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040-1329-61-000
kv 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 it)(m)] 'ermit Holder's Name. City Village Township DCCI Investments LLC TOWN OF TROY ST BM Elev: Insp. BM Elev: BM Description. 7Ltr o F P-rft FA I IAIVf1 IrvrUKIVIA I IUIV TYPE � W o 92:W CAPACITY Septic r 6 Dosing LP Aer Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing ` /O ` t I JO Aer n PUMP/SIPHON INFORMATION Manufacturer Demand �� GPM ,j q8-�J;Nzq Model Number F-PU)$ TDH Lift `I zt Friction Loss System Head 1 +55 1 TDH Ft 24 ,qb Forcemain Len / Dia. ,I 2 Dist. to Well 5zI SOIL ABSORPTION SYSTEM ELEVATION DATA County St. Croix Sanitary Permit No. 645452 State Plan ID No Parcel Tax No 040-1329-61-000 Section/Town/Range/Map No: 17.28.19.2361 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer 9S, 2_4 St/Ht Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bo(. System 2$ 10$, 2L Final Grade St Cover S a5. 6 Ttf lt, a8 9H. `17 BED/TRENCH DIMENSIONS Width Length 1 —11) No Of Trenches (a U4 7 PIT DIMENSIONS No. Of Pits Inside Dia Liquid Depth 1 SETBACK SYSTEM TO I BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT ManufacturerINFORMATION Type Of System: i O L 1n1 t/L I Z �p �21 J R Model Number: "y L 10 I RIGID I IL)IV J T J I CIVI Header/Manif�l II Distribution Pipe(s) I 1 Ix Hole Size _ �D � 5/3Z x Hole Spacing Vent to Air Intake / t Length Dia Length Dia Spacing . ,3 �p 1 lr 2 JVIL LV V CR x Prr?RSIIrP Rvsfamc Only vv Mnnnrl nr er_rr„1� Q,," n. li .% — .7, . �_ _— Depth Over Bed/Trench Center Depth Over Bed/Trench Edges xx Depth of Topsoil n ��2 IB xx Seeded/Sodded Yes i� No xx Mulched �/ x Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Insp #1:�,L�L� Inspection #2: (O/2j/Zo Z 3 Location: 447 FIELDSTONE CT '�/}�'/'I 1 1.) Alt BM Description = YI, JU' ` I� ` "` ��`e /%I/ y� /J�' /i ►� 2.) Bldg sewer length = �`� It Il /i�oWI r� aVl► ��'�E7 V/`�' � UUU°0° ff' - amount of cover ok- �tw.se Plan revision Required? f ,, Yes No a I 3 --- Use other side for additional information. � /12 Date Insepctor's Sig ture Cent. No. SBD-6710 (R 3/97) '!�-� 6 -)� . 5 Department of Safety county ST CROIX i & Professional Services, Sanitary Permit Number (to be filled in by Co.) 14S �5 OCT 3 2022 Industry Services Division COm � t _Uupty� t Application State Tran1ctjc� ,,5 Z (� G l� In accordance with SPS 383.21(2), 1s. m CoUe_, su mission of this fo n unit Project Address (ifdifferent than mailing address) is required prior to obtaining a sanitary permit. Note. Application forms for state owned POW S are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s- 15.04(1)(m), Stars q-l1 _ / �� I. Application Information - Please Print All Information Property Owners Name Parcel # DCCI INVESTMENTS LLC 040-1329-61-000 Property Owner's Mailing Address Propert Location /57. Z-Q 1505 HWY 65 PO BOX 445 Govt. Lot City, State Zip Code Phone Number NEW RICHMOND WI S W y, SE v,, Sectionl 7 T 29 ZON R 19 E or N%( II. Type of Building (check all that apply) Lot # ® 1 or2Family Dwelling - Number ofBedrooms 4 61 Subdivision Name rn� Block # ❑ Public/Commercial -Describe Use ❑ City of ❑ State Owned - Describe Use ❑ Village of CSM Number 2�>Pu� ® Town of TROY III. Type of POWTS Permit: (Check either "New" or "Reep\lacement" and other applicable on line A. Check one box on line B. Complete line C i applicable.) A New Svstem El Replacement System El Other Modification to Existing System (explain) ❑Additional Pretreatment Unit (explain) B. ❑ Holding Tank ❑ At -Grade Moyne ❑ Individual Site Design ElOther Type (explain) (conventional) conventional) Z ((// C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber 1 ❑ Transfer to N w Owner 1st Previous Permit Number and Date I$sued t Expiration K "76' / !� �Z ��U.✓ �t �( ��M �f ZZ IV. Dispersal/I'reat t m Area and Tank Infortion: O✓1 To o t' = O Design Flow (gp Design Soil Application Ra gpd/sf) Dispersal Area R uired (sf) Dispersal Are roposed (st) System Elevation 600 .6 630 �pda 630�3.3 105.6 Tank Information Capacity in Gallons Total Gallons # of Units anufacturer �V ( c 0 v 2 New Tanks Existing Tanks a.0 C, ti wC7 a Septic or Holding Tank X 1200 1 WIESER Dosing Chamber 800 WIESER 5a V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signet a MP/MPRS Number Business Phone Number PAUL R KOEHLER 225410 715-246-2660 Plumber's Address (Street, City, State, Zip Code) 321 WISCONSIN DR NEW RICHMOND WI VI. County/Department Use Only Approved El Disapproved Permit Fee 5. Date Is ued Issuing Agent Si re ❑ Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval -vA 71 SYSTRA OWNER: 1. Septic tank, effluent filter and disersal celmanagetruiment be se nc provided as per mane ement plan rust be b lum /t%r1 / ✓5 /�� o/� r / by p ed l I / �� / s S / C Nit �'f �rl"t kKa 2. All setback rcyuirementg must be maintained sEperapplicowo .ridk/tirttiflbfite§: �t Y/_o �✓lr� �di ifa ���P. �'l r/ p'( 77 ��'1 Ta rrl� /v/'�j+ Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 03/22) C)C C-1 J � Vecs-t mtnts �Lc. rr got b I (1 swyYSE%ySI? TalN RI%Aj Goa I ncy„XSV-,,(3 S TC,cvJ Qtnc-\ no To P �' PVC, Slops. ��O�b t \m CP ©1� Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, WI 53707 October 12, 2022 CUST ID NO.: 225410 PAUL R KOEHLER 321 WISCONSIN DR NEW RICHMOND, WI 54017 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/12/2024 MUNICIPALITY: TOWN OF TROY ST. CROIX COUNTY SITE: DCCI INVESTMENTS LLC LOT 61 HUDSON, WI 54016 SW1/4 SE1/4 S17 T29 N R19W FOR: Design Wastewater Flow Value: 600 Bedrooms: 4 Limiting Factor(s): 14" Maintenance Required: Effluent Filter Phone: 608-266-2112 Web: hqp://dsps.wi.gov Email: dspsawisconsin.gov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS- I 02202532-C Application No.: DIS-092248899 Site ID No.: SIT-107900 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES �, %/..'G.Z L - t SEE CORRESPONDENCE EZflow Mound Component Manual - (December 15, 2017) Pressure Distribution Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with 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 basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code S SPS 383.540). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, diii9► 7/� o�� Tim Vander Leest POWTS Plan Reviewer Division of Industry Services Phone: 608-516-6134 Email: tim.vanderleest@wisconsin.gov Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 Refund Expected: $0.00 EZFLOW MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: dcci investments Owners Name: Conditionally APPROVED Owner's Address: DEPT. OF SAFETY AND PROFESSIONAL 1505 hwy 65 SERVICES "DUSTRY SERVICES new richmond wi �r. %/.a„a., L --t Legal Description: sw 1/4 set/4 s17 t29n r19w RESPONDENCE Township: troy County: st Croix Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: 040-1329-61-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 EZFIow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Designer: paul r koehler License Number: 225410 Date: 09/29/22 Phone Number: 715-246-2660 Signature: ::: Designed Pursuant to the EZFlow, Mound Component Manual (N. 06/03), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (o1/81) EZFIow Mound Version 1.2 (R. 02/04) Page 1 of 8 ti EZFIow Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 19.00 Site Slope (%) 103.70 Installation Contour Line Elevation (ft) 14.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd/ft2) Distribution Cell Information ll Cell Width (ft)3.4. 6.7.9. or 10 Only Dispersal Cell Design Loading Rate (gpd/ft2)Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c or e) el Center or End Manifold 3.001 Lateral Spacing (ft) 31 Number of Laterals 0.1561 Orifice Diameter (in) (e.g. 0.25) 3.501 Estimated Orifice Spacing (ft) _ 1.50 Forcemain Diameter (in) 40.00 Forcemain Length (ft) 94.00 Inside Pump Tank Elevation (ft) (�\ 4.55 System Head (ft) x 1.3 11.12 Vertical Lift (ft) 3.61 Friction Loss (ft) 19.27 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. 0.75 1.00 1.251.502.003.00 Nionschoice Note: Sand fill (D) calculations assume a Table 83-44-3 in -situ soil treatment for fecal coliform of - 36 inches. 100.00 Contour Length Available (ft) 70.00 = Dispersal Cell Length (ft) Are the laterals the highest point in the distribution I Y network? Enter Y or N If N above, enter the elevation ft of the highest point. 10.50 ft%rifice Does the forcemain drain back? F Y Enter Y or N 3.67 Forcemain Drainback (gal) 94.40 5x Vold Volume (gal) 98.07 Minimum Dose Volume (gal) 32.31 System Demand (gpm) Manifold Diameter Selection in. dia. options choice 1.25 1.50 x x 2.00 x 3.00 Gallons/Inch Calculator (optional) Treatment Tank Information lil Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) of lock Filter Manufacturer 22.241 Dose Tank Volume (gal/in) 525 Filter Model Number wieser IManufacturer Project: dcci investments Page 2 of 8 Mound Plan View u .� : Ob. don Pipe J�J •,r J• J•J •JN•JM•J•� J•J J• • y Nf,,, .Y+.+• .+ 5 {• �.J.1.J. .t •••. B C: L I Mound Component Dimensions A 9.00 ft E 42.52 In H 1.00 ft K 14.07 ft B 70.00 ft F 12.00 in z 35.19 ft L 98.13 ft D 22.00 in G 0.50 ft J 6.37 ft W 50.56 ft 630.00 (ft2) Dispersal Cell Area 1 3093.02 (ft) Basal Area Available 8.57 (gpd/ft) Linear Loading Rate 1 7.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 107.53 (ft) W ♦ H I� F oispemal Cdl 106.03 (ft) Lateral 60 Dispersal Cell Invert Elevation Elevation p 1�:'��,:^?"�'��,'J���`d� i�.;1 ���1��5`i�'��c'<L'.�?ci�:i�3�.�.?��..�ti.S'S<`c{.mac R�w'`.t.•„lr 19.0 %Site Slope 103.70 (ft) Contour Elevation Typical Dispersal Cell Topsoil Cap Shading Key T See Page 3 0 — ❑2 J777 Subsoil Cap a g 2.0 ft Geotextile Fabric Dover ®MI ASTM C33 Sand •1;�{j +;{ + �. , ' Tilled Layer _c• i�%ti { ; }� . { ' .,•y +;c F © M EZFIow Media 0 5 ft + + c J•J � � 0 A _— See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: dcci investments Page 3 of 8 End Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below P Turn-u p wr ba I1 valve or oil as n out pi u D E — Z -mil 1st orifice located at z IF x —)1 An laterals idertkal, with orftes equ* spaced- � s Force main connection via tee or cross to marNbid at any post. Laterals i4 face main of PVC soh 40 (Der c0 MM Table 84.30.5) s s Orifices poklt up except every Sth one poirts down for drainage, Number of Laterals Lateral Diameter Lateral Length (P) Lateral End (Z) Lateral Spacing (S) Lateral Flow Rate System Flow Rate 3 Orifice Diameter in Orifice Spacing (X) ft Orifices per Lateral ft Orifice Density ft Manifold Length gpm Manifold Diameter gpm Forcemain Velocity 0.156 in ft ft2/orifice ft in ft/sec 1.50 3.61 69.30 20 0.70 10.50 3.00 6.00 10.77 1.50 32.31 5.87 Dose Tank Information Locking cover with warning label and locking device, and sealed watertight Electrical as per NEC 300 and ---� Comm 16.28 WAC 4 in. min. onn Discect i_ Tank component is property vented wieser Manufacturer Capacity 800.00 Gallons Volume 22.24 gal/inch DimensioM3597 llons Al2.81 B44.48 C4--11. 98.07 D44.64 Total00.00 T A B C t D 3" Bedding under tank. Alarm Manufacturer Isj rombus Alarm Model Number Fps patrol Pump Manufacturer oulds Pump Model Number Jep05-- Pump Must Deliver 32.31 gpm at 19.27 ft TDH IE Alternate outlet location Forcemain diameter 1.5 in. Weep hole or anti - siphon device Pump off elevation (ft) 94.92 Dose tank elevation (ft) 9-4 00 Project: dcci investments Page 4 of 8 EZFIow Distribution Cell Media Layout • [::::1-.50 DSIdewall to Lateral (ft) Distribution Coll Cross-section Arrangements Drag appropriate drawing to space below. .i1ti1 �• � 1 •111� .i111 •�" 1 .1"1`1� .1111 -i' :1 .�i11� ! • - ►1�11 .11.11 �1111►`111` .11� �111111►1111►�1.1111ti11 ��11> �11;� `;t11 •�11��11>> ��tii� ��>;> >�iti� ��1>> Component Legend ® 6" EZFIow Bundle - EZ0601A, 5 or 10 Foot Lengths ® 12" EZFIow Bundle - EZ1203H, 5 or 10 Foot Lengths 12" EZFIow Bundle - EZ1203HP, 5 or 10 Ft Lengths O 4" Distribution Pipe With Pressure Lateral Inside 0 Tumup Enclosure — — — — Lateral Distribution Cell Plan View Layout - Typical 9.00 Cell Width - A (ft) 70.00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Drag appropriate drawing from left to space below. Eft Mound System Maintenance and Operation Specifications Service Provider's Name countryside plumbing Phone F 7-1-5-246-2660 POWTS Regulator's Name i Phone System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 630 ft1 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other) Service Frequency Ins ect and/or service once eveMeveryl.5 Should inspect and clean at least onc Test once eve 3 ear Should test month) Laterals should be flushed and pressure tespect for pondin and seepage onc Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the EZFIow mound component manual. 2. Dispersal cell media conforms to EZFIow products approved for use with the EZFIow Mound Component Manual approved 6/3/03. EZFIow media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ••..........•• ............... Grade \ 4 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins —� ' - - . • • ► "11 1111111111111111111' �_�.• -- �- • 1�111ti111wVwww 11Y • - • - 1111111111�1111ti11• ►��.��� ��.�1111�11�1111111111' • Project: dcci investments Page 6 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [EZFIow Mound Component manual 6/3/03 and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. if the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at feast once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 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 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: dcci investments Page 7 of 8 O C C j J� Vecst mots i Lc. � c w �.��, r,r, ��,d F►�, rn cad ow R�d��, o� Yo� supsEtYS1? T21N R*lj TC o,) i x cau,&, Qcnc;�\ I j' , � ,�t TNA I 100, oo ToF, �-pdCU. '► / 1 AT, 1 � 1 Q 131 1 L v Ott. ,��' rd� 1 1 a 1 1 � Wastewater TIT METERS FEET 10 9 30 8 25 U 6 20 Q Z 5 } 0 15 J H 4 O ~ 3 10 2 5 1 0 0 - —�1-4-- 5 GPM 2.5 FT - -- - - EPOS --- ----- EP04 0 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m3/h CAPACITY MODEL INFORMATION Order HP Vohs Amps Minimum Circuit Phase Float Switch Cord Discharge Minimum Minimum Minimum Maximum Shipping Number Breaker Style Length Connection On Level Off Level Basin Solids Weight Diameter Size Ibs.kg EP041 1 .4 115 12 20 1 No Plug/ SwitEP041 10, 1 %2" Manual Manual 15" %<" 20 / 9.1 1 A Piggyback / Wide -Angle 10, 12" 6" 21 / 9.5 EP0411 F Plug / No Switch 20' Manual Manual 20 / 9.1 EP041 1 AC Piggyback / Wide -Angle 20' 12" 6" 21 / 9.5 EP0412 230 6 10 Plug / No Switch 10, Manual Manual 20 / 9.1 EP0412F Plug / No Switch 20' Manual Manual 20 / 9.1 EP051 1 F / Plugl No Switch 20' Manual Manua 22/1p .5 115 13 20 EP051 1AC Piggyback / Wide -Angle 20' 12" 6" 23 / 10.4 EP0512F 230 6.5 10 Plug / No Switch 20' Manual I Manual 22110 PAGE 3 A PA DLkox- lnC. Innovations in Precast, Drainage Zabel` & Wastewater Products 0 A Division of Poylok Inc PL-525 Effluent Filter PL-525 Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent wont leave the tank. Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. PL-525 Installation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. 5. Replace and secure the septic tank cover. PL-525 Maintenance: The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is properly aligned and completely inserted. 7. Replace and secure septic tank cover. 1/16" Filtration Slots Accepts 4" & 6" SCHD 40 pipe NSF Outdoor SmartFilter® Alarm Polylok, Zabel & Best filters accept the SmartFilter® switch and alarm. Alarm Switch (Optional) Accepts 1" PVC Extension Handle Rated for 10,000 GPD 525 Linear Ft. of 1/16" Filtration Slots Certified to NSF/ANSI Standard 46 Gas Deflector Automatic Shut -Off Ball Extend & LokTM Easily installs into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com 0 w 'rD 13'-8" _______ - II j 4" CAST -A -SEAL I l d IJ U II HIT A. I roti� ,-, iiii- I I I 11 II II � (III II l i FILTER OR i i 1 I 11 BAFFLE I1 I IIII - 4" CAST -A -SEAL ANT OUTLET tZ m PUMP PAD TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS WLP1200/800-MR TANK SPECIFICATIONS 0 0 a I a I � DIMENSIONS: u o WALL: 3" a a BOTTOM: 3" COVER: 6" 6i MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53" o LENGTH: 13'-8" > WIDTH: 8'- 0" BELOW INLET: 41" LIQUID LEVEL: 36" 0 WEIGHT: BOTTOM 14,800 LBS. a 0 m COVER 8,170 LBS. II 3 0 0 INLET AND OUTLET: m 0 0 a 4" CAST -A -SEAL BOOT OR EQUAL GASKET w ; INLET AND OUTLET BAFFLE AND FILTER: N o o1 w El WISCONSIN, SEE DETAIL #10 W 0 (OTHER STATES SEE CHART) LIQUID CAPACITY: 33.46 GAL/IN (SEPTIC) 22.24 GAL/IN (PUMP) v LOADING DESIGN: 8'-0" UNSATURATED SOIL O Z 00 TANK CAN BE USED AS: C7 w a N SEPTIC / HOLDING / PUMP OR SIPHON o I COVER: MIX DESIGN #8 (NO FIBER) CD TANK: MIX DESIGN #9 (SMALL FIBER) (N W CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE M 3 REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: � J I Q O Z) O Z 00 Q I M O U N CL w POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION Owner DCCI INVESTMENTS LLC Permit # DESIGN PARAMETERS Number of Bedrooms 4 ❑ NA Number of Public Facility Units ❑ NA Estimated flow (average) 400 al/day Design flow (peak), (Estimated x 1.5) 600 al/day Soil Application Rate .6 al/da /ft' Standard Influent/Effluent Quality Monthly average` Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BOD6) 5220 mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ❑ NA Fecal Coiiform (geometric mean) 510' cfu/100ml Maximum Effluent Particle Size Ye in dia. ❑ NA Other: ❑ NA `Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity 1200 gal ❑ NA Septic Tank Manufacturer WIESER ❑ NA Effluent Filter Manufacturer POLY LOCK ❑ NA Effluent Filter Model 525 ❑ NA Pump Tank Capacity 1800/1100 gal ❑ NA Pump Tank Manufacturer WIESER ❑ NA Pump Manufacturer GOULDS ❑ NA Pump Model EP04 ❑ NA Pretreatment Unit ❑ NA Cl Sand/Gravel Filter ❑ Peat Filter ❑ Mechanical Aeration ❑ Wetland ❑ Disinfection ❑ Other: Dispersal Cell(s) ❑ NA ❑ In -Ground (gravity) ❑ In -Ground (pressurized) ❑ At -Grade A Mound ❑ Drip -Line ❑ Other: Other: ❑ NA Other: ❑ NA Other: ❑ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 ❑ monthyeaarss)r() l (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) l year(s) ❑ NA Clean effluent filter At least once every: 1 month(s) year(s) ❑ NA Inspect pump, pump controls & alarm At least once every: 3 ❑ month(s) Xl year(s) ❑ NA Flush laterals and pressure test At least once every: ❑ month ) ❑ yeaarr(ss) AS NEEDED ❑ NA Other: At least once every: ❑ month(s) ❑ year(s) X NA Other: Qi NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector, POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page 2 of -Z.- START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal ceillsl. If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal call(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. T a o mg ank MA �� alua ' be ' e ai a flZDI418 i(�n � P- �>� 00NJ5-Mdc7'l ONJ ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name COUNTRYSIDE PLUMBING Phone 715-246-2660 POWTS MAINTAINER Name PAUL R KOEHLER Phone 715-246-2660 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name MARKO SEPTIC Phone 715-386-2130 a v L 20ej This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.540), (2) & (3), Wisconsin Administrative Code. ft 1tt Urw"' � w. P= f #2156 Page 1 of 3 Pro Iona rvkres 4y7 FieldSiQlne Schmitt Soil Testing, Inc. ►r..�,.�.-' St. Croix County Attach complete site pia o MOt as in size. Plan must County include, but not limited t . an orizontal reference point (BM), direction end ----- ---- St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 04 0-' a2.q W - 000 Please print all Infonnat/on. Reviewed By� �Date Z / Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location DCCI Investments, LLC Govt. Lot SW1/4, SE1/4, S17, T291N, R1 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1505 Hwy 65 61 Meadow Ridge Of Troy I at AcWn City State Zip Code Phone Number ❑ City ❑ Village Fj Town Nearest Road New Richmond WI 1 54017 1 612-599-4244 Troy I Meadow Ridge Trail REC ETW D partment of iafetyartWL 28 2021SOI In ace I Se EV RT mice with Comm 85, Wis. Adm. Code El New Construction Use: rXI Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Glacial till over limestone (Ritchey Series) Flood plain elevation, it applicable NA ft. General comments Area is suitable for a mound system, System elevation is 105.54' based off the canlour line established at 103.70'. Slope of the and recommendations: area is 19%. Depth to limiting factor is 14 '. -e v,4 yC Boring # ❑ Borirlp � T 1- V Q Pit Ground surface elev. 98.60 _ ft. Depth to limiting factor 14 Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consists ndary Roots GPD/fl° "Effrrl •Efrrz 1 0-6 10yr3/3 none sil 2mgr mvfr as 2c,2m 0.6 0.8 2 6-14 10yr5/6 none sici 2msbk mfr as -- 2f,2vf ------ 0.4 0.0 0.6 0.0 3 14+ 10yr6/6 FRACTURED LIME STONE -- aBoring ❑ ring # ® pit Ground surface elev. 101.60 g. Depth to limiting factor 16 in. Soil Application Rate Horizon Depth in. Dominant Color Munseil Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM2 "Eif#1 'Eff#2 1 0-8 10yr3/3 none sil 2mgr mvfr as 2c,2f 0.6 0.8 2 8-16 10yr4/6 none sicl 2fsbk mfr as 2f,2vf 0.4 0.6 3 16+ 10yr6/6 FRACTURED LIME STONE -- -- ------ 0.0 0.0 " Effluent till = 130D5> 30 < 220 mg/L and T55 >30 < 150 mg/L " Effluent 02 = BOD5 00 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd St. New Richmond, WI 54017 5/24/2021 715-760-1978 S13D4330 (rt.m/oo) Property Owner DCCI Investments, LLC Parcel ID # at Page 2 of 3 3 F❑ B°ring # Boring ❑ Pit Ground surface elev. 105.0 ft. Depth to limiting factor 72 in. oll Application Rate Horizon Depth In. Dominant Color Munsell Redox Descxiption Qu. Sz, Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM •01lf1 •EM 1 0-9 10yr3/3 none sit 2mgr mvfr as 2c,2f 0.6 0.8 2 9-18 10vr4/4 none sid 2fsbk mfr gw 1c,2f 0.4 0.6 3 18-27 10yr4/6 crone sd 2msbk mfr gw ic,2f 0.4 0.6 4 27-48 7.5yr4/6 2 none 2 A lmsbk mfr gw ------ 0.4 0.7 5 48-72 2.5yr4 none/6 7.5 2 scl lmsbk mfr as ------ 0.2 0.3 6 72+ 10yr6/6 FRACTURED LIME STONE -- - ----- 0.0 0.0 F Boring # ❑ Boring 0 Pit Ground surface elev. 95.30 ft. Depth to limiting factor 7 in. it Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDW •Ef1#1 -FM 1 0-7 10yr3/2 none sil 2mgr mvfr as 2c,2m 0.6 0.8 2 7+ 10yr6/6 FRACTURED LIME STONE --- ---- 2f,2vf 0.0 0.0 FS-1 Boring # Boring Pk Ground surface elev. 104.10 ft. Depth to Ilrnaing factor 10 In. SoY Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIft' •Elf#1 -EfW 1 0-7 10yr3/3 none sil 2mgr mvfr as 2c,2f 0.6 0.8 2 7-10 10yr4/6 none sid 2fsbk mfr as lc 0.4 0.6 3 10+ 10yr6/6 FRACTURED LIME STONE -- -- ------ 0.0 0.0 ' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <-150 mg/L . Effluent #2 = BOD5 < 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. SBW330 R L07M) SdvMt Shc TesWV, Inc. Property Owner DCCI Investments, LLC Parcel ID # 6l Page 3 of 3 F6 ]Boring # ❑ Boring Pit Ground surface elev. 104.20 ft. Depth to limiting factor 29 in. II Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roofs GPDM2 Eff#t `Ef #2 1 0-9 10yr3/3 none sit 2mgr mvfr as 2vf 0.6 0.8 2 9-20 10yr4/4 none Sid 2fsbk mfr gw 1vf 0.4 0.6 3 20-29 7.5yr4/6 none sl lmsbk mfr as lvf 0.4 0.7 4 29+ 10yr6/6 FRACTURED LIME STONE ---- -- -- 0.0 0.0 F-1 Boring Al ❑ Boring ❑ 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/ft= •Etf#1 `Effr2 F-1Boring # ❑ Boring PR Ground surface elev. ft. Depth to limiting factor In. ❑ Soll Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft' `Efftft *Eff#2 ' Effluent #1 = BODS> 30 < 220 mg/t. and TSS >30 <_150 mg/L ' Effluent #2 = BOD6 < 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. SBD4330 nL07/00) SdVM W Tesft, Vr- P ;L/S-6 Conducted by: Schmitt & Sons Excavating, Inc.. Thomas J. Schmitt, CST 227429 586 Valley View Trail Somerset,Wl 54025 Phone: 71 0-1978 8lpnatu Date N Backhoe Pit A Bench Mark 1 El. 100.00' Top of 2" PVC pipe A Bench Mark 2 El. 105.62' Top of 2" PVC Pipe Slope= 19% Scale 1 "= 60' Contour Line El. 103.72' Page y of 4/ Conducted For: Name: DCCI Investments, LLC Address: 1505 Hwy 65 City, State, Zip: New Richmond, WI 54017 Subdivision: Meadow Ridge of Troy Lot No.: 61 Legal Description: SW1/4 SE11/4 S17 T29N R19W Township, County: Troy Township, St. Croix County Contour Line Length 100' . QI .f - 66.50 ft 55,162 SQ. FT. Z 1 1.266 ACRES ip a 1 , f-SE tJ► 66,088 Q. 1 1.517 RE �N W ► 2 , 1 , 60 45,646 SQ. FT. to / 1.048 ACRES / zl. "LOT 63 .r ST. CRO NTY SANITARY SYSTEM File #: l r:�r<<,,.,;r; Office Use Only OWNERSHIP/ADDRESS FORM Created2/2027 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. OWNER/BUYER INFORMATION Owner/Buyer DCCI Land Planner Mailing Address PO Box 445 City/State/zip New Richmond WI 54017 Phone Number (required) 715-246-2320 Email Address (required) sskinner@derrickbuilt.com Parcel Identification Number (found on the property tax bill) 040-1329-61-000 NEW SYSTEM: LEGAL DESCRIPTION Property Location '/a , -L`d�a -Sec. , T N R W, Town of Subdivision Plat: Meadow V�}c of Troy 1 son Addtion Lot # 61 Certified Survey Map # Volume . Page # Warranty Deed # 79�5 05 3 (before 2006)Volume , Page # Number of bedrooms 4 Spec house 13 yes ■ no Lot lines identifiable ■ yes 13 no `7 I,/OFFICE USE ONLY �J New Property Address -/ L ( � ld-5/0t- 67t (Verification of new address required from Community Development Department for new construction.) 9 t� (Staff Initials) (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 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.gov YNJ. RAT igblG6. L" — I/ .ni>e rtsr - N' uaT Iewrltl6 r/cars - r11A„ Rpt<yf rt.I.M r R. MAI./110.T MI>ll.LrgY �R r.fMIF L,sal �(! • Mlpt f6. K61L lRIWL .LV1N Iet Ia ADOYM L Im TILT. rel R.YI Olptgl M1/!1 M rpt QLYL)W null u roars, Lgro • I,w no,b I/W al.mr rel )� osa .y1� I Y Ic �sanrw. rcw u ewn .npt >r..Ts rQ cac d .n. rLu I>IId .I-M rNl R[bl �.l:r'fJ� ..�rLl1L. rt6. ICt nN1 w..e ro w ?PICAL HALL SECTION OWNSA'S Subs OINBR'S BITB Y R A.la . pc OL BSBBOOY/J I BfBBOO///i SECTION 14 114"= �._011 Rln VFT—A/nT LIM) I Alromnr2nmrn.. oamrcn� ours AOB M1YBE0. 102522 OIIAMN BY: Yd1YY ?4E)/ 5°�5 BID SET —NOT FOR CONSTRUCTION OIS➢K �E AGNS INC. OF MPLS. o W � c') W ~ N NWT hv� C3 W 'J C9 �w�� �q`OA Muhlenpoh & Associates �o� noc xo�B �OfBB/R, W. SSI A-�2R1 6i2-NO-KN +Ylepbe[�ml.un ISSUE DAM. M-02-22 REWS & JOB NIIYBER: 1025Y1 fMAW BY: Y. YORYN SR- 2�5 REAR ELEVATION 1/4 "=1 '-0" FRONT ELEVATION 1/4"= 1'-0" RID RPT-NnT FnR nnmQrD•rn,r.n.r asnrcnv� o6as Z Iwo w w W4�� o�oo �qCO wWo� A�N� Muhlenpoh & Associates ,aR"In .MOM. YR sin m n2-w��ra w :mod. sac DAM a 07-22 Rc�ons JOB Y —R: 102522 eR�RY BY: Y. YdIMI sH¢r� 1�5 s-CAA CAAACL 674 SO. Pr. e s _ I I-SLASON PORCH .ac. - M1 cw yy_ EI' - D!NlNC ROOM -` i 9 a.w * vaww,c _ _ _ _ _ _ PATIO cvon-noel-cfml '6RLAT ROOY' a u..cu maw rro �� OXNLR'S SUIrL 6-6 l'--------1' 4e $ ----------- PANTRY---- DQ� X.I.C. eye YUDROOY 6-OX/- 44 /j --ao._______. T OPPICL C POYLR lJUNDR !0-BX8-0 B-8X8-e a-sX6-O cw �r* iw urtl C g � via HILL-!N R 8-8718-J �� • E OWNER'S BATH I� COYLRLD POACH• mxrwnc c� cnl Ea II n M s MAIN LEVEL PLAN 1848 SQ. FT. 174 SQ. FT. 4-SEASON 2022 SQ. FT. TOTAL 114"= 1'-0" R/n CFT_R7nr cnn nn xrc mr 11 U! Llu ul l illy' END GARAGE ELEVATION 1/4"=1'—O" fern CFT_NnT CnD nn>.Tc —rrn Jnr....l Wc.aWU Cv � � � co q C9W� hv� Muhlenpoh & Associates for Dart /Bo a000rm.� al»�-Jxo Ze imc ova. oe-w-u RE�a~s JOB YUI�B: 102511 ORI1111 BY: Y YtAYY 9aFT/ 4�5 EDD 021SOI EV Oorizontal #2156 RT in acco dance with Comm 85, Wis. Adm. Code Page 1 of 3Profe 1.5 447 f-►etdstG�e, Ct Schmitt Soil Testing, Inc. untyCountyAttach complete site plahes in size. Plan must St. Croix include, but not limited al reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 04 0-' 329- kQ 1 - 000 Please print all information. Personal information be for (Privacy Law, s. 15.04 (1) (m)). Reviewed By� Date you provide may used secondary purposes Z/ n Property Owner Property Location DCCI Investments, LLC Govt. Lot SW1/4, SE1/4, S17, T29N, R1 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1505 Hwy 65 61 rt i Meadow Ridge Of Troy I A1� _ - - - - - - -- - - -- City State Zip Code Phone Number -- _ - - - --- -- - --_ -- City - Village Town Nearest Road New Richmond WI 1 54017 1 612-599-4244 Troy I Meadow Ridge Trail New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 _GPD Replacement Public or commercial - Describe: Parent material -Glacial till over limestone (Ritchey Series) _- Flood plain elevation, if applicable NA ft. General comments Area is suitable for a mound system. System elevation is 105.54' based off the contour line established at 103.70'. Slope of the and recommendations: area is 19%. Depth to limiting factor is 14 ". Zot tf- w—' ❑ Boring /4 -t- b Boring # Pit Ground surface elev. 98.60 ft. Depth to limiting factor 14 Soil Application Rate Horizon i Depth in. '; Dominant Color Munsell Redox Description Qu. Sz. Cont. Color j Texture i Structure Gr. Sz. Sh. I Consistence undary i Roots i GPD/ft' 'Eff#1 -Eff#2 1 0-6 10yr3/3 one sil I 2mgr mvfr as 2c,2m 0.6 0.8 2 3 6-14 14+ 10yr5/6 I 10yr6/6 none FRACTURED sicl LIME 2msbk STONE mfr j -- i as -- 2f,2vf ------ i 0.4 0.0 0.6 0.0 i i i I 2 Boring Boring # - -, Pit Ground surface elev. 101.60 ft. Depth to limiting factor 16 in. Soil Application Rate Horizon i Depth I in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistenc Boundary j Roots GPD/ft' 'Eff#1 'Eff#2 1 0-8 10yr3/3 none sil 2mgr mvfr as 2c,2f 0.6 0.8 2 8-16 10yr4/6 none sicl 2fsbk mfr as 2f,2vf 0.4 0.6 3 16+ 10yr6/6 FRACTURED LIME I STONE -- -- I ------ i 0.0 0.0 t- j Effluent #1 = BOD,> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOO 5.30 mg/L and TSS - 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd St. New Richmond, WI 54017 5/24/2021 715-760-1978 JI L"33U(K.U/!UU) Property Owner DCCI Investments, LLC Parcel ID # G/ Page 2 of 3 3 Fj Boring Boring # Pit Ground surface elev. 105.0 ft. Depth to limiting factor 72 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/ft' •Eff#1 'EM 1 0-9 10yr3/3 none sil 2mgr mvfr as 2c,2f 0.6 0.8 2 9-18 10yr4/4 none Sid 2fsbk mfr gw lc,2f 0.4 0.6 3 18-27 10yr4/6 none scl 2msbk mfr gw 1c,2f 0.4 0.6 4 27-48 7.5yr4/6 7 nsone/z sl imsbk mfr gw ------ 0.4 0.7 5 48-72 j 2.5yr4/6 7 none Z scl imsbk mfr as ------ 0.2 0.3 6 72+ 10yr6/6 FRACTURED LIME STONE -- -- ------ 0.0 0.0 F�l 4 Boring Boring # Ph Ground surface elev. 95.30 ft. Depth to limiting factor 7 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/ft' 'Eff91 'Efr#2 1 0-7 10yr3/2 none sil 2mgr mvfr as 2c,2m 0.6 0.8 2 7+ 10yr6/6 FRACTURED LIME STONE --- ---- 2f,2vf 0.0 0.0 77 Boring 5 Boring # Pit Ground surface elev. 104.10 ft. Depth to limiting factor 10 in. 0 Soil Application Rate Horizon Depth in. Dominant Color Munsell T Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDfft' •Eff#1 'Eff#2 1 0-7 10yr3/3 none sil 2mgr mvfr as 2c,2f 0.6 0.8 2 7-10 10yr4/6 none sid 2fsbk mfr as lc 0.4 0.6 3 10+ 10yr6/6 FRACTURED LIME STONE -- -- ------ 0.0 0.0 ' Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 4150 mg/L ' Effluent #2 = BOD5 < 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. SBD-8330 (R.07100) Schmitt soil Testing, Inc. Property Owner DCCI Investments, LLC Parcel ID # G1 Page 3 of 3 FL. 6 ]J Boring Boring # Pit Ground surface elev. 104.20 ft. Depth to limiting factor 29 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/fF `Eff#t •Eff#2 1 0-9 10yr3/3 none sil 2mgr mvfr as 2vf 0.6 0.8 2 9-20 10yr4/4 none Sid 2fsbk mfr gw 1vf 0.4 0.6 3 20-29 7.5yr4/6 none sl imsbk mfr as ivf 0.4 0.7 4 29+ 10yr6/6 FRACTURED LIME STONE ---- -- -- 0.0 0.0 F-1Boring (] Boring # pit Ground surface elev. ft. Depth to limiting factor in. ❑ Soil Application Rate Horizon Depth I in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD1W 'Eff#t 'Eff#2 I F-1 Boring Boring # 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 •Eff#1 •Eff#2 Effluent #1 = BOD5> 30 -� 220 mg/L and TSS >30 <150 mg/L ' Effluent #2 = BOD5 < 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. SBD-8330 (R.07/00) Schmitt sod TCStlfg, tmC. P X1s6 Conducted by: Schmitt & Sons Excavating, Inc.. Thomas J. Schmitt, CST 227429 586 Valley View Trail Somerset, W 154025 Phone: 715, 0-1978 Signatur _ Date ■ Backhoe Pit A Bench Mark 1 El. 100.00' Top of 2" PVC pipe A Bench Mark 2 El. 105.62' Top of 2" PVC Pipe Slope= 19% Scale 1"= 60' Contour Line El. 103. T 1 Page I of Conducted For: Name: DCC1 Investments, LLC Address: 1505 Hwy 65 City, State, Zip: New Richmond, WI 54017 Subdivision: Meadow Ridge of Troy Lot No.: 61 Legal Description: SWIM SE1/4 S17 T29N R19W Township, County: Troy Township, St. Croix County Contour Line Length 100' S9& �f i3edf*oo on .54 . ftvix couN-nr NO. 645452 STATE SANIARY PERMIT rrclsip C4. LU�AANS�K'AL PRH110t15"N� OWNER N�s LU. PLUMBER Paul �ioe � �,t� LIC.# ZZS00 TOWN OF Ti�.1 _ SEC 9T ' AND/OR LOT N, R (1 E BLOCK UBDIVISION Zo1,c- 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 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. 67 //l �+ / AU'(HORjZED ISSUING OFFICER -DATE LO 1Z3 Z THIS PERMIT EXPIRES / 7,3 UNLESS RENEWED BEFORE JtHAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20) U 2731 P 551 LIMITED WARRANTY DEED Document No. This Deed made between VALLEY LAND COMPANY, a Mimiesota corporation, Grantor and DCCI LAND PLANNERS, INC., Grantee Witnesseth, That the said Grantor conveys to Grantee certain real estate in St. Croix County, State of Wisconsin, legally described on Exhibit A hereto (the "Property"), Together with all and singular hemditan=ts and appurtenances thereunto belonging. 7l954ats3 REGISM OF DEEDS ST. CROIX Go., VI REJCEIVED FOR RECORD 111/14/2005 81:08PK WARRANTY DEED Elm # REC FEE: 15.00 TRANS FEE: 10950.99 CCOOPYYF s PAGES: 3 Effil- MI This conveyance is without warranty, except Grantor covenants and represents the Grantor has not made, done, executed or Tax LD.: /4p -eoz suffered any act or thing whereby the above - described property or any part thereof, now or at any time hereafter, shall or may be imperiled, charged or encumbered in any manner, and Grantor will warrant title to the above -described property against all persons claiming the same from or through Grantor as a result of any such act or thing, provided, however, that the conveyance hereby made and the warranty of Grantor is further limited by and subject to those matter set forth on Exhibit B hereto. Dated this — day of January, 2005. VALLEY LAND COMPANY, A Min corpor By: Its: ACKNOWLEDGEMENT STATE O COUNTY OF SS Personally came before me this Oday of January, 2005, the above named Gary B. Valley, as President of Valley Land Company, a Minnesota corporation, having full authority to do so and to me known to be the person who executed the foregoing instrument and acknowledged the blic, State of c mmission (expires): U 2731 P 552 I2Vo4 LEGAL DESCRUMON/pLANNERS PARCEL A LOCATED. IN THE SE'/: OF I IJE -BE'/; SW:'/.OF THESE'/ ANb PART OF THE�NW'>i OF -THE SE %; tJE Y. OF THE SE %; SW % THE NE % AND* THE SE Y. OF THE NW Y. ALL IN SECTION. 17, TOWNSHIP 28 NORTH, RANGE 19 WEST, TOWN OF tROY, ST. CROIX COUNTY, WISCOJJ8IN: BEGINNING AT THE SE CORNER OF SAID. SECTION 17; THENCE S88'51'31'W, ALONG THE SOUTH LINE OF THE SE % OF SAID- SECTION, 2629.36" FEET TO THE WEST LINE OF THE SE Y.OF SAID SECTION; THENCE N00°05'44'E, ALONG SAID WEST LINE, 2060.38 FEET TO THE CENTER OF SA)D SECTION; -THENCE S886 45'22'W, 18.79 FEET.TO A -POINT ON A 148.00 FOOT RAQIU6 CURVE CONCAVE NORTHWESTERLY, WHOSE , CENTRAL ANGLE MEASURES. 'IO°10'5T, WHOSE CHORD BEARS N45°44'30'E AND MEASURES 26.27 FEET; THENCE NORTHERLY ALONG THE ARC OF SAID CURVE*AND SOUTHERLY RIGHT OF WAY OF EAST COVE ROAD 26.90 FEET TO SAID WEST UN .OF THE SE•Y.; 11JENCE N0000544'E, ALONG SAID WEST LINE 124.75 FEET; THENCE N88051'31."E, 249.43 FEET, THENCE S00005'44'VI/, 413.44-FEET; THENCE N88°51'31'E, 2042.11 FEET TO THE CENTERLINE -OF TOWN • ROAD (TOWNSVALLEY ROAD) BEING A POINT ON A. 3754,00 FOOT RADIUS CURVE, CONCAVE SOUTHWESTERLY WHOSE CENTRAL ANGLE MEASURES 9°28128-, WI-JOSE CHORD BEARS S36°43'35'E AND MEASURES 620.06 E=EEl'; THENCE SOUTHERLY ALONG THE ARC OF SAID CURVE, 620.76 FEET TO THE EAST LINE OF THE SE % OF SAID SECTION; THENCE S01007'30'W, ALONG SAID FAST LINE, 1886.26 FEET TO THE POINT OF BEGINNING. I Kevin Grabau Subject: 645452 - Koehler/Countryside - Tank Start: Wed 12/14/2022 9:30 AM End: Wed 12/14/2022 10:30 AM Recurrence: (none) Organizer: Kevin Grabau Categories: POWTS Scheduled with KG - via email with Tim DeYoung - 1211212022. 447 Fieldstone CT 17.28.19.2361 040-1329-61-000 Lot 61 - Meadow Ridge of Troy Town of Troy 1