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HomeMy WebLinkAbout040-1281-70-000 c R f a go c IZ I I p n w N v 0 ° N t� a t 4., �±. N = < � K N P M�1 2S OD -4 O y W 0 n O t0 r 0 C o ir a O !r c c 0 R N co D H ( W 3 0 O I L ' ti C Z o o m VMMm I o 00 0 =a y,.� o Is -� 4 CAa IA go m •• � o Q z 0 �( 0 7 = O n 7 < 3 N M C Z 4b I Vi N• I � Z I o in y d A z 3 C'f G N to o a z m �� I n 3 ` a m a W I I o a CL n o � Z a o I < � 4f � j b y I I I I I �v I � I s w I � Es O ti ° o a ,,, . 0 7 ■ ju 0 e I , ; § Z $�j�$\ K , 7 0ƒ £$0 «2 / 2 - 2 i k ± m( 2\ \ g / k B \ ° 0 k \ i E 2 G @ J &§/ 2 °3 - . 0— o o � \ . @ z > _ \ a > ® E p § ,j @ -4 0 � � / a \ ƒ w w 3 . � � k �- A T .. § \ 2 k § \ §2 @G ■k §/ E ■ @ K 0 ■ g 2 f � � E � \ § •• _ . e z .. / / m ® ƒ g 7 § 7 i / o I / ! ƒ m § CD & co g % CL } 2 N / w ■ o � e ■ z m z E E g ) g ; / j § C E § z � t E 7 G ) / r 00. I .a ; $i0 ƒ y 0 � a ( 0 7 cn c D § { � § \ 2 0 \ CD \ _ o �4 � g Wisconsin Oepai tment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety andAailding Division INSPECTION REPORT Sanitary Permit No: 420683 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Derrick Construction Inc. Tro Township 040 - 1281 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: . f 0 4. /ol L S T — Pct ' • 116 M 19.28.19.1588 TANK INFORMATION ELEVATION DAT TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. e tic S p t �� Benchmark �� 1 Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic + ` 1 Dt Bottom M -• J I Dosing Header /Man. e 3 11(ps Aeration Dist. Pipe Holding Bot. System Se Final Grade �S1A. P MP /SIPHON INFORMATION Manufacturer Demand St Cover (D O 1, Z r Model ber TDH Lift on Loss System Head TD Ft For ain Length Dia. SOIL ABSORPTION SYSTEM BEDITRENCH Width Lenith No Qf Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYST M TO I P/L JBLDG IWELL LAKE /STREAM LEACHING Manuf tur INFORMATION Type Of System: CHAMBER OR /� ,„ C , UNIT Model Number &%,W �_ DISTRIBUTION SYSTEM L4 �a �, to/z_ 1� Header /Manifold tF Distribution x Hole Size x Hole Spacing Vent to Intake Pipe(s) .' I V I Length_ y Dia Length Dia pacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Ed es Topsoil g Yes No Yes No � (Include dish ci , persons present, etc.) Inspection #i' Yid'f 3 Inspection #2: -- J --T"' ol cation: 230 Muirfield Ti �!�fu -dson, I4 1/4 SW 1/4 19 T28N R19W) Troy Village 4th Lot 125 Parcel No: 19.28.19.1588 1.) Alt BM Description = . ` 2.) Bldg sewer length ~ � = l - 7 - amoun of cover= t �, t k CJ ( M 4o .91 C � (� 3 w cl�•s- K a�- ,<�e -chi - - -- 5 ' 3 Z ,Z Plan revision Required? [ Yes No Use other side for additional information. >N ' Z� SBD -6710 (R.3/97) ` atic ,� (1- Insepctor's Signature Cert. No. ` y c p,JK- M ' soft mad >aaliaa� lilfri�i�t 301 W. Tl~m Am. ROL faa 7142 � ,r� --.- -- �� IMMISMoN,. V1 3�#1�1- 71f1� is A�If..e lamawd,4. am. will. Adw a.. � o Sa o P 3 �r•.• i a;;= ..e bred "NOW JIA r. � rfr L4 p - l c 1'I-NPrrs o■..r s awa! AMMO � C !r lw taoeaia. QQ a® S - S 7 N R • �v t3gr. as ZIPC.1ede llr�elMr�tlur '1.tlt SAN Illig t'.9M ! a �. wrs�s +le�•eR a i.e. �. � .� D� �,,, Q Dfue.ie th. O are Oa.d view LAIN v1 rt f ) ML TAPat Ylae,t0 l0.& af* aw bat m r ba"d••w- Congo.. a it miggimmo / lx-� d s O MONO a TMAOSIr artt+rsMirt�� �Ifrorft w.oa..�t ioo..d 1ti.f� lR.r.r u.es i...d n Ty" atllaraat Roma aw +ll (0 440 Mm -# it kbrM=.a no mome :0 0 Co mmmaa WmbM dA%P f.. a O 14 wd ft4k ef.d apt 0 b.Rift To* N ❑ am* man st 0 ro* Lim 7 � f -ti,b�( x s o I � Q AKi..1r 46 D Aa.atic 11q„e i%ft 40 © D 30 O 06W 14w Afw• a4..r Aa. sd AMPOat.. amde w4a.d ✓ arm* ff ✓ 112.5 1 xoo �� N A gg S vi *vae bb armor to aw d,..n,dOW roars are saw ra. P bbc- HIM w1 jWa A -16z) �.de �•,�� -� 1 der Imc) ' Mr. ua► d�.iisatti.rM.oiiM 2 >wr.d.r �.iner.l� oaf illfs.r s a S Use C1� sMaMtr, ha.it welt+. clerY..a.� Dow �... `/�/ o � (ova F'4t~ war a t7l�C 1012,3 100 c- ecno.ed �va e alt �RZ�1 1 >4 ew "Alas a 1�c�u�r ed1 5 y5�- vu fi a r �►�r t,c� l �.1 sa kds szf' Gff 0 2- u, vr� u a u�r(� ,J �` - PowT.57 /t �. �la�r, . OurnQ , Pry Yna i n-cu s Ci�trl -+ QR !1R 1 pa � Ste- i , 1 i Sw _ , : I ! o _ i tv IL tj ts ����t� Iw •w��.�_ -- - �.C� -� d�- C�- 1�F�_ -( ?.a -odd- - - - - - -- -__ - i 1 _— � ! �5.1 - � Tye __-,-� _ I _l� 1✓- -1 � 1�{,c- _ � j -i.- _I - i - _ ao• I � f , I ' , i w i I 1 1 i I 1 4 1 I i I , - � -- � - - - -- - - -- - --� -- ,per -- - - - - - - -- -- -- - -I - - - -- I I I I , , wor i `�er� -;c�C �O►'�'��e� `,m. -x �': �►�vr.� 'sc► ->`I� sw`l s � R `��`ts IU �1Q 1�t c N rem.. 1s7 C r o y All s {� a • 4. w ` ,� � 3� O - _No r Use A .K1e 11it Io1a31C)v Cs -r _ _ _. _ _ ._ I -- I wr w • r r rr r s EZ1203H Ty Pd, 4.6 • r � r S i • +wr ♦r• ww rs♦ ire 1 It ' wws ww♦ 1 • • • ... "2 Circ, wr►vv + +ww•wi w •T •♦ wTw♦♦ ♦• +w•wwwr••♦ s s ♦ • • +•rr♦ �* •° +••errs•+• ♦w ♦i ♦•+ rr•srst♦ »ice ww• r•ss •twee•♦ 36 19 4 yp 12- I / tt DIA.. (tyrp.) Vaid CoefPtoient in Agg"ate Oven at S7.4X SO tQ ea Aria O.O. of 4 ° lII: IQ EL Void ? PrPK " 4 i:tciKS Sidcwait z (_ SW,,, U votutnt Pre' iiecear ft. _ 11 .( tzs>d � 3.13 ,. • — - a j 't X0.117re Batt ft om O. D, of 1 ' 12j.1 seater cylioder = 1'2S inches 2.00 Vo v olume in a Total Soil tnttrface Area 8$+t 8are Of ( ( tercyfindcra ftj` ).14.12..1t25i. } 5.1 -05(1, l l t2we� � I'.s�as.a22 tY O.D. ofou ul, cylinder, ., 12 ind� // Void volum in outside cyl' ttKets / tnu Projected Trench Arta 112in /l1] tN Sid eWali Height. 12 in. •2 :2.00 Sq.Ft. 'aid v olum e at bottom between cylindcrs r sw Bottom = j -2 _ti,_� _ g � } 36 in. = 3.00 Sy.Ft. ((( 1 • tliaeR� ( 1.1� ! °0,215 fe 12iotft� J Projecttd Trench Area - t Void volume at outside bottom 508 Sq.Pt. e eoettets (1!: Orvaed volume between cylukkn) 0.215 ,' 2 - 0 .10$ fN Total void volum - 0. 117 + 0.422 + 0.901 w 1.763 cubic h / ft Gallons Per It = 1,763 X 7.43. l ns tur it_�� � A EPS Aggregate Trench System FZ1203H 6 5 § Lndustriof Grou _ OW I ndustrial Pork Rd. { Qokland Tt4 -18060 i SCOAX F" ewe EZ1203N. rat tlET: 1 at t tt -27- -W 1 { Wisconsin Department of Commerce SOIL EVA,�Y1 , `N REPORT Page of Division of Safety and Buildings -��' L in accordance with Cola - �5, fNis. Adm.&Code t Attach complete site plan on paper not less than 8 142 x 11 in size. P ��i� 1 l \ include, but not limited to: vertical and horizontal reference p " �� ), irection and + '' P� - �Jbt ?ar 1 I.D. N 6 percent slope, scale or dimensions, north arrow, and tocation �dista 1d n&r9st t9 - Please print all information c +o x Flew Date ol Personal Information you provide may be used for secondary purposes (m)) L (Pfiv Property Owner t S • COOK � -, Property Lo rP, i 114SW1/4 S I T Z$ N R IpJ E(or W Property Owners Mailing Address 8t #- - lock # Subd. Name or CSM# \1$ QO spr, NE SUL` z- LOD I - tLOV \lLl, AG l Wl� PfpD, City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road [� New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate OQ GPD ❑ Replacement ❑ Public or commercial Describe: Parent material LAS yL{ Glp� L p -g f j Flood Plain elevation if applicable General comments and recommendations: LQSTIt -l- 3 � ot= 1�1G H 1�RCl ry SI p )wDt;R L k4 Cltit�i>a S C � Boring # ❑ Boring ® pit Ground surface eiev. ft. Depth to limiting factor 7 1 Z S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft in. Munsell Qu. Sz: Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1_ o -t 1 7 -1 z — :51 1 �sb>c wt `�h et.;J 1 v� •Z • S1 tm'I )m s h aka 3 3 y -qi I��tz ul6 C's 1�sbk m v��• cs — .� �. Z u1 - 6q ion 2 s! -- �s qsi I 1Csbk m f-i- cS — • 2 - 3 S p_\ZS - 16'1 r?- v /b — S O S9 m) \Zy Boring # ❑ Boring ® Pit Ground surface elev. Sg S -3 fL Depth to limiting factor t ZO 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 o -}.p to`2►ZZl 1 -Z.0 t0`�ft 313 S t 1 Z'F vvl CS — . S .9 3 2D -37 ! Oti R V& 7•Sy2S /$ S - 1�'�I2 5l6 — `�_ g9 3 ell <, ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatu CST Number Arthur L: tdegerer - a 40 �31g- 1�Z-5- 220254 Ad dress W e g e r e r Soil Testing & . Design Service Date Evaluation Conducted Telephone Number 421 N. Bain St. River Falls, WI 54022 1ra _2-'3 -00 715 -425 -0165 1 i Property Owner C0" -) Z L ) _ CDT p Parcel ID # PPT�Q ©)N6 page Z of 3 1Z S Boring # [3 Boring A ® pit Ground surface elev. Y- 2 ft. Depth to limiting factor la in. Soil Application Gate 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 o -\tS 1 u Iz z z - s t) Z-`Is bk m+, C w v s • b ZS 3& — s� Z-S h1`�1 CS -5 • £'& 1:S6 -q2i IO m I C S -9 5 q3- \ l 1 c�`11Z yet; — S d S 9 vn 11 S Boring # ❑ Boring t ® Pit Ground surface elev. g� ft. Depth to limiting factor 7 L t b 2 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 o —1 l� 1O�t iL ZLZ — ., S J � � `�Sb►Z Vvl.`FY• C..Lv 1 U'F • 2. • 3 3 Z -39 )Olm sJ -- �s 1 biz m vTV cS . L1 U 9 118 IDYLL y/6 S OS ►M z'` F-1 Boring # 11 Boring El 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 t ► g .: 1�L io rat $S.3 v 3 Z C 4 L S LI A71EM S L° t AJ C IZZ - aL W'K3 '2 e_ • Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < ISO mg/L • Effluent #2 = BOD 130 mg/L and TSS < 30 mg& 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. 5004330 (R6/00) PLOT PLAN Page 3 of 3 Scale 1' =.Std' in -EI- 8aZ.39 o" +P a. 17-k4 c Fq3 8Qy a«u D LuT �Z�-/ Z95 89b b ' 3 /,2 Fl o LOT tZ S OL L s•izsa l3�w —� 894.tp C - IN) _ W Sit LIZ - -�r j_sr�rn AT Lqt�37 t 7L " 1 Aj t '��► S PAD ! i'otZ1Z qty 13uT `rvO'1' - -- b 12.M��/ E S�IS�1'I LZ- L�J�T1U� ST T71E OF itv%`i tri- l.CtU1V 715- 425 -0165 220254 db -3i8- 1Is CST Signature Date Telephone No. CST Pto. Job NO. Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of safety and Buildings Page of 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 l X include, but not limited to: vertical and horizontal reference point (BM), direction and Q�� ©) percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. !lJ 6 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 py} , �o S . 0�3Ok Property Location CUI J`nQEtlj `PAC Cxj PC Sl`Q 1/4 S W 1/4 S T Zg N R Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# XLb(30 P/BZAZrO( .� Sr. AjE \-Z \AU KE q` ADc::,, city State Zip Code Phone Number ❑City ❑ Village ®Town Nearest Road �Sg ��,,PCtNE f"tN gq (763)' 57 -75bb - T_\Z.OLf Mut%1F1EL.0 T2, ( New Construction Use: ® Residential / Number of bedrooms Y Code derived design flow rate boo GPD ❑ Replacement ❑ Public or commercial Describe: Parent material Ll.) Flood Plain elevation if applicable K3 A ft General comments and recommendations: LQSr't<_L or= �k161 �,fCy >r�tt,� SI p ) L C1�i R�I� S S . lAJ STA t.Le _ 0+j 1 C� Boring # ❑ Boring ® pit Gro und surface elev. fL Depth to limiting factor N-L S in. ` Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftZ in. Munsell Qu. Sz. ' Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 fL - L 11 - si! 1`F-sbk rn�r lu'F •Z -3 Z ( -3y ZO`�izYlb -- S1 d stl l wl SD 'IC 3 Y 41 -60 ioK s! 7 — �s�tsi �c_sbk m cS • 2 . S o -�ZS to�t2�r16 - 12 y Boring # ❑ Boring ® Pit Ground surface elev. Depth to limiting favor ? ! 2 - 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 - 'Eff#2 1 0_l0 +o�►ZZt - -- - s I Z'Fs�,k rti�- � tb� , 5 . . 10 ZO Si 1 2_'Ps6k rn cs 3 ?Z -Y7 W-1 2 X16 _ S11 1 7.Sy 2S19 s 1. pv_ S �S' -t ZD Jo'�2 S16 S_ 3 rutl — 1. Z ' Effluent #1 = SOD > 30 < 220 mgt and TSS >30 < 150 mg/L • Effluent #2 = BOD, < 30 mg/L and TSS _< 30 mg/L CST Name (Please Print) Signatu CST Number Arthur L'. _Wegerer - 0 , V ` - .. 003"R - - Z5' 220254 Address W e g e r e r Soi Testing &. Design Service Date Evaluation conducted Telephone Number 421 N. Main St. River Falls, WI 54022 -00 715- 425 -0165 Property Owner �AJ�1Ut _ C°0'{Z:(� Parcel ID # - Page �- of 3 F S Boring # ❑Boring IN I ® Pit Ground surface elev. Y- Z ft. Depth to limiting factor la 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 o -�S t a`t tZ ZL z — s t) Z,�� bk m`�• cw ) u • S - C6 36--g3 lo\•fp -S _ L'FS v g rn 12- Boring # ❑ Boring t ® Pit Ground surface elev. g�� Y ft Depth to limiting factor t t 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 0 -10 Z 10 -1 1p4fZ 313 S ) 1 ) VMS m CS 3 LZ -39 !OL /v SIL C.sb1z m U cS - 1 4 9 -118 W12 - VIC _ S OS vn ! -- .� t -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. ssD.e330 lR.srool PLOT PLAN Page 3 of 3 Scale 1'=5W -EL 8x +� a.aq c F93 eQy 8 -tut D LuT 1"Zy a45 89b r Lu'T tZ 5 L g93 ol' g4 y S•LZSA 8'9S 84 $.tZ.S13 a,v LOT VU t Z l Aj Tb - tit S PCB D f'� iZLZ Utv _ _� - - - - - -- �J �iwlix/ SKS71"I E - JKnw1 S f}T 7771E OF 11�15`i'PCti -I_ Cl1V - jp CO 715- 425 -0165 220254 00 3ig 125 v CST Signature Date Telephone Ito. CST No. Job NO. c ^ ' 1.028 ACRES l S 89 °33' 26" E Z L - 44,774 SF. _ 24.04 W 3 - - - - - - - - - - - N 89 °40' 20" W � 331.17' - '^ rn � � N 89 °55' 19" E 124 o 1.010 ACRES o , . ;� 37.2z' , � i • o £X /STING 66' WIDE '' ✓lL L A GE " L _ 44,016 s. F. ° ° S 89 °55' 19" W in SIN V1fLUM 153, f cO M N 89 °40' 20" W v 43.85' 33 Iv I 3 3 �- cn � - ----- � I � i � � � W � LD T 3 125 I Z 3 _C.S.M_ ri N 1.012 ACRES ' M °OO ° o w VOL. 4 44,065 S.F. tin ° ° rn , O p = W PAGE 9 rn N 89 0 40' 20" W �' O J, v 1 N 1_ -' O O 331.40 �- �� 126 N+ II ¢N� 1.027 ACRES 04 JI - - - - - - 44,743 S.F. I N 89 0 40' 20" W + N w i l - - 334.37' _ I 0 � !N �I � II �i I 127 I , OUTLOT 1. 1.022 ACRES N ( 0.550 ACRES 44,532 S.F. - U� 1 + 1 23,974 S.F. w 3 Ln -- -_ —___ N 89 °28'54" W 325.00' - r� i ,� N U) oo aoO n� M Mpp 10 128 O O o0 N; O DO ti 1.037 ACRES i / '� �� r - / Z to AA 45.173 S.F. / / 1 i / 3 0 f S M PAGE 04 °1 12 I 9 , `�� �'�� o ,� 1.036 ACRES i / , / V O`- W 45,130 S.F. / N ✓XLAGE gyp I O O S 89 °28' 14" E G�� , X11 al POINT OF fn y `I �0\� BEGINNING N �IVI VI (6 � G�6 � 7 -` .62' M c d r- O N 0 89.28' 14" W 57.89' O•� m 1 Z 3 1 66. ' 1 210.3 3' N 89 0 28' 14" W 395.17' B -352 t l x r 900.3 � � ZV I 899.20 12 X 0 3 , / I ` / �' / �' / ol t O, B -410 1t x 899.5 B-411, i 1 ,' I B-351 Q 1 1 f I ' � �� O 1 ! / 0 897. 895.7 / 1 \ 1 ., \ \ •L•�•••r B -40 / ^ ""'B-407"' LOT 4 I C.S.M. / O VOL. 4 PAGE 99; r / • / . B -406 H--408 B -350 — ' 893. 1 / 0� �• r ' I '/ r / O / 0 1 /',o, / R O — — — — — — — — — — — — — — — — — — - B -405 / $9 1 / 3 r ol r/ r �� r LOT 3 894.6 C.S.M. YQL. 4 / / / H -3491 l > ` ,• " \ �' j / 911.1 93 dIC 4 ,6 1 ' n � � � � WT/ g 26.89 � • I � � ,. n rl / Q4403 v \91 8 I I 5 4;04 l i ( w 8 -348 o '� i P ' 63 +64.09 1 B-40 ,' \ "(( � OUZO 909.3 L , LOT 1 10 C.S.M. ol VOL. 6 PAGE 1627 1 8-1347 of page -12 P+OWTS QWIVER S MANUAL & MANAGEMENT PLAN SYSTISIiI SPECjfM'nONS 0 NA :*E NORMAIION Tank Marwfacttxer W � .PS t1rs v ( Permit # Septic D Dose ❑ Holding Vol. l Opp Permit ao g3 Tank Man ❑ NA PARAMETERS D NA O Septic ❑ Dose ❑ Holding Vol. gat Number of Bedrooms ❑ NA Number of Public Facility U nits �I+jA Effluent Filter Marwfectur� �'���- t7t7 Effluent Mode( Estimated (average) flow �� at Design (peak) flow = (Estimated x 1.5) ,jt'� ai /d pump Manufacturer slid !ft" pump Model Soil Application Ante . Pretreatment Unit NA monthly a standard lnflueM/E �_'�" 0 m /!. ❑Sand /Grave! Fitter Peat Fitter Fats, Oil & Grease (FOG) 53 9 Cl emand {BOD 5220 mglb. NA [3 Mechanics! Aeration D Wetland Biochemical Oxygen ❑ Disinfection ❑ Other' Total Suspended Solids (TSSI 5150 mg/L Monthly average Manufacturer DNA Pretreated Effluent Quality monthly Cell(s) Biochemical Oxygen D eman d tBOO -,= MOIL )(,NA in- Ground (gravity) ❑ in- Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L At -Grade [I Mound Fecal Conform (geometric mean) 1OUmf j [3 Othe ❑ Drip -LiOe r: Maximum Effluent Particles Size Y in dia. O NA El NA O NA Oth®r Other. C3 NA +'Values typical for domestic wastewater and septic tank effluent. MpiNTENANCE SCHEDULE r Frequency Service Event ❑ month(s) (Maximum 3 years) ❑ NA Inspect condition of tank(s) At least once every: ar(s) El When combined sludge and scum equals one -third (Y,) of tank volume D NA Pump out contents of tank(s) ❑ When the high water sfarm is activated D month(s) (Maximum 3 Yaws) ❑ NA At least once every: month(s) t Inspect dispersal cell(s) h moth(s) 0 NA Clean effluent filter �S N -- -�' At least once every: ts) ❑ mbeth(s) O NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) (s) ❑ NA R [3 ush laterals and pressure test At least once every: O t h month(s) ❑ NA Other At least once every: Q years) O NA Other: AAAINTENANCE iNSTR IMONS ane of the foNowing licenses inspe or certifications: ctions of tanks and dispersal cells shall be made by an individual carrying Servicing Operator (pumper). Master Plumber, Master Plumber Restricted Sewer, POWTS inspector, PO any mi Main n aware, identify any cracks or Tank inspections must include a. visual inspection of the tanks) to identify of effluent on the ground leaks, measure the volume of combined sludge and scum and a check for back °f P °� and to check for any surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in8Ge may indicate a failing condition and por►ding of effluent on the ground surface- The ponding of effluent on the ground requires the immediate notification of the local regulatory authority or more of the tank volume, the When the combined accumulation of sludge and scum in any treatment tank equals one -third tY,l with chapte r NR 113, tire contents of the tank shall be removed by a Sept8ge Servicing Operator and disposed of in accordance en Wisconsin Administrative Code. nts, pretreatment of effluent filters, mechanical or pressurized compose Ali other services, including but not limited to the senricing b a fl POWTS Maintainer. units, and any servicing at intervals of 512 months, shall be perf ormed by 1 O days of completion a# any service event' A service report shell be provided to the local regulatory autho�Y GMW (2102) I Page "Z-- STARTUP AND OPERATION Pa 9 Z - ' °f For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting chemicals that may impede the treatment process and /or damage the sod dispersal olvents or other have the contents of the tank(s) removed by a $� cell(s). If high concentraoncentra tions are detected septage servicing operator prior to use. System start up shall not occur when sail conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cdi(s) in ore large dose and may overload them resulting in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually o pu perati the controls to restore normal levels within the pump tank. ng mp Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area Within 15 feet down slope of any mound or at -grade soil absorption Wea. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics, baby wipes; cigarette butts, condom: cotton swabs: degreasers: dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter 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 shag be removed and properly disposed of by a Septage Servicing Operator. • "After pumping, all tanks and pits shag be excavated and removed or their covers removed and the void space filled with sob, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: I, 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 and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. O 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 rent area. If no replacement area is available a holding tank may be Installed as a last resort to replace the failed POWTS. C) Mound and at -grade soil absorption system may be reconstructed in place fallowing removal of the bio e mat at th infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNiNG> > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN 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 IN T'ERIOR OF A TANK MAY 13E DIFFICULT OR IMPOSSIBLE. ADOITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Nam c O tt -p rS Name Phone t s s t c Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name S'f � � .p Phone Phone This document was drafted by the staffs of the Green lake. Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapter Conan 83.22(2)(b)(1)(d)&(f) and 83.54111. (2) & (3). Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND . OWNERSHIP CERTIFICATION FORM Owner/Buyer �J �ILR —1 t C �S j C d tom( 60 , 41(, Q Mailing Address X L r (.qA4 4 0 � � �, ��`'��� � , Property Address (3 1111 -41 tZ t C L, 4 ! L_ (Verification required from Planning Department for new construction) e 40.5. City/Stat � Parcel Iientification Ntuntier LEGAL DESCRIPTION Properly Locatio ' /,, ' /., Sec. . T N -R W, Town of T'W Subdivision y Y' L-LA Q* I , Lot # Certified Survey Map # , Volume . Page # Warranty eed # $�' -7 / �� i4 7S_ . ty . Volume . Page # Spec house / Ryes ❑ no Lot lines identifiableXes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature faihne to handle wastes. Proper maintenance consists of pumping out the septic tank every time years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and' by a masterphm>ber, journeymanplijmber, restrictedphunberor a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if nocessary), the septic tank is less than 113 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification . stating tha5 your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of a three year expiration SIdNATURE OF APPLICANT � DATE OWNER CERTIFICATION I ( ) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of thAATURE esc b above, b e f a wa my deed recorded in Register of Deeds Office. // � 3 SI OF APPLICANT DATE Any information that is mis- represented 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 a copy of the certified survey map if reference is made in the warranty deed i ssao�� KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2 _ IOU REGISTER OF GEED -S WARRANTY DEED ST. CROIX CO. WI 8.3 AArf. �� RECEIVED FOR RECORD Vni (. This Dead, made between 01- 14 -200B 9:40: M WARRANTY DEED ?i 1 t ra on. d M nnesc+ta rvorat ° CE�COPY FEE; ��. Crantor. COPY FEE: :l and t TRANSFER FEE: 9,1&70 _ a Wi �er+nn a i n ln n►- ►�nrst i rm RECORDING FEE: 11.00 PABES1 Crantre. Grantor, for a valuable constder0on convtye and warrants to Grantee tht followln$ described heal estate to St. Cro _ Couruy. State of Wixonctn: Ro Lot 125 of the plat of Troy Village 4th ~ � r "� ~ Addi�in the Town of Troy, St. Croix County, _ NOM WKI RCM^ Addnaa Wisconsin. INV PrVaLOO'MENT C�t�ARAT�ON Subject to Declarations of Covenants, Conditions and 1"M A�h � �h STAWI , SI rrE ioo Restrictions for Troy Village recorded in Vol. 1241, & PA M)V Page 256, ae Doc. No. 559964, and the Declaration of Golf Course. Covenants, Conditions and Easements, :::::,• recorded in Vol. 1241, Page 301, as Doc. No. 559969, all as appearing in the office of the Register of Deeds 040 -1281- 70-000 for St. Croix Count Wisconsin, and sudh other Porcet18aw Nur Nkatlili W(PIM li easamts rest rit: ; and reservations of record, Th Is not homestead pmperty. or in use, and the "Ituyero obligations contained in (ts) (is not) the P11 rcWwe Agreetaent for thia lot. I is f' iE ' I( Exc epti on s I cepd ns to Warranties: Dated this 6th d of December 2001' _ !� l s . (SEA4 (SEAL) • Charles 8. Cook, President Troy Development Corporation (SEAL) - _ - (SEAL) 'i AUTHENTICATION ACKNOWLEDGMENT ' rl Stgnatun {a) Mi State of W+toors+hr, Anoka County. authenticat this day or Perrornlly Come before me this 6th day if — R . , the above namod I —Charles—$ Cook President f Troy Deveit>ttent Cornord on �' 11=: MEMBER STATE BAR OF WISCONSIN P (If not, me known to bq the Penon who executed the foregWrtB 3' autharited by 5706.06, WAS. State.) Ittstrumtrtt and a4mwledge the same. THIS INSTRUMENT WAS ARAFTEO By f TROY DEVr -0?H NT CORPORATION Rick A.. Johnson l � Notary PuW Count Kinn. ' Charles S. Cook, President My c"miseton is Permanent. pr not, state expirayon date' , (Signatures tray be authenticated or acknowledged. Roth are not Jari 1 2006 ' ' ua�rY' 3 x 1 • I . Naptn of tsr.wr.IprrY u 1 .er TAIWIty neat 11V 1"I w IrnrrM,1 Iwkrw dx rt. WARRANTY D161) FrATII PAN OF WISCONSIN wee"thLow NVA40s. 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