HomeMy WebLinkAbout024-1027-60-100 (2)i
Wisconsin 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 xm))
Permit Holders Name: city village iownsnip
Bomaz Inc I TOWN OF PLEASANT VALLEY
r
e
TANK INFORMATION
TYPE
MAN FAT $QR
CAPACITY
Septic
Dosing
—
ding
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG. I
Vent to Air Intake
ROAD
Septic
Dosing
tt
kAAera
tt
�llim_•
ll
r.r.
t.l
olding
1
PUMP/SIPHON INFORMATION
Manufacturer / I gG�•'1't� Demand
(, 7 GPM(
Model Number 50 b� •b
TDH Litt A Friction Loss System H ad TDF� Ft
Foroemain Length Dia. (t Dist. to Well
SOIL ARSORPTI N SYSTEM
ELEVATION DATA
.. r . IMIMM-
eRMINE
--mrj�
��
901�
wall
BEDRRENCH
DIMENSIONS
Width
PR DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
(O�y
1T�
SETBACK
SYSTEM TO
P/L JE14
WELL
LAKE/STREAM
LEACHING
Manufactu
INFORMATION
CHAM NIT OR
Type Of Sty str:
S _ _
del Number
DISTRIBuTibN SYSTEM
LHeaderNfilrbitj
'�
Length do Dia Spacing f
x Hole Sl;g7� t/
x Hole Sped ng
Vent to Air In take
SOIL COVER v D.....m Rv trams innly YY Mound Or At -Grade Systems Only
Depth Over
Depth Over
xx Depth of
)or Seeded/Sodded
xx Mulched
Bedrrrench Center
Bedrrrench Edges
Topsoil
C Yes [a' No
[, Yes [9--1 No
COMMETTS: �gclude a discr ndes, persons present, etc.)
V ""
Kftoff& 29q 162ND ST
Inspection q1: 'Z3�2 pL Inspection #2:
1.) Alt BM Description = S l�+N Jt (; • �I.[L�
2.) Bldg sewer length
- amount of cover = J
3)S.so'r;,ro.�.No
Use e�a�:.d�•1.�.m..f(��o.a'r•�ay5s-rwu�dr�.r�;��,ynP���
Plan revision Required?
Use other side for addib 39i
SSM710(R 3197)
1p.0 .;r ' " �/' a..� �n�� .yL ST�rL •� 6oH. G4cL.�NO �. leale� _
how, cl,olvk 4 Ift",
Kevin Grabau
Subject: PLOW-644746--Joe Walter--BOMAZ
Location: Town of Pleasant Valley --"RED"
Start:
End:
Recurrence:
Organizer:
Categories:
291 162nd St
024-1027-60-100
20.28.17.165C
Tue 8/23/2022 8:30 AM
Tue 8/23/2022 9:30 AM
(none)
Kevin Grabau r
POWTS
Scheduled on phone with Joe 8-16-22—"RED"
GL�
G�
R%ALII 1, ((
Safety and BLAiingd Division
County
�-f CPO -rx
Sanitary Permit Number (to be rued ion by Co.)
„
12 2022 1 W. Washington Ave., P.O. Box 7162
Madison, W1 53707-7162
/// JUL
f
34
Croix fount eat
10— emit Applicati k
State Transaction Number
PwTs O6aa c
In accordance with SPS 39321(2), Wis. Aden. Code, submission of tlus form to the appropriate govamneoM unit
Project Address (if dift than mailing )
is required prior to obtaining a sanitary permit NOW Application farms for state-owned POWTS we submitted to
the DVattment of Safety and Professional Sesvies. Personal information you provide may be used for secondary
murposes in accordance with the Privacy Law, s. 15.04(1 m , Starts.
433S E
1. Applicadow Information - Please Print All Information
Property Owner's Now
Property owner's Mailing Address
on
6
Gov[ Lot --
NF %, /r Lf� %ti Sec ion 0
Zincode
Phone Number
City, State
_
He?/rliYlon d (�L�C
+0
a�.Z-339-3 1 �
jPde
T ✓� 8 N; R EarEj
if. Type of Bsilding (cbeck all that a Ply)
Lot a
Subdivision Name
Al 21amily Dwelliwng-N of
2 �.a4,
Block Y
❑City of
i - Use t4A1�
_
❑ State Owned - Descnhe Use
❑ Village of
14 Town of p/f •� Sdn� d / t'
CSM Nmnber � ; ( Z 3
p
E
IQ. Type of Permit (Check only omlslsox on line Ad Complete Use B if applicable)
A'
ew S
❑ Replacement System
❑ Treemnera/Holdmg Tank Rmiscement Only
❑ Other Modificafioo to Fasting System (Wlato)
B.
❑ Pemit Renewal
❑ Permit Revision
❑ mange of Plumbs
❑ Permit Transfer to New
List Previous Permit Number and Dale Issued
Before E Timtiom
owner
IV. Type of POWTS S m nenUDeviee: (Cbeck all that
❑ Non-Prasurittd In{itgmd ❑ prrss o=d w4sc ud ❑ m-orade Mound > 24 is of sir '1 ❑ Mood < 24 in. of suitable soil
❑ Holding Tads ❑ Odw Dispersal Component Ovfttalfficrit Device ( ) M
V. Dili reatmea t Aran Information:
Design Flow (wet) Design Sul Application RodMW
X
Dispersal Arta Required (30 Dispersal Area (so System McIrtion
i G 74-
o C7 0-8
/SO O
VL Tank Info
Capacity in
Gallons
Oso
trom
Unitsof
Man
_1pr �`
�, F Ms
3
g
V
U
Q•
a
6 V
s $2
in `.�
New Tasks
Emtioa Tacks
Septic orHoldingTask
/006 2S0O
s00
a
ell J CSe—
amsbar
16' .f .S`
i64s
Z
�v� C-S.e.-
VII. Responsibilky Statement- L. the andersigned, assume responsibility for iaaw%ties of the POWTS shown as the attached pram
hVINI S Number Business Phone Number
Plumber's Name (Print) Plumber's Siggat're
1---2�0673 is- cq.�/ -343 b
t(/r s6 Cv- fZ�c-�
Plumber's Address (Street, City. Starts. Zip Coder)
'7710y /�sCt
M-e, y/-r Gr ST_ 0z: 00-7f
tment Use n
VIIL Cons ADO rtp
Approved ❑ Dis SPermit F Dole Issued Issued Issuing Agent Signshi e
❑ e for Denial
IX Conditions pprov 1 3 ,,,��.�. — (.�RtA�u --
SYSTEM OWNER: L L_ off% errs ?2oZ2
1. Septic tank, effluent filter and �� ) 1 _
dispersal cell must be serviced / maintalned �1 n ' �N 1 �� _Q n.e_ th K'��
by / �•� "� `�
as per management plan provided plumber.
2 All setback requirements must be maintained
as per appucaoiecoaerarusmatnwwrwer—,K—=���-� •�--��� ��� -
✓H+z
�n�Cvra� {� pre er
SBD-63" (R. 1111 l )
Plot Plan
Page // of 15'
PROPERTY
Legal
Aaat+ P y
ZM*Zz 511Kc 14 AR&AAIb s
y CMAMTE•D PWrrs)
_ BMw ror C� 1
i
(�AitiKlhl(o 'jRC� /.OIgBWEI � j � ��
�RfcA 6tou0- AswAo
i _ S
VVELL-ro Bt ; i 25 PRoM40SEsfe; / 9r�
TANKK
=1; "Pb 530 COta
P
i
PRAPosED O\4<ap.P�,�� 4
i / I �
1" = 40 FT.
(except where noted)
= baddme pit
em.V-R&S
�w � Nol �a>rGN�DY� North
LIME
A PP R A' 14.5
Te,ak4 pt�-
�"� 47' or- ZIIAaTM Dzb('s "40 FOKA"*Id
BB�OM � Zi oF-�i'•Asr
CbuPt-K) s�•4o blltrf
(,10T.g1. BEiwCeA! rous�� T.41JRS�
Pt W Wtesep,wr,P_ I000-AtR
Af ki WI'f581% UMF Z'SOO MR 56PTTC TAAK
NW %AASS FC WO 4AS MP ?kMP TANX 4Pu. rti FILTER
per discussion 6/23, additional septic tank ok.
GI not required & POWTS Designers cannot
specify GI; also, wastes would have to be
separated per SPS 382.34(5)(b)2.a.
Site location:
x
Copy
r I OF /S-
June 30, 2022
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2024-06-30
Plan Review: PWTS-062201252-C
MARY JO HUPPERT
25720 Firefly Lane
Webster WI 54893
SITE: BOMAZ EVC-
30th Ave
Town of PLEASANT VALLEY
St. Croix County
Total Amount: $325.00
Division of Industry Services
2331 San Luis PI
Green Bay, WI 54304
www.dsos.wi.aov
Tony Evers - Governor
Dawn Crlm - Secretary
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
SEE CORRESPONDENCE
FOR: 1200 gpd — 8 BRs ( 2 x 4 BRs) — New Construction — (2) Cell Mound
24" Limiting Factor — Effluent Filter — Maintenance Required
Geomat Mound Component Manual — Edition 1
Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P IN 01/01, R 02/18)
The above submittal has been reviewed for conformance with Wis. Admin. Code (WAC) & Wis. Stat., and has been
CONDITIONALLY APPROVED. This private onsite wastewater treatment system (POVM shall be installed in
accordance with the enclosed approved plans and any above referenced component manual(s) and specifications.
The owner, defined in Wis. Stat. § 101.01(10), is responsible for compliance with all code requirements.
Prior to install, a 1NI1NZJNMNKAhdLkJJftftd from the county where located and inspection shall be
arranged per Wis. Stat. § 145.19 and 145.20(2)(d). No person may engage in or work at plumbing unless licensed
to do so per Wis. Stat. § 145.06. A copy of the approved plans, specifications, and this letter shall be onsite during
install and open to inspection by authorized representatives of the Department. All permits required by the state,
county, and local municipality shall be obtained prior to commencement of any construction/install/operation.
This approval shall be subject to the following conditions:
• Frith fa nN Mirk y ar unr 101M ifotrrd ss+rta..... d area- soil moisture content shall be checked at
deaths from 0 to 8-inches. Smearing & compacting of wet soil reduces infiltrative capacity. By hand a golf ball
size soil sample shall be kneaded & rolled into a ball. if it can then be rolled into a wire down to 1/4-inch thick_
the site is too wet to proceed: if it crumbles before reaching 1/4-inch thick the site is dry enough to proceed.
• Prior to plowing POWTS dispersal component area, tall grasses and shrubs shall be cut short and this and all
loose organic material shall be removed from the area to prevent matting.
• Areas occupied by rock fragments, tree roots, stumps and boulders reduce the amount of soil available for
proper treatment. if no other site is available, trees in the POWTS dispersal component area shall be cut off at
ground level and removed, along with boulders; stumps and roots shall remain in place. A larger infiltrative area
is necessary when any of the above conditions are encountered.
Page 1 of 2
• POWTS component areas & horizontal setbacks shall be preserved prior to and during construction —
prevent disturbance, compaction, fill or use of areas.
• Horizontal setbacks of all POWTS components and Imes, especially from buildings, OHWM of navigable
waters, and wells, shall be verified prior to install to conform to WAC § SPS Table 383.43-1.
• Wastewater from contractor equipment & tool use & cleaning and leftover products shall not be discharged
to POWTS but shall be otherwise properly disposed of on or off site.
• Tank install shall conform to all manufacturer's requirements.
• All piping shall conform to WAC § SPS Tables 384.30-3 and 384.30-5.
• Insulation of building sewer length beyond 30 feet shall conform to WAC § SPS 382.30 (11)(c).
• Existing, unused POWTS components shall be abandoned per WAC § SPS 383.33.
• Surface water diversion/drainage away from all POWTS component areas shall be provided.
• Any changes impactine dosine specifications reauire State verification of TDH & GPM specifications.
• For new construction, it is recommended to not activate dose pump(s) until all tanks are pumped by a DNR
certified septage servicing operator after conclusion of all significant construction and interior finishing.
• Submitter shall provide owner a copy of this letter, the owner's manual & management plan, and all
instructions for proper operation & maintenance of this POWTS, for which the owner shall be responsible, per
WAC § SPS 383.54(1). Owner shall provide this information to any subsequent owners.
• Owner IbM reewt each inspection, evaluation, maintenance, or servicing to county per WAC § SPS 383.55.
• If any POWTS component malfunctions so as to create a health hazard, the owner must follow the
contingency plan described in this approval.
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. Nothing in this approval shall relieve the designer of
the responsibility for designing a safe building, structure, or component, per Wis. Stat. § 101.12(2).
Inquiries concerning this correspondence may be made to me at the telephone number or email listed below.
Best Regards,
Jake Shedivy I POWTS Plan Reviewer
iacoh.shcdivv'uµi.go% 1608-261-7932
Page 2 of 2
Project Name:
Owner's Name:
Owner's Address:
Property Address:
Legal Description:
Township
Subdivision Name:
Lot Number.
Parcel I.D. Number.
Plan Transaction No.:
INDEX AND TITLE PAGE
)MAZ INC. DEPT. OF SAFETY AND
SAME -- ---
426165TH STREET
HAMMOND, WI 54015
SEE CORRESPONDENCE
30TH AVENUE
NE NW S 20 T 28 N R 17 W
Pleasant Valley County: St Croix
NA
3 Block Number. NA CSM& V32,P7111
OzAJ- (02.7.Lo- 100
Page 1
Index and title
Page 2
Data entry
Page 3
GeoMat mound drawings
Page 4
Lateral
Page 5
Dose tank
Page 6
Distribution media
Page 7
System maintenance specifications
Page 8
Management and contingency plan
MARY JO HUPPERT
Date:
_a ?
HUPF:.RT
D 18-39
Page 9
Pump curare and specifications
Page 10
Tank cross sections 6&4!D b)
Page 11
Site Diagram
Page 12
Soil test
Page 13
"
Page 14
"
Page 15
Aerial
,4TfAC'►tA6
: CsM
"�-R�S
Q 'ri A L
1 o
License Number. 1859 - 007
Phone Number. 715-426-1775
State of Wisconsin Approval Stamp:
WI
•Q'�r ,! t. �``�� Deabrred Pursuant to tho
9< Mound Component Manual (Edition 1. 2017). (N. 4117),
SS� Dasipn of Pressure Distribution Networks for ST,W (Oif81) and
pro=" Dk& budon Component Manuel Ver. 2.0 SBD-10700-P (N. 01101, R. 10112)
GeoMat Mound Edition 1, 2017 Pagel of 15
R Residential or Commercial Design
ISD Required?
$00.00
Estimated Wastewater Flow (gpd)
1.50
Peaking Factor (e.g. 1.5 = 150%)
Design Flow (gpd)
5.00
Site Slope N
98.30
Installation Contour Line Elevation (it)
24.00
Depth to Limiting Factor (in)
0.80
In -situ Soil Application Rate (gpolft2)
130.00 Contour Length Available (ft)
Cell Width (ft) 3 25 or 6.5 Only
Dispersal Cell Design Loading Rate (gpd?W)
60.00 Designer Input Cell Length (it)
60.00 Dispersal Cell Length Required (ft)
Influent Wastewater Quality (1 or 2)
2 Number of Cells
Center or End Manifold
Number of Laterals
Lateral Spacing (S) (ft)
Lateral Spacing Between Cells (V)
Foroemain Drainback (gal)
Forcemain Filter Loss (ft)
Forcemain Diameter (in)
Forcemain Length (ft)4*..,
Inside Pump Tank Elevation (ft)
Orifice Diameter (in) (e.g. 0.25)
Estimated Orifice Spacing (ft) _
System Head (it) x 1.3
Vertical Lift (ft)
Friction Loss (ft)
Total Dynamic Head (ft)
5x Void Volume (gal)
Minimum Dose Volume (gal)
System Demand (gpm)
Lateral DiamWar Selection
in. dia.
options
choice
0.75
1.00
1.25
1.50
x
2.00
x
x
3.00
x
Are the laterals the highest point
in the distribution Y
network?
If N above, enter the elevation ft
of the highest point.
Does the forcentein drain back? I Y
6.5a ft2/odks 47' on plot plan
+2.2' friction loss
plenty of pump capacity
+4.4 gal drainback = 200 gal min
minor impact on -200 gal dose
dose setting "C" could be 5.0 in
Manffold Diameter
Selection
in. dia.
options
choice
1.25
1.50
2.00
3.00
x
x
Treatment Tank Information Effluent Filter Information
2500.00 Se tic Tank Ca aciq in m tank Filter Manufacturer
Wieser Concrete Products. Inc. Manufacturer Ina Filter Model Number
Dose Tank Information Gallonsflnch Calculator (optional)
1645.00 Dose Tank Capacity (gal) Total Tank Capacity (901)
43.32 Dose Tank Volume n) Total Working Liquid Depth (in)
Wieser Concrete Products, Inc. Manufacturer gal/in (enter result in cell DoseTankVolums)
Project: BOMAZ INC.
Page 2 of 15
Mound Plan View
......
------------
..................................
RRHIMinnnnnnnnn
-------------
No..
toe extension made.
Al6.50 ft E in H 1.00 ft
B 60.00 ft F in I 9.25 ft
D 0.00 in G ft J 4.78 ft W 33.03 ft
uphill cell E = 3.9 in M 6.00 ft
dhill cell D = 7.5 in
uphill cell K = 7.5 ft 1500.00 Basal Area Required 1695.00 (ft) Basal Area Available
dhill cell K = 9.4 ft 6.00 (ft) 1/10 B Obs. Pipe Placement 750.00 Basal Area Available Upslope
390.00 (ft) Dispersal Cell Area Per Cell 945.00 Basal Area Available Downslope
10.00 (gpd/ft) Linear Loading Rate
IK
L
8.43
R @center
R b/w cells
76.85
GeoMat Dispersal Area
entire 12.5 ft width b/w centers of
outside cells shall have 12" cover soil
12" ASTM C 33 sand as Observation Pipe
required for Geo Mat GeoMat Distribution Cell
component GeoMat + 12" ASTM C-33 sand)
6 /
,99.38 Finish Grade Cover Material
98.30 Lateral Invert Elevation 3J IF 5.0
Dispersal Cell E a • D Slope
Elevation
s: Contour Elevation 98.30
Tilled Area
Forcemain
In situ soil
1 Q
Topsoil Cap
2 Q
Subsoil Cap
3 t�
ASTM C 33 sand (F)
4 Q
ASTM C 33 sand (D)
5 0
Tilled Layer
6 Q
Geo Mat
See details on page 4 for number. size, and spacing of laterals.
Project: BOMAZ INC. Page 3 of 15
Ist & last orifice 1.0 ft from edge of cel
Z & P should be spec'd from manifold as
2.600 spec bot pg 7/15 is inconsistent
point down
Number of Laterals
Lateral Diameter
Lateral Length (P)
_ Lateral End (Z)
b°o
� o0 000000°00000000
• = Turn -up w/ball valve or
cleanout plug V
7�0_O�O G O i
40 per SPS Tabs
o00
5
4 Orifice Diameter
2.00 in Orifice Spacing (X)
59.00 ft Orifices per Lateral
-I..gq Orifice Density
iTse tt 3.25 anifolq I P� -n�—
Lateral Spacing Between Cells (V)
9.2
Lateral Flow Rate
16.1
System Flow Rate
64.E
Total Dynamic Head
15.2
Diameter
001IM101
1.50in
6 6.
ft
ftZ/orifice
Project: BOMAZ INC. Page 4 of 15
Locking cover with warning label.
locking device and water tight seal ,
A��4'Vcntfover
Electrical box
as per NEC 3W
and SPS 31613 WAC r
Clan out Pipe II O control
ball v vc
Wires From Electric source JJ i to �� em or
efnuera dose
1 Bed stopfl:�=
4• ASirq 303 pipe t 1
and watertoms
forme a onto
11I,
tight gasketolid
pound Furrtcv
High water alarmn-
r
On Float
3IPump
cucI
Pump Off Floa
Dimension
Inches
Gallons
A
21.53
932.68
B
2.00
86.64
C
4.44
192.48
D
10.00
433.20
Total
37.97
1645.00
Mock
Wieser Concrete Products, Inc.
Capacity
1 1645.00
Volume
43.32
Filter Manufacturer
INEW SEPTIC SOLUTIONS
Filter Model Number
ICLEARWATER
Alarm Manufacturer
FSJE RHOMBUS
Alarm Model Number
JAB TANK ALERT
Pump Manufacturer
Pump Model Number
U
Pump Must Deliverat
15.20 ftTDH
Note: Switches containing mercury may not be used in this system.
Project: BOMAZ INC.
Forcemain diameter
2 in.
Pump df elevation (ft)
90.83
Dose tank elevation (ft)
90.00
gaUnch
Page 5 of 15
Goollat Dfstributlon CAN
6.50 Call Width (it) 1.63 Sldewall to Lateral (ft)
Distribution Cell Cross-section Arrangements
Component Leg
O Distribution Pipe with Pressure Lateral L.Jorifice sh es required over every orifice
Tumup Enclosure — — — — — Pressure Lateral
GeoMat is covered with approved geotextile fabric as per the their product approval.
Distribution Cell Plan View Layout - Typical
6.50 Call Width -A (ft) 60.00 Cell Length - B (ft)
End Connection Lateral Layout Diagram
Distribution Lateral
ll, Orifice Shield
Pipe Dia. Approved Infiltrative Fabric
3 R GeoMat
` component
Infiltrative Surface/Plow Layer
Ii�rPalr
i waM il.hr �
a•MM I Q Topsoil Cap
Toilet Flange< 2 0 Subsoil Cap
3 �'1 ASTM C 33 sand (F)
a � ASTM C 33 sand (D)
t Min 1raWlat 1 Min S 0 Tilled Layer
6 -� 6 0 Geo Mat
AAYGAai + + 3 +
Project: BOMAZ INC. Page 6 of 15
Service Provider's Namel DARRELL SEPTIC SERVICE Phone 715-425-1025
POWTS Regulator's Name St Croix County SPIA - Zoning Office Phone 715 386 4680
Design Flow - Peak 1200 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 800 gpd Maximum BOD5 30 mg/L
Septic Tank Capacity 2500 gal Maximum TSS 30 mg/L
Soil Absorption Component Size 390 ft Maximum FOG 10 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform 10E4 cfu/100 mL
Septic and Pump Tanlo
Effluent Filter
Pump and Controls
Alain,
Pressure System
Mound
Other
Service Freauency
In and/or service once every 3 years
Inspect and dean as necessary at least once every 3 years
Test once every 3 years
Should test periodically
Laterals should be flushed and Dressure tested every 3 years
Inspect for pording and seepage once every 3 years
Na"llaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as
shown in the Synergy Systems GeoMat Mound Component Manual Version 1, 2017.
2. Dispersal cell media conforms to GeoMat products approved for use with the Synergy Systems GeoMat Mound
Component Manual Version 1, 2017. Media is covered with an approved geotextile fabric.
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.
Lab" Turn -up Detail
0 0 0
6-8" Diameter °� oo �{ 3 qo �op Threaded Cleanout
> o°o 0 0 °4k Finished
Lawn Sprinkler
y_V V °o°o°
0 0 0 0 o Grade ° o Plug or Ball Valve
Box �o o_ _ o oo°a°L .� oo°o
Lateral Ends at last OMm Where
Distribution
2.5 Feet
Long Sweep 90 or Two
Degree Bends Same
Diameter as Lateral
Project: BOMAZ INC. Page 7 of 15
nSS NEW SEPTIC
SOLUTIONS
CLEARFLOW
FILTER
INSTALLLATION AND SERVICE INSTRUCTIONS
MODEL NO. NSSCFF324
FILTRATION 1/16" (.062" diameter holes) 0.50
FLOW RATE 83.8 gallons per minute @ 1psi.
TDH Increase the total dynamic head loss by .05 feet
of head to overcome friction loss from the filter
Address: N6643 Blue Lagoon Lane
City, State, Zip: Casco, Wi 54250
Telephone: 608-333-3610
Email: info@newsepticsystems.com
Website: www.newsepticsolutions.com
INSTALLATION
The NSSCFF324 ClearFlow is made to fit on the discharge port of any pump with
a 2-inch NPT discharge. The filter can be adapted to fit pumps with a smaller
diameter discharge. Install the filter in a position where it will be easy to service.
• Place a 2-inch Schedule 40 PVC male adapter (MIPT x socket) on the end of filter.
• Measure the amount of Schedule 40 PVC (tail section) needed between the filter
and pump. Cut the pipe to the desired length and insert into the pump & filter.
• The filter housing has a 2-inch Camlock coupling connection to the force main.
DO NOT REMOVE FILTER IF WATER LEVEL IS ABOVE FILTER CANISTER
The length of time required between service intervals is unique to every application.
As such, we recommend the filter be checked within 12 months of installation to
determine future service intervals. Systems with known or suspected high volume
usage should be checked six months after installatinn
- -•- -- w .�cmv�cu
DO NOT ALLOW SOLIDS TO FALL INTO FILTER CASE
• Unscrew the 4-inch cap and remove the screen from the filter housing.
• Taking proper protection, clean the screen using a hose with a spray connection.
• After cleaning, inspect the screen for damage or corrosion. (Replace if necessary.)
• Place the screen back into the Filter housing and screw the cap back on, taking care
not to cross the threads.
QUALITY
The filter housing, cap and coupling are made of heavy-duty ABS injection molded
plastic. Injection molding insures the first part made and the ten thousandth part
are virtually the same, insuring consistently high quality in every part.
The stainless steel screen is made of 316L ((L stands for Low - meaning low carbon)
316L stainless contains molybdenum, an alloy which increases strength & hardness
and enhances resistance in areas high in salt air and chloride, giving it the nickname
'marine grade' stainless steel.
REM NO. rater Body PART NUMBER
I
2
Cam Lock
3
Fitter Cap
4
Large Gasket
5
teen Ntar
ITEMVNO.SW-File
N---'Re Name)
screen
2Flange
3wire
handle
4arge
Flange
Mound System Management Plan
Pursuant to SIPS 383.54, Wis. Adm. Code
General
This system shall be operated in accordance with SIPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals [Synergy Systems L.L.C., Geonat Mound Component Manual version 1, 2017, Pressure Distribution Component Manual Ver. 2.0
SBD-10706-P (N. 01/01) and SSW MP Publication 9.6 (01/81)) and local or state rules pertaining to system maintenance and maintenance
reporting -
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 tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or
subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking
device to prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48. Stats. The contents of the septic
lank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filler shall be
assessed at least once every 3 years by inspection.
The outlet filler shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions
are made to retain solids in the tank that may slough off the 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 fitter alarms may indicate surge flows or an impending continuous
alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the lank 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 as to
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 Wisconsin Department of Commerce.
Pump Tank
The dosing (pump) 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. If the force main has a weep hole, it
should be noted if it is functional during pump operation, and if not, it should be cleaned.
" No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.""
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for
vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the
mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the
mound be heavily mulched as protection from freezing.
Influent quality into the mound system may not exceed 220 mg1L BOD5, 150 mg/L TSS, and 30 mglL FOG for septic tank effluent or 30
mg/L BOOS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be
flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test when
the system was installed to determine lt orifice dogging 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.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in
proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately
repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced
in its' present location by increasing basal area if toe leakage occurs or by removing biologically dogged absorption and dispersal media, and
related piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 7 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Project: BOMAZ INC. Page 8 of 15
12/04/2006 12:36 FAX 715 2i3 0444 NELSON -PLUMBING
ME Series
1/3 through 14/2 HP
Effluent Pumps
Performance Curve
1W
90
90
70
W
W
U. 60
_2
O
SO
I
40
O
30
20
15, zo
MWW
CAPACITY LITERS PER MINUTE
100 150 200 /250 300 350 400 450
24 ¢N¢
41
20 i
Z
F. E. Myers. A Pentair Company • 1101 Myers Parkway. Ashland, Ohio 44WJ-1923
4W269-1144 FAX 419/4B9.OW Talax 9B-7443
a61V1+M2 SNC.
Pump Specifications
0
60 t
50
40
M
d
v
30
d
20
10
0 +
0
FL50_PI R&IM017
epCA�lI-va
Igr�3 �Zo aZ
Flow (Liters Per Minute)
38 76 114 151 189 227
265 303 341 379
18
15
12
6
3
0
10 20 30 40 50 60 70 80 90 100
Flow (GPM)
CCopyright 2017 Liberty Pumps Inc. All rights reserved. Specifications subject to change without notice.
T
F11-50-Series Dimensional Data
1 1.2in
[ 285mm ]
O
7.Oin
[ 179mm] ® 1-1/7' NPT DISCHARGE FLANGE
(OPTIONAL 7' NPT DISCHARGE
O WHEN FLANGE IS REMOVED)
R3.4in
[ 87mm ]
16.4in
[ 417mm ]
12.8in
[ 325mm ]
e.
ae .
4.6in
[ 118mm]
115V CORD ASSEMBLY 230V CORD ASSEMBLY
AND PIGGY BACK SWITCH AND PIGGY BACK SWITCH
I... .
en000tne..tat FL 50 SERIES DIMENSIONAL
If[ �t¢f COfR,WtD N Ir6
txnwaq 6 M POl! rlf0allftY Or
lb'*OOUCf*N IN NMrS K. AJtt
OLE
ACHOln ltlW ww0fi,1 PetkimoN Of Wf Nov 29 /N12
LOU" FUN" NC.5 NC-110M A
arxCr,igrf t>o ftOi su.te oluwNG
kYf�A Yryt11Ul
FLSO P2 RS/b'2017 CCopyrighl 2017 Liberty Pumps Inc. All rights reserved. Specifications subject to change without notice.
WLP1000-MR
GREASE INTERCEPTOR
4" CAST -A- S 4" CAST -A -SEAL DIMENSIONS:
WALL: 2 1/2-
BOTTOM: _3'
J _ _ CO!e.
,jai W��LL//{{�. J
MANHOLE: 24' I.D. PRE CRETE RISER
HEIGHT: 53 1/4'
LENGTH: B'-B'
N ' I BELOW I
uoulD 36•
{\ 711 vlEl 90 LBs y s
IN OUTLET. g i
��• �� CAST -A -SEAL BOOT OR EQUAL GASKET `
` o
--' __-- ASAN�O OUTLET BAFFLE: W
SPS 382.34 (5)(c)1.a. The liquid depth of LIQUID CAPACITY: 27.63 GAON s
the interceptor shall not be less than LOADING DESIGN: 6'-0" UNSATURATED SOIL s Ln
42" nor more than an average of 72' . T �SE ��
i N
OVER: MIX DESIGN #8 (NO FIBER) g 1
(See note on site diagram page 11) NK: MIX DESIGN �10 (STRUCTURAL FIBER) O
x00
CUSTOMIZED TAWS -
FOR
CUSTOM TANKS CONTACT WNESEIi CONCRETE o
rVITI CT
N LA
- T -
T-
n ,
~ 1 a7N"�A
s
II I
I
-- ---- REV1 � F
PUMP PAD REVIEW DA 3
SIDE VIF-W DRAWINGS SU ED 3 �j
FOR APPROV
APPROVED BY: ;VT N0.
APPROVAL DATE:
PRODUCTS NEEDED 8Y:
/AMUAMLIFACTUMRIED TO MEET OR EXCEED ASTM C-1227_& C-1613 REQUIREMENTS
9
11
i
IN
T
— —
.
Vf
~
j
f
n
OunEi
In
• � V 'rn
CL
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
WLP2500Lp
TANK SPECIFICATIONS
o
DIMENSIONS:
WALL- 3'
BOTTOM: 3'
HEAVY - 5'
c
COVER: 6'
MANHOLE: 24' I.P. PRECAST CONCRETE RISER
HEIGHT: 52-3/4 O.D.
LENGTH: 1&5-1/40 O.D.
i
WIDTH: 101-1/4' O.D.
BELOW INLET: 41 " O.D.
,� o
LIQUID LEVEL: 36
WEIGHT: TANK - 3" BOTTOM 12,560 LBS•
TANK - S BOTTOM 15,527 LBS•
0
N
W
WEIGHT: COVER 9.300 LBS.
r
INLET AND OUTLET:
4' CAST -A -SEAL BOOT OR EQUAL
m
ky
INLET AND OUTLET BAFFLE AND FILTER:
o o G
WISCONSN, SEE DETAIL /10
(OTHER STATES SEE CHART)
W �
LIQUID CAPACITY: 69.44 GALAN
;E
HOLDING TANK:
U-)
OUTLET HOLE PLUGGED
ACTUAL CAPACITY: Z639 GALLONS
v
LOADING DESIGN: 6' 0' UNSATURATED SOIL
N
TANK CAN BE USED AS:
W or
SEPTIC/ HOLDING/ PUMP OR SIPHON
COVER: MIX DESIGN /B (NO Fes)
TANK: MIX DESIGN /9 (SMALL FlBER)
CUSTOMIZED TANKS:
CONTACT WIESER CONCRETE
FOR CUSTOM TANKS
o
N
1,n
r- 12'-2'
4' CAST -A -SEAL 4' CAST -A -SEAL
A
II FILTER OR
Ir1Ji1' BAFFLE
I' ---------ITT---------�- Tyr _�
TOP VIEW
W
w
!Y
I ce
INLET - - - —
t _
to
t � ♦ 1
caplE VIEW
i1
UCTT nR FYCFED ASTM C—
-- _ OUTLET
I
� �a
I V .
I a a
I =�
PAD
WLP1645—MR
TANK SPECIFICATIONS
DIMENSIONS:
WALL: 3'
BOTTOM: 3'
COVER: V
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
HEIGHT: 54 1/2-
LENGTH: 12'-2'
WIDTH: 7*-0•
BELOW INLET: 43"
UQUID LEVEL: 38*
WEIGHT: 14.000 LBS.
INLET AND OUTLET:
4' CAST -A -SEAL BOOT OR EQUAL GASKET
INLET AND IOUTLET N. SEE BAFFLE
/� FILTER:
WISCONS110
(OTHER STATES SEE CHART)
UOUIO CAPACITY: 43.32 GAL/IN
HOLDING TANK:
OUTLET HOLE PLUGGED
ACTUAL CAPACITY: 1.733 GALLONS
LOADING DESIGN: 8'-0` UNSATURATED SOIL
TANK CAN BE USED AS:
SEPTIC / HOLDING / PUMP OR SIPHON
COVER: MIX DESIGN /8 (NO FIBER)
TANK: MIX DESIGN /10 (STRUCTURAL FIBER)
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
0
_q ' m
I REVIEW DATE I
DRAWINGS SUBMITTED
FOR APPROVAL
APPROVED BY:
APPROVAL DATE:
PRODUCTS NEEDED BY:
OF
4
I�
Plot Plan
Page // of /5'
PROPERTY OWNER: F70MA-z- lie -
0
3
BEM*Zf SP�:F �"� aRouNn
— -""—AIZ
WO
�ntix �Nra JFAC r.o'A"
AREA 6xouND- �swNt:
w1eLL-TO $_ . > 23' A FROM
y 50FROM T*N
(�I IM4 wil B3t?
BF PIMPosED I q9. t5
v
Bf[tjpOM
C Du vlt�ll
Site location:
is
5A i=
T
M
1" = 40 FT.
(excWw em no>tedl
a=backhoe pft
ll w on>E Mr -AsaW#4JM 1
North
G
i
i6VJ Ut
t
E
O 0 t
U cats,
S I /
a
O° <`�ab-"1V'
O`y
i
``J' 4%� DF' Z.11 /I SiM D?yb5 yL♦1. VO T-0R=*'4
A vP row, !�
TO -XP%Aq
4 u oFv"A$+M5r4.40 prfYf
CWTAL� 3rTw&vW .0am" k -TAWAS)
p1Bn� W(E` T\ WL_v- IoaO-MR
WLP 7--500-AkR SEPTIC L.%I;
NEM% W1£5ER WlA Md4s"MP PKMP TAMr FI�fEQ
per discussion 6/23, additional septic tank ok.
GI not required & POWTS Designers cannot
specify GI: also, wastes would have to be
separated per SPS 382.34(5)(b)2.a.
-PV'.S 11 J rs
P A -IN CST- a o as _ 00�
POP 4
SOIL EVALUATION REPORT! a—
�pN 1 b rrni sPs 30. vNa Adrn cods county ST. CROIX
Attach Pa^ an auan t a t t Indlea in aim. Plan mwt q _ 1027 - 60 - 100
iruciuds. bui nal tayp�ril t� MW, dnKbon and ft LD. 9i1q 1
ParcmM bul n and locationn and distance b near" rose. Dale
T- pissss print sM—.--snavrL by
Psnarr alwal"ma-PwAdemgbeaaaefor saoardwP+P IA rV+'•.aIt1t!N)-4
r.
BOMAZ INC. GaA Lot --
NE tµ NW tµ S 20 T 28 N R I7 t (or)W
naer.s. Ld s 3 utoca s stbd N.ne a csats prnd i.u► P7l
426 163TH STREET _ 3Z
_ _ _ T...-. NNwaI Road
City era lraroo r 162ND STREET
HAMMOND, WI 1 54015 1292 1339 - 3261
} 1200 Gpp
Q Nsw coruauoWxu LhaQ ReeidsMlal / Number ofbedrooms
6 R8 code derived de•gnlow fells 900
Pubic or commercial - Descrba: �. J„n• � e.
pamtnteler11 LOESS OVER TILL Flood PNYtslevmifgWkW,*
mrn'
General corwks pRETREATMENf GEOMAT MOUND SYSTEM — 1Ni.0 FT. SAND FILL — 0.8 LOADING RATE
and raoorrrmrsLYons:
F1tioMp 0 • � p Ground s rfeW WOv. 98.95 IL DaO b 1rw^0 90GW 24 K, Sol Application ft
Canraslarros tioudery Rods
Horizon Depth
in.
1 0-12
Darira Radon
Muyd t]u. SL
7.5YR2.5/2
2 12-20
7.5YR3/3
3 20-24
7.SYR4/6
4 24-30
7.5YR4/6 mid S
pwor"on TvAue i2fabk
4ML rqa sit mfr as
sil mfr cw
sl mvfr aw
f RW
mfr,
U Bork
❑ BorMp a El pit p Grand awl" el"-97.40 R. DWM to &WWV lam —
5WR:d:0wtt RsdmuDescron Texture sbucturs CornWa
ure1 pu Sz Coal Color Gr. SL Sh
YR2.5/2 — sil 3f-msbk mfr
SYR3/3 sil 3fabk mfrYR4/4 ail 2fabk mCrY t4/6 midSYRa/6 sclome gr
• ElArarul N • BOD > 30 _< �10 myl and TSS >-W
New FMW F41M
F fE
1 vf-m 0.6 0.9
Ivf-f 0.6 0.8
Ivf-f 0.6 I.0
0.0 0.0
30
in.
Sol Rt
cs�Rooh C'PD/R
'EIMt 'EIla7
as*Ivf-f
0.6 0.8
a 0.6 0.8
as 0.6 0.8
0.0 1 0.0
and TSS S 70 no
S?� CST Number
1 J -- - 715 - 426 - 1775
28497 KING ARTHURS CT.. DANBURY. WI 54830 1 I - 30, 202:
cwRfl7n lRn
f RW
mfr,
U Bork
❑ BorMp a El pit p Grand awl" el"-97.40 R. DWM to &WWV lam —
5WR:d:0wtt RsdmuDescron Texture sbucturs CornWa
ure1 pu Sz Coal Color Gr. SL Sh
YR2.5/2 — sil 3f-msbk mfr
SYR3/3 sil 3fabk mfrYR4/4 ail 2fabk mCrY t4/6 midSYRa/6 sclome gr
• ElArarul N • BOD > 30 _< �10 myl and TSS >-W
New FMW F41M
F fE
1 vf-m 0.6 0.9
Ivf-f 0.6 0.8
Ivf-f 0.6 I.0
0.0 0.0
30
in.
Sol Rt
cs�Rooh C'PD/R
'EIMt 'EIla7
as*Ivf-f
0.6 0.8
a 0.6 0.8
as 0.6 0.8
0.0 1 0.0
and TSS S 70 no
S?� CST Number
1 J -- - 715 - 426 - 1775
28497 KING ARTHURS CT.. DANBURY. WI 54830 1 I - 30, 202:
cwRfl7n lRn
• ElArarul N • BOD > 30 _< �10 myl and TSS >-W
New FMW F41M
F fE
1 vf-m 0.6 0.9
Ivf-f 0.6 0.8
Ivf-f 0.6 I.0
0.0 0.0
30
in.
Sol Rt
cs�Rooh C'PD/R
'EIMt 'EIla7
as*Ivf-f
0.6 0.8
a 0.6 0.8
as 0.6 0.8
0.0 1 0.0
and TSS S 70 no
S?� CST Number
1 J -- - 715 - 426 - 1775
28497 KING ARTHURS CT.. DANBURY. WI 54830 1 I - 30, 202:
cwRfl7n lRn
BOMAZ Inc.
Prod l00
024 - 1027 - 60 - 100
3 4
pap a_
3
s U 8oi1rq Boup Q ptt Gmud wrfm a elay. 98.1 S R Depth to �tp 4cior 31 in Sal Role
Haim
Depth
In.
Do iireCater
muted
Radom Deaaom
Gu. Sz. Cod. Cole
Test"
&Am:k a
Gr. Sz Sh.
Crtaiale m
Baadety
Rools
GPDM
-am
I •EIY2
1
041
7.5YR2.5/2
—
ail
2f-msbk
mfr
as
2vf-m
0.6
0.8
2
I1-24
7 /3
_
sil
3fabk
mfr
cs
Ivf-m
0.6
0.8
3
24-31
7.SYR4/6
_
sl
1 f-msbk
mvfr
aw
1 of--f
0.4
0.7
4
31-36
7.5YR4/6
m I d SYR4/6
scl
Om
0m
—
0.0
0.0
some Sr/few
stones
m :. . 0
l=ml
' Ef\atnt e1 = SOD, > 30 < 220 myL and TSS >30 < 150 m &
Sx 41%1491 III
' ENuar t 02 = BOD, 130 myL and TSS 130 mplL
' Ef\atnt e1 = SOD, > 30 < 220 myL and TSS >30 < 150 m &
Sx 41%1491 III
' ENuar t 02 = BOD, 130 myL and TSS 130 mplL
Plot Plan
PROPERTY
ram„ PILa R�xw LiN QZ W"%
Page 3ofy
1" = 40 FT.
(eweptwhom noted)
,211 = baddwe pit
7. oc`{`. ,,4USS
North
l
3M#Z= 5rW4F 14 CRMPJI> - I
yq A PP FOJ�,
PINES) 11i5
of ,wjw Iw IzY0 �
SEE !.0'AWA pf r
s¢ew�D- AssuNE
XX.tmrt�oM B3t?
dF PIWZGCb
DvfFivNG ���.
.1
l�
v
Site location:
Lv'rs
—Milt,,., rens-
mo odapr� �.13r l�
'MS d GrXaa Ab ! Aai 'A' sfA M "M a AI111�11n Amlrlal{ Arladc" Ar{ r mVrtr ai it Oral Oarr. Cam"" Slaw&, anerrrw uei A ~,m
be
As (a' A wv ar as Scam Aa w am a map Q S our tint )
baw lame o lr ION ARMaMA atraitts � ar ra[ Aor niltaatr CrAa ar, ai a at • � R � mr� � v r Aw i wmm w or sto icYM a at► ryAm
aawrrA A�tlrt O Aq Salto ritir 1rR as eta' MaY. Sr slat ui AA rlmY a to for t, aaV{ f Oaooataao A
A"A%OlA N Alltli�
(3Oa�O'X7 tF99O'j --ya t v to wa raaevt SarX__ — — — MI coca ucT »
NTS 1" _ 130'
W
Bomaz Inc Duplex Floorplan
Identical units, both 1328 sq ft. 4 Bedroom, 2 Bath
Szu"—
rep
I
ST. CR NTY SANITARY SYSTEM Rles:
"rNe 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. If you would like to view your issued sanitary permit online, you can
do so by using the PropeM Files Scanned weblink.
OWNER/BUYER INFORMATION
Owner/Buyer B c rs» ,;r 1E,-
Mailing Address 4.�_' C /6Sy Sf
City/State/Zip * Q Sri /moo r1 CIJl .� `f D%,S�
Phone Number (required) 2C ,;Z 3,2 6-
Email Address (required) _ b o m sZ .�? I'- ar 01 -x P c e7 tcc pY 7e /• A P -71'
Parcel Identification Number 0.2 4 — / o d? % — 66 O — /O O
(found on the property tax bilk
NEW SYSTEM: LEGAL DESCRIPTION r /
Property Locatio!74/� 1/4 /�W Y4 , Sec. +�, T>-8 N R) ZW, Town of Pl e d .rage f
Subdivision Plat: Lot #
Certified Survey Map # Volume 3 c,2, Page #
warranty Deed # / Q-2 3 is 8tf (before 2006)Volume . Page #
hc;L4.x-ejOlodi a »-•
Number of be rooms , Spec house 0 yesKno Lot lines identifiableXyes 0 no
oFFKE USE ONLY
New Property Address �S �� fA Ave yY(^64 d
+ /G Y�fication of
new address required from Community DevekWWnt'Department for new construction.)
/` / •'! / GCJ / 2622,
(Staff initials) (Date)
This form must be submitted with aU 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 mode in the warranty deed.
Community Development Department - Land Use Division
715-386-4680 St. Croix County Government Center
cdd@IaNi.aov 1101 Carmichael Road, Hudson, WI 54016
715-245-4250 Fax
µ WWsCcWL9Qv
Parcel #: 024-1027-60-100 07/2s/2022 12:54 PM
PAGE 1 OF 1
Alt. Parcel #: 20.28.17.165C 024 - TOWN OF PLEASANT VALLEY
Current ❑ ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
04/27/2022 00 0
Tax Address:
BOMAZ INC
Owner(s): O = Current Owner, C = Current Co -Owner
O - BOMAZ INC
426 165TH ST
HAMMOND WI 54015
Property Address(es): • = Primary
' 291 162ND ST
Districts: SC =School SP =Special
Type Dist # Description
SC 2422 SCH D ST CROIX CENTRAL
SP 1700 NORTHWOOD TECH
Notes:
2022 FOR 2023 KEEPING 024-1027-60-100 AS
LOT 2 (FKA LOT 1 CSM 14-3859) AND NEW
024-1027-60-130 AS LOT 3 OF CSM 32-7111
Legal Description: Acres: 7.000
SEC 20 T28N R17W PT NE NW BEING LOT 1
Parcel History:
CSM 14/3859
Date Doc # Vol/Page
Type
01/08/2016 1023683
SO
06/02/2000 624105 1515/512
WD
Plat: • = Primary
Tract: (S-T-R 40% 160i GQ BlocklCondo Bldg:
' 3859-CSM 14-3859 024-2000
20-28N-17W NE NW LOT 1
2022 SUMMARY Bill #:
Fair Market Value: Assessed with:
0
Valuations:
Last changed: 05/19/2021
Description Class Acres
RESIDENTIAL G1 7.000
Land Improve Total State
33,300 174,800 208,100 NO
Reason
Totals for 2022:
General Property
7.000
33.300
174,800 208,100
Woodland
0.000
0
0
Totals for 2021:
General Property
7.000
33.300
174,800 208.100
Woodland
0.000
0
0
Lottery Credit: Claim Count: 0 Certification Date: 08/1612019 Batch #: 19-05
Specials:
User Special Code Category Amount
Total Special Assessments Special ChargeesDelinquent Charges
0.00 0 0 0 00
SHERIFF'S DEED ON II IIIII�IIII�I�NII�I �I �I
FORECLOSURE
14CV184 8 3 4 6 3 8 3
Document Number 1 TITLE OF DOCUMENT Tx:4287536
WHEREAS, pursuant to a judgment of foreclosure and sale rendered in
the Circuit Court of St. Croix, Wisconsin, in an action between, Ocwen Loan
Servicing, LLC as servicer for Deutsche Bank Trust Company Americas, as
Indenture Trustee for the Registered Holders of Saxon Asset Securities Trust
2005-2 Mortgage Loan Asset Backed Notes, Series 2005-2, plaintiff and
Margaret W. Bossen and Mark S. Bossen, defendant(s), and after due
advertisement, the mortgaged premises hereinafter described was sold on August
4, 2015 to the third party bidder, Bomaz Inc., for the sum of $204,001.00.
AND WHEREAS, the said purchaser Bomaz Inc. is now entitled to a
conveyance according to law, NOW THEREFORE, the undersigned conveys to
the third party bidder, Bomaz Inc., the tract of land in St. Croix County,
Wisconsin as described below.
PROPERTY ADDRESS:
291 162nd Street, Hammond, W154015
1023683
BETH PABST
REGISTER OF DEEDS
ST. CROIX CO., WI
01/08/2016 2:10 PM
EXEMPT*: NA
REC FEE: 30.00
TRANS FEE: 612.30
PAGES: 1
Record this document with the Register of Deeds
Name and Return Address
Bomaz Inc.
426 165th St.
Hammond, WI 54015
LEGAL DESCRIPTION I
Lot 1 of Certified Survey Map recorded in Volume 14 on Page 3859 as Document
No. 623662 being a part of the Northeast Quarter of the Northwest Quarter,
Section 20, Township 28 North, Range 17 West, Town of Pleasant Valley, St. 024-1027-60-100
Croix County, Wisconsin. Parcel Identification Number (PIN)
Subject to easements, restrictions and rights -of -way of record, if any.
�herffJohn A Shilts
S ie iff of St. Croix, County
Date:0 zzO
STATE OF WISCONSIN
St. Croix COUNTY
On 9 /y / 2('15 before me came Sheriff John A Shilts known to be the individual and officer described
in said document and who executed the above conveyance and acknowledged that he executed the same for such sheriff,
for the uses and purposes therein set forth.
Print Name:
Notary Publ
My commission expires: I I I t a711"
This instrument was drafted by Scott D Nabke
165 Bishops Way, Suite 100
Brookfield, WI 53005
St Croix County 1023683 Page 1 of 1
6
p"p ti
p1au�w�^ ion
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-FEW WORN C76PREED FEBRUARY 14. 2=
-PISS covet P0S71LN5 vvwn BY WS
-EDGE Or NEXAND AND EEYA ZONE A- AREA AS SNOW IS APPRaWA4 W AL TV"L SETBAOM APPLY. CONTACT iNE ST. CRdX COUNTY C%^XWIY OETELOPIENT O FXC FOR NOW AfORMA77LTV.
-NE NW OOVBX POSIRON 0* SAD SEcmm 20 HAS BEEN AL7ELEA SEE 1r SNEET OARD 7 //2m BY SANTTNR IY DODGE RE SUBSEQUENT PR0DUCD0N 1X SAD SEC77LN 20 NOW PL.AM
SAD LOT 1 R7 SECTKW WMMV WARIFRS W004 MW NOT MENOU LY CALLED OUT. PC OINER n ADVt= TO SEX LEGAL GOUNCE BMW U7VZWG LAND N PEW AREAS
-BY MIRE Or Sr C W C"rYS APPROVAL OF MS CERW O SLRLEY YAP, PK 1W AW NY SET BACOT LAW AS POW OV SAD LOT 1, SHALL W AWOV7R AM
CORNER SECIM 20c
CAPPED MONUMENT
L I L f,7,Y�16LfSE.ii�P14TL611-
(Sb70'26-E 66990)
9
�a
ERIC D.
KNAUF
S-2884
EAU CLAIRE
1
I
�sLLn
I
pI
YouND WLOT 2
C-WWO R/W
13O.W2 Lp.11.
3.00 oom
EXaU W RIW
10 (� 4,562 Nq.R.
LN 2.40 acres
rr N\GMALS E3 RRED
I`
LOT �
174,240 Bq.R.
4.00 acres
EXG7LWWO R/W
161,991 ,6LFR.
3.72 acres
4 !
,
:AL i
,
L/IPPm �
'A- AREA ----- -'' AL i
97.97' I�
MC
0
VONUVEN7 LES r3.5' WEST
D< N-5 "RE `ENCE
L&22y LRBIAM I&Vi
0 ---- WT 1' OUTENDE DIAMETER w 14- ROM PPEWDGHM Q 50 ,Oo 200
• ---_ FOUND 11.T OMTSDE DIA3 POUNDS IEM IRORON PI E
c ---- RECORDED AS SCALE.- 1' : 100'
2a
VT LIES 14' REST
UK FENCE
R?UL $
420 1657H STREET
NAM OM0. W 5/015
Fn
rq
CERTIFIED SURVEYMQ
IN THE SW'/4 OF THE SW'/4 AND THE SE% OF THE S W Y., SECTION 17,
AND IN THE NW'/. OF THE NW'/4 AND THE NE'/. OF THE NW'/., SECTION 20,
TOWNSHIP 28 NORTH, RANGE 17 WEST,
TOWN OF PLEASANT VALLEY, ST. CROIX COUNTY, WISCONSIN
BEING LOT 1 OF CER77FIED SURVEYAfAP RECORDED BV VOLUA7E 14 OF CERnFIED SURVEY AMPS ON PAGE
3839, AS DOCUMENT Na 623662
SURVEYOR'S CERTIFICATE:
L ERIC D. KNAUF, PROFESSIONAL LAND SURVEYOR, HEREBY CERTIFY:
THAT BY THE DIRECTION OF BOMAZ, INC., I HAVE SURVEYED, DIVIDED, AND MAPPED THE LAND
PARCEL WHICH IS REPRESENTED BY THIS CERTIFIED SURVEY MAP.
THAT THE EXTERIOR BOUNDARY OF THE LAND PARCEL SURVEYED AND MAPPED IS AS FOLLOWS:
A PARCEL OF LAND BEING PART OF THE SWY. OF THE SW V. AND THE SEY. OF THE S WY. SECTION 17,
AND IN THE NW Y. OF THE N WY. AND THE NEV. OF THE NW V. SECTION 20, TOWNSHIP 28 NORTH, RANGE 17
WEST, TOWN OF PLEASANT VALLEY, ST. CROIX COUNTY, WISCONSIN, LOT 1 OF CERTIFIED SURVEY MAP
RECORDED IN VOLUME 14 OF CERTIFIED SURVEY MAPS ON PAGE 3959, AS DOCUMENT No. 623662 AND
BEING SUBJECT T) EXISTING EASEMENTS.
THAT THIS CERTIFIED SURVEY MAP IS A CORRECT REPRESENTATION OF THE EXTERIOR
BOUNDARY SURVEYED AND DESCRIEED, AND THE DIVISION OF IT.
THAT I HAVE FULLY COMPLIED WITH THE PROVISIONS OF CHAPTER 236.34 OF THE WISCONSIN
STATUTES, A-E 7 OF THE STATE OF WISCONSIN ADMINISTRATIVE CODE, AND THE SUBDIVISION
REGULATIONS OF THE TOWN OF PLEASANT VALLEY AND ST. CROIX COUNTY, WISCONSIN IN SURVEYING
AND MAPPING THE SAME.
�QgA;;e DATED THIS 20 �' DAY OF Agpj 2022
ERIC D. KNAUF,PI-S. S-2834
CERTIFICATE OF COUNTY TREASURER
(STATE OF WISCONSIN M.ClViX COUNTY) SS
1, E knisp Andaman . BEING THE DULY ELECTED, QUALIF® AND ACTING TREASURER OF THE
COUNTY OF ST. CRODC, DO HEREBY CERTIFY THAT THE RECORDS IN MY OFFICE SHOW NO UNREDFEMED
TAX SALES AND NO UNPAID TAXES OR SPECIAL ASSESSMENTS AS OF
&QW AFFECTING THIS CERTIFIED SURVEY MAP.
(D TE)
oQW ZQV QaAftn DATED THIS Mat, DAY OF f)pil 2022
ST. CROIX COUNTY TREASURER
Kk.1lILJ
71US CERTIFIED SURVEY MAP IS APPROVED OF AS COMPLYING WITH CHAPTERS 13 AND 15
COUNTY CODE OF GENERAL ORDINANCES,
EACH PARCEL SHOWN HERON 1S SUBJECT TO STATE, COUNTY, AND TOWNSHIP LAWS, RULES, AND
REGULATIONS (FE., WETLAND REGULATIONS, ACCESS TO PARCEL, MINIMUM LOT SIZE, ETC.) BEFORE
PURCHASING OR DEVELOPING ANY PARCEL CONTACT THE ST. CROIX COMMUNITY DEVELOPMENT
OFFICE AND THE APPROPRIATE TOWN BOARD FOR ADVICE.
911-e W� DATED THIS DAY OF i iYlrt l 2022
ST. CROD(OOUNTVFLAND USE ADMINISTRATOR �T
ERIC D.
KNAUF
3.2584
EAU CLAIRE
WI
St Croix County 1152193 Page 2 of 3
SHEET 2 OF 3
CERTIFIED SURVEYMAP
IN THE SW'/. OF THE SW'/. AND THE SE% OF THE SW%, SECTION 17,
AND IN THE NWV4 OF THE NW'/. AND THE NEY. OF THE N W A, SECTION 20,
TOWNSHIP 28 NORTH, RANGE 17 WEST,
TOWN OF PLEASANT VALLEY, ST. CROIX COUNTY, WISCONSIN
BEING LOT] OF CERTIFIED SURVEY MAP RECORDED by VOLUA& 14 OF CEMFIED SURVEY MAPS ON PAGE
3859, AS DOCUA&W No. 623662
TOWN BOARD RESOLUTION
RESOLVED, THAT THIS CERTIFIED SURVEY MAP, IN THE TOWN OF PLEASANT VALLEY, IS HEREBY
APPROVED BY THE TOWN BOARD OF PLEASANT VALLEY, ST. CROIX COUNTY, WISCONSIN.
DATE APPROVED NI6lAT& (PRINTNAkM Kt c L
TOWNCH
(SIGNATURE) DATE y a'l
1 HEREBY CERTIFY THAT THE FOREGOING IS A COPY OF A RESOLUTION ADOPTED BY THE TOWN
BOARD OF THE OF PLEASANT VALLEY, ST. CROIX COUNTY, WISCONSIN.
(SIGNATURE)
11 TOWN CLERK
ERIC D.
KNAUF
S-28M
EAU CLAIR E
wl
St Croix County 1152193 Pape 3 of 3
SHEET 3 OF 3
3a--7111
7D9 CSao � — 00fmaw
X
1 2Q22 SOIL EVALUATION REPORT � I ar 4
with SPS 383, tKLs. Adm. Cade
pa sd'Own 1 x 11 inches in size. Plan must County ST. CROIX
induce, b� point (BM), direction and �a�Oi02a - ]027 - 60 - ]00
Peroarltsl~- crow, and locab'on and distance to nearest road. Parcel I.D.
Please prod ON 1Mfonwatlol►. ReViWied by;) a Dam
ner PemM rM"I0n you wale mey be US" for �d•hr PwPae4 (PdI Law. c 15.04 (1) (m)1. /�/, "'ill , w 2(-J4 ( I,—
P BINC.Govl LLot--- NE 1/4 NW 1M S 20 T 28 N R 17 (E W
roParb Owneh's Addressw ;;[[]Village
Block S Subd. Name or CSAM,7 (M C� pent l
426 165TH STREET — 14/3859
City Slats LP Phone Number Town Nearest Road
HAMMOND, WI 54015 if 292) 339 - 3261 162ND STREET
PTPA4ZAhITVAITVV I
New Construction III Residential / Number of bedrooms 6 OR 8 Code derwed 750 OR 1200 GPD
design flow rate
Replaoemenl Public or aomrnerdal - Describe:
Parent material LOESS OVER TILL General commentsFlood Plain elevation ifapplicable N.A.se ft.
and recaThmendations:
PRETREATMENT GEOMAT MOUND SYSTEM — 1.0 FT. SAND FILL — 0.8 LOADING RATE
I(�aSa��t Scf��s
' I Boring 9 u �ng
u n Pit Ground surface elev. 98.95 R_ ruwrh, r h:, s. f . 24
Horizon
Depth
in.
Dominant Cokm
MtrnseN
Redox Description
Qu. Sz. Coral Color
Texture
_
Structure
Gr. Sz. Sh.
�..
Boundary
Rods
Sail ication Rate
G
-EfR1
'Effs2
1
0-12
7.5YR2.5/2
—
sil
3f-ma&sbk
mfr
as
Ivf-m
0.6
0.8
2
12-20
7.5YR3/3
—
sit
2fabk
mfr
Cw
lvf-r
0.6
0.8
3
20-24
7.5YR4/6
—
sl
2fabk
mvfr
aw
lvf--f
0.6
1.0
4
24-30
7.5YR4/6
m I d 5YR4/4
scl
Om
0.0
0.0
Boring n as rou Grvlwafw aia. 9740 N 30
Boring 0 ❑ .
Horizon
Depth
in.
Dominant
Munsel
Redox Description
Qu. Sz. cont. Color
Texture
Structure
Gr. Sz. Siv
ConsistenceBoundary
Roots
Sol Rate
GPD/IF
wEffil
wEffs2
1
0-12
7.5YR2.5/2
—
sit
3f-msbk
mfr
0.6
0.8
2
12-24
7.5YR3/3
—
sit
3fabk
mfr
cs
Ivf-r
0.6
0.8
3
24-30
7,5YR4/4
—
sil
2fabk
mfr
as
Ivf-f
0.6
0.8
4
30-36
7.5YR4/6
m I d SYR416
scl
Om
mfr
_
0.0
0.0
some gr
JV nvL ano 1 AA < JG mghL
CST Nave (Please Print) MARY JO HUPPERT Hollistees Soil Testin & Design)Number
0 L CST Num
ber
Address 224832
Date Evalubtionol7onducted Telephone Number
29497 KING ARTHUR'S CT., DANBURY, WI 54830 11 - 30, 2022 715 - 426 - 1775
SBD-8330 (R07/ 13
—... (A�n1Cr _ran Parcel ID --'
{
Property Owner BOMAZ Inc. ParoelID*
Fq Boring * Boring
98. 15
0 Pit Ground surface elev. ft.
024 - 1027 - 60 - 100
Depth to limiting factor 31 in.
3 4
Page of
Honzon
Depth
in.
Dominant Color
Munsd
Redox Description
Ou. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Conststerm
Boundary
Roots
GPD/W
'E1191
'ER*2
1
0-I1
7.5YR2.5/2
—
sil
2f-msbk
mfr
as
2vf-m
0.6
0.8
2
11-24
7.5YR3/3
—
sil
3fabk
mfr
cs
Ivf-m
0.6
0.8
3
24-31
7.5YR4/6
sl
I f-msbk
mvfr
aw
Ivr-r
0.4
0.7
4
31-36
7.5YR4/6
mId5YR4/6
scl
Om
Orn
0.0
0.0
some gr/few
stones
Boring * Boring
Pit Ground surface elev. fl. Depth to limitim factor in. _
• 1
Hng* IH�
Pit Ground surface elev. ft. Depth to limifirg factor in.
Effluent *1 = BODE > 30 1220 nxyL and TSS >30 < 150 rrg1L
saD.833o rRui, r 3 i
Effluent *2 = BOD, < 30 mglL and TSS < 30 mg/L
Plot Plan
Page :3ofq
PROPERTY OWNER:BQMA-z— T r.
0
CR01)C &U&Mfo I.)I:5MS0\l 2 q1 1(02"w1 ST,
1" = 40 FT.
(examtwhere noted)
L7 = backhoe pit
7. "0.1V'. MS
�& q
3M#2 = s�KF Ml sttouan A Pr Rou.
CPlMRED FIVES
OF 6RIO It"
jA&C- !.0'AW
6RouND- AswNE
100.rt
A AFMX• LWTICM ( 5%
OF PfbVaED
DwF UAW-
Site location:
Fla
Y
IT
ti15
Lf\rovo
RO Ik couNTv NO. 644746
STA E SANITVAY PERMIT
30—ilE
PREVIOUS,NO.
OWNER %p��
PLUMBER
TOWN OF�
SEC ZO ,T
AND/OR LOr
LIC.# 673
N, R
r BLOCK
=11TZ 19 3 SUBDIVISION
CHAPTER 145.135 (2) WISCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow Installation
Of the private sewage system described in the permit.
(b) The approval of the sanitary permit Is hued on
regulations In fore on the date of approvaL
(c) The sanitary permit is valid and may be renewed for a
specified (d) Changed regnlstious will not impair the validity of a
unitary 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.
(f) The sanitary permit is transferable.
History: 1977 c.168; 1979 c. 34,221; 1981 c. 314
Note: If you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
M" AWAK b ZED ISSUING OFFICER - DATE '(z) b2'Z
PERMIT EXPIRIEES.7(?Z/Zbzq UNLESS RENEWED BEFORE THAT DATE
POST IN PLAIN VIEW
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (RI1/20)