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HomeMy WebLinkAbout042-1046-50-275 C ounty: St. Croix Wisconsin Department of commerce PRIVATE SEWAGE SYSTEM Sanitary Permit No: 0 Safety and Building Division INSPECTION REPORT 538785 (ATTACH TO PERMIT) State Plan ID No. GENERAL INFORMATION Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. parcel Tax No: cit village X Township 042 - 1046 -50 -275 Permit Holder's Name: , Warren Town of Renstrom, Mark & Ma Section/Town /Range /Map No'. oa CST BM Elev: f Insp. BM Elev: BM gescription 17.29.18.262830 `T e g q� . gz ` �C ELEVATION DATA TANK INFORMATION CAPACITY STATION BS HI FS ELEV TYPE MANUFACTURER Benchmark A z 1 1- W Septic �` 5 I 1 Alt. BM Dosing _�� Bldg. Sewer Aeration I St/Ht Inlet -�3• `7 , t g(�,SS Holding T St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet r ti !02 � r � Dt Bette + P ti IO. 8 3 •26 Septic 14 Header /Man. Dosing I I l l t t St.� ` "— Dist. Pipe Aeration Bot. System Holding Final Grade PUMPISIPHON INFORMATION aQ 0 Demand St Cover Manufacturer G L /y _ �� GPM - �CK- r f Model Number Friction Loss System Head TDH Ft TDH Lift Dist. to Well Forcemain Length Dia. 11 SOIL ABSORP ION SYSTEM ✓ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid e th BEDITRENCH Width Length o. of Trenches DIMENSIONS LAKE /STREAM LEACHING Manuf er: SETBACK SYSTE O P/L BLDG ELL CHAMBER OR — INFORMATION Type Of Syst UNIT M el Number: DISTRIBUTION YSTEM x spacing t '' x Hole Size Header /Manifold Distribution Pi L th Dia ength is SOIL COVER x Pressure Systems Only xx M nd Or At Grade Systems Only xx Mulched T l xx Depth of xx Seeded /Sodded Depth Over Depth Over Topsoil Yes D No ] Yes Bedrrrench Center Bed/Trench Edges _ Ins ection #1: � / �0 /� Inspection #T — � COMMENTS (Include code discrepencies, persons present, etc.) p Location: 990 101st Street R berts, WI 54023 (NW 1/4 NW 1l4 17 T29N R18W) NA Lot 1 �, e4r 61" 1.) Alt BM Description = (/ 1 '/ t , ;4K. 2.) Bldg sewer length = 6�� �° �°'�'� �- �'`' D ► `� _ amount of cover = > b • D Plan revision Required? 0 Yes - - 0 e t. No. - IIIJI � ti Use other side for additional informati Pn Da a Insepctor� �( `1 /�� SBD -6710 (R.3/97) —l Y � l �,{i�^ t+ O r L o C/) O 0 y O I c m o m �1 c w *! 3 ;I 5 S 3 � nl. ro (D g co - E. m m O A Z y Z O (T '0 < J A O• n N CD N O au O O .+ °' C °. oD j w iv ^' *0 CL 00 0 'O O. p 1 N C p G 7 O S (D O't of 5' m U) a 3 ° 0) O u' � n = N ro W ro n N W N !\ c ro c m n o 5L 3 N N vi 9. ! o cn tt3 c Q > Cl) D (D ° m o A v Q a 1 A m a IW 1 CD ro °oIW co 3 HOC �o,l o rn p t v Q N N O ' ' O w 0 N .y.. �1 CD C O O O O O '1I N w C lei H 0) 0) a 3.. a a C/) G. fD. 'o a V 0 m n O o '', I '�* h • ro CD O O O O O a jI O * * * o s - * * ca ca * w j', I o > D 0 3 to c tin 3 h v v C m v N ro A CD o� i (D m� I rn yw iw 3 3 m o l 3 m w > ��I � N M z z z z 9 j D D O D D j Z a a I "*A m Z N CD N (D CD V� 1 c � I c 7 (p N Er A (D'' (D N ',.I A Z n N C N C 1 r e•' a a m N N Z N J �°� Wm �z CL O O .. 3 .. ! 1 Z �! (D > A ro W ro o D y a m am�� n ?v ° 3 �0. o: vm o' 5. 7 � Qn v c <G ro 3 ° Z < O d 3 3 v m a a o Z o ro n m c ro D1 y O CD aC m �N N (D (n N c 0 a Q a y O CD N N C- C• fi N Q cn 6 O N N .l. ro cD Q (D `C N S CD CD O a w I fi ° E; CD < N N co C O N W' =7 S �-7 0 0 VO O C Q 'U O 7 ti 3 CL O ICL A N O CD 'I A to (fl O O O I y ° o Q 1 o CD i commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix t l e s ims rt me Madion, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) nt of Commerce �53X 7Y Sanitary Permit Applicatio Nate Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the ap -at ei a unit is required prior to obtaining a sanitary permit. Note: Application forms for state -o PO project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you prod e may be used o con "try p urposes in accordance with the Privacy Law, s. 15.04 1 m , Stats. Same I. Application Information — Please Print All Information Property Owner's Name Parcel # 042 - 1046 -50 -275 Mark & Mary Renstrom J e • 2 & 2 Property Owner's Mailing Address Property Location 990 101 Street J UN S7 �Q Govt. Lot City, tate ty 54023 � 0 MAA3 'V o rr/C NW -/,,NW Section 17 Roberts, WI T 29 N; R 18 W (circle one) II. Type of Building (check all that apply) Lot _ # F ® or 2 Family Dwelling —Number of Bedrooms A(� Subdivision Name 1 CSM 21/5191 ❑ Public /Commercial — Describe Use Block # Na City of ❑ State Owned — Describe Use CSM Number ❑ Village of Vol. 21, Pg. 5191 ® Town of Warren III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System ❑ Replacement ® Treatment/I4oid ng Tank Replacement Only ❑ Other Modification to Existing System (explain) System B. ❑ Permit ❑Permit Revision ❑ Change of ❑ Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner L (v Z 3 210 Expiration IV. Type of POWTS System/Component/Device: Check all that a 1 ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground Ll At -Grade ® Mound ? 24 in. of suitable soil ❑ Tank ❑Mound < 24 in. of suitable soil Holding ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 600.00 sq. ft. VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units z w U • New Tanks Existing Tanks w z w> O A Septic or Holding Tank 1200 1200 1 Wieser Concrete ® ❑ Fj El ❑ Dosing Chamber 800 800 1 Combination ST/PC D 17 ❑ ❑ VII. Responsibility Statement- I, the un ersigned, ass me responsibili r in llation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumbe; s Sign MP/MPRS Number Business Phone Number James K. Thompson 5-- - 30021 (715) 248 - 7767 Plumber's Address (Street, City, State, Zip Code 340 Paulson Lake Lane, Osceola, WI 54020 - 5413 VI . Coun /De artment Use Onl Approved _ Disapproved Permit Fee Date s7 d Issuing Agen Sign _ Owner Given Reason for Denial $ 2 5'O pJ � p / IX. Conditions of Ap_proval/Reasons for Disapproval 3 �/� S7l/�� Y�C�/� �/,�GK(G�� SYSTEM OWNER: " Y 1 Septic tank, eff luent filter and ti, • 83. 3 3 dispersal cell must all be serviced I maintained as per management plan provided by plumber. r � r � d UxAa �. 2. All setback requirements must be maintained U /v �(lt (� (' � as per app ica e p ns for the system aqJ submit to the County only on paper not les than 81/2 a 11 'nches in size Ze;y - - U� SBD -6398 (R 01/07) Valid thru 01/09 Sc.a.le: 99e / rimier n, I 4tlenue �a�j• '�a�2- lob -501 �ei�q z.,�..2 acres i 4 �G /s6 erriSfi: - Sl i�sT�►q eA 303 , 1 ;.Ff7liwrE /,•ne �_ 45o be IW6 i ylac . EX� fp tl�,w/�;pin�a+�e1 Qa�;,/ince J ate ./ 1 _ 3v3�/' /u+r�lnr ! 1 � f�rrp�oserl ce7i�Ser ��a /y�c'/' szs �b�do•, �,r.�s,� eadr. i Qr�tofls� ex, j 1 - �.1<. Index & Tilte Sheet - Existing Septic Tank/Pump Chamber Replacement Project Name: Ryan Deneson & Nikea Connolly 4 bedroo Septic Tank/Pump Chamber Replacement Buyer's Name: Ryan Deneson & Nikea Connolly Buyer's adress: 990 101 st Street, Roberts, WI 54023 Site address: Same Project Location Subdivision: Lotl, CSM 21 -5191 Legal Description: NW1 /4 NW1 /4, Sec. 17, T.29N., R. 18W., Town of Warren, St. Croix Co., Wl. Parcel ID #: 042 - 1046 -50 -275 Page 1 Index and Title Sheet Page 2 Site Plan Page 3 Pump chamber cross - section Page 4 Mound system management plan Page 5 Septic Tank Maintenance Agreement Page 6 Waranty Deed Attachments: None Mater Pl ber Res 'cted Service: James K. Thompson, Dept. of Comm. efit jal #30021 Signature: 5 ' Date: Page 1 Of 6 Design pursuant to In- Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD- 10705 -P (N.01/01) i La�1, CSwt dof' LI,,�. I� p �1 �vl�1W See 17 5o,.�7S e 3o3s1FF'la /,•.,e J '1,a be << /J ace p.'j or• 5D Cane! ?c if 3 Ejri -sfi 1 3035 /uI;nc / w/aa /y La�i' LS.zS �bandonrd�s,o�rexle. % eAr a or - / /(tcw,2 old zro'^ziyla%n Rv.e, .�'orCtFyi0.in � 3107 ?� �J,�i /o ea�ion e f' ExiS�n�s n(d�„d e4 3 End ConneOr Lateral Lay ut Diagram Force main c onn"ion via teer 01 Gf65S to matWoNd b inn Laterals ate ideraia al 1 P s : gurrl -up W bd 11 oily# or � — + � lit s 4 , kxct m ain of l V C $ t.* 4* ol einovtplug r M1 Table 8430-5 Holes dnikd on the bottom of the lateral Number of Laterals 3 iriifflice ce Diameter 0.125 in Lateral Diameter 1.50 in Spacing (X) 2.54 ft Lateral Length (P) 58.42 ft Orifices per Lateral 24 Lateral Spacing (S) 3.33 ft Orifice Density 8.33 ft /orifice Lateral Flow Rate 9.89 gpm Manifold Length 6.67 ft System Flow Rate 29.66 gpm Manifold Diameter 2.00 in Total Dynamic Head 26.68 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ---► ii Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented F Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in. Ca aci 800.64 Gallons �— Volume 22.24 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 18.36 408.28 B 2.00 44.48 C Pump off elevation (ft) C 4.64 103.24 —t 83.42 D 11.00 244.64 D Total 36.00 800.64 ` Do se tank elevation '2 � 5� �J lr 3" Bedding un er tank. 82 50 �M}C s Alarm Manuafacturer LevelArm WAS 8-2-91 Alarm Model Number DLV Pump Manufacturer JZoeller Pump Model Number BN 153 Pump Must Deliver 29.66 gpm at 26. ft TDH Project: Renstrom /Deneson 3 bedroom tank replacement �X Page3 of 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), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706 -P (N. 01/01)] 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 subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. 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 tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD 30 mg /L TSS, 10 mg /L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specked in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related 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. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Pagel of �. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Buyer Mailing Address Property Address 9RO (Verification required from Planning & Zoning Department for new construction.) City /State G cti Parcel Identification Number el S/l —16(f "- LEGAL DESCRIPTION Property Location /) 10 1 /4 , & 0 '/4 , Sec. , T _g!j�_ R Town of e Subdivision Plat: ,Lot # Certified Survey Map # , Volume / , Page # Warranty Deed # (before 2007)Volume , Page # Spec house no Lot lines identifiable es iazw SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(l) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE * * *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 09/07) �, Soft 931936 SHERIFF'S DEED BETH PABST Document Number REGISTER OF DEEDS ST. CROIX CO., WI [Drafted by: Duncan C. Delhey RECEIVED FOR RECORD 02/09/2011 08:09 AM e No. 10 -CV -129 EXEMPT # 14 REC FEE: 30.00 PAGES: 1 ls Fargo Bank, N.A. * *The above recording information verifies that this document has been electronically recorded Plaintiff, & returned to the submitter vs. Mark D. Renstrom Sr. and Mary L. Renstrom THIS SPACE RESERVED FOR RECORDING DATA Defendants. NAME AND RETURN ADDRESS: Gray & Associates, L.L.P. Pursuant to a judgment of foreclosure entered in this matter, the subject Attorneys at Law premises was sold at auction to the highest and best bidder, Federal Home Loan 16345 West Glendale Drive Mortgage Corporation. Therefore, the sheriff does hereby grant and convey New Berlin, WI 53151 -2841 unto said successful bidder, all of the following described land, located in the County of St. Croix, State of Wisconsin, to wit: 042 - 1046 -50 -275 Lot I of Certified Survey Map recorded in Volume 21 on page Parcel Identification Number (PIN) 5191 as Document No. 822630 being a part of the Northwest Quarter of the Northwest Quarter (NW '/4 of NW %4), Section 17, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin. SHERIFF - nnnT.T�� (Strike the inappropriate title) Dcv\ STATE OF WISCONSIN ) )Ss COUNTY OF ST. CROIX) Personally came before me this � day of ' 2010, the above named n W m i s r personally known to me as the officer described above, and who executed this document as the sheriff o ^n "e„-� ^I fT; sheri of this county. Notary Public St. Croix Co , n W , i con�si My commission expires: by . 47 WdeU Notary mum State of Wisconsin 1 of 1 ti TOTAL DYNAMIC HEAD /CAPACITY HEAD .CAPACITY CURVE PER MINUTE j EFFLUENT AND DEWATERING MODEL 152/153 lz W MODEL 152 153 50 Feet Meters Gal. Liters Gal. Liters 153 5 1.5 69 261 77 291 12 40 152 10 3.1 61 231 70 265 15 4.6 53 201 61 231 _ 20 6.1 44 167 52 197 25 7.6 34 129 42 159 } 30 9.1 23 87 33 125 0 20 35 10.7 -- -- 22 85 40 12.2 -- -- 11 42 4— Lock Valve: 38.0 Ft. (11.6m) 44.0 Ft. (13.4m) 10 owae 0 20 60 80 100 GALLONS LITERS p 80 160 240 320 6 1/4 3 27/32 4 5/8 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 • rimed closilng panels avablle. y • EleWW altemaW, fbr duplex systems, are available and supplied with 3 27/32 1 an alarm. • Variable level contrd switches are avmWe for conlyding single plmse C 1 I • Doude plggpilad Vanabie leVei float SWlttheS ate aVallable for Vafiai>fe � level long and short cycle controls rt • Sealed Qwac -Box avabble lor'outdoor installations. See FM1420. • Over 130•F. (54 0 C.) special Wotalim fe9 1MN53 Soda 12 1/8 Model vohls•Phr No& skapkx OUPWI 51/8 N152 115 1 1 Nat 8.5 1 2r3 BN152 115 1 _ Aub 8.5 bduded 2ocr3 E152 230 RM 463 1 2or3 eKZOSr BE152 230 1 Aab 43 WkWed 2or3 N153 115 Non 10.5 1 2or3 BN153 115 1 Aub 105 Induded I 2or3 SELECTION GUIDE E153 230 1 No 13 1 2or3 1, Sin* pWybad variable level Boat swdch ordouble piggyback variable level float BE163 230 1 Awo 5.3 bdWed I 2or3 y*h, Refer bFM0477. L 2. See FMO712 br a n)d model of Electrical Apemabr E4 Al las didoa d caabois. POW= dsv(ess and wkW slxW be does by A qua80ad 3. Variable level coi*d wAcb 10.0225 aged as a control acivabr. spe* duplex (3) maned . NecbkM M dsd*d ad safely codes abaald be %lowed 9 ere gloat or (4) float system ,wnt >radoaat t3sctric cod. ptEt.7 cad tb. d safely aria h t�11b Ad t RESERVE POWERED DESIGN For unusual conditions a reserve saf* factor is engineered NO the design of every Zoe&v pump. MAR T0: P.O: BOX 18317 co Lei&^ KYrirbed LoWswitrk rn M/ -1101 ;(6& rP&M 5••UW IgW ,►m„o�►rrw.:o� coin PUlL1P !O. " ' � ' " 4 0 Copyright 2000 Zoeller Co. AN rights reserved. N O N O O N O O N N O 60). 0 6p, 6 t� Oq O C C a) M a 0 c O a c0 o C N N c0 0 c o E' =� E �� E = Vlaa C C 0-0 a a C N@ O .0.. O N C cp ' > a) o E> a) O E U) E 0 y E O a C O 0 ;_O = 0 O 0I a C N C a L C N O O T cu .0 7 C 10 O — J (D 3 � :S v _ c 3 0 o y m z O= >� a m� n 'O Z •� N O O .� zE N NO , c6 3 CU O_ p�L�Q 0 4 V a LL C N V N N = r N O •m o 0 a = a"0 E E a 'rn Q o z to Q `o z� m w m v Z E Z = O nF-Z am N O Z m a) N N E E c6 r CY 7 � Q O Q I! Z Z N _ c cn N c0 CL L N W a1 Q) C C a) a) < 0 U) U) V) El 8 O a O O a O O Z > r F- F- F- S U U E U U a�333 a0 O a0 O 0 O O O 'N �aan. > j a 1� 3 O M N (O CO N J U p N N Q Z Z Z a) U Z tE cO O Q O o _ a a E E =° O O C ml O o C G d. CO O C d Q Q A (n Z (n Q Q A M Z (n �p Q 7 r+ Lf) O Iv N [Q = N O E o a Q Lo a m a 'm .c °) u a o u c rn o o V N O L `= O a) c6 C 11 ° ca v N E c w m N m c a N w d c I'', r co w m 5 c (fl c o `o c Q) m ° U O} C7 Y N N O} O y 00 N N O CO p a 7 > a N E C (D° r Q) C a = E O CO v o z N Y z w a (n z N Y z a (n L d IL 'mil o v c c o _1 A Ua�i!,0UiU F7J /LL /zrjuz) 17.'+1 r1JfYJif1 ••..... - CERTIFIED S U R MAP LOCATED IN THE NW1 /4 OF THE NW1 /4 OF /� g SECTION 17, T29N, R1 SW, TOWN OF WARREN, V, J 1 / ST. CROIX COUNTY, WISCONSIN. OWNERS SURVEYOR ELDO $ MARIAN HAMANN EDWIN C FLANUM 1019 100TH AVENUE NORTHLAND SURVEYING, INC. ROBERTS, WI 54023 P.O. BOX 14 ROBERTS, WI 54023 SCALE IN FEET I' m 1 50' NW CORNER NOTE; SECTION 17 NO OWNER OR RESIDENT SHALL DO 160 O 1 ANYTHING THAT WOULD INTERFERE WITH OR CHANGE OPERATION OF THE PONDING SHOWN ON THIS CERTIFIED AREA SURVEY S MAP. THIS INCLUDES BUT 13 NOT o Ceg ` LIMITED TO BUILDING UPON, � 8q, OBSTRUCTING, ALTERING, FILLING, - � i „W 36 EXCAVATING OR PLANTING IN THE /,�, \� DRAINAGE AREA. �' 8 2 gg,9► 1 ' 100TH A C s�' � 44 _a$ Z30•o2� '� , o � O ^} BENCHMARK o m TOP OF REBAR N I ELEV. =1061.69 LOT 1 '--"�'� p z 1 N"• / m I N /� 2.22 ACRES g 96,904 SO, FT. ' ♦ 1 Ig I K3 N.B.A. = 1.7 AC. I z ' I� 1 m I lel \��a L.B.O 1066.14 i 1 V I 1 N83 °30'A4 '6 3 7B r+ 1 T3 I�I� s BENCHMARK I� ®� ` � �o�o�o o_m., I 4 S t \ TOP OF REBAR ; 1 y1 I� _° I � � 5a try ELEV, = 1073,11: 66' N �+\ I v1� � u w aC'T N89 0 194 1 48"W 388.O CI m �\\ �� LOT 2 �' � &A 300.00 �' �, 2.37 ACRES o L5 � 103,358 SO. FT, �, '• � / 1 j p N':B,A. �. 2.2 AC. o� I ` vl • CENTER LOT 3 I A 2.51 ACRES N85 1 �p 1 109.277 SQ. FT. I 1 q r N,B,A, _= 2.5 AC. l 760.40 1 i N8b °pg'S5 "E e26,40' 60' RADIUS TEMPORARY 1 TO 13E REMOVED UPON ROAD EXTENSION AND 1 1 EASEMENT EXTINGUISHED. I I SOUTH LINE OF THE NW OF THE NW1 14 Ln DRAINAGE AREA LINE TABLE LEGEND NUMBER BEARING DISTANCE ALUMINUM COUNTY SECTION m L1 S07 "1 9'45 'E 113.49' CORNER MONUMENT FOUND N { L2 S51 "68'40`W 90.73' L3 • 1 5/16" O.D. IRON PIPE FOUND S15°18'40"E 103.35' L4 S17 °47'24 "E 158.17' 3/4" IRON REBAR FOUND L5 $72 °12'38'W 50.00' L6 N1 7 °4724 "W 159.25' O 3/4" X 18" IRON REBAR SET WEIGHING vn 1 130 oco I IAICAO Cnn wiscongin r- §lpartmentofCommerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety ail!d Building Division 6 t ' I f INSPECTION REPORT Sanitary Permit No: 488246 k�O�D 1� e we (ATTACH TO PERMIT) GENERAL INFORMATION��„ ��` State Plan ID No: Personal information you provide may used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: nelson, ary Warren, Town of 642 - 16q f, - 5o - 2 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: / l UU / 5 �� �ut �r'i uz_ 17, z`1 I $ . Z(-Z 6-3,b TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 0 Benchmark Dosing Alt. BM I c �(02 Aeration Bldg. Sewer W 303 16 -o P �•S _6�-ez' Holding 9 t /Ht Inlet TANK SETBACK INFORMATION Y/ Ht O ut l et +4 V enttoAirintake ROAD Dt Inle eptic � / Bottom rh �•q osmg ea er A eration LP D ist. Pipe 6J, C9 o ing Bot. 5ystem m PUMP /SIPHON INFORMATION � e anu ac urer /' n / �/- n GPM an over v m odel um er i ric ion Oss ys em ea_ rY. 2 .v U_ S Zto.�9 T77ce rnain Lengin i . DIMENSIONS 1 / Ul � I CH INFORMATION l l ye) ��N�_ �� , UNIT „ nom '7 ulu Pipe(s) 0 _ ' /� r•S �--- > _ rQ Dia Length Dia Spacing 6 � x Pressure Systems Only xx Mound Or At - Grade Systems Only Bed /trench Center Bed /Trench Edges Topsoil Yes No ;Yes r No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / /Inspection #2: Location: 990 101st St Roberts, WI 54023 (NW 1/4 NW /4 17 T29N R18W) NA Lot 1 �" � � (� Parcel No: 1.) Alt BM Description M 2.) Bldg sewer length = 3 - amount of cover Plan revision Required? Yes � ' No G Use other side for additional information. L Date- {ns� Sigrtat SBD -6710 (R.3/97) r Safety and Buildings Division County ar 201 W. Washington Ave., P.O. Box 7I62 j iseonsin Madison, WI 53707 — 7162 Sanitary Permit Number ( to be filled in by Co.) Department of Commerce (608)266 -3151 Z/ Sanitary Permit Application State Plan I.D. Number � In accord with Comm 83.21, Wis. Adm. Code, personal information you e ' ° 1 3JV55 7 may be used for secondary purposes privacy Law, s] 5.04(1 Project Address (if different than mailing address) I. Application Information — Please Print I Inf Property Owner's Name P Lot Block # AUG 2 5 2006 ^GLJ / � \ Prop s mg Address ST. CROIX COUNTY Property ti City, State Zip Code Phone Number 4 Y- JJ�- %, Section Z7 ` �` circ a cam) II. T e of Building i R orQW yp g (check all that apply) I or 2 Family Dwelling — Number of Bedrooms $� O J C -- a CSM Number _ M:.__: ✓61 7 ❑ pubIic /Commercial — Describe Use ❑ State Owned — Describe Use (p D /A J., ❑City Village NlTowmship of III. Type of Permit: (Check only one box online A. Complete line B if applicable) A ❑ New System ❑ Replacement Y� ep System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner Zq �No.—P..,surizedln-Ground POWTS S stem: Check all that a X Mound > 24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ At - Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized I.Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recircul ' g Sand Filter ❑ ❑ ❑ ❑ ❑ 7 q i Recirculating Synthetic Media Filter Leaching Chamber Drip Line Gravel -less Pipe Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application RaWgpdsf) Dispersal Area Requi (sf) Dispersal Area Propos sf) System Elevation . 111' Sao° 9 b1 / V1. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plasti Gallons Gallons of Units Concrete Constructed Glass New Existing /� 5z5 ^/ Tanks Tanks L✓ t1 ` �, Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Respons Statement- I, the undersigned, a e responsibility for installation of the POWTS shown on the attached plans Plumber's N e nt Plumber's i MP/MPRS Number Business Phone Number Plum er's dress (Street, City, State, Zip Code) 4d ��k-�,Z ) I A *ppr.ved Coun /De artment Use On ❑ Sanitary Permit Fee (includes Groundwater D Lssu lssuin gent Sign ps Surcharge Fee) I]=- ven R eason for ial 75 • 6 0 $ 28 fv IX. Conditions of Approval/Reasons for Disapproval 3) -AL 4--& Ke- i. pptic tat*, effluent ° !'er apd di Mrsal cell must al. be 5$ as por manage fnent plea , 2 M s4ick requirement§ 7,, ,� rhAMNIM NOS /&lr�• Attach complete plans (to the County only),for the system on paper not less than SM x I1 ioehes in s ize SBD -6398 (R. 01/03) = t -KigP t A40 MITSYS 16-o 'a, c -22 goo 1p O - T.S* co ' � () f C,09 %VIGS ID )45 E SPONDEN G S ................. X F r s n 3c;OL/E j op � � V { v f / � w r te+• .,70 / / P.O• / Z conditio nay P OVEN COMMERC OF D SU1LD%% EPA, g10N4M O R E SPONDE � C � `�.� EE G � S I � b a i Safety and Buildings 4003 N KINNEY COULEE RD commerce .Wl.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.commer isco gov/sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary August 22, 2006 CUST ID No. 224263 ATTN. Pam KIM A O CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/22/2008 Identification Numbers Transaction ID No. 1314559 SITE: Site ID No. 713547 Gary Neslon Please refer to both identification numbers, 100TH St above, in all correspondence with the agency, Town of Warren St Croix County NW 1/4, NW1 /4, S17, T29N, R18W Lot: 1, FOR: Description: 4 Bedroom Design Object Type: POWTS Component Manual Regulated Object ID No.: 1078188 Revision; Maintenance required; 36 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /O1); Poly -Lok PL -525 Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes 10 and Wisconsin Statutes The submittal has been CONDITIONALLY APPROVED This s'y o tt �tv coo"As "W', W Q• attd °located in abtrartce with thegrt�vd plate attd vi ctxapotteat matival(sefeett ab�. C ,011 The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. 5o The following conditions shall be met during construction or installation and prior to occupancy or use: 5 Reminders • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD- 10706 -P (N.01/01). • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD- 10691- P(N.01 /01). • The revision for this previously approved plan affects the length and width. This in turn required a change in the distribution network. All other aspects remain essentially unchanged from the original design. 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 KIM A O CONNELL Page 2 8/22/2006 required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 75.00 Fee Received $ 75.00 Balance Due $ 0.00 D enri R Sorenson Wastewater Specialist , Integrated Services WiSMART code: 7633 (608)785 -9336, dsorenson @commerce. state. wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Kim A. O'connell, K 0 Construction s q MOUND AND PRESSURE DISTRIBUTION COMPONENT DESI G �' 1 Residential Application 6' INDEX AND TITLE PAGE YJ Project Name: GARY NELSON y49 Owner's Name: GARY NELSON Owner's Address: 1027 110TH ST ROBERTS WI 54023 Legal Description: NW -NW -SEC 17-- T29N --R18W Township: WARREN County: ST. CROIX Subdivision Name: CSM Lot Number: 1 Block Number: Parcel I.D. Number: Plan Transaction No,: 1276294 S. Pagel Index and title ��y�dlty Page 2 Data entry fop Page 3 Mound drawings Page 4 Lateral and dose tank 0f cOMMERCEpG'i Page 5 System maintenance specifications MEN EZ Np gpt�p Page 6 Management and contingency plan 'f S Page 7 Pump curve and specifications r ON pENC� Page 8 Plot Plan GORRESP Designer: KIM A OCON ELL License Number: 224263 Date: 08/02/06 Phone Number: 715 - 755 -3145 7V KZI 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 4.01 (R. 09/04) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of <= 36 inches. 600.00 Design Flow (gpd) 7.00 Site Slope ( %) 99.04 Contour Line Elevation (ft) 36.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd/ft Distribution Cell Information 60.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft 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) E Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) = 8.33 ft /orifice 2.00 Forcemain Diameter (in) - 100.00 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 16.31 Forcemain Drainback (gal) 15.3 , Vertical Lift (ft) 80.40 5x Void Volume (gal) Friction Loss (ft) 96 Minimum Dose Volume (gal) Total Dynamic Head (ft) 29. System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options I choice in. dia. options I choice 0.75 1.25 x 1.00 1.50 x 1.25 x 2.00 x X 1.50 x X IF 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 1260.00 Total Tank Capacity (gal) 1260.00 Septic Tank Capacity (gal) 58.00 Total Working Liquid Depth (in) WEEKS Manufacturer 21.72 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) PLOY -LOK Filter Manufacturer 21.76 Dose Tank Volume (gal /in) PL- -525 Filter Model Number WEEKS Manufacturer Project: GARY NELSON Page 2 of 8 Mound Plan View 1/10 B J Observation Pipe ..�::::::: — FK O A w ....... B . ....:.......................... I Ll L Mound Component Dimensions A 10.00 ft E 14.40 in H 1.00 ft K Eaft ft B 60.00 ft F 9.50 in 1 9.46 ft L ft D 6.00 in G 0.50 ft J 4.44 ft w 600.00 (ft 2 ) Dispersal Cell Area 1 1167.72 (ft) Basal Area Available 10.00 (gpd /ft) Linear Loading Rate 1 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.33 (ft) --► ♦ H F Dispersal cell 100.04 (ft) Lateral G�) Invert 3 ii'i i ;iii''' iii; :;'iii ;i:-:.:iii i iiii'i i i.•:;:;.,' Dispersal Cell Elevation D� ; 3 � s :� ~�`�':`::: - E t 4 99.04 (ft) Contour Elevation 7.0 % Site Slope Geotextile Fabric Cover Shading Key 'o $', - T Dispersal Cell See lateral details on [] , Topsoil Cap .a 1.5 ft Page 4 for number, size, Q " " " "' Subsoil Cap c Q and spacing of laterals. ,,.,,,.,, /'�'Q Q ASTM C33 Sand :o `° � � / F Laterals are equally 0.5 ft Typical Lateral spaced from the ® Tilled Layer c °�' distribution cell's ❑5 Aggregate a ❑ o 5 centerline in the �--- A distribution cell ( Project: GARY NELSON Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over the A & B dimension •— Turn -up vdball valve or cleanoutpluo e P All laterals are identical I<- x Hol es drilled on the bottom of the lateral s equally spaced Laterals & force main of PVC Sch 40 3 (per COMM Table 84.30 - Force main connection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.54 ft Lateral Length (P) 58.42 ft Orifices per Lateral 24 Lateral Spacing (S) 3.33 ft Orifice Density 8.33 ft /orifice Lateral Flow Rate 9.89 gpm Manifold Length 6.67 ft System Flow Rate 29.66 gpm Manifold Diameter 2.00 in Total Dynamic Head 23.77 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover wfthwarning 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 E— Alternate outlet location Forcemain diameter WEEKS Manufacturer 2 in. Cap acityl 800.00 Gallons Volume 21.76 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 22.32 485.68 B 2.00 43.52 C P um off e levation (ft) C 4.44 96.72 t 84.67 D 8.00 174.08 D Total 36.76F D� ose tank elevation (ft) 3" Bedding 4er tank. 1 84.00 Alarm Manuafacturer SEPTRONIC INC Alarm Model Number TM1 / Pump Manufacturer STA -RITE Pump Model Number EC4 Pump Must Deliver 29.66 gpm at 23.7 ft TDH Project: GARY NELSON 26 10 1 Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name KIM A OCONNELL Phone 715- 755 -3145 POWTS Regulator's Name ST. CROIX COUNTY ZONING Phone 715 - 386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1260 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency .Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once ever y 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 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 ...� • .............0 Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral mss. Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: GARY NELSON Page 5 of 8 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 subject to failure must be replaced. Exposed access openings greater than 84nches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are 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 fitter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verity 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 seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 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 specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the some or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related 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: GARY NELSON Page 6 of 8 ®7f COMPOSITE CURVES STA -RITE' EFFLUENT/S PUMP CAPACITY LITRES PER MINUTE 0 50 100 150 200 250 300 350 400 450 500 550 90 Gyj 26 A 80 24 22 70 Fc FC `2 20 \ �yA 60 18 ti FC Aso S0 `�� 16 W I W hip yo , �- LU 50 14 0 c W y 0 40 6s0 / 12 c � 10 .o y� 30 20 yo 6 FC •� 4 10 2 A 0 0 25 50 75 100 125 150 CAPACITY GALLONS PER MINUTE NOTE.• Please see page 11 forS T.E.P Plus' Series performance curves. 20 1903 j SOIL EVALUATION REPORT p age 1 of 3 Wisconsin Deparhnerrt�Commerce Division of Safety and Buildings in accor Comm 85 is ARW A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8'% x 11 inc in ust County St. Croix include, but not limited to: vertical and horizontal reference point rr and percent slope, scale or dimemsions, north arrow, and location and rest *. Y 0 2 N@@ I. D. Prt of 042 -1046- 0 -000 Please print all infonnadon. ST. CROIX G 6W4wed Date Personal arbrmahm you provide may be used for secondary WPom (fteY Law, s. 5.04 (t) (2MNING 0 FILE Property Owner Property Location Eldo E. & Marian E. Hamann Govt. Lot NW 1/4 NW 1/4 S 17 T 29 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1019100th Ave. 1 1 Proposed CSM City State Zip Code Phone Number J City _f Village a Town Nearest Road Roberts WI 1 54023 1 (715) 749 - 3903 Warren 1 100Th Ave. 91 New Construction Use: W1 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial - Describe: Parent material Glacial till Flood plain elevation, if applicable na General comments and recommendations: Install mound system with 5' 90' dispersal cell. System elevation to be 99.54' at 6' above 99.04' contour. tab 1 - 1 Boring # J Boring 10 Pit Ground Surface elev. 99.04 ft. Depth to limiting factor 3 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 1 Oyr3/2 none sil 2fsbk mvfr cs 2fm,1 c 0.6 0.8 2 9 -16 1Oyr4/4 none sil 2fsbk mvfr gw 2fm,1c 0.6 0.8 3 16-24 7.5yr4/6 none sl 2msbk mfr cw 1vf,f 0.6 1.0 4 24-38 7.5yr4/6 none scl 1csbk mfr aw 1vf 0.2 0.3 5 38-46 10yr6/8 none LSBR Na Na - - 0.0 0.0 2] Boring # -1 Boring 01 Pit Ground Surface elev. 99.04 ft. Depth to limiting factor 39° in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 1Oyr3/3 none sil 2fsbk mvfr cs 2fm,1c 0.6 0.8 2 8-18 1Oyr5/4 none sicl 2fsbk mvfr gw 2fm,lc 0.6 0.8 3 18-39 7.5yr4/6 none sl 2msbk mfr cW 1vf,f 0.6 1.0 4 39-62 7.5yr4/6 f2f 7.5yr5/8 scl 1 msbk mfr aw 1vf 0.2 0.3 5 62 -71 5yr4/4 1cp 7.5yr5/8 scl Om mfi - - 0.0 0.0 • Effluent #1 = BOD 30 < 220 mg/L a TSS >30 < 1 1` ' E uent #2 = BOD <30 mg/L and TSS <,0 mg/L CST Name (Please Print) Signature: CST Number James K Thompson 7 � 3602 Address A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, 154020 4222005 715- 248 -7767 y Property owner Eldo E. & Marian E. Hamann Parcel ID # Prt of 042- 1046 -50 -000 Page 2 of 3 3] Boring # J On g Pit Ground Surface elev. 96.64 ft. Depth to limiting factor 36" 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 1 0-9 10yr3/3 none sil 2fsbk mvfr cs 2fm,1c 0.6 0.8 2 9 -21 10yr5/4 none Sid 2fsbk mvfr gw 2fm,1c 0.6 0.8 3 21 -36 7.5yr4/6 none sl 2msbk mfr cw 1vf,f 0.6 1.0 4 36-49 7.5yr4/6 f2f 7.5yr5/8 scl 1 msbk mfr aw 1 of 0.2 0.3 5 49 -56 5yr4/4 1 cp 7.5yr5/8 Sd 0m mfi - - 0.0 0.0 F 4] Boring # Boring 60,1 Pit Ground Surface elev. Na ft. Depth to limiting factor Na in. Soil Application Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0 -15 10yr3/3 none sl 2fsbk mvfr aw 2fm 0.6 1.0 2 15-18 10yr5/6 none Is 2fsbk mvfr aw 2fm 0.7 1.6 3 18-33 10yr3/2 none SO 2fsbk mvfr gw 2f 0.6 0.8 4 33-42 10yr4/3 none sil 2fsbk mvfr gw 1vf,f 0.6 0.8 5 42-60 10yr5/4 none SH 2msbk mfr cw 1vf 0.6 0.8 6 60-73 10yr4/4 f2f 7.5yr5/8 sl 2msbk mfr cw - 0.6 1.0 Soil evaluation comp ed to identify soil conditions within designated "drainage area ". 5] Boring # J Boring Pit Ground Surface elev. Na ft. Depth to limiting factor Na 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 1 0 -19 10yr3/3 none I 2fsbk mvfr aw 2fm 0.6 0.8 2 19-24 10yr4/6 none Is 2fsbk mvfr aw 2fm 0.7 1.6 3 24-40 10yr3/2 none sit 2fsbk mvfr gw 2f 0.6 0.8 4 40-46 10yr4/3 none sil 2fsbk mvfr gw 1vf,f 0.6 0.8 5 46-58 10yr5/4 none SO 2msbk mfr cw 1vf 0.6 0.8 6 58 -83 10yr52 m3d 7.5yr5/8 sid 1 msbk mfr - - 0.2 0.3 Soil evaluation completed to identify soil conditions within designated "drainage area ". 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 m an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777. .. ♦ EX� fi •��' rz /� N Q 0' N � /�e.�•' ;� i903, Rimed /o�� iGV ` Alc `I �I ■ � II i I � � I � 1 97 so' 99sc' i Co�rfr�u� i c; 1 / 1 �E 9942 / r I t 62 e ,�l />< • FJ.in. � 7 - oF'y�. � � ✓. G. �J; pt . �ssu.n ed' 1 � ✓. c. N,;oe. Elm = 9G.SS' 2/e� = /CYl• �' pa q0 0 MAY 0 2 100 ZONING OFFICE CERTIFIED SURVEY MAP LOCATED IN THE NW1 /4 OF THE NW1 /4 OF SECTION 17, T29N, R1 8W, TOWN OF WARREN, ST. CROIX COUNTY, WISCONSIN. OWNERS SURVEYOR ELDO & MARIAN HAMANN EDWIN C FLANUM NW CORNER 1019 100TH AVENUE NORTHLAND SURVEYING, INC. SECTION 17 ROBERTS, WI 54023 P.O. BOX 14 ROBERTS, WI 54023 \may \ / ; 9 \ �,� I - 9 1 -1044 46 ? 4a „w 35a W ?° 4 w ci w_ g4'4fl'W 286.9 I w w S7 230.02 , \ 100TH A W - -- — C2 �- —•�— —T- A = o o m � 1 I min I N I co C1>4 m A I °o J ............... co ��o I 0 �........ LOT 1 ” o c o ( 2.22 ACRES m I \ 96,904 SQ, FT. I 33' 133' I co O 1 N.B.A. = 1.7 AC. I z 01 I � Op z (SA�. 409 0 (_ S �8\ \w ; ° ` V I G°3GC�OG°DGDI W \ \ \ \\ N83 °30'44 "E 367.78' `• I J i N I �( N I e° � Ln I W rn 0 1 w \ 50 \ rp ca (71 O a I �� O� \ \ \ N i I I ❑ o I \ N89 0 54'46 "W 366.0 N \\ \\ °' I j)o 0 300.00' 66.00' \� , LOT 2 I �1� N O � 2.37 ACRES \ I W p a 103,358 SQ. FT. I ` v1 ° N.B.A. = 2.2 AC.: 80'R TE P. -� LOT 3 i CUL S ' Nn1 2.51 ACRES N85 °05'55 "E 387.98' CC rn I 109,277 SQ. FT. ' N N.B.A. = 2.5 AC. 0) 0 1 760.40' 80 I ' RADIUS TEMPORARY W N85 °05'55 "E 826.40' CUL -DE -SAC EASEMENT TO I MMpdLa44C D dLQMD� BE EXTINGU ON ROAD EXTENSION I ------------- - - - - -- I o SOUTH LINE OF THE I o \\ NW1 /4 OF THE NW1 /4 A \ � DRAINAGE AREA LINE TABLE LEGEND I A NUMBER BEARING DISTANCE I ALUMINUM COUNTY SECTION ML 0 I L1 S00 °53'26 "W 110.57' CORNER MONUMENT FOUND ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address s Property Address s (Verificatio required from Planning & Zoning Department for new construction.) City /State fiz, �-- Pa rcel Identification Number LEGAL DESCRIPTION Property Location _d 1/ ice' /4 , Sec., T R Town of Subdivision - - Lot # XCertified Survey Map # R�� .s �� , Volume , Page # Warranty Deed # , Volume , Page # Spec house es o- Lot lines identifiable no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on - site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms_ IGN OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** L-iclude with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) 82?'?'l62 State Bar of Wisconsin Form 7 -2003 TRUSTEE'S DEED KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX GO., MI Document Number Document Name RECEIVED FOR RECORD 06/19/2086 02:58PH THIS DEED, made between Eldo E. Hamann and Marian E. Hamann TRUSTEES DEED as Trustees e€ and successor Trustees of the Eldo E. Hamann and Marian E. Hamann EXEMPT # Revocable Living Trust dated December 22, 2003 (°'Grantor," whether one or more), and Gary D. Nelson and Jillienne J. Nelson, husband and wife REC FEE: 11.00 TRAITS FEE: 186.00 COPY FEE: ("Grantee," whether one or more). C AGE : 1 Grantor conveys to Grantee, without warranty, the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Recording Area St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Name and Return Address Wisconsin Assured Title, LLC 1810 Crest View Drive, #1 B 6 07t1 f Certified Survey Map recorded in V olume 21 on Hudson, WI 54016 page 5191 as Document No. 822630 being a part of the oN rthwest Quarter of the Northwest Quarter (NW% of 042 - 1046 - 50 - 000 Dart of NWI /4), Section 17, Township 29 North, Range 18 West, Parcel Identification Number (PIN) Town of Warren, St. Croix County, Wisconsin. Dated June 162006 (SEAL (SEAL) * Eldo E. Hamann, Trustee * Marian E. Hamann, Trustee (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) authenticated on ) ss. St. Croix COUNTY ) NOTARY Personally came before me on this 16" day of JUNE, 2006 the above -named Eldo E. Hamann and Marian E. Hamann TITLE: MEMBER ST R O N as Trustees of the Eldo E. Hamann and Marian E. Hamann 9� Revocable Living Trust dated December 22. 2003 (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. S e,G o nd acknowled s e "PHIS INSTRUMENT DRAFTED BY: s Richard K.Y. Lau - Redmon Law Chartered , 2217 Vine St., Ste. 204 — Hudson, WI 54016 Notary Public, State of Wisconsin My Commission is permanent) (expires: l! O hl 50 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. TRUSTEE'S DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 7-2003 • Type name below signatures. I Of I r . 82263 VOL 21 PAGE 5191 KAT11LESA H. REGISTER OF DEEDS ST. CROIX Co., WI CERTIFIED S V RVE V MAP RECEIVED FOR R E CORD LOCATED IN THE NW1 /4 OF THE NW1 /4 OF CERTIFIED SURVEY MAP SECTION 17, T29N, R18W, TOWN OF WARREN REC FEE: 15.00 ST. CROIX COUNTY, WISCONSIN COPY FEE: 4.00 PAGES 3 OWNER HAMANN SURVEYOR `a4 ��s i CpNS; j� 1019 100TH AVENUE NORTHLAND SURVEYING, INC. ROBERTS, WI 54023 P.O. BOX 14 s EDWIN C. ROBERTS, WI 54023 Ft SUM £ SCALE IN FEET 1" = 1S0' NW CORNER NOTE: _ AMERY SECTION 17 NO OWNER OR RESIDENT SHALL DO WIS Aso O 150 ANYTHING THAT WOULD INTERFERE WITH (j OR CHANGE OPERATION OF THE PONDING AREA AS SHOWN ON THIS CERTIFIED g� SURVEY MAP. THIS INCLUDES BUT IS NOT - �Y LIMITED TO BUILDING UPON, \ � OBSTRUCTING, ALTERING, FILLING, - — w 355.19 v � � EXCAVATING OR PLANTING IN THE �—"'.rogq`48 m DRAINAGE AREA. 1_ S 66. 91, o IOOTH A - - -- \ _ ___ cz 5 I � 1 BENCHMARK H.VI 1O4{. �! � I rr 1 m TOP OF REBAR 44t4 I ; 2 , N N ELEV. = 1061.69 N p '� c LOT 7 C-) M 1 co m N 0 i 96,904 R.O. FT. •. I �� p I i is I N.B.A. = 1.7 AC. I 3 I I O L.B.O. - 1066.14 w a �'\ , N83 °3044 "E 367.78 _� � o�oLfVU O O Lf�J I io BENCHMARK yl j� o U \ TOP OF REBAR . = 1073. ELEV71 ` w o - - - - -- - 665' \ rn\ 50 \ 33'`33' Iu o 12 N89 °54'46' W 366.00' \\ \\ LOT 2 A 7 II � 300.00 66.00 L - 2.37 ACRES - / l ` a n� Q 103.358 SO. FT. l 1 v _ A + N.B.A. = 2.2 AC. / 1 I� a c 1 I � -� A LOT 3 W ? . I CENTER p. 2.51 ACRES N85 °0555 "E 387.98' / 1 Q N 109,277 SO. FT. A N.B.A. = 2.5 AC. - 1 L. - -. — 760.4U— 1 N85°05'55 'E 826.40' 80 RADIUS TEMPORARY o C Fg) CUL -DE -SAC TO BE REMOVED 1 KUP&A - UPON ROAD EXTENSION AND I 1 SOUTH LINE OF THE EASEMENT EXTINGUISHED. 1 1 C�— NW1 /4 O F THE NW1 /4 DRAINAGE AREA LINE TABLE LEGEND ii NUMBER BEARING DISTANCE ALUMINUM COUNTY SECTION N L1 S07 °19'45 "E 113.49 CORNER MONUMENT FOUND � L2 S51 °5940 - W 90.73 L3 S15 °18'40 "E 103.36 1 5/16" O.D. IRON PIPE FOUND L4 S17°47'24 "E 158.17' 314" IRON REBAR FOUND L5 S72°1236"W 50.00' F LU L6 N17 159.25' p 314"X 18" IRON REBAR SET WEIGHING N W1 /4 CORNER 1-7 N15 °18'40"W 91.65' 1.50 LBS. PER LINEAR FOOT C) ILS SECTION 17 N78 °54'S9'W 17.51' A SOIL TEST w o CURVE DATA TABLE ¢ ¢ —X X EXISTING FENCELINE tL 8 NUMBER C7 C2 af RADIUS 1302.00' 1335.00' 100' BUILDING SETBACK LINE w it CENTRAL ANGLE 2 °30'59" 2°45'42" �k Z �4• PROPOSED DRIVE ti 0 CHORD BEARING S79 ° 00'17.5W S79 °07'39"W _Z X CHORD LENGTH 57.18' 64.34' N.B.A. = NET BUILDABLE AREA p ARC LENGTH 57.19' 64.36 m v TANGENT IN S77 "W S77 °44'48'NV _ -. - -. _ 12' WIDE UTILITY EASEMENT TANGENT OUT S80 S80 L.B.O. = LOWEST BUILDING OPENING THIS INSTRUMENT DRAFTED BY SAM ADAMS JOB NO. 05 -14 DATE 3 -29-05 SHEET 1 OF 3 SHEETS H.W.L. = HIGH WATER LINE ELEVATION 1 of 3 Vol 21 Page 5191 r Safety and Buildings Division County ` m = 201 W. Washington Ave., P.O. Box 7162 iseonsin Madison, WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) 151 Z Sanitary Permit Appliea on State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal informatio ovide 7_0�S • /A* ; 62 9 may be used for secondary purposes Privacy Law, s15.04(Ixm) Project Address (if different than mailing dress) I. Application Information — Please Print All Information F_ R ECE _ 1 VEQ ---- 1 Property Owner's Name y Parse # Lot # Block # Property Own Mailing Address 1 ST. CROIX COUNTY '/ 1 city, Y., Y.., Section J y tY, Zip Code / 7 circle o e) Te N; RE o II. Type of Building (chec 11 that apply) I or 2 Family Dwelling — Num of Bedrooms -� CSM Number ❑ Public/Commercial — Describe Use li • ❑ State Owned — Describe Use ❑City ❑Village Township of ,t III. Type of Permit: (Check only one bo n line A. Complete line B if applicable A. ,XNew System ❑ Replacement Sy ste ❑ Treatment/Holding Tank 1 Only ❑ Other Modification to Existing System B• ❑ Permit Renewal ❑ Permit Revision I N g, of ❑ t Transfer to New List Previous Permit Number and Date Issued Before Expiration Pl er IV. Type of POWTS System: Check all that a k M p ❑ Non — Pressurized In- Ground X Mound > 24 in. of suitable soil ound < 24 in. of suitable soil ❑ At -Grade El Single Pass Sand Filter El Constructed Wetland 11 Pressurized In -Ground 11 Holding Tank ❑ Pea 'Iter . ❑ Aerobic Treatment Unit 11 Recirculating Sand Filter El Recirculating Synthetic Media Filter C1 Leaching Chamber 11 rip Line 101 el Pipe 11 Other (explain) i V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required ( Dispersal Area Proposed (sf) System El T• VI. Tank Info Capacity in Total umber ufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Units W jP,' 7 Concrete Constructed Glass New Existing /� an ` T Tanks Tanks Septic or Holding Tank Aerobic Treannent Unit Dosing Chamber 7 VII. Responsibility Statement I, th4undersigned, assn a responsibility for installation of the POWTS shown ON he attached plans. Plumber's ame (Print) Plumber' Si e , MP/MPRS Number Business Phone Number P u Ad m er's ress treet, City, S , Zip Code ) / ✓ S� l E c9 VIII. Coun epartme On X Approved ❑ Disapp ed Sanitary Permit Fee (in ludes Groundwater Date Issued Issuing Agen 'gnature (No tamps) . , Denial Surcharge Fee) SL-�,_ Z 3 IX. Conditions Approv It Val I - - SYSTEM NER: 3) /Jo P o.7� ' O6 S s Co-� w 1 Septic tank, effluent filter and (� ' a dispersal cell must all be serviced / maintained o`'� as per management plan provided by plumber. c�lj. S 2. All setback requirements must be maintained as per applicable code /ordinances. 6 Attach complete plans (to the County only),for the system on paper not lens than SW x 11 inches i SBD -6398 (R. 01/03) 1903 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Dim of Safety and Buildings in ✓, CQgim 85, Me. '" a ' A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 894 x 11 i in ust '' Courrty St. CfODC include, but not limited to: vertical and horizontal reference point and percent slope, scale a dmemsions, north arrow, and location and ' est Y 0 2 I I.D. Prt of 042- 1046 - 50-000 Please print all information. ST. CROIX C 600pied Date Personal information you provide may be used far secondary p (may Law, s. 5.04 (t) (09NING 0 ICE Property Owner Property Location Eldo E. & Marian E. Hamann Govt. Lot NW 1/4 NW 19 S 17 T 29 NR 18 W Property OwrWs Mailing Address Lot # Block # Subd. Name or CSM# 1019100th Ave. 1 Proposed CSM City State Zip Code Phone Number t City ] Village M Town Nearest Road Roberts WI 1 54023 1 (715) 749 - 3903 Warren 1 100Th Ave. JM New Construction Use: 1A Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Id Public or commercial - Describe: Parent material Glacial till Flood plain elevation, if applicable na General comments and recommendations: Install mound system with 5'x 90' dispersal cell. System elevation to be 99.54' at 6' above 99.04' contour. Boring # j Boring id Pit Ground Surface elev. 99.04 ft. Depth to limiting factor 38" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/lf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/2 none sil 2fsbk mvfr cs 2fm,1 c 0.6 0.8 2 9 -16 10yr4/4 none sil 2fsbk mvfr gw 2fm,lc 0.6 0.8 3 16-24 7.5yr4/6 none sl 2msbk mfr cw 1 vf,f 0.6 1.0 4 24-38 7.5yr4/6 none scl lcsbk mfr aw 1vf 0.2 0.3 5 38-46 1Oyr6/8 none LSBR Na Na - - 0.0 0.0 Boring # Boring Pit Ground Surface elev. 99.04 ft. Depth to limiting factor 39" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. *Eff#1 *Eff#2 1 0 10yr3/3 none sil 2fsbk mvfr cs 2fm,1c 0.6 0.8 2 8 -18 1Oyr5/4 none sicl 2fsbk mvfr gw 2fm,1c 0.6 0.8 3 18-39 7.5yr4/6 none sl 2msbk mfr cw 1vf,f 0.6 1.0 4 39-62 7.5yr4/6 12f 7.5yr5/8 scl 1 msbk mfr aw 1 of 0.2 0.3 5 62 -71 5yr4/4 1cp 7.5yr5/8 scl Om mfi - - 0.0 0.0 Effluent #1 = BOD 30 < 220 mg/L ar I TSS >30 < 1 mg/L * E uent #2 = BOD s mg/L and TSS <-30 mg/L CST Name (Please Print) Sigrrature: CST Number James K Thompson �O 3602 Address A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane Osceola, 154020 4222005 715 - 248 -7767 � F " Property Owner Eldo E. & Marian E. Hamann Parcel ID # Prt of 042 - 1046 -50 -000 Page 2 of 3 3 F Boring Boring # 96.64 ft. Depth to limits factor 36 In. Pit Ground Surface elev. � " Sat Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff ll *Eff#2 1 0-9 1Oyr3/3 none sil 2fsbk mvfr cs 2fm,1c 0.6 0.8 2 9 -21 10yr5/4 none sicl 2fsbk mvfr gw 2fm,1c 0.6 0.8 3 21 -36 7.5yr4/6 none sl 2msbk mfr CW 1vf,f 0.6 1.0 4 36-49 7.5yr4/6 f2f 7.5yr5/8 sd 1 msbk mfr aw 1 of 0.2 0.3 5 49-56 5yr4/4 1cp 7.5yr5/8 sd Om mfi - - 0.0 0.0 a Boring # Boring Pit Ground Surface elev. Na ft. Depth to limiting factor Na in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -15 10yr3/3 none sl 2fsbk mvfr aw 21m 0.6 1.0 2 15-18 10yr5/6 none Is 2%bk mvfr aw 2fm 0.7 1.6 3 18-33 10yr3/2 none sil 2fsbk mvfr gw 2f 0.6 0.8 4 33-42 1Oyr4/3 none sil 2fsbk mvfr gw 1vf,f 0.6 0.8 5 42-60 10yr5/4 none sil 2msbk mfr cw 1vf 0.6 0.8 6 60-73 1 Oyr4 /4 f2f 7.5yr5/8 si 2msbk mfr cw - 0.6 1.0 Soil evaluation completed to identify soil conditions within designated "drainage area ". F I Boring # Boring Pit Ground Surface elev. Na ft. Depth to limiting factor Na in. Soil Application Rate Horizon Depth Dominant Color Redox Demotion Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -19 1Oyr3/3 none I 2fsbk mvfr aw 2fm 0.6 0.8 2 19-24 10yr4/6 none Is 2fsbk mvfr aw 21m 0.7 1.6 3 24-40 10yr3/2 none sil 2fsbk mvfr gw 21' 0.6 0.8 4 40-46 1Oyr4/3 none sil 2fsbk mvfr gw 1vf,f 0.6 0.8 5 46 -58 1Oyr5/4 none sil 2msbk mfr cvrr 1vf 0.6 0.8 6 58 -83 1 Oyr52 m3d 7.5yr5/8 sid 1 msbk mfr - - 0.2 0.3 Soil evaluation completed to identify soil conditions within designated "drainage area ". ' Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD <30 mg/L and TSS < V mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. I I () IV Soi/ eckt llict,E;� �O, t � edlvE/ I �I . o Ttcrn 0 i Co�rfou�' -, 9941' i SyA A A i rl�i l 82 e I 7 eo/ � 1 /o.,/. c. �o,;oe. E7Q.r� = 9G.ss' Elegy = /CY•Cn' aa C I p ioo o ' i d � r o. G � G Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LA GROSSE WI 54601 -1831 : TDD #: (608) 264 -8777 i seo ns i n www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary May 31, 2006 CUST ID No. 224263 ATTN.• PAM KIM SIO CO LL ZONING /OFFICE K.O. C STRUCTION ST CROI 504 3RD E 1101 CA OSCEOLA 54020 HUDSO CONDITIONAL PROVAL Identification Numbers PLAN APPROVAL XPIRES: 05/31/2008 Transaction ID No. 1276294 SITE• Site ID No. 713547 Gary Neslon Please refer to both identification numbers, 100TH St above, in all comes ondenc0 with the lagenc Town of Warren St Croix County NW1 /4, NW1 /4, S17, T29N, R18 Lot: 1, FOR: Description: 4 Bedroom Design Object Type: POWTS Component Manual ulated Object ID No.: 1078188 Maintenance required; 36 in Soil minimu de to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 691 -P .O1 /01), Pressure Distribution Component Manual -Version 2.0, SBD- 10706 -P (N.O1 /O1); Poly -Lok PL- 5 Biofilte .,�P Al ® The submittal described above has been re, ewed for conform a with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal h been CONDITIONAL Y APPROVED. ; The owner, as defined in chapter 101. (10), Wisconsin Statutes, is re onsible for compliance with all code „a requirements. e`5 No person may engage in or work lumbing in the state unless licensed to so by the Department per s.145.06, stats. The following conditions shall b met during construction or installation and prior occupancy or use: Reminders • This system is to be co tructed and located in accordance with the approved plans and the "Pressure Distribution Compon Manual for Private Onsite Wastewater Treatment Systems Version " SBD- 10706 -P (N.01 /01). • This system is to b constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD- 1069 1 -P(N.0 1/0 1). A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. • KIM A O CONNELL Page 2 5/31/2006 In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 ' )e V n V ms R renson Wastewater Specialist, Integrated Services WiSMART code: 7631 (608)785 -9336, dsorenson @commerce.state.wi.us MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: GARY NELSON Owner's Name: GARY NELSON Owner's Address: 1027 110TH ST ROBERTS WI 54023 Legal Description: NW-- NW - -SEC 17-- T29N - -R18W Township: WARREN County: ST CROIX Subdivision Name: CSM Lot Number: 1 Block Number: Parcel I.D. Number: Plan Transaction No.: s G Pagel Index and title RECEIVED Page 2 Data entry Page 3 Mound drawings MAY 2 3 2006 Page 4 Lateral and dose tank , Page 5 System maintenance specifications l ;, S �' BUILDING$ Page 6 Management and contingency plan pt8 Page 7 Pump curve and specifications Page 8 PLOT PLAN "` S p0NO � NG � GO Designer: KIM A OCONNELL License Number: 224263 Date: 05/18/06 Phone Number: 715 -755 -3145 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01101), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.01 (R. 09/04) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 600.00 Design Flow (gpd) 7.00 Site Slope ( %) 99.04 Contour Line Elevation (ft) 36.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 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) a Center or End Manifold 3.00 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) = 9.09 ft /orifice 2.00 Forcemain Diameter (in) 105.00 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 17.13 Forcemain Drainback (gal) 15.37 Vertical Lift (ft) 90.43 5x Void Volume (gal) 1.70 Friction Loss (ft) 107.56 Minimum Dose Volume (gal) 23.57 Total Dynamic Head (ft) 27.19 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 X 1.25 2.00 1.50 x X 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 1260.00 Total Tank Capacity (gal) 1260.00 Septic Tank Capacity (gal) 58.00 Total Working Liquid Depth (in) WEEKS Manufacturer 21.72 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) QIRLM -LOK Filter Manufacturer 21.76 Dose Tank Volume (gal /in) PL- -525 Filter Model Number WEEKS Manufacturer Project: GARY NELSON Page 2 of 8 Mound Plan View ...................... .. ........ ............................... T 1/10 B ............ J Observation Pipe 3 - ::::;: : : (p 0 A ............. ....... ...................... W . i ............:......:.... B :' ' : : :':::::.� . . ........ ...•.......... ....... .................. I :. . L Mound Component Dimensions A 6.00 ft E 11.04 in H 1.00 ft K 7.51 ft B 100.00 ft F 9.50 in 1 8.40 ft L 115.01 ft D 6.00 in G 0.50 ft J 4.44 ft W 18.84 ft 600.00 (ft Dispersal Cell Area 1 1439.87 (ft) Basal Area Available 6.00 (gpd /ft) Linear Loading Rate 1 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.33 (ft) --► --. :, ♦ H ,,,,,,,,,,,,,,. G j I F e 100.04 (ft) Lateral 99.54 (ft) —► :. . D ispersal Cell _ ...... ..... .:.:.:....:.:.:.:... ... Invert Dispersal 3 .....`.; Cell .....�] ..:.:...:.:.:.: ......................•.. ...,.......,.,. "., ....•.........,• t Elevation E D s 4 99.04 (ft) Contour Elevation 7.0 %Site Slope Geotextile Fabric Cover Shading Key m Dispersal Cell See lateral details on Q Topsoil Cap c fl- 1.5 ft Page 4 for number, size, Subsoil Cap c 0 0 and spacing of laterals. Z a F ASTM C33 Sand Laterals are equally 0 Tilled Layer a 0.5 ft Typical Lateral spaced from the Aggregate 05 a o El distribution cell's centerline in the A distribution cell (AxB). Project: GARY NELSON Page 3 of 8 End Connection Lateral Layout Diagram Laterals centered over the A &B dimension 9= Turn- upvWbaIIvalveorolean out plug P All laterals are identical IE X —.I Hol es drilled on the bottom of the lateral equally spaced S Force main connection via tee or Dross 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) 3.08 ft Lateral Length (P) 98.56 ft Orifices per Lateral 33 Lateral Spacing (S) 3.00 ft Orifice Density 9.09 ft 2 /orifice Lateral Flow Rate 13.59 gpm Manifold Length 3.00 ft System Flow Rate 27.19 gpm Manifold Diameter 1.50 in Total Dynamic Head 23.57 ft Forcemain Velocity 2.78 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and —► 0 Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented E-- Alternate outlet location Forcemain diameter WEEKS Manufacturer 2 in. Ca acit 800.00 Gallons — fi Volume 21.76 gal /inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 21.82 474.84 C B 2.00 43.52 Pump off e levation (ft) C 4.94 107.56 84.67 D 8.00 174.08 D Total 36.761 800.00 Dose tank elevation (ft) 3" Bedding un e-r tank. 84.00 Alarm Manuafacturer SEPTRONICS INC Alarm Model Number TM 1 Pump Manufacturer STA -RITE Pump Model Number EC440120M Pump Must Deliver 277% pm at 23.57 ft TDH Project: GARY NELSON Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name KIM OCONNELL Phone 715- 755 -3145 POWTS Regulator's Name ST CROIX COUNTY ZONING Phone 715 - 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BODS 220 mg /L Septic Tank Capacity 1260 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliforml >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should ins ect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthl Pressure System Laterals should be flushed and pressure tested every 1.5 years Moundi Inspect for ponding and seepage once every 3 years 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 I........ 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: GARY NELSON Page 5 of 8 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 subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. 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 tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are 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 filter 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 tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. 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 seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related 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: GARY NELSON Page 6 of 8 • � C.>..tr° JY��sd�I � S O� S let - �6t�nJQ 5 I y feeesrADC / A I 4 3 / • • T at z R i 1xv COMPOSITE CURVES STA -RITE" c !� EFFLUENT/SPECIALTY PUMPS CAPACITY LITRES PER MINUTE 0 50 100 150 200 250 300 350 400 450 500 550 90 F yn 26 A 80 24 22 70 Fc FCj�oO \�y 20 60 18 FC y �s o 7/2 16 c tip y W Uj 50 .G W z z G 14 W Q -j Fc x I 40 6p 12 C2 10 .o y 30 a z 8 i zo �oyA 6 FC i a �n \ y 2 A 0 25 50 75 100 125 150 CAPACITY GALLONS PER MINUTE NOTE Please see page 11 for STEP Plus" Series performance curves. 20 Safety and Buildings 4003 N KINNEY COULEE RD commerce.wl.gov LA CROSSE WI 54601 -1831 isconsin TDD #: (608) 264 -8777 n www.commerce.wi.gov /sb/ l tl� e of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 22, 2006 ; CUST ID No. 224263 TTIC Pam SCI I KIM A O CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/22/2008 Identification Numbers Transaction ID No. 1314559 SITE: Site ID No. 713547 Gary Neslon Please refer to both identification 100TH St-- +`-Q— numbers, above, in all Town of Warren correspondence with the agency. St Croix County NW1 /4, NW1 /4, S17, T29N, R18W Lot: 1, vl 0 FOR - Description: 4 Bedroom Design Object Type: POWTS Component Manual Regulated Object ID No.: 1078188 Revision; Maintenance required; 36 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01); Poly -Lok PL -525 Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD- 10706 -P (N.01 /01). KIM A O CONNELL Page 2 8/22/2006 • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD- 10691- P(N.01 /01). • The revision for this previously approved plan affects the length and width. This in turn required a change in the distribution network. All other aspects remain essentially unchanged from the original design. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 75.00 Fee Received $ 75.00 Balance Due $ 0.00 Dennis R Sorenson Wastewater Specialist, Integrated Services WiSMART code: 7633 (608)785-9336, dsorenson@conirnerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Kim A. O'connell, K 0 Construction 07/22/2005 19:47 7157491719 NORTHLAND SURVEYINU CERTIFIED S U R'VEY MAP LOCATED IN THE NW1 /4 OF THE NW1 /4 OF / SECTION 17, T29N, R18W, TOWN OF WARREN, V" ST. CROIX COUNTY, WISCONSIN. OWNERS SURVEYOR ELDO 6 MARIAN HAMANN EDWIN C "NUM 1019100TH AVENUE NORTHLAND SURVEYING, INC. ROBERTS, WI 54023 P.O. BOX 14 ROBERTS, WI 54023 SCALE IN FEET NW CORNER NOTE; SECTION 17 NO OWNER OR RESIDENT SHALL DO 150 O 160 ANYTHING THAT WOULD INTERFERE WITH OR CHANGE OPERATION OF THE PONDING AREA S SHOWN ON THIS SURVEY MAP. THIS INCLUDES BUT IS NOT p phi C�_ �® ST►N C NTE N LIMITED TO BUILDING UPON, OBSTRUCTING. ALTERING, FIWNG, EXCAVATING OR PLANTING IN THE \� DRAINAGE AREA. �� $� 2 91 I 1 GOTH A G 5 77 .44'n� �po7�— 1 m 1 1 - BENCHMARK Z TOP OF REBAR N 1.14 I I 7s 11� r P I ^1 ELEV. a 1061. I ., ", LOT 1 `—"� Im r // O w m 2.22 ACRES I p .� ( 98,904 SO, FT. ; ♦ 1 Ig + I I !� 1 I -n I XX p I N.B.A. a 1.7 AC. I N I t A t�� ��sv, L.B.O. A 1088.14 ; I A I Ng3 °3 +E 367.79 ♦ ' Tai 11 .�A m BENCHMARK © - ot 7°IMJ � J 1 �j � �\ TOP OF REBAR ELEV, = 107 : , • � 1 A - _ _ NOW54 388.0cl �, �� LOT Z • I I I 300'OfY 66' \� J 2.37 ACRES 1 103,358 SO. FT, l O A & N.B.A, m 2.2 AC. '� I ox & w f 2 ham. I CENTE LOT 3 I • 2.51 ACRES X185 °05'55 "E 387.98' `w.. 109,277 SQ. FT. ,� -1f►� I go �N.B,A 2.5 AC. � 760.40 a NBS °OW5S 626.41 W RADIUS TEMPORARY T O BE UPON ROAD EXTENSION AND I 1 EASEMENT EXTINGUISHED. SOUTH LINE OF THE NW1 /4 OF THE NW1 /4 SS_.."«.. DRAINAGE AREA LINE TABLE LEGEND NUMBER BEARING DISTANCE ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND a L1 S07 ^1945E 113.49' N I' L2 S51 °58'40'W 90.73' , L3 S75 103.35' • 1 5/16" 0.0, IRON PIPE FOUND L4 S17 158.17' 3/4' IRON REBAR FOUND L5 S72 °t2'36'VN 50.00' i L6 N17 0 47'24 'W 159.25' O 3/4" X 18' IRON REBAR SET WEIGHING r 1.50 LBS. PER LINEAR FOOT L7 N15 °18'40"W 91,65' o U' WS /4 CORNER L8 N78 °54 17.51' a SEC11ON 17 ♦ SOIL TEST p � CURVE DATA TABLE — X — X EXISTING FENCELINE u W O p NUMBER Cl C2 -+►+ ' U RADIUS 1302A0' 1335.00' "' 100 BUILDING SETBACK LINE CENTRAL ANGLE 2 2°45'42• —1 PROPOSED DRIVE CHORD BEARING S79°00'17,5 W S71;r0r39`W 1 CHORD LENGTH 57.18' 54.34' i N.B,A•- NET BUILDABLE AREA ARC LENGTH 57.19' 64.35' TANGENT IN S77 °44'48" W S77 °44'48'VV _ _ . _ _ .. 12 WIDE UTILITY EASEMENT TANGENT OUT S80°15 SBO'30'30"W L.B.O. = LOWEST BUILDING OPENING p THIS INSTRUMENT DRAFTED BY SAM ADAMS JOB NO. 06 -14 DATE 3 -29.05 SHEET 1 OF 3 SHEETS N : HIGH WATER LINE ELEVATION