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040-1275-10-000
\y 22 Q� jk � \ % #g 7 .0 ~ 8 §� � CL ]a8 ) �f) � §/ E °` °/( _z 2 m � 3 c a / � \keg <o£= z } z ^ k 2 & / \ IL © ) 3 \ $ � \ / 2 Z § © � 1 b \ .� % \ § 3 . Q }zz \ ) m E / ~ f (D L §f 0 23 a IL _ . & . % \ / \ � - k 0 a 2 a = B CL U) 0 n m u f § § ƒ / \ 3 \ a o S § # = E W / E_ § _2 / ® S E E { r a 0 � a k / D % 2 % ® /S - o . o - Q � o \ \ / } Cl) o } : } \ / $ L % E) k r a f / 3 a 2 o U) 3 Wisconsin Departmentndustry, Labor and Human Rela SOIL AND SITE EVALUATION REPORT Page � of 3 Division of Safety r4 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 1 es in size. Plan must include, but- not limited to vertical and horizontal reference poiQt tSMh direction of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and disfiinde to nearest road. ' APPLICANT INFO RMATION- PLEASE"AiNT A�,, I WWATION REVIEWED BY DATE P7 i PROPERTY OWNER r ,.r PROPERTY LOCATION QW- W fl KiD V*%%� . SM U� " G(Aq. LeT SL�11/4 NIA 1/4,S 11 T ? 8 ,N, 19 E (oo W PROPERTY OWNER':S MAILING ADDRESS. s LOT # BLOCK # SUBD. NAME OR CSM # ;>o&2 P CITY, STATE ZIP CODE PHONENi W9f - CITY (]VILLAGE ,MOWN ' NEAREST ROAD l alua - L 1S , � S�tsZz,(61Z) RAG -a z. T�z p poste (>Q New Construction Use Residential / Numberof bedrabrrts 4 (] AdditiQn to existing building j J Replacement [ ] Public or commercial describe Code derived daily flow 1 01')z) gpd Recommended design loading rate -- _ bed, gpd/ft trench, gpd/ft Absorption area required St» bed, ft Sat, trench, ft Maximum design loading rate • 5 bed, gpd$ ,b trench, gpd/ft Recommended infiltration surface elevation(s) ° L9 - . S ft (as referred to site plan benchmark) Additional design/ site considerations l`'1 bU► � L / h lyIMUM t Z ` o F S, A Fi LL Parent material 1_n Ql�S cju\z_ . 6 rrt•, t_. Flood plain elevation, if applicable ft L S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDWG TANK U= Unsuitable for system I CIS EJ U I [as 13 U I [Is O U [IS ®.0 [is RU [IS Q U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color f Mottles (Texture ( Structure lCons' �nce Bawnxd[ ry Roots GPD /fi in. Munsell I Qu. Sz. Cont Color Gr. Sz. Sh. I I Bed Y 1p `1 R- � L Z S L -Z HVrz ►� L`Fl- �t v - . S .� Z Ti l 3'Nbk yn -S •� Ground 3 2$ _AE `l -S `i Iz ylV elev. q a•2 ft 4 yl-6b �S�23 - s I � � rup wP Depth to limiting factor Remarks: Boring # o--L2 lb''LIZ 3L2 — St bk W`A_ O _ .S Z- Ground q Z ft CJQI Depth to limiting factor ZS Remarks: T Name: - Please Print Phone: Arthur L. We erer 715- 425 -0165 egezer Soi Testing & Design Service -P.O. Box 74 Rive .Falls,WI.54022 Signature: I Date: CST Number.. oe -11$- ) S -,S —� 220254 PROPERTY OWNER t"W Smell SOIL DESCRIPTION REPORT Page? -of 3' PARCEL I.D. # NG Boring # Horizon Depth Dominant Color Mottles Texture Str ucture GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. I Sh. Consistence Boundary Roots ;.: ': x�� Bed Trench r ,:s. 3 Ground l��ItZ�lz — Sl i "r: • 4 Ground 3 Z.p A� t2 3�6 S! ��S�p h1`f C •S elev. gq Sft. Z� -6b - 1.5 `t2 31v Depth to limiting factor Remarks: Boring # - F1 :., wz Ground elev. It. Depth to — limiting factor L - Remarks: Boring # 4h Ground elev. - ft. Depth to limiting factor Remarks: 3oring # �.'•.'•'v `vas:. around Nev. IL )epth to imiting actor Remarks: _ •rl n•r •rrlrf� •.r .. n • PLOT PLAN Page 3 of 3 SCALE 1 "= L4) ' GoU<Uv2 EL _ 48 - r 3ZST"nm of eL. zS ' �25 S t eL9q _ awr v, Z - e - , 0.)_3'a� - s -S V 1plii wlL-Pr7N 1 1 0 Z S� LTLOLOL r i 3Q ��y4 btA, PUC PIPE Qz s 1`T� .TC.N N � G r 'RD Luu G f'Aef0CW b X76 �_1 -I zzozsy S S -0O ( 715 ) 47.5 -n7 r;5 _ CST Signature Date Signed Telephone No. CST # " Labor and Human Relations orr us SOIL AND SITE EVALUATION REPORT Page of 3 Division of Safety & Buildngs in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must include, but ST' C not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dmensioned, north arrow, and location and distance to nearest road. ' APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER PROPERTY LOCATION W FrFjJ `C'l - S�'11_� GA1 6T— S L�11/4 t 1/4,S Z l T Z8 ,N,R ) 9 E (a W PROPERTY OWNER•:S MAILING ADDRESS. LOT # BLOCK # SUBD. NAME OR CSM # tits L,,J- bLULSMQ 'B -r- V P CITY, STATE ZIP CODE PHONE NUMBER OCITY OVA GE ,MOWN ' NEAREST ROAD 2 �Z '7Pr115`,�1 S�o22(blZ) X66 -a6Z8 epos® K New Construction Use Residential I Number of bedrooms [ J AdditiQn to existing building [ j Replacement (] Public or commercial describe Code derived daihr flow gpd Recommended design loading rate -- bed, gpd/ft trench, gpd /ft Absorption area required Sow bed, ft SDrj trench, ft Ma dmum design loading rate � 5 bed 2 •b 2 gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design site considerations Y'`1Dv►�,� � / S '�CtOp� `T1Z�� V-VJ' 1LwtUM VL 0'F- Sf�. Fi LL Parent material 1 z eaS o U)E)2 6 L prL Flood plain elevation, if applicable N r u Suitable for system CoWeMONAL MOUND MROUND PRESSURE AT -GRADE SYSTEM IN FILL. HOLDING TANK = Unsuitable for stem 0S 9S3 U I 2S O U 0S O U I 0S RU 0S RU I EIS IO U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell I Qu. Sz. Cont Color I Texture I Gr. Sz. Sh. Consistence I Y I Roo Bed rench ��� o - Le�.cZ Utz - sL Z�sbh ►�.fi- ew - .S ,6. Z �Z tt, `i [Z 3L6 S i 1 3`�sbk r►'t Cl- �S - ' S Ground 3 Z$ 4l `l -S `iP- Wtf _ SL 1 C S�k WM. 0_a' - - - L ,3 elev. g 4 yl-6b �S�-Z23Lyr - sI �� �'P►UP Depth to limiting factor L � Remarks: Boring # ' n 13 z 1Z zo l r3 tiz -5 s i I Z`Fs b>z mfr �S •s :� Ground 3 - 2b ZS - 1'S 4R-,WY Si I Z` k elev. S :. q .Z fl ZS-6l - 1 •S K23l� S } C� 11't — NP` w� Depth W limiting ZS" Remarks: T Name: — Please Print Phone: Arthur L. We erer 715- 425 -0165 egexer Soil Testing & Design Service -P.O. Box 74 River Yalls,WI 54022` Signature: Date: CST Number.. 00 -118 -1 S - -� 220254 PROPERTY OWNER SOIL DESCRIPTION REPORT Page Zot 3� PARCEL I.D. # NG Boring # Horizon Depth I Dominant Color Mottles Texture Structure GPD /ft � In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. f*• Z Consistence Bound Roots J: � , � N; 'Z ° °'` Bed tench 3 •� a -�3 10�I.tiZ --31 Ground 3 ?D=27 Z�`l2 ��� S1 �`�� h1�� C •S �i elev. gq S tt. Z -66 1 5 `/ 2 3L S� b1ti, Depth to limiting Li tac�or_ 1 ` ' Remarks: Boring # Ground elev. it. Depth to limiting (actor + - I-- I I _ - . . .... . .. ..... i Remarks: Boring # u{ tiF� Ground elev. fl. Depth to limiting factor Remarks: 3oring # ;round ',lev. it. )eplh to miting actor Remarks: _ rrl n•r •rNI'� ..r •.... PLOT PLA Page 3 of 3 SCALE 1 "= 1 4 1 zO ' g4. S zs �'zS r 1 o 1 1 1 � 1 I �_ I �Lg'rvz8 - nil S f (� _ 1 S� "L 3.1 ZS' P • ® -)lcJ bLA.. pUC PIPE I © � 3 - -- -- -- - zzozS41 S; 5—O0 ( 715 425 -n1 n5 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430090 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: Mazac, Ken I Troy Township 040 - 1275 -10 -000 CST BM Elev: Insp, BM Elev: BM Description: Section/Town /Range /Map No: D0- 6 1 ,106 .6 � a� ✓G J 6� � I 1 21.28.19.1527 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ..�� (, Benchmark (ds /� �• U Dosing ` Alt. BM� v45971 A '- Aeration � Bldg. Sewer ! tlo•a� Holding St/Ht Inlet 5i:k [ 'l o `e t � St/Ht Outlet ���t TANK SETBACK INFORMATION A k L4 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ` Dt Bottom Dosing / Head Ma q � � n. Aeration Dist. Pipe 141 (y Holding B ot. Syste PUMP /SIPHON INFORMATION Final Grade t' S S� r F- Manufacturer ( Demand St r � 41 ) GPM r-e 14. i9 l- / / Model Number TDH Li ,, Frictior(L s I System y H Head J T?� Ft `P Force m Lent Dia. Dist. to well r_ i _. T SOIL ABSORP ION SYSTEM BED/TRENCH Width f Length I No. Of T e cues PIT DIMEN NS No. Of Pits Inside Dia. Liquid Depth t DIMENSIONS f1'7� / d SETBACK SYSTEM TO ((J(J P/L BLDG IWELL LAKE /STREAM L ACHING Manufacturer. INFORMATION Typ Ot System: CHA OR �[ ,/ lel > lob, / /� IT Model Number: DISTR UT � SYSTEM Header/ anifold Dt le ' x Hole Size x Hole Spacing Vent t i t ,t ^j y Pipe(. ) - -C — L. j`' r V" _4 Length � __ Dia (� Length �t I Dia t Spacing � / 3 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only *1 M4V Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No (: €, 1 Yes j No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 l Inspection #2: Location: 524 West Ridge Circle Hudson, WI 54016 (SW 1/4 NW 1/4 21 T28N R19W) West Rid a Ares Lot 1 Parcel No: 21 28. 91597 1.) Alt BM Description = s) � � � � � o - t a4aZb4ftJcz 2.) Bldg sewer length = (,7� - amount of cover =_ 11� Plan revision Required? j . Yes [ o Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Sig ature Cert. No. Safety and Buildings Division County Nvi 201 W. Washington Ave., P.O. Box 7162 ST. CROIX i 7�Or�SI1�_ Madison, WI 53707 - 716 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 �� O Sanitary Permit Application State Plan n I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ° o(0 & / I f may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Info atio ��` I �� 5� a�� r ' Property Owner's Na me JU 1 6 200 Parcel # Lot # / Block # KEN & JULIE MAZAC ,� .I�.� �I Property Owner's M ailing Address JN I Y I Property Location �O ^JI'� (�FFICc 524 WEST RIDGE CIRCLE SW � NW 14,secdon 21 City, State Zip Code Phone Number RIVER FALLS WI 54022 (circle e) II. Type of Building (check all that apply) 0J� 46 Subdivision Name CSM Number �D� T 28 N; R 1 9 E or� � 1 or 2 Family Dwelling - Number of Bedrooms 4 I"` `� ❑.Public /Commercial -Describe Use WEST RIDGE ACRES ❑ State Owned - Describe Use ❑City ❑Village ElTownship of TROY III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A, XX New System ❑ R System y p y ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. El Permit Renewal El Permit Revision El Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. ; Ty _ pe of POWTS System:. (Check all that ap I ply) ❑ Non - Pressurized In- Ground 11 Mound > 24 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 Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil A�icatiop jtate(gpdsf) Dispersal Ar�,a Requ'ed (sf) Dispersal Area Proposed (sfl System Elevation 600 1, p S 1 600 /Zaaq 600 / jot 100.0 ✓ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1250 1250 1 WIESER CONCRETE X Aerobic Treatment Unit Dosing chamber 750 750 1 i WIESER CONCRETE I X VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumbe 's Si gnature MP /MPRS Number Business Phone Number BENNIE IELGESON tic. 220292 715/772 -3278 Plum r s Adare (Street, City, State, tip Code) W1229 770TH AVENUE, SPRING VALLEY, WI 54767 VIII ount Department Use Onl Approved El Disapproved Sanitary Permit Fee ' cludes Groundwater Da Is uing A nt Signatur tamps) Surcharge Fee) ^1� �— 3 ❑ Owner Given Reason for Denial YY �c,G , IX. Conditions of Approval/Reasons for Disapproval 3•.rz. 3 Z- /! /7/b Z >G/'lt i • [!lv►'!� �.oQ.�,f�•� .� 63'l ���� ✓,mod v�c� /L�O.f�� — �LC.��j1'lll.Q� lt2 Y�Jt.f�u.e.+' -Ld ` �c At h complete plans (to the County only) for the s t on a not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) Scale 1 - Page 3 of �1 wQV c 0 00 0 30` or-z i PVC` F. d S CP l� 63 t 2y _ • Ll 3_E 7 S 0 YvI Du7 � 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 \Z'SO gallon capacity manufactured by w 1 Cryj w17� - 8 op ztpt trey? 4 Bench mark �. Divert * surface water around system to prevent ponding at the uphill side. t Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary November 07, 2002 CUST ID No.267341 ATTN: PO WTS 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: 11/07/2004 Identification Numbers Transaction ID No. 806611 SITE: RECEIVED Site ID No. 653107 Ken & Julie Mazac Please refer to both identification numbers, Westridge Circle SEC above, in all correspondence with the agency. Town of Troy 9 2002 St Croix County ST. CROIX COUNTY NW1 /4, NW1 /4, S21, T2 8N, ZONINGOFFICE FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 880327 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.0 1(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 Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the Y PP P "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SB D- 10706 -P (N.01 1). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are P rohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption I Nonal J' area. chs. NR 811 & 812c 0 A Sanitary Permit must be obtained from the county where this project is located in accordance with the v�D • COMMERCE requirements of Sec. 145.135 and 145.19, Wis. Stats. GEC • • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the POND E designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • 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. I I I ARTHUR L WEGERER Page 2 11/7/02 Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. 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 7 '2 /�� Fee Received $ 175.00 Balance Due S 0.00 Charles L Bratz POWTS Reviewer It , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz @commerce. state. wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 i i I II I I I c TITLE SH * - � (� �C'� `�� ge 1 of '7 MOUND SYSTEM + �,9 FOR � A t BEDROOM RESIDENCE `40 - This plan has been prepared in accordance with t '40, end Component Manual SBD 10691 -P and the Pressure Distribution Mankal SBD - 10706 -P (N.01 101) tiw_�jw pr'� (N.01 101) LOCATED IN THE S W 1 /4 OF THE "�J 1 /4 OF SECTION -2 , T �8 N, R 1 9 W TOWN OF '���� _ SZ'. °L \?,yU( COUNTY, WISCONSIN. LOT s INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MAIIAGEMENT 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 r2 V L`tZ PjAruS, w l S X10 zZ PREPARED BY L�IEGEFtER SCI I L .TESTS !VG AND. IDES 2 C-3" S�F?V I CE P.O. Box 74 421 N.Main St. River Falls, WI 54022 Phone 715- 425 -0165 Fax 715- 425 -6864 � j'V ••1 qq K. Conti: fi�L WORTH I gpl?V.� Jn SEE CoRFZE JOB NO. C7Z - Z -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 tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, 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 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 prorfltite 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 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 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 ( san_� ns�� o .os,o.,� and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. _ Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment 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. Continoencv 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. I If the dosing tank, pump,. pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. p 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 l`J - � -y, 6 p Q S : �•�1,�vX The system installer at 1 LS -'Z6$ - 69c UTGP�1Zb The tank manufacturer at S 0� =_ �_2S —� yS VV L � C12 The effluent filter manufacturer at _ `o�pQ— 2,,z - S-1LA-Z The pump manufacturer at - - - -, - 611 PLOT PLAN Scale 1 "_ ,gyp ' - Page 3 of �7 a CO *~ S� ¢ �q Y Zvi - • 30 r- .-� 0 Z pV(+ F.M. o c�( C S -- 0 �'`• - ��pu� Q � r S �7 100,0 WR 1 ?VC._pip,;_ - FTfLR NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4 observation i es with approved Z P P caps. PP P � required). 3. Septic tank to be 1ZS0 gallon capacity manufactured by w I E�s eiZ - CCI\j cr Wjj - 4 Bench marks S� pS�yE 5. Divert surface water around system to prevent ponding at the uphill side. Pace Or 7 Approved Synthetic Covering ASTH C33 Distribution Pipe Medium. Sand To - H _ W _ a ✓ Topsoil F Elev. l b0 _ 3 E , t o W. PIN VZ/1 e S % Slope Distribution Cell of Force Main Flawed i" to 2- Aggregate From Pump Layer E \ . 3 Ft. CROSS SECTION OF A MOUND SYSTEM ' F D• 8 Ft. 0 d-S Ft. A Ft. H t -O Ft. Linear Loading Rate= {,,o GPD /T.N FT B loo Ft Design Loading Rate= bi.33.GPD S FT I 1Z Ft. J 6 Ft. K �1 Ft. 4 ' Position L 11 $ Ft. of Force Main W Z L / Ft. q + - Observation Pipe j ---------- - - - - -- - --� �Qiz C�s --------- - - - — - - Sax C --- `. - - - - -- -- - - - = -- ---------------------- Distribution \•— Cell f %" I _ o z to 2Z Pipe aggregate Observation Pipe (Anchbr securely) PLAN VIEW OF A MOUND SYSTEIN . t " Distribution Pipe Layout Page 5 or' 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 ur with the use of Iong turn or 45' fining to a point within $i inches of the final grade. Te.- =mate the ends of the Late. -als with a valve, :threaded = or • threaded PIS. Provide access from final grade for the valve; threaded cap or threaded plus. T'-t 'F.NCr L C. F�a� Svc Lateral Manifold Lateral X x x z x/2 I xQ x x z x Lateral Length —� Lateral L_ =oath — P Qistn6utian Line � P j ; ftCzzzS SQL c I r, • t' 1 ��c� n�try - - 1 P U Ft. Hole Diameter Inch S 3 F Lateral 1 Inches) X 3 lO Inches Manifold " Inches Force Main " Inches # of holes /pipe V1 Invert Elevation of. Laterals IDD-S Ft. yi r"1 .. : PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE OF lb VEIJT CAP 4'C.I- VEMT PIPE WEATHER PROOF APPROVED LOCKING MANHOLE '- 10' FROM DOOR, JuIJCTlOU 80X COVER WITH WARNING LABEL wINOOW OR FRESH (2'MIL1. AIR IAITAKE GRADE EL l 0 0 $ y' MIIJ. 18 MIIJ. COf,JDUIT � -- 19 11� INLET PROVIDE AIRTIGHT SEAL ! I I APPROVED JOINT A I I I APPROVED .IOUJ I ALARM C ( oN •f i - - ELV Fr PUMP -� OFF 0 L Z •00 COAICRETE BLOCK RISER EXIT PERMI1fED OWLtJ IF TANK MA)JUFACTURCR HAS SUCH APPROVAL —IL101po QoV- 860� I t�14 SPECIFICATIOUS DOSE wti��SZ C TwkIK MANUFACTURER: )JUM9EA OF DOSES: 5 �� PER OAy TANK 51ZE: �S� GALLOWS DOSE VOLUME I ALARA 111 A 1 1LiFACTURGR' aLeZTT J INCLUDING, OACKFLOW: GALLONS MODEL QUMBER: ) D l ``vW ` CAPACITIES: A =? 0 WCHE5 OR L 0 s J.. W►LLOUs SWITCH TYPE: D - IAICHES OR GQLLOfJs puM? MAMUFACTURCR: GO L_DS C = 6 IUCHES OR ' 21 2 GALLOIJS MODEL NUMDER: -- E'�`014 D = � INCIiESOR lg � S GALLOAIS SNITCH TUPE: e�Z DOTE: PUMP AUO ALARM R TO bCo-, It MIWIMUM DISCKARGE RATE "�� GPM INSTALLED OIJ SEPARATE CIRCUITS VERTICAL DIFFEKENCE OETWECU PUMP OFF AUD.OISTRIgUTIOM PIPE., , FEET � /��- + M ' NETWORK SUPPLti PRESSURE . • . • . • • • . � G -SO -FE.ET r5_Q Y_ ), 3) f 3 FEET OF FORCE ! U►I1J X FT tx FRtcTlou FACTOR. 0- S l FEET —. .-._ TOTAL DyUAMIC HEAD = - •FEET -� As per.*manufacturer • 24.ZI?j gal /in. Liquid dept Goulds i?+ovGE 1 °V Submersible Effluent Pump 3871 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 115 230 15 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, , built in overload ad witit h 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 ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. 3 /4 maximum. • Power cord: 10 foot plastic Semi -open design AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for • Total heads: up to 24 feet. with three prong grounding mechanical seal protection. SP• Canadian Standards Association • Discharge size: 1 1 /2" NPT. plug. Optional 20 foot IN EP05 Impeller: Thermo - g 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 7" or "AC".) BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 (40 continuous superior strength and 140OF (60 intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. _ 10 • Capable of running dry without damage to s 30 f components. _ j Pump: EP05 a — s -- --= L--- -+ • Solids handling ' 9 capability: 25 o 3 /4" maximum. z Lu • Capacities: up to 60 GPM. s 20 { — • Total heads: up to 31 feet. 9 I I • Discharge size: 1V NPT. • Mechanical seal: carbon- > 5 i rotary/ceramic - stationary, ° 4 15 BUNA -N elastomers. • Temperature: 3 104OF(400C)continuous Ll 140OF (60 intermittent. 2 i 5 1 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 Wlh CAPACITY ®1995 Goulds Pumps, Inc. Effective May, 1995 HELGES N EXCAVATI 0 N, Inc. SEWER AND WATER SPECIALISTS Plumber /CST Cert. #220292 BEN HELGESON Office (715) 772 -3278 W. 1229 770th Ave. Home (715) 772 -3127 Spring Valley, WI 54767 Fax (715) 772 -3387 June 13, 2003 St. Croix County Zoning 1101 Carmichael Road Hudson, WI 54016 Dear Sirs: Enclosed are all of the papers for the sanitary permit for Ken & Julie Mazac. The plans were submitted to the state by Art Wegerer and we were told that you already have conies of the approved plans. Since we do not yet have a copy of the ap roved plans, co uld you please see tha wa eet a cony when you have approved the permit. 0 Also we are enclosing a set of the house plans that we need back. Please send the permit back to us after it has been issued. Thank you. Sincerely, Bennie Helgeson President BH:cb Enc.5 Wisconsin a ngel atiti Industry Hu man Relations SOIL AND SITE EVALUATION REPORT labor and Human T Pa g of 3 D&ision of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code ` R COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ST, C not limited to vertical and horizontal reference point (B 4m,)c ion_ and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and dista tq 4rest road.' ' r R APPLICANT INFORMATION – PLEASE �C�}� ALL INFORMATION BY - -DATE PROPERTY OWNER ! PROPERTY LOCATION -GQ9_ LQL M3A3 1/4 MA) 114,S 1 T Z8 ,N R 1 q E (oi W PROPERTY OWNERS MAILING ADDRESS. LOT # I BLOCK # SUBD. NAME OR CSM # - CITY, STATE ZIP CODE PHONE NUMBER OCITY []VILLAGE ,MOWN ' NEAREST ROAD K New Construction Use Residential ! Number of bedrooms _ [ ] Addition to existing building j J Replacement [ J Public or commercial descr'Ibe Code derived daily flow gpd Recommended design loading rate – bed, gpd/ft 35 trench, gpd/ft Absorption area required St>>l bed, ft S b trench, ft ' Maximum design loading rate 5 bed, gpolft ` b trench, gpd/ft Recommended infiltration surface elevation(s) t, 1 4- S ft (as referred to site plan benchmark) Additional design / site considerations W l 5 'X! Op `1MW J . " Mum a OF 1= tL.L._ Parent material 1_z QlSS out. 6l-q pru n LL Flood plain elevation, if applicable S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for stem El 21 U ER S ❑ U ❑ S ®U I❑ S [�.0 ❑ S ®.0 ❑ S O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color I Mottles Texture Consistence Bourrtaly Roots I Structure I GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. BW W& 2 3Lb Ground 3 32-'S6 elev. N -6 ft. u VIV rz ow, Depth to limiting factor �Z N Remarks: Boring # Q-- l��cyz3Lz S ! Z�'sbk v✓t`ft, acs, — •S -b 3 z�-60 is Ll ►L�f Ground — S opt — 1_�P € Y`►p elev. 1 o\t.S ft. Depth to _ limiting factor Remarks: T Name: — Please Print Phone: Arthur L. We erer 715- 425 -0165 egezer Soil Zesting & Design Service –P.O. Box 74 River Yalls,WI 54022 " Signature: ,p Date: CST Number. . S —S—oci 220254 PROPERTYOWNER tAT�"rs2 SOIL DESCRIPTION REPORT PARCEL Pale ?of 3 1.1). � 1 NG Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Consistence Botx>dary Roots o -1 u Lb YZ , / Z Bed Trench 3 s z `f sb ► z M - ... Ground �, - 1 •Sti2 3CY WtshWLy elev. 1hZ5 tt. Depth to limiting factor Remarks: Boring # ,,, s <.:" Ground elev. It. Depth to limiting factor Remarks: Boring # Ground elev. It. Depth to limiting factor Remarks: 3oring # around ;lev. It. )epth to imiting actor Remarks: r � • R y ' PLOT PLAN Pa 3 of 3 SCALE 1 "= L Z —fit. q4_�' ou 31t/``Dtfi. l0 16 H, 31g Dlfl_ PuC Pipe WlLtr ,' \�v c P i PE W l LAyCt•I GC1,ps3 S' - `T1� - �� • o P� c� \ SS�CzS S'tt� 3 Mi�'V t�IUL s zs t izS' j� -IDL z,S '1 co�u�R• �. , t o35 LJL-- Loq,5 8.Z EL w S J S7 G s � L.00r;�Irz TJ N G a ZoLUNG ��� bQ.tug �f f - -- __ z•zoZS . S ;.S ( 715 ) 425 -0165 CST Signature Date Signed Telephone No. CST # MAY -28 -03 07:19 AM P.01 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT A OWNERSHIP CERTIFICATION FORM Ownerh3uyer 1 r Mailing Address Property Address aLi -t- amneat for new constntction) (Verification required from Planning Dep Parcel Iderititication Number A City/State y 0 Y6 PLC E 0 &I' 'AJ "" s d 1 T�N-RW� Town o Property Locati f 7 on SW _ f•,- �'� S� ' l'Z1 D C S Lot # Subdivision � Certified Survey Map y , Voluttle �9 7 , Page # W rra Deed t't Volume Pa # Spec house Q yes �kl no Lot lines identifiable yes 0 no SDIEK NA2UN W premature failure to handle wastes. Pmp� �t� Improper use and maintenanceof your septic system could result ill its p What you put into the systeat consists of pumping out the septic tank every three years or sooner, if needed by a licensed puutper. can affect the A madon of the septic task as a treatment stage in the waste disposal system The proper owner agrees to submit to St. Croix Zoning Department a certification fond, signed, by � °� and by a m r ven that ithe on-site wastewatardisPosal aYatem master plumber, journeyman plumber, restricted plumber or a licensed pumps �'� the Kptie tattle is l than 113 f sp of �lttdge. is in proper operating condition an&or (2) niter inspection and pumping (if necessary), Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal syalem with tits set forth, hereiw. as act by the Department of Commerce and the Department of Ns" Resources' Stale of Wiaeauesio. C stating that your septic system has been maintained trust be completed and returned to the St. Croix OMIY Zm tAg OAce w" days of the three year expiration date. /06 DATE JSN OF APPeCAN OWNER C IO lmowled a I (we) am (ate) the ow8W') of I (we) certify that all statements on this form are true to the best of my { our ) g the property described above, by virtue of a warranty dead recorded in Register of Deeds Office. ` DATE sr ATURE OF APPLIC rrrrrr Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Depactrnent• �� "�� me Include with this application: a stamped warranty deed from the Register of Deeds orrice a copy of the certified sutvcy mop if reference ie made is the warranty deed U 1887P 156 STATE BAR OF WISCONSIN FORM 2 - 1999 AATHLE N. Doeumeht Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX Co., MI This Deed, made betwe E. W. Homes, In c., a Wisconsin — RECEIVED i Cotparatio — - 05 - 09 -2002 4;30 AM Grantor, and Ver r&t3t M. Mazac and Julie A. Mazac, husband and EXEIP7 t wife, FEE: 13.00 TRANS FEE: 289.50 r.__ -- - -- COPY FEE: CERT COPY FEES ' Grantee. — —. PAGES: 2 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ County, State of Wisconsin (if more space is needed, please attach addendum)* (See Attached Exhibit "A ") Recording Area Name a'IWASTMM OGLANO ATTORNEY AT LAW P.O. BOX 359 HUDSON, Wi 54018 _ 1 , 7-� Part of040- 1083.50 -Wo Parcel Identification Number (PIN) This is not _ - - „— homestead property. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. 01) (is not) Dated this —�� day of May 2002 E. W. rocs, la AUTHENTICATION ACKNOWLEDGMENT Signatures) E. W. Homes, Inc., a Wisconsin Corporation, by STATE OF WISCONSIN ) Mark B. Sylla, Presiden ) ss. _ County ) authenticat thi .Ilay of May 2002 +— — Personalty came before me this _ _ _ day of the above named • Kristi m Ogland TITLE: MEMBER STATE BAR OF WISCONSIN _ (If not, to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized 706.0 g by § 6, Wis. Stars.) THIS INSTRUMENT WAS DRAFTED BY s — Attorney Kristian Ogtand Notary Public, State of Wisconsin Hodson, WI Olb M Commission is Y permanent- (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both an not necessary.) • Names of persons signing in any capacity must be typed or printed below their signature. Wo mahan Pwiaua,aa comt,,,y. pone du Lao. W STATE BAR OF WISCONSIN eoosss W1 WARRANTY DEED FORM No. 2- 1999 U 1s87 157 EXHIBIT "A" Lot 1, West �A&cres- Also, a parcel of land located in part of the NW' /. of the NW/ of Section 21, T28N, R19W, Towns of Troy, St. Croix County, Wisconsin, also being part of Lot 2 of the plat of West Ridge Acres; described as follows: Beginning at the noetheast comer of said Lot 2 of the plat of West Ridge Acres; thence S21'19'02'E 161.75 feet along the east line of said plat; thence S88'50'32"W 285.15 feet along the north line of Lot 1 of said plat; thence N06'08 35"W 152.22 feet; thence N8W50'41'E 239.99 feet along the north line of said Lot 2 to the point of beginning. St. Croix County, Wisconsin. :HU7ns N091A3 100 -olos :e :31va 131vN OD eor Iwcl l.x7w 52�6100SSE /juniIISUOo • q?nv n M 3N3 b0! o3SV313 Lo0_olOS ,�,� t3b NISN00SIM 1�1Nf100 X10210 '15 'dIHSNM A0211 oo /oo /so rl N Loo r3lu No Y.r / 1MAIILL1M Y�tK-M W ���� d un- IIL -/IL PL /IM-tR -111 ML 00 /,.o /so 73<wa Iln/u �•• °•.•a NO ISIAIO8f1S S380V 30412 iS3M y�1 oil Y Rum 1 CPC 1133rOtl0 W Hold MB 0370310 YMi WTI 113 NM a" Q°M°i 101 rl)l ue tovna o 0 IM � R -- -- - - - --- n O Z r � ::i Q- 9 vi 0 U - -� O \ \ ° ° -- g o - - -- \ \\\ o \ \\ g Ld i o ! o \ \\ i -4> \ \ . -._ ._._._. i o \ CHINNOCK LN _ N \ Ln EU. LJO o vi >� v, i fill \ \ u n I I � \ \ I I I I I � I 0 00 ...... \ ROLLING MEADOW DRIVE UNPLATTED LANDS OWNED BY OTHERS 0002 6E :91 :vl 80 APW UOW 6Mp'200 -0L05 \200 - 0109 \VIdd.