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040-1257-30-000
irtment of Commerce r PRIVATE SEWAGE SYSTEM County: St. Croix ng Division INSPECTION REPORT Sanitary Permit No: 430286 0 INFORMATION (ATTACH TO PERMIT) Late Plan ID No: - i nformation you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)I. (,� 1&18V - - T +S • / ermit Holder's Name: City Village X Township Parcel Tax No: Barnabo, Larr Tro Townshi 040 - 1257 -30 -000 CST BM Elev: Insp. SM Elev: BM Description: Section/Town /Range /Map No: 24.29.20.1366 TANK INFORMATION ELEVATION DATA TYPE MANUFACTUR CAPACITY STATION BS HI FS ELEV. ��1 /(7• p 0 I / Septic Benchmark , f �Z °I 1 Gam. Dosing Ivi Aeration Bldg. Sewer Holding n e h V�� o /aZ St/Ht Outl t J TANK SETBACK INFORMATION .I ° 2 /D z Z/ TANK TO P/L WELL ] j D 5 G . Vent to Air Intake ROAD Dt I_ nI Septic , �s/ Dt B ottom / r 2 Dosing 1 Header /Man t 1 . S ti �3 Aeration Dist. Pipe 1.0Z los' Holding Bot. Sys ,v _(oS f �. c�S•03 Fin I Grade - v PUMP/ IPHON INFORMATION k �, ( + I + 5�, m ter Manufacturer r Demand over / p GPM l�tSeYS :� OS Mode! m f , t l �` 119 �o (0= TDH A Friction Loss System Head TDH Ft / - 16 . 4411 p , 3 S G• So 3. ,�`L.0 Z Forcemain Length Dia. Dist. to Well S z Z•4 /0 SOIL ABSORPTION SYSTEM 4YEd /TWEW(W Width f Length r No. Of #epsLees PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS • (. I 17 SETBACK SYSTEM TO I P/L JBLDG WELL LAKE /STREAM L HING acturer: INFORMATION CHAMB Type Of System: g l O a I �\ U odel Number: IMt9u -►l o J Il i l DISTRIBUTION SYSTEM La So . P L Header /Manifold Distribution ry t x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) I� 3 3 3 1 rf Length 3 7 j Dia Length T 23 Dia ' Z Spacing g - 3 Dia 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 1 Yes p' No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / IDspection #2: t' / / Q 3 Location: 265 St. Anne's Parkway Hudson, WI 54016 (NW 1/4 SE 114 24 T28N R20W) Troy Village U ota cel No: 24.29.20.1366 . ,6 /, 1.) Alt BM Description - � • �'�"`""`^' ''" � T S nnatlt eQ d t� c 2.) Bldg sewer length = 7 - amount of cover = ` � � j�(os v s�— „fie c �, P 6e- s a,� It•�S �Q,a -� 4 - PI2n revision Regwred . Yes No Use other side for additional information. � u O �ti S Date In tor's Signature SBD -6710 (R.3/97) Cert. No. 1 1 aK. � p„� ,L `�) � ti ���C�r yy (�{iC.�_� L � CO Std S� Safety and Buildings Division County 201 W. Washington Ave., P' OU Dox 7082 ST. CROIX �SCOnS n ` Madi%m, Wi 53707 - 7082 Sanitary Permit Nu (to be fill by Co.) f3epartment of Commerce (608) 261 -6546 _ o _ State Plan I.D. Number Sanitary Permit Application In accord with Comm 83.21. Wis. fit. Code, personal information you provide may be used for sovandary purposes Pnvacy law, sl AW t xm) Project Ad&ess (it different U maiFing address) I. Application Informatioa Pkxse Print All Information Property (Xviff's Name ° m -°° -- -~ - ° ---I Parccl # Lot # 06 Mock LARRY BARNABO R E C E . N 1 Property Omwt's Mailing Adche* : Property Location 6331 PAINTED TURTLE RD NW /, SE 24 City, Stills: Zip Code 1 1'lt�e Ntrt�lx LINO LA KES, M N 55014 T 28N N; R ) IL Type of Building (check all that apply) IX I or 2 Family Dwelling -- Number of fledrooms 4 Suttdivision Name C5hi Number U tubtiecoum avial - mmuit c ( i __ / /o // TROY BURNE VILLAGE )Z ❑ state owned – t]cscribe I ire 7" – - , ❑cily_Uvittage L' I rawnsntp of TROY Ill. Type of Permit: (Check only on box on litre A Complete li if *pplicwble) A wSys<cm V1 KrlacxanetdSyatata ❑ Tretlntetd /ttuktieTmrkltepta�KneetEkity ❑ (kls ModificatitnttoltingSystem 8 • [I Permit Renewal ❑ Permit ttevmon 11 change of U Permit Transfer to New List Previous Permit Number and Date Issued HetoNe Expiration rkm*a owner IV. typ of POWTS S to Check all that i i U Ncros –Ytc trued fu C txrnd K f.W .? 24 in. of itatrie soft Pfau to �c soil ❑ At -Grade H single ft s sari Filter ❑ Canctructed wettami ❑ Pmwuri, In- (;rand H llolding't'ardc ❑ Prat Piittr FJ Aerobic Try Unit ❑ Recirculating Sand Fibw ❑ Rerirrtttating SyntbsAic Media Fiker n teaching Chamber n Drip line n (r avel - less Pipe ❑ wain) V. Dis rsuVr esatmeut Area Inton ation: O.e^'tt� -� � 2�•�L �•r��� Dmigu Flow (gpd) t)csign Soil AMh on Rate(gpds) Dispersal Rcqu (s) (st) System " a/ 600 0 .5 0 �/ & --4" l 200 UU 1669 .._- .- 0 105.00 VL Tank Info Total Number Matadacturer Site Steel Fiber Plastic Gail (: kwn ofI;nits C.onmate Constructed Glass New Tanks T ankx Te>t�s Septic raIfolding3w*k X 1250 1 WIE6LR X Aerobic Treatment Unit r1r. .t'" = '" he ` X 1000 1 WIESER X VII. Responsibility Statemremt- 1, the mWersigned, a oume rmrosr Aili/y for ht l ow of the PoWrs am— ww lice attached phrts. Plumber's Name (Print) PkVnber' re A(P /MFRS Number wKinc4e K~ Number TODD FEATHERSTONE 242514 71 381 -1704 Plumber's Address (5trect, City, State, ZFadc) P.O. X 467, H WI 5 4016 AUGUST , 2003 V Coma !De artment Use Only� �— -- A ❑ Disappruued — Swaar y Permit Fee (includes Groundwater Date Isstwtl Issuing Sigrbttttre Its) serge Fee) J1 `= ❑ Owtwr Given (teaser for Denial Conditions of Appmval/lieasonsfor Ifisapproval - - � CSj-L 3 /� /�j�/B�C� — �,t.�- 2- clQ�cth� Gr-4 �'t't' S Ox-- �Q�t(GC�+H• �- YSTE OWNER: � �X � �w�S�•� 1 Septic tank, effluent filter and 3 ) OAF- Pl dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as - per appl icable code! 11 ptara ( to the C—ty system eo per nd ses thaw trtra z tf is sine - ��ZGc 6�r� -r�,� . h4-� d4t-f- -r)-q 4�j d • Cl i . s c, Y ' J � o lira- Tom add J l R cs �/d r � Safety and Buildings �# PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 N visconsin www.commerce.state.wi.us /sb Department of Commerce www.vAsconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary August 01, 2003 CUST ID No.242514 ATTIC• 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: 08/01/2005 Identification Numbers Transaction ID No. 896480 SITE 4 -k' 51 y Site ID No. 663200 6teve Barnabo Please refer to both identification numbers, Lindsay Rd above, in all correspondence with the agency. Town of Troy St Croix County NW1 /4, SETA, S24, T28N, R20W Lot: 106, Subdivision: Troy Burne Village FOR: Object Type: POWT System Regulated Object ID No.: 915303 MOUND/ DWELLING 600 GPD The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. fora 6 A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits 4 ' required by the state or the local municipality shall be obtained prior to commencement of y e' [CEP construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of th POWTS. L Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Robert Kanter POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (608)261-7735, Monday -friday 8:OOAM - 4:45PM rkanter@conunerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 MCEIVED JUL 2 8 2003 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGNSAFETY & BLDGS. DIV. Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: STEVE BARNABO Owner's Address: 6331 PAINTED TURTLE RD LINO LAKES, MN 55014 Legal Description: NW1 /4 SE1 /4 S24 T28N R20W Township: TROY County: ST. CROIX Subdivision Name: TROY BURNE VILLAGE Lot Number: 106 Block Number . N/A Parcel I.D. Number: Plan Transaction No.: -�.. t! I Page 1 Index and title Page 2 Data entry Page 3 Mound drawings 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 Soil Test Page 10 Plot Plan Page 11 ;PkPOWTS Owner Manual.Mgmnt P lan Pa a it/e/POWTS A licatio For Review X - Lar c,V'v Designer: TODD FEATHERSTON License Number: 242514 Date: 07/23/03 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 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 400.00 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. 600.00 Design Flow (gpd) 9.00 Site Slope ( %) 104.00 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 90.001 Dispersal Cell Length Along Contour (ft) = 6.67 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd/fl?) 1 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 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 10.00 ft /orifice 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 102.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 16.31 Forcemain Drainback (gal) 2.50 Vertical Lift (ft) 81.16 5x Void Volume (gal) 1.35 Friction Loss (ft) 97.47 Minimum Dose Volume (gal) 10.35 Total Dynamic Head (ft) 24.72 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 x 1.50 x 1.25 x 2.00 x 1.50 x X 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1250.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) WIESER 1250 1 Manufacturer gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1000.001 Dose Tank Capacity (gal) JZabel 11 Filter Manufacturer 27.831 Dose Tank Volume (gal /in) IA100 I Filter Model Number WIESER 1000 Manufacturer Project: Page 2 of 12 Mound Plan View 1/1 B J Observation Pipe . . _ l K... T A :. W z 3 ❑. L Mound Component Dimensions A 6.67 ft E 19.20 in H 1.00 ft K 9.28 ft B F 9.50 in z 11.88 ft L 108.55 ft 1 0 in G 0.50 ft J 5.41 ft W 23.96 ft 00 (ft) Dispersal Cell Area 1 1669.52 (ft Basal Area Available(/ 6.67 (gpd /ft) Linear Loading Rate 1 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 106.79 (ft) G t H F .....r j 105.5 (ft) I 1 — Dispersal Cell 0 Lateral 105.00 ft —0 Invert Dispersal Cell] 1 Elevation E D 3 104.00 (ft) Contour Elevation 9.0 % Site Slope Geotextile Fabric Cover Shading Key o, Dispersal Cell See lateral details on 1❑ _ Topsoil Cap = 1.5 ft . 4 for number, size, . Subsoil Cap . spacing of laterals. Q : FA o : ❑: ; '`t`' :'`. ' ';:.:' }'' and spa g ASTM C33 Sand 10 ° F Laterals are equally Tilled Layer c 0.5 ft Typica{ Latera{ spaced from the 5 :: distribution cell's Ag g re gate d ❑: 5 ::' :�: ?''�:::::`:.;:;:;:::;::.:;:: --� centerline in the * p` distribution cell (AxB). Project: Page 3 of 12 r 1 Center Connection Lateral Layout Daigram Force main connection Via tee or cross to manifold at any point. Laterals are identical P 5 I Al- 0= Turn -up M ba I I valve or I{ X I W2 .2 I x+ 2 ->I Laterals & force main of PVC Sch 40 clean out pl u g per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.05 ft Lateral Length (P) 44.23 ft Orifices per Lateral 15 Lateral Spacing (S) 3.33 ft Orifice Density 10.00 ft /orifice Lateral Flow Rate 6.18 gpm Manifold Length 3.33 ft System Flow Rate 24.72 gpm Manifold Diameter 2.00 in Total Dynamic Head 10.35 ft Forcemain Velocity 2.52 ft/sec Dose Tank Information Locking cover with waming ___7 label and locking device and sealed watertight Disconnect Electrical as per NEC 300 and —� Comm 16.28 WAG 4 in. min. Tank component is properly vented < E— Alternate outlet location Forcemain diameter WIESER $M lOaO Manufacturer _ 2 in. Capacity 1000.00 Gallons Volume 27.83 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 18.43 512.91 C B 2.00 55.66 1 P ump off e levation (ft) C 3.50 97.47 —t 1 103.00 D 12.00 333.96 D Total 35.931 1000.00 Dose tank elevation (ft) 3" Bedding under tank. 102.00 Alarm Manuafacturer LEVEL ALARM Alarm Model Number LVL -1 Pump Manufacturer ZOELLER Pump Model Number 53 Pump Must Deliver 24.72 gpm at 10.35 ft TDH Project: Page 4 of 12 1 Mound System Maintenance and Operation Specifications Service Provider's Name IFE ATHERSTONE EXCAVATING, INC Phone 715 - 381 -1704 POWTS Regulator's Name ST. CROIX COUNTY Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1250 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600 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 every 1.5 years Mound Inspect for ponding and seepage once every 3 years 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 .•.........•••• 0006.....•••• ............. . . Grade 6 -8" Diameter Lawn Threaded Cleanout ..... ........ PI or Ball Valve Plug Sprinkler Valve Box ........ ........ 9 Distribution Lateral Long P Swee 90 or Two 45 Degree Bends Same Diameter as Lateral Project: 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.01101) 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 finer 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 filter shall be serviced if the alarm is activated continuously. intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tan the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall ad vise 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 BQP150 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 1 d cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specific 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 flue 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. Contingency 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: Page 6 of 12 HEAD CAPACITY CJPVF MODELS 53-55 57-59 Model "53/55/57/59" 25 - Ft. Meters Gal. Ltrs. 5 1.S2 43 20 - < 3.05 34 129 L3 10 LLJ 15 15 4,57 19 72 4- 13-3 Lock Valve: 19.25 ft. (5.9m) 'f 10 a;V- '4 6 5/.17 2 4 5/8 1/2 N F' 10 20 30 40 50 U.S. GALLONS LITERS T 80 FLOW P MINUTE OMB97 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Variable level Float Switches available. • Variable level long cycle systems available. • Available with special cord lengths of 15', 25', 35' and 50'. • Alarm systems available. • Duplex systems available. L i 3/32 . .......... q " SELECTION GUIDE I Integral float operated mechanical switch, no external control required. Single Seal Control selection J 4. See FM0712 for correct model of Electrical Altemator. Uhanas A Model 1 Vohs-Ph Mode — A - CM UL 2. Single piggyback variable level float switch or dou ble piggyback variable level Am Simplex__,--- -Duplex y float switch. Refer to FM0477. M53/55 & M5769 115 1 Auto 8,D 1 or1 &7 y Y y- 3. Mechanical alternator "M -Pak" 10-0072 or 10-0075. - WIM - 06 - 7 - 69 115 - Non 8,0 - 2or2&6 3or4&5 y 1 Auto y y ON53 y BN57 115 1 Auto 8.0 N Y 5. Variable level control switch 10-0225 used as a control activator, with Electrical — BE53/57 Auto 4.0 y Y_ Alternator (3) or (4) float system. N3_155& D5715 __ Z3Q_____ I Auto 4-0 1 or _1& 7 y y 6. Four (4) hole J-Pak, junction box, for watertight connection or wired-in simplex or E53155&E57159 230 1 t - Non 4.0 2 or 2 & 6 _ 3 or Y y 2 pump operation, P/N 10-0002. Single piggyback switch included. 7. Two (2) hole J-Pak, junction box for watertight Connection or splice, P/N 10 -0003. FA - CA - U - 7 - 10 - N - 1 For information on additionalZoeller products teferlo catalog on Piggybacl(Variable Level Float Switches, FM0477 ' All installation of controls, protection devices and wiring should be done by a q ualified Electrical Aftemator, FM0486;MechanicalAlferrator, FM04g5;Sump/SewageBasft, FMO487; and Single Phase licensed electrician. All electrical and safet codes should be followed including the most Simplex Pump ConlrollAlarrr Systems, FM0732. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MA& TO: P.O. BOX 16347 FJ Louisville, KY 40256-0347 Manufacturers of SHIP TO: 3649 Cane Run Road Louisville, KY 40211-1961 778-2731.1(7 00) 928-PUMP http.lAvww.zoaller.com 1 (502) FAX(502)774-3624 0 Copyright 1998 Zoeller Co. All rights reserved. /V cc FROM T0M0at)d0STACEY0NELSCN PHONE N0. : 00000000000000000 MPF. 0I 1999 12:15p9 P2 Ymlmxm(ttDtlpsdt'ttsntofcomff w SOIL AND SITE EVAL UATION Page of 3 v[tiott d Stdetfi +trtd in AcWcd vMh Comm 83 -M Wis. Adm. Cade Attach comoW BAs oWn 41 papa ttt leas Im 8% x 13 inch" iR *n=. Phn must bckxw. but nat know UK *erslva! am HorJxenglra wwwo point (Mq &*cow and �n" percent siopa. st d! w �. tl m m"W, and 1oowm end &bwk a to naantt toad St L`(OiX — Pwcd 1D AP'P'I. ANT WRMATKiN - Pfsteast pmt stet kntematforr. pm to tMunwfN yw v►o►+dr M' br "MW rhr 660WO ary t+ AVOM+•'A"" UW, k 15. n? 0n)) Rerinwed By 1 Ptopit r o Pmp vty tncadnn Comuutftt Develo pment_ Gmt. Lot NW 1/4 SE IA 3 24 7 213 N,R 20 W E}Nt W$ M#Iftq Rd"M tats # t3todc s � , sZ. rams orc 12301 Camrsl AveMm NZ Suite 230 _ 106 _ I_ Tmy su m Vilisfe CAY stab DA C*" Phw*Nuwkw C" C* D vnvo zr 1+leereet Road � MiMMAM MN 55434 1 TMY 4 Lindsay mad New l cwoU*fl um Aastder" I iVw4ff of bedreorm 4 �;Addi ors m eaos€� btt np Pubk or corrxnercw ft= am Cori urttrod d* Aow 60 oad Rr,wwty ded dent losdny raw I.2 bad. gpdV .: _ kerxk gpW Ahalim mom0m MQ _,., 1>lsi,}P _. _ vent Fe Mmdmm de ►3-m" 1.2 { d. W W 1.2 h nach..gidM Restxlrt>erlddd kftadon surf," awnw(s) ft (as referred b 3* pw bonchrm AddWE Z9 design / atr rs+ Parent md" Loes4 over 86d Rock Flood oWm !tot n. d appkabW N a R S=Sub irr for sNmm irt p?&* a AT Grads syo*m in FA ( NcicfY� Tic U--Uft ud" for aysbm C8 K n s D u C o s !E1 u iL s% U n S N I 0 s :0 U IL DESCRIP'Tl00, oom Uovst rMA Cd" Wks sbvetzre i Roots GP01 E^yhlgt f taritnn in. Wnsd Qu. Sz Corti Odor Texmv 1 Gi'. Sr. < Bed ; rertm .t� 1 0 1 0yr3r? - �il i 2mobk 1, a"a j cw ` 2,!' h 2 7 -24 � 10yr4 / s ki 2n�i3bic _ _ I _ �� c�y If � (► 3 24 30 1QvTgn +� -- - _ + RED1LX trc R etnarW. :z 1 E azz ! zoyr3x'3 si 2msbk mfr ow 2f i 5 5 _ 2 j 11 -37 10yr9 /4 - 3a 2.-n0k 1 mft i e E If ' { CST Pinta spleens Print) Si�nat4 � . � Tm pttom No. i homts C. iVcimn �� 71 �'�Er -2�' FROM TOMOandOSTACBYONE -SON PFD NO. ;OOO000Q0000@0 91 1999 12' 7PM P3 imwff Lonwp", $OIL DE$CR1PT16H REPO T P� I.0 Q 2 d 3 Haim I cola ; Moft ia. mesa cu. SL corn cobr f T' �"'° l or. SL $4. Roots I r f Bed : TR'.mb zmsbc mfr car 2f c 2msbk rn9- cw l f 5 6 G 3 3135 10yr8/3 f 31 D"Ib to Remarks: ------------- 3 ia[n •1e4. c J r �1 e^ s I •� •o � J 1 �yy r R' bo Old XK Ad • Atdfi`� t FZW cis , .,j w t� 1 > r <q t "Ilea \' o n o it � \ -� Yl �1 0� ,� /• � x � � f hf G � x Wisconsin Department of Commerce SOIL AND SITE EVALUATION, Page 1 of 3 Division of Safety and Buildings in accord with Comm 83,0$, \Nis: Adm. Code Environmental By Design Attach complete site plan on paper not less than 8 x 11 inches in size. Plary� Is County include, but not limited to: vertical and horizontal reference point (BM), dire n`a �3� tt� St. Croix percent slope, scale or dimensions, istan sions, north arrow, and location and ce n crest robY CEI VE �J Parcel I.D.# L APPLICANT INFORMATION - Please print aft m mat P O U /-2S�" A�'r Personal information on you provide may be used for secondary purposes (Privacy Law 04 (f) (in7).' Reti' li Date S /t Property Owner rty Lodk% Continental Develop t° 0 NiNGC ?FF WJ - /4, ' S1 1/4 S 24 T 28 N,R 20 W Property Owner's Mailing Address L %, ` fi ame or CSM# 12301 Central Avenue NE, Suite 230 1 ► Tro 4iw1e Village City State Zip Code PhoneNumber u City _ illage Town Nearest Road Minneapolis MN 55434 Troy ` Lindsay Road New Construction Use: � Residential / Number of bedrooms 4 ❑Addition to existing building ❑ Replacement ❑ Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate 1.2 bed, gpd/W 1.2 trench, gpdff Absorption area required 500 bed, fl 500 trench, ft Maximum design loading rate 1.2 bed, gpd/W 1.2 tr ench, gpd/ft Recommended infiltration surface elevation(s) 107.50 ft (as referred to site plan benchmar Additional design / site consideration Parent material Loess over Bed Rock Flood plain elevation, if applicable Na ft S= Suitable for system Conventional Mound In - Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system [IS N U , ® S❑ U ❑ S NU ❑ S® U EIS ®U I ❑ S® LI SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ff goring# Horizon in. Munseli Qu. Sz. Cont. Color Texture Gr. Sz. Sh. iConsistence Boundary Roots Bed Trench 1 1 0 -7 i 10yr_ 4/3 i - i sil 2msbk mfr i cw 2f S .6 2 7 - 24 10yr4/4 - A 2msbk mfr cw if .5 .6 Ground 3 24 -30 10yr8/3 - BEDRX - - - - - - elev 103.56 ft D;rpth to c (49 limiting factor 24" Remarks: 0 / CA I 2 1 0 -11 I 10yr3/3 I - sil I 2msbk I mfr I cw I 2f I 5 6 2 11 -37 10yr4 /4 - sil 2msbk mfr cw if 5 ! .6 Ground 3 elev 1 37 -39 10yr8/3 i - i BEDRX I - I - - - - - 101.18 ft � Depth to 07• limiting factor 37 I I I I I I J Remarks: CST Name (Please Print) S' Telephone No. Thomas C. Nelson 715 - 246 -2454 Address Environmental BY Design Date CST Number Ref # 1432 120th Street, New Richmond, W1 54017 12/29198 227387 82 I I PROPERTY OWNER: Continental Devel opment . SOIL DESCRIPTION REPORT ® Page 2 of 3 PARCEL I.D.# Environmental By Desi Horizon Depth Dominant Color Mottles Texture Structure lConsistencel Boundary ! Roots l GPD/fF� in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ! Trench 3 1 0 -12 10yr3 /3 - sil 2msbk mfr cw 2f 5 6 2 l 12 -31 10yr4 /4 l - l sil 2msbk mfr ew if .5 i .6 Ground elev 3 31 -35 10yr8/3 - 13EDRX - - - - - 106.95 ft Depth t0� I I I I I I I limiting { { { ` factor 31 I I I I I I I Remarks: I I I I i I I I I I I I I I I t t Ground elev I I I I I I I I I I I I I Depth to l l l limiting factor I I I I I I I I I Remarks: Ground I I I elev I I I I 1 I I I I Depth to limiting factor i I I I I I I Remarks: I I i I I I I I I I I I I I I I I Ground elev I I I I I I I Depth to limiting factor I I I I I I I i I I I I I Remarks: HP 120' MR NEW 00KOND. Wil(MIN V1S1 Wo 6y 70A-os NO SON TROY VILLAGE - Lot ##I NW -4' SE ;4, S>x TION 24 r 28 N. v 20 w Tro% "➢(IN 'trnship, St. Croix Counts Wist -Ensin Page 3 u 1 48mi J SCALE 1" =40 Tom Nelson BM 1. NE LOT CORNIER "1'OI' M IRON PIPE ELEV. 100' 227387 BM 2. SE LOT CORNER TOP OF IRON PIPE ELEV. 08M S. r .930 40 _ \ N,!. N - 2 \ - B -243 9940 \ \ ' \ �•�. ' B- ' CL \ \ '\ < . 1 , 97 x `� • ...•• t 1 \\ \ \ \ .. �� \ { • \ 912.5 � \ o i I / 1 J 94 �/� \ �j� \ `B - �.5 �]\ `� \ :� •�•. `, ` \ 0 .• ru B -262 t \� L�J \ . ;.5 -89 \ r t. \ ' 5-87 II CJ B — �3� . , \ B I OOP I 1 B -2121 � / ' I B -261 - . \ / '• / 1 I d -• ❑ I B -84 I t 942.8 / /'. �i / / / // // /� • \ I/ , /,. / / ♦ _ / , I I I ry / /' // �'B- 260y /i // y / 1 / 1 1 /� // I I I I �; / B -2 1, /•� / / IB -2114 8� -259 / . •�. - ' + I _ l �, J J 10 1 B / / ! / `•• / / I I • J ., y � � t 8 +2 7/ l / t f / .' �11 I t B -215 ♦;; / 8 I B�-A40 I j - r 0 ! , , , -' / ♦!•, ! B 238 r / -254. l ' ! �� I / /' / `.�!• , / / / B-239 1 i \ o B -253 B-256 �. , // / / / I / �.�,•'••� � / ,' I Q , 0 . B- 87 V / B -235 B -252: • i' l / ► J I / / / t -"B -237 / x-73 /' / : • rn ,/ ,� \ / B-236,,- 5. '� �. � • ' .4.' r 1 / J 1 ► � : / � � � / „_,,tom ,o . \ / _ - - � /' / • /' /' I ( l l 11 l l 8 � B -72 / /� / / / , / / //: / /' x a -2�1 � .. , , ,! I �• ♦ / / / �•,. / . / B -230 _ lo-I i FROM TOMOandOSTACEYONELSON PHONE NO. : 00000000000000000 MAR. 01 1999 12:17PM P4 INV 1 IN" ST IR NEW PKIAOND, WOO 051 W0 6Y V"$ NEW 717 216 ?fit TROY BURNS VILLAGE - Lot ' NW': SE V,, SECTION 24 T 28 N, R 20 W Tray Township, St Croix County, Wisconsin Page 3 c 61 5 b S� SCALE V —40 Tom Nelson BM 1. NE LOT CORNER TOP OF IRON PIPE ELEV. loot 227387 BM 2. SE LOT CORNER 'POP OF IRON FIFE ELEV. OSM, ej s. 21 � APPLICATION FOR REVIEW POW-rS - Complete all pages- Safety & Buildings Division ( ) Check if Conknnation is Desired (} faxed, () nailed Bureau of Integrated Services Several counties have been delegated certain authority to review plans in lieu of Commerce For a current list of those courrhes and their delegation check our webaite at hft:/ www.commercastata.wi lua/S81SB- PowtsProgram.html NOTE: Personal Information you provide may be used for secondary Confirmation of assignment to a reviewer. pugxm s[ Pri 1. Private Se wage Submittal 2. Type of Submittal: System Type ( X) New Previous Related Trans. ID: ( ) Soil Saturation ( ) Revision Estimated Completion date: Ddennination Report ( ) Interpretive ( ) Replaomnent Assigned Revi Detemrnation ( ) Additi (X( POWTS �� ( ) Petition (attach form SBD A fie: ( ) Holding Tank ( ) ExpwimorC approvarlt Clrcie your choice of off es below: ( ) Nonpresscoized In ( } Com;w0t t+ftanuat (Include each Ground component manual name, # and 1. Next available appointmertt in any voice, Z Green Bay, 3. Hayward, ( ) PressurizW Irr date on title page of plan) 4 LaCrosse, ii. Madison, S. Shawano, 7. Waukesha Ground ( ) tromuat S'ste Design ( X) Mound ( } Aerobic Trestment Unit 3. Project Information - F ill in all known information. ( } Sand Filter ProjecMite Name STEVE BARNABO —$WxJle Location, Number a Street of projsct fd unknown, indicated nearest road) LINDSAY ROAD` _recirculating { ) Constructed Wet)and Legal description: NW1 /4 SE1 /4 S24 T28N R20W { } Drip Line co ST. CROIX cay v*1age _ _CX Town of TROY ( ) Other: Bo#d Type (aleck ale): 4. Aft" plans are reviewed, please: (check all that apply) ( ^) Dwelling, t or 2 tarruly X Call customer (circle nurnberr 'Refers to customer number from below ( ) PublidCommercial ReCuestim party will Dick up Bui ng State-owned Building plans to customer 1, 2, 3.4 (circle number)* ( ) — Gallnns per n2y 600 �__T.__ _� __ __ S. Cornplate Om foibwing designwlownerlraquesfing intormstion. UNize #w check boxes when designer owner or requesting party is the same to avoid rep!Aing information. Designer Information (Customer 1) Mail To Party if Werent than dea;4w (Customer 3 First Name a aSt Name Uistomer Number First Name Last Name Customer Number TODD FEATHERSTONE 242514 Company Name Company Name FEATHERSTONE EXCAVATING, INC. Address Address P.O. BOX 467 cit State Zip+4 (9digi ts) City State Zip+4 (9digits) HUDSON WI 54016 Phone Number (area code) Fax or Internet CON phone Phone Number (area code) Fax at Intemm 715- 381 -1704 Check others it applicable Check others if applicable ( J owner owner Owner Information (Customer 2) Other Pleases (Custorrw 4) First Name Last Name Customer Number First Name Last Name Customer Number STEVE BARNABO Company Narne Compwry Nam Address A ddress 6331 PAINTED TURTLE ROAD City State 7-ip+4 (9ftft) City State Zip+4 (9dK*) LINO LAKES, MN 55014 Phone Number (area code) Fax or Internet Phone Number (area code) Fax or Irdemet 651 -483 -1309 Check others d applicable (Mali To) Check others if applicable { ) other ( } Other MAKE CHECKS PAYABLE TO DEPT OF COMMERCE TOTAL AMOUNT Out $ 175.00 Attach check hue Review Code 703 r S. Plan Review Fees for Private Onsite Wastewater Treatment Systems a Type of ♦project ( CIRCLE THE APPROPRIATE PEE BELOW) FEE f, AD treatment components are previously approved under s. Comm 84.10 (2) or (3): Design wr3tCMdler nuw ur the proptbed system. 1,000 gpd or iess • .. . .. .. ..... ............................. .. _............ ............ $175.00 1,001 — 2,000gpd ...... .... .... .. -- - -. - -- .........$ 2,001 — 5000 gpd ....................... .... ...... .. ............................... . $275.00 greater than 5,000 gpd ...... ......... ............................... ..-3300,00 plus $0.05 for each gallon over 5000 gpd 2. One or more treatmenl components are not previouety approved under a. Comm 84.10 (2) or (3): (Individual Wte docignVdeviation from component manuals and use of components without product approva0: Design wastewater now of the proposed system: 1,000 gpd or less ........ ............................... .................. ............................... 5300.00 1,001 — 2,000 gpd ............... ................................... ............................... $400.00 2,001 — 5,(M opd SSW an greater than 5.000 gpd ............................ ............................... ........................$600.00 plus $0 -05 for each gallon over 50M gpd HOLDING TANKS tN11LY 3. 1-10k1ing tanks previously approved under s. Comm 84.10 (2) (3 Design wastewater flow of the proposed system: 5,000 go or less ........................................... ............................... ...............$50.00 5,001 — 10,000gpd ... ... ... ... ...... ....... ..... ............ .................. ..................... .....$vcim greater than 10,000 gpd..._ ....... ......... ........ ......................... _$150.00 4. Holding tarots NOT prewmi;Ay epprvvW un(ha b. Collar 84.10 (2) or (3) at KJ sle w rob utAoU tdilks Design wastewater ftow of the proposed system: 5,000 gpd or less ........ .......... ............................... ............ $120.00 5,001 — 10,000 gpd ................................ ............................... .:......................5200.00 greater than 10,000 gpd ..................... ........ -- ................ -- --- •-- ..................... --$.300.00 Experimental System (addluonal one time feey . ............................... ................. ................. 5300.00 Reftom to Approved ................... ............................... $60.00 Petition for Variance (tnctude form SOD- 9890) ... ... ......................... .... ............. . _........-- ..$225.00 Re6ision to a preuiousiq approved Petition for Variance....._ ............... ............................... $75 00 i Soil Saturation Determinatim Report — Per SO (other than a proposed subdivision) ............. .....$100.00 Interpretive Determination Report. .. .. . ............ .... ............................... ............... - 5100.00 175.00 Subtotal ......... ............ ... .......... Priority Review I=nter same amount as subtotal ... ............................... Prior approval from a section chief is required for a priority review. If approval is granted, the priority will be revievYed wittrin 5 days Of receipt. Enter TOTAL (rounded to the nearest dollar) here $ 175.00 , and on bottom of FRONT PAGE (Vote: 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 information. 7. Apgoinhrrent, Sche"rig i4owrrstion, and Plan Submittal Checklists. POWTS scheduling is not available, Plano will be assigned to B reviewer i after receipt of plans. If you wish to receive confirmation of the assigned reviewer and estimated completion date please check the box in the upper right corner of the front page. Also note in the same location that you can desig - ore a specific office for meview. If you select a speaft office your estimated completion date may be considerably greater than what would be possible in another office. Subtr*Ws nweived Withal a specific office indicated on the form may be assigned to offices other than the receiving office depending on reviewer availability. To obtain a submittal checker cal the rnaterlal order unit at BOB -26&3 81 a or one of the Rm service offices listed below. You may enud technical code questions to Powistedi0conwrierce.state.wims Madison S88D Hayward S&BD LaCrosse S58D- Shawano S&M Green Bay S&RD WaulteSlra SLM 201 W Washington Ave 10541 N Ranch Rd 4003 N Knney 1340 E Green Bay 2331 San Luis Place 401 POO Court 53703 1 Hayward Wi 54843 Coulee Rd Shawano WI 5411 Green Bay, Wi 54304 Waukesha WI 53188 PO Box 7162 715'634 -4870 LaCrosse W154WI- 715 - 5243626 920492-5601 262 -548 -8600 Madison Wi 53707 -7162 Fax' 715- 634 -5150 1831 Fax 715-524 -3633 FAX' 920492-5604 Fair 262-548-8614 608 - 266-3151 Email. 508-785.9334 Email: Email. PtanSchedule@ Email_ Par Schedule@ Faye: 608 -267 -9568 PlanSchaduta@ Fax:OW785 -0330 PlanSeheduleCb commeree.state."me commeree.state.wime TDD 608-2644YM commerce.state.wi.us Email: commerce.state.wims Email: PtanSchedule@ PtanSched" commerce. state -wins cummerce.state.wi.us ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer gR BARNABO i Mailing Address 6331 PAINTED TURTLE ROAD LINO LAKES, MN_55014 Property Address' "' (Verification required from Planning Department for new construct6a City/State Parcel Identification Number ^� L O LEGAL DESCRIPTION Prop Location Nw uls, SE d l., Sec. 24 . T 28 N -R 20 W, Town of T ROY Subdivision TROYQ� VILLAGE JA Lot # 10.66,. . Cerffied Survey Map # . Volume . Page # Warranty Deed # , Volume � 3 a . Page # 0 3 v 711 � '3 Spec house 0 yes 0 no Lot lines identifiable ® yes Cl no . kpW= use acrd maanDeaaneeof your septic system could result is its firrYure tohand1cwasteshopct aondsts of paining out Hie septic teak every three years or sooner. if goaded by a licensed pumper. What you put iwo the system can affect $ie 5m ;dm of *aseptic tank as a treatment stage in the: waste disposal system. MW propaty owner agrees to submit to St. C rok Zoning DeputdI at s certification foam, signed by the owes and 'by a pI�Y�Preseictodpluml�ecocali�vensedpumpervaflriagtimt (1)fiie�itewastewatertrystem is is props operating condition. and/or (2) after inspocxion and pumping necessary), ttia septic - tuk is less ttuan 1/3 foll of sludge. Ywa, the wed bave read Hie above requirements and agree to maintain Hu private sewage disposal system with' die standards sct forth, herein. as let by the Department of Commerce ce and ttye Dcpartmant of Natural Ro omms, State of Wisconsin. Cati ocahon stating Huai your septic system has been. maintained mast be completed and Manned to die St. Croix County Zoning Office wHbin 30 days of the throe year expiration date. L• MOU URWOF AWU *A OWNER CERTxFICATTON I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the ptnpetiy above, by of a wamaty deed recardod in Register of Deeds Office. SWM F APPLI ATE •*«• «s Am information that is mi&4Vresentedmay result in the sanitary permit being revoked by the Zoning Depav"Mt- «« Include with this application: a stamped warranty deed &tom the Register of Deeds office a copy of the certified survey sup if reference is made in the warranty deed POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner STEVE BARNABO Septic Tank Capacity 1250 a l ❑ NA Permit # _ 30 2Z h Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturar ❑ NA Number of Bedrooms 4 ❑ NA Effluent Filter Model 1 00 ❑ NA Number of Public Facility Units NA Pump Tank Capacity a l ❑ NA Estimated flow (average) 60Q g al/day Pump Tank Manufacturer ❑ NA WIESER Design flow (peak), (Estimated x 1.5) gal /da Pump Manufacturer ZOELLER ❑ NA 1-5 Soil Application Rate . 5 al /da /ft2 Pump Model ❑ NA Stan4WA Influent /Effluent Quality Monthly average* Pretreatment Unit 11: t4 A Fats, Oil & Grease IFOG) S30 mg /L (A Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids ITSS) 5150 mg /L ❑ Disinfection ❑ Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD _ <30 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade )] Mound Fecal Coliform (geometric mean) 510' cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other. W44 Other: JVNA Other: $A "Values typical for domestic wastewater and septic tank effluent. Other: A�rNA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3yearsl ❑ NA ,� 4 yearisl 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 Clean effluent filter At least once every: ❑ month(s) ❑ NA 5Pyear(s) Inspect pump, pump controls & alarm At least once every: p Years) s) 13 NA ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) Other: ❑ month(s) KNA At least once every: ❑ year(s) Other: c 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 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) t� Page _J, of START UP AND OPERATION < For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations 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 cell(s) 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 chnology a holding tank may be installed as a last resort to replace the failed POWTS. s' a not been eval ed to i ntify a suitbl ement area. Upon re the 1 a soi and site Xpert - a al on m t be ed to locate b replacement rea. IFn or acement area is available a holding tank may a installe ast 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 FEATHER Phone - 7l �©• (� Phone 715 381 - 1704 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PINKY'S Name ST. CROIX CO UNTY Phone 651- 436 -5788 Phone 715 -3 This document was drafted in compliance with chapter Comm 83.220(b)(1)(d) &(f) and 83.54(7), (2) & (3). Wisconsin Administrative Code. I t 2 3 0 Y 9 P O 3 O 729598 KATHLEEN H. W ALSH REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM 2 - 1998 ST. CROIK Co. MI WARRANTY DEED RECEIVED FOR RECORD 07/10/2003 09:30AN - WARRANTY DEED This Deed, made between EXE1'PT i T roy Development Corporation, a Minnesota corporation REC FEE: 11.00 Grantor, TRANS FEE: 419.70 and Larry D E: and Coral L Barnabo COPY CC ES: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real #state In St. Croix County, State of Wisconsin: 1 I Recd"inq Area Lot 106 of the Plat of Troy Village 3rd I ° "_= "'—= 11 Addition in the Town of Troy, St. Croix County, Nems and Return Address Wisconsin. Larry & Coral 6 0 Subject to Declarations of Covenants, Conditions and 6331 Pain Turtle Road '.'. Restrictions for Troy Village, recorded in Vol. 1241, Lino dkes, MN 55014 Page 256, as Dix:. No. 559964, and the Declaration of Golf Course, Covenants, Conditions and Easements, = l l i recorded in Vol. 1241, Page 301, as Doc. No. 559969, 040-1257 -30 - 000 all as appearing in the office of the Register of Deeds for St. Croix County, Wisconsin, and such other Parcel Id"ficslbn Numbs, (PIN) easements, restrictions and reservations of record, This is not homestead property. or in use, and the "Buyer" obligations contained in (is) (is not) il l the Purchase Agreement for this lot. i ! LAND TITLE, INC. SUITE 200 I IL'C0 SILVER LAKE ROAD NEW BR;GHTO,y, FILE NO. <! y I ri I) Exceptions to warranties: 1• Dazed this 15th day o f May 2003 r Develo y plflent Corporation E J (SEAL) (SEAL) • Charles S. Cook, President Troy Development Corporation li (SEAL) (SEAL) II i AUTHENTICATION ACKNOWLEDGMENT Signature(:) Minnesota ; State of W+acorrs+n, ss. Anoka County. I authenticated this day of Finso nelly came before me this 15th _ named Charles S. Cook, President Troy Development Corporation 1 TITLE: MEMBER STATE BAR OF WISCONSIN to 1{ (If rot me known to be the person _ who executed ilia foregoing ' authorized by 5706.06. Wis. Scats.) Instrument and ackrowi e t e �f is THIS INSTRUMENT WAS DRAFTED BY TROY DEVEQPMENT CORPORATION R i ck A. Johnson ' Notary Public, Sraw k -, @4*Anoka County, Minn. 1 Charles S. Cook, President My commission Is permanent. (If not. state expiration date: ; (Signatures may be authenticated or acknowledged. Both are not January 31 2006 n#cnsary I• 1 ' N.e,. « pwwn.ynNy N uy.sp•tay n.n, b ryp,d a gNt.e t,.a. Ihrir .yew,,,w. ,I WARRANTY ORBD STATE A No WISCO ws. ' RICK A JOHNSON tauaraw�C•aeNxEaow MY COMMISSION EXPIRES JM LWW 91, 2WO • 1 I I 1 1 EA — WEST 1 S ECTIO N LINE I � 'LATTED LAND 1 r ) 07 E 8.58' 98.45' 259.05' s, 38 104 ° � °o., / / / C��% -�• N M oi ti 1.055 ACRES W ^ Rio 45,975 S F' 0 ° Z � 103 1.649 ACRES 71,828 S.F. / / / (01 �O r/ s 2° O, cs °o -- s� 1.201 ACRES 52,328 S.F. 102 1.340 ACRES 58,390 S.F. 106 r r ' 1.243 ACRES 10 0 j r l r o' 00'- w / / / /�h ti 54,12 Se � 2 p 61 72.14, 1.000 43,5E h 107 Q o, 9° 101 1.300 ACRES 103 ACRES / h ,�° h 56,649 S.F. ,627 S.F. 100, � / �� N` NW 3ppS30p w ���� 1 13 • o 1.026 ACRES 0 44i 44,674 S.F. 25 0.11' • O � o, Q � W 317. 1� / 2 N / 1 N / V/ / 2 1.385 ACRES 23 ° oo• j 60.3 10 S.F. 92�, oa w / j : , N ° po• „ ti 1.059 ACRFS 0