Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
040-1256-60-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building DivisV n W INSPECTION REPORT sanitary Permit No: (ATTACH TO PERMIT) 430285 0 GENERAL INFORMATION State Plan ID No: q � Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). �/ Shp * -- ( &5L 11pMS ,M. Permit Holder's Name: City Village X Township Parcel Tax No: Mer ens, Kevin I Troy Township 040 - 1256 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: I`'C- - ma C A14 0 �•�"� 24.29.20.1360 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer / 0-13 C) 3 0 :1 Holding St/Ht Inlet r TANK SETBACK INFORMATION St/Ht outlet 11 ,kr qZ• 3r' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 4v + 32 f Dt Bottom O Q 30' Dosing `I '2 / �Z / + Header /Man. 2 ,ld n'. 90, Aeration Dist. Pipe , U 2 Holding Bat. System ,�p Or o ff , 3o ( �, Fi nal B adp PUMP /SIPHON INFORMATION � %_ ( (Z. j ` Manufacturer ems St Cover GPM Model Number Z?'-d Lift t Friction Loss System ad ]TDH t N ,top 2 . .�' . S 5 Forcemain Length Dia. 2 t( Dist. to Well � � , ( O ,� v 1 .11%0 C SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS �� Q 4 SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEAC G Manufacturer: INFORMATION CHAMBE R Type Of System: / 1 5-5 odel Number: DISTRIBU ON SYSTEM Header a ' Distribution 1 ry pp I x Hole Size x Hole Spacing Vent to Air Intake 11 1 Length _Z .�* Dia 17 4 Spacing / 3.1+ 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 F ] No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: II / 17 / t3 Inspection #2: D& ,[.b Location: 260 St. Annes Parkway Hudson, WI 54016 (NW 1/4 SE 1/4 24 T29N R20W) Troy Village 3rd Addition Lot 100 Parcel No: 24.29.20.1w- 1.) Alt BM Description = 2.) Bldg sewer length = ,^Z J,P P t ° "`• ` r Q amount of cover Plan revision Required? LJ Yes No l Use other side forditional informs ion. __ '+•!� �- SBD -6710 (R.3/97) / — Date G 3 In cto ' Signature e-14- / 7 _ Cert. No. } Satety and Buildings Division County 201 W. Washirtston Ave., P.O. Box 7082 ST. CROIX '\) i ����� Madimm, W1 53707 -- 7082 Sanitary Pennit Number ( to be filled in by Co.) Department of Commerce (008) 201 -6546 30 Sanitary Permit Applicatifm RECEIVED Plan I.D. Number In accord witb Ctman 83.21. Wis. Adm. Code, perwnal infomtation a provide 93 656 r 1 t^aNS. IA . maybe wA4 for sat o Wmy purposes Pnvacy taw, s1 MP4(I m) j a Ad&ws (it diffaetrt than mauling address) 0 ST. ANNES PARKWAY I. Application Information — Pieaae Print AN Information - - -- L Prape6yOmm'sNantc ZONINGOFFICE 1# Lot# 100 # KEVIN P. MERGENS 040 - 1256 -60 -000 Ptoperty Owner's Mailing Adds S. (0 3 k !1/l ley Locatim __..��.^ 502 2ND ST., SUITE 204 cO • U A NW y, SE 24 City, Stair Zip Code Phone Nuraba S HUDSON WI _ 540"16 715- 386 -5050 T 28N N., R i� 2)U0 IL Tyre of Building (check all that apply) I or 2 Family Dwelling - Numbtxd'6edhroums DRM AS PER SUBMITTED HOUSEPLN s " f°'stO" Name CSht Number tublir:Cmurict iai _DocribcUse � 0.dmvhctt � r� fGcs TROY VILLAGE - 3rd ADDITION ❑ state owned - D..ribc 1 isc rrr �C S Uviltage &.w1wW of R� OY ^i IQ. Type of Permit. (Check only one Iron on line A. omp ae if Applicable) A - 1A New System ❑ RgA amterd Syslwn ❑ TreatmenMoldierg Tank Repl acement ( t (fir Mo&ficak or► to Existing Sy�Acm i(evinos ❑ change of I_ i Permit TrarWer to New Lim Preview Permit Number and Dale pmmt Rene" Feraut IleforeExpirabon Plumber Owner 'f 3oZg5� ��20 %3 IV. T e of POWTS Sys tem : Check all that i t i Ni, -Pr€ uriaed In�(�utttd �4cuuul % 24 in. ofsuitahte soil Moutxi , 24 in of suitable soil ❑ AI -Crack H Single Pass Sand Filter Constructed Wetlarxl ❑ l'm wized ind)rourd H Peat Filter f I Aerobic TreMment Unit ❑ Recirculating Sand Fitter ❑ ResirrrdatirtE Synthdie Media Fiber n ie hing ber H Drip Ii n Crravel -less ❑ od1cr (explam) V. his rsal/Trttttment Area Information abel Al 00 filter : 17 = oeller 98 pump ee attached .63X80' moun Design Flow (gpd) Design Soil Application RaWgpdsf) DiI)cmal Area Required (st) Dispersal Area Proposed (Pit) I syslem Elevation 450 .5 u• S .d1 900 (450 CELL ) 102 -- q5 ca'01 101.15 VL Tank Info Cady in Total Numb Manu ac'turer sae Steel Fiber Plastic Gallons (; kwdt of I inits Cone"ta Ccatrintated CAM New ExlstlnA Tanks Tanks Septic or Uoklizig ;mn X 1000 1 WIESER X Aerobic Trralment Unit t rK . X 1000 1 WIESER X VII. Responsibility Statement- 1, the aattroe respoasiliaity iron et tide 1'DWTS aiW.- aw Nre auac6ed plwt Plumber's Name (Prw) s S' P MP /MPRS Number t;trsirtocc lrboee Number TODD FEATHERSTONE 242514 715 - 381 -1 Plumber's Address (Street, City, State, Z C ) P.O. B OX 467 HUDSON, W 540 VIIL Coun tDe artment Use Only Sandwy Permit Fee (mchtdes (3soundwater Date Issued Issui gem Sigmture (No Stamps) Approved U Disapproved Surcharge Fee) , / El omvv, Given R.--,m for Denial 5D �— _ 0./ . D T �b !X. Conditions of Approval/Reasens for Ihsapproval SYSTEM OWNER: S ��.. • ; �o —`� 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained ';'s;& �� as per management plan provided by plumber. (ySt o� &0- n 2. All setback requirements must be maintained t� S as per applicable code /ordinances. / 7� Attach canwiete plain (to the cattaty only) %r do "Wwan M paper Iwt teas tins Na z 11 iacht:a is stmt I Safety and Buildings ` PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 hsconsin w ww.cornrn www.wisconsin.gov www.wiscon isconsin.gov n.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary October 21, 2003 CUST ID No.242514 ATTN: POWTS Inspector TODD C FEATHERSTONE ZONING OFFICE FEATHERSTONE EXCAVATING INC ST CROIX COUNTY SPIA 368 TOWER RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/21/2005 Identification Numbers Transaction ID No. 931656 SITE: Site ID No. 663038 Kevin Mergens - Dwelling Please refer to both identification numbers, St Annes Pkwy I above, in all correspondence with the agency. Town of Troy, St Croix County NW1 /4, SETA, S24, T28N, R20W Lot: 100, Subdivision: Troy Village FOR: Description: Mound System / 450 gpd / Revision To 894225 Object Type: POWT System Regulated Object ID No.: 914754 P C « ''Z The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes t and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in APOWFI chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code re quirements. DtVt DEp A copy of the approved plans, specifications and this letter shall be on-site during construction and open to t 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 S EF construction/installation /operation. � t _ 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. /Sincere Fee Required $ 60.00 Fee Received $ 75.00 Refund Amt $ 15.00 YPlaa Refunds of $25 or Less Will Be Private Sewage iewer Inte rated Services Made Only On Written Request. g (608)266-2889, M - F, 0630 - 1500 Hrs WiSMART code: 7633 pepagel @commerce. state. wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 r MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: BRUCE LENZEN HOMES, INC. Owner's Name: KEVIN MERGENS Owner's Address: 502 2ND ST., SUITE 204 HUDSON, WI 54016 R �C�1VE 0 1 3 2003 00 Legal Description: NW 1/4 SE1 /4 S24 T28N, R 20W S AY 8,%D 5s DIV . Township: TROY County: ST. CROIX Subdivision Name: TROY VILLAGE Lot Number: 100 Block Number: N/A 0 Parcel I.D. Number: 040-1256-60-000 p� . O gC1 Plan Transaction No.: ty'�C Page 1 Index and title e GF Page 2 Data entry " Page 3 Mound drawings O Page 4 Lateral and dose tank ��` ^ ✓�\ Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Soil Test Page 9-,-/r Test Page 1f Plot Plan Page 10-4 POWTS Application Page OWTS Management Plan iy �S Designer: TODD FEATHERSTON nse Number: 242514 Date: 10/07/01 Phone Number: 715 - 381 -1704 Signature - Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.11 (05/01) Page 1 of 12 A Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 450.00 Design Flow (gpd) 1.00 Site Slope ( %) 100.65 Contour Line Elevation (ft) 31.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 80.001 Dispersal Cell Length Along Contour (ft) = 5.63 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /f12) 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) C Center or End Manifold 2.81 Lateral Spacing (ft) If N above, enter the elevation (ft 4 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 8.65 ft /orifice 2.00 Forcemain Diameter (in) 95.00 Forcemain Length (ft) Does the forcemain drain back? Y 93.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 15.50 Forcemain Drainback (gal) 7.65 Vertical Lift (ft) 50.02 5x Void Volume (gal) 1.62 Friction Loss (ft) 65.51 Minimum Dose Volume (gal) 13.82 Total Dynamic Head (ft) 28.00 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. o tions choice in. dia. options choice 0.75 1.25 x 1.00 x 1.50 x 1.25 x X 2.00 x 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) WIESER IManufacturer gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1000.001 Dose Tank Capacity (gal) JZabel Filter Manufacturer 27.831 Dose Tank Volume (gal /in) IA100 Filter Model Number WIESER Manufacturer Project: BRUCE LENZEN HOMES, INC. Page 2 of 12 Mound Plan View t 1/10 B J Observation Pipe ._.. K. l .::... T A 5 W — ...... a ...❑ . L Mound Component Dimensions A 5.63 ft E 6.68 in H ffmft ft K 6.90 ft B 80.00 ft F 9.25 in 1 ft L 93.79 ft D 6.00 in G 0.50 ft J fl: W 16.43 450.00 (ft 2 ) Dispersal Cell Area 1 902.06 (ft Basal Area Available 5.63 (gpd /ft) Linear Loading Rate 1 8.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.92 (ft) ► fit;;; G H 1 F ......... 101.65 (ft) Lateral 1 _ Dispersal Cell -► () 101.15 ft - Invert Dispersal Cell Elevation E D r ,z 100.65 (ft) Contour Elevation 1.0 %Site Slope Geotextile Fabric Cover Shading Key �a �, —� Dispersal Cell See lateral details on ❑� 1 Topsoil Ca .a . :•: :.::; :;:::;:,:::;:,;::;:: ; :. :;::;:;.:;: : :::::::::::.:::: P P 1.5 ft Page 4 for number, size, o c ©; Subsoil Cap u► o ;L't;':`' s ;' ": :'`:: and spacing of laterals. :.:::: ;: ASTM C33 Sand 10 F Laterals are equally ? .SsT ;;-' ical Lateral Tilled Layer m 0.5 ft Yp....... , spaced from the •::: distribution cell's 5 Aggrega v 0 -i- centerline in the A distribution cell (AxB). Project: BRUCE LENZEN HOMES, INC. Page 3 of 12 r Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at ang point. Laterals are identic al P S sL •= Turn -up mlball vahre or IE X- 4IExl2 I id2 -) Laterals & force main of PVC Sch 40 oleanoutplug per COMM Table 84.30 -5 Hales drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.14 ft Lateral Length (P) 39.25 ft Orifices per Lateral 13 Lateral Spacing (S) 2.81 ft Orifice Density 8.65 ft /orifice Lateral Flow Rate 7.00 gpm Manifold Length 2.81 ft System Flow Rate 28.00 gpm Manifold Diameter 2.00 in Total Dynamic Head 13.82 ft Forcemain Velocity 2.86 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ----► Comm 16.28 WAC Disconnect 4 in. min. Tank component is property vented •-- Alternate outlet location Forcemain diameter WIESER Manufacturer �_ 2 in. Ca aci 1000.00 Gallons Volume 27.83 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 19.58 544.87 B 2.00 55.66 C P ump off _elevation (ft) C 2.35 65.51 94.00 D 12.00 333.96 D Fl Total 1 35.931 1000.00 Dose tank elevation (ft) 3" Bedding under tank. 93.00 Alarm Manuafacturer IZABEL Alarm Model Number IA100 Pump Manufacturer IZOELLER Pump Model Number J 98 Pump Must Deliver 1 28.00 gpm at 13.82 ft TDH Project: BRUCE LENZEN HOMES, INC. Page 4 of 12 Mound System Maintenance and Operation Specifications Service Provider's Name TODD FEATHERSTONE Phone 715 - 381 -1704 POWTS Regulator's Name ST. CROIX COUNTY Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 ft' Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Freguency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Ins ect for pondin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ...�•�•......•• ..•......•...•. Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: BRUCE LENZEN HOMES, INC. Page 5 of 12 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] 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 shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subj 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. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tan shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assesse least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The finer cartridge should not be removed unless provisions a made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the fitter is equipped with an alarm, the fitter 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 tan the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the ne> 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 used they shall be approved for septic tank use by the Department of Commerce. 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 seed 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 sr compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulcl as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L 60,150 mg /L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 1ff cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specie 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 flus 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 le above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contina ncv 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 pro operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repair 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 its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and re piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: BRUCE LENZEN HOMES, INC. Page 6 of 12 I T 7/8 6 1/4 W HEAD CAPACITY CURVE MODEL "98" 4 5/8 �{ 1 30 ` B 25 0 3 5/8 6 20 _ ® + ° 4 4 3/16 t0 2 5 � \ 1 1/2 -11 1/2 NPT \1 0 U.S. GALLONS 10 20 30 40 5C 0 70 80 LITERS 0 80 160 2 FLOW PER INUTE MODEL 8 60 CYCLE N � PUMP PERFORMANCE CURVE MODEL 151/152/153 TOTAL DYNAMIC HEAD /FLOW 50 PER MINUTE 14 45 153 EFFLUENT AND DEWATERING 12 MODEL 151 152 153 1 10 152 Feet Meters Gal. Liars Gal Liters v 30 5 1.5 50 189 69 261 77 291 $ 10 3.0 45 170 61 231 70 265 c 8- 25 151 15 4.6 38 144 53 201 61 231 rJa 20 6.1 29 110 44 167 52 197 6 25 7.6 16 61 34 129 42 159 30 9.1 - - 23 87 33 125 15 35 q 10.7 - - - - 22 85 10 • 40 1 12.2 - - - - 11 42 Shutoff Head: 30 ft. (9.1m) 38 ft. (11.6m) 44 R (13.4m) y 5 0145088 0 10 20 30 40 50 60 70 80 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 2CS o FLON PER MINUTE e1450&A Model 151 Models 1521153 CONSULT FACTORY FOR �— 6 7,/32-1I 6 1 SPECIAL APPLICATIONS 3 7/6 - 4 5,8 � • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and j 3 '' Y ; �! 3 2 7/32 supplied with an alarm. - e • Variable level control switches are available for controlling ��� 7;8 \.� 3 27/32 single phase systems. e • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik -Box available for outdoor installations. See FM1420. . • Over 130 °F. (54 °C.) special quotation required. MAIL T0: P, 0. BOX 16347 Louisville, 49 402560347 Q • � SNIP T0: 3649 Cane Run Road Manufadurersof. . a Louisville, KY 40211 -1961 OO PUMP !O. (502) 776 - 2731.1(600) 928-PUMP Qfe2�ry P S cE /.7aJi9 htrp: //www.zoeffer.com FAX (502) 774 -3624 Sep 19 03 07:05a David Steel 715 -246 -5085 P.1 1356 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page t of 3 Division of Safety and Buildings in amordanoe with Comm 85, Wis. Adm. Code Steel Soil Service Attach Courtl COmpkte she plan on paper not less than 8Y: x 11 indrFS in size. Plan must St. C roix include, but not limited reference ited to: vertical and horizontal refe point (SM), deection and - — -- - -- - Percent slom scale or Ormnsiars, north arrow, and location and distance to nearest road. Paroel 1.D- 040- 1 256 - 60-0 Please print aAlnformation. ._ - __-- ._._ -- - - -- Personal inforrrr#im you pro*e may be used for secarday Purposes (Privacy I sw, s. 15.04 (1) (m)) Reviewed BY Date Property Owner Property Location Meryens, Kevin Gov Lut na NW 1!4 SE 1M S 24 T 28 N R 20 W Property Ownet's Mailing Address Lot # Bbck # � Subd. Name or CSM# 502 2nd ST Su ite 204 100 na Troy Villa City State Zip Code Phone Number City Village ✓ Town Nearest Road Hudson WI i 54016 , 715 386 - 5050 Troy I St Annes Parkway ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 4 50 GPD Replacement Pubic or commercial - Describe-na -- Parent material L08 o ver O utwash Flood plain elevation, if applicable —. - - -- Genera( comments and recommendations: Mound design,system elevation 101.65ft based on contour line elevation 100.65ft. Boring # __ Boring, Be- Pit Ground Surface elev. 100.75_ ft rpppth to limiting factor .__ 47 - -in Sdt A W licafioe Rate Horizon Depth Dominant Cola Redox Description Texhire Structure Corisilence Boundary Rods _�� GPD� In. Mutsell Qu. Sz. Cont. COW Gr. Sz. Sh. ' 1 0-9 ! 1 n sil 2msbk l dfr w 2f 5 8 8 - - - -- - 2 9 1 4/4 none I sic( 2msbk tlir gw tvf .4 6 3 1 25-47 7. 4/4 none sl 2msbk mfr gw na S 9 4 47 -50 j 10yr8/2 Fractured lime stone i na na na( 0 .0 - � - - - r P] 40� Boring rt -- Boring Pit Ground Surface ele,r. 4 00.75 ft. Depth to limiting factor 45 -_. in. Sol icab on Rate Horizon Depth Dominant Cola Redox Description Texture ! Struchme Consistence Botrrrdary Roots G PD_/W in Munsee Qu. Sz. Cont. Color i Gr. Sz. Sh. "Eff#1 - Eif#2 1 0 -10 10yr3/2 none sit 2msbk dtr I cs 2f .5 .8 --� -- 2 9019 10yr4/4 none sid 2msbk dfr qw 1vf .4 .6 i s! i gw na 3 19-45 7.5 r4/4 none 2msbk mfr , 4 45 - 48 10yr812 Fractured - lime stone na na na .0 .0 ii _ - -- - Effluent #1 = BOD 30 < mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOC !!� 30 mg/L and TSS ;30 mg/L CST Name (Please Print) Signatur : CST Number David J. Steel `', 2 48956 Address steal Soil Se,vico - Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond. Wf 54017 9/17/2003 715 246 - 5085 t� I Prooeirty owner Mergarts D40 -1256-60-" paw 2 of 3 a Boring " I B rg Pit Ground Surface elev. _100.45 Depth to limiting factor 31 in. — Sod Awkewn Rate Horizon Depth f Dominant Color Redox Degc*Dn �' — TexUre - Struclure Corsisterice 1 111. Mansell QtL Sz. Corn Color Gr. Sz. Sh '001 `EM 1 0-10 1 Oyr312 ail 2mshk 'q none - -- 2 + 10-27 1 Oy r414 j none sicJ 2msbk dfr gw 1 Vf A 3 1 27-31 1 7-5yr4/4 I none SCI 2msbk mfr na .4 .6 gw 4 31- lime stone Fr actured na na na Boring 0 Boring Pit Ground Surface elev. ft Depth to limiting factor in. Sail Awlicablin Rate Horizon Degh Domir&t Color T Desorption Texk. Ttn cwms*m B-aday Roofs In MLIFIGE111 Qu. SZ, Colt C0101' Gr. Sz. Sk : 1 'Eff#2 E Boring it Boring l pit Ground Surface elev. it Depth to limiting factor in. SON ;pp�n PAR Horizon D¢pth Dairtnarit CaO — ge — dox Descriplim Tw&n Structure Consiskence Boyidary Root' - Eff*l *FfW2 in_ Musd a", Sz- Cow rd, rr 9z Sh 4 Effluent #1 BOD 5 30 220 mgVL and TSS 30 150 mgfL • Effk*nt #2 8OD �.30 mg/L and TSS 30 mg(L The Dopar:mcnt of Commerce i5 an equal opportunity service provider and employer. 1f you need assistance to access services or need material in an alternate format. please contact the department at 609-266-3151 or TTY 608-264--8777, V t Sep 22 03'12:50p David Steel 715 - 246 -5085 p.l Page 3 of 3 STEE SOIL SERVICE INC. David I Steel � 1564 Cty Rd GG CST- POWTSM Kevin Mergens New Richmond,WI 54017 Lie. #248956 NW1/4,SEV4,S24,T2,3N,1R20w Bus.(715) 246 -6200 Town of Troy, St. Croix Co. Fax (715) 246 -9372 Lot 100, Troy Village Legend r I,, = 40' A =Benchmark Ele. IMOOR A 1 Top of '' /y PVC Pipe • - Alt Benchmark Ele. 100.00ft Top of 'W' PVC pipe F- Borings Boring Elevations B 1 = 100.75Ft 132 = 100.75Ft B3 = 100.45f3 134 = 00.00ft t n` L � c3an+ow -1,: r `4. ir3D. 3S�i- ��elyn SJotP �'+}n5 � L2_ �-! / v X411 ,ale Y 3d I oc P 1 _ 1 If rt i� la � 4 �� 41 S�FT54C: - too rl, k 1 i r� �f )I 7 t • .. . - Complete all page r%jyY ■ 0 Safely & Bu ildings Vvision ) Chedr if Confirawboa is Desired: ( )faxed, ( ) nwiled Bureau of kttegraiNd SWfts Several counties have been delegated certain authority to review ptsris in keu of Commerce. For a current Wt of those counties and their dekVabon check our websile at hf tp : /Avww.commercastate.wi.USMB/SB- PowtsProgram.hbni. NOTE: Pal irtforrnedim you pride may be used for eeoondary Conf nation of assignment to a re viewer. purpo [P rivacy Law s. 1 5." 1 xm), Stills.] _ ..�- 7rsrrsactiory ID. 1. Mt f Sewa Sultntittal 2. Type of Sijbinktal System Type { X) New Previous ReMbd Traits. ID. ( ) Soli Saturation ( ) Revision Estimated Completion Date: Determination Report ( ) Interprebw ( ) Replaoenlent Assigned Rr4ewer: 00141 rrrnation ( ) Addni ( X) POWTS System ( ) Petition (attach form SBaMW) Assigned Office: ( ) At _:Made ( } ExpwWwnt. Approval_ Ghele low coulee of office, beWW ( ) oidrng Tank N aipressurized in ( ) Component Manual (Include each ( } Ground component mmrjg name, _ and 1. Neat avMiable appoltrfrrrerit in arty oWme, 2. Grew Bay, 3. Hayward, { ) Pressurized In- date on title page of plan) 4. LaCross a, S. Madison, IL ShaAmm, 7. Waukesha { X) Ground { X) kedtvl W She Design ( ) Aerobic Treahnent unit 3. Project kdommhon - Fill in � infonriation { ) Sand FBer projecilsite Name BRUCP L ME HOMES, INC. —ate p— Location, Number 3 Strait of projed (if unknown, indicated nearest road) ST ANNES PARKWAY ,recirculating ( ) Constructed Welland Legal: N W 1 /4 5E 1 /4 S24 T28N R20W ( ) Drip Line cousty ST CROIX COY tiiMrrJe �X town of TROY { ) Other. Budding Type leheck one): 4. Allier plans are reviewed, plessm (rtieck all that apply) ( X) Dwedw9, 1 or 2 lamily X Can custonrier 1.2, 3, 4 (circle nurnberr ' Refers to customer nkrnim 8om below ( ) Publiier–ommercisl Requeshm party will pick up Buikung l,aif plan to customer 1.2.3.4 (circle number)" ( ) State -owned Duftnq — Gallons per Day 450 & Compiatn ow meowing damign Wri q — o fing intenswhon. _Maize tiv cheek boxes when design.., owner or requesh" ply is the ssrne to avoid r! information. DasiaM Information Customer 1) Mail To Party if current than dKJWW (Customer 3 FM Name Last Name CAMOmer Number Fast Name Last Name customer N TODD FEATHERSTONE 242514 Company Name Company Name FEATH ERSTONE EXCAVATING, INC. Addms Address P.O. BOX 467 City State Zp+4 (9dlgits) City State Zip+4 (9digits) HUDSON WI 54016 Phone Number (area Code) Fax or Inferno[ cW phone Phew Number (wrap node) Fax or internal 715- 381 -1704 715 - 386 -6885 Check others it applicable Check others if applicable onwnor ( Owner owner Information 4Custoi w 2) - - other Pteess sWfy fCustopw 4) l=ust Nil Last Name Customer Number First Name Last Name Customer Number Corntui Name Company Name BRUCE LENZEN HOMES, INC. Address Address 502 2ND ST-, SUITE 204 cov Stele Zip+4 (9digis) City Stale Zip+4 (9tlipils) HUDSON, WI 54016 Phone Number (area code) Fax or Internet Phone Number (area code) Fax or Irkarnet 715- 386 -5050 715- 386 -1999 Check others s wokmhie (Mait To) Check auiena 4 appiic8144 ( ) OHM ( ) other MAKE CHECKS PAYABLE TO DEPT OF COMMERCE TOTAL AMOtMIT DUE $ Rttarh chock here Review Code 7835 n �� * 1 yRe o r rToj (.'[ r) tririH6G 1 nc rw r fl rn r I. r 6 art. K• r t. AN ftestatent componennts are prevfoush ovrd under s. Comm 8+410 (2) or (3): De*n w0Acw4lcr flwr ut uic Pam sysstem: 1,000 gpd or less ......... . .. ...................... ............................... ........................$ 1, 001 - 2.000 9Pd ................ - -. - -- .................. $225.00 2 ,001 - 5.000 gpd ............ - -. - ............. ................................ .... 5275.00 greater than 5.000 gpd .... .............................................. ............................... $300.00 ppu $0.05 for each gallon over WW gpd 2. One or more b+esbfrenl components are not previously approved under s. Comm 84.1 b (2) or (3); (individual "a deeigNdavietfon bon+ component manuals and use of components wMW product approval): Design wasl eviater flow of the proposed sysWw 1,000 gpd or less ... ............................... .. , ......... 5300.00 1,001 - 2,000 gpd ... - , -- .......... ..............5400.00 2,0011 - 5,030 gpd ssm W grww man 5,000 gpd ... ..... ........ .............................................. ............. ........s600.00 plus $0 -05 for each gallon over 5000 gpd HOLDING TANKS ONLY 3. Holdaig to ft previously approved under s. Comm 84.10 (2) (3 Design wadwaler flaw of the proposed system: 5,000 gpd or less ......... -- .......... ... ........................... .................. ...... 160.00 5,001 - 10,000 gpd .................. ...................... ,................$100.00 greater than 10.000 gpd ................................................. ............................... $150.00 4. Hokling taroks NOT pnewousiy ap uvwrJ wxw S. Conan 54.10(2) tx (3) MR) �s8 wrsaUtltiW tM Design wastewater flow of the proposed system. 5 .000 gpd or less ........................... --............................. ............................... $120.1JD 5.001 - 10.000 gpd,-.... . .................. .. ... ...... ... ... ... .. . .. ......... ........................$200.00 greater tftan i0,000 gpd - . ..... .. - - -- • - -- - ....... ..........$300.00 Experimental System (9ddltlonal one time fee) ..................................... ............................... $300.00 Revlsioris to Approved Plan..... ... . - .. . ... ... . ............................ .. ....... 360.00 Pettiort for Variance (Include form S8D" 9890) ........ ......................... . . .... .......................:$725.00 Revision to s previously approv d Petition for Variance .. _. - s75 oo Soil Saturation Determination Report - Per Sft (ofhar than a proposed subdivision) ............ .....5100.00 InterpretiwDetefrniffationRgW ............................ ..... .......................... ............ ... ...... ... - 5100.00 Sulam . .. ..................... ...... Priiorfty Review: Enter same amount so subtotal ... ............................... Prior approval Erwin a serJiao chief is nm*ired for a priority review. If approval is granted, the priority will be reviewed within 9 days Of receipt. Enter TOTAL (rounded to the nearest dollar) here $ 75.00 and on bottom of FRONT PAGE Note: Fees are pursuant to Ch_ Comm 2 and are subject to change annually: please contact any of the offices listed below for the most recent copy of this form. Comm 2 provides for a partial fee refund if a plan action has not been taken within the 15 days Of receipt of all required infon Tation. 7. Appointment, Schw%ding tntaWWAOort, and Plan Submittal Cheddisft. POWTS scheduling is not *vsib4*. Plans will be assigned to a reviewer after receipt of plans. tf yam wish to receive confirmation of the assigred reviewer and mSiN ed completion date please check the box in the upper right corner of the front page. Also note in the same location (trot you can designate a specific office lot review. It you select a specific office your estimated completion dame may be comslderabq greater than what would be possible in another office. Submittals received Willu ut a Specific office indicated on the form may be assigned to onset oltmer than the receiving office dependirig on reviewer avaibMilly. To of tain a subrrsiltaf checirfist cap the meftnal order u it at 608- 26&181 8 or one of the full Service ofr;ces listed below. You envy amNlf wwwat code questions to wf statewims Madison Sitr13Q Hayward SUD lacrosse S&W. Shawano "110 tureen Bay S&W WaWieshs UW 201 W Washington Ave 10541 N Ranch Rd 4003 N Kirxeey 1340 E Green Bay 2331 Sam Luis Place 401 PM Court 53703 Htfwnd Wi 54(343 Cailee Rd Shawano WI 541186 Green Bay, Wt 54304 Waukesha WI 53168 PO Box 7152 715-534070 LaCrosse Wl 54901 715 - 5243= 920 262 Madison Wl 53707 -7162 Fax 715 -634 -5150 1931 Fax- 715 - 524 -3633 FAX- 920492 -5604 Far. 262-5"14 608-266-3151 Email: 608.7859334 Email: Email. PdanSchedule@ Email. PWnSdw&Ae@ Fax: 608- 267 -9rr66 PianSchedula@ Fax: WS- 785.0330 Plan5chedule@ car►rrreroe.state.wi.u6 canmarce.etate.wi.us TOD 608. 2648777 com"Wee.stata.wi.us Email: canmerowstate.wi,us Email: PlarSahedule@ PfanSchedij*@ cormreroe.stete.wi_us 1 comnwoe.stalie.wims /� AA 3NFORMATION SYSTEM SIDE ' CATIONS Owner BRUCE LENZEN HOMES INC. Septic Tank uopacity 1000 a l ❑ NA Permit # Septic Tank Manufacturer WIE5Eg ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 7AgFL C3 NA Number of Bedrooms 3 ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA Estimated flow iaverage! 450 gal /day Pump Tank Manufacturer ❑ NA WIESLR Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer ZOELLER ❑ NA Soil Application Rate . 7 galiday /ft� Pump Model ❑ NA Stani;W Influent /Effluent Quality Monthly average* Pretreatment Unit J"A Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Fitter ❑ Peat Filter Biochemical Oxygen Demand MOD,) 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Call(s) ❑ NA Biochemical Oxygen Demand (BOD :530 mg /L D In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ) b Mound Fecal C O IR Orm (geometric mean) 510 cfu /IOOmI ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other' W.NA Other: WNA Other- 4NA 'Values typical for domestic wastewater and septic tank eff twit. Other: ONA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tankls) At least once every: ❑ month(s) IMaximum 3 years) 1:1 NA ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cells) At least once every: 0 mon $ (sl (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ ear(s)is). ❑ NA ❑ month(s) ❑ NA Inspect um um controls & alarm At least once every: ar P pump, pump ❑ ye (s) ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) Other: At least once eve C1 month(s) 1KNA every: ❑ year(s) Other: t9.NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cells) shall be visually inspected to check the effluent levels in the observation pipes and to check for any pondinf of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 11 Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent fitters, mechanical or pressurized components, pretreatmem units, and any servicing at intervals of :512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) *ST'AS' T UP *AND Of ERATION For new construction, prior to use c s POWTS check treatment tankls) for the p ice of painting products or other chemicals that may impbde th4treatment process and /or damage the dispersal cell(s). If high'wncentrations are detected have the Contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the ceills) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal ceps. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain ►sump pump► water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administratnre Code: All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN following measures have been, or must be taken, to provide a code compliant If the POWTS faits and cannot be repaired the replacement system: —A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name p( Name FEAT R L XC,AVATING INC Phone Phone 715-381-1704 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PINKY'S Name ST. CR OIX COUNTY ::: Phone 651 -436 -5788 Phone 7 15 - 386-4680 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.5411), 12) & (3). wisconsin Administrative Code. 5 I r - r 1356 Wisconsin Department of Commerce SOIL EVALUATION REPORT P age 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 040- 1256- 60-000 Please print all information. viewed By Date Personal information you prov' h7 y Law, s. 15.04 (1) (m)). ' zc Property Owner LE B Property Location Mergens, Kevin Govt. Lot na NW 1/4 SE 1/4 S 24 T 28 N R 20 W Property Owner's Mailing Addre ss `3 E P ') 3 2003 Lot # Block # Subd. Name or CSM# 502 2nd ST, Suite 204 100 na Troy Village City StateSZip.Cbd6KFWdfiAMUmber _j City J Village _e Town Nearest Road Hudson Ur - 50 Troy St Annes Parkway 16 New Construction Use: le Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD I Replacement I Public or commercial - Describe na Parent material Loess over Outwash Flood plain elevation, if applicable na General comments and recommendations: Mound design,system elevation 101.65ft based on contour line elevation 100.65ft. Boring # J Boring k' Pit Ground Surface elev. 100.75 ft. Depth to limiting factor 47 ,E in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0 -9 10yr3/2 none sil 2msbk dfr cs 2f .5 .8 2 9 -25 10yr4/4 none sicl 2msbk dfr gw lvf .4 .6 3 25-47 7.5yr4/4 none sl 2msbk mfr gw na 5 9 4 47 -50 10yr8/2 Fractured lime stone na na na .0 .0 Boring # J Boring I" Pit Ground Surface elev. 100.75 ft. Depth to limiting factor 45 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 *Eff#2 1 0 -10 10yr3/2 none sil 2msbk dfr cs 2f .5 .8 2 10 -19 10yr4/4 none siel 2msbk dfr gw 1vf .4 .6 3 19-45 7.5yr4/4 none al 2msbk mfr gw na .5 .9 4 45-48 10yr8/2 Fractured lime stone na na na .0 .0 * *Effluent #1 = BOD 30 <_ 220 mg/L and TSS >30 < 150 mg /L Effluent #2 — — BOD S30 mg /L and TSS <-30 mg/L CST Name (Please Print) Signature: CST Number David I Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number I 1564 CR GG, New Richmond, WI 54017 9/17/2003 715- 246 -5085 d Property Owner Mergens, Kevin Parcel ID # 040 - 1256 -60 -000 Page 2 of 3 3 ] F Boring # J Boring V1 Pit Ground Surface elev. 100.45 ft. Depth to limiting factor 31 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDJr in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10yr3/2 none sil 2msbk dfr cs 2f .5 .8 2 10 -27 10yr4/4 none sicl 2msbk dfr gw 1 of .4 .6 3 27 -31 7.5yr4/4 none scl 2msbk mfr gw na .4 .6 4 31 -36 10yr8/2 Fractured lime stone na na na .0 .0 F-1 Boring # I Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # I Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 - 264 -8777. I Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST - POWTSM Kevin Mergens New Richmond,WI 54017 Lic. #248956 NWl /4,SE1 /4,S24,T28N,R2 Bus.(715) 246 -6200 Town of Troy, St. Croix Co. Fax (715) 246 -9372 Lot 100, Troy Village Legend 1" = 40' I e ♦ = Benchmark Ele. To of %z" PVC Pipe = Alt Benchmark Ele. 100.00ft Top of 'h" PVC pipe '�— ❑ = Borings Boring Elevations B1 = 100.75Ft B2 = 100.75Ft B3 = 100.4511 B4 = 00.00ft 3,1 2 ' W�5 r r C.Y :BUG. - 2?'�03 (WED) 10 :40 BF LENZEN INC 'TEI ' P. 001 �! 2262 cos 5TAT1? MR OF WISCONSIN FORM 2 -1499 K ATHL �E NN p . MLLSH t)acameot Number WARRANTY DEED ST. I C8011 . NI RECEIVED FOR RECORD Thin Deed, made between Christopher J. Wendell, 86I8312963 118:38AT1 WARRANTY DEED EXEMP i Grantor, and K evin P. Mcrgens, _ gEC FEE: 11. TRANS FEES 19U.00 C FIRS CC FEBt PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croln County, State of Wisconsin (if Mora spacci is needed. please a tech addendum). Rowrding Area �troy Village Tfbird AdOtion in "Town of Troy, St. Croix Name and Rennn Address County. Wisconsin. o4a�zsb�o -coo Parcel identiticotion Number ( This homestead property. (is) (is not) Exceptions to warranties: Easements, restricliuns and rights -of -wiry of record, if any. Dated tl day of May , 2003 9 Christap or Wendell AUTHENTICATION ACKNOWLEDGM$NT STATES OF WISCONSIN j _ County j �(/� authenticated this day of Personally came before me thi 1 — h L\ day of May . 2063 the above named - Chrlstopher J. Wendell, TITLE' MGM]SER STATE BAIL: OF WISCONSIN o wWfW ecuted the foregoing (1f not, _ Y , s authorized by § 706.06, W is. Stars.) .— THIS INSTRUMENT WAS DRAFTED BY Attarno lli;ristime Oaland Notary Pub udson, y f 360 My Commission s permanent. (f not, stare explimtion dat (3ignaWrm may be authonlit alad of acknowlodykd. Both an not nocessay) ' Names of persons signing to way capacity must be typrxl or printed bel their signature. Ira yam °""° t arnpsnr �'�*TE BAR oFwtsca;vsrn rY H , ram au r °c'vn Kota WA RRANTY DEED � +�� FORM No, 2 -1999 StatO of Wisconsin t Wisconsin Department of Commerc.- PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division I INSPECTION REPORT Sanitary Permit No: 430285 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: Mer ens, Kevin I Troy Township 040 - 1256 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 24.29.20.1360 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number: I DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of ded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx Seeded /Sod Yes u No ]Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 260 St. Annes Parkway Hudson, WI 54016 (NW 1/4 SE 1/4 24 T29N R20W) Troy Village 3rd Addition Lot 100 Parcel No: 24.29.20.1360 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? [] Yes R No I Use other side for additional information. � — __— _'i _ _ SBD -6710 (R.3/97) Date Inse ctor's Signature Cert. No. Safety and Buildings Division county 201 W. Washington Ave,, P.O. Box 7082 ST. CROIX COUNTY Madis mi W1 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) *isconsin (608) 201-6546 q30 Department of Commerce State Plan I.D. Number Sanitary Permit Application In aocord with CAmm 83-21. Wis. Ad m. Code, pm-W idorniat— YOU PfOvmk i& zz may be USW for W"xjary purposes Privacy Law, WN.04(l)(m) "ect Address (if than mailing address) L Application information - Please Print All InformaW n ""D V L 00 Parcel Y 10100 Mock BRH8E 6FP4WmP4-WQMF=G- ptoperiv Ownci'y, Mailing Addr i on 502 2ND ST., SUITE 204 titi SE 24 city, State zip Code Sm — Number HUDSON 1 54016,- 3.86-5050n 28 N., it 20 IL T ype o f I N I heck all that apply) Cui we, 0- Subdivision Name CSM Number - 7 g w 2 Family llin -Z x 1 TROY VILLAGE Dawx --- -, AAA% r LIViliage IATwnship of T Y ct �, a ❑ SW Owned iqc f ❑eity- too InKlype of Permit. (Check only (1111IL!x1r, on H2 A. — Comp Cline D if *PPfic1"V6-- Now System F1 RqA.— I" ❑ Tr"imcnVHolding Tank (Mly Other modificatio" to E?dsfmg System A- Pq 'NC 40P 8. er and F1 Permit Kmewal D Permit Fe%qmm C1 C tange of H Transfer to -N Ust pkevkw Permit Number Dal • Before Expiration plumber b H e of IV. Type of POWTS at a System: Check all that 11 010 ❑ Non Prc=rized In-Ctrvund LT M(xiiiii 24 in. of suitable ❑ M 1 24 in. OfVWAft so gj1c 'and Fitter Constructed wetland ❑ Premwized in-crmnd I I I]-kh-g'r ❑ Fip.., R Fiber ❑ Rcy-iroplatingSynthetic Media Futter F1 i aching Chamber H Drip Gravel-less Pipe ❑ V. DispersaUTrfttment Area Information L A B EL 100 JFR, ZOELLER 152 PU S I IA ACH ED Design Flow (gpd) I Design Soil AMfication Rawmdd) D 1 ArlVeWired (go D4—.-1 (Sit) 450 .5 0 1029 100.5 VL Tank Info Capacity in Total N actemr Prefab ite S1 fiber 1?ias Callan (Wkvm of Concrew eii ass Tanks TwAs Scroic rA 11oldn Tsnk X 1000 11 WIESER X Affabic Trraftnmt I Jnit 'r F)rwing 100 1 WIESER VII. Responsibility Statement- i, doe a."J.41 sswroe rve for imsta"Imm ortbe AV" shown ow the Attached rhum Plumber's Name (Print) MP/MPR9 Number Wimber TODD FEATHERSTONE 242514 715-381-1704 Plumber's Address (Suxed, City, Sta P.O. BOX 467 HUDS �54 016 AUGUST 12, 2003 VtM Apluovixl Count fDe artment Use Oq& U Diapproved s , Sanitary Permit Fee (includes Groundwater Ewe 1 su Agm Signature Sta mps ) Surcharge Fee) 0- ❑ OvdierGiven for Denial I 1— :5 IX. Conditions of Approval/ s for Ihsapproval SYSTEM OWNER: R / I Septic tank, 6 nt filter and ust dispersal cell ust all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. ady) ter tin; sysiem we paw Raw= than 8= IL 1.1 imam ia VM f r V Ir 8 :'' lift r Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TD #: (608) 264 -8777 hsconsin www. w ww.cornrnerce.state.wi.us/sb v wisconin.gv Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary July 30, 2003 CUST ID No.242514 ATTN: POWTS Inspector TODD C FEATHERSTONE ZONING OFFICE FEATHERSTONE EXCAVATING INC ST CROIX COUNTY SPIA 368 TOWER RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/30/2005 Identifi on Numbers Transaction ID .894225 SITE: Site ID No. 66 8 Uk Bruce Lenzen Homes - Dwelling Please refo both identification n bers, St A es Pkwy above, in affcorrespondence with enc . Town Troy, St Croix County NW 1/4, /4, S24, T28N, R20W Lot: 100, Su 'vision: Troy Village FOR: Description: New and System / 450 gpd Object Type: POWT em Regulated Object ID No.: 914754 The submittal described above has n reviewed for conformance applicable consin Administrative C and Wisconsin Statutes. The submitta been CONDITIONAL APPROVED. The owner, as def chapter 101.01(10), Wisconsin Statutes, is onsible for comph ce with all code requireme The following conditions shall be met during cons tion or ' tallation and prior to occupancy or use: P.0 ♦ On page 4, the distribution pipe drawing is incor The distribution network will actually consist of Coid two distribution pipes connected by and end ma A 0`1 Iff A copy of the approved plans, specifications and this er shall h -site during construction and open to DE P EN inspection by authorized representatives of the Dep ent, which clude local inspectors. All permits DIVISi required by the state or the local municipality shal a obtained prior to encement of construction /installation/operation. SEE CORK) In granting this approval the Division of Safe & Buildings reserves the right t quire changes or additions should conditions arise making them necessary for de compliance. As per state stats 10 2(2), nothing in this review shall relieve the designer of the responsibi for designing a safe building, structure, component. Inquiries concerning this corresponde may be made to me at the telephone number list below, or at the address on this letterhead. The above left addressee shall p ide a copy of this letter to the owner and any others who are re nsible for the installation, operation or main ance of the POWTS. TODD C FEATHERSTONE Page 2 7/30/03 Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 P ter Pagel POWTS Plan Re vi er II , Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pepagel@commerce.state.wi.us cc: Leroy G 7ansky, Wastewater Specialist, (715) 726 -2544 ' t t ' MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: BRUCE LENZEN HOMES, INC. Owner's Name: BRUCE LENZEN HOMES, INC. Owner's Address: 502 2ND ST., SUITE 204 HUDSON, WI 54016 Legal Description: NW 1/4 SE1 /4 S24 T28N, R 20W Township: TROY qp County: ST. CROIX -, - t l Subdivision Name: OY VILLAGE V ETY & BIDGS pN Lot Number: 100 Block Number: /A i Parcel I.D. Number: Plan Transaction No.: ♦ . Page 1 Index an itl Page 2 Data entry, 11a f j� CORRECTION NEEDE P e 3 Moo d nd do S tank Late SEE CORRESPONDEN Sy m mainten specifications r F E c Page 6 nagement and tingency plan S Page 7 ump curve and sp cations C Page Soil Test W0 1VDE , Pa g Soil Test P 10 So Test ge 11 Plot Plan aaee 12 Platted Sub - division Designer: TOD EATHERSTONE L cen umbe ise r: NW14 Date: 07/ 1 03 Phone Number: 71 1 -1 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01101), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01181) Version 3.11 (05/01) Page 1 of 12 t � I i � � I �. .� �!�: , r � �, ,�. � ,�.,� ;, �:; - �� ,� �'' i t.. w , , w* :.y. �N' 4�._� '� l Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 450.00 Design Flow (gpd) 5.00 Site Slope ( %) 100.00 Contour Line Elevation (ft) 30.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 80.001 Dispersal Cell Length Along Contour (ft) = 5.63 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /fl 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) E Center or End Manifold 2.81 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 8.33 ft /orifice 2.00 Forcemain Diameter (in) 160.00 Forcemain Length (ft) Does the forcemain drain back? Y 80.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 26.10 Forcemain Drainback (gal) 20.00 Vertical Lift (ft) 50.03 5x Void Volume (gal) 1.78 Friction Loss (ft) 76.13 Minimum Dose Volume (gal) 28.28 Total Dynamic Head (ft) 22.24 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x 1.25 x X 2.00 x 1.50 x 3.00 2.00 x 3.00 x Gallons /inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) WIESER I Manufacturer I gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1000.001 Dose Tank Capacity (gal) JZabel I Filter Manufacturer 12700 Dose Tank Volume (gal /in) IA100 ]Filter Model Number WIESER I Manufacturer Project: BRUCE LENZEN HOMES, INC. Page 2 of 10 Mound Plan View T 1/10 B J Observation Pipe .._ _ 1 K .�.�. T :::::::.:.::.........: :::,::::. 5 A W B. I ❑. . L Mound Component Dimensions A 5.63 ft E 9.38 in H Mft ft K 7.23 ft B 80.00 ft F 9.25 in 1 ft L 94.47 ft D 6.00 in G 0.50 ft J ft W 17.49 450.00 (ft Dispersal Cell Area 1029.41 (ft Basal Area Available 5.63 (gpd /ft) Linear Loading Rate 8.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.27 (ft) --► ;;'Lt; G I H F "er 101.00 (ft) Lateral I — Dispersal Cell 100.50 (ft)—► Invert 3 Dispersal Cell � D Elevation E .. -.. s 100.00 (ft) Contour Elevation 5.0 %Site Slope Geotextile Fabric Cover Shading Key a Dispersal Cell See lateral details on ❑ Topsoil Cap 'ii 1.5 ft • :r ::::::.:: : :: : <:;::.: ; ::: ; :: ; :: ; .:: ; .::: : ;:: •:::;:.:.:.:. :.: Page 4 for number, size, Subsoil Cap o 5 and spacing of laterals. �a a _;•;;:::.::;::::::.;:..;: Laterals are a uall ASTM C33 Sand :� : F q Y Tilled Layer 0.5 ft ;: Typical Lateral spaced from the ;:; 5 distribution cell's ': Aggreg ❑: 5 :` 0 ❑ -i- centerline in the p` -� distribution cell (AxB). Project: BRUCE LENZEN HOMES, INC. Page 3 of 10 r cp .End is ram Cp� �� p �FFD Force main connection via tee or cross to manifold at ang point. Laterals are identical �Df FD I P A 0= Turn -up wtbsll valve or I<- X -- +x12 I xf23f Laterals & Force main of PVC Sch 40 cleanoutplug per COMM Table 84.30.5 �!! 2illed an the bottom of the lateral. Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.02 ft Lateral Length (P) 78.52 ft Orifices per Lateral 27 Lateral Spacing (S) 2.81 ft Orifice Density 8.33 ft /orifice Lateral Flow Rate 11.12 gpm Manifold Length 2.81 ft System Flow Rate 22.24 gpm Manifold Diameter 2.00 in Total Dynamic Head 28.28 ft Forcemain Velocity 2.27 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and - -► Comm 16.28 WAC Disconnect 4 in. min. 1 � Tank component is properly vented 1E ---- Alternate outlet location Forcemain diameter WIESER Manufacturer 2 in. Capacityl 1000.00 Gallons Volume 12.00 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 62.99 755.87 C B 2.00 24.00 P ump off elevation (ft) C 6.34 76.13 81.00 D 12.00 144.00 D Total 1 83.331 1000.00 Dose tank elevation (ft) 3" Bedding under tank. 1 80.00 Alarm Manuafacturer IZAB Alarm Model Number JA1 00 �— Pump Manufacturer IZOELLER Pump Model Number 108 / Pump Must Deliver I 22.24 gpm at 2 ft TDH Project: BRUCE LENZEN HOMES, INC. Page 4 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name TODD FEAT HERSTONE Phone 715 - 381 -1704 POWTS Regulator's Name ST. CROIX COUNTY Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ............ so ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution .... / .... ..... " -, - .. .. .. .. .. Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: BRUCE LENZEN HOMES, INC. Page 5 of 10 S ound System Management Nall* Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] 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 shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subj 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. 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 tan shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fifter shall be assesse 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 a 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 fiftei shall be serviced if the alarm is activated continuously. Intermittent fitter 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 tan the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the ne) 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 used they shall be approved for septic tank use by the Department of Commerce. 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 Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seed 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 sr compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulct as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOP 150 mg /L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg /L TSS, 10 mg/L FOG, and ld cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specifi( 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 flus 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 le• above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency 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 pro operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repair 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 its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and re piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: BRUCE LENZEN HOMES, INC. Page 6 of 10 u— EAD/CA' ;A.CI HEAD C0ACf *,URVE F- I ` t `. ` t111 MODEL 152/153 50 L!° ` 153 40 — - - I � 1 i ` � /U 12- 152 L- - -- - -- -- o 201 E1 73' _ - - I r 6 ' 14 167 i2 19 8 30- - -- — - _;a 1 Z ? ;c 33 li5 a - 20 C) 4 V;�Ira� SB.Q F. ;1'.5m1 4�.0 iL �'3.1 rri 10 - ... .___ ......___. _ ___. ` 014500 I i 0 20 40 60 80 100 GALLONS _ LITERS 0 80 160 240 320 FLOW PER MINUTE:�� T � .: 3 27/ CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. \o: )`/V •Electrical alternators, for duplex systems, are available and supplied with N •+-�- ": ' } an alarm. — { • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. j • Sealed Qwnk -Box available for outdoor installations. See FM1420. r z - -1 • Over 130 °F. (54 °C.) special quotation required. fi r_ 1521153 Series ' l_ 15VI53 MODELS _ Control Selection _ I� Model - volts-Ph Mode Amps S implex D_ uplex N 152 115 1 Non 8.5 1 _ 2 or 3 BN1521 115 1 Auto 6.5 Include 2 or 3 t ( V I SK2� E152 230 1 Non 4.3 1 2 or 3 �`t I BE152 230 1 Auto 4.3 Included 2 o r 3 N 153 115 1 Non , 10.5 1 2 or 3 BN153 115 1 1 1 Auto 10.5 I Include 2or3 SELECTION GUIDE E153 230 1 Non 53 1 — 2 or 3 1. Single piggy ck variable level float switch or double piggyback variable level float - - -- BE153 230 1 ±J Auto Indu ; 2 or 3 –_ _ switch. Refer to FM0477. ♦ caUTION 2. See FM0712 r correct model of Electrical Altemator E -Pak. All Installation of controls, protection devices and wiring should be done by a qualified 3. Variable level ontrol switch 10 -0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float sy em. RESERVE POWERED DES113IN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. • MAIL TO: P.O. BOX 1634 Z Louisville, KY 40256 -0347 Manufacturers of . . 0 SHIP TO: 3649 Cane Run R d r; Luulsvdle KY 402r1 -1961 Qaa L7TY P U ar PS SN�E /939 httpafwww.zoetter.com PUMP ICY (502) FAX(502) 774-362 MP © Copyright 2000 Zoeller Co. All rights res ed. r - } Wisconsin nrofCornrnerce SOIL AND SITE EVALUATION tl+v wn of �ety and Buidings Page I of 3 i in accord with Comm 83.05, Wis. Adm. Code Aft&ch but a irn ed�b. an paper than not less 8% x 11 inches in size. Plan must F- ► By Design vertical and horizot8at reference pant {Bf4f), direction and County percent stops, scale or dimernworw north arrow, and location and distance to nearest road St. Croix APPLICANT INFORMATION - Please print all inf0rmatti0n. Paroa t D # Personal idarrr�n6on you W- d& mar be u-d for aseandwy purpoem (pfkw y Law- a 15 04 (1) (m) >. Reviewed By Date 1 1, on Property Owner TEI(4 n tinental Develo ent NW 1/4 SE 1/4 S 24 T 28 P roperty Owreft �7ing Address ck # Subd. Name or CStul# N,R 20 W 12301 Central Avenue NE Suite 230 8y State 4 Code PhoneNumber Troy Y e M hs MN 55434 612- 757 -7568 vIlme Nearest Road Troy St. Armes Parkway ® New Construction Use: ® Residential / Number of bedrooms 4 ❑ Replwxnent ❑ Public or commercial des0be ❑Addition io existing binding Code Derived daily flow 600 gpd Recommended design loading rate 1.2 bed, gpd/lC� 1.2 lion area required 500 bed, W 0 trench, f1l Ma urnu t design lading r be 1.2 bed , M� trench. 1.2 tr ench, gpolli? Recommended infiltration surface elevation(s) 101' 9Pd Additional design / site considerations ft (as referred l site plan berxhmar Parent material Loess Over Glacial Outwash for system Convention S= Suitable al Mor,rd Flood lain elevation, if na ft U= Unsuitable for system ❑ S O U In Ground Pressure AT-Grade Systom in FA Holding Tank ®s ❑U ❑S ®U ❑S ®U ❑S ®U OSQU SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles St7rctrrre Boring# in. Munseti Qu. Sz. Coat Color Texture risisbe Boundary Roots GPDNP Gr. Sz Sh. Trench 1 1 0 -9 10yr3 /2 - 1 2msbk mfr cvt+ 2f 5 6 2 9 -24 10yr4/4 - Sil 2msbk mfr cw 1 f 5 6 Ground alev 3 24 -30 7.5yr4/4 - Is 2msbk mvfr ew - .7 8 4 30-32 7.5yr5 /8 _ BRX Depth to limiting factor C�� s Remarks: 2 1 0-9 10yr3/� - 1 2msbk mfr cw 2f .5 .6 2 9 -32 10yr4/4 - sit 2msbk mfr cw if 5 6 -- Ground 3 - 32-48 7.5yr4/4 _ is 2msbk mvfr cw - .7 .8 -49444 4 48-50 7.5yr5 /8 - BRX 100.93 - - - - - _ Depth to — -_ limiting factor 48 Remarks: CST Name (Please Print) Sgnatun3: -- - Thomas C. Nelson �-`- Telephone No. Address Environnx W By Design 715-246-2454 1432120th SbveL New Richmond, Wl 54017 Date CST Number R- = 4/22/99 227387 3 i r�ROp:RTY ovINM conunww Dmtaa f SOiL DESCRIPTION REP ;j� t i G C, ,30 p&A 2 Of 3 De th Dominant Color Mottles &mot er �' Horizon p Structure in. Munsell Qu. Sz. Cont Cola' Texture Gr. Sz. Sh. Boundary Roots GPD/tP Bed : Trench 3 1 0-9 10yr3/2 fr - 1 2msbk m cw 2f .5 6 2 9 -18 10yr4/4 - siI 2msbk mfr cw If 5 6 Ground elev 3 18-30 5yr5 18 - sc1 imsbk mvfr cw - 7 8 4 30-32 BRX limiting factor 3 Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to timiting factor Remarks: Ground elev Depth to limiting factor i Remarks: A INViNNAERTAL �Y Of5 143212e STREET, NEW RICHMOND, WISCONSIN 715 -246 -2454 Tom Nelson Certified Soil Testa 227387--- Regiaered Sanitarian SR00713 TROY VILLAGE —Lot V w V NW' /. , SE %., SECTION 24 T 28 N, R 20 W Troy Township, St. Croix County, Wisconsin Page 3 �i t f0 .2- 72 f 6 1 c`t q3 + �a ,1 X05 SCALE V =40 BM I. � . SE lot corner ELEV 109 S �C P�.G -- i /�Ir� r � 00 00 317 71 411 ct/ 30 lf�f I 1. G A HE AQ, r LL, J � C -�' t L �� -0 Q q14 Nk" Ice D r `�Irw tvv ` ` i a a.dwr MM �T «+ao!gef4c as +w o � Ants ~I { fo N'll in in P, V ., `_\ 1 « IA \ 2N r+ ol + yb Hvi f ,pmt •.!{,N,�OM I ....�..r..-- ..r�r— ' 1 Qd111 031111'k�lft ' � i � - �� � 's � r � ' , � � �, -� •- t' Y� .t apt, f� i. �(•.. }: • Y `f > �* . I APPLICATION FOR REVIEW PO�S • - Complete all pages- • Safety & Buildings Division ( ) Check if Confirmation is Desired: () faxed, ( ) mailed Bureau of Integtabed Services Several counties have been defegated certain authority to review plans in lieu of Commerce. For a current list of those counties and their delegation check our website at httpJ/www.00mnwmsta*.wi.LmmwSB- PowtsProgram.htmi. NOTE: Personal information you provide may be used for secondary C ot1f nnatlon of assignment to a reviewer. ptxposes [Privacy tarn s 15 04(1)(m), Stft.3 Transaction !D: _ 1. Private Sewatre Submittal 2. Tvpe of Submittal: System Type ( Previous Related Traua. ID: X) New ( ) Soil Sahsalion Resort ( }Revision Estimated Completion Date: Dderryination ( ) Interpreove ( ) Repiaoem Assigned Rev%Wer: Determination ( ) Additi ( X) POWTS System ( } Peirtim (attach form SBD- 91390) Assigned Office: ( } At Grade ( ) approvaia ( } Holding Tank Cfn:le your choice of offices below ( } Nonpressutized In ( } Component %Untual (Inc ide each Ground component mantraf name, s and 1. Next avallable appointment in any office, 2. Green Say, 3. Hayward, ( } Pressurized In- date on title page of plan) 4• LaCrosse, S. Madison, 6. Shawano, 7. Waukesha Ground ( X) tnrlvidual S6te Design ( X) AAound ( } Aerobic Treatment Unit 3. Project Information - Fill in al Iotown information, { ) Sand Filter Project/Site dame BRUCE LENZEN HOMES, INC. —$"'ile t— Location, Number a Street of Project (d unknown, indicated nearest road) ST ANNES PARKWAY _recirculating ( ) Constructed Welland Legal Description. NW 1 /4 SE 1 /4 S24 T28N R20W ( ) Drip Line county ST CROIX Cily tfi(t X Town of TROY { ) Other: Building Type (dleck one): 4. After plans are reviewed, Please: (check all that apply) ( X) Dweding, 1 or 2 tahhily X Cali customer 1, 2, 3, 4 ( cirde number)` 'Refers to customer ritimber from below ( ) PubliclCommer6al Requesting party wit pick up ( ) St Buf ate -owned Building Mail plans to customer 1, 2, 3, 4 (circle number)' Gallons per flay 450 & Corrrpiete the "owing desi9ne+/ownerins9ues#mg iroww won. Utilize the cheek boxes when designer, owner or requesting party is the same to avoid repeating information. Des nor Information (Customer 1 Mail To Party if different then designer (Customer S First Name Last Name Customer Numbe FWW Name t.ast Name C ustomer Number TODD FEATHERSTONE 242514 Company Name Company Name FEATHERSTONE EXCAVATING, INC. Address Address P.O. BOX 467 City state Zip+4 (9digts) City State Zip+4 (9di6ft) HUDSON WI 54016 Phone Number (area code) Fax or Internet cell phone Phone Number (area code) Fax or Internet 715 - 381 - 1704 715 - 386 - 6885 Check others it apppcat ie Check others if applicable LID ( Owner Owner Information (Customer 2) Other Pleases Customer 4) First Name Last Name Customer Number First Name Last Name Customer Number Company None Company Name BRUCE LENZEN HOMES, INC. Address Address 502 2ND ST -, SUITE 204 City State Zip+4 Mdigits) City state Zip+4 ("gits) HUDSON, WI 54016 Phone Number (area code) Fax or Internet Phone Number (area code) Fax or Internet 715- 386 -5050 715 - 386 -1999 Check others if applicable (liibul To) Check others it apoicable ( ) Other ( ) Other MAKE CHECKS PAYA TO DEPT OF COMMERCE TOTAL AMOUNT DUE $ Attach check here Review code 7633 6.s Plan Review Fees for Private Onsite Wastewater Treahnent Systems Type of Project ( CIRCLE AP APPROPRIATE FEE BELOW )l FEE 1. An hv9trnent components are)lrevto under s. Comm 84.10 (2) or (3): • Design wrastewdlrr fluor of the pr's systt rrr: 1,000 gpd or less ............... .. ............................... . .. ................ .. ._ - ---- - -- -......3175.00 1,001 — 2,000gpd ......... .. .. .................................... ............. ...........$225.00 2 ,001 - 5,000 gpd .......................................... ............................... ............... $+275.00 greater than 5,000 gpd .............. ............................... ........................ .. . . . . . .. . .. 3300.00 plus $0.05 for each gallon over 5000 gpd 2, one or more treabnerd components are not previously approved under a. Comm 84.10 (2) or (3): (Irnfividual site deeign1daviation from component manuals aid use of component without product approval): Design wastewater now of the proposed system: 1 000 gpd or less .. ...... ............................... ........................3300.00 1 ,001 - 2,000 gpd ............... .. ... . .............. ..................... ............................... $400.00 2,W1 — 5,0W gpd SSW W greater than 5,000 god ................................................... ........ ........................$600.00 plus $0.05 for each gallon over 5000 gpd HOLDING TANKS ONLY 3. Holding tanks previously approved under s. Comm 84.10 (2) (3 Design wastewater ftow of the proposed system- 5,000 gpd or less ................................. ......................... ...... .........................360.00 5,001 — 10,000 gpd ..................... ............... ..........................s1moo greater than 10.000 gpd ......................... ............................... ........................5150.00 4. Hol ling tank NOT previously dppr+arfW ur09 b. Con 04.10 (2) w (3) dA RJ S4ts v'v1uUU44e U tanks Design wastewater now of the proposed system: 5,000 gpd or less ....................... ............................... . ....... ........................ $120.00 5.001 - 10,000 gpd ................................ ............................... ........................$200.00 greater than 10,000 gpd ............................ . ............... ........................$300.00 Experimental system (additlonal one time fee). ................................. ................................. $300.00 Revisions to Approved .................... ............................... $50.00 Petition for Variance (include form SBD- 9890) .................... .............................. . ............322500 Revision to a preuiously approved Peftion for Variance.... .. _ . ...... __ ..... $7500 Soil Saturation Determination R — Per Sito LotfW then a pr oposed subdivision ............. .....5100.00 Interpretive Determination Report. . . .......... . ...... ........... .............................. ....$100.00 Subtotal - - - - - - - - - -- Priority Revs -. Enter same amount as tub total ... ............................... Prior approval from a section chief is required for a priority review. If approval is granted, the priority will be revw*md within 5 days of receipt. Enter TOTAL (rounded to the nearest dollar) here $ 175.00 and on bottom of FRONT PAGE Note: Fees are pursuant to Ch_ Comm 2 and are subject to change annually; please contact any of the offices listed below for the most recent copy of this form. Comm 2 provides for a partial fee refund if a plan action has not been taken within the 15 days Of receipt of all required inform ton. 7. Appointment, Sr:itedt ng IrWonvisdon, and Plan Submittal ChecklWs. POWTS scheduling is not available. Plans will be assigned to a reviewer after receipt or plans. K you wish to receive confirmation of the assigned reviewer and estimated completion date piease check ft box in the upper right corner of the front page. Also note in the same location that you can designate a specific office for review. If you select a specft office your estimated completion date may be considerably greater than what would be possible in another office. Submittals received without a specific office Indicated on the form may be assigned to offioes other than the receiving office depending on nwiewes avaifabMy. To obtain a submittal checklist cad the material order unit at 808-26&1818 or one of the m service offices listed below. You may email technical code questions to po wlsted0commerce.state.wims Madison S&SD Hayward S&BD LaCrosse S&I3D_ Shawano S&SO Green Bay S&8D Waukesha Sam 201 W Washington Ave 10541 N Ranch Rd 4003 N Knxtey 1340 E Green Bay 2331 San Luis Piece 4D1 Pdot Court 5WO3 Hayward WI 54843 Goatee Ind 5hawam WI 54186 Greg Bay, WI 54304 Waukesha WI 53188 Po Box 7152 715.634 -4870 LaCrosse Wl 54601- 715 - 524 -3626 920 - 492 -5Wl 262- 548.8600 Madison WI 53707-7162 Fax 715 4n4,5150 1931 Fw. 715-624-3633 FAX. 920492 -5604 Faar. 262 -549 -8614 608 -266 -3151 Email: 608- 7859334 Email Email PlanSchedule@ Email. PianSdvduie@ Fax: 608- 267 -9566 PlanSchedulo@ Fax: SM785-9330 PlanSchedulea cornmerce.state.% ime comrnerce.etate.wi.ue TDD 608-2645777 commerce.state.wims Email: commerce.state.wims Email. PlanSchedulep PlanSchenu ieg carrrrserce- state.wi.us commerce.state.wims FILE INFORMATION SYSTEM SP&ftATIONS Owner BRUCE LENZEN HOMES INC. Septic Tank achy al ❑ NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ NA Estimated flow (average) g al/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer ZOELLER ❑ NA Soil Application Rate .7 gal/day/ftz Pump Model ❑ NA Stani;Wd Influent /Effluent Quality Monthly average" Pretreatment Unit j"A Fats, Oil & Grease (FOG) 630 mg /L O Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD,,) 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) <30 mg /L ❑ NA ❑ At -Grade )r L7 Mound Fecal Coliform (geometric mean) 510" cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: 21�4A Other: AMNA Other: 4NA "Values typical for domestic wastewater and septic tank efflwnt. Other: W NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ mo,nth(s) (Maximum 3 years) 13 NA 6 year(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA years) Clean effluent filter At least once every: ❑ month(s) ❑ NA gears) Inspect pump, pump controls &alarm At least once every: ❑ month(s) ❑ year(s) ❑ NA Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: At least once eve ❑ month(s) NA �" O year(s) Other: dRLNA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of s12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) A4 _f *, r Page 2 of 2 START UP AND OPERATION For new construction, prior -to use 4 POWTS check treatment tank(s) for the p ce of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high centrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cells) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: � A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name FEATHERST Phone — 7pr Phone 715 381 - 170 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PI K N Y'S Name ST. CR01X CO UNTY Phone 651 - 436 -5788 Phone 5 _ This document was drafted in compliance with chapter Comm 83.22(21(b)(t1(d) &(f) and 83.54(1), (2) & (3). Wisconsin Administrative Code. r - Wisconsin SOIL AND SITE EVALUATION,_ Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis.'Adm. Code Environmental By Design Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must `+> County � -- include, but not limited to: vertical and horizontal reference point (BM), direction and t St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road Parce_ 1'tiI.D.# APPLICANT INFORMATION - Please print all infoinnallon. Date Personal w4 rnm m tion you provide may be used for secondary purposes (Privacy Law, s. 15 (1 on) Revie �� Property Owner Property Locatifillj Continental Development 'Cab Lot - tNc * t/4 1/4 S 24 T 28 N,R 20 W Property Owner's Mailing Address Lot Block # 810 v ame or CSM# 12301 Central Avenue NE, Suite 230 1 i t " I ` Troy Wage City State Zip Code PhoneNumber City r lage ®Town Nearest Road i Minneapolis NN 55434 612 - 757 -7568 1 Troy I St. Armes Parkway ❑ New Construction Use: ❑ Residential / Number of bedrooms 4 ❑Addition to existing building El Replacement Public or commercial describe P lacemeM ❑ Code Derived daily flow 600 gpd Recommended design loading rate 1.2 bed, gpolfs? 1.2 trench, gpd/ft? Absorption area required 500 bed, fF 0 trench, ftz Maximum design loading rate 1.2 bed, gpdffl 1.2 tr ench, gpd/fF Recommended infiltration surface elevation(s) 101 ft (as referred to site plan benchmar Additional design / site consideration t Paren t material Loess Over Glacial Outwash Flood lain elevation, if applicable na ft ble for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank uitable for system ❑ S ®U ® S ❑ u El Nu ❑ S ®U ❑ S ®u El s ® U SOIL DESCRIPTION REPORT N".> C 6 .1 Borin Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/f 2 9# in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ; Trench 1 1 0 -9 10yr3/2 - 1 2msbk mfr cw 2f 5 .6 • S 2 9 -24 10yr4/4 - sil 2msbk mfr cw if .5 .6 f Ground 3 24 -30 7.5yr4/4 - is 2msbk mvfr cw - .7 .8 • �- elev 100.96 ft 4 30 -32 7.5yr5/8 - BRX - - - - - - _.-- Depth to limiting factor 30 Remarks: 2 1 0 -9 10yr3 /2 - 1 2msbk mfr cw 2f .5 .6 • t 2 9 -32 10yr4 /4 - sil 2msbk mfr cw if .5 .6 . S Ground 3 3248 7.5yr4/4 - is 2msbk mvfr cvv - .7 ? .8 elev 99.41 ft 4 48 -50 7.5yr5/8 - BRX - - - - - - Depth to limiting factor 48 Remarks: CST Name (Please Print) Signature: Telephone No. Thomas C. Nelson 715- 246 -2454 Address Environmental By Design Date CST Number Ref # 1432 120th Street, New Richmond, W1 54017 4/22/99 227387 130 t PROPERTY OWNER: continental Development SOIL DESCRIPTION REPORT db f Page 2 of 3 PARCEL I.D.# Environmental Bv Desian Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed !Trench 3 1 0-9 10yr3/2 - I 2msbk mfr cw 2f .5 .6 • S 2 9 -18 10yr4 /4 - sil 2msbk mfr cw if .5 .6 Ground elev 3 18 -30 5yr5/8 - scl lmsbk mvfr cw - .7 .8 . 97.50' ft 4 30 -32 - - BRX - - - - - - Depth to limiting factor 30 Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: I r [RV1 1 1432 120' STREET, NEW RICHMOND, WISCONSIN 715 -246 -2454 Tom Nelson Certified Soil Tester 227387 -- Registered Sanitarian SR00713 ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** TROY VILLAGE — Lot NW %4 , SE %4, SECTION 24 T 28 N, R 20 W Troy Township, St. Croix County, Wisconsin Page 3 J I 61 M Sb 0 I 3 T, q ti ,o dori ti I SCALE I" =40 2 9 9 ° 4 Tom Nelson BM 1. Top of iron pipe SE lot corner ELEV 100' 3 - I 7 i 5(7 BM 2. Top of iron pipe SE lot comer lot 97 ELEV 100.66' I [KV 1 * P0KA[K7A L 1432 12e STREET, NEW RICHMOND, WISCONSIN 715- 246 -2454 Tom Nelson Certified Soil Tester 227387 -- Registered Sanitarian SR00713 ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** TROY VILLAGE — Lot* ' SP /4, SECTION 24 T 28 N, R 20 W f � NW /4, e Troy Township, St. Croix County, Wisconsin � 1 Page 3 . S r o � l In � no `t n� 30S SCALE 1" =40 Tom Nelson BM 1. Top of iron pipe SE lot corner ELEV 100' �- BM 2. Top of iron pipe SE lot corner lot 97 ELEV 100.66' r - l—o4 1 00 T �� e MOUND PLAN VIEW observation pipes (typical) .I W= 29.4 ft A A= 5.0 ft 1.52m 8.96 m — 6 = 100 ft 30.48 m B =K J= 10.0 ft 3.05m I I = 14.4 ft 4.39 m K= 13.4ft 1 4.08m —— L = 126.8 ft I 38.7 m typ. obs. pipe A X 6 refers to absorption cell width and length (anchored securely) J = upslope width I = downslope width K = end slope dimension 6" 050 mm) T MOUND CROSS SECTION D = 24.0 in 61.0 cm lateral topsoil G u subsoil cap E = 27.0 in 68.6 cm invert 105.5 ft F = 9.9 in 25.1 cm elev. 132.161m see note F G = 12.0 in 30.4 cm E D AsTM C33 H = 18.0 in 45.6 cm Sys. 1105.0 ft T Sand Fill elev. 132.00 m ft contour 5 6 mW om slope Note: Absorption cell media will D = upslope fill depth plowed layer consist of aggregate and pipe E = downslope fill depth or leaching chambers and pipe F = absorption cell depth as specil'ied eAggregate G = subsoil + topsoil depth at cell wall at right. Chamber H = subsoil + topsoil depth at cell center Designer notes: If aggregate is used, it is covered with code compliant material. Project: Plan I.D. Page 3 of Wisconsin Department of Commerce, SOIL AND SITE EVALUATIO © � d Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. C e ty TV° Environmental By Design Attach complete site plan on paper not less than 8' /z x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal referef►ce col , direction and $t. Croix percent slope, scale or dimemsions, north arroyr; imd 16citidn and i ce to nearest road. ��, Parcel I.D.# APPLICANT INFORMATION - 0 09Se print aginfor" b By Personal information You provide may used secondary ��� .� ..04 (1) (m)). k�l Property Owner perry Location Continental Develop r ` �" lgqq ZVt- Lot NW 114 SE 1/4 S 24 T 28 N,R 20 W Property Owner's Mailing Address ST 4140X t # Block # Subd. Name or CSM# 12301 Central Avenue NE, Suite 230 COUNT' 100 Tro Will e � City State �ap Code d City Village ®Town Neared Road Minn lis MN 55�I34:. ; :..,__. Troy Lindsay Road ® New Construction Use: Residenb r of bedrooms 4 ❑Addition to existing building ❑ Replacement 0 Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate 1.2 bed, gpdhY 1.2 trench, gpd/ft= Absorption area required 500 bed, fF 500 trench, fl? Maximum design loading rate 1.2 bed, gpolftz 1.2 tr ench, gpd/fr? Recommended infiltration surface elevation(s) 108 ft (as referred to site plan benchmar Additional design / site consideration t Parent material Loes s Over Glacial OutWash Flood lain elevation, 'If licable ft ble for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank itable for system EI S 0 u M S❑ U ❑ S ®U ❑ S® u EIS O U ❑ S® u SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/fP Boring# in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 1 1 0 -5 10yr3 /2 - sil 2msbk mfr cvv 2f .5 .6 2 5 -25 10yr4 /4 - sil 2msbk mfr cw if .5 .6 Ground 3 25 -30 10yr8 /3 - BEDRX - - - - - - elev 106.57 ft Depth to limiting factor 25 " Remarks: 2 1 0 -10 10yr3 /2 - sil 2msbk mfr cw 2f .5 .6 2 10 -25 10yr4 /4 - sil 2msbk mfr cw if .5 .6 Ground 3 25 -30 10yr8 /3 - BEDRX - - - - - - elev 100.54 ft Depth to limiting factor 25" Remarks: CST Name (Please Print) Signature: _ Telephone No. Thomas C. Nelson �� - - -- i 715- 246 -2454 Address Environmental BY Design Date CST Number Ref # 1432 120th Street, New Richmond, WI 54017 12/18/98 227387 82 ° PROPERTPOWNER: Continental Development SOIL DESCRIPTION REPORT ® Page 2 of 3 PARCEL I.D.# Environmental Bv Design Depth Dominant Color Mottles Structure GPD/f 2 Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. o Boundary Roots Bed !Trench 3 1 0 -6 10yr3 /2 - sil 2msbk mfr ew 2f .5 .6 2 6 -25 10yr4 /4 - sit 2msbk mfr cw if .5 .6 Ground elev 3 25 -30 10yr8 /3 - BEDRX - - - - - - 105.14 ft Depth to limiting factor 25" Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: t ♦ c _f N BY D E51GN 1432 120 STREET, NEW RICHMOND, WISCONSIN x'15 -246 -2454 TROY 'PILLAGE PAGE 3 NW Y4 SE ___f, SECTION. 24___ T._ 28 _N, R -_- 20_W TOWNSHIP TROY ('OUN JY St. Croix Wisconsin Q31 I } 3 + \ V� �7 i i , J i 4 t `1 SCALE 1" =40 �� Tom Nelson BM 1. Top of nail in elm tree ELEV 100' V 227387 BM 2. Top of nail in elm tree I-1,FV 101.70' ST CROIX COUNTY SOC TANK MAINTENANCE AGREEI&W AND OWNERSHIP CERTIFICATION FORM Owner/Buyer &VIN P• M&LGc -mss' Mailing Address 502 gbQ STREET. SUITE 204 —7/ Property Address (Verification required from Planting Departiucat for new construction) Cit3atate Parcel Identification Number 0 "' Z _4 C — ON EGAL ESCRI � D PTI Property Location NW 14, SE V Sox. 24 , T 28N N -R 20 W, Town of TROY Subdivision TROY VILLAGE . Lot # 100 Cec(ified Surrey Map # . Volm ne . Page # Warranty Deed # 72-4 � ______, Volume Z Z4�, 2 Page # o 0 6 Speo house a yes (3 no Lot fines identifiable ® yes 0 no SYSILM MAMMA= haproper useanduninten anocof y our septic system could nxait m its pre =tumfailurc to handle wastes. Propermainte ante Consists of pumping out the septic hale every three years or soak if needed by a licensed pamper. What you put into the: system can affect the function of the septic tank as a treatment stage in the waste disposal system. TIM pmpectp owner agrees to submit to SL Croix Zoning Deb arms nt a catification. farm, signed by the owner and by a masterplaarbryjontaeymanplan w, zestactedphunberorahoensedpumpervcdfyingthat( I )theon4tewastemlerduposalsystem is in pvV er operating condition and/or (2) after Wgxx: ion and pumpiog f if necessary). the septic teak is less than 1/3 h1l of sludge. L*% dha andasig nee. have read the above rcquitcmeaft and agree to whin the private sewage disposal system with Su sUndar& set forth, Herein, as set by do Department of Cmin cnx and ft Department of Natural Resources; State of Wisoonsiu. C=Ocaticn stating that your septic system has been maintained must be Completed and retamed to the St. Croix County Zoning Office widdn 30 days a throe iradon date- '2 1 1 3 OF APP DATE OWNER f:jCQATCON I (we) certify that all statements on this forcer are true to the beat of my (our) lmowlaige. I (we) am (are) the owner(s) of the property described above. by virtue of a warranty deed twArded in Register of Deeds Office. SIC NAITIRE OF APPLICANT DATE ' * «' «• Any information that is mis- representod may result in the sanitary pcnuit being revoked by the Zoning DepactnicUL « « « « «« •' Include with this application: a stamped warranty deed f = the Register of Deeds office a Copy of the certified survey map if reference is made: in the warranty deed From: Tfl,;PAk4 Date: 8/28/2003 Time: 2:04:46 PM Page 1 of 2 FACSIMILE COVER PAGE To: PAM From Sent : 8/28/2003 at 2:03:18 PM Pages : 2 (including Cover) Subject : FW: THIS IS THE WARRENTY DEED YOU NEED TO COMPLETE AND ISSUE FOR LENZEN - TROY VILLAGE LOT 100. THANKS, SHERYL FromA To: PAr4 Date: 8/29/2003 Time: 2:04:46 PM Page 2 of 2 AUG. -z7' 0�5 (WED) 10:40 BRUCE LENZEN INC TEL:7153861999 P. 001 2262 P 006 rl 7�42Af+3 STATE MR OF WISCONSIN FORM 2 -1994 KATHLEEN H. WALSH (itWISTER OF DER Document Number WARRANTY DEED ST. CROIX CO., MI RECEIVED FOR RECORD This Deed, made between Christopher J. Wendell, 08/03/2003 0s:30Afi WARREAM DEED XEZ Graotor, and _K evin P. MaEuns, REC P291 11. TRAMS PEEL itd e. oo COPY Flat CC PER: P Granted. AGESt 1 Grantor, for it valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more spacts is needed, please attach Addendum): Recording Ares Lot 100, Troy Village Third Addition in the Town of Troy, St. Croix Namo and Return Address County, Wisconsin. Raw — U9 F Odb- 12Sb•60.000 Parcel Identification Number (YIN) This _ homeatend property, (is) (is not) Exceptions to warrturtics: Easements, restrictions and rights -of -way of record, if any. Dated t a-W day of May P 2003 + • Chrbta�lrer ft rid. AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATES Olt WISCONSIN ) ss. — ^ _ County ) authenticated this dny of Personally crone before me thi - day of may _ ' . 2003 the above named Christopher J. Wendell, TITLE- Mr-MBER STATC OAR OF WISCONSIN o wn to e t p rson(s) who executed tho foregoing (If no[, i st a o l g t cc me. authorized by § W is. Stars.) TKLS INSTRUMENT WAS DRAFTFID BY • Attorne Krishna O i�and Notary Public tale of Wisconsin My Commission s permanent- (if not, state expiration date: (Signatures mny be aulhenliesta4 or acknowledged. Bodo are not necassmy -) ) IrYa I cnab company, FwA du Lac, VA • Names of persons signing in any capacuy must be. typol or printed below their signature. ttao ass t STATE BAR OF WISCONSIN Notary 1J�iiQ WARRANTY DEED FORM No, x -1999 State of Wisconsin k , < TROY ....... ILLAGE THIRD ADDITION .aN} wow THE `jSE. T 1/4 OF 'A: l' AN f+()Y�SI� ` 114 KfC4XJI SE 1 i`S(:ONSIN r` � ...._. «_. _......_ «.. _.. .. a ..�...._" .d:�.r ...:. ..... ..... .. ... BEINC, P rat <F JU L 3 ' THE PLAT of TROY vi11.ACE. LfJ . ATRC 3,0.K) . 4 r • �A� 1 .,. ' ` y Q, YlGd1VltfI7Xi. 1 x41 3 5: 1 rrh 120 4 j \ B cl ; r i ¢ ' I(,1 4 gq J A v u � M x x .. .... .....x u: wwA•^ 1f UNBµ •aa5 wt acp �g 14;r ' .,w .a: „�` � C rrsu *. .m. rn ,. rn x... n .a..:. *. • u}x. w.ru.,; awr SCAIF N FEE` l 1 IT 9. ) a rM ✓.f. 1.. Must v zz I I I r _ a • ���., �, � � � , �� � � a ��� �� � �o