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HomeMy WebLinkAbout040-1083-30-000 r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 420628 0 GENERAL INFORMATION z (ATTACH TO PERMIT) tate Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 4ST j , - r e604 . ilt Permit Holder's Name: City Village X Township Parcel Tax No: - 7 Pierce, Ann Troy Township 040 - 1083 - 30-000 CST BM Elev: Insp. BM Elev: BM Descripti I ' / !vo *o s S► (J�l TANK INF RMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark ( r p rctSt -�2 �o AD Alt. 103. >1Ja,o Dosing (' / tt Alt. 3, 0 . S `' /d Aeration A,pp • Bldg. Sewer • 'Y �1 Holding St/Ht Inlet � ( �) O/ q � St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic y so >too! 41 Dt Bottom q 6 • qo t I Dosing L . �a rs / Header /Man. Sz Aeration Dist. Pipe • �2 T r ��� 5 3 1�• / Holding Bot. System �•� final Grac�e� 'Za{ Cdr PUMP /SIPHON INFORMATION Uvw� Manufacturer Demand St Cover GPM ,,,,q to Model Number 4 • � TDH Li;), 0 Friction Loss System Head TDH Ft I . Forcemain Lent D g Dia. Dist. to Well SOIL ABSORPTION SYSTEM •SIC> �• $b C- BED/TRENCH Width I Length t No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. iLiquidpepth DIMENSIONS 1 6 0. ) 1 � . � � SETBACK SYSTEM TO P/L B III LDG IWELL LAKE /STREAM LEACHIN M acturer: INFORMATION Type Of System: CHAMBER OR N1au� 1 -3 oJ y UNIT Model DISTRIBUTION SYSTEM Header /Manifold � Distribution t (�` x Hole Size` x Hole Spacing Vent to Air Intake 13. Pipe(s) Av') (� Length Dia Length 'e Dia • Spacing Q 2 2 7 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes [] Not T ❑ Yes FO] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #11 —�� "" n #2.-A /9 / 2rA [� Location: 535 Chinnock La River Falls, WI 54022 (SE 114 NW 1/4 T R19W) NA Co Parcel No: 2 .28.19.327D It BM Description = �`f �"" A ( A p /Y/ • 2.) Bldg sewer length = S - amount of cover = > 36" -gyp 3.) Contour = q} .(pQ Pf�n revis ibn Requi d? Yes No - ZZ Use other side for additional information. -�� i SBD -6710 (R.3/97) I e� C Insepctor's Signature Cert. No. 1 Safety and Buildings Division County ` m 201 W. Washington Ave., P.O. Box 7082 S scons,n Madison, WI 53707 — 7082 Sanitary P it Number (to be filled in by Co.) Department of Commerce (608) 261 -6546 d fAV1 z0 I Sanitary Permit Application 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, sl5.04(1)(m) Project Address (if different than mailing address) I. Application Information — Please Print All Information , S3� Property Owner's Name . Parcel # Lot # Block # Property Owner's Mailing Address Property Locati City State . Zip Co Phone Number --Z v. AJ A Section - FJ 4 .. 1 a 7/s _ E or one) II. Type of Building (check all that apply) ; RE or W I or 2 Family Dwelling - Number of Bedr i ion Name CSM Number ❑ Public /Commercial - Describe Use z ( 7. - —�- ❑ State Owned - Describe Use Cr X 5 ❑City ❑VillageATTownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) (? - 3 0 — d A ' JfNew Sy R lacement System ys ep y ❑ TreatmentJHolding 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 Issued ❑ Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl D ❑ Non - Pressurized In -Ground K 2 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pi ❑ Other (explain) &AP V. Dispersal/Treat ent Area Information: * foal_. Des' Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation � - - " 7- 5 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Tanks Tanks Septic or Holding Tank M � Aerobic Treatment Unit Dosing Chamber / C ® / C VII. Responsibility Statement I, the undersigned, assume responsibility for i allation of the POWTS sh wn on the attached plans. Plu bet's Name (Print) J Plumber' ign re ( PRS Number Business Phone Number Plumber's Address (Street, City State, Zip o e) yq _ /1 VIII. County/ e artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groun ater Date Issued Is uin gen` Signa a Stamps) Surcharge Fee) p / El Owner Given Reason for Denial 3z�7 �^ , (! 0 IX. Conditions o Approval/Reason sfor Disapp oval C Attach complete plans to the County only) for the system on paper not less than 8I t2 x 11 inches in size SBD -6398 (R. 08/02) rLU'r rLA.v Page 3 of Scale 1"= 30' ------ - - - - -- S 3 S CL�'t►JlJU C1z W i G' S oli x P -S b 4"pVC rm V=� ZO' 97 X. bo nor I � o *CT D�s�s poi za 7 cl 6 IIoMM 0E- cis _ �4 ' 0rJ 6IUWD S\ - zRRCE 1)-T 1�jUSE Ca 2NgZ.: __ C o rte" otJ WLIA L is > Poo 6 1r c F M. out - — -_ NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be X 400 1 6 SD gallon capacity manufactured by Lv1 rig CthJC 1 ►•�/ A_1&00 FrIL_r;* 4. Bench mark c, S COVE �. Divert surface water around system to prevent ponding at the uphill side. Marion Standaett I Subject: 420628 - Pierce /Utgaard Tank knot Location: Troy Start: Wed 7/9/2003 11:30 AM End: Wed 7/9/2003 12:30 PM Recurrence: (none) ap 5,T-, Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TDD #: (60$) 264 -8777 sconsin www.commerce i www.wisc wiscon sin.gov in.gov Department of Commerce F C APR 1 4 3 Jim Doyle, Governor ST Cory L. Nettles, Secretary ZONING OFFICE April 08, 2003 CUST ID No.267341 ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 04/08/2005 Transaction ID No. 855170 SITE: Site ID No. 653728 Ann Pierce Please refer to both identification numbers, 535 Chinnuck Lane above, in all correspondence with the agency. Town of Troy St Croix County SE 1/4, NW1A, S21, T2 8N, R 1 9W FOR: Description: Proposed Three Bedroom Mound System - (Revised from Two Bedroom) Object Type: POWT System Regulated Object ID No.: 883033 Revision The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The approved revisions will become an addendum to the plans that were previously approved on November 25, 2002 under Transaction ID No. 814403. All other portions of the plans shall remain the same. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans. • A slate approved CMUCnt finer is required. Maintenance inforziation must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). >'F.0. T S. ARTHUR L WEGERER Page 2 4/8/03 Owner Responsibilities Continued: • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 60.00 &46� Fee Received $ 60.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633' jswirn@cornmerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 r TITLE SHEET Page of 7 FOUND SYSTEM FOR A BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD -105 7 P and the Pressure Distribution Manual SBD- 10573 -P C 2. b / aq C 2. 6 1q4� LOCATED IN THE SE-= 1/4 OF THE MLJ 1/4 OF SECTION -'- , T Z8 N, R 19 W, TOWN OF T\-_o 1 - y S 1 COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MAINAGE PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUI.4PING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE i PREPARED FOR R ECEIVED _ 1 V�ZL�, APR - 7 [.N"13 S 3 S Cl l t,j Vj0 LP;, J� SAFETY & BOGS DIV- cz�v z FA t-kS, L -,, s -o z-z PREPARED BY WEGEF:;tEF;Z SOIL - TEST I htG AND. DES Z CSM ICE P.O. Box 74 421 N.Main St. '0,4 River Falls WI 54022 Phone 715- 425 -0165 Fax 715- 425 -6864, t wnreas� g c > =ai5 v „ ELLSWC41f h, G �t 4 3 3DCZ- 1 ^'1.. O;MEM ti=p WM )°r Z D1 S 5T13A4 , d � Laos y_U —o3 APPROVED DEPARTMENT OF COFAMERCE IVISIgN O F Y AND BUILDl�1GS t JOB NO. QZ-U0 R SEE CORRES NDENCE Mound System Management Plan Page Z-- of Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. 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 tar 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 113 the liquid vclurre 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, Safety and Buildings Division. Pumg 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 for frost protection. Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg/L TSS, and 30 mg /L FOG. 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 eve 18 months. When a ressur rY a test is pe rformed 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6199)] 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 aid 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. Contin enc 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 shall be .imme i mmediate ) r P diately r epaired 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 adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning ;Office at 3 -- b L!- 0 8Q Ste , CtiI( The system installer at `llS Z6 — b ggs U The tank manufactu -r) rer at j pU 3� $ S6 The effluent filter manufacturer at q The pump manufacturer -at PLOT PLA,y Scale 1"= 31(31 Page of O bt , { WtTL S x P S is ( OF Z ►3DTLM ri 9(,o Z�ti'VC F, > I . I ° /U �> prtr az ►s I `mss P P L s YTI)'" Qt= e � N1 MJ . - 7, S z�. ii ' f J RM = am Wz - :'LN . �i�. L4 orJ Gj DUND SvR FfleE t) 1A} USF C421V�2, -- C Oir'1� NOTES: QG Tth.h.:s - M 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation i es with a P P roved caps. PP P � Z required). 3. Septic tank to be 1 q 000 1 6 Sb gallon capacity manufactured by 4. Bench mark S = S �BOUE 5. Divert surface water around system to prevent ponding at the uphill side. Page Ll OT - 7 Alonrove^ Synthetic Covering AST-H C33 Distribution Pipe Medium Sand Topsoil '" o- W fG Ab 3 E 0 I e 3. Slope Distribution Cell of Force Main Plowed 2" to 2- " Aggregate From Pump Layer D O•S FC. E O. - 1 - 7 Ft. CROSS SECTION OF A MOUND SYSTEM F DA Ft. C 0-5 Ft. A Ft. h' 1 • d Ft. Linear Loading Rate =q -O GPD /LN FT 8 So Ft. Design Loading Rate =p_y GPD /SQ FT j Ft. J S Ft. K S Ft. L (, Ft . -- Ftree — W Z y. Ft. 1 - Observation Pipe }`— E =-- K Ao— �-- - -� $ - - -- --- - - - - -- -------- - - - - -- --- - -- W 6 - - -- - - - - - -- ----- - - - - -- ---- - - - - -- Force Main a o O�P Distribution 1 „ k " Pipe � C of 2 to 2 z aggregate Observation. Pipe cmchcr securely) ' ' PLAN VIEW OF A MOUND SYSTEM Distribution Pipe Layout Page S of Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 45' fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a valve,-'threaded cap or . threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug- - T`tP L . �Zi�SS SC�10N PVC Lateral M nifald � x x x x x!2 V2 x x x x Lateral Length — Lateral Length — p Distribution Line • P -� � r�ct soX S • P\0 CwQC` >7P - --0 — Lq P Ft. Hole Diameter ��8 Inch 5 3 Ft. Lateral n 1 Inches) X Inches Manifold Z Inches - Force Main " Indies # of holes /pipe 1 3 Invert Elevation of- Laterals q ) Ft. S .33 x 6_ 3 L.48 GPI _ - Combination Septi.c; and PUMP CHAMBER CROSS SECTIOM AND ' SPECIFICATI NS PAGE - 7 0 � OF NEWT CAP WEATHER PROOF JUWCTIOW BOX ti C.I. VEMT PIPC APPROVED LOCKIMr. 1 FROM DOOR, &WHOLE COVER IvtM %i1kIOOW OR FRESH wARHJI►JG LPs6FL u o,J P IPE AJ.R. INTAKE S cowD� Ft iV LSI{p Is•r�I�I. --- -- - - -- tAJLET PROVIDE I - -- `�'' �"AIRT16HT SEAL 8Ar - •� III . Approved r•t ° � I Approved joint w/ I joint w/ PVC pipe �1000� b . I L ALARM PVC pipe i I I I oW c�' � c • I I CLCV. FT. I PUTT ' OFF D COWCRETE LZ� ". C) ; 00 BLOCK - f - KIS ER. EXIT PERMITTED OQLy IF TA MAIJUFACTURW-K HAS SUCH APPROVAL 3 " ApPQoti�p �BtDD t>vit SEPTIC F SPCC.IFICATIOUS DOSE TAAIK MALI U FACT UQCR: WUMBER OF DOSES: S - -�) PER DA ., TAMK 51ZE: 100 / SO GALLOQ DOSE VOLUME r ALARM !'tA)JUFACTUFLCR: S l �L� Y1 ?() I —SLI IAICLUDING 6ACKTLOW: 1 OZ- GAttONS P%ODEL ►DUMBER: _LQ ` �w CAPACITIES: A= 1S IUCHES OK ZSS c� GALLOlJ S 5WITCH TtIPE: g = Z I►JCHES'OR GpLLpWs PUMP MAWUFAGTURCR: G b LD C = 6 IUCHES OR 1 Q GALLOWS L1 MODEL i —_ 1 =P �'� " s \ -S INCH�ES�OR —2-,5, �s GALLOWS SWITCH TYPE: L�U�ZC/ DOTE: PUMP AMD ALA , TO 6 b MIMIMUM DISCHARGE RATE- �� GPM INSTALLED OM 5EPARATF CIRCUITS VERTICAL DIFFERENCE DETWEEW PUMP OFF AIJO 015TRIBUTIOW PIPE.. FEET + MIIDIMtUM iDETWORK SUPPLY PRESSURE , , , , , .. . . (�'SO FEET 3) - - I - �S FEET OF FORCE MAIM X I.1'9 - FT FRI 710 F A CTOR..-- ` * .fL C LJ ACTOR..____ 7 FEET TOTAL DtIUAMIG HEAD F,EET As per manufacturer 1 gal /in. Liquid depth 38 �` Goulds °� Submersible f Effluent Pump i 3871 EPO4 EP05 0 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and •Farms manual operation. Automatic 'and float switch attachment • Heavy duty sump EPO4 Single phase: 0.4 HP, models include Mechanical RP points. • Water transfer RP M, , built in overload with 230 V, Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewateling automatic reset. preset at the factory. rated oil and water resistant. • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with construction. ■ EPO4 Impeller Thermo- . P Solids handling capability: automatic reset plastic Semi -open design 3 /a' maximum. • Power cord: 10 foot AGENCY LISTING • Capacities: up to 55 GPM. standard length 16/3 SJTO with pump out vanes for mechanical seal protection. 0 Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for (CSA listed model numbers rotary/ceramic- stationary, three prong grounding plug improved performance. end in "F" or "AC ".) BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 0 C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 I � Capable of running . s dry without damage to . . . . . . 9 30 components. Pump: EP05 s - — ----_ t . s=ue • Solids handling capability: c 25 ` %" maximum. W z • Capacities: up to 60 GPM. 6 20 { • Total heads: u p to 31 fe et. — • Discharge size: 1 1 )9 NPT. _ • Mechanic al seal: carbon- c 5 15 s• rotary/ceramic- stationary, 4 . g I ► �, l BUNA -N elastomers. • Temperature 3- 10 104 °F (40 °C) continuous R 140 °F (60 °C) intermittent 2 ! q — 1 • 0 Op 10 20 30 40 50 GPM 0 2 4 6 8 /0 12 m °Ih CAPACITY ©1995 Goulds Pumps, Inc. Wisconsin D�artment of Commerce SOIL EVALUATION REPORT Page 1 of Division of S fety 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 Z� include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. D 0 -! 3- 30 --000 Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Lew, s. 15.04 (1) (m)). Proper— tyOwner Property Location Property Owner's Mailing Address ' S 1/4 N 1/4 S Z j T Z� N R E (or) W j Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number R�()EZ- Ff _- _S 1�V S�jO ZZ ❑City ❑Village E] Town Nearest Road 1 ( S ) 4 Z6_4Z8S i�t,Ux�oc.Jz �� ❑ New Construction Use: R1 Residential / Number of bedrooms Z Code derived design flow rate 3 0 O GPD Replacement ❑ Public or commercial - Describe: � Parent material g OV '2 `I ] Flood Plain elevation if applicable Nv t General comments ft- and recommendations: 1"�, OUIv� '�� b x S O � � �S'rT� (.� U `iZ u:•J i D �LL. Boring # ❑ Boring Pit Ground surface elev. — 1 b • 7 ft Depth to limiting factor _ y in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft� in. Munsell Qu. Sz. Cont Color Gr ../ S 1 z. Sh. 'Eff #1 *0#2 6 -10 1 �` l7 31 Z S1 Z T q `✓1� U�l� 1 -v Z v • S Z 1D -31 60'�2� si I Z�sbk MA- cl.,-) _ S ,V � b SS 7 I Boring # ❑ Boring a Pit Ground surface elev. ft Depth to limiting factor S 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 V+ • S . 43 1 ��Yi_31L S) 32 -S S CS C/ - - L �p�2613 LS8t2 ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 _< 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg& CST Name (Please Print) ignatu CST Number Arthur- L Wegerer Z- Z S 220254 Gv Date Addrm W e g e r e r Soil, T e s t i n Q & Design Service Evaluation conducted Telephone Number 421 N. I-lain St. River Fails, tJI 54022 ' 1 � -$ =0Z '- 715 -425 -0165 t J��LLiz afety and Buildings NEY COULEE RD SE WI 54601 -1831 D #: ( 608) 264 -8777 �scons�n erce.state.wi.us /sb CF www.wisconsin.gov Department of Commerce ON Callum, Governor . Albert, Secretary November 25, 2002 CUST ID No.267341 ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/25/2004 Ident' tion Numbers Transaction 0.814403 SITE: Site ID N 3728 Ann Pierce Please er to both identification numbers, 535 Chin Lane abov all correspondence with the agency. Town of Troy St Croix County SE 1/4, NW1 /4, S21, N, R19W FOR: Description: Proposed Two droom Mound System Object Type: POWT System gulated Object ID No 88 3 The submittal described above has been viewed for confo ce with applicable Wisconsin Administrative Code and Wisconsin Statutes. The submittal ha een CONDITI ALLY APPROVED. Th owner, as defined in ` chapter 101.01(10), Wisconsin Statutes, is r onsible fo ompliance with code ements.04 The following conditions shall be met during c true ' or installation and oc ncy or General Approval Conditions: • This system is to be constructed and located ' a rdance with the enclosed appr • • Pursuant to outlet filter product approval ulations, aintenance information in e giv o the owner of the POWTS explaining that period' cleaning of t eptic tank outlet filter is requ' The access r opening used to service the filter shall inate at or abov ished grade with a w ' t cover. • A Sanitary rmit must be obtaine om the coup where this o is located in accorda to �' h' r P requirements of Sec. 145.135 an 45.19, Wis. Stats. • Inspection of the private sewa system installation is required. Arrangements for inspe shall be made w' the designated county off accordance with the provisions of Sec. 145.20(2)(d), is. Stats. • Comm 83.22(7) - A copy the approved plans, specifications and this letter shall be on -site during construction and open to spection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). P.O.W.T.S. Conditionally APP nxim .� r :� .y � � A ~ �..'�' lY., v •? r ��. '! a � a. 'Y. M �' �; o r *. { *;�s y.a� '� �!D ,, � « v `� 3 t e* ARTHUR L WEGERER Page 2 11/25/02 Owner Responsibilities Continued: • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim @commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 TITLE SHEET Page of 7 BOUND SYSTEM FOR A Z BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD -1057 P and the Pressure Distribution Manual SBD- 10573 -P Ccz. b /cl j C2, 6 LOCATED IN THE SP_: 1/4 OF THE WW 1 OF SECTION Z l , T Zg N, R �9 W, TOWN OF T\Zp 4' ST. ��? 1�C COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR I'luCEI EQ NOV 2 0 2002 S 35 c ��urv� L✓P� SA FETE( & BLDGS, DIV. PREPARED BY WEG1— SO I I . TEST S NCG AND. DES I Gam! P.O. Box 74 421 N.1Iain St. 4' ti . fiver Falls, WI 54022 Phone 715 -425 -0165 Fax 715 - 425 -6864 WEGeHe = ElL n 5WUH7w DEPARTMENT OF COMMERCE DIVISION'O FETY AND BUILUINGS hN1M �a A31 SEE GORRES DENCE JOB NO. (3 Z -" 0 Mound System Management Plan P -L 7 Pursuant Pag of j to Comm 83.54, Wis. Adm. Code Septi c Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. T erating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. Th �'utiet fills hall be cleaned as necessary t o ensure ro r o eral . The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may s ough off a 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 113 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 However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. 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 S tem 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 for frost protection. Influent quality into the mound system may not exceed 220 mg /L 8005, 150 mg/L TSS, and 30 mg /L FOG. 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R.-6/99)] arid local or state rules pertaining to system main reporting. - 9 Y main tenance and maintenance 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 sh ould op enings uld be inspected for water tightness s P P g used for service and soundness. Access ice 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. Continaencv Plan If the se septic c tank or any of its component p s become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. I If the dosing tank, pump,. pump controls, alarm or related wiring becomes defective the defective component shall be mmediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begi . g ns to discharge wastewater to the lac r9 round surface it will p ed in its r 9 II be repaired or replaced present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning-Office at Ll 0 80 S57- CtZ4 ;:The system installer at `1l �6 b _ b qqs UTGMt) The tank manufacturer at 1 � - pQ = Azs c - $ LL 6 w`� The effluent filter manufacturer at The pump manufacturer at - - -- PLOT PLAN - •Page 3 of — 1 Scale 1"=313 _0 N °t`tw�.t� SgpTLC 1 ��K x P -S 1S`oF y' /puC Z BDiZr� zo' 017 x. J i I I IJ 3 - 7.S' zo , - g7 M 6 C \—or UVL�� Rte_ �� • lQ U. ' 0 1'sO -- _ C�8. L4 ' G120�ND Sv�Ff<E 1) N3USF ConN* C o r'1 oYJ vw'T L I.S > Poo �T- CF-- M ova NOTES: 1. Elevations shown are exi ing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be Vp 1 - 6 St gallon capacity manufactured by 4. Bench mark c-, S 1Pn3pV E 5. Divert surface water around system to prevent ponding at the uphill side. .. Pace � Or Approved Synthetic Covering ASTH C33 Distribution Pipe Medium. Sand Topsoil - _L� H = =W - 41 _ Elev. of�..S 3 E t I e 3 % Slope r • . Distribution Cell of Force Main Plow i" to 2 Aggregate From Pump L e.► S Ft'. E o . 68 Ft. CROSS SECTION OF A MOUND SYSTEM F o -S Ft. G o. S Ft . A 1 6 Ft. H 1.0 R. Linear Loading Rate = b- O GPD /L`v FT B S 0 Ft. Design Loading Rate= O'•y.GPD /SQ FT I � F S t. Ft. t . ` W Ft. I n Pipe 7 . E K --r - - -- -- - -- — I A � - f t " . I/ ------------ - - - - -- --- - - - - -- o W - - - - - - -- -- -------------- - - - - -- I Force in � Distribution `- --Cell of z" to 2 2" �Pu31 f�`7 t Pipe aggregate Observation Pipe (Aachbr securely) PLAN VIEW OF A MOUYD SYSTEM Distribution Pipe Layout Pace S of Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each late uD with the L of IonQ t= or =5° f sting to a point withLZ siA inches d the fnaI Vie. Te,==e the ends of the late. -als with a valve treaded c= or • threaded plug. Provide access from final grade for the valve; threaded cap or threaded pig- Lateral Manifold x x x x x2 Lateral Len 1h r. r - 3 ) y � F � ib t. Diameter Inch 5 3_ Ft. Late 1 �Z . InchEes X_ Inches Manifol Inches J Force Main " Z Inches l of holes /pipe 2 S Invert Elevation of- Laterals qa• Ft. - 2_5 Y- 0, = lb.stz _ 33:i� GPI Combination Sepl4c: and PUMP CHAMBER CRO55 SECTION ARID SPECIFI ' PAGE OF t •VEUT CAP WEATHER PROOF JUNCTION BOX . N'C.I. VENT PIPC % APPROVED LOCKING � ].O' FROM DOOR, MA3JHOLE COVER !•v1V :nAIDOW OR FRC5H wP+fiN1UG Ll�gEL.. w motto recap A�R INTAKE cor�pu�r r , rj I Ft iv tSHp 18 IIJLET PR0VtEE `• ' AIRTIGHT SEAL I III V .,, Approved z»8�t �� A �I( Approved joint w/ ! joint w/ PVC piDe �100� a i ALARM PVC pipe • I I I 1 ow U� c C 1 I CLEY. is FT. I PUMP OFF D COIJCRETE (<' 1_ . CJ C) . O O I BLOCK RISER EXIT PERMITTED OIJLy IF TALJ MAUUFACTURE.R H R V A L Br<041 N4 SEPTIC f SPECIFICATIC)QS � DOSE w `� 1J L°. TA N K M C AIJUFACTURR: '� IJI1Mf5EA `��SES: 3' - Z . / J PER DA , , TAMK 51ZIL: - 100o LLOIJS DOSE'', LIME r ALARfA MAIJUFACTUFLCR: c-- Z , LL C� LS INCLt 1AJG BACK MODEL WUMBER: C CITIES: `A= �S IUCHES OR ZSS SWITCH TyPC: - � �iZ-� C,/ �L( j� CALLOUS / B = Z IAJCHES'OR G�LLOLJS PUMP MAI.IUFAGTURCR: � OV L�] MODEL NUMBER: — �P k-,) C=—�--IUCHES OR 1 �� GALLOUS D: \S INCH �ES�O,R - S �S GALLOIJS SWITCH TUPE: L�V NOT PUMP AJJD ALARM ARE TO 6 b MINIMUM DISCHARGE RATE 3 �'� CP STALLED ON 5EPARATE CIRCUITS VEKTICAL DIFFERENCE DETWCEU PUMP OFF A1JO..D157 18UTIOIJ PIPE.. 6'� EET + MIUIMUM METWORK SUPPLY PRESSURE . 3.2 S FE C Z -SX L, 3 � + �� S FEET OF FORCE MAIN X 3 Z F l o zFRICT1o1J FACTOR.. O FEET TOTAL Oy MIG HEAD = FEET As per manufacturer — 1.0 gal /in. Liquid depth 38 "` Goulds oi= • Submersible Effluent Pump 3 1 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover. Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and • Farms manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 ■Power Cable: Severe RPM, built in overload with Float Switch assembled and duty • Dewatering automatic reset. preset at the factory. rated oil and water resistant. • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ E construction. PO4 Impeller. Thermo- • Solids handling capability: automatic reset. plastic Semi -open design 3 /4 maximum. • Power cord: 10 foot AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for mechanical seal protection. C- Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding • Discharge size: 1'/2 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F' or "AC ". rotary/ceramic - stationary, three prong grounding plug improved performance. ) BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 30 ' i :• components. Pump: EP05 — - , • Solids handling capability: c 25 3 /4' maximum. Q 7 ! - i W — -- •Capacities: up to 60 GPM. 2 s 20 I 1 I • Total heads: up to 31 feet. • Discharge size: I NPT. z 5 • Mechanical seal: carbon- c 15 rotary/ceramic - stationary, .j 4 i ! j BUNA -N elastomers. o EPOS; • Temperature: 3 10 - 104 °F (40 °C) continuous I i 140 °F (60 °C) intermittent. 2 5 0 00 10 20 30 40 50 GPM L 0 2 4 6 8 10 12 m 3 /h CAPACITY ®1995 Goulds Pumps, Inc. Effective May. 1995 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page , of Division of Safety and Buildings . in accordance with Comm 85, Wis. Adm. Code S� • C� Attach complete County site plan on paper not less than 8 1/2 x 11 inches in size. Plan must � � T include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 3 3 v —U Q Please print all information. qevie d b �3 Y ate Personal information you a may be used for secondary purposes (Privacy aw, s. 15.04 (1) (m)). z�9 /�Z Property Owner Property Location 1/4 S Z I T 4'- (5 N R I E (o W Property Owner's Mailing Address ' ° Lot # Block # Subd. Name or CSM# S ").3UCA s City State Zip Code PhorI6 Nu n%dy ❑City ❑Village El Town Nearest Road Rtv�Z �L.tS (-) )l.6 -u?8 S `1 t'� Opt' �K2o.�x�oc� Lt ❑ New Construction Use: Residential Bedrooms Z- Code derived design flow rate 3 0 O GPD ,Replacement ❑ Public or commercial - Describe: Parent material s OV LZZ Y7 Flood Plain elevation if applicable ft. General comments and recommendations: Y`'10Ulvsj lvl � C ) .b T] Boring # ❑ Boring ❑ � pit Ground surface elev. —` b -7 ft. Depth to limiting factor in. Soil APP lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Eff#1 'Eff#2 a —1 t� 1p� � 31 Z — si � Z `E'- �- yn v`�/- ��v z v • s • � Z 1� -31 Lo'Ll 3 0 sV 231 n n ss ❑ Z Boring # ❑ Boring ® pit Ground surface elev. S ft. Depth to limiting factor S 0 n. 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 Z ►b -3Z 1 �`Zrz 3)L — S as - .5 .15 Z -5' 1.S 2 3� 12 v'E� C S 1 so_SL �13 IJ 2613 - ISW? ' 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) pSignaturS CST Number Arthur' L. Wegerer Q Z — Z S 220254 Address t� e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 ii. Hain St. River Falls, WI 54022 D •715 - 425 - 0165 Property Owner Parcel ID # a `t — ! U 3 3[J -�� (� Pag Z of F�] 3 Boring # f❑ Boring Lll Pit Ground surface elev. C11b ft. Depth to limiting factor S 1 in. Soil Application Rate Horizon Depth Von4nant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 1 o -l0 � D`�2 3lz - 1 Z � V`Pr Gw Z� �F s _� Z Z3 t��ft_316 _ S 9 1 1 Z`�s1�fr C , S 3 Z3 3 Z 10-M >,h _ ) 1 — 3Z_S l - 7.5-J231 - -13 nyn- m UfP CS - 3 5 S y o b P 7, S J sel w/ Om 1�`�1 — . (2� . 0 VIS 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 --- Fl oots 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 /ftZ 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 -315'1 or TTY 608 - 264 -8777. SBD -5330 (R.6/00) 'r PLOT PLAN Page 3 of 3 ✓Scale �t'{wL'1L� ��FTLC x x Dq �6 �7 97 ZO' h_ i J I J I n -3 66 Dd ivp P Atr az� c, �1.p - 7, S z� q7 53r1J^- CZ , lOr�' OrJ 13 o�Dw1 OF 1�E`StD)h/6 ✓ ►^'t 1 ENV Div . (4 o)J Gj 0 .Sv�Z�e P Cv'2 C iS > roo • 1� -u - 715 -425- 2 0165 220254 OZ_Z S�[ CST Signature Date Telephone No. CST No: Job NO. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ow: er/Buy cn ' „ ,.�. Mai ing Ac.d °r: ;s /* n0 Prcq erty Ad i:r .,ss _ 'Gy�� `!// ' S - L4Z , _._. . (Verific ►tion required from Planning Department for new construction) Cit' , State Parcel Identification Numbe J —000 LEA; -AI. D It' ; PTIOi J Prel. rrty Ia►c ion ; '!., Sec.- TZLN -R�W, Town of Sul) 1 ivisior , Lot # Ceir ified S u r ey Map f . Volume . Page # Wa► rttuty 1) o: it # d ZLl �� . Volume O? ? , Page # Spe- house ["I ;ees Xno Lot lines identifiable JPW v s C] no SY._'; CEM l !►9 ,:! . I NTENAI 4CE Impr r.)l. c!;; use and mai atenanceof your septic system could result in its premature failure to handle wastes. Proper m; ,a tenance comil is of pc m 4ai tg out the s ptic tank every three years or sooner, if needed by a licensed pumper. What you put into i r'. c; system can, , feet the f u , lion of the septic tank as a treatment stage in the waste disposal system. The, iar a,<< :rty owner ; !grees to submit to St. GroLx Zoning Department a certification form, signed by this owner � ad by a mast r plumb t: jjC ttrneyman p .umber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater dispo ; t i system is in roper q;)e -;ii ing conditic a and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full i±i'sludge. Vwc:, he und:.n i; , ied have recd the above requirements and agree to maintain the private sewage disposal system with thin , ;iandards set 4 i r th, herein , ; s set by the %apartment of Commerce and the Department of Natural Resources, State of Wisconsin. Cco i r fication static ,that y(ir ii � .ptic system has been maintained must be completed and returned to the St. Croix County Zoning; Of ice: r4,itbin 30 days .f the d! : %gar expirati an date. Si V V A,PPLICAP T DATE _ER ;-:I L' ICA7 ION I (wo :.c,: lify that all statements on this form are true to the best of my (our) knowledge. I (we) am (arc:) the o' � er(s) of tine erty clr u ed above, by virtue of a warranty deed recorded in Register of Deeds Office. Aj SIG? TURF T DATE Any in 'C, oration that is mis- represented may result in the sanitary permit being revoked by the Zoning Departme! ** Ii dude will :, "Is applicae ion: 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 Y2/17/2002 03:15 17154261846 ROGER KARSHBAUM PAGE 02 '3_ • !, 20 ?7P 151 _ � ?PJie165 STATE BAR OF WISCONSIN FORM 2. 1999 VALSH D Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX Co., tR This Deed, made botween Joel W. Za mzow and Julie A . - Zamzow RECEIVED FOR RECORD husban and wile 12/1112802 12:20PM EXEMP I Grantor, and A lV Pierce, — °-^-- REC FEE t 13.80 —_ — TRAMS FEE: 495.00 COPY FEE: — — CERT COPY FEE: Grantee. .� PAGES: 2 Grantor, Por a valuable consideration, conveys to Grantee the following described real estate in St . Croix _ _ County, State of W isconsin (if more space is needed, please attach addendum): Recording Area r lj 2 1 Name and Regan Address - See Attached Exhibit "A ". l SO, t I -77 -77 )V4/ s3 v 3 9 040- 1 083 - 30-000 1q�-� Parcel ldentlficationNumber (PIN) j?�Qt t 'Phis homestead progeny, (it) (is not) Fxceptions to warranties: Easements, restrictions and rights -of -way of record, if any. V � Dated this /_ of November 2002 - -!5 y d' OTApY LtJ �ct.,. PUBLIC • • Joel W. Zamzow • Julle A. Zamzow AUTHENTICATION ACKNOWLEDGMENT Signature;s,► STATE OF WISCONSIN ) ss. County ) authenticated this day of `^ — — - Personally came before me this day of November 2002 the above named Joel W.Zamzow and Julie A,Zamzow, husband a wife TITLE. MEMBER STATE BAR OF WISCONSIN —° (ti' not to me known to be the person(s) who executed the foregoing �— instrum t and ac wl d ed the same. authorized by l; 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED SY • _ Attorney Kristin* 0gland Notary Public, State of Wisconsin HuQsonI S3b73 «�� ��� My Commission is permanent. (If not, state expiration dote: (Signatures may be authenticated or acknowledged Both arc not ncceeyary,) .,._ f,4C A/ � �. ___ _ - , &�f — ) ' Names of persona signing in any capacity must be typed or printed below their signature, Irrormaan PIOOI$ionaie convaev, Ford du tee, Inn WARRANTY DEAD STATE BAR OF WISCONSIN 6004aa.zo2+ FDRM No. 2 - 1999 12/17/2002 03:15 17154261646 ROGER KARSHBAUM PAGE 03 2077P 152 EXHIBIT "A" PANT OF THE 9E Y, OF THE NW % OF SECTION 21, TOWNSHIP 28 NORTH, RANOH ill W EST, DESCRIBED AS FOLLOWS: COMMENCING AT NORTHWEST CORNER OF sAID SECTI" 21; THENCE EAST ON NORTH LINE OF SAID SECTION 21, 1040.3 FEET TO CENTERLINE OF *TOWN ROAD; THENCE S2i*517. ON SAID CENTERLINE 1433.4 FELT, THENCE NOS 344:8 FMT TO PLACE OF BEGINNING; THENCE N68 °57 150 FEET: THENCE 51 200 FEET; THENCE 7'1N 150 FEET; THENCE HT 46V 200 FEET TO PUKE OF BEGINN*40 ALSO, PART OF THE SE. Ya OF THE NW , OF SECTION 21, TOWNSHIP 28 NORTH, RAPIIMR 16 WEST. DESCRIBED AS FOLLOWS: COMMENCING AT NORTHWEST CORNER OF SAID SpCTIk'1tN 21; THENCE EAST ON NORTH LINE OF SAID SECTION 21, IWA FEET TO CENTERLINree OF T. ROAD; THENCE 82MIS ON SAID CENTERLINE 1433.4 FEET-' TO POINT OF BEGINNIM; TW.NCE N88 304.8 FEEL; THENCE S1 204 FEET; THENCE 5118°STW TO CCNTERL06 Ofl LAID TOWN ROAD; THENCE N21 ON SAID CENTERLINE TO POINT OF BEGINNING. 5wte- < Marion Standaert X • �O Subject: 420628 - Pierce /Utgaard plowing Location: Troy Start: Tue 7/8/2003 11:00 AM End: Tue 7/8/2003 12:00 PM Recurrence: (none) 21.28.19.327D I C f foac (2 3;30 P °'� �2 I/� -�'$ r !/ U �f . (v