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Home My WebLink About032-2128-50-000 (2)VN#sconsm Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law. s. 15.04 (1)(m)[ Permit Holder's Name. City Village Township Mark & Bridgette Woitas TOWN OF SOMER 1M.6r I _ ; .oI TANK INFORMATION lr erc- or TYPE (p,6j,rNUFACTURFR Z O� CAPACITY Septic Dosing Ceti Aerati Holdi TANK SETBACK INFORMATInN-------� TANK TO P/L WELL BWG. Vent to Air Intake ROAD Septic D � Dosing It 14 " 33' Ae n Holdin PLIMPISIPHON INFORMATION Manufacturer Model Number 16-3 TDH Lift ,„ l Friction Loss System Head TDHa Fl 3,t &•Sb Ia . Forcemain Len tD,, Dia. 4 Diat to well 44 M 1120wr[r I IV17 a T.7 1 tM dth I Length iWONS I If,, INFORMATION SYSTEM ® � CAM TION DATA STATION BS HI FS ELEV. Benchmark • 23- In D O Alt SM Bldg. Sewer ' SVHI Inlet SUHt Outlet DtInlet Dt Bottom Header/Man. Dist. Pipe Z, oS, zz Bo(. System final Grade 11 41o;, I CoverSf `) v a CHAMBER UNIT Dia Header/Mandolo s� (o Length �� Dia Distribution 11 ( Pipes) � 412q I va g 3 •� LengM l Dia Spacing x Hide ilia I �S If x Hole Spacing Ia (8 ` Vent to Air Intake -� snu rnvco _ Depth Over Depth Over xx Depth of Willy xx Seeded/Sodded xx Mulched Bad/Trench Center Bed[Trench Edges Topsoil ^, Yes No __ Yes - No vvnn.r r=r= r �• (Include code discrepancies, persons present, etc.) Inspectki" 1p I�V115 Inspection #t2 fi jaL2 Location: 1631 52ND ST �Y Q• 1.) Alt BM Description = 2.) Bldg sewer length = t^OJC tit grZ_ `/U� 4 , - F - amount of cover = 1 r'+� /��1 Plan revision Required? Yes YNo �IL�L2� I� •0 Use other side for additional information. SBD-6710(R1/97) a�gnature -_- -- �Cen No ' Indtn fry Se vkm Division county St Gobs S A N � a 1,DDP Pont Number (to be filled to by Co.) Madhm ..�jw (p 3 3 9 �o sc e-# as unutly IF 't Applica ' n T"°°'c10ON'` In accordance with SPS 39321(2), war. Adm. Code, subminM of this form to unit - () 2 L6 0 q07-' C tAildrists is required prior b obWning a smuitary permit Note: Application forms for dipt the Department of Sdety and Profbeeiooal Savica. Parsmal ioforaratioo you r (ddiftamt Barr marling address) mirposcs in accordance wdb'Ibc Privacy Law, s. 15,04(i)(ml Stun. 1631 52'a St I. ApplfatiesblIb raden-MainePrintABLfarmadem Property Owner's Name Parcel A Mart A sridgette woibn 032-2129-504)DO Pro" Owner's Mining Address Property location 14591 1& St N Gout. LAX Nw Y., Sw Y., Section 09 City, Star Zip Code Pbme Number StilhMar, MN 54082 (651) 442.6491 (circle one) T30N19; RwEorw IL Type of iq (chm* all twat apply) J A Subdivision Name _ ®1 or 2 Family ly DweOemg-Naseber ti%. � q c s� w.�rer Block A ❑ Pablie/(,a®atcial - Daerrbe ❑ City of as ❑ Stareaer e Owned - Dibe Use ❑ Vllage of CSM Number ® Town of Somerset an IIL Tyw of Penult: use bog a We A Comisilleft Mae B if a A New System O Replsoemmt Syarrm ❑ TremmmtlHoWmg Tank Replaommort Only ❑ Other ModiSaim to t3tisdrmg System (eapLm) B. ❑ Permit Renewal Permit Ravhion ❑ Clisup of ❑ Permil Tmunft to New List Pre ous Permit Number and Dale Issued Before amitstioa Plumber Owner 633978 homed 1WIS41 IV. T vix of POWTSSystem/Component/Device: Checlt all that ❑ Non-Premurmed Wn Groud ❑ hcmwimd Indlsou d ❑ At4)m& 11@ Maard > 74 in. of Maud < 24 in. of aft" soil O Howing Tank ❑ othw D*arsal Ccmpw— ( ) ❑ Pretreatment Device (esplaer) r t t F3 �fIV V. IfrVintment Area lafar�afba: . Design Flow (Vd) Dew Soil .410 ' phperaal Area Required (al) Dispersal Area Proposed (st) Sy'slam F�evvatioa Ra1e(®dat) "0.00 R fl. absorption area 900.00 sq ft. absorption wan 900.00 I.0 sand f =.6 nobve and 1 3W.00 so. I bead area 2,392.58 sq. & bm1 area 104.6(r. 10' ahwe 103.77 conbrc VI. Tank lmfo Capacity in Oallam Total GWk m A of llnift L (� II -- '' C Now Tsdm IDtisGeg Talks Septic or Holding Tads 1 1 1 Wiese Concrete Doting Cbmuber 1.100 1,100 1 wiew Concrete VII, Stsfuaeet- I, tie mace for hataoaao. of the raw19 alrowa a• tie attaKicd Plumber's Name (Prior) S' MP/MPRS Number Braun Plain Number Ann BoWncesta 222904 (715) 760-01I7 Plumber's Addman (Street. City, Slat, Zip Code) 1070 Hwy 35, Hudmq wI 54016 VUL Ceara sat Use Only Pd Approved ❑ Disapproved Pemut Fee Wiping Aq!� S Owner Girm Realm for Denial S ~ /l '�ZZ pL, Ca aditioa s of ApprovalfRiumemi for Dhq*toval, 3� �yy i Ab STEM OWNER: i tin 6 f d' `� V e Ie s►, o-✓� 1 Septic tank, effluent filter and dispersal cell must be serviced / mainteirfed as per management plan provided by plumbef. 1 2 00 . I-�t,eUIVA- S ✓1�r�, _ CJ� mtin}�indt � / l �►^�"�Al lu'rra as per applicable code/ordRIl ''66�0 ' bra*""" r sai(�,�I th' as Plilji1 banLlOod y✓1Ql SBD-6398 (R03/14) K IL .,. ml ` March 14, 2022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2024-03-14 Plan Review: PWTS-032200407-C JAMES K THOMPSON 340 Paulsen Lake Ln Osceola WI 54020 SITE: Woitas 6 Bedroom Residential Mound 1631 52nd St. Town of Somerset St. Croix County NW, SW, Sec. 09, T30N, R19W Total Amount: $250.00 DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY N 54304-5211 Contact Through Relay httpJ/dsps-wi.gov/prc)grams/ffwkjst]rY-ser4ices www.wisconsin.gov Tony Evers - Governor Dorn Crian - Secretary r:lfndstinnativ AYLJ•Jr \\/t^1 I nPOT nr C A CCTV A un ocnccoernu Al JCRYrI.CJ FOR: Description: Six Bedroom Mound system \ Sloped Site Mound Component Manual — Ver. 2.0, SBD-10691-P, (N.01/01, R 10/12), Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-p (N.01/01, R 10112), 900 GPD, 26 inches to limiting factor from original grade, Maintenance required, Effluent filter, New Construction 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 any 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 • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 114- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. In granting this approval the Division of Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Afiwr d POWTS Plan Reviewer — Wastewater Specialist Department of Safety & Professional Services ) Division of Industry Services email: Cell: 608-574-1189 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Woitas 6 bedroom nwkiw tail mound Owners Name: Mark & Bridgett Woitas Owners Address: 14581 16th St. N., Stillwater, MN 55082 Site Address: 1631 52nd SL, Somerset, WI 54025 Legal Description: NW1/4SW /4, Sec. 09, T.30N., R.19W. Township: Somerset County: St. Croix Lot Number. 19 Block Number. Na Parcel I.D. Number. 032-2128-50-" Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings ��;�j�SCONd Page 4 Lateral and dose tank ��. Page 5 System maintenance specifications Page 6 Management and contingency plan =O K Page 7 Pump curve and specifications S Page 8 Site Plan 3 m E a9IA Page 9 Attached Sod Evaluation Report s4'WFC� Designer. Jim Th n License Number. Designer #2390-7 Date: 03/08/22 Phone Number. (715) 248-7767 Signature: Designed Pursuant W the Mound Component Manual for POWTS Version 2.0 SSD-10891-P (N. 01/01, R..11/12), and both SSWMP Publication 9.6 Design of Pressure Dlstribudw Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. OV01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet site Information (R or C) R1 Residential or Commercial Design 600.00 Estimated Wastewater Flow (90) 1.50 Peaking Factor (e.g. 1.5 = 15096) 900.00 Design Flow (gpd) 12.00 Site Slope N 103.77 Contour Line Elevation (ft) 25.001 Depth to Limiting Factor (in) ft 601 In -situ Soil Application Rate (gpol ) Distribution Cell Infomtatton loo.001 Dispersal Cell Length Along Contour (ft) _ 1.001 Dispersal Cell Design Loading Rate (gpd/ft) 1 I Influent Wastewater Quality 0 or 2) Pressure Disributlon Information (C or E) c Center or End Manifold 3.00 Lateral Spacing (ft) of Laterals Orifice Diameter (in) Estimat Orifice Spacing ANumber Forcemain Diameter (in) Foocemain Length (ft) Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 14.10 Vertical Lift (ft) 4.85 Friction Loss (ft) 0.00 In -line Filter Loss (ft) 25.45 Total Dynamic Head (ft) ...- ©v ��v v r : Sand fill (D) calculations assume a le 3&1.44-3 in -au soil treatment for fecal co ffam of <= 36 inches. 9.00 Cell Width (ft) Are the laterals the highest point — in the distribution Y network? Enter Y or N If N eabove, high enter the elevata�n ft ---, of the highest point (ft) = 9.38 felorifice Treatment Tank Information Wi180.0Stic Tnk Capacity (gal) eCManufacturer Does the foroemain drain back? CJ Enter Y or N 24.47 Forcemain Drainbac k (gal) 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) 94.22 118.69 39.54 GallonsAnch Calcubdor (optional) M49.2N Total Tank Capacity (gal) Total Working Liquid Depth (in) gaUin (enter result in cell B49) Does Tank Information Effluent Flkiir Infortnatbn Metw Dose Tank Capacity (gal) P ok Filter Manufacturer Dose Tank Volume (gaifin) PL 2 Filter Model Number ncrete Manufacturer project Woitas 6 bedroom residentail mound Page 2 of 9 ♦ 'mot «— rrO r.1 r L J cQ O 2 M LL rl I I W� I odld uoptnjosgo POROIS *IIP'uI t O cpncp� d UUVmm pF- oo�© rn 0 c+� V C IA 9 i Project: Center Connection Lateral Layout Diagram FaaewdaaorarnraatalebeCff s b P •-Td�waiprao< 1 Hdiusibd or rftr�oMarad ibfirral Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Fbw Rate Total Dynamic Head 'L&V"baMltitnaw 1.91111111,111110 a ft Omsk r sch 4O PVC pw SPs T.be 1164.ao-6 Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Foroemain Velocity Dose Tank Information EWcbical as per NEC 300 and so SPS 316.300 WAC Tank component is property vented Weiser Concrete Capacityl 1099.94 Volume 1 25.58 Manufacturer Gallons gaVnch Dimension Inches Gallons A 24.36 623.13 B 2.00 51.16 C 4.64 118.69 D 12.00 306.96 Total 43.00 1099.94 A i B C Alarm Manuafacturer JSJE Rhombus Alarm Model Number JJB Plugger XL Pump Manufacturer JZoeller Pump Model Number JBN 153 Pump Must Deliver 39.54 gpm at 25.45 ft TDH Woitas 6 bedroom residentail mound Locking cover with warning label and k#»g device and sealed watertight 4 in. min. Forcernain diameter ---I 2 in. Weep hole or anb- siphon device Pnn ofl ekwation (ft) 91.00 d Dose tank shrAidon (it) 90.00 Note: Switches containing mercury may not be used in this system. Page 4 of 9 Mound System Maintenance and Operation Saecifications Service Providers Name Jim Boumeester —� Phone 715 386-9020 POWTS Regulators Name St Crobc County Zoning Dept Phone 715 273-6747 $Mom Flow and Load Parameters Design Flow - Peak 900 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 600 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 18M gal Maximum TSS 150 nVL Soil Absorption Component Size 900 fl? Maximum FOG 30 m91L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filtef Pump and Controls Alarrr Pressure Systerr Mounc Service Frequency Inspect and/or service once every 3 years Should inspect and dean at least once every 3 years Test once every 3 imam Should test monthly Laterals should be flushed and pressure tested every 1.5 years I nSD8Ct for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are sloded and materials Conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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. Finished ••..••.....••• Grade vl 6-8" Diameter Lawn Sprinkler Valve Box Lslbaal Turn4op DettaN ............... Threaded Cleanout Plug or Ball Valve ��y�eeD 90 or Two ree Bends Same Dia r as Lateral Project Woitas 6 bedroom residentail mound Page 5 of 9 CL C O 1ID � -0 FIR CLU d �S � � it s0I I w' w - ; 1 a o 8 a cga S 10 O 1 s EC m 4 3 tax I I a I i E'ou i X= 01 m m Q Qoo gmX! o .g c� �g wcr a gill !j I cr I H CD Pj co R R m 8 m oCA N •irl.edwat�liiil..;lr1�:; � . . • altalfal�i!liiili��lr+�y��..iirl.ar IMM521153 3vIM �L7E�iC�i�SIR1�® C �W"29[l 'TIM!< 7® tA TOTAL DYWAW Wi NWIN MAME E#Fl��yll6�IlF7lISG am am .,.. ,w 4 sm ew as is a ul SELECTION DUDE lass r .�w, .i tar/.�p�r.rprrwiEa.Iwo�.ra.erv+wru. bawrt ® wrla *fr' ti FMW. .... ilw%Iirl l�liiiiMr irdo" todM., ly M "ditd 2 ewAtlhQierewwl w1/11i1flMr!N14ur1 EAMk IMNOW a,elna 4 AN •M,YMYui,MrMW.rYaMN IM,wM MMle,l Iww111roM/GieMo Cod,ft""d"vft Advw4 Al j YIIIC01�'d '7V�® r{bl�iiF/oN��.�iJd (l) Q(Ij104 .. - . RESERVE MftRO DESIGN F�.wwrllawiwl �Irtwllr�ilfr wobri.gnr.a inl�lljiw�jl dwiwy7b11wpnp. . • ireiar sa eaor�a - a.�`.a�"ar Mrl.aw.... .: �.,� � r:• L�°ri1�rIIn�11>, �/IIL/rBiv � •Cap111M 2W4ZAdWOo.MftWowwwd. 6.7w?. 9 -Caw b�nabw, 3a: fI fivtE s;� •f'i1 s�7k-�a7�Sr.�: •BAR• Rd.C.Pygridd 00 lyres L A^•�d !. Ar�drawr. tot S./uti✓�tRbi►s�� Af.�KAi CSraL�t��.c�it�nsf�9° ,CoE/9,B�hdoF �n�r- Esd.,E,es, �noEi;bti�►i 4s�E.va�Ac yr.Y'ea;,M3.3PK�.�t � AG wrniQresCr .Tw�'A 6vfOQ et"CAW 60, / / P,L* { .8af9 'A �i� 0 t 0 r Bork,,. ❑ ®Pit Oland turbos dw. ima R Depth to Wt*0 factor IV in. Horizon Dsplh in. Dorrirnl Color MrMat Radom Desr:iptlon Qu. AL Cant Color Twdua Jlnrahas Gr. Sz. Sh. Condebnoe Baadry Root tm Rate WnW 'ES)1 'Elli2 1 0.12 10y1m none at 21pr n rr ae 2vfim (Le 0.8 2 12-28 10yr414 rroris N 2fgr mtr ON2N.im Q6 0.8 3 28-40 7.5p" now Aral lCahh mtr ow 1tR,rrn 0.4 0.7 4 40-58 7.5ymm f2d Myr5/8 pr d Om mtr - 0.2 Q8 ❑ R Ground suhos dw. _ t Dow to t Nft E012or _ In. Sol Rate Horizon Depth Darirtd Cola Rader Daaalpflon Taapaa SYucWm CanaAtarros Boundary Root G Mg" ln. ltura8 Qu. Az Cont. Co Or. ft Sh. -- - - - c "ft0 ❑&ft ❑ pt Ground surface aim. _ t. Depth to WrftQ factor _ Yn. I kT--_ Sd (cotton Role Horizon Depth DominrrtCobr RadmrDeaalptbn Tendnne Structure CaahMnca Boundary Roola GPWFi= In. Mum Qu. Az. Cori wor Gr. Sz Sh. E101rerd f1 . BOD, > 30 5 220 ffQ& WW TSS > 30 5150 ffg& • &&N t 12 - BOO, > 30 5 220 "V& and TSS > 30 5150 nplt • Propo•se�l .L�•s:d..,c.e I ♦� ,Loe419,�b�eFn�r N�li�-��; Ja�.o9, .3o�y�2. �9�►�, Pu• aaz-arse-Sb N KP� &u�7sel+rs J rag r I r � r/ d,/ r / . 3 a3 APPLICATION FOR RE1/IEW Private Onsite -ComIleft ON pages- Wastewater Treatment yd NOTE Personal information You provide may be used for secondary purposes w [Privacy Laws. 15.04(lXm), Stets.] Systems Division of industry Services ❑ Plana to be E-filed. Provide SharePoint User name below For plan status, check our website at httoJldsos.wi.aov Several counties have been delegated certain auft* to review plans in lieu of Division of Industry services. For a current list of those counties and their designation dieck our website at httnl/dsac u i ri , 1. Pro)eet Information - Fill In all known information. Project/Site Name: YY2rae6 Bedroom Residential Mound Location, Number & Street of project (if unknown, indicated nearest road) 1631 52n° a Somerset WI Legal Description: Lot 19 Plat of Wanner Estes NMASW+u Sec.no T.30N.. R19W . County Tn. of Sorrteaet, SE Croix Co., NA. 2. After plans are reviewed, m - 1: (check all that apply) ❑ Call customer 1, 2 (circle numbery ❑ Requesting party will pick up ® Mail plans to customer 1, 2 (circle number) - 'Refers to customer number from below. Confirmation of assIgIn ent to a rovirror. Transaction ID: Previous Related Trans. ID: Estimated Completion Dale: Assigned Revlewsr. Assigned OBo s: Mall to your olllce of cholce below: Hayward, LaCrosse, Waukesha NOTE: Ylia reserve the right to redistribute plane to another office If Treaded to reasonably balance turnaround tines. Check httyJ/deos.wh.aov for office availability and next available review dab Comp 3. avoMdwrepsatlrrY Morm1111a's bd ruldbm. Ullla the streak boxas wh 0 dlraWm. owner or requesting party is the sane b DDissig ier Information (Clwlomw 1) DSPS First Nam Last NanaCullitbrim NumberCorttpany James Name Thompson A.C.E. Sol d Sao Evaluation., Address LLC 340 Paulsen Lake Lane Cry Stale 020 elm) Osceola yyl Phan Number (area code) E-meN address Car phone (715) 248-7767 OONOidNmrdWnstnot Check if applkaable ❑ Owner Fist Narme �� Belssr (Cuslor er 2) DSPS Last Name Customer Number Comparry Nana city State Zp.r4 (9 digits) Phan Number E-mail address Cep phone (area code) . Chedk If app4cable or eperJy reutanship Information and Plan Submittal Cllsdkilillds POWiS u -. "' -qt my re.awwno at a DSPS office. Submittals received may IL pre adiedtding is not avaiable. Plans willbe asei twit llD a reviewer after receipt assigned to oRices other than the receiving Submittal checklists can be k"W in each cable oRioa On reviewer availability. fttmJ/dsos wi oov/oho/sbHooal000lom �i00�� manual appearing on the POWrS Pubrr�tlprla page, dmde result oholPOWfSM/POWTS COMPONENT MANUAL. You may email technical code lima lorla to DSPSSBPowtaTechHtwi oov Haymd DSPS LaCrosseAron DSPS Ranch Wl 84 Hayward 3824 N Creekside Waukesha DSPS 141 NW Barstow Sl 7 Holman w 546W 4" Fbor Fax: 715 634515o 08 771F CH�34 E) Waukesha W 531883789 Email: D bPlanSehedub&Dien aov Fax: SM785-93M Emrk Fair 262. 54ga614 EmN age Make Checks Payable to: Division of Industry Servk= OR ❑ Check box to invoice designer and sign below Designer signature SPS-10577 (R 10/15) TOTAL AMOUNT DUE $ 250.00 Row low Code 7M 5. POWTS SUBMITTAL (check all that apply — Incomplete fortes may result In processing delays) ® NEW ❑ Aerobic Treatment Unige) ❑ Chlorinator ❑ Tank Replacement Only ❑ REPLACEMENT ❑ Commercial System ❑ UV Disinfection Unit ❑ Add Effluent Fitter SYSTEM TYPE($) NOTE: Submit separate shoots for each system If submitting multiple systems on the same sib Enter Fee ❑ Revision to previously approved plan $86.00 ❑ Miscellaneous Review Ps. replacement of a septic tank, addition of an effluent filter or pretreatment device to an @dating system, etc.) 8801hr ❑ Component Manual Design All treatment components am previously approved ❑ At -Grade Component Manual - Ver. 2.0, SBD-10854 (N.03/07, R. 1112) Wastewater Flow In under a. SPS 364.10 (2) or (3): ❑ In -ground Component Manual - Ver. 2.0, SBD-10705-P (N.01101, R 10/12) ® Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01/01, R 10172) Gallons Per day Design wastewater flow of the proposed system: ® Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01/01, R 10112) 2N 1,000 gpd or Was $250.00 260, ❑ Other- Please specify GPD 1,001 —2,000 gpd $325.00 2.001 — 5 000 400.00 ❑ Soil Based Individual Site Design' One or more treatment components are not previously approved under s. SPS 384.10 (2) or (3): ❑ At Grade (Individual site deslgn/dovistlon from component ❑ Non-Proesurtsed In -ground Design manuals and use of components without product ❑ Pressurized In -ground Wastewater Flow in approval): ❑ Mound ❑ Drip -line Gallons Per day Design wastewater flow of it* proposed system: ❑ Constructed Watlands GPD 1,000 � or less $450.00 — ' Documentation must be provided to support treatment and dispersal claims. in a parsto se 1.001-- 2,000 gpd 5600.00 statement, provide rationale for this project and attach supporting documents (code sections, lest 2,001 — 5,000 gpd $750.00 reports, technical papers, research articles, etc) greater than 5,000 gpd $900.00 plus $0.08 for each gallon over 5000 gpd State-owned facliftles: Design Holding tanks previously approved under s. SPS ❑ h;oidirg Tank Component Manual, Ver. 2.0, SBD-10855-P (N.03/07, R1/12)' Wastewater Flow In 384.10 (2)(3). Design wastewater flow of the peed system: Gallons Per day ' Non -state owned Commercial and Residential Holding tanks that completely utilize this manual 5,000 gpd or Ins $90.00 and have an estimated daily flow of less than 3000 gallons per day must be submitted to the GPD 5,001—10„000 gpd $150.00 — appropriate govemmental unit for review Inatead or the Department. (ses SPS 383.32(3Xa)) greater than 10,000 gpd $225.00 ❑ Holding Tank Individual Site Design*, (i.e. of constructed, <5 day holding ospecity, Co- Holding tanks Including site constructed tanks NOT mingled wastewater, etc.) leasteDDesiig Flow In approved under a. SPS 354.10 (2) or (3). Pbes aspotty _ Go Gallons Per day Design wastewater flow or the proposed system: ' Docun oft Ion must be provided to support the rationale for the project In a separate abbrtsnt, 5,000 gpd or leas $180.00 great — — pleaes Include all code sections, test reports, technical papers, lees rch article*, at.) GPD than 1 00 "N$300.00 prosier than 10,000 gpd i450.00 ❑ Soil Saturation Determination Report (using observation pipes) ❑ Interpretive Determination t240.00 ❑ Experimental System (One time addltlonal fee). Submit fee for Individual system as per appropriate above system type) Experiment Number _ $400.00 Prior approval from a section chlef Is required for a priority review. If approval is granted, the priority will be reviewed within 5 days of reoelpt. Priority Review (enter same amount as normal review fee Bated above) Enter Total (rounded to the nearest dollar) s _ 8 MA SPS-10577 (R 10/15) Residential Mound POWTS Index & Title Sheet Project Name: Woitas 6 Bedroom Residential Mound Owners Name: mwk tit Bridgette Woitas Owners address: 14581 16th St. N., Stillwater, MN 55082 Site address: 1631 52nd St., Somerset, WI 54025 Subdivision: Lot 19, Wagoer Estates Legal Damiption: NWl/4 SWl/4, Sec. 09, T.30N., R.19W., Town otSommet, St. Croix Co., WL Parcel ID #. 032-2129-50.000 Page I Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Mader Ph®ber Restricted Service: Jim r\ ' T Signature: Index and Title Sheet State Approved Mound Design Fiber Specifications SepwPur p Tank Cross Section Ownership/Address Form Parcel Map Warranty Deed DSPS Credential #222904 r Page 1 of 7 DaiW pma mm to In.4m.e sod Abompbm Campmot Mamrl for POwTS, va n=10 SBU-10705-r (N.olrot) awrnaw*kk P'Ir525 Filter PI-525 Effluent Filter The PL-525 Filter is rated for 10AM GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank Features • Rated for 10AM GPD (gallons per day). • 525 linear feet of 1/16" filtration • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. PL.525 Irisbllation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 2 Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend do Lok or piece of pipe to center filter. 4. Insert the PLr525 filter into its housing. 5. Replace and secure the septic tank cover. The PLr525 Effluent Filters will operate efficiently for several years under normal conditions before requuu►g cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. 9 the installed filter contains an optional alarm, the owner will be notified by an alarni when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary 3. Do riot use plumbing when filter is removed., 4. Pull PL.525 cartridge out of the housing. S. Hose off filter over the septic tank. Make sure all solids fall back into septic tank 6. Insert the filter cartridge back into the housing making sure the felts is ptopedy aligned and completely inserted. 7. Replace and secure septic tank cover. 1/16" Filtration Slots Aoxpts 4"&6" SCHD 40 pipe I L Outdoes SmortFilterm Alum Polylok Zabel & !lest filters accept the SmartFilterO switch and alarm Alarm Switch (am) Accepts 1' PVC Extension Handle Rated for IOAW GPD 525 linear Ft. of 1/16" Filtration Slots cart>ttw to NWIA qt Stood rd 46 Gas Deflector Automatic Shut -of Ball Extend h Lokw Easily installs into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 loll Free: 877.765.9565 Far. 203.284.8514 www.polylok.00m PQ , I&A7 w a8 W c �^- t 5' - 4" 71" �------ --------- - - - - -- IIII Y I 4" CAST —A —SEAL inn 4" CAST -:A —SEAL IIII fill ilk I I 1 I f�1 c0 � � I � `•fJ n IT FILTER OR I f I I Q3 BAFFLE I n l II{I Y f fill ---------------------III------------- 4" VENT r ,VN I . ^_^ r•1 M J I rU CL 1 ] � 'co L 1♦ � I I =1� I �1 ----->—J% n WLP1800/1 > 00 TANK SPECIFICATIONS CL DIMENSIONS: WALL: 3" BOTTOM: 5" COVER: 6" MANHOLE: 24" I.D. PRECAST -CONCRETE RISER < HEIGHT: 62 3/4" LENGTH: 15'-4" YADTH: 8'-8" BELOW INLET: 50" LIQUID LEVEL: 43" c WEIGHT' BOTTOM 18.017 LBS. 8 COVER 9.300 LBS. _ INLET AND OUTLET.- 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: M Wyg < F W ffi o E WISCONSIN. SEE DETAIL /10 (OTHER STATES SEE CHART) W Lu x LIQUID CAPACITY: 41.80 GAL/IN (SEPTIC) LU 25.58 GAL AN (PUMP) LOADING DESIGN: 8'-0" UNSATURATED SOIL rc m z TANK CAN BE USED AS: I Y i Ln 04 PSEPSIPHONPTIC/PUMP, z pq OR �o COVER: MIX DESIGN 08 (NO FIBER) y co TANK: MIX DESIGN #9 (SMALL FIBER) W � CUSTOMIZED TANKS, FOR CUSTOM TANKS CONTACT WIESER CONCRETE 8 U REVIEWED BY REVIEW DATE _ 5 F DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: SH T N0. APPROVAL DATE: PRODUCTS NEEDED BY: OF ST. G2 uwlry SANITARY SYSTEM File office use Only OWNERSHIP/ADDRESS FORM Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. Owner/Buyer Mark & Bridgette Woitas Mailing Address 14581 16th St. N. City/State/Zip Stillwater, MNI 54082 Phone Number (required) (651) 442-6491 Email Address (required) KiSSm ss@yahoo.cc Parcel Identification Number 032- 128-50-000 (found on the property tax bill) Property Location NW '/4 , SW 14, Sec. Subdivision Plat: Wagner Estates Certified Survey Map # Warranty Deed # Number of bedrooms 0 t0 0 T 30 N R 19 W, Town of Somerset Lot # 19 Volume Page # ( ore 2006)Volume . Page # Spec house 0 yes ■ no Lot lines identifiable ■ yes 0 no New Property Address b31 a''a 06� C-41 (venficat n of new address required from Community Development Department for new /O r (s4ffI itia s (Date 1 This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System Include with this form 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. Community Development Department - Land Use Division 715-386-4680 St Croix County Government Center cdd@sccwi.aov 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax www.sccwLaov p5,$af7 SANITARY SYSTEM File #: Onfy OWNERSHIP/ADDRESS FORM Wiz; 021 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. Owner/Buyer Mark & Bridgette Woitas Mailing Address 14581 16th St. N. City/State/Zip Stillwater, MNI 54082 Phone Number (required) (651) 442-6491 Email Address (required) Kissmyass@yahoo.com Parcel Identification Number 032-2128-50-000 (found on the property tau bile ` Property Location NW t/4 , SW t/4 , Sec. 09 , T 30 N R 19 W, Town of Somerset Subdivision Plat: Wagner Estates Certified Survey Map # Warranty Deed # Number of bedrooms ] New Property Address (Staff Initials) Volume_ . Page # Lot # 19 . (before 2006)Volume Page # Spec house O yes ■ no Lot lines identifiable ■ yes 0 no (Verification of new address required from Community Development Department for new construction) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified stirvey map if reference is made in the warranty deed. Community Development Depa nt - Land Use Division 715-386-4680 St Croix County ( ment Center cddCdsccwi.aov 1101 Carmichael Road, Hudson, WI 54016 715-24SA250 Fax www.sccwi.aov P5' � a,-F 7 E 410.: • ., a ::a H.W.L. _ sa onnwnae 900.0 C- - - - - - - - -�� • .....: �arArrso'wr.'.: .: .......::..............aaiio ::. 'ACMW - H.W.L. : : ..............t. 892.0 - :s ► / wETLAND H.W.L. / 900.G .......... � . ,s ........... ...... .................. .............. GE�ERSPO�/:: ::......::::::......::i ::::: is r:: riati::.: i_r.:::::::' } •:•.•.• . woc.aa•. VENT N89.4418"W 2236.97' IED LEGEND R - - - - - - ROADWAY SETBACK LINE AS SHOWN NOTE A GRADING THAT WOULD ALTER THE CAPACITY OF THE STORM WATER RETENTION AREA _ 12WIDE UTLf1YEASE]4fT ISPROIIENRED '- -- PROPS DRIVE NOTE B IAJLDINGS ARE PROMWED WITHIN THE STORM WATER RETENTION AREA 4• x S EXISTING FENCEL INE STORM WATER TEIEIJSON AREA TO HIGHWATERLNE H.W.L - HIOH WATER LINE ELEVATION CONTIGUOUS BUILDABLE E AREA PER TOWN OF SOMERSET I' P.toW7 3 G ST- .oL/ q 3 7 Wvisio of DepaIndus ices �C Divisionoflndus Zr Page 1 of 3 NOV 22 2021 SOIL EVALUATION REPORT In anoe with SPS 385, WiS. Adm. Code County Attach complete sit plan orx�aIWd?9t j4"4 In 8 1/2 11 inches in size. Plan must include, St. Croix but not limited to: v 1c�b"r,;l�ipfj TW4" eoi t (BM), direction and Percent slope, Parcel I.D. scale or dimensions, nce to nearest road. 032-2128-5G.000 Ref# 2656 Please print all Inforrnatlon. lte)iewed by n n nato Property Owner Property Location — _ ❑ Mark & Bridget Wortas Govt. Lot NW % SW Y. S 09 T 30 N R 19 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 14581 16" St. N 19 na Wa ner Estates City State Zip Code Phone Number ❑ city ❑ Village ® Town Nearest Road Stillwater MN 651 442-6491 Somerset 164m Ave LN r uw wnsuucuon Use: N Residential / Numberof bedrooms 6 Code derived design flow rate 750 GPD ❑ Replacement ❑ Public or commercial — Describe: _ Parent material Glacial Till pnawi:q ---An-kap Flood Plan elevation if applicable _ ft. General comments and recommendations: Site sutable for mound dispersal cell. Recommended infiltrative surface = 104 ' at 10" a e 103,73' contour. f , ,rC Ft Boring # ElBoring -- spa Ground surface elev. 103.82 ft. Depth to limiting factor 26" in. Horizon 1 Depth In. 0-10 Dominant Color Munsell 10yr32 Redox Description Qu. Az. Cont. Color none Texture sit Structure Gr. Sz. Sh. 2fgr Consistence mvfr Boundary as Roots 2vf,fm Soil Application Rate GPD/Fta 'Ef1#1 0.6 •Eff#2 0.8 2 10-15 10yr4/4 none sil 2fsbk mvfr cs 2vf,fm 0.6 0.8 3 1526 7.5yr4/4 none Sid 2msbk mfr cw tvf,f 0.4 0.6 4 26-42 7.5yr4/4 f2d 7.5yr5/8 sicl 1csbk mfr aw lvf 0.2 0.3 I 2 I Boring N ❑ Boring l_J ® Pit Ground surface elev. 10043 ft. Depth to limiting factor W in. a pq Horizo Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil lication Rate GPD/FN In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. 1 0- 1.Oyr3/3 none sil 2fgr mvfr as 2vf,fm 'Efl#1 0.6 •Eff#2 0.8 2 — Zi7 10yr5/4 none sit 2fsbk mh cw 2fr,fm 0.6 0.8 3 20-30 7.5yr4/4 none grsl 1csbk mfr cw 2vf,fm 0.4 0.7 4 3 35 7.5yr4/6 f2f 7.5 gr Is Osg ml cw 1vf,im 0.7 1.6 5 3548 7.5yr4/4 fad 7.5yr5/8 gr sl Om mfr 1vf,f 0.2 0.6 ' Effluent #1 = BOO > 30 5 220 a TSS > 30 5 Effluent 2 = BOD > 30 5 220 L and TSS > 30 5 150 malL CST Name (Please Print) Signature : CST Number James K. Thompson S^— . 30021 Address a Evaluation Conducted Telephone Number 340 Paulsen Lake Ln. Osceola WI 54020 November 8 2021 715 248 7767 ZSt5t}n3W (RO4/15) 3 Boring # ❑ Boring LJ ® Pil Ground surface elev. 103.73 R. Depth to limiting factor 40" in Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eff#1 'Eff#2 1 0-12 10yrM none sit 21gr mvfr as 2vf,fm 0.6 0.8 2 12-28 10yr4/4 none sil 2fgr mfr cw 2vf.fm 0.6 0.8 3 28-40 7.5yr4/6 none grat Icsbk mfr cw 1vf,fm 0.4 0.7 4 40-58 7.5yr4/6 f2d 7.5yr5/8 gr sl 0m mfr 0.2 0.6 I Boring # El Boring U ❑ Pit Ground surface elev. _ ft. Depth to limiting factor _ in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 OEM 'Eff#2 ❑ ❑ Pit Boring # ❑ Boring Ground surface elev. _ ft. Depth to limiting factor in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eff#1 •Eff#2 Effluent #1 = BOD, > 30 s 220 mg/L and TSS > 30 5 150 mg/L • Effluent #2 = BOD, > 30 S 220 mg/L and TSS > 30 S 150 mg/L so,�cr4/�bot,P;E e)("s 6", ra r1,.J{�sro.+�l, 3ec..a9,T3o�fy,p. iy� T•ofSa^iai3c%5� CAV. be,'� 3.cr�racres tom(. fo p✓.C. ppe..(ssk .0 d slts=fa10•A�� Acise / _ t �. 3 oF3 MS.", �!�!�101M AY 2. 4vT E 1�� / Cary .Y V Industry Services Division St. Croix 1400 E Washington Ave 01 20 P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) OCT feAadi�ort, W1 53707-7 - 3 3 9 � Com it Applicatio State Transaction Number In accordance with SPS 383.21(2), Wis. Adm Code, submission of the rpm to proprnme goo it , �t 'S 02 3 TD - is required prior to obtaining a sanitary permit Note: Application forms for SUM WME� sutmd to die Deparm cat of Safety and Professional Services. Personal m1otmtion you provide mabeodllaWy Project Address (if different than mailing address) pirposes in accordance with the Privacy Law, s. 15.04(lXmk Stm& 1631 52i, St 1. Application Information - Please Print All Infsrmation Property Owner's Nano Patel s Mark & Rridgetle Woitas 7V A)1G 032-2128-50-000 Property Owner's Mailing Address Pity Location 14581 16" St N Go". Lot NW '/4. SW ''/% Section 09 City, State Zip Code Phone Number Stillwater, MN 54082 (circle one) T30N19; R orW E If. Type of Baildin eek all that pply) Lot 0 Subdivision N ® 1 or 2 Family Dwell in [sober of 0 I Qb Pee ,1 Wagner Fstates Block 0 ❑ PubliwOCommercial - Descri / ❑ City of no ❑ State Chvnod -Describe Use 1 ❑ Village of CSM na ®i0 rsd Ill. pe of Permit: Cheek only one box ORINC A. Complete line B a A New System ❑ Replacement System TrestmentrHol T t Only ification to siting SyNo.. (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ of T to Prevpus Permit mbar and Doe Issued Rcfon Expiration plumber IV. Type of POWTS S stem/Com e:nUDevice: Check that 1 — , ❑ Non -Pressurized In -Ground ❑ Pressurized In-<�routd ❑ At > 24 in. ❑ Mo 24 in. of suitaWc soil ❑ Holding Tank ❑ Other Di Corrnpanern ( �) ❑ t Device (cx ) 1 V. D' VlrestmentArea Information: Design Flow (gpd) Design Soil Application Area Requi Arta (sf) System Elevation 900 Rate(gpdst) 00 sq R ahaorpticn 00.00 sq ft area 100.50' at 120 �9 59'mntuur 1.0 sad 0110.5 native soil 800.00 , R basal sea 1928.35 . ft. area VI. Tank Info Capacity in Gallons �• 2 Total it of u New Tanks F�tism a Gallons Unit in a U H i±. 5 fa. Siptie or Holding Tank 1,800 1 800 1 Wieser Concrete Dosing Chamber 1100 1100 I Wieser Concrete V 11. Responsibility Statement- 1, the amame . for installation of the POWTS shown on bed plam. Plumber's Name (Priem) PI Sieester MP/MPRS Number Business Phone Number JimBoum 715)760-0117 Plumber's Address (Street, City, Stare, Zip Code) 1070'Hwy 35, Hudson. WI 54016 Vlll. Compty/Departmest Use Only Approved ❑ D Permit Fame Dat4lsst*dI ui Ages S Given Reuorn for Daniel 1 $ �Jj, ��pp pia Al ate t.en TEM �1VNER: APP eptic tank, effluent filter and isperssl cell must be keryiced / maintained s per management plan provided by plumber. �� (,tw�L-{� d¢ -j W/tCLt�r1C L as per appncawe coueiorolnanms-" r "`mow "a- - SBD-6398 (R03114) Residential Mound POWTS Index & Title Sheet Project Name: Woitas 6 Bedroom Residential Mound Owners Name: Matk & BrMgette Woitas Owner's address: 14581 16th SL N., Stilhve»or, MN 55092 Site address: 1631 52nd SL, Somerset, WI 54025 Project Location: Subdivision: Lot 19, Wagner Estates Legal Description: NW I/4 SWl/4. Sec. 09, T30N., R.19W., Town ofSomerset, St. Croix Co., WI. Parcel ID #: 032-2128-50-M . Page 1 Index and Title Sheet Page 2 State Approved Mound Design Page 3 Fihat Specifications Page 4 Septic/Pump Tank Cross Section Page 5 Ownership/Address Form Page 6 Parcel Map Page 7 Warranty Deed Maier Plumber$estricted Service: Jim Bomneeater. DSPS Credezrdal #222904 Page 1 of 7 Daign pummu to In-0mund Soil A6empdm Componem ManuW for POW7S, m3m 2.0 SBD-10705-P (N.01/01) September 23, 2021 CONDITIONAL APPROVAL PLAN Plan I James Boumeesl 1070 State Road Hudson, WI EXPIRES:2023-9-23 SITE: Woitas 163152n° Ave Somerset Township St Croix County NW % SW Y4 S9 T30N R19W FOR: DNBION Of MOUSTRY SERVICES 10541 N RANCH No HAYWARDW 54/43.&W Corded Thoto Refry Id1D.AAftM" r waconen go. Tony Eveee - Ooverno/ Down Orr -- Eetee4_� Description: 6 Bedroom — 900 GPD — 27 limiting factor- Effluent Filter - Maintena required. The submittal described above has been Administrative Codes and Wisconsin Sta system is to be constructed and located component manual(s) referenced abov Statutes, is responsible for compliancy No person may engage in or work at lu s.145.06, stats. ound Component Manual — Ver. 2.0, SBD- 0691-P (N.01/01, R 10/12) ssure Distribution Component Manual — Ver. 2. BD-10706-P (N.01/01, R. 10/12) wed for conformanc ith applicable Wisconsin s. The submittal has been ONOffIONALLY APPROVED. This accordance with the enclose proved plans and with any he owner, as defined in chapter 01(10), Wisconsin h all code requirements. ping in the state unless licensed to do so by the Department per The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the Mound site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. • Components and soil removed from an existing drain field shall be properly disposed of so that there is no risk to public or environmental health. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2Hd), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • 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. Owner Responsibilities • The current owner, and each su\anmaintained t owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriation and maintenance manual(s) and be responsible for ensuring that POWTS is operatein accordance with this chapter and the approved management plan under s. SPS 1. / In the event this soil absorption system or y of its component parts malfun s so as to create a health hazard, the property owner must foil the contingency plan as de abed in the approved plans. The owner is responsible for submitting a maintena verificati report acceptable to the county for maintenance tracking purposes. Reports shall be su itt t intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services r erves th\telephone changes or additions should conditions arise making them necessa or code costate stats 101.12(2), nothing in this review shall relieve the desig r of the resgning a safe building, structure, or component. Inquiries concerning this correspondence maybe made tome at the r listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Joshua Rowley POWTS Plan Reviewer, Division of Industry Services (715)813-9111 Joshua. rowlevt@wisconsin.gov APPLICATION FOR REVIEW r -CompMbs all pages - NOTE: Personal information you provide may be used for secondary purposes a� [Pnvaoy Laws. 15.04(1)(m), Slats.] Private Onsite Wastewater Treatment Systems Division of Industry Services ❑ Plans to be E-filed. Provide SharePoint User name below. For plan status, check our website at htto://dsps.wi.aov Several counties have been delegated certain authority to review plans in lieu of Division of Industry services. For a current list of those counties and their clesignabon check our website at httl0dws.wi. v 1. Pooled Information - FIN In all known IrMarrnafion. Gon imwtion of assignment to a reviewer. Project/Site Name: Wotas 6 bedroom residential mound Transaction ID: Location, Number a Street of project (if unknown, Indicated nearest road) Previous Related Trans. ID: 1631 52' Ave.. Somerset. WI Estimated Completion Date: Legal Description: Lot 19, Plat of Wagner Estates. NWt/4 SWIM, Sec.30. Assigned Reviewer: T.30N., R.19W. Assigned office: County St. Croix El City [I Village ® Tom of Mail to office of choice below: Hayward,Hayward,, lL a Crosse, Green Bay NOTE: We reserve the right to redistribute plans to another office if 2. After plans ate reviewed, please: (choclk all that apply) ❑ Call customer 1, 2 (circle number)* heeded to reasonably balance tumaround times. Check ❑ Requesting party will pick up huDdIdsps.wi.gov for availability and next available review date ® Mail plans to customer 1, 2 (cirde n r)• 'Refers to number from below. 3. Complete the following designedo nedrequeatl Ublkw are check designer, owner or requesting party is the same to 7"""'" avoid repeating Information. Designer lnfonna&m (Customer 1) DSPSNNr Other Specify Below (Customer 2) DSPS First Name Last Name Custome F Last Name Customer Number Jim Bourrreester 222904J K. Thompson 30021 Company Name Clilimpany Name Bourneester & Sam Excavating 69C.E. Soil 3 Site Evaluations LLC Address rhoress 11070 Hwy. 35 auksen Lake Ln. City State Zip+4 (9 digits) City State Zrp*4 (9 digits) Hudson WI 54016 Osoeo WI 54020 Phone Number E-mail address Cell phone Phone N E-mail address Cell phone (area code) (area code) 715-760-0117 isrboumeeste ail.com 715.248-7767 acesoilifWTonfiernet net Check if applicable Check if appwabb Spec" y relationship ❑ Owner Owner relationship Consultant Information and Plan Submittal Checkftft. POWfS preiftdiieduling is not available. P II be assigned to a reviewer after receipt at a DSPS office. Submittals received may be assigned tqfAoes other than the receiving office on reviewer availability. Submittal cleddits can be found in each applicable com manual appearing on the POWf ublications page, h ://d .wi. / o I COMPONENT MANUAL. You may email technical code guesfiorts to DSPSSBPowtvrect0wi.aov. Hayward DSPS LaC Area DSPS Green Bay DSPS 105.41 N Ranch Rd 3824 a Ln 2331 San Luis Place Hayward WI 54843 WI 54636 Green Bay, W 54304 715-634.4870 608-765.9334 920-492-5601 Fax. 715434-5150 Fax: 606-785-9330 Fax 920-492-5604 Email: DsosSbPlanSchedule@wr.gov Enalt DsoaSbPlanScheduk4Dwi.gov Email: DspsSbPlanSchedulegkm.gov Make Checks Payable to: Division of Industry Services is ❑ Check box to invoice designer and sign below Designer Signature SPS-10577 (R 5/16) TOTAL AMOUNT DUE $250.00 Review Code 7633 5. POWTS SUBMITTAL (check all that apply — Incomplete fors may result In orocesslno delaysl ® NEW ❑ Aerobic Treatment Unit(s) ❑ Chlorinator ❑ Tank Replacement Only ❑ REPLACEMENT Cl Commercial System ❑ W Disinfection Unit ❑ Add Effluent Filter SYSTEM TYPE(S) NOTE: Submit separate shesta for each system If submitting multiple systems on the some site Enter Fee ❑ Revision to previously approved plan $85.00 ❑ Miscellaneous Review (i.e. replacement of a septic tank, addition of an effluent filter or pretreatment device to an existing system, .) S801hr ❑ Component Manual Design All treatment usly approved ❑ At -Grade Component Manual - Ver. 2.0, SBD-10854 (N.03/07, 1112) Wastewater Flaw in under a. SPS/384.10(2)or ❑ In -ground Component Manual -Ver. 2.0, SBD-10706-P (N.01/01, 10/12) ® Mound Component Manual —Ver. 2.0, SBD 10891 P (N.01/01, R 1 2) Gallons Per day Design wastesed system: ❑ Pressure Distribution Component Manual —Ver. 2.0, SSD-10706-P 1/01, R 10/12) 1,000 god or l$250.00 INA ❑ Other - Please specify GPD 1.001 — 2,000$ 325.00 2.001 — 5.000 $400.00 ❑ Soil Based Individual Site Design* One or m treatment components are not ❑ At Grade previo approved under a. SPS 384.10 (2) or (3): (In ual site design/dwAstlon from component ❑ Non -Pressurized In -ground Design usls and use of components without product ❑ Pressurized In -ground We r Flow I pproval): ❑ Mound Gallen d ❑ Drip -line Design wastewater flow of the proposed system: ❑ Constructed Wetlands " Documentation must be provided to support treatment and dispersal claims. In a separate d or leas $450.00 1,001 — d $600.00 statement provide rationale for the protect and attach supporting doamerits (code seftns, Feet 2.001 — 5, �� $750,00 reports, technical papers, research articles, etc.) greater than 5,000 gpd $9W.00 plus $0.08 for each gallon over 5000 go State-owned facilities: sign Holding tanks previously approved under s. SPS ❑ Holding Tank Component Manual, Ver. 2.0, SBD-10855-P (N.03/07, R1//mal Wastewater Flew Wastewater 384.10 (2)(3). Design wastewater flow of the proposed system: j Gallon' Per day Non -state owned Commercial and Residential Holding tanks that completely utilize t 5,000 gpd or leas S90.00 and have an estimated dally flow of less than 3000 gallons per day must be submitted 5,001 — 10„000 gpd $160.00 appropriate governmental unit for review instead of the Department. (see SPS 383.32GPD greater than 10,000 gpd $226.00 ❑ Holding Tank Individual Site Design*, (i.e. site oonstruaied, <5 day holding tapacky, Co- Holding tanks Including site constructed tanks NOT mingled wastewater, eta) Design Wastewater Flow In previously approved under s. SPS 384.10 (2) or (3). Please specify _ Gallons Per day Desgn wastewater flow of the proposed system: ' Documentation must be provided to support p pport the rationale for the project. In a separate statement, 5,000 gpd or leas $180.00 5,001 — 10,000 please Include all code sections, test reports, technical papers, research articles, etc.) GPD greater than 10,000 gpd $450.00 ❑ Soll Saturation Determination Report (using observation pipes) ❑ Interpretive Determination $240.00 ❑ Experimental System (One time additional fee). Subm" fee for individual system as per appropriate above system type) Experiment Number _ $400.00 r nv, ayysavai rrwn a w iv" rnwr is requirev nor a priority review. If approval Is granted, the priority will be reviewed within 5 days of receipt Priority review fee to double the normal review fee. Priority Review (enter same amount as normal review fee listed above) Enter Total (rounded to the nearest dollar) SPS-10577 (R 4116) MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Woitas 6 bedroom residentail mound Owners Name: Mark & Bridged Woitas Owners Address: 14581 16th St N., Stillwater, MN 55082 Legal Description: Township: County. Site Address: 1631 52nd St., Somerset, WI 54025 NW114SW /4, Sec. 09, T.30N., R.19W. Somerset St. Croix Subdivision Name: '%4Yllagner Estates Lot Number: 19 Block Number Na Parcel I.D. Number: 032-212 mNy 00 CondftioAPP OVED EFT. OF SAFETY AND PROFESSIONAL Plan Transaction No.: SERVICES DIVISION OF INDUSTRY SERVICES Page 1 Index aa _` _ p _i Page 2 Data entry` ``�'� Page 3 Mound d74,e:fi Page 4 Lateral aSEE CORRESPONDENCE Page 5 System ons Page 6 Managemlan Page 7 Pump cuPage 8 Site Pla Page 9 Attachqp Soil Evaluation Report Designer Jim Boumeester License Number: 222904 Date: 08/26/21 Phone Number: (715) 386-9020 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01101, R. 11112), and both SSWMP Putilko ion 9.6 Design of Pressure Distribution Networks for ST-SAS (01 /81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01101, R. 10112) Version 7.0 (R. 11112) 1 Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet (R or C) Site Information Residential or Commercial Design Estimated Wastewater Flow (gpd) Peaking Factor (e.g. 1.5 = 150%) Design Flow (gpd) Site Slope (%) Contour Line Elevation (ft) Depth to Limiting Factor (in) In -situ Sal Application Rabe (gpd(ftz) R 600.00 1.50 900.00 6.00 99.50 24.001 0.50 (C or E) Distribution Cell Information "0.001 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information Center or End Manifold S Spacing (ft) r of Laterals iameter (in) rifice Spacing (ft) _ Forcemain (in) Forcemain L (ft) ystem Head (ft) x 1.3 12.00 Vertical Lift (ft) 4.85 Friction Loss (ft) 0. In -line (ft) 23.351 Total Dynamic Head (ft) Lateral Diameter Selection in..dia. options choice 0.75 1.00 x 1.25 x k 1.50 x 2.00 x 3.00 x Treatment Tank Information 1800.001 Septic Tank Capacity (gal) Wieser Concrete IManufacturef Note: Sand fill (D) calc ulatims assume a Table 38344-3 In -situ soil treatment for fecal coliform of r_ 36 inches. 9.00 Cell Width (ft) Are the later the highest point in the dist ution DY /ne Enter Y or N enter the elevation (ft) est pant. the forcemain drain back? r Y� Enter Y or N Soroemain Drainback (gal) 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) IMan d Diameter Selection in. dia. options choice 1.25 1.50 2.00 x x 3.00 Gallonsiinch Calculator (optional) 1099.941 Total Tank Capacity (gal) 43.00 Total Working Liquid Depth (in) 25.58 gal/in (enter result in cell t349) Dose Tank Information Effluent Filter Information 1099.9±1 Dose Tank Capacity (gal) lPotyLok I Fitter Manufacturer 25.58J Dose Tank Volume (gaUn) PL-525 Filter Model Number Weiser Concrete Manufacturer It Project: Woitas 6 bedroom residentail mound Page 2 of 9 • ♦ �� Qom_ N'__+ Cat:. �o C 8 g9 GD' L y odld uopwosgo Pqols TIP •ul t K le a Project: Center Connection Lateral Layout Diagram Fora►malncomeotionviatmorcrossto wim �E P f.Tum-upWbsllvalve or I4- 04pnoutplup Holes dnUd on Uw bottom of t1w Warat Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head Electrical as per NI SPS 316.300 Tank component is property vented Weiser Concrete Capacityl 1099.94 Volume F 2-5.58 Laterals arc Wer4oal Letweia Rforcerndn Sch 40 PVC per SPS Tonle 384.3" 6 Orifice Diameter 1.25 in Orifice Spacing (X) 9.29 ft Orifices per Lateral 3.00 ft Orifice Density 6.59 gpm Manifold Length 9.54 gpm Manifold Diameter 3.35 ft Forcemain Velocity Dose Tank Information and —0 Manufacturer Gallons — T gal/inch A / Dimension Inches Gallons A 24.36 623.13 B 2.00 51.16 C 4.64 11869 D 12.00 306.96 Total 43,001 1099.94 0 0 tank. a Alarm Manuafacturer JSJE Rhombus Alarm Model NumberFJ—B-Plugger XL Pump Manufacturer jZoefler Pump Model Number I BN 153 Pump Must Deliver 39.54 gpm at 2-3-3-51 ft T D H Woitas 6 bedroom residentail mound cover with warning raXled d locking device and watertight 4 in. min. E-- Alternate outlet location Forcemain diameter ---1 2 in. Weep hole or anti - siphon device off elevation (it) 89.00 49 Dose tank Note: Switches containing mercury may not be used in this system. Page 4 of 9 Mound System Maintenance and Operation Specifications Service Providers Name Jim Boumeester--Phone 15 386 9020 POWTS Regulators Name St Croix County Zoning Dept. Phone 715 273-6747 System Flow and Load Parameters Design Flow - Peak 900 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 600 gpd Septic Tank Capacity 1800 gal Soil Absorption Component Size 900 ft� Type of Wastewater Domestic Service Frequency Septic and Pump Tanl Effluent Fifte Pump and Controk Alarrr Pressure Systerr Mounc Othei Maximum BODS Maximum TSS Maximum FOG Maximum Fecal Coliform 220 mg/L mg/L mg/L cfu/1 150 30 >10 In and/or service once every3 ars S in and clean at least once 3 ears Test once eve 3 ea Should test mon Laterals shop d flushed and tested eve 1.5 ears Ins for i and once eve 3 ears 1 Observation pipes are slotted and materials conform to T I PS and are secured in as shown in the mound component anua 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i Wis. Ad 3. All gravity and pressure piping materials conform to require 4. Tillage of the basal area is accomplished with a m board or this 5. The mound structure and other disturbed areas wi seeded and and help reduce frost penetration. Finished Grade 6-8" Diameter Lawn Sprinkler Valve Box Distribution \1� Tunwp DMAN 384 30-1, have a watertight cap, Code is in SPS 384, Wis Adm Code. to prevent soil erosion Threaded C Plug or Ball Long Sweep 90 or Two 45 Degree Bends Same Diame�tteerr as Lateral Project Woitas 6 bedroom residentail mound Page 5 of 9 mL Mound System Management Plan Pursuant to SPS 383.64, Ws. Adm. Code Gerwal This system shall be operated in accordance with SPS 382-84 Will, Adm. Code, and shall maintained In accordance with its' component manuals (SBQ10691-P (N.O1/01, R. 11/12), SSW WF Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SM 10706-P (N. 01/01, R 10/12)) and local or state rinds pertaining to system makderiance 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 SIPS 383.33, 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 tightinesa 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 B-Itches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component ImIttic; Tank The septic tank shall be maintained by an Individual certified to service septic tanks under s. 251.48, Stars. 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 shag be assessed at least once every 3 years by inspection.. The outlet fitter 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 fitter when removed from its enclosure. If the filter is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. 411 The septic tank shall have its contents removed when the volume of sludge and scum It the tank exceeds tr3 the liquid volume of the tank. 11 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 maAnum scum and sludge accumulation in the tank. The addition of biological or chemical ad" to enhance septictank performance is generally not required. However. a such products are used they shall be approved for septic tank by the Department of Commerce. Pismo Tank The pump (dosing) tank shall be inspected at bast every 3 years. All switches, ale and pumps shall be tested to verify proper Operation. If an effluent filter is installed within the tank it s be inspected and serviced necessary. No trees or shrubs should be planted on the mound. plantiAngse made and the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent eroaibn and lo ptlon from host penetration. Traffic (other than for vegetative maintenance) on the mounds not recommended sn may hinder aeration of the infiltrative surface within the mound and snow compaction n the winter will promote frost pweather Installations (October -February) dilate that the mound be heavily mulched as protection from freezing. Influent Quality lino the mound system may not exceed 2201 TSS, and 30 mtgR FOG for septic tank effluent or 30 mg/L BODE, 30 rtgA TSS, 10 mg/L FOG, and 10' chJ100 mL Influent flow may not exceed maximum design flow specified iin the permit for this installation. The pressure distribution system is provided with a flushin e and of a lateral, and lt is recommended that each lateral be flushed of accumulated solids at least Once every 18 months.essure tests rformed d should be cortnpared to the initial test when tine system was installed to determine f orifice cbggYg hed and if orifice aping s required lo maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall he checked for effluent ponding. Ponding els shall be reported to the owner, and any levels above 6Inches considered as an impending hydraulic }allure requiring additional, more cent monitoring Conlinoancv Plan If the septic tank or any of its components become defective the tank or component shall be repa =s) ced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective 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 brig 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. PriMeabnent Unfts The information andschedule of mananagement and maintenance for pretreatment devices such as aerobic treatinent units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project Page 6 of 9 -r. D. PUrp PEraf %LgICE CURVE MODEL 151M52H53 CONSULTyMT�M F� �' d)s� ra' SPECIAL APPLICATIONS 6A2 3IN !Y TOTAL DYNAW HEAGIFLOW PER MINUTE EFFLUENT AND DEWATERING ©OOL�7iL700©I 00oo©o©v� 000�©oov vo©©0000 omos�©oov o0©©©sue©0 oms�s0000 s�amasssoo oosssamo ME:M=30�>•IM33=>•esIrt=Z>. • Tined dosg pumb &vAdW ' amakkd -ar1 , . for &06 ■ql*d vdel an dam - and • Variable laiM daft ufthee are aralebtbr iatpfe pIIM ayaleale, ' Dabs P�ibrk raieble leeei Iloet eealrhaa n Air vsiabb Nwi loop and chart cyda omtah. • Seeied CA*-B t avde6le far arldoar iulddm Sea FM1420. • Over 1300F.1u'C•) qmW PwMm requed. 15111521153 Series te� � am" a— ms1 115 1 Nm .0 1 2a3 ems+ m 1 At to kww 2a3 E151 231 1 Ilar 12 1 2a3 BE151 2a 1 AIY 12 edWW 2a3 m52 115 1 No a5 1 2a3 ME 115 1 Ai as erided 2a2 52 Ia 1 1 a 23e 1 a 53 fly 1 Nm a3 emb 115 1 Aub /0.5 bdid 2a3 Eta3 Mm as 1 2a3 BE1 >0 1 AW 53 bdbded 2a3 Model 151 i sm 4 sm Models 1521153 3VO F ur SELECTION GUIDE 3adlr t sbple pbpy6aak wilEiy I" teal etdah or dm m pwybsrh vaeble reel eeel wltYclt lbla 1s F110171. Ae insleeetion cr mower Po,eeebe dacha n d rdMe ehoAd be do" by a Quefilyd e2 So FN�12 braalydatOdl01 []eebral Aaentda EA ek gneed Necb1cWn. AA de0wlwl end �dy mdu ehedd be beowed I ecbdlep dw ele.d ,Rent Nedmd FJwtric Code II&Q erd tae Oeowpeeoed eiy WA Hotta Abt IomN. 3. Vmftb bnl001 bd aA t 10-=5 used as a 0a11Yd mc&A a, pdp dWM (3) a (4) abd slween RESERVE POWERED DESIGN — - - - --- For wwww oorrd&m a mane ad* fi cbr a w9neemd mb to dmV of every Zoeler PL"- m mk na m "w � tartak Av dalapN2 d,witwep d � ar/20t 2MCwAlrAlyd O CopyrW 2004 Zoean Co. M rlpnts rajar ed • Zoe l.,&d o!'S�0 sfa,1t'e v,7 Qtk2%Uaiien �,"E a,34' y+vdiQk+! Scat® �Whl SWf'Y, 5ce. 09, T. 3oK Q. igwl., C4)/. fae,i,q 3.co7ac.�es. l 5.2"d 56 ie, f 6 r. % �rP' �� S ��' Propns•d w:cser('i„rre� / � W�P/�lai�/boo t!eM6iaEo►� ,r/Pa/y Apra pmw&ziq. vo �d.C.%nrXasct .F L.t 1 � r G i � •� si • : rr � � P�epas�d � r b 6sdeoon / y R.s:d�000 tl s41 Mo'"4daf s.SoGX AS 15 w;i4 /4 es -VA /A(X4v 29 .-)//4 �rri. •y CCt P!/1C%r eed4LI6 s i�` SrJfGr1 B/lK 6C /dO.S�'a E ice' a GaNe 99. Sn'C�..f�ow z H �►�a�;�p e�'' u l�tS�tQ'e. .xsc..Med CIQ✓, c !� !X!' P pior 1 OOR�iB16 , - S P" slapir t .. y f'1W �B�JG 8 �b 9 w' /�®"' y - . L 4('�KI lv y;_.�isyyy.ic ,•.., ... .a±.�a�a. �`•1. 71�,��1 � �i-.F�^S 'jtllYlq(�f Pi�`�f�A�Ca�•�a� - �... t'N Tumn _. -Nearest Road - v �11'�10li y Code daffy Uow - y rS .6 tench, gpdr Nq iaBWlflmended r s MW REPORT Hofb=� _ ``' ' y 1 0-q ..x: t 2 2Lim U 0-6 9-2 1 l0 " esfits• ac 1 a o-5 0.6 —' - --- 3 21-30i' If 0.5 0.6 r 4_' 30-48.. YRfOA 03 0.4 'Y oAplhlo ,> fxaor . 1 0.10 1 .._ - as 2F,Im 0.5 �0.6 2 {0 21 �Qyr4J4 3adbk. .R as 16n 05 0.6 3 2731 ai if 0.5 06 VF trdor ; 7146 35d6# 3;o�lioni.aloe � • , -��• R1f11: - 3403a r too I i Ak wWON O rtiwrattrruawaat.�i ® ztaaal• PL-525 Effluent Filter l Merasls= A=41P*bYYa; PL-525 Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filter; in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank Features: 1/16" Filtration Slots • Rated for 10AW GPD (gallons per day). AlarznSwitch • 525 linear feet of 1/16" filtration • Accepts 4" and 6" SCHD 40 pipe. Accepts t• PVC Extension Handle • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. Rated for to,000 • Accepts PVC extension handle. PL-525 Installation: Ideal for residential and commercial waste flows up to 525 Dear Ft. 10,000 gallons per day (GPD). of t/16^ Filtration Slob 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump necessary. 3. Glue the filter housing to the 4" or 6" ou ipe. If SC D ,ti" ppipe the filter is not centered under the access a Polylok Extend 6c Lok or piece of pipe to center fil 4. Insert the PLr525 filter into its housing. 5. Replace and secure the septic tank cover. Certufed to NWIA lsl Staednd 46 PL-525 Maintenance: s The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is xecommended that the filter be cleaned ► every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be dame by a certified , Gas Deflector septic tank pumper or installer. Automatic 1. Locate the outlet of the septic tank. Shut-off Ball 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed.' 4. Pull 1`L525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank 6. Insert the filter cartridge back into the &msmg making erne the filter is property aligned and completely ir�rted. �Om s�F'iter® Alarm Extend k Lokw Polylok Zabel & Beat filters accept Easily installs 7. Replace and secure septic tank cover. the SmartFilterm switch and alarm into existing tank,. Polylok, Inc. 3 Fairfield Blvd. Wallingford, Cr 06492 W Free: 877.765.9565 Fax 203284.8514 www.poMoLcom Pj, 3&PI 1s'-a„ J ---------------------�Ilr------------< Hill Y 4" CAST -A -SEAL in, 4" CAST--A—SEAL Inl I _, mtia — till 1 • 'c ,� �� I fl co IT so i II1 1 ` I I1 � I I � �iiii� FILTER OR 1II I (L BAFFLE l n l till' II I• I 1111 � I ul >'---------------------{I I)-------------- 4/VENT if T 07 II I N j • fi U i+1� n 1n 1 1 a a I dU I �v 1 I •f TANKS WLP1800/1100 TANK SPECIFICATIONS DIMENSIONS: WALL' 3' BOTTOM: 5" COVER: 8" MANHOLE 24" I.D. PRECAST 'CONCRETE RISER HEIGHT: 82 3/4" LENGTH: 15'-4" WIDTH: 8'-8" BELOW INLET: S0- LIQUID LEVEL 43" WEIGHT: BOTTOM 18,017 LBS. COMER 9,300 LBS. INLET AND TIET: 4" Co A —SEAL BOOT OR EQUAL GASKET INLET OUTLET BAFFLE AND FILTER: WI SIN, SEE DETAIL /10 ER STATES SEE CHART) ACITY: 41.86 GAL/IN (SEPTIC) 25.58 GAL/IN (PUMP) LOADING DESIGN: 8'-0" UNSATURATED SOIL TANK CAN BE USED AS- SEPTIC/SEPTIC, SEPTIC/PUMP, OR SEPTIC/SIPHON COVER: MIX DESIGN /8 (NO FIBER) TANK: MIX DESIGN /9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WESER CONCRETE REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: Mr� OF ..., golipg a h■RA M IA IA IA IA IA IA xr 000 a i ff , f tiff I 5 0 M z T MENOM ==I BA$T-JUNE20104LEVEL eerwYisw�wrwrw� AM011/L{DIUO L7M1ot wow wlrs� � �wr�wnmsrrw�uar wrir..r.Ir.srw� w�wr.we+osr tY ��y��.I/�/�p rrrrw�r/r/01/erA� � wAli/ Y ��wwf Y•�I R•1'� /"LNR� YK10at101 OfMMG�/10YY MQ 1ra•wh I/[ w•ri rraww/.wiewrwu ��--•-- ww.s.wra OAW ... BAST - AJNE 2010 4 LEVEL YI FOUNDATION M�/�if�1.1�/�IY•M�.1Y�• .n...,..a......«...n..w. _�� AAA o 6/12 a 9/12 9/12 qQqwyOuT KMN RRw 6/12 - FLOOR a ROOF I OMW - If El W Wsorftmi Department Of Commerce SOIL AND SITE EVALUATION Page I of 3 Divwon of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code 16 3,1 Attach complete site Plan on Paper not less than 9'r4 x 11 inches in size. Soil & Site Evaluationse. Plan must County include, but not limited to: vertical and horiza tel reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. St. OIX Parcel I.D.If o7 / 06 APPLICANT INFORMATION 032- - tip � — Personal information you wowde may be uses for ( , a 15.04 (1) (m)). Dab Property Owner / ECEtVEO ropa� Location NW I/4 SW 1/4 S 9 T 30 N,R 7,9 W Properly t3wrlere Mailing Alddress / No& tf Subd. Name or CSMB — 498 150th Avenue 19 _ Plat Of Wagner Estates Clly Staff City ❑1llNepe ®Town -Nearest Road 3olrteYse< W I 5 7�6 73 Somerset 50Th Shm ®New Construction Use: /Number of 4 []Addition to existing building ❑ Replacement Code Derived dairy flow 600 gpd Recommended design loading rate .5 bed, gpdr .6 trench, gpdff Basal area required 1200 bed, ft 1000 Bch, ft2 Maximum design loading rate .5 bed, gpd/W .6 trench, gpdV Recommended infiltration surface elevation(s) 100.5' at 12" above 99.5' conto r. ft (as referred to site plan benchmark) Additional design / site considerations (�/� I Z" ' (� Parent material Glacial till Flood plain elevation, if applicable NA ft S--Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank U=Unsuitable for system S :: U I ❑ U ❑ S® u ❑ S:; U ❑ S NU :7 S E U WWI r=0r451E1r%&J o1=n^ff r 1 Ground elev 98.10 R Depth to limiting factor 30' Pa Gmund SIM 97.94 R Deplr to 27' Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color I Texture Structure Gr. Sz. Sh. Consistence Boundary RootsBad GPDIIP 7 1 0-9 2 9-21 3 21-30 4— 30-48 1Oyr3/3 None None None d�f7.5yr5/8 sil sil sl sl 2fsbk 2msbk 2msbk Om mvfr as mvfr as mfr aw mfi 2f lm lfm If ,0.5 OY�Of� 0.5- 0.3 0.6 p�6- 0.4 1Oyr4/4 5 3/4 5yr3/4 nc1 i idi w. I 0.10 2 10-27 3 27 ,731 4 31-45 IOyr3/3 None None m2d7.5yr5/8 12f7.5yr5/8 sil sit -- sil sl 2fsbk 2msbk _- 2msbk Om mvfr_j_ mvli — mvk mfi as 2t Im - as lfin ai 1 f 4.r 0yr4/4 1 Oyr4/4 OAST 0.5 0.6 5yr3/4 0.3 0.4 - ,ST Name (Please PrinQ Sig Telephone No. James K Thompson ..0��- 715-248-7767 lddrees A.C.E. Sol & Site Evaluations f Date CST Number Ref $ 340 Paulson Lake lmw, Osceola 54020 5/8/D0 3602 1238 PROP&TYOrIMI1 R %YbaShcrllio>e naf�GreaJohrm SOIL DESCRIPTION REPORT T2w 0 �? _of_3 PARCEL LD.t 032-2035-10 ID/9.30.19.607 . ,. � ._, . i� .-__.__�___ 100.39 ft Da* b krav %dw 42' Groun elev Depth limitim factor Ground elev Depth to limiting factor Ground elev Depth to limiting factor H011W1 Depth In. Do111inantCdw Hansel Mottles Texture Structure Du. Sz. Cont. Color Gr. Sz. Sh. ftindarRools.� 4 GPW M BeTrench 1 0-10 10yr3/3 None sl 10yr4/4 — _None sl 2fsbk mvfr as 2CIm Aw5 96— 2 10-18 2msbk m� as Ifm Qj� 4�6- 3 18-42 yr4/4 None sl 2msbk mfr aw if Q.5 - Q1r 4 42-61 10yr4/4 cIp5yr5/8 sil Om mfr - 0.3 0.4 mCIIIdrRS. 11-1 W 11 nj naN uigu amu PCF%Jcmlrw. pj. 3e{.) Alf e/CW,6;or-> PrOP s-& N-Y--* 2,e,Sfingi2nce/ne T . of So nu5 C. C,-O;,r C cJ/. ffs,com,664r t5encl, 06e Top W /ole $& t . 14--. 8. rAdj cn wcoda l Assanud clee : /m,cz; +'encepos6. ElejA : /o%co Red: /.L38 Parcel #: 032-2128-50-000 Ov1tu2005 I OFM PAGEE 1 OF 1 Alt. Parcel 0: 9.30.19.1147 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): ' = Current Owner • NORD, CYNTHIA A CYNTHIA A NORD 603 W MYRTLE ST STILLWATER MN 55082 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description • 1631 52ND ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3,007 Plat: 2577-WAGNER ESTATES 2000 SEC 9 T30N R19W N1/2 SW1/4 LOT 19 WAGNER Block/Condo Bldg: LOT 19 ESTATES Tract(s): (Sec-Twn-Rng 401/4 1601J4) 09-30N-19W NE SW Notes: Parcel History: Date Doc # Vol/Page Type 10/18/2000 631994 1551/536 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 11541 60,100 Valuations' Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.007 51.000 0 51,000 NO Totals for 2004: General Property 3.007 51,000 0 51,000 Woodland 0.000 0 0 Totals for 2003: General Property 3.007 51,000 0 51,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Chargaas Delinquent Chargas Total 0.00 0 00 � (b0OPP6 iiw l �_L�vKcoUNry NO. 633970 STAT(I SANIJA I �Y PERMIT Q+W"N W3► 51 sre) ""'- L PREVIOUSiNO. OWNER(&RK k IwQV Q&1 AND/OR LOT SUBDIVISION ISSUING OFFICER - NE 145.135 (2) WISCONMN STATUTES "M wne purpose of the unitary permit is to allow Installation of the private sewage system described in the permit. (b) The approval of the sanitary permit Is based on regulations in force on the date of approval. (c) The unitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations In force at the time renewal is sought, and that changed regulations may Impede renewal. (Q The unitary permit is transferable. History: 1977 c. 168; 1979 e. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county ylthority. DATE I S RENEWED BEFORE -THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20) 1 • 11 . a .' II H.V.L. = 4 W ow WAAGA900.0 $ :.� \� :.m..�rs:.:.. , 1 , + :...::. :. ........... 892.0:�* v a s �� ; :•:..............:: g / � :! 19 .............. ................. cel�sac ::;`� s� .:......::A: l I: sa': ...... MENT N89.44118"W 2236.97' g IED Mind_&4 rS t L a&mLdg OO Ali I�1m ®rl OO vm[Em 7 LEGEND ROADWAY SETBAM LINE AS SHIUM NOTE A GRADING THAT WOU D ALTER THE CAPACRY OF THE STORM WATER RETENRON AREA 12 WIDE UnWY EASEMENT IS PF40HB D >- PROPOSM DANE NOTE B BLEDOGS ARE PROHMED WrTHN THE STORM WATER RETENTION AREA 4' STORM WATER FETENSM AREA TO R FENCFUNE H.W.L. XXX HIMWATERLINE H.W.L. — HW WATER LIME ELEVATION OONTKILIOUS BULDABLE AREA PER TOWN OF SOMERSET P 4W7 State Bar of Wiscontlin Fonn 1-2003 WARRANTY DEED Doc®es Nue*w I Doesrr P THIS DEED, made between Kale Vero¢ and Yen Nbmurt Vane, mouses married to each other ("Grantor," whether One Or mere), andMark Lee Wopas and Mary Bridget %000, kimbana m a fQ ("Grantee,' whdher one or mere). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profit, fndlaes and other appurtenant interests, in St Croix County, State of Wisconsin ("Property') (if more space is needed, please attach addendum): Lot 19, Plat of Wagner Estates in the Town of Somerset, St. Croix County, W iKonsin. 1138237 BM PAOST REGISTER OF DEEDS Sr. CROIX Co., va RECEIVED FOR RECORD 09/01/2021 02:03 PM EXEMPT!: REC FEE 30.00 TRANS FEE 300.00 PAGES: 1 **The above recordirq information verifies that this document has been eteetronicany recorded i returned to the submitter Reootdoa Ara Nave and Relmn Ad3en Remdu Title 11200 W.7M Street Edm Ptaeq MN 55344 032 212a-504M I'M d dmtif mbm Nmebv (PiN) 1ii 15 NOT honeatad popeaty. (is) (is mod Grantor warrants that the tide to the Property is scrod, indefeasible in foe simple and free and clear of encumbrances except: c0v6Mnta, restrictions and esaemmt of reccsd, if any Dated &24/2021 * /SEAQ* (SEAL) AMBINTICATION State of Wisconsin 7 1: • MEMBER STATE BAR OF WISCONSIN (If not, auffiori2ed by win. Std. 4 706.06) THIS INSTRUMENT DRAFIID By: ACKNOWLIEDGMIIVT STATE OF WISCONSIN ) St Cmbc COUMy ) Personally cam before me on b)/24/2021 the above.nemed Knox Vano mvi V.n Kf&mm.w v..... to me k9bwo to be the person(s) who exeg 4 foregoing ledycd the same. ` Surenne Bushard/ Results Title *Robin Woolfe 11200 W. 78th Street Eden Prairie MN 55344 Notary Public, State of Wisconsin My Commission (is pamormd) (expires:07/1(J2022 ) (SiMINrme may be sedwookoW or adwowkjw, North am an necongry.) NOTE: THIS IS A STANDARD yoRM. ANy MOMMATIONB TO THIS w FORM SHOULD !!R r�.m y IDCfPr1PIED. DEEDete. • Tyypepe ancne below b riSrp.a. O 2aa0 STATit SM or wzscoNsw FORM 140.1-IM St Croix County 113M7 Pape 1 of 1 Q ,�' State Bar of Wisconsin Form 1-2003 WARRANTY DEED Darumcw Nmnba 1 Document Name THIS DEED, made between Kous Vans and Yen Mariam Vann, spouses married ("Grantee," whether one or more). Grantor, for a valuable oonsidmalion, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St Croix -County, State of Wisconsin ("Property? (if more space is needed, please attach addendum): 1138237 BE" PASST REGISTER OF DEEDS FT. CRont Co., WX RECEIVED FOR RECORD 09/01/202102:03 PM EXEMPT*: REC FEE 30.00 TRANS FEE 300.00 PAGES: 1 a aTheabove tecording Information verifies that this document has been eleetroMeally recorded i returned to the submitter Reewdios Area Name and Ream Address RcsWu Title Lot 1 Plat of Wagnertates in the Town of 11200 W. ism street agrter Somerset, St. Croix Canty, Wisconsin. Eden Prairie, MN 55344 032-2128-50-M Pmuel Ideaufiation Number (PIN) This Is NOT boamind property. (is) (k w) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: covenants, restrictions and easernents of record, if any Dated 8/24/2021 0 (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) WO F )Ss. autharticatod on Otal"Y Public St Croix COUNTY ) State Of Wisconsin Personally came before me on 8/24/202 t , a the a -named Koua Vang and Yea Margaret Vang, spouses TITLE: MEMBER STATE BAR OF WISCONSIN each other of not, to me k wn to be the person(s) who exec foregoing authorized by Wis. Star. § 706.06) i acknowledzed the same. THIS INSIRUAB24C DRAFTED BY: Su anne Bushard/ Results Tide •Robin Woulre 11200 W. 78th Street Eden Prairie, MN 55344 Notary Public, State of Wisconsin My Commission (is per n utem) (expires:07/16/2022 ) (34pasres may be Mtbee dewed or aelwwkd8ed. Barb are air seresaary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 02M3STATE BAR OFWISCO14SIN FORM NO.I-2M3 • Type now beID si8ortaes. St Croix County 1138237 Pape 1 of 1