Loading...
HomeMy WebLinkAbout042-1074-80-100 Parcel #: 042 - 1074 -80 -100 11/20/2007 04:22 PM PAGE 1 OF 1 Alt. Parcel #: 27.29.18.420A 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - J E T PROPERTIES OF WISCONSIN LLC J E T PROPERTIES OF WISCONSIN LLC 34 PENINSULA RD DELLWOOD MN 55110 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 15.766 Plat: N/A -NOT AVAILABLE SEC 27 T29N R18W NW NW EXC PT TO CSM Block/Condo Bldg: 16/4349 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 27- 29N -18W NW NW Notes: Parcel History: Date Doc # Vol /Page Type 09/11/2007 860225 LC 11/01/2001 660745 1751/391 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/11/2003 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 14.766 2,300 0 2,300 NO UNDEVELOPED G5 1.000 100 0 100 NO Totals for 2007: General Property 15.766 2,400 0 2,400 Woodland 0.000 0 0 Totals for 2006: General Property 15.766 2,400 0 2,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 onsin DA partment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix afEty and Building Division I INSPECTION REPORT Sanitary Permit No: 404995 0 GENERAL INFORMATION, (ATTACH TO PERMIT) State PI n ID No: _ Personal information you propide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Miller, Way I Warren Township 042 - 1074 -60 -000 CST BM Elev: Insp. y�BM7Ele /v: BM Description: } , - f [ - bU L .-, O-r TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Bench rk I Z56 � Z' lr7 05 - 1 97 - 6 0 Dosing ! Alt. BM ` , 31 L I1tTD 03 Aeration Bldg. Sewer ' lo Z- Holding St/Ht Inlet 1 4 e, m • mo TANK SETBACK INFORMATION St/Ht Outlet �e• g0• �o� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 25 r T Z) _ y I Dt Bottom I Z - f , L 1 Dosing 25 , { �+ T 5 1 Header /Man. Aeration ` Dist. Pipe �, 5 -q5 t J�1.31 Holding Bot. System 1 . 4'-f& /UO b f 6.0 1— 1 O'p./m Final rade PUMP /SIPHON INFORMATION IZ + So c vV Manufacturer Demand St Cover GPM 3.30 1214 Model Number M6 To � /� _ (� ... T 1,�'yl, 7 / TDH Lift Friction Loss System Head T ^y Gt ary, (� 5• t9•t.S 3 -z S' - R - 2-9 C (�. cemain Length t Dia. j1 Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width 1 Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / 4e-o( �rxJ �S SETBACK SYSTEM TO P/L C B WELL STR AM L CHI anufa INFORMATION CH R OR 2 Type Of Syste ,� 9 � > v ` O IT M Number: DISTRIBUTION SYSTEM j"- Ideadw anifol Distribution x Hole Size x Hole Spacing Vent to Air Intake I U pipes) 1 A t l 1 3 U —� Length 3 '� Dia Z Length Dia Spacing 3 •� /��. SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil s Yes g No Yes Qj No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:__V / 13 / d'-" Inspection #2 o afiort 9249 Cnty �berts, WI 54023 (NE 114 NW 114 27 T29N RI 8W) N d TT ;Roberts, L t C�"" " - Parcel No: 27.29.18.4 A ����� 1.) Alt BM Description 2.) Bldg sewer length= �$I r' / /� - amount of cover = tr + l ( I. t"S( J." tw l� C.-k 3.) Contour Plan revision Required? Yes , No Use other side for additional information. I I — SBD -6710 (R.3/97) q� to Insepctor's Signature Cert. No. ,. Safety and Buildings Division Coun 201 W. Washington Ave., P.O. Box 7162 T . CUM � hsconsirn Madison, WI 53707 - 7162 Site Address „ Department of Commerce * 12. 49 C: � ek' TT Sanitary Permit Application Permit In g In accord with Comm 83.21, Wis. Adm. Code, petso ❑ Check if Revision ma be used for secondary purposes Privacy w, s VED I. Application Information - Please Print All Informatio State Plan I.D. N ber G 4/ :II-3P3 ' Property Owner's Name APR 0 3 2 002 Parcel Number 27. 1 ST. CROIX COUNTY J 4 1 Al D A ( Al 6CWV0 Property O is Mailing Address A ZONING OFFICE Property Location 23 7 ka [ 1 F -A IV W',4i:S A7TO2 N,R City, State Zip Code Phone Number Lot Number Block Number � 'VO ;E7 7 f S - 7 �- �p Subdivision Name CSM Number II. Type of Building (check all that apply) oy per 4u.6^" ❑City R I - or 2 Family Dwelling - Number of Bedrooms _ �rvs� (y o^^s • , ❑��V V�illage ❑ Public /Commercial - / Describe Use 6PJ'Township J. /- ❑ State Owned `C���" `iq 6S Nearest Road / �^ 6, X oo, t, ^ �O / ((2. a to _ )P l 7 111. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A For County use 1 New 2 11 Replacement System 3 11 Replacement of 6 11 Addition to system Tank Existing stem B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply) numbering scheme is for internal use) 44 ❑ Non - Pressurized In- Ground 21 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dis p ersal/ IYeatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate( Gals. /Days/Sq.Ft.) (Min.Ilmh) Elevation X00 41 G ©o -� '� ��� 2 100,6 /03 S VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank A,,-' C"4A — a Dosing Chamber /AAD 1 C tJ�e.t.e Alk VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature RS Num Business Phone Number Plumber's Addrres�s (Street, City, State, Zip Code) ` ,y l�v7 /T� tom �OL�F- ts, 60T /Ov� VIII. Coun 7Determination ent Use Onl ,Approved proved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) rp r Given Initial Adverse IX�Conditions ' of Approval/Reasons f l approv o t��n�ntste , SrtT6 � ft Pk, 1, Attach complete plane (to the County ody) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 05101) (P4 P ( _ � C_) Safety and Buildings :R2 PO BOX 7162 MADISON W I 53707 -7162 TDD #: (608) 264 -8777 Visconsin [487 www.commerce.state.wi.us /sb 8 7= �� www.wisconsin.gov Department of Commerce 2 Scott McCallum, Governor 0 6t�' i Y Philip Edw. Albert, Secretary March 26, 2002 CUST ID No.226375 ATTN: POWTS Inspector ROBERT W ULBRICHT ZONING OFFICE ULBRICHT & ASSOCIATES CO ST CROIX COUNTY SPIA 655 O'NEIL RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 03/26/2004 Transaction ID No. 719751 SITE: Site ID No. 642393 Wayne & Brian Miller - Residence Please refer to both identification numbers, Cty Rd Tt above, in all correspondence with the agency. Town of Warren, St Croix County NE1/4, NW1 /4, S27, T29N, R18W FOR: Description: New Mound System / 600 Gpd Object Type: POWT System Regulated Object ID No.: 833945 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 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. Sincerer, 9 Fee Required $ 175.00 Fee Received $ 175.00 n Balance Due $ 0.00 Peter E Pagel POWTS Plan Revie er 11 , Integrated Services WiMARFcode x'3 °3 (608)266 -2889 , M - F, 0630 - 1500 Hrs pepagel@commerce.state.wi.us ,� ......,.._....,� ..... ,. ...._.....,,�._ . _ ...._ � p as r 7 Oe s /ST z k ee ` C3 ,VIE our C ,u ?/?OjPos E D p P G n, a CO Q A T. 9 -G s\ X83 -75 y A t ,f a IN -- 3 0 fir. To fd x r Of / r� / ° p� d �� "-, l VAA 2 P S y S7,(, .G�� l�rf % /4 A . 7 foU,e 00 0 G 14 �Fi it /DD • G 5 � � v � u pZ-6 PLltA T Co i Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 Isconsin www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Scott McCallum, Governor Ph ilip Edw. Albert, Secretary March 26, 2002 CUST ID No.226375 A77N: POWTS Inspector ROBERT W ULBRICHT ZONING OFFICE ULBRICHT & ASSOCIATES CO ST CROIX COUNTY SPIA 655 O'NEIL RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES. 03/26/2004 Transaction ID No. 719751 SITE: Site ID No. 642393 Wayne & Brian Miller - Residence Please refer to both identification numbers, Cty Rd Tt above, in all correspondence with the agency, Town of Warren, St Croix County NEI /4, NWI /4, S27, T29N, R18W FOR: Description: New Mound System / 600 Gpd Object Type: POWT System Regulated Object ID No.: 833945 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 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. 0 1 0 1" The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the f installation operation or maintenance of the POWTS. p DIVIS FF�R41E Sincerely; Fee Required $ 175.00 tj,C r , Fee Received $ 175.00 Balance Due $ 0.00 S E P�tki Pagel' POWTS Plan Revir II , Integrated Services WiSMARTTde 76' (608)266-2889, M - F, 0630 - 1500 Hrs pepagel@commerce.state.wi.us t UL.BRICHT & •ASSOCIATES CO. 655 O'Neil Road ' Hudson, WI 54016 Reg. Designers of Engineering Systems 715 -386 -8185 Private Sewage Consultants PROJECT INDEX Plan I .D. # Date Owner Gt/�4y�/�/� //' I3,Pi�4 /�I % /1E�2 'Phone ��5 7�"9 350,P Of Address / 2 57 C7`y. ��. T T: /��/3�.� % S , Cv /S . SYoZ Legal Descri ption pevD 1 *,v 6- 3 gCLP 0-S1 . Lo 7 /-9 O t�� N� / V0V y Ste. z'7, T- / q / < 9 w Town of ',v County S C.S.T. �, '�l�j,p /' 7--- Z 37S Installer Local Authority/ Supervision S7--. G, / C T D-0- r T PROJECT DESCRIPTION 1PEW CdNSTjfj)6r /O/j i /Z- Y all f 5 7�e 7 /o zv y /0 y GPa� Z BUT 51 f -7- a -- L 1 +j&P �¢-% ,32''•. 14- Zt Sl;v C ON } .0 0 WK ULBnICHT VED f'. _ - 01160 f � _ �,, UDSON, WI AIAR 2 5 2011I TQ , :'N' o' SAFETY OLDGS aa� ^g. .; ... ,c. Pg.1 PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS (REVERSE SIDE DETAILS INSPECTION PIPES & FABRIC /TOP FILL DETAILS) Pg.3 PIPE LATERAL LAYOUT (REVERSE SIDE SHOWS DETAILS OF LATERAL CLEAN OUTS) Pg.4 DOSING CHAMBER CROSS SECTION & SPECS. Pg.5 PUMP PERFORMANCE SPECS (REVERSE SIDE SHOWS PUMP DETAILS) .6.OPE RATION , P 9 MAINTENANCE REQUIREMENTS (REVERSE SIDE SHOWS SITE & SPECIFIC PROJECT DETAILED INF OR MATION UNI Q UE TO LOCALE AND GOVERNMENTAL UNIT AREA) The attached plans and specifications are based on the following approved manuals: "Mound Component Manual For Private Onsite Wastewater Treatment Systems " (Version 2.0 SBD 10691 P(N.01 /01) and "Pressure Distribution Component Manual For Private Onsite Wastewater Treatment Systems" (version2.0) SBD - 10706- P(NO1 /01). f y 7- T f � 13,1 'u, c L syS •2lv j�o.t I {� a NF S TAen ovT p 5�� oo �� poS E ��K C. O n , D S �avu ri S� o � p P 7,5 7 P o w o J�s/ f6a �.� o v) H -vo ` g s75 apt Rod Sy s ? �� io N ��� Ile- G � fi �i / DD • G 5� � � r� T y 19Z,6 PL 11-A) P 2 o f- � ci?os5 SECT 1 0 0 o M00AJ D to i r ti t3 E D 4 Oev a I I ro PER PLUMBING PRODUCT APPROVAL 1' Ayg4cS,yTE ;CODES, ALL ABOVE- GROUND PVC' Vi STRiOuT%co PIPING (FROM TANKS & SYSTEM AREAS) Tki cka 9 pi MUST BE SCH.40 PVC MEETING ASTMG' , Fs °P so u ,/ �E�,y 5 ysTEM D1785 OR 02665 STANDARDS. of T EIEVArioP3 00 i F OR M To E- 160 s Ur r� H , •• MEIN. � � . • • • • �� SAND � /// plowl�iD ToP uu�FdR 7 % SloPE FO R n1 EIWATAOO uNM J) / Fr. -- ELEV Arlo► 0 5 -- i E / y Fr. • lm v6Rr o /Z_ I AT£RA(5 101.1- • - ro p o f R o Lk /� /• y8 G . 5 F /� 101. • To o � �-- I S H /, o T , p I ATE A F f PLA VIEW of M00-0D -- wi rat 13E I roRcE MMO R G Fr• 13 /11!� F r F�, •- — - -- a — - -- • I i L /2-2- r 0 w FT W 3 0 N o Fr Ba of PVc cAPPF -D �- 013 5ERVAT IOO A aJ3 PEI ArTE pip 10e,4 7-1'0,V6 r - 0,A l or . C PERMA,jE FAARkERS RE(gviRED (3 A5AL hREA 901t- W- filrR y sa. F cAfAciTy r, PRopo5r -v (3ASAI AReA = '� s at . r T. Observation pipe -1 Distribution cell Fill material _---°y �,! Cover material (.ASTh4 C33, fine _ y — � aUGfa x N yat e1 W Tilled area f�-- -- •Slope Force main Figure 6. Cross- section of a Mound System Water tight cap Top of 4" min. dia. - �� leaching Repair couplings chamber Slot 6" rein. rain. 4" min.. I Infiltrative surface Water Closet Collar Bar(3/8" min. dia.) Figure 8 — Observation Pipes � . 3 0 Ire Tot ,9 .Pj e - - - - - - - - - C 0� U ` c c c - Cp �1i�lJ D� I , 1 /f 77,6-7- ► o' /�- 57°_0 C 33 7 w �;IS�t -�?i QUTI0� PipE' LAYOU CEOTRAL, M 1-a �l� 1 �o P $ T ` Z2Z FAR Fr \ �� 3.a R Fr E ORAL r oPcE - MM k) X -- INCHES C r� �, 3o Fr o Z PUG Y /---� _ �NCHE 5 PARI *AQLE . oTAL V(91D Uojo %, � . GAIS T N olE _D1%IHErMR �� I1v L.hj t RR L '' I z - D� rcvalE'K ,� C E,jTR h L M AM P O L d I I tic .�' CIF HIE /�i pE 17 _tPVERT E LEVATIOKJ or LATERAI S SEA V-'tUEPSE SIDE Fps WAL Cho btTA(L 1D E TA P r F(�FR ATE DEv Sf'T` y R EM o v E All D R i l l R v R R S �'� � NoI�S �dcATEb o,v f3oT1'oM EWAIIY SPACED IMni�• �1 5TRi 13uT'10,�1 tilschARC>E R ATS �o EA Ch �/�•r d ERA L Gqt_ M��. / oR� lCr'c�s TOTAL 17i5T RMOTIo,J 'PI ^R RA TE r ►VAT woR k yy �� GA��1''11 a• MI'NI'MUM oF C/o PqL �iu�Sff�v /�'IDU,vD y�P,¢D� ,4 «mss �� 9 �o s d 2 - r/66E��x o f b-q4 1 ,5 - elo e to e lk / 0 /RUC 134 v4 I PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS P 41E I of �o S 6 4 , ¢b 3 ? /D fo G(>iNOocJ �700� / n - V E U T CAP I P 1 P E , WEATHER PROOF APPROVED LOCKING VEIJT PIPE JUUCTION BOX MAMHOLE COVER 1 12 "MItJ. I G,/ 4i, 1A/3E /0 �E Ui1 /O n/ I GRADE > I 'i" MIIJ. l / � I I B" MIIJ. 1 it COUDUIT -- 9�• o Hg ---- - - - - -- lEl/.4 1"i cn, 11� IMLE T PROVIDE I -- = -- -._- +�- -- ! - - - -- AIRTIGHT SEAL _ G I I I APPROVED P E JOINT A INy �K i iil A PPROVED JOM PIPE ZXTENDING 3' 'I�OI I II ALARM EXTE►JDI 3' 0VJTO SOLID SOIL. q o i II ONTO SOLID SOIL sC , 4o Poi s �� ( 3 v 1 I I 5C4 . Fo Pucl I I o N F LEV. FT. —' PUMP OFF ZfSC ,3 O,Q P�l�� is D I q n I • � r. �1o�f'E sF 4011 k `�E L tj 0 f FDA) BLOCK RIStR EXIT PERMITTED oucq IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E S PE C. I F I'CATI ON S DOSE CDU�Ty CON TANKS MA NUFACTURER: / "� IJ UMBER OF DOSES: PER DAy TAKJK SIZE: / O C GALLOUS DOSE VOLUME /D ALARM MANUFACTURER: 5 ' �' �/ -QC INCLUDING BACKFLOW: GALLONS MODEL KJUMBER: -loy - 31o CAPACITIES: A= INCHES OR GALLONS SWITCH TYPE: /�e T B = INCHES OR ��/C`� GALLOIJS� PUMP MANUFACTURER, MEYA9 5 e C = INCHES OR GALLONS MODEL MUMBER: M -4- , A 1 0 ��� ^�' D= 1 INCHES OR f� GALLONS SWITCH TYPE: -/- 1. gj7' / � A � � 1 MOTE: PUMP AND ALARM ARE TO BE MIMIMUM DISCHARGE RATE _! �� GPM INSTALLED ON 5EPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. (p.l� FEET fi/jok 9P C 5 - MII"IMUM NETWORK SUPPL'J PRESSURE , , , , , , , , 3' 25 FEET 6ACk 4 • F EET OF F MAIN X '� 9� F Yo FT.F RICTIOIJ FACTOR.. * &5 FEE (� f S 2-3.25 = TOTAL 091JAMlc HEAD = /0 FEET IHTERNAL DIMEWSIONS OF TAUK: LENGTH— ;WIDTH &2- ;LIQUID DEPTH y.0 • 1 • 17. THIS POWT SYSTEM SHALL INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL FILTER MODEL # A - ! 4'0 - I,,I < 2 0 3 000 PER PLUMBING PRODUCT APPROVAL !N G 0 fst LdLG,^ ;CODES, ALL ABOVE - GROUND PVC PIPING (FROM TANKS & SYSTEM AREAS) S 77C 7k�,tr ��� MUST BE SCHAO PVC MEETING ASTM 01785 OR 02665 STANDARDS. I -#Q SEPTIC TANK, per Comm.83.44 (2) (c) shall be equipped with an outlet attached approved filter devir -> (Zabel fliter). Tank shall have an approved - a>ave ground locking manhole cover for regular (every 12 months or lest) insper_-11ion - :;ervi( * ?,y a licensdd service pumper. (e ME40 Series 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 U) 30 IL H 25 8 f 20 6 J FQ- 15 J �•� ` f' 4 F- 0 5 2 ' 0 0 10 20 30 40 50 60 70 80 90 100 0 CAPACITY GALLONS PER MINUTE F.E. Myers, A Pentair Company -1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 4191289 -6658 Telex 98 -7443 K3326 7/91 Printed in U.S.A. r 1 IWE 40 S E RIE W S,, 4/10 HP Effluent and Drain Water Pumps POWER & FLOAT CORDS PLUG DIMENSIONS Quick- connect, watertight Replaces switch assembly fittings are interchange- for manual operation. able, replaceable from - — — - pump exterior. MECHANICAL FLOAT (38.1 mm) /� Discharge SWITCH Disch � _ - - r — Mercury -free. 90 angle operation. - - - 5.66 r - (144mm) { I 11.68 j (296.5mm) MOTOR HOUSING " - -- Cast iron for efficient } --- _ - -_ -- -- heat transfer. - OVERLOAD SWITCH Built -in to protect against overload conditions. - 4/10 HP MOTOR 1600 rpm, 60 Hz, 115 or o ` i °� $ 230V, single phase. Oil- N a i cooled and lubricated. _ — ROTARY SHAFT SEAL Carbon, ceramic faces. - j p - -1 PERFORMANCE C TM 1 -- CAPACITY LITEM PER MINA/TE 0 5o Igo Is 0 200 250 300 350 40 i ' VOLUTE/IMPELLER SEAL 12 RING 35 Maintains high efficiency 30 10 and reduces recirculation, - replaceable. b 2s r ENCLOSED TWO VANE e IMPELLER 20 High efficiency, passes HIGH EFFICIENCY ABS I s r s '34" spherical solids, with VOLUTE stainless steel wear ring, Corrosion resistant. Passes ~ 10 1 4 O THRUST Wig RIMME 3 /4" spherical solids. ► �j- BEARINGS NPT discharge. Smooth opemtion o and extend Pump life. o Io 20 30 40 so 60 7o eo go loo 0 CAPACITY GALLONS pER �E K3319 5/92 I A Printed in U.S.A. ® F. E. Myers, A Pentair Company 1101 Myers Parkway Ashland, Ohio 4 4805 -1923 41 9/289 -1144 FAX: 419 /289 -6658, TLX: 98 -7443 Pg. 6 of 6 Mound System Management Plan _ Pursuant to Comm 83.54, Wis. Adm. Code n Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stals. The contents of the septic tank shall be disposed f ' p o m accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain'solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation In the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump 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 for frost protection. Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This systern shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual (SBD- 10572 -P (R. 6/99)] 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. ' 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 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 adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintenance of this system should be directed to your county zoning or health inspector. SEE REVERSE SIDE Pg.6 FOR MAINTENANCE REQUIREMENTS SPECIFIC TO 'I'IIfS SITE, DESIGN, AND COMPONENTS •r t OWNER' s MAINTAINCE PAGE 6' VEVEKSE SIDE OF SEPTIC SYSTEM - POWTS - f ` ' • -�. maintenanceowner)Is reP°nsible for of mainten s system. Regular Proper °peration and s ervici n g is necessary for the Periodic inspections and system. The owner is re safe healthy operation of.this maintenance /inspection 9 eports to ired by code to submit all necessary the controlling ,authorities. SPECIFIC CONTACT AGENTS * Governmental authority/ inspectors: 'r C'�-' 34 * Licensed installer m aintenance of „ r esponsible Users manual: for Providing an o peration/ Licensed serv&ce / inspection agent other tha n installer: * Electrician for pump, electric controls 77e4el — ile 'S wirin units: IMPORTANT OWNER MAINTENANCE RE UIREMENTS 1 • Winter traffic area shall not (sledding, shovetinq etc. the cell Permitted, or frost can) across the freezing up winter the system. /will penetrate (a vacaction Discontinuos into lead to freeze trip, resultilig in no use in the ups• water use) can also 2 • 'Ka ter conservation Kater onsi needs to be exercised! desi y overloaded and destroyed. Thisr syste can be fined for a maximum wastewater flow OF IS was 3. POWT &D� gals. dail ' S are n ly. of designed to accomodate disposal unit, or an wastes Any introduction y other unnatural sources f a garbage destro °f such waste materials °f waste. Y this system. will overload and 9• If a power Outage occurs, or a pump fail I a g s cell temporary overload of effluent it may result . which may adversel being pumped into the recommended that a ers impact the cell l re commended pumper em (leak It , Consult lowing the installer e pump to return to dosing pth the rest Your o r advice, the correct dosing tank, Immediately for amounts. 5 • Neglect of the erosion Vegetative cover (the cells preventive insulation traffic also ) can lead to failure. & em beneath IS REGULARLY can destroy t he system. or WATER Tf1E VEGETATION Ystem. It IS NECESSARY TOheavy the syst OVER A SYSTEM!! grass cover NOT suffir.lent Effluent ii, aior,c t0 maintai;l a � 6 • Periodic inspections by the owner necessary. Inspection pipes and ports have been incorporated . or his agents, Into system: gents, Inspecti ot � the mound basal Inspects Pipes)' clean out terming area (effluent at each ti is on level out. The filter s P - for flushing and the pressurized ground cove /man system in the tanks (via alloced the laterals Person should )• Only a licensed P locked above & severe be Performing Quali6ied inv olves safety risks, g th is work which sYstem's tre-itment Evidence of effluent involves health cell shall also be Ponding in the regularly inspected. fA y. <Wisconsrn Department of commerce SOIL EVALUATION REPORT `3 tivision of Safety and Buildings Page / of In accordance with Comm 85, Wis. Adm. Code Q Attach cornplele site plan on paper riot less Than 8 1/2 x 11 Inches in size. Plan must County _ sT • G /`b� �(. Include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 0 /�� /a 7 y, Please print all informatlon. Re ewed by Dale Personal Information you provide may be used for secondary purposes (Privacy Law, S. 15.04 (1) (rr , Q 2ft Properly OwneAAr Property Location Govt. Lot Al G 114" ' 14 S Z7 T -2 4 1 N R Xd n (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# z 3 . 7 CT AP . 7 - T cif 3 :4 G,.CS . State ZIP Cot: Phone Number El City Village Nearest Road �o/�t�fS �v /. sy� z3 ( 7�5, 7yy'•3So� f . w � 7-T New Construction Use: 0 Residential I Number of bedrooms Code deflved design flow rate ' t e e GPD ❑ Replacement ❑ Public or commercial - Describe: i ]/1 At •1 2002 (- Parent material Flood Plat l� elevation if do'iliay"Y' _ /t General comments (p(} 17Y and recommendations: ZCt4 NG0FFfCE u -v v 45 Y- F Boring # L] Boring s• , Pit Ground surface elev. • �OS fl. Depth to limiting factor Z e n. 7� Soil Application Rate Horizon beplh Dominant Colo Texture Structure Consistence Boundary Roots GPDfli In. Munsell Gr. Sz. Sh. 'Eff#1 'Eff #2 •� y ioYR 3 /3 SL zfshk s 3 �o • 3t. /l.S Z K Y s 5, Dr S �,, CS _ �• Z me r S �• 79 /0 k to f 2 NA z. M a 'f s 5 GL �f 5 /IM U .2- , 3 . s V4 fA U Boring # L] Boring q I le . . pit Ground surface elev. / • bS it. Depth to limiting factor Z in. Horizon --- Depth 4 Mu ngel Color Redox Description Texture Structure Consistence Boundary Roots Soil Ap GPD Rate In. Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 / 0 •/3 - — - Z iNI s hK S 4V Zf . • 9 �- / • 3,z • s y S , �rt,v o . s o ,hl t! sL 2' s y CZ- A MOTS Z.. Effluent #1 = Boo > 30 < 220 mg IL and TSS >30 < 150 mgA- ' Effluent #2 = BOD < 30 mg1L and TSS < 30 mgn- CST Name Please Print) Signature ^ CST Number 'or3ER7 - 21 /,6 4; jt_'OV '�I'kl /a � ST 4 3 r s Address Date Evaluation Conducted Telephone Number ov• z3 .�/ 7is•3d'�•�i� Ulbricht & Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 Before local zoning permits can be '� o granted - THIS PROJECT WILL REQUIRE STATE LEVEL PLAN APPROVAL. Plans will need to be submitted by a qualified designer per Comm. 83.22(2)(C)l. Property Owner �' ` / / / r f t .� Parcel ID # 2- 3 U Poring # ❑ Boring Page of Pit Ground surface elev. 4 7 : Z - P�il Depth to limiting f ac t or v 7 Y I s- 's-1 . h Texture rizon Depth Dominant Color Redox bescri lion Soil Application Rate P Structure Consistence Boundary Roots GPO /g: In. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #f '1511#2 z 0. L /OyR -3/, sG fsbk s 3 Y4 sc �s w / 5 • �D /6 � ,8�,t� ?S 's o�S M► tL �i.s 7 <. Z y c� � SL r+D•tS � a S - El Boring # t ❑7 Boring L1 Pit Ground surface eiev. It. Depth to limiting factor In. Horizon Depth Dominant Color Redox Descri lion Soil Application Rafe P Texture Structure Consistence Boundary Roots GPO /R� In. Munselt Qu. Sz. Cont. Color Gr.'Sz. Sh. • Efffll • Eff#2 r Boring # Borin ❑ g ❑ Pit Ground surface elev. 0 • Depth to limiting factor In S Horizon Depth Dominant Color Redox Description Texture Soil Application Rale In. Munselt Structure Consistence Boundary Roots GPD /It1 Gr. Sz. Sh. • E1f#t •E Qu. Sz. Cont. Color if#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 opportunit q pportunit service provider qnd employer. If you need assistance to access services or need.material in an alternate format, please contact file department at 608 -266 -3151 or TTY 608 -264 -8777. i \ I w y, 7 T f_ P • _ 139 i f a ,e,,t 0 STAB I7 ou7- , ppo pos p o , a cower a " Q �2 a 00 �1 s ys7 W.IUr %0 N °tif°�,e aD �14 �� �l goo • G s k- 19 �� o f 3— • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer iv au AL ffUL & ^^ Mailing Address %L'�'� /10� 3 7 Property Address 9 ^�~ (Ve required from lRanning Department for new construction) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location ,9, %, a v, Sec. - z 7 . T �N -R Zj—w, Town of CJ o_r-F a 0( Subdivision _ PoS� YO AA-t" Lot # Certified Survey Map # . Volume . .Page # Warranty Deed # � 6 a 7 1 Volume / 7S/ , Page # 3) Spec house [yes ❑ no Lot lines identifiable yes ❑ no SYSTEM MANTENANCE 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 - The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the On-site wastewaterdisposal 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 Zoning Office within 30 days of the three �year re expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the property described above, b virtue of a warranty deed recorded in Register of Deeds Office. ; �� 4 / z SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed y1 x.1751 Pb,r 391 STATE BAR OF WISCONSIN FORM 2.1998 �' 6 Q /� 4 S KATHLEEN H. WALSH WARRANTY DEED Rt-GISTER OF DEEDS Document Number ST. CRO.IX CO., Wf This Deed, made between Stanley C. Miller and Viola M. Miller, RECEIVED FOR RECORD husband and wife 11 -0i -2001 9:3D AM WARRANTY DEED Grantor, and Wayne S. Miller and Kath ryn A. Miller, husband and wife EXEMP CEkT C N 17 COpY FEE: r COPY FEE: TRANSFER FEE: RECORDING FEE: 11.40 PAGES: Grantee. ) Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St Croix OP County, State of Wisconsin: Re Area Ns m and Address Thomas as an A. M PO Box 2120 d Baldwin, WI 54002lp �Sr `yy 042 - 1074 -10, .30, 40, -5 , - 60, n-90-95 b` elf' Parcel Identification Number O not OW Northwest Quarter (NW 1/4) EXCEPT part to St. Croix County in Volume 423, page 364; (IS not) , •` ke c7 1 Northeast Quarter (NE 1/4) EXCEPT part to Donald H. and Rochelle D. Graf in Volume 511, page 507; All in Section Twenty -seven (27), Township Twenty -nine (29) North, Range Eighteen (18) West, Town of Warren. Said description includes Lot 1 of Certified Survey Map in Volume 4 of Certified Survey Maps, page 1125. s This Deed is given in full satisfaction of that certain Land Contract between the parties dated and recorded December 11, 1995, in Volume 1153 of Records, at Page 178, as Document No. 537374, office of the Register of Deeds for St. Croix County, Wisconsin. Exceptions to warranties: Easements and restrictions of record, and except and liens or encumbrances created or suffered to be created by the acts and defaults of the grantees, their heirs, successors or assigns. Dated this / 7 f� day of me ° �t'1 2001 G W a s Stanley . Miller J, 2n �� � . Viola M. Miller AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) )SS. Signature(s) St Croix County. ) Personally came before me this 7) day of authenticated this _ day of Q� r_ +,i h¢ ✓ 2001 the i&Vi futmed Stanley C. Miller and Viola M. Mi��!• t. TITLE: MEMBER STATE BAR OF WISCONSIN tome known to be the person(s) who. g (Ifmt, strum a acknowl ge the same. )q. authorized by § 706.06, Wis. Stats.) r = _0 ` `•• „` •�� THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack • C • 4. r 1 L yv Baldwin, WI 54002 Notary Public, Staid of ^Lj C5 , (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. not, state explra on e: n=ssary.) *Names of pmons signing in any capacity should be typed or printed below their signatures STATC BAR OP W ISCONSIN WARRANTY DEED FORM N. 2 • 1993 INFORMATION PROFESSIONALS COMPANY FOND DU LAC. WI 1100-655 -2021