W LL 25 2 = Z Z Z < 15 _.--. — _- - - {.__ -_.. .4 W 20 6 c = _ Lu J = ° Q 15 J O 1 0 _ r f- 10 O j -z 2 5 — ' S i 0 0 10 20 30 40 50 60 70 80 90 100 0 8 L o ao so e0 100 1zo 1ao 0 CAPACITY GALLONS PER MINUTE o x CAPACITY GALLONS PER MINUTE 23833A275 11 MYERS LIMITED WARRANTY F.E. MYERS warrants that its products are free from defects in material and workmanship for a period of 12 months from the date of installation or 18 months from the date of manufacture, which- ever occurs first. During the warranty period, and subject to the conditions hereinafter set forth, F.E. MYERS will repair or replace to the original user or consumer parts which prove defective due to defective mate- rials or workmanship of MYERS. This remedy is exclusive and is the only remedy available to any person with respect to such MYERS product. Contact your nearest authorized MYERS distributor or MYERS for warranty service. At all times MYERS shall have and possess the sole right and option to determine whether to repair or replace defective equipment, parts or components. Start -up reports and electrical system schematics may be required to support warranty claims. This warranty is effective only if MYERS supplied or authorized control panels are used. LABOR, ETC. COSTS: MYERS shall IN NO EVENT be responsible or liable for the cost of field labor or other charges incurred by any customer in removing and /or reaffixing any MYERS product, part or component thereof. THIS WARRANTY WILL NOT APPLY: (a) to defects or malfunctions resulting from failure to properly install, operate or maintain the unit in accordance with printed instructions provided; (b) to failures resulting from abuse, accident, or negligence; (c) to normal maintenance services and the parts used in connection with such service; (d) to units which are not installed in accordance with appli- cable codes, ordinances and good trade practices; or (e) if the unit is moved from its original instal- lation locations, and (f) unit is used for purposes other than for what it was designed and manufac- tured. RETURN OR REPLACED COMPONENTS: Any item to be replaced under this Warranty must be returned to MYERS at Ashland, Ohio, or such place as MYERS may designate, freight prepaid. PRODUCT IMPROVEMENTS: MYERS reserves the right to change or improve its products or any portions thereof without being obligated to provide such a change or improvement for units sold and/ or shipped prior to such change or improvement. WARRANTY EXCLUSIONS: As to any specific MYERS product, after the expiration of the time period of the warranty applicable thereto as set forth above. THERE WILL BE NO WARRANTIES, INCLUDING ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PAR- TICULAR PURPOSE. Some states do not allow limitations on how long an implied warranty lasts, so the above limitation may not apply to you. No warranties or representations at any time made by any representative of MYERS shall vary or expand the provisions hereof. LIABILITY LIMITATION: IN NO EVENT SHALL MYERS BE LIABLE OR RESPONSIBLE FOR CON- SEQUENTIAL, INCIDENTAL OR SPECIAL DAMAGES RESULTING FROM OR RELATED IN ANY MANNER TO ANY MYERS PRODUCT OR PARTS THEREOF. Some states do not allow the exclusion or limitation of incidental or consequential damages, so the above limitation or exclusion may not apply to you. This Warranty gives you specific legal rights and you may also have other rights which vary from state to state. Direct all notices, etc. to: Warranty Service Department, F.E. Myers, 1101 Myers Parkway, Ashland, Ohio 44805. Myers® F.E. Myers, 1101 Myers Parkway, Ashland, Ohio 44805 -1969 419/289 -1144, FAX: 419/289 -6658, TLX: 948 -7443 Printed in U.S.A. 6/95 23833A275 mss � v Sanitary Permit Application Sooty & Buildin Division Wisconsin 201 W. Washington Ave. ♦ • isconsin In accord with Comm 63.21 <Wis Adm.. Code P.O. Box 7302 Department of Commerce See reverse side foriustructions for ca this G/ Madison, WI Completed form Sobmit Complleted form to county if Personal Information you provide in f b e leto ry y state owned) S L S — ri5. Attach cos6plete plans (to the county copy only th to on PRANot g- a4l chin in she County State ila it um r revision to preA os applications State Pfau I.D. Number St. Croix s g L Application l$formm ition - Please Print aB Information , pl ! j '? Location: Property Owner Name "~� ST ' . David Berger - SE NE 18 28 Ng, 19 Property Owners Mailing Address - � :P: Lot Number 5933 Scenic Place "`/ �, ,'' 6 City, slate Zip Code Ph ,.. ` ` J ..� , � : ,_, _... � � `� ` :'` 3ubdiviion Name of CSM Number Minnetonka, Mn 55343 �97'�- 3, Deer Valley II. Type of Building: (check one) 4 a,y fev 5 y bryti rS . ❑ City FX_1 1 or Family Dwelling- No. of Bedrooms VilVillage ` F-1 .Public / Commercial (describe me) ❑ Tro Town of State Owned Nearest Road 'III. Type of Permit (Check only one box on Hue A. Check box on One B If applicable) E. Cove Road Parcel Tax Number (sj 1. New system 2. Replacement 3. Replacement of 4. Addition to T p A � .. ❑ system ❑ Taak only ❑ Existing system 2 P • / S►, r O Permit Number Date Issued B) ❑ A Sanitary Permit was previously Issue , II 11 Type of POWT System: ( Check au that apply) 1 .. I Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed ..❑ - Pressurise In- ground ❑ Holding ❑ Single Pass ❑ Drip Line 1:1 1:1 1:1 Aerobic Treatment unit El ❑ Other: an V. Dispersal / Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate / / /(((��� C. system Elevation 7. Final Grade Required 5- 0V Proposed, Rate (GaIL/day /sq.ft.) Odin/inch (1 600 49t94 39Q 1.2 C •�� 92.50' VI. Tank Capacity in Total N of Manufacturer Pefab Site Steel Fiber- Plastic Gallons Gallons Tanks coo- con - glass IIIf04'111ati0II Crete structed New Existing Tanks Tanks Septic 1250 1250 1 Huf Butt X ��a 7 4 X VM Responsibility Statement: 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's. Name (print) 5nabIr's Sigaiture o s mps) ' MP7MPRS No. Business Phone Number Donald A. Proulx 221675 715- 723 -9655 � / : 2 7 3� Plumber's Address (Street, City, State, Zip Code) 1280 W. River Street Chippewa Falls, Wi 54729 Vill. County / Department Use d ,�/ c Sanitary Permit Fee (Inc es Groundwater ag Agent Signiture o stamps) ❑ Disapproved Surcharge Fee) V- Approve El Owner Given Initial Adverse it 2—Z f IX. Conditio f royal / Ressol for Disapprov �e�s w�„�C-. rc /� t t cV I� A p�. / « __� V5 ,/�9. ps.4st G d c (i cy ► �n �-�,1 259. a • Ui n v q ZZ _ m N o U i 2 • Q o 'h �((/� O � a O c ,VZ II W \ CIO^ N oo d C t al o j 0 Q Y' x' w 2 ti o U Oi : 0 d ail La IC O ^ U n li k $¢ I I$N� wWl w ' 2:011 l 0 U 1 ° 0 0.a Z N p 7 FO 9 I PG W .a z � U aw0 F E tarnaFV, r IC I DAVID BERGER = 100' - TOP OF 1" PVC PIPE SE - NE - S18 - T28N - R19W LOT # 6 - DEER VALLEY TOWN OF TROY BENCHMARK = 102'- TOP OF 1" PVC PIPE ST. CROIX COUNTY I :E1 " =50' 04,4 colvs t o o , • Donald A. Proulx �• �. 221 675 r po ! d I ✓� N .P RIs I 7Z C Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 _ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 040 - 1071 - percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z Property Owner Property Location DAvid Bercrer Govt. Lot SE 1/4 NE 1/4 s 18 T 28 N R19 XE (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 5933 Place 6 na Deer Valle City State Zip Code Phone Number ❑ City ❑ Village 6a Town Nearest Road Minnetonka I MN 1 55343 (952 ) 975 -3823 Troy E. Cove Rd. New Construction Use: [2 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material pu} Flood Plain elevation if applicable na ` ft• General comments and recommendations: / trenches @ el. 92.50' ' Borin # F] Boring ❑1 g Ground surface elev. 96. 00 ft. Depth to limiting factor 120 Pit cation I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bound " ' jteQts GP ` in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -12 10yr3/3 none L 2msbk mfr cs 2f 10 yr474 none sl 2msbk mfr gW if .5 .9 3 24-12C 7.5yr4/4 none cos Osg ml na na .7 1.2 `tZ.S � 7, Borin # Boring � g ® Pit Ground surface elev. 9 6.00 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 -8 10 3 3 none L 2msbk mfr cs 2f .5 .8 2 -22 10yr4/4 none sil 2csbk mfi 9K if •5 •8 3 2 -35 10yr4/4 none sl 2msbk -nvfr qW 1f .5 9 4 5 -120 7.5yr4/4 none cos 0sq ml na na G�Z * Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 90ent #2 = BOD 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature . CST Number Gary L. Steel 02298 Address c �'�te — Evakfation Con ucted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 11 -30 -2001 715- 246 -6200 f y Property Owner David Berger Parcel ID # 040 - 107 - Page 2 of 3 31 Boring # ❑ Boring 3 ® pit Ground surface elev. 98.10 ft Depth to limiting factor 140 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 1 0 -12 10yr3/3 none L 2tnsbk 2f .5 .8 2 12 -36 10yr4/4 none sil 2csbk mfi I rTW if 5 3 36 -14 7.5ry4/4 none Co 7 row 2 03 . Z 3 F-1 Ong # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 ❑Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F 1:1 pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' Effluent #1 = SOD, > 301 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 30 mg/L and TSS .5 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, lease contact the department at 608- 266 -3151 or TTY 608 -264 -8777. P P SBD -8330 (R6100) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 David Berger New Richmond, WI 54017 MPRSW -3254 SE 4NE4 S18 T28N - R19W (715) 246 -6200 town of Troy lot #6 -Deer Balley " =40' IBM. = top of 1" pvc pipe @ el. 100.00' ✓ ✓alt. BM.= top of 1" pvc pipe @ el. 102.00' � r V p F Gary L. Steel 11 -30 -2001 Zabell^ A100 -8 Series Residential & Commercial Effluent Filter Product Specification 1. Applications: Residential and light Commercial applications between 800 and 2400 gpd. Used where increased reductions in TSS and SOD are required. 2. Performance Specification 2.1. Multiple fifters may be installed in manifolds to handle larger flows. Use a Zabel Flow Control Plate Model FC100 to set the effluent flow to predetermined limits. 2.2. TSS: Reductions in TSS within six months of installation - 50 to 90 percent. The higher the pre - filtered TSS the greater the percentage of reduction. 2.3. BOD Reduction in BOD within six months of installation - 20 to 45 percent is dependent on the make -up of the wastewater. 3. Materials of Construction: All materials are non- corrosive. Case, support pipe, and handle - PVC, Lid and ffter discs - Polystyrene 4. Service Frequency: The filter requires cleaning when the septic tank is normally inspected and pumped as required by local regulation. The Al 00-8's are designed to slough most normal solids off the inside of the vertical disc dam walls and back into the tank when the effluent flow is in a resting state. Installation of an effluent filter may increase the frequency of service if the homeowner discharges materials that are harmful to the system. A certified Za bel installer/pumper should � erform all onsite service. P 5. Warranty: The Al 00-8's are warranted to be free from defects in material and workmanship for the life of the original purchaser. Zabel's liability is limited to repair or replacement of the part and in no event shall Zabel be liable for any consequential damages of any kind. 6. Dimensions: A100 -8x12 8" 11.5" 1/16" 800 246 in 678 in 39 A100 -8x18 8" 18.5" 1/16" 1200 492 in 1,356 in 78 A100 -8x26 8" 25.5" 1/16" 1800 738 in 2,034 in 117 A100 -8x32 8" 1 32.5" 1 1/16" 1 2400 984 in 2,712 in 156 7. Multiple Filters may be installed 4 •, 40 or s• srn ao to handle larger flows. 3' scn 40 4° 5DR 3; amt Poe 8. Outlet hub accepts 3 ", 4" or 6" aN PO WN pipe pipe. see illustration at right 9. Extra support for the 26" and 32" long models may be achieved by extending a 4" support pipe from the reducer hub to the bottom of the tank. The products) shown are covered by the following patents: U.S. 4,710,295, 5,593,584 Other Patents Pending Call Direct to ORDER 1- 800 -221- 5742.Or Order Online: www.zabol.com r Te ero The trliftttrator Chamber System is a direct replacement for old -fash- • ' toned stone and pipe leachfields. InsUAW In 2 to Voot -wide trenches car beds, Infiltrator chambers pro- .. mote fluent infiltration into the soil with 100% efficiency. The greater efWe infiltrative capacity f o Infiltrator chambers means that they van require as little as half the space of old- fashioned stone and p4m systems for equal or superior performance. This gives designers, inWjlM and homeowners greater fleadbiifiy In placement of the septic k*4#leK while minimizing disruption of the landscape and saving money. . Compared with stone and pipe systems, Infiltrator chambers offer the following advantages: ■ Smaller footprint with equal or better performance ■ Larger effective infiltrative area per linear foot ■ Fast, easy installation ■ Equivalent or greater storage capacity ■ Higher Long -Term Acceptance Rate (LTAR) ■ Patented sidewalls provide maximum infiltration Private Onsite Wastewater Treatment Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Aden Code each Private Onsite Wastewater System ( POWTS ) shall include information and procedures for maintaining the system within parameters of Comm 83 and 84, and the conditions of approval by the department, governmental unit. The approved plans and permits for system are on file at the county zoning or health department This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorbtion Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567 -p (R6/99) Table 1: System Design Specifications Sanitary Permit Number I Number of Bedrooms 4 Design Flow - Peak (gpd) 600 Estimated Flow Average (gpd) 450 Septic Tank Capacity (gal) 1250 Soil Absorption Component Size (sq.ft.) 500— r Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 2 Ti 2- Maximum Influent Particle Size (in) N/A 1/8 ` Maximum BOD (mg /L) N/A 220 Maximum TSS (mg /L) N/A 150 Maximum FOG N/A 30 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Should inspect once a year and clean once every 3 years Soil Absorbtion Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individua certified under s. 281.48 Stats. The contents of the septic tank shall be NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks Pumping Intercepters, Seepage Beds, Seepage Pits, Seepage Trenches, Wivies, or Restrooms). The operating condition of the spp•ik �tret e.� and outlet filter shall every three years by inspection. Th shall be cleaned as v � oppe�ratt�ion. The filter cartridge sho ov ess in t�tank that may slough off the filter when removed from its enclosure. with an alarm, the filter shall be serviced if the alarm is activated alarms may indicate surge flows or an impending continous alarm. Pate 1 i Management Plan for a Septic Tank and Soil Absorption Component The septic tank shall have its contents removed when the volume of scum and sludge 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 an 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. 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 tank. No one should enter a septic or other treatment or holding tank for Any reason without being in full compliance with OSHA standards for Entering, a confined space. The atmosphere within the septic or other Treatment or holding tank may contain lethal gases, and rescue of a Person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component.. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording levels of ponding, if any, in the observation pipes, and visual inspection for any evidence of surface seepage or dicharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair untill weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier organic clogging of the soil Plantings of deep rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. Page 2 Contingency Plan Conventional Soil Absorption Component IN THE EVENT OF FAILURE: 30 Infiltrator Chambers would need to be installed in alternate or replacement area as shown on plot plan. — or remove biological clog mat & replace component media as necessary to bring system into proper operating condition. Contacts in the Event of Component Failure: Regulatory Agency: St. Croix County Zoning St. Croix Governmental Center 1101 CarMichal Road Hudson, Wi 54016 Name of Installer: Bohl & Proulx Plumbing, Inc. 1280 W. River Street Chippewa Falls, Wi 54729 Phone 715- 723 -9655 Tank Manufacturer: Huffcutt Concrete 737 Herbert Street Chippewa Falls, Wi 54729 715 - 723 -7446 Chamber Manufacturer: Infiltrator Systems Inc. 4 Business Park Rd. P.O. Box 768 Old Saybrook, CT 06475 Phone 1- 800 - 221 -4436 Filter Manufacturer: Zabel Industries, Inc P.O. Box 1484 New Albany, In 47150 Phone 812- 738 -1197 Page 3 January 10 2002 St Croix Count Zoning Office o y g St Croix Government Center 1101 Carmichael Road Hudson, WI 54016 Re: Sanitary Permit Application Enclosed you will find all of the required information for the sanitary permit application process. If you have any questions you can reach me at 612- 671 -2045 or at the address below. When the application is approved, please send the final paper work directly to me at the address below. Thank you. Sincerely, David Berger 5933 Scenic Place Minnetonka, MN 55345 I 01/09/02 WED 13:03 FAX 715 386 4686 ST CRX CO ZONING Z001 ST CROIX COUNTY SBPTIC TANK MAIM TBNANCE AGMEMBNT AND OWNBRSHW CBRTMCATION FORM Owner/Buyer _., + � v i rN ;5 i- -4 11 ems_ Mdft Address s `3s Sc. c�� i ' 3 property Address cl VG, i (�. , v (Verification required from Planning Department for new construction) city/State /'r e--� v�1 Parcel Identification Number ; U O - MAL DESCRIPTION Property Location S 1 t/4, 22 t /4, Sec. - L - E, T Zvi -RAW, Town of Subdivision L/cti f 1 q Lot # _ fit? . Certified Survey Map # (1 1 Z D Volume J 7 2( Pl c, f S_ Page # g Wamnty Deed # , - 7 13 . Volume _ I . Page # 3 Z - Spec house ❑ yes 1 no Lot lines identifiable 09 yes ❑ no SYSTEM MAINI�NA Improper use and maintenance of your septic system could result in its premature failure to Dandle wastes. Proper maintenance consists of pumping out the septic tank every am years or sooner, if receded by a licensed pumper. What you put into the system can affect the f mcdon of the septic tank as a treatment stage in the waste disposal SYstem- The property owner agrees to submit to St. Or= Zoning Department a cerdfication form, signed by the owner and by a tnastCrptnnber jquncyman per, lumb restrictedphunber or a licensodpuwper verifying that (1) the on - site wastewaterdisposal system inspection and pumping (if necessary the septic tank is less than 1/3 full of shudge. is in proper operating condition and/or (2) after Vw% the underdpeed Dave read the above reWirements sad agree to matntam the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Departmen t of Natural Resources, State of Wisconsin. Certification Office within 30 stating ntat your septic system has been maintained trust be completed and returned to the St. CXoix County Zoning days of the three year expiration date- _.w / 19 /y `L 4 OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that an statements on this form are true to the best of my (our) knowledge. I (we) stn (ate) the ownet(s) of the property desenbed above, by virtue of a warranty deed recorded in Register of Deeds Office' Z i'� DATE « « «« «« A information that is this - represented may result in the sanitary permit being revoked by the Zoning Departmen Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey trap if reference is made in the warranty deed Wisconsin Department of Industry $OIL AND SITE EVALUATION REPORT Page 1 of 3 Labor ayt Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point 7 r �r6ad of slope, scale or PARCEL # dimensioned, north arrow, and location and dis oas / f� —j - 7 2 - l 0 R VIEWED BY APPLI CANT INFORMATION- PLEASE DATE la,NiF'f A N�RMAT10�1 PROPERTY OWNER: ROPERTY LOCATION Derrick Construction, I e~ i JjJ'A (IOVT. LOT SE 1/4 NE 1/4,S 18 T 28 N,R 19 R(or) W PRO PERTY 1505 H �NER':S S . A ADDRESS Z �T Gq�, i 6# BLnaK# Valley CITY, STATE ZIP COD R CITY ❑VILLAGE MOWN NEAREST ROAD New Richmond, WI. 54017 X7.1$ 2 32a Troy E. Cove Rd. [)] New Construction Use Residential / Nu f bhr 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate • 7 bed, gpd /ft2 - 8 trench, gpd /ft Recommended infiltration surface elevation(s) 94,55.- - ft (as referred t site plan benchmark) Additional design / site considerations na P VT w w eh0 (- a t °D Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ®S ❑U 19S ❑U M S ❑U AS ❑U ®S ❑U EIS O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tre & 1 1 0 -20 10 r 2 2 none 1 2 20 -41 10 r 4 4 Ground 3 41 -90 7.5 r 4/4 none cos elev. 9 8.0 ft. Depth to limiting factor +90 Remarks: Boring # 0 -15 1Or22 nn mfr 2f 2 `'' 2 15 -26 10 r 4/4 U Ground 3 26 -96 7.5 r 4/4 none cos o elev. 98. 8ft. Depth to limiting S! factor +96 Remarks: CST Name: -- Please Print GXy L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Ave w Richmo d 54017 Signature: Date: 6 -2 -99 CST Number: m02298 PROPERTYOWNER Derrick Constructio SOIL DESCRIPTION REPORT Page 2 Df 3 PARCEL I.D. # , Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bamdary Roots GPDfft ................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Twch .................. ................. .................. ................. ?; 3 1 0 -12 10 r 3 3 none sl m mfr 2f ` ...... 2 12 -86 7.5 r 4/6 none cos osci ml na na .7 .8 Ground elev. 97.7 ft. Depth to limiting factor +86" Remarks: Boring # 1 0 -12 10 r 3/3 none 1 2msbk mfr cs 2f .5 .6 2 12 -84 7.5 r 4/6 none cos os ml na na .7: . 8 Ground elev. 96.2 ft. Depth to limiting factor Remarks: Boring # 1 0 -12 10 r 3/3 none 1 2msbk mfr cs 2f .5 .6 5 2 12 -84 7.5 r 4 6 none cos os ml na na .7 .8 ................. . Ground elev. 96.5 ft. Depth to limiting factor +84" Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, INc. 1554 200th Ave. CSTM2298 SE4NE4 S18- T28N -R19w New Richmond, WI 54017 MPRSW -3254 town of Troy (715) 246 -6200 lot #6 -Deer VAlley This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. il" =40' top of 1" pvc pipe el. 100.00' r t. BM.= top of nail in Pine tree C el. 95.05' & 3 i f 3 N Gary L. Steel 6 -2 -99 VOL 15'17PAGE323 10 ,!� i STATE BAR OF WISCONSIN FORM 1 1998 j 63? 1 33 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Number ST. CROIX CO., WI . .... . .......... . . . . . ................ . . . . ....................... .. . . .. .. ........... RECEIVED FOR RECORD This Deed, made between JUNE M. ERDMAN, a single person 01-22-2001 9:30 AN WARRANTY DEED Grantor, EXEMPT # and DAVID E. BERGER and KRISTINE M. BERGER, CERT COPY FEE: COPY FEE: husbMffd TRANSFER FEE: 250.50 RECORDING FEE: 10.00 PAGES: I Grantee. Grantor, for a valuable consideration, conveys to Grantee the following 1 described real estate in St. Croix i County, State of Wisconsin (the "Property"): Recording Area ................ Name and Return Address Barry C. Lundeen MUDGE, PORTER, LUNDEEN & SEGUIN Plat of Deer Valley in the Town of Troy, Post Office Box 4 Q—S—L--troix County, Wisconsin. Hudson Wisconsin 54016 040 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except — none Dated this 18th day of January 2001 W q3 z N89'26'42 "W 622.89' h �' 1 u °W° I� ° z r 100' 3.471 ACRES �. �� • • • • • • 151,185 SQ. FT. o j Q I EXCLUDING ROAD EASEMENT o !, 2.989 ACRES N - • -• -•- • tg0 SQ. FT 1 3333' 89'26'42 "E N�3 p3 4°- - _ C32_ b _ o 66' ROAD EASEMENT To TOWN L-- 3 . C29S S• 4 � SO DO• a---- .�?��Z ' 6 4 N sS�Op� C26 M ,N89 "W 234.94' 1 I 3 89'26'42 "W 35 \N' _uy7n _' T - - 9.04' 1 Ls•- I N89'26'42 "W ^ -•__� � 0 5.67' /' o Z . y o � Q HAL =854.5 J ,,. 00. ' .j......... o Ld F- 4.742 ACRES t Q 206,543 SQ. FT. J N / EXCLUDING ROAD EASEMENT Z 4ENT 1 , 0 1 �! 4.261 ACRES a: 185,623 SQ. FT. / MINIMUM BUILDING j AND SEPTIC SYSTEM CIO ELEVATION IS J ON LOT 7 58 i T44" � Q , W 560.31 8 ' •� W �8 L.2 s. - �� / • o 9 E ?20 .0' I 6 ©! M rERLWE 40' u') / � r ;/ •.�� 2.766 ACRES d- E / � �• • 120,470 SQ. FT. N M co 'SENT / ► ,.._ � d- N n • � � iV N M , t w rO N76 '39'00 "W 5 o B8.6 � 5 z MATCH LINE SEE SHEET 3 MICHAEL ERICKSON JOB NO. 98 -26 DATE: 7/21/99 r F THE NE >/4, PART OF THE S W 1 r CTION > 8, T28N, R > 9 W, TOWN OF TROY � 1 220.09' S813� 00 "E 209 33'' - - - - �,.� ©� 6 I ' � T q M / S M CH CAN N S HEET e 3 w r 568.67' O 2.757 ACRES 120,111 SO, FT. u i j 1 \ o \ N N7610 y1, 2 97 4 4,050 ACRES 176,433 SO, FT, EXCLUDING DRAINAGE EASEMENT 6 3,703 ACRES °o `�8 \ 161,323 SQ. FT, � vi r 9.b2 � ' N83'41'44 "W 584.44'