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HomeMy WebLinkAbout026-1298-06-000 (2)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)(m)j. Permit Holder's Name: City Village Township Kyle D. & Sarah A. Kopczyk I TOWN OF RICHMOND CST BM Elev: Insp. BM Elev: BM Description: GI GVATICIN Ill�TA TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TAMV ccroAfli IIJFf1RMATI17IN- TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding D IMPIAIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft rrcemainTngth Dia. Dist. to well SOIL ABSORPTION SY5TF-M BED/TRENCH Width Length No, Of Trenches DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL INFORMATION Type Of System: DISTRIBUTION SYSTEM Length Dia ILength Dia Spacing_ SOIL COVER x Pressure Systems Only DepthDepth Over Bed/Trench Center Bed/Trench Edges COMMENTS: (Include code discrepencies, persons present, etc.) Location: 1222 128TH AVE 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? 0 Yes 0 No Use other side for additional information. Date SBD-6710 (R.3/97) County: St. Croix Sanitary Permit No: 645494 State Plan ID No: Parcel Tax No: 026-1298-06-000 Section/Town/Range/Map No: 34.30.18.1564 STATION BS I HI I FS I ELEV. Benchmark Alt. BM Bldg. Sewe St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover No. Of Pits Inside Dia. Liquid LEACHING Manufacturer: CHAMBER OR UNIT Model Number: x Hole Size x Hole Spacing (Vent to Air Intake xx Mound Or At -Grade Systems Only xx Depth of xx Seeded/Sodded xx Mulched Topsoil Yes No Yes No Inspection #1: Inspection #2 Insepctor's Signature Cert. No. Zpu --3(o 1 County s Sergees Division �$ y 1400 E Washington Av i Sanity Permit Number (to be filled in by Co-) ps" FEN p.o. i3ox7162 1 ,/ ',Madison, W1 58,707--71 /,, ( f �srovr+ St. Cro ;< l(/ I J 7/ / r � lication State Transaction Number - - - In accordance with SPS 333 1-( Wis. Adm. Code, subn»ssion o_"this form to the appropriate governmental unit is required prior to obtaining a sanitary permit_ Note; Application forms for state-owned PONyTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary Project Address (if different than mailine address u es in accordance with the Privacy Law, s. 15.04(1)(m), Slats. I. Application Information — Please Print All Information / �A UE, Property Owner's Name K w L Parcel P 0 a6 Property Owner's Mailing Address 8, •Z + property Location Govt. Lot /v 0-1'/, /Vtt.-ITS, Section,3,., T 3� N R / (ciEorrcle one) City, State /V lr Zip Code 7 �7oif ( Phone Number II. Type of Building (check all that apply) 011 or 2 Family Dwelling —Number of tooms ❑ Public/Commercial — Describe Use r Lot r 6 Subdivision Name Block- # ❑ State Owned — Describe Use Q City of [I Village of Town of CSM Number III. Ty a of Permit: (Ch only one box on tine A. Complete line B if applicable) A. Q Replacement System, Q Treatment/Holdina Tank Replacement Only Q Other Modification to Existing System (explai B. ❑ Permit Rene+vaf a jo Permit Revision l ❑ Chunee of Q Permit Transfer to New List Previous Permit Number and Daw Issued Before EV. iration I Plumber Owner IV. Type of POWTS System/Component/Device: (Check all that apply) ❑ Non -Pressurized In -Ground Q Pressurized In -Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil Q Mound < 24 in. of suitable soil ❑ Holding Tani 21 Ot C (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Ar a n: l )C 17-0 ttq qr Desigtt Flow (�rd) Design Soil Application Dispersal Area Requir (sf) Dispersal Area {sI) System Elevatio Rate(�dsf) �2' � �% % 9 � l%. / - It �/ 7 01 Vt. Tank Info Capacity in Gallons T P� v Total Gallons = of Units klanufacturer F = _ _. _ o " + tier; Tanks Existing Tanks = _ c` v ✓ it = Septic or Holding Tank ❑ ❑ ❑ Dosing Chamber 1Su ❑ 111 1 ❑ v la. nesponstotnty btatement- !, the undersigned, assume responsibility for installation of the POTS show n on the attached plans. Plumber's Nance (Print) Plumber'ber Business Phone Number �A0 V UZ, 7 7f,5-- 766 - 09Y Plum er's Address (Street, City, State, Zip Code) i� 3 %4my 4z.,e7- S'Vao VIII. Couno,/De JN Approved [I W rtment Use Ontv Disa prov Permit Fez I; ed I , o Agent Sienatur, O+ iven fur Denial S 9 5� Z L ` ••e IX. Conditions Ap ov SYSTEM OWNER: 10.t7'S;cQsZo�� 1. Septic tank, effluent filter and dispersal cell C-ZS) must be serviced / maintained as per p v s ioY• �r�-Q n1• � � S � 3 1 D I a r the s�shm a smbmrit to tie !r mute �nT per mot less n S l2 a i 1 in sin [� eW u � S+ i e o �-t3�S l-s �►'�� / JI1 ` Ve c '-{ P, P__ a 604t Plot Plan K o r ,.- 11 ZYL� pRoPERV OWNER L@pi Al 0 qf ®r Site locati isma r, i tEDIP) w/ 11 c-r page q of /(a jj* tmd 40 FT. (@XC@pt where noted) �:� backho@ pit North In Ground and Dosing Distribution Component Design ne intornowul, N ISD Required? R Residential or Commercial Design r, 500.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e g 1 5 = 150%) 0 t)0 Design Flow (gpd) 2.00 Site Slope (%) g7.» j Pmp. System Elevation (ft) 39.00' 'Depth to Limiting Factor (in) 0.80 In -situ Soil Application Rate (gpd/ft�) 99.00 Lowest Original Grade Ele In System Area (ft) :10 Highest Original Grade Ele In System Area (ft) 06 80 Limiting Factor Elevation (ft) _ ,� 20 Depth Below Grade Cell Width (ft) 1 Number of Cells 3.00 Dispersal Cell Design Loading Rate (gpd/ft`) 2 Influent Wastewater Ouahty ( t or 2) Distribution information E Center or End Manifold, Dist Box or Drop box V --t Y 1 Number of Laterals System dosed_ _____J 000 Lateral Spacing (ft) 9 79 Forcemain Drainback (gal) Does the forcemain dram back7�__Y 0.50 Forcemain Filter Loss (ft) 2.00 Forcemain Diameter (ir1) 60 FT, X 13W100 FT: a 0,83 FRICTION FACTOR 60.00 Forcemain Lenqth eft) 84.00 n1side Pump Tank ElevabOn (1i) 0 001 System Head (fit) X 1,3 15 901 Vertical Lift (ft) fit _ 17 23 Total Dynamic Head (ft) Designer must enter friction loss and system demand (gpm) WT791 Minimum Dose Volume (gal) 25.00 System Demand (gpm) Manufacturer Information `ffi tdnent Tank Int6ftnation Effluent FiIW Ifs 1585 00 Septic Tank Capacity (gal) Polyp#r/ ftW FNtnr Manui•3d&& Poncrete ProdUft Int, Manufacturer 528 Filter Model Number Dose Tank Information Gallons/Inch Calculator 0_O. Dose Tank Capacity (gal) Total Tank Capacity (gal) 2956 OWCose Tank Volume (gal/in) � Total Working Liquid DeplFosc% Concrete Productii 1�, . Manufacturer �_� gal/in (enter result in cell C}b5t1�ar11iVblUrfiO F(pj"KYLE D. & SARAH A. KOPCZYK Page 2 of Id m-23-2.3 n�-f . In Ground Plan View Calculations j 2.29 ft A Basal Area Required !37.6 M j 1 20 ft Basal Area Proposed 939•8 ft� L 122 ft ft alai AFl1i Calculation lh3Mat Dispersal ell Plaaal Area WW atian f Loadin at! _ � Loading R � 0 ..® q#lhq say 750 " 2 00 t? fill®y TMAI _.. .9 7 5 it, total 37$ R Piovosed 39® ft'_ LN � v._ ! I20.WI� t.InNl �A�9t 07 �eoMat Required 1 15 d Coll Lott h 12 nnm Ce Lett tip 116�4 R Llntal Nt ® ooMot prWosed Call Mpacin ft NOTE W $ cpWnoW =1' terrtIair�t+(�ri ft LifFtitin aiStdF .� � �L _ FatlryFl f1 2' W uirectrons Play with cell length to get desired cell spacing, length and width Remember system SHOULD be longer than it ,s wide it , t also Satisfy basal loading rate and GeoMat cell loading rate ProjoW. KYLF D & SARAH A, KOPCZYK Page 3 of 4 a End Connection Lateral Layout Diagram H@I@ "Wro 1§ t:atofal gfac g Pip@ DAMMOf 4 Utl Distribution Ceti Cross Section • $"#li" r�M+ LWOWlevel IR �! iMisi: Top of g@omai to b@ at jWOW W*iRai gra4@ � i a a ss aasaa aaoa semis s.�r �r yyy wsass,s m� asap me ez sa issrwc-- - --��T� C as tears se: �.� Observ*Won Pipes "I it v�ser 4H" Mao T' oe Prot KY A 0 i SAW A KMZVK Pogo 4 of 6 Notes/ Maintenance Requirements MANAGEMENT PLAN This private onsite wastewater (POWTS) has been designed, and is to be installed and maintained in accordance with SPS 383, Wis. Admin. Code, the in -Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0 SPS-10705-P (N.01/01). GeoMat in ground Component manual Version 1. 1. This POWTS has been designed to accommodate a maximum daily flow of 75 gRons of wastewater per day. The quality of influent discharge into the POWTS treatment or dispersal component shall be equal to or less than all of the following. A monthly average of 30 mg/L fats, oil and grease A monthly average of 220 mg/L BOD5 A monthly average of 150 mg/L TSS Wastewater shall not discharge to the POWTS in quantities or qualities that exceed these limits or that result in exceeding the enforcement standards and preventative action limits specified in ch. NR 140Tables 1 & 2 at a point of standards application, except as provided in DSPS 383.03 (4), Wis Admin. Code. 2. The owner of this POWTS is responsible for system operation and maintenance. 3. Defects or malfunctions identified during maintenance described above shall be repaired in conformance with SPS383 Wis. Admin. Code, and the pertaining county Private Sewage Systems Ordinance. The user's manual, provided to the owner of the POWTS includes the names and telephone numbers of the properly licensed individuals to contact for such repairs. 5. No product for chemical or physical restoration or chemical or physical procedures for POWTS may be used unless approved by the Dept. of Commerce in accordance with SPS. 384, Wis. Admin. Code. 6. If the POWTS is replaced, or its use discontinued, it shall be abandoned in accordance with SPS 383.33, Wis. Admin. Code. NOTES Two Effluent Filters to be installed where possible 1 to be installed in ST, and or 1 in pump tank in order to insure particle size less than or equal to 1 /8". Filters should be cleaned once in spring, and once in fall. Also, strainers in sinks in the building shall be maintained, so that solids and fats are minimized to flow into system. A minimum of 2 observation pipes per cell shall be installed. These pipes shall be located approximately at the end of each cell. The plumber, or county shall see to it that a copy of these plans including this page, maintenance folder, and maintenance agreement is given to the homeowner. This system may contain a dose chamber. If a pump, float, electrical outage causes the dose tank to fill, the homeowner should see to it that the effluent level in the tank is brought down gradually and not all dosed to the system at once. One large dose could cause damage. Contact a pumper or your installer if this problem occurs. The homeowner is responsible for formulating a water conservation plan that will ensure the system is rarely overloaded. I.E. spread laundry out over time, not 6 loads in 2 hours, while everybody showers, and uses the toilet, ETC. CONTINGENCY PLAN FOR COMPONENT FAILURE A. Septic Tank. Any structural failure resulting in cracks or leaks in the tank must be corrected by replacement of the septic tank component. Leaks in the joints between manhole risers or covers shall be repaired by replacing faulty seals with approved materials to make joints water- tight. B. Outlet Filter. The outlet filter shall be replaced or repaired when it is either no longer capable of preventing the discharge of particles larger than 1 /8 inch or when it has become permanently degraded by clogging so as to interfere with the design flow out of the septic tank. C. Dosing chamber and pump. The dosing chamber shall be replaced if any structural failure is found. Leaks in joints between manhole risers or covers shall be repaired by replacing faulty seals with approved materials to make joints water -tight. The pump and controls shall be replaced when they are no longer capable of functioning according to the design plan. D. Pressure Distribution Piping. Partial clogging of the distribution network may result in unduly long dosing cycles. The ends of the distribution laterals may be exposed and the threaded end caps removed. The piping can be disconnected on the outlet end of the pump. The distribution piping may then be back flushed to cleanse any accumulated matter from the piping. It is recommended that the dosing chamber then be pumped by a licensed plumber. E. Soil Absorption Celt. The discharge of sewage or wastewater to the ground surface is strictly prohibited due to the human health hazard created by the effluent. All failures created by surface discharge shall immediately be reported to the appropriate county. The pump shall then be immediately disconnected to prevent further discharge to the ground surface via the soil absorption cell. The existing septic tank and dosing chamber shall be used as a temporary holding tank until the necessary repairs to the soil absorption cell can be achieved. The replacement shall be initiated only after any necessary plan approvals have been obtained from the appropriate plan review authority and the required sanitary permit is obtained from the county. Project: KYLE D. & SARAH A. KOPCZYK Page 5 of 16 In Ground System Maintenance and Operation Specifica Service Provider's Name POWERS POWTS Regulator's Name ISt Croix County SPIA - Zoning Office System Flow and Load Parameters Design Flow - Peak 750 gpd Estimated Flow - Average 500 gpd Septic Tank Capacity 1585 gal Soil Absorption Component Size 390 ft2 Type of Wastewater Domestic Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System In Ground Phone 1715-246-5738 Phone 715 386 4680 Maximum Influent Particle Sizea30 in Maximum BODSmg/L Maximum TSSmg/L Maximum FOGmg/L Maximum Fecal Coliformcfu/100 mL Service Frequency Inspect and/or service once every 3 years Inspect and clean as necessary at least once every 3 years Test once every 3 ears Should test periodicall Laterals should be flushed and pressure tested eve 3 ears Inspect for pondina and see a e once eve 3 years Miscellaneous 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 GeoMat In Ground Component Manual Ver. March 20, 2017. 2. Dispersal cell media conforms to GeoMat products approved for use with the GeoMat In Ground Component Manual Ver. March 20, 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. Scarification of basal area is accomplished with a rake or other tool. 5. All disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail 0 0 ovo"c 6-8" Diameter �o�aoo6oao�000�<Finished ' ° "" Threaded C eanout Lawn Sprinkler ���oaoa�o�oQatGrade Plug or Ball Valve >�pp-anaOapaC.. BOX >000aoao o arop�q`�'Odc�p�..��Ci"i-, > n 0,C) ^ Lateral Ends at Last Orifice Where rooao 0 00000ooa ,oa000a00000a0000n; ` , apcoQ000Qo�000aa000a <: oa0000000- 000000aor Long Sweep 90 or Two 45 Degree Bends Same 3 a a o 0 0 0 nar°coo _o�>aUo_o°o°o°" Diameter as Lateral Distribution lateral -1 Lateral Cleanout 97.8 Feet Page 6 of 16 Project: KYLE D. & SARAH A KOPCZYK proj"; clan ow pipe Dose tank Information l'oCkifill Gover %ilh 'A an) I illo WIVI. :9 MW %'Alef 00,1 xal 4" Y011474COWOF tF p per bw % Alt v ka o"Ift', be"a 'If wir.m. urmp 111voriv witirvo i cfflueMlvi,�4M.,d *11op and %filof light paskVI 10h %%jiligslam e ptimp OF I:kvI8 Faf"'Milim diff"411101' 2 in - pump off awV11110A lRl 8407 Do&@ tank @I@Vdtl§n (ft) 64= Ponc,r@to products, Inc. gm-Ity 0 Zo ! volume 25,00 gallinch Fim(Manufaduref FNF-vv s1 pTIC SOLUTIONS Filter Model Number L324 Alarm MIMUfUtUfIf WE fihgimbul 6' Ala(M Model Number [A�ST—ANK ALKni—i Pump Manufacturer Zo@0W Company vlump Model Number I puffip muot c)@ii,@f r ga qpm at 17 53 It TDH Note Switches containing mercury may not be used in this system KYLE M & BARAN A, KOPCZYK Page 7 of 10 AWi6&4,' 401-25-0 Geoilliat distribution COO MO" L�-_ width MI �Iidewail to Lateral (ft) Distribution Cell Cross-section Arrangements Component Legend 0 Wlamww Flo@ mvofod with #ppf@v@d ONOWIM WC so W Ow Ow ~1 t)jgUjbmVOn C*1 Pion View LAVOIA - TYPWNI CON L*rg$h - 11 (it) Typical NISOMMINK ........ . .. LO-M ass as •s A4kT;VE SOIC O�ff M46 go Pf@W4 KYLE D A SARAH A KOPOZYK bmutmv,e Oto MAT.ww_&r;pomeaI fAfiltitadve Surface png@ it of 01. 23 Plot Plea fte ] of l(0 40 FT. PROPERTY OWNER: Ky 4c �� � RAk A, KQ pC�`f K-_-.-- 1" == (except whe(O nOtW) (backhoe pit tool Doguiptiun. n`f 14 1�u.^ iN� Pvti� Ra ` _= �W'%y 4, fi; U, 'kgm PICtfM0&l , Irrgow, DSO Aom.` . u AT9, u�tscoFa�thl• lz�z, 1:-�'�k �;yii:n��a� � pub-iz�tB-Q4� Goo North Ph- mr (L IF Volf it Bern L#�AIN = TeP of ` t'V C it ( Z1 D qq, q ` 2 i� Site Iocati • �WEW SEPTIC Address: N6643 Blue Lagoon Lane Ii 0 1, U T l ® N 1 City, Stag, Zip: Casco, WI 54250 Telephone 6013=333=3610 C LEAR F LOW Email- InfolfDnewsepticsy$tems,Corn Website: www.newsepticsolUtion$,Com FIL—TER INSTALLLATION AND SERVICE INSTRUCTIONS ItAOD6L NO, NSUFF324 FILTRATION 1/16" (.062" diameter holes) FLOW RATS 83.3 gallons per minute 61psl, � TDH Increase the total dynamic 44d loss by .05 fetat of head to overcome friction loss from the filter INSTALLAY11ON The NSWF324 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 &Moller diameter discharge. Install the filter in a position whEre It will be easy to service- + Place a 2-inch Schedule 40 PVC male adaptov (MIP—f x toiekit) on the and of filter. • Measure the amount of khedule 49 PVC (tail section) needed between the filter and pump, Cut the pipe to the desired length and insert into the pump A filter, • The filter housing hill A 2-inch Camlock Coupling connection to the force main- sERvfCE NQT 111— ag(- FILTER IF WATER L VAL IS ABOW FILTER OAMIISTER The length of time required between service intervals is unique to every application, As such, we recommend the filter he Checked within 22 months of installation to determine future service Intervals. Systems with known or su§pected nigh volume usage should be checked six months after Installation, . �OT USIJ P'L.UMBII146 WHILE FILIMR 18 1119011 " CLEANING THE SCREEN �oO NOT ALLOW 9W05 TO PALL INTO FILTER OliSlt Unscrew the 44nch cap and remove the Screen romthe filter housing. Taking prober protect(on, Clean the screen using a hose with a spray connection, o After cleaning, inspect the $Freon for damage or corrosion. (Replace if neC@gury,) c Place the licreon back into the filter housing and screw the cap back on, taking care not to cross the threads. QUALM The filter housing, cap and Coupling are made of heavy-duty ABS injection molded pla$tiC. Injection molding insdreff the first part made and the ten thousandth part arc+ virtually the same, insuring consistently high quality in every part. The itainle+ts sled 4treen is mane of 116L M stands for Low = meaning low Carbon) 316L stainless contains molybdenum, an Allay which increases strength & hardness and enhances resistance in areas high In salt air and chloride, giving it tho nickname I RM N©: I PAIif Nu►rlW 1 I fiNar s�1r 2 _ 69m t®ek 4 La s 0"110 `marine grade' stainless steel. 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A" OPOP L:—Ll I - ENoWIM id 9Wjw 30412D nVI and TSS 4 The LIeWINKIII of Cv"wvfdw k an MOA oppmwlly twvw P*Www wid "vwJw, Ityss MW awmam to bum MVWAI W need mWmId in 311 d1cruide fornaL plc�%c conw IN dtpbv" A 6064WISI w M 6wm4m, owhodo"TAL *G: 15 si lip 3of3 5TREL95 SOIL SERVICE INC" David I Steel Sr�llion L iopmMt LWBSldWJ& W1340M CST-POWTSM SEt/4,NWt/4; %,`130N IIW Dim711-760.0347 Lic. #248956 Town of RKhdoml, St_ CFOW COF'm 715-04-3449 Riding, Meadows Sub. Lot, 6 Thk WA &*kwrtim vm inducted to satiety a zoning mqv be notable for Ymw use. The locnliae of this trst ririy or may not be as stfowns as p ermanem lot thus were hot dished at the time the sal test was OWKWded. Legee9 l - 40` 100.00 It Top of'4" R=w PIP p 99.95 It .4 . -A" Top of 3/d" PW gW Cl - Bowing Boring Elevation" gl = 98-35 it B2 = 98.35 R 03 = 99.65 R sow- 0An vw" /y .0,1 4 fLow Pa id#M COWPJLT FACYMY FOR WfM AM"WO ykw &W* 0w--db WOW aeckkal aft "Wo""K ad mwiwva an abm V"w W4 om*a am" if! 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AUPLLIWMNI!�MM14MCAiMaELEEMEMWOIM IS 70 RECOOMI"ATEIS 71 CONTRACTORSHALL MWDEADEQUATC BRACING ANojOA9MARlMQ•TQIENBURESTAUCTUAAl41AMLDM OF RUILDIW DURNGCOMMUCTIONI. a, ALL NvTEfRAt mwqHs AmD imimiwummisaur wruwmm E)"Mw91w%G6 0"D014sk WERIDWTMW, Awtmmqmm"o HJO'ERGWM1LLWQm, ETC. %+AU- REAPPROVED'- N CUSTOMER. 9) oc;Wr"'A"THE m"m719cmhwwawAUYAYS7ME RIMEN11111 eVWSMED Dlmstmms. InITHECOMMACT13*3HALLVEMMALL DtWt#MUMA14WMD]KREgMIESIWPLWAttDMMW"RWM TO ANDIGM 14 %oRjwTj+e S7WOj4CCMMjnCp4 AMPHUDESIGMUMAM VM"VWW1'AffLMALSUILD)W.AMMESn+EWiNI); AL DISCREPANCIES. M'IwNO0SE S4fflL MINIM DIMV46KM BE SCALED PRO* PwA SECTTONS' MDETAUS GN,DRXWIWr. 1 91ALL MMEWOW117OPEMWSARE ROUJIM111ANNG UNLESS NOTED GrAESWIZ 01i'ALL 3J'REMiQPi9 TO grUDWATTRMAISARC 70 THE FACE ORITUD UNLESS MOM OTHERWISE. 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C-fmfmot W* and Wt. PPC- difilft Or *an -r the —M"".f 4 loille l'— ov vjo4-.,p H�n1eF Wawa Mgm@s Now Richmond $75 North Knowloh Avo KARCZYK ORMW PA65WQAEI Naw RI6bm9Rd, WI *54017 �►.- 715.24CW04 1222 128TH AVE PRELIMINARY 5FT deiaAnir+g00Bui�A*WOlWiW4 smiIhj@Wa�14�Nhi1Rip4•Wm NEW flICNMAN4 WI �AP17 --- mc's exdusnr. coprn�t herein and agree not eo dkPWV,airt,lWre, reprodsre, mo�tr, or use q,esepl�(!?RMM�ia ocher,han for the consnuctlon MaslnaehomepV ypysy Xq,nea New Pkhrggn4 m Way I _•, . I � it r ., I I I II I II I II il ......... ...... pna°ww'asirv�a� 9. u'wro.. caae.mie,rso.m �:ss��..�, ARE i I- II II II p II II II I'. 11 II Iwv II 11 II II II II II II ...._..... II II II un�r n 2ow Wall 1!QII'CI-IMNR01.11r ' I Wa'- v=m (azxasli rtmrscurnroos�n: iuex Gb.p quer8 rnacape:9BG T=Cij9" Wa11,HmphxIWna,1! �" sa7/9'wead��aln`fu:n:ml. s mmtlonsate.Feamng(Th+PFrMne:. a'l H1®dB's9Yad�.B14 wowpy Hamm, New ftichrnorA 575 Noah Knowl@A Avg KOPCZYK uR28IFY HA$$WPQO Now glChMqnd, WI $4017 UR179TH AVE PRELIMINARY fiff ONO, WI $4017 eW— C-POP&M h—j, ana agree noc 7d. �11011.., I=-, modify, t i k, li3 I � 1, IN t 9 I W4k*@u "— ,@s Npw 90monci $75 North Know* Avs KOPCZYK QQ47FV aA55WPPE) Now Rir hmPnd, WI 54017 _ 7154-40,9M4 tA�7 IMTH AVE PRELIMINARY 5ET neaek.g'uduaa Ev.,e smrth,#waufauhnmascom NEW RIGHMgN©, Wt 54017 ...- mFk eYrlkWecopyri�,c hewrc ar:n agree notio djspl,T(, dptgtum, regp aAuce, medrfy,gl�ee mesa plx,cWwMngs akmr ahan Sort-.. . .,ehW9e py Wwcau Homes Newxkpmme. mmm- r r% -11- %FMEM P-F S=M&R wle Vqmeft M4;R1 rjAf Ir,W' OIW=AM! smm nmil lhr,=Vv"(RZOW lv,Ar. = r4.. (Zwm) T"cAl =will sgmm z9ll=IrLw'l(22w9! Zlm"=rLwlzb"� E < Vqmeft M4;R1 rjAf Ir,W' OIW=AM! smm nmil lhr,=Vv"(RZOW lv,Ar. = r4.. (Zwm) T"cAl =will sgmm z9ll=IrLw'l(22w9! Zlm"=rLwlzb"� E < rate UT I Jill r. r7l 1 1-4, Ai < ! NOR 100-11 1::[IM111" I =011111MM-11 M A WaWatj Homes New Richmond 74 North Knowles Ave KOPCZYK DRM7FV 0 A55WPOP N" gichmpnil, W1 54017 PRELIMINARY SFT MA WaTH AVM It NEW RICHMOND, W1 54017 o\X Se st. CCU. Oe% (ttsµn s h4m; i! - J�. - - - �' -� pwarlaaat of 1110e4 & I raf"do"I AM11CM ttd®Rtq Iz#n1W 11*11;i011 &mitaq Permit Application (ptu t (�pcnptHlst+��4({FBM{ im+c (1et!is�cyj{�1�"u.s RI% NEW R1C>tli!1lOND. W1 ±rQ .A _ APt:.k Lui � N-A-,El �,- f-►�=sue � �� w 467TasL _-- BRADY VTGA SYSTEM OWNER: 1. Sept tank, effluent filter and dispersal cell mus be serviced I maintained as per mana ement plan provided by plumber. 2. All set as pq Vw as { ablMN Mei3 ode 1 ordinances. Jill L NA Jill JMTH AVEINVE (ts t.:.-yam licit i N _ A- rq,� � RIDI � 1 tip N. i•�� �.•.ana asatiiii�-- �-- yCµYAW V -. �s{dbb{iFl az thsiBFF -' (�` 19Pr iF�:Nni ?j. J X Epp rµRT e,4 i tome II (COMBO) ----- i �&96J � NV es I 6'r ` is (jeQMat IN GROUND AND DOSING Dj5 I KIDU I VW" — INDEX AND TMI! PAGE Owner Proiect NSMG' KYLE_0 & SA & A. KOPMK owner's Niffd.' (SAME) Owner's Addre45 644 HIGHVIEW_M_UNIT A NEW ACHMOND, WI 54017 Info Property Address; Legal Description Township Subdivision Name Lot Number' Parcel IA Number: Plots Transaction No Index ages J22212BTH AiiENUE NW NW 8 34 T 30 N Ft 1® W RicfinlOPtd County: $t. Chobi RIDING MtAbOWS NORTH 6 Ebt ck Number NA GSM#; NA 026 - 1298.Od 000 Page 1 Index and titl! Page 2 Data entry Page 3 GeoMat disf Cell drawings & calculations Page 4 Lateral and cell cross section Page 5 Management & contingency Page 6 Maintenance & specifications Page 7 Tank cross sections Page 8 Distnbution media Page 9 Plot plan Page 10 Filter specifications Page I I Soil test Page 12 Soil test Page 13 Soil test Pop 14 tom_ MA9 1f PUMp Curve & Specg__.J,._^ MARY JO Wt1PPERT License NU~; 1859-fl07 Date 12lr�i122 0! ?�_�� Phone NurnbW, 7�5 42�i=1776 ,411V It, Signature' Designer St'2M ,.. Designed Pufauarif to ft GeoMa1 In Ground Component Manual Ver June 26, 201f1 Versions �iJ1v Page 1 of 1f-:i GeoMat IN GROUND AND DOSING DISTRIBUTION COMPONENT DESIGN INDEX AND TITL9 PACK Owner Infor Project Name KYLE D:& SARAH A. KOPCZYK__...._.._, Owner's Name __(SAMCL_ Owner's Address: 644 HIGHVIEW DR, KNIT A NEW RSICHMONC WI 54017 Property Info Property Address 1222128TH AVENUE Legal Description NW NW 11 34 T,_. 3 N 1s W Township RkhMorld County St: Dry Subdivision Name RIDING (MEADOWS NORTH Lot Number ® Block Numb. C811flM NA Parcel I D Numbe = 1298 _ �! - 000 Plan Transaction N0 Index Pages Page 1 Index and titleage 9 Pbt plan Page 2 Data entryRage 10 Fifter spectcations Page 3 GeoMat dist cRage I Page 4 Lateral and cepage 12 Sod test Page 5 Management Page 13 Soil test Paget Maintenance 8 Page i4 ill l MAP_ Page 7 Tank cross se+ = If PFUMP"DuNL & Specs Page 8 Distribution media)j%p�eiac, _ MARY JO HUIN Number 185g-007 Dato: 12/07/22Ph Number: 71 5-426-1775 Signature. Designer Designed Pursuant to the GeoMat In Ground Component Manual Vet. June 26, 2018 Version) OwAy Page 1 of `IG� In Ground and Dosing Distribution Component Design Site Information R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.001 Design Flow (gpd) 2.00 Site Slope (%) 97.80 Prop. System Elevation (ft) 39.00 Depth to Limiting Factor (in) 0.80 In -situ Soil Application Rate (gpd/ft2) 99.00 Lowest Original Grade Ele. In System Area (ft) 99.10 Highest Original Grade Ele. In System Area (ft) 95.801 Limiting Factor Elevation (ft) _ -0.201 Depth Below Grade Distribution Cell Information 3.25 Cell Width (ft) 2.00� Dispersal Cell Design Loading Rate (gpd/ft2) i Influer#,Wastewater Quality (1 or 2) Distribution li N ISD Required? 11 Number of Cells Center or E Manifold, Dist. Box or p Box System dosed Y Number of Lat als Lateral Spacing Forcemain Drainb k (gal) Does the forcemain drain back? � Y Forcemain Filter Lo (ft) Forcemain Diameter (i Forcemain Length (ft) X 1.39/100 FT. = 0.78 FRICTION FACTOR Inside Pump Tank Elev o (ft) System Head (ft) x 1.3 Vertical Lift (ft) Friction Loss (ft) Total Dynamic H (ft) Designer must enter friction ions and system demand (gpm) Minimum Dose'flume (gal) System Deman (gpm) Manufacturer Treatment Tank Information Effluent FYAer Infc 1200.001 Septic Tank Capacity al) Pol lok Inc./ bel [Wieser Concrete Products, Inc. Manufacturer Filter Manufacturer Filter Model Number Dose Tank Information Gallonslinch Calculator 800.00 Dose Tank Capacity (gal) Total Tank Capacity (gal) 22.24 Dose Tank Volume al/in) Total Working Liquid Depth (in) Wieser Concrete Products Inc. IManufacturer gal/in (enter result in cell DoseTankVolume) Project' KYLE D. & SARAH A. KOPCZYK Page 2 of 10 In Ground Plan View Cann eoftt .,s.a a •• •. ea9 a�Y ii�gip � .-•. ••. r.-r-+--. j...L.T'^'rT'-r--r',-• '- ,•q xrtt ftys aata tgtYgs ssar tyary..stfi gqar. t1 apit aYY .'' "CD{°O"UoiD�y°OeF,O�°oO3D07U�0°so o�O�°0r!Di7�noOao C�/�o�Oqti0D.4o ca_nDprD°_u#Jo)s°oo L(iI°ooiCr°Ot_tC "0oCiDuif'GC I f�ortd�'b�°t�_r=°1ite�10LrTO"t�"i�*":i1�pr0>°000000°°000Dl0l00 0Oo01[°DO i�D00.°°t00 .7r°O0 i0pmo0o0oO ° lU "°Oc °° o° o°tas#T°""io"r°0 Q000oo 0000 0-0 °IIO0000i C0000O000OC�0OOO 7O0000 oo 00o0000 C O0 0tp?0O `G•Yp=aera YYf9Q Y • - • i `2 Il -1 'T `t-9-`t-`� `�-`i. •--•, • Y a Y a . . . •�YYYYYY Yp.♦ • YxYY rYYyY Y x Yrf�YpY 3 i �. Calculations 2 17 ft — -- A -- Basal Area Required 750 fe l ` 100 f Basal Area Pro osed 759 fe 1 ft 0.00 10 W 7. It GeoMat Dis ersal Cell Basal Area Calculation Basal Area Calculation -- -- — D Loadin Rate GPp LoadingGP Rate —0.8 600 2 00 gallsq ft/day 600 9 q ft/day Total 300 fe Total 750 Proposed 325 ft2 GeoMat Width 3.25 ft Number of Cells - Cell Length 1 .0 Lineal Feet 07bmMat Required 92.3 Min. Cell Len th 92.3 ft Lineal Feet of GeoMat Pro" sad 100 Cell S acin 0.00 ft NOTE.- Min S dimension id V System Elevation 97.8 ft Limitin Factor 95.8 ft Separation 2 ft 2' Min Directions: Play with cell length to get desired cell spacing, length and width. Remember system SHOULD be longer than it is wide. It must also Satisfy basalloadingrate and GeoMat cell loading rate. Project: KYLE D. & SARAH A. KOPCZYK Page 3 of 10 End Connection Lateral Layout Diagram Hole spacing is every 12" , 112" hole at 4 & 8 O'clock, starting 4 O'clock 6" from en, dand 8 O'clock Holes at 12" from end. Lateral Spacing __ 0.00 ft Pipe Diameter �QQ in Distribution Cell Cross Sp4ption ��f �.�' 99.1 ft Finished C COV*t -0.2 ft `— 2in—. FipeDi>t i op of geomat to be at o ■ - - - - elow original grade 1 r_��rsa ri ri d aB sv4 s G GGG�� 39 ft y pes "A 1t 12" Min. 48" Max. 97.8 ft TWIG s'Tip� . t7n�tbctioo n�►ea Latud I.evd 12-4 _ � fafiltistive Fabric _GEO MAT -,� li - Lzfiltsstive Sw'face � ff5I= `VESOI .. F uW �rsw 4- Mi. DV Project: KYLE D. & SARAH A. KOPCZYK Page 4 of 10 Notes/ Maintenance Requirements MANAGEMENT PLAN This private onsite wastewater (POWTS) has been designed, and is to be installed and maintained in accordance with SPS 383, Wis. Admin. Code, the in -Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0 SPS-10705-P (N.01/01). GeoMat in ground Component manual Version 1. 1. This POWTS has been designed to accommodate a maximum daily flow of 60� �Rons of wastewater per day. The quality of influent discharge into the POWTS treatmentdispersal component of 30 shall fats oieand gr grease than all of the following. A monthly A monthly average of 220 mg/L BOD5 A monthly average of 150 mg/L TSS Wastewater shall not discharge to the POWTS in quantities or qualities that exceed these limits or that result in exceeding the enforcement standards and preventative action limits specified in ch. NR 140Tables 1 & 2 at a point of standards application, except as provided in DSPS 383.03 (4), Wis Admin. Code. 2. The owner of this POWTS is responsible for system operation and maintenance. 3. Defects or malfunctions identified during maintenance described above shall be repaired in conformance with SPS383 Wis. Admin. Code, and the pertaining county Private Sewage Systems Ordinance. The user's manual, provided to the owner of the POWTS includes the names and telephone numbers of the properly licensed individuals to contact for such repairs. 5. No product for chemical or physical restoration or chemical or physical procedures for POWTS may be used unless approved by the Dept. of Commerce in accordance with SPS. 384, Wis. Admin. Code. 6. If the POWTS is replaced, or its use discontinued, it shall be abandoned in accordance with SPS 383.33, Wis. Admin. Code. NOTES Two Effluent Filters to be installed where possible 1 to be installed in ST, and or 1 in pump tank in order to insure particle size less than or equal to 118". Filters should be cleaned once in spring, and once in fall. Also, strainers in sinks in the building shall be maintained, so that solids and fats are minimized to flow into system. A minimum of 2 observation pipes per cell shall be installed. These pipes shall be located approximately at the end of each cell. The plumber, or county shall see to it that a copy of these plans including this page, maintenance folder, and maintenance agreement is given to the homeowner. see the effluent level inmay thetanin aks brought downose chamber. fgradually and not all 'dosed cal tto the system atage causes the donce. Onose tank e largehdose could ncauseoda age.o it that Contact a pumper or your installer if this problem occurs. The homeowner is responsible for formulating a water conservation plan that will ensure the system is rarely overloaded. I.E. spread laundry out over time, not 6 loads in 2 hours, while everybody showers, and uses the toilet, ETC. CONTINGENCY PLAN FOR COMPONENT FAILURE A. Septic Tank. Any structural failure resulting in cracks or leaks in the tank must be corrected by replacement of the septic tank component. Leaks in the joints between manhole risers or covers shall be repaired by replacing faulty seals with approved materials to make joints water- tight. B. Outlet Filter. The outlet filter shall be replaced or repaired when it is either no longer capable of preventing the discharge of particles larger than 1/8 inch or when it has become permanently degraded by clogging so as to interfere with the design flow out of the septic tank. C. Dosing chamber and pump. The dosing chamber shall be replaced if any structural failure is found. Leaks in joints between manhole risers or covers shall be repaired by replacing faulty seals with approved materials to make joints water -tight. The pump and controls shall be replaced when they are no longer capable of functioning according to the design plan. D. Pressure Distribution Piping. Partial clogging of the distribution network may result in unduly long dosing cycles. The ends of the distribution laterals may be exposed and the threaded end caps removed. The piping can be disconnected on the outlet end of the pump. The distribution piping may then be back flushed to cleanse any accumulated matter from the piping. It is recommended that the dosing chamber then be pumped by a licensed plumber. E. Soil Absorption Cell. The discharge of sewage or wastewater to the ground surface is strictly prohibited due to the human health hazard created by the effluent. All failures created by surface discharge shall immediately be reported to the appropriate county. The pump shall then be immediately disconnected to prevent further discharge to the ground surface via the soil absorption cell. The existing septic tank and dosing chamber shall be used as a temporary holding tank until the necessary repairs to the soil absorption cell can be achieved. The replacement shall be initiated only after any necessary plan approvals have been obtained from the appropriate plan review authority and the required sanitary permit is obtained from the county. Project: KYLE D. & SARAH A. KOPCZYK Page 5 of 10 In Z__ ystem Maintenance and Operation Specifications Service Provider's Name POWTS Regulator's Name Phone 715-246-5738 „u Phone 715 386-4680 Design Flow - Peak 0 pd Maximum Influent Particle Size 1/8 in mg/L Estimated Flow - Average 4 gpd Maximum BOD5 30 Maximum TSS 30 mg/L Septic Tank Capacity 12 gal Maximum FOG 10 mg/L Soil Absorption Component Size 62 Maximum Fecal Coliform 10E4 cfu/100 mL Type of Wastewater D estic Service Fregtienctt Septic and Pump Tank Ins ect and/or servic nce ever 3 ears Effluent Filter Ins ect and clean as ne ssa at least once eve 3 ears Pump and Controls Test once every 3 years Alarm Should test periodically ----- Pressure System Laterals should be flushed and ressure tested every 3 yosit - in Ground Ins ect for ondina and see a e once every 3 y6att Miscellaneous Construction and Materials Standards and materials conform to Table SPS 384.30-1, have a watertight cap 1. Observation pipes are slotted and are secured in as shown in the GeoMat In Ground Component Manual Ver. March 20, 2017. the GeoMat In Ground Component 2. Dispersal cell media conforms to GeoMat products approved for use with Media is covered with an approved geotextile fabric. Manual Ver. March 20, 2017. and piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 3. All gravity pressure 4. Scarification of basal area is accomplished with a rake or other tool. and help reduce frost penetration. 5. All disturbed areas will be seeded and mulched to prevent soil erosion Lateral Turn -up Detail Threaded Cleanout 6 8" Diameter c, 000�o `�iiiished �G0000�co{ plug or Ball Valve Lawn Sprinkler ,,icy Grade � ao�f Lateral Ends at Last Orifice Where ;jt; 0 e6a0oOo J��o,voQo6oJ�oV0G0�0.1Qvo'�oLc�_ _':o"i0000 ooco,ooc; .::,: Long Sweep 90 or Two 45 Degree Bends Same p0000G0000e o oo�oGoo o'oGo` c" ^ Diameter as Lateral OOOQGOGQOOGO�OpOpOp0000000G00GOG� 00pQ 00 00 FJ000000 G�. 000. 2 O U , '• 0 0 O O O O n00_V )C7 C>G OO 17� OOOGGOG o oGc�oo��GG_� n n c5 c� Distribution Lateral -F Lateral Cleanout 97.8 Feet Page 6 of 10 Project: KYLE D. & SARAH A. KOPCZYK Dose Tank Information t,oe.king cover Atitlr rcamin lalxl. Ip@l 4w 11evi@@ and t%aler light 4@411 \� d" Ycatetl rrpY@i` Clcclrical tip.4 €I@aa W1 pip@ Aptlpaal mil v Iv@ to wntrol.ripkyd of Wir@>i Rrpm f lwirle §ptitk'o 614ir—-kqffiW@nt k@Ia do -CA Forcemain diameter BrAlk MOP 1 4" ARTMt 3e3 pip@ to 2 in. ail Wat@f o is - +slid tiroilnA tihi �asl @i Rurn@p weep now of >3++i 41pi" data h writer alarm. MV 'unipi Oil Float q11iltup otr Float puiap �, � —__-- Pump off elevation (ft) 84.33 Aloc,i Dose tank elevation (ft) 84.00 Dimension Inches Ga s A 26.86 59n13 g 2.00 44. G 3.11 69.13 D 4.00 88.96 Total 35.97 800.00 Filter Manufacturer Filter Model Number Alarm Manufacturer Alarm Model Number Pump Manufacturer Pump Model Number Pump Must Deliver Note: Switches containing Concrete Products, Inc. a acit 800.00 olume 22.24 gal/inch Ipm at I 17.18 f XH may not be used in this system. Project: KYLE D. & SARAH A. KOPCZYK Page 7 of 10 GeoMat D' 1 Media Layout 3.25 Cell Width (ft) 2.63 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements O Distribution GeoMat is cove d with approved geot#A le tkb& as per ,P prodder iapptoval: Dis ution Cell Plan View Typical Cell Wi A (ft) Cell Length - B (ft) En onnection Lateral Lavo ial y • �. o oiai a o as ' a • -.'• •".te".tea-�� I Typical Dispersal Cell Finished GrndeWn t 11 12 48 .T INst inFv'e abric Pipe _ - _GFA MAT ^l l 2" ASTM 31 Seen i 9 �. ' 1 1 ' 1 Tnfiltr fm Surface � Z See details on page 4 for number. size. and spacing of laterals. Project: KYLE D. & SARAN A. KOPCZYK Page 8 of 10 plot plan PROPEIM OWNER,.-- i N, �A �►U4v.1'� Ai Orti � ` l�(Y�1 �N df '��� Levi pipin: e 90 vit! TIMOMI Zb --... kW. I u.1ISO nn1,60110 If 4/ �4 I � t gT M 7 �,,.,►i'�� i V vy M♦ , r Te�VC qq, , site Iocab gof/(a 40 FT. (9mpe where not*d) M im b:ckhos ph �,60 Ao ob North Li W '� .? �t 'TANK ryzalas�a�,,i� Address: N6643 Blue Lagoon Lane ®I i i A ►i City, State, Zip, Cameo, WI 54250 i 1 / Telephone:606=223-361d C LEAR F' L.O y � gll�ili info@n�tYVkepticsysterYti♦.Cof41 W@bsite: www,n@wsepticsoiutions,Com FIL-TER INSTALLLATICIN AND SERVICE INSTRUCTIONS MODEL NO, NSSCFF 124 p.50 FILTRATION 1/160 (,062" diameter holes) FLOW RATE 83.8 gallons per minute @ tpsi. TDM increase the total dynamic head 1694, hy'05 feet of head to overcome friction loss frorn the filier INSTAUATION 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 IN smaller diathete► discharge. install the filter in a position wher@ It will be easy to iservice, place A 2=Inch khedUI6 40 PVC shale adaptor (MIPfi a socket) on the end of filter, Measure the amount of Schedule 40 PVC (tall section) needed between the filter and pump. CUIt 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, 00 NOT REMOVE PILYER IF WATIN LEVEL ��� Fl6"I�fi NIl3i�� SERVICE --� The length of time required betYV@@h WMI.0 interVals Is unlque to every applkfon' As such, w@ r@€ommend the filter be checked within 12 month@ of Installation to determiitfl+ future service intervals, Systems with known or suspected high Volume usage should be checked i DO NfDY tl 9 IJWHU FILTER IS 99 CLEANING THE SCREEN g IiOY A6I:,I3Mi GOON YID PtALL INTO PILTEEN CASE Unscrew th@ 4=inch cap and remove the ureefl trom the filter housing. Making proper protection, clean the scr@*n using a hose with a spray connection. a After cleaning, inspect the screen for damage or corrosion. (Replace if necessary.) G Place the screen back into the filter housing and screw the cap back on, taking care not to cross the threads - he filTY The try=duty ABS Inj@ction molded Tfilter housing, cap and coupling are made hei plastit, Injection molding insures the first part made and the ten thousandth part are virtually the same, insuring consistently high vitality in every part, The stainless steel screen IS Cmado of 226L ((L stands for Low - meaning low carbon) 226L stainless contains molybdenum, on alloy which increases stri►ngth & hardness n reas high in salt air and chloride, giving it the nickname@ "M N®. PART NUAAIEfl d®m A aan few and enhances resistance a I 'Morino grade' stainless steel. sWY N®�e� I tin _7:3 _.—.�WirahAndl@ [,: 0 4 0 1 61713 - r� ALtlA`�ii�Fi �EP4RT i 10 3 go L wismirsin 4="CWWi*'WZ Adm Cod. N.'sio moil a ca Out, cam" t1~nion of Sa1el,► na less Ptsn me+t :- Attac" uomplate see pw on t di Ilion and t a: Z 1ncLids, Dul not w"&d 10. "Asicai and hortraebl re N to neall nsod P ,�►�.,� aynorth .r.aw. aneii1 6� P7 Pasa+rt,Manrsoiirarw - - _ity locaion Nf�' µr1�1l119M�+� ,stiow _ �ropenv c JUL 1 2005� 5lelliott Devell.M:IlC _ _- f Bbr!' Addns ST CROik OUNT 1 d no A'- 1221 Oft AV*� � ION;PI(�A��" _ � ') � —� � Vibga i j Town 120Th St Richmond GPD W#chmond Vif1 Wiz i 715.724&S440 _ 1 darthiad daslOn pow wts � -- j (°�` New Constnictian t 1 Coal—beA ` pb _ IL F ppe"+. ad vapr� esda�p" 09 s� - _ Parent Mawlal Ries' em 00.E bused On COMM*0 �•� Genersi Curlhta Moarrd or ^1 grade System I and rsM-n&fKWArI - In Appticatidt t�f is booing t bd- 39 - GPDm' ® ��' t3round surtax elev •t9N1� IRoCtsf - nSell Ou Sz Cant CoaY1 - �� A tt1 ®� 77_�= Hotta _ 2'"—sttc _ mM1 = . _ ® rd ,4 .b dd 2msda - — ,0 10yt3/3 crone ®1pgr7/6 7:"Ift 9w na na .p Y�r�l'= _._^ate � . =u — aBaring 1 ; ; around svrt"aos OW,PIK Horinor► Detllh MO. RedoR L SZ. CDM CJD1t1t inOu. 1 0-19 10yt3/1 raw t , 2 *38 Y"+ 4.,.. MW 3&16 jJrilit/4 a i q c2d 7.5rSffi ­47— _T=7� ,. = 30 < 27o,nya wa 154 j. (Jew! J Steel _ - OAWI as WON W, Sarvru. iris MA 200M SL t;$~. VO-- in. Bow RooO - -_ -- --� _ A .p M* ON goal A 1.0 m~ p 0 130 04L GST Nun+bii7 - dab E vsharon Condutfsd YNeoharra 6127J2005 ? 15 7W-0347 s i the n m.oa 010 r _ e PvCs� b � As :all�liW ii � _, :65.� A O�DN b bnw+O lWiw - - ~ �31►a�' Pam F 10r1r ()pmini+r) Color Slrweuee 8ouno+�Y Pooh �PFif E M? 7iYff f IMP its If f 2 WOO NOW Sid Z M * .�j _ .b 3 1/� moire sf 2nesbk ra s >� ,. "off Is asgff ► a - - fItS11C 'Ad a" = RIf1 N N 1 f.iiw+ rw. L i_ --- Nff�i► GPDW DO&+ ^ T s*� °"s$tentt 9our�P men � - W f " c. Sz Sh _ -- - The DgwlmcM of Co MOO is NI Willy wvroc pmvNW and employe+. 1fyou nccd rmi-4wKc w.ecess Q"vm tjr need mW"W to all WWroji &K*,% f conW IM jcpwncni ss 40i-166-31 s 1 or M 608-264-AM Goo-„as"R., f�ot- ; 1 z i 3ot3 STEEL'S SOS SI&RINC velopment �C Stallion De�. David I. Sled �� � �� CST-POWTSM sEua,t�w ua;s3a,T3oN,R tavv �� 915-7604347 Lic. 0246956 Town o[ Richiftoad, St. Croix Co. �� "����� Eliding Meadows Sub. Lot, b Twia nail avalt,ati�oin %"a � to satisfy a zoii nfg regaire+ne. n may or Mq 00 be stutable WPM usc. not established at the The location of this test tnsy or may not be as shawo, as P lot lines were time the soil lest was conducted. N LcRt"d I" - 40' 9®0.00 R I i '. gpt hmark Ele. Top of 3!4" Pvt: PiPe �•� R • = All Benchmwk rle- r( Top of 3/4" PVC PiPe 1 Cl - Boriop Boring Elevations BI - 9935 ft g? = 96.35 ft ft B3 = 99.65 R B4 = 0.00 { I I \ *4: ea e{ Ila lFjfl�,�� r<< � �% MIN ft* Ulam CONSULT FACTORY FOR SPECLAL APPLICA"M ykad dosi* pwtgs avaiaW geieirltal a6wakm iff doom gfda.., M a*&* wd 19' VIM an aimm VXab* W'd CWW &AMW are -w-60 9 *19W pk— SYSWI* DmdAe pgWbad -mums *40 %d 4 A i - am aoaiallie too ipadwse k%xq " and ~ cyck cOl - • sealed CxWkw avabW bf NON t jjStMja6ar&. Sw FIA1420, - Over l30rF-(54"C.)VedW*MftWnVe4L* - IMS] Series low omo* S01416010- soft- -DNP• - NKi {tom_ _AMP!. _2sr3 115 Ado wn Sa —Y'w two L100 Wail" J Naft NO emu is &* I* & *A%d m e*eaieal aM $*W =ft "am it ,.MR "Mmia arcw cv* (wq -d 101AL"'Aw WNM WA—Pwly FO w onwow lu 153 EMI 1M[ Lam U 1.9 0 261 10 3.1 $1 131 '.'A ­17 7;— Za— —4-3— i on, 3Q 0:1 44 J� 34 in 42 SO 30 9.1 U 23 87 33 175. 101 22 65 4i 42 A, (11.40 Oak flowe I"M Und wboollou*" *e* &Onp or ROOM POWEPED ow" F. *400 060'ores li 06 til go* 6ft b W#wwad *AD the design 016107 &00W PUM01 "we Ir D&W 340MCNISAWIFft0d KY 4w I -owl PA;�J /b b yiae _C2 I p4wr a rtenirlc�a mNtlHquCtNLAMtOWVWPARINAMWIrOC.EIL10tlMLe10Tn[' MIS V,AN'9L``nYtl AtlfCrNhw L111NONMNL 41 gCtlWOH IRI Y Y�M1iPNiLV�AbrN�(W W CLM11 MLgNT YNWYLMCEV 'y MCRMOICM MAMR WrNtlD WtP NY rOR11PApet IYRC. trap vncto rnr reR rfANwr u•tic nw nw rq w couwoNwlroRw n[°iRitl�R✓eln�rER°MA[i i nn°NRin°.w°w LTAPw. t Nr LRNa r tnoes. it PP Ia1tN PAW IlH'iDR LUttIt1Y N` OC. nIq MKMO. fYYNDMIAL rµouwr� L�MTM�Ppwu Rt°wmuykL RLNie worn nnRNLR[. L 0°M�i i[ o aRralwuaxaswlLLMreeawrceLWlN rw RLutRRewwf[avra RN rAA1t14twOMNYO tIFw.wtAL01N0A4 MKIWRF AWILIfwM /Rt•rORR t. AcCORW[LR.LVlIT1AlMP[OUMLOMINIM NCANLRWIFi�MN�iO~.IH[iu INLKAKY f. WL{b WHLMMLe ENNIM LOUTfOAT INCH LIO ROt i01.1 OItMCFpAMiOwM'CFRN W IO H rEtr iIPH Mf nD wPceORMNCEwnNiwWl /�A LdMfRN6rg11IMCOMINWl6Lv pH[T WTtg0EAlwLI EF M/LYORRANCt WIIN IlCTIOIf Rpp H I. � MwR1RNCY EnWfLNMw[w Wh1 MN[ltYWlNdI lRCFw MI[fT wACAMGWCE W M NCiwNRtn_IAi. f. e. rRcwww LM vcra lw+i ror FYaFOEAien oN cENHA �ImP�TI^�"IPf911• ©�[Ems Pal sm. -m #I�rfl?JI# telf#Flrl�'711�#I�7#�'L���#�:�#siJ.t•�E7I/' ET7 �F7•�`'1��-7 rl�til• SIi# iFi#�Cr�Et:�� �!t i# oar frr #_;.# #l•](i #�Ii# #[,'# f il'!• rEi� RUM UT DATIL 7• Wal r1rAWSeTn DATW 1.724027 MOSS "I Y DATt We ^^11 dlxWirsr. �,4IIf wN tAoou WO20ORT nlrr 7/22/2022 txALe: 79w1 111Y • 1'Ay I1R17 I1H'• 1'-07 "D/!"EfDD1eDE MNII /1pa11 .'>d q rr 4aW111�EVa. • YDwrT OAA�Of w 10' W R �r .,dawn MITUL ¢T DATE f.+4tOZ1 IlEvneo an n DATE: ).#4a9t qEN{FD9ET Yt WTE. MVUDaETSI 'Et wNulaon: W026RT uTt: Tr22r2o22 "Lpl 11M • 147 11./1 11rt'. ItD1 SANITARY SYSTEM File #: ST. C RO UNTY Office Use Only ' OWNERSHIP/ADDRESS FORM Created212027 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 Property Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer , 1ro / CZ. Mailing Address C,:� q y ht 1 i ci Ul Ir-JA ' RS/ 1 N� City/State/Zip N� LL { ► `�,�,.,.� Lc-c 5-` �/ Phone Number (required) Email Address (required)—� Parcel Identification Number C") (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location 1/4 , '/4 , Sec. � T 3� N R1 W, Town of Subdivision Plat: I tbfri.) �G'��tc�S , Lot # Certified Survey Map # Volume , Page # Warranty Deed # I v S (before 2006)Volume , Page # Number of bedrooms Spec house ❑ yes no Lot lines identifiable JI(yes ❑ no New Property Address (Sta AC, USE ONLY C— (Verifica ion of new address required from Community Development Department for new construction.) 1 �- zg Z (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 survey map if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cdd@sccwi.gov sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.gov WARRANTY DEED THIS DEED, made between Susan K. Parkhurst and Randall A. Parkhurst, wife and husband as survivorship marital property, Grantor, and Sarah A. Kopezyk and Kyle D. Kopezyk, wife and husband as survivorship marital property, Grantee, WITNESSETH, that the said Grantor, for a valuable consideration of One Dollar ($1.00) and other good and valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin: See legal description attached hereto as Exhibit A. 1151858 BETH PABST REGISTER OF DEEDS ST. CROIX CO.r WI RECEIVED FOR RECORD 04/21/2022 10:02 AM EXEMPT#: REC FEE 30.00 TRANS FEE 159.90 PAGES: 2 **The above recording information verifies that this document has been electronically recorded & returned to the submitter RETURN TO: 213 4 0 2 2 - 01919 �►�r h i�1.1'Yin�C7 + 1'i 1 ' 0. 4Ko c Ly 1; Ri lrneElMe j 3 E)^ue Rd. 026-1298-06-000 Hudson, Wf 54016 Parcel Identification Nmaber Together with all and singular the hereditaments and appurtenances thereunto belonging; and the Grantor warrants that This is not homestead property. the title is good, indefeasible in fee simple and free and clear of encumbrances, except municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and municipal services, recorded building and use restrictions and covenants, and general taxes levied in the year of closing, and will warrant and defend the same. DATED this/J day of 2022• Susan K. Parkhurst AUTHENTICATION Signatures of Susan K. Parkhurst and Randall A. P#hurst authenticated this ,/q_ day of (l' 1 2022. (Print Name) TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY: Attorney Jordan C. Sundell Ruder Ware, LI,.S.C. Per Legal Description Provided Randall A. Parkhur ACKNOWLEDGMENT STATE OF WtSEANFAN mf): : SS. COUNTY OF c . too, , S : Personally came before me this � day of r► 2022, the above -named Su6afi K. Parkhurst and Randall A. Parkhurst, to me known to be the persons who executed the foregoing instrument and acknowledged the same. () (Print Name) Notary Public, State of Wisconsm� ^ ,� 2 My Commission --� R C J Eiko Notary Public Minnesota 312023 My Cmffj OR E*V es January St. Croix County 1151858 Page 1 of 2 EXHiBiT A Legal Description Lot 6, Riding Meadows North, a County Plat, Town of Richmond, St. Croix County, Wisconsin. Tax Key No.: 026-1298-06-000 Property Address: 1222 128th Ave., New Rieliniond 4893-0704-1307, v. 1 St. Croix County 1151858 Page 2 of 2 —N89"37'1 4 " E 35" Trail Easement for lots platted hereon 831.74"- 611.17' 241.00' FAA 7 6 6,5,625 sq. ft. 5 C5 .:1'- 0 0 6 5, 50. f t. N 1. 51 acres 7. ft. N C�65,554 sq ft. "N C� N �4 r-, N r- 1. 50 acres CN r-� 'es 0 C-4 t 50 acres b N ZD C-4 0 ....... -- ....... 0 ...... ........... z I' , , , , * ........... z ......... ...... o$ r34.2. 2.41.00' 241.00' 134.551 4'0 E 1133.50' CJ S89-37'1 4-W 488.91' C� C 6 250-00, 250.00 238­41 IF t nt #1713 NVisconsin SOIL EVALUATION REPORT Page 1 of 3 Department of Commerce in accordance wCode with Comm 85, Wis. Adm. Steel's Soil Service, Inc. Division of Safety and Buildings County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Z �-6Qd percent slope, scale or dimensio north arrow, and location and distance to nearest road. Plea all i Revie d Date Personal information you provide m for s(;rrvacy L , s. 15.04 (1) (m))- 3 / Property Owner roperty Location Stallion Development LLC a -JUL 2005 ovt. Lot na SE1/4, NW1/4, S34, T30N, R18W Property Owners Mailing Address of # Block # Subd. Name or CSM# ST.CROIX000NT; Riding Meadows IvaI -� 1221 130th Ave 6 —I na 9 --- City j City [-'I Village 'j Town Nearest Road New Richmond 1WI 54017 j 715-246-5440 Richmond 120Th St New Construction Use: Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD [1 Replacement J Public or commercial - Describe: na Flood plain elevation, if applicable na ft. Parent material Ridges, foot slopes, and valley escarpments of sandstone General comments Mound or At grade system, system elevation 100.05ft based on contour line elevation 99.05ft and recommendations: Boring # Boring ® pit Ground surface elev. 98.35 ft. Depth to limiting factor 39 in. Horizon Depth Dominant Color Redox Description ure Con7,stenBoundary Roots in. Munsell Qu. Sz. Cont. Color. Sh. 1 0-20 10yr3/1 none bk cs 1vf Soil Application Rate GPD/ft2 'Eff#1 *Eff#2 .6 .8 2 20-39 10yr3/3 none bk Fandston(residuum mfr cs na .4 .6 3 39-58 10yr7/8 c2d 7.5yr5/6 um mfr gw na 0 0 4 58-72 10yr8/2c2d 7.5yr5/6 um mfr na na .0 .0 Boring # i-� Boring Pit Ground surface elev. 98.35 ft. Horizon Depth Dominant Color Redox Description Texture in. Munsell Qu. Sz. Cont. Color 1 0-18 10yr3/1 none sil Depth to limiting factor Structure Consisten Gr. Sz. Sh. 2msbk mfr 56 Boundary Cs in. Roots if Soil Application Rate GPD/ftz -Eff#1 -Eff#2 .6 .8 2 18-38 10yr4/4 none sicl sl/Is andstont 2msbk 2msbk residuum mfr mfr na gw gw na na na na 4 .6 0 .6 1.0 0 3 38-56 7.5yr4/4 none 4 56-76 10yr8/2 c2d 7.5yr5/6 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L CST Name (Please Print) 7K7;S;ignature:_ David J. Steel Address Steel's Soil Service, Inc. 994 200th St. Baldwin, WI 54002 Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L Date Evaluation Conducted 6/27/2005 248956 Telephone Number 715-760-0347 SBD-8330 (R.07/0M Property Owner Stallion Development LLC Parcel ID # pending Page 2 of 3 3 ] Boring Boring # n pit Ground surface elev. 99.65 ft. Depth to limiting factor 84 in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Soil Application Rate GPD/ft2 *Eff#1 -Eff#2 1 0-23 10yr3/1 none SO 2msbk mfr cs if .6 .8 2 23-35 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 35-48 10yr4/4 none sl 2msbk mfr cs na .6 1.0 4 48-84 7.5yr4/6 none Is osg mvfr cs na .7 1.6 5 84-100 5yr4/4 none scl om mfr na na .0 .0 ❑ Boring Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. F-1 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Soil Application Rate GPD/ft2 *Eff#1 *Eff#2 ❑ Boring # Boringf a pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 *Eft#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Steel's Soil Service, Inc. SBD-8330 (R.07/00) STEEL'S SOIL SERVICE INC. 3 of 3 David J. Steel Stallion Development LLC 994 200`" St. CST-POWTSM SE1/4,NW1/4,S34,T30N,R18W Baldwin, WI 54002 Lic. #248956 Town of Richmond, St. Croix Co. Direct 715-760-0347 Riding Meadows Sub. Lot, 6 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend N 1" = 40' ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe y • = Alt Benchmark Ele. 99.95 ft �( Top of 3/4" pvc pipe Borings Boring Elevations BI = 98.35 ft �a B2 = 98.35 ft w 99.65 ft B4 = 0.00 ft d� e b r F� r6, � 6 _ 2 7- 0 e ' .979.2 �x 987.6 x x 981.2 982.8 / x t/ tom NERow ' ayNER x NER 241 ' 1 ER 41 ' `ot DER 976.7 97 981.3 x N 5 V 977.3 acres 7 �' 1.50 acres ^'. 1.50 a es ------------- .--- •-------.---------------......... ..... .------------- x 981. Iona FR 41 ' 241 ' laxs NER 2 �8.8 I - - I .... .. ----------------- --------- N 1.50 es acres I = 987.4 x= — — x 250' 992.1 250' 991.6 x w 01/31/2012 03:26 PM Parcel #: 026-1298-06-000 PAGE 1 OF 1 026 - TOWN OF RICHMOND Alt. Parcel #: 34.30.18.1564 ST. CROIX COUNTY, WISCONSIN Current ,Xi Application # Permit # Permit Type # of Units Creation Date Historical Date Map # SalesOArea 01 /18/2006 00 C - Current Co -Owner Tax Address: SUSAN K & RANDALL A PARKHURST 3946 COLGATE AVE MINNETONKA MN 55345 SC = School SP = Special Districts: Type Dist # Description SC 3962 SCH DIST NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres. SEC 34 T30N R18W PT NE NW & PT NW NW BEING RIDING MEADOWS NORTH ('06) LOT 6 (1.500AC) Owner(s): O = Current Owner, - O - PARKHURST, SUSAN K & RANDALL A Property Address(es): ` = rrimary " 1222 128TH AVE 1.500 Plat: 10-097-RIDING MEADOWS NORTH 026-06 LOTS 1/l Block/Condo Bldg: LOT 06 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-30N-18W NW NW 34-30N-18W NE NW Parcel History: Doc # Vol/Page Type Notes: Date WD 04/06/2006 01/18/2006 822035 816695 10/0097 PLAT Bill #: Fair Market Value: Assessed with: 2011 SUMMARY 17,400 168703 Last Changed: 09/27/2011 Valuations: Land Improve Total State Reason Description Class Acres 1.500 17,100 0 17,100 NO 10 RESIDENTIAL G1 Totals for 2011: General Property 1.500 17,100 0 17,100 0 Woodland 0.000 0 Totals for 2010: General Property 1.500 42,500 0 42,500 0 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: Amount Category User Special Code Special Assessments Special Charges 0.00 Delinquent Charges 0 00 Total 0.0 i 0 qC couNnr STAT SAil, 1222,11 � e IL CAA OWNER GLe i SUBD AV 41K 5,0 100 POST IN PLA No. 645494 IT CHAPTER 145.135 f2) 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 based on regulations in force on the date of approval. (c) The sanitary 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. (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 SION the permit, please contact the county authority. _ . ICER - DATE RENEWED BEFORE THAT DATE VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20) 4g=rP-f%D � 0 qC cou ST PLUMBER TOWN PREVIOU T'— Sri X, 1 1 / �l EXPIRES BLOCK SUBDIVISION O. CHAPTER 145.135 f2) 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 based on regulations in force on the date of approval. (c) The sanitary 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. (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. G OFFICER - DATE SS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)