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HomeMy WebLinkAbout040-1257-40-000 Z k � \ 0 e CO k� g kg> /k)2 /)k� A k> k'c 2q =�2m &7 �§� 2c §\�.o b teEE, —� m mom 2 �k)2(f) 2 §f23�$ � .�$ cc = 2 � =§�,E moot G kt }2 «�] k�E /, —M § % ■%yA� § §� S \$ �k E - -06 f%�t9fa\ 22+)7dkj z E - X G a 0 . E c 4) 4) §� k / 0e , 9525§ ® §,iz _aoc0 $2c 0 §k)§k2■ /GI\m : -k . <�s =_o2cEW-= = ■_Em2a « � W 1 Z § z .. $ 0 z _ k z k 7 / 2 � � 2 � � I � § k \ i 7 § E \ 2 ) ) S �- if} } k z � . § � ■ � � ' J j U 0 ƒ "C3 - E I 2 a a $ z J z J I * 8 E k/ c c k k o % o ¥ o § k @ ) CM q o o $$ d . - \ \ / i z 0- a. ■ � J 0 a , Wisconsin Department sf Commerce Count Safetyand BuildinlDi 'sion PRIVATE SEWAGE SYSTEM St. Croix INSPECTION REPORT Sanitary Permit No: 4304 0 K4 V105 GENERAL INFORMATION (ATTACH TO PERMIT) State Pan ID No: Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: American Classic Homes I Troy Township 040 - 1257 -40 -000 CST BM Elev: Insp. BM Elev: D scription: Section/Town/Range /Map No: / b 1 /0 b --- BM 7-- �� `SE 24.28.20.1367 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark tab 0 1 '/ -5 / / 3 . loo . c� Dosing /I /2 U� Alt. BM 5 Aeration I/tJ Bldg. ewer Holding St/Ht Inlet fR Ih TANK SETBACK INFORMATION St/H tOutlet y( 5 L 37 9, 7 TANK TO P L WELL BLDG. Vent to 11 Int ke ROAD Dt Inlet S 34 ' a. A D 7 to Septic / A) ' Dt Bottom - &d Do „' Z / Header /Man. h q G Aeration Dist. Pipe /s q' 9 � Holding Bot. Syste it o,�,•I.c D . � SOP• � Final Grade / PUMP /SIPHON INFORMATION (13 Manufacturer Demand St Cpve GPM Model Number 5� 0 ItJ lt D o7 l TDH Lift Friction Loss Syste H Ft ^ �• q 2 Z Forcemaih Len�th� / Dia. , ist. tp Yv�J1 I �j SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of � rgnches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Z r ,/ SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM EACH G Manufacturer: INFORMATION T ��D��ee� QQQQf System: Model Number. C IT OR / / ( / �' C-,< DISTRIBUTION SYSTEM 221°kU �„ scy ? 1. � Header / r Distributio ��2 / ole ize,�/ h I x Hole Spacing ntt Air I� Lengt •� Dia �' Length �� Dia /� 5 Spacing I� �j t' 9 l d / 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 1 ' Bed/Trench Edges Topsoil l Yes 0 No Yes � No COMMENTS: (Includ code discrepencies, persons present, etc.) Inspection #1: 1 7, , l /03 Inspection #2:/ / b 3 Location: 263 St. Annes Par wa Hudson WI NW 1/4 SE 1/4 24 T28N R20W Troy Villa9 dditi Lot 107 Parcel No: 24.28.2 Y 54016 ( ) Y 1.) Alt BM Description =� Ci�w d �. 2; 2.) Bldg sewer length = 7� / � - amount of cover = 6 3(0 sion Required? [] Yes No :ide for additional information. ;.3/97) Date Insepctor's gnat-re Satdy and Buildings Division county 201 W. Washington Avd., P.U. Box 7082 ST. CROIX I� �O i�� Madistrn, W i 53707 - 7082 Satuilary PermA Number (to be fi in by Co.) i�epartment of Commerce (008) 261-6546 �f 30 Ta S Sanitary Permit Application State Plan I. In accord with Comm 83.21. Wis. Arlon. Code, personal information you provide / 7 may be used lot soxindary pu►ix Pnvacy Law, sl').04(t)(m) Fwject Address (it different than trailing address) ! _ _ -265 ST. ANNES PARKWAY L Application Information — Please Print All I si iiirm C E I V E D C:' 0 3 Property Ovater's Nance I'arc ci # Lot 107 Block # AMERICAN CLASSIC HOMES INC. DEC U 4 2 003 040 - 1257 - 40 - 000 1 ty Ownct s Mailing Addrm Property Locadson `- ST.CROIX000NTY / /3(07 P.O. BOX 4143 - ZONING OFFICE NW SE 24 City, Sims: 7.ip Code 7651 - 351 - 0995 rarrle me) NumDa HASTING MN 55033 T 28 N; R 201fV iv IL Type of Building (chick all that apply) I or 2 Family Dweilin g Number or �6B ROMPER SUBMITTED HOUSE PL Subdivision Name C5i4i Number .� �� - L! t'ulriie%C;arraiarc:iat __ 1)cactibi: t;� TROY BORNE VILLAGE _ U State O...d -- Describe 1 fse D 1ST. C- - - (p • d ` 12 ' (M. �'� ?71 LW 107 Z6 ❑eity_Uvittagc [ rowttship of TROY ........... 111. Type of Permit: (Check only one box on line A. Complete line B if Applicable) A. P New System t J RgAacanetit Systern U Treatmetdflioiding Tank Replacement Only I] Other modification to Existing Sysleari 8 • n Permit Renewal Permit ttevisitaa - — ❑ cJtange of U Permit Trarafer to New List. Previous Permit Number and Date issued Wftxc F,xpiration — Ylunow Owner IV. Type of POWTS S tem: Check all that a i U Non - Preswrizetl in- (tround U Mound _ 24 iot. of suitable soil Pq Xlound { 24 in. of suitable soil U :fit -Grade H Single Pass Sand Filtcv ! Ccxcctructed Wetlatrd U Prom rizcd in- Ground 1I tlolding , r" rat Hirer l Acrobic Trea icat 1.1int U Recirculating Sand Filter U Rcrirrsii atinS SynUhLtie Media Filler n 1 ewhing Chamber Fl ]hip line U [navel -less Pips: ❑ [titter (explain) V. Dispe rsalffres t ment. Am Information: LEVEL ALARM -LVL1 AND ZOELLER #152 PUMP Gl/h Design Flow (pd) Msign Soil lication hate( Dispersal Area Required (if) l�ispe ' Area (st) System Elevation ,t 900 1 4 / • ° ,0 Y 2250 x 02 11 0. 53 Oo, 2 109.1 k1la, VI. Tank Info in "rout Number - Ititam actemer 1 Prefab Site Steel Fiber Plastic Gallons Gallorm oftinits ��. Concrete Constructed Glass t3ew Existing Tu:tcs Tsnks Septic Ott °'' " — X 1665MR 1 WIESER ma ' _ X /aerobic Tresunent t Jnit ---- - - - -- TlmiT hAntLr X 1200 1 WIESER X VII. Responsibility Statement- 1, the rmtle assume — r--cib icy for wA-HMk- of dw POWTS sbuwn tas the attached plat. Plumber's Name (Print) MP /MPRS Number pine Number �� ��� 242514 TODD FEATHERSTONE 715 - 381 -1704 Number's Addmns (Stroo, City, Matc, ip (. •) P.O. B OX 467 HUDSON, WI 54 016 V C(ME /De artmrent Use Only -- -- ApprovW L] Disapproved Mary Permit Fee (includes Grcnrrtdtvaler Bate swing Age Si rc nps} Surcharge Fee) � /,9 -, N �� ❑ Owner Given Reason for Denial 1X. Conditions of App Reasons for Disapproval 1 Septic tank, effluent filter and a ry m 3. 57 -. MI . ,k la , dispersal cell must all be serviced i maintained " r managemen an rovided b lumber � 2. A ac requirements must be maintaine .� d6o D�'' ' �� "� as per applicable code /ordinances. '3 lutseh ctt.mid. a. Cauatr unity) feu t ."A. n 4 tlaaa z tl i i s is Aw _ �� v3 0 101E t CN c LENG�N QO`°J n A1 - 00,00, I X 10' 3r4 • y � �l� .e � , 6 TOP 9F . $� 94p 2 2oA0 ''�''� TOP OF SPIN J NG S etiyXnOt4 .. 96.82 KUNF X 983 X q 98 g tiro �° a H 0 \0 LU 8X I l N ° T OP of SPIKE V �(.1 g M cq : ►� c k p.n� � 10 c y a tuX X 98 9 1 A�: co o . z _ 25' BULDING SETBACK LINE � ............................. 30 0 i N70 300.53 O Bider - - - -- — ---- - - - - -- - - - - - - - 1 ` O Lot 1 c - -- - -- 265 p Troy 't\ Job 4 Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 N www.commerce.state.wi.us /sb www.wisconsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary November 14, 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 f CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/14/2005 Identifica tiers Transaction ID V�4240 SITE• Site ID No. 6637 Troy Burne Village - Lot 107 Please refer to both identification numbers, 263 St Annes Pkwy above, in all correspondence with the agency. Town of Troy St Croix County NW1 /4, SETA, S24, T28N, R20W Lot: 107, Subdivision: Troy Burne Village 'W ° FOR: Description: R evision Mound System / 90 Q.,a �')? Object Type: POWT System Regulated Object ID No.: 916760 '.. (4 ti The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes C) a pP D i_ p � i.� 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. .. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to - GO c -S inspection by authorized representatives of the Department, which may include local inspectors A l l permits required by the state or the local municipality shall be obtained prior to commencement of cons ction/inst nttian /_ n_nPr`tl 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 ins a s r maintenance o t e POWTS. Sincerely, Fee Required $ 60.00 Fee Received $ 60.00 Balance Due $ 0.00 Robert Kanter POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (608)261-7735, Monday -friday 8:OOAM - 4:45PM rkanter @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: AMERICAN CLASSIC HOMES Owner's Name: AMERICAN CLASSIC HOMES Owner's Address: P.O. BOX 4143 HASTINGS, MN 55033 Legal Description: NW1 /4 SE1 /4 S24 T28N R20W Township: TROY County: ST. CROIX Subdivision Name: TROY BURNE VILLAGE r Lot Number: 107 Block Number: Parcel I.D. Number: 040- 1257 -40 -000 -E Plan Transaction No.: 899027 = TRANS. 10# a'su' tau acs 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 9v0_ Soil Test Page 1 Plot Plan Page OWTS Application Page A,K POWTS Mgmnt Plan Designer: TODD FEATHERSTON License Number: 242514 Date: 11/04/03 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) Pagel of 12 i 1 J�ORO G j�A 1p159 CEO L�NG�K � QOLJ A/+ ' n TG a . 0 °0 ,rsa 0, W ,eF .e 1� TOP OF 4 gg.t8 5 t 0 b / N► X981 X 9Qa ly 2o`.oa 25'g ��� o i x �� x 1Q20 TOP OF SPIKE' e vxn N 9 83 .2 C OD 1 N X g6 g 3b , i viod zi ' 6 - N 'Q ' j 2SX 20.00' X ASR/ - . r �$ Lu LU N ��A �SPI 3 \ a y �► 25' BUILDING SETBACK LINE i 30 X � N70 0 00'00 °W 300.53' � � , 7 Bidermae Lot 107 T � 265 St. Al p Troy Tow �O o - ti Job #204 ,v a -- aF it � SP p '� • B. lab cx� �T Sc.ag qy, 3,3 i, Norbert & Pamela roy Village Ines Parkway iship, Wi �I f 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 600.00 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. 900.00 Design Flow (gpd) 10.50 Site Slope ( %) 107.26 Contour Line Elevation (ft) 15.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 129.001 Dispersal Cell Length Along Contour (ft) = 6.98 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 3.49 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) = 10.71 ft /orifice 2.00 Forcemain Diameter (in) 50.00 Forcemain Length (ft) Does the forcemain drain back? Y 106.85 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal) 1.66 Vertical Lift (ft) 81.25 5x Void Volume (gal) 2.07 Friction Loss (ft) 89.40 Minimum Dose Volume (gal) 8.28 Total Dynamic Head (ft) 45.23 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 - 1.0 - 0 1. I x 1.25 x x 2.0 x x 1.50 F0 0 2.00 3.00 x Gallons /inch Calculator (optional) T t Tank Information Total Tank apace gal) 'mil � , Septic Tank Capacity (gal) -� f- -- Total Working Liquid Depth (in) ff III S Y QQQ ER Manufacturer gal /ln enter result In cell B49) V P. Dose Tank Information Effluent Filter Information 1200.001 Dose Tank Capacity (gal) JZabel Filter Manufacturer 31.161 Dose Tank Volume (gal /in) JA100 Filter Model Number WIESER Manufacturer Project: AMERICAN CLASSIC HOMES Page 2 of 12 i� , Mound Plan View t ::1/10 B J Observation Pipe 0 : K. l ;:5:s T A W — B 3 : - • .. . L Mound Component Dimensions A 6.98 ft E 29.79 in H 1.00 ft K Eaft ft B 129.00 ft F 9.25 in z 16.44 ft L ft ,/D Ain in G 0.50 ft J 6.89 ft W 900.00 (ft Dispersal Cell Area 3020.53 (ft Basal Area Available 6.98 (gpd /ft) Linear Loading Rate 12.90 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 110.78 (ft) - --► 4 1 s ate; G I H F Disp 109.51 (ft) Lateral ,,,,. . I _ Dispersal Cell 10 ft —► Invert () Dispersal Cell :.::::❑ :::::::::::::::. D 3 Elevation :::: ::❑ ::::::::::::::::::::::::::.. 107.26 (ft Contour Elevation 10.5 % Site Slope Geotextile Fabric Cover Shading Key V a T Dispersal Cell See lateral details on 1 Topsoil Ca .a 5 ft 1. ;: ::::::.:::::::.::<:;:::::::.::.: :::.:;.:::;::::;.::.::,;:,:.:.; Page 4 for number, size, ❑� P P o Q ; Subsoil Cap 5 '`" Z o and spacing of laterals. ❑ .....::: :::::::;,.';;:`:;;`=:._:.::;;:: ` '::: ''''' Laterals are equally ASTM C33 Sand ::::: 4 Y : F g 0 Tilled Layer 0.5 ft :. Typical Lateral spaced from the - .c < }; distribution cell's 5 : ` :;': Aggregate .r 0 ❑❑ centerline in the A distribution cell (AxB). Project: AMERICAN CLASSIC HOMES Page 3 of 12 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical ri i P s •= Turn -up vdball valve or IE X�I <Lx12 I s12 +I Laterals & force main of PVC Sch 40 clean out plug per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals Ale, Orifice Diameter 0.156 in Lateral Diameter 1.25 Orifice Spacing (X) 3.11 ft Lateral Length (P) ft Orifices per Lateral 21 Lateral Spacing (S) 3.49 ft Orifice Density 10.71 ft /orifice Lateral Flow Rate 11.31 gpm Manifold Length 3.49 ft System Flow Rate 45.23 gpm Manifold Diameter 2.00 in ,/ Total Dynamic Head 8.28 ft Forcemain Velocity 4.62 ft/sec Dose Tank Information Locking cover with waming label and locking device and sealed watertight Electrical as per NEC 300 and --► - Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented E— Alternate outlet location Forcemain diameter WIESER Manufacturer 2 in. Cap acityl 1200.00 Gallons Volume 31.16 gal /inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 21.64 674.36 B 2.00 62.32 C P � ump off elevation (ft) C 2.87 89.40 t 1 107.85 D 12.00 373.92 D Total 38.51 1200.00 Dose tank elevation (ft) 3" Bedding under tank. 106.85 Alarm Manuafacturer LEVEL Alarm Model Number LVL1 Pump Manufacturer IZOELLER Pump Model Number 1152 Pump Must Deliver 1 45.23 gpm at 8.28 ft TDH Project: AMERICAN CLASSIC HOMES Page 4 of 12 r Mound System Maintenance and Operation Specifications Service Provider's Name FEATHERSTONE EXC. INC. Phone 715- 381 -1704 POWTS Regulator's Name ST. CROIX CO. Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 900 gpd Maxi Influent Particle Size 1/8 in Estimated Flow - Average 60 Maximum BOD5 220 mg /L Septic Tank Capaci 665MR gat Maximum TSS 150 mg /L Soil Absorption Component Size Maximum FOG 30 mg /L Type of Wastewaterl Domestic %( ` imum Fecal Coliform >10E4 cfu /100 mL Servic�Freauencv "?Y S tic and Pump Tank Ins e and /or service on every 3 years Effluent Filter Should inspect and clean at leas rs 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 -u p 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: AMERICAN CLASSIC HOMES Page 5 of 12 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Genera 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 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 fttei 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 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 fitter 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 mulct as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BQ,p150 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 10` cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specifies 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. Continraency 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: AMERICAN CLASSIC HOMES Page 6 of 12 TOTAL DYNAMIC 'ICAD /GP,PIICI[Y I I[AD CAPACITY CURVE FF k MiNUTF EFFLUENT AND DEWATER!NG MODEL 152/153 i�� MODEL Fret ' McN. Gal. Liters }' Gal Liters 153 5 1 -3 69 261 j 77 ; 291 12 44 __ _--- - - -___ 1 D 3. 61 231 1 70 265 o i 5 4.6 53 201 r 61 231 s _ 20 6.1 44 :6? ; 52 191 U 30) 2 7.6 1 34 129 1 42 159 8 _ I._ .30 9.1 j 23 i 87 33 125 � f 4 ZO - - — Z5 10.7 j� j -- 22 P5 3 „ 40 1 2.2 42 4 IN , ! :;ck ti t!,e, 38.0 44.0 GI ! 1 3 4`ni i 1 014904 20 40 60 80 100 GALLONS LITERS -- a 1/4 "1 0 80 184 244 320 3 2 U-a-+ - -7-4 SIri— i i FLOW PER MINUTE 27/32 Timed dosin nds available. ry* pa 1 21 = Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase 1 i systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls, v ii • Sealed (:N* -Box available for outdoor installa4ons. See FM1420. • Over 130aF. (54 °C.) special quotation required. _I E i i i 152- JeF7ti 7 r/R rJ iW153 MODELS Control sel ection � 4 I hs f Modal Vo-Ph U;;; i Am i %npisy -r_..- N152 1 1 115 1 1 Non ! 6Z 1 2or3 BN152 115 1 i Ado 85 h"ad 2or3 l E152 Z30 1 N� 4 1 2or3 1 3"064 BE152 230 1 i Auto 4.3 iru A l 2 a 3� t N153 _ 115 1 Non 10-5 1 2 or 3_ j i BN153 115 1 i Auto 10.5 tnckxied i 2or3 E153 230 1..,. Non 53 1 ! ?, i 3 Be153 2 31! 1 ! 5.3 x�kWed 2 or 3 1. Single piggyback variable tevel float swtt h or double piggyback vale level float switch. Reber to FM0477. v CAUTION 2. See FW712 for curwct model of Ekb -tai Altemator E - Pak "' %> " 3. Variable level control switch 10-0225 used as a cordrol activator, specify duplex (3) a n A ')SPA, or (4) Boat system. RESERVE POWEREC) [)F TG'N For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. XA& To: P.O. BOX 16347 L&Av*, 40255 -0347 D snap To n4o Ccw* u, Rood Menufechxa+'sot.. e e1 Louiswft, KY 40211 -1961 m f7 �+ /�iJa/ hftp;lAyww zoelter corm - Pl!/1aP �0 (502) 778A (W� ? 3624 �� �f) Coovriaht 2001 Zoeller Co. All riahts reserved. r POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2 FILE INFORMATION' SYSTEM SPECIFICATIONS Owt►er AMERICAN CLASSIC HOMES Septic Tank Capacity 5M al O NA Permit # Septic Tank Manufacturer WIESEg ❑ NA DESIGN PARAMETERS Effluent Filter ManufacturerZABEL ❑ NA Number of Bedrooms 6 ❑ NA Effluent Filter Model Al 00 ❑ NA Number of Public Facility Units �NA Pump Tank Capacity al ❑ NA Estimated flow (average) g al/day Pump Tank Manufacturer ❑ NA WIESER Design flow (peak), (Estimated x 1.5) 13 ra I gal/day Pump Manufacturer ZOELLER ❑ NA Soil Application Rate . 4 al /da /ftz Pump Mode! ❑ NA Stan d Influent /Effluent Quality Monthly average" Pretreatment Unit XL4A Fats, Oil & Grease (FOG) s30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Susp Solids (TS S) 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 IN Mound Fecal Coliform Igeometric mean) 510 cfu 1100ml / ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ,�A Other: ON Other: Xr NA "Values typical for domestic wastewater and septic tank effluent. Other: Air NA MAINTENANCE SCHEDULE l' Service Event 3 Service Frequency Inspect condition of tank(s) At le t once every: 3 month( (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell 11 month(s) s) At least once every: year(s) (Maximum 3 years) ❑ NA ❑ month(s) ❑ NA Clean effluent filter At least once every: 51zlyear(s) Inspect pump, pump controls & alarm At least once every: ❑ year(s) month ❑ NA Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: At least once every: O month(s) WNA ❑ yearls) Other: C"A 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. 9 ry 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. r A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page 2 of 2 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) 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 Sys 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. 0 A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS f technology a holding tank may be installed as a last resort to replace the failed POWTS. N T e has not en oval ed to id y a suitab r acement a Upon re of the a soil and site e al atio mu be erfor ed loc e a s itable placem a. If n cemen available a nk m be installed as a a resort to replace the i ed POWTS. Mound and at-grade soil abs orption 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 FEATH ST Phone �� _ — -7�(-1 Phone 715 381 - 1704 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PINKY'S Name ST. CROIX COUNTY ZONING Phone 651 -436 -5788 Phone 715 - This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.540►, (2) & (3), Wisconsin Administrative Code. 1368 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service County Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and parcel ID percent slope, scale or dimensions, D. sions, north arrow, and location and distance to nearest road. 040- 1257 -40 -000 Please pnn i ma6on. Re ' wed B Date Personal information you provide may be for A M) Law, s. 5.04 (1) (m)). 3 3 Property Owner roperty Location American Classic Homes ovt. Lot na NW 1/4 SE 1/4 S 24 T 28 N R 20 W Property Owner's Mailing Address of # Block # Subd. Name or CSM# P.O. Box 4143 ST. CR . f 107 na Troy Village City State it) -CodiQ9ih" 199rlaia> E J City J Village a Town Nearest Road Hastings I MN 1 5033 651- 248 -3871 Troy St Annes Parkway l New Construction Use: it Residential / Number of bedrooms 6 Code derived design flow rate 900 GPD Replacement _ f Public or commercial - Describe-ma Parent material Loess over Bedrock Flood plain elevation, if applicable na General comments and recommendations: Mound design, system elevation 108.95ft based on contourline elevation 107.20ft. Minimum 21_of ASTM C33 sand. , S �� So, p, Boring # J Boring V1 Pit Ground Surface elev. 108.10 ft. Depth to limiting factor 35 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *E Q Ke Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 - 10yr3/2 none sit 2msbk mfr cs 1f .5 .8 2 9 -19 10ur4/6 none sicl 2msbk mfr gw na 4 .6 3 19 -35 7.5yr4/4 none Is osg mvfr cs na .7 12 4 35 -48 10yr8/2 Limestone Residuum na na na na .0 .0 Boring # J Boring V1 Pit Ground Surface elev. 108.10 ft. Depth to limiting factor 15 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 P D /fl 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -8 10yr3/2 none sil 2msbk mfr gw 1f .5 .8 2 8 -15 10ur4/6 none sicl 2msbk mfr cs na 4 .6 3 15 -22 10yr8/2 limestone Residuum na mfi na na .0 .0 * Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number David J. Steel 1 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 11/3/2003 715 - 246 -5085 Property Owner American Classic Homes Parcel ID # 040-1257 -40 -000 Page 2 of 3 31 Boring # J Boring ✓J Pit Ground Surface elev. 103.9 ft. Depth to limiting factor 32 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -8 10yr3/2 none sil 2msbk mfr gw 1f .5 .8 2 8 -32 10ur4/6 none sicl 2msbk mfr cs na .4 .6 3 32 -36 10yr8/2 limestone Residuun na mfi na na 0 .0 ❑ Boring # J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑Boring # J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 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. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST- POWTSM New Richmond WI 54017 , American Classic Homes Lic. #248956 NW1 /4,SE1/4,S24,T28N,R20W Bus.(715) 246 -6200 Town of Troy, St. Croix Co. Fax (715) 246 -9372 Troy Village, Lot 107 Legend 1 = 40' ♦ =Benchmark Ele. 100.00Ft Top of '' /2" PVC Pipe • =Alt Benchmark Ele. 101.30ft Top of %2" PVC Pipe ❑ = Borings Boring Elevations BI = 108. l0Ft B2 = 108.10Ft B3 = 103.90ft B4 = 00.00ft i u r H� z ;Z6� slo�Q / z�S7 53 .S' , ��, � /o5•7 5,yL - 11/03/03 MON 16:15 FAX 715 386 4686 ST C CO ZONING a 001 �D LAND ♦ /� E .45 MOW 38 �` , j / / ` •r��, /i N 104 e ' ,' a ^ N 1.055 ACRES � /,�`�/ 45.975 S F '9 5 • d� i � N z 0) 103 1.649 ACRES 71 S.F. I ��� •1 a 6 > �• s •ao• �~ w � �' 105 1.201 ACRES . 52,328 S.F. � 1.340 ACRES r r ♦ ♦ ' �� y� h ry � . , `' 58.390 S.F. 10 6 t ADO. ♦ ♦ ♦ ' 1.243 ACRES / 54.128 S.F. As 114 1.000 ACRES 10 7 43,562 S.F. o ti• '`,►� � 1.300 ACRES ? 56,649 S.F. , tES o v� 113 / / g A W NW —S w ".� 1.026 ACRES $ 44,674 S.F. 108 r 1.385 ACRES / 60,310 S.F. `^ N 1.059 ACRES 1 00' / \ \f'�~ w �� 46,122 S.F. ' r i � \ * 9•�a/ � / r 109 • \ S 1.581 ACRES 168.854 S.F. I J 22281' 315 719664 KATHLEEN H. WALSH REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM 2 - 1998 ST. CROIX CO., MI WARRANTY DEED RECEIVED FOR RECORD DWAiment NWU W 05/02/2003 11: 36AM This Deed, made between WARRANTY DEED EXEMPT t T roy Develo t Co at on, a Minnes a Corporation REC FEE: 11.00 Crantor, TRANS FEE: 419.70 and eriCan ass1C ones, COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable conaideraUon. conveys and warrants to Grantee the following described real estate In St. Croix County. State of Wisconsin: Lot 107 of the Plat of Troy Village 3rd IR `"� I�. W .. si I! Addition in the Town of Troy, St. Croix County, Narm and Return Address � Wisconsin. erican Clas _ LLC 11 ( Subject to Declarations of Covenants, Conditions and P x Restrictions for Troy Villager recorded in Vol. 1241, Aas ngs, MN 55033 Page 256, as Doc. No. 559964, and the Declaration of Golf Course,Covenants, Conditions and Easements, it recorded in Vol. 1241, Page 301, as Doc. No. 559969, tl all as appearing in the office of the Register of Deeds 040 - 1257 - - 000 i! for St. Croix County, Wisconsin, and such other PamelItl""'Re""n Nun" 0 " I' easements, restrictions and reservations of record This is not homestead property or in use, and the "Buyer" obligations contained in (is) (IS not) li the Purchaae Agreement for this lot. 1 ii I f i' Exceptions to warranties: Ij Dated this 29th day of April 2003 i i; ems- selm:!5� (SEAL) (sEAt.) • Charles S. Cook, President it Troy Development Corporation (SEAL) (SEAL) ;( AUTHENTICATION ACKNOWLEDGMENT �I Signature(s) Minnesota State of W+scorratn, Anoka Count �I authenticated this day of Personally came before me this L9th day of April named Charles S. Cook, President Troy Development Corporation TITLE: MEMBER STATE BAR OF WISCONSIN to (If not, me known to be the person _�._ who executed the foregoing authorized by 5706.06. Wis. Stau.) instrument and acknowledge ame. THIS INSTRUMENT WAS DRAFTEO BY TROY DEVELOPMENT CORPORATION i t •M ick A. Johnson Notary Pubfk, Sate- aLwteeewN -Anoka County, Minn. Charles S. Cook, President My commission Is permanent. (If not, state expiration date: , 'i (Signatures may be authenticated or acknowledged. Both are rot January 31 2006 .) necessary) Neer of Peramr $WbV in an cavecb ,t.w he typed w or,txad below dwir si8,w,ne. F WARRANTY DRBD STATE BAR OF WISCON Co., We FORM Nn, t - 1998 RICK A;;;( O i "� -""«• NURRYP■w- law W � JV&WW 31, 2008 �a 1 � �� /j 1 / /i /�/ / / '/j r/ / / / / /// �� \ \ \ ♦ N., \ Nb 8-1 as/ Cl LO Up \ \ \\ ttc97 \\ \\ I \ \ .; / /� / 943.5 78 \ \ \ \ \ ;LA < / / // // / i / /// l \ ' \ \ \0. / B , B -262` \ \� `B-95 \ \ �\ \ ` O X 0 3 1 \ B -F / ' 1 I S O B • O \ \ / C ( B -2121 / % \ BL213 / Er /82 i B -261 37. to !! 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O C O ~ m y NO n (p^ n N_ N N S CD 3• (D n v ca to A N p N O ID < Oq O A o �, Safe(y and Buildings Division county ZOl W. Washington Ave., Y.O. Box 71182 ST. CROIX N) ri s a a � �S l l n Madisent, W 1 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) Department os Comrtierce (b08)2fil G54t, --� state Plan I.D. Number Sanitary Permit Ap icafti , In accord with Comm 83.21, Wis. Ad n. Code iu r ntatan you provide 9 g 0 Z.; may be ww for w(xmdary purposes Pnvacy t'ttyest Address (if different than mailing address) 263 ZSTNES PARKWAY L Applicat� Informatics - Please PrW All Informs ' 1 Lot # 107 Block # Pu>petty E}wner's N 'Q�/1� ��'S � - 1257 - 40 - 000 _Q610ING"109 T Property Owner's Mailing Address Property on PO BOX 4143 NW y,, SE 24 City, State Zap Erode Phone Nth HASTINGS MN 55033 651- 351 -0995 T 28N N. x 20%V Faw ) IL Typc of Building (check all that apply yy Subdivision Name CSM Number � :t I or 2 Fnmtily Dwell* - Nutttbtx oi' S �.. te. - -- -- ��_�� f1 ❑ PttbliefCursar�rciai - DescribeL Ott a -11>l✓ TROY BWFUVt VILLAGE /t t l4i tx,t�1 y_ � — ❑ t�errb� isc �. occu c' ❑va T or JJL Type olrPermit: (Check only care bo line A Complete line B ' pplicam -) �- (00 � D a. O �Q,z 4 New System ❑ Rel/acr ..nt S ❑ Treatnretd111oid' ank Replacerment Only ❑ Odw Modification to Existing System B • F] Fmat e Renewal C1 Feral Revision ❑ ge of ❑ Permit Traw er to New 1 i Na - to Betixc Expunhon Y! Owner IV. Type of POWYS S tern: Check all that appW i ❑Nom - 1'ressafriaed In- (3rtuurd 1f..d >24 in. oFrWtable soil ❑ M \<24 . of suitable soil ❑ AI -Grade Singre Pass Sara! Filter , c—t �cted wesland ❑ P wu ieed In•Groimd ❑ Ilolains'r [I PF1 Aerobic T-stment Unit r] Remmilatatg Sand Filter Rerirriitating Synthdic MediaFiltcr ❑ [!ae ing her Drip rine -lessPipee ❑ E) (explain) V. Dis rsaU'Pmtment Area Llfonoati ZABEL ILT R A -100 NFRP D 153 Design Flow (pd) Design Soil A pplication Rate(gpdst) r]is wml rea Purposed (art) system Elevation 750 .5 1500 100.52 VL Tank Info C. tly in Total Number Prei'ab Site Steel Fiber Plastic Gallons C:arGxa of I inits concrete Constructed Glass New Extsturg Tanks Taiks Septic or 1jehling Twk X 15 1 WIESER X Aerobic Tn-alment Unit nrm her X 1200 1 WIESER X VII, Responsibility 5tateantent- 1!, b 1!OWI S aho+ .ttac6ed plre* Plumber's Name (Print) Pio re MP /MPRS Number tk iness whore Afumlfer TODD FEATHERSTONE 242514 7 15 - 38 -17 Plumber's Address (Street, City, State, .odc) P.O. BOX 467 HUDSON, WI 540 _ V[II. Cone !De artaneet Use onl �Approvud ❑ !)isappraved ��Y Fermat Fee ( Groundwater Date Tssrrl+�l ssu' Agent Signature o Stamps) Surcharge Fee) p ❑ 0,. Cs . Reason for Derma! �M �7 d 1 IX. Conditions of ApprovalfReasons for Disapproval 00 SYSTEM OWNER: / 1 Septic tank, effluent filter and 5--1; cc=' dispersal cell must all be serviced / maintained as per management plan provided by plumber. %CeA lZ- S�-4e+M S! 2. All setback requirements must be maintained as per applicable code /ordinances. Attach ankle ph— (to the County only) forr tiro system an paper notiess tbxu 8W :11 iaehas ra tUt 4 I Pam Quinn Subject: On -site w /Leroy Jansky Location: Lot 107 Troy Village, Troy Start: Fri 10/31/2003 11:00 AM End: Fri 10/31/2003 12:30 PM Recurrence: (none) Need to evaluate damaged area on north end of the original mound and see what can be salvaged for re- design 0,. 13Y� } I I I I I I r 1 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 430425 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: O 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: American Classic Homes Tr Toyvnshi - 040 - 1257 -40 -000 00 CST BM Elev: Insp BM Elev: IBM Description: Section/Town/Range /Map No: too ,-0 v` , 3 (� r L-0'1" /D 24,28.20.1367 TANK INFORMATION 0 tLEVATION TYPE MANUFACTURER CAPACITY STATION $S HI FS ELEV. 1 07 4 1 DF Septic Benchmark 9 ' (O q I 16-5 Z- ( 3 Dosing Alt. BM Aeration Bldg. Sewer Holding t /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. i Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number F I , OYi VDU, TDH Lift Friction Loss System Head TDH Ft Z - o 1 Forcemain Length Dia. Dist. to well o P� SOIL ABSORPTION SYSTEM d BEDITRENCH Width Length No. Of TrenchesPIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header /Manifold I D istribution 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 xx Seeded/Sodded xx Mulched BedlTrench Center Bed/Trench Edges Topsoil Yes M No Fa-1 Yes 0 No i COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 / 0 / Z 2j ' / 63 Inspection #2: / / Location: 263 St. Annes Parkway Hudson, WI 54016 (NW 1/4 SE 1/4 24 T28N R20W) Troy iIV lage 3rd Addition Lot 107 Parcel No: 24.28.20.1367 1.) Alt BM Description - �— / � 2.) Bldg sewer length = r6V 1 S P,d M //1� " tN/ Su f Sf 00. - amount of cover - , r J S 0 -Ff YO f- d eo Yj,�Mx� cr; ( a- � a�5i'3 -=- q`� , 8'2 L31 - 36' 04 29'I"J ��QS ; && f Yloy'k o�F 15' u-' FI L Plan revision Required? es [R No — F L Use other side for additional information. Date�j r1 / ,n - Insepctoes Signature Cart. No. SBD 6710 (R.3/97) _(',?" K!/ l�� j S P- ,.,,, 4I O� SalG4 Ph- ✓- r • ENVIPOK 0 6M M"? 120 STREET. NEW ROMOND, Wi509N LAq SAVED $r lvo/ $ WSW 715 296-24'►4 TROY VILLAGE Lot' NWI /: SE %4, SECDON 24 T 28 N, -z 20 W Troy Township, St. Croix County, Wisconsin Page 3 i 3 I 30 ' Q t' � I ` LG•(�vY" c33 ! 0,y\ I N 9q �Z', l� r 53 LO 109 em _ � BM L am . LOT CORNER TOP OF �° � n �? + ELL b � ad �'�"`� eoln Nelson V goo ` �a--- , , 227387 Safety and Buildings PO BOX 7162 Al MADISON WI 53707 -7162 TD #: (608) 264 -8777 �sconsin www. w ww.cornmerce.s tate mi. us/ s b wisconin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary October 02, 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: 10/02/2005 Identification Numbers Transaction ID No. 899027 SITE: Site ID No. 663756 American Classic Homes - Dwelling Please refer to both identification numbers, Lindsay Rd L above, in all correspondence with the agency. Town of Troy, St Croix County NW1 /4, SETA, S24, T28N, R20W Lot: 107, Subdivision: Troy Burne Village FOR: Description: New Mound System / 750 gpd Object Type: POWT System Regulated Object ID No.: 916760 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. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required b the state or the local municipality shall be obtained p rior to commencement of C'I1 q Y P h' P a construction /installation/operation. In rantin this approval the Division of Safe & Buildings reserves the right to re require changes or additions should .� g g pP Safety g q Dt;p 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 SEF 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. I Sincerely Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 c_ Peter E bagel ' POWTS Plan Revi er II , Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pepagel@conunerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: AMERICAN CLASSIC HOMES Owner's Name: AMERICAN CLASSIC HOMES Owner's Address: P.O. BOX 4143 HASTINGS, MN 55033 Legal Description: NW1 /4 SE1 /4 S24 T28N R20W Township: TROY County: ST. CROIX Subdivision Name: TROY BURNE VILLAGE R D Lot Number. 107 Block Number: -- R► iG G Parcel I.D. Number: SAFETY & BLOGS. IIIV, Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank 41 2 TS' Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications �T F Page 8 Soil Test Y q a Page 9 Soil Test i Page 10 Plot Plan Page 11 POWTS Application Page 12 POWTS Management Plan c Designer: TODD FEATHERSTON License Number: 242514 Date: 08/06/03, Phone Number: 715 - 381 -1704 Signatur . 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 (01/81) Version 3.11 (05/01) Page 1 of 12 r . 4 1 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 500.00 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. 750.00 Design Flow (gpd) 5.00 Site Slope ( %) 99.60 Contour Line Elevation (ft) 25.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information I 10.001 Dispersal Cell Length Along Contour (ft) = 6.82 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /fi 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 3.41 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) = 10.14 ft /orifice 2.00 Forcemain Diameter (in) 255.00 Forcemain Length (ft) Does the forcemain drain back? Y 84.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 41.59 Forcemain Drainback (gal) 16.02 Vertical Lift (ft) 99.42 5x Void Volume (gal) 5.09 Friction Loss (ft) 141.02 Minimum Dose Volume (gal) 27.61 Total Dynamic Head (ft) 30.48 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 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) 1565.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) WIESER Manufacturer gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1200.001 Dose Tank Capacity (gal) JZabel Filter Manufacturer 31.161 Dose Tank Volume (gal /in) IA100 Filter Model Number WIESER IManufacturer Project: AMERICAN CLASSIC HOMES Page 2 of 12 Mound Plan View T :::1/10 B J Observation Pipe ..._... — l . A W 3 ❑ .... ...• .................... L Mound Component Dimensions A 6.82 ft E 15.09 in H 1.00 ft K 8.64 ft B 110.00 ft F 9.50 in z 9.00 ft L 127.27 ft D 11.00 in G 0.50 ft J 5.76 ft w 21.58 ft 750.00 (ft Dispersal Cell Area 1739.71 (ft 2 ) Basal Area Available 6.82 (gpd /ft) Linear Loading Rate 11.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.31 (ft) ► G I H F D ispersalCell 101.02 (ft) L ateral I — Invert ft —► Inve 100.52 ( Dispersal Celt ❑ :.:.:.:.....:.:. D Elevation 4 tJ 99.60 (ft) Contour Elevation 5.0 % Site Slope Geotextile Fabric Cover Shading Key 'a �,- Dispersal Cell See lateral details on ❑1 _Topsoil Cap 1.5 ft Page 4 for number, size, .. 5 .s: :._; ;s; nd s acin of laterals. ©: Subsoil Cap ❑ : a p g ra eo ` Laterals are equall ASTM C33 Sand F — ;. ::::?`::: q Y © ° m 0.5 ft Typical Lateral spaced from the ® Tilled Layer iA distribution cell's : <:: 5 Aggregate 0 ❑ ❑ : �;: �':` �:?-:' 1��:: �:::;;��:``�.:::: :::::::::::::: -1- centerline in the } A distribution cell (AxB). Project: AMERICAN CLASSIC HOMES Page 3 of 12 End Connection Lateral Layout Diagram Laterals centered over the A & F3 dimension 0 = Turn -up wdball valve or cleanoutplug p ,I All laterals are identical If X—.>I Holes drilled on the bottom of the lateral equally spaced S Force main connection uia tee or cross to maniFold at any point. Laterals & force main of PVC Sch 40 (per COMM Table 84.30 -5) Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.01 ft Lateral Length (P) 108.36 ft Orifices per Lateral 37 Lateral Spacing (S) 3.41 ft Orifice Density 10.14 ft%rifice Lateral Flow Rate 15.24 gpm Manifold Length 3.41 ft System Flow Rate 30.48 gpm Manifold Diameter 2.00 in Total Dynamic Head 27.61 ft Forcemain Velocity 3.11 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 4 in. min. Disconnect Tank component is properly vented LForcemain Aftemate outlet location diameter WIESER Manufacturer 2 in. Cap acityl 1200.00 Gallons Volume 31.16 gal /inch A Weep hole or anti- , Dimension Inches Gallons B siphon device A 19.99 622.74 B 2.00 62.32 C Pump off elevation (ft) C 4.53 141.02 ♦� 85.00 D 12.00 373.92 D Total 1 38.511 1200.00 Dose se tank elevation (ft) 3" Bedding un er tank. 84.00 Alarm Manuafacturer LEVEL Alarm Model Number LVL1 Pump Manufacturer IZOELLER Pump Model Number 1153 Pump Must Deliver I 30.48 gpm at 27.61 ft TDH Project: AMERICAN CLASSIC HOMES Page 4 of 12 Mound System Maintenance and Operation Specifications Service Provider's Name FE ATHERSTON E 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 750 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 500 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1565 gal Maximum TSS 150 mg /L Soil Absorption Component Size 750 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 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 .• ............. ..•.......••.. ..................... . 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: AMERICAN CLASSIC HOMES Page 5 of 10 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 fitter cartridge should not be removed unless provisions a made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the fitter 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 fitter 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 mulct as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOP ISO 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 16 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 flu$ 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 8 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: AMERICAN CLASSIC HOMES Page 6 of 10 fOTX DYNAMIC I IEAD � CAPACITY f URVE ?�k MiNU F LFFLUENT AND DEWATER!NC MODEL 152/153 i - -- - MODEL 50 Frr-t WI(. fk L tern + Gal. ;Liter; — a F 5 1.� 69 1 261 - 77 I 291 12 j i D 3. F I 231 70 1 265 - - j 15 4.6 53 201 i 61 231 Fr a - i _ 20 G.1 44 ' f ; 52 191 30 8 C Z` 7.6 1 34 t li 9 42 159 3u 9. i G3 c87 33 125 C c 20 - -- 5 10.E -....- ' - - Z 2 85 *" i 40 j 122 -- j -- 1. 42 10 3,.G F, 11.fi. l� 4 rJ .t i 011508 20 40 60 80 100 GALLONS LITERS 0 80 160 244 324 6 /4 3 21/S2--� - 4 S /6--j I I I i FLOW PER MINUTE - i 27/.32 '6 Timed dosing panels available. _ �'. i� 2 • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control sitches are available for controlling single phase i i systems. • Double piggyback variable level float switches are available for variable ' level long and shod cycle controls. -�i • Sealed Clly* -Box available for outdoor installations. See FM1420, i • Over 134 °F. (50C.) special quotation required. I r 152!153 MODELS i Control Selection �+f :�J Mndal Voke Mode Amp. i ! _N 115 — 1 trial ! H I 1 2 or W52 115 1 i Auto 85 irllilded 2 or 3 1 —� sxzoes E152 23G 1 Nan 4.3 1 2 o r -3 - -� - BE152 230 1 Aura 4.3 Gxi ded 2 or 3 � N153 115 1 Non 10-5 1 2 or 3 BN153 115 1 I Auto 10.5 Included I 2 or 3 Ei53 j 230 1 Ntn - 53 1 !— 2 a 1. Single piggyback variable level float swtch or double piggyback vaile level float BE153 230 1_ Auto 5.3 IneWed ! 2or3 I — - - -- -- - -- - -- 1 - -- — — —' switch. Refer to FA40477. a CALITIpN 2. See FMC712 for correct model of Electrical Altemator E - Pak ' S n ,;,..,,,� 3. Variable level control switch 1M225 used as a walrol activator, specify duplex (3} �i I. Line 1 rho nuF: or (4) float system. RESERVE POWERE0 For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. NAB. ra P.O. BOX 163 ` lads -w*, KY 40256 -0347 manufachrrersot•, srar ro e, K c� Run Road Lol a RSV>,ie, KY 40211.1961 recrryRE shzr Ifsla7 Q 502 77&2731. 1(W0 928 -POW //�/p { ) hftp 11mvw zoeller corn PL✓lY1P CQ . FAX (502) 774.3624 4c7 Coovriaht 2001 Zoeller Co. All riahts reserved. 08/04/03 MON 10:22 FAX 715 386 4686 ST CRX CO ZONING Z001 WtsoonsRr Depalnnent of Commence SOIL- AND SITE EV N Page 1 of 3 D'nrision of Safety and 9uildirrgs in aoeard with Comm t�ri 'ma ` FXiviroorrne=1 By Pdtach Gomplete site plan on paper not loss titian 8%x 11 Fiches in size_ P include, but not tirnmed 10: verWA &W hadunlal reference Point (BAA}, dir k► Oun t, percent slope, scale or dimensions, north arrow, and WAVon a est r WMiVL ll I I.D.# 1 Croix APPLICANT INFORMATION - Pfiwatse pdot aH irtfCN7t/it r,� F7 ' d By. Data Pwwnsl informadm you prcwdo may be wm for secondary pa�Qe (Pony S: i'.04 } (rn) . PiapedY bwiler � pe LrihF'�` �•, I � � Cont inental Develcrpnlettt lN60FFK w `" E 1/4 S 24 7 28 KR 20 W Prop6q Ol hFatfng /fddrasts Name oresW 12301 Central Av enne NE, Suite 230 Troyawa yoiao 3 .4 Clly State Zip Code PhafeNumber L] City V91aAe ®Town Neanmt Road M lis MN 55434 Troy Lindsay Road EXI New Construction Use: Aesiderrdal / Number of bedrooms 4 DAddition to e)ddng buiding Replacernent Fj Public or commercial describe Code Plerived daily flow 600 gpd Recorrmtertded design loading r& — 1.2 bed, gpdff 1.2 trench, gpdAP unam(equimd 50 0 bed,P 504 $enchjtz MaadMWR4e6gnload"4M 1..2 pad, -gpd� 1 -2 .inaactr<,.,gpdAF Recommended infith'adion surface elevadon(s) 100.3 ft (as mlerred tD silt plan benelvm Addif had dasfgn I site considera bo Parent malarial Loess over Bed Rock Flood plain elevation, V 22e kable Na A S Suitable for sySi+Lm Corrrentional Wound In -Ground Pressure AT -Grade System in FW , Tank U= UnstitaHle for system ❑ S 2 U ® S ©U (; s ®u r7 3 u ❑ s 2U ❑ s® u SOIL DESCRIPTIQ R REPORT Depth Dominant Color Mottles Structure GPONF Boring# horizon in. Munseg Qu. Sz. Cont Color TeXhm' Gr. Sz. Sh. on Boundary Roots Bad :trench 1 - su 2msbk udi Cw 2f :s 2 7 -18 10yr4/4 - ail i 2 mfr cw if _.5 6 Ground 3 1g -2,5 7.5yr3/4 Cl 2msbk j mfr C w - A 5 elev - _ - 100.72 R 4 25 -30 10yr8/3 - BEDRX Depth tD i I Renwks: _ 1 0 V 1 0yr3/2 - si! Zmsbk mfr CW 2f .5 .6 2 7 - 10yr4/4 - sil 2msbk mfr ow if .5 .6 Gro und 3 t 18-2$ 7.Slrr3f4 d _ - _ 2msbk Haar cur .4 5 96.50 It 4 28 -32 10yr813 - BEDRX - - - - - Depth to satinr 26 L-7 Remarks: CST Name (Please Print) Signature: Te"ne No. Tlrarrtas C- N*" - -- " 715- 246 -2454 Address Envirommilal By Design Date CST Number Ref # 1432 120th Street ,Ncw Ric}i „,.,.t WI 51017 12/29/98 227387 82 08/04/03 MON 10:22 FAX 715 386 4686 ST CRX CO ZONING 1&02 ` AOPERTY OWNER c oasn catal >i SOIL DESCRIPTION REPORT ® PaW 2 of 3 PARCIEL W$ __ EMv4Mxwwl Horizon Dep Domnant. Color Motbes Thlre Structure consistence Boundary Roots GPDM WOW in nW . Qu. Sz. Cont Color ex Gr. &. Sh. Bed : TMAch 1 0-7 10YO/z _ ail mfr -cw _2f _5 A . .6 2 7 -19 1 4l4 1f sil 2msbk mfr cw 5 Ground ewv 3 19 - 34 Syr4 /6 - cl 2msbk I mfr cw - .4 5 98.39 ft 4 3438 1 Uyr$13 - BEDRX Depth Lo Ibtiting _ � - -- I Remarks: 1 0 -7 10yr3 /2 - sil 2msb �I mfr cw 2f 5 2 7 -19 10yc4/4 - sil 2msbk mfr cw if .5 .G Ground e►ev 3 19 -25 7.5yt - cT 2msbk mfr cw - .4 .5 93.37 ft , 4 23-30 ! .14yt 3 T3Fsf3R C _ _ _ _ Depth to I I Imltl `�` fdCQ Remarks: Ground elev ry Depth to lun�"ulg � fadar { Remarks: Ground - Depth t o — I limiti Remarks; �_ _.__._ ,• _........._. i CAL GGy � r��r�j- / }c 2 ova r l p r O U G y n � �fZ) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner AMERICAN CLASSIC HOMES Septic Tank Capacity al 0 NA Permit # U`f Z S� Septic Tank Manufacturer WIESEg ❑ NA DESIGN PARAMETERS Effluent Filter Manufacture ❑ NA Number of Bedrooms 5 ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA Estimated flow (average) 7 g al/da y Pump Tank Manufac ❑ NA WIESER Design flow (peak), (Estimated x 1.5) 1125 gal/day Pump Manufacturer ZOELLER ❑ NA Soil Application Rate . 5 al /da /ft2 Pump Model ❑ NA StanilWO Influent /Effluent Quality Monthly average' Pretreatment Unit Fats, Oil & Grease (FOG) 530 mg /L ❑ 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 (BODd _ <30 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) _ <30 mg /L ❑ NA ❑ At -Grade �0 Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: a:�slA Other: J"A Other: 9 NA *Values typical for domestic wastewater and septic tank effluent. I Other: AjrNA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) 13 NA y ear(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: ❑ year( ►(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: 11 month(s) ❑ NA 5Pyear(s) Inspect pump, pump controls & alarm At least once every: p month ❑ NA Y Flush laterals and pressure test At least once every: ❑ mo ❑ year (s) l ❑ NA lsl Other: ❑ month(s) KNA At least once every: ❑ year(s) Other: GRLN A 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 tanks) 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. effluent The dispersel cell(s) she!l be visually inspected to check the levels in the observation pipes and to check for any ponding f n n the round surface may indicate a failing of effluent on the ground surface. The ponding o effluent o g Y 9 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 9 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) II Page 2 of 2 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) 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 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 7l _ �� (� Phone 715 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PINKY'S Name ST. CROIX COUNTY Phone 651- 436 -5788 Phone 715 - This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.540►, (2) & (3), Wisconsin Administrative Code. APPLICATION FOR REVIEW POWTS -Complete all pages - Saiity $ Buildings Division ( ) Check ii Con*rnetion is Desired: ) faxed, () mailed Bureau of "raNd services Several counties have been delegated certain a dhordy to review plans in lieu of Commerce. For a current list of those counties and their delegation check our website at http://www.00mmmrmstaft.wi.LMISBISB- Powtsprogram.himl. NOTE: Personal information you provide may be used for secondary Confirmation of assignment to a reviewer. purposes EPri+racy Law s- 15.04(1)(m), Stars -1 1. Private Sewaae Submittal 2. Type of Submittal - System Type ( New Previous Related Trans. ID: ( ) Sol Saturation ( } Revision Estimated Completion Date: Determination Report { ) Interpretive { ) Replacement assigned ReYieMler Determination ( } Additi (X) POW7S System ( ) Petition (attach iorm SsD -9M) assigraf Office: ( ) At Grade ( } Exparfiriant, approvaW --- _ _ ( } Holding Tank CULle your cholce of offk= below: ( ) Nonpressuaized In- ( ) Corriponerit dual (Include each Ground cwnponerit manual name, a and 1. Next avaitabte appoinbrerN in any office, Z. Green Bay, 3. Hayward, ( ) Pressurized fn- date on title page of per) 4. LaCrosse, S. Madison, 6. Shawano, 7. Waukesha Ground ( ) lrxbvkluei4 Site Design ( X) Mound ( ) Aerobic Treatment Unit 3. Project Information - Fill in eM to~ inforrrration_ ( ) Sand FMter Project/Site Name —ekoe t— Location, Number a Street of project fit unknown, indicated nearest road) LINDSAY ROAD recirculating ( } Constructed Wetland Legal Descriptim. NW1 /4 SE1 /4 S24 T28N R20W { } Drip Line county ST. CROIX v A_ Town ofTROY ( ) Other: Bt*d1n9 Type (check one): 4. After plans are reviewed, please. (check aN that apply) ( ) Dwelling, t or 2 tanuly X Call customer 1, 2, 3, 4 (circle number)* *Refers to customer nurnber from below ( ) Public/Commercial " – Reques&u party wit pick up Bullarng ( ) State-owned Building — Aft( plans to customer 1.2.3.4 (cirefe number)* SMIons Per 132y _Z50 6. Complete the h owing dlesignerAwnedrequesting iniborm ation. LNize the check boxes when designer, owner or requesting party is the same to avoid repeating information. Designer Information castor ar 9 Mail To Party if dillerent then desWier Customer S First Name r_ast Name Customer Number First Name Last name Customer Number TODD FEATHERSTONE 242514 Company Nam Company Name FEATHERSTONE EXCAVATING, INC. Address I Address P.O. BOX 467 City State Zip+4 (9digRs) City State Zip+4 (9ftits) HUDSON WI 54016 Phone Number (area code) Fax or Internet cap phone Phone Number (eras code) Fax or Intemet 715- 381 -1704 715 - 386 -6885 (FAX) 612- 366 -4100 Check others it applicable Check others if applicable ( Owner owner Owner Information (Customer 2) Ot her Pleas Customer 4) First Name Last Name Customer Number First Name Last Name Customer Number AMERICAN CLASSIC HOMES Company Name I Company Name AMERICAN CLASSIC HOMES Address Addraas P_O. BOX 4143 City State Zip+4 (9digits) city State Zip+4 (9digrts) HASTINGS, MN 55033 Phone Number (area code) Fax or Internet Phone Number (area coda) Fax or Internet 651- 351 -0995 651- 439 -3417 Ctreck others 9 applicable (Marl To) Check others if applicable ( ) Other ( ) Other MAKE CHECKS PAYABLE TO DEPT OF COMMERCE TOTAL AMOUMT DUE $ 175.00 Attach check here Review Code 7633 G. Plan Review Fees for Private Onsite Wastewater Treatment Systems Type of P'rojea (CIRCLE THE APPROPRIATE FEE BELOW) FEE 1. AD treatrnent components air previously approved under s. Comm 54.10 (2) or (3): Design wmtewdtm fluvi ul thi prop xwd system: 1,000 gpd or less ................. ............................... . ......... ... ......................$17500 1,001 -2,OOO d.... . . .. ....................... .............. ........... . .. . .. ........$ 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 treabrreni components are rot previously approved under a. Canwn 84.10 (2) or (3)e (Irxiividuai site deek.Wdemiation from component manuals and use of components wiflxrut product approvaq: Design wastewrdfer now of the proposed system: 1,000 gpd or less .......................... . . ............................... . ............................ $300.00 1 ,001 - 2,000 gpd ...... . .. ......... ....................................... ............................... $ 400.00 2,001 — 5,000 old SSW 00 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 flaw of the proposed system: 5 ,000 gpd or less ...................... --...... ............................... .........................$60.00 5,001 - 10,000 gpd ............. ............................... ................. ........................3100.00 greater than 10.000 gpd... ................................. $150.00 4. Hokkng tanks NOT previvusty appruvwi units 6. Conran 54.10 (2) ur (3) zap site %mrslru61W tanks Design wastewater flow 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 Expedme" System (s"lonai Mute time fee) ............. ............................... ........................5300.00 Revisions to Approved Plan........ .............. _- .............................................................. -.. $W.00 Petition for Variance (Include form SSD-9M) ....................... ..$225.00 .... .................... Revision to a preuiou* appmwo Pa4.ibon for Variance........... ................ .........................575.00 Soil Saturation Determination Report - per Site (other than a proposed subdvision) ............. .....5100.00 Interpretive Determination Report ............. .. . .. ....... .. ... .................... ............................... ....$100.01) Sub total .... ........... ................... Priority Review: Enter same amount as subtotal ... ............................... Prior approval ham a section chief is required for a priority review. It approval is granted, the priority will be reviewed 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. Gomm 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 violin the 15 days of receipt of all required information. 7. Appow6ne lt, Schedukm kA mration, and Plan Submittal Checklists. POWTS scheduling is not avoallable. Plans vWN be assigned to a reviewer 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 comer of the front page. Also note in the same location that you can designate a specific offrae for review. It you select a specific office your estimated completion date may be considerably greater than vrttat would be possible in another office. Sulornifts received without a specific office indicated on the term may be assigned to offices other than the receiving office dependirg on reviewer availability. To obtain a submittal checklist can the nraterlal order unit at 60e -26&1 ai a or w* of the full seevcoe offices listed below_ You may email technical code questions to wtst state wi.lm Madison S&SD Hayward S&8D LaCrosse SARD_ Shawano S&BD Green Bay SABD Waukesha 844 201 W Washington Ave 10541 N Roach Rd 4003 N Kinney 1340 E Green Bay 2331 Sari Luis Place 401 Pilot Court 53703 Haywdid Wt 54543 Gouiee Rd Shawano WI 54106 Greg Bay, Wr 54304 Waukesha WI 53158 PO Box 7162 715634-9870 LaCrosse Wl54601- 715- 524 - 3626 920 - 492-5601 262-548 -8600 Madison WI 53707 -7162 For 715-634 -5150 1831 Far, 715524 -3633 FAX: 920 -482 -5604 Farr. 262-5"14 WO- 26&3151 Email: 606- 785.9334 Email: Email PianSchedule@ Email: PlanSc heduteQ Fax: 608- 267 -9566 PlanSchadula@ Fax: SM785 -6330 Planscheduw@ conxnerce.statemAme commerce.statemime TDD 608- 264-8777 commerce.state.wiais Email: commerce.state.wims Email: PlanSc hedule@ PlanScheduie@ oarnmerce- state.wi.us comnMoe.state.wims Wisconsin Department of Commerce SOIL AND SITE EV N Page t of 3 Divisiomof Safety and Buildings accord with Comm r C Environmental By TDesip Attach complete site plan on paper not less than 8% x 11 inches in size. P � County include, but not limited to: vertical and horizontal reference part (am), *W#W m r, St. 'Croix percent slope, scale or dimensions, north arrow, and location and distan arest rFa'LUN ... an I I.D.# APPLICANT INFORMATION - Pieaso priti'f all info"" � yy Personal information you provide may be used for secondary purposes (Privacy i .04 (1) (m)). t✓ `+ (�'ti ftevisvd By Date S Property Owner perty Lc6ftWTY i y Continental Develop Go � 0NINGJFFI%W,f, 4 SSE 1/4 S 24 T 28 N,R 20 W 122 Prop* ai Avenue NE, Suite 230 4 � . � � � £ ! .�� 5ut�: Name or CSM# �e Vill e 3 r `� �., city State Zip Code PhoneNumber El city 7 V_ftW. Town Nearest Road - Minneapolis MN 55434 Troy Lindsay Road IN New Construction Use: �tesidential I Number of bedrooms 4 Addition to existing building Replacement r 1 Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate 1.2 bed, gpdff 1.2 trench, gpd/fF Absomtion _arearEquired 500 d, 2 500 trench, #2 Ma dmurn desagnloading rate 1.2 -bed, gp 1.2 tr ench4pi fl= Recommended infiltration surface elevation(s) 100.5 ft (as referred to site plan benchmar Additional design / site consideration Parent material Loess over Bed Rock Flood plain elevation, if applica Na ft S - - Suitable for system I Conventional I Mound In - Ground Pressure AT - Grade i System in Fill Holding Tank U= Unsuitable for system ❑ S R U ® S❑ U ❑ S 6ZI U ❑ S U ❑ S U n S M U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles , Structure GPD/ff= Boring# Horizon in. t Munsell Qu. Sz. Cont Color I Texture I G Sz. Sh. IConsistencat3oundary t Roots Bed ; Trench 1 t 0 -7 i 10yrV. t - sil 1 2msbk 1 mfr 1 cw I 2f I :5 .6 2 7 -18 10yr4/4 - sil 2msbk mfr -cw if 5 6 Ground 3 1 18 -25 7.5yr3/4 I - I c1 2msbk mfr I cw I - . .5 elev 100.72 ft 4 25 -30 1 10yr8/3 I IBEDRXI - - - - Depth to limiting factor 25 Remarks: 2 1 0 -7 10yr3 /2 - A 2msbk mfr cw � I - 2ff .5 .6 2 fi 7 -18 t 10y,W4 t - t sil t 2msbk I mfr t cw I if I .5 .6 Ground 3 t 18-28 7.5yr3/4 - i C1 2msbk mfr i ew t .4 .5 - elev 96.50 ft 4 28 -32 , 10yr8/3 , - BEDRX - Depth to limiting factor 28 t i t r Remarks: CST Name (Please Print) Signature: Telephone No. Thomas C. Nelsm -- 715- 246 -2454 Address Environmental 13Y Design Date CST Number Ref # 1432 120th Street, New Richmond, W1 54017 12/29/98 227387 82 r - 4 PROPERTY OWNER: Continental Development SOIL DESCRIPTION REPORT ® Page 2 of 3 PARCEL I.D # _ EnvixrmmeataI $v Des Depth Dominant Color Mottles Structure GPD11 Horizon im. Munsetl Texture Consistence Boundary Roots 4u. Sz. Cont Color Gr. Sz. Sh. i, W Tram i 1 ! 0 - ! 1 3J _ sil mfr cw ?� ! 5 6 0yr , 2 17 -19 I 10yr4 /4 I - I sit I 2msbk I mfr , cw i if I 5 6 Ground elev 3 119 -34 5yr4/6 - c1 I 2msbk I mfr I cw - .4 .5 98.39 ft - 4 34-38 1 10yr8 /3 I IBEDRXI - - - - - Depth to t r r 1 limiting factor , 34 j I i I I I l Remarks: I i 1 i i I i 1 i 4 1 0 -7 10yr3/2 - sil 2msbk mfr cw 2f .5 .6 2 7 -19 10yr4/4 I - 7 Sill i 2msbk mfr cw if .5 .6 Ground eiev 3 r 19 -25 't 7.5yr3/4 i - i el 2msbk t mfr M I - i .4 3 93.37 ft _ 4 25-30 i -1 s/3 r — f BEDRX Depth to 4rniting fad25 I I i t I t I Remarks: Gf6ttnd elev l i i t Depth to I I I limiting factor I 1 I 1 f I Remarks: I I I I ! 1 I I ( I Ground efgv I i t I t i i i i Depth to limiting factor 1 i t I I i r Remarks: [AVf �Y 0[51 11,) 00" S7P[7. NEW POMOM, A(Kk- L6i SAV(P 0 10t,,M W I W' 7D X1)4 TROY $VWAW VILLACT -- Lot 0 1 1 �4 '�)FCIION 24 1 2. 8 N 2 NA w V rf)V'j St. Page 3 r3 X00 SCALIE I" =40 Tom Nelson BM 1. LOT CORNER TOP OF HIEV. too, 227387 4 BM 2. � (� t Elio From: To: JEFF 1 Z.+l�. ► �.6.. .... Pa ge 2 ... of . . ............... 1�001 ........ 10/07/03 . .... .. TUE 13: . .. U 29 32P 62 10 FAX 715 KATHLEEN H. WALSH • REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD � 10/09/2003 09:00AN oocrrnerR N�xnber AFFIDAVIT St. Croix county EXEMPT M REC FEE: 11.00 Occupancy Affidavit TRANS FEE: COPY FEE: CC FEE: DoNr��v �j PAGES: 1 Name - (Owner) Typed or printed being duly sworn , states, under oath, that: 1. HeJsbe is ft owner /pan owner of the folloisc wing met of land loca l Croix County, Wisconsin, recorded in Val Page Recv0 Area Nund e�,�A$9t- Croix County Register of pads Office: Name drld Return Addre6e .'VJ�"�P /cf���cR A parcel of land located is &W -MA? of *45 -eV of Section . T N -. R a0 W, Town of 7'iQ �iq�7r•✓G -s, /nic/ Sc� 3 County, W� scn ia, being duly da'bod as follows (include lot no. and Mk&visloa/CSM or detailed legal desc ription) , - ZOT / 07 0 •� Parcel IderrtitrceRlw'Number(PIN I acknowledge that the septic system serving this Mstdence is steed for a As owner of the above descrl�ed property, The design flow calculated by *seaming 150 gpd for 2 . , 4- bedroom home, or a design flow of 7So 9pd• are penni tsd kidivicluSiS per bedroom. There ape currentty A- occupants living in this residen / �, oocup rant. HOwevw based on the design flow. Therefore the septic system serving ttli5 r the need to be nderswrld that if ft" intentions to exceed the number of perm that 1 wiN make modified to accomodate any increased wastewater flows and/or oorrtaminant loads. 1 also acknowledge this information available to any future parties interested in purchasing this PmPArtY• Dated 1Ms �� day orv�4 t • ACKNOYYLEDG"ENT OMCAT1014 STATE Op WIS90 ) Stenature(s) �• Q Ts/ suy+enilCated this day d ��� personally came before me tl 0 3t� day oT the above r►am � - N � oN TITLE: mEMBER STATE BAR OF WISCONSIN ����� and * �� (If not, O authorised by § 706.06, Wis. State - ) THIS ROTRUMENr WAS DRAFrt:D By $hell R TUtM Come on "p If nd, eate apt date: (Signatu may be autivant�+ried « adated9ed- Both ar a not fj MENT - DO NOT REMOVE" T& kdbMWbd "i'Hte PAGE IS PART OF'TMS LEGAL OOClJ pllrarMl aNdr ai 9W must bo oonpiatsd by >1��4�ttl� -- Wig (r 1 offt gnw ft ape, Joao desalptbn. ep y he f s9 a ��rtfAre d " hde �s erl pris brat pope SY/s, 56,617. abctrnen! BM lies of tMa cover pie am pee' 1"01' dMMOM 10/06/2003' 12:09 6514393417 AMER CLASSIC HOMES PAGE 01/01 Rrom To: JEFF D ata: 10M=3 Tian: 10:27;00 AM Page 2 of 2 s TANiK mAwrmvk)lcx AGIRN uENT AND oi wmno csltaMCAMOK POW AMERICAN CLASSIC HOMES 49 g P.O. BOX STINGS, MN 55033 �extr Addtnaea ST. for ear taeati+a►r� TROY WI pond )[dmtmmam Xwobw 04 0�7 -40 -000 '�opat!► SE T 28N j�I -mow• To= of TROY TROY BURNE VILLAGE :e ims sn"r map a '-_ Vdh= Palo III — WmmmmW DeM f ��� Vabomse 72Z? pw# 3 t 5 - ►pm Isaac [Q LD n0 7 to Imes idaodt" CJ yes 0 fro �wetatdt»e oaeamed sepbiea�enae.ld�.�ti�iap N plubmwks fts-p"p —im OF an amt at m wo tok dope lose r ■ maK iteesbdbr a Itietaesedpmwm llJ4et ]� � low ft e� as �esttbt♦ leree!"a� of �e � !self a reheat sh�pa ht lhe.� rupaulq� lu peopetty owm s at b b IL CWk I�oeeis Din �. �a � the owner aadby a �.3�ri�i' 1�Walio,eadpr■4er : iapsopar apmft oso&am =dAw M +wd ,r.� the eandemipeed banns � flea sbe+ea and aka fs the ptiwlC tetaalpc dl� rrittt the eltsddtk et fiord. b ac.etby dine Dwooftwo c m Qppr�eeoe and the Depuha�td NtMMaI Heeseenes Dale of Wieooim. Latta; hthatyweeraaptiesraoraeetae ;tasaa erncl�saemplotosndteewtreodat�� .owinOorbr•�� tine thtaa 3rar h�nlon '[U= ON AWLtdArM E Mim CSI= I (we) am" d� an muftmwmmqa ma taaw mm Roue fo de baee.tw ( 1we a t I*re3 san taw) tbn o ,,, aa (sj of he p tll &mc* d dom by of a wammo deed eaoaede I iw &q*W o[tloede Ofikr- \ oUMIXM OF A>arLICANr �- ie m, melt m tiro emdtsrlpeseaiR •�.�otoedlnr +lee ""' lGedmk TIM ode appl[esd m e+ .amnq deed fins the Rgleoa at t)aods aortae a Dopy Draw alto d m woq =WIT ' ' I nee is made In On dood From: To: JANE Date: 10/3/2003 Time: 1:41:38 PM age 2 of 2 JUL -24 -2003 03:59 COt''TINENTAL DULP CORP 763 757 2532 P.01/01 ST CROIX COUNTY SHPT IC TANK MAMTENANCE AGREEMENT' AND OWNERSHW CMnFICATION FORM /g Cr Tro 0evelo meet Cor r S Mail[[tg Address 11 Aberdeen Street N. E., Suit e Z 5 4 properly Address Z eri 'on rw m Planning Deparuncat farwaw co iou) City<Stata Troy, Wisconsin \/3 a �� Qa LEGAL DE Wisconsin Properly Location '/, Y,, Se, Town of r Subdivision Lot # 1 0 7 . Certified Survey Map # � Vol Page # Wo anty Deed # l 9 ° `f Volume Page # ! Spec house U yes ❑ no Lot lines idematimfi a 13 yes ❑ no SYSTEM MAUS i'ENANG Improper ass and maintenaaoeof yc amde system could result in its premature to handle wastes. Proper mainteaancc eoolim of pt®piag out the septic tank three yew or sooner if needed try a licensed What you Port into the system can affect the function of the septic tank a treatment sage in the Waste disposal system. Mw property owner agues t to SL Croix Zoning DeMmUmnt a cesUdcatiore by the owner and by a so uWplacox4 jou meyman P . dpluudxr Ora liot owpumpea vaafying that (1) then em wasba tes disposal system is in proper opetatin$ condi tion ea (2) of k r inspection and pumping (if nevtssary), the septic tank is than W full of sludge. Vwee, dw des %d have above roquwcmean sad agree to maintain the private sewage disposal witb the standards net fart!, heroin, as at by of Cea®metoe and the Depattsnemt of NabxW Rcsoarees, State of W tio0 stating dust your �c has been maintained must be eompletod and MW MA to the St C roix County days of the three year rite date. &6n SIGNA'TUR Qnmam 1 (45 cent* tbat all statements on this form are hue to the hest of my (our) knowledge. I (we) am (are) the owners) the operty b described above, virtue of a warranty deed rwv dod is Register of Deed$ Office. y 7 2f7 �ff $1WATU" OF APPLICANT VATS +� « +• « Any information that is wis- teprosente d may result in the sanitary permit being revoked by the Zoning DePactraent. 9 * Iarlade with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified auvey map if refmnoe is made is the wattrtttty deed TOTAL P.01 r 7 J 2228P 315 719664 KATHLEEN H. WALSH REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM 2 - 1998 ST. CROIX CO., WI WARRANTY DEED RECEIVED FOR RECORD Document N 05/02/2003 11: 30AM This Deed, made between WARRANTY DEED EXEMPT # T roy Development Corporat tut, a Minnesota Corporation REC FEE: 11.00 Grantor, TRANS FEEL 419.70 and A merican Llassic omes, COPY FEE: CC FEE: _ PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate In St. Croix County. State of Wisconsin: 3rd + Rocaanp Arai Lot 107 of the Plat of Troy Village -..- __...... ... ___- _--- ...: -.— Addition in the Town of Troy, St. Croix County, Name wW Return Address I � Wisconsin. rican Clas LLC Subject to Declarations of Covenants, Conditions and P c Restrictions for Troy Village, recorded in Vol. 1241, as ngs, MN 55033 Page 256, as Doc. No. 559964, and the Declaration of Golf Course Covenants, Conditions and Easements, it recorded in Vol. 1241, Page 301, as Doc. No. 559969, .I jI all as appearing in the office of the Register of Deeds 040 - 1257-40 -000 II I! for St. Croix County, Wisconsin, and such other premWmAestlonNrrNswIPINI I' It easements, restrictions and reservations of record, This is not homestead property. l or in use, and the "Buyer" obligations contained in (IS) (Is not) i the Purchase Agreement for this lot. ! i ,I it �i ii I+ l h Exceptions to warranties: l Dated this 29th day of April 2003 J / (SEAL) (SEAL) 'I • Charles S. Cook, President Troy Development Corporation Ji (SEAL) (SEAL) j AUTHENTICATION ACKNOWLEDGMENT Slgnsture(s) Minnesota ; State of W+teoms+rr, 8 ss. Anoka County,. it authenticated this day of Personally came before me Ihts L9th day of �I April above named Charles S. Cook, President Troy Development Corporation li TITLE: MEMBER STATE BAR OF WISCONSIN to I of not, me known to be the person who executed the foregoing authorized by 5706.06. Wis. Stats.) Instrument and acknowledge sine. THIS INSTRUMENT WAS DRAFTED BY �(a�L (- ti • ! TROY DEVELOPMENT CORPORATION R A. Johnson 4 ll Charles S. Cook, President M�e c ommission S u��N *Anoka County, Minn. M y permanent. ()f not, state expiration date: , I (Signatures may be authenticated or acknowledged. Both are not January 31 2006 .) ! teary) 4 • N-ar W P --18-1-9 In -ry r-Pexy ­w b yp.d a pW,d bow rhrlr,,Rr ""rte. I WARRANTY DEED STATE SAR OF WISCON B1W G.. K. FORM N... a - lass JO,� w.rh.,, w•. 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