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HomeMy WebLinkAbout040-1275-50-000 ti Z ° °o o ^ v) M O N C O a O O N I N C I � I I c E: w 0 v � I � 3 m LL C I O I I z E v 0 CL m cn O O Z a U @ d Z d cn c O N O N O O • M 1p ", Lo N ,0, p O 04 -� , d`J . C6 N CS Q 2 L' o o LL Z Z z o N E m _ - 1 L ` d d 4. .Z. - Y O d a E m LO H H H Q � M (1) J U I. 0 0 00 Of } V 00 MME NO Z O O O �] O r N N Y O — =)� O O = F co LL O CO r n h e N 'V Oi C C O E E r- u? t2 Lo N H 2 N :E u p ca •- •- C 00 N N W U) N n O N W Cl) O z :.: (D CL l ca = E v �r✓ ✓' °' xt _c, d a E L 'E ' C — 1 A U G r L I o fA U Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: ip 395212 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: S Ila, Mark Troy Township 040 - 1275 -50 -000 CST BM Elev: Insp. BM Elle/ev:: BM Description: �V TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing 1 b Alt. BM Bldg. Sewer Hold' � Fn — iet St/Ht O 1 TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing — 7 L Q , 3 � , Header /Man. ,` Aeration Dist. Pipe , D 14 - 3 e -3 Holding Bot. System SOS �S PUMP /SIPHON INFORMATION final Grade Manufacturer Demand St Cover GPM Model Number Z TAP TDH Lift Friction Loss Systenj Head TDH Ft ,09 .SD 3D, Forcemain Length , Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches / PIT ENSIGNS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO G/ P/L BLDG WELL LAKE /STREAM ING ufacturer. INFORMATION Type Of System: r CHAMB IT Moe er: DISTRIBUTION SYSTEM Header /Manifold Distribution I x Hole Size I x Hole Spacing Vent to Air Intake 3 L 0 Pipe(s) SD 3 j Length Dia Length Di a Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of r7eeded /Sodded Mulched xx Bed/Trench Center Bed/Trench Edges Topsoil Yes � No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: Q � / Z a Inspection #2:_H /� / 0 Location: 523 Westridge Circle River Falls, WI 54022 (SW 1/4 NW 1/4 21 T28N R19W) Welstridfee / k ) Parcel No: 21.28.19.131 1.) Alt BM Description = p ;� `�', l ty d i` Ivvt.c� kh e 2.) Bldg sewer length - amount of cover 3.) Contour= 5-y0 -z Plan revision Required? ❑ Yes ] No _ �-- Use other side for additional information. /S Date Insepct is ignature Cart. No. SBD -6710 (R.3197) �; M� -.,,.. 1..,� 1 .�. .� i �'�� - �h �._, z oo _ �,�, a �� -- __ �� \\ �� 5afery uid Buildings L' tvl s x-n Cou.:tY ' 201 W. Wathlapton Ave., P.O. Box 7162 STG Yo �` r M its Addrats adjw, WI 33707 - 7162 D aggLIMent of gjM moro a o .... ` �;? r ftwtuy Permit Applic u 3RSl in saw wldt '1i■11 OZ. ft. Min. ��dh l ow W� you provide; � Q Cluusk 1f ibv�ion 2 L Appt{ +li JAt�er low ki MW IS mod= an om oa - P t a biftm r I ,� a Pl4n L1a I+ltttaabrr 64 /I 3 L ' petiY tai VAL- Ptapwy OwttMr'1 PM P WW A CIr / r !� i4 d 34' S T�� N A , lee / City. Sea } r _ N ` ' -, tfm t, /81nck :Vutnba! CSM Numbez 'f rolls Type of Sw whop (do* all tw apply) � OCay N uatber of 8rdedoxns o r 3 i - llllese Q Publiott�ot�ataemlal- PetMrlbe UM ,,,_, r�nsil �y �_ I a Steel o*TMti Nearest RW M. Tp+pr osr Perntle (CMA aa(y orio bast an A t mbatrlal aebame for iateraal 04). Coql lime B if appUuble) A 3 Hrk 3 13 RrpiMOtmeet System 3 0 Ifeplec Moot of 6 Q Addition W i►or Couaty un S ate D. Q Cheek U Auhaq Puma ?reviouriy I sawdt P ft l Number Dan Issued t Type at perfpaltt ( ap ly) mborl" eme is for koemal uee) 41 C1 Nun - Prauurised ItaQrratnd ' itdouad 47 C Su:d Filter So C Cowouzed Wetland 22 C ppmurlMed In4mud 4t ❑ Howl" Teak 44 ❑ SiMle PW sl Q Arip Lim 45 As 460 big Tsratxneot Unit ro " Ae ui 30 V. iri ,rj� ! i y Asp Area ApplleMdon Pares adaa um Stun Alevatlott I Pinei Grade pwpoted Rw(t3a1sJTJMys/Sq.Pt.) } (lviin.ttttcls) ; Elevation Toad R ;; r — MuNf wor Pre Sias 814$1 ; Ifibe! , Pixstic "I= of T Coaente Cat+tttttcted Gins I V& ' , BtaeMMUeot- fie arms me for o PQW'l'8 4*00" oa the ottubw ftwW t r 8usimst Am Number 0 4 Ste= r d t (INK CIWWV - ) Dub O lets ( Qtoundw%w Paw URIC* Arent pmtcre I,lt'c tampa� i bjell"So 7") ❑ Cww Chet >bidel Adwo 3 Z l� $ ( o ( I LY. at ear f'es L1iMpaeewl �q t I �ta kilv�tOW►��• i�b 6AI,,Y4 t«u.caet 'tj`t5�t (Mart '3 . � 4 0» peN►� M J m . ;p S$ 08 OL 05101) t , I'+ Safety and Buildings !� 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Visconsin www.commer . res / �,� www.wisconsin.gov Department of Commerce, Scott McCallum, Governor Brenda J. Blanchard, Secretary r July 24, 2001 CUST ID No.691727 ATTN.• POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX 1✓OUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 07/24/2003 Transaction ID No. 661983 SITE: Site ID No. 633144 Mark Sylla - Rolling Meadow Drive Please refer to both identification numbers, St. Croix County, Town of Troy above, in all correspondence with the agency. SW 1/4, NW 1/4, S21, T28N, R19W Lot 5 - nameless subdivision FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 802754 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "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" SBD - 10706 -P (N.01 /01). • 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 must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information regarding proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • A state approved effluent filter is required. Maintenance information 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. Slats. • 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 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS c2gnp8nents after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. ` ARTHUR L WEGERER Page 2 7/24/01 • 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. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/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. Sincerely, - A' FEE REQUIRED $ 175.00 Au FEE RECEIVED $ 175.00 _� . — - — . s. BALANCE DUE $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services 608 - 789 -7892 Mon - Fri 7:15 AM to 4:30 PM WiSMART code: 7633 jswim@commerce.state.wi.us cc: Mark Sylla TITLE SHEET Page of MOUND SYSTEM FOR A _L4_ BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10691 -P and the Pressure Distribution Manual SBD- 10706 -P (N.01 101) LOCATED IN THE SW 1/4 OF THE MVJ 1/4 OF SECTION Zl ,T DB N,R 1q W, TOWN OF S ( COUNTY, WISCONSIN. INDEX PAGE 1 of -7 TITLE SHEET PAGE 2 0£ - 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 Qr J s`TLEEr V'�� PREPARED BY I�IEGEI�EF2 SO 2 L . TEST' I !V G AND . P.O..Box 74 421 N.Hain St. River Falls, WI 54022 ���t�� Phone 715- 425 -0165 eO Fax 715 - 425- 6864,..�»•.., Tr iF i h ti W Q • A aR A _ MN ER":A OA T o-a,y 1 �S• C onditional l y llLSXGHiH- A PP IVIED I I ptPARTMEEr AND BWWINCIi �N�N DIVISION G0 f♦) • p, ENCE SP N� SEE �' JOB NO. Mound System Management Plan Pag Z of Pursuant to Comm 83.54, Wis. Adm. Code g 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 aTank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps 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 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 acid local or state rules pertaining to system maintenance and maintenance reporting. s -1� CtJO1101> No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Continaencv 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 immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by Increasing basal area if toe leakage occurs or by removing biologically dogged 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 — 1 15 — 304 ST I C t0 IX The system installer at SC�h1wLA�2�R The tank manufacturer at Qipo ,3ZS_�t.[$b h LI;z'S (FVz The effluent filter manufacturer at $6()_ 7 -.SlgZ Zi . The pump manufacturer at . - - 6 's0 �(� - PLOT PLAN - Page 3 of _] Scale 1"= ' 0 N 3 `DU )v OT e- MPAp f_r oK \ '�• coNTOvtZ �z , 1p4, p lafv�ZQ B•) 60 OK ° I L -s ngm 0 3 a 2 -'4L. q 4.0 ' , — — L oy- aN 1 `� LROti F l�� y i - P , 41 1 P L r . Lo Ll ZOL+v u► 'DTz o �,t. 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 t1 /8op gallon capacity manufactured by Wt�!stM 0 0j omem P not)U CTS wz A- 18 0C) ZPtBk !=-) t_tj�ft* 4. Bench marks S OU 5. Divert surface water around system to prevent ponding at the uphill side. Pace L4 Of -] Approved Synthetic Covering AST2 C33 Distribution Pipe Medium. Sand G Topsoil - — _ H _ F Elev. . I k) .S 3 E b Y % Slope �- Distribution Cell of Force Main Plowed z" to,2 z" Aggregate From Pump Layer Ft. E 3 Ft. CROSS SECTION OF A MOUND SYSTEM F 0-8 Ft. G b. S Ft. A f t - :� Ft. H 1.O Ft. Linear Loading Rate= 6.13 GPD /LN FT B 101) Ft Design Loading Rate= o;3g.GPD /SQ FT j 10 Ft. J S Ft. K $ Ft. L 11 b Ft. ef . �s�c -.MMa zia W Z I Ft. . I I j - Observation Pipe 7. K C�-r- - - - - -- --- -- - Box Sg — i - - - = -- - -- - W Force Main Ll coistribution Cell of to 2� ' " l " -� . Pipe aggregate , Observation Pipe (Anchor securely) PLAN VIEW OF A MOUND SYSTEM Distribution Pipe Layout PA &e s of 7 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 Ion; 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. - _L,�.CESS BOx_ t C. Fvc Svc Lateral Manifold Lateral x x x z W2 I xa x x z x Lateral Length — Lateral Length — P Distribution Line 1 h f111 Fc! tQ S W RCE r, RiN P qq• S Ft. Hole Diameter l ��i Inch" S Ft. Lateral Inch(es) 3 � - X ' Inches Manifold Z Inches Force Main " Z Inches # of holes /pipe 1 Invert Elevation of. Laterals 105.6 Ft. .. - Combination Sepl ic;.Tank and • PUMP CHAMBER CROSS SECTION AMC) SPECIFICATIONS PAGE 6' OF 7. -VEWT CAP WEATHER PROOF JUIJCTIOIJ BOX . ti C.Z. VEIJT PIPE APPROVED LOCKIMG 1 10' FROM DOOR, MANHOLE COVER AJ :iltvDOW OR FRESH wA(t1J11JG LPt01:L. u.�BP�giolJ �IpE A�IIJT/lKE � cor.�Durlr wlfttRllsW Gt•P s , G mim ---- - - - - -- IS•/'l ---- - - - - -- IIJLET �'Q PROVIDE _ AIRT16HT SEAL I ! I 8 AFFLE •�, I l l � ~ v f Approved Z �-��' '� I Approved joint w / 14- t900 AL AR x PVC n pipe PVC pipe I c i I I CLEY g� -�S FT - -J PUMP 1 OFF L D COU FLETE tz 1 ej • Is - 1 - O b l DLOCK - RISER EXIT PERM11fED OIJLy IF TAWK MA HAS SUCH F I N4 H APPROVAL 3NooINr. t SEPTIC F SPECIFICATIOUS DOSE TALIKS tAALIUFACTURER: - �Nj«L Z ANC �F WLMB OF DOSES: S PER DAw TAMK SIZE:: — 2 Z fJ 00 CALLOUS DOSE VOLUME r ALARM MAIJUFACTURER: IMCLUDI 6ACKFLOW: \ S gls GALLONS MODEL 1JUMBER: lOI E�w CAPACITIES: A= 19!2 IU CHES OR Lit 1 --7 GALLOWS SWITCH T:JPC: eaJJR -- ` / gc Z IIJCFIES'OK y'i' G�LLOLIS PUMP MAMUFACTURCR: -_ �0 U \ t C C = -7// Z IUCHES OR 1 5 GALLOWS MODEL IJUMHER: — 38`�S' WEOS D = ' IMCHES OR X 86- GALLOWS SWITCH TYPE: MOTE: PUMP AUO ALAR AR E TO a- .8 MIMIMUM DISCHARGE RATE Z7-Bgi GPK INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEIJ PUMP OFF AuD..DISTR18UTIOU PIPE.. ), ' $5 FEE7 f MILJIMUM M ETW ORK SUPPLY PRESSURE . C__SO FEET rS_0�A- 1, 3� + Z Z S FEET OF FORCE MAIN X F o fLFRlC71O FACTOR.. S FEET TOTAL OyWAMIC. HEAD FEET " - h As per manufacturer ZO- (00 gal /in. Liquid depth 3$ �vMP FZLF0Zy_i1MvcE CUZUE - P , �f - 7 uouias Submersible Effluent Pump 3885 P� �J APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Specifically designed for the be provided in starter unit. bronze impeller available as without damage. • Shaft: threaded 400 series an option. following uses: � ■Bearings: Upper and • Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing • Farms • Bearings: ball bearings tYP Y a for maximum efficiency. construction. • Trailer courts upper and lower. 2" NPT discharge adaptable • Motels • Power cord: 20 foot for slide rail systems. ■ Power Cable: Severe duty w ater rr resistant. st andar d es • Schools s ngths rated oil n length (optional s Mechanical Seal: SILICON Epox seal on motor end • lengths available). P xY Hospitals CARBIDE VS. SILICON provides secondary moisture • Industry Single phase: • Effluents stems •'/3 and'/ HP —'16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket Effluent-systems Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three gUNA -N elastomers. wicking. SPECIFICATIONS prong plug. - • 3 /4 - 1'/2 HP —14/3 STO with ■Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities:' Three phase: design. Locknut on three and oil leakage. - W maximum. •'/2 - 1 ' / 2 HP —14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities; up to 128 GPM. listed models — 20 foot on accidental reverse rotation. • Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in SP Canadian Standards Association TDH. are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat Underwriters Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide- stationary seat, 300 ■ Designed for Continuous series stainless steel metal ■Impeller: Cast iron, semi - open, non -clog with pump- Operation: Pump ratings are • Temperature: parts, B tune: elastomers. out vanes for mechanical seal within the motor manufacturer's 104 °F (40 0 C) continuous Protection. Balanced for recommended working limits, 140 °F (60 °C) intermittent. • Fasteners: 300 series METERS FEET so ! stainless steel. ' ` ` !SERIES: 3885 ! l ! i ! 7 — _r — j SIZE: W SOLIDS • Capable of running dry 25 80 l Y 1 ; ; ( (. i RPM: VARIOUS without, wE damage,to --. scPM components. 70 ! i WE1 5 FT ! Motor o 20 l , Single phase: _ 60 01+ ! ! ! •% HP, 115V,200V,230V, ! i i 15 5 0 - I t 60 Hz, 1750 RPM; /2 HP, z 115 V, 60 ,Hz, 3500 RPM; 0 40 1 'EO % HP.— l%HP,'230V, 60 Hz, 3500 RPM. ° i o 30 t_ I z$ • Built-in overload with WE03 L { ( t t automatic reset.` 20 " 5- i - ! Class B,insuiation i - - - - 10 Thr ee phase �' „ •'% HP * ._1 %HP 2001230/ _ o o ! I I 460 V, 60'H2, RPM. 0 10 20 30 40 50 60 70 80 90 100 110 120 130GPM Class'B insulation ' o io 20 30 mom CAPACITY ®1995 Goulds Pumps, Inc. Effective May, 1995 11 83885 r Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 www. N *hsconsin www.commerce. Asco n s wiscosin.gov Department of Commerce Scott McCallum, Governor Brenda J.ttchatd�Secretary July 24, 2001 CUST ID No.691727 ATTN. POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX'COUNTY SP *� �N r J PO BOX 74 1101 CARMICHAEL RD 1p�C RIVER FALLS WI 54022 HUDSON WI 54016 ` Z00 CONDITIONAL APPROVAL Id PLAN APPROVAL EXPIRES: 07/24/2003 ID No 6 Transaction D No 6619 1983 SITE: Site ID No. 633144 Mark Sylla - Rolling Meadow Drive Please refer to both identification numbers, St. Croix County, Town of Troy above, in all corresppndence with the agency. SW 1/4, NW 1/4, S21, T28N, RI 9W Lot 5 - nameless subdivision FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 802754 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- .10691 -P (N.01101) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 101). • 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 must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information regarding proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • A state approved effluent filter is required. Maintenance information 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. Slats. • 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 83.52(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 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS o2Wnents after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. ARTHUR L WEGERER Page 2 7/24/01 • 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. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of 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, component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, � � FEE REQUIRED $ 175.00 ,u FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services 608 - 789 -7892 Mon - Fri 7:15 AM to 4:30 PM WiSMART coder: 7633 jswim@conunerce.state.wi.us cc: Mark Sylla .a• Wisconsin DepartnentofIndustry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Division of safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code ' COUNTY... Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ST, C not limited to vertical and horizontal reference point (SMy, drii%on and % of slope, scale or PARCEL .D. # 1 /kJG dimensioned, north arrow, and location and dist�e to nearest road. ' ��� APPLICANT INFORMATION - PLEASE "IN„T ALL IMORMATION R I D BY D PROPERTY OWNER. PROPERTY LOCATION Z�rZ_ S`'1 a 6611 E0T S h1 1/4 NW 1 /4,S Z l T ?$ ,N,R 19 E (aa W PROPERTY OWNER MAILING ADDRESS • LOT BLOCK;* SUBD. NAME OR CSM 111 I� _ bll.lLSLO S — Po9 P CITY, STATE ZIP CODE PHONE fTY []VILLAGE ,MOWN ' NEAREST ROAD -- p�to L-13 5VaZ:- (bIZrr�t 6 -abZ8 rry os� K New Construction Use N Residential / Nurittier pf bedrooms y [ J Addition to existing building (] Replacement [ ] Public or commercial describe Code derived daily flow bb6 gpd Recommended design loading rate _ bed, gpd/ft - trench, gpditt Absorption area required SW bed, ft SOO trench, ft Ma)dmum design loading rate • S bed, gpd$ • 6 trench, gpd/ft Recommended infiltration surface elevation(s) 1. 6.0 ' It (as referred to site plan benchmark ) Additional design / site considerations t iD Wl8 'x- 6,S' @gyp , Wt w V tz' 0 r- � � u Parent material 1 n Q-tS c yuNe& 6 I Flood plain elevation, if applicable it S = Suitable for system COWENTIONAL I MOUND IN-GROUND PRESSURE FST= L HOLDHO LDING G TANK U= Unsuitable for stem ❑ S U S❑ U ❑ S O U I AT -GRADE ❑ S RU RU I [I S Q U SOIL DESCRIPTION REPORT Boring # Horizon ITexture Consistence N Roots Depth Dominant Color Mottles Structure GPD /ft I I in. Munsell Qu. Sz Cont Color Gr. Sz. Sh. Bed rerxh I 3 L2 -S , Z lo`IiZ 3/6 Ground 3 - q -So - 1 S `te- 3! y! - s) o w�wc►2�y - ►-�P U elev. , P l o3•S it Depth to limiting factor Z9" Remarks: Boring # E l n -1 L 1Z, Z to -zn. >o7e 3f - Sr l zf sbk wf — -S Ground 3 20 -19 - 1 .S `? R .3 /fir _ L �btir m fi eLc) — •Y - elev. 39 S �� 3! y .S `i rZ s� L a rn`p _ _ Z oV_o ft •y :. Depth to limiting fact a Remarks: T Name: — Please Print Phone: Arthur L. We erer 715 - 425+-0165 egezer soij Testing & Design Service -P.O. Box 74 River-Falls WI 54022 Signature: Date: CST Number.. oo -11S- S - S -S-l�6 220254 PROPERTY OWNER PARCEL [1). p SOIL DESCRIPTION REPORT Page 7?_ 3 �1 NG Boring # ff Don inant Color Mottles Structure In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots GPD /ft Bed l li 3 Li `rench w e ro nd S `t Iz 3L}r _ S bk rnf�, tie6 rt. y -�9' 1p� -t'� SIZ. ��- sy�t.S�B s i C 0�,.� ►n� ; _ PJP Np Depth to limiting factor 3z0 Remarks: Boring # Ground elev. ft. Depth to — limiting factor Remarks: Boring # Ground elev. It. Depth to limiting factor Remarks: 3oring # ,round 3lev. rt. )epth to imiling actor Remarks: _ •h a•r•V1 rt� •.r . .. • PLOT PLAN Pa 3 of 3 J SCALE 1 "= 14) ' S, e1 -to63 s 3 / \ \ �oTTUh'l OF � o ►� o� e.a�,�R-eT ate � N y � � � . tOb .� <' TL to s t tao►a piPC -. — — — L,oT 6 S\'C� LOCi�1p TJ �'� 0 -- ,_/ zzozsy ( 715 ) 425rtQ1 6S CST Signature Date Signed Telephone No. CST # ; Wisconsin Department of Industry, Labor and Human Relations SOIL AND SITE EVALUATION REPORT Page of 3 Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code C0U Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, b Sr' not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL! # �F? I h1G , dimensioned, north arrow, and location and distance to nearest road. ' APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION n BY DATE PROPERTY OWNER PROPERTY LOCATION SOT S 1/4 KW 1/4,S Z l T 18 ,N 19 E (oo W PROPERTY OWNER':S MAILING ADDRESS • LOT # BLOCK # SUBD. NAME OR M # tilt w _ bLULSUoQ ST- S os .p CITY, STATE ZIP CODE PHONE NUMBER ❑CITY IL GE ,MOWN ' NEAREST ROAD Sz1.U�Z - -4LLS,I.,3 5 -Ot 8 1-�z.p ipoSm [� New Construction Use Residential / Number of bedrooms y [ ] Addition to existing building j J Replacement (J Public or commercial describe Code derived daily flow -tea gpd Recommended design loading rate y bed, gpd/ft - . trench, gpolft Absorption area required SW bed, ft Soo trench, ft Maximum design loading rate • S bed, gpd$. - b trench, gpd/ t Recommended infiltration surface elevation(s) L b.o It (as referred to site plan benchmark) Additional design / site considerations W/8 'x 6.3 ' @e:� . M w I MUM tl' o r Siti F LL Parent material 1 - n ew3S o u'z 6 u'zr t.L- Flood plain elevation, if applicable N ft S = Suitable for system CONVENTIONAL MOUND IN•GROUND PRESSURE AT•GRADE S STEId IN FILL HOLDING TANK U= Unsuitable for stem O S 0 U I EIS ❑ U ❑ S ®U 0S RU S ®.0 I [IS 1a U SOIL DESCRIPTION REPORT Boring # . Horizon Depth (Dominant Color I Mottles (Texture I Structure (Consistence easrary Roots GPD /ft in. ` Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed r I J 0 - LZ. 3 L2 S I Z`� rn'Fi- C1v ' . S lo`-IR- 316 Ground 3 Zq,So efev. S J '' c► r — NP Up Depth to limping factor N Remarks: Boring # 3 Ground 3 za 39 1..5 L 1 c°sblz mti• cbv y o 39-68 S `� �- 3! y -� .S Lf rzs?`a L Uw, rn`Fy - - •y Depth to limiting iact� a . Remarks: T Name: — Please Print Phone: Arthur L. We erer 715 - 425-»0165 egexer Soi ?esting & Design Service -P.O. Box 74 River.Falls,41 54022 Sgnature: Date: CST Number:. 00- 118 - S S-S-45(3 220254 PROPERTYOWNER +-S2 S�-ll.P� SOIL DESCRIPTION REPORT ~ PARCEL I.D. # P age -2 -01 3 Boring # Horizon Depth Dominant Color Mottles Texture Structure ,., In. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Consistence law - dary Roots GPD /ft ` a p _ ►b `1 R 31.2, S 1 Bed Trench Ground 3 ZS - 30 `7 S `i R elev. es ,� • 4 . s A63 rt. y - v 9 ' _sLl1Z 5A s i C 0 Ni Depth to limiting factor 3w Remarks: Boring # >�. ... . . . . 1 .: rte. v. Ground elev. — ft. Depth to — limiting factor Remarks: Boring # Ground elev. It. Depth to limiting factor Remarks: 3oring # around ?lev. fl. )epth to imiling actor Remarks: _ PLOT PLAN Pa 3 of 3 SCALE 1 "= 4 j ' • S, B .Z ,� � b y 7"ts �1 y� L,oT 6 � O x p t - iJ N� a ro��uuG ri�c�ow octu¢ � OQ_�,l$ -S - _ zzoZ ... f 715 ) 425 : z()16 9 r CST Signature Date Signed Telephone No. CST # FROrl Sckumaker Plumbin q FHX h10. 7153PE3121 Hug. 01 2391 10:439R P3 ST MOM COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O ( WNERSHIP CERTIFICATION FORM Owner/Buy m ar k — &, d ,, Mailing Address 111 GJ . O v i s t o,n S T - R , ,�� (F�, 1, 44 �S j2 (( I Property Address 1 ^o f S G./a.5 a_ Arc S - o1 3 Q (Verification required from Planning Department for new construction) t� City/State ��� �s C/r SYQz2- Parcel Identification Number LEA. DESCRIPTION Property Location Sec. 2 / . T Ly N -R � W, Town of Subdivision G`�¢STr �C !✓c ,� Lwt # .5 CertMed Survey Map # _ . Volume . Page # Warranty Deed # AFC Z s'/ z Volume /S3 s , pop # S 3 G Spec house 0 yes l(no Lot lines identbUble yes ❑ no STEM 1 TTENAANQ Improper use and maintenance of your septic system could result in its premature failure to handle wastes_ Propermawzenance consists of pumping out the septic tank every three years of sower, if needed by a licensed pumper. What you put into the system Van affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to -%*=t to St Croix Zoning Departmcnt a certification fom signed by the Owner and by a nuL ttsplumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is loss than 1/3 full of sludge. Vtm the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards sett forth, herein, as set by the Department of Commerce and the D&rtment of Natural Resources, State of Wisconsin. CcrtiSoation stating that your septic system. has been mainsni wd must be comp/ and returned to the St. Croix County Zoning Office within 30 days of She three year expi ti n date. C'�K - I" SIGNATURE OF AP LICANT DATE PVMR CERCATLON I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner($) of the pr p, rty ddescribed above, virtue of a waaanty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE 0 0•••' Any information that is mis- represented may result W%K sanitary permit being revoked by the Zoning Department.'""` '• Include with this application_ a su=iped warranty deed froup the Register of Deeds office a copy of the certified survey map if rcfcrenoc is trade in the wansnt4y decd 07/25/00 TUE 09:43 FAX 1 715 386 6560 ZILZ & ESTREEN 002 . i V01.1529PAG6 KATHLEEN H. WALSH STATE BAR OF-WISCONSIN FORM 2. 1999 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between Paul M. SyIla and Patricia Sylla husband and wife, 07- 27 -2000 9:30 AM WARRANTY DEED EXEMPT N Grantor, and E. W. Homes, Inc., a Wisconsin Corporation, CERT COPY FEE: COPY FEE: TRANSFER FEE: 825.00 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in SL Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot One (l) of Certified Survey Map in Volume Four (4) of Certified Survey Recording Area Maps, Page 1157, as Doc. No. 377181, filed in St. Croix County Register of Na111C OG Lq ND Deeds office on April 20, 1982, being part of NW 1/4 of Section 21, 728N, Z 11Z EStrt;en & O R19W, EXCEPT Lot 2 of Certified Survey Map in Vol. 10, Page 2819, as a O Box 359 gland A Doc. No. 521597, and EXCEPT Lot 5 of Certified Survey Map in Vol. 14, P- 0- On W Page 3893, recorded as Doc. No. 626220. I 54016 Pt - & 040-100-50--000 Parcel Identification Number (PM) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. 04) (is not) Dated this day of Ju 2000 + • Pa M. SyIla AA// ' . Patricia Syl -- la AUTHENTICATION ACKNOWLEDGMENT Signature(s) Paul M. Seta and Patricia Sylla, husband and STATE OF WISCONSIN ) wife, Ss. County ) authenticated t ' day of July , Z000 Personally came before me this day of the above named • ICriatin■ Oglan TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stars.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kriatina Ogland Notary Public, State of Wisconsin Hudson, WI 5 16 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) • Names of persons signing in any capacity must be typed or printed below then signature. rl flan Prufaucmis C�4wV, Fax du r.e M STATE BAR OF WISCONSIN o0o e6szazf WARRANTY DEED FORM No.3 -1999 • ', • fi ATED IN PART OF THE NW1 /4 OF THE NW1 /4, PAF 1 OF THE NW1 /4 OF SECTION 21 T28N, RI 9W, / �I E' 'BEING PART OF LOT 1 OF CERTIFIED SURV LOT 2 s LOT 1 F C2 \ d T 4 LO Lu m WELL EXISTING B ILDING Non�coa - LOT 5 . 5.00 ACRES I" N 218,006 S0. FT. EXISTING CONCRETE EXISTING BI N88 "E 228.33' I 0 I EXISTING �I - 10M ES, o l PARKS I vi a r � r © C4 a I I 0 FURTHER SL 9 7. �I rl� I BY THE ST. OI I